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Fabry disease is a rare, progressive, X-linked inherited storage disorder due to absent or deficient of lysosomal alfa galactosidase A activity. Deficient activity of alfa-galactosidase A results in progressive accumulation of globotriaosylceramide in a variety of tissues and organs including myocardium, kidney and nerve system. This disorder predominantly affects males; however, female heterozygotes may also be affected with a less severe clinical picture. Classic Fabry disease is usually diagnosed in early age of childhood because of multiorgan involvement whereas cardiac and renal variants of Fabry are manifested in 30-50 years of age because of late onset of clinical picture in which other organs involvement are uncommon. Although Fabry is known as a very rare disease, its prevalence is reported to be higher in patients with ventricular hypertrophy, chronic kidney disease and cryptogenic stroke. From the cardiology point of view, the most important key finding of the disease is unexplained ventricular hypertrophy. However, in clinical practice, ventricular hypertrophy is usually thought to be due to hypertrophic cardiomyopathy in the absence of hypertension or aortic stenosis and Fabry disease is often undiagnosed or overlooked. Early diagnosis and enzyme replacement therapy have been shown to significantly improve prognosis. The aim of this paper is to provide a comprehensive review including epidemiology, prognosis, clinical presentation, diagnosis and therapeutic approaches of cardiac variant of Fabry based on the available data in the literature. © 2020 Türk Kardiyoloji Derneği

Teknolojinin gelişimi ilebirlikte bilişim teknolojilerinin endüstriyel sistemlerde kullanımı da artmaktadır.İş istasyonlarının daha az enerji ve kaynak kullanımı ile yüksek verimliçalışma ortamlarına dönüşebilmesi için bu teknolojilerden yararlanılmaktadır.Bu doğrultuda kullanılan, Dijital İnsan Modelleri (DHM) yaklaşımı buuygulamalardan biridir. Dijital insan modelleri ile ergonomik işyeritasarımında, üretim öncesi bilgisayar ortamında yapılan analizler ile ürüngeliştirme süreçleri kısaltılarak gereksiz prototipler ortadan kaldırılabilirve maliyet düşürülebilmektedir. Bu çalışma kapsamında ise, araç bakımkanallarının dijital insan modelleri ile ergonomik analizi, CATIA V5 R21programı kullanılarak RULA (Rapid Upper Limb Assesment) analiz metodu ileyapılmıştır. Analiz sonucunda elde edilen veriler, var olan çalışma ortamınınçalışanların kas ve iskelet sistemi üzerinde yarattığı risklerdeğerlendirilerek yeniden tasarım sürecine gidilmiştir. Tasarlanan yeni çalışmaortamının ergonomik analizi yapılmış ve elde edilen sonuçlara göre çalışanınkas iskelet sistemi üzerinde pozitif yönde gelişme sağlandığı tespitedilmiştir., With the development oftechnology, the use of information technologies in industrial systems is alsoincreasing. These technologies are used to transform workstations intohigh-efficiency working environments with less energy and resources. TheDigital Human Models (DHM) approach used in this direction is one of theseapplications. In the ergonomic workplace design with digital human models, theanalysis of the pre-production computer environment can be used to shorten theproduct development process and unnecessary prototypes can be eliminated andthe cost can be reduced. In this study, digital human models and ergonomicanalysis of vehicle maintenance channels were performed by using RULA (RapidUpper Limb Assesment) method by using CATIA V5 R21 program. As a result of theanalysis, the data obtained from the analysis, the existing work environment onthe muscles and skeletal system by evaluating the risks created by the processof re-design. Ergonomic analysis of the new working environment has been madeand it has been determined that the musculoskeletal system positively improvesaccording to the results.

Human papillomavirus (HPV) infection is the most significant risk factor of the development of cervical cancer. The distribution of HPV prevalence and genotype varies widely between regions. In this study, it was aimed to investigate the prevalence and genotype distribution of HPV, retrospectively. One thousand one hundred and seventy patients who applied to the department of obstetrics and gynecology were included in this study. Samples were collected from patients for cervical HPV DNA and Pap smear. The Pap samples taken for Pap smear were fixed with alcohol and analyzed according to the modified Bethesda system. HPV identification and typing were performed using the "Linear Array HPV Genotyping Test (Roche Molecular System, USA)". Patients were divided into 5 groups due to their age. Total HPV ratio was most frequently found among the patients who were between 17-30 years old, while HR-HPV was most frequently found between 51-60 years. Nine hundred seventy-eight of 1170 (83.6%) patients had normal cytologic findings whereas 192 (16.4%) had abnormal cytologic findings. HPV was detected in 37.2% of the total patients. high-risk HPV (HR-HPV) rate was 21.2%, probable high risk (PR-HPV) rate was 6.4% and low risk HPV (LR-HPV) rate was 9.5%. When the relationship between cytologic findings and HPV was examined, normal cytology/HPV negative 67.8%; abnormal cytology/HPV negative 37.5%, normal cytology/HPV positive 32.2%, abnormal cytology/HPV positive 62.5% were detected. The highest prevalence of HPV was 8.9% with HPV 16, followed by 6, 53 and 52/53/35/58. A total of 354 patients were biopsied, 177 of whom were normal, 111 of whom were cervical intraepithelial neoplasia (CIN) 1, 66 of whom were CIN 2 and over. In the group with normal pathological findings, HR-HPV ratio was found as 15.8%, while in CIN 1 44.1% in CIN 2-3 63.6%. Sensitivity, specificity, positive predictive value, and negative predictive value of screening tests were examined in CIN 2 and more lesions. Sensitivity and specificity for HR-HPV were 63.6% and 73.3%, respectively, the same rates were 81.8% and 58.7% for HPV. The highest sensitivity was found in combination of HRHPV and Pap smear, the highest specificity in HPV. In conclusion, the HPV prevalence and genotype distribution in our study are similar to those reported in the world, but higher than previous studies in our country. These results may be due to our methodology and hospital based nature of our study group. We conclude that only smear or HR-HPV testing are not sufficient as a single pronged screening test, and that the participation of other genotypes of HPV in screening increases the sensitivity. © 2019 Ankara Microbiology Society. All rights reserved.

Human papillomavirus (HPV) infection is the most significant risk factor of the development of cervical cancer. The distribution of HPV prevalence and genotype varies widely between regions. In this study, it was aimed to investigate the prevalence and genotype distribution of HPV, retrospectively. One thousand one hundred and seventy patients who applied to the department of obstetrics and gynecology were included in this study. Samples were collected from patients for cervical HPV DNA and Pap smear. The Pap samples taken for Pap smear were fixed with alcohol and analyzed according to the modified Bethesda system. HPV identification and typing were performed using the "Linear Array HPV Genotyping Test (Roche Molecular System, USA)". Patients were divided into 5 groups due to their age. Total HPV ratio was most frequently found among the patients who were between 17-30 years old, while HR-HPV was most frequently found between 51-60 years. Nine hundred seventy-eight of 1170 (83.6%) patients had normal cytologic findings whereas 192 (16.4%) had abnormal cytologic findings. HPV was detected in 37.2% of the total patients. high-risk HPV (HR-HPV) rate was 21.2%, probable high risk (PR-HPV) rate was 6.4% and low risk HPV (LR-HPV) rate was 9.5%. When the relationship between cytologic findings and HPV was examined, normal cytology/HPV negative 67.8%; abnormal cytology/HPV negative 37.5%, normal cytology/HPV positive 32.2%, abnormal cytology/HPV positive 62.5% were detected. The highest prevalence of HPV was 8.9% with HPV 16, followed by 6, 53 and 52/53/35/58. A total of 354 patients were biopsied, 177 of whom were normal, 111 of whom were cervical intraepithelial neoplasia (CIN) 1, 66 of whom were CIN 2 and over. In the group with normal pathological findings, HR-HPV ratio was found as 15.8%, while in CIN 1 44.1% in CIN 2-3 63.6%. Sensitivity, specificity, positive predictive value, and negative predictive value of screening tests were examined in CIN 2 and more lesions. Sensitivity and specificity for HR-HPV were 63.6% and 73.3%, respectively, the same rates were 81.8% and 58.7% for HPV. The highest sensitivity was found in combination of HRHPV and Pap smear, the highest specificity in HPV. In conclusion, the HPV prevalence and genotype distribution in our study are similar to those reported in the world, but higher than previous studies in our country. These results may be due to our methodology and hospital based nature of our study group. We conclude that only smear or HR-HPV testing are not sufficient as a single pronged screening test, and that the participation of other genotypes of HPV in screening increases the sensitivity. C1 [Kaleli, Ilknur; Aksoy, Levent; Demir, Melek; Mete, Ergun; Onder, Sedef Zeliha] Pamukkale Univ, Dept Med Microbiol, Fac Med, Denizli, Turkey. [Bir, Ferda] Pamukkale Univ, Dept Med Pathol, Fac Med, Denizli, Turkey. [Kaleli, Babur] Pamukkale Univ, Dept Obstet & Gynecol, Fac Med, Denizli, Turkey.

Sepsis is a serious clinical problem and estimated to be responsible for 18 million annual deaths worldwide. Therefore, the use and the rapid processing of blood cultures are important for the transition from empiric therapy to directed therapy. The aim of this study was to assess the best blood culture practices in Turkey. We have examined the collection practices and techniques at four different hospitals, and a total of 165.443 blood culture bottles were evaluated (2013-2015). At the preanalytical phase most of the data which were important and which could support hospital quality systems/practices were not entered into the HIS and EpiCenter system. At the analytical phase loading of the bottles and removal of positive bottles primarily occurred between 6:00 and 9:00 AM but the positivity rate of the bottles showed a homogeneous distribution throughout the day. In other words, there were significant delays at processing positive blood culture bottles related to laboratory workers. The effect of education regarding best practices, transition from single bottle to two bottle cultures was successful in all hospitals. Single bottle usage decreased below 10% in all hospitals. Significantly more positive cultures were detected at multiple cultures when compared with the single bottle collection practice. In retrospective patient records, it was seen that all the laboratories reported the results of Gram staining to the clinics. However, these data were not recorded to the Epicenter. The contamination rates of Ankara Numune Hospital and Akdeniz University Faculty of Medicine Hospital are 6.2% and 5.4% respectively, contamination rates were not reported in other hospitals. The most common isolates detected in blood cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. The mean time for the detection of these organisms were less than 20 hours in the aerobic bottle and anaerobic bottles. A total of 79.6% of facultative anaerobic isolates were detected in both bottles; 9.8% were detected only in the aerobic bottles; 10.6% of the isolates were detected only in the anaerobic bottles. As a result, the educational efforts in Turkey have met with success for transition from collecting single bottle blood culture sets to two bottle blood cultures. However, further efforts are needed to increase the number of blood culture sets collected during a 24 hour's period. In addition, errors at the preanalytical, analytical and postanalytical periods (taking samples, loading bottles into the system and processing positive blood cultures) should be eliminated. C1 [Basustaoglu, Ahmet] Baskent Univ, Dept Med Microbiol, Fac Med, TR-06790 Ankara, Turkey. [Suzuk Yildiz, Serap] MoH Gen Directorate Publ Hlth, Dept Microbiol Reference Lab & Biol Prod, Ankara, Turkey. [Mumcuoglu, Ipek; Kursun, Senol] Ankara Numune Training & Res Hosp, Lab Med Microbiol, Ankara, Turkey. [Karahan, Zeynep Ceren; Evren, Ebru] Ankara Univ, Dept Med Microbiol, Fac Med, Ankara, Turkey. [Ogunc, Dilara; Ozhak Baysal, Betil] Akdeniz Univ, Dept Med Microbiol, Fac Med, Antalya, Turkey. [Kaleli, Ilknur; Demir, Melek] Pamukkale Univ, Dept Microbiol, Fac Med, Denizli, Turkey. [Murray, Patrick] BD Diagnost Syst, Hunt Valley, MD USA.

Sepsis is a serious clinical problem and estimated to be responsible for 18 million annual deaths worldwide. Therefore, the use and the rapid processing of blood cultures are important for the transition from empiric therapy to directed therapy. The aim of this study was to assess the best blood culture practices in Turkey. We have examined the collection practices and techniques at four different hospitals, and a total of 165.443 blood culture bottles were evaluated (2013-2015). At the preanalytical phase most of the data which were important and which could support hospital quality systems/practices were not entered into the HIS and EpiCenter system. At the analytical phase loading of the bottles and removal of positive bottles primarily occurred between 6:00 and 9:00 AM but the positivity rate of the bottles showed a homogeneous distribution throughout the day. In other words, there were significant delays at processing positive blood culture bottles related to laboratory workers. The effect of education regarding best practices, transition from single bottle to two bottle cultures was successful in all hospitals. Single bottle usage decreased below 10% in all hospitals. Significantly more positive cultures were detected at multiple cultures when compared with the single bottle collection practice. In retrospective patient records, it was seen that all the laboratories reported the results of Gram staining to the clinics. However, these data were not recorded to the EpiCenter. The contamination rates of Ankara Numune Hospital and Akdeniz University Faculty of Medicine Hospital are 6.2% and 5.4% respectively, contamination rates were not reported in other hospitals. The most common isolates detected in blood cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. The mean time for the detection of these organisms were less than 20 hours in the aerobic bottle and anaerobic bottles. A total of 79.6% of facultative anaerobic isolates were detected in both bottles; 9.8% were detected only in the aerobic bottles; 10.6% of the isolates were detected only in the anaerobic bottles. As a result, the educational efforts in Turkey have met with success for transition from collecting single bottle blood culture sets to two bottle blood cultures. However, further efforts are needed to increase the number of blood culture sets collected during a 24 hours' period. In addition, errors at the preanalytical, analytical and postanalytical periods (taking samples, loading bottles into the system and processing positive blood cultures) should be eliminated.

PubMed ID: 30982817, Objective: Heart failure (HF) is an important health issue of the 21st century and the prevalence in Turkey has been reported as 2.9%. A national profile, frequency data, characteristics of different phenotypes, and risk factors have not yet been well established. The Snapshot Evaluation of Heart Failure Patients in Turkey (SELFIE-TR) was an analysis of a representative sample of HF patients from Turkey. Methods: A total of 23 centers with at least 2 cardiologists from the 12 NUTS-1 regions of Turkey were invited to participate in the research. The contributing centers shared the data of a consecutive enrollment of HF patients, as confirmed by an investigator, on a pre-selected day of each week for the month of October or November of 2015. Results: The mean age of the entire cohort was 63.3±13.3 years (male/female ratio: 751/303, 71.3%/28.7%). There were 712 acute HF patients and 342 chronic HF patients. The total number of HF patients with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction, and heart failure with preserved ejection fraction was 801 (75%), 176 (16.7%), and 77 (7.3%), respectively. The patients with chronic HF were younger than those with acute HF (61.1±13.3 years vs 67.9±12.1 years; p

Sepsis is a serious clinical problem and estimated to be responsible for 18 million annual deaths worldwide. Therefore, the use and the rapid processing of blood cultures are important for the transition from empiric therapy to directed therapy. The aim of this study was to assess the best blood culture practices in Turkey. We have examined the collection practices and techniques at four different hospitals, and a total of 165.443 blood culture bottles were evaluated (2013-2015). At the preanalytical phase most of the data which were important and which could support hospital quality systems/practices were not entered into the HIS and EpiCenter system. At the analytical phase loading of the bottles and removal of positive bottles primarily occurred between 6:00 and 9:00 AM but the positivity rate of the bottles showed a homogeneous distribution throughout the day. In other words, there were significant delays at processing positive blood culture bottles related to laboratory workers. The effect of education regarding best practices, transition from single bottle to two bottle cultures was successful in all hospitals. Single bottle usage decreased below 10% in all hospitals. Significantly more positive cultures were detected at multiple cultures when compared with the single bottle collection practice. In retrospective patient records, it was seen that all the laboratories reported the results of Gram staining to the clinics. However, these data were not recorded to the EpiCenter. The contamination rates of Ankara Numune Hospital and Akdeniz University Faculty of Medicine Hospital are 6.2% and 5.4% respectively, contamination rates were not reported in other hospitals. The most common isolates detected in blood cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. The mean time for the detection of these organisms were less than 20 hours in the aerobic bottle and anaerobic bottles. A total of 79.6% of facultative anaerobic isolates were detected in both bottles; 9.8% were detected only in the aerobic bottles; 10.6% of the isolates were detected only in the anaerobic bottles. As a result, the educational efforts in Turkey have met with success for transition from collecting single bottle blood culture sets to two bottle blood cultures. However, further efforts are needed to increase the number of blood culture sets collected during a 24 hours' period. In addition, errors at the preanalytical, analytical and postanalytical periods (taking samples, loading bottles into the system and processing positive blood cultures) should be eliminated. © 2019 Ankara Microbiology Society. All rights reserved.

Enterococci have recently become important due to their increased isolation rates in community-based and nosocomial infections and resistance to many antibiotics, including glycopeptides. The aim of this study was to evaluate the antimicrobial susceptible patterns and virulence factors of various clinical specimens; urine (n= 149), blood (n= 38), wound (n= 17), stool (n= 13), and other (n= 12) with a total of 229 enterococci including 138 E. faecalis and 91 E. faecium isolates. Aggregation factor (AF), enterococcus surface protein (esp), cytolysins and gelatinase encoding genes (asa1, esp, cylM, cylBcyl A, cylll, cylls, gelE, respectively) were investigated by molecular methods. Haemolysin production and gelatinase were studied phenotypically. A total of 30 isolates, 29 of E. faecium and one of E. faecalis isolates were resistant to vancomycin. High-level gentamicin and high-level streptomycin resistance in E. faecalis were 40.7% and 63.7% however, they were 47.1% and 55.8% in E. faecalis isolates. All strains were susceptible to linezolid. Ampicillin, penicillin and vancomycin resistance in E. faecium isolates were found to be higher than E. faecalis isolates (p= 0.001, p= 0.008 and p< 0.001). Asa1 (p< 0.001), cylll (p= 0.002) and cylls (p< 0.001) as well as gelatinase activity in isolates of E. faecalis were significantly higher than the isolates of E. faecium (p< 0.001). The most common virulence genes in our study were asa1 gene (45%), cyLs gene (33.2%) and esp gene (32.3%). Ciprofloxacin resistance in cylLL and cyLs gene positive isolates of E. faecalis were significantly higher compared to isolates that do not contain these genes (p= 0.035 and p= 0.047). Likewise, haemolysin producing E. faecium isolates were significantly more resistant to vancomycin compared to isolates that do not produce hemolysin (p< 0.001). When the virulence factors of vancomycin resistant and susceptible isolates were compared, the esp gene level in VRE E. faecium isolates was found to be 24.1%, while no esp gene was found in VRE E. faecalis isolates. The existence of asa1was negative in both VRE E. faecium and VRE E. faecalis isolates. The activity of hemolysin was found 42.3% for E. faecalis and 19.3% for E. faecium. In vancomycin-sensitive enterococcus (VSE) species, esp gene activity was 35.1% for E. faecalis, 29.4% for E. faecium, asa1 gene activity was 60.8% for E. faecalis and 47.1% for E. faecium, hemolysin activity was 52.8% for E. faecalis and 23.5% for E. faecium. In our study, it was found that VSE isolates have more virulence genes than VRE isolates. It should be kept in mind that VRE can causeinfections which are difficult-to-treat especially in hospitalized patients and VSE have significant virulence factors that can cause severe infections.

PubMedID: 28976402 Along with the medical technology that has developed in recent years, the elderly population has started to increase all over the world due to the extension of human life. Chronic diseases have been commonly diagnosed with the increasing population of elderly people. Cardiovascular diseases are the most common cause of death in men and women over 65 years of age. High morbidity and mortality due to cardiovascular disease in elderly patients requires effective prevention and treatment in patients. The incidence of cardiovascular diseases is in direct proportion to age; therefore, hypertension, coronary artery disease, carotid artery disease, stroke, heart failure, arrhythmia and valvular diseases can be identified as common cardiovascular diseases in the elderly population.

PubMedID: 28947726 Atrial fibrillation (AF) is the most common persistent cardiac arrhythmia and causes mortality in the community. Cardioversion and catheter ablation are frequently used methods for rhythm control. Oral anticoagulants have been used for many years in the prevention of thromboembolic complications in patients with AF. Both cardioversion and catheter ablation have been associated with certain complication risks especially thromboembolism, which can be significantly reduced by adequate anticoagulation. In this review, we discuss the efficacy and safety parameters of continuous rivaroxaban treatmentn compared with dose-adjusted vitamin K antagonist therapy in patients who were planned to undergo cardioversion and catheter ablation according to the data of X-VERT and VENTUREAF trials.

2017 International Artificial Intelligence and Data Processing Symposium, IDAP 2017 -- 16 September 2017 through 17 September 2017 -- -- 115012 Feature selection is addressed an important problem in data mining. To be high dimension of the data obtained from the sources is encountered as an issue in many issues such as computation cost. For this reason, eliminating the unnecessary ones among these data and choosing the appropriate ones makes it possible to evaluate the information correctly. In this study, it is tried to suggest a method that can be used in feature selection on data sets. In this method, The Whale Optimization Algorithm, which is one of the new meta-heuristic algorithms, is used to select appropriate features. Training with artificial neural networks takes place during the evaluation process of selected features. At the end of the training, the features that provide the minimum error value are selected. In the performance evaluation of the method, known data sets will be used and the results will be given in comparison with the Particle Swarm Optimization method. © 2017 IEEE.

In this study, preservice teachers’ levels of rewarding preferences while maintaining classroom discipline were investigated. This is a survey study which has quantitative research design. The study was conducted with 163 pre-service teachers studying at the departments of Computer and Instructional Technologies Education, Foreign Language Education, Elementary Science Education, and Primary Education during the 2010-2011 academic year. Data were collected through 39 items measuring implementation of psychological, social, and material rewards under the dimesion of Reward Implementation which is one of the dimensions of the “Classroom Discipline Methods Scale”. Results were examined according to three variables; gender, type of instruction and the department. Results revealed that pre-service teachers preferred psychologic and social rewards more often than material rewards. They agreed with the items related to the implementation of psychological and social reward at ‘always’ level while they agreed with the items related to the implementation of material rewards at ‘sometimes’ level., Çalışmada öğretmen adaylarının sınıf içi disiplini sağlamak için hangi ödül uygulamalarını ne düzeyde tercih etme eğiliminde oldukları araştırılmaktadır. Nicel araştırma desenlerinden betimsel tarama modeline sahip bu çalışmada, 2010-2011 yılında Çanakkale Onsekiz Mart Üniversitesi Eğitim Fakültesi Bilgisayar Öğretimi ve Teknolojileri Eğitimi, Yabancı Diller Eğitimi bölümlerinde, Fen Bilgisi ve Sınıf Öğretmenliği anabilim dallarında öğrenim gören 163 öğretmen adayına ulaşılmıştır. Veri toplama aracı olarak “Sınıf İçi Disiplin Yöntemleri Ölçeği”nin psikolojik, sosyal ve maddi ödül uygulamalarına yönelik 39 maddeden oluşan ödül uygulamaları boyutundan oluşan ölçme aracı kullanılmıştır. Çalışma sonucunda cinsiyet, öğretim türü ve bölüm değişkenleri altında, öğretmen adaylarının psikolojik ve sosyal ödül uygulamalarını maddi ödül uygulamalarına oranla daha çok tercih ettikleri; psikolojik ve sosyal ödül uygulamalarına “her zaman” düzeyinde, maddi ödül uygulamalarına “bazen” düzeyinde katıldıkları sonucuna ulaşılmıştır.

PubMedID: 26875124 [No abstract available]

Palmar hyperhidrosis is a disease characterised with excessive sweating of the hands that can be seen in every decade and can have negative effects on quality of life.Treatment for palmar hyperhidrosis is not easy and several methods are used. Treatment options include topical and systemic agents, iontophoresis, botulinum toxin injections, surgery,and sympathectomy with chemicals or radiofrequency. In this article we presented a palmar hyperhidrosis case treated by oral amitriptyline and sympathetic ganglion blockade with a local anaesthetic implying that this technique is effective and tolerable., Palmar hiperhidrozis, her yaşta görülebilen, ellerde aşırı terleme ile karekterli, insan yaşamını olumsuz etkileyen bir hastalıktır. Tedavisi genellikle zordur ve çeşitli yöntemler uygulanmaktadır. Tedavi seçenekleri olarak, topikal ve sistemik ajanlar, iyontoforezis, botilinum toksin enjeksiyonları, cerrahi, kimyasal ve radyofrekans ile yapılabilen sempatektomi sayılabilir. Bu makalede oral amitriptilin ile birlikte lokal anestezikle yapılan sempatik ganglion blokajı uygulanan bir palmar hiperhidrozis olgusu sunulmuş ve bu tekniğin etkili ve iyi tolere edilebilir olduğu kanısına varılmıştır.

Son yıllarda işletmeler, dağıtım kanalında kendileri ile birlikte çalışan aracı müşterileri ve tedarikçileri ile kısa vadeli ilişkiler geliştirmek yerine, uzun dönemli, işbirliğine dayanan iyi ilişkilere önem vermeye başladılar. Bu iyi ilişkilerin geliştirilebilmesi için de, alıcı ve satıcı işletmeler arasında ilişki pazarlaması ile birlikte, işbirliğine dayalı pazarlama, veri tabanlı pazarlama, yinelemeli pazarlama, bire-bir pazarlama ve doğrudan pazarlama yöntemlerinin de kullanıldığı görülmektedir. İşletmeler arası pazarlamada, bu yöntemlerin birlikte kullanımının aralarında bağıntılar oluşturabileceği düşüncesinden yola çıkarak; bu çalışmada, ilişki pazarlaması ile işbirliğine dayalı pazarlama, veri tabanlı pazarlama, yinelemeli pazarlama, bire-bir pazarlama ve doğrudan pazarlama arasındaki bağıntılar analiz edilmektedir.

Son yıllarda dünyanın bilimsel ve entelektüel gündemine damgasını vuran ve her geçen gün daha da belirginleşen bir takım argümanlar, arayış ve eğilimler, alışageldiğimiz pozitivist dünya düzeni ve paradigmanın ilke ve öngörüleri üzerine temellendirilmiş bulunan bilimin bir kurum olarak işlevselliğini yitirdiğini, geleneksel anlayış ve postülatlara dayalı bilimsel bilgi ve metodolojilerin artık sonuna gelindiğini çeşitli platformlarda ortaya koymuş, bilimin sonuç ve çıktılarının, insanlığı büyük ölçüde beklenmedik ve arzulanmayan neticelerle yüz yüze getirdiğini, pozitivist postülatlar üzereine temellendirilmiş bilimsel bilgininin hakikate ulaşmada tek başına yeterli olmayabileceğini, bilimsel bilgiye ulaşılmaya çalışılırken kullanılan araç ve gereçlerin, yöntem ve tekniklerin esaslı bir paradigmatik değişimden geçmesi gerektiğini ortaya koymuştur. Söz konusu argümanların ışığında bir belit (aksiyom) olarak ortaya çıkan bir hakikat insanoğlunun daha emin bir geleceğe doğru ilerlemesinin önkoşulunun artık eskimeye yüz tutmuş bulunan paradigmanın yerine yenisinin tesis edilmesi olmuştur. "Bilimsel Bilgi ve Metodolojilerin Sonu " başlıklı bu betimsel makalede, seküler ve mekanistik bir dünya telakkisine dayalı salt rasyonel bir aklın toplumsal, siyasal ve ekonomik alandaki fenomenleri izah edemeyebileceği anlayışından hareketle, pozitivist bilimin eleştirisinin yanısıra bilimin zamanı ve mekanı aşan, disiplinlerarası ve daha kadim bir üst anlatı ve retorik üzerine temellendirilmesi gerektiği pozitivizmin ve maddesel gerekirciliğin kavram ve olguları üzerine temellendirilmiş bir dünyada beşeriyetin yeni yaşamsal reçetelerin arayışına koyularak yepyeni bir epistemoloji üzerinde terakki ve tekamül göstermesinin yeni paradigmanın inşa edilebilmesi açısından hayati bir önem arz ettiği vurgulanmıştır.

In this study, preservice teachers’ levels of rewarding preferences while maintaining classroom discipline were investigated. This is a survey study which has quantitative research design. The study was conducted with 163 pre-service teachers studying at the departments of Computer and Instructional Technologies Education, Foreign Language Education, Elementary Science Education, and Primary Education during the 2010-2011 academic year. Data were collected through 39 items measuring implementation of psychological, social, and material rewards under the dimesion of Reward Implementation which is one of the dimensions of the “Classroom Discipline Methods Scale”. Results were examined according to three variables; gender, type of instruction and the department. Results revealed that pre-service teachers preferred psychologic and social rewards more often than material rewards. They agreed with the items related to the implementation of psychological and social reward at ‘always’ level while they agreed with the items related to the implementation of material rewards at ‘sometimes’ level. Çalışmada öğretmen adaylarının sınıf içi disiplini sağlamak için hangi ödül uygulamalarını ne düzeyde tercih etme eğiliminde oldukları araştırılmaktadır. Nicel araştırma desenlerinden betimsel tarama modeline sahip bu çalışmada, 2010-2011 yılında Çanakkale Onsekiz Mart Üniversitesi Eğitim Fakültesi Bilgisayar Öğretimi ve Teknolojileri Eğitimi, Yabancı Diller Eğitimi bölümlerinde, Fen Bilgisi ve Sınıf Öğretmenliği anabilim dallarında öğrenim gören 163 öğretmen adayına ulaşılmıştır. Veri toplama aracı olarak “Sınıf İçi Disiplin Yöntemleri Ölçeği”nin psikolojik, sosyal ve maddi ödül uygulamalarına yönelik 39 maddeden oluşan ödül uygulamaları boyutundan oluşan ölçme aracı kullanılmıştır. Çalışma sonucunda cinsiyet, öğretim türü ve bölüm değişkenleri altında, öğretmen adaylarının psikolojik ve sosyal ödül uygulamalarını maddi ödül uygulamalarına oranla daha çok tercih ettikleri; psikolojik ve sosyal ödül uygulamalarına “her zaman” düzeyinde, maddi ödül uygulamalarına “bazen” düzeyinde katıldıkları sonucuna ulaşılmıştır.

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Clotting is a process that occurs following the consecutive reactions of almost 20 different molecules in the blood. The diseases that appear due to the mutation of these molecules resulted in, intravascular thrombus bleeding. Our case who admitted to our hospital due to acute abdominal pain six year before was operated under the emergency conditions and superior mesenteric vein occlusion was observed. Partial resection of 70 cm small intestine with end to end anostomosis was performed. Faktör V leiden mutation was found in the postoperative diagnostic investigations Six year later, the same patient was admitted to our clinic with abdominal distention and diagnosed to be portal vein thrombosis and appropriate treatment was in this report, we presented the diagnostic and treatment characteristics of the case. © 2009 OMÜ Tüm Haklari Saklidir.

Objective: : It was aimed to determine bacteria distribution and S. aureus colonization in nares, fornix and eyelid margin of patients with atopic dermatitis (AD) compared to controls and to investigate it's relationship with skin and eye involvement., Methods: Patients' dermatological and opthalmologic examinations were done. The standart tear break-up time and Schirmer tests were performed. Samples were taken from fornix, eyelid margin and nares for bacterial culture., Results: Tweenty seven patients and 28 controls were included. There was no difference between the patients with and without eye involvement with respect to dry eye (p>0.05). The bacteria was more frequently isolated in patients (85.2%) than controls (60.7%), however S. aureus colonization (51.9%, 50.0% respectively) didn't differ in both groups (p=0.042, p>0.05). The disease severity was positively correlated with S. aureus colonization (p=0.031). There was no difference between the patients with and without eye involvement with respect to S. aureus colonization and presence of bacteria (p>0.05). No bacteria was isolated from patients whom tear function analyses were performed., Conclusions: It wasn't established an increased percent of S. aureus colonization in AD patients compared with controls. There was no association between dry eye and eye involvement. No comment could be remarked about the possible relation between dry eye and bacterial colonization.

PubMedID: 18676310 [No abstract available]

Pseudomonas aeruginosa is an important opportunistic pathogen. P.aeruginosa strains secrete several virulence factors, in the form of extracellular proteins. Adhesins, pyocyanin, proteases, hemolysins, exotoxin A and exoenzyme S are some of the virulence factors found in P.aeruginosa strains. In this study, the presence of siderophore, total matrix protease and elastase activities were investigated in a total of 157 P.aeruginosa strains isolated from lower respiratory tract (n: 81; sputum, bronchoalveolar lavage, tracheal aspirate) and extrarespiratory sites (n: 76; urine, wound, blood) of hospitalized pati ents. Chrome. azurol S (CAS) agar plates were used for detection of siderophore activity. Hide powder azure was used for the investigation of total matrix protease activity and elastin congo red was used to test elastase activity. All strains gave positive reaction on CAS agar. Enzyme activities of the test strains were compared with the activity of P.aeruginosa PAO1 positive control strain. Mean total matrix protease and elastase activities were less than P.aeruginosa PAO1 activity in the test strains, however, some strains exhibited activity higher than PAO1. There was no significant difference for mean protease and elastase activities between the strains isolated from lower respiratory tract samples and the others (p

Pseudomonas aeruginosa is an important opportunistic pathogen. P. aeruginosa strains secrete several virulence factors, in the form of extracellular proteins. Adhesins, pyocyanin, proteases, hemolysins, exotoxin A and exoenzyme S are some of the virulence factors found in P. aeruginosa strains. In this study, the presence of siderophore, total matrix protease and elastase activities were investigated in a total of 157 P. aeruginosa strains isolated from lower respiratory tract (n: 81; sputum, bronchoalveolar lavage, tracheal aspirate) and extrarespiratory sites (n: 76; urine, wound, blood) of hospitalized pati ents. Chrome azurol S (CAS) agar plates were used for detection of siderophore activity. Hide powder azure was used for the investigation of total matrix protease activity and elastin congo red was used to test elastase activity. All strains gave positive reaction on CAS agar. Enzyme activities of the test strains were compared with the activity of P. aeruginosa PAO1 positive control strain. Mean total matrix protease and elastase activities were less than P. aeruginosa PAO1 activity in the test strains, however, some strains exhibited activity higher than PAO1. There was no significant difference for mean protease and elastase activities between the strains isolated from lower respiratory tract samples and the others (p > 0.05) [corrected] as well as no difference with respect to antibiotic resistance (p > 0.05) [corrected] It was found that ceftazidime and cefoperazone were the most resistant agents in both groups (67.9% and 57.9% for ceftazidime and 49.3% and 48.7% for cefoperazone, respectively). It was concluded that further in vivo studies are necessary to clarify the role of virulence factors of P. aeruginosa in the establishment of infection in different body sites.

In this research, we aimed to investigate the production of Turkish type bread better in quality, production cost and its nature by using modified Liquid ferment system. So, the standardization and mechanization of this method was studied. As a natural nitrogen source, wheat germ, active soy flour and high yield wheat flour (type 850) were used instead of yeast food (DAHP + MgSO4). In the both production sizes, with 1 liter at lab, 1000 liter at commercial size fermenter, the liquid ferment breads produced by 1 % yeast inoculations, gave similar results to the control breads produced with 3 % compressed yeast by the direct method, being superior in crumb properties than that of the control. As natural nitrogen source, instead of yeast food (DAHP + MgSO4), 5 % wheat germ or active soy flour were substituted in ferment flour especially at laboratory case, the results were similar to the bread quality produced by yeast food addition. Wheat germ addition gave higher volume and symmetry with better crumb texture and brightness, while soy flour addition shows more volume and yield with whiter crumb. At the commercial condition, the performance was decreased in bread volume and this could be removed by the yeast nutrients additions in addition to wheat germ or active soy flour substitutions., Bu araştırmada Türk tipi ekmek üretiminde, modifiye likit ferment sistemini kullanarak, daha yüksek maya performansı ile daha ucuz, doğal ve daha kaliteli ekmek üretimi araştırılmış, bu amaçla geliştirilen metodun standardizasyonu ve mekanizasyonu üzerine çalışılmıştır. Denemelerde maya gıdası (DAHP+ MgSO4) yerine, doğal azot kaynağı olarak buğday ruşeymi, aktif soya unu ve yüksek randımanlı un (tip 850) kullanımları araştırılmıştır. Laboratuvar (1 lt.) ve ticari ölçekte (1000 lt.) fermentörlerde, % 1 maya inokülasyonu ile üretilen likit fermentlerden yapılan ekmekler, % 3 yaş maya ile direkt usulde üretilen ekmeklere göre eşdeğerde ekmek dış özellikleri ve daha üstün ekmek içi özellikleri sağlayarak, maya kullanımında tasarruf sağlanmıştır. Maya gıdası (DAHP + MgSO4) yerine, doğal azot kaynağı olarak ferment ununa % 5'lik buğday ruşeymi veya aktif soya unu ikamesi, özellikle laboratuvar tipi ekmeklerde, maya gıda katkısına eşdeğerde kalite göstermiştir. Performans olarak, buğday ruşeymi katkısı hacim ve simetri ile ekmek içi tekstürü ve parlaklığında, aktif soya unu ise ekmek hacmi ve verimi ile ekmek içi beyazlığında diğerlerine göre, ticari şartlarda daha iyi olmak üzere yüksek performans göstermiştir (p

Different methods are used recently in order to measure bone mass, bone densitometry and bone mineral value of the different parts of the skeleton. In this study simple conventional radiography and conventional radiography (BMD) was compared.Thirty-seven patients were included. Radiographic measurement of vertebral body height was compared with the bone mineral densitometric value of the same level.There was no difference between the BMD value and vertebral height loss statistically, Günümüzde iskeletin değişik bölgelerinde kemik kütlesinin, kemik dansitesinin ve kemik mineral içeriğinin saptanması için çeşitli metodlar kullanılmaktadır. Bu çalışmada bu yöntemlerden en basiti olan konvansiyonel grafilerle, en gelişmiş teknik olan kemik mineral dansitometrisi arasındaki ilişkiyi araştırdık. Çalışamaya alınan 37 hastanın vertebra yükseklikleri konvansiyonel grafilerle ölçülüp aynı seviyedeki kemik mineral dansitometri değerleriyle karşılaştırıldı. Çalışma sonucunda; BMD değerleriyle vertebra yüksekliklerindeki kayıplar arasında istatistiksel olarak anlamlı bir ilişki bulunamadı.

Bu çalışmada, farklı katkılama ve ortam şartlarında üretilen sıvı-un fermentinde kullanılan maya (S.cerevisiae) performansının artırılması amaçlanmıştır. Denemelerde, 100 gram un esasına göre; ferment hazırlamada üç farklı yaş maya miktarı (% 0.75, 1.0 ve 1.5) ve iki farklı un oranı (% 10 ve 15) ile optimum seviyelerde üç farklı maya gıdası "Diamonyum hidrojen fosfat (DAHP)", "NH_4Cl KH_2PO_4" ve "DAHP MgSO_4 " kombinasyonları, kullanılmıştır. Üretilen sıvı ferment örnekleri, ekmek yapımında kullanılmış ve sıvı fermentte kullanılan maya performansını ölçmede parametre olarak ekmeğin dış (ağırlık, hacim, spesifik hacim, simetri ve kabuk rengi) ve iç (tekstür, gözenek yapısı, renk ve sertlik) özellikleri kullanılmıştır. Bu ekmekler, % 3 yaş maya ile direkt usulle üretilen şahit ekmeklerle karşılaştırılmıştır. "DAHP MgSO_4 " kombinasyonu, % 15'lik ferment un miktarı ve artan maya düzeyleri; kabuk rengi ve simetri özellikleri dışında, tüm ekmek özelliklerini geliştirmiştir. Sıvı fermente % 15 un ve % 1.5 maya ilavesi ile "DAHP MgSO_4 " maya gıdası kombinasyonu; % 3 maya ile direkt usulde üretilen şahit ekmeklere göre daha olumlu sonuçlar vermiştir. Aynı şartlarda % 1 maya ile üretilen sıvı ferment, şahit ekmeklere eşdeğerde performans göstermiştir., In this study, it was aimed to increase the performance of yeast {Saccharomyces cerevisiae) used in liquid-flour fermet wihch was produced in various additive and medium conditions. In the experiments, based on 100 g flour use, three yeast inoculation levels (0.75, 1.0 and 1.5 %), two flour replacement levels (10 and 15 %) and three yeast food combinations "Diamonium hydrogen Phosphate (DAHP)", "NH_4Cl KH_2PO_4" and "DAHP MgSO_4 " at optimum levels obtained with pre-experiments were used as factors. The liquid ferment samples were used in breadmaking. As parameters, the external (loaf weight, volume, specific volume, symmetry and crust color) and the internal (crumb texture, porosity, color and compressibility) properties of the breads were measured. These breads were compared with control bread obtained by straight dough method with 3 % compressed yeast addition. The "DAHP MMgSO_4 " combination and the 15 % ferment flour and increasing yeast levels enhanced the all bread properties apart from the crust color and symmetry. 15 % ferment flour and 1.5 % yeast inoculation with "DAHP MgSO_4 " yeast food combination gave the most satisfactory results than the control breads made by straight dough method with 3 % bakers' yeast addition. The breads made of the liquid ferment prepared with 1 % yeast addition gave similar results to those of the controls.

Serum resistance is one of the major virulence factors of Gram negative bacteria. The aim of this study was to investigate the serum resistance of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from various clinical samples (19 tracheal aspirates, 14 urine, 7 sputum, 7 wound and one peritoneal fluid specimens). Forty-eight P. aeuginosa and 48 A. baumannii strains were tested for human serum bactericidal effect by using Benge's method. Thirty-five (72.9%), 9 (18.7%), and 4 (8.3%) of P. aeruginosa strains were found to be resistant, intermediate sensitive and sensitive to serum, respectively. These rates were detected as 81.2% (39/48), 14.5% (7/48), and 4.1% (2/48) for A. baumannii strains, respectively. It can be concluded that, high serum resistance rates of P. aeruginosa and A. baumannii isolates might have an important role in the pathogenesis of infections of these bacteria.

Myocarditis is an inflammatory disorder of the myocardium with necrosis of myocytes and associated inflammatory infiltrate. Although the etiological agent is usually a virus, some bacteria, fungi, autoimmune disorders and medical drugs may also be implicated. Myocarditis has a variable clinical manifestation from latent to very severe clinical forms, such as acute congestive heart failure and sudden death. Scintigraphy, echocardiography and cine magnetic resonance angiography are useful methods to identify myocarditis. Endomyocardial biopsy, using the Dallas criteria for histopathological classification, has remained the gold standard for the diagnosis of acute myocarditis. In this review, pathological mechanisms, modalities of diagnosis and treatment strategies of myocarditis are discussed. Copyright © 2006 by Türkiye Klinikleri.

Diastolic dysfunction is frequent in patients with congestive heart failure and hypertension. It can be defined as "an abnormality of ventricular filling with low pressure like with normal cardiac function and compensatory increased atrial pressure". Diastolic dysfunction has 3 different categories: impaired relaxation, pseudonormalization and restrictive pattern. Although a lot of invasive and noninvasive methods could be used, classical pulsed wave Doppler (PWD) method which include mitral flow and pulmonary venous flow are the most used methods for assessment of diastolic dysfunction. Nonetheless, PWD is affected from preload and there are some difficulties distinction about of normal from pseudonormalization. Due to these limitations, there is necessity of new method for accurate assesment of diastolic dysfunction. Tissue Doppler Imaging (TDI) is a new method which allows assessment of systolic and diastolic function of myocardium and mitral annulus. Diastolic function could be easily evaluated with TDI independently from preload. This method allows differential diagnosis of diastolic dysfunction from constrictive pericarditis and restrictive cardiomyopathy and also distinction of normal and pseudonormalization which it could be done by using PWD. Therefore, TDI method recently has been replaced to traditional methods.

In the present study, we investigated the role of pre-treatment highly sensitive C reactive protein (hsCRP) and serum amyloid A (SAA) levels in predicting the success of thrombolytic treatment in patients with acute ST elevation myocardial infarction STEMI. Forty two patients (4 female and 38 male) between the ages of 28 and 70 (mean age 54.8 ± 9.4 years) treated for STEMI were included in the study. After serum samples were collected for the assessment of CK-MB, troponin T, lipids, hsCRP and SAA levels, the patients were all given thrombolytic treatment. Electrocardiography obtained at presentation and 3 hours later were evaluated. An ST segment resolution 70% and above with respect to the initial ST elevation was accepted as complete resolution, while resolution values of respectively 31-69% and 0-30% were designated as moderate and weak resolution. On their 5th day of hospitalization, a second serum sample was collected from all patients for the determination of hsCRP and SAA values. Their coronary angiography and TIMI flow patterns were also evaluated. There was an inverse relationship between the initial hsCRP and SAA levels on one hand and the ST resolution after thrombolytic treatment on the other, which persisted at the 5th day after presentation. Complete resolution was predicted with a sensitivity of 67% and a specificity of 74% in patients with hsCRP levels below 3.5 mg/dl. Conversely, for patients with hsCRP values above 7.0 mg/dl, poor ST resolution was predicted with a sensitivity of 70% and a specificity of 88%. Serum hsCRP level measured before thrombolytic therapy in patients with AMI with ST elevations is a practical and reliable method in determining the efficacy of thrombolytic treatment.

Morphometry is a newly applied method for investigation of the in-vitro growth dynamics of dermatophyte colonies. This study was undertaken to evaluate the correlation and agreement rates between the morphometric data obtained by different observers. For this purpose, five different Microsporum canis growth data were evaluated by six observers. The results of the study suggested that the agreement rates among the data obtained by different observers were low (R1 = -5.3509), while the results obtained by a single observer at different reading time points were consistent and correlated with the estimated growth rate. We thus recommend the evaluation of morphometric test results by a single observer for optimal standardization and consistency.

PubMedID: 14675882 Objective: When mitral stenosis is associated with other valve lesions, diagnosis, prognosis and the treatment strategies are affected. Mitral valve prolapse may occur in some patological settings that affect mitral apparatus. We investigated the incidence of valve lesions including mitral valve prolapse that accompany mitral stenosis and assessed the relation between echocardiographic measures. Methods: Two hundred and one patients (31 male, 170 female) between 16 and 72 years of age (mean age 40.9±11.4 years) with mitral stenosis were included in the study. Patients were divided into three groups according to the mitral valve area obtained by echocardiography using planimetric method as Group I (MVA 1.5 CM2). Results: Mitral stenosis with mitral regurgitation, aortic regurgitation, aortic stenosis, combined aortic valve disease, tricuspid regurgitaion and tricuspid stenosis were found in 117 (58.2%), 84(41.8%), 18 (9%), 9 (4.5%), 62 (30.8%) and 6 (3%) patients, respectively. Twenty-three patients (11.4%) had mitral valve prolapse in only anterior leaflet. Nobody of patients had mitral valve prolapse of posterior mitral valve leaflet. Age, gender, rhythm, degree of stenosis, degree of mitral and aortic regurgitations, mean pressure gradient, left atrial diameter, ejection fraction and valve score did not differ in patients with and without mitral valve prolapse. Conclusion: Our study has shown that valve lesions including mitral valve prolapse frequently accompany mitral stenosis and the incidence of mitral valve prolapse in patients with mitral stenosis is high.

ÖZET 2000 ve 2001 YILLARINDA TURK BANKACILIK SEKTÖRÜNDE YAPILAN YASAL ve KURUMSAL DÜZENLEMELER M.Ö. 3500'lü yıllarda, ticaret hacminin başlangıçta ülke içindeki insanlar arasında, daha sonra da ülkelerarasında artmasıyla, tahsil ve ödemelerin sağlıklı ve güvenli işleyişinin temin edilmesi ihtiyacı ortaya çıkmış ve böylece bankacılık sisteminin oluşumu başlamıştır. Geçen zaman içindeki gelişmeler bankaları, finansal kesimin en önemli ve en büyük oyuncuları haline getirmiştir. Bu önem dolayısıyla bankalar, içinde bulunduğu finansal piyasayı etkileyen ve bu piyasadaki gelişmelerden direkt olarak etkilenen kurumlar haline gelmişlerdir. Bu çalışmada Kasım 2000 ve Şubat 2001 dönemlerinde Türk ekonomisinde yaşanan krizler öncesinde ve sonrasındaki Türk Bankacılık sektörü yapısı incelenmiş, sektörün bu krizlerden nasıl etkilendiği ortaya konmaya çalışılmıştır. Türk ekonomisinde yaşanan bu son krizler, ekonomi tarihinde yaşanan krizlerle karşılaştırıldığında, etkisi ve sonuçlan itibariyle en ağır hissedilenleri olmuşlardır. Bunun en önemli nedeni; bu sorunların giderilmesine yönelik radikal tedbirlerin alınmaya ve kurumsal düzenlemelerin yapılmaya başlanmış olmasıdır. Her değişimde olduğu gibi bu yeni yapı, teorik açıdan ne kadar mükemmel olsa da, etkileri ekonomideki oyuncular açısından sancılı olmuştur. Çalışmada belirtildiği gibi teorik olarak kurgusu başardı yapılan bu düzenlemelerden bazılarının, uygulamaya aynı başarıyla konulamadığı görülmüştür. Türk Bankacılık sektöründeki kırılganlığın; öncelikle sermaye yetersizliği, plansız büyüme, etkin bir aktif-pasif yönetiminin bulunmaması, kamu bankalarının sistem içerisindeki yüksek payı, yetersiz iç kontrol, risk yönetimi ve kurumsal yönetişim gibi nedenlerden kaynaklandığı görülmüştür. 2000 ve 2001 yıllarında yapılan yasal ve kurumsal düzenlemeler öncelikle bu aksaklıkların giderilmesini hedeflemiş ve Türk bankacılık sektörünün geleceğini önemli derecede etkileyecek kurumsal yapı oluşturulmaya başlanmıştır. n ABSTRACT THE LEGAL AND CORPORATE REGULATIONS THAT WERE SET IN THE TURKISH BANKING SECTOR IN 2000 - 2001 In the years of BC 3500's, due to the increasing amount of trading not only between the people in the beginning but also between the nations later, the requirement of providing the collections and payments in safety has been appeared; thus the formation of the banking system has been started. By the developments that have been vanished in the passed years, the banks had become as the most significant and the effective players in the financial system With this study, the structure of the Turkish banking system and the effects of the crises which revealed on November 2000 and February 2001 are inspected. When comparing with the crises in the history of the Turkish economy, these last crises, are the most impressive ones regarding to the effects and the results. The most important reason of this is starting to take radical precautions in order to avoid these problems and to make corporate regulations. However the teoric structure is perfect, as in every structural changes, the effects of these new regulations had been difficult. As it is mentioned in the study, it is a fact that some of the regulations which were succesfully setted in theory did not get the same success while putting in practise. It seems that the vulnerability of the banking system is because of the reasons such as inadequate capital, unplanned growth, non-efficient asset-liability management, the height of the share of the public banks in the system, insufficiency of internal control, risk management and corporate governance. It is fixed that the regulations that have been formed had primarily targeted to remove these breakdowns and the corporate structure, that is going to have an important effect on the Turkish economy, is started. m 103

Insanlığın başlangıcından bu yana en önemli şey bilgi ve bunun kayıt edilmesi oldu. Geçen bunca yıl boyunca insanoğlu bir çok teknik kullandı ve bunun en önemlisi yazmaktı. Ancak ilerleyen teknolojik gelişmeler hayatımıza ilk olarak telefon ve faks ile girdi. 80'li yıllarda üretilen kişisel bilgisayarlar kullanıma sunuldu. 80'lerin sonu ve 90'ların başında ise gelişen üretim teknikleri ile hemen hemen tüm firma ve kişiler bu elektronik cihazlara sahip olmaya başladı. Kullanıcıların elektronik cihazlarla olan etkileşimleri ve hayatlarının içerisinde yarattıkları kolaylıklar arttıkça yeni standartlar ve kurallar oluşmaya başladı. Ancak bu standart ve kurallar, teknolojinin hızla ilerlemesi ile çok çabuk eskimeye ve kullanım amaçlarının dışında kalmaya başladılar. Yapılan yenilikler ile teknoloji yaşamın her noktasında kendini göstererek yeni üretim teknikleri, yeni ürünler ve yeni mecralar sunmaya başladı. Bu mecralardan en önemlileri ise tarihsel gelişimlerine göre gazete, radyo, televizyon vb. Kitle iletişim araçları oldu. Bu kitle iletişim araçlarına son olarak, tüm dünya geneline yayılan ve özellikle son 10 senedir yoğun bir şekilde kullanılmaya başlayan internet eklendi. Internet insanlara her türlü konuda inanılmaz bir bilgi alabilme özgürlüğü ve şansı getirdi. Ve böylelikle iletişim pazarında yoğun bir rekabet yaşanmaya başladı. Çünkü 1995 yılında internet kullanıcı sayısı 10 milyonken bu sayı günümüzde 350 milyona ulaştı. İletişim sektörü ve teknoloji uzmanlarına göre bu sayının 2005 yılında 1 milyar kullanıcı sayısına ulaşması bekleniyor. Bu yoğun kullanım talebi ve potansiyeli doğrultusunda internet tüm sektörleri doğrudan etkileyen bir noktaya ulaştı. İnternet genelinde kullanılan bilgi verme ve alma özelliği kurumsal ve kişisel kullanıcılar tarafından hem ticari anlamda, hemde akademik anlamda kullanılmaya başlandı. Bu kullanım kriterleri internet mecrasını dünyanın en önemli kitle iletişim noktasına taşıyarak, rekabetin en üst noktaya ulaşmasını sağladı. Rekabetin artması ile de internetin standartları teknik, görsel ve içerik anlamında sorgulanmaya başladı.Standartların kullanıcıların keyif, beğeni ve eğitim seviyesi ile doğrudan ilişkili olması, farklı kullanıcı standartlarını ve internet üzerinden bilgi aktarımı yapacak olan kurumsal, bireysel ve akademik platformlarında bu noktalara maksimum özen göstermesi gerekliliğini getirdi. İnternet üzerinden bilgi aktarımının maliyet ve erişilebilirlik açısından diğer mecralara göre düşük olması, bilgi veren kaynak sayılarının artışını gündeme getirdi. Bu artış ise beraberinde diğerleri arasından sıyrılabilme ve daha çok kullanıcı tarafından ziyaret edilebilme isteklerini doğurdu. Son 10 sene içerisinde her açıdan internet mecrasından olan kurum ve bireyler, kalite standartlarının belirlenmesinin ve kullanılmasının ne kadar önemli olduğu konusunda birleştiler. Böylelikle internet üzerinde yer almak ne kadar kolay olsada, kullanıcılar tarafından farkedilebilmek ve kalıcı olmak adına, bu mecranın değerleri, teknikleri, kriterleri ve standartları belirlenmeye çalışılarak ortak bir platform oluşturulmaya çalışıldı. Bu ortak platform bugüne kadar kullanılmış olan iletişim mecraları için oluşturulan kaynaklardan beslenerek, kendi kurallarını yarattı ve günümüzde internet üretim kriterlerini ve bilgilerini ortaya çıkardı. 80

8.ÖZET Günümüz insanında, kentleşme ve nüfus anısına paralel olarak, toplu beslenme eğilimi artmış ve dolayısıyla hazır yemek üretimi bir sanayii haline gelmiştir. Ancak, üretimde gereken hijyenik ve teknolojik koşullara özen gösterilmemesi, halk sağlığı açısından bir çok problemlere neden olabilmektedir. Özellikle salatalar gibi başka bir işleme gerek duyulmadan doğrudan tüketime sunulan gıdalar daha büyük bir risk unsuru olarak değerlendirilmektedir. Bu nedenle, lokanta, kafeterya, restaurant gibi toplu tüketim noktalarında tüketiciye sunulan gıdalardan salatalarda, muhtemel mikrobiyolojik riskleri saptamak ve önlemler almak amacıyla bu çalışma yapıldı. İstanbul'un çeşitli semtlerinde yer alan lokanta, kafeterya ve restaurantlardan 19 farklı gruptan toplam 225 numune toplandı. Bu numuneler Toplam aerob bakteri sayısı, koliform bakteri sayısı, fekal koliform bakteri sayısı, koagulaz pozitif Staphylococcus aureus sayısı, sülfit redükte eden anaerob bakteri sayısı, küf ve maya sayısı ile E.coli varlığı açısından incelendi. 225 numunenin 5 1'inde (% 22.7) E.coli. 24'ünde (% 10.7) S.aureus, 6'sında (% 2.7) sülfit redükte eden anaerob bakteri izole edildi. Elde edilen bulguların değerlendirilmesi sonucu, incelenen hazır salataların üretiminde hijyene gereken özenin gösterilmediği ve halk sağlığı açısından önemli bir risk unsuru olabileceği sonucuna varılmıştır. 45 9.SUMMARY Microbiological quality of some ready-to eat salads consumed in restaurant and cafeteria. In recent years, habit of eating ready foods has increased parallel to the increase in population. As a result of this catering has become an industry. However; not showing enough care to hygienic and technological conditions during production cause many problems related to public health. Especially, ready-to-eat salads are important for public health. Because it is consumed directly. Thus, this study was performed to determine the possible risk in salads for public health and to take some precautions. According to this, 225 samples from 19 different groups of various cafeteria and restaurants were collected. They were analysed for total aerob mesophilic bacteria, coliform and faecal coliform bacteri, E.coli, coagulase positive S.aureus, sulphide reductant anaerob bacteria, yeasts and moulds.. As a result of the analyses, 51 of total 225 (22.7 %) samples were found to contain E.coli. 24 of 225 samples (10.7 %) contained coagulase positive S.aureus, 6 of 225 samples (2.7 %) contained sulphide reductant anaerobs. As a result of the evaluation of the findings, hygiene level of ready-to-eat salads were low, and it is an important risk factor for public health. 46 55

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Karşılaştırmalı eğitim alanında yapılan bu araştırma ile Irak, İran ve Suriye eğitim sistemlerindeki benzer ve farklı yönler saptanmaktadır. Araştırma, incelenen ülkelerin eğitim sistemlerine etki eden faktörler, eğitimin amaçları, ilkeleri, yasal dayanakları, okul sistemlerinin öğretim kademelerine göre yapısı ile eğitim uygulamalarında karşılaşılan sorunları ortaya koymaya yöneliktir. Bu doğrultuda kullanılan veriler, ulusal ve uluslararası dokümanların incelenmesi ile ve hazırlanan `Görüşmeli Anket Formu` çerçevesinde ilgili ülkelerin Büyükelçiliklerindeki yetkili kişilerle görüşülmesinden elde edilmiştir. Sağlanabilen veriler ışığında, söz konusu ülkelerin eğitim sistemlerine etki eden faktörler, coğrafi durum, nüfus, dil, din, politik sistem ve ekonomik durum açılarından değerlendirilmiştir. Söz konusu faktörlerin, ilgili ülkelerin eğitim sistemlerini önemli ölçüde etkilemediği ancak etnik ve dinsel çeşitliliğin olduğu bulunmuştur. Irak ve Suriye eğitim sistemlerin amaçlan temelde sosyalist eğitim anlayışı doğrultusunda saptanmıştır. İran eğitiminin amaçları ise İslami anlayış doğrultusunda saptanmıştır. Irak ve Suriye eğitimde Arap milliyetçiliği ile laikliği temel ilke olarak kabul etmiştir. İran eğitiminde ise dinsel eğitim temel ilke olarak kabul edilmektedir. Her üç ülkede özel yeteneklerin eğitilmesi de temel ilkeler arasında yer almaktadır. İncelenen ülkelerin eğitim sistemleri, anayasaları ve eğitim yasaları ile yapılandırılmıştır. Bu yasal dayanaklara göre her üç ülkede de ilköğretim zorunlu ve parasızdır. Ortaöğretim Irak ve Suriye'de 6 yıllık zorunlu ilköğretim üzerine 3+3 modeline göre yapılandırılmış iki devre halindedir. Bu iki ülkede, zorunlu ilköğretim devresinden başlayarak bir üst öğretim kademesine geçişte merkezi sınav uygulanmaktadır. Bu yönüyle Irak ve Suriye okul sistemi eleyici bir yapıya sahiptir. İran'da ortaöğretim ise 5 yıllık zorunlu ilköğretim üzerine 3+4 modeline göre yapılandırılmış iki devre halindedir. İran'da bir üst öğretim kademesine geçiş rehberlik çalışmaları ile sağlanmaktadır. İncelenen ülkeler, ortaöğretimde mesleki ve teknik eğitime önem vermektedir. Ancak okullaşma oranlan düşüktür. Üç ülkede de nitelikli öğretmen yetiştirme sorunu vardır. Irak, İran ve Suriye eğitim sistemlerinin yönetimi merkezîdir. Üç ülkede de yükseköğretim bakanlığı vardır. Yukarıdaki bulgulara paralel olarak ulaşılan sonuçlar ise, incelenen ülkelerde okur-yazarlık oram oldukça düşüktür. Zorunlu ilköğretim süresi yetersizdir. Nitelikli öğretmen yetiştirme sorunlar vardır. Okullaşma oranlan düşüktür. Bu sonuçlar, aynı zamanda söz konusu ülkelerin eğitim sistemlerindeki sorunlar da yansıtmaktadır. Bunlara karşın, ilgili ülkelerin, eğitim sistemlerini geliştirme yönünde önemli çabalan vardır. This search tends to bringup the structure of educational systems from levels to levels the problems the Factors which reflect the systems of these countries aims of educational the principles and legal things. This knowledge has been taken from the embassy, international an national documents and public survey related to these countries. These factors have been put to use point of view geographic position, population, language, religion, polictic systems and economical position. In fact, the factors don't affect the educational systems of these countries however there have been found ethnic and religious between these countries. The aims of educational systems in Iraq and Syria include the concept of socialist. The islamic understanding is in the educational of Iran. Iraq and Syria have accepted Arabic nationalism and secularism. Religious educational has been accepted in Iran. The basic aim of these three countries is to educate special abilities in people. Their educational systems are in their constitution Primary education in these countries is obligatory and they don't pay money for this education. Secondary education last six years in Iraq and Syria and this is called three plus three (3+3) model. There is a general exam after every education, beginning primary education till the upper education. The educational system of Iraq and Syria have an elimination structure in many points of view. Primary education is five years and obligatory in Iran after this education there is another one called three plus four (3+4). It has two terms while passing the upper education in Iran they need studies of guidance. The Countries searched give importance to occupational and technique. But they don't set up many schools. The rate of schools is low. There is a problem of training qualified teachers in these three countries. Their educational systems depend on the authorities. These three countries have higher education ministries. To sum up, the rate of literacy is very low in these three countries. The period of time of obligatory primary education is not enough. There is a problem of training qualified teachers. The rate of schools is low. These problems also reflect the problems in their educational systems. 138