Comparison of stabilization and fusion methods with xenograft plate screws after anterior lumbar corpectomy in dogs

AIM: Fusion development is the primary goal in spinal surgeries that are conducted for the treatment of vertebral body pathologies such as trauma, tumor and infection. Stabilization using metal plate screws together either with an autograft, allograft or xenograft is used. We evaluated fusion development in stabilizations that were carried out with xenograft (XG) with XG plate-screw (XPS) and XG with metal plate-screw (MPS) systems in dogs' lumbar vertebrae (L5-7 segment) in terms of radiological, biomechanical and histopathological aspects. MATERIAL and METHODS: The animals were divided into 4 groups, each including 5 subjects. The experiment consisted of Control group 1 which did not go through any procedure and was stabilized, Control group 2 which underwent instability with only L6 anterior corpectomy, Experimental group 1 which was stabilized with intervertebral XG and XPS after L6 corpectomy, and Experimental group 2 which was stabilized with intervertebral XG and MPS after L6 corpectomy. Development of fusion in the Experimental groups 1 and 2 was evaluated in terms of radiological and histopathological aspects. RESULTS: Comparison of Control and Experimental groups showed an increase in resistance in all activities on biomechanical tests (p0.05). CONCLUSION: Xenograft plate screws and metal plate screws provide equivalent fusion and stabilization in anterior lumbar stabilization

Cavernous hemangiomas of the third ventricle: Alternative surgical routes in two cases

Cavernous Hemangiomas (CH) arise from any part of the cerebrum. Intraventricular lesions are rare and pure third ventricular localization is rare for CHs. Cavernomas of the ventricles may present with bleeding or signs associated with hydrocephalus. Radical excision is advocated for optimal management of cavernomas. In the present study, we present two cavernomas of the third ventricle which were completely excised via interhemispheric transcallosal transforaminal and Sylvian approaches. Radical excision should be the aim of the surgeon since reoperation for residual cavernomas is more commonly associated with complications and poor outcome. Total excision should be the goal of the treatment due to risk of rebleeding or regrowth

COMBINING DIFFERENT MCDM METHODS WITH THE COPELAND METHOD: AN INVESTIGATION ON MOTORCYCLE SELECTION

There are many different multi-criteria decision making methods in the literature. These methods, which enable criteria with different measurement units to be examined together, allow choosing between alternatives. However, different methods can produce different results depending on the data set. The aim of this study is to combine the results obtained by applying different methods to the data set with the Copeland method. To this end, a problem with real data was first addressed. Technical data of motorcycle alternatives that can be preferred for individual needs were collected in terms of different criteria. The weights of these criteria were found by the PIPRECIA method. Six different multi-criteria decision making methods were used to evaluate motorcycle alternatives. These methods are MOPA, MOOSRA, COPRAS, SAW, WPM and ROV. The sequencing results obtained from these methods were combined with the Copeland method and the results were discussed

Comparison of Wiltse and classical methods in surgery of lumbar spinal stenosis and spondylolisthesis

Aim Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy. Materials and methods We enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31). Findings In the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group. Conclusion The Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain

Relationship between Hba1c and blood glucose level in hemodialysis patients with diabetes mellitus

Within in the scope of this study, a researchwas aimed at the relationship between HbA1c markersand blood glucose levels with DM, chronic renal failureand receiving dialysis treatment.Methods: In this study, monthly glucose levels and quarterlyHbA1c markers of 131 patients (53 female, 78 male)receiving dialysis treatment in a private dialysis centerbetween January 1, 2009-July 31, 2010 were evaluatedretrospectively.Results: The average age of 131 cases was 63.3±11.2years (range, 30-91). Gender distribution of the cases: 53female (40.5%), 78 male (59.5%). While the age averageof the females was 62.2±11.2 and the males’ was64.1±11.2. The average glucose level of the females andmales have a correlation to average HbA1c (Female:p<0.001, r=0.761, Males: p<0.001, r=0.743). The averageglucose level of the both case groups have a correlationto average HbA1c (p<0.001, r=0.755). While 32.8%of the examined HbA1c results were observed underthe level 6,5%, and 67.2% of the examined results wereobserved above the level 6.5%. While 18.3% of the preprandialblood glucose levels were obtained under 126mg/dl level, and 81.3% of the results were obtained above126 mg/dl level. It has been observed that the mean bloodglucose level has a correlation to average HbA1c level.Conclusion: The measurement of HbA1c and blood glucose(pre-prandial and postprandial) and the correlationbetween them, by virtue of the fact that, are vitally importantin cardiovascular mortality and morbidity, monitorof DM for the dialysis patients with diabetic nephropathy.Key words: Hemodialysis, diabetes mellitus, HbA1

Multilevel Noncontiguous Spinal Fractures: Surgical Approach towards Clinical Characteristics

Study DesignThe study retrospectively investigated 15 cases with multilevel noncontiguous spinal fractures (MNSF).PurposeTo clarify the evaluation of true diagnosis and to plane the surgical treatment.Overview of LiteratureMNSF are defined as fractures of the vertebral column at more than one level. High-energy injuries caused MNSF, with an incidence ranging from 1.6% to 16.7%. MNSF may be misdiagnosed due to lack of detailed neurological and radiological examinations.MethodsPatients with metabolic, rheumatologic diseases and neoplasms were excluded. Despite the presence of a spinal fracture associated clearly with the clinical picture, all patients were scanned within spinal column by direct X-rays, computed tomography and magnetic resonance imaging. When there were ≥5 intact vertebrae between two fractured vertebral segments, each fracture region was managed with a separated stabilization. In cases with ≤4 intact segments between two fractured levels, both fractures were fixed with the same rod and screw system.ResultsThere were 32 vertebra fractures in 15 patients. Eleven (73.3%) patients were male and age ranged from 20 to 64 years (35.9±13.7 years). Eleven cases were the American Spinal Injury Association (ASIA) E, 3 were ASIA A, and one was ASIA D. Ten of the 15 (66.7%) patients returned to previous social status without additional deficit or morbidity. The remaining 5 (33.3%) patients had mild or moderate improvement after surgery.ConclusionsThe spinal column should always be scanned to rule out a secondary or tertiary vertebra fracture in vertebral fractures associated with high-energy trauma. In MNSF, each fracture should be separately evaluated for decision of surgery and planned approach needs particular care. In MNSF with ≤4 intact vertebra in between, stabilization of one segment should prompt the involvement of the secondary fracture into the system

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Determination of optimum measurement intervali for axially symmetrical regular light distribution curves

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Sosyal Bilimler Enstitüsü, 1999Thesis (M.Sc.) -- İstanbul Technical University, Institute of Social Sciences, 1999Bu çalışmanın amacı aksiyal simetrik regüler ışık dağılım eğrilerinin çıkarılmasında kullanılan ve deneysel olarak bulunan ışık şiddeti değerlerinin optimum ölçme aralığım bulmaktır. Çalışmada ışık şiddeti değerleri 2.5 derece aralıklarla bilinen farklı açılarda 6 adet armatür kullanılmıştır. Işık şiddeti değerlerinin 10 veya 5er derece aralıklarla bilindiği varsayılarak 2.5 derece aralıklı tahminler yapılmıştır. Işık dağılım eğrisi üzerine yapılan çalışmaların iyi anlaşılabilmesi açısından Bölüm 2 ve 3. bölümde temel kavramlar ve fotometrik ölçme hakkında genel bilgi verilmiştir. 4. bölümde en küçük kareler yönteminin kullanıldığı regresyon analizi, hatalar ve korelasyon analizi anlatılmıştır. 5. bölümde bir nöral program kullanılarak iki farklı yöntemde tahminler yapılmış, standart hataları ve korelasyon katsayıları karşılaştırılarak en uygun yöntem bulunmaya çalışılmıştır. Regresyon analiziyle yapılan tahminlerde genel olarak 2. dereceden denklem uydurmasının daha uygun olduğu görülürken bu yöntemde, bazı durumlarda regülerliğin bozulmasından dolayı iki ayrı 2. dereceden denklemin ortalamasının ve regülerliği düzgün olan kısımların alınmasını öneren karışık yöntem önerilmiştir. En küçük kareler yöntemi ve nöral program tahminlerine ait ışık dağılım eğrileri gerçek ışık dağılım eğrileriyle birlikte Ekler kısmında verilmiştir. 7. bölümde bir önceki bölümde çizilen ışık dağılım eğrilerine ait tahminlerin standart hataları ve ışık şiddeti eğrileri değerlendirilerek ışık şiddeti düşüş hızı tanımı yapılmış ve bu tanım ışığında nöral program ve regresyon analizi karşılaştınlmıştır.Theme of this study is to obtain the optimum measurement interval of the luminous intensities winch are used at the derivation of light distribution curves and are found experimentally. In the study 6 different lighting fixtures of different light distribution angles of which the luminous intensities are known at 2.5° intervals are used. Assuming that the luminous intensities are known at 10° or 5° intervals, they have been estimated for 2.5° intervals. In order the studies made on to be well understood, the basics of photometry and measurements have been described at Section 2 and Section 3. At Section 4 the regression analysis for which the smallest squares method has been applied, errors and correlation analysis have be described. Neural network has been described at Section 5. At Section 6 estimations have been made with two different methods by using regression analysis and a neural program. Their errors and correlation factors are compared and a best method is tried to be found out. In general while second degree equation fittings were better Ihan first degree equations, the damage of the regularity was its handicap. For that reason a mixing method, trying to make a midpoint estimation by taking the average of two second degree equations and using the undamaged regular parts of them has been suggested. Drawings of both the smallest square method and neural program estimations of light distribution curves and real curves are given in the appendices. At Section 7 the errors given in the previous section and light distribution curves given in the appendices are examined, a luminous intensity falling speed is defined and both neural program and regression analysis is compared under this definition.Yüksek LisansM.Sc

Deneysel subaraknoid kanamanın yol açtığı vasküler ve hemodinamik değişiklikler

Objective: In this experimental subarachnoid hemorrhage (SAH) model, pathophysiological processes that accompany acute vasospasm, morphological changes in the basilar artery, and the effect of altered cerebral blood flow (CBF) on mortality were examined. Material and Methods: In the hemorrhage group of rats (n= 51), experimental subarachnoid hemorrhage was induced and mean arterial pressure (MAP) and cerebral blood flow (CBF) measurements were performed following bleeding. Histopathological assessments were performed in controls (n= 7) as well as in rats surviving for 72 hours. Results: An abrupt reduction of 63.2% +/- 10% was observed in CBF, followed by 38.1 +/- 13% and 29.1 +/- 11% lower values as compared to baseline at 35 and 60 minutes, respectively (p < 0.001). The average CBF following hemorrhage was significantly lower in rats that died within the first 24 hours and than those that survived for 3 days (p < 0.01). Histopathological examination showed thickening in arterial walls, reduced vessel lumen diameter, and vasculopathy findings. Conclusion: Our findings suggest that following subarachnoid bleeding the fall in CBF alone does not impact the mortality rates and that the duration of the reduction in CBF seems to represent an important prognostic factor for survival

An analysis on the film “a Tale Of Three Sisters” within the framework of home and deterrıtorialisation

Rasyonel aklın ve tekniğin yükselişine şahitlik eden modern insan, şehirleşme ve göç hareketleriyle birlikte köklerinden koparılarak varoluşsal pek çok kaygı ve sıkıntı içerisinde adeta arafta bırakılmıştır. Arafta bırakılma durumunun toplumsal görünümünü izah etmek için Heidegger’in yanı sıra Deleuze ve Guattari’nin yoğun çabaları ile belirginleşen ‘yersizyurtsuzlaşma’ kavramları sıklıkla önem kazanır. Bu çalışmada son dönem Türk sinemasında yurt ve yuva kavramlarının özneler üzerindeki etkisinin yoğun biçimde gözlendiği Emin Alper’in Kız Kardeşler (2019) filmi incelenmiştir. Film sosyolojik film çözümlemesinin yanında Heidegger, Deluze ve Guattari’nin ortaya koyduğu yersizyurtsuzlaşma ve yuva (heimat) felsefi kavramsallaştırmaları merkeze alınarak çözümlenmiştir. Sonuç olarak filmde yersizyurtsuzlaşmanın kentte olandan farklı olarak taşrada ortaya çıkan görünümleri beyaz perdeye yansıtılmış ve modern dünyada yuva kavramının neredeyse tamamen yok olduğu karakterler üzerinden imgeleştiri,lmiştir. Filmde üç kız kardeşin şehre ve şehrin ifade ettiği yaşam tarzına yönelik duydukları özlem Delueze ve Guattari’nin bakış açısından yersizyurtsuzlaşmaya karşılık gelirken, taşranın kendisi modern ve ilerlemeci şehrin aksine zamanın yavaş ve döngüsel bir heterotopya olarak izleyicinin karşısına çıkarılmıştır.Modern human who has witnessed the rise of rational thinking and technique was drifted in limbo suffering from numerous essential anxieties and problems through deracinating by means of movements of urbanization and migration. In order to explain the social outlook of the event of deracination, the concepts of “deterritorialisation” which has become clear thanks to the intensive efforts of Deleuze and Guattari as well as Heidegger frequently gains importance. In this study, the film of “A Tale of Three Sisters” (Kızkardeşler) (2019) by Emin Alper which has been observed to have the effects of the motherland and home Turkish cinema of the latest period was analyzed. In addition to the sociological analysis of the film, the film was analyzed using the philosophical conceptualization of deterritorialisation and home (haimat) which were presented by Heidegger, Deluze and Guattari through focusing on them. In conclusion, the reflections of deterritorialisation on the rural area different than that in cities were turned into a movies and it was imaged through characters in which the concept of home almost disappears in the modern world. In the films, the longing of three sisters for the city and the life style that city represents equals to the deterritorialisation in terms of the perspective of Deluze and Guattari, the rural area itself, on the contrary to the modern and progressive city, was given to the audience as a slow and cyclic heterotopy of the time