Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
- HÜAES, Hacettepe Üniversitesi bünyesinde üretilen kitap, makale, tez, bildiri, rapor gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.
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Recent Submissions
Correlation of Swede score colposcopy scoring system and histopathological results in patients with high-risk HPV infection other than HPV16 and 18
(Tıp Fakültesi, 2020-01-30) Murat Alan; Ilker Gunyeli; Murat Gultekin; Muzaffer Sancı; Kunter Yuce; Kadın Hastalıkları ve Doğum
Objective: Triage with HPV genotyping has some caveats and debates for HPV positive cases other than 16 and 18. The Swede score colposcopic scoring system has not previously been evaluated in this group of patients.
Objective: To use the Swede score colposcopic scoring system to compare scores and final histopathological results in women who have undergone colposcopy owing to infection with high risk-HPVs other than HPV16 and 18 and to establish new cut-off values to predict pre-malignant lesions in this group of patients.
Methods: This study was conducted in 613 women undergoing colposcopic evaluation because of abnormal cervical cytology together with high-risk HPV infection. All patients referred were evaluated by an expert colposcopist, given a Swede score (using the Swede score colposcopic scoring system) by using five variables (acetowhiteness, margins plus surface, vessel pattern, lesion size, and iodine staining), and had at least one biopsy procedure (either colposcopically directed or by a loop electrical excision procedure). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio values, and receiver operating characteristic curves for each clinico-pathological variable to detect low-grade and high-grade squamous intra-epithelial lesions, and any squamous cell abnormality (low-grade + high-grade squamous intra-epithelial lesions) were evaluated individually.
Results: Final histopathological results of the patients were normal in 53.2% of cases, low-grade lesions in 32.5% of cases, and high-grade lesions in 14.4% of cases. Swede score was ≥8 (median 7.97) for high-grade lesions and ≥5 (median 5.06) for low-grade lesions. The area under the curve values (95% CI) of Swede scores for low-grade and high-grade squamous intra-epithelial lesions, and low-grade + high grade lesions were 0.92, 0.98, and 0.96, respectively. A Swede score cut-off value ≥6 had a sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios of 92%, 98%, 93%, 98%, and 50 (22.6 to 110.8), respectively, for high-grade lesions at the final pathology (P<0.001). One high-risk HPV type (except 16 and 18) was no better than another for calculating the median Swede score during colposcopy (P=0.43).
Conclusions: The Swede score colposcopic scoring system appears to be a useful tool for evaluating atypical cervical cytology in women with high-risk HPV infection other than HPV types 16 and 18.
Keratokonus Evresi ile Retina Sinir Lifi Tabakası, Makula Kalınlığı, Gangliyon Hücre Tabakası Parametrelerindeki Değişikliklerin Optik Koherens Tomografi Kullanarak İncelenmesi
(Tıp Fakültesi, 0005-03-26) Farida KAZIMOVA; Göz Hastalıkları
Kazımova F. Evaluation of the Relationship Between Keratoconus Stage and Changes in Retinal Nerve Fiber Layer, Macular Thickness, and Ganglion Cell Layer Parameters Using Optical Coherence Tomography.
Department of Ophthalmology, Hacettepe University Faculty of Medicine, Medical Specialty Thesis, Ankara, 2025.
Introduction and Objectives: The aim of this study was to investigate the relationship between keratoconus stage and full-thickness foveal as well as individual retinal layer thicknesses using spectral-domain optical coherence tomography (SD-OCT) in patients diagnosed with keratoconus and staged according to disease severity. We also aimed to determine which retinal layers contribute to increases or decreases in thickness, to evaluate whether there is a difference in macular layer segmentation, to assess the presence of thinning in the retinal nerve fiber layer, to compare findings with a healthy control group, and to compare preoperative and postoperative measurements in the subgroup of patients who underwent corneal cross-linking.
Materials and Methods: Demographic data, clinical examination findings, corneal topography, and spectral-domain OCT examinations of patients followed at the Hacettepe University Cornea Unit were evaluated by creating a dataset. A total of 282 eyes were included in the analyses comparing the patient and control groups. Of these, 202 eyes belonged to 101 patients in the keratoconus group, and 80 eyes belonged to 40 individuals in the control group. When the distribution of eyes in the patient group according to disease stage was examined, 22.8% were stage 1, 39.1% were stage 2, and 38.1% were stage 3. In the subgroup that underwent corneal cross-linking, analyses comparing pre- and postoperative measurements were performed on 33 patients with complete pre- and postoperative data. When the distribution of disease stages was examined, 8.0% of patients were stage 1, 34.0% were stage 2, and 58.0% were stage 3 in the preoperative period; postoperatively, these rates changed to 12.0%, 42.0%, and 46.0%, respectively. In this group, measurements were obtained from only one eye in 16 patients and from both eyes in 17 patients.
Results: In the study, retinal layer thicknesses in the patient group differed according to disease stage when compared with the control group. In particular, statistically significant increases in inner retinal layers (NFL, GCL, IPL, INL, OPL, and IRL) were observed in stage 2 and stage 3 groups compared to the control group, while decreases were observed in outer retinal layers (RPE, ONL and ORL). In the corneal cross-linking group, no significant changes were observed in most retinal layers in the early period (1–3 months), whereas statistically significant changes emerged in certain retinal layers at 6 months and particularly at 12 months and beyond.
Conclusions: The findings indicate that retinal layer thickness in keratoconus patients may vary in relation to both disease stage and follow-up duration after corneal cross-linking. As the disease stage progresses, more pronounced increases in inner retinal layers are observed, while decreases in outer retinal layers are noteworthy. The absence of significant changes in retinal layers in the early postoperative period suggests that the procedure does not have a marked short-term effect on retinal structure. However, significant changes observed in long-term follow-up (particularly ≥12 months) indicate that retinal measurements may change over time.
Over Kanseri Transkriptom Verisinde Paklitaksel Direnci ile İlişkili Genlerin Araştırılması
(Sağlık Bilimleri Enstitüsü, 2025-07-21) Akten, Ezgi; Biyoinformatik
Ovarian cancer has the highest mortality rate among gynecological malignancies, with most patients being diagnosed at an advanced stage. Although the standard treatment consists of surgical intervention combined with platinum-taxane-based chemotherapy, the development of chemoresistance over time reduces treatment efficacy and negatively affects survival. In this thesis study, to elucidate the molecular mechanisms underlying paclitaxel resistance, differential gene expression analysis was performed by comparing paclitaxel sensitive and resistant ovarian cancer cell lines (OVCAR3, SKOV3, TOV21G). Based on the analysis of transcriptome data obtained from the Gene Expression Omnibus (GEO), 34 genes were found to be commonly differentially expressed in all three cell lines. GO, KEGG, and PPI analyses of these genes revealed that paclitaxel resistance is associated with biological processes such as immune response, lipid metabolism, angiogenesis, and extracellular matrix organization. Genes including ABCB1, IL6, CXCL8, MCAM, CMPK2, and PSMB9 were found as hub genes in the network, and some were associated with survival. These findings demonstrate that paclitaxel resistance develops through multifaceted and complex mechanisms and highlight the importance of considering these genes as potential biomarkers and therapeutic targets.
Özgül Öğrenme Bozukluğu Olan Çocuklarda Dans/Hareket Terapisinin Psikososyal Etkilerinin İncelenmesi: 6 Ay Takipli Randomize Kontrollü Çalışma
(Sağlık Bilimleri Enstitüsü, 2025-08-06) Gökcen, Arif; Ergoterapi
This study
aimed to investigate the effects of Dance/Movement Therapy (DMT) on anxiety,
depression, self-esteem, and social skills in individuals diagnosed with Specific
Learning Disabilities (SLD). A total of 44 individuals with SLD were enrolled and
randomly assigned to two groups: 22 participants received routine special education
programs, while 22 participants received DMT in addition to the standard educational
interventions. Pre- and post-intervention levels of anxiety, depression, self-esteem, and
social skills were evaluated. Assessment tools included the Coopersmith Self-Esteem
Inventory, the Revised Child Anxiety and Depression Scale–Parent Version, and the
Social Skills Rating System. Baseline, post-intervention, and follow-up measurements
were compared. The results revealed statistically significant improvements in selfesteem
(p=0.001), depression and anxiety levels (p=0.006), and social skills (p=0.001)
in the DMT group following the intervention. Furthermore, the improvement in these
areas was found to be maintained after a 6-month follow-up period. In contrast, no
statistically significant differences were observed in these areas within the control
group. In addition, intergroup comparisons of the results revealed a significant
difference in terms of self-esteem in the post-intervention and 6-month follow-up
assessments. Based on these findings, it is believed that DMT can offer a beneficial
and alternative perspective in the rehabilitation of children with SLD. Consequently,
these results suggest that incorporating DMT as a complementary approach to routine
special education programs is important for children diagnosed with SLD.
Alkol Dışı Steatohepatit Hastalarında Aerobik ve Dirençli Egzersiz Eğitiminin Hepatik Fonksiyonlar, İnflamatuvar Belirteçler ve Fonksiyonel Kapasite Üzerine Etkisi
(Sağlık Bilimleri Enstitüsü, 2025-06-20) Kumbaroğlu, Fatma Birgül; Fizyoterapi ve Rehabilitasyon
This study aimed to examine the post-intervention and long-term effects of a
combined exercise intervention on liver function, inflammatory markers, and
functional capacity in individuals with early-stage non-alcoholic steatohepatitis
(NASH). A total of 23 participants were included: intervention group (n=12; 45.9±9.3
years) and control group (n=11; 48.0±6.9 years). Assessments were conducted at
baseline, and at the 2nd, 4th, 6th, and 12th months. Liver steatosis and stiffness were
assessed through radiological imaging, along with biochemical analyses, body
composition, physical fitness, and psychosocial parameters. The intervention group
followed a 4-month supervised aerobic and resistance exercise program with a
physiotherapist and adhered to a diet plan. The control group followed a home-based
moderate-intensity aerobic exercise and dietary routine. After four months, liver fat
decreased by ~50% in the intervention group and 16% in the control group (p<0.001).
Liver stiffness improved by one stage in the intervention group (p=0.002). ALT and
AST levels dropped significantly in both groups (p=0.025; p=0.011, respectively). TNF-
α and IL-6 levels showed a trend toward reduction in the intervention group,
approaching statistical significance (p=0.051; p=0.066, respectively). TGF-β increased
in the control group but decreased in the intervention group (p=0.043). Galectin-3
levels significantly dropped in both groups (p=0.021). Liver parameters and physical
fitness gains were largely maintained during follow-up. The personalized combined
exercise and diet model improves liver health and physical fitness in individuals with
NASH. Physiotherapists' individualized exercise planning and follow-up significantly
contribute to this process, and regular monitoring plays a critical role.