Purpose: This study evaluates the knowledge of surgical residents in a tertiary hospital regarding the operational principles, potential complications, and mechanisms of energy devices used in surgery. Methods: A 16-question test was developed using educational materials in the “Fundamental Use of Surgical Energy (FUSE)” program, prepared by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for educational purposes, and from literature on energy devices. The test was shared online with surgical branch residents via Google Forms, and they were asked to complete it. Participants were given one week to complete the test and return the results online. Results: A total of 108 residents voluntarily participated in the study. The average number of correct answers was 6.5 out of 16. There was no significant difference between the correct answer rates for surgical branches. However, an increase in surgical seniority was associated with a higher number of correct answers (P < 0.001). Conclusion Theoretical education about energy devices in surgical training needs to be improved. Surgical residents reported insufficient knowledge regarding the devices’ operational principles and complication mechanisms.

Purpose: This study evaluates the knowledge of surgical residents in a tertiary hospital regarding the operational principles, potential complications, and mechanisms of energy devices used in surgery. Methods: A 16-question test was developed using educational materials in the “Fundamental Use of Surgical Energy (FUSE)” program, prepared by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for educational purposes, and from literature on energy devices. The test was shared online with surgical branch residents via Google Forms, and they were asked to complete it. Participants were given one week to complete the test and return the results online. Results: A total of 108 residents voluntarily participated in the study. The average number of correct answers was 6.5 out of 16. There was no significant difference between the correct answer rates for surgical branches. However, an increase in surgical seniority was associated with a higher number of correct answers (P < 0.001). Conclusion Theoretical education about energy devices in surgical training needs to be improved. Surgical residents reported insufficient knowledge regarding the devices’ operational principles and complication mechanisms.

Purpose: This study evaluates the knowledge of surgical residents in a tertiary hospital regarding the operational principles, potential complications, and mechanisms of energy devices used in surgery. Methods: A 16-question test was developed using educational materials in the “Fundamental Use of Surgical Energy (FUSE)” program, prepared by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for educational purposes, and from literature on energy devices. The test was shared online with surgical branch residents via Google Forms, and they were asked to complete it. Participants were given one week to complete the test and return the results online. Results: A total of 108 residents voluntarily participated in the study. The average number of correct answers was 6.5 out of 16. There was no significant difference between the correct answer rates for surgical branches. However, an increase in surgical seniority was associated with a higher number of correct answers (P < 0.001). Conclusion Theoretical education about energy devices in surgical training needs to be improved. Surgical residents reported insufficient knowledge regarding the devices’ operational principles and complication mechanisms.

Purpose: Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. Methods: This survey was prepared to collect participants’ demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. Results: There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar’s length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). Conclusion Patients’ expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.

Purpose: To investigate the predictors of contralateral hypertrophy in patients treated with unilobar transarterial radioembolization (TARE) with yttrium-90-loaded resin microspheres due to unresectable right-liver tumors. Methods: Patients who underwent right unilobar TARE with resin microspheres between May 2019 and September 2021 were screened retrospectively. Contralateral hypertrophy was evaluated by calculating the kinetic growth rate (KGR) in 8–10 weeks after TARE. The predictors of increased KGR were determined with linear regression analysis. Results: A total of 24 patients (16 with primary and 8 with metastatic liver tumors) were included in the study. After right unilobar TARE, mean volume of the left lobe increased from 368.26 to 436.16 mL, while the mean volume of the right lobe decreased from 1576.22 to 1477.89 mL. The median KGR of the left lobe was 0.28% per week. The radiation dose absorbed by the healthy parenchyma of the right lobe was significantly higher in patients with increased KGR (31.62 vs. 18.78 Gy, p = 0.037). Linear regression analysis showed that the dose absorbed by healthy parenchyma was significantly associated with increased KGR (b = 0.014, p = 0.043). Conclusion Patients who received right unilobar TARE for liver malignancies could develop a substantial contralateral hypertrophy, and the radiation dose absorbed by the healthy parenchyma of the right lobe was significantly associated with increased KGR in the left lobe. TARE could have a role for inducing contralateral hypertrophy as it offers the advantage of concurrent local tumor control along with its hypertrophic effect.

OBJECTIVE: The aim of this study was to compare the buccolingual inclination of maxillary and mandibular molars in adults with different vertical facial types. METHODS: Cone-beam computed tomography images of 135 adult patients (age, 20–45 years) with skeletal Class I maxillomandibular relationships were assigned to normodivergent (n = 46), hypodivergent (n = 49), and hyperdivergent groups (n = 40) according to linear and angular sella-nasion/gonion-menton measurements. The normodivergent group consisted of 24 females and 22 males, hypodivergent group of 26 females and 23 males, and hyperdivergent group of 24 females and 16 males. Buccolingual inclination of the maxillary and mandibular first and second molars was measured relative to the occlusal plane. One-way analysis of variance was used for intergroup comparison. Gender differences were evaluated using independent t-tests. RESULTS: Buccolingual molar inclinations did not differ significantly between females and males (p > 0.05). There were no statistically significant differences among the buccolingual inclinations of the first and second maxillary and mandibular molars of the groups (p > 0.05). CONCLUSIONS: Buccolingual inclinations of maxillary and mandibular molars are similar in normodivergent, hyperdivergent, and hypodivergent adults with Class I sagittal relationships.
Adult ; Cone-Beam Computed Tomography ; Dental Occlusion ; Female ; Humans ; Male ; Molar*

STUDY DESIGN: Retrospective. PURPOSE: This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia. OVERVIEW OF LITERATURE: Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia. METHODS: We examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS). RESULTS: Fifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months. CONCLUSIONS: Age, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results.
Anesthesia, Spinal ; Body Mass Index ; Cesarean Section* ; Consensus ; Female ; Humans ; Low Back Pain* ; Parity ; Pregnancy ; Prospective Studies ; Retrospective Studies ; Risk Factors* ; Sacrum*

PURPOSE: To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. METHODS: Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10–100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. RESULTS: Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10–100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10–100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease. CONCLUSION: Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.
Calcitonin* ; Diagnosis ; Hashimoto Disease ; Humans ; Pentagastrin ; Renal Insufficiency ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule

BACKGROUND AND OBJECTIVES: Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension. SUBJECTS AND METHODS: Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded. RESULTS: Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern. CONCLUSION: Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; C-Reactive Protein ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension* ; Logistic Models ; Plasma

BACKGROUND: Behcet's disease (BD), first described in 1937 as a triadic complex of symptoms (oral aphthae, genital ulcers, and hypopyon uveitis), is a chronic, relapsing, multisystemic idiopathic inflammatory disease. OBJECTIVE: The objective of this study was to investigate the usability of messenger RNA (mRNA) expression of cytokine genes for following up patients with BD and also assess polymorphisms in these genes as to how they influence mRNA expression. METHODS: This study investigated the role of the IL1A -889(C/T), IL1B -511(C/T), and IL2 -330(T/G) polymorphisms by polymerase chain reaction (PCR)-restriction fragment length polymorphisms and the expression levels of the genes by real-time PCR in BD. RESULTS: The frequency of the IL2 -330 G allele was found to be significantly higher in patients with BD. A decreased level of IL1A gene expression was found in the patient group with clinically active BD compared to controls. Increased IL1B gene expression levels werefound in patient groups with active, inactive, or ocular BD (p<0.001). IL2 gene expression level manifested no significant change compared to controls in the patient group with clinically active BD; it increased in the groups with clinically inactive BD or ocular involvement. CONCLUSION: IL1A, IL1B, and IL2 gene expression, and IL2 promoter polymorphisms, may be valuable markers for predicting risk in the development of BD. We believe that the results reveal the importance of achieving a better understanding of BD and the prospects of developing future therapeutic strategies.
Alleles ; Gene Expression ; Humans ; Inflammation ; Interleukin-2 ; Interleukins* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; RNA, Messenger* ; Stomatitis, Aphthous ; Ulcer