Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Descemet Membrane Endothelial Keratoplasty: Outcomes in the First Year of Experience(2018) Altinors, Dilek D.; Asena, Leyla; 0000-0001-5223-0279; 0000-0002-6848-203X; 29528002; AAK-8077-2021; E-5914-2016Objectives: We aimed to report the clinical outcomes of Descemet membrane endothelial keratoplasty in our first year of experience. Materials and Methods: Patients who underwent Descemet membrane endothelial keratoplasty at the Baskent University Faculty of Medicine, Department of Ophthalmology, between 2015 and 2016 were included in the study. Patient demographics, cause of endothelial dysfunction, best-corrected visual acuity, central corneal thickness, graft survival, follow-up duration, and intraoperative and postoperative complications were recorded. Results: Five eyes of 5 patients (4 female, 1 male) with a mean age of 53.4 +/- 12.7 years were included. Cause of endothelial dysfunction included corneal endothelial dystrophy in 3 patients, pseudophakic bullous keratopathy in 1 patient, and endothelial graft failure after previous penetrating keratoplasty in 1 patient. Pre-stripped Descemet membranes obtained from the Ankara State Hospital Eye Bank were used. Mean duration of postoperative follow-up was 7.4 +/- 3.7 months. Mean preoperative Snellen best-corrected visual acuity and central corneal thickness were 0.24 +/- 0.15 and 625.5 +/- 97.4 mu m. Mean best-corrected visual acuity increased to 0.67 +/- 0.26 (P = .02) in the first month and to 0.84 +/- 0.11 (P < .01) at the end of follow-up. Mean central corneal thickness decreased to 546.6 +/- 28.4 pm (P = .03). Graft detachment was observed in 1 patient on the first postoperative day, and it was reattached successfully by injection of air into the anterior chamber. There were no intra-operative complications. All corneas were clear at the end of follow-up. Conclusions: Descemet membrane endothelial keratoplasty provides a new and exciting option for endothelial transplant and has the potential to become the primary procedure for surgical management of Fuchs endothelial dystrophy and corneal endothelial disease. Rapid visual rehabilitation with few and manageable complications and good visual outcomes are the major advantages of this procedure.Item Functions Of The Endothelium And Its Role In Hematopoietic Cell Transplantation(2022) Pepedil-Tanrikulu, Funda; 35120826; GXH-4007-2022The endothelium is a single-layered structure that responds to physical and chemical signals with various factors it synthesizes. In the early days of its discovery, as the inner wall of the vessels, the endothelium was thought to be a simple barrier that lays on the surface. Over time it is discovered that endothelium maintains body homeostasis with the molecules it synthesizes, despite its simple single-layer structure. It has been accepted as an important organ that contributes to the maintenance of vascular tone, cell adhesion, inflammation, vascular permeability and coagulation. Any imbalance in these physiological and pathological events causes endothelial dysfunction. This can cause many diseases such as atherosclerosis, hypertension, diabetes, or it can occur because of these. Endothelial related disorders may also complicate hematopoietic stem cell transplantation (HSCT), which is used to treat various hematologic and neoplastic diseases. These life-threatening complications include graft-versus-host disease, hepatic veno-occlussive disease, transplant-associated thrombotic microangiopathy and diffuse alveolar hemorrhage. They share a similar pathophysiology involving endothelial cells with different clinical presentations. Therefore, current researche on the issue is putting the endothelium under the spotlight for novel markers and treatment options that should be used to monitor or treat at least some of these complications following HSCT.Item The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functions(2017) Caldir, Mehmet Vedat; Celik, Guner Koyuncu; Ciftci, Ozgur; Muderrisoglu, Ibrahim Haldun; 27965510Objective: The cardiovascular effects of short-term high-dose steroid treatment (pulse steroid treatment) have not yet been clarified. We examined the short-and long-term effects of pulse steroid treatment in demyelinating diseases on endothelial and cardiac functions. Methods: In this prospective study, we included 35 patients (20 females and 15 males; mean age, 32.8 +/- 9.3 years) who were not treated with steroids and who were previously diagnosed with multiple sclerosis or neuromyelitis optica. Patients were evaluated before, 1 week after, and 3 months after the steroid treatment. Brachial artery flow-mediated relaxation and cardiac systolic/diastolic function were evaluated using echocardiography to assess physical examination results, carotid intima-media thickness, and endothelial function. Results: There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intima-media thicknesses in the three evaluation periods. There were significant increases in the body mass index, body weight, and systolic/diastolic blood pressure measurements at 1 week and 3 months after treatment (p<0.001). There was a significant decrease in brachial artery flow-mediated relaxation at 1 week and 3 months (1 versus 2, p=0.042; 1 versus 3, p=0.003). In Doppler measurements at 1 week and 3 months, there was an increase in mitral A velocity, IVRT, and EDT values and a decrease in the E/A ratio in line with diastolic dysfunction. Conclusion: Pulse steroid therapy used for demyelinating diseases deteriorated endothelial and left ventricular diastolic functions in the early and late periods. Future studies are needed to evaluate the development of cardiovascular mortality and morbidity in patients receiving this type of treatment.