Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    The Retrospective Analysis of the Effect of Balloon Kyphoplasty to the Adjacent-segment Fracture in 171 Patients
    (2014) Civelek, Erdinc; Cansever, Tufan; Yilmaz, Cem; Kabatas, Serdar; Gulsen, Salih; Aydemir, Fatih; Altnors, Nur; Caner, Hakan; https://orcid.org/0000-0002-3988-4064; https://orcid.org/0000-0002-2353-8044; https://orcid.org/0000-0003-2691-6861; https://orcid.org/0000-0002-7535-1804; https://orcid.org/0000-0002-3400-9025; 24795949; ABI-6105-2020; AAK-2948-2021; AAA-3069-2020; AAJ-5746-2021
    Study Design: Analysis of the adjacent-segment fractures in 171 balloon kyphoplasty (BK)-performed patients. Objective: The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures (VCF) after BK. Summary of Background Data: Although there are many studies about the incidence and possible risk factors for occurrence of adjacent-level fractures, there is no consensus on the increased risk of adjacent-level fractures after BK. Methods: We performed a retrospective analysis of 171 patients treated with percutaneous kyphoplasty. The follow-up period was 41.04 +/- 21.78 months. The occurrence of new symptomatic VCF was recorded after the procedure. We evaluated the variables of patient age and sex, the amount of injected cement, the initial kyphotic angle (KA) of VCF, the change of the KA after BK, the severity of osteoporosis, and the percentage of height restoration of the vertebral body. Furthermore, possible risk factors were reported for new symptomatic VCFs. Results: The only 2 factors identified as being significantly associated with adjacent-level fractures were the sex (P=0.001) of the patient and the preoperative KA (P=0.013). The patients with new symptomatic compression fracture had higher initial KA than those without fractures. The female group had higher risk than the male group in occurrence of the new vertebra fractures. The severity of the osteoporosis (low bone mineral density) was not a determinant in occurrence of the new VCF after BK. Conclusions: If the patients experience severe or mild back pain with higher preoperative KA, especially in the first 2 months, then they deserve detailed radiologic examination. To avoid subsequent fracture in the same or adjacent level, vertebral body should be filled adequately and sagittal balance should be obtained with KA correction. BK alone did not influence the incidence of subsequent VCF.
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    Sorafenib and Lithium Chloride Combination Treatment Shows Promising Synergistic Effects in Human Glioblastoma Multiforme Cells in Vitro but Midkine Is not Implicated
    (2014) Sabanci, Pulat Akin; Erguven, Mine; Yazihan, Nuray; Aktas, Esin; Aras, Yavuz; Civelek, Erdinc; Aydoseli, Aydin; Imer, Murat; Gurtekin, Mehmet; Bilir, Ayhan; https://orcid.org/0000-0002-3988-4064; 24512012; ABI-6105-2020
    Objectives: The objectives of this study were to test the effects of the new combination treatment modality, sorafenib (SOR) and lithium chloride (LiCl) and to assess whether midkine (MK) protein has a role in any potential effects. Methods: Monolayer and spheroid cultures of T98G human glioblastoma multiforme (GBM) cells were treated with LiCl and SOR (inhibition concentration 50 value = 100 mu M), or their combination, or were left untreated (control). Cell proliferation and apoptotic indices, the mechanism of action, and the levels of apoptotic and anti-apoptotic proteins were evaluated in monolayer cultures and ultrastructure was evaluated by transmission electron microscopy (TEM) in spheroid cultures after for 72 hours. Results: All drug applications decreased cell numbers and increased the apoptotic index. The combination shows a synergistic effect. In the combination group, the decrease in cell numbers and the increase in the apoptotic index were significantly greater than with the individual drugs (P < 0.01). The combination treatment led to the greatest decreases in MRP-1 and p170 levels; but the greatest decreases in p-STAT-3, p-ERK (P < 0.05), p-AKT, p-GSK-3-beta (P < 0.01), EGFR (P < 0.01), NF-kappa-beta levels were with SOR alone, followed by the combination. The decreases in MK levels in the SOR and combination groups were similar (P = 0.06). Severe ultrastructural damage was more frequently observed in the combination group compared with the other groups. Conclusions: These results suggest the possibility that the addition of LiCl to SOR could improve the prognosis in at least some patients who need both cancer and psychotherapy and indicate the need for further studies.
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    Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long-Term Effects
    (2019) Kircelli, Atilla; Demircay, Emre; Ozel, Omer; Coven, Ilker; Isik, Semra; Civelek, Erdinc; Kabatas, Serdar; 0000-0003-2109-1274; 29617062
    Objective To investigate the short- and long-term effects of ganglion impar radiofrequency thermocoagulation (RFT) treatment in patients with chronic coccydynia. Methods We retrospectively analyzed the medical records of patients who underwent RFT of the ganglion impar between 2009 and 2011. Pain intensity visual numeric scale (VNS) scores and Euroqol 5D (EQ-5D) index scores were recorded pre-intervention and post-intervention at the first, sixth, and twelfth months. The differences between pre-procedural VNS scores and post-procedural VNS scores at the first, sixth, and twelfth months were evaluated. The success of the intervention was recorded as the percentage difference between the pre-intervention VNS scores and post-intervention VNS scores at the first, sixth, and twelfth months. Results The mean age of the patients, including 11 females (55%) and 8 males (45%), was 48.7 +/- 14.3 years. The average follow-up duration was 17.3 +/- 2.9 months. Statistically significant differences were observed between the pre- and post-procedure VNS scores (P < 0.0001). Improvements in VNS scores were correlated with improvements in EQ-5D index scores. Mid-term (sixth month) and long-term (twelfth month) evaluations after the intervention revealed that 67.4% and 61.1% of the patients had successful outcomes, respectively. Conclusion Our data suggested that RFT of the ganglion impar in patients with chronic coccydynia resulted in effective outcomes, and patients who responded to RFT had significantly lower post-RFT pain scores.