Semih Öz

Son yıllarda sağlık sektöründe dijital dönüşümün hız kazanmasıyla birlikte, üç boyutlu (3B) baskı teknolojileri ve yapay zekâ (YZ) sistemleri sağlık uygulamalarında devrimsel bir değişimin önünü açmıştır. Bu teknolojiler hem klinik hizmetlerin etkinliğini artırmakta hem de sağlık eğitiminin niteliğini yeniden tanımlamaktadır. 3B yazıcılar; anatomi öğretimi, cerrahi planlama, protez ve implant üretimi ile biyoyazıcı tabanlı doku mühendisliği gibi birçok alanda kişiselleştirilmiş çözümler sunmaktadır. Yapay zekâ ise tıbbi görüntüleme, hastalık teşhisi, ilaç keşfi, hasta izleme ve bireyselleştirilmiş tedavi süreçlerinde önemli karar destek mekanizmaları geliştirmektedir. Eğitimsel bağlamda, bu iki teknolojinin entegrasyonu öğrencilerin öğrenme süreçlerini güçlendirmekte, soyut kavramların somutlaştırılmasını sağlamakta ve problem çözme yetkinliğini artırmaktadır. Bu çalışma, 3B baskı teknolojisi ve YZ sistemlerinin sağlık alanındaki güncel kullanım alanlarını, eğitim kurumlarına entegrasyon yöntemlerini ve mesleki yeterlik gelişimi üzerindeki etkilerini kapsamlı biçimde incelemektedir. Bulgular, 3B baskı ve YZ tabanlı eğitim sistemlerinin öğrencilerin bilişsel performansını artırdığını, klinik uygulamalarda hata oranlarını azalttığını ve öğrenme motivasyonunu güçlendirdiğini göstermektedir. Ayrıca, bu teknolojilerin sağlık kurumlarında maliyet etkinliği sağladığı, üretim süreçlerini hızlandırdığı ve hasta güvenliği standartlarını yükselttiği belirlenmiştir. Bununla birlikte, 3B yazıcı ve YZ teknolojilerinin etik, yasal ve ekonomik yönleri de sağlık sistemlerinin sürdürülebilir dijital dönüşümünü belirleyen kritik faktörler olarak öne çıkmaktadır. Özellikle veri gizliliği, algoritmik önyargı, biyoyazıcı ürünlerin klinik kullanımı ve telif hakları gibi konular, geleceğe yönelik uygulamalarda düzenleyici çerçevelerin önemini artırmaktadır. Çalışmanın sonuçları, 3B baskı ve YZ tabanlı teknolojilerin sağlıkta sadece teknik bir yenilik değil, aynı zamanda pedagojik ve etik bir paradigma değişimi yarattığını ortaya koymaktadır. Bu bağlamda, sağlık hizmetleri meslek yüksekokulları başta olmak üzere tüm eğitim kurumlarının, bu teknolojilerin potansiyelini stratejik planlarına dahil etmeleri ve disiplinler arası bir yaklaşımla dijital sağlık okuryazarlığını güçlendirmeleri önerilmektedir.

Objectives: This study aims to compare ozone with the commonly used methylprednisolone in experimental facial paralysis and to investigate whether combining ozone with methylprednisolone provides additional benefits over methylprednisolone alone. Materials and methods: The prospective randomized controlled animal study was conducted between November 2023 and January 2024. Thirty-two male Sprague-Dawley rats (mean weight: 300±30 g; range, 270 to 330 g; mean age: 8±1 weeks) with experimentally induced facial nerve injury were divided into five subgroups: control, paralyzed, methylprednisolone (2 mg/kg/day, intramuscular), ozone (1.1 mg/kg/day, intraperitoneal), and combination (ozone+methylprednisolone). Treatments were administered for 14 days. Functional, histologic, and immunohistochemical examinations were made. Results: Posttreatment comparison of treatment groups showed that whisker movements (p=0.001) and total clinic scores (p=0.023) were significantly higher in the combination group compared to the ozone group. In histologic analysis, vascular congestion was significantly lower in the methylprednisolone group than in the ozone group (p=0.012). On the other hand, apoptosis levels, indicating cell death in the facial nerve, were significantly lower in the combination group compared to the methylprednisolone (p=0.016) and ozone (p=0.036) groups. Conclusion: The combination of methylprednisolone and ozone lead to the most favorable functional and cellular outcomes. Further studies are required to confirm the benefits of ozone therapy for human facial paralysis, understand the molecular mechanisms behind its effectiveness, and determine the optimal doses for combined treatment.

Ischemia-reperfusion injury activates both apoptotic and necroptotic pathways, contributing to neuronal damage. This study aimed to investigate the effects of pannexin-1 inhibition by probenecid on these pathways in a rat model of transient focal cerebral ischemia-reperfusion. Additionally, the synergistic neuroprotective potential of co-administering probenecid and the pan-caspase inhibitor Z-VAD-fmk was evaluated. Transient focal ischemia was induced by clamping the right common carotid artery for 2 hours, followed by 24 hours of reperfusion. Male Wistar rats were divided into six groups, receiving either probenecid, Z-VAD-fmk, both, or vehicle. Gene and protein levels of apoptotic (caspase-3, caspase-8) and necroptotic (RIPK1, RIPK3, MLKL) markers were assessed by qRT-PCR, ELISA, and immunohistochemistry. TTC staining was used for infarct visualization, H&E for tissue morphology, and TUNEL assay for DNA fragmentation. TNF-α levels were measured to evaluate inflammation. Probenecid reduced necroptotic and apoptotic markers and suppressed TNF-α levels. Notably, Z-VAD-fmk reduced apoptosis but paradoxically increased necroptotic signaling, highlighting a cell death switch between these pathways. Simultaneous treatment significantly attenuated both pathways, reduced infarct size, and preserved tissue architecture. TNF-α levels were most effectively reduced by the combination therapy. Simultaneous inhibition of pannexin-1 and caspase activity provides superior neuroprotection in cerebral ischemia-reperfusion injury. This dual-targeting strategy effectively limits cell death and inflammation. Importantly, these findings may help explain the limited success of prior anti-apoptotic monotherapies in stroke and emphasize the necessity of targeting both apoptosis and necroptosis to achieve meaningful neuroprotection.

Amaç: Ülkemizde fetal yapılarla ilgili çeşitli nomogram çalışmaları yapılmıştır. Ancak bu çalışmalar, diğer ülkelerle kıyaslandığında henüz yeterince kapsamlı değildir. Araştırmanın amacı, 18-38 haftalık gebelik sürecinde humerus ve femurun ultrasonografi ile morfometrik incelemesini yaparak, fetüsün büyüme ve gelişimini değerlendirmektir. Bu ölçümlerin ülkemizde yapılacak olan standartlaştırma çalışmalarına katkı sağlayacağı düşünülmektedir. Yöntem: Çalışmada, Eskişehir’de bir özel hastaneye başvuran ve son adet tarihi baz alınarak 18-38 haftalık gebelik sürecinde olan 348 kadın üzerinde gerçekleştirilmiştir. Gebe kadınların fetüslerinde humerus ve femur uzunlukları morfometrik olarak incelenmiştir. Ultrasonografi yöntemi ile yapılan ölçümlerde, baş çevresi ve diğer fetal yapıların değerlendirilmesi de gerçekleştirilmiştir. Bu ölçümler arasında Femur Uzunluğu (Femur Length, FL), Biparietal Çap (Biparietal Diameter, BPD), Baş Çevresi (Head Circumference, HC), Humerus Uzunluğu (Humerus Length, HL) ve Karın Çevresi (Abdominal Circumference, AC) bulunmaktadır. Gebelik haftalarına göre uzunluklar karşılaştırılmıştır. Bulgular: 18-38 haftalık gebelerin fetüslerine ait FL, BPD, HC, HL ve AC ölçümleri incelenmiş ve trimesterlere göre karşılaştırılmıştır. Yapılan analizlerde tüm parametreler açısından gruplar arasında istatistiksel olarak anlamlı farklar bulunmuştur (p0,05). Bu bulgular, fetal biyometrik ölçümlerin gebelik haftalarına bağlı olarak anlamlı şekilde değiştiğini, ancak bu değişimlerin tüm hafta aralıklarında eşit şekilde olmadığını göstermektedir. Sonuç: Ülkemizdeki nomogram çalışmaları, diğer ülkelerle karşılaştırıldığında yetersiz kalmaktadır. Bu nedenle, fetal femur ve humerus uzunluklarının değerlendirilmesi için farklı topluluklara ait nomogramlar kullanılmaktadır. Gebeliğin 18-38. haftalarında fetüslere ait FL, BPD, HC, HL ve AC değerleri gruplara göre incelendiğinde; gruplar arasında istatistiksel olarak anlamlı farklar göstermiştir. Bu çalışmanın, literatüre katkıda bulunacağına inanılmakla birlikte bu konuda toplumu temsil eden örneklemlerde daha kapsamlı çalışmalar yapılmasına ihtiyaç vardır.

Background and Objectives: The aim was to evaluate nerve healing using immunohistochemical, histological, and functional techniques and to compare the effects of two different therapeutic ozone application methods by perineural and intraperitoneal ozone treatment in rats with a crush injury model of sciatic nerve. Materials and Methods: Forty male Sprague Dawley rats were divided into four subgroups of ten rats each: (1) Control group: The left sciatic nerve incised and closed without crush injury, no treatment; (2) Paralyzed group: Crush injury to the left sciatic nerve, no treatment; (3) Perineural ozone group: Crush injury to the left sciatic nerve, treated with perineural ozone therapy; (4) Intraperitoneal ozone group: Crush injury to the left sciatic nerve, treated with intraperitoneal ozone therapy. The treatments were administered for a 14-day period. Hematoxylin and eosin (H&E) and toluidine blue staining were used for histological examination; TUNEL staining was used for immunohistochemical examination. Pinch test and rotarod performance assessment were utilized for functional evaluation. Results: The pinch test scores showed significant improvement in perineural and intraperitoneal ozone treatment groups after treatment (p < 0.001 and p = 0.003, respectively). The scores of myelin degeneration, vascular congestion, vascular wall thickness, inflammation, and toluidine blue and TUNEL staining were significantly lower in both ozone treatment groups compared to the paralyzed group (p < 0.001). Vascular wall thickness scores were significantly higher in the perineural ozone group compared to the control and intraperitoneal ozone groups (p = 0.004 and p = 0.013, respectively). The Schwann cell proliferation scores were significantly higher in the perineural ozone group compared to the control group and intraperitoneal ozone groups (p < 0.001). Conclusions: Both applications of ozone therapy accelerated the healing of nerve regeneration, reduced inflammation and apoptosis based on histopathological results, and enhanced nerve function in rats with sciatic nerve injury. Perineural ozone therapy has been demonstrated to be an efficacious alternative to systemic ozone treatments in the management of sciatic nerve injury. Further studies are needed to determine optimal ozone dosage and administration protocols for the treatment of nerve injury.

A novel fiber optic biosensor was purposed for a new approach to monitor amyloid beta protein fragment 1–42 (Aβ42) for Alzheimer’s Disease (AD) early detection. The sensor was fabricated by etching a part of fiber from single mode fiber loop in pure hydrofluoric acid solution and utilized as a Local Optical Refractometer (LOR) to monitor the change Aβ42 concentration in Artificial Cerebrospinal Fluid (ACSF). The Fiber Loop Ringdown Spectroscopy (FLRDS) technique is an ultra-sensitive measurement technique with low-cost, high sensitivity, real-time measurement, continuous measurement and portability features that was utilized with a fiber optic sensor for the first time for the detection of a biological signature in an ACSF environment. Here, the measurement is based on the total optical loss detection when specially fabricated sensor heads were immersed into ACSF solutions with and without different concentrations of Aβ42 biomarkers since the bulk refractive index change was performed. Baseline stability and the reference ring down times of the sensor head were measured in the air as 0.87% and 441.6 μs ± 3.9 μs, respectively. Afterward, the total optical loss of the system was measured when the sensor head was immersed in deionized water, ACSF solution, and ACSF solutions with Aβ42 in different concentrations. The lowest Aβ42 concentration of 2 ppm was detected by LOR. Results showed that LOR fabricated by single-mode fibers for FLRDS system design are promising candidates to be utilized as fiber optic biosensors after sensor head modification and have a high potential for early detection applications of not only AD but possibly also several fatal diseases such as diabetes and cancer.

PurposeCerebral ischemia is the result of decreased or interrupted blood flow to the brain. It is the third leading cause of death after cardiovascular disease and cancer. Cerebral ischemia is reversible or irreversible in neurons in the affected area, and subsequent free radical damage can be exacerbated if reperfusion occurs. Ciproxifan is used to study the involvement of histaminergic neurons in different phases such as wakefulness and cognition. We wanted to find out whether ciproxifan has a protective effect on the brain of rats with cerebral ischemia-reperfusion injury.Materials and methodsA total of 64 adult rats (32 male and 32 female) were used for the experiment. Eight cages were formed with randomly selected rats. No substance was administered to the rats in Group 1 and no surgical procedure was performed. The cerebral ischemia-reperfusion model (clamping of the left common carotid artery for 15 min followed by reperfusion for 24 h) was applied to rats in Group 2, Group 3, and Group 4 after 7 days/single dose of saline and ciproxifan (10 mg/kg, 30 mg/kg). After that, the activitymeter, forced swim test (FST), and Morris water maze (MWM) were performed on all animals.ResultsRats treated with ciproxifan exhibit neurons and glial cells with histologic structures similar to those of the control group, and interestingly, these differences became more pronounced with increasing dose. Rats administered ciproxifan improved motor coordination, decreased total distance behavior, and improved learning ability. However, when the groups were compared by sex, no significant difference was found in the parameters.ConclusionThus, we could conclude that ciproxifan has a protective effect on the brain to a certain extent, regardless of the dose. Cerebral ischemia is one of the leading causes of death.Cerebral ischemia is a common mechanism of acute brain injury that results from impaired blood flow to the brain.Ciproxifan is a well-investigated histamine H3 receptor inverse agonist/antagonist.Ciproxifan presynaptically inhibits glutamate release in rat hippocampus