Hukuk Fakültesi/ Faculty of Law

Permanent URI for this collectionhttps://hdl.handle.net/11727/1398

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Association between treatment with coil embolization of renal artery aneurysm and resistant hypertension
(2016) Duman, Enes; Yildirim, Erkan; Ciftci, Ozgur; Cifci, Egemen
Hypertension is the number one risk factor in preventable causes of death in the world. Resistant hypertension is defined as blood pressure that remains uncontrolled despite at least three antihypertensive medications including a diuretic. Treatment of hypertension includes many modalities from lifestyle changing to multiple drug using, angioplasty. In this case report, we aim to emphasize the effects of renal artery aneurysm treatment on resistant hypertension.
Balloon Dilatation of Iatrogenic Ureteral Strictures after Upper Urinary Tract Reconstruction
(2015) Duman, Enes; Yildirim, Erkan; Akillioglu, Ishak; Yucesan, Selcuk
Purpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by balloon dilatation after failed surgery. Material and Methods: Between 2008 and 2013 6 children were treated. Five patients had undergone open pyeloplasty for UP stenosis and, one has uretero-vesical anastomosis stricture after ureteroneosistostomy. Percutaneous antegrade balloon dilatation and double J stent placement were performed in three of six patients. In the other three patients retrograde endoscopic balloon dilatation and double J stent placement were performed. Results: Primary technical success was %50 and %100 for antegrade and retrograde approach respectively. Antegrade approach has failed in 3 patients (%50) and, retrograde approach and treatment were successful in all of these patients. Secondary and tertiary balloon dilatations were done through antegrade approach in 3 patients. Mean duration of double J stent was 114 days. As of today, five patients are followed smoothly. One patient who has UP stenosis underwent secondary open surgery. Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children.
Effect of the Bioadhesive, BioGlue, on Impaired Colonic Anastomose Healing in Rats
(2015) Ekici, Yahya; Akcay, Eda Yilmaz; Moray, Gokhan
Colonic anastomotic leakage is still a problem in general surgery practice. We sought to investigate the effect of a new tissue adhesive, BioGlue, on the healing of normal and impaired colonic anastomoses. Sixty-four rats were randomized into 4 groups. In all animals, a 1-cm segment of the left colon was resected, and an end-to-end sutured anastomosis was created. Animals were then divided into 2 groups: normal and impaired anastomosis. These 2 groups were further subdivided into 2 additional groups: animals that received BioGlue and those that did not. All rats received intraperitoneal injections of either 0.9% NaCl or 5-fluorouracil (5-FU). Anastomotic evaluation was done 7 days after surgery. Macroscopic healing, mechanical strength, and histopathologic healing parameters were evaluated. Leakage of the anastomosis was significantly higher in rats in the impaired group compared with those in the BioGlue groups (P = 0.043). The adhesion formation score was significantly higher in rats in the impaired anastomosis group compared with the other groups. Bursting pressures were significantly lower in the impaired anastomosis group than in the other ones (P = 0.001). Neoangiogenesis and fibroblast activity were different among the groups (P = 0.001). Inflammatory cell infiltration and collagen deposition did not differ among the groups (P = 0.07). Immediate postoperative intraperitoneal administration of 5-FU after colonic anastomosis inhibits intestinal wound healing. Covering colon anastomoses with BioGlue after suturing conferred beneficial effect on healing.
The Efficacy of Flow Diverter Stents in the Treatment of Wide-Necked Intracranial Aneurysms
(2017) Duman, Enes; Yildirim, Erkan; Ozdemir, Adnan; Arslan, Serdar; Aytekin, Cuneyt; Bovyat, Fatih; 0000-0002-9057-722X; F-4230-2011; ABI-3856-2020
Background: To present our findings obtained from the treatment of wide-necked intracranial neurysms with flow diverter stents. Patients and Methods: Intracranial aneurysms were determined in 19 patients (14 females, 5 males; mean age, 56.6 years) between May 2011 and June 2014, and the patients were treated using flow diverter stents. A total of 28 flow diverter stents, including 9 Silk and 19 Pipeline stents were used. Occlusion rates evaluated with computed tomography at the end of month 6 and digital subtraction angiography after one year, intraoperative success, morbidity and mortality rates were determined. Results: A total of 20 endovascular interventions, including two interventions in two different aneurysms in one patient were performed in 19 patients. Flow diverter stents were successfully implemented for wide-necked aneurysms at a success rate of 100%. Coil treatment had previously been performed in four patients. Aneurysm occlusion rates were 77.2% at month 6 and 90.9% at the end of month 12. Conclusion: The use of flow diverter stents is a reliable and effective method in the treatment of wide-necked intracranial aneurysms with high aneurysm occlusion, and low morbidity and mortality rates.
Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula
(2016) Celik, Guner Koyuncu; Yildirim, Erkan; 0000-0002-9057-722X; 0000-0002-2477-3660; 28077946; ABI-3856-2020
A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report.
Evaluation of peripheral perfusion in term newborns before and after Yintang (EX-HN 3) massage
(2015) Tugcu, Ali Ulas; Cabioglu, Tugrul; Abbasoglu, Aslihan; Ecevit, Ayse; Ince, Deniz Anuk; Tarcan, Aylin; 26742308
OBJECTIVE: To identify how acupressure on the acupoint Yintang (EX-HN 3) impacts oxygen saturation, pulse rate, and peripheral perfusion in term-born infants without underlying disease. METHODS: Infants born between weeks 37 and 42 of gestation were included in this study. The polyclinic's neonatology room was noise-controlled and made half-dark to prevent the perfusion index from being confounded. A pulse oximeter was linked to the baby's left lower extremity. Acupressure was applied on Yintang (EX-HN 3) for 30 s clockwise, held for 30 s, and then acupressure was applied for another 30 s counterclockwise. The baby's SaO(2), pulse rate, and perfusion index were recorded for each minute before and after acupressure. RESULTS: When pre- and post-acupressure pulse rate values were compared, a significant decrease in pulse rate values after acupressure application was observed. When pre- and post-acupressure oxygen saturation values were compared, a significant increase in post-acupressure oxygen saturation was observed. In addition, peripheral perfusion increased significantly after acupressure. CONCLUSION: Acupressure application has been used in traditional medicine for many years. However, it is not yet widely used in modern medicine. This study shows the impact of acupressure on neonatal skin perfusion, oxygen saturation, and pulse rate. (C) 2015 JTCM. All rights reserved.
Evaluation of Prostatic Artery Embolization Efficiency in Benign Prostatic Hyperplasia Patients with High Comorbidity
(2018) Duman, Enes; Yildirim, Ismail Okan; Firat, Ali; Celik, Huseyin; Sarac, Kaya
Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.
A FULLY ONLINE COURSE EXPERIENCE FROM STUDENTS' PERSPECTIVE: READINESS, ATTITUDES AND THOUGHTS
(2019) Cabi, Emine; Kalelioglu, Filiz; 0000-0002-7729-5674; AAF-8110-2019
The purpose of the study was to reveal the effect of a course taken through distance education on students' readiness and attitudes. Sequential explanatory design method was used as a research method in which qualitative and quantitative measurements were used in the research. For the quantitative data, a single group pre-test/post-test design was used as an experimental model; for the qualitative data, open-ended questions were asked in order to elicit students' opinions following the experimental process. The study group consisted of 266 students from different faculties and departments who were studying undergraduate and associate degree programmes at a private university in Turkey. Results indicated that the course taken through distance education had a significant effect on students' gaining Computer and Internet SelfEfficacy and was effective in improving undergraduate students' self-directed learning skills. Moreover, the course taken through distance education had a significant effect on students' familiarity with e-learning. Additionally, the course was found to be effective in decreasing the escape attitudes from e-learning.
How to Approximate Cosine Curve with 4(Th) and 6(Th) Order Bezier Curve in Plane?
(2022) Kilicoglu, Seyda; Yurttancikmaz, Semra
There are many ways to approximate cosine curve. In this study we have examined the way how the cosine curve can be written as any order Bezier curve. As a result using the Maclaurin series we have examined cosine curve as the 4(th) and the 6(th) order Bezier curve based on the control points with matrix form in E-2. We give the control points of the 4(th) and the 6(th) order Bezier curve based on the coefficients. Also we give the coefficients based on the the control points of the 4(th) and the 6(th) order Bezier curve too.
The Impact of a Semiotic Analysis Theory-Based Writing Activity on Students' Writing Skills
(2016) Sarar Kuzu, Tulay
Problem Statement: In entering the world intellectually and affectively equipped, humans develop in a systemic way that encompasses both thought and art education and in which written, oral, and visual texts are important tools. In particular, visual literacy, which refers to the interpretation of elements other than written text, including images, symbols, shapes, and colors, has come into prominence through new learning approaches that emphasize the importance of using numerous stimuli. All texts convey a meaning and a message, which to comprehend requires textual analysis, the different theories and methods of which vary among various types of texts. As discussed in this article, the semiotic analysis theory provides tools for textual analysis concerning the dimensions of narrative discourse. Purpose: This study aimed to determine how a writing lecture activity based on semiotic analysis theory affects students' writing skills. To that end, cartoon caricatures were selected as visual texts for analysis. Method: This experimental research based on pre- and post-tests was conducted with a dependent group of 40 7th-grade students in a school within Turkey's Ministry of Education. Data collection involved having each student develop two texts for caricature analysis: one prior to an experiment based on the traditional approach, and the other after an experiment based on the semiotic method. The differences between scores received for each text by all students were analyzed. Findings: Results revealed that textual analysis based on the semiotic theory was more effective for the writing skills of students than the traditional writing method with respect to three areas of evaluation: understanding the subject, accessing the message, and multidimensional interpretation. Conclusion and Recommendations: The findings suggest that the proposed method of semiotic analysis is an alternative to traditional methods used in Turkish-language courses that can enhance the effectiveness of learning and positively affect students' creative-writing skills.
Long-Term Oral Nutrition Supplementation Improves Outcomes in Malnourished Patients With Chronic Kidney Disease on Hemodialysis
(2014) Sezer, Siren; Bal, Zeynep; Tutal, Emre; Uyar, Mehtap Erkmen; Acar, Nurhan Ozdemir; 24436491
Background: There is no consensus on the type, time of initiation, or duration of use of enteral nutrition in patients with chronic kidney disease (CKD). This study aimed to compare the effects of a renal-specific oral nutrition supplement (RS-ONS) and a standard recommended nutrition regime on biochemical and nutrition markers in malnourished patients with CKD on hemodialysis. Methods: Sixty-two malnourished patients with CKD, divided into experimental (RS-ONS; n = 32; mean [SD] age, 62.0 [11.3] years; 55.2% female) and control (CON; n = 30; mean [SD] age, 57.2 [12.3] years; 31% female) groups, were evaluated for anthropometric, biochemical, and inflammatory parameters. Results: Mean (SD) serum albumin levels were significantly increased in the RS-ONS group from 3.5 (0.3) g/dL at baseline to 3.7 (0.2) g/dL at 6 months (P = .028). Significantly fewer patients had serum albumin levels of <3.5 g/dL after month 6. Dry weight of patients significantly increased in the RS-ONS but decreased in the CON groups (P < .001 for each). Percent change from baseline revealed negative results for bioelectrical impedance analysis (P < .001) in the CON group. Malnutrition inflammation score at 6 months (P = .006) and erythropoietin (EPO) dose requirements were higher in the CON group (P = .012). Conclusions: Our findings indicate that consuming RS-ONS improves serum albumin and anthropometric measures, as well as reduces EPO dose, in patients with CKD.
New-Onset Diabetes and Glucose Regulation Are Significant Determinants of Left Ventricular Hypertrophy in Renal Transplant Recipients
(2015) Sezer, Siren; Uyar, Mehtap Erkmen; Tutal, Emre; Bal, Zeynep; Guliyev, Orhan; Colak, Turan; Hasdemir, Efe; Haberal, Mehmet; 25945353
Background. New-onset diabetes after transplantation (NODAT) is associated with decreased graft survival and an increased risk for cardiovascular disease. The objective of this study was to evaluate the risk factors for development of NODAT and its' relationship with arterial stiffness and left ventricular mass index (LVMI) in kidney transplant recipients. Methods. 159 kidney transplant recipients were selected from our transplantation center who underwent renal transplantation between years 2007 and 2010. Results. Among 159 patients, 57 (32.2%) patients were with NODAT who were significantly older than patients without diabetes (P: 0.0001). Patients with NODAT had significantly higher pulse wave velocity (PWv) (P: 0.033) and left ventricular mass index LVMI (P: 0.001) compared to patients without NODAT. Further analysis was done according to LVMI as follows: LVMI > 130 g/m(2) (n: 57) and LVMI <= 130 g/m(2) (n: 102). We observed higher office systolic and diastolic BP, serum trygliceride, glucose, creatinine, age, and HbA1c (P: 0.0001) levels in patients with LVMI > 130 g/m(2). Linear regression analysis revealed that HbA1c was the major determinant of LVMI (P: 0.026, beta: 0.361). Conclusions. HbA1c is the major determinant of LVMI, so strict control of serum glucose levels is essential for preventing cardiovascular disease in patients with NODAT.
The outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate.
(2019) Yildirim, Berna; Cem, Onal; Kose, Fatih; Oymak, Ezgi; Sedef, Ali Murat; Besen, Ali Ayberk; Aksoy, Sercan; Guler, Ozan Cem; Sumbul, Ahmet Taner; Mertsoylu, Huseyin; Ozyigit, Gokhan; 0000-0001-6908-3412; D-4793-2014; AAC-5654-2020
A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature
(2017) Erdogan, Haluk; Eldem, Halil Olcay; 0000-0002-9033-4236; O-2247-2015; AAE-6201-2021
Legionnaires' disease (LD) is a systemic infectious disease caused by Legionella species. It mainly presents with lung involvement. Herein, we present a case with suspected myocarditis associated with LD and review of the relevant literature. An 81-year-old male tourist patient with high fever, cough, imbalance while walking, and confusion presented to the emergency department. The patient was diagnosed with LD based on increased density in the left lower zone on chest x-ray and a positive Legionella urine antigen test. He was administered a combination of claritromycin and levofloxacine on the day of admission. The diagnosis of acute myocarditis was made after worsening of the cardiac functions, ST elevation and troponin I positivity. The patient's symptoms regressed with antibiotic therapy and the patient was transferred to his home country by ambulance plane ten days after admission. A search of PubMed and Web of Science using the keywords "Legionella and myocarditis" revealed 15 case reports, nine of which were in English and were reviewed. There were three female and six male patients with a mean age of 44 years (range: 32-56 years). Seven were diagnosed with LD by urine antigen testing, one by serological testing and culture, and one by direct fluorescent-antibody staining and culture. Myocarditis was diagnosed by biopsy in two patients and by clinical and laboratory findings in the rest. Myocarditis without existing pneumonia was detected in one case. Electrocardiography abnormalities such as atrial flutter, atrioventricular block, torsade de pointes, sinus tachycardia, QT prolongation, ST elevation, and T wave inversion were detected in seven patients. Ventricle dysfunction on echocardiography and cardiac marker abnormality were detected in all but one of the patients (not tested in one patient). Antimicrobial monotherapy was chosen for three of the cases. One patient died due to myocarditis. In conclusion, myocarditis may develop rarely during the course of LD. Clinical suspicion is essential for the diagnosis. Early diagnosis and appropriate treatment may be life-saving.
Percutaneous Placement of Pancreatico-biliary Drainage Catheter for the Treatment of Complicated Pancreatic Anastomotic Leakage: an Alternative Treatment Option
(2016) Duman, Enes; Yildirim, Erkan; 0000-0002-9057-722X; 27994344; ABI-3856-2020
A 58-year-old female patient who had anastomotic leakage after a Whipple operation was treated with a percutaneously placed pancreatico-biliary drainage catheter. Complete secondary healing of the anastomotic defect and leakage was seen on control cholangiography examination on the 35th postoperative day, and the pancreatico-biliary drainage catheter was removed. She was discharged on the 39th postoperative day uneventfully. Percutaneous pancreatico-biliary drainage should be kept in mind as an alternative treatment option of complicated pancreatic anastomotic leakage after a Whipple operation.