Search

Aim: The aim of this study was to evaluate the prognostic value of the preoperative systemic inflammatory markers in patients with serous-type ovarian cancer and to reveal their relationship with survival.Materials and Methods: Data from 86 serous type ovarian cancer patients were evaluated retrospectively. Neutrophil-lymphocyte (NLR), lymphocyte-monocyte (LMR) and platelet-lymphocyte (PLR) ratios were used as preoperative inflammatory markers. The patients were grouped as high or low risk according to NLR, LMR and PLR values. Median values were used as cut-off values for categorizing groups. The effects of NLR, LMR and PLR values on disease-free survival (DFS) and overall survival (OS) with clinical, surgical and pathological variables were investigated.Results: The median age of the patients was 58.03 years (range; 25-80). The stage of the disease was found as 12 patients stage I-II and 74 patients stage III-IV. The median follow-up was 29.45 months (range; 1-63), during this period 21 (24.4%) patients developed recurrence and 15 (17.4%) patients died due to the disease. The mean DFS time was 46.32 ± 3.00 months and OS time was 51.30 ± 2.43 months in the whole study group. For DFS; omentum metastasis, splenic metastasis, diaphragmatic metastasis, colon metastasis, surgical outcome and adjuvant treatment success and for OS; omentum metastasis, whether the patient received adjuvant therapy and adjuvant treatment success were found to be significant (p0.05).Conclusion: It was found that preoperative inflammatory markers could not predict disease-free survival and overall survival in serous type ovarian cancer., Amaç: Seröz tip over kanserinde preoperatif sistemik inflamatuar belirteçlerin prognozu predikte etmedeki etkinliğini değerlendirmek ve sağ kalım ile ilişkilerini tanımlamak amaçlandı.Gereç ve Yöntemler: Çalışma grubu seröz tip over kanseri nedeniyle tedavisi yapılan 86 hastadan oluşturuldu. Hastalara ait veriler retrospektif olarak tarandı. Preoperatif inflamatuar belirteçler olarak nötrofil/lenfosit oranı (NLO), lenfosit/monosit oranı (LMO) ve trombosit/lenfosit oranları (TLO) kullanıldı. Hastalar NLO, LMO ve TLO değerlerine göre yüksek veya düşük riskli olarak gruplandırıldı. Grupları kategorize etmede sınır değer olarak ortanca değerler kullanıldı. Klinik, cerrahi ve patolojik değişkenlerle birlikte NLO, LMO, TLO değerlerinin hastalıksız sağ kalım (HSK) ve genel sağ kalım (GSK) üzerindeki etkisi incelendi.Bulgular: Hastaların ortanca yaşları 58.03 (aralık; 25-80) yıldı. Evre 12 hastada evre I-II ve 74 hastada evre III-IV’tü. Ortanca takip süresi 29.45 aydı (aralık; 1-63) ve bu süre içerisinde 21 (%24,4) hastada rekürrens geliştiği ve 15 (%17,4) hastanın hastalıktan dolayı öldüğü tespit edildi. Tüm çalışma grubunda ortalama HSK süresi 46.32±3,00 ay ve GSK süresi 51.30±2.43 aydı. HSK için; omentum metastazı, dalak metastazı, diyafragma metastazı, kolon metastazı, cerrahi sonuç ve adjuvant tedavi başarısı, GSK için; omentum metastazı, hastanın adjuvant tedavi alıp almaması ve adjuvan tedavi başarısı anlamlıydı (p0.05).Sonuç: Seröz tip over kanserinde, preoperatif inflamatuar belirteçlerin hastalıksız sağ kalımı ve genel sağ kalımı öngörmede yönlendirici olmadığı tespit edilmiştir.

The accelerating case numbers of COVID-19 in Asia, Europe and America obliged us to take strict precautions in order to restraincommunity transmission in hospitals where diagnosis, treatment and management are actively performed. Turkish Ministry of Healthissued a circular on time to stop all elective procedures, but emergency and oncologic cases. During COVID-19 pandemic, we,as surgeons take the responsibility to assist caring infected patients, in addition to perform emergency surgery and operate ononcologic cases for whom deferring surgery has a negative impact on prognosis. Surgical interventions are the basic communityhealth services categorized as elective and emergent. Operating theaters are the places with high risk of transmission of respiratoryinfections due to emergencies, high volume of personnel, and airway procedures to be done. Our institutes and systems are verywell prepared to usual high-risk transmission status. However, in extraordinary circumstances like pandemics, high prevalenceof disease and limited resources led to great pressure over surgical and operative team which has the potential to increase thesystem load and tendency to make mistakes. Accordingly, our primary mission is to act immediately to protect our team and patientsvia preserving and appropriately utilizing valuable resources in order to maintain surgical functioning in terms of emergency. Thepriority should be to design our surgical approach dynamically in regard to the COVID-19 status and resources of the facility we areworking in. We, Zonguldak Bülent Ecevit University The School of Medicine Department of General Surgery aimed to redesign oursurgical algorithms during Covid-19 pandemic according to Turkish Ministry of Health circular and experiences of our colleagues andrecommendations of the international surgical societies guidelines. To share our experiences, practices and recommendations is outmost important in these days during which we do not have enough time to wait for the data with high level of evidence. Surgeonsshould pay great attention on their facility’s COVID-19 status and resources before surgical decision making to establish best clinicalpractice and save patients’ lives during these unprecedented period of time., COVID-19, Asya, Avrupa ve Amerika kıtasında yüksek ivme ile yayılırken, özellikle hastanelerhastalığın tedavisi ve yayılımı konusunda en aktif noktalar olup topluma transmisyonun artmamasıadına katı tedbirlerin alınması gerekliliği ortaya çıktı. Türkiye’de Sağlık Bakanlığı genelgesi ileacil ve ertelenemeyecek onkolojik vakalar dışında tüm elektif cerrahi müdahalalerin durdurulmasısağlandı. Bu pandemi sürecinde cerrahlar olarak enfekte hastaları iyileştirmeye yardım etmeninyanısıra cerrahiyi ertelemenin prognozu etkileyecek hastalar ile acil cerrahi uyguladığımız hastalarımızınsorumluluğunu almakla yükümlüyüz. Cerrahi girişimler elektif ve acil girişimler şeklindetüm sağlık sistemleri içinde yer alan temel toplum sağlığı hizmetleridir. Ancak, ameliyathaneleracil durumlar, çok sayıda ekip elemanının görev alması ve havayolu müdahalesi gibi yüksektransmisyon riskine sahip aktiviteler sebebi ile solunum yolu enfeksiyonlarının yayılımı açısındanyüksek risk bölgeleridir. Hastanelerimiz ve sistemlerimiz olağan, yüksek riskli transmisyon durumlarıiçin oldukça iyi şekilde organize edilmiş olmasına karşın, pandemi durumları gibi hastalıkprevelansının yüksek, kaynak kısıtlılıklarının olası, ekip üzerindeki baskı ve basıncın fazla olduğudurumlar transmisyon riskini yükselterek sistemin zaten ağır olan yükünü artırma potansiyeli taşımaktadır.Bu nedenle görevimiz hemen harekete geçerek değerli kaynaklar ile hasta ve ekibimizikoruyarak sistemimizin elzem cerrahi girişimlere destek verebilmesini sağlamaktır. Tüm zorluklararağmen dünya genelinde meslektaşlarımızın tecrübelerinden de faydalanarak pandemi süresincekurumumuzun COVID-19 statüsü ve kaynaklarını rasyonel ve dinamik şekilde dikkate alıp cerrahiyaklaşımımızı planlamak önceliğimiz olmalıdır. Zonguldak Bülent Ecevit Üniversitesi Tıp FakültesiGenel Cerrahi Anabilim Dalı olarak pandemi süresince uygulayacağımız cerrahi yönetim planımızıSağlık Bakanlığımız genelgesi doğrultusunda Amerika Birleşik Devletleri, Avrupa ve Asya’dapandeminin hızla yayıldığı ülkelerin cerrahi dernek önerilerini dikkate alarak dizayn etmeyi amaçladık.Hekimler olarak deneyim, uygulama ve önerilerimizi paylaşmamız yüksek kanıt düzeyinesahip verileri bekleme şansımızın olmadığı bu süreçte, hastanemizin COVID-19 durumunu vekaynak miktarını göz önünde bulundurarak hastalarımıza yarar sağlayacak en iyi uygulamalarınkullanıma girmesi ve hayatların kurtarılması adına büyük önem taşımaktadır

Multiple system atrophy (MSA) is an adult-onset, sporadic, idiopathic, a rarely seen neurodegenerative disease. MSA is clinically characterized by a variable combination of autonomic dysfunction, parkinsonism, cerebellar ataxia and pyramidal symptoms. One of the symptoms of autonomic dysfunction is orthostatic hypotension. Orthostatic hypotension can worsen due to sepsis and severe hypotension requiring intravenous vasopressor therapy can develop. If these patients are dependent on vasopressors, long-term treatment options must be considered. One of the treatment options is pyridostigmine. Pyridostigmine is a cholinesterase inhibitor recently started to be used in the treatment of orthostatic hypotension. In this case report, we presented a patient admitted to our intensive care unit with the diagnosis of urosepsis in whom vasopressor dependent hypotension due to MSA developed. Although the findings of sepsis were retreat in the follow-up, the need for vasopressor continued. Pyridostigmine was used to correct hypotension associated with autonomic dysfunction in this patient resistant to weaning from vasopressors. Increasing of the pyridostigmine dose to 180 mg/day resulted in stabilization of the mean arterial pressure and the vasopressor therapy was gradually reduced and discontinued.

Computed tomography (CT) may show toxic effects of methanol on central nervous system in acute methanol intoxication, which may be helpful in diagnosing and predicting prognosis. In this article we discussed two cases of acute methanol intoxication with neuroimaging findings.

Giriş: Tiroid göz hastalığı (TED), Graves hastalarının% 25-50’sini etkileyen en yaygın orbital hastalıktır. Bu hastalarda retro-orbital inflamatuar süreçler kornea biyomekanik özelliklerini düzenleyebilir. In-vivo kornea biyomekanik parametreleri, Oküler Tepki Analizörü (ORA) kullanılarak değerlendirilebilir. TED’in şiddeti bir NOSPECS derecelendirme sistemi ile tanımlanabilir. Bu çalışmada, korneal biyomekanik parametreler TED’li hastalar ile sağlıklı grup arasında karşılaştırıldı. Hastaların NOSPECS sınıflandırması, biyomekanik değişiklikler ve hastalık şiddeti arasındaki ilişkiyi tanımlamak için de kullanılır. Materyal ve Metodlar: Bu çalışmaya, beş yıldan uzun bir süredir tiroid hastalığı tanısı konan, tiroid göz hastalığı olan 22 hasta ve 47 sağlıklı katılımcı dahil edildi. Tüm olgulara tam endokrinolojik ve oftalmolojik muayene yapıldı. NOSPECS sınıflandırması hafif (derece 1-3) ve ağır (derece 3-6) hastalık olarak değerlendirildi ve gruplandı. Her grup için kornea histerezisi (CH), kornea direnç faktörü (CRF), merkezi kornea kalınlığı (CCT), Goldmann ile ilişkili göz içi basıncı (IOPg) ve korneal kompanse göz içi basıncı (IOPcc) parametreleri, Oküler Tepki Analizcisi ile ölçüldü. Sonuçlar: TED hastalarında yaş ortalaması 38,8 ± 11,6, kontrol grubu için 44,6 ± 16,0 idi. Ortalama CRF, CH ve KKT değerleri, TED hastaları ve sağlıklı katılımcılar için sırasıyla aşağıdaki şekilde ölçüldü: 10.43 +/- 2.04 vs 10.16 +/- 1.90 mmHg, 10.18 +/- 1.81 vs 10.07 +/- 1.71 mmHg ve 550.31+ /-35.73 vs 543 +/- 38.39 mikrom. Bu değerler gruplar arasında anlamlı değildi, ancak TED hastalarında erkeklere göre kadınlarda anlamlı olarak daha yüksekti (p, Introduction: Thyroid eye disease (TED) is the most common orbital disease that affects %25-50 of Graves’ patients. In these patients, retro-orbital inflammatory processes can alter corneal biomechanical characteristics. In-vivo corneal biomechanical parameters can be evaluated by using Ocular Response Analyzer (ORA). The severity of TED can be identified with a NOSPECS grading system. In this study, corneal biomechanical parameters are compared between patients with TED and healthy group. The NOSPECS classification of patients is also used to identify relation between biomechanical changes and disease severity. Materials and Methods: In this study, 22 patients with thyroid eye disease, diagnosed with thyroid disease for more than five years, and 47 healthy participants were included. All subjects underwent complete endocrinologic and ophthalmologic examination. The NOSPECS classification was assessed and grouped as mild (grade 1-3) and severe (grade 3-6) disease. For each group, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), Goldmann-correlated intraocular pressure (IOPg) and corneal compensated intraocular pressure (IOPcc) parameters were measured by Ocular Response Analyzer. Results: The mean age was 38.8+/-11.6 years for the TED patients and 44.6+/-16.0 years for the control group. The mean values of CRF, CH and CCT were measured for the TED patients and healthy participants as following: 10.43+/-2.04 vs 10.16+/-1.90 mmHg, 10.18+/-1.81 vs 10.07+/-1.71 mmHg, and 550.31+/-35.73 vs 543+/-38.39 microm, respectively. These values were not significant between groups, but they were significantly higher in females compared to males in TED patients (p

Karaciğer transplantasyonu, farklı tedavi yöntemleri ile tedavisi olmayan, karaciğer yetmezliğindeki hastalara önerilen tek tedavi yöntemi olarak tanımlanmaktadır. Bu çalışma karaciğer nakli bekleme listesindeki hastaların nakilden beklentilerinin ve yaşadıkları güçlüklerin belirlenmesi amacı ile gerçekleştirilmiştir. Bir üniversitesi hastanesinin organ nakil merkezinin bekleme listesinde yer alan 37 hastanın tamamı çalışmanın örneklemini oluşturmuştur. Çalışmada nicel yöntem kullanılmış, araştırmacı tarafından 37 hasta üzerinden veriler toplanmıştır. Nicel verilerin analizinde sayı, yüzde, Ki Kare test ya da Fisher test istatistiği kullanıldı. Ölçek toplam puan karşılaştırılmasında ise Student t-testi ve ANOVA analizleri kullanılmıştır. Karaciğer nakli bekleme listesindeki hastaların nicel araştırmadan elde edilen sonuçlara göre hastaların cinsiyet, medeni durum, gelir durumları, hastalık tanısı zamanı ve nakil bekleme zamanı değişkenleriyle karaciğer nakli sırasında yaşadıkları sorun ve güçlükler üzerinde istatistiksel açıdan anlamlı farklılıklar olduğu tespit edilmiştir (p

Objective: Emotional and physical burden is heavy in the intensive care unit (ICU) employees, and the risk of burnout has significantly increased. The purpose of this study is to determine the frequency of burnout and depression in nurses serving in tertiary ICUs in a university hospital by questionnaire.

Mikro takimlarin uc nokta Frekans Tepki Fonksiyonlari (FTF) darbe testi ve modal (bicim) analizi vasitasi ile belirlenememektedir. Ayrica, mikro islemler yuksek hizlarda gerceklestirilmekte ve jiroskopik momentler ve merkezkac kuvvetleri nedeniyle takim uc nokta FTF’sinde degisimler meydana gelmektedir. Bu calismada, mikro takimlar kesici uc geometrisini ve operasyon etkilerini icerecek sekilde analitik olarak modellenmistir. Ayrica, is mili geometrisinin bilinmedigi durumlar icin deneysel olarak elde edilen duragan is mili dinamigi ve analitik olarak hesaplanan donen takim ve tutucu dinamiginin birlestirilmesini mumkun kilan yeni bir yontem gelistirilmistir.

National Conference on Electrical, Electronics and Biomedical Engineering (ELECO) (2016 : Bursa, Turkey), Nowadays, unmanned aerial vehicles became an important research area. Search and rescue, transportation, fire monitoring, commercial and journalism, military and defence, crop spraying and scientific research are some of the areas which UAVs can be used [1,2]. Because of their agile manoeuvrability, quadcopters are often used for controller designs. In this paper a sliding mode controller is developed for altitude and attitude control, and the obtained simulation results are discussed. After the design is made, coefficients are tuned by iteration method. Also a drawback called chattering effect is explained and reducted to achieve better control. The rest of the paper provides more detailed information about abovementioned topics.

Obsessions are repetitive thoughts, phantasies and opinion which cannot be removed from people's mind. In the literature various types of obsessions and compulsions were defined. The main function of the compulsions is to reduce disturbing thoughts and instincts. Sexual dysfunctions are common in obsessive compulsive disorder. Patients can effort to avoid disturbing thoughts and situations. Inhibated ejaculation is prevention of ejaculation with drowning hands of the penis. Thus, retrograde ejaculation occurs. Due to obstacles to the urethra, ejaculate fills into the bladder. Despite a feeling of orgasm, liquid is not output from the penis. In this article, a case with obsessive compulsive disorder, who blocked ejakulation in order to avoid feel guilty and sinfulness. Keywords: Obsessive compulsive disorder, compulsive avoidance, blocked ejaculation, retrograd ejaculation putation, extremity reconstruction

Amaç: Bu çalışmada nazion sınır olarak kullanılarak koronal sütür lokalizasyonu tespit edilmeye çalışılmıştır. Nazion-koronal sütür arası mesafe bildiğimiz kadarı ile Türk toplumunda ilk defa bu çalışma ile literatüre sunulmaktadır. Yöntemler: Bu çalışmada 30 kranium ve 30 frontal kemik kullanılmıştır. Her bir kafatasında mezuro yardımı ile nazal sütürden koronal sütüre olan mesafe ölçülmüştür. Sonuçlar: Nazal sütür-koronal sütür arası mesafe 12,2 cm (minimum 10,3-maksimum 13,5 cm) olarak tespit edildi. Tartışma: Nazion cilt üzerinden kolayca palpe edilebilen bir işaret noktasıdır. Naziondan 12 cm posteriorda orta hattan 3 cm lateralde yapılacak küçük bir cilt insizyonu ile drenaj noktası kolayca tespit edilebilir. Bu bilgi beyin cerrahları için her zaman kullanabilecekleri pratik bir bilgi olarak literatüre sunulmaktadır., Objective: In this study we aimed to determine a landmark that can be measured through the skin with nasal mid-point (bregma) to coronal suture, and additionally an average value was calculated. We report, to our knowledge, the distance between the nasion-coronal sutures is reported for the first time in Turkish population. Methods: The study included 30 craniums and 30 frontal bones. Each skull from midline nasal suture to coronal suture curved up at the distance was measured with tape measure. Results: Mean values were determined. Nasal suture between coronal suture distance average 12,2 cm (min10,3 cm, up to 13,5 cm) were detected. Conclusion: Nasal suture is an easily palpable area through the skin. A small incision is carried down through skin to bone at the spot 12 cm back from the nasion 3 cm lateral to the midline for ventricular drainage operation. This data provide practical information for neurosurgeon and is available everywhere. J Clin Exp Invest 2014; 5 (3): 368-370

Objective: In the femoral "3-in-1 block", obturator nerve block is routinely unsuccessful. Anatomical studies are not available to explain why blockade of obturator nerve or lumbar plexus does not occur. The aim of this study was to examine the effectiveness of femoral "3-in-1 block" obturator nerve block on a cadaver model. Materials and methods: Totally, 12 mature adult human cadavers were selected. Methylene blue dye (30 ml) was in-jected under the fascia iliaca in eight cadavers and into the femoral nerve sheath in four cadavers. Careful bilateral dissections were performed following dye injections. Results: It was seen that the dye did not spread to the medial part of the psoas major muscle and the obturator nerve was not stained with the dye in eight cadavers in whom dye was injected laterally into the femoral sheat. In four ca-davers in whom dye was injected into the femoral nerve sheat, metylene blue spread through fascial layers in the plane under the psoas muscle and stained the obturator nerve just before emerging medially from the fascia psoas. At this point, the obturator nerve pierced the psoas fascia and extended extrafascially in the medial and deep borders of the psoas muscle. In this area, the upper section of the obturator nerve was found also to be stained with the dye. Conclusion: We concluded that the cause of an unsuccessful obturator nerve block might be the fascial anatomy of this region. The lateral cutaneous femoral nerve and the femoral nerve easily can be blocked in the fascia iliaca com-partment, but the obturator nerve block fails because of its being extrafascial in this region., Amaç: Femoral "3-1 blok" uygulamalarında obturator sinir bloğu genellikle başarısız olmaktadır. Obturator sinir veya lomber pleksus bloğunun niçin oluşmadığını açıklayıcı yeterli sayıda anatomi çalışması bulunmamaktadır. Bu çalışma-nın amacı, femoral 3-1 obturator sinir bloku etkinliğini bir kadavra modeli üzerinde incelemektir. Gereç ve yöntem: Toplam 12 erişkin insan kadavrası seçildi. Sekiz kadavraya 30 ml metilen mavisi iliak fasiya altına ve dört kadavraya da femoral sinir kılıfı içerisine enjekte edildi. Daha sonra dikkatli bilateral disseksiyon yapıldı. Bulgular: Femoral kılıfın lateraline metilen mavisi enjekte edilen sekiz kadavrada metilen mavisinin psoas major kasın medialine yayılmadığı ve obturator sinire ulaşmadığı görüldü. Femoral sinir kılıfı içine metilen mavisi enjekte edilen dört kadavrada ise metilen mavisinin psoas kasının altından fasialar arasında yayıldığı ve obturator siniri boyadığı görüldü. Bu noktada obturator sinir psoas fasiyasını delerek ekstrafasiyal olarak psoas kasının orta ve derin kenarında ilerlemek-tedir. Bu alanda obturator sinirin üst bölümü de boyandı. Sonuç: Sonuç olarak başarısız obturator sinir bloğunun buradaki fasiya anatomisine bağlı olarak gelişiyor olabilir. Fe-moral ve lateral femoral kutanöz sinir subfasiyaldir ve bu iki sinir fasiya iliaka alanında kolaylıkla bloke olmaktadır, an-cak obturator sinir bu bölgede ekstrafasiyal alanda bulunduğu için bloke olmamaktadır.

Huzursuz bacak sendromu, nörolojik bir hareket bozukluğudur. Ek psikiyatrik belirtiler, hastalığın sonucu olarak ortaya çıkabilir. Ayrıca başka patolojilere veya ilaçlara bağlı olarak da meydana gelebilir. Pramipeksol, huzursuz bacak sendromu tedavisinde kullanılan bir dopamin agonistidir ve mezokortikolimbik dopaminerjik uyarıma bağlı psikotik ve hipomanik belirtilerin ortaya çıkmasına sebep olabilir. Bu yazıda, literatürde seyrek bahsedilen bir pramipeksole bağlı hipomani hastası sunularak tartışılmıştır.

Obsessions are repetitive thoughts, phantasies and opinion which cannot be removed from people's mind. In the literature various types of obsessions and compulsions were defined. The main function of the compulsions is to reduce disturbing thoughts and instincts. Sexual dysfunctions are common in obsessive compulsive disorder. Patients can effort to avoid disturbing thoughts and situations. Inhibated ejaculation is prevention of ejaculation with drowning hands of the penis. Thus, retrograde ejaculation occurs. Due to obstacles to the urethra, ejaculate fills into the bladder. Despite a feeling of orgasm, liquid is not output from the penis. In this article, a case with obsessive compulsive disorder, who blocked ejakulation in order to avoid feel guilty and sinfulness

Yüz tanıma, sosyal ilişki ve benlik gelişimi arasında bir bağlantı vardır. Ördeklerde yumurtadan çıkar çıkmaz ilk yirmi dört saat içinde, kritik periyod devresinde yavruların hareket eden nesneleri takip ettiği bilinmektedir. Bunun gibi bebeklerin de annenin yüz hareketlerini takip ederek sosyal ilişkiyi ve benlik gelişimini sağladıklarını öngörebiliriz. İnsanın yüz tanımayı dil işlevinde olduğu gibi önemli ve karmaşık bir dizge üzerinden gerçekleştirmesinin bir nedeni olmalıdır. İnsanların birbirilerini yüzlerinden tanımaları, dostu düşmanı yüz üzerinden ayırmaları, bütün dostluklarını yüz üzerinden kurmaları onun dış dünyada insan için ne kadar temel bir rol oynadığını ortaya koyar. Ortak benliğin iç dünyada kurduğu bütünlüğün benzeri dış dünyada yüz üzerinden kurulmaktadır. İnsanlar yüz üzerinden birbirlerine bağlıdır ve bütünlüklerini yüz üzerinden sağlarlar. Bir bebeğin yüzün yapısal düzenine ilişkin karmaşık bilgiyi hemen ilk aylarda dışarıdan elde etmesi zordur. Yüz tanıma becerisi doğumdan sonra edinilen bir beceri olmaktan çok doğumla birlikte hazır getirilen bir bilgi gibi durmaktadır. Bu bilgi ortak benliğin ürünü olarak bebekte var olmaktadır. Duygu tanıma becerisinin de yüz tanımayla birlikte geliştiği söylenebilir. Prosopagnozi gibi nörolojik bozukluklardan yola çıkarak benliğin beyindeki merkezine ilişkin araştırmalar ve yorumlar yapılmaktadır. Özellikle uyarılmış potansiyellerle yapılmış çalışmalar bu konuda önemli bir altyapı sağlayacak gibi durmaktadır. Bu yazıda yüz tanıma ile benlik gelişimi arasındaki ilişkiye nöropsikolojik açıdan değinmek amaçlanmıştır.

Foramen caroticoclinoidale ve interklinoid köprüleşmeler hakkındaki anatomik bilgi bu bölge patolojilerine ve özellikle tuberculum sellae menengiomalarına ve anevrizmalara yönelik girişimlerde güvenlik ve etkinlik açısından önemlidir. Bu çalışmamızda 50 kafa iskeleti tabanında bu yapılar incelenmiş ve anatomik özellikleri sunulmuştur.

Aim: In the present study which we performed four different supraclavicular block techniques on the same cadaver, we aimed to inverstigate the required needle depth to reach plexus brachialis and its correlation with demographic data. Materials and Methods: The study was performed on ten cadavers. After the dissection was completed, the skin of the cadavers was restored in its original position and then they were re-positioned according to the technique evaluated. Four different supraclavicular block techniques (Vongvises, Dalens, Plumb-Bob and inter-SCM) were applied. The needle depth required to reach plexus brachialis was measured and the demographic data were recorded. Results: The needle depth was minimum in the Dalens technique and maximum in the inter-SCM technique. There was no correlation between the needle depth and demographic data in Plumb-bob technique. There was a significant correlation between the needle depth and the height of the cadavers in all the other techniques. A significant correlation between the needle depth and the weight of the cadaver was observed only in the inter-SCM technique. Conclusion: The needle depth was minimum in the Dalens technique and maximum in the inter-SCM technique. We observed that when Dalen’s technique is used the needle may pass through the first intercostal space and lead to pneumothorax if pushed deeper in adults. When compared to the other techniques, moving the insertion point approximately 1 cm caudal and maintaining the anteroposterior needle direction in Vongvises technique would result in a successful brachial plexus block, Amaç: Aynı kadavra üzerinde dört farklı supraklaviküler blok tekniğini uygulayarak gerçekleștirdiğimiz bu çalıșmada, plexus brachialis’e ulașmak için gerekli olan iğne derinliğini ve bu parametre ile demografik veriler arasındaki ilișkiyi araștırmayı planladık. Gereç ve Yöntem: Bu araștırma, 10 adet kadavra üzerinde gerçekleștirildi. Diseksiyon tamamlandıktan sonra cilt tekrar eski konumuna getirilerek kadavranın bașına ve kollarına üzerinde çalıșılan tekniğe uygun pozisyon verildi. Kadavralarda 4 farklı supraklaviküler blok tekniği (Vongvises Dalens, Plumb-Bob ve İnter-SCM) uygulandı. Plexus brachialis’e ulașmak için gerekli olan iğne derinliği ölçüldü ve demografik veriler kaydedildi. Bulgular: İğne derinliğinin (Dalens tekniğinde ise en az) inter-SCM tekniğinde en fazla olduğu belirlendi. Plumb-Bob tekniği ile demografik veriler arasında korelasyon saptanmadı. Diğer tekniklerin tümünde, iğne derinliği ile kadavraların boy uzunluğu arasında korelasyon vardı. İğne derinliği ile kadavraların vücut ağırlıkları arasında korelasyon sadece inter-SCM tekniğinde tespit edildi. Sonuç: İğne derinliğinin (Dalens tekniğinde ise en az ) inter-SCM tekniği’nde en fazla, olduğu belirlendi. Erișkinlerde Dalens’in blok tekniği uygulanacağı zaman, iğne fazla ilerletildiği takdirde 1. interkostal aralıktan girilerek pnömotoraks gelișebileceği gözlendi. Vongvises tekniğinde cilde giriș yerinin yaklașık 1 cm altından girilerek, iğnenin masa düzlemine dik olacak șekilde antero-posterior yönde ilerletilmesiyle, plexus brachialis’in bașarılı bir șekilde bloke edilebileceği düșünüldü.

Amac: Orta serebral arterin (a. cerebri media) literaturde cokca tartisilmamis dali olan temporal arterin anatomik olarak kadavra uzerinde degerlendirilmesi ve kanlanmasini sagladigi temporal lobdaki (lobus temporalis) verdigi kortikal dallarin dagilma paternlerinin ortaya konulmasi amaclanmistir.Gerec ve Yontem: 27 insan beyni (54 hemisfer) uzerinde calisildi. Beyinlerin arterleri yikandiktan sonra renklendirilmis lateks ile doldurulmak suretiyle diseksiyona hazir hale getirildi. Temporal arter tanimlandi. Orjin aldigi yerler, verdigi kortikal dallar ortaya konuldu. Bu arterlerin caplari, sulama alanlari ve birbirleri ile olan iliskileri gosterildi.Bulgular: Temporal arterin hemen tum hemisferlerde goruldugu belirlendi. Temporal loba verdigi kortikal dallarin 2 ila 4 adet dal arasinda degistigi goruldu. Hem temporal arterin, hem de verdigi kortikal dallarin erken dal olarak orijin almalari durumunda arter caplarinin arttigi gosterildi.Sonuc: Temporal arter, anatomistlerin ve norosirurjiyenlerin cogu zaman gozunden kacan bir arter olmustur. Hâlbuki, suladigi alanin onemi ve verdigi dallardaki degisken yapi goz onune alindiginda dikkate alinmasi gereken bir vaskuler yapi oldugu dusunulmektedir.

Yalcinozan, Mehmet/0000-0002-2772-1137 WOS: 000312464900006 PubMed: 23145757 Objectives: This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group who were blinded to the arthroscopic diagnosis in patients with known bucket handle meniscal tears. Patients and methods: In this study, MRI scans of 28 patients who were operated due to bucket handle meniscal tear with sufficient documentation were evaluated. Radiographic evaluation was performed by two different groups, including an orthopedist and radiologist. In the first group, evaluation of MRI scans was performed by the specialists who were aware of the arthroscopic diagnosis and marked the defined MRI signs of bucket handle meniscal tear. In the second group, evaluation was done, remaining blinded to the diagnosis, with only initial complaints at admission. The second group also evaluated the MRI scans and marked the pathologic signs. The sensitivity of radiological signs marked by both groups was compared. Invariables were found using blinded evaluation. Results: Double posterior cruciate ligament and free fragment in the intercondylar notch were invariable sensitivities found in the MRI scans by blinded evaluation. The sensitivity of coronal truncation, anterior flip and any free fragment signs were significantly decreased in the setting of blinded evaluation. Conclusion: Preoperative differentiation of reparable bucket-handle tears from irreparable is of utmost importance. As meniscal repair improves knee stability and functional results, surgical repair of meniscal injuries particularly in younger individuals who are scheduled for anterior cruciate ligament reconstruction have a positive effect on clinical outcomes.

• Objective: This study included 1226 pregnant women who gave birth in our hospital's Department of Obstetrics and their newborns to evaluate the effects of maternal smoking on neonatal anthropometric measurements. • Material and Method: Information about daily cigarette smoking patterns were collected by a questionnaire and the neonatal anthropometric measurements were recorded. The mothers with high risk pregnancies, multiple births and chronic diseases and the preterms, neonates with congenital anomalies and hospitalized neonates were excluded. • Results: Of the 1226 women 940 (76.6%) never smoked; while 286 (23.4%) were smoker. Two hundred and five mothers smoking 1-5 cigarettes daily were classified as mild smokers, whereas 81 women smoking more than 5 cigarettes daily as heavy smoker. Eighty one heavy smokers constituted 28.3% of the 286 mothers who smoked and the 6.7% of the whole study population. There as no statistical difference between smokers and non-smokers regarding to socio-cultural and economic status. The average weight, height, chest and head circumference of children born from heavy smoker mother group was 160 gr, 0.65 cm, 0.38 cm and 0.28 cm smaller than the non-smoker group respectively. A statistically significant difference was found regarding height and weight, but not for head and chest circumference. • Conclusion: It was found that as the number of cigarettes smoked increased by mother, especially the weight of the newborn decreased and the height also is adversely affected.

This study was prepared and conducted for identifying youth people's opinion and aweareness of Turkish cousine which has a wide range of selections. 490 University students whose ages range between 18 and 25 were taken into account. Questionnaire form consisted of demographical information and young people's opinion about Turkish cultural couisine, and whether local dishes and special day dishes are cooked in their families. The collected data was evaluated using SPSS 11.0 package program. According to the collected statistics 55.3% of youth population did not like "keskek", 80.4% did not like "ogmac" and 44.9% did not like "hosmerim"; opposingly 90.4% did like "manti", 89.0% did like stuffed grape leaves ("zeytinyagh dolma") and 82.4% liked "karmyank". In the meantime it was pointed out that the regional dishes were not cooked as often as they used to be, and young population more likely preferred easy-to-cook food. 64.0% of young population indicated that the Turkish cousine is lost which was one of the flash data outcome on the other hand, 53.0% of young people thirds of Turkish cuisine is recognized around the world, 32.0% percent if the information on this subject, 15.0% recognized the world thinks of Turkish cuisine. Granting the vast majority of young people in the world of Turkish cuisine is quite irrelevant to this issue that does not express an opinion about the show. For this reason it was pointed out that the introduction of our cousine to domestic and foreigner tourist in hotels an restaurants, as well as preparing intense and continuous studies for young people to learn Turkish cuisine, especially by young people of Turkish cuisine and the recognition it deserves in terms of where it is important to arrive.

In the works that belong to Haci Bektas Veli who is one of the most leading names of Turkish Sufi Movement, the terms, Alevism and Bektassm, are relatively mentioned. With an important part of these terms is handled and evaluated in different works, it seems that most of them are not sampled. By considering the evaluation of historical development of Sufi perception in different ways, according to the thought of Haci Bektas Veil, the finding of basic values that compose the Sufi perception gains quiet importance.

WOS: 000287635700011, PubMed: 21341163, Intravenous catheterization can lead to colonization as well as a broad spectrum of infections ranging from catheter site infections to catheter-related blood stream infections (CRBSIs). The aim of this study was to evaluate the distribution of causative agents and their antibiotic susceptibility patterns in CRBSIs and catheter site infections along with the colonization rates and colonizing microorganisms in Zonguldak Karaelmas University Hospital, Turkey. The results of cultures from catheter tips and/or intracatheter blood cultures and simultaneously taken peripheral blood cultures were sent to medical microbiology laboratory and were retrospectively investigated for 201 patients hospitalized between September 2007 and September 2009. The catheter tips were cultured by semi-quantitative and quantitative culture methods. Blood cultures from the catheters and peripheral veins were performed in BACTEC 9120 (Becton Dickinson, USA) blood culture systems. The antibiotic susceptibility tests were done by Kirby-Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Out of 201 patients included, 28 (13.9%) had CRBSIs and 13 (6.4%) had catheter site infections while colonization was defined for 55 (27.3%) patients. Of 28 patients with CRBSIs, Acinetobacter spp. were isolated from 11 including five carbapenem-resistant strains, methicillin-resistant coagulase-negative staphylococci (MRCNS) from eight, methicillin-susceptible coagulase-negative staphylococci (MSCNS) from two, Klebsiella pneumoniae from two patients and one of each patient's cultures yielded methicillin-resistant Staphylococcus aureus (M RSA), carbapenem-resistant Pseudomonas aeruginosa, Enterococcus spp., Escherichia coli and MRCNS + Enterococcus faecium. Of 13 patients with catheter site infections, five MSCNS, two methicillin-susceptible S.aureus (MSSA), two E.coli, and one of each K.pneumoniae, MRCNS, Enterococcus spp., K.pneumoniae + P.aeruginosa were isolated. No resistance to vancomycin and teicoplanin were detected among the staphylococci isolated from CRBSIs and catheter site infections. The distribution of the 55 colonizing microorganisms were as follows; 18 MSCNS, 18 MRCNS, four Acinetobacter spp., five K.pneumoniae, three E.coli, two MSSA, and one of each MRSA, P.mirabilis, P.aeruginosa, Corynebacterium spp., Candida albicans. In this study, the predominant microorganism isolated from CRBSIs was Acinetobacter spp., followed by coagulase-negative staphylococci. This unexpected distribution of the agents was related to the Acinetobacter spp. that have gained endemic potential following an Acinetobacter outbreak in our hospital in 2006. We emphasize that it is critical for any individual hospital to assess periodically the distribution and susceptibility profiles of isolates obtained from catheter-related infections to set out rational empirical treatment strategies.

WOS: 000277896300021, PubMed: 20549970, In this study, a total of 390 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens between April 2004 and June 2008, in a university hospital in Zonguldak (located at Black Sea region), Turkey, were evaluated retrospectively for reduced susceptibility to vancomycin Brain heart infusion (BHI) plates containing 4 and 6 mu g/ml of vancomycin were used to screen for vancomycin intermediate S aureus (VISA) strains Additionally, vancomycin minimal inhibitory concentrations (MIC) of the isolates were determined by agar dilution method No growth was observed on the screen plates after 24 and 48 hours of incubation None of the isolates revealed MIC values equal to or higher than 2 mu g/ml, MIC(90) and MIC(50) values were 1 mu g/ml Although VISA isolates were not detected in this study, no data was obtained for heterogeneous VISA isolates since macro-E test or population analysis were not performed It was concluded that systematic surveillance of MRSA isolates is of particular importance to investigate the presence of VISA/hVISA isolates which may lead to treatment failures and hospital epidemics

WOS: 000284385400013, PubMed: 21063977, Hepatitis C virus (HCV) is one of the significant causes of hepatitis, cirrhosis and hepatocellular carcinoma all throughout the world. There are six genotypes and more than 50 subtypes of HCV. HCV genotyping is of crucial importance in the determination of the treatment protocols and the follow-up of the clinical course since treatment success is low and the duration of treatment is longer in HCV genotype 1 infected cases. The aim of the present study was to evaluate the HCV genotype profiles of the patients with chronic hepatitis C in Zonguldak, providing the first data about HCV genotypes from western Black-Sea region, Turkey. The HCV genotypes of 44 patients (26 female, 18 male; age range: 29-89 years, mean age: 60.05 +/- 10.81 years) with positive anti-HCV antibody and HCV-RNA results, admitted to the hospital between May 2007 and July 2009, were retrospectively evaluated and included in the study. Alanine aminotransferase (ALT) levels of the patients were between 8-160 IU/L (mean 63.99 +/- 37.15 IU/L) and the aspartate aminotransferase (AST) levels were between 17-160 IU/L (mean 62.77 +/- 36.75 IU/L). HCV antibody was determined by ELISA method (Abbott Laboratories, USA), and HCV-RNA was determined by two commercial real-time polymerase chain reaction systems [Cobas Taqman (Roche Diagnostic, USA) and Rotor-Gene 6000 (Corbett Research, USA)]. The genotyping was performed by a reverse hybridization based method, Versant (R) HCV Genotype Assay (LiPA) 2.0 (Bayer Health Care, Belgium). HCV genotypes could not be determined for 5 (11.4%) patients since HCV-RNA levels were low. Genotyping could be performed for 39 (88.6%) patients and 38 (97.4%) had genotype 1b and one (2.6%) patient had genotype la. In conclusion, in concordance with the other studies conducted in our country, genotype 1b was found to be the most prevalent genotype in patients from our region.

Upon isolation of the first vancomycin resistant enterococcus (VRE) from the urine sample of a nine months old patient in pediatric unit of Van Yuzuncu Yil University Hospital (located in eastern part of Turkey), we aimed to search for the presence of VRE isolates in the unit, to determine the resistance genotypes and to evaluate the clonal relationships among isolates. A total of 28 rectal swabs and 28 skin swabs from the patients, 12 skin swabs from the staff giving care to the patients, 15 skin swabs from the mothers of the patients and 96 environmental samples from the pediatric unit were screened. Antibiotic susceptibilities were tested and the resistance genotypes were determined. Molecular typing of the isolates was performed using pulsed-field gel electrophoresis (PFGE). Apart from the first case, 13 more VRE isolates, one being a clinical isolate from the urine of a patient and 12 isolates from the screening samples (8 rectal swabs, one skin swab and three swabs from patients' beds) were obtained. All of the isolates were identified as Enterococcus faecium with similar antibiotic susceptibility patterns. VanA gene was present in all of the isolates. PFGE demonstrated two major clones and five clones closely related with the major ones. This was the first VRE isolation and colonization reported in our region. The isolates belonged to more than one clone. Currently, VRE did not seem to be a significant pathogen in Turkey, however, there may be an underestimation of the problem and continuous surveillance studies should be undertaken in every region.

WOS: 000271840400003, PubMed: 20084906, Upon isolation of the first vancomycin resistant enterococcus (VRE) from the urine sample of a nine months old patient in pediatric unit of Van Yuzuncu Yil University Hospital (located in eastern part of Turkey), we aimed to search for the presence of VRE isolates in the unit, to determine the resistance genotypes and to evaluate the clonal relationships among isolates. A total of 28 rectal swabs and 28 skin swabs from the patients, 12 skin swabs from the staff giving care to the patients, 15 skin swabs from the mothers of the patients and 96 environmental samples from the pediatric unit were screened. Antibiotic susceptibilities were tested and the resistance genotypes were determined. Molecular typing of the isolates was performed using pulsed-field gel electrophoresis (PFGE). Apart from the first case, 13 more VRE isolates, one being a clinical isolate from the urine of a patient and 12 isolates from the screening samples (8 rectal swabs, one skin swab and three swabs from patients' beds) were obtained. All of the isolates were identified as Enterococcus faecium with similar antibiotic susceptibility patterns. VanA gene was present in all of the isolates. PFGE demonstrated two major clones and five clones closely related with the major ones. This was the first VRE isolation and colonization reported in our region. The isolates belonged to more than one clone. Currently, VRE did not seem to be a significant pathogen in Turkey, however, there may be an underestimation of the problem and continuous surveillance studies should be undertaken in every region.

WOS: 000255444000009, Pseudomonas putida is a Gram-negative, nonfermentative, saprophytic soil bacterium with versatile metabolical features. We presented an 18-year-old male patient who developed tibial osteomyelitis due to P. putida after a traffic accident. He had open comminuted fractures in the right fibula and tibia and the site of open fracture was contaminated with dust and soil. He underwent surgical debridement and irrigation of the fracture site followed by fracture reduction and application of an external fixator. Despite empirical antibiotic treatment, there was a discharge from the pin tract on the postoperative fifth day. Cultures obtained from soft tissue and bone during repeat debridement and irrigation yielded P. putida. The patient recovered after four weeks of parenteral antibiotic treatment without any sequela. A case of posttraumatic tibial osteomyelitis caused by P. putida has hitherto not been reported in the literature.