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Purpose In this study, we aimed to assess the effectiveness of malignancy stratification algorithms of the American College of Radiology (ACR) and European Thyroid Association (ETA) in the delineation of thyroid nodules using a database of nodules that were unequivocally diagnosed by means of histopathological examination and meticulously matched with the imaged nodules. Methods A total of 165 patients having 251 thyroid nodules with histopathologically proven definitive diagnoses during a 5-year period were included in this study. All patients had preoperatively undergone ultrasonography (US) examination, and US characteristics of the thyroid nodules were retrospectively analyzed and assigned in compliance with the thyroid imaging reporting and data system categories recommended by the ACR (ACR-TIRADS) and ETA (EU-TIRADS). The diagnostic effectiveness in the delineation of thyroid nodules and unnecessary fine-needle aspiration (FNAB) rates were evaluated. Results Overall, 189 nodules (75.30%) were diagnosed as benign, while 62 nodules (24.70%) were reported to be malignant based on histopathological assessment. Sensitivity and specificity rates were 71% and 75% for ACR-TIRADS and 73% and 80% for EU-TIRADS. The area under the curve values were 0.78 and 0.80 for ACR-TIRADS and EU-TIRADS, respectively. The unnecessary FNAB rates were 61% for ACR-TIRADS and 64% for EU-TIRADS as per the recommended criteria of each algorithm. Conclusion The diagnostic performance of both malignancy stratification systems was signified to be moderate and sufficient in a cohort of nodules with definite histopathological diagnosis. In light of our results, we demonstrated the strengths and weaknesses of the ACR- and EU-TIRADS for physicians who should be familiar with them for optimal management of thyroid nodules.

Aim: To evaluate epidemiologic features and survival outcomes of 8450 patients treated with the diagnosis of thyroid cancer in Ege University Hospital (EUH) between 1992-2017 and compare them with the literature.Materials and Methods: The thyroid cancer patients’ data that was collected by Ege University Cancer Research Center, was recorded to CANREG computer program, and analyses was performed according to WHO and SEER system definitions. Chi-square, General Linear Model and Kaplan-Meier survival analyses was performed for further analyses. Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) and Tarone-Ware statistics was used for survival analyses. P, Amaç: Ege Üniversitesi Hastanesinde 1992-2017 yılları arasında tanı alan ve tedavisi yapılan 8.450 tiroit kanserli olgunun epidemiyolojik ve sağ kalım özelliklerini analiz etmek ve sonuçlarını literatürle karşılaştırmak amaçlanmıştır.Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan tiroit kanseri verileri CANREG özel bilgisayar programına kayıt edilmiş, DSÖ ve SEER sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Ki-kare, General Linear Model, Kaplan Meier sağ kalım analizleri uygulanmıştır. Kaplan Meier sağ kalım analizinde Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p

Background/Purpose: There has not been an international multicentric study to examine the relationship between thyroid cancer clinical outcomes and geographic location for South Korea, Colombia, and Turkey, whereas thyroid cancer is amongst the highest three cancer types seen in South Korea and Turkey. the aim of the study was to assess regional differences of T1 papillary thyroid cancer outcomes in Korea, Turkey and Colombia. Methods: This is an observational non-randomized study. A total of 2720 patients who have been operated for T1 papillary thyroid cancer between 2011 and 2014 and are on routine follow-up have been recruited. the mean follow-up was 46.4 +/- 10.7 months. Data were collected in a commonly used database and analyses were conducted. Results: Patients participated in South Korea (88.2%), Turkey (9.1%) and Colombia (2.6%). Eighty percent were female. Female dominance tended to be higher in Colombia (p = 0.01). Mean age at diagnosis was 45.2 years. There was no mortality. Recurrence tended to be higher in Colombia (p < 0.001). Moreover, statistical analysis revealed differences among patients regarding symptoms (p < 0.001), family history (p < 0.001), euthyroidism (p < 0.001), anti-Tg and/or anti-TPO positivity (p < 0.001), FNAB results (p < 0.001), type of resection (p < 0.001), prophylactic central node dissection (p < 0.001), tumor size (p < 0.001), multifocality (p < 0.001), bilaterality (p < 0.001), tumor subtype (p < 0.001) and radioactive iodine treatment (p < 0.01). Conclusion: Thyroid cancer is becoming more commonly diagnosed worldwide. This international multicentric study has identified differences in disease presentation, treatment approaches and outcome, which need to be investigated, especially by increasing the number of participating countries. Future comparisons will facilitate developments in treatment for the benefit of patient outcomes. (c) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Both from a medical and legal point of view, the quality of operative notes are important. in this study we hypothesized that the quality of operation notes could be improved by audit, education session and using a proforma. Methods: A total of 150 operation notes were audited for compliance with the Royal College of Surgeons guidelines. Results were announced in -clinic training session and guidelines were dis- cussed. An aide-memoire containing guideline parameters placed in the operating theaters. After eight months, operation reports were re -audited on an equal number of patients. An operative note proforma was developed and third audit was carried out. the results of each audit were compared. Results: in the first audit, it was found that fourteen parameters were written with more than 90% accuracy. the first audit revealed seven poor areas in documentation: time of operation (0%), identification of emergency/elective procedure (0%), identification of any prosthesis or devices used (65.3%), details of closure technique (36.6%), name of anesthesiologist (0%), pa- tient position (1.3%), and amount of bleeding (0%). in the second audit there was an incom- plete, but significant improvement in these seven parameters (28%, 28.6%, 82%, 75.3%, 31.3%, 32%, and 34% respectively). Following introduction of the proforma; third audit cycle demonstrated a clear improvement in operation note documentation with at least 80% compli- ance in all parameters. Conclusion: This study revealed that the accuracy of the operating room documents can be improved through audits, education of surgeon and using proformas. the use of proforma pro- vides much better results. (C) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B. V. This is an open access article under the CC BY-NC- ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Kinar, Abdullah/0000-0002-2968-4165 WOS:000586724600001 PubMed: 32396031 Sudden sensorineural hearing loss (SSNHL) is sensorineural hearing loss of 30 dB or more in 3 consecutive frequencies within 3 days.The incidence rate is 5 to 20/100 000. It is commonly seen after 40 years of age. A detailed history taking and physical examination should be done for the differential diagnosis. The etiology is unknown in 85% of cases. The identifiable causes of SSNHL include autoimmune inner ear diseases like Behçet disease, Cogan syndrome, and systemic lupus erythematosus (SLE); infections like meningitis, Lyme disease, and syphilis; some neoplasms like vestibular schwannoma or cerebellopontine angle (CPA) tumors; neurological diseases like migraine, multiple sclerosis, and pontine ischemia; ear diseases like Meniere disease and otosclerosis; some ototoxic drugs like aminoglycosides and chemotherapeutic agents; trauma; and vascular diseases such as sickle cell anemia. Cases with unknown etiology are defined as idiopathic sudden sensorineural hearing loss (ISSNHL), which has vascular, viral, and immune theories. However, its etiopathogenesis has not yet been clearly delineated. In previous studies, inflammation has been found to play a role in SSNHL. Response to steroid therapy supports this theory. Clinical in vitro animal studies and human temporal bone studies support this etiology. For example, erythrocyte sedimentation rate is a nonspecific marker of inflammation. Erythrocyte sedimentation rate was found to be elevated in patient with ISSNHL in several studies.

Recent studies imply the effects of micronutrient intake on the development of several cancers including primary brain cancer (PBC). The biological effects of vitamin D, a member of the fat-soluble vitamin family acting as a steroid hormone, was carried out by binding its receptor (VDR) through vitamin D-binding-protein (VDBP). The present study aims to investigate the effects of vitamin D levels and VDR rs2228570, VDR rs731236, VDBP 7041 polymorphisms on PBC development. The study group consisted of 71 patients and 84 controls. Vitamin D levels were determined by high-pressure liquid chromatography where polymorphisms by polymerase-chain-reaction and restriction fragment length polymorphism methods. The distribution of VDR rs2228570 variants in PBC and its subgroups were determined as FF>Ff>ff; VDBP rs7041 variants were TG> GG>TT, however, VDR rs731236 variants were Tt>TT>tt in PBC and meningioma and TT>Tt>tt in glioma. Vitamin D levels were measured below normal levels in all patients and control groups, which shows the deficiency in Turkish society in line with the literature. Our results show that low serum vitamin D level may be an individual risk factor in the development of brain tumors, however, VDR rs2228570 and rs731236 and VDBP rs7041 polymorphisms have no effect on the risk of disease development., Son çalışmalar, mikrobesin alımının primer beyin kanseri (PBC) dahil olmak üzere çeşitli kanser türlerinin gelişimi üzerindeki etkilerine işaret etmektedir. Yağda çözünen vitaminler sınıfında yer alan ve steroid hormon olarak etki gösteren D vitamini biyolojik etkilerini reseptörü (VDR) ile vitamin D bağlayıcı protein (VDBP) aracılığıyla gerçeklestirmektedir. Çalışmamızda, D vitamini düzeyleri ile VDR rs2228570, VDR rs731236, VDBP 7041 polimorfizmlerinin PBC gelişimi üzerindeki etkilerinin araştırılması amaçlanmıştır. Çalışma grubu, beyin kanseri tanısı konmuş 71 hasta ile 84 sağlıklı bireyden oluşturulmuştur. D vitamini düzeyi, yüksek basınçlı sıvı kromatografisi yöntemiyle, VDR FokI (rs2228570), TaqI (rs731236) ve VDBP rs7041 polimorfizmleri polimeraz zincir reaksiyonu ve restriksiyon parça uzunluk polimorfizmi yöntemleriyle belirlenmiştir. Çalışmamızda VDR FokI gen varyantlarına ait dağılım primer beyin kanseri ve alt gruplarında FF>Ff>ff; VDBP rs7041 varyantları TG>GG>TT olarak, VDR TaqI varyantlarının ise primer beyin kanseri ve meningiomada Tt>TT>tt, gliomada TT>Tt>tt olduğu tespit edilmiştir. D Vitamini düzeyleri tüm hasta gruplarında ve kontrol grubunda normal düzeyinin altında ölçülmüş, bu durum Türk toplumundaki vitamin D düzeylerinin literatürle uyumlu bir şekilde düşük seviyede olduğunu göstermiştir. Çalışmamız sonuçları, beyin tümörleri gelişiminde düşük serum D vitamini seviyesinin bireysel bir risk faktörü olabileceğini, ancak VDR rs2228570 ile rs731236 ve VDBP rs7041 polimorfizmlerinin hastalık gelişim riskine etkisinin olmadığını göstermektedir.

Aim Parathyroid surgery has witnessed a significant evolution with the introduction of more efficacious preoperative localization imaging techniques and the use of rapid intraoperative parathormone assays. Parathyroid surgery can now be performed with the minimum of invasion. Through the adaptation of the transoral endoscopic thyroidectomy vestibular approach (TOETVA), the technique has now been adopted for parathyroid surgery, known as the transoral endoscopic parathyroidectomy vestibular approach (TOEPVA). We present here the initial experiences of 11 centers carrying out TOEPVA surgery in Turkey. Materials and methods Participating in the study were 11 centers, all of which were tertiary care institutions carrying out endocrine surgery. A retrospective review was made of 35 primary hyperparathyroidism patients who underwent the TOEPVA procedure between July 2017 and January 2020. Results of the total 35 patients, 32 patients underwent the TOEPVA procedure successfully. All patients but one were female, and the mean age was 47.2 (20-73) years. According to localization studies, 18 of the lesions were lower left, 12 were lower right, 3 were upper right and 2 were upper left. The mean operative time was 116 (30-225) min, and three cases were converted to an open procedure. Simultaneous thyroidectomy was performed in seven cases. The average PTH level dropped to normal within 20 min. after the resection in all cases. The complication rate was 19% (ecchymosis, subcutaneous emphysema, nasal bleeding, surgical site infection and seroma). There were neither recurrent nerve palsies, nor mental nerve root or branch injuries. The average hospital stay was 1 day. No persistence was documented on follow up. Conclusion TOEPVA is a "hidden scar" parathyroidectomy procedure that can be safely performed on parathyroid adenomas, in cases that have scar-related concerns. Having its own procedure-related complications, the procedure provides satisfactory objective results, particularly in centers experienced in endoscopic and endocrine surgery.

The ectopic spleen (ES) is a rare variation occurred depend on the absence or laxity of the suspensory ligaments. The ES is a rarely diagnosed clinical condition. Less than 500 symptomatic patients have been reported. Less than 0.25% of splenectomies are performed on the ES. Patients are usually asymptomatic. It's diagnosed incidentally in general. The incidence is not clear. ES incidence is reported less than 0.5%. However, this rate covers all of the relocations. The spleen can be found anywhere in the abdomen or pelvis, depends on the length of the vascular pedicle. The pelvic ES is a rarely encountered situation. Knowing this anomaly is essential for early diagnosis and prevention serious problems such as torsion, infarction and acute abdomen. A 21 years old female patient with ES was presented on pelvic magnetic resonance imaging.

OBJECTIVE RET/PTC in FNA (Fine needle aspiration) biopsy smears could improve the FNA diagnosis. The aim of study determining the prevalence of RET/PTC mutation in cases where thyroid nodules in ATA USG according to risk catogory is determined and investigating the relation of malignancy. METHODS RNA was extracted from 60 routine FNA. RET/PTC rearrangements were detected by real-time quantitative polymerase chain reaction, and, in parallel, RT-PCR is used to detect the chimeric RET/PTC1, RET/PTC2 and RET/PTC3 transcripts in RNA extracted from FNA. RESULTS A total of 75% FNA RET rearrangements were detected in the 20 PTC patients. RET/PTC positive was detected in 35% of cases without cancer (sensitivity 75%, specificity 65%) (p = 0,003). Significant correlation was found between A-high suspicion USG group (80%), B- intermediate suspicion USG group (45%) and C- low suspicion USG group (20%) in of RET/PTC rearrangements (p = 0.001). A significant correlation was found between the USG groups and the PTC (respectively group A,B,C: 60%, 30%, 10%)(p = 0.003). There was a statistical difference related to in the USG groups frequency between Classic type PTC (70%) and Follicular type PTC (30%)(p = 0.019). There was a statistical difference related to between RET/PTC and PTC types in the USG groups (p = 0.012). There was a statistical difference related to between usg groups tumor diameter A and C (P = 0.010). CONCLUSİON Molecular testing of FNA samples improves presurgical diagnosis. RET/PTC was found to be significantly higher in the diagnoses of the PTC with 75% sensitivity and 65% specificity

Background: Acute mesenteric ischemia (AMI) is a catastrophic abdominal emergency characterized by sudden critical interruption to the intestinal blood flow which commonly leads to bowel infarction and death. AMI still has a poor prognosis with an in-hospital mortality rate of 50-69%. This high mortality rate is related to the delay in diagnosis which is often difficult and overlooked. Early intervention is crucial and gives a chance for intestinal viability. Methods: The charts of 140 patients who were hospitalized with AMI between May 1997 and August 2013 in Ege University Faculty of Medicine, Department of General Surgery were retrospectively reviewed. Demographical and clinical features of patients constituting the best predictors of morbidity and mortality were evaluated with Multiple Logistic Regression analysis by Enter method after adjustment for all possible confounding factors. Results: Out of 140 patients, 77 were men (55%) and 63 were women (45%). The mean age was 66.6 +/- 14.5 (16-94) years. Demographical findings, comorbidities, ASA scores, drugs used for mesenteric ischemia and diagnostic imaging materials were summarized. The most common comorbidities were cardiac problems (42.9%). Twenty-seven (19.3%) patients had diabetes mellitus. The median ASA score was 3. Abdominal computed tomography (CT) was the most commonly used imaging modality and it was performed in 119 (85%) patients. Twenty-five (17.9%) patients were in shock and 48 (34.3%) had acidosis. The time of delay between the onset of acute abdominal pain to surgery was 24 hours in 80 patients (57.1%). The most common etiology in AMI was thrombus, in 69 patients (49.3%). The most affected or involved organ was both small and large bowel - in 80 patients (57.1%) in total. The most commonly performed surgery was small bowel resection - in 42 patients (30%).As many as 127 (90.7%) of all patients underwent surgery and 18 (12.9%) patients underwent a second-look laparotomy. Small bowel length of less than 100 cm was recorded in 46 patients (32.9%). The length of hospital stay was 7 days (1-90 days). Morbidities were found in 51 patients (36.4%) and death in 74 patients (52.9%). Conclusion: The purpose of this study was to evaluate the prognostic factors of AMI to better understand it and optimize both medical and surgical management with improvement of treatment results. We suggested that the diagnosis of AMI should be based on suspicion of a clinician only and that laparotomy should be performed as soon as possible, before the onset of the clinical signs of peritonitis. Age and time of delay between the onset of acute abdominal pain and surgery longer than 24 hours are the most important prognostic factors for mortality in patients presenting with shock and acidosis.

Objectives/Hypothesis During intraoperative neuromonitoring in thyroid surgery, two different kinds of stimulator probes, monopolar and bipolar, are commonly used to stimulate the laryngeal nerves. We explore the unique characteristics of both of these probes as they relate to intraoperative laryngeal nerve mapping. Methods Twenty-one patients undergoing neuromonitored thyroidectomy by a single surgeon were enrolled. Electromyography (EMG) amplitude and latency measurements were prospectively recorded concurrently from 1 mA stimulation of vagus nerve (VN) and inferior/superior recurrent laryngeal nerve before (with and without fascia) and after thyroid resection using bipolar and monopolar stimulator probes. Results Significantly higher amplitudes were obtained with monopolar stimulator probes as compared to bipolar probes, in several stimulation scenarios such as at right VN pre-resection (carotid sheath intact), right VN pre-resection (carotid sheath dissected), right VN post-resection and left VN (carotid sheath dissected). No significant differences were found between amplitudes and latency values in all other stimulation scenarios. Conclusions According to this study, both probes are reliable and safe for neural mapping. The kind of probe used during neural monitoring is based on surgical situations and surgeon preference. Level of Evidence Level 3 (According to Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence) Laryngoscope, 2021, Ege University Scientific Research Projects Commission, This study was funded by Ege University Scientific Research Projects Commission.

BACKGROUND The most commonly used recording-side method in intraoperative neural monitoring (IONM) detects the stimulus with the endotracheal tube surface (ETS) electrodes placed in the endotracheal tube during thyroidectomy. The thyroid cartilage needle (TCN) electrode method is an alternative recording-side system in IONM. This study compared two recording-side techniques in IONM. METHODS Data were retrospectively analyzed from 885 patients who underwent thyroidectomy between January 2012 and December 2020, with 110 ETS and 775 TCN electrodes. Patients' demographics, diagnosis, surgery type, and amplitudes of all stimulation steps were compared. Costs per patient were calculated. RESULTS No significant differences were found in the demographic data between the two groups. All amplitudes were higher in the IONM system where TCN electrodes were used than that with ETS electrodes (all stimulation steps p

Objective: Transoral endoscopic thyroidectomy vestibular approach ( TOETVA) is a scarless method that enables thyroidectomyusing natural orifice of the body. The opinion which is even common among TOETVA performing surgeons is that this surgery involves a small percentage of thyroidectomy applied patients. In this study, based on the currently accepted exclusion criteria, we aimed to determine what percentage of patients, who underwent thyroidectomy in an endemic area are actually suitable for TOETVA. Methods: Between January 2017 and December 2019, 1197 consecutive patients who underwent surgery for thyroid pathology in our clinic were analyzed retrospectively. Pre-operative evaluations were made according to the current exclusion criteria and as a result, patients with no previous neck surgery, no history of radiotherapy, no retrosternal thyroid extension, and none lymph node dissection operation been made and whose thyroid gland diameter is

Alçı, Erman (Balikesir Author), Background: In the present study we determine the feasibility of intraoperative neuromonitoring following the administration of a nondepolarizing neuromuscular blocking agent during thyroid operations, as well as the influence of rocuronium on the achievement of optimal vagal stimulation during intraoperative neuromonitoring in thyroid surgery. We further investigate whether accelerometry is a reliable approach to obtaining an ipsilateral vagus signal prior to recurrent laryngeal nerve dissection. Methods: Included in the study were 61 thyroidectomized patients whose demographic data, indications, type of surgery, vagus, and recurrent nerve values before and after resection were obtained. We created five groups of patients based on the twitch values recorded during ipsilateral vagus stimulation prior to the recurrent laryngeal nerve dissection: (1) [removed]75%. Results: The average electromyography amplitudes of the vagus nerve prior to the determination of the recurrent laryngeal nerve for each group were 552 μV, 463 μV, 543 μV, 513 μV and 551 μV, respectively. No difference between the groups was observed in this regard (p > 0.05). Conclusion: It can be expected that as soon as the effects of neuromuscular blockers on the peripheral muscles begin to abate, it will be possible to obtain the ipsilateral vagus signal prior to recurrent laryngeal nerve dissection at the desired levels. It can be concluded from this study that accelerometry using the pollicis muscle is an unreliable tool for the interpretation of the proper electromyography signals of the vagus nerve prior to the determination of the recurrent laryngeal nerve. © 2020

Knowledge of imaging findings related to therapy administered to patients with sarcoma is pivotal in selecting appropriate care for these patients. Imaging studies are performed as surveillance in asymptomatic patients or because symptoms, including anxiety, develop. In addition to detection of recurrent disease and assessment of response to therapy, diagnosis of conditions related to therapy that may or may not need treatment has a marked positive impact on quality of life. The purpose of this review is to assist radiologists, nuclear physicians, and others clinicians involved in the diagnosis and treatment of these patients in recognizing imaging findings related to therapy and not to activity of the previously treated sarcoma. Imaging findings are time dependent and often specific in relation to therapy given.

Background: With increased utilization of robotic technology, robotic adrenalectomy (RA) became popular in certain high-volume centers as an alternative to conventional laparoscopic adrenalectomy (LA). the aim of the present study was to evaluate clinical and surgical outcomes of RA in two high-volume centers in Turkey. Methods: Between 2012 and 2019, consecutive patients who underwent robotic transperitoneal adrenalectomy in two referral centers for surgical endocrine diseases in Turkey were analyzed retrospectively. Results: A total of 111 patients were analyzed. Mean diameter of the tumor in preoperative imaging was 38.6 +/- 2.0 mm. Total operation time was 135.4 +/- 47.9 min. the analysis of the learning curve period and the post-learning curve period in both centers demonstrated that the total surgery time decreased from 152.68 +/- 48.6 to 118.8 +/- 37.1 min, and the console time decreased from 113.2 +/- 38.9 to 81.6 +/- 35.1 min (P

Thyroglossal duct cyst is the most frequent midline congenital neck anomaly. Carcinoma of the thyroglossal duct cyst is a rare entity, and papillary carcinoma is the most frequent malignancy of this uncommon entity. There are a limited number of studies on this subject in the literature, and in some series, it is associated with papillary thyroid carcinoma. There is no consensus on prophylactic thyroidectomy after diagnosis. In this study, a case, operated for thyroglossal duct cyst and diagnosed with papillary carcinoma and our approach consisting of follow-up without thyroidectomy are presented in light of the current literature., Tiroglossal kanal kisti en sık görülen orta hat konjenital boyun anomalisidir. Tiroglossal kanal kisti karsinomu nadir görülen bir durumdur. Papiller karsinom, bu nadir görülen varlığın en sık görülen malignitesidir. Literatürde bu konuyla ilgili kısıtlı sayıda çalışma vardır ve bazı serilerde bu durum tiroid papiller karsinomu ile birliktelik göstermektedir. Tanıdan sonra profilaktik tiroidektomi konusunda fikir birliği yoktur. Bu çalışmada, papiller karsinom tanısı konan tiroglossal kanal kisti için opere edilen ve tiroidektomi olmadan takip yaklaşımımız güncel literatür bilgisi ışığında sunulmuştur.

Objective Vast majority of laboratory errors occurs in preanalytical phase and in vitro hemolysis is the most common among preanalytical errors. Automated serum index measurement is being used in routine biochemical analysis in Antalya Public Health Care Laboratory, since June 2014. Our aim in this study is to reveal the impact of serum index usage on rejected samples and rejected test rates due to hemolysis. Materials and methods Hemolysis, icterus and lipemia (HIL) spectral interference reagent and program have been used in our laboratory since June 2014. In the current study, the number of samples and tests that were rejected due to hemolysis in June–August 2014 were compared with those rejected in the same period of 2013. Results In 2014, the sample rejection rate was 2.53% and the rejected test rate was 0.48%. In 2013, the sample rejection rate was 0.56% and the rejected test rate was 0.55%. When compared two periods, statistically significant increase in rejected sample number due to hemolysis in 2014 is result of, visually undetectable hemolyzed samples previously can be identified by HIL method (p Conclusion Usage of hemolysis index program in automated systems for detecting hemolysis was evaluated as a method which is standardized, semi-quantitative, with high reproducibility and allows test based rejection.

For the treatment of thyrotoxicosis, alternative treatment modalities may be necessary if anti-thyroid drugs cannot be used due to side effects, inefficiencies, or there is a need to start a rapid action such as thyroid storm. By using therapeutic plasma exchange (TPE), it is possible to effectively and rapidly remove the increased thyroid hormones. We evaluated our results and experience on a rapid, effective, and reliable alternative treatment modality in thyrotoxic patients. TPE was performed in 46 thyrotoxic patients at the Adult Therapeutic Apheresis Center. Forty six patients with a median age of 30 years (interquartile range [IQR] 30–50) were assessed. In 40 (87%) of the cases, the diagnosis was Graves’ disease. The other causes of thyrotoxicosis were amiodarone-induced thyrotoxicosis (n = 4) and toxic nodular goiter (n = 2). The median and IQR of fT3 values in patients before TPE were 9.9 (6.5-16.8) pg/mL (N: 2.3–4.2) and the median and IQR of fT4 values were 2.9 (2.3–4.1) ng/dL (N: 0.74–1.52). When the procedure was terminated, the median and IQR of fT3 values in patients were 4.0 (3.1–5.2) pg/mL and the median and IQR fT4 values were 1.6 (1.4–2.0) ng/dL. The decrease in both free thyroid hormones was found to be statistically significant (p

Objective. Left circumflex (LCx) artery originating from the right coronary arterial (RCA) system has been reported as the most common form of anomalous origination of a coronary artery from the opposite sinus (ACAOS). However, some studies claim that RCA originating from the left coronary sinus (LCS) is the most frequent form. The aim of this study was to determine the most common type of ACAOS in a single center.Materials and Methods. The database of the catheterization laboratory was retrospectively searched. All patients who were performed coronary angiography between 1999 and 2006 were included to registry. All examinations were carefully analyzed to determine the most frequent type of ACAOS.Results. We detected ACAOS in 35 cases (16 RCA originating from the LCS, 13 LCx from the RCS or the RCA, and 6 others) out of 5165 coronary angiograms. The most common form was RCA originating from LCS. Moreover, we revealed that 5 cases with RCA originating from the LCS were previously misdiagnosed and not reported as a coronary anomaly.Conclusions. RCA originating from the LCS was the most common form of ACAOS in our registry. The high change of misdiagnosis or underreporting of this anomaly could have biased the true prevalence.

Objective Heart fatty acid binding protein (HFABP) is a low-molecular-weight free protein that is abundant in the intracytoplasmic space of myocytes. Due to its unique features, serum HFABP levels may increase in myocardial ischaemia. The aim of this study was to evaluate the effect of myocardial ischaemia induced by dobutamine stress echocardiography (DSE) on serum HFABP levels. Methods and results A total of 30 consecutive patients with suspected myocardial ischaemia underwent DSE examination. HFABP levels were measured immediately before and 1 hour after DSE. HFABP rose significantly in individuals in the DSE positive group (1.66 ± 1.18 ng/ml vs 2.65 ± 1.34 ng/ml, P = 0.004), but remained unchanged in the DSE negative group (1.61 ± 0.77 ng/ml vs 1.85 ± 0.76 ng/ml, P = 0.066). Conclusion Serum HFABP levels increased significantly at 1 hour in the presence of ischaemia induced by DSE in patients with stable clinical coronary syndromes. No such increase was evident in the absence of ischaemia.

[No abstract available]

The 2019 novel coronavirus disease (COVID-19) was initially seen in Wuhan, China, in December 2019. World Health Organization classified COVID-19 as a pandemic after its rapid spread worldwide in a few months. With the pandemic, all elective surgeries and non-emergency procedures have been postponed in our country, as in others. Most of the endocrine operations can be postponed for a certain period. However, it must be kept in mind that these patients also need surgical treatment, and the delay time should not cause a negative effect on the surgical outcome or disease process. It has recently been suggested that elective surgical interventions can be described as medically necessary, time-sensitive (MeNTS) procedures. Some guidelines have been published on proper and safe surgery for both the healthcare providers and the patients after the immediate onset of the COVID-19 pandemic. We should know that these guidelines and recommendations are not meant to constitute a position statement, the standard of care, or evidence-based/best practice. However, these are mostly the opinions of a selected group of surgeons. Generally, only life-threatening emergency operations should be performed in the stage where the epidemic exceeds the capacity of the hospitals (first stage), cancer and transplantation surgery should be initiated when the outbreak begins to be controlled (second stage), and surgery for elective cases should be performed in a controlled manner with suppression of the outbreak (third stage). In this rapidly developing pandemic period, the plans and recommendations to be made on this subject are based on expert opinions by considering factors, such as the course and biology of the disease, rather than being evidence-based. In the recent reports of many endocrine surgery associations and in various reviews, it has been stated that most of the cases can be postponed to the third stage of the epidemic. We aimed to evaluate the risk reduction strategies and recommendations that can help plan the surgery, prepare for surgery, protect both patients and healthcare workers during the operation and care for the patients in the postoperative period in endocrine surgery.

Background: The number of TOETVA surgeries has increased worldwide but the anatomical passage of trocars is not clearly defined. We aimed to define detailed surgical anatomical passage of the trocars in cadavers. The incisions in oral vestibule, anatomical pathways of trocars, affected mimetic muscles, neurovascular relations of trocars and histological correlation of surgical anatomy were investigated. Methods: Four cadavers and 6 six patient oral vestibules were used. The locations of optimised vestibular incisions were measured photogrammetrically. Initial steps of TOETVA surgery were performed on cadavers according to those optimal incisions. TOETVA preformed cadavers dissected to determine anatomical passages of the trocars. Afterwards, flap of lower lip and chin were zoned by software appropriate to the trocars routes. Histological analyses of the zones were made in correlation with dissections. Results: Mimetic muscles associated with median (MT) and lateral trocars (LT) are orbicularis oris, mentalis, depressor anguli oris, depressor labii inferioris and platysma muscles. Trocars affect mimetic muscles in the perioral, chin and submental regions in different ways. The risk of mental nerve injury by MT is low. LT pass through the DLI muscle. The transmission of LT to the subplatysmal plane in the submental regions can be in two different ways. The arterial injury risk is higher with LT than the MT. Conclusions: The surgical anatomy of the perioral, chin and submental regions for the initial TOETVA steps has been defined. Detailed surgical anatomical passages of the MT and LT were determined. Anatomical pattern to reach subplatysmal plane are presented. Mimetic muscles effected by trocars were determined. Endocrine surgeons should know the anatomical passage of TOETVA trocars. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Collective teacher efficacy, as an important factor for school effectiveness, can be improved by leader behaviors in schools. Unlike the sum of individual teachers' efforts, the concept of collective teacher efficacy points to a greater impact on student achievement when teachers unify their efficacies. Therefore, examining the leadership orientations that play a role in the development process of collective teacher efficacy was seen worth for study. In this context, the purpose of the study is to find out the relationships between teachers’ perceptions about four-frame leadership orientations of principals and collective teacher efficacy. 452 primary school teachers participated in the study in which Leadership Orientation Scale and Collective Teacher Efficacy Scale were used. The teacher perceptions showed that leadership frames preferred by school principals are, respectively, structural, political, human resource and symbolic frame. It was also found that the collective teacher efficacy perceptions of teachers were influenced by seniority of teachers and settlement location of schools. Controlling for the variables of seniority and settlement location of school, all leadership frames were found to be predictors of the collective teacher efficacy. Accordingly, while the strongest predictor was the symbolic frame, the weakest predictor was the structural frame.

Natriuretic peptides have long been introduced into clinical practice. These biomarkers have certainly been shown to provide useful information in the diagnosis, prognosis and risk stratification in heart failure and also may have a role in the guidance of heart failure therapy. Although, there are some limitations in using of these markers such as lack of specificity, aging, renal dysfunction or obesity, among the huge number of candidates for heart failure biomarkers, only natriuretic peptides are currently widely used in daily clinical practice in heart failure. Recent heart failure guidelines recognize natriuretic peptides as an essential tool in the new diagnostic and therapeutic algorithms. Furthermore, natriuretic peptides are not only used in the diagnosis or prognosis of heart failure, but also these biomarkers are referred to have some potential role in primary prevention, cardio-oncology, advanced heart failure, assessment of response to cardiac resynchronization therapy, pulmonary arterial hypertension, acute coronary syndromes, atrial fibrillation and valvular heart disease. in this article, natriuretic peptides have been reviewed for their updated information and new recommendations in heart failure and also potential role of these biomarkers in the management of various clinical conditions have been addressed in the form of expert opinion based on the available data in the literature. (Anatol J Cardiol 2019: 21 Suppl 1; 1-40)

AGCAOGLU, ORHAN/0000-0003-1617-3953; Akbas, Melis/0000-0002-0903-3429, WOS: 000495310800006, PubMed: 31244390, Background. Robotic surgery has gained increasing popularity over the past 2 decades. However, factors including patient comorbidities and tumor characteristics are still crucial factors for outcomes of surgery. in this study, we evaluated the impact of body mass index (BMI) on perioperative outcomes in patients who underwent robotic adrenal surgery. Methods. Between May 2012 and November 2017, 66 consecutive patients who underwent robotic adrenalectomy were included in this study. Patients were divided into 2 groups based on their BMI: nonobese (= 30 kg/m(2)). Additionally, patient demographics, tumor size, total operative time, docking time, console time, estimated blood loss, conversion to open, complications, additional analgesia requirement, length of hospital stay, and rough costs were evaluated. Results. of the 66 patients, a total of 26 patients were obese (30%). Between study groups, the median BMI was calculated as 26 (18-29) and 33 (30-57). the groups were similar in terms of age, gender, American Society of Anesthesiologists scores, and previous history of abdominal surgery. Likewise, there were no significant differences between groups regarding total operative time (P = .085), docking time (P = .196), console time (P = .211), estimated blood loss (P = .180), complications (P = .991), length of hospital stay (P = .598), and rough costs (P = .468). Five cases were converted to open surgery. Nonobese cases required additional analgesia (P = .007). We had no unexpected hospitalizations in either group. Conclusion. Guidelines express the advantages of robotic surgery in obese patients. No statistically significant differences were detected between the 2 groups except for the additional analgesia required in nonobese patients.

BACKGROUND AND AIMS Minimally invasive surgery of the adrenal gland is widespread. Although reports demonstrate the safety and feasibility of robot-assisted adrenalectomy, the objective benefits are still unclear, compared to those of conventional laparoscopy. Recently, robot-assisted approach has also become possible for pheochromocytoma resection. Since cardiopulmonary changes during robot-assisted dissection of the pheochromocytoma patient has not been studied in detail, we aimed to assess these concerns, compared to the routine laparoscopic technique. METHODS In this case-control study, 19 consecutive robot-assisted adrenal resections were compared with a control group consisting of 14 conventional laparoscopic adrenalectomy. Patient characteristics and intraoperative hemodynamic and respiratory parameters were assessed. Groups were compared using the χ2 test for categorical variables and Student's t-test for continuous variables. Significance was considered p < 0.05. RESULTS The robot-assisted procedure was performed successfully in all patients, except one. The duration of the robot-assisted procedure, compared to the conventional laparoscopy group, was significantly longer (p < 0.05). Intraoperative blood loss was significantly less in the robot-assisted group (p < 0.05). Dissection of pheochromocytoma showed a significant difference between the groups, according to the incidence of intraoperative blood pressure fluctuations (p < 0.05). The robot-assisted approach resulted in less incidents. Other hemodynamic and respiratory parameters did not differ between groups significantly. There were no perioperative deaths. Complication rates and postoperative hospital stays were not significantly different. CONCLUSION Robot-assisted adrenalectomy is a safe and technically feasible procedure for a pheochromocytoma patient. Robot-assisted resection of pheochromocytoma minimized the occurrence of intraoperative blood pressure fluctuations and blood loss.

WOS: 000456525700013, PubMed ID: 30664431, Ectopic parathyroid glands can be located at any anatomical location from the base of the tongue to the mediastinum. One-third of these glands migrate deep into the mediastinum, which are not accessible with a low cervical incision. In this article, we described the robotic approach to an ectopic mediastinal parathyroid gland. This management method of mediastinal adenomas has significant advantages when compared to conventional surgery.

WOS: 000440304500003, PubMed ID: 30023969, Objectives: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of

Oncocytic neoplasms of the adrenal gland are extremely rare tumors. These tumors differ from their nononcocytic counterparts in some respects. The aim of this study was to review and discuss the clinical, histological, and immunohistochemical features of as well as the prognosis for these rare tumors. In total, 16 cases diagnosed as adrenocortical oncocytic neoplasms between January 2011 and December 2016 were included in the study. The demographic data, gross characteristics, histological data, and immunohistochemical data (Chromogranin-A, Synaptophysin, α-Inhibin, Melan-A, Ki67, PHH3) were reevaluated. The follow-up data for these patients were added in January 2017. Of the 16 cases, 12 were adrenocortical adenoma, 1 was borderline adrenocortical tumor, and 3 were adrenocortical carcinoma. The tumors equally affected both genders. The tumors were not generally large. Tumor cells had pleomorphic nuclei in ten cases, but it was more obvious in one case. The mitotic figure count was low in most tumors. Atypical mitosis and necrosis were observed in three and four tumors, respectively. None of cases included sinusoidal invasion, vascular invasion, or capsular invasion. We detected the expression of at least one specific marker (e.g., Melan-A, Inhibin-α) of the adrenal cortex in all tumors. None of the tumors were immunoreactive for Chromogranin-A. Ki-67 proliferation index was lower than 5% in all cases except three oncocytic carcinomas. In two cases, PHH3 positivity was not seen, while it was lower than 3 of 10 high-powered fields in ten cases and higher in 4 cases. All patients were alive and disease free except for two patients with adrenocortical carcinoma. In conclusion, determining the clinical, histological, and immunohistochemical characteristics of these extremely rare tumors can provide important information for early diagnosis, treatment, and follow-up of these cases.

The approach to patients with an indication for oral anticoagulation (OAC) for atrial fibrillation (AF) who undergo coronary stenting and thus need dual antiplatelet therapy has long been debated. Dual antiplatelet therapy accompanied by OAC (so called "triple therapy") carries a high bleeding risk and thus should either be avoided or used for a limited period. The lack of relevant prospective randomised trial data have largely been overcome by the recently published PIONEER AF-PCI trial, the results of which will be summarized in this article.

In recent years educational organizations have begun to be administered by more sharing, participation and democratic principles. The school-based management approach accelerated during the decentralization period in education is also seen as a cause for spread of leadership throughout the school. This trend is reflected in the educational leadership literature, which began to describe as distributed leadership (DL), the process/approach of spreading leadership organization-wide. However, the extent to which leadership in educational organizations is distributed cannot be easily delineated, particularly in countries such as Turkey where the system was established and managed centrally. Yet, DL attracts researchers’ attention in terms of the organizational behaviours. It ascribes to teachers, such as their commitment and associated psychological contracts (PCs). In this study of Turkish schools that are centrally organized, we consider the relationship between DL and teachers’ perceptions of their PC levels. As the research variables are multilevel, the data collected from 466 teachers working in 34 different schools were analysed by hierarchical linear modelling. The analyses indicated that the distribution of leadership among school managers was a significant predictor of the PCs of the teachers. However, the observed variance in the PC was determined to be explained by the service periods of teachers.

Introduction: Pathologic splenic rupture (PSR) is described as the spontaneous rupture of a histologically diseased spleen in the absence of trauma. Although it is a complication that often occurs related to infectious diseases, it may rarely be observed in hematologic malignancies. A limited number of case reports about PSR exist in the current literature, even though the spleen is commonly involved in hematologic diseases. Hence, there is a lack of data in the current literature in terms of the clinical symptoms, treatment, and outcomes of the disease. In this study, we aimed to contribute to current data by discussing clinical outcomes of a case with PSR related to spleen lymphoma. Case Report: A 57-year-old woman with a 5-month history of colic left upper abdominal pain was referred to our clinic. In her imaging tests, a splenic mass with a measure of 6x4 cm was detected. The patient underwent splenectomy due to PSR while preparing for elective surgery. Conclusion: PSR should be considered a rare complication in hematologic malignancies. Early diagnosis and treatment are the major factors that determine prognosis. Splenectomy seems to be the most appropriate approach in the treatment of PSR, even though a conservative approach is suggested in some cases.

Objective: Statins are widely used to lower LDL-cholesterol levels. Two of the most important side effects are hepatotoxicity and myopathy. Myopathy is rare and characterized by widespread muscle pain, fatigue, and increased serum creatine phosphokinase levels. In this study, we aimed to show if isokinetic muscle strength is affected in patients on statin therapy.

BACKGROUND To evaluate the effect of human milk on ocular morbidity in infants who did not breast feed during the first 6 months of life. MATERIAL AND METHODS This retrospective randomized study included 154 subjects who were first or second grade elementary school students, 66-84 month of age. These children were randomly selected from 2080 students during health screenings. All of them were born at term and were normal birth weight. The study was composed of 3 age- and sex-matched groups. Group 1 included 52 subjects who had never been breast fed. Group 2 included 42 subjects who were breast fed and also received additional food (infant formula). Group 3 included 60 subjects who were only breast fed until 6 months old (no formula) except for the first month of life. All subjects underwent a complete ophthalmic examination and any morbidity was recorded. Frequencies of ocular morbidity were compared among the groups by using the chi-squared test. RESULTS We found significant refractive errors in 12 (23%) subjects in Group 1 (no breast feeding). There was no significant refractive error in Group 2 (breast feeding and formula) and Group 3 (breast feeding only). The difference among the groups was statistically significant (p=0.014, chi-squared test). Allergic conjunctivitis was found in 5 subjects in Group 1, 3 in Group 2, and 2 in Group 3. There was no significant difference among the groups (p=0.395). CONCLUSIONS Refractive errors were more frequent in Group 1 (no breast feeding) than in Group 2 (breast feeding and formula) or Group 3 (breast feeding only). There is a need to confirm this finding by performing studies with larger sample sizes.

WOS: 000397833300001, PubMed ID: 28382288, Purpose: To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. Methods: Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10-100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MIC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. Results: Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10-100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10-100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and beta-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (+/- PG stimulation) to the preoperative work-up, resulted in is an element of 912.68 per MTC patient to detect the disease. Conclusion: Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.

Objectives Methemoglobinemia (MetHb) is a rare condition that may have mortal consequences. Literature shows cases of methemoglobinemia due to the use of lidocaine and other local anesthetics. This is a cross-sectional study to determine the incidence of methemoglobinemia after the application of lidocaine. Methods In this study, 88 patients admitted to the emergency department of a university hospital between May 2014 and May 2015 and needed lidocaine application for small surgical procedures were included. When compared before and after the administration of lidocaine 2 mg/kg, there was not a significant difference in the level of methemoglobin, hemoglobin, or in the hematocrit (p=0.604, p=0.502, and p=0.367, respectively). Results Mean age of the patients was 33.85 (±17.58) years, and 83% of the patients were male. Methemoglobin levels were not significantly different before and after the procedures (p>0.05). Conclusion The results of our study were consistent with the literature; lidocaine associated methemoglobinemia is a rare complication.

WOS: 000461107900005, Objective: We aimed to evaluate the necessity and the worthiness of postoperative vocal cord examination in cases with no loss of signal during intraoperative nerve monitoring (IONM) in thyroid and parathyroid surgery. Material and Methods: We retrospectively evaluated cases that had no loss of signal during intraoperative nerve monitoring in cases who underwent thyroid and parathyroid surgery in our endocrine surgery unit, between January 2014 - January 2017. Results: A total of 171 patients were analyzed who had no loss of signal during IONM. It was observed that 94 of the patients (55%) had at least one previous surgery and 77 (45%) underwent their first operation. Ninety-one patients were monitored with continuous-IONM and 80 with intermittent-IONM. All patients' preoperative and postoperative laryngeal examinations were identical and no postoperative vocal cord problems were observed. Conclusion: The signal from the vagus nerve is sufficiently sensitive to show the postoperative vocal cord functions after resection in patients having no loss of signal during IONM. We support the idea that postoperative vocal cord examination may be neglected in these patients.

WOS: 000423437800003, PubMed ID: 29142831, Background: Bleeding after thyroidectomy is life-threatening. The aim of the study was to evaluate whether controlling of further bleeding with Valsalva maneuver following Trendelenburg's positioning has an impact on hemostasis. Methods: This prospective study included 68 consecutive patients undergoing thyroidectomy. Study protocol consisted of performing manual intra-abdominal pressure increase and Valsalva maneuver to check hemostasis and treating any bleeding point identified, after Trendelenburg's positioning. All identified bleeding points and treatments were recorded. Results: Total number of bleeding points identified in Trendelenburg's tilt was 49, while it was 41 when using Valsalva maneuver. Abdominal pressure increase, carried out before Valsalva maneuver, identified 14 bleeding points, which was less than bleeding after Trendelenburg's positioning and Valsalva maneuver (P

PubMedID: 29512625 Objective: The goal of this study was to define clinical practice patterns for assessing stroke and bleeding risks and thromboprophylaxis in nonvalvular atrial fibrillation (NVAF) and to evaluate treatment outcomes and patient quality of life. Methods: A clinical surveillance study was conducted in 10 tertiary healthcare centers across Turkey. Therapeutic approaches and persistence with initial treatment were recorded at baseline, the 6th month, and the 12th month in NVAF patients. Results: Of 210 patients (57.1% male; mean age: 64.86±12.87 years), follow-up data were collected for 146 patients through phone interviews at the 6th month and 140 patients at the 12th month. At baseline, most patients had high CHADS2 score (?2: 48.3%) and CHA2DS2-VASc (?2: 78.7%) risk scores but a low HAS-BLED (0–2: 83.1%) score. Approximately two-thirds of the patients surveyed were using oral anticoagulants as an antithrombotic and one-third were using antiplatelet agents. The rate of persistence with initial treatment was approximately 86%. Bleeding was reported by 22.6% and 25.0% of patients at the 6th and 12th month, respectively. The proportion of patients with an INR of 2.0–3.0 was 41.8% at baseline, 65.7% at the 6th month, and 65.9% at the 12th month. The time in therapeutic range was 61.0% during 1 year of followup. The median EuroQol 5-dimensional health questionnaire (EQ-5D) score of the patients at baseline and the 12th month was 0.827 and 0.778, respectively (p

ObjectiveThe purpose of this study was to evaluate the effectiveness of demineralized bone matrix (DBM) with and without platelet-rich plasma (PRP) in the treatment of osteochondral defects (OCDs) of the talus. We hypothesized that treatment with DBM would result in more bone formation than no treatment in control OCDs, and that PRP would further enhance the regenerative capacity of DBM.MethodA standardized 6-mm OCD was created in each talus of 16 adult goats. According to a randomization scheme, one OCD of each goat was treated with allogeneic DBM hydrated with normal saline (n = 8) or hydrated with autologous PRP (n = 8). The contralateral OCD (n = 16) served as control. After 24 weeks, the animals were euthanized and the tali excised. Various outcome parameters were analyzed with use of macroscopic evaluation, micro-computed tomography (μCT), histology, histomorphometry, and fluorescence microscopy.ResultsNone of the analyses revealed statistically significant differences between the groups for any of the parameters analyzed in any volume of interest. For example, the mean bone volume fraction (BV/TV) of the defect, as measured by μCT, was 0.56 (95% confidence interval [CI], 0.44-0.68) for DBM hydrated with normal saline and 0.52 (95% CI, 0.40-0.65) for DBM hydrated with PRP, compared to 0.53 (95% CI, 0.45-0.61) and 0.54 (95% CI, 0.44-0.64) for the internal controls, respectively (P > 0.05).ConclusionIn contrast to our hypotheses, no beneficial treatment effect of DBM with or without PRP was found for OCDs of the caprine talus.

The purpose of the present study is to determine whether the level of academic achievement of B. A. students in Gaziantep University is a meaningful predictor of the quality of teaching processes and learning resources of their higher education institution in 2014-2015 educational year. The study is designed in the correlational survey model and the data are obtained by applying the scale to randomly selected 796 students. In data analysis, SPSS 20 program is used and Independent Samples T Test and Multiple Linear Regression among parametric analyses are applied to the data set showing normal distribution and .05 is accepted as the significance level. According to research findings, the participants’ views differ significantly in four of the sub-dimensions according to their gender and these sub-dimensions - career guidance services, teaching processes, campus life and assessment and evaluation - are found to predict about %15 of students’ grade point averages . It is extrapolated that some variables related to the teaching processes and learning resources in higher education institutions have a significant role in student achievement. The findings and results are discussed in parallel with similar researches and some recommendations are taken place in this respect.