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This study investigates the seismic retrofit of substandard reinforced concrete (RC) columns through external jacketing of potential plastic hinge zones using sprayed glass fiber-reinforced mortar and basalt textile reinforcement. An innovative spraying method was used to apply the matrix material to the concrete surface. A total number of eight full-scale columns (four reference, four retrofitted) were tested under constant high axial load to capacity ratio and reversed cyclic lateral loading. Columns were constructed using low-strength concrete and transverse reinforcement with various spacing and inadequate hook detailing to mimic the columns in substandard structures. Test results are evaluated in terms of lateral load-drift ratio relationships, displacement ductility, stiffness degradation, energy dissipation, and residual displacements. Evaluation of the test results showed that the proposed technique is effective for seismic retrofit of substandard RC columns, particularly in terms of enhancement of displacement ductility, energy dissipation capacities, and reduction of residual displacements. [ABSTRACT FROM AUTHOR]

Earthquakes have caused catastrophic results in cities since the beginning of settled life, and the cumulative experience of these events has indicated that the lack of seismic resilience brings enormous economic losses and threatens human life. Consequently, the importance of seismic risk mitigation of earthquake-prone structures has arisen to reduce the primary and secondary losses resulting from seismic events in the last decades as developments in the earthquake engineering field occur. The first step for ensuring seismic resilience is the identification of risky buildings, which is a difficult challenge for metropolises like Istanbul since the building stock consists of over a million buildings. Applying code-based detailed assessments to so many buildings is not practical in terms of time and cost. Moreover, the current code-based detailed assessment methodologies such as Provisions for the Seismic Risk Evaluation of Existing Buildings under Urban Renewal Law (2019) and Turkish Building Earthquake Code (2018) provide discrete predictions for existing buildings as either risky or non-risky or satisfying life safety/controlled damage or not. However, a ranking system based on a reliable and realistic risk classification to prioritize the buildings is needed. Therefore, as a pilot project, nearly 23,000 reinforced concrete buildings in 37 different districts of Istanbul have been investigated by Istanbul Metropolitan Municipality (IMM) through PERA2019 performance-based rapid assessment methodology by considering the Design Level and Scenario-Based Earthquake cases. This is the most up-to-date and comprehensive site survey and analysis conducted in Istanbul up to now. In this paper, the characteristics of the building stock in Istanbul based on the conducted site work and the outcomes of the rapid seismic safety assessment efforts are summarized. Then, a discussion on the seismic risk evaluation of the existing residential buildings based on the prioritization of the examined buildings is presented through the results obtained for the Design Level and Scenario-Based Earthquake cases. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the prognostic factors for and determine the effect of neoadjuvant chemotherapy (NACT) on oncologic outcome in stage IVB pure serous endometrial carcinoma patients who received taxane and platinum. Forty-two patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IVB uterine serous carcinoma were enrolled from six gynecologic oncology centers and a study group was created. The study group had a 2-year disease-free survival (DFS) of 32% and 2-year disease-specific survival (DSS) of 73%. On univariate analysis; lymphadenectomy (not performed vs. performed), paraaortic lymph node metastasis (positive vs. negative) and number of metastatic lymph node count (≤5 vs. >5) were found to have statistical significance for DFS (p < 0.001, p = 0.026 and p = 0.044, respectively). Adnexal metastasis (positive vs. negative) and type of cytoreductive surgery (maximal vs. optimal and suboptimal) had statistical significance for DSS (p = 0.041 and p = 0.015, respectively). Receiving NACT did not affect DFS and DSS in stage IVB uterine serous carcinoma patients. As our sample size was small, precise conclusions could not be made for suggesting the use of NACT in advanced stage uterine serous carcinoma. For more accurate results, more randomized controlled studies are needed in this patient group. What is already known on this subject? Endometrial carcinoma is the most common type of gynecologic tract malignancies and usually it is diagnosed at early stages. Although the favorable prognosis, uterine serous carcinoma (USC), one of the rarest subtypes, has a poorer prognosis when compared to other histological subtypes. USC has a propensity to spread beyond pelvis. Due to this aggressive behavior, surgical intervention could not be feasible in advanced stage disease. What do the results of this study add? Our study evaluated the prognostic factors that affect survival in advanced stage USC patients. Also we investigated that neoadjuvant chemotherapy (NACT) could improve oncologic outcomes. Performing lymphadenectomy, presence of paraaortic lymph node and adnexal metastasis, number of metastatic lymph nodes and type of cytoreductive surgery improved survival in advanced stage USC patients. However, NACT did not have a statistical significance as a predictor for disease-specific survival (DSS) and disease-free survival (DFS). What are the implications of these findings for clinical practice and/or further research? Maximal surgical effort should be performed in advanced stage USC according to our results. On the other hand, NACT had no impact on DSS and DFS rates. For this reason, we could not be able to suggest the routine use of NACT in advanced stage USC. But more randomized controlled trials are warranted for confirmation of our results. [ABSTRACT FROM AUTHOR]

Maximum mid-expiratory flow (MMEF) is one of the pulmonary function tests that report small airway disease. Our study aimed to investigate the role of MMEF values in asthma control, the prevalence of small airway disease, and their effect on asthma control in patients with asthma with normal forced expiratory volume in one second (FEV1) values. Patients who presented to the Chest Diseases outpatient clinic of our hospital between 2018 and 2019 and were diagnosed as having asthma were included in the study. The characteristics of the patients, pulmonary function tests, their asthma treatment, and asthma control test (ACT) scores were recorded. Patients with FEV1 <80 in the pulmonary function test, those with additional lung disease, those who had an attack in the last 4 weeks, and patients who smoked were excluded from the study. MMEF <65 was defined as small airway disease. The MMEF% and MMEF (L/s) values of the group with uncontrolled asthma were found to be statistically significantly lower than those of the controlled asthma group (p = 0.016 and p = 0.003, respectively). MMEF% and MMEF (L/s) values in those with wheezing were found to be significantly lower compared with those without wheezing (p = 0.025 and p = 0.049, respectively). The MMEF% and MMEF (L/s) values of the patients with nocturnal symptoms were found to be statistically significantly lower than in patients without nocturnal symptoms (p = 0.023 and p = 0.041, respectively). ACT values of patients with MMEF <65 were found to be statistically lower than those of patients with MMEF >65 (0.047). Considering small airway disease in patients with asthma may be beneficial in clinical practice. [ABSTRACT FROM AUTHOR]

In this study, a novel retrofitting intervention on the Hirka-i Serif Mosque (constructed in 1851), which has a significant importance for Muslims due to its historical relic preservation unit keeping the cloak of the Prophet Muhammad, was illustrated. For this purpose, first the seismic performance of the mosque was investigated through site investigations and structural analyses. A 3D finite element model of the Mosque was established, and the structural system was analyzed under the combined effects of the vertical loads and seismic actions. Additionally, the existing damages observed on the walls and vaults were investigated thoroughly. By taking the existing damages and the analyses results into consideration, a rehabilitation and seismic retrofit scheme was proposed and applied by making use of innovative materials. Throughout the study, recommendations of the guideline for earthquake risk management of historical structures in Turkey (2017) has been considered. [ABSTRACT FROM AUTHOR]

This paper aimed to estimate the reference evapotranspiration (ET0) due to some limitations of the Food and Agriculture Organization-56 Penman-Monteith (FAO 56-PM) approach by using five alternative machine learning models. The study makes an important contribution to the ET0 estimation success for of the ET0 of 12 stations with variable climate characteristics in the Central Anatolian Region (CAR). The performances of the models were compared with the coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE) metrics that are frequently cited in the literature, and also with the performance index (PI). Long short-term memory (LSTM), artificial neural networks (ANN), and multivariate adaptive regression splines (MARS) models provided the best performance in eight, three, and one stations, respectively. The R2, MAE, RMSE, and PI values of the selected models from each station vary in the range of 0.987-0.999, 1.948-4.567, 2.671-6.659, and 1.544-4.018, respectively. [ABSTRACT FROM AUTHOR]

We aimed to evaluate whether adjuvant radiotherapy had a survival benefit for patients with early-stage cervical carcinoma with intermediate-risk factors. This study included patients who underwent radical hysterectomy and lymphadenectomy according to Wertheim–Okabayashi for stage IB1-IIA2 cervical carcinoma. Each patient had at least one intermediate-risk factor including tumour diameter ≥4 cm, deep stromal invasion, and positive lymphovascular space invasion (LVSI). Patients with lymph node metastasis, parametrial invasion, and positive surgical margins according to the final paraffin section were excluded. In total, 183 patients were included. Seventy-three (39.9%) patients had one, 85 (46.4%) had two, and 25 (13.7%) had three intermediate risk factors. Sixty-seven (36.6%) patients received adjuvant radiotherapy. There was a statistically significant difference in terms of stage, LVSI, and endometrial/uterine invasion between the groups that did and did not receive adjuvant radiotherapy (p =.024, p =.018, and p =.001, respectively). These two groups were homogenised by performing propensity score matching (PSM) analysis. In the new matched cohort (n = 134), 5-year disease-free survival (DFS) was 89.5% in the group that received adjuvant radiotherapy and 82% in the group that did not (HR: 0.484, 95% CI: [0.171–1.369]; p =.171). Also, receiving adjuvant radiotherapy was not associated with an improvement in oncologic outcomes in patients with one, two, or more intermediate risk factors. In univariate analysis, none of the risk factors was associated with DFS. In conclusion, adjuvant radiotherapy had no favourable effect on survival outcomes in patients with early-stage cervical carcinoma with only intermediate risk factors. What is already known on this subject? Radiotherapy after radical hysterectomy in cervical carcinoma is accepted as the standard of care when high-risk factors – positive surgical margins, lymph node metastasis, and parametrial involvement – are found in the surgical specimen. However, the necessity of adjuvant radiotherapy in patients with intermediate-risk factors – deep stromal invasion, positive LVSI, tumour diameter ≥4 cm – is controversial. What do the results of this study add? We compared patients who received adjuvant radiotherapy and those who did not. No significant difference was found between the two groups in terms of oncologic outcomes. There was no difference between the two groups in terms of pelvic and extrapelvic recurrence rates. The number of positive intermediate-risk factors did not affect survival. Moreover, age, tumour type, stage, number of removed lymph nodes, grade, bilateral salpingo-oophorectomy, and endometrial/uterine invasion were not associated with DFS among patients with stage IB–IIA cervical carcinoma with only intermediate-risk factors. What are the implications of these findings for clinical practice and/or further research? Debate remains over the prognostic factors and the adjuvant treatment options in patients with early-stage cervical carcinoma who possess intermediate-risk factors. Adjuvant radiotherapy can be ignored if initial adequate surgery has been performed in this patient group. [ABSTRACT FROM AUTHOR]

Nitrogen and water should be applied at the right time and amount to obtain optimum crop yield in arid and semi-arid regions. The study was carried out in 2017–2018 to investigate the effects of different supplementary irrigation levels applied after harvests, and different nitrogen sources on water use efficiency (WUE), yield and quality characteristics of sun-cured tobacco. The study included five different nitrogen sources (N1: zero-nitrogen, N2: ammonium nitrate, N3: ammonium sulfate, N4: calcium ammonium nitrate, and N5: urea) and four different irrigation treatments (I0:No irrigation; I33:66% deficit, I66:33% deficit and I100:100% full irrigation). The effects of nitrogen sources and supplementary irrigation treatments on plant height, leaf number, leaf width, leaf height, yield, quality grade, sugars, nicotine, phenolics, WUE and irrigation water use efficiency (IWUE) were statistically significant. Seasonal crop evapotranspiration values ranged between 117.7 and 235.3 mm. The highest WUE 1.65 kg m−3 and IWUE: 10.48 kg m−3 were recorded in I33 treatment. Plant characteristics were different between nitrogen sources; however, the results did not indicate a prominent nitrogen form. The results for supplementary irrigation revealed that the I100 treatment in semi-arid conditions increased the sun-cured tobacco yield by 22% with acceptable quality improvements. The gross income increased 1705 $ ha−1 with the increase in tobacco yield and sale price per hectare. [ABSTRACT FROM AUTHOR]

We investigated the association between preoperative ratios of inflammatory markers and the prognosis in patients with invasive cervical cancer (CC). In this single-centre study, we retrospectively enrolled 163 CC patients who underwent radical hysterectomy between February 2008 and October 2018. Among the evaluated ratios, a high neutrophil-to-lymphocyte ratio (N/L) was significantly associated with deep stromal invasion and tumour size larger than 2 cm, whereas a high M/L was significantly related to advanced-stage CC (IB3–IIIC2), lymphatic metastasis (total) and pelvic lymph node metastasis (p=.002, p=.046 and p=.046, respectively). The neutrophil count plus monocyte-to-lymphocyte ratio (NM/L) and platelet-to-lymphocyte ratio (P/L) were significantly higher in patients with deep stromal invasion, advanced stage and tumour size larger than 2 cm (p=.01, p=.044 and p=.007; p=.004, p=.005 and p=.003, respectively). In the multivariate analysis, high NM/L (>168) was associated with a statistically significant hazard ratio of 3.04 (95% CI: (1.38–6.72); p=.006) for recurrence and 9.05 (95% CI: (2.10–38.99); p=.003) for death. Both stage and NM/L are independent prognostic factors that are significantly associated with recurrence and overall survival in CC. What is already known on this subject? Previous studies suggested that there is a relationship between inflammation and the formation, development and progression of cancer. However, the relationship between cervical cancer (CC) and inflammatory blood parameters is incompletely understood. What do the results of this study add? This study investigated the relationship between systemic blood inflammatory ratios and clinicopathological patient characteristics and disease outcomes in CC. What are the implications of these findings for clinical practice and/or further research? According to this study, systemic blood inflammatory ratios may help predict the prognosis and survival of patients with CC. [ABSTRACT FROM AUTHOR]

Epilepsy is a chronic neurological disorder that is treated with multiple medications that can have significant side effects. This study investigated the potential effects of antiepileptic drugs on thyroid function. The participants in this study were epileptic adults who had been consistently monitored in follow-up care. The effects of antiepileptic drugs on the serum levels of the thyroid stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) of these patients were investigated retrospectively by comparing laboratory recordings in three defined periods: prior to antiepileptic drug treatment, between 6 months and 1 year of treatment (early stage), and after 1 year of treatment (late stage). A total of 300 epileptic patients (F/M: 175/125) were included in the study. Significant differences in TSH and fT4 serum levels in the late stage compared to the pre-treatment stage (p = 0.006 and p = 0.0005, respectively) were found. TSH values in the late stage of treatment were abnormally high in one case and low in five cases; all six of these cases had normal pre-treatment and early-stage TSH values. Patients who received monotherapy with valproic acid, levetiracetam or carbamazepine were evaluated separately and there was no statistically significant difference in TSH and fT3 levels, while fT4 levels were significantly increased during treatment in each treatment group. A significant increase in TSH levels was found in epileptic patients on polytherapy. Our results give us the opportunity to highlight the potential unique or cumulative effect of antiepileptic drugs on thyroid hormone levels. [ABSTRACT FROM AUTHOR]

Trichobezoars are hairballs that combine with food residue in the digestive tract as a result of ingesting hair. A 17-year-old girl was admitted to the emergency department with abdominal pain and vomiting for 3 days. She had been having digestive difficulty and bloating for the previous 2 months. An abdominal radiograph demonstrated air-fluid levels consistent with ileus, and an ultrasound showed hyperechoic material in the stomach and ileum. Computed tomography demonstrated images of trapped air which was considered diagnostic of a bezoar. At laparotomy, a large mass was removed from the stomach. As the bezoar extended through the pylorus and duodenum and there were mobile masses palpable in the ileum, it required a second incision to remove them. For some years she had had a habit of swallowing hair which she found on her pillow and there was a history of an obsessive personality trait and hyperactivity for which she agreed to attend a psychiatric clinic. Abbreviations: BMI: body mass index; CT: computed tomography; Hb: haemoglobin; IV: intravenous; WHO: World Health Organization [ABSTRACT FROM AUTHOR]

We aimed to evaluate clinicopathological data in high-risk early-stage cervical cancer and to define the prognostic factors determining the oncological outcomes. This retrospective study included 158 patients with stage IB–IIA cervical cancer who underwent radical hysterectomy plus lymph node dissection. Each patient had at least one high-risk factor. The median tumour diameter of the study group was 30 mm (range, 6–80). Seventy-five (47.5%) patients had parametrial invasion, 32 (20.3%) had positive surgical margins, and 108 (68.4%) had lymph node metastasis. The median duration of follow-up was 42 months (range, 1–228). During this period, 28 patients developed recurrence, and the recurrent disease occurred in a distant area in 18 patients. Five-year disease-free survival was 77.5%, and five-year disease-specific survival was 85%. In multivariate analysis, adjuvant radiotherapy was identified as an independent prognostic factor for recurrence and death. The recurrence (Odds ratio: 10.139, 95% CI: 1.477–69.590, p =.018) and mortality rates (Odds ratio: 16.485, 95% CI: 2.484–109.408, p =.004) were higher in patients who did not receive adjuvant therapy. What is already known on this subject? The decision to proceed with adjuvant therapy in the patients with early-stage disease treated with surgery depends on the presence of risk factors in pathological examination. Various prognostic factors have been identified in cervical cancer (CC). However, there is a limited number of studies describing the prognostic factors in early-stage CC with high-risk factors. What do the results of this study add? In current study, the recurrence and mortality rates were higher in patients who did not receive adjuvant therapy. No relationship was found between the survival outcomes and the number of high-risk factors. Most of the patients who developed recurrence had the recurrence in the distant localisation. This result questioned the adequacy of adjuvant therapy. What are the implications of these findings for clinical practice and/or further research? There is still a debate over the prognostic factors and the adjuvant treatment options in the patients with early-stage cervical cancer who possess high-risk factors. Adjuvant RT or adjuvant concomitant chemoradiotherapy must definitely be used in this patients. However, adjuvant therapy fails approximately 14–32%, thus multimodal treatment modalities must be developed to improve the recurrence rates and the survival. [ABSTRACT FROM AUTHOR]

Vehicle emission analysis currently faces a trade-off between easy-to-use, low-accuracy macroscopic models, and computationally intensive, high-accuracy microscopic models. In this study, we develop a surrogate model that leverages microscopic traffic and emission simulations to predict link-level emission rates. The input variables are obtained by aggregating 1 Hz simulated vehicle trajectories into hourly traffic condition factors (e.g., link average/variation of speed, truck fleet percentage, road grade, etc.). The emission ground truth data are generated using the Motor Vehicle Emission Simulator (MOVES) opmode-based analysis module. We explore different parameter and machine learning model structures to establish the statistical relationship of the input variables and the link-level emission rates. We demonstrate the ability of our model to accurately estimate vehicle-related emissions by using the Columbia, South Carolina road network as an example. This model can serve as a high-level planning tool to assess the impacts of emissions from transportation projects. Implications: Vehicle emission analysis is facing trade-offs between easy-to-use macroscopic emission models with low accuracy and computationally intensive microscopic models with high accuracy. Existing studies attempted to cope with the trade-off by pre-selecting representative emission rates but are still subject to the risk of not considering differentiated traffic patterns by using single emission rate. To fill in the knowledge gap in the literature, we develop a surrogate approach that fully integrates driving trajectories of heterogenous traffic patterns into a link-level emissions estimation model considering road characteristics. The model can achieve high accuracy and utilize publicly available traffic data in vehicle emission prediction. We apply the proposed model in a middle size city road network and demonstrate its capability to capture and quantify the impacts of traffic patterns on link-level vehicle-related emissions. Additionally, the proposed model can serve as a sketch planning tool for researchers and transportation air quality practitioners to quickly assess bounds of emissions benefits due to traffic operational and transportation strategies. [ABSTRACT FROM AUTHOR]

Metastatic cardiophrenic lymph node resection following full-thickness resection of right diaphragm for advanced ovarian carcinoma. Cardiophrenic lymph node (CPLN) metastasis is detected at the time of diagnosis in 5% to 28% of patients with advanced-stage epithelial ovarian cancer (EOC) (Mert et al. [6]; Nishikimi et al. [7]). Lopes et al. ([4]) reported histologically confirmed metastasis rate as 87% and median resected lymph node number as 1.5 (range, 1-6) in 24 CPLN resection performed patients. In their study, they also reported the median duration of cardiophrenic lymph node resection as 28 min, median size of the enlarged cardiophrenic lymph nodes as 14 mm. [Extracted from the article]

Purpose: This study aimed to determine the relationship between birth weight, and maternal serum insulin-like growth factor-binding protein-1 (IGFBP-1) and kisspeptin-1 (KISS-1) levels, and first-trimester fetal volume (FV) based on three-dimensional ultrasonography.Materials and Methods: The study included 142 pregnant women at gestational week 11°-136. All fetuses were imaged ultrasonographically by the same physician. Maternal blood samples were collected at the time of ultrasonographic evaluation and analyzed for IGFBP-1 and KISS-1 levels via enzyme-linked immunosorbent assay (ELISA). Maternal and neonatal weights were recorded at birth. Birth weight ≤10th and the >90th percentiles was defined as small and large for gestational age (SGA and LGA), respectively.Results: Median crown-rump length (CRL), FV, and maternal serum IGFBP-1 and KISS-1 levels were 58.2 mm (35.3-79.2 mm), 16.3 cm3 (3.8-34.4 cm3), 68.1 ng mL-1 (3.8-377.9 mL-1), and 99.7 ng L-1 (42.1-965.3 ng L-1), respectively. First-trimester IGFBP-1 levels were significantly lower in the mothers with LGA neonates (p < .05). There was a significant positive correlation between CRL and FV, and between the IGFBP-1 and KISS-1 levels. IGFBP-1 levels and maternal weight at delivery were negatively correlated with neonatal birth weight. There was no correlation between CRL or FV and maternal IGFBP-1 or KISS1 levels (p > .05). The maternal IGFBP-1 level during the first trimester was a significant independent factor for SGA and LGA neonates (Odds ratio (OR): 0.011, 95%CI: 1.005-1.018, p < .001; and OR: 1.297, 95%CI: 1.074-1.566, p = .007, respectively). There was no significant relationship between SGA or LGA, and CRL, FV, or the KISS-1 level.Conclusions: As compared to the maternal KISS-1 level, the maternal IGFBP-1 level during the first trimester might be a better biomarker of fetal growth. Additional larger scale studies are needed to further delineate the utility of IGFBP-1 as a marker of abnormal birth weight. [ABSTRACT FROM AUTHOR]

1. Two experiments were conducted to determine the effect of slaughter weight on the incidence and intensity of deep pectoral myopathy (DPM) ofM. pectoralis minor(p. minormuscle) in commercial conditions in Turkey and to evaluate the impact of DPM on meat quality traits ofpectoralis major(p. major) muscle in broilers. 2. In Experiment 1, a total of 116 250 carcasses from 59 Ross-308 broiler flocks, classified according to slaughter weight as 2.0–2.2, 2.2–2.4, 2.4–2.6 and >2.6 kg, were evaluated for occurrence of DPM. In Experiment 2,p. majorsamples from unaffected broilers and each DPM stage were evaluated for meat quality, oxidant and antioxidant properties, nutritional value and fatty acid profile. DPM was characterised as 1: muscles with coagulative necrosis, 2: muscles with fibrous tissue texture and pink to plumb and 3: muscles with green necrotic area. 3. The average incidence of DPM was found to be 0.73% in Experiment 1 and independent of slaughter weight. 4. In Experiment 2,p. majormuscle of broilers with DPM 1 and 2 had higher pH values with higher redness and drip loss. All DPM stages resulted in an increase in lipid content and malondialdehyde activity and lowered ash content ofp. majormuscle compared with unaffected birds. DPM 2 increased superoxide dismutase and glutathione peroxidase activities inM. p. major. Thep. majorof broilers with DPM had lower content of C18:2 conjugated linoleic and C20:3n-6 fatty acids than those of unaffected broilers. Lower Δ6 desaturase and thiosterase activities and 18:2n-6 to 18:3n-3 ratio were observed for all DPM stages compared to unaffected. 5. It was concluded that these changes obtained inp. majormuscle of broilers with DPM might indicate biochemical characteristics of muscle degenerations. [ABSTRACT FROM AUTHOR]

Background . Starting continuous ambulatory peritoneal dialysis (CAPD) immediately after insertion of a peritoneal dialysis catheter is essential in end-stage renal disease (ESRD). In relation to the insertion methods, various mechanical and infectious complications may arise. In this study, we aimed to compare early complications of the laparoscopic tunneling method of CAPD placement that we developed recently in order to minimize the complications, with those of the conventional percutaneous method. Subjects and method . Included in this study were 12 consecutive patients with ESRD to whom we introduced catheters for CAPD by way of laparoscopic tunneling between April 2003 and July 2003 and followed up for at least 6 months, and 30 patients to whom the catheters were placed percutaneously in the same time period with the same follow-up time. The complications seen during the first 6 months after catheter placement with these two different methods were compared. Results . In all of the subjects, dialysis was started soon after catheter placement. No per-operative morbidity was seen in any of the patients. While with laparoscopic tunneling method no mechanical problem was seen, the percutaneous method resulted in early leakage in 10%, pericatheter bleeding in 3.3%, and hernia in 3.3% of the patients. As infectious complications, peritonitis occurred as one episode/36 patient-months in laparoscopic tunneling and one episode/22.5 patient-months in percutaneous method; catheter insertion site infection was seen in none in the laparoscopic method, while one episode/90patient-months was seen with the percutaneous method. Tunnel infection did not arise in any of the subjects. Conclusion . The authors of this study think that the peritoneal tunneling method for introducing CAPD, which has been recently developed and began to be routinely used by them, is rather safe in terms of early complications. [ABSTRACT FROM AUTHOR]

Objective: Determination of the number and type of allergens needed to be tested in epidemiological studies is important in order to identify most of the sensitized subjects with a cost-effective approach. This study aimed to investigate the minimum skin prick test panel for the identification of at least 95% of the sensitized subjects with symptoms of asthma and/or allergic rhinitis (AR) in Ankara, Turkey. Methods: Skin prick test results of 7492 patients who were referred to our outpatient clinic with clinical symptoms of asthma and/or AR between 1991 and 2005 were evaluated retrospectively. Seven allergens were tested in all and 13 allergens in 4202 patients. The allergen group needed for detection of 95% of the sensitized subjects was determined for both the 7 and 13 allergen panels. The study protocol was approved by the local ethics committee of Hacettepe University. Results: The atopy prevalences in the whole study population and in 4202 patients tested with the 13 allergen panel were calculated as 32.2% and 42.6%, respectively. Three allergens ( Phleum pratense, Dermatophagoides pteronyssinus and Artemisia vulgaris) within the 7 allergen panel were adequate for the identification of at least 95% of the sensitized subjects. Olea europae was added to the previous three allergens when the 13 allergen panel was applied. Conclusion: Three to four allergens are sufficient for identification at least 95% of sensitized subjects with asthma and/or AR in Ankara, Turkey. [ABSTRACT FROM AUTHOR]

Aim: Similar protective effect of ischemic and ozone oxidative preconditioning (OzoneOP) in hepatic ischemia-reperfusion (I/R) injury was demonstrated, providing evidences that both preconditioning settings shared similar biochemical mechanisms of protection. We investigated the effects of OzoneOP on liver regeneration after 70% partial hepatectomy (PHx) in rats. Methods: Rats were divided into three groups: PHx, I/R + PHx, and OzoneOP + I/R + PHx groups. Ozone (intraperitoneal, 1.2 mg/kg) was given to rats subjected to I/R and 70% hepatectomy daily five times before operation. At 24 hr and 48 hr after resection, samples were collected for the measurement of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor alpha (TNF-α), and interleukin-6 (IL-6). Moreover, liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling index, mitotic index, and histopathological examination were evaluated. Results: OzoneOP reduced liver injury determined by liver histology and serum transaminases. There was a rise in serum TNF-α and IL-6 levels in the I/R + PHx group whereas OzoneOP significantly decreased the rise in the level of TNF-α but not IL-6 on the 24 hr and 48 hr of reperfusion. Moreover, liver regeneration in OzoneOP + PHx group, as assessed by the regenerated liver weight, mitotic, and PCNA-labeling index, was significantly improved when compared to I/R + PHx group. Conclusion: These results suggest that OzoneOP ameliorates the hepatic injury associated with I/R and has a stimulatory effect on liver cell regeneration that may make it valuable as a hepatoprotective modality. [ABSTRACT FROM AUTHOR]

Background: This study aims to find association of fetuin-A with serum lipids, QT dispersion (QT-d), and P dispersion (P-d) in dialysis patients. Methods: Fetuin-A serum levels were assessed in 50 dialysis patients. Results: Serum fetuin-A levels were significantly associated with QT-d ( r = 0.289, p = 0.044), P-d ( r = 0.39, p = 0.005), total cholesterol ( r = 0.526, p = 0.000), low-density lipoprotein cholesterol (LDL-C) ( r = 0.456, p = 0.00), triglyceride ( r = 0.360, p = 0.011) and highly sensitive C-reactive protein (hsCRP) ( r = −0.347, p = 0.030). In step-wise multiple regression analysis including being on hemodialysis (HD), presence of diabetes mellitus (DM), total cholesterol, LDL-C, triglycerides, hsCRP, only total cholesterol ( b = 0.419, p = 0.03), and hsCRP ( b = −0.316, p = 0.03) proved to be independent predictors of serum fetuin-A levels. QT-d showed a linear correlation with total cholesterol ( r = 0.309, p = 0.029), LDL-C ( r = 0.304, p = 0.038), P-d ( r = 0.390, p = 0.005), and fetuin-A levels ( r = 0.289, p = 0.044). In multiple regression analyses, the independent predictor of QT-d was being on HD ( b = −0.417, p = 0.004), whereas total cholesterol, LDL-C, presence of DM, serum fetuin-A levels, and P-d had no independent effect on corrected QT (QT-C). Being on HD and age were important determinants of P-d whereas presence of DM, total cholesterol, LDL-C, fetuin-A, and QT-d had no independent effect on P-d. Conclusions: Lower fetuin-A levels are associated with high hsCRP and low cholesterol levels in dialysis patients. [ABSTRACT FROM AUTHOR]

In this study we focus on the South African experience with inflation targeting. We make two major claims in this paper. First, the South African experience with inflation targeting before the crisis was not successful, not in terms of advocates' self-stated goals and certainly not in terms of key, ultimate real sector goals such as lower unemployment and higher economic growth. Second, as in a number of other countries, the SARB policy regime as well as its rhetoric about monetary policy significantly changed in response to the crisis of 2008. While these changes are an important step in the right direction of reorienting monetary policy toward important real goals of employment generation and economic growth, they are nevertheless still not adequate to the crucial task of creating a macroeconomic framework geared toward achieving these crucial goals. [ABSTRACT FROM AUTHOR]

Persistent hyperinsulinemic hypoglycemia in neonatal period is characterized by insulin hypersecretion. The major feature is severe hypoglycemia, generally unresponsive to routine medical treatment. Subtotal or total pancreatectomy is performed in unresponsive cases. In this case report, we present a newborn with persistent hypoglycemia unresponsive to medical treatment with dysrhythmic left ventricular hypertrophy. The insulin/C-peptide ratio was 58 as a confirmation of diagnosis. Since hypoglycemia persisted after the initial medical treatment, a subtotal pancreatectomy was performed followed by near-total pancreatectomy. A histologic examination revealed diffuse insulin islets. At the 70th post-natal day, death occurred due to heart failure and ventricular dysrhythmia. To our knowledge, severe dysrhythmia and left ventricular hypertrophy in persistent hyperinsulinemic hypoglycemia (PPH) is identified in the patient. [ABSTRACT FROM AUTHOR]

Introduction: Resveratrol (RSV) is a natural polyphenolic compound found in grape skins and the red wine which improves histological reorganization of the regenerating tissue in dermal wound healing. Since anastomotic healing possesses paramount importance to prevent complications in colorectal surgery, the present study is aimed to evaluate the effect of RSV on the healing of experimental left colonic anastomoses. Methods: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with RSV and the control group received tap water instead. The rats were sacrificed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline (OHP) content, histopathology, and biochemical analysis. Results: Compared to the control group, the RSV-treated rats displayed a higher bursting pressure (p < .001) and anastomotic OHP content (p < .05)]. RSV treatment leads to significant increase in PON activity at both time points and decrease in malondialdehyde levels on postoperative day 3 (p < .001). Histopathological analysis revealed that RSV administration leads to a better anastomotic healing in terms of mucosal ischemia, neovascularization, reepithelialization, fibroblast, and lymphocyte infiltration. Conclusion: The study results suggest that exogenous RSV administration exerts a positive effect on experimental colonic wound healing in the rat. Although the precise cellular mechanisms by which RSV enhances anastomotic wound healing is not clear, stimulation of neovascularization, generation of collagen synthesis, inhibition of overinflammation, and restriction of oxidative injury seems to be of paramount importance. [ABSTRACT FROM AUTHOR]

Introduction: 2-octyl-cyanoacrylate may be a good alternative in ischemic colon anastomosis without impairment of tissue perfusion. Methods: Forty male Wistar albino rats were randomized into four experimental groups (n = 10 in each group). In group 1 (control), a well-perfused left colonic segment was transected, and free ends were anastomosed by propylene sutures. In groups 2, 3, and 4, the animals underwent a standardized surgical procedure to induce ischemic left colon anastomosis. In group 2, an end-to-end anastomosis was created using six interrupted 6-0 polypropylene sutures between ischemic edges. In group 3, after approximating the mesenteric and antimesenteric edges of the anastomosis with two 6-0 polypropylene sutures, 2-octyl-cyanoacrylate was applied between the edges. In group 4, anastomosis was created by the same technique as described in group 2, and additionally 2-octyl-cyanoacrylate was applied on suture line. Rats were killed on day 4 following operation. Anastomotic integrity, intraperitoneal adhesion scores, anastomotic bursting pressures, and tissue hydroxyproline levels were recorded. Histopathological examination of the anastomosis was also performed. Results: There were no statistically significant differences among groups with respect to anastomotic integrity (p =.142). The mean bursting pressure values were 81.1 ± 23.83, 43.3 ± 26.06, 15.8 ± 11.3, and 17.6 ± 18.02 in groups 1, 2, 3, and 4, respectively. There were no statistically significant differences among groups 2, 3, and 4 with respect to tissue hydroxyproline levels and bursting pressure levels. The highest adhesion scores were observed in groups 3 and 4. Discussion: 2-octyl cyanoacrylate does not have additional advantages in the healing of experimental ischemic colon anastomosis. [ABSTRACT FROM AUTHOR]

Introduction: Hemorrhage is a leading cause of death after trauma. It is also the major cause of operating room deaths among patients who undergo liver surgery. Various techniques and materials have been attempted to manage bleeding, but a standard method has not been defined yet. We studied the hemostatic effects of Ankaferd Blood Stopper on liver injury in comparison with regenerated oxidized cellulose. Materials and Methods: Thirty Wistar albino rats underwent partial hepatic laceration by scissors. The animals were randomized to the treatment of resected surface with either Ankaferd Blood Stopper® (ABS, n = 11) or regenerated oxidized cellulose (Surgicel®, n = 9), or were left untreated (controls, n = 10). All the animals were resuscitated with lactated Ringer's solution at 3.3 ml/min/kg to a mean arterial pressure (MAP) of 100 mmHg. Survival time, total blood loss, resuscitation volume, and MAP were recorded for 30 min or until death. The rats that were alive at the end of 30 min were sacrificed with blood withdrawal from catheters. Results: Rats in the ABS and Surgicel groups survived significantly longer than rats in the control group (p =.0001). There were no significant differences between the ABS and the Surgicel groups in survival (p =.91). Application of ABS and Surgicel was associated with a significant reduction in blood loss compared to controls (p =.008), with no significant differences between active treatment groups (p =.74). The resuscitation volume was not different. Conclusions: ABS is as effective as Surgicel in achieving hemostasis following partial liver excision in an experimental rat model. [ABSTRACT FROM AUTHOR]

Background/Aims. The aim of this study was to identify oxidative damage of kidney during ischemia reperfusion injury (IRI) by evaluating changes in lipid peroxidation markers in tissue and blood by an experimental model. Oxidized LDL (ox-LDL) was used as an oxidative stress biomarker, whereas paraoxonase (PON-1) activity was used as an antioxidative biomarker. Methods. Sixty-three male Wistar rats were randomly assigned into three groups: renal IRI, sham, and control. In the renal IRI group, the right kidney was removed and the artery and vein of the left kidney were clamped for 90 minutes. The presence of ox-LDL in the kidney tissue sections was determined by using an immunofluorescent staining method. Results. The plasma ox-LDL levels did not increase significantly at the 24th hour following IRI, made a peak at the 48th hour, and declined at the 72nd hour. Accumulation of ox-LDL was detected in the kidney tissue on the 24th, 48th, and 72nd hours of the renal IRI. Serum PON-1 levels have peaked on the 24th hour and then declined. Conclusion. This study demonstrates the accumulation of ox-LDL molecules in the renal tissues of the IRI model. Future strategies aimed to reduce the lipid peroxidation during the initial hours of renal IRI may be useful to prevent complications of ischemia. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to evaluate the efficacy of hylan G-F 20 (Synvisc) in the treatment osteoarthritis (OA) of the hip joint. Method: Twenty-seven patients (32 hips) with hip joint OA were enrolled in an open-label, prospective study. Demographics included 11 men and 16 women, 12 of whom had mild to moderate OA and 15 of whom had severe hip OA according to the Kellgren–Lawrence radiological grading system. Ultrasound-guided hyaluronic acid was administered to the affected hip from the lateral aspect of the joint at 1 week intervals, with a total of 3 treatments. The clinical assessment included visual analogue scale (VAS), Lequesne functional index, global patient assessment, Short-form 36 (SF-36), and use of paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). All patients were evaluated at preinjection and at 2, 6, 12 weeks. Results: When compared with the preinjection values, there was a statistically significant reduction in the VAS and Lequesne index at 6 and 12 weeks. There was also clear improvement in the quality of life score at the end of the 12 weeks. The percentages of paracetamol or NSAIDs use decreased to 25.9%. Adverse reactions were observed in nine patients after the injection. [ABSTRACT FROM AUTHOR]

Giant cell granulomas account for 7% of all benign tumors of the jaw. They are commonly seen as asymptomatic masses. A 4-year-old boy with an exophitic, crusty, hemorrhagic mass on the anterolateral region of the right maxilla was referred to our department. Pathological examination was reported as giant cell granuloma. A mixture of prednisolone, lidocaine and adrenaline was injected intralesionally once a week and oral fluocortone was added to this therapy. A limited surgery could be performed. Intralesional prednisolone and systemic fluocortone therapy seems to be effective, as the lesion stopped growing and increase in bony structures was observed radiologically. [ABSTRACT FROM AUTHOR]

The article presents a case study of a case of a foetus who had a single umbilical artery with a massive bilateral pleural effusion with a novel genetic mutation. Topics include as a part of pleural effusion, evaluation karyotype was obtained by cordocentesis, and there was no other underlying cause, spontaneous resolution of foetal pleural effusion was noted and such chromosomal aberration might be the sole cause of pleural effusion.