Biomedical subjects

Ugur Kocer

Publications and source records attributed to Ugur Kocer.

10 recordsLinked to original sources

PubMed2006

Examination of the skin perforators of the posterior tibial artery on the leg and the ankle region and their clinical use.

BACKGROUND: There are many treatment alternatives for reconstruction of leg and foot defects. One of these treatment alternatives includes local flaps. A detailed understanding of the blood flow of the leg region is essential for producing new alternatives for the reconstruction of defects of this region. METHODS: The leg and foot region blood flow was examined on 11 fresh cadavers, and perforators of this region were examined in three zones. Perforator numbers and their diameters were defined at this region. It was determined in cadaver studies that especially zones I and II were more suitable for the planned flaps based on perforators of the posterior tibial artery. In a clinical study that accompanies this anatomical study, eight patients underwent reconstruction by flaps based on the perforators of the posterior tibial artery. RESULTS: Patients were followed for 3 to 14 months. In three patients, venous drainage problems had developed, and in one of them, partial flap loss had developed. This partially necrosed region was left to heal by secondary intention. Venous drainage problems resolved in 5 to 7 days in the two remaining patients. No other complications were seen. CONCLUSION: Regarding the results of the clinical study, the authors observed that this flap can provide the desired soft-tissue support for defects that expose the bones, tendons, and neural and vascular bundles.

Adult↗

PubMed2006

Multi-centric basal and squamous cell skin malignancies of the craniofacial region.

The etiology of skin malignancies is evaluated as multi-factorial. The human phenotype, syndromes, precursor lesions, and immunologic differences play as risk factors as well as environment. Twenty-seven patients with multi-centric skin malignancies investigated as if having predisposing syndromes. The etiological factors and the classification of skin malignancies are assessed. We last discussed about the management options. The mean age was 47 (9-91). Men to women ratio was 16:11. Four out of 27 patients having multi-centric skin malignancies were realized as syndromic. The localization of these tumors was entirely at the head and neck region. Ninety-eight areas were distinguished as having skin malignancies in 27 patients. Sixty-one incisional biopsies for type analysis and 37 excisional biopsies were handled. Of the 98 malignancies, 24 were squamous cell cancer, 67 were basal cell cancer, and seven were basosquamous cell cancer pathologically. Wound closures were carried out as primarily in 39 excisions; using skin grafts in 21 excisions, local flaps in 28 excisions, and distant flap procedures in 10 regions. The follow-up period was between six and 25 months. No complications or recurrences were seen. Eight patients applied with new lesions on new regions, six patients had excision, and two were treated with radiotherapy.

Adolescent↗

PubMed2005

Anatomy of the platysma muscle and the evaluation of it for the reconstruction of facial defects.

Reconstruction of the defects with various flaps is the main issue in plastic and reconstructive surgery. Tissues used for the repair of the defects of the face should be convenient for this most important aesthetic unit. Color, elasticity, and volume of the transferred tissues have the utmost importance for successful results. Platysma muscle flap appears to be a good alternative method for the reconstruction of the facial defects. Anatomic dissections on five fresh cadavers for the evaluation of the vascular structures and 11 clinical cases of reconstruction of the defects of the face and the neck with platysma muscle and musculocutaneous flaps are performed in this study to evaluate the efficacy and reliability of platysma flaps. Cadaveric dissections were performed on the face and the neck regions on both sides. Eleven patients with various defects on the face and the upper neck regions were surgically treated: three transverse cervical artery-based transverse musculocutaneous platysma flaps, seven facial artery-based vertical musculocutaneous platysma flaps, and one superior thyroidal artery-based platysma muscle flap were used for the repairs. The patients ranged in age from 42 to 74 years. The defects measured 2x3 cm to 6x9 cm and the flaps 3x3 cm to 7x10 cm. The follow-up periods were 2 to 21 months. Postoperative venous congestion between the 5th and 9th days was observed in seven patients. One patient had infection of the donor site, and another had infection of the recipient site; both recovered with systemic and topical antibiotherapy. Partial flap loss occurred in one patient. Our study concluded that platysma flaps showed sufficient tissue match with successful results for the reconstructive procedures of facial defects.

Adult↗

PubMed2005

Evaluation of osteogenic and chondrogenic activities of prefabricated periallografts.

Reconstruction of cartilage and bone defects has always been a challenging problem for the surgeon. Basic elements that are responsible for the repair process of these tissues are periost and perichondrium. Although several methods for the use of periost and perichondrium are proposed in the literature, the osteogenic and chondrogenic capacities of these tissues were shown to be the most important factor for a successful outcome. Bone and cartilage formation in acellular dermal matrix (ADM) prefabricated with periost and perichondrium was studied in 20 New Zealand rabbits. Morphologic and histologic evaluation and comparison of the newly formed tissues were evaluated. Four rabbits were excluded from the study because of infection, and specimens were obtained at 4, 6, 8, and 12 weeks after the study began from the remaining 16 rabbits. A gradual increase in bone and cartilage tissue formation through the 4th to 12th weeks was documented by reason of perichondrium and periost activation infiltrating into acellular dermal allografts. In view of the data obtained, it was concluded that periost or perichondrium prefabricated over ADM may be an alternative technique of cartilage and bone formation that may provide adequate tissue with elastic and osteo- and chondroconductive properties for the reconstruction of challenging defects.

Animals↗

PubMed2005

Axial pattern composite prefabrication of high-density porous polyethylene: experimental and clinical research.

Currently, various alloplastic materials are being used for reconstruction of three-dimensional structures, and high-density porous polyethylene is so far the best and the most commonly used material. Various indications for high-density porous polyethylene have been defined for closure of craniofacial defects, correction of congenital anomalies, and aesthetic augmentations. A common property of various studies published so far is that after being fixed to the bone or underlying structures, high-density porous polyethylene has been covered primarily or by skin flaps. For reconstruction of complex three-dimensional structures such as the ear and nose, the success of current methods is limited by the thinness and pliability of the skin flap. In this study, the authors' aim was to investigate the graftability of high-density porous polyethylene after prefabrication with an axial pedicle and to explore possible clinical applications in light of the new data obtained. In the experimental study, three-dimensional implants (rectangular prism) carved from high-density porous polyethylene were prefabricated using bilateral superficial epigastric arteries and veins of 25 New Zealand rabbits. After a waiting period of 2 to 6 weeks in five groups, control samples were obtained and the prefabricated implants that had been left in place were directly grafted. The results showed that high-density porous polyethylene was vascularized 75 percent after 4 weeks and 90 percent after 5 weeks, and 95 percent of the grafts had survived after 8 weeks. In the clinical study, three nose defects, three ear defects, and one hard palate defect in seven patients ranging in age from 21 to 72 years were reconstructed using the same method. High-density porous polyethylene has been prefabricated and directly grafted for the very first time on a clinical basis. No serious complications have been observed, except for minimal graft loss in two patients. It is obvious that full-thickness skin grafts that are thinner than flaps will adapt better to the fine details of high-density porous polyethylene and will highly increase the detail obtained in the reconstruction of three-dimensional defects.

Abdomen↗

PubMed2004

Soft tissue hemangioma formation within a previously excised intraosseous hemangioma site.

Intraosseous hemangiomas are rare benign lesions, occurring often in verbrata and skull. These lesions can present in the head and neck region being the next most common site with a predominance of the mandible. Herein we report a patient who experienced a soft tissue hemangioma occurring at the previous surgical site three years after the first operation.

Adipose Tissue↗

PubMed2004

Angiokeratoma circumscriptum.

Angiokeratoma circumscriptum is one of five types in the group of the angiokeratomas. These lesions are usually present at birth and are not related with systemic diseases. Angiokeratoma circumscriptums are hyperkeratotic papules or nodules occurring frequently unilaterally on the leg. These lesions are very rare and very few cases have been reported since its first description. It is of particular clinical importance because of its morphologic similarities to malignant skin tumors such as malignant melanoma or pigmented basal cell carcinoma. Therefore, this rare but significant lesion must be recognized by physician and surgeons who manage skin tumors.

Adolescent↗

PubMed2003

Familial neurofibromatosis-1 and Gilbert syndrome.

BACKGROUND: Neurofibromatosis (NF) is a genetic disorder of the neural sheet, affecting almost all organ systems. METHOD: A family that consisted of the father and his three children, two males and one female, having NF-1 is evaluated in detail for cosmetic purposes. The routine preoperative laboratory examinations, including complete blood counts, serum biochemistries, urinary analysis, extremity and chest roentgenograms, ultrasounds of the abdomen and the affected regions, and pelvic computed tomographies, revealed characteristics of NF-1 and unexpected hyperbilirubinemia. The patients are evaluated further for the cause of hyperbilirubinemia by the fasting test. Variously localized plexiform neurofibromas of the three children are totally excised. RESULTS: The father was affected as a result of a mutation, and his three children had inherited the disease. The father, having subcutaneous neurofibromas, differs from the children, as they have elephantiasis neurofibromatosa. The children had various rare clinical presentations besides disfiguring deformities. Two male patients had retroperitoneal neurofibromas, and one had splenomegaly and osseous changes. Gilbert's disease was diagnosed, interestingly, and coincidentally in the three patients with elephantiasis due to NF-1. DISCUSSION: An interesting diagnosis of NF occurring coincidentally with Gilbert's disease in a family is reported. This clinical study is the first report of Gilbert's disease accompanying familial NF.

Adult↗

PubMed2003

Intravenous pyogenic granuloma of the hand.

BACKGROUND: Intravenous pyogenic granuloma is the intravasal counterpart of cutaneous pyogenic granuloma. This rare, benign lesion appears clinically as a subcutaneous nodule usually located in the upper extremity or neck in middle-aged people. It is hard to make an exact diagnosis on clinical basis, and there is a risk of recurrence because of undertreatment. OBJECTIVE: To report a case of an intravenous pyogenic granuloma located in the hand and to describe the clinical and histopathologic features of this rare vascular tumor. METHODS: An operation was performed on a 58-year-old female who presented with a small, painless mass in the right palm, and the pathologic examination revealed an intravenous pyogenic granuloma. CONCLUSION: This rare lesion should be differentiated from a regular pyogenic granuloma and should be excised with the vein segment to avoid recurrence.

Female↗

PubMedDate not supplied

Reconstruction of heel defects with a proximally based abductor hallucis muscle flap.

The main goals of reconstruction of plantar defects include appropriate soft tissue coverage to facilitate weight bearing, and sufficient blood supply to prevent osteomyelitis. This retrospective study presents the clinical results of 11 patients who received a proximally based abductor hallucis muscle flap for coverage of calcaneal defects. The mean patient age was 43 years (range, 23-69 years). Four patients were women and 7 were men. Seven were non-diabetic patients with neurologic deficits of varying etiology or patients who had pressure ulcers after prolonged hospitalization. Four patients had diabetes with or without neurological deficits, and 6 patients had calcaneal osteomyelitis. In 6 patients, the origin of the muscle was dissected and rotated over the defect. The flap was elevated as an island flap in 5 patients. Postoperatively, partial flap loss was observed in 1 patient, who was then treated successfully with a fasciocutaneous flap. Two patients developed seroma and hematoma at the donor site, which resolved uneventfully after surgical drainage. The 6 patients with calcaneal osteomyelitis showed no recurrence after 1 year of follow-up. The abductor hallucis muscle flap provides enough stability and sufficient blood supply for calcaneal defects up to 3 x 6 cm.

Adult↗