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Objective. Peptic ulcer disease (PUD) in children is an uncommon disorder. An estimated 1.3 percent to 20 percent of people die from perforated peptic ulcers (PPU), a PUD consequence. Using a database, we assess the prevalence and prognosis of PPU in patients. We also do radiological and laparoscopic operations for PPU in young patients. In pediatric patients, sufficient accumulation of knowledge about laparoscopic repair is at the level of case reports. This study aims to assess the results in pediatric cases operated for PUP by open or laparoscopic surgery and determine the role of computed tomography (CT) in diagnosing PUP. Methods. Data was collected from the Department of Pediatric Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Turkey, from 2015 to 2020. Patients under 18 years of age who were operated on for PUP between 2015 and 2020 were divided into two groups. Group 1 involved those patients operated by laparoscopic surgery, whereas Group 2 involved those used by open surgery. Both groups were retrospectively evaluated in terms of demographic data, clinical findings, preoperative-intraoperative findings and surgical methods (open or laparoscopic), duration of surgery, duration of nasogastric intubation, time of return to oral feeding, length of hospital stay, and postoperative complications. Results. 18 patients consisting of 15 boys and 3 girls were included in the study. Group 1 involved 10 patients, whereas Group 2 involved 8 patients. In Group 1, the symptom onset period was 1.6 ± 1.9 days, and in Group 2, it was 6.6 ± 6.1 days. In the erect abdominal radiographs (AXR) of 10 (58.8%) patients, the air was under the diaphragm. Six patients whose erect AXRs showed no attitude under the diaphragm but had abdominal pain and acute abdominal manifestation were given abdominal computed tomography (CT) scanning. In all patients with PUP, laparoscopic/open surgery involves primary suturing and repair by omentoplasty (Graham patch). The mean operative time was 87.0 ± 26.3 minutes in Group 1 and 122.5 ± 57.6 minutes in Group 2. The mean length of hospital stay was 3.9 ± 1.3 days in Group 1 and 5.8 ± 2.1 days in Group 2. Neither group developed any major surgical complications. Conclusions. Adolescents with a history of sudden onset and severe abdominal pain may present with peptic ulcer perforation even if there is no known diagnosis of peptic ulcer or predisposing factor. In cases suspected of PUP, it is vital to order and carefully examine erect AXR, which is an easy and inexpensive method. Computed tomography should be the first choice in patients without free air in ADBG but whose anamnesis and findings match peptic ulcer perforation.

Objectives In this study, we aim to discuss our experience with laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis (IHPS) and skills development throughout our learning curve. Methods We retrospectively collected data from 15 patients with IHPS who underwent laparoscopic pyloromyotomy between 2016 and 2019 in our clinic. Evolution in operation techniques, peroperative and postoperative surgical complications were analysed. Results In this research, 15 patients (male-to-female ratio:2.7/1) were studied. The median age at presentation was 36.5 days (25-100 days). Non-bilious projectile vomiting was seen in all of the patients, and in eight cases, marked failure to thrive was seen. Situs inversus totalis was seen in one of the cases as an associated anomaly, no other anomalies were noted. A palpable olive-shaped mass was found in only 33% of infants (five cases). A patient was detected to have no IHPS peroperatively. One of the cases was converted to open technique due to peroperative technical difficulties. A patient underwent 2nd operation due to incomplete pyloromyotomy. The duration of the first and last cases was 110 mins and 35 mins, respectively. Conclusion The laparoscopic approach in patients with infantile hypertrophic pyloric stenosis can result in good postoperative outcomes and satisfying surgery in the hands of surgeons who perform minimally invasive surgery routinely.

Background Intussusception is the most common cause of intestinal obstruction between 6 months and 36 months of age. There is no defined etiology in at least 75-90% of patients. Recurrent intussusception occurs in 5-16% of all intussusceptions and the treatment strategy is controversial in this patient group. Treatment of continued recurrent intussusception is a challenging problem when no lead point is revealed despite recurrence. We aimed to review our 10 years of experience in recurrent intussusception and describe a new operative technique for recurrent intussusception cases without any lead points. Results We retrospectively reviewed the data of patients with recurrent intussusception in our referral pediatric surgery clinic between 2007 and 2017. Ultrasound-guided hydrostatic reduction was performed on all patients. Surgery was performed on those patients who had findings of acute abdomen and complete intestinal obstruction or 2 failed attempts of UGHR for diagnostic purposes if a pathologic lead point was suspected based on patient findings and age. Laparoscopy or laparotomy was performed according to surgeon preference and experience. A total of 87 UGHRs were performed. Thirty-three patients were admitted to our clinic due to recurrent intussusception. The mean age was 12.75±14.14 (6 -84) months, and 19 were males and 14 were females. Abdominal pain, agitation and vomiting were common symptoms. UGHR was performed on all 33 patients on at least 2 different occasions. The time between the first and second UGHR treatments was 42.6 ± 186.19 (0-899) days. The success rate of the second UGHR was 27 out of 33 patients (81.8%). Surgery was performed on 6 patients. Manual reduction was performed on 5 patients and one was operated by the laparoscopic reduction of intussusception and Meckel’s diverticulum resection. Conclusions Surgeons should try to find permanent solutions for patients with multiple recurrent intussusceptions that are resistant to treatment. Surgical excision of the lead point will help prevent recurrent intussusception. Satisfactory results can also be obtained by ultrasound-guided hydrostatic reduction even in patients with recurrences. Laparoscopy is helpful in diagnosis, detection of lead points and treatment of irreducible intussusception. This new operative technique can be satisfactory for recurrent intussusceptions without any lead points.

In the structure of the polymer electrolyte membrane fuel cell (PEMFC), there is a need for porous electrodes in order for the gas to move to the active regions of the electrocatalysts. The electrode should provide a loud surface catalyst field to maximize the reaction ratio (current density) and minimize electrode polarization. In this chapter, the PEM provides information on porous metal materials for fuel cells. © 2021 Elsevier Inc. All rights reserved.

Because of its simple handling and low temperature sensitivity, the direct methanol fuel cell (DMFC) system is very important to the development of energy converters. Also, the factors that inhibit the commercialization of DMFCs have a number of negative effects, such as the sensitivity of the polymer to the osmotic swelling of the electrolyte membrane, the passing of methanol through the membrane, the high cost, and the limited working temperature. The prepared product is based on the production and properties of polymer electrolyte membranes (PEMs) used in DMFC applications. © 2021 Elsevier Inc. All rights reserved.

Autosomal-dominant polycystic kidney disease (ADPKD) is associated with oxidative stress and hypertension development before renal function decline and cardiovascular disease development. Oxidative stress-responsive kinase-1 (OSR-1) participates in the signaling regulating Na+ transport during oxidative stress and also plays a role in the regulation of cell volume and blood pressure. Therefore, we aimed to investigate the potential role of OSR-1 in ADPKD patients. Eighty ADPKD patients, 80 healthy controls, and 80 non-ADPKD patients with hypertension were enrolled in this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood samples were taken after 12-h fasting for the measurement of biochemical parameters and OSR-1 gene expression. Vascular dysfunction was assessed using ischemia-induced forearm flow-mediated vasodilation (FMD). Briefly, of the 80 ADPKD patients, 41(51%) were male, and 53(66%) of them were hypertensive. The mean age of the 80 controls was 35.3 +/- 12.6 years, and 37(46%) of them were male. The mean age of the 80 non-ADPKD patients with hypertension was 44.6 +/- 11.9 years, and 38(47.5) of them were male. There were significant differences in serum OSR-1 gene expression between the ADPKD patients and the control subjects. Serum OSR-1 gene expression was also significantly increased in hypertensive ADPKD patients in comparison with both normotensive ADPKD counterparts and non-ADPKD hypertensive subjects. Serum OSR-1 gene expression was increased in patients with ADPKD than healthy subjects. Low estimated glomerular filtration rate (eGFR), OSR-1 gene expression, total kidney volume (TKV), and high-density lipoprotein (HDL) were also independently associated with hypertension in ADPKD patients.

In this paper, we present the synthesis of different metal-doped TiO2 compounds (pure TiO2, Fe doped TiO2 (FexTi1-xO2), Ni doped TiO2 (NixTi1-xO2), Zr doped TiO2 (ZrxTi1-xO2)) thin films in order to improve the performance of dye-sensitized solar cell (DSSC). Undoped TiO2 particles and Ni, Fe and Zr transition metals doped TiO2 particles were synthesized by the sol-gel method for the utilization of the anodic part of the DSSC. The cathode of the DSSC was a carbon electrode. Fluorine Doped Tin Oxide (FTO) coated electrodes on the glass surfaces and electrolyte solution containing I/I2 was obtained a dye-sensitized solar cell. Pure TiO2 and Ni, Fe and Zr doped TiO2 nanopowders were characterized by DLS, XRD, SEM/EDX, and UV–Vis Spectroscopy. The thin films have been deposited on the glass substrate by the doctor blade method. The effect of synthesized nano-materials on the cell performance of DSSC was investigated by J-V curves. J-V characterization of solar cell module shown that the highest power conversion efficiency was the solar cell module that fabricated with 10% of Zr doped TiO2 with the short circuit current (Jsc) and the efficiency was at 0.13 mA cm- 2 and 0.020%, respectively. However, yields on the cell performance of other nanomaterials were obtained as 0.019%, 0.017% and 0.015% for pure TiO2, Fe doped TiO2, and Ni doped TiO2, respectively. © 2019, Türkiye Bilimsel ve Teknolojik Araştirma Kurumu, M.U. and K.C. acknowledge the Scientific and Technological Research Council of Turkey (TUBITAK) - BIDEB 2218 for the Postdoctoral Research fellowship.

Renal amyloid A (AA) amyloidosis is one of the systemic etiologies of nephrotic syndrome (NS) in adults. Chronic inflammatory conditions including rheumatoid arthritis, familial periodic fever syndromes, spondyloarthropathies, and chronic bacterial infections such as tuberculosis and chronic osteomyelitis are the common causes of secondary AA amyloidosis. In this case report, we reported a patient presented with nephrotic syndrome and secondary AA amyloidosis due to chronic hepatitis B infection in the absence of any glomerulonephritis.

Purpose - This study investigates whether size of 112 publicly listed firms in manufacturing sector affects their profitability in Turkey during the period 2005-2013. Methodology - Dynamic panel data approach (i.e. two-step system GMM estimator) taking into account potential endogeneity of firm-level variables is employed to estimate the effect of alternative firm size indicators on firm profitability. Findings- Estimation results suggest that after controlling for financial risk, liquidity level, growth opportunities, unsystematic risk, firm age, and the other factors, the indicators of firm size measured by firm’s assets, sales and number of employees tend to have a positive influence on the profitability of firm measured by operating return on assets. Conclusion- There is enough statistical evidence to support a linear relation between firm size measures and profitability of firms in the period analyzed. However, our empirical results do not support the quadratic or cubic association between size measures and profitability.

Purpose - The aim of this study is to determine the bank-specific, sector-specific and macroeconomic factors that affect the profitability of 23 deposit banks in Turkey. Methodology- in this study, we employ panel regression analyzes as well as mean and median tests. Our study using quarterly data covering the period 2005Q1-2015Q4 is divided into two groups: listed banks and non-listed banks. Findings- According to the results of the mean and median tests, there are significant differences between the listed banks and non-listed banks in terms of bank-specific variables. Regression results also indicate that the bank profitability is significantly affected by the variables such as bank size, bank capital, liquidity risk, economic growth, inflation, policy rate, exchange rate, and market concentration. Conclusion- When our results are evaluated in general, it could be said that the factors affecting profitability significantly differ according to whether the banks are traded at the Borsa Istanbul.

OBJECTIVE: Metastatic infection is a rare but serious complication in patients undergoing hemodialysis (HD). In this retrospective study, we aimed to analyze the clinical aspects, responsible microorganisms, treatments, and clinical outcomes in HD patients with metastatic infection.

Ionic polymer-metal composite (IPMC) have great applications, in terms of being utilized in areas, such as actuators, artificial muscles and more. These composite can also be used for robotics, biomedical and biomimetic applications. Among these applications, ionic polymer metal composite actuators are mostly preferred devices used in some applications, such as biomimetic robotics, biomedical devices, manipulation systems etc. For these types of actuators, ion-exchange polymer-metal composite (IPMC) is very attractive and active materials, and the synthesis and characterization conditions are very important parameters that should be thought. For this reason, this chapter provides information on ionic polymer metal composite actuators that can be operated under dry conditions.

The ionic polymer-metal composite membranes are generally perfluorinated membranes such as Nafion and Flemion. These composites are mostly electroactive materials and they can be used as activators and sensors. The electrochemical-mechanical properties of ionic polymer-metal composites depend on many factors, such as the nature of the solvent, the morphology of the electrodes, and also other factors. This chapter provides general information about the preparation methods of the ionic polymer-metal composite membranes.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of chronic kidney disease. The intriguing role of innate immune system and inflammation become a target for potential therapeutic approach to slow progression. When toll-like receptors (TLRs) signaling and their receptors activate, they start a cascade of intracellular signaling that induces the production of the inflammatory cytokines and chemokines. Thus, we aim to investigate the association of TLRs between progression of ADPKD. Ninety ADPKD patients and ninety matched controls were enrolled this prospective study and were followed during 3 years. TLR-2 and TLR-4 gene polymorphisms and expressions were measured. Hypertension was diagnosed with ambulatory blood pressure monitoring. Rapid progression was defined as sustained decline in estimated glomerular filtration rate (eGFR) of more than 5 mL/min per 1.73 m2 per year. TLR-4Asp299Gly polymorphisms were significantly different between patient and control group (P

Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease characterized by recurrent attacks of fever, usually accompanied by sterile polyserositis. Although colchicine is the main medical treatment option for FMF, potential adverse effects and drug interactions should be considered during the follow-up of these patients. Herein, we presented a case of a hemodialysis patient with FMF, who developed rhabdomyolysis due to concomitant use of colchicine and clarithromycin for pneumonia treatment.

Peritoneal dialysis (PD) patients have different peritoneal membrane permeability (transport) characteristics. High peritoneal membrane permeability is associated with increased mortality risk in the patient population. In this study, we aimed to investigate possible risk factor(s) related to high peritoneal membrane permeability.The study included 475 PD patients (46.1 ± 14.5 years of mean age; 198 female and 277 male). The patients were divided two groups according to peritoneal equilibration test (PET) result: high-permeability group (high and high-average) and low- permeability group (low-average and low).In both the univariate and multivariate logistic regression analyses, it was found that diabetes mellitus and hypoalbuminemia was significantly associated with high peritoneal membrane permeability [relative risk (RR): 1.90, 95% confidence interval (CI): 1.26-2.86, p: 0.002 and RR: 2.14, 95% CI: 1.44-3.18, p0.001, respectively].Diabetes mellitus and hypoalbuminemia were closely associated with high peritoneal membrane permeability. Diabetic patients had 1.9 times the likelihood of having high permeability. However, the relationship between hypoalbuminemia and high peritoneal permeability appears to be a result rather than cause.