Acıbadem Üniversitesi Açık Erişim Sistemi
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Is denervation surgery possible in the treatment of hallux rigidus? An anatomic study of cadaveric specimens
No full textObjective: The aim of this study was to provide anatomic considerations in the first metatarsophalangeal joint (FMPJ) innervation and to evaluate the feasibility of the denervation surgery in the treatment of hallux rigidus. Methods: In this cadaveric study, 14 fresh frozen cadaveric transtibial amputation specimens was used. For nerve dissection, dorsal and plantar longitudinal incision centered over the FMPJ were performed. Deep peroneal and dorsomedial cutaneous nerves were dissected in the dorsal aspect of the joint. Medial plantar nerve branches, medial and lateral hallucal nerves, were dissected in the plantar aspect of the joint. The presence, number, and location of articular branches to the FMPJ capsule were recorded. Dorsal and plantar incision length for proper dissection were also recorded. Results: Nerve dissection of the 14 specimens revealed the following number of articular branches from the relevant nerves: 14 from dorsomedial cutaneous nerves, 11 from deep peroneal nerves, 6 from medial hallucal nerve, and 5 from lateral hallucal nerve. Dorsal incision mean length was 60.53 (range, 42.48-85.12) mm, and the plantar incision mean length was 88.08 (range, 77.32-111.21) mm. Conclusion: Evidence from this study has shown that partial dorsal denervation of the FMPJ may be a technically feasible procedure along with the presence of superficially easily dissected nerves with relatively small incision.4JUL327-3315
Determination of Face and Content Validity of Cadaveric Model for Holmium Anatomic Endoscopic Enucleation of the Prostate Training: An ESUT AEEP Group Study
No full textBackground: Bench and virtual reality nonbiological simulator models for anatomic endoscopic enucleation of the prostate (AEEP) surgery have been reported in the literature. These models are acceptable but have limited practical applications. Objective: To validate a fresh-frozen human cadaver model for holmium AEEP training and assess its content validity. Design, setting, and participants: Holmium AEEP operations on fresh-frozen cadavers performed by an experienced surgeon were recorded, and a video, including the main steps of the operation, was produced. Outcome measurements and statistical analysis: The video and an accompanying questionnaire were subsequently distributed electronically to ESUT AEEP study group experts and associates (N = 32) for assessment of the AEEP training model. A ten-point Likert global rating scale was used to measure the content validity. Results and limitations: A total of 26 answers were returned (81\%). The experts agreed on the model's suitability for AEEP training (mean Likert score: 8). According to the responses, ``identifying anatomic structures and landmarks{''} was the most valuable aspect of the model in terms of AEEP training (median Likert score: 9). Conversely, the experts found the model's ability, in terms of demonstrating laser and tissue reactions, to be weak (median Likert score: 6) Conclusions: Based on the content validity assessment, the fresh-frozen cadavertraining model for laser AEEP seems to be a promising model for demonstrating and learning the correct prostate enucleation technique. Patient summary: An increasing number of researchers have proposed that anatomic endoscopic enucleation of the prostate (AEEP) should replace transurethral resection of the prostate surgery and become the gold standard for treatment of bladder outlet obstruction due to benign prostatic hyperplasia. AEEP requires anatomic familiarity for enucleation, technical knowledge, and a solid training program before starting with the first cases. This is the first cadaver study to assess the content validity of a fresh-frozen human cadaver model for AEEP training. (C) 2021 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.OCT28-343
Outcomes of patients with anal cancer treated with volumetric-modulated arc therapy or intensity-modulated radiotherapy and concurrent chemotherapy
No full textAims: To evaluate the results of chemoradiation with intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) for the treatment of anal canal cancer patients at three institutions that had advanced devices. Materials and Methods: A retrospective analysis was performed for patients treated with 5-fluorouracil and mitomycin-based chemotherapy and IMRT or VMAT for anal cancer from 2011 to 2013. Complete response (CR) rates, colostomy-free survival (CFS), disease-free survival (DFS), overall survival (OS), and toxicities were investigated. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events, Version 3.0. Results: Fifteen patients were included in the analysis. The majority of patients had T2 (53.3\%) and N0 (40\%) disease according to the staging system that was developed by the American Joint Committee on Cancer. CR was observed in 14 patients (93\%), and the median follow-up was 26 months (13-42 months). The 3-year CFS, DFS, and OS were 86\%, 86\%, and 88\%, respectively. Acute Grade 3 toxicities were observed as 6\% of hematological, 26\% of gastrointestinal, and 26\% of dermatological. Conclusion: Early results confirm that IMRT or VMAT for anal cancer treatment reduces acute toxicities while maintaining high control rates.1JAN-MAR51-551
A comprehensive study on identifying the structural and functional SNPs of human neuronal membrane glycoprotein M6A (GPM6A)
No full textGlycoprotein M6A, a stress related gene, plays an important role in synapse and filopodia formation. Filopodia formation is vital for development, immunity, angiogenesis, wound healing and metastasis. In this study, structural and functional analysis of high-risk SNPs associated with Glycoprotein M6-A were evaluated using six different bioinformatics tools. Results classified T210I, T134I, Y153H, I215T, F156L, T160I, I226T, R247W, R178C, W159R, N157S and P151L as deleterious mutants that are crucial for the structure and function of the protein causing malfunction of M6-a and ultimately leads to disease development. The three-dimensional structure of wild-type M6-a and mutant M6-a were also predicted. Furthermore, the effects of high risk substitutions were also analyzed with interaction with valproic acid. Based on structural models obtained, the binding pocket of ligand bound glycoprotein M6-A structure showed few core interacting residues which are different in the mutant models. Among all substitutions, F156L showed complete loss of binding pocket when interacting with valproic acid as compared to the wild type model. Up to the best of our knowledge this is the first comprehensive study where GPM6A mutations were analyzed. The mechanism of action of GPM6A is still not fully defined which limits the understanding of functional details encoding M6-A. Our results may help enlighten some molecular aspects underlying glycoprotein M6-A. Communicated by Ramaswamy H. Sarma8MAY 242693-27013
How does the obstetric anesthesia in cesarean section affect the wellbeing of the newborn?
No full textAim: The well-being of newborns after a cesarean section (CS) is the main important point when choosing anesthetic methods. APGAR score, cord blood gas levels, and early feeding of the newborns after CS are indicators of the newborn's well-being. In this study, it was aimed to evaluate the effects of different anesthesia methods (regional and general) on Apgar score and cord blood gas, and the second aim is to evaluate the onset time of breastfeeding after CS with different anesthesia methods. Material and Methods: A total of 364 mothers who underwent CS in our hospital, between January 2020 and April 2020 and their newborns' records were evaluated retrospectively. Results: General anesthesia(GA), regional anesthesia (RA) anesthesia were applied during CS to 50\% (n = 182), 50\% (n = 182). There were no significant differences between the two groups (all p>0.05) in terms of APGAR score, umbilical cord arterial blood gas. The rate of breastfeeding in the first hour in the RA group was significantly higher than in the GA group (p <0.001). Discussion: Two anesthesia (RA and GA) methods could be preferred safely for newborns in terms of APGAR score and umbilical cord blood gas, however, the timing of breastfeeding initiation was earlier with RA than GA.1JAN45-481
Treatment of glioblastoma by photodynamic therapy with the aid of synthesized silver nanoparticles by green chemistry from Citrus aurantium
No full textBlood brain barrier is very important to provide treatment locally for the treatment of glioblastoma. The use of nanoparticles has shown promise for glioblastoma treatments in recent years. In this study, the effect of the combined treatment of silver nanoparticles (AgNPs) synthesized from Citrus aurantium with photodynamic therapy (PDT) was investigated on U87 glioblastoma cells. AgNPs were characterized by FTIR, zeta potential and SEM images. U87 cells were treated with AgNPs (10 mu g/mL) and/or PDT (0.5 mJ/cm(2)) at 24 h. Cells antiproliferative effect, migration levels, colony formation capability, Bax and Bcl-2 protein/gene expression, and caspase-3 activity levels as apoptotic markers were measured. AgNPs size were found at 141 +/- 3 nm and 18.1 +/- 1.3 mV as zeta potential. It was found that cell proliferation, migration and Bcl-2 protein/gene levels decreased, and Bax protein/ gene levels and caspase-3 activity increased via AgNPs and PDT combined treatment. As a result, nanoparticles synthesized from Citrus aurantium are eco-friendly and their size can cross the blood brain barrier. If AgNPs is used with PDT, it may be a new therapy for clinically treatment of glioblastoma in the future.5641-6522
Variant analysis of SARS-CoV-2 strains with phylogenetic analysis and the Coronavirus Antiviral and Resistance Database
No full textAims: This study determined SARS-CoV-2 variations by phylogenetic and virtual phenotyping analyses. Materials \& methods: Strains isolated from 143 COVID-19 cases in Turkey in April 2021 were assessed. Illumina NexteraXT library preparation kits were processed for next-generation ]sequencing. Phylogenetic (neighbor-joining method) and virtual phenotyping analyses (Coronavirus Antiviral and Resistance Database {[}CoV-RDB] by Stanford University) were used for variant analysis. Results: B.1.1.7-1/2 (n = 103, 72\%), B.1.351 (n = 5, 3\%) and B.1.525 (n = 1, 1\%) were identified among 109 SARS-CoV-2 variations by phylogenetic analysis and B.1.1.7 (n = 95, 66\%), B.1.351 (n = 5, 4\%), B.1.617 (n = 4, 3\%), B.1.525 (n = 2, 1.4\%), B.1.526-1 (n = 1, 0.6\%) and missense mutations (n = 15, 10\%) were reported by CoV-RDB. The two methods were 85\% compatible and B.1.1.7 (alpha) was the most frequent SARS-CoV-2 variation in Turkey in April 2021. Conclusion: The Stanford CoV-RDB analysis method appears useful for SARS-CoV-2 lineage surveillance.3NOV157-1671
Artificial Intelligence in magnetic Resonance guided Radiotherapy: Medical and physical considerations on state of art and future perspectives
No full textOver the last years, technological innovation in Radiotherapy (RT) led to the introduction of Magnetic Resonance-guided RT (MRgRT) systems. Due to the higher soft tissue contrast compared to on-board CT-based systems, MRgRT is expected to significantly improve the treatment in many situations. MRgRT systems may extend the management of inter- and intra-fraction anatomical changes, offering the possibility of online adaptation of the dose distribution according to daily patient anatomy and to directly monitor tumor motion during treatment delivery by means of a continuous cine MR acquisition. Online adaptive treatments require a multidisciplinary and well-trained team, able to perform a series of operations in a safe, precise and fast manner while the patient is waiting on the treatment couch. Artificial Intelligence (AI) is expected to rapidly contribute to MRgRT, primarily by safely and efficiently automatising the various manual operations characterizing online adaptive treatments. Furthermore, AI is finding relevant applications in MRgRT in the fields of image segmentation, synthetic CT reconstruction, automatic (on-line) planning and the development of predictive models based on daily MRI. This review provides a comprehensive overview of the current AI integration in MRgRT from a medical physicist's perspective. Medical physicists are expected to be major actors in solving new tasks and in taking new responsibilities: their traditional role of guardians of the new technology implementation will change with increasing emphasis on the managing of AI tools, processes and advanced systems for imaging and data analysis, gradually replacing many repetitive manual tasks.MAY175-1918
Biological variation and reference change value data for serum copper, zinc and selenium in Turkish adult population
No full textObjectives: Calculation of biological variation (BV) components is very important in evaluating whether a test result is clinically significant. The aim of this study is to analyze BV components for copper, zinc and selenium in a cohort of healthy Turkish participants. Methods: A total of 10 serum samples were collected from each of the 15 healthy individuals (nine female, six male), once a week, during 10 weeks. Copper, zinc and selenium levels were analyzed by atomic absorption spectrometer. BV parameters were calculated with the approach suggested by Fraser. Results: Analytical variation (CVA), within-subject BV (CVI), between-subject BV (CVG) values were 8.4, 7.1 and 4.3 for copper4.2, 9.1 and 13.7 for zinc7.6, 2.5 and 6.9 for selenium, respectively. Reference change values (RCV) were 30.46, 27.56 and 22.16\% for copper, zinc and selenium, respectively. The index of individuality (II) values were 1.65, 0.66 and 0.36 for copper, zinc and selenium, respectively. Conclusions: According to the results of this study, traditional reference intervals can be used for copper but we do not recommend using it for zinc and selenium. We think that it would be more accurate to use RCV value for zinc and selenium in terms of following significant changes in recurrent results of a patient.5OCT587-5924
Endovenous Laser Ablation of Varicose Veins of the Lower Extremities: Report of the relationship Between Vascular Access And Procedural Pain
No full textABSTRACT
Objective: The aim of this study is to evaluate the effects of vascular access (proximal or distal) on postoperative pain in
patients diagnosed with isolated varicose small saphenous vein who underwent endovenous laser ablation.
Materials and Methods: Medical records of 49 patients (35 female, 14 male) with isolated saphenous venous insufficiency
were reviewed. Endovenous laser ablation was performed in all patients at an emission wavelength of 1470 nm, using
7 Watt laser energy at the proximal and distal ports. The pain was evaluated using a visual analog scale at 7 days, 1, 3
and 6 months.
Results: In 30 of the 49 patients, vascular access was performed from the distal to the below the knee section of the
small saphenous vein and in 19 cases from proximal to the small saphenous vein. The results of these two groups showed
that access into the larger proximal part of the varicose vein provides an easy route with reduced local pain scores in the
endovenous laser ablation of varicose veins (p<0.001).
Conclusion: In patients diagnosed with isolated varicose small saphenous vein and undergoing endovenous laser
ablation, the vascular access route (proximal or distal) did not have a significant effect on postoperative pain, but the
proximal route was more easily accessed and the procedure lasted shorter