Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study

Akpinar, Hatice The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.4

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke

Akpinar Cetin Kursad,Gurkas Erdem,Aykac Ozlem,Inanc Yusuf,Giray Semih,Ozdemir Atilla Ozcan 대한신경중재치료의학회 2020 Neurointervention Vol.15 No.2

Purpose: In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy.Materials and Methods: This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement.Results: Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0–2) was 38% (8/21).Conclusion: DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.

Elevated Red Blood Cell Distribution Width May Be a Novel Independent Predictor of Poor Functional Outcome in Patients Treated with Mechanical Thrombectomy

Akpinar Cetin Kursad,Gurkaş Erdem,Aykac Ozlem,Uysal Zehra,Ozdemir Atilla Ozcan 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.1

Purpose: Red blood cell distribution width (RDW) evaluates the variation (size heterogeneity) in red blood cells. Elevated RDW has been identified as a predictor of poor functional outcomes for acute ischemic stroke. The association between elevated RDW level and poor functional outcome in stroke patients undergoing mechanical thrombectomy has not been reported before. This study aims to investigate this relationship.Materials and Methods: This was a multicenter retrospective study involving the prospectively and consecutively collected data of 205 adult stroke patients who underwent mechanical thrombectomy for anterior circulation large vessel occlusion (middle cerebral artery M1, anterior cerebral artery A1, tandem ICA-MCA, carotid T) between July 2017 and December 2019. RDW cut off levels were accepted as >16%. The effect of elevated RDW on poor functional outcome (modified Rankin scale 3–6) was investigated using bivariate and multivariate regression analysis.Results: Elevated RDW was significantly associated with poor functional outcome in bivariate and multivariate analysis (odds ratio [OR] for RDW >16%, 2.078; 95% confidence interval [95% CI], 1.083–3.966; P=0.027 and OR for RDW >16%, 2.873; 95% CI, 1.342–6.151; P=0.007; respectively).Conclusion: These findings suggest that elevated RDW may be an independent predictor of poor functional outcomes in ischemic stroke patients undergoing mechanical thrombectomy.

Energy and Exergy Aanalyses of Drying of Eggplant Slices in a Cyclone Type Dryer

Akpinar E. Kavak The Korean Society of Mechanical Engineers 2005 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.19 No.2

In this paper, the energy and exergy analyses of the drying process of thin layer of eggplant slices are investigated. Drying experiments were conducted at inlet temperatures of drying air of 55, 65 and $75^{\circ}C$ and at drying air velocities of 1 and $1.5\;ms^{-1}$ in a cyclone type dryer. Using the first law of thermodynamics, energy analysis was carried to estimate the ratios of energy utilization. However, exergy analysis was accomplished to determine type and magnitude of exergy losses during the drying process by applying the second law of thermodynamics. It was deduced that eggplant slices are sufficiently dried in the ranges between $55-75^{\circ}C$ of drying air temperature and at 1 and $1.5\;ms^{-1}$ of drying air velocity during 12000-21600 s despite the exergy losses of $0-0.739\;kJs^{-l}.

Energy and Exergy Aanalyses of Drying of Eggplant Slices in a Cyclone Type Dryer

E. Kavak Akpinar 대한기계학회 2005 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.19 No.2

In this paper, the energy and exergy analysis of the drying process of thin layer of eggplant slices are investigated. Drying experiments were conducted at inlet temperatures of drying air of 55, 65 and 75℃ and at drying air velocities of 1 and 1.5 ms-¹ in a cyclone type dryer. Using the first law of thermodynamics, energy analysis was carried to estimate the ratio of energy utilization. However, exergy analysis was accomplished th determine type and magnitude of exergy losses during the drying process by applying the second law of thermodynamics. It was deduced that eggplant slices are sufficiently dried in the ranges between 55-75℃ of drying air temperatures and at 1 and 1.5 ms-¹ of drying air velocity during 12000-21600 s despite the exergy losses of 0-0.739 kJs-¹.

Mathematical modelling and experimental investigation on sun and solar drying of white mulberry

E. Kavak Akpinar 대한기계학회 2008 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.22 No.8

The drying kinetics of white mulberry was investigated in a solar dryer with forced convection and under open sun with natural convection. The constant rate period is absent from the drying curve. The drying process took place in the falling rate period. The drying data were fitted to the different mathematical models. The performance of these models was investigated by comparing the determination of coefficient (R), reduced chi-square (χ2) and root mean square error (RMSE) between the observed and predicted moisture ratios. Among these models, the drying model developed by Logarithmic model showed good agreement with the data obtained from the experiments in the solar dryer with forced convection drying mode. The Verma et al. model has shown a better fit to the experimental mulberries data for open sun drying with natural convection mode than the other models. The effective moisture diffusivity values were estimated from Fick’s diffusional model. These values were 3.56x10-9 m2/s for solar drying and 2.40 x10-9 m2/s for open sun drying.

Evaluation of Internal Resistance in Asphalt Concretes

Zandi, Yousef,Akpinar, Muhammet Vefa Korea Concrete Institute 2012 International Journal of Concrete Structures and M Vol.6 No.4

Composites are somewhat more difficult to model than an isotropic material such as iron or steel due to the fact that each layer may have different orthotropic material properties. In finite element literature the asphalt mixes are represented by using rectangular meshes, not the actual picture of their cross-sections. Asphalt aggregate size and distribution in the asphalt concrete sample, aggregate shape, and fractured surface effects are ignored. In this research, the actual image of the sample including all these effects were directly considered in the finite element. The samples, were cut into cross-sections and were scanned. The image-processing toolbox of Labview was utilized in obtaining the rectangular gray images of the scanned images. In the rectangular sample the aggregates were white and the asphalt binders were black. The grayscale images were converted by LABVIEW into the format required by ANSYS as an input file, with the same dimensions. The nodes at the bottom of the model were constrained in both x and y directions. Left and right edges were symmetry and top was free. Certain amount of pressure was applied along the top surface to simulate the tire pressure.

A Neuro-Behçet's Case Operated with the Intracranial Mass Misdiagnosis

Tokgoz, Osman Serhat,Akpinar, Zehra,Guney, Figen,Seyithanoglu, Abdullah The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.5

Behçet's disease (BD) is an inflammatory systemic disorder with oral and genital ulcers, as well as ophthalmologic and cutaneous symptoms. Neurological manifestations in BD represent between 2.2% to 50% of the cases. The 25-year-old male patient, diagnosed with BD three years earlier, was admitted to our clinic with complaints of recurrent headaches. Tumor-like-parenchimal involvement was detected on a cranial magnetic resonance imaging. The lesion was removed surgically and then he suffered from right hemiparesis and epilepsy. Pathological examination of the lesion noted a demyelinating non-tumoural etiology. A neuro-Beh$\check{g}$et's case with parenchymal involvement has been examined in light of the literature, in terms of a tumor and a demyelinating disease differential diagnosis.

Numerical analysis of elasto-plastic adhesively single step lap joints with cohesive zone models and its experimental verification

Simay Bayramoglu,Salih Akpinar,Ahmet Çalık 대한기계학회 2021 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.35 No.2

Adhesive bonding method is used as an alternative to mechanical bonding methods, and it is frequently used in automotive, space and aviation industries. In the present study; the displacement and failure load capacity characteristics of single step lap joint was measured experimentally and compared with results of finite element (FE) analysis. In addition, the change in the length and the thickness of the material and adhesive in this joint type, stresses on the adhesive was examined by numerical analysis that have affected. Also, the effects of overlap length and material thickness on the stresses in adhesive were examined with numerical analysis for the single step lap joint. AA2024-T3 aluminum alloy adhered material and double component DP460 structural adhesive was used as adhesives in the single step lap joint. In the numerical analysis of this joint type, two different material models including multilinear isotropic hardening (MISO) and cohesive zone model (CZM) were used in the adhesive layer. During the experimental tests, two cameras were used to measure the displacements and crack propagations. As a result, the data obtained from the numerical analysis were compared to the experimental data of the single step lap joint type, the use of CZM in the adhesive region was found to be very important in terms of compliance. Thus, the difference between CZM and MISO results in terms of damage load in adhesive is 7 %, while this difference is 32 % in terms of displacement. Also, it has a great importance to get the displacement data via a video extensometer for the compatibility of FE and experimental analyses. Another result obtained from the study is that changing the material thickness, the adhesive thickness and the overlap length in the joint, changes the stress concentrations and shear stresses at the ends of the overlap area.

Preparation of Responsive Zwitterionic Diblock Copolymers Containing Phosphate and Phosphonate Groups

Yasemin Samav,Bernice Akpinar,Gökhan Kocak,Vural Bütün 한국고분자학회 2020 Macromolecular Research Vol.28 No.12

In this study, novel zwitterionic diblock copolymers, namely poly(2-(Nmorpholino) ethyl methacrylate))-block-poly(2-(methacryloyloxy)ethyl phosphate) (PMEMA-b-PMOEP) and poly(2-(N-morpholino)ethyl methacrylate))-block-poly ((methacryloyloxy)methyl phosphonic acid) (PMEMA-b-PMOMP), were synthesized via reversible addition-fragmentation chain transfer controlled radical polymerization. Solution properties of these phosphorus-based diblock copolymers were investigated using dynamic light scattering, transmission electron microscopy and proton nuclear magnetic resonance spectroscopy. Since the PMEMA block has both saltand thermo-responsive properties, PMEMA-b-PMOEP and PMEMA-b-PMOMP diblock copolymers formed core-shell micelles in basic aqueous media as the PMEMA block formed insoluble micelle core with the addition of Na2SO4 or an increase in temperature in basic solution. Additionally, PMEMA-b-PMOMP diblock copolymers interacted strongly with calcium cations and yielded reverse micellar structures via complexation of phosphate with metal cation in aqueous media.