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Purpose: To investigate the clinical and macular spectral-domain optical coherence tomography (SD-OCT) findings after intravitreal ranibizumab treatment for type 1 retinopathy of prematurity (ROP). Methods: Eighteen eyes of 10 premature infants with type 1 ROP were retrospectively studied. All eyes were treated with intravitreal ranibizumab as monotherapy. Macular SD-OCT was performed before and after intravitreal ranibizumab therapy using a portable SD-OCT machine; the follow-up images were taken 1 day, 1 week, 1 month, and 2 months after therapy. Results: Among the 10 infants, there were six males and four females. Mean central foveal thickness before and 2 months after intravitreal ranibizumab was 292.5 ± 61.4 and 171.6 ± 21.7 µm, respectively. Differences were statistically significant ( P = .01). Sixteen eyes of eight patients had macular edema before treatment. Two eyes of two patients developed a crack in the outer hyperreflective line on SD-OCT corresponding with retinal pigment epithelium with serous retinal detachment 1 day after treatment. Macular edema regressed in all patients 2 months after intravitreal ranibizumab therapy. Mean follow-up time was 11.4 ± 1.5 months. No recurrence was seen except in both eyes of one patient treated with intravitreal ranibizumab monotherapy. Conclusions: Intravitreal ranibizumab injection is effective for the treatment of type 1 ROP as a monotherapy agent; however, macular changes not seen with indirect ophthalmoscope may develop. [ J Pediatr Ophthalmol Strabismus. 2015;52(3):152–158.]

Introduction. Some cases with aortic dissection (AD) could present with various complaints other than pain, especially neurological and cardiovascular manifestations. AD involving the carotid arteries could be associated with many clinical presentations, ranging from stroke to nonspecific headache. Case Report. A 71-year-old woman was admitted to emergency department with vertigo which started within the previous one hour and progressed with deterioration of consciousness following speech disorder. On arrival, she was disoriented and uncooperative. Diffusion magnetic resonance imaging (MRI) of brain was consistent with acute ischemia in the cerebral hemisphere. Fibrinolytic treatment has been planned since symptoms started within two hours. Echocardiography has shown the dilatation of ascending aorta with a suspicion of flap. Computed tomography (CT) angiography has been applied and intimal flap has been detected which was consistent with aortic dissection, intramural hematoma of which was reaching from aortic arch to bilateral common carotid artery. Thereafter, treatment strategy has completely changed and surgical invention has been done. Conclusion. In patients who are admitted to the emergency department with the loss of consciousness and stroke, inadequacy of anamnesis and carotid artery involvement of aortic dissection should be kept in mind.

Eighty-two-year-old patient with a pacemaker using warfarin due to arrhythmia and having an intraocular lens in the right eye, developed spontaneous hemorrhagic choroidal detachment one day after the use of combined preparation of 0.5% timolol maleate and 0.004% travoprost, due to primary open-angle glaucoma. Hemorrhagic detachment was detected by anterior and posterior segment examination, as well as B-scan ultrasonography. After the detachment, excessive increased intraocular pressure was controlled with oral carbonic anhydrase inhibitor, cycloplegic and steroid therapy. After four months, visual acuity was 20/20 and the intraocular pressure was under control with 0.5% timolol maleate and 1% brinzolamide. Controlled reduction of the intraocular pressure should be considered, particularly in older patients under anticoagulant therapy and that had undergone prior ocular surgery. Paciente de oitenta e dois anos de idade com marca-passo e utilizando varfarina devido à arritmia cardíaca e com uma lente intraocular no olho direito, desenvolveu descolamento de hemorrágico espontâneo de coroide um dia após o uso de colírio combinado de maleato de timolol a 0,5% e travoprosta a 0,004%, devido ao glaucoma de ângulo aberto primário. O descolamento hemorrágico foi detectado por análise do segmento anterior e posterior, bem como ultrassonografia modo B. Após o descolamento, o aumento excessivo da pressão intraocular foi controlado por inibidor da anidrase carbônica via oral, terapia cicloplégica e esteroides. Após quatro meses, a acuidade visual era 20/20 e a pressão intraocular estava sob controle com o maleato de timolol a 0,5% e brinzolamida a 1%. A redução controlada da pressão intraocular deve ser considerada, especialmente em pacientes idosos sob terapia anticoagulante e que tinham sido submetidos à cirurgia ocular prévia.

The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. Os autores apresentam tomografia de coerência óptica com profundidade de imagem aprimorada (EDI OCT) e autofluorescência de fundo (FAF) características de um paciente com osteoma de coroide bilateral e tentam correlacionar as duas técnicas de imagem. Dois olhos de um paciente com osteoma de coroide foram submetidos a exame oftalmológico completo. Tomografia de coerência óptica com profundidade de imagem aprimorada revelou padrão em gaiola, correspondente à região de calcificação do tumor. Imagens de autofluorescência de fundo da mesma área mostraram ligeira autofluorescência positiva. Três padrões de refletividade diferentes foram definidos na área descalcificada. Nas áreas com fluido sub-retiniano, foram observados prolongamentos dos segmentos externos semelhantes aos da coroidorretinopatia serosa central. Manchas autofluorescentes positivas foram evidentes em autofluorescência de fundo na mesma área. Porções calcificadas e descalcificadas do osteoma de coroide, bem como a atrofia da camada coriocapilar, demonstraram diferentes padrões de tomografia de coerência óptica com profundidade de imagem aprimorada e de imagens de autofluorescência de fundo. Ambas as técnicas se mostraram úteis no diagnóstico e acompanhamento de osteoma de coroide.

AMAÇ: 112 ambulanslarında çalışan yardımcı sağlık personeline verilen üç günlük eğitim modülünün etkinliğinin değerlendirilmesi amaçlanmıştır. YÖNTEM: Kursa Kırıkkale İl Sağlık Müdürlüğüne bağlı olarak 112 ilk ve acil yardım ambulans sisteminde çalışan tüm personelin katılımı öngörülmüştür. Eğitime katılan tüm personele 20-25 kişilik gruplar halinde 6 grup olarak üçer günlük sürelerle teorik ve pratik ilk yardım eğitimi verilmiştir. Tüm gruplara eğitim öncesi ve eğitim sonrası 50 soruluk form uygulanmıştır. BULGULAR: Eğitime Kırıkkale ili dâhilindeki ambulans sistemi çalışanı 132 kişi katılmıştır. Çalışmaya katılan personelin %63,6’sı erkek ve %66’sı evliydi. Yaş gruplarına göre sınıflandırıldığında %44’ünün 26-35 yaş grubunda olduğu saptanmıştı. Meslek gruplarına göre gruplandırıldığında ATT’ler %47’yi, sağlık memurları ise %40,2’yi oluşturmaktaydı. Eğitim durumları değerlendirildiğinde %53,0’ının lise, %43,2’sinin önlisans mezunu olduğu saptanmıştır. Tüm kursiyerlerin %50,8’i 1-5 yıllık mesleki tecrübeye sahipti. Tüm gruplar birlikte değerlendirildiğinde ön test başarı puanı (29,58±6,74) ile son test başarı puanı (39,81±4,68) arasında istatistiksel anlamlı farklılık mevcuttu (p, AIM: It was aimed to evaluate the efficiency of the three days module given to the assistant health personnel working in 112 ambulances. METHODS: It was assumed that all the personnel working in the 112 ambulance systems under the health directory of Kırıkkale city would be involved. Theoretic and practical first aid training was given to all the personnel attending to the course in 6 groups of 20-25 with duration of 3 days for each. A 50 itemed questionnaire was applied to all the groups before and after the training. RESULTS: 132 people working in ambulance system in Kırıkkale city were involved in training. 63.6% of the personnel involved in the study were male and 66% were married. When they were grouped according to age, it was determined that 44% of them were in 26-35 age group. When they were grouped according to branches, it was determined that 47% of them were emergency medical technician (EMT) and 40.2% were health officer. When their level of education was taken into consideration, it was determined that 53% of them were graduates of high school and 43.2% were graduates of associate degree. 50.8% of all the personnel had a job experience of 1-5 years. When all the groups were evaluated together, there was a statistical meaningful difference (p

Conformational multiplicity of proteins under different environmental conditions is satisfactorily described herein by simple analytical methods. To efficiently monitor the equilibrium landscape and to orchestrate the population shifts, we derived the following set of equations originating from continuum mechanical considerations: i) the equilibrium equation of each repeating unit, ii) the constitutive relation for each (non)bonded short and/or long-range contact, and iii) the compatibility equation between the fluctuation of an element and fluctuations of its neighboring bonds. Together with the updated incremental Lagrange formalism, we put forward an effective single-molecule manipulation methodology. After each incremental move due to the perturbation induced by a ligand, the response kernel is updated and the new position on the free-energy surface is calculated.In this study, we additionally demonstrate that cooperatively inserted intra-residue fluctuations, resembling different ligand insertions into the protein, moderate the positional motion of residues that are responsible for desired activities of the protein. We identify a feedback mechanism between sensory regions and adaptively distributed actuating parts. We construct a template that is a subset of the native structure containing the controller and we show that the template is conserved within the families of evolved sequences. These templates are shown to be the key elements for protein-protein interactions.We study the relationships between the statistical and spectral properties of networks derived from the protein conformations located at the different minima of the landscape. We determine how the shortest path betweenness distribution of the edges is altered from one minimum (apo form) to another one (holo form). Furthermore, the results indicate that the changes in the redundancy index, which is the ratio of the number of alternative two-step paths a given residue i generates to its non-bonded contacts and its overall reachability, is significant.

Amaç Nazolakrimal kanal tıkanıklığı bulunan hastalarda uygulanan eksternal dakriosistorinostomi cerrahisi sonuçlarının ve kullanılan insizyon şeklinin fonksiyonel ve estetik sonuçlara etkisinin değerlendirilmesi. Gereç ve Yöntemler 2004-2008 yılları arasında nazolakrimal kanal tıkanıklığı nedeniyle eksternal dakriosistorinostomi uygulanan ve gerektiğinde bikanaliküler silikon tüp entübasyonu yapılan 49 hastanın sonuçları retrospektif olarak değerlendirildi. 2004-2005 yıllarında uygulanan oblik insizyon ile 2006-2008 yıllarında uygulanan vertikal insizyonun fonksiyonel ve kozmetik sonuçlar üzerine olan etkileri değerlendirildi. Hastalar preoperatif semptomlar, fonksiyonel sonuç, skar dokusu ve kozmetik memnuniyet açısından anket yöntemi ile sorgulandı. Sonuçlar istatistiksel olarak karşılaştırıldı Bulgular Kırk dokuz hastanın (35 kadın, 14 erkek) yaş ortalaması 42.6315.57 (19-72) idi. Başka merkezde 2 hastaya yapılan cerrahi dışında 47 hastanın ilk cerrahileri bizim merkezimizde yapılmıştı. Beş hastaya fonksiyonel başarısızlık nedeni ile revizyon cerrahisi gerekli oldu. Epiforası devam eden 3 hastadan birine Jones tüpü implantasyonu uygulandı. Hastalarda cerrahi sonrası sızıntı şeklinde nazal hemoraji dışında önemli bir komplikasyon gözlenmedi. Belirgin epiforası devam eden 2 hasta ile birlikte toplam 3 hasta operasyondan memnun değildi. Yirmi bir hastaya cerrahi sırasında silikon tüp entübasyonu uygulandı. Kırk altı hastada sonuçlar memnuniyet vericiydi. Her iki grupta da 7’şer hasta, skarın belirgin olduğunu belirtmişti, fakat hastalar estetik açıdan memnunlardı. Kullanılan oblik veya vertikal insizyonun fonksiyonel cerrahi üzerine etkisi tespit edilemedi. Kozmetik sonuçların ise vertikal insizyon ile daha iyi olduğu tespit edildi. Sonuç Eksternal dakriosistorinostomi, nazolakrimal kanal tıkanıklığı olan hastalarda başarılı bir cerrahidir. Insizyon şekli, cerrahinin fonksiyonel sonuçlarını etkilememekte, ancak kozmetik sonuçları olumlu yönde etkilemektedir. Aim Evaluation of external dacryocystorhinostomy surgery in patients with nasolacrimal canal obstruction and the effects of the incision type on the functional and esthetic outcomes. Material and Methods Outcomes of 49 patients who underwent external dacryocystorhinostomy and bicanalicular silicon tube intubation(when necessary) for nasolacrimal canal obstruction between 2004 and 2008 were evaluated retrospectively. The effects of oblique incision, used between 2004-2005, and the vertical incision, used between 2006-2008, on the functional and cosmetic outcomes were evaluated. The patients were asked to complete a survey on preoperative symptoms, functional outcomes of the operation, and the patient satisfaction with the scar tissue and cosmetic outcomes. The results were compared statistically. Results Mean age of the 49 patients (35 females and 14 males) was 42.63±15.57 (19-72). Except for the 2 patients operated in other centers, first operations of 47 patients were performed in our clinic. Five patients required revision surgery due to functional failure. Jones‘ tube implantation was performed in 1 of the 3 patients with persistant epiphora. No serious complications were observed postoperatively, except for mild nasal hemorrhage. Three patients, (2 of witch had persistent epiphora), were not satisfied with the surgery. Silicon intubation was performed to 21 patients during surgery. Outcomes were satisfactory in 46 patients. In each of the 2 incision groups, 7 patients had noticeable scars but they were satisfied esthetically. It was observed that the type of incision used, either oblique or vertical, had no effect on the functional outcome of surgery. On the contrary, it was determined that vertical incision yielded better cosmetic outcomes. Conclusion External dacryocystorhinostomy is a successful surgery for patients with nasolacrimal canal obstruction. Incision type does not affect the functional outcomes of the surgery but it does affect the cosmetic outcomes.

Aim: Evaluation of external dacryocystorhinostomy surgery in patients with nasolacrimal canal obstruction and the effects of the incision type on the functional and esthetic outcomes. Material and Methods: Outcomes of 49 patients who underwent external dacryocystorhinostomy and bicanalicular silicon tube intubation(when necessary) for nasolacrimal canal obstruction between 2004 and 2008 were evaluated retrospectively. The effects of oblique incision, used between 2004-2005, and the vertical incision, used between 2006-2008, on the functional and cosmetic outcomes were evaluated. The patients were asked to complete a survey on preoperative symptoms, functional outcomes of the operation, and the patient satisfaction with the scar tissue and cosmetic outcomes. The results were compared statistically. Results: Mean age of the 49 patients (35 females and 14 males) was 42.63±15.57 (19-72). Except for the 2 patients operated in other centers, first operations of 47 patients were performed in our clinic. Five patients required revision surgery due to functional failure. Jones’ tube implantation was performed in 1 of the 3 patients with persistant epiphora. No serious complications were observed postoperatively, except for mild nasal hemorrhage. Three patients, (2 of witch had persistent epiphora), were not satisfied with the surgery. Silicon intubation was performed to 21 patients during surgery. Outcomes were satisfactory in 46 patients. In each of the 2 incision groups, 7 patients had noticeable scars but they were satisfied esthetically. It was observed that the type of incision used, either oblique or vertical, had no effect on the functional outcome of surgery. On the contrary, it was determined that vertical incision yielded better cosmetic outcomes.Conclusion: External dacryocystorhinostomy is a successful surgery for patients with nasolacrimal canal obstruction. Incision type does not affect the functional outcomes of the surgery but it does affect the cosmetic outcomes.

Amaç: Ambliyopi özellikle çocukluk çağında en yaygın olarak gözlenen bir görme bozuklu ğudur ve prevalansı yaklaşık olarak % 1,6-3,5’dir. Kontrast duyarlılık fonksiyonu çeşitli hasta lıkların hem tanı hem de takibinde değerli bir testtir ve özellikle de ambliyopinin değerlendi rilmesinde yararlıdır. Bu çalışmada, anizometrik ambliyopili hastaların sağlam ve ambliyopik gözlerindeki kontrast duyarlılıklarının sağlıklı bireylerin kontrast duyarlılıkları ile karşılaş tırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada, anizometropik ambliyopili 81 hasta ile 81 sağlıklı kontrolün kontrast duyarlılık fonksiyonları ölçüldü. Kontrast duyarlılık fonksiyonları 1,5, 3, 6, 12 ve 18 cpd olan beş frekansta “Functional Acuity Contrast Test” (F.A.C.T.) ile ölçüldü. Tüm veriler istatistiksel olarak SPSS programı karşılaştırıldı. Bulgular: Hasta grubu ile kontrol grubunun kontrast duyarlılık düzeyleri karşılaştırıldığında; kontrol grubuna göre hasta grubunun hem ambliyop hem de ambliyop olmayan gözlerinde tüm frekanslarda azalma olduğu saptandı. Bu azalma istatistiksel olarak anlamlı idi (p0,05). Ayrıca, hasta grubunun ambliyop gözü ile ambliyop olmayan gözleri karşılaştırıldığında ambliyop olan gözlerin kontrast duyarlılık fonksiyonları tüm frekanslarda ambliyop olmayan göze göre daha düşük bulundu. Bu fark ta istatistiksel olarak anlamlı idi (p0,05). Sonuç: Sonuç olarak, ambliyopi her iki gözü etkileyebilen binoküler bir hastalıktır. Bu nedeni ile yapılacak ileri çalışmalar ambliyopinin tanı, tedavi ve takibinde kontrast duyarlılık testinin rolünün belirlenmesinde faydalı olacaktır. Aim: Amblyopia is a vision disorder which is most commonly seen in childhood with an estimated prevalence of 1.6-3.5 %. Contrast sensitivity function is a valuable test for both detecting and following up various eye diseases and is of particular importance in assessing amblyopia. The study aimed to compare the contrast sensitivity functions of the amblyopic and non-amblyopic eyes of the anisometropic patients and also to compare these values with those of the healthy individuals. Material and Method: In this study, contrast sensitivity of 81 patients with anisometropic amblyopia and 81 healthy control subjects were evaluated. Contrast sensitivity functions were assessed by “Functional Acuity Contrast Test“ (F.A.C.T.) in five frequencies with 1.5, 3, 6, 12 and 18 cpd. Statistical comparisons was performed by SPSS. Results: All frequencies of contrast sensitivity were significantly decreased in both amblyopic and non-amblyopic eyes of the patients compared to the control group (p

Amaç: Skleral fiksasyonlu göz içi lens (SF-GİL) implantasyonu sonuçlarını değerlendirmek Gereç ve Yöntem: Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı’nda Aralık 1998-Mart 2005 tarihleri arasında SF-GİL implantasyonu uygulanan 15 hasta retrospektif olarak değerlendirildi. Bulgular: Hastaların 10’una komplikasyonlu katarakt cerrahisi, 5’ine künt travma sonucu gelişen lens patolojileri nedeniyle SF-GİL yerleştirildi. Hastaların 3’ü afak, 4’ünde vitrede GİL, 4’ünde vitrede nükleus, 4’ünde GİL subluksasyonu, 2’sinde korteks bakiyesi vardı. Ek olarak, 1 hastada vitreus hemorajisi, 1 hastada retina dekolmanı ve 2 hastada sekonder glokom mevcuttu. Dokuz hastaya pars plana vitrektomi ve 6 hastaya ön vitrektomi ile skleral fiksasyonlu GİL implantasyonu yapıldı. Sonuçlar: SF-GİL implantasyonu yeterli kapsül desteği olmadığı için sulkusa veya kapsül içine GİL implante edilemediği durumlarda kullanılabilecek etkin bir yöntemdir. Aim: To evaluate the results of scleral fixated intraocular lens (SF-IOL) implantation. Material and methods : Fifteen patients who underwent SF-IOL implantation in Ondokuz Mayıs University, Faculty of Medicine, Department of Ophthalmology between December 1998 and March 2005 were evaluated retrospectively. Results: In 10 patients, SF-IOL implantation was performed due to cataract surgery complications and in 5 patients, it was performed because of lens pathologies developed due to a blunt trauma. Three of the patients were aphakic, 4 had IOL in vitre, 4 had nucleus in vitre, 4 had IOL subluxation and 2 had cortex residue. Additionally, 1 patient had vitreous hemorrhage, 1 patient had retinal detachment and 2 patients had secondary glaucoma. SF-IOL implantation was performed with pars plana vitrectomy in 9 patients and with anterior vitrectomy in 6 patients. Conclusion: SF-IOL implantation is an effective method for the cases in which the implementation of IOL into sulcus or capsule is not possible due to insufficient capsule support.

Tüm dünyada ve ülkemizde lunaparklar çocuklar başta olmak üzere tüm yaş grupların ilgi gösterdiği eğlence merkezleridir. Eğlence merkezi araçlarının düzenli aralıklarla kontrollerinin yapılması gerekir. Bakımı ve güvenlik önlemleri yetersiz olanların kullanılmasına izin verilmemelidir. Aksi takdirde çok ciddi sonuçlar doğurabilecek şiddette Lunapark kazaları oluşabilir. Bu çalışmada lunaparkta bulunan “ahtapod” olarak adlandırılan eğlence aracından düşme sonrasında acil servise başvuran üç olgunun sunulması amaçlandı, Funfairs are entertainment centers which draws mostly children’s and also all other age groups’ attention both in our country and in the world. Fun center equipments should be controlled regularly. Equipments that are not renewed in proper intervals and don’t have appropriate security measures should be banned. Otherwise, funfair accidents that can cause really serious results can ocur. It is aimed in this study to present three cases who came to emergency room after a fall accident from the fun equipment that is called ‘octopus’

Sahiner, Ibrahim Tayfun/0000-0002-3921-7675 WOS: 000259385100011 PubMed: 18988057 BACKGROUND The aim of this study was to evaluate demographics, methodological data and writing style of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery. METHODS Study design, institutions and number of authors, appropriateness of the title, use of a structured abstract, word count, fluency, accuracy of the statistical evaluation, and conclusion-abstract accordance were assessed in 451 abstracts. RESULTS Nearly 49% of abstracts were retrospective and 29% were case reports in design. 33%, 26%, and 24% of abstracts were related to isolated organ, single system and multi-system injuries, respectively. Approximately two-fifths of presentations were university-based. Approximately one-third of presentations were multidisciplinary in origin. The mean number of authors was 5.6 +/- 1.8, and a statistical significance was found between abstract contributions from university versus other hospitals (p=0.001). Three-fourths of the abstracts had an appropriate title and 91% were structured. Word count was 100-250 in 57% and 250-500 in 42% of abstracts. Statistical analysis was used in only 19% of abstracts. Most of the abstracts were fluent. Conclusion-abstract accordance was present in 71% of the abstracts. CONCLUSION Our results indicate there are some deficiencies in the abstract writing process. The use of a structured abstract may intensify fluency and compliance to abstract writing guidelines. Clinical studies regarding multi-traumatized patient groups and experimental studies should be encouraged.

In this study, we aimed to assess the quality and quantity of tears among premature and term newborns. Tear ferning and Schirmer's tests were conducted over the first 10 days of life. Correlations between tear ferning patterns, Schirmer's scores, post-conceptional age, and birth weight were evaluated. Forty-six newborns (23 preterm, 23 term) were enrolled, with a mean post-conceptional age of 36.6 weeks and a mean weight of 2598.2 g. Mean total, basal and reflex Schirmer's test results were 13.5 mm, 6.7 mm and 6.8 mm, on the right and 14.0 mm, 7.1 mm and 6.9 mm on the left eye, respectively. Median ferning score was 2 (range 1-3) bilaterally. Schirmer scores were correlated with ferning capacity and post-conceptional age. Our study shows that newborns secrete moderate quantity, good quality tears. Ferning capacity, Schirmer scores and post-conceptional age are correlated.

AMAÇ: V. Ulusal Travma ve Acil Cerrahi Kongresi’nde sunulan bildiri özetlerinin öz yazım kılavuzuna uygunluğu değerlendirildi; demografi, metodoloji ve yazım tekniği yönünden incelendi. GEREÇ-YÖNTEM: Kongre kitapçığındaki 451 bildiri değerlendirmeye alındı. Değerlendirilen parametreler; çalışmanın türü ve içeriği, çalışmanın yapıldığı kurumlar, yazar sayısı, başlık kullanımının uyumluluğu, yapısal öz kullanımı, sözcük sayısı, dilin akıcılığı, uygun istatistiksel değerlendirme ve sonuç-öz ilişkisiydi. BULGULAR: Çalışmaların %49’u retrospektif, %29’u olgu sunumuydu. Bildirilerin %33’ü izole organ yaralanması, %26’sı tek sistem yaralanması, %24’ü çoklu sistem yaralanmasına ilişkindi. Çalışmaların %43’ü üniversite, %38’i devlet hastanesi kökenliydi. Çalışmaların %40’ı genel cerrahiyle ilgiliydi, %29’u ise multidisiplinerdi. Çalışmalardaki ortalama yazar sayısı 5,6±1,8 idi; üniversite ve devlet hastaneleri arasında istatistiksel olarak anlamlı farklılık saptandı (p=0,001). Bildirilerin %91’inde yapısal öz vardı, %57’si 100-250, %42’si ise 250-500 sözcük içermekteydi. Çalışmaların %73’ü akıcı olarak değerlendirildi. Tüm bildirilerin %19’unda istatistiksel yöntem uygulandığı belirlendi. Bildirilerin çoğu akıcı idi. İstatistiksel analiz uygulama yönünden üniversite ve devlet hastaneleri arasında anlamlı fark saptandı (p=0,001). Sonuç-öz ilişkisi bildirilerin %71’inde yeterli olarak değerlendirildi. SONUÇ: Bildiri özeti yazma konusunda bazı sorunlarımızın olduğu saptanmıştır. Yapısal öz kullanımı, akıcılık ve yazım kurallarına uyumu artırmaktadır. Özellikle çoklu yaralanlamaları irdeleyen klinik çalışmalar ve deneysel çalışmalar özendirilmeli, bu yönde araştırmalar teşvik edilmelidir. BACKGROUND: The aim of this study was to evaluate demographics, methodological data and writing style of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery. METHODS: Study design, institutions and number of authors, appropriateness of the title, use of a structured abstract, word count, fluency, accuracy of the statistical evaluation, and conclusion-abstract accordance were assessed in 451 abstracts. RESULTS: Nearly 49% of abstracts were retrospective and 29% were case reports in design. 33%, 26%, and 24% of abstracts were related to isolated organ, single system and multi-system injuries, respectively. Approximately two-fifths of presentations were university-based. Approximately one-third of presentations were multidisciplinary in origin. The mean number of authors was 5.6±1.8, and a statistical significance was found between abstract contributions from university versus other hospitals (p=0.001). Three-fourths of the abstracts had an appropriate title and 91% were structured. Word count was 100-250 in 57% and 250-500 in 42% of abstracts. Statistical analysis was used in only 19% of abstracts. Most of the abstracts were fluent. Conclusion-abstract accordance was present in 71% of the abstracts. CONCLUSION: Our results indicate there are some deficiencies in the abstract writing process. The use of a structured abstract may intensify fluency and compliance to abstract writing guidelines. Clinical studies regarding multi-traumatized patient groups and experimental studies should be encouraged.

BAYDIN, AHMET/0000-0003-4987-0878 WOS: 000256795600016 PubMed: 17978905 Subcutaneous emphysema is the inadvertent introduction of air into tissues under the skin covering the chest wall or neck. The common causes of subcutaneous emphysema are rib fracture, parenchymal lung wound and esophageal trauma. Rarely, it occurs after oral and nasal surgery or maxillofacial trauma. We observed subcutaneous emphysema spread out from periorbital region to upper mediastinum in a patient presented to emergency department following minor maxillofacial trauma and admitted due to a simple fracture at his frontal maxillary wall. We present this present case to emphasize early initial management and close observation of minor facial traumas which can prevent further unexpected complications.

A protein structure is represented as a network of residues whereby edges are determined by intra-molecular contacts. We introduce inhomogeneity into these networks by assigning each edge a weight that is determined by amino-acid pair potentials. Two methodologies are utilized to calculate the average path lengths (APLs) between pairs: To minimize (i) the maximum weight in the strong APL, and (ii) the total weight in the weak APL. We systematically screen edges that have higher than a cutoff potential and calculate the shortest APLs in these reduced networks, while keeping chain connectivity. Therefore, perturbations introduced at a selected region of the residue network propagate to remote regions only along the non-screened edges that retain their ability to disseminate the perturbation. The shortest APLs computed from the reduced homogeneous networks with only the strongest few non-bonded pairs closely reproduce the strong APLs from the weighted networks. The rate of change in the APL in the reduced residue network as compared to its randomly connected counterpart remains constant until a lower bound. Upon further link removal, this property shows an abrupt increase, towards a random coil behavior. Under different perturbation scenarios, diverse optimal paths emerge for robust residue communication., 21 pages with 6 figures

AMAÇ Ülkemizdeki Acil Tıp Anabilim Dalları’na (ATAD) bağlı acil servislerinin iç ve dış mimari yapıları araştırıldı. GEREÇ VE YÖNTEM Tanımlayıcı tipteki bu araştırmada, çalışmanın yapıldığı tarihte mevcut olan 26 ATAD’ye anket formları gönderildi. Bu anketle acil servislerin iç ve dış mimari yapıları ve fonksiyonel hizmet durumları sorgulandı. Anketi yanıtlayan 22 ATAD’nin verileri değerlendirmeye alındı. Henüz kurulma aşamasında olan ve hizmet vermeyen iki Anabilim Dalı çalışmaya dahil edilmedi. BULGULAR Geri bildirimlerin değerlendirilmesinde ATAD’den ancak %59’unun (n=13) hizmet verdikleri alanın acil servis alanı olarak planlandığı izlendi. Acil servislerin ambulans girişlerinin %77 oranında uygun olmadığı, %54,5 ATAD’de (n=12) acil servis girişinde ambulansların hasta bıraktığı alanın hava koşullarından korumalı olmadığı görüldü. Gelen yanıtlara bakıldığında ancak %59 ATAD’de (n=13) acil serviste triyaj ünitesinin bulunduğu, yine sadece bir ATAD’de (%4,5) acil serviste temizlenme (dekontaminasyon) odası bulunduğu bildirildi. Halen hizmet vermekte olan ATAD’lerine bağlı acil servislerin ancak %32’sinde (n=8) mevcut lokal risk faktörleri doğrultusunda genişleyebilme düzeyinin yeterli olabileceği belirlendi. ATAD’lerin sadece %18’inde (n=4) özürlü tuvaletinin var olması ülke genelinde özürlülere yönelik mimari değişikliklerin eksikliğinin acil servislerde de olduğunun göstergesidir. Acil tıbbın ülkemizde 12 yıllık geçmişi olduğu düşünüldüğünde ATAD’lerin ancak %68’inde (n=15) seminer odalarının var olması, akademik yapılanmaya fiziksel alt yapı yetersizliği olan yerlerde başlandığının göstergesidir. SONUÇ Ülkemizdeki acil tıp yapılanması içerisinde acil servis mimarisine gereken önemin verilmediğini, verilen hizmetteki bilimselliğin mimari yetersizliklerle gölgelendiğini göstermiştir. Acil servis mimari tasarımı, bilimsel veri ve kurallar çerçevesinde sağlanmalıdır. Bunun için hastane ve özellikle acil servis mimarisi hakkında bilgi ve tecrübesi olan mimar veya mimarlar yetkili kişiler ile hedefler üzerinde bir anlaşmaya varmalıdırlar. BACKGROUND In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. METHODS In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed.Two Emergency Medicine Departments that were not operating at that time were not included in the study. RESULTS The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academical efforts in this field is emerging in challenging physical conditions. CONCLUSION The results of our study revelaed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

OKTAY, CEM/0000-0001-7993-0566 WOS: 000256734900004 PubMed: 17310408 BACKGROUND In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. METHODS In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. RESULTS The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academical efforts in this field is emerging in challenging physical conditions. CONCLUSION The results of our study revelaed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

Amaç: Tonopen ve Goldmann aplanasyon tonometresi ile elde edilen göz içi haşine ölçüm sonuçlarını karşılaştırmak ve tonopen kullanarak Goldmann aplanasyon tonometresine en yakın değeri elde etmek için uygun vönlemi tespit etmek. Gereç ve Yöntem: Bölümümüze ait polikliniğe başvuran 50 hastanın 100 gözünde Goldmann a-planasyon tonometresi ve tonopen ile göz içi basıncı ölçüldü. Tonopen ile alınan altı ölçümün dört farklı şekilde hesaplanan ortalamaları Goldmann aplanasyon tonometresi ile alınan iki ölçümün ortalamasıyla karşılaştırıldı. Bulgular: Tonopenle alınan altı ölçümün en yüksek ve en düşük değerleri arasındaki fark gözlerin % 61 inde 4-7 mmg idi. Bu fark gözlerin %4 'ünde 2 mmHg 'dan daha azdı. Tonopende elde edilen, ilk üç ölçümün ortalama değeri, Goldmann aplanasyon tonometresinden elde edilen ortalama değerler ile karşılaştırıldığında, gözlerin sadece % 23 'ünde 1 mmHg fark bulundu. Goldmann ile karşılaştırıldığında, gözlerin % 51'inde 3mmHg fark vardı. Sonuç: Tonopen ölçümlerinin 4 farklı kombinasyonunun herhangi biri Goldmann değerlerine yaklaşmada diğerine üstünlüğe sahip değildir. Goldmann aplanasyon tonomelresi ile tonopen ölçümleri arasında anlamlı fark vardır. Bu nedenle tonopen, taramalar ve Goldmann aplanasyon tonometresi kullanımına uygun olmayan hastalar için önerilebilir. Aim: To compare the results of intraocular pressure measurements obtained with Goldmann applnation tonometry and lonopen and to determine the suitable method to gel the closest values to Goldmann applanation tonometry by using tonopen. Material and Methods: Intraocular pressures at 100 eyes of 50 patients who admit ted to outpatient clinic of our institution were measured by using Goldmann applanalion tonometry and lonopen. The means of six measurements obtained with lonopen, which were calculated in four different ways, were compared with the mean of two values obtained with Goldmann applanalion tonometry. Results: The difference between the highest and lowest values of the six measurements obtained with Tonopen, was 4-7 mmHg in 6l% of eyes. It was less then 2 mmHg in 4% of eyes. When the mean value of the first three measurements obtained in tonopen was compared with the mean values obtained in Goldmann applanation tonometry, 1 mmHg difference was found in only 23% of eyes. There were 3 mmHg difference in 51% of eyes when compared with Goldmann. Conclusion: None of the four different combinations of lonopen 's measurements has superiority to each other in approaching to the Goldmann values. There is a significant difference between the meas¬urements of tonopen and Goldmann applanalion tonometry. Therefore tonopen may be recommended for screening and for the patients who are not suitable for using of Goldmann applanation tonometry.

ÖZET: Amaç: Bu deneysel çalışmada amacımız hemorajik şok oluşturulan sıçanlarda kontrollü olarak gerçekleştirilen hipoterminin hemodinamik parametreler, beyinin elektriksel fonksiyonları, 48 saatlik takip döneminde yaşam süresi ve nörolojik durum üzerindeki etkilerini araştırmaktır. Metod: Toplam 41 adet erkek wistar cinsi erkek sıçan, biri kontrol grubu olmak üzere 4 gruba ayrıldı. Sıçanlara halotan ve N2Û:02 (%50:50) ile anestezi uygulandı. Sıçanları EEG elektrotları, hemodinamik parametrelerin takibi için EKG elektrotları, arteriyal ve ven hatları yerleştirildikten sonra total vücut kan volümü hesaplandı. Total kan volümünün %40'ı femoral venden enjektör yardımıyla çekilerek sıçanlarda hemorajik şok sağlandı (Faz 1=0-30 dakika arasında). Kontrol grubunda kanama oluşturulmadı. Faz 2 (30-90 dakika) döneminde normotermik grup (grup NT)'da 37 °C, hafif hipotermik grup (grup HH)'da 34 °C, orta derecede hipotermik grup (grup OH)' da 30 °C ve kontrol grubunda (grup K) 37 °CTik rektal ısılar sağlanacak şekilde sürdürüldü. Faz 1 ve faz 2 döneminde ortalama arter basıncı (OAB), kalp atım hızı (KAH), solunum sayısı (SS) ve rektal ısı (RI) sürekli olarak monitörize edilip 10'ar dakikalık periyotlarla kaydedildi. Bu dönemde sürekli EEG kaydı alınıp elde edilen verilere daha sonra kayıtlı dosyalar üzerinde ayrıntılı sayısal analiz uygulandı. Faz 3 (90.dakika-48 saat) boyunca anestezi ve tüm kayıtlar kesilerek nörolojik defısit skoru (NDS) ve sağkahm takip edildi. Elde edilen tüm verilerin değerlendirmesinde Tukey ve Bonferroni çoklu karşılaştırma testleri, student-t testi ile yaşam tablosu analizi kullanılıp, p0,05). Deney grupları arasında kanama miktarı açısından fark yoktu (p>0,05). Deney gruplarında kanama dönemi sonunda (faz 1 sonunda) OAB 51,9 ± 3,49 mmHg düzeyine düştü. Faz 2'de OABTarı hipotermik gruplarda normotermik gruba göre yüksek bir seyir gösterdi. Solunum sayısı; hipotermik gruplarda grup K ve NT'ye göre düşük seyretti IVArter kan gazı sonuçlan istatistiksel olarak karşılaştırıldığında grup K ile diğer gruplar arasında 30.dk'da pH (pO.001), baz açığı (pO.Ol), HCO3`(p0.05). The bleeded blood volume were similar in groups NT, MH and MoH (p>0.05). The MAP in the first 30 minutes decreased to 51, 9 ± 3, 49 mmHg. But between the 30 and 90 minutes the MAP in hypothermic groups were higher than normothermic groups. The RR in hypothermic groups were lower than the group C and group NT in all recorded minutes (p

Lazer isaretleyicinin lazerine maruz kalma sonucu makula yanigi gelisen hastanin sunumu amaclanmistir. Yirmi bes yasinda erkek hastanin sag gozu, birkac saniye lazer isaretleyicinin lazerine maruz kalmistir. Hastanin muayenesinde gorme keskinliginin tam, on segment bulgularinin dogal fakat santral gorme alani alt kisimda sekillerde kirilma ve egilme gibi gorsel semptomlarin oldugu tespit edilmistir. Arka segment muayenesinde, foveada lazere bagli sari yanik gorulmustur. Tedavisinde oral ve topikal steroid, topikal karbonik anhidraz inhibitoru verilerek takibe alinmis, sonrasinda hastanin semptomlarinin tam olarak duzeldigi gozlenmistir. Macular burn associated with exposure of pointer laser It was aimed to present a case of macular burn associated with exposure of pointer laser in the study. Twenty five years old male patient had exposed laser pointer beam to his right eye for a few seconds. Eye examination disclosed his vision was intact except lower central disturbances like refraction and bending errors and natural anterior segment findings. Posterior segment examination showed laser-induced yellow burn on the fovea. The patient was treated with topical carbonic anhydrase inhibitor, oral and topical steroids and followed up. It was observed that vision of the patient resolved completely at the end of follow up period. J. Exp. Clin. Med., 2012; 29:S97-S98

Monte Carlo simulations combined with anisotropic network model (ANM-MC) were used to investigate transition pathways between two different crystal structures such as open and closed states of proteins. The transition pathway is identified by an iterative process that involves selecting the collective ANM mode that overlaps best with the target direction and minimizing the conformational energy of the selected ANM mode via Monte Carlo simulations. In the current study, the conformational transition pathways and pathway intermediates involving shear and hinge type of motions were analyzed via the ANM-MC algorithm. The results show that the collective modes contribute significantly to the conformational transitions in both types of motions. In hinge-bending proteins, generally a single low-indexed mode predominantly drives the conformational transition, whereas a collection of slow modes is necessary to describe a shear-type transition. Targeted ANM-MC approach was found to provide and efficient method to explore sequences of events in transition pathways in both types of motions. Applications of the algorithm to large, multi-chain proteins will also be presented. A computer server based on the ANM-MC algorithm will be made available to the scientific community.