Aim: To evaluate the effects of theranekron in respect of autophagy on gastric cancer that is the fifth leadingcancer type worldwide.Metods: In the present study, metastatic AGS and non-metastatic MKN-45 human gastric cell lines were usedtogether with HEK-293 non-cancer cells as controls. Cytotoxic effect of theranekron besides appropriatetreatment time was investigated through cell proliferation by using Cell Proliferation assay Kit (MTT) usingdifferent concentrations of the drug. The autophagic effect of the drug was determined using the LC3-GFPtranslocation assay and western blot analysis. All experiments were performed also using the ethanol sinceTarantula cubensis spider was processed and diluted in 60% alcohol to generate as a drug.Results: MTT assay results demonstrated that the half maximal inhibitory concentration of theranekron was~100 μM, its effect was found to be significant at 6 hrs, and theranekron decreased the cell viability in all celllines without specificity in respect to the increasing concentrations. Additionally, a significantly increased GFPaccumulation was detected in the autophagosomes of the cells treated with theranekron compared to nontreated cells, indicating the presence of autophagy.Conclusion: These findings were confirmed by LC3-I to LC3-II conversion with the western blot analysis.The data of ethanol experiments; however, demonstrated that ethanol also induced a cytotoxic effect andautophagic cell death. Our results suggested that theranekron results in cell death and stimulate autophagyprocess, but it is not specific for cancer cells since it represented similar results on non-cancer control cells.Moreover, the effect of theranekron on cell death might mostly occur through alcohol in which it is extracted.
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Aim: To demonstrate the decrease in patellofemoral pressure with an anterior elevation of tuberositas tibia.Therefore, we have performed Maquet’s Technique to evaluate the patella pressure on femoral trochlea bybiomechanically in an animal experiment model.Methods: This study includes total of 42 knees of 21 New Zealand rabbits. Animals were divided into twogroups. The first group including 21 right knees was designated as the control group. In the second groupincluding 21 left knees, anterior elevation of tuberositas tibia (Maquet’s technique) was performed. Pressuremeasuring film layer “prescala” was placed on the patellofemoral joint under anesthesia in both groups. Meanvalues of both average and maximal pressure measurements in two groups were compared.Results: There is a statistically significant difference in between average pressure and maximum pressure inthe right and left legs of the rabbits. Average pressure and maximal pressure at rabbit knees performedMaquet’s procedure were significantly lower than knees without Maquet’s procedure.Conclusion: Anterior elevation of tuberositas tibia is successful in reducing patellofemoral joint pressurewhich can be used in cases with patellofemoral pain syndrome non-responding to conservative treatment.
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Aim: To investigate the complications that occur in our patients who underwent thoracic surgery, as well asthe relationship between postoperative pain and complications.Method: Of the 117 patients who underwent surgery between January 2018 and December 2018, there were99 patients with pain and the other parameters whose data’s were complete. Medical records of the patientswere investigated in terms of age, gender, smoking status and frequency, diagnosis, treatment, length of stayin the hospital, postoperative complications and visual analog scale (VAS). The postoperative complicationsand VAS values were compared statistically.Results: The mean age of the patients was 50.52±18.46 years, 26 (26.3%) patients were female and 73 (73.7%)were male. The average length of stay in hospital was 4.08±3.06 days and average pain severity was 3.92±2.07.The most common diagnosis in our cases was lung cancer, and the most common complication was prolongedair leakage. There was a significant relationship between the severity of pain and the presence of postoperativecomplications in our patients (p=0.001). However, the correlation relationship was found to be low (r=0.322).Conclusion: The results of our study revealed that optimal postoperative pain control is an important factorfor preventing postoperative complications.
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Ganime Esra SOYSAL, Arzu İLCE, Ümmühan YİĞİT SEYFİ, Hülya ÖZTÜRK TEL, Murat BİLGİ
Ganime Esra SOYSAL, Arzu İLCE, Ümmühan YİĞİT SEYFİ, Hülya ÖZTÜRK TEL, Murat BİLGİ
Aim: To investigate the effects of using the active warming method on children with hypothermia in the perioperative period and examining the effects of hypothermia on awakening time, pain, shivering and hospital stay. Methods: This study included patients 18 years of age and younger who underwent surgery in the pediatric surgery department of a tertiary hospital. The active warming group consisted of 28 patients and the control group consisted of 29 patients. The first group of patients was actively warmed during the surgery and the second group was treated as the control group and did not actively receive any warming therapy. Preoperative body temperatures of the cases were measured. In addition, body temperatures were recorded every 15 minutes in the intraoperative and postoperative periods. Results: There was no statistically significant difference in preoperative body temperature between the control group and the active warming group. When body temperature were examined in the intraoperative period, there was no significant difference between the groups at the first 15 minutes of operation; however, the mean of the body temperature in active warming group was significantly higher than the control group at the 30th, 45th , and 60th minutes of operation. It was determined that patients in the control group had a longer stay in the hospital and the amount of time for waking at the end of the anesthesia was shorter in the active heating group than in the control group. Conclusions: The results of our study suggest that active heating with a carbon fiber resistant system is an effective method to prevent unplanned hypothermia in operated children.
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Fatma AVCIOĞLU, Fatma SİRMATEL, Mustafa BEHCET, Oğulcan OZARSLAN, Hasan Tahsin GÖZDAŞ
Fatma AVCIOĞLU, Fatma SİRMATEL, Mustafa BEHCET, Oğulcan OZARSLAN, Hasan Tahsin GÖZDAŞ
Aim: Candida infections develop especially in intensive care unit (ICU) patients and increase the mortality rates. So, early and accurate diagnosis of Candida infections and determination of risk factors are very important. We aimed to retrospectively investigate Candida infections in terms of species and risk factors for candidemia caused by fungi. Methods: Candida infections in critically ill patients hospitalized in the Intensive Care Unit of Bolu Abant Izzet Baysal University Training and Research Hospital between January 2014 and December 2018 were retrospectively analyzed. The isolated Candida species were evaluated according to the sample types. The cases were investigated in terms of mortality due to candidiasis, previously used antibiotics and isolated Candida species. Results: 34 Candida species isolated from fungal cultures in ICUs were included in the study. Candida albicans (73.5%) was the most prevalent species isolated (NAC 26.5%). Patients with Candida isolated in their urine samples (76%) had a higher mortality rate than patients with Candida from other regions. Conclusion: The results of our study suggest that the highest rate of candidiasis (88%) is in patients who received beta-lactam antibiotic treatment. In addition, we think that when Candida species are detected in the urine samples of critically ill patients in the ICU, care should be taken in terms of candidiasis.
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Feyzi GÖKOSMANOĞLU, Atilla ÖNMEZ
Feyzi GÖKOSMANOĞLU, Atilla ÖNMEZ
Aim: Levothyroxine (L-T4) requirements in obese hypothyroid patients receiving L-T4 therapy decrease following bariatric surgery. L-T4 absorption is also thought to decrease after surgery. The purpose of this study was to evaluate L-T4 requirements in hypothyroidism cases before and after weight loss through bariatric surgery. Methods: Seventy-six cases of hypothyroidism receiving L-T4 replacement therapy and with a body mass index over 40 kg/m2 were included in the study. Patients losing at least 10% of basal body weight following bariatric surgery were assessed in terms of thyroid hormone levels and L-T4 requirements over follow-up of at least one year. The L-T4 requirements of patients in whom euthyroidism was achieved were compared in terms of bariatric surgery procedures and hypothyroidism etiology. Results: Seventy-six patients (56 women, 20 men) with a mean age of 38 years (18-51) were included in the study. Mean weight before bariatric surgery was 121.6 ± 6.8 kg, and mean body mass index was 49.5 ± 1.6 kg/m2. Euthyroidism was confirmed at pre- and post-bariatric surgery evaluation. No statistically significant postoperative changes were determined in thyroid-stimulating hormone or free thyroxine-3 and -4 (p > 0.05). A statistically insignificant decrease was observed in L-T4 dosages after surgery in cases of Hashimoto’s thyroiditis (p = 0.064). A statistically significant decrease was determined in L-T4 dosages in cases of non-Hashimoto hypothyroidism (p = 0.001). L-T4 requirements decreased in both surgical procedures (p = 0.001) Conclusion: Postoperative L-T4 requirements decrease with weight loss. In addition, no decrease appeared to occur in L-T4 absorption following the surgical procedures in this study.
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Aim: We visually and quantitatively investigated the success of using 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) [Dynamic contrast enhancement (DCE) and diffusion weighted imaging (DWI)] separately and together in detecting axillary lymph node metastasis in patients with newly diagnosed breast cancer. Methods: One hundred and thirteen patients who underwent 18F FDG PET/CT were evaluated, 102 patients of these patients had also MRI (DEC + DWI). Primary tumour size (Tsize), SUVmax of primary tumour (SUVmaxT), short diameter of largest axillary lymph node on PET/CT (LnDPET/CT), SUVmax of axillary lymph node (SUVmaxLn), metabolic tumour volume of the primary tumour (MTV), short diameter of largest axillary lymph node on MRI (LnDMRI), the presence of fatty hilum absence and apparent diffusion coefficient (ADC) were evaluated. Results: In visual analysis, sensitivity and specificity values of 18F FDG PET/CT, MRI and MRI+18F FDG PET/CT were 78.85, 94% – 72.27%, 96.15 – 83.87%, 98.04%, respectively. In the quantitative evaluation, ADC≤1.2 x 10-3 mm2/sec (OR = 6.665, p = 0.001, 95CI%: 2.181–20.370) and LnSUVmax> 2 (OR = 15.2, p<0.001, 95CI%: 4.587–50.376) were independent predictors in detecting axillary lymph node metastasis. Conclusion: LnSUVmax >2 and ADC ≤ 1.2 x 10-3 mm2/sec can be used as independent predictors of detecting axillary lymph node metastasis in patients with newly diagnosed breast cancer.
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Aim: To investigate the effectiveness of the non-union scoring system (NUSS) in predicting the result and in guiding the treatment by comparing the treatment methods applied to non-union patients we treat in our clinic with the treatment methods suggested by the NUSS. Methods: The study included 116 patients, who were diagnosed with long bone (femur, tibia and humerus) non-union and treated in our clinic. Of the 116 patients with non-union, 48 had femur (41.38 %), 39 had tibia (33.62%) and 29 had humerus (25%) non-union. The patient scores were calculated according to the NUSS criteria. The patients were divided into four groups according to their total scores. There were 34 patients in the first group (0-25 points), 49 patients in the second group (26-50 points), 30 patients in the third group (51- 75 points) and three patients in the fourth group (76-100 points). Results: Union that was achieved in 79 (68.10%) of all patients was detected in 97.05% of the patients in the first group, 83.67% in the second group, and 16.66 % in the third group. Amputation, arthroplasty and arthrodesis were applied to three patients in the fourth group. While union rate was 100 % in the femur and tibia in the first group, it was 90% in the humerus. The union rates were 85.71% in the humerus, 75% in the femur and 100% in the tibia in the second group. They were 20 % in the humerus, 15.38% in the femur and 16.66% in the tibia in the third group. The number of patients treated with the treatment proposed by the NUSS: 100% in the group 1, 83.67% in the group 2, 20% in the group 3 and 100% in the group 4. The risk of non union in those who were not treated according to the NUSS recommendations was 28 times higher than that of others. Conclusions: The results of our study suggest that more frequent use of the NUSS procedure in non-union treatment planning may increase treatment success. In addition, NUSS can provide information about the treatment process of non-unions.
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Aim: Thyroid cancers are the most commonly encountered endocrine system malignancies. The incidence continues to rise worldwide. Our aim in this study is to investigate the frequency and histopathological subtypes of thyroid cancer in our clinic. Methods: The present study was conducted with 3614 patients who were followed up in our endocrinology and general surgery clinic and operated with the diagnosis of multinodular and/or nodular goiter between 2015 and 2021. The histopathological types and information of patients diagnosed with thyroid cancer were obtained retrospectively from the pathology reports. Among the patients included in the study, a total of 570 people who were reported to have thyroid cancer due to histopathology were included in the study. Results: The data of a total of 3614 biopsy reports were examined for the study. Among these patients, 570 (421 females, 149 males) were operated and whose pathology reports were accessed were included in the study. The mean age of the patients was 49.12±10.4 years. As a result of the operations, malign postoperative tissue histopathology was 98.9% (n=564), and uncertain malignancy potential was reported to be 1.0% (n=6). In our study, the histopathological distribution of thyroid cancers was as follows; thyroid papillary cancer 89.4% (n=510), follicular cancer 7.3% (n=42), medullary cancer 2.1% (n=12), and malignancy potential uncertain 1.0% (n=6). Conclusion: The results of our study suggest that thyroid cancers are more common in women in our country, in parallel with the similar rates reported in the literature, with the increase worldwide.
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Aim: To investigate whether there is a relationship between both massive and sub-massive pulmonary embolism (PE) and eosinophil counts in order to evaluate it as a predictor factor. Methods: This retrospective study included 108 patients (64 sub-massive and 44 massive) who received both tomographic and clinical diagnoses of pulmonary embolism, and 75 subjects served as controls. Hemogram parameters were compared between patients with massive and sub-massive pulmonary embolism and those of control groups. Results: In terms of white blood cell and eosinophil counts, the lowest value was evident in the massive PE group whereas the control group had the highest value. The eosinophil counts increased significantly one week after the treatment when compared to those at the presentation with PE (0.112 (0.003-0.853) vs. (0.144 (0.011- 0.914), p=0.01). Spearman correlation test showed a significant positive correlation between right ventricular dysfunction or elevated cardiac troponin level and massive PE (r=0.54, p <0.001), whereas a negative correlation was detected between eosinophil count and the presence of massive PE (r=-0.36, p<0.001). Conclusion: The results of our study suggest that lower eosinophil counts may lead a physician to suggest a higher probability of acute massive pulmonary embolism rather than sub-massive pulmonary embolism. However, further randomized studies are required to confirm these findings.
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