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    Comparison of 21 G and 22 G EBUS TBNA Needles Diagnostic Value in Mediastinal and Hilar Lymph Nodes
    (Alanya Alaaddin Keykubat Üniversitesi, 2020) Dirol, Hulya; Uzun, Ruşen; Sadullahoğlu, Canan
    Aim: EBUS TBNA is an important diagnostic procedure for the intrathoracic lymph nodes. 21 G, 22 G and 25 G needles are used for sampling. Better samples can be expected to be taken via 21 G needle, as the inner diameter of 21 G needle is larger. However, the results of the studies comparing 21 G and 22 G needles are controversial. Methods: The study population consists of patients with EBUS TBNA performed via 21 G needles (Group 1; n=40) and the patients for whom 22 G needles used (Group 2; n=40). The data of patients were retrospectively analyzed. ROSE was performed for all samples.Results: The sensitivity, specificity and diagnostic accuracy of the procedure with 21 G needle was 95%, 85%, 93%, respectively. The diagnostic accuracy of 21 G needle was found to be higher than that of 22 G needle (93% versus 80%). In the procedure performed with 21 G needle, fewer samples were sufficient for the diagnosis than 22 G needle (r = 0.03, p <0.05).Conclusion: The diagnostic accuracy rate of 21 G needle was higher than 22 G needle. According to that result, it is better to prefer 21 G needle. With a 21 G needle, a smaller number of sample was sufficient for diagnosis than a 22 G needle. Diagnostic opportunity with less sample obtained with 21 G needle may provide time advantage to the cytopathologist who performs ROSE. Due to this advantage, in EBUS TBNA with ROSE, 21 G needles can be prioritized.
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    Cromolyn sodium and masitinib combination inhibits fibroblast-myofibroblast transition and exerts additive cell-protective and antioxidant effects on a bleomycin-induced in vitro fibrosis model
    (John Wiley & Sons Ltd, 2024) Goksu, Azize Yasemin; Dirol, Hulya; Kocanci, Fatma Gonca
    Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal fibrotic lung disease. While recent studies have suggested the potential efficacy of tyrosine kinase inhibitors in managing IPF, masitinib, a clinically used tyrosine kinase inhibitor, has not yet been investigated for its efficacy in fibrotic lung diseases. In a previous study on an in vitro neurodegenerative model, we demonstrated the synergistic antitoxic and antioxidant effects of masitinib combined with cromolyn sodium, an FDA-approved mast cell stabilizer. This study aims to investigate the anti-fibrotic and antioxidant effects of the masitinib-cromolyn sodium combination in an in vitro model of pulmonary fibrosis. Fibroblast cell cultures treated with bleomycin and/or hydrogen peroxide (H2O2) were subjected to masitinib and/or cromolyn sodium, followed by assessments of cell viability, morphological and apoptotic nuclear changes, triple-immunofluorescence labeling, and total oxidant/antioxidant capacities, besides ratio of Bax and Bcl-2 mRNA expressions as an indication of apoptosis. The combined treatment of masitinib and cromolyn sodium effectively prevented the fibroblast myofibroblast transition, a hallmark of fibrosis, and significantly reduced bleomycin / H2O2-induced apoptosis and oxidative stress. This study is the first to demonstrate the additive anti-fibrotic, cell-protective, and antioxidant effects of the masitinib-cromolyn sodium combination in an in vitro fibrosis model, suggesting its potential as an innovative therapeutic approach for pulmonary fibrosis. Combination therapy may be more advantageous in that both drugs could be administered in lower doses, exerting less side effects, and at the same time providing diverse mechanisms of action simultaneously. Illustration of the Anti-Fibrotic and Antioxidant Effects of Masitinib and Cromolyn Sodium in a Pulmonary Fibrosis ModelThis graphical abstract presents an overview of the experimental design and methodologies used to investigate the anti-fibrotic and antioxidant effects of masitinib and cromolyn sodium in a bleomycin/H2O2-induced pulmonary fibrosis model. Fibroblast cultures were treated with bleomycin and/or H2O2 24 hours after the experiment began, followed by the application of masitinib and/or cromolyn sodium 48 hours later. Multiple assessments-including cell viability assays, morphological evaluation, nuclear DNA staining, immunofluorescence staining, measurements of total oxidant and antioxidant capacities, and analysis of Bax/Bcl-2 mRNA expression levels-were performed to evaluate the effects on fibroblast-to-myofibroblast transition, apoptosis, and oxidative stress.image