Cengiz Acikel

Gulhane Military Medical Academy, Engüri, Ankara, Turkey

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Publications (119)212.49 Total impact

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    ABSTRACT: Vascularized composite allografts can undergo immune-mediated rejection, and skin biopsies are needed for monitoring of the transplant. However it is an invasive method, and requires processing time and pathological assessment. The purpose of this study is to use a new noninvasive monitoring method of the reflectance confocal microscopy (RCM) to determine severity of the allograft rejection on rats. Five groin flap allotransplantation were performed between 10 male Sprague-Dawley rats. Immunosuppressive therapy with cyclosporine A was given to the recipients during 10 days after surgery and was ended at the 10th postoperative days to allow acute transplant rejection. Following cessation of CsA, concomitant RCM evaluation and skin biopsy was performed every other day from each animal until total rejection of the allograft. Complete rejection of the allograft took nearly about 10 days and 4 or 5 RCM evaluation and skin biopsy was performed from each rat during this period. A total of 17 specimens were evaluated. A scoring system was developed based on the RCM findings. Skin biopsies were evaluated according to the Banff 2007 working classification criteria. RCM evaluation revealed epidermal irregularity and collagen destruction, however mild perivascular inflammation and degeneration of the basal epidermal layer were observed in early and late rejection period respectively with histopathologic evaluation. High correlation was found between the RCM scores and histopathologic grading. The RCM may be the useful tool to reduce the need for skin biopsy for monitoring of the skin containing vascularized composite allograft. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. © 2015 Wiley Periodicals, Inc.
    Microsurgery 05/2015; DOI:10.1002/micr.22419 · 2.42 Impact Factor
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    ABSTRACT: Objectives The aim of this study was to investigate the mandibular third molar pericoronitis flora by using real-time polymerase chain reaction (PCR).Materials and methodsThe quantitative values of Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf) were evaluated in comparison with the healthy third molar flora by using real time PCR.ResultsAa, Cr, Pg, and Pi were not statistically significant but numerically higher than the pericoronitis group. In contrast to samples from control subjects, statistically significant higher numbers of Tf were detected in samples from pericoronitis patients. The study revealed the strong relation between risk of pericoronitis and the presence of Tf. Individuals who have Tf in their samples present with an almost eight times relative risk of pericoronitis as the individuals with an absence of Tf in their samples.Conclusion Tf plays an important role in the development of clinical symptoms related to pericoronitis.
    05/2014; 64(4). DOI:10.1111/idj.12109
  • Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):738-738. DOI:10.1136/annrheumdis-2012-eular.2438 · 9.27 Impact Factor
  • Pediatric Rheumatology 11/2013; 11(Suppl 1):A163. DOI:10.1186/1546-0096-11-S1-A163 · 1.62 Impact Factor
  • Pediatric Rheumatology 11/2013; 11(Suppl 1):A43. DOI:10.1186/1546-0096-11-S1-A43 · 1.62 Impact Factor
  • Pediatric Rheumatology 11/2013; 11(Suppl 1):A42. DOI:10.1186/1546-0096-11-S1-A42 · 1.62 Impact Factor
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    Pediatric Rheumatology 11/2013; 11(Suppl 1):A81-A81. DOI:10.1186/1546-0096-11-S1-A81 · 1.62 Impact Factor
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    ABSTRACT: BACKGROUND AND AIM: Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations of the MEFV gene. We analyse the impact of ethnic, environmental and genetic factors on the severity of disease presentation in a large international registry. METHODS: Demographic, genetic and clinical data from validated paediatric FMF patients enrolled in the Eurofever registry were analysed. Three subgroups were considered: (i) patients living in the eastern Mediterranean countries; (ii) patients with an eastern Mediterranean ancestry living in western Europe; (iii) Caucasian patients living in western European countries. A score for disease severity at presentation was elaborated. RESULTS: Since November 2009, 346 FMF paediatric patients were enrolled in the Eurofever registry. The genetic and demographic features (ethnicity, age of onset, age at diagnosis) were similar among eastern Mediterranean patients whether they lived in their countries or western European countries. European patients had a lower frequency of the high penetrance M694V mutation and a significant delay of diagnosis (p<0.002). Patients living in eastern Mediterranean countries had a higher frequency of fever episodes/year and more frequent arthritis, pericarditis, chest pain, abdominal pain and vomiting compared to the other two groups. Multivariate analysis showed that the variables independently associated with severity of disease presentation were country of residence, presence of M694V mutation and positive family history. CONCLUSIONS: Eastern Mediterranean FMF patients have a milder disease phenotype once they migrate to Europe, reflecting the effect of environment on the expression of a monogenic disease.
    Annals of the rheumatic diseases 03/2013; DOI:10.1136/annrheumdis-2012-202708 · 9.27 Impact Factor
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    ABSTRACT: We designed one-and-a-half-barrel vascularized free fibular flap which is a further modification of the double-barrel technique, and we tried to overcome the discrepancy between mandible and fibula flap. We used this flap in case of a segmental mandibular defect that occurred as a result of a giant cell reparative granuloma excision. This new modification eliminated volume insufficiency of the classical technique and volume excess of the double-barrel technique.A segmental mandibular defect that occurred as a result of giant cell reparative granuloma excision was reconstructed using one-and-a-half-barrel vascularized free fibular flap. The size discrepancy between mandible and free fibula flap is a well-known problem, and this new modification of free fibular flap eliminated volume insufficiency or excess problems of the other techniques.
    The Journal of craniofacial surgery 03/2013; 24(2):e167-9. DOI:10.1097/SCS.0b013e31827c840f · 0.68 Impact Factor
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    ABSTRACT: Objectives: The residual alveolar bone height at the implant recipient site plays a key role in determination of the risk of sinus membrane perforation during crestal sinus elevation. In this study, we aimed to determine the correlation between residual ridge height and perforation limit of sinus membrane and to examine the safety range for the sinus membrane continuity in crestal sinus elevation. Formalin-fixed cadavers were used for the experiment to observe outcomes. Method and Materials: Crestal sinus elevations were performed on 14 preserved human cadavers' heads. Residual ridge heights were measured using a bone caliper. The physiodispenser was preset to 30 Ncm and sinus floors were elevated by a concave sinus screw with diameter of 4 mm until sinus membrane perforation occurred. The perforations were identified either as Class I or Class II and the portion of the concave sinus screw in the sinus was measured each time using a ruler. Spearman's correlation coefficient was calculated to show the relation between the residual ridge heights and the membrane elevations at the time of perforation of the sinus membranes. Results: In general, the perforation limit of sinus membrane after elevation was higher with greater residual ridge height. A statistically significant correlation was found between residual ridge heights and perforations of the sinus membrane (r = 0.620, P < .001). Conclusion: Although it is not always possible to extrapolate results from cadavers to an in vitro clinical setting, it could be considered to have clinical significance. Our findings suggest that higher subsinusoidal elevation may be achieved when the residual ridge bone height increases. The conclusions of this study should be verified with studies of more rigorous design.
    Quintessence international (Berlin, Germany: 1985) 02/2013; 44(9). DOI:10.3290/j.qi.a29185 · 0.73 Impact Factor
  • Pediatric Rheumatology 01/2013; 11(Suppl 2):P318. DOI:10.1186/1546-0096-11-S2-P318 · 1.62 Impact Factor
  • Pediatric Rheumatology 01/2013; 11(Suppl 2):P217. DOI:10.1186/1546-0096-11-S2-P217 · 1.62 Impact Factor
  • Pediatric Rheumatology 01/2013; 11(Suppl 2):P185. DOI:10.1186/1546-0096-11-S2-P185 · 1.62 Impact Factor
  • Pediatric Rheumatology 01/2013; 11(Suppl 2):P200. DOI:10.1186/1546-0096-11-S2-P200 · 1.62 Impact Factor
  • Pediatric Rheumatology 01/2013; 11(Suppl 1):A80. DOI:10.1186/1546-0096-11-S1-A80 · 1.62 Impact Factor
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    ABSTRACT: Objective: When a mandibular third molar is partially impacted in the soft tissue, it must be determined whether the extraction wound should be left partially open or completely closed. We hypothesize that a blood clot preserving a surgical wound with easily cleanable surfaces by primary closure and drain application would postoperatively minimize dry socket and/or alveolitis development. Method and Materials: Twenty patients requiring bilateral extraction of partially soft tissue-impacted mandibular third molars in a vertical position were included in the study. The existence of dry sockets, alveolitis, pain, facial swelling, and trismus were evaluated on the second, fifth, and seventh days of the postoperative period. Results: On the second day, pain, trismus, and swelling were higher in the drained group; however, pain reduced progressively in the drained group over time. There were no cases of dry sockets or alveolitis except for a single patient on the seventh day in the drained group over the 7-day study period. On the other hand, in the secondary closure group, the number of dry sockets was 8 (40%) on the second day. The number of alveolitis was 10 (50%) on the fifth day and 4 (20%) on the seventh day. Conclusion: Closed healing by drain insertion after removal of partially soft tissue-impacted third molars produces less frequent postoperative dry sockets and/or alveolitis development than occurs with open healing of the surgical wound. In cases with a risk of alveolitis development (lack of oral hygiene, immunocompromised patients, etc), it can be avoided with the "kiddle effect" and related undesired complications by implementing closed healing with drain insertion.
    Quintessence international (Berlin, Germany: 1985) 11/2012; 43(10):863-70. · 0.73 Impact Factor
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    ABSTRACT: Ameloblastoma is a benign tumor of the mandible, which is not commonly diagnosed in the early stages. The extensive mandible resection may be needed for treatment. In this report, we present 6-year follow-up results of a patient who had undergone hemimandibulectomy and mandible reconstruction with free vascularized fibular flap, costochondral rib graft to restoration of the temporomandibular joint, and iliac bone graft to enhance the vertical height of the mandible. The long-term results are very satisfactory.
    The Journal of craniofacial surgery 08/2012; 23(5):1373-4. DOI:10.1097/SCS.0b013e31825653ad · 0.68 Impact Factor
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    ABSTRACT: The term "fourth-degree burn" is not very often found in the literature because it is often associated with lethal injury. These injuries are characterized by exposure of viable tissue such as tendon or bone and are associated with challenging wound closure. The goal of reconstruction is to provide adequate soft tissue coverage and restoration of function. Several treatment modalities have been used to serve this purpose. We present four male patients with fourth-degree burns of the extremities, treated with negative pressure wound therapy. The patients' age ranged from 15 to 49 yr (mean, 28 yr). The total body surface area burned ranged from 3 to 60% (mean, 34.25%). Negative pressure wound therapy was applied for 16-30 days (mean, 23.75 days). Three split-thickness skin grafts and one bipedicled local flap were performed. Wound closure was completed in 28 to 50 days. The results were satisfactory for both physicians and patients. Our longest follow-up was three years. The results achieved in this group of patients revealed the negative pressure wound therapy was a reliable alternative method in the treatment of fourthdegree burns.
    The Annals of Fires and Burn Disaster 06/2012; 25(2):92-7.
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    ABSTRACT: Neurosensory deficits are the most common complication following orthognathic surgery. Le Fort I and sagittal split ramus osteotomies have been widely studied but there is a lack of data about the neurosensory alterations resulting from anterior maxillary osteotomy (AMO). This paper evaluates the neurosensory alterations in cutaneous regions including lower eyelid, cheek, nose, upper lip and vestibular and palatal mucosal areas using simple clinical tests following AMO performed with Bell's incision so patients can be properly informed about the extent of sensory loss and its rate of recovery following AMO. Twenty-four sides of 12 patients (eight females; four males) with a mean age of 14.20±1.86 years (range 12-17 years) were examined. Pin prick sensation, light touch sensation, static and dynamic two-point discrimination tests were used. Following AMO, vestibular mucosa, upper lip, nose and cheek were the most commonly affected sites. No alterations were detected in lower eyelid and palatal mucosa. The neurosensory deficits in cheek, nose and upper lip resolved 10 days after surgery. The vestibular mucosa showed normal sensation on day 30. In conclusion, following AMO, neurosensory alterations can occur, but it will resolve spontaneously in 30 days.
    International Journal of Oral and Maxillofacial Surgery 04/2012; 41(11):1353-60. DOI:10.1016/j.ijom.2012.03.021 · 1.36 Impact Factor
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    ABSTRACT: Objective: While developed countries do age estimation for the purpose of identification, in countries such as Turkey, it is used to determine the real age of a person with an already known identity because of inaccurate birth records. The aim of this article was to investigate whether the calcification degree of the first costal cartilage could be a marker for age determination. Material and Methods: We retrospectively analyzed the postero-anterior chest x-rays of 471 patients (270 males, 201 females; mean age ± standard deviation 42.38±20.69 years) who presented to the radiology department for various reasons. The calcification degree of the right first costal cartilage was classified in four stages based on criteria used by Barchilon and Garamendi, and the patients were classified in seven groups regarding their ages. The correlation between the calcification stage of the right first costal cartilages and age group was analyzed by Spearman's rho. Results: According to the first costal cartilage calcification stage, the mean ages were 5.56, 25.49, 45.39 and 66.02 at stage 0, 1, 2 and 3, respectively. The calcification degree of the right first costal cartilage and age correlated significantly in males and females [Spearman's rho=0.904, p<0.001 (0.924, p<0.001 in males and 0.864, p<0.001 in females)]. Conclusion: Although there are overlaps among age groups, the assessment of the calcification degree of the first costal cartilage on chest x-rays may be useful to predict the bone age. This age determination method can be used in criminal courts and forensic anthropology as a contributory technique.
    Turkiye Klinikleri Journal of Medical Sciences 03/2012; 32(5):1361. DOI:10.5336/medsci.2011-27529 · 0.10 Impact Factor

Publication Stats

904 Citations
212.49 Total Impact Points

Institutions

  • 1998–2015
    • Gulhane Military Medical Academy
      • • Department of Plastic and Reconstructive Surgery
      • • Department of Public Health
      • • Department of Medical Oncology
      Engüri, Ankara, Turkey
  • 2013
    • Hacettepe University
      • Department of Pediatrics
      Ankara, Ankara, Turkey
  • 2011–2013
    • Acibadem Üniversitesi
      İstanbul, Istanbul, Turkey
  • 2001–2011
    • Istanbul Surgery Hospital
      İstanbul, Istanbul, Turkey
  • 2004–2008
    • University of Texas Southwestern Medical Center
      • Department of Plastic Surgery
      Dallas, TX, United States
  • 2007
    • Uppsala University Hospital
      Uppsala, Uppsala, Sweden
  • 2005–2006
    • İstanbul Eğitim ve Araştırma Hastanesi
      Cebelibereket, Osmaniye, Turkey
    • The Jikei University School of Medicine
      • Department of Plastic and Reconstructive Surgery
      Tokyo, Tokyo-to, Japan
    • University of Texas at Dallas
      Richardson, Texas, United States
  • 2000–2005
    • Istanbul Training and Research Hospital
      İstanbul, Istanbul, Turkey
  • 2002
    • Haydarpasa Numune Research and Teaching Hospital
      İstanbul, Istanbul, Turkey