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Recent Submissions
Effect of the Shelving Technique on the Outcome of Embolization in Intracranial Bifurcation Aneurysms
(2022) Arat, A; Cay, F; Radyoloji
Abstract
Background and purpose: Stent bulging technique has been introduced as a technique that improves the outcome of aneurysm coiling. Our aim was to evaluate the utility of this technique, which involves the intentional herniation of stents into the bifurcation aneurysms during coiling.
Materials and methods: Unruptured bifurcation aneurysms treated by stent-assisted coiling using a single type of low-profile braided (LEO Baby) stent between November 2012 and October 2018 were retrospectively evaluated. The clinical (age and sex) and morphologic characteristics (aneurysm size, neck size, proximal/distal diameters of the stented artery, incorporation of the origins of the side branches to the aneurysm neck, and bifurcation angle) and response to antiplatelet therapy were evaluated.
Results: Sixty-one patients (29 men, 47.5%; mean age, 55.95 [SD, 12.33] years) with 66 aneurysms were included. There were 36 aneurysms in group A (treated with the stent bulging technique) and 30 aneurysms in group B (treated by classic stent-assisted coiling). There was no significant difference in the patient and aneurysm characteristics in the groups except for the larger size and wider neck of the aneurysms in group A (P = .02 and P = .04, respectively). At the mean follow-up of 27.30 (SD, 17.45) months, there was no significant difference in the complication rate, the occlusion status, and the early and long-term occlusion rates between the groups. The stent bulging technique did not predict total occlusion (Raymond-Roy I) at the final imaging follow-up.
Conclusions: The stent bulging technique enables the coiling of larger, wide-neck aneurysms; however, we did not observe an added flow-diversion effect with the stent bulging technique compared with conventional stent-assisted coiling. We, therefore, suggest that bifurcation aneurysms should be coiled as densely and as safely as possible using this technique.
MEDULLA SPİNALİS YARALANMALI BİREYLERDE ALT EKSTREMİTE ORTEZİ KULLANIM MEMNUNİYETİNİN FONKSİYONEL BAĞIMSIZLIK DÜZEYİ VE YAŞAM KALİTESİ İLE İLİŞKİSİNİN İNCELENMESİ
(Sağlık Bilimleri Enstitüsü, 2023) akyüz, sinem; Erbahçeci, Fatih; Fizyoterapi ve Rehabilitasyon
Akyüz, S., Investigation of the Relationship Between Orthosis Satisfaction, Functional Independence and Quality of Life of Spinal Cord Injured Individuals Using Lower Extremity Orthosis, Hacettepe University Graduate School Health Sciences Prosthetics-Orthotics and Biomechanics Department, Master Thesis, Ankara, 2023 The aim of this study was to examine the relationship between satisfaction with lower extremity orthosis use and the levels of quality of life and functional independence in individuals with Spinal Cord Injured. A total of 107 individuals with a mean age of 42,38±17,91 were included in the study. Orthosis satisfaction was assessed using the Quebec Assistive Technology User Satisfaction Assessment Questionnaire. Functional independence was measured using the Spinal Cord Independence Measure ( S CIM III), and quality of life was evaluated using the Short Form 36 (SF-36) questionnaire. Gait assessment was performed using the Walking Index for Spinal Cord Injury (WISCI II) scale. No statistically significant correlation was found between orthosis satisfaction and functional independence with quality of life parameters (p>0.05). Patients were divided into therapeutic ambulation and functional ambulation groups according to their WISCI II score and no significant difference in orthosis satisfaction was observed between the two groups (p>0.05). The patients were grouped based on the type of lower extremity orthosis they used. Among the groups, the group with the highest orthosis satisfaction score was the group that used the dorsiflexion band orthosis and no difference was found among the other groups (p>0.05). The patients were also grouped according to their neurological levels. Among the groups, the group with the highest orthosis satisfaction score was the group with L1-L5 level, and no difference was found among the other groups (p>0.05). As a result of the study, the lack of correlation between orthosis satisfaction with functional independence and quality of life indicates that the study is an important step in investigating which factors affect orthosis satisfaction in individuals with SCI. Since the use of orthoses is an indispensable part of the rehabilitation process in individuals with SCI, it is thought to be appropriate to plan studies on orthosis satisfaction and provide a different perspective to professionals working in the field.
Kalıtsal Metabolik Hastalıklarda Otofaji, Oksidatif Stres ve İnflamasyon İlişkisi
(Sağlık Bilimleri Enstitüsü, 2023-08) Özaydın, Eda; Dursun, Ali; Çocuk Sağlığı Enstitüsü
The complications such as epilepsy, cataract, hepatic failure, chronic renal disease may develop during the clinical follow-up of the patients with inherited metabolic diseases. The aim of this study is to investigate the role of autophagic dysfunction, inflammation and oxidative stress in the development of these complications. Forty-eight patients with the diagnosis of classic galactosemia, maple syrup urine disease, hereditary tyrosinemia type 1, lysinuric protein intolerance and ten healthy children were included in the study. Laboratory investigations were performed such as analysis of autophagy ( Beclin 1, LC3B-II, p62) and inflammasome (NLRP3, ASC, Caspase 1, NF-Ƙβ) gene and protein expressions, measurement of oxidative stress biomarkers (total thiol, native thiol, disulphid, thiol/disulphide homeostasis, total antioxidant capacity and total oxidative stress), cytokine levels, immune phenotyping with lymphocyte subgroup and lymphocyte activation markers, metabolomic analysis with untargeted metabolomic profiling in the patient and healthy control group. The highest levels of total thiol, native thiol, TOS and TAS were observed in MSUD group. The highest disulphide, the lowest TAC levels were detected in LPI groups. The cytokine levels showed no significant difference between patient and control group. In all groups, NLRP3/p62 gene expressions increased. The highest fold changes were observed in the patients of galactosemia and LPI groups. Autophagy dysfunction was detected in all groups. NLRP3/p62 gene expressions were positively correlated. p62 seems to be a key player which links the antioxidant (Nrf2), autophagy and inflammation pathways in the patient groups. NLRP3 gene expressions were found to be higher with specific clinical phenotypes such as cataract in galactosemia patients, lung involvement in LPI group or hepatic fibrosis in tyrosinemi patients. Significant statistical differences were observed with respect to T and B lymphocyte, DNT, NKT, CD3HLADR, classic and non-classic monocyte levels in the patient groups. PLS-DA analysis revealed statistically significant different metabolites in the patient group compared with healthy control group. The metabolites enriched in general metabolic pathways such as steroid hormone and aminoacid biosynthesis, lipid, purine-pyrimidine metabolism, energy metabolism were principally detected by metabolomic analysis in the patient group. The metabolomic profiling of LPI patients were resembling with the pathways affected in chronic inflammatory diseases. This is the first study which investigates the inflammasome and autophagy gene and protein expressions, the relationship between oxidative stress, autophagy and inflammation, immun functions and metabolomic profiling simultaneously in intoxication type inherited metabolic diseases. The results of the study revealed that autophagic dysfunction, oxidative stress, inflammation, immun dysregulation might play an important role under the pathogenesis of metabolic diseases.
Rezonans Ses Ediniminde Klinisyen Geri Bildirim Özelliklerinin Etkisinin İncelenmesi
(Sağlık Bilimleri Enstitüsü, 2023) TAĞIL, Hanife Nur; ESEN AYDINLI, Fatma; Dil ve Konuşma Terapisi
There are clinical researches which aim to adapt motor learning principles to voice therapy and which examine individual differences that underlie of behavioral changes and skill acquisition. While there are many studies at the ‘practice’ phase regarding the characteristics of clinician feedback for motor learning principles in the field of voice therapy, there are few studies available in the ‘prepractice’ phase. In this thesis study, by keeping the prepractice phase components motivation, verbal information and modeling steady; resonant voice training was applied by 2 Speech and Language Therapists to 6 different groups (n=90) consisting of women with healthy voices between the ages of 18-35, in which feedback characteristics changed. These 6 groups; consists of groups that do not receive any feedback, receive knowledge of result feedback and receive knowledge of performance feedback (4 subgroups). Auditory-perceptual and acoustic assessments were made before and after the training. Auditory-perceptual assessment was made by 3 experts experienced in the field by grading the quality of the resonant voice, and a statistically significant difference was found between the groups when the participant groups were compared (p<.05). According to the results of multiple comparison analysis, a statistically significant difference was found between the group that did not receive feedback and the kinesthetic + visual + auditory feedback group after the Bonferronni correction (p<.05). According to the findings of the analyzes of acoustic assessment, there was no significant difference between the groups in terms of the intensity and the Cepstral Peak Prominence, but an increase in the repetitions at the end of the training was detected in the feedback-given groups. The findings of the study indicate that it is beneficial to give feedback by using different sensory modalities in the prepractice phase and to use knowledge of result feedback in the acquisition of the resonant voice.
Melanomanın Topikal Yolla Tedavisine Yönelik Metformin Yüklü Polikaprolakton Nanopartikül İçeren Jel Formülasyonu Hazırlanması ve İn Vitro Değerlendirilmesi,
(Sağlık Bilimleri Enstitüsü, 2023-09) Eke, Ziyneti; Erdoğar, Nazlı; Farmasötik Teknoloji
Melanoma is one of the most challenging types of cancers to treat with a high metastatic capability. Resistance to chemotherapeutic drugs used in melanoma treatment leads to reduced treatment efficacy. Furthermore, systemic side effects can also occur with chemotherapeutic drugs, which can cause damage to healthy tissues. In addition to chemotherapy, radiotherapy, photodynamic therapy, and gene therapy are also applied in melanoma treatment. However, these methods have their advantages and disadvantages as well. Considering the poor prognosis and the shortcomings in treatment, innovative treatments are needed for melanoma. In this thesis, metformin HCl, a biguanide derivative antidiabetic drug that has shown anticancer activity in the literature, was chosen as the therapeutic agent. The aim of the study was to increase the skin retention after topical application by enabling the drug to be applied locally to the pathological area and encapsulating metformin into nanoparticles. Overcoming the stratum corneum, the outermost layer of the skin, is quite challenging in topical applications and limits treatment. In this thesis, metformin HCl (Met) was encapsulated in Polycaprolactone (PCL) nanoparticles to reduce particle size and enhance the penetration of the drug into the skin. Cell culture studies showed that the Chitosan (CS) gel formulation containing metformin HCl-loaded PCL nanoparticles was more effective compared to the gel containing free metformin. In vitro characterization studies and ex-vivo studies concluded that the chitosan gel formulation containing Met-loaded PCL nanoparticles is a promising system for the topical treatment of melanoma.