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PURPOSE Although attention deficit hyperactivity disorder (ADHD) is one of the most frequently seen psychiatric disorders in childhood, its etiology and pathophysiology are not fully elucidated. The aim of the present study was to investigate the association between ADHD and RELN gene in Turkish children. METHOD DNA samples were harvested from 102 patients with ADHD and 94 healthy controls. Three single-nucleotide polymorphisms of reelin gene (rs1270519, rs362691, and rs734147) were genotyped using real-time polymerase chain reaction. RESULTS A significant difference was detected between ADHD and control groups regarding rs1270519 polymorphism while no significant difference was detected between the groups regarding reelin rs362691 and rs734147 polymorphisms. CONCLUSION It was found that reelin rs12705169 gene polymorphism could play a role in ADHD etiology, indicating the need for further studies to investigate the relationship between ADHD and reelin gene polymorphism.

İş Süreç Yönetimi ile iş akış yönetimi kavramlarının uygulayıcılar, otomasyon üretenler ile henüz farkındalık oluşmayan sektörler bazında incelenmesi ve kavram kargaşasının ortadan kalkması gerekmektedir. Süreç çıktı elde etmek için, birbirleriyle etkileşim içerisinde bulunan iş gücü, ekipman, malzemeler, yöntemler ve çevresel unsurların bir toplamıdır. İş Akışı veya Workflow terimi herhangi bir kurum ya da kuruluşun ortaya koyduğu faaliyetlerin belirli bir düzen ve planlama içerisinde devam etmesini içermektedir. Daha çok iş hayatının en çok ihtiyaç duyduğu alanlar olan transfer işlemleri, belge ve evrak işlemleri gibi konularda etkin bir şekilde kullanılmaktadır. İş süreci yönetimi, büyük ölçüde, iş süreçlerinin optimizasyonu için çabaları yönlendiren, sistematik bir yönetim vasıtasıyla verimliliği ve etkililiği artırmayı amaçlayan bir metodoloji olarak bilinir. İşletmeler, global rekabet koşullarında ve kalite ile ilgili artan talepler karşısında İş Süreç Yönetimi altyapısı ve Süreç Mimarisini oluşturmak zorundadır. Türkiye de maalesef bu fark kavramsal olarak yerine oturmamıştır. Çalışmada özellikle Türkiye bağlamında bu iki kavramın doğru algılanması alan yazı ve genel bilgiler araştırılmış ve sonuçlar ortaya konmuştur. Bu sonuç konunun akademik açıdan da henüz incelenmemesi açısından önemlidir.

INTRODUCTION[|]The aim of this study was to investigate the long-term quality of life and vision level of keratoconus patients who underwent implantation of intrastromal corneal ring segments (ICRS).[¤]METHODS[|]During February 2012, 23 keratoconus patients that had ICRS implanted were included in this retrospective study. The patients were divided into 3 severity subgroups. After 4 years, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA) and Kmax values were recorded. A Turkish version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ 25) was administered to all of the patients retrospectively.[¤]RESULTS[|]There was a notable increase in all patients' BCVA (p=0.001) and UCVA (p=0.021). The Kmax values were reduced in all cases (p=0.01); however, this reduction was not statistically significant in subgroup 2 (p=0.285). The peripheral vision score was also lower in type 2 (p=0.049). A significant correlation was found between BCVA/UCVA and NEI-VFQ 25 scores, except for general health, social functioning, general vision, dependency, and driving.[¤]DISCUSSION AND CONCLUSION[|]Patients' quality of life and vision scores support ICRS implantation as an acceptable option before penetrating keratoplasty for keratoconus treatment. But, the satisfaction and vision levels were not better in patients in the early stages of keratoconus. So it may be considered that early treatment of ICRS implantation is not a necessary protocol.[¤]

This study aims to make a thematic classification of possible misconceptions about solid friction by reviewing papers in the literature which include conceptual difficulties about friction; in this way, the study contributes to the literature. The study’s scope was limited to the dry friction that occurs with the interaction of two solid objects, as this is included in several curricula. Papers in the literature addressing the conceptual difficulties associated with friction were reviewed. Hence, 42 primary data sources (papers) accessed from various databases were subjected to content analysis. Possible misconceptions about friction were determined by the data collection techniques or tools of the study, the educational levels of the sample, and the countries in which they took place. At the end of the study, a list of possible misconceptions about solid friction were classified and listed under four themes: definition and existence, direction, type and magnitude, and effects of friction. Most of the possible misconceptions are in the type and magnitude theme and the least were in the direction theme. But friction is always opposite to the direction of the motion as a possible misconception was detected in the highest number of papers. Related to this, the possible misconception that friction prevents movement was frequently encountered. It was also found that both the distinction between sliding and rolling friction and kinetic and static friction was often ignored. In addition, some of the possible misconceptions were found to be similar regardless of country, culture, or education system, as in the previous literature. One of the results of the study is that possible misconceptions are not only held by the students but also held by teachers and preservice teachers. In this respect, the results of the study are also considerable in terms of the direction of teachers in in-service training studies.

The human beta defensin 3 (hBD3) is widely expressed in the oral cavity and exerts strong antibacterial and immunomodulatory activities. Hence, we hypothesized that hBD3 could play a protective role in the maintenance of periodontal homeostasis, and that it could be found in gingival crevicular fluid (GCF) of healthy individuals and those with periodontitis at levels correlating with the degree of periodontal health. By using an ELISA assay to quantify hBD3 in GCF, we demonstrated that the peptide is present at levels easily detectable in the majority of healthy individuals, but it is drastically reduced in GCF from those with periodontitis. Furthermore, hBD3 levels inversely correlate with the severity of the disease and the degree of colonization by combinations of bacterial species with elevated periodontopathogenic potential. Both genetic factors and host/ bacterial proteases released in diseased sites may be responsible for the observed low/null hBD3 levels in GCF from individuals with periodontitis. [ABSTRACT FROM PUBLISHER]

Mycobacterium bovis bacillus Calmette-Guérin (BCG) is capable of directly stimulating several effector functions of human natural killer (NK) cells in the absence of interleukin-12 and professional antigen presenting cells. To assess the contribution of two main human NK-cell subsets (CD56dim and CD56bright) to the overall in vitro NK-cell response to BCG, peripheral blood mononuclear cells depleted of nylon wool-adherent cells or purified NK cells were stimulated with live BCG. By combining intranuclear bromodeoxyuridine (BrdU) staining and analysis of CD56 marker intensity, statistically higher percentages of BrdU+ cells were found among the CD56bright subset than the CD56dim subset after 6 days of stimulation with BCG. Similarly, evaluation of intracellular interferon-γ (IFN-γ) revealed that CD56bright cells were those mainly involved in IFN-γ production in response to BCG. In contrast, the CD56dim subset contained higher levels of perforin and granzyme A, two key molecules for exocytosis-mediated cytotoxicity, than the CD56bright subset. Although 16–20-h stimulation with BCG did not substantially alter the expression of cytotoxic molecules by the two subsets, a decrease in perforin content was observed in the CD56dim, but not in the CD56bright subset, following 4-h incubation with the NK-sensitive target K562 cell line. This decrease in perforin content correlated with the induction by BCG-stimulated NK cells, of early markers of apoptosis on target cells to a greater extent than unstimulated cells suggesting a major role for the CD56dim subset in cytotoxic activity in response to BCG. Taken together, these results demonstrate that CD56bright and CD56dim human NK-cell subsets exert different functional activities in response to a live bacterial pathogen. [ABSTRACT FROM AUTHOR]

Tujuan penelitian ini menguji ketahanan luntur zat warna tekstilbatik yaitu re­aktif dan azo pada uji pencucian menggunakan SNI ISO 105-C06: 2010 dan uji ke­ringat pH asam dan pH basa menggunakan SNI ISO 105-E04: 2015 dengan pe­nye­suai­an DSTI. Sampel uji untuk zat warna reaktif adalah material katun dan sampel uji azo menggunakan sutera sebagai bahan baku utama untuk produk batik di Jawa Ti­mur. Nilai perubahan warna dan penodaan warna dievaluasi pada konsentrasi larutan yang berbeda sesuai standar uji masing-masing. Hasil penelitian menunjukkan bahwa per­bedaan konsentrasi larutan zat reaktif tidak menyebabkan perbedaan yang nyata pada skor perubahan warna dan perbedaan warna katun untuk semua pengujian. Se­men­tara konsentrasi larutan zat azo yang berbeda menyebabkan perbedaan yang nyata pada skor perbedaan warna untuk pengujian sutera.

AIM:To evaluate the mineralocorticoid receptor(MR)gene - 2G/C single nucleotide polymorphism in central serous chorioretinopathy(CSCR), polymorphism and plasma cortisol level relationship.METHODS:Sixty CSCR patients and 50 controls were included in the study. Inclusion criteria for patients were acute manifestation of CSCR characterized by serous retinal detachment, RPE detachment or dysfunction without evidence of any other possible cause of fluid exudation, such as choroidal neovascularization, inflammation or infiltration. Peripheric blood sample was collected from the participants between 8 and 10 a.m. to avoid the diurnal changes of cortisol levels. MR (NR3C2)gene polymorphism(rs2070951)and plasma cortisol levels sere studied.RESULTS: The genotype frequencies in CSCR group were G/C(46.6% ), G/G(26.7%)and C/C(26.7%).There was no statistically significant difference in terms of genotype distribution among groups(P=0.96). The plasma cortisol levels were also studied and the results were 401.2±162.1 nmol/L in the CSCR group and 296.8±130.1 nmol/L in the control group and the difference was statistically significant(PP=0.50).CONCLUSION: The MR (NR3C2)gene polymorphism is not associated with CSCR and the plasma cortisol levels.

The proliferative responses of distinct cell subsets from healthy, bacille Calmetle-Guérin (BCG)- vaccinated blood donors were assessed after in vitro stimulation with live or UV-killed Mycobacterium tuberculosis and Myco. avium or with soluble extracts obtained from either mycobacterial species. Proliferation of cell subsets was evaluated by flow cytometric determination of 5- bromo-2'-deoxy-uridine incorporation into DNA and simultaneous identification of surface phenotypic markers. In the presence of monocytes, the response to whole (live or killed) bacteria was characterized by a predominant proliferation of CD4+ αβ+ T cells and. to a lesser extent, of CDS+ αβ+ T cells. Proliferation of CD8+ αβ+ T cells was primarily elicited by live rather than killed bacilli (P < 0.05). Conversely, when soluble bacterial extracts were used as stimulators, a preferential proliferation of γδ+ T cells, expressing predominantly Vγ9+ and Vδ2+ T cell receptor chains, was recorded. Moreover, when monocyte-depleted cell populations were directly cultured with live bacteria, a marked proportion of CD3-CD16+ (natural killer (NK)) cells was detected among the responding cells. Although both αβ, γδ and NK cells have been previously shown to react with mycobacteria in vitro, their relative contributions to the response have been difficult to assess. Using a flow cytometric technique which allows direct identification of proliferating cells within complex cell populations, our study demonstrates significant differences in the ability of various mycobacterial antigen preparations to elicit proliferation of distinct cell subsets. [ABSTRACT FROM AUTHOR]

Immature double positive (DP, CD4+CD8+) and mature single positive (SP, CD4+CD8- and CD4-CD8+) human thymocytes from nine thymi were analysed for their complete patterns of relative TCR Jβ multigene member usage in relation to six rearranged Vβ family exons (Vβ 5.1, 6.1-3, 8, 9, 12 and 18). Each sample tested contained mRNA transcripts corresponding to all potential Vβ (Dβ)Jβ combinations. Individual Jβ gene segments were expressed in a similar, highly non-random manner both in SP and DP thymocytes, irrespective of original genomic position of the individual associated Vβ exon. In addition, ranges of family usage and frequency of individual over-representations of Jβ gene segments, as determined in DP and SP thymocyte populations, displayed no significant differences. Upon comparison of DP and SP thymocytes, however, a discrepancy in one aspect of Jβ gene utilization was established: decreasing Jβ family 1/ Jβ family 2 ratios were determined to be positively correlated with increasing maturity of thymocytes, a condition further supported by data previously obtained from studies of PBL T cells. At the individual Jβ gene level, the observed gradual modification of the relative family usage can largely be explained by a significant shift from a higher Jβ 1.1/Jβ 2.7 ratio in DP to a higher Jβ 2.7/Jβ 1.1 ratio in SP thymocytes. Altogether, the present results imply that selectional processes in the thymus appear to have only minor consequences on the distribution pattern of expressed Jβ exons. Hence, the disproportionate pattern of TCR Jβ gene usage seems to be established mainly at the recombinatorial level followed by minor adjustments during thymic and post-thymic events. [ABSTRACT FROM AUTHOR]

The immunophenotypic characteristics of the skin pathergy reaction (SPR) at 48 h in Behçet's disease (BD) were investigated in 12 patients with BD and in five controls. The findings in 11 positive and one negative SPR lesions of patients with BD were evaluated in comparison with those of normal adjacent skin and with the negative pathergy biopsies from the controls. Positive SPR biopsies showed variable epidermal thickening and cell vacuolization, as well as subcorneal pustule formation. In the SPR dermis, a variable dense focal mononuclear cell (MNC) infiltrate was seen around vessels and skin appendages, extending into the deep dermis. The MNC infiltrate was predominantly composed of T lymphocytes and monocytes/macrophages. The majority of the T lymphocytes were CD4+. and almost all expressed CD45RO. Approximately half of the infiltrating cells strongly expressed HLA-DR. Neutrophils constituted less than 5% of the infiltrating cells, but were present as clusters of elastase-positive cells at the needle-prick sites. Vessels within the lesion showed marked congestion and endothelial swelling. The endothelial cells expressed ICAM-1 strongly, and E-selectin moderately. VCAM-1 was not expressed on endothelial cells. The basal and mid-epidermal layers of keratinocytes expressed HLA-DR and ICAM-1 strongly, particularly so in areas close to the dermal MNC infiltrates. In negative pathergy biopsies, there were increased numbers of neutrophils and a few small clusters of macrophages and T lymphocytes only at the needle-prick site, and the endothelial cells of vessels close to these areas expressed E-selectin weakly. The immunohistological findings of the SPR appear to indicate an augmented antigen-independent non-specific induction phase of the inflammatory response. Absence of VCAM-1 expression by endothelial cells suggests that direct epidermal injury is the cause of the cutaneous inflammation. [ABSTRACT FROM AUTHOR]

The frequency of γδ+ T cells in the peripheral blood of 26 Turkish, 24 Swedish, 35 Japanese and 14 'Asian' (non-Japanese) healthy blood donors and healthy volunteers were investigated by flow cytometry. In the Turkish group, 9,3% (median value) of the CD3+ peripheral blood T cells expressed the γδ T cell receptor, A similar level of γδ+ T cells was found in the non-Japanese 'Asian' healthy volunteers (9.2%), while significantly lower values were detected in the Swedish (4.2%) and Japanese (4.5%) groups. These dramatic differences in normally occurring γδ+ T cells in different groups of healthy individuals were further reflected by a low incidence of > 10% γδ T cells in the Swedish (0/24) and Japanese (6/35) groups compared to the Turkish (12/26) and 'Asian' (5/14) groups. The described γδ+ T cell differences between distinct ethnic groups are thus likely to be a consequence of environmental factors, but additional genetic influences cannot be ruled out. The present study demonstrates the potential importance of the ethnic origin and environmental history of subjects examined in studies of γδ+ T cells-disease relations. [ABSTRACT FROM AUTHOR]

Objectives: Dry eye is an important problem in Parkinson’s disease (PD) with a potential to affect life quality. Tear osmolarity, accepted as the gold standard in dry eye diagnosis, has not been studied in this subset of patients so far. Therefore, in this study we aimed to evaluate tear osmolarity, Schirmer’s test scores and tear film break-up time (TBUT) in PD patients. Materials and Methods: PD patients with a minimum follow-up of 1 year and healthy controls who admitted for refractive abnormalities were enrolled to the study. Subjects using any systemic medication with a possibility to affect tear tests were not included in the study. The presence of any ocular surface disorder, previous ocular surgery, previous dry eye diagnosis, any topical ophthalmic medication or contact lens use were other exclusion criteria. Age, gender, disease duration, and Hoehn and Yahr (H&Y) score for disease severity were noted, and blink rate (BR), Schirmer’s test score, TBUT and tear osmolarity of the right eye were measured in both groups. Results: Thirty-seven PD patients and 37 controls were enrolled to the study. The groups were age and gender matched. The mean disease duration and H&Y score were 5.70±2.64 years and 1.70±0.93, respectively. H&Y staging and disease duration were not correlated to BR, Schirmer’s scores, TBUT, or tear osmolarity (p>0.05). The mean BR was 8.54±4.99 blinks/minute in PD patients and 11.97±6.36 blinks/minute in the control group. Mean Schirmer’s scores, TBUT and osmolarity values were 9.08±4.46 mm, 11.38±4.05 seconds and 306.43±12.63 mOsm/L in the PD group and 17.16±9.57 mm, 12.81±3.66 seconds and 303.81±16.13 mOsm/L in the control group. The differences were significant only in BR and Schirmer’s scores. Conclusion: BR and Schirmer’s scores decreased significantly in PD patients. Although not significant, the demonstrated tear osmolarity increment might be important to document the dry eye and inflammatory process of the ocular surface in PD patients. (Turk J Ophthalmol 2015; 45: 142-145)

This is the last of a series of articles on invasive fungal infections prepared by opinion leaders in Turkey. The aim of these articles is to guide clinicians in managing invasive fungal diseases in hematological malignancies and stem cell transplantation based on the available best evidence in this field. The previous articles summarized the diagnosis and treatment of invasive fungal disease and this article aims to explain the risk categorization and guide the antifungal prophylaxis in invasive fungal disease.

AIM: To investigate the effects of selenium in rat retinal ischemia reperfusion (IR) model and compare pre-treatment and post-treatment use. METHODS: Selenium pre-treatment group (n=8) was treated with intraperitoneal (i.p.) selenium 0.5 mg/kg for 7d and terminated 24h after the IR injury. Selenium post-treatment group (n=8) was treated with i.p. selenium 0.5 mg/kg for 7d after the IR injury with termination at the end of the 7d period. Sham group (n=8) received i.p. saline injections identical to the selenium volume for 7d with termination 24h after the IR injury. Control group (n=8) received no intervention. Main outcome measures were retina superoxide dismutase (SOD), glutathione (GSH), total antioxidant status (TAS), malondialdehyde (MDA), DNA fragmentation levels, and immunohistological apoptosis evaluation. RESULTS: Compared to the Sham group, selenium pre-treatment had a statistical difference in all parameters except SOD. Post-treatment selenium also resulted in statistical differences in all parameters except the MDA levels. When comparing selenium groups, the pre-treatment selenium group had a statistically higher success in reduction of markers of cell damage such as MDA and DNA fragmentation. In contrast, the post-selenium treatment group had resulted in statistically higher levels of GSH. Histologically both selenium groups succeeded to limit retinal thickening and apoptosis. Pre-treatment use was statistically more successful in decreasing apoptosis in ganglion cell layer compared to post-treatment use. CONCLUSION: Selenium was successful in retinal protection in IR injuries. Pre-treatment efficacy was superior in terms of prevention of tissue damage and apoptosis.

AIM: To investigate the association of serum glucocorticoid kinase gene-1 (SGK-1) DNA variants with chronic central serous chorioretinopathy (CSC). METHODS: We enrolled 32 eyes of 32 patients who were diagnosed with chronic CSC and composed 32 normal eyes as a control group. Peripheral blood was used for DNA extraction and polymerase chain reaction (PCR) amplification. SGK1 gene was sequenced by using BigDye® Terminator v3.1 cycle sequencing KIT (Applied Biosystems, Foster City, CA, USA). The SGK1 gene and its variants were investigated in CSC patient group and control group. RESULTS: We identified a new polymorphism M32V in two person in the patient group (Minor allele frequency (MAF)=0.009) on the region of 1-60 amino acids. The rs1057293 was located in the encoder region of the SGK 1 gene but not associated with CSC (P=0.68). An intrinsic rs1743966 is also not associated (P=0.28). CONCLUSIONS: The new polymorphism M32V is located on the region of 1-60 amino acids which is necessary for localization to the mitochondria in CSC patient. This mutation is probably important for the energy metabolism and plays an important role in the cellular response to hyperosmotic stress and other stress stimuli. Both rs1057293 and rs1743966 are not associated with CSC.

Objective: Warfarin is the most commonly used oral anticoagulant around the world. The most important complication of warfarin is bleeding. This study was conducted to evaluate the patients who were admitted to our emergency department due to complications related to warfarin treatment.Material and Methods: Eighty-nine patients (32 females, 57 males) were enrolled into this retrospective study. The patients were evaluated according to their age, gender, duration of therapy (year), co-administered drugs, bleeding localization, treatments, amount of blood transfusions, duration of bleeding, initial and after-treatment PT, INR, complete blood count, and aPTT.Results: Mean duration of anticoagulant use was 3.05±2.87 years. The most common indication of warfarin was atrial fibrillation. The most frequent bleeding localization was the upper gastrointestinal tract. Thirty-four (38.2%) of the patients had major bleeding, and 55 (61.8%) had minor bleeding. Age, co-administered drugs, amount of erythrocyte suspension transfusion, presence of previous warfarin overdose history, Hb levels at admission, and duration of follow-up in the ED were different between the bleeding types.Conclusion: In this study, we found that the bleeding complications of warfarin were associated with the aged population, presence of previous warfarin overdose history, and concomitant drug use.

We live in an increasingly heterogeneous society. The rate of international migration has contributed to cultural diversity in many nations. Libraries of all types have started to address cultural and linguistic diversity while providing information sources and services. According to The IFLA Multicultural Library Manifesto (2008), each individual has the right to a full range of library and information services, and libraries should serve all members of the community without discrimination. Special attention should be paid to cultural and linguistic groups which are underserved such as minorities, refugees, immigrants, including those with temporary residence permits. Public libraries are considered useful social instruments in the democratization of information. They are agents for social change and excellent tools for the integration of immigrants. They prepare immigrants for citizenship by introducing them to the values of their new nation, and frequently sustain them through the initial period of adaptation. They are spaces where patrons can readily access information, not only to increase their knowledge, but also to improve their abilities and skills in order to participate in society. As the key for life-long learning and success not only in school and the work place but also in daily life, information literacy skills must be developed by immigrants, refugees and foreign residents in order for them to integrate into their adopted country. Knowing how to access, use and communicate information effectively will enable the social inclusion of newcomers. Therefore, developing special information literacy programs to equip such groups with information literacy skills should be among the priorities of public libraries. In this study, the importance of information literacy skills in multicultural societies in terms of the social inclusion of immigrants will be underlined. Findings of a survey which has been conducted to ascertain information needs of foreign residents in Turkey and the level of fulfillment of their information needs will be presented. The findings of the research will also be used to make suggestions for developing information literacy programs which address the specific information needs of culturally and linguistically diverse communities./İçinde yaşadığımız toplum giderek çeşitlenmektedir. Uluslararası göç hareketleri birçok ülkede kültürel çeşitliliği artırmaktadır. Kültürel ve dilsel çeşitliğe sahip toplumlarda bilgi kaynaklarının ve hizmetlerinin sağlanmasında her türden kütüphane adres gösterilmektedir. Uluslararası Kütüphane Dernekleri ve Kuruluşları Federasyonu (IFLA) tarafından yayımlanan Çok Kültürlü Kütüphane Bildirisi’ne göre toplumda her bireyin kütüphane ve bilgi hizmetlerine tam ve eksiksiz erişme hakkı vardır. Dezavantajlı gruplar olarak adlandırılan azınlıklar, göçmenler gibi kültürel ve dilsel çeşitliliğe sahip topluluklara bilgi hizmetlerinin sağlanmasında özel önem gösterilmelidir. Halk kütüphaneleri bilginin demokratikleşmesinde sosyal aracı niteliğindeki önemli kurumlar arasındadır. Göçmenlerin sosyal ve kültürel bütünleşme sürecinde sosyal değişimin sağlanacağı yegâne kuruluşlar halk kütüphaneleridir. Ev sahibi ülkenin değerlerinin kavranması, vatandaşlık bilincinin kazandırılması ve yeni bir kültüre uyumun sağlanması aşamasında göçmenleri yeni hayatlarına hazırlarlar. Kütüphaneler kullanıcıların bilgiye erişmesini sağlamanın ötesinde onların toplumsal katılımını artırmak amacıyla bilgi ve becerilerini geliştirecek alanlar yaratırlar. Örgün ve yaygın eğitimde, gündelik yaşamda yaşam boyu öğrenmenmenin kilit noktası olan bilgi okuryazarlığı becerileri göçmenler ve yabancılar tarafından göç ettikleri ülkeye uyum sağlayabilmeleri ve bu uyumu sürdürebilmeleri için geliştirmeleri gereken temel beceriler arasındadır. Bilgiye nasıl erişileceğinin ve kullanılacağının etkin bir şekilde öğrenilmesi göçmenler arasında sosyal bütünleşmeyi artırıcı faktörler arasındadır. Bu nedenle dezavantajlı gruplara yönelik özel hazırlanmış bilgi okuryazarlığı programları halk kütüphanelerinin öncelikleri arasında yer almalıdır. Bu çalışmada, çok kültürlü toplumlarda bilgi okuryazarlığı becerileri göçmenlerin sosyal bütünleşmelerini artırıcı bir faktör olarak ele alınmaktadır. Türkiye’de yaşayan yabancıların bilgi gereksinimlerinin belirlenmesi amacıyla uygulanan anket sonuçları, bilgi gereksinimlerinin önem düzeyi ve bu gereksinimlerin karşılanma düzeyi sunulmaktadır. Araştırma sonucunda elde edilen bulgular aynı zamanda kültürel ve dilsel çeşitliliğe sahip toplulukların özel bilgi gereksinimlerini karşılayacak bilgi okuryazarlığı programlarının geliştirilmesine yönelik öneriler sunmak amacıyla kullanılmıştır.

Pentingnya Pengetahuan tentang Pengelolaan Keluarga Bagi Ibu Rumah Tangga

Pur po se: To evaluate the results of posterior chamber phakic intraocular lens implantation in myopic patients. Ma te ri al and Met hod: Posterior chamber phakic intraocular lens (STAAR ICL) implantation was performed in 58 eyes of 33 patients with mean spherical equivalent of -13.12±5.31 diopters (D) (-2.5 - -24.75 D) between August 2007 and October 2010 at Dr. Lütfi Kırdar Kartal Training and Research Hospital, Second Eye Clinic. The mean age of the patients was 32.84 ± 9.95 years (18-55 years) - 24 (72.7%) were male and 9 (27.3%) were female. The study was designed as prospective case series. The patients were evaluated regarding visual acuity, refraction, endothelial cell count, and complications in postoperative period. Re sults: The mean follow-up time was 21.5±4.9 (12-24 months) months. The mean spherical equivalent was -1.29±1.53 D (-5.6 D - +2.60 D) at the last postoperative follow-up visit. Visual acuity was better or equal to preoperative best-corrected value in 42 (72.4%) of eyes at the last follow-up visit postoperatively. Mean spherical equivalent was regressed to -1.13±1.59D at 1-month and -1.39±1.53D at 24-month postoperative follow-up visit. Pupillary-block glaucoma in 1 eye (1.7%), anterior subcapsular opacification not affecting the vision in 4 eyes, and retinal detachment in 1 eye were detected at follow-up visits. Dis cus si on: ICL implantation was observed to be an effective and safe method for correction of myopia in two-year follow-up. As possible retinal complications may develop, the patients must be followed carefully during the preoperative and postoperative period. (Turk J Ophthalmol 2012; 42: 349-54)

Purpose: To compare the status of corneal endothelium and central corneal thickness within the first four postoperative years after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in patients with keratoconus. Materials and Methods: Thirty-nine eyes (Group A) which had PK and 44 eyes (Group B) which had DALK for the treatment of keratoconus were included in this retrospective study. The endothelial cell density (ECD), the mean endothelial cell area and the coefficient of variation of cell area were assessed with a non-contact specular microscope, and the central corneal thickness (CCT) was measured with an ultrasound pachymeter. Results: Mean ECD loss rate at two years was 36.24% in Group A and 18.12% in Group B (P

Purpose: To evaluate the safety, efficacy and potential risks of Artiflex foldable iris-fixated phakic intraocular lens (pIOL) implantation for the management of myopia. Materials and Methods: Seventy-eight eyes of 40 consecutive patients with a mean spherical refraction of −11.70 ΁ 3.77 diopters (D; range −5.50 to −17.5 D) were included in this prospective, noncomparative, interventional case series. Main parameters assessed were uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BSCVA), corneal topography (Orbscan II, BauchandLomb, Rochester, NY, USA), manifest and cycloplegic refractive errors, endothelial cell density (ECD) and applanation tonometry. Results: After 2 years, BSCVA was 20/40 or better in 82% of the eyes and UCVA was 20/40 or better in 84% of the eyes. After 1 month, 1 year, and 2 years, 51.3% (37 of 72 eyes), 58.9% (46 of 78 eyes) and 76.0% (38 of 50 eyes) of eyes gained 1 line or more of BSCVA, respectively. Compared to preoperative values, the mean endothelial cell loss was 2.6% at 1 month, 4.9% at 1 year and 7.4% at 2 years. Pigmented or non-pigmented precipitates were observed in17 eyes (21.7%) which were treated with topical corticosteroids. At the second postoperative year, pigmented precipitates persisted in nine eyes. However, this was not associated with a loss of BSCVA. Conclusion: The implantation of Artiflex pIOL is an effective surgical option for the management of high myopia. The most common complication observed within 2 years of follow-up was accumulation of pigmented precipitates with no effect on the final BSCVA.

Pur po se: To evaluate the clinical findings of toxic keratopathies secondary to topical proparacaine (Alcaine, Alcon) abuse and the results of medical and/or surgical treatment options. Ma te ri al and Met hod: We retrospectively analyzed twenty-two eyes of 25 patients who developed toxic keratopathy secondary to topical anesthetic abuse between March 2005 and December 2009. Severe pain unresponsive to medical treatment with persistent epithelial defects (PED) and stromal ulcers were managed with amniotic membrane transplantation (AMT). Some cases have undergone optical penetrating keratoplasty (PK). Clinical findings and complications were assessed, and visual acuities were measured before and after treatment. At the sixthmonth follow-up visit, endothelial cell densities (ECD) were determined with specular microscopy in both affected and unaffected eyes for statistical comparison. Re sults: The mean time interval between the initiation of topical anesthetic use and admission to our clinic was 2.26 months. Epithelial defects, circular stromal keratitis and corneal edema were present in all eyes. Epithelial defects were healed with medical treatment in 15 eyes (60%). AMT was performed in 10 eyes, following a mean of 26.1 days after initiation of medical treatment. Visual acuity before the treatment was 0.1 or below in all eyes. At the last control visit including 3 eyes having had PK, best-corrected visual acuities were 0.5 or better in 13 eyes (52%), between 0.2 and 0.4 in 7 eyes (28%) and 0.1 or worse in 5 eyes (20%). No statistically significant difference was found between ECD of affected and unaffected eyes of 13 patients in whom specular microscopy was possible. Dis cus si on: Topical anesthetic abuse may cause severe toxic keratopathy and lead to significant visual loss related to stromal opacities despite intensive treatment. AMT was found effective and successful in healing PED and stromal ulcers as well as in breaking the vicious circle of anesthetic abuse with the relief of pain. (Turk J Ophthalmol 2012; 42: 30-4)

The aim of this study was to evaluate the effect of education on the knowledge, attitude and behavior of anesthesiology staff and residents towards low-flow anesthesia. The staff and residents in the Department of Anesthesia and Reanimation, Zonguldak Karaelmas University were given theoretical and practical training in delivering low-flow anesthesia. To evaluate their attitudes and behaviors toward low-flow anesthesia, we collected data during the 6 months before training, during the first 3 months after training, and at 4–6 months after training. Anesthesia follow-up records, operation time, volatile anesthetic agent used, and the amount (in liters) of fresh gas low mid-anesthesia were recorded in all three stages. A total of 3,158 patients received general anesthesia and inhalation anesthesia was used in 3,115 of these patients. Our study group consisted of 2,752 patients who had no absolute or relative contraindications to low-flow anesthesia. While the mean fresh gas flow was 4.00 ± 0.00 L/min before training, this level dropped to 2.98 L/min in the first 3 months after training, and to 3.26 L/min in the following 3 months. The mean fresh gas flow was significantly lower at the two post-training assessments than before training (p < 0.05). In conclusion, low-flow anesthesia may be used more frequently if educational seminars are provided to anesthetists. The use of low-flow anesthesia may increase further by allocating more time to this technique in anesthesia training programs provided at regular intervals.