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Amaç: Omuz ekleminden ve özellikle de eklem çevresindeki yumuşak dokulardan kökenalan problemler üst ekstremite ağrılarının en önemli nedenini oluşturur. Çalışmamızın amacıomuz ağrısı yakınması ile başvuran hastaların klinik özelliklerinin değerlendirilmesidir.Gereç ve yöntem: Omuz ağrısı yakınması ile başvuran 709 hastanın 744 omuzuretrospektif olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 55,16  10,88 yıl idi ve 395 hastada sağ, 279 hastadasol ve 35 hastada her iki omuz etkilenmişti. Vakaların %35,4’ünde travma öyküsü mevcuttu.Klinik ve radyolojik olarak yapılan değerlendirmelerde hastaların %45’inde subakromiyalsıkışma sendromu, %39,4’ünde rotator kaf rüptürü, %1,5’inde bisipital tendinit, %6,5’indeakromioklavikuler eklem dejenerasyonu, %2,2’sinde kalsifik tendinit, %5’inde donuk omuzve %0,4’ünde glenohumeral eklem artrozu saptandı. Subakromiyal sıkışma sendromu olanhastalar ile rotator kaf rüptürü olan hastaların karşılaştırılmasında rüptürü olan hastalarınyaş ortalamalarının daha yüksek ve “American Shoulder Elbow Score” (ASES) skorlarınındaha düşük olduğu ancak “Constant” skorları arasında herhangi bir fark olmadığı görüldü.Bu iki grup etiolojideki travma açısından değerlendirildiğinde rotator kaf rüptürü olan gruptatravma öyküsünün subakromiyal sıkışma sendromlu hastalara göre anlamlı olarak dahafazla olduğu ve travma öyküsünün rotator kafta rüptür riskini 2,9 kat arttırdığı görüldü. Sonuç: Omuz ağrısı nedenleri arasında rotator kaf sorunları çok önemli bir yer tutmaktadır.Travma ve yaş rotator kafta rüptür insidansını arttırmaktadır

Objective: Not only are regulatory T cells (Tregs) an essential component of the immune system in maintaining immunologic self-tolerance by suppressing expansion of immune cells but they are also involved in the suppression of anti-tumour immune responses. The transcription factor forkhead box P3 (FOXP3)[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Objective: Brown tumor is as a result of untreated primary or secondary hyperparathyroidism. A “brown tumor” is known as osteitis fibrosa cystica or von Recklinghausen disease, is not a true neoplasm. Patients with chronic renal failure (CRF) on long-term haemodialysis are at risk of secondary[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Ab initio DFT calculations were performed on GenSem nanoclusters (n=2, 3, 5, 6, 12; m=6-9, 14, 16, 30) that represent the local structure of GeSe2 glass and on some defect' GenSem clusters that are thought to be related to the inhomogeneity of the structure at the nanoscale. The optimal geometries, total energies and their derivatives as well as the electronic properties of GenSem nanoclusters were calculated using traditional DFT method. In addition, the TD-DFT method has been applied to calculate the electronic band gaps of the clusters. The calculated physico-chemical properties of GenSem nanoclusters and their couplings with the local-and medium-range order structure formations in GeSe2 glass are analysed and discussed.

Apiaceae (Umbellİferae) familyası Türkiye'deki sekizinci büyük familyadır ve 53'ü sadece bir tür taşıyan 101 cinse ait 451 türle temsil edilir. P. H. Davis' "Flora of Turkey and the East Aegean Islands, vol. 4 in 1972" adlı eserinden sonar Türkiye florasına 4 cins 53 tür ilave edilmiştir. 37'i tehlike altında 159 endemik türle familya'nın Türkiye'deki endemism oranı %33'tür. Oldukça local 4 monotipik endemik cins bulunur: Ekimia bornmuelleri, Microsciadium mimttum, Olymposciadium caespitosum ve Crenosciadium siifolium. Diğer endemic cinsler (Vo\QQ endemik): Rhabdosciadium (2 sp.), Muretia (1 sp.), Kundmannia (2 sp.), Froriepia (1 sp.), Stenotaenia (1 sp.).Ferula hahphila ve F. Orientalis Bern Sözleşmesi Ek I'de kayıtlı, habitatı mutlaka korunması gereken türlerdir.

We studied the contribution of the CD28-B7 costimulatory T cell activation pathway to the pathogenesis of experimental autoimmune encephalomyelitis in the Lewis rat model. Systemic administration of CTLA4Ig suppressed clinical disease and was effective even when CTLA4Ig was delayed until day 10 postimmunization, a time when pathologic disease is evident. This protection was not reversible by systemic administration of high doses of IL-2. Detailed immunohistologic studies showed that CTLA4Ig therapy resulted in suppression of the inflammatory response with inhibition of Th1 (IL-2 and IFN-gamma) and sparing of Th2 (IL-4, IL-10, and IL-13) cytokines in the central nervous system. These results indicate that the CD28-B7 T cell costimulatory pathway plays an important role in experimental autoimmune encephalomyelitis, a Th1-mediated disease, and suggest that blockade of this costimulatory pathway protects against active disease by causing a state of immune deviation towards Th2 function. The ability of CTLA4Ig to treat animals with pathologically established disease may have important clinical implications for patients with multiple sclerosis.

Objectives: Transcutaneous electrical nerve stimulation (TENS) is an analgesic current that is used in many acute and chronic painful states. The aim of this study was to investigate central pain modulation by low-frequency TENS. Methods: Twenty patients diagnosed with subacromial impingement syndrome of the shoulder were enrolled in the study. Patients were randomized into 2 groups: low-frequency TENS and sham TENS. Painful stimuli were delivered during which functional magnetic resonance imaging scans were performed, both before and after treatment. Ten central regions of interest that were reported to have a role in pain perception were chosen and analyzed bilaterally on functional magnetic resonance images. Perceived pain intensity during painful stimuli was evaluated using visual analog scale (VAS). Results: In the low-frequency TENS group, there was a statistically significant decrease in the perceived pain intensity and pain-specific activation of the contralateral primary sensory cortex, bilateral caudal anterior cingulate cortex, and of the ipsilateral supplementary motor area. There was a statistically significant correlation between the change of VAS value and the change of activity in the contralateral thalamus, prefrontal cortex, and the ipsilateral posterior parietal cortex. In the sham TENS group, there was no significant change in VAS value and activity of regions of interest. Discussion: We suggest that a 1-session low-frequency TENS may induce analgesic effect through modulation of discriminative, affective, and motor aspects of central pain perception.

In literature cervical disc extrusions are considered by most neurosurgeons a definitive indication for surgery. This approach may stem from a fear of disc fragment migration with neurological deterioration. We report a rare case of cervical disc sequestration with a seldom prognosis which resolved spontaneously in a two-month follow-up on magnetic resonance imaging (MRI), emphasizing the efficacy and applicability of conservative treatment in cervical disc herniations. Even with the basic conservative treatment methods we observed the prominent decrease in symptoms and spontaneous total resorption of the sequestered fragment. Conservative treatment in sequestered cervical discs with no neurological deficit can be an alternative therapeutic approach with the guidence of MRI.

In literature cervical disc extrusions are considered by most neurosurgeons a definitive indication for surgery. This approach may stem from a fear of disc fragment migration with neurological deterioration. We report a rare case of cervical disc sequestration with a seldom prognosis which resolved spontaneously in a two-month follow-up on magnetic resonance imaging (MRI), emphasizing the efficacy and applicability of conservative treatment in cervical disc herniations. Even with the basic conservative treatment methods we observed the prominent decrease in symptoms and spontaneous total resorption of the sequestered fragment. Conservative treatment in sequestered cervical discs with no neurological deficit can be an alternative therapeutic approach with the guidence of MRI.

Microscope work is straining both the visual and the musculoskeletal systems. Many ergonomic risk factors are presented in the microscope work for musculoskeletal system complaints. Awkward and static posture, high repetition, contact stresses and working for a prolonged time are the risk factors. A survey investigating musculoskeletal pain and ergonomic arrangement was developed and sent to pathologists who work in various hospitals in İzmir and the cities nearby to investigate the frequency of musculoskeletal problems and its relationship with some ergonomic factors and duration of work in pathologists. Neck, upper back and finger pain was significantly higher in subjects who worked more than 4 hours a day when compared with subjects who work less than 4 hours. The effects of microscope work on the occurrence of musculoskeletal disorders should be taken seriously in pathologists.

In this paper, we define B-smooth discontinuous dynamical systems which can be used as models of various processes in mechanics, electronics, biology and medicine. We find sufficient conditions to guarantee the existence of such systems. These conditions are easy to verify. Appropriate examples are constructed., Comment: This paper has been withdrawn by the second author, since precised results of the paper are published in the book: Principles of discontinuous dynamical systems, Springer, 2010

In order to compare the prevalence of antibiotic resistance in different geographical areas, it is necessary to ensure agreement between laboratories on the assignment of strains to ‘susceptible’ and ‘resistant’ categories. An international quality assessment was performed to investigate the performance of susceptibility testing of Klebsiella spp. Ninety-five strains of klebsiellae were selected from clinical isolates at the London Hospital Medical College (LHMC). These included strains with a diversity of susceptibility profiles to amoxycillin/clavulanate, piperacillin, ceftazidime, cefuroxime, ciprofloxacin, gentamicin and trimethoprim. The strains were sent to 13 participating laboratories in Europe and the USA and laboratories were asked to test the susceptibility of these strains to these antibiotics by their usual methods. They were also asked to provide details of the method used to test susceptibility. Several different standard recommended testing methods were used. Reporting of susceptibilities was generally accurate, but a number of anomalies were noted. Discrepancies of reporting between the LHMC and the participating laboratories was more marked for resistant strains, particularly in the detection of resistance to cefuroxime and ciprofloxacin, as well as the assignment of susceptibility and resistance to piperacillin and amoxycillin/clavulanate. Some discrepancies could be attributed to the use of different breakpoints, leading to differing assignment of susceptibility. Methodological variations including disc content, inoculum and failure to measure and interpret zone sizes consistently also led to anomalies. This quality assessment programme has helped to identify problems in susceptibility testing which should be investigated further.

In order to compare the prevalence of antibiotic resistance in different geographical areas, it is necessary to ensure that agreement is achieved between laboratories on the assignment of strains to 'susceptible' and 'resistant' categories. An international quality assessment study, involving 15 laboratories in eight countries, was performed to investigate the standard of performance of the susceptibility testing of Haemophilus influenzae. One hundred and fifty strains of H. influenzae were distributed from the London Hospital Medical College (LHMC) to all laboratories who were asked to test the susceptibility of the strains to ampicillin, chloramphenicol, tetracycline, trimethoprim, cephalosporins and ciprofloxacin. Laboratories were also asked to provide the details of methodology to test the susceptibility. Significant discrepancy between the LHMC and the participating laboratories appeared in the detection of resistance to ampicillin (especially β-lactamase-negative strains resistant to ampicillin) as well as the assignment of susceptibility and resistance to chloramphenicol, tetracycline and trimethoprim. Often these reflected the use of inappropriate breakpoints which led to erroneous assignment of susceptibility. Other variations including disc content, medium and supplement, inoculum as well as failure to measure zone sizes properly also led to some repeating anomalies.

Susceptibility to infection is widely recognized as the major cause of morbidity and mortality in patients with CLL and MM. The present study was designed to investigate the serum bactericidal (SBA) and serum opsonic activities (SOA) in 12 CLL and 12 MM patients, and results were compared to 20 normals. SBA and SOA were measured by a new radiometric assay. SBA was found to be normal in 11 patients with CLL and in all 12 patients with MM. In contrast, SOA was significantly lower in 11 out of 12 patients with CLL. Ten of twelve patients with MM also had significantly lower SOA compared to those of controls. No correlation was detected between the serum immunoglobulin and complement levels of the patients or between the degree of the opsonic defect and the incidence of infection. In mixture experiments, untreated normal serum partially corrected the opsonic activity of CLL and MM serum. The results suggest the presence of a possible inhibitor in the serum of patients with two well-known B-lymphocyte-derived disorders.

The aim of this study is to evaluate the relationship between traumatic unilateral shoulder instability with Bankart lesion and generalized joint hypermobility. Twenty eight patients and 28 control subjects were included in the study. All of the patients had had their first episode of dislocation during a single definite trauma and had traumatic Bankart lesion which was detected with magnetic resonance imaging. All patients and control subjects were evaluated using Beighton scoring system for generalized joint hypermobility. The mean age of the shoulder instability group and the control group was 26.10 ± 7.60 and 26.64 ± 7.47 years, respectively. Beighton score was found as 3.21 ± 2.11 in the patient group and 2.39 ± 2.06 in the control group. Thirteen cases (46.4%) in the instability group and nine cases (32.1%) in the control group were found to be hypermobile. This difference was not statistically significant. Two patients were reoperated because of recurrence. Both of them had generalized joint hypermobility. Hypermobility may be a predisposing factor to acute traumatic anterior instability and this hypothesis can be investigated in larger series.

After kidney transplant recipients who received Prograf were switched to generic tacrolimus, most differences in the safety and effectiveness of the medications were not considered clinically relevant.

Background A rapid and reliable diagnostic test is needed to reduce mortality through early diagnosis of invasive aspergillosis (IA) in patients with hematological malignancies. Objective To evaluate the efficacy of serum and bronchoalveolar lavage (BAL) Aspergillus galactomannan lateral flow assay (GM-LFA) in IA diagnosis and determine the correlation of GM-LFA with GM enzyme immunoassay (GM-EIA) in patients with hematological malignancies. Methods In this prospective multicenter study, we used serum and BAL fluid samples from patients with hematological malignancies and suspected IA and performed GM-LFA and GM-EIA. According to the EORTC/MSGERC criteria, patients were grouped as proven (n = 6), probable (n = 22), possible IA (n = 55), or no IA (n = 88). The performance of serum GM-LFA at 0.5 optical density index (ODI) and area under the curve (AUC) were calculated. Spearman’s correlation analysis and kappa statistics were performed to determine the agreement between the tests. Results GM-LFA showed an AUC of 0.832 in proven/probable IA (sensitivity [SEN], specificity [SPE], negative predictive value [NPV], and diagnostic accuracy were 75%, 100%, 92.6%, and 93.9%, respectively, at a 0.5 ODI) versus that in no IA. A moderate positive correlation was noted between the GM-LFA and GM-EIA scores (p = 0.01). The observed agreement between the tests at 0.5 ODI was almost perfect (p \0.001). After excluding patients who received mold-active antifungal prophylaxis or treatment, the SEN, SPE, NPV, and diagnostic accuracy for proven/probable IA were 76.2%, 100%, 93.3%, and 94.5%, respectively. Conclusions Serum GM-LFA demonstrated high discriminatory power and good diagnostic performance for IA in patients with hematological malignancies.

Background and objectives: In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small.Design, setting, participants, & measurements: We performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 “The Post-Transplant Glomerular Disease” study centers in Europe, North America, and South America.Results: Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donorspecific antibodies (hazardratio, 2.59; 95%confidence interval, 1.09 to 6.19).Afterkidneytransplantation,development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence.Conclusions: In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.

Background and objectives FSGS recurrence after kidney transplantation is a major risk factor for graft loss. However, the natural history, clinical predictors, and response to treatment remain unclear because of small sample sizes and poor generalizability of single-center studies, and disease misclassification in registry-based studies. We therefore aimed to determine the incidence, predictors, and treatment response of recurrent FSGS in a large cohort of kidney transplant recipients. Design, setting, participants, & measurements The Post-Transplant Glomerular Disease (TANGO) project is an observational, multicenter, international cohort study that aims to investigate glomerular disease recurrence post-transplantation. Transplant recipients were screened for the diagnosis of idiopathic FSGS between 2005 and 2015 and details were recorded about the transplant, clinical outcomes, treatments, and other risk factors. Results Among 11,742 kidney transplant recipients screened for FSGS, 176 had a diagnosis of idiopathic FSGS and were included. FSGS recurred in 57 patients (32%; 95% confidence interval [95% CI], 25% to 39%) and 39% of them lost their graft over a median of 5 (interquartile range, 3.0–8.1) years. Multivariable Cox regression revealed a higher risk for recurrence with older age at native kidney disease onset (hazard ratio [HR], 1.37 per decade; 95% CI, 1.09 to 1.56). Other predictors were white race (HR, 2.14; 95% CI, 1.08 to 4.22), body mass index at transplant (HR, 0.89 per kg/m2; 95% CI, 0.83 to 0.95), and native kidney nephrectomies (HR, 2.76; 95% CI, 1.16 to 6.57). Plasmapheresis and rituximab were the most frequent treatments (81%). Partial or complete remission occurred in 57% of patients and was associated with better graft survival. Conclusions Idiopathic FSGS recurs post-transplant in one third of cases and is associated with a five-fold higher risk of graft loss. Response to treatment is associated with significantly better outcomes but is achieved in only half of the cases.

We study structural properties and surface formation of undoped, n- and p-type doped GaAsBi alloys with various bismuth compositions using Micro-Raman, Fourier Transform (FT) Raman, Photoluminescence (PL) and Atomic Force Microscopy (AFM) techniques. PL is used to determine the suitable excitation source for Raman measurements and evaluate the Raman spectroscopy results. Room temperature PL results reveal that the bandgap energy of GaAsBi decreases with increasing bismuth composition at a rate of 82meV/%Bi. In micro-Raman spectra recorded using 532 nm laser line, a peak at around 185 cm(-1) and a broad peak located between 210 and 250 cm(-1) are observed. The absence of these peaks in the Raman spectrum of low temperature (LT) growth GaAs indicates that those peaks are bismuth-induced vibrations. Besides, the forbidden transverse optical (TO) mode (269 cm(-1)) becomes more pronounced for the samples as bismuth composition increases. FT-Raman spectra taken by 1064 nm laser line of the n- and p-type samples exhibit different characteristics; while TO and longitudinal optical (LO) peaks (291 cm(-1)) are present in n-type sample as sharp vibrational peaks, a broad peak located at slightly lower wavenumber than TO mode appears and LO peak is suppressed. The ionised acceptor and free hole system respond incident electromagnetic field as plasma oscillations. Moreover, the amplitude of the plasma oscillations enhances with higher doping density. Therefore, the appearance of the broad peak in FT-Raman spectrum of p-type GaAsBi is explained with an LO-plasmon coupling (LOPC). As for n-type samples, free electrons are compensated by free holes in GaAsBi that originate from Bi-induced acceptor-like defects. Therefore, we do not observe the effects of plasma oscillations in FT-Raman spectrum. AFM results reveal that all samples have surface droplets, and the size of the droplets is not affected from doping density or doping type, but bismuth composition. The surface droplets are removed by a chemical process to investigate the effect of the droplets on Raman spectrum. Our results reveal that removing surface droplets does not change the characteristic of Raman spectrum, but enhances the Raman intensity due to the reflected light by droplets decreases, leading to more photons penetrate and scattered from inside the sample. (C) 2017 Elsevier B.V. All rights reserved.