PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
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Article Assessment of Stiffness-Dependent Autophagosome Formation and Apoptosis in Embryonal Rhabdomyosarcoma Tumor Cells(2025) Sezen, S.; Adiguzel, S.; Zarepour, A.; Khosravi, A.; Gordon, J.W.; Ghavami, S.; Zarrabi, A.Remodeling of the extracellular matrix (ECM) eventually causes the stiffening of tumors and changes to the microenvironment. The stiffening alters the biological processes in cancer cells due to altered signaling through cell surface receptors. Autophagy, a key catabolic process in normal and cancer cells, is thought to be involved in mechano-transduction and the level of autophagy is probably stiffness-dependent. Here, we provide a methodology to study the effect of matrix stiffness on autophagy in embryonal rhabdomyosarcoma cells. To mimic stiffness, we seeded cells on GelMA hydrogel matrices with defined stiffness and evaluated autophagy-related endpoints. We also evaluated autophagy-dependent pathways, apoptosis, and cell viability. Specifically, we utilized immunocytochemistry and confocal microscopy to track autophagosome formation through LC3 lipidation. This approach suggests that the use of GelMA hydrogels with defined stiffness represents a novel method to evaluate the role of autophagy in embryonal rhabdomyosarcoma and other cancer cells. © 2024. Springer Science+Business Media, LLC.Article Autoimmune Encephalitis and Musicogenic Epilepsy: a Case of Gad65 Antibody-Associated Seizure(Wiley, 2025) Mohammadi-Asl, Ali; Bahadori, Amir Reza; Sabzgolin, Iman; Davari, Afshan; Razmafrooz, Mohammad; Tafakhori, Abbas; Ranji, SaraMusicogenic epilepsy (ME) is a rare form of reflex epilepsy with a prevalence of 1 in 10,000,000. Recent research suggests a potential link between ME and autoimmune encephalitis, particularly involving glutamic acid decarboxylase 65-isoform (GAD65) antibodies. A 48-year-old female presented with a one-year history of music-triggered seizures. Her episodes were characterized by an initial aura followed by unresponsiveness and oral automatisms. Electroencephalography revealed abnormalities in the left anterior temporal lobe and temporal leads. Laboratory studies showed positive anti-GAD65 antibodies. The patient was treated with a combination of antiepileptic medication (Lamotrigine) and corticosteroids and intravenous immunoglobulin. This case contributes to the growing evidence supporting an association between ME and autoimmune mechanisms, particularly GAD65 antibody-mediated autoimmunity. It highlights the importance of screening autoimmune factors in ME patients and highlights the need for further research into targeted treatment strategies.Article Can Super Resolution via Deep Learning Improve Classification Accuracy in Dental Radiography(Oxford University Press, 2025) Celik, Berrin; Mikaeili, Mahsa; Genç, Mehmet Zahid; Çelik, Mahmut EminObjectives Deep learning-driven super resolution (SR) aims to enhance the quality and resolution of images, offering potential benefits in dental imaging. Although extensive research has focused on deep learning based dental classification tasks, the impact of applying SR techniques on classification remains underexplored. This study seeks to address this gap by evaluating and comparing the performance of deep learning classification models on dental images with and without SR enhancement. Methods An open-source dental image dataset was utilized to investigate the impact of SR on image classification performance. SR was applied by 2 models with a scaling ratio of 2 and 4, while classification was performed by 4 deep learning models. Performances were evaluated by well-accepted metrics like structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), accuracy, recall, precision, and F1 score. The effect of SR on classification performance is interpreted through 2 different approaches. Results Two SR models yielded average SSIM and PSNR values of 0.904 and 36.71 for increasing resolution with 2 scaling ratios. Average accuracy and F-1 score for the classification trained and tested with 2 SR-generated images were 0.859 and 0.873. In the first of the comparisons carried out with 2 different approaches, it was observed that the accuracy increased in at least half of the cases (8 out of 16) when different models and scaling ratios were considered, while in the second approach, SR showed a significantly higher performance for almost all cases (12 out of 16). Conclusion This study demonstrated that the classification with SR-generated images significantly improved outcomes. Advances in knowledge For the first time, the classification performance of dental radiographs with improved resolution by SR has been investigated. Significant performance improvement was observed compared to the case without SR. © 2025 Elsevier B.V., All rights reserved.Article Comparison of Posterior and Antero-Lateral Renal Tumors in Retroperitoneal Laparoscopic Partial Nephrectomy: a Propensity Score Matching Analysis(Codon Publications, 2023) Anil, Hakan; Yildiz, Ali; Guzel, Ahmet; Akdemir, Serkan; Karamik, Kaan; Arslan, MuratThis study aimed to compare the antero-lateral and posterior localized renal masses in laparoscopic partial nephrectomy with the retroperitoneal approach in terms of operative, functional, and oncological outcomes. Patients who underwent retroperitoneal laparoscopic partial nephrec-tomy by a single surgeon between January 2013 and January 2021 were included in the study. A one-to-one propensity score matching (PSM) analysis was conducted to obtain two balanced groups. The patients were divided into two groups as posterior and antero-lateral according to the localization of the mass. A total of 239 patients were included in the PSM analysis, with 65 patients allocated to each group. The mean operative time was 79.2 & PLUSMN; 11.2 min in the posterior group, while it was 90.0 & PLUSMN; 11.6 min in the antero-lateral group (P < 0.001). Warm ischemia time was 15.9 & PLUSMN; 2.4 min in the posterior group and 18.6 & PLUSMN; 2.7 min in the antero-lateral group (P < 0.001). The median decrease in eGFR at 1 year was 4.8 (IQR, 2.9-6.9) mL/min in the posterior group and 5.0 (IQR, 2.8-11) mL/min in the antero-lateral group (P = 0.219). The warm isch-emia time and clamping technique were found to be significant factors for predicting eGFR change after surgery (13:0.693, 95% CI: 0.39-0.99, P < 0.001; 13:6.43, 95% CI: 1.1-11.7, P = 0.017, respectively). We report that retroperitoneal laparoscopic partial nephrectomy provided longer warm ischemia and operative time for antero-lateral renal masses than posterior masses. However, long-term oncological and functional results were similar for both localizations.Article Comparison of Three Different Modalities for the Treatment of Bladder Calculi by Size(Sage Publications Ltd, 2022) Yildiz, Ali; Anil, Hakan; Erol, Ibrahim; Karamik, Kaan; Ercil, HakanPurpose: Treatment recommendations for kidney or ureteral stones are based on stone size; however, this is uncertain for bladder stones. This study aims to determine the best approach to bladder stones based on their size. Materials and methods: We retrospectively analyzed 401 patients with bladder stones. Patients were divided into three different groups according to stone size (11-20 mm, 21-30 mm, 31-40 mm as groups 1, 2, and 3 respectively). Patients had transurethral cystolithotripsy (TUCL), percutaneous cystolithotripsy (PCCL), and open cystolithotomy (OCL) performed. Results: Stone fragments were removed completely in all patients. When catheter time, postoperative stay, and hematocrit decrease values were compared, the results were significantly higher for OCL in all three groups (p: 0.001). When the relationship between stone sizes and operation time is evaluated, TUCL had shorter operation times (34.1 +/- 10.6 min) in group 1. However, TUCL had longer operation times in group 2 and group 3 compared to OCL and PCCL. Conclusion: TUCL may be preferable due to better postoperative outcomes and shorter operative time for <= 2 cm stones. As the stone size increases, PCCL is more favorable in terms of operation time.Article Diagnostic Value of Shear Wave Velocity in Polycystic Ovarian Syndrome(Medical Communications, 2021) Gursu, Turkan; Cevik, Halime; Desteli, Guldeniz Aksan; Yilmaz, Birnur; Bildaci, Tevfik Berk; Eraslan, AlperAim: In polycystic ovarian syndrome, the ovaries become stiffer due to chronic anovulation. We aimed to compare tissue elasticity in terms of shear wave velocities measured using acoustic radiation force impulse imaging technique between the ovaries of polycystic ovarian syndrome women and non-polycystic ovarian syndrome women. Material and methods: The study was designed as a retrospective data analysis of women who underwent transvaginal ultrasound and acoustic radiation force impulse imaging in a university hospital between July 2014 and March 2015, for various reasons. There were 32 polycystic ovarian syndrome patients and 32 patients without a diagnosis of polycystic ovarian syndrome. Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin, antimullerian hormone levels, and menstrual patterns with clinical hyperandrogenism were evaluated. On the menstrual cycle days 2-4, by performing a transvaginal ultrasound scan, the ovarian volumes and antral follicle counts in both ovaries were recorded for each woman. The ultrasound system was converted into the elastography mode, and acoustic radiation force impulse imaging was performed. Shear wave velocity (m/sec) was measured at least 5 times for each ovary, and the mean value was calculated for each polycystic ovarian syndrome and non-polycystic ovarian syndrome woman. Results: Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin levels were similar between the groups (p 0,05). Antimullerian hormone levels, antral follicle counts, and mean ovarian volumes were statistically different between the groups (p <0,05). Mean shear wave velocity values for both ovaries were 2.12 +/- 0.82 (0.78-4.9) m/sec in the polycystic ovarian syndrome group, and 1.18 +/- 0.41 (0.77-2.0) m/sec in the non-polycystic ovarian syndrome group, which was statistically significantly different (p = 0.016). Conclusion: In our study, we found significantly higher shear wave velocity levels in polycystic ovarian syndrome women than non-polycystic ovarian syndrome women, which indicates an impact of the condition on shear wave velocity. The increased acoustic frequencies cause a decreased response in time to transition, and motion becomes out of phase; in other words, scattered waves are faster in stiffer ovaries. Our results are thus compatible with the pathophysiology of the disease. Shear wave velocity is a beneficial tool for evaluating ovarian elasticity in polycystic ovarian syndrome patients in whom the levels are found to be significantly higher than non-polycystic ovarian syndrome women. In light of these findings, shear wave velocity is expected to be slower than polycystic ovarian syndrome levels in ovulatory women.Article Diagnostic Value of Voiding Scores of the "International Prostate Symptom Score" and the "Bristol Female Lower Urinary System Symptoms-Short Form" Questionnaires in Women With Voiding Dysfunction(Wolters Kluwer Medknow Publications, 2024) Erbay, Mehmet Erkan; Sevinc, Burcu Hanci; Tarhan, FatihIntroduction:We aimed to investigate the diagnostic value of International Prostate Symptom Score voiding symptom score (IPSS-VS) and Bristol Female Lower Urinary Tract Symptoms-short form voiding score (BFLUTS-VS) in female patients with urodynamically diagnosed voiding dysfunction. Methods:The medical records of female patients who underwent urodynamic examination between May 2007 and November 2021 for lower urinary tract complaints were retrospectively evaluated. A total of 1858 female patients were included in the study. Patients investigated between 2007 and 2014 were asked to fill the IPSS, and patients investigated after 2015 were asked to fill the BFLUTS-SF. Results:The mean age of the patients was 49.06 0.33 in the IPSS group and 50.02 +/- 0.47 in the BFLUTS group. On the pressure flow study, voiding dysfunction was found in 14.8% (n = 95) in the IPSS group and 15.1% (n = 183) in the BFLUTS group. The area under curve value was found to be 0.58 for IPSS and 0.64 for BFLUTS. Threshold values were found as >9 for IPSS-VS and >4 for BFLUTS-VS. The sensitivity, specificity, false negative, and false positive rates for IPSS-VS were 33.3%, 78.8%, 66.7%, and 21.2%, respectively. The same parameters were 45.5%, 78.9%, 54.5%, and 21.1% for BFLUTS-VS, respectively. Conclusion:The diagnostic performance of both the questionnaires was found to be low for diagnosing voiding dysfunction in female patients according to our data. Therefore, the assessment of the voiding phase in women should not solely rely on the current questionnaires. However, further studies using questionnaires including all voiding symptoms are required.Article Do External Female Genital Measurements Affect Genital Perception and Sexual Function and Orgasm(Galenos Yayıncılık, 2020) Kaya, Aski Ellibes; Dogan, Ozan; Yassa, Murat; Basbug, Alper; Ozcan, Canan; Caliskan, ErayObjective: To provide baseline data for the anatomy of the external female genitalia and to investigate the correlation between those measurements and sexual function and genital perception. Materials and Methods: This prospective cohort study consisted of 208 healthy premenopausal women. The Female Sexual Function index (FSFI) and the Female Genital Self-image scale (FGSIS) questionnaires were administered. Participants were divided into two groups according to their female sexual dysfunction (FSD) status. External genital measurements and anterior and posterior vaginal length were measured. Results: The external female genital measurements were (cm, mean +/- standard deviation): clitoral prepuce length 2.05 +/- 0.48; clitoral glans length 0.87 +/- 0.21; clitoral glans width 0.60 +/- 0.15; clitoris to urethra 2.24 +/- 0.55; anterior fornix depth 7.75 +/- 0.92; posterior fornix depth 9.25 +/- 0.75; labia minora width, right 2.12 +/- 0.86, left 2.20 +/- 0.96. A weak negative correlation was found between total FGSIS scores and clitoral prepuce length (p=0.01, r=-0.17), whereas a weak positive correlation was seen between total FGSIS scores and anterior-posterior vaginal lengths (p=0.04, r=0.13; p=0.02, r=0.15, respectively). No statistically significant difference was found between the genital measurements of participants with FSD (n=82, 39.4%) and those without FSD (n=126, 60.6%), and the total FSFI scores and orgasm subdomain scores. Conclusion: The female genital measurements were found to be distributed over a wide range. Although the relationship between genital measurements and genital perception varied, no significant relationship was found between genital measurements and sexual functions or orgasm. These findings suggest that a more cautious approach should be taken towards genital surgeries for cosmetic purposes.Article Does Transition From Standard To Retzius-Sparing Technique in Robot-Assisted Radical Prostatectomy Affect the Functional and Oncological Outcomes(Pagepress Publ, 2021) Anil, Hakan; Karamik, Kaan; Yildiz, Ali; Savas, MuratObjective: To appraise the outcomes on the Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) learning curve of a surgeon with previous experience of anterior (standard) RARP. Materials and methods: The first 50 cases during the Rs-RARP learning curve (group 1) and 50 cases after the second 100 cases with the standard approach (group 2) were comprised in the study. Patients who used zero or one safety pads were considered continent. Erectile function recuperation was characterized as the competence to achieve penetrative intercourse without receiving any medication. All patients were reevaluated at two weeks, first, third, sixth, and 12th months after surgery using LIEF-5, PSA level, and continence status. Results: Immediate continence rates following catheter removal were 32/50 (64%) in Rs-RARP group and 26/50 (52%) in S-RARP group (p = 0.224). The continence recovery rate was 48/50 (96%) in Rs-RARP group and 46/50 (92%) in the S-RARP group at 12 months follow-up (p = 0.400). Total nerve-sparing surgery was enforced in 36/50 (72%) patients for group 1 and 35/50 (70%) patients for group 2. Potency recovery was 27/43 (62.8%) in Rs-RARP and 30/44 (68.2%) for S-RARP at 12 months follow up (p = 0.597). Surgical margin positivity was detected in 6/50 (12%) cases in the Rs-RARP group and in 4/50 (8%) cases in the S-RARP (p = 0.444). Conclusions: Functional and oncological results are not negatively affected in the first 50 cases for a surgeon who is experienced in S-RARP before transition to the Rs-RARP method.Article Double Congenital Abnormalities of Left Anterior Descending Artery: a Technical Modification for Closing Wide Neck of Aneurysm and Fistulae-A Case Report(Oxford Univ Press, 2025) Guvenc, Rengin Cetin; Al Arfaj, Abdullah Ayar; Dogan, Demet; Ozer, NihatBackground The duplication of the left anterior descending coronary artery and coronary artery-to-pulmonary artery fistulae are infrequent congenital anomalies described in literature. These anomalies can lead to life-threatening conditions such as myocardial infarction, rupture, cardiac tamponade, and heart failure.Case summary A 73-year-old male with chronic kidney failure was admitted for a preoperative cardiovascular assessment. Initially, he did not report any chest pain. However, while awaiting myocardial perfusion scintigraphy, he developed chest pain and coughing, leading him to present to the emergency department, where his troponin levels were found to be elevated. Coronary angiography and coronary computed tomography angiography showed a dual left coronary artery where one of the left anterior descending arteries completely transforms into a congenital aneurysm and fistula. In order to reshape the aneurysm neck and prevent the migration of coils into the left main coronary artery by creating a landing zone and to reduce the number of coils and the procedure time, two stents were first placed inside the aneurysm neck. Then, the fistula and aneurysm were successfully closed by coil implantation.Discussion Some case studies and centre experiences recommend interventional closure using cover stents, vascular plugs, and coil embolization techniques for symptomatic fistulae and those resulting in complications. Despite these recommendations, determining the best treatment strategy remains challenging due to the lack of clear guidelines. The novel modified technic consisted of two nested stents and coil embolization to close the aneurysm and fistula and prevent secondary complications due to myocardial infarction.Article The Effect of Atlantoaxial Stabilization on Juvenile Idiopathic Scoliosis Involving Chiari Malformation and Syrinx(Wolters Kluwer Medknow Publications, 2025) Emre, Sen Harun; Serkan, Simsek; Erkan, KaptanogluIdiopathic scoliosis (IS) is frequently asSociated with Chiari malformation (CM) and syringomyelia, conditions thought to share a common underlying cause: Atlantoaxial instability. Atlantoaxial stabilization has recently emerged as a novel treatment option. A 4-year-old girl presented with progressive scoliosis (Cobb angle of 28.6 degrees), neck pain, CM, and syringomyelia. The patient was diagnosed with central or axial atlantoaxial instability and underwent C1-C2 fixation. Postoperatively, she experienced significant relief from neck pain. Follow-ups demonstrated progressive syrinx reduction, while X-rays revealed a Cobb angle decrease to 21 degrees in 18 months. This case highlights the potential of atlantoaxial stabilization to halt scoliosis progression in IS patients with CM and syringomyelia. Unlike traditional multisegmental stabilization, C1-C2 fixation offers a minimally invasive approach and preserves spinal mobility in growth-age patients. Atlantoaxial instability should be considered in IS cases with CM and syringomyelia. Atlantoaxial stabilization alone may provide effective treatment with favorable clinical and radiological outcomes.Article The Effect of Topiramate on the Cerebellum of the Obese Female Rats: a Stereological, Histochemical and Bioinformatical Study by Investigation of Tnf-Α Interaction(Wiley, 2025) Alkan, Isinsu; Altunkaynak, Berrin Zuhal; Akbari, Amir Mahdi; Altun, Ceren Erdem; Baycu, CengizThe rising incidence of obesity underscores the necessity for alternative obesity treatments. Patients commonly prefer medication aiding in weight reduction. Topiramate, an antiepileptic drug, is gaining popularity among obese patients for its weight loss benefits. This study aims to explore Topiramate's impact on the cerebella of obese female rats. In the experiment, 24 female rats (200-250 g) were divided into four groups: non-obese control (NOC), obese control (OC), non-obese topiramate (NOT) and obese topiramate (OT). The non-obese rats were given a standard diet, while the obese rats received a high-fat diet (40% fat). After 9 weeks, topiramate was administered intraperitoneally daily for 6 weeks. Following this, the rats were euthanised, and their cerebella were removed. The volume of the cerebellum and mean numerical density of the molecular neurons, granular neurons and Purkinje cells were estimated using stereological methods, and the link between obesity-caused cerebellum damage and TNF-alpha was assessed through immunohistochemical and bioinformatic techniques. Additionally, histopathological evaluations of the tissues were conducted. The cerebellar volume in the OC group was decreased compared to the NOC group. The topiramate groups exhibited a decrease in molecular or/and granular neuron numbers in the NOT and OT groups. Notably, neurons with dark cytoplasm were observed in the topiramate-treated groups, alongside neuronal degeneration was seen in the obese groups. The connection between TNF-alpha and obesity or obesity-caused cerebellum damage was confirmed through both immunohistochemical and bioinformatics analyses. These findings suggest that topiramate might have a degenerative effect on the cerebellum, especially following obesity.Article Endovascular Treatment of Hepatic Arterioportal Fistula Complicated With Giant Portal Vein Aneurysm Via Percutaneous Transhepatic Us Guided Hepatic Artery Access: a Case Report and Review of the Literature(Springernature, 2019) Oguslu, Umut; Uyanik, Sadik Ahmet; Gumus, BurcakBackgroundHepatic arterioportal fistulas are rare, abnormal, direct communications between hepatic artery and portal venous system. Treatment options shifted from surgery to endovascular interventions. Catheterization may be challenging. We report a case of a hepatic arterioportal fistula treated successfuly with Amplatzer Vascular Plug II via percutaneous transhepatic hepatic artery access after failed transfemoral approach.Case presentation58year old woman presented with right heart failure, kidney insufficiency and massive ascites related to portal hypertension caused by hepatic arterioportal fistula. She had a history of previous abdominal surgery. Colour Doppler ultrasound and computed tomography revealed a giant portal vein aneurysm related to large hepatic areterioportal fistula. Endovascular treatment was planned. Catheterization of the hepatic artery could not be realized due to severe tortuosity and angulation of the celiac artery and its branches. Access to the hepatic artery was obtained directly via percutaneous transhepatic route and fistula site was embolized with Amplatzer Vascular Plug II and coils. Immediate thrombosis of the aneurysm sac and draining portal vein was observed. Patients clinical status improved dramatically.ConclusionTranscatheter embolization is the first choice of the treatment of hepatic arterioportal fistulas but the type of the therapy should be tailored to the patient and interventional radiologist should decide the access site depending on his own experience if the routine endovascular access can not be obtained.Article Evaluation of the Effects of Orthopedic Treatment on the Dentofacial Structure and Upper Airway of Subjects with Skeletal Class III Malocclusion(Galenos Publishing House, 2024) Ciger, Semra; Kan, Hilâl; Sozen, Tevfik; Öğretmenoğlu, OğuzObjective: The present study aimed to evaluate the effect of rapid maxillary expansion (RME) and face mask treatment on the upper airway in patients with maxillary retrusion in two dimensions using digital cephalograms and volumetric evaluation using acoustic rhinometric measurements. Methods: A total of 22 individuals with a concave profile and skeletal and dental Class III malocclusion during growth and development with a mean age of 9.9±1.38 years were included in the study. A bonded RME appliance and a petit face mask were adapted for the patients. Before treatment (T0) and after maxillary protraction (T1), lateral cephalometric films and acoustic rhinometric recordings were obtained. The dependent sample t-test was used for statistical evaluation. Results: Cephalometric analysis revealed forward movement of the maxilla and backward downward rotation of the mandible. A significant increase was observed in the nasopharyngeal and oropharyngeal regions of the upper airway. Three-dimensional evaluation of the upper airway by acoustic rhinometry revealed only an increase in the volumes of the left nasal cavity after decongestant administration. A statistically significant increase in acoustic rhinometric measurements in nasal valves. When the correlation of the cephalometric findings of the nasopharyngeal region with the acoustic rhinometry findings was examined, no statistically significant relationship was found. Conclusion: As a result of this study, we observed an increase in the cephalometric measurements of the nasopharyngeal and oropharyngeal areas. A significant increase was observed in the minimal cross-sectional area measured by acoustic rhinometry.Article Exploring the Link Between Sound Quality Perception, Music Perception, Music Engagement, and Quality of Life in Cochlear Implant Recipients(MDPI, 2025) Karaman Demirel, Aysenur; Akbulut, Ahmet Alperen; Ciprut, Ayse Ayca; Bal, NiluferBackground/Objectives: This study investigated the association between cochlear implant (CI) users' assessed perception of musical sound quality and their subjective music perception and music-related quality of life (QoL). The aim was to provide a comprehensive evaluation by integrating a relatively objective Turkish Multiple Stimulus with Hidden Reference and Anchor (TR-MUSHRA) test and a subjective music questionnaire. Methods: Thirty CI users and thirty normal-hearing (NH) adults were assessed. Perception of sound quality was measured using the TR-MUSHRA test. Subjective assessments were conducted with the Music-Related Quality of Life Questionnaire (MuRQoL). Results: TR-MUSHRA results showed that while NH participants rated all filtered stimuli as perceptually different from the original, CI users provided similar ratings for stimuli with adjacent high-pass filter settings, indicating less differentiation in perceived sound quality. On the MuRQoL, groups differed on the Frequency subscale but not the Importance subscale. Critically, no significant correlation was found between the TR-MUSHRA scores and the MuRQoL subscale scores in either group. Conclusions: The findings demonstrate that TR-MUSHRA is an effective tool for assessing perceived sound quality relatively objectively, but there is no relationship between perceiving sound quality differences and measures of self-reported musical engagement and its importance. Subjective music experience may represent different domains beyond the perception of sound quality. Therefore, successful auditory rehabilitation requires personalized strategies that consider the multifaceted nature of music perception beyond simple perceptual judgments.Article Extraperitoneal Laparoscopic Versus Transperitoneal Robot-Assisted Laparoscopic Approaches for Extended Pelvic Lymph Node Dissection During Radical Prostatectomy(Mary Ann Liebert, inc, 2022) Yildiz, Ali; Anil, Hakan; Akdemir, Serkan; Aksaray, Eren Erdi; Ates, Mutlu; Arslan, MuratBackground: We aim to directly compare the feasibility and safety of extended pelvic lymph node dissection (PLND) during transperitoneal robotic-assisted radical prostatectomy (Tp-RARP) and extraperitoneal laparoscopic radical prostatectomy (Ep-LRP). Materials and Methods: We retrospectively identified the prospectively maintained database records of 162 patients diagnosed with prostate cancer (PC) who underwent Ep-LRP or Tp-RARP with extended PLND. Patients with risk of nodal metastases over 5% according to Briganti nomogram received extended PLND. All data analyzed in this study were based on the documentation in our PC database including age, body mass index, Charlson comorbidity index score, preoperative prostate-specific antigen, history of abdominal surgery, biopsy Gleason score, total operation time, postoperative pelvic drainage time, pathological results, lymph node yield (LNY), percentage lymph node involvement (%LNI), and perioperative complications. Patients were followed up for biochemical recurrence in the postoperative period. Results: Eighty-two of the 162 enrolled patients were in group 1 (Ep-LRP+PLND) and 80 were in group 2 (Tp-RARP+PLND). There were no statistically significant differences between the groups regarding preoperative demographics and clinical characteristics. The median LNY was 17 (range 8-27) and 17.5 (range 10-29) in groups 1 and 2, respectively, and no statistically significant difference was found. There was no significant difference between the groups in terms of biochemical recurrence-free survival with mean follow-up of 44.8 months after radical surgery. Conclusion: Our results support the view that extended PLND through the Ep-LRP approach is a feasible and safe procedure without compromising oncological efficacy compared with a similar template attempted during Tp-RARP. Clinical Trial Registration number is 01/21-2.Article Factors Affecting the Formation of Lymphedema Due to Breast Cancer (Is Primary Systemic Treatment an Independent Factor in the Formation of Breast Cancer Related Lymphedema?)(Galenos Publ House, 2025) Gökçek, Berk; Gunaydin, Melek; Gunay, SemraObjective: This study aimed to evaluate the local and systemic risk factors associated with breast cancer-related lymphedema (BCRL), with a focus on whether primary systemic treatment (PST), particularly taxane-based chemotherapy, is an independent risk factor. Material and Methods: A prospective clinical study was conducted on 80 breast cancer patients discussed at our institution’s weekly breast cancer council. Patients were grouped based on PST status. Clinical examinations and measurements were performed preoperatively and postoperatively at 1, 6, 12, 18, and 24 months. Only the operated arm was assessed using tape measurements and the truncated cone formula. Arm volumes were calculated, and lymphedema (LE) was diagnosed based on a volume difference (≥200 mL or ≥2 cm circumference). Results: No statistically significant differences were found between PST and non-PST groups regarding age, body mass index, menopausal status, smoking, or tumor characteristics. LE was detected in 7 (8.8%) patients, all Stage 1. PST and taxane-based chemotherapy were not significantly associated with LE development. However, seroma presence (p=0.038) and axillary radiotherapy (p=0.043) were significantly associated with LE. Arm volume increase was most significant at 1 and 18 months postoperatively (p=0.055 and p=0.044, respectively). Conclusion: PST, including taxane-based chemotherapy, does not appear to be an independent risk factor for BCRL. In contrast, postoperative seroma and axillary radiotherapy are significantly associated with LE development. Early identification and management strategies should target these modifiable factors to reduce the risk of LE.Article Factors Affecting the Level of Reflective Thinking and Clinical Decision-Making Skills in Medical Faculty Students(Kare Publ, 2023) Senturk, Erol; Sarıkaya, Ozlem; Hafız, Aysenur Meric; Teker, CenkObjectives: The aim of this study is to evaluate the reflection skills of students at the Faculty of Medicine and the factors influenc- ing these skills, as well as to measure the impact of students' reflection skills on their clinical decision-making. Methods: This study is an educational research project conducted on fifth-year Ear Nose Throat (ENT) interns at Vakif University's Faculty of Medicine. The \"Reflective Thinking Level Determination Scale\" and the \"Clinical Decision-Making Scale,\" which are valid and reliable, were used to assess the reflection skills and clinical decision-making abilities of the 125 students participating in the study. Results: In our study, the mean score of the sub-dimensions of the Groningen Reflection Skills Scale was 77.04±5.14 for the fifth- year student population surveyed. Scores from the \"Self-Reflection\" and \"Reflective Communication\" sub-dimensions of the Gron- ingen Reflection Skills Scale were compared based on gender, participation in summer internships, receipt of scholarships, mem- bership in social sciences clubs, place of residence, school attended, diary-keeping habits, study styles, and cities of residence. Although there were some differences between the groups, these differences were not statistically significant. The total scores of the students on the Clinical Decision-Making Scale sub-dimensions ranged from 98 to 169, with a mean score of 146.18±10.97. A statistically positive and moderate correlation was found between the total scores of the participants on the Groningen Reflection Skills Scale and the total scores they obtained on the Clinical Decision-Making Scale (r=0.403; p=0.001). Conclusion: Consequently, an increase in the reflection skills of participants is associated with higher clinical decision-making scores. Reflection is the primary means of transitioning students from novices to experts, enhancing both comprehensive learning and learning experiences. Therefore, every medical school should develop a training program for student reflection, along with a feedback and assessment system integrated into the curriculum.Article Human Papilloma Virus Frequency and Genotypes; Evaluation of the 4879 Screenings Made With Polymerase Chain Reaction and Chip Array Between 2001 and 2019 in Istanbul(Kare Publ, 2021) Vural, Gurcan; Polat, NedimObjectives: The aim of this study is the documentation of human papilloma virus (HPV) frequency and types seen in the city of Istanbul, Turkey, as well as evaluation of the relationship between these subtypes and cytological and pathological diagnoses. Methods: 4879 cases were studied in our molecular pathology department between 2001 and 2019 in Istanbul. Between 2001 and 2010, 1692 cases were screened for HPV 6, 11, 16, 18, 31, and 33 by conventional hybridization and polymerase chain reaction (PCR). Since 2011, up to 49 HPV typing has been performed for 3187 cases with chip array. The cases were referred to the pathology center and the hospital pathology department by clinicians for screening before HPV vaccination and on the observation of precancerous changes and koilocyts in cytological-histopathological evaluations. Results: In this study, the frequency of HPV was found to be 10.8% (527 HPV-positive cases). Among these, 348 cases were high-risk groups, whether or not they were previously associated with a low-risk group. When we look at the distribution of the cases according to the high-risk HPV types, HPV 16 is the most common type. The frequencies of occurrence of other HPV types are as following: HPV-16: 41.7%, HPV-31: 11.7%, HPV-52: 7.9%, HPV-51: 7.1%, HPV-33: 6.9%, HPV-45: 6.5%, HPV-18: 6.3%, HPV-39: 6.1%, and HPV-58: 5.8%. It was further found that multiple infections were 28% of high grade squamous intraepithelial lesion cases. HPV frequency was 38% and 72%, respectively, in cases with cytologically or histopathological precancerous, low-grade squamous intraepithelial lesion, and HSIL changes. As a final note, HPV was detected in 9 of 10 cases with cervical cancer (90%). Only 1 adenocarcinoma case detected in the series was a double infection with HPV types 18 and 45. Conclusion: HPV 16 was the most common type found in this study. It is followed by types 31, 52, 51, 33, 45, 18, 39, and 58, respectively. The most common association observed in double infections was between HPV 16 and 58. It was also observed that the incidence of HPV in the city of Istanbul, Turkey, was similar to other developed countries. As a final note, in addition to screening tests, PCR and chip array studies should be conducted and the community should be informed about preventive medicine and the importance of condom use.Letter Investigation of Trace Element and Toxic Metal Blood Levels in Obese Children(AVES, 2025) Kılıç, S.
