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

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Kemik dolu mühendisliği için doğal kökenli silika takviyeli çift fiberli matrisler

Graft therapy is used to treat bone tissue loss, which has drawbacks; donor scarcity, risk of disease transmission and immune reaction. Tissue engineering scaffolds can overcome these drawbacks. In this study, a 3D scaffold that will support tissue regeneration at defect site was developed using mainly natural materials. Scaffold was produced by co-electrospinning and had two distinct fiber phases; first fiber phase was produced from a bacterial origin polymer, Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), and small amount of Polycaprolactone (PCL) to support fiber structure, second fiber phase was formed by pullulan (PUL) polymer and diatom silica shells (DS) from single cell algae origin. Also, in the study, PHBV production by Cupriavidus necator bacterial strain was optimized and used to produce scaffold groups. PHBV/PCL/CA:PUL/DS scaffold group was produced as dual fiber matrix and a new crosslinking method for PUL was developed for crosslinking through electrospinning. Cefuroxime Axetil (CA) antibiotic was loaded into hydrophobic PHBV fibers to sustain antibiotic release from scaffold. Characterization studies revealed that, in aqueous environment scaffold degrade slowly, take less water and has stable structure, support controlled release of antibiotic and improved compressive strength due to incorporated DS and double fiber structure. In vitro studies revealed that DS bearing groups improved Saos-2 cell viability and co-electrospun groups that have hydrophilic PUL fibers supported L929 cell viability. Scanning electrone microscopy and confocal laser scanning microscopy analyses showed that cells distributed through co-electrospun scaffold with healthy morphology. In the study, a novel, 3D, dual fiber scaffold was produced with natural origin base materials and has potential to be used for bone tissue engineering applications.-Ph.D. - Doctoral Progra

Lenfoma tedavisine yönelik lenfosit hücrelerine özgün antikor ile hedefli, doksorubisin içeren çift etkili yeni lipozomal salım sistemi geliştirilmesi.

Three doxorubicin loaded drug carrier systems were prepared against Lymphoma diseases. The first approach was to target DXR loaded liposomal system by attaching cell specific antibodies. Non-internalizing anti-CD20 antibody was used to target Namalwa cells and internalizing anti-CD30 antibody was used to target B lymphoma cells. Targeted DXR loaded liposomes were prepared and their cytotoxicity against Lymphoma cells were compared with untargeted DXR loaded liposomes. The targeted liposome formulations were optimized to have around “92” anti-CD20 and “31” anti-CD30 antibodies per single 100 nm sized liposome (HSPC:CHOL:DSPE-PEG; 2:1:0.2). After 48 hours of incubation with Namalwa cells, anti-CD20 targeted DXR loaded liposomes caused over 87% toxicity while untargeted liposomes resulted with 19% cell death. However, anti-CD30 targeted liposomes toxicity improvement compared to untargeted liposomes was not clear due to less number of targeting moieties/cell in the study. So, this system will be further optimized. A second study was performed to investigate possible doxorubicin cytotoxicity enhancement by calcitriol pretreatment on Namalwa cells. The combinational effect of both agents was investigated firstly by treating Namalwa cells with their free form. We showed that Namalwa cells are more susceptible to DXR after 72 hours of calcitriol pretreatment. Then both agents co-loaded to liposomes and cytotoxicity compared with only doxorubicin loaded liposomes. Calcitriol and DXR co-loading to liposome, enhances cytotoxicity with in a shorter time with lower concentrations. Both modified liposomal systems prepared successfully and caused improved toxicity relative to DXR loaded liposomes.M.S. - Master of Scienc

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

DRUG CO-LOADED MATRİCES WİTH DUAL THERAPEUTİC EFFECT FOR BONE TİSSUE ENGİNEERİN

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

DRUG CO-LOADED MATRİCES WİTH DUAL THERAPEUTİC EFFECT FOR BONE TİSSUE ENGİNEERİN

KEMİK DOKU MÜHENDİSLİĞİ İÇİN ÇİFT TERAPÖTİK ETKİLİ İLAÇ YÜKLÜ MATRİSLER

KEMİK DOKU MÜHENDİSLİĞİ İÇİN ÇİFT TERAPÖTİK ETKİLİ İLAÇ YÜKLÜ MATRİSLE

Antikanser İlaç İçeren Ve Cd 20 Karşıtı Antikor İle Hedefli Lipozomal Sistemin Lösemi Ve Lenfoma Hastalıkları Tedavisinde In Vitro Etkinliğinin Araştırılması.

Bu projede, kan kanseri (Lösemi) tedavisinde kullanılan ilaçlardan istenilen özellikteki iki ilacın birlikte kullanılmasıyla çift etkili ve aynı zamanda hedefli lipozom ilaç sistemi geliştirilmesi ve özelliklerinin incelenmesi planlanmaktadır. Geliştirilecek sistemin kanserli hücrelere hedeflendirme başarısının optimizasyonu için kanserli ve sağlıklı hücrelerde in vitro araştırmaların yapılması ve konvansiyonel ilaç uygulamaları ile karşılaştırılması amaçlanmaktadır. Lipozom sistemine eklenecek PEG molekülü, lipozomun opsoninlerden gizlenerek kanda daha uzun ömürlü olmasını sağlayacaktır. Lipozom sisteminde taşınacak model ilaç Doksorubisin olarak belirlenmiştir. değişik lipid oranlarında hazırlanacak lipozomların, boyut dağılımı, ilaç yükleme oranları, kararlılığı, salım kinetikleri, hedefleyici ajanın yapıya eklenme oranı (konjugasyon yüzdesi) v.b yönlerden optimizasyonu gerçekleştirilecektir. Hedefli lipozom sistemi ile bir yandan lipozom yapısının getirdiği içerdeki ilacın kontrollü salımı, diğer yandan hücresel hedefleme özelliği olan anti-CD20 antikoru (kanser tedavi özelliği) ile hızlı başlangıç etkisi sağlanacağı ve tedavi başarısının arttırılacağı düşünülmektedir

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

BİYOAKTİF AJANLARIN LOKAL SALIMI İLE KEMİK DOKU MİHENDİSLİĞİNİN GELİŞTİRİLMES