Search

Bu çalışmada XRD (X-Işınları kırınımı) yöntemiyle yüksek karbonlu östenit faz hacim oranı belirlenmesinde yüzey koşullarının yüksek karbonlu östenit faz hacim oranı üzerine etkisi araştırılmıştır. Böylelikle XRD analizinde uygun yüzey koşulunun belirlenmesi hedeflenmiştir. Bu amaç doğrultusunda, alaşımlı küresel grafitli dökme demire 900°C’de 2 saat östenitleme ve 375°C’deki tuz banyosunda 2 saat östemperleme ve ardından oda sıcaklığına havada soğutma işlemi uygulanmıştır. Isıl işlem sonrası dört eşit parçaya ayrılarak farklı yüzey koşullarında hazırlanan numuneler optik ve SEM (Taramalı Elektron Mikroskobu) ile incelenmiş, XRD analizleri yapılmış ve makro sertlik ölçümleri gerçekleştirilmiştir. XRD yöntemiyle yüksek karbonlu östenit faz hacim oranı ölçümlerinde farklı yüzey koşullarının östenit faz hacim oranı ölçümü üzerinde oldukça etkili olduğu gözlemlenmiştir. XRD yöntemiyle faz hacim oranı belirlenmesinde polisaj+dağlama işleminin yüzey pürüzlülüğünü azalttığı için oldukça etkili olduğu tespit edilmiştir. In this study, the effect of surface preparation conditions on high carbon austenite phase volume fraction measurement in determination of high carbon austenite phase volume fraction by XRD (X-Ray Diffraction) method was investigated. Thus, it was aimed to determine the appropriate surface condition in XRD analysis. For this purpose, alloyed ductile iron was subjected to austenitization at 900 ° C for 2 hours, austempering at 375 ° C for 2 hours and then air cooling to room temperature. After heat treatment, the samples were divided into four equal parts and examined samples having different surface conditions by optical and SEM (Scanning Electron Microscope), XRD analysis and macro hardness measurements were performed. It was observed that different surface conditions were highly effective on austenite phase volume fraction measurement in high carbon austenite phase volume fraction measurements by XRD method. It was determined that polishing+etching process is very effective in detecting the phase volume fraction by XRD method because it reduces surface roughness.

Amaç: Liken planus (LP) kronik enflamatuvar bir hastalıktır. Karotis intima-medya kalınlığı (KİMK) ölçülmesi ve lipid profilinin değerlendirilmesi aterosklerotik risk tahmini için kabul görmüş bir metottur. Bu çalışmada LP hastalarında kardiyovasküler hastalık (KVH) risk faktörlerinin prevelansı ve subklinik ateroskleroz riskinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu olgu-kontrolü çalışmaya LP tanısı alan 60 hasta grubu ile yaş ve demografik özellikler açısından benzer 60 kontrol grubu dahil edildi. Gruplar arasında bazal karakteristik özellikleri, KVH risk faktörleri, biyokimyasal ve hematolojik parametreleri, konvansiyonel 2-boyutlu ve Doppler transtorasik ekokardiyografik parametreleri, sol ventrikül kitle indeksi (SoVKİ) ve KİMK karşılaştırıldı. Bulgular: Çalışmaya yaş ortalaması 46±13 yıl olan, 73’ü kadın (%61), 47’si erkek (%39) olmak üzere toplam 120 hasta alındı. Total kolesterol (TK) seviyeleri LP grubunda kontrol grubuna kıyasla daha yüksek bulundu (sırasıyla 209, 192, p=0.038). Gruplar arasında SoVKİ ve konvansiyonel ekokardiyografik ölçümler benzer bulundu. LP grubunda KİMK 0.88±0.16 mm iken kontrol grubunda 0.59±0.10 mm olarak ölçüldü (p< 0.001). Kutanöz LP ile mukozal LP arasında ise KİMK benzer bulunmuştur. LP grubunda hastalık süresi ile KİMK arasında güçlü bir korelasyon izlenmiştir (r=0.61, p

Objectives: We aimed to evaluate the effects of morphological characteristics of the solitary pulmonary nodules (SPN) on metabolic activity assessment. To the best of our knowledge, this is the first study to compare the volumetric metabolic activity parameters according to the morphologic parameters of the nodules. Methods: In this retrospective study, 18F-FDG positron emission tomography and computed tomography scans performed between 2011 and 2018 were evaluated by a nuclear and diagnostic radiologist. One hundred thirteen patients with SPNs with biopsy-proven diagnosis were included. SPNs were classified as solid, partially solid (PS), and ground glass opacity (GGO). Results: SPN diameter, SUVmax, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and density were significantly higher in the malignant group. SUVmax, MTV, TLG increased in direct proportion to the diameter. There was no a significant difference between GGO, PS, and solid nodules in terms of SUVmax values. MTV and TLG values increased in parallel with the density of the nodules, but this increase was only significant in the malignant group. There was a significant difference between SPNs

The metabolic activities of tumors can be calculated volumetrically during positron emission tomography/computed tomography (PET/CT) imaging using metabolic tumor volume (MTV) and total lesion glycolysis (TLG). This study aimed to evaluate the roles of MTV and TLG in predicting the malignancy risk of incidental thyroid nodules detected by PET/CT imaging.Active metabolic areas of each section were manually drawn by region of interest to calculate the MTV of nodules, and all obtained values were then summed. TLG, the product of mean standardized uptake value and MTV, was calculated by multiplying two values. All participants underwent thyroid ultrasonography imaging. All nodules were divided into risk classes according to the European Thyroid Image Reporting and Data System (EU-TIRADS) that was developed by the European Thyroid Association. The American Thyroid Association Guidelines were used to determine which thyroid nodules would undergo thyroid fine-needle biopsy (FNAB). Results were classified according to the Bethesda scoring system.TLG levels were significantly higher in malignant or malignant-suspicious nodules than in benign nodules (p=0.013). Although MTV levels were high in malignant or malignant-suspicious nodules than in benign and non-diagnostic nodules, it was statistically insignificant at limit values (p=0.079). Areas under curve (AUC) were 0.726 (p=0.005) and AUC: 0.668 (p=0.039) for TLG and MTV, respectively. The 2.3 g cut-off value of TLG has a sensitivity of 85.7% and specificity of 59.0%. The 1.7 mL cut-off value of MTV has a sensitivity of 78.6% and specificity of 60.4%.We believe that TLG evaluation will be useful in predicting high-risk malignancy or malignancy suspicion based on EU-TIRADS risk classification of incidental thyroid nodules detected in PET/CT images. We believe that unnecessary thyroid FNABs can be avoided for thyroid incidental nodules if such relation and cut-off values are determined and that it will be useful in hastening the operation of the necessary patients.Tümörlerin metabolik aktivitesi pozitron emisyon tomografi/bilgisayarlı tomografinin (PET/BT) görüntüleme sırasında hacimsel olarak hesaplanabilir. Bunlar metabolik tümör hacmi (MTV) ve toplam lezyon glikolizidir (TLG). Bu çalışmanın amacı, PET/BT görüntüleme ile saptanan tesadüfi tiroid nodüllerinde malignite riskini tahmin etmede hacimsel olarak metabolik aktivite gösteren MTV ve TLG’nin rollerini değerlendirmektir.Nodülün MTV’sini hesaplamak için, her bölümün aktif metabolik aktif lezyonlara ilgi alanları ile manuel olarak çizildi; daha sonra elde edilen tüm değerler toplandı. Ortalama standardize uptake değeri ve MTV’nin ürünü olan TLG, iki değer çarpılarak hesaplandı. Tüm katılımcıların tiroid ultrasonografileri yapıldı. Tüm nodüller, Avrupa Tiroid Birliği (ETA) tarafından geliştirilen “EU-TIRAD”a göre risk sınıflarına ayrıldı. ATA Kılavuzu’na göre hangi tiroid nodüllerinin tiroid İİAB geçireceğine karar verildi. Sonuçlar Bethesda puanlama sistemine göre verildi.TLG düzeyleri, benign nodüllere göre malign veya malign-şüpheli nodüllerde anlamlı olarak yüksekti (p=0,013). MTV düzeyleri malign veya malign-şüpheli nodüllerde benign ve tanısal olmayan nodüllere göre yüksek olmasına rağmen sınır değerlerde istatistiksel olarak anlamlı değildi (p=0,079). Eğri altındaki alan (AUC) TLG için 0,726 (p=0,005) olarak hesaplandı. TLG için 2,3 g kesme değeri için duyarlılık %85,7 ve özgüllük %59,0 olarak bulundu. MTV için AUC 0,668 olarak hesaplandı (p=0,039). MTV için 1,7 mL cut-off için duyarlılık %78,6, özgüllük ise %60,4 idi.PET/BT ile saptanan tesadüfi tiroid nodüllerinde, yüksek riskli malignite veya malignite şüphesine sahip olma açısından TLG değerlendirmesinin, EU-TIRADS’ye göre yüksek ve çok yüksek riskinin tahmin edilmesinde faydalı olacağına inanıyoruz. Böyle bir ilişki ve kesim değerlerinin kesin olarak tespit edilmesi durumunda, tiroid tesadüfi nodüller için gereksiz tiroid İİAB’lerinden kaçınılabileceğini ve gerekli hastaların ameliyatının geciktirilmemesi açısından faydalı olacağını düşünüyoruz.

Calcific aortic stenosis (AS) is a common valvular disease especially in elderly population. Inflammation plays significant role in the pathophysiological mechanism. Systemic immune-inflammation index (SII) is a novel marker of immune system and inflammation that includes neutrophil, lymphocyte, and platelet cell counts. The aim of this study was to investigate the predictive value of SII in calcific severe AS.Severe calcific AS patients were categorized into two groups: High flow-high gradient (HFHG) AS (n = 289) and low flow-low gradient AS (n = 79). Control group included 273 patients with similar clinical and demographic characteristics but without AS. SII was calculated as absolute platelet count × absolute neutrophil count/absolute lymphocyte count.SII levels were 525 ± 188, 835 ± 402, and 784 ± 348 in control, HFHG AS, and LFLG AS groups, respectively (P .001). Correlation analyses revealed significant and positive correlation between SII and mean aortic transvalvular pressure gradient (r = .342, P .001), and negative and significant correlation between SII and AVA (r = -.461, P .001). Multivariate analysis performed in separate models demonstrated sex, CAD, LDL, and SII levels (Odds ratio [OR]: 1.004, 95 CI%:1.003-1.004) as independent predictors of severe AS in Model 1. According to Model 2, sex, CAD, LDL, and high SII (661) (OR:5.78, 95 CI%:3.93-4.89) remained as independent predictors of severe AS.SII levels can be useful to predict severe calcific AS patients and significantly correlate with AVA and mean aortic transvalvular pressure gradient.

Introduction Role of systemic inflammation response in prognosis of several solid tumors has been evaluated in quite a lot of recent reports. Objectives In this study, we aimed to investigate the effect of a novel immune response marker; systemic immune-inflammation index (SII) on metabolic response to chemoradiotherapy and outcome in patients with non-small cell lung cancer (NSCLC). Other several inflammatory indices such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) were also evaluated in terms of predictive value. Methods Files of 66 newly diagnosed NSCLC patients who underwent curative radiotherapy were retrospectively analyzed. Factors correlated with overall survival was evaluated via univariate and multivariate survival analysis. Results In 20.05 months of median follow-up 22 (33.33%) patients were alive. Median overall survival, 3 and 5 years survival for the entire group were 25.49 (95% CI: 19.07-31.91) months, 54.9% and 20.1%, respectively. Among investigated inflammatory indices, only low PNI (≤45.45), was found significantly correlated with poor response rate (P: .024). None of the prognostic factors and inflammatory indices were found statistically significant in terms of overall survival via univariate and multivariate analysis. Conclusions Immunoinflammatory indices are feasible prognostic indicators for clinical use with easily accessible components. In this study, we demonstrated that pretreatment PNI ≤ 45.45 was statistically significant for predicting poor treatment response. None of the indices were significantly correlated with radiation pneumonitis.

This study summarizes research into the effect of high boron additions on the microstructure of cast steel under the certain carbon (0.42 C wt.%) and chromium (11.65 Cr wt.%) content. Varying amounts of boron between 0.48 - 4.75 wt.% was added into steel melt. The boron analysis of the alloys was conducted by wet chemical analysis. The microstructure of the specimens was characterized with optical microscope, Scanning Electron Microscope with Energy Dispersive X-Ray Analysis (SEM/EDX) and X-Ray Diffraction (X-RD). The experimental results showed that high boron steel was successfully produced by sand casting with high casting yield. The microstructure of boron alloyed high chromium cast steel consists of three dimensional networks of M2B borides surrounding the martensitic matrix in as cast condition. Under the certain carbon and chromium content, boron carbide volume fraction is directly depended on the boron additions. Due to the high amount of chromium and boron, carbides and borides were embedded in each other in all additions. In the specimens having less than 2.44 B wt.%, carbide/boride structure was fishbone type with dendritic distribution over the matrix whereas rod/needle like structure with randomly distribute was observed in specimens having 2.44 - 4.75 B wt.%. In all specimens containing boron, M2B and M7 (C, B)5 type carbides/boride peaks were detected by X-RD analysis.

WOS: 000429745000008, Triple-A syndrome is a rare, multi-systemic disease and is characterized by adrenal insufficiency, achalasia, or alacrima. The symptoms may also involve neurologic manifestations, including pyramidal findings and peripheral motor neuropathy. Other findings include autonomic dysfunction and cerebellar ataxia. In the present study, we present the case of two siblings with triple-A syndrome with neurologic manifestations. The neurologic abnormalities can lead to misdiagnosis owing to resemblance to the manifestations of other neurologic disorders. Therefore, the cases with triple-A syndrome should be carefully evaluated and examined for clinical and neurophysiologic signs.

A 52-year-old woman presented with a complaint of neck swelling. The patient showed signs of hyperparathyroidism: hypercalcemia, and hypophosphatemia. Tc-99m MIBI dual-phase parathyroid scintigraphy and SPECT revealed increased activity in a regular-bordered, “doughnut”-shaped mass on the left side of the thyroid gland with a central hypoactive area. The cervical ultrasound identified a mixed echoic thyroid nodule with a central large cystic portion, and no parathyroid gland abnormality. Total thyroidectomy and parathyroid exploration was performed. Pathological evaluation of the resected thyroid specimen reported a giant intra-thyroidal hemorrhagic parathyroid adenoma.Boyunda şişlik şikayeti ile başvuran elli iki yaşında kadın hastada hiperkalsemi, hipofosfatemi ile hiperparatiroidizm saptandı. Yapılan Tc-99m MIBI dual faz paratiroid sintigrafisinde ve SPECT çalışmasında tiroid bezinin sol lobunu kaplayan, ortasında hipoaktif alanlar izlenen, artmış aktivite tutulumu gösteren “doughnut” görünümlü lezyon izlendi. Boyun ultrasonografide sol lobun üst ve orta kesiminde ortasında kistik komponent görülen, karışık ekoda tiroid nodülü gözlendi, ancak paratiroid patolojisi izlenmedi. Hastaya total tiroidektomi ve paratiroid eksplorasyonu yapıldı. Tiroid cerrahi spesimeninin patolojik deperlendirmesi dev intratiroidal hemorajik paratiroid adenomu olarak raporlandı.

New communication technologies provide people with an environment in which they can express themselves and share their thoughts without any pressure. Social media, which is one of these environments, has an important place for individuals who are from different socio-economic and socio-cultural levels to come together and interact. In these environments where the number of members is increasing day by day, it is noteworthy that users share their intimate situations in the form of still and moving images such as photos and videos. Therefore, many information and situations, which have been regarded to be private until today, are willingly shared on social media environments and transformed into a kind of panopticon in terms of surveillance for the hegemonic powers. The aim of this study is to determine the views and opinions of graduate students in the field of communication, which is thought to have high level of awareness about surveillance, in this study, where internalization of surveillance in social media is discussed. The study becomes important as it will deal with the phenomenon of surveillance especially for the students who continue their graduate education in the field of communication dipcipline. In this study, which has a descriptive approach and based on the qualitative method, a purposive sample based on the improbable method was formed from the student universe that continues postgraduate education in the field of communication at Atatürk University and detailed interviews were conducted with the students in the sample. In this study, which has a descriptive approach and based on the qualitative method, a purposive sample based on the improbable method was created from the student universe that continues postgraduate education in the field of communication at Atatürk University and in-depth interviews were conducted with the students in the sample. As a result of the analysis of the data obtained, it has emerged as an important outcome that graduate students in the field of communication, which is thought to be highly aware of mass communication processes and surveillance, internalize surveillance in social networks., Yeni iletişim teknolojileri insanlara, kendilerini ifade edebilecekleri ve düşüncelerini herhangi bir baskı altında kalmadan paylaşabilecekleri bir ortam sağlamaktadır. Bu ortamlardan biri olan sosyal medya, farklı sosyoekonomik ve sosyo-kültürel düzeylerden bireylerin bir araya gelebilmeleri ve aralarında etkileşim sağlayabilmeleri yönünden önemli bir yere sahiptir. Her geçen gün üye sayısının arttığı bu ortamlarda, kullanıcıların kendileri ile ilgili mahrem durumları fotoğraf ve video gibi durağan ve hareketli görüntüler biçiminde paylaştıkları dikkat çekmektedir. Dolayısıyla, daha düne kadar mahrem sayılan birçok bilgi ve durumun isteğe bağlı olarak paylaşıldığı sosyal medya ortamları, bu haliyle iktidar odakları açısından gözetim bağlamında bir nevi panoptikona dönüşmektedir. Sosyal medyada gözetimin içselleştirilmesi konusunun ele alındığı bu çalışmada, özellikle gözetim konusunda farkındalık düzeylerinin yüksek olduğu düşünülen iletişim alanındaki lisansüstü öğrencilerinin görüş ve düşüncelerinin belirlenmesi amaçlanmaktadır. Haliyle çalışma, iletişim disiplini alanında lisansüstü eğitimlerini sürdüren öğrenciler özelinde gözetim olgusunu ele alacağı için önem kazanmaktadır. Betimleyici bir yaklaşıma sahip olan ve nitel yönteme dayanan araştırmada, Atatürk Üniversitesi’nde iletişim alanında lisansüstü eğitimlerini devam ettiren öğrenci evreninden olasılıksız yönteme dayanan amaçlı örneklem oluşturulmuş ve örneklemdeki öğrencilerle derinlemesine mülakat gerçekleştirilmiştir. Bu kapsamda, önceden hazırlanan yapılandırılmış soru formu üzerinden 10 lisansüstü öğrenci ile görüşülmüştür. Elde edilen verilerin analiz edilmesi neticesinde, kitle iletişim süreçleri ve gözetim konusunda farkındalığı yüksek olduğu düşünülen iletişim alanındaki lisansüstü öğrencilerin sosyal ağlarda gözetimi içselleştirdikleri önemli bir bulgu olarak ortaya çıkmıştır.

Kalp yetersizligi, insan yasam omrunun uzamasi, kullanilan ilac ve ilac disi tedaviler ve ilerleyen tetkik ve tani yontemleri nedeniyle klinik hayatimizda karsimiza daha fazla cikmaktadir. Bu kitapta kalp yetersizligi tanisini, baska hastaliklar ile iliskisini, tedavisinde kullanilan ilac, cihaz ve cerrahi yontemleri pratik bilgiler de sunarak anlatmaya calistik. Kardiyoloji, Ic Hastaliklari ve Aile Hekimligi uzmanlari basta olmak uzere kalp yetersizligi ile ilgilenen tum hekim arkadaslarin ilgiyle okuyacaklarini dusunmekteyiz.Bu sebeple son yayin ve kilavuzlar isiginda kalp yetersizligi ile iliskili guncel verileri iceren “Kalp Yetersizliginde Pratik Bilgiler” isimli kitabimizi siz okuyucularimiza kazandirmaktan gurur duyuyoruz.Kalp yetersizligi ile ilgilenen hekim arkadaslarimiza faydali olacagini umdugumuz kitabin bolumlerin yazilmasinda emegi gecen tum degerli meslektaslarimiza tesekkur ederiz.

WOS: 000471902200025, PubMed ID: 31203594, Background/aim: High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined. Materials and methods: TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center. Results: A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2-2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 +/- 1472 mg/dL) than the mean TG level afterwards (948 +/- 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE. Conclusion: TPE is a safe, fast, and effective treatment modality in experienced centers.

Background and Objectives: Lichen planus (LP) is a mucocutaneous inflammatory disease. Inflammation plays a major role in the progression of atherosclerosis. Epicardial fat tissue (EFT) has been shown to produce and secrete various proatherogenic and proinflammatory hormones and cytokines. The aim of this study was to assess EFT in patients with lichen planus. Methods: Fifty-four patients with LP and 50 controls were enrolled in the study. LP was diagnosed according to the World Health Organization criteria. EFT was measured on the free wall of the right ventricle in parasternal long-axis view, as previously described and validated. Results: There were positive correlations between EFT thickness and platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, duration of LP, and high-sensitivity C-reactive protein (hsCRP) (p

Objectives: The aim of this study was to investigate the elastic properties of the aorta and the myocardial performance index of the left ventricle (LV) in patients with lichen planus (LP). Subjects and Methods: A total of 54 patients with LP and 50 controls were enrolled in the study. The 2 groups were well-matched regarding age, gender, body mass index, any smoking history, diabetes mellitus and systolic and diastolic blood pressure (SBP and DBP). The echocardiographic examination was performed on the study subjects and the controls. Aortic elasticity parameters and the myocardial performance index of the LV were calculated. The Student t test, the χ2 test and multiple linear regression were used for the statistical analysis. Results: Aortic strain (AS, 4.77 ± 1.81 vs. 8.95 ± 2.22; p < 0.001) and aortic distensibility (AD, 0.25 ± 0.009 vs. 0.42 ± 0.120; p < 0.001) were significantly lower, and aortic stiffness index β (ASIβ, 3.65 ± 1.03 vs. 2.70 ± 0.91; p < 0.001) was significantly higher in the LP group than in the controls. The myocardial performance index (Tei index) was significantly higher in the LP group than in the control group (p = 0.001). The duration of the LP was negatively correlated with AS (r = -0.364, p < 0.001) and AD (r = -0.279, p = 0.006), and positively correlated with the Tei index (r = 0.324, p = 0.001) and ASIβ (r = 0.364, p < 0.001). After adjustment for relevant confounders (age, male gender, smoking, SBP, DBP, diabetes mellitus and low- and high-density lipoprotein cholesterol), LP and its duration were still associated with AS, AD and ASIβ. Conclusion: In this study, AS and AD were lower and ASIβ and myocardial performance index higher in LP patients than in controls.

Amaç: Görüntüleme yöntemlerinin kullanımının artmasıyla birlikte adrenal insidentaloma tespit edilme oranı da artmıştır. Bu çalışmada adrenal insidentalomalı vakalarımızın klinik özelliklerini sunuyoruz. Gereç ve Yöntem: Şubat 2013 ve Şubat 2014 tarihleri arasında Ege Üniveristesi Endokrin polikliniğimize başvuran adrenal insidentalomalı hastalarımızın kayıtları incelendi. Yaş, cinsiyet, komorbidite, lokalizasyon, büyüklük, fonksiyon, operasyon şekli ve histolojik bulguları retrospektif olarak kaydedildi. Bulgular: Toplam 80 hastanın 55’i kadın (%68.7), 25’i erkekti (%31.3). Ortalama yaş 55.7 (30-72) olarak bulundu. Adrenal adenomların sıklıkla 50-60 yaş aralığında olduğu görüldü. Lokalizasyon açısından analiz yapıldığında, adrenal kitlelerin %51.3’nün solda, %38.5’nin sağda, %10.2’sinin bilateral olduğu tespit edildi. Verisi incelenen 80 hastadan hormonal taranması yapılan 76 hastanın verileri analiz edildiğinde; adrenal kitlelerin %73.7’sinin nonfonksiyone olduğu tespit edildi. Hastaların %19.7’sine subklinik Cushing sendromu (1 mg DST’nde eşik değer 1.8 ?g/dL alındığında), %5.3’ünde feokromositoma, %1.3’ünde Conn sendromu tanısı kondu. Bir mg DST’nde eşik değer 5?g/dL alındığında subklinik Cushing sendromu oranı %2.6’ya geriledi. Adrenalektomi uygulanan 17 hastadan verilerine ulaşılabilen 10 hastada kapalı adrenalektomi ve 5’inde robotik cerrahi ile adrenalektomi uygulandığı görüldü. Patolojik verileri analiz edildiğinde; 9 adenom, 4 feokromositoma, 2 myelipoma ve 1 onkositom tespit edildi. Sonuç: Kliniğimizdeki adrenal insidentaloma vakalarındaki özellikler genel olarak literatür verisiyle uyumu bulunmuştur. Ancak subklinik Cushing sendromunda alınan tanı kriterine göre oran değişiklik gösterebilmektedir. Bir mg DST sonrası eşik değer 1.8 ?g/dL alındığında testin spesifisitesi azalabilmektedir., Aim: The detection rate of adrenal incidentaloma with the increasing use of imaging techniques has increased. In this study, we present the clinical features of our cases with adrenal incidentaloma. Materials and Methods: We investigated the data of the cases with adrenal incidentaloma admitted to Endocrine clinic of Ege University between February 2013 and February 2014. Age, sex, comorbidity, localization, size, function, operation method, histological findings were retrospectively recorded. Results: Out of 80 patients, 55 were female (68.7%) and 25 were male (31.3%). Mean age was 55.7±9.7 (30-72). Adrenal incidentaloma was often found between 50 and 60 years of age. In the localization analysis, 51.3% of adrenal mass was detected on the left side, 38.5% on the right and 10.2% was bilateral. When 76 out of 80 patients undertook a hormonal analysis, 73.7% of the adrenal masses were found to be non-functioning. 19.7% of our patients were diagnosed as subclinical Cushing syndrome (when threshold value was taken as 1.8μg/dL in 1mg dexamethasone suppression test-DST), 5.3% pheochromocytoma and 1.3% Conn syndrome. When threshold value was taken as 5μg/dL in 1mg DST, the rate of subclinical Cushing syndrome decreased to 2.6%. Out of 17 patients underwent adrenalectomy, it was observed in the ones with available medical reports that 10 patients were operated with laparoscopic and 5 with robotic surgery. In the pathological data analysis, there were 9 adenoma, 4 pheochromocytoma, 2 myolipoma and 1 oncocytoma. Conclusion: The features of our cases with adrenal incidentaloma were generally found to be in compliance with the the literature data. However, the number of the patients with subclinical Cushing syndrome after 1mg DST may vary according to threshold values. When threshold value was taken as 1.8 μg/dL in 1mg DST, specificity of the test may decrease.

Purpose: The growing prevalence of obesity has become a major concern. The efficacy of medical treatment, diet and behavior therapy in morbidly obese patients is limited. Obesity surgery is a treatment option for selected morbidly obese patients. Material and Method: Data of 47 patients (n=39 women, 8 men) who underwent bariatric surgery were investigated. Results: Out of 47 patients, 20 underwent Roux-en-Y gastric bypass (RYGB) (43%) and 27 had sleeve gastrectomy (SG) (57%). The mean age of the patients was 37±9.5 (19-59) years. 17% of patients were men and 83% were women. In the analysis of data on weight that could be found for 31 out of 47 patients, we detected preoperative and postoperative (1st and 3rd month) mean weight values as 125.4±15.9 kg, 112.7±13.2 kg (p

Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines. Results: The study population comprised 48 male and 35 female patients. Of the 2010 AHA guideline patients, 39.21% experienced pulmonary contusion, while 54.83% of 2015 ERC guideline patients had pulmonary contusion. It was found that 11.76% of 2010 AHA guideline patients and 3.22% of 2015 ERC guideline patients had pneumothorax, while 9.8% of 2010 AHA guideline patients and 12.9% of 2015 ERC guideline patients experienced hemothorax. Incidence rates of lung contusion, pneumothorax, and hemothorax were higher in patients with rib fractures. Conclusion: In this study, traumatic thoracic complications were investigated in patients with ROSC after CPR. The incidence of CRP-related injuries did not decrease on application of the new 2015 ERC CPR guideline recommendations. The most common injury in this study was rib fracture, followed by sternal fracture, lung contusion, hemothorax, and pneumothorax. Statistically, rib fracture had a positive relationship with lung contusion, hemothorax, and pneumothorax.

WOS: 000443340300009, Thyroid hemiagenesis is a rare congenital anomaly in which one thyroid lobe fails to develop. We recently observed a case of thyroid hemiagenesis accompanied by parathyroid adenoma and papillary thyroid microcarcinoma in a 51-years-old woman. The patient's serum calcium level was 10.9 mg/dL and that of intact parathyroid hormone was 218 pg/mL. Although she had a history of thyroid hemiagenesis, the patient was in a euthyroid state without thyroxine replacement. Thyroid ultrasonography detected no right lobe and four nodules of varying sizes in the left thyroid lobe. Tc-99m scintigraphy also demonstrated the absence of the right thyroid lobe. In addition, MIBI-parathyroid scintigraphy showed a parathyroid adenoma at the lower pole of the right cervical region. Based on the diagnosis, parathyroid adenoma excision and thyroidectomy were performed. Postoperative pathological diagnosis revealed parathyroid adenoma and papillary thyroid microcarcinoma in the form of a 0.4 cm sized tumor in the left thyroid lobe. The coexistence of thyroid hemiagenesis, primary hyperparathyroidism, and papillary thyroid microcarcinoma is truly exceptional and has never been reported in the literature before.

Bu çalışmada Konya'nın Ilgın ilçesindeki linyit kömür yatağındaki doğal olarak oluşmuş radyoaktif çekirdeklerden kaynaklanan karasal gama doz oranları belirlenmiştir. Ölçümler, toprak yüzeyinin üstünde ve NaI(Tl) gama-ışın detektörü kullanılarak gerçekleştirilmiştir. Ayrıca, ölçülen bu karasal gama doz oranları kullanılarak her bir ölçüm noktası için ortalama harici yıllık etkin dozlar hesaplanmıştır, This study assesses the terrestrial gamma radiation dose rates from the naturally occurring radionuclides in the lignite coalfield of Ilgın district of Konya. The measurements were performed above the surface soil using NaI(Tl) gamma-ray detector. The average external annual effective doseswere also calculated using these terrestrial gamma radiation dose rates for each measurement location

Nowadays, simulation is a tool for a variety of usages as well as analyzing and developing production systems inbusinesses.. The predominant features of simulations are its allowance of setting a system model up and experimenting itwithout enduring financial costs and time in real-world. In this study, a simulation model was set up for the present situationof a textile factory‟s production system. ProModel 9.2 was used for the simulation program. With the model set up with thisprogram, it is possible to follow the production of the department of the stitching in the factory visually and consequentlygetting quantitative analyses. It was seen that targeted quantity of production in the working hours was not produced and therate of use of some machines were low. Accordingly, two alternative scenarios were developed. In the first scenario, twomachines were removed from stitching tapes and approximately 30% increase was observed in the rate of the use of machine.However, working hours were exceeded. Because in this scenario the working hours were still exceeded, a second scenarioin which unused machines named „supporting was developed and the completion of production in working hours wasensured. Thanks to this, the rate of use of machine exceeded 90%., Simülasyon günümüzde pek çok farklı kullanım alanıyla birlikte işletmelerinde üretim sistemlerini analiz etmek vegeliştirmek için kullanabilecekleri bir araçtır. Sistemin modelini kurup bu model üzerinde gerçek dünyadaki para ve zamanmaliyetine katlanmadan denemeler yapmaya izin vermesi simülasyonun en öne çıkan özelliğidir. Bu çalışmada bir tekstilfabrikasının üretim sisteminin mevcut durumu için simülasyon modeli kurulmuştur. Simülasyon programı olarak ProModel9.2 kullanılmıştır. Bu program ile kurulan model sayesinde fabrikanın dikiş bölümünün bir gün içerisindeki üretiminibilgisayar ortamında görsel olarak takip etmek ve sonucunda sayısal analizler elde etmek mümkündür. Bu analizlersonucunda hedeflenen üretim miktarının mesai saatleri içerisinde yetiştirilemediği, bazı makinelerin kullanım oranlarınındüşük olduğu görülmüştür. Buna göre iki adet alternatif senaryo geliştirilmiştir. Birinci senaryoda dikiş bandından ikimakine çıkarılmış ve makine kullanım oranlarında %30‟lara varan artış gözlenmiştir. Ancak buna rağmen mesai saatleriaşılmaktadır. Bu senaryoda halen mesai saatleri aşıldığı için “destek atma” olarak adlandırılan boş kalan makinelere işatamanın uygulandığı ikinci senaryo kurulmuş ve mesai saatleri içerisinde üretimin tamamlanması sağlanmıştır. Bu sayedemakine kullanım oranları %90’ı aşmıştır.

This study examines the level of knowledge of and attitudes toward biotechnology of preservice teachers from Lebanon, Lithuania, Slovakia and Turkey. Data were gathered from a total of 768 preservice teachers from these four countries. The Biotechnology Knowledge Questionnaire and the Biotechnology Attitude Questionnaire were used for data collection. Three-way MANOVA was conducted to analyze the cross-cultural data. The results revealed that preservice teachers’ knowledge of biotechnology in all four samples was below average. The results also demonstrated that there were significant differences in attitude towards biotechnology among preservice teachers in the four countries. In addition, significant gender differences were observed between male and females. Implications for teaching and further research are discussed. Key words: biotechnology, knowledge, attitude, cross-cultural.

Background: Diabetic foot ulcers and lower extremity amputations are leading causes of mortality and morbidity in diabetic patients. Diabetic neuropathy and peripheral vascular diseases are major reasons for the development of diabetic foot ulcer. Most of the studies showed that hyperhomocysteinemia is related with microvascular and macrovascular complications in diabetic patients. In addition, hyperhomocysteinemia is related to poor ulcer healing. In this study, we investigated the relationship of hyperhomocysteinemia with diabetic foot ulcers. Materials and Methods: Fifty-one patients with diabetic foot ulcers, 35 diabetes patients without foot ulcers and 60 healthy individuals were enrolled in the study. Wagner classification of diabetic foot ulcers was used. Plasma homocysteine levels were measured by Florescence Polarization Immunoassay.Results: The median age was 60.0±10.5 years (Range: 38-85 years) in diabetic foot ulcer group, 57.8±9.6 years (range: 41-74 years) in diabetic group and 55.6±6.8 years (range: 40-70 years) in control group (p=0.062). The groups were similar in terms of mean age and sex distribution. The mean homocysteine levels were 10.7 μmol/l (range: 7-22 μmol/l) in control group, 16.27 μmol/l (range: 8.1-31.8 μmol/l) in diabetic foot ulcer group, 13.38 μmol/l (range: 7/23.6 μmol/l) in diabetic group and were showing statistically significant difference between the groups (p0.05). Multiple logistic regression analysis showed that, peripheral neuropathy and hyperhomocysteinemia (OR 10.558, p=0.008 and OR 1.186, p=0.013, respectively) were independent risk factors for the development of diabetic foot ulcer. Conclusion: Serum homocysteine values are associated with diabetic foot ulcer. Türk Jem 2011; 15: 106-10

In some previous papers the author gave an upper bound estimation for the Ricci curvature of a hypersurface in a hyperbolic space and in a sphere, see [4] and [5]. In the present paper, we give a lower bound estimation for the Ricci curvature of a compact connected embedded hypersurface in a hyperbolic space via the maximum principle given by H. Omori in [11].

Objective: In this study, we aimed to investigate the effect of glycemic regulation, duration of diabetes and antidiabetic treatment on the quality of life (QOL) and to detect other factors that may affect QOL in type 2 diabetic patients using the short form-36 quality of life scale (SF-36). Materials and Methods: One hundred patients diagnosed with type 2 diabetes (according to the American Diabetes Association criteria) upon admission to the Endocrinology clinic of Adana Numune Training and Research Hospital between 1 July 2007 and 31 October 2007 were included in the study. One hundred healthy age- and gender-matched cases were also included as a control group. QOL assessments were made using the SF-36, and blood and urine samples were also collected. Results: In this study, we found several factors that affect QOL parameters. We detected a specific impairment in QOL among diabetic patients compared to healthy control subjects. The presence of more complications, neuropathy, retinopathy, low education level, lack of diabetes education, insulin treatment, inadequate metabolic control, long duration of disease, concomitant chronic disease and being a woman were all additional factors found to negatively affect the QOL. Conclusions: While our results mostly support the current literature, we believe that physiologic, demographic, and behaviour/attitude characteristics should be evaluated together with diabetic complications. Therefore, along with achieving metabolic control, attempts to identify risky patients are gaining importance as a way to improve the QOL of patients with type 2 diabetes. Turk Jem 2008; 12: 68-72

Simülasyon günümüzde pek çok farklı kullanım alanıyla birlikte işletmelerinde üretim sistemlerini analiz etmek ve geliştirmek için kullanabilecekleri bir araçtır. Sistemin modelini kurup bu model üzerinde gerçek dünyadaki para ve zaman maliyetine katlanmadan denemeler yapmaya izin vermesi simülasyonun en öne çıkan özelliğidir. Bu çalışmada bir tekstil fabrikasının üretim sisteminin mevcut durumu için simülasyon modeli kurulmuştur. Simülasyon programı olarak ProModel 9.2 kullanılmıştır. Bu program ile kurulan model sayesinde fabrikanın dikiş bölümünün bir gün içerisindeki üretimini bilgisayar ortamında görsel olarak takip etmek ve sonucunda sayısal analizler elde etmek mümkündür. Bu analizler sonucunda hedeflenen üretim miktarının mesai saatleri içerisinde yetiştirilemediği, bazı makinelerin kullanım oranlarının düşük olduğu görülmüştür. Buna göre üç adet alternatif senaryo geliştirilmiştir. Birinci senaryoda dikiş bandından iki makine çıkarılmış ve makine kullanım oranlarında %30'lara varan artış gözlenmiştir. Ancak buna rağmen mesai saatleri aşılmaktadır. Bu senaryoda halen mesai saatleri aşıldığı için 'destek atma' olarak adlandırılan boş kalan makinelere iş atamanın uygulandığı ikinci senaryo kurulmuş ve mesai saatleri içerisinde üretimin tamamlanması sağlanmıştır. Bu sayede makine kullanım oranları %90'ı aşmıştır. Son senaryoda ise fabrikanın aynı gün içerisinde iki ayrı ürün grubunu üretme durumu ele alınarak siparişten teslimata kadar olan sürenin kısaltılabileceği görülmüştür. Nowadays, simulation is a tool for a variety of usages as well as analyzing and developing production systems in businesses.. The predominant features of simulations are its allowance of setting a system model up and experimenting it without enduring financial costs and time in real-world.In this study, a simulation model was set up for the present situation of a textile factory's production system. ProModel 9.2 was used for the simulation program. With the model set up with this program, it is possible to follow the production of the department of the stitching in the factory visually and consequently getting quantitative analyses. It was seen that targeted quantity of production in the working hours was not produced and the rate of use of some machines were low.Accordingly, three alternative scenarios were developed. In the first scenario, two machines were removed from stitching tapes and approximately 30% increase was observed in the rate of the use of machine. However, working hours were exceeded. Because in this scenario the working hours were still exceeded, a second scenario in which unused machines named 'supporting was developed and the completion of production in working hours was ensured. Thanks to this, the rate of use of machine exceeded 90%. In the last scenario, taking into account the case of production of two different groups of products in the same day, it was seen that time from ordering to delivery could be reduced. 113

Bu araştırmanın amacı iki yönlüdür. Birincisi, farklı alan ve sınıflarda öğrenim gören öğretmen adaylarının Türkiye'deki güncel eğitim reformları hakkındaki farkındalık düzeylerini, bu reform çalışmalarını takip etme ya da etmeme gerekçelerini ortaya koymak ve reform çalışmalarının Türk eğitim sisteminin sorunlarına çözüm üretme konusundaki görüşlerini derinlemesine betimlemektir. İkincisi ise, öğretmen adaylarının güncel eğitim reformlarını takip etmede ve paylaşmada ne tür bilgi kaynaklarını kullandıklarını ve bu reformlarla ilgili güvenilir bilgilere ulaşmada yaşadıkları sorunları açığa çıkarmaktır. Araştırma, Akdeniz Üniversitesi Eğitim Fakültesi'nden iki aşamalı örnekleme yöntemi kullanılarak seçilen toplam 23 öğretmen adayı ile gerçekleştirilmiştir. Veri toplama aracı olarak araştırmacılar tarafından geliştirilen, 4 kişisel ve 12 açık uçlu sorudan oluşan Yarı Yapılandırılmış Görüşme Formu kullanılmıştır. Kayıt altına alınan görüşmeler çözümlenmiş ve görüşme kayıtları nitel veri analizine tabi tutulmuştur. Analiz sonuçları, özellikle 1. ve 2. sınıf öğrencilerinin 3. ve 4. sınıf öğrencilerine göre eğitim reformu çalışmalarını daha az takip ettiklerini göstermektedir. Yine analiz sonuçları güncel eğitim reformlarını takip etme düzeyini düşük olarak belirten öğrencilerin büyük çoğunluğunun ders programlarının yoğunluğu nedeniyle zaman ayıramadıklarını ancak, kendi alanlarıyla ilgili reformları gelecek kaygısı taşıdıkları için daha fazla takip ettiklerine işaret etmektedir. Ayrıca sonuçlar, öğretmen adaylarının gündemde yer alan eğitim reformları hakkında yetersiz ve yanlış bilgilere sahip olduklarını ve eğitim reformlarıyla ilgili yeterli ve güvenilir bilgilere uzmanlar tarafından verilecek olan konferanslar aracılığıyla ulaşmayı beklediklerini de ortaya çıkarmaktadır. Pedagojik formasyon alan adaylarla ve eğitim fakültelerinin farklı alanlarından öğretmen adayları ile benzer araştırmaların yürütülmesi alana daha geniş bir perspektif ve anlayış sunacaktır., The main purpose of the present study is twofold: (a) to investigate the awareness and attitudes of prospective teach-ers from different departments and class levels regarding current educational reforms in Turkey and the reasons why they do or do not adhere to these reform activities, and (b) to gain thorough knowledge about information re-sources that they use and the problems that they encounter while learning about and sharing current educational reforms. The study was conducted with 23 prospective teachers drawn from the Education Faculty of Akdeniz Uni-versity, and it used a two-stage sampling method. A semi-structured interview form developed by the researchers was employed as the data collection instrument. The interview form included four demographic and 12 open-ended questions. The tape-recorded interviews were transcribed and verbatim transcriptions were analyzed via quantitative data analysis. The results indicated that freshman and sophomore prospective teachers adhered to the education reform developments less frequently than their juniors and seniors. Most of the prospective teachers who rarely fol-lowed educational reforms indicated that they did not have enough time to do so due to their heavy schedule, but they concentrated on educational reforms in their own field of study since they had concerns for the future. Prospective teachers often had insufficient and false information about educational reforms; they indicated interest in obtaining more reliable information through conferences featuring presentations by experts. Further studies conducted with prospective teachers enrolled in additional departments or pedagogical formation courses would provide a more complete understanding of attitudes toward educational reforms.

The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behçet's disease and to compare it with that in healthy subjects. MATERIAL AND METHODS. The subjects were divided into 3 groups: the active disease, inactive disease, and control groups. NO concentrations were determined by a nitrate/nitrite colorimetric assay kit and measured spectrophotometrically at 540 nm. RESULTS. The tear nitrate/nitrite levels were 0.06 nmol/μL (SD, 0.05) in the active disease group, 0.05 nmol/μL (SD, 0.05) in the inactive disease group, and 0.02 nmol/μL (SD, 0.01) in the control group. The tear nitrate/nitrite levels of both active and inactive groups were higher than those of the control group (P=0.001 and P=0.047, respectively), but there was no significant difference between the active and inactive groups. CONCLUSION. Our results demonstrated that the tear NO levels were elevated in the patients with Behçet's disease. We imply that a better understanding of NO function in the pathogenesis of Behçet uveitis is necessary to develop new therapies based on the inhibitors of NO synthases.

We give an estimate for the Ricci curvature of a complete hypersurface M in a hyperbolic space H and in a sphere S under the same condition. As its application, we give the condition for unboundedness of a complete hypersurface M.

The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behçet’s disease and to compare it with that in healthy subjects. Material and Methods. The subjects were divided into 3 groups: the active disease, inactive disease, and control groups. NO concentrations were determined by a nitrate/nitrite colorimetric assay kit and measured spectrophotometrically at 540 nm. Results. The tear nitrate/nitrite levels were 0.06 nmol/μL (SD, 0.05) in the active disease group, 0.05 nmol/μL (SD, 0.05) in the inactive disease group, and 0.02 nmol/μL (SD, 0.01) in the control group. The tear nitrate/nitrite levels of both active and inactive groups were higher than those of the control group (P=0.001 and P=0.047, respectively), but there was no significant difference between the active and inactive groups. Conclusion. Our results demonstrated that the tear NO levels were elevated in the patients with Behçet’s disease. We imply that a better understanding of NO function in the pathogenesis of Behçet uveitis is necessary to develop new therapies based on the inhibitors of NO synthases.

The purpose of this case study was to investigate curricular (within school) and extra-curricular (out-of-school) activities undertaken to develop students’ environmental awareness. In-depth information was gathered from six middle-school students (three females and three males) and three science teachers (all females) through the use of a semi-structured interview. Furthermore, selected classes and laboratories, and also school halls were observed by using an observation sheet. The interview transcripts and observation notes were subjected to content analysis. The results revealed that the students were not completely aware of their environment due to their lack of interest in environmental issues. The selected school for the study undertook various within and out-of school activities to increase students’ awareness, such as tree planting, clean-ups, and re-using and re-cycling products., Svrha ovoga studijskoga primjera jest istražiti nastavne (školske) i izvannastavne (izvanškolske) aktivnosti koje se provode radi razvoja učeničke ekološke svijesti. Detaljni podaci prikupljeni su od 6 učenika viših razreda osnovne škole (tri djevojčice i tri dječaka) te triju nastavnica prirode putem polu-strukturiranog intervjua. Osim toga, promatrani su odabrani razredi i laboratoriji te školski hodnici uz popunjavanje obrasca za opažanja. Prijepisi intervjua i bilješke s opažanja podvrgnuti su analizi sadržaja. Rezultati su pokazali da učenici nisu imali potpuno razvijenu svijest o svom okolišu zbog nedostatka interesa za ekološka pitanja. Škola u kojoj je provedeno ovo istraživanje provela je niz izvannastavnih aktivnosti radi povećanja svijesti učenika, poput sađenja drveća, čišćenja školskog okoliša, ponovnog korištenja, i recikliranja.

So far, in different articles and books the concepts of modern definition of geometry and Minkowskian, Galilean planes and spaces have been introduced. In this paper, we are going to describe geometry that is improved by W. Thurston and then we are going to introduce you to geometries that are suitable to this description in 2 dimensional planes.

in order to define the generalised Euler formula in a dual manner, we studied the angles between two hyperplanes in Rn+1 and we obtained that the Gauss curvature can be expressed by the normal curvature and its dual form.