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Hepatitis E is a self-limited enterically transmitted acute viral hepatitis that occurs frequently in epidemic outbreaks and as sporadic hepatitis in many tropical and subtropical countries. The aim of this study was to evaluate the seroprevalance of hepatitis E virus (HEV) antibodies in rural and urban areas in Erzurum. A total of 340 sera were collected from people with different socio-economic levels and age groups. Sera were examined for IgG to HEV using a commercially ELISA kit. HEV seroprevalance was found to be 10.3%. This value was 11.8% in the group of low socio-economic level and 8.8% in the group of high socio-economic level. In respect of prevalence, there was no significant difference among groups of socio-economic level, sex, and age (p> 0.05). As a result, HEV seroprevalance rate was found higher in Erzurum than average in Turkey. more...

Esophageal perforation may occur spontaneously, iatrogenically or in connection with traumas. Sepsis may develop in connection with mediastinal and pleural exposure in a very short time as a consequence of disintegration of the esophagus. Esophageal perforation is an emergency accompanied with a high level of mortality and morbidity. Rate of mortality for the perforations in the thoracic region is higher than that in the cervical and abdominal regions. Delay in diagnosis and treatment is the most important factor to affect the mortality. A quick and true diagnosis of esophageal perforation is prerequisite for a successful treatment. There is no certain consensus in relation with the optimal treatment of that life-threatening condition. However, in the event that perforation is detected early in a healthy esophagus, then primary repair is recommended. When it is detected late, nonoperative conservative treatment would be appropriate. The rates of mortality for the operations following a period of 24 h after rupture formation are higher than 50%. Esophagectomy is a type of an operation that is to be considered in the event of an end stage benign esophageal disease or of a large esophageal damage that does not allow primary repair. Significant decrease has been observed in the morbidity and mortality of esophageal perforation due to the improvements in the endoscopical techniques today. Minimally invasive techniques, in which drug eluting stents come first, will become an important step for the treatment of esophageal perforations in the forthcoming years. more...

Bu calismada; terorizm, dogrudan yabanci yatirimlar ve portfoy yatirimlari arasindaki iliskiler incelenmektedir. Ayrica calismada, ilgili degiskenler arasindaki iliskilerin dis yardim akimlarindan nasil etkilendigi gelismekte olan ve azgelismis ulkeler itibariyle 2005-2011 donemi icin dengesiz panel veri analizleriyle arastirilmaktadir. Bu amac dogrultusunda ilk olarak degiskenlere ait duraganlik sureci incelenmis ve degiskenlerin farkli duzeylerde duragan oldugu saptanmistir. Bunun yani sira, estumlesme analizleri de uygulanmis ve Pedroni ve Kao Estumlesme Analizleri ifade edilen degiskenler arasinda uzun donemli iliskilerin varligini ortaya koymustur. Ilaveten, Granger Nedensellik Analizi sonuclari ilgili degiskenler arasinda en azindan tek yonlu bir nedensellik iliskisinin varligini gostermistir. Sabit etkili tahmin modeli sonuclari, terorizmin dogrudan ve dolayli yabanci yatirimlar uzerinde negatif yonlu bir etki yarattigini ortaya koymustur. Ayrica dis yardim akimlarinin, terorizmin yabanci yatirimlar uzerindeki olumsuz etkilerini azalttigi da gorulmustur. more...

The Two Faces of Unionist Movements: The Analysis of its Impact on the Economic Growth in OECD Countries Even though identifying the causes of economic growth has been the subject of numerous empirical studies, little is known about the impact of unionist movements on differences in the process of economic growth between the countries. Besides, there is still no consensus on how unions affect a state’s economy. Therefore, in this study the impact of unionist movements on economic growth in 33 OECD countries from 1970 to 2011 is examined by using panel data analysis. The results of the analysis show that there are both cointegration and causality relationship between the unionist movements and economic growth. In addition, it is found that an increase in unionist movements would impact the process of economic growth negatively more...

Gastrointestinal system (GIS) cancers account for a significant percentage of morbidity and mortality worldwide. Free radicals may play a role in the development of GIS cancers at various stages. The goal of this study was to analyze the relationship between gastroesophageal cancer and plasma levels of vitamin A and vitamin E, a significant part of antioxidant defense. Materials and methods: Twenty-six patients with gastroesophageal cancer diagnosed by endoscopy and histopathologic examination and 26 healthy volunteer subjects were included in this study. Plasma vitamin A and vitamin E levels were determined by high-performance liquid chromatography using a commercially available kit. Results: Plasma vitamin A and vitamin E levels were significantly lower in the gastroesophageal cancer group (1.39 ± 0.137 µmol/L and 13.5 ± 1.29 µmol/L, respectively) than in the control group (2.79 ± 0.163 µmol/L and 21.29 ± 2.58 µmol/L, respectively). The difference was significant at P < 0.001 for vitamin A, and P < 0.05 for vitamin E values. However, we could not detect any significant difference in plasma vitamin A and vitamin E levels when the stage of the disease was taken into consideration (P > 0.05). Conclusion: Decreased plasma vitamin A and vitamin E levels, as important antioxidant components, may be contributory in the development of gastroesophageal cancer. Diets rich in antioxidant vitamins may be protective against the development of upper gastrointestinal tract disease. more...

Intercellular adhesion molecule-1 (ICAM-1) is a membrane-bound molecule primarily involved in cell-cell adhesive interactions of the immune system. It is a cytokine-induced glycoprotein involved in the recruitment of cells into tissues undergoing inflammatory responses. The levels of soluble ICAM-1 were measured in sera of patients with systemic lupus erythematosus (SLE) using sandwich enzyme-linked immunoassay. Serum levels (mean +/- SD) of soluble ICAM-1 (sICAM-1) were significantly higher in 24 patients with SLE than in 20 controls (372+/-42 ng/dL vs 231+/-29 ng/dL, P0.001). A statistically significant positive correlation was observed between sICAM-1 levels and SLE disease activity index (SLEDAI) score in SLE patients, and no correlation was found between sICAM-1 and CRP, SLEDAI and CRP, or SLEDAI and ESR in patient groups (P0.05). These findings suggest that sICAM-1 measurement may serve as an additional serologic marker of disease activity in patients with SLE. more...

Coronary artery anomalies are usually incidentally diagnosed at the time of coronary angiography or autopsy. In a large series of 70,850 patients undergoing coronary angiography, the incidence of coronary anomalies was found to be 0.24–1.3%. The majority of these were reported to be anomalies of origin or distribution, with separate ostia of the left anterior descending artery and left circumflex artery being the most common.1 Although many of the primary congenital coronary anomalies are hemodynamically insignificant, it is important to know the anatomic variants in patients with coronary artery disease who are undergoing either surgical myocardial revascularization or coronary angioplasty.2 Double right coronary artery is a very rare coronary abnormality that is generally considered benign. In this report, we present two cases of double right coronary artery (RCA). Case Report 1 A 40-year-old woman was admitted to our center with dyspnea. She had been experiencing shortness of breath and dyspnea on exertion for two months. Her risk factors for coronary artery disease included a history of diabetes mellitus and a family history of premature atherosclerotic heart disease. Her physical examination was unremarkable; cardiac and lung auscultations were normal. Her blood pressure was 125/80 mmHg and pulse was 64 beats/min. The chest X-ray was normal. Routine blood and biochemical laboratory tests were nonspecific and nondiagnostic. The electrocardiogram showed a sinus rhythm with clearly negative T waves in D2–D3 and aVF. An exercise stress test showed ST-segment depression in the inferior leads at peak exercise, which was asymptomatic. The patient underwent selective left and right coronary artery angiography. The left coronary angiography revealed a normal origin and course of the left main artery (LM), the left circumflex artery (LCx) and the left anterior descending (LAD) arteries. The LCx and LAD arteries were normal. The right coronary angiography revealed two different right coronary arteries arising from a common ostium in the right coronary sinus. Both coursed along the atrioventricular groove and terminated via individual posterior descending arteries (PDA) (Figure 1). Both arteries were free of any angiographically identifiable atherosclerotic lesion. Figure 1 Left anterior oblique view showing a double right coronary artery. Case Report 2 A 66-year-old woman was admitted to our center with chest pain. She was complaining of angina and dyspnea on exertion lasting one week. Her risk factors for coronary artery disease included a history of diabetes mellitus and hypertension. The physical examination was completely normal. Cardiac enzymes and troponin–T were also found to be normal. The patient underwent selective left and right coronary artery angiography. The left coronary arteries were of normal origin and distribution. The right coronary angiography revealed two separate RCAs originating from a single ostium in the right sinus of Valsalva. Both RCAs gave off branches with typical courses and in parallel distribution (Figure 2). Both arteries were free of any angiographically identifiable atherosclerotic lesion. Figure 2 Selective right coronary angiography (left anterior oblique projection). DISCUSSION Coronary anomalies are incidentally detected during routine coronary angiography. Congenital coronary anomalies are seen in approximately 1% of adult patients.3 Double RCA is a very rare type of coronary abnormality. There was no mention of this anomaly in a series of 126,595 patients who underwent coronary angiography.3 The first report about double RCA anomaly in the literature was by Barthe et al.4 They observed double RCA originated from one ostium. The vessels were within the right atrioventricular groove. After the origin of a conus artery and a ventricular branch, the most anterior RCA descended toward the acute margin of the heart and terminated in a small posterior descending artery. The second RCA terminated in a small posterior descending and posterolateral branches. In our cases, both right coronary arteries were almost identical in size and both gave rise to a PDA. The correct diagnosis of double RCA is not easily made based on conventional coronary angiography because it is difficult to distinguish this variation from that of a high takeoff of a large right ventricular branch. This alternative diagnostic possibility creates uncertainty in making the correct diagnosis of double RCA.5 Though double RCA is a relatively rare entity, it is not necessarily benign, as it has been associated with atherosclerosis, life-threatening arrhythmia and myocardial infarction.6,7,8 However, our patients’ coronary arteries were free of atherosclerotic lesions. In the absence of atherosclerotic stenosis, ischemia can be a result of anatomical malformations, including an acute takeoff angle of the anomalous vessel, myocardial squeezing, vasospasm and a small artery.1 In these cases, double RCAs were identified as isolated coronary anomalies. Two previous studies have reported double RCA in combination with other anomalies.9,10 Double RCA has been reported 18 studies and in 20 cases.11 Interestingly, 12 of these cases were identified in the Turkish population. This suggests that certain coronary artery anomalies may be associated with a particular genetic background. The double RCA anomaly is seen mostly in males, as are other congenital coronary anomalies, though our patients were both female.12 In conclusion, although double right coronary artery is a rare anomaly, every operator should be familiar with it in order to perform an adequate examination. more...

WOS: 000330050000001, PubMed ID: 24400646, Background: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. Methods: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. Results: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. Conclusion: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series. more...

Carpal tunnel syndrome is the most common upper extremity neuropathy in the wrist that may be associated with anatomic variations of median nerve. Trifurcation of the median nerve has been very rarely reported in the literature. We report coexistence of bilateral median nerve variation in the wrist and its radiological features. Ultrasonography and magnetic resonance imaging was performed to the patient after Tinel and Phalen tests. There was bifurcation and trifurcation of the median nerve in right and left wrists respectively. Bilateral carpal tunnel syndrome was caused by bilateral median nerve variation in the present case. When a median nerve variation is detected in one wrist, a possible variation at the other side should be kept in mind and hence should be evaluated. A thorough knowledge of the variations of the median nerve is essential in order to avoid surgical complications and to ensure optimal patient outcome. US is an easy and cheap radiological method for diagnosis and it should be the first chosen radiological technique to evaluate median nerve variations in idiopathic CTS patients. more...

The osmotic demyelination syndrome (ODS) has been identified as a complication of the rapid correction of hyponatremia for decades (King and Rosner, 2010). However, in recent years, a variety of other medical conditions have been associated with the development of ODS, independent of changes in serum sodium which cause a rapid changes in osmolality of the interstitial (extracellular) compartment of the brain leading to dehydration of energy-depleted cells with subsequent axonal damage that occurs in characteristic areas (King and Rosner, 2010). Slow correction of the serum sodium concentration and additional administration of corticosteroids seems to be a major prevention step in ODS patients. In the current report we aimed to share a rare case which we observed in our clinic. more...

The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.Bu çalışmanın amacı batında perfüzyon bilgisayarlı tomografi (BT) uygulama spektrumuna çağdaş bir yaklaşım sağlamaktır. Yeni görüntüleme teknikleri sadece organların yapısını değerlendirmek için değil aynı zamanda farklı organların fonksiyonel analizlerini yapmak için de geliştirildi. Son zamanlarda, geliştirilen bu cihazlar arasında perfüzyon BT abdominal organların ve hastalıkların değerlendirilmesinde bu gibi görüntüleme modalitelerinin uygulanabilirliğinde çoğu araştırmacının ilgisini çekti. Perfüzyon BT tümörün vasküler fizyolojisini tanımlama olanağı sağlar. O non-invazivdir ve onun uygulaması ve analizi kolaydır. Dahası, O tümör ilişkili anjiogenezin more...

Paraesophageal hiatal hernia is an uncommon condition that requires urgent correction to prevent life-threatening complications. It is present in 14% of all hiatal hernias. The incidence of Morgagni hernia among all diaphragmatic defects is 3-4% and about 90% of the hernias occur on the right, 8% are bilateral and 2% are on the left. The combination of a Morgagni hernia and paraesophageal hernia is very rare and only four cases have been reported in the literature. All of them occurred in the right. This report describes an old case admitted to our clinic with dyspnea, chest pain and chronic gastrointestinal symptoms, found to have combined left Morgagni and paraesophageal hernia. Surgical repair was performed via transabdominal approach. This unusual case and surgical approaches are discussed in light of the data presented in the literature. more...

OBJECTIVE A link between uric acid levels and cardiovascular diseases has been previously reported. Coronary artery calcium score (CACS) is a marker of atherosclerotic disease and a predictor of cardiovascular events. We sought to determine if serum uric acid level is an independent risk factor for the presence of calcium in coronary arteries. METHODS Four hundred and forty-two patients who were evaluated in the cardiology outpatient clinic for suspected coronary heart disease with a low-moderate risk for coronary artery disease were included in this observational case-controlled study. Serum uric acid levels were measured with colorimetric methods. CACS were performed using a 64-slice CT scanner. Patients were divided to 3 groups according to their CACS value (Group 1: CACS=0, Group 2: CACS 1-100, Group 3: CACS>100). RESULTS The demographical characteristics and laboratory findings of 3 groups were similar, except age, fasting glucose levels and serum uric acid levels. Serum uric acid levels were found to increase significantly with increasing CACS (p=0.001). Patients were grouped according to presence CAC (CACS=0 and CACS≥1) and in the multiple regression analysis, age (OR, 1.11, 95% CI, 1.07-1.16), smoking (OR, 3.83, 95% CI, 2.06-7.09), serum uric acid levels (OR, 1.26, 95% CI, 1.04-1.54) and average 10-year total risk of Framingham risk score (OR, 1.13, 95% CI, 1.04-1.09) appeared as independent factors predictive of presence of CAC (p more...

The purpose of this study was to evaluate the native coronary artery (CA), coronary atherosclerotic plaque, coronary by-pass grafts and coronary stents with 128-slice CT, comparison of findings with literature and technical optimization. In one hundred fifty patients who had undergone coronary computerized tomography angiography using 128-slice CT (CCTA), CAs were examined in terms of visibility, atherosclerotic plaque characteristics, by-pass graft and stent patency. In each case, CAs were divided into fifteen segments according to the American Heart Association (AHA) classification and then evaluated. Out of one hundred and fifty (150) cases, 2250 CA segments were examined according to AHA classification. A total of 1045 segments below 2 mm were examined for visibility. Fifty segments could not be visualized. Soft plaques were observed in 97 cases (4 cases with calcium load = 0). Atherosclerotic plaques were observed in 450 segments. By-pass grafts were observed in ten cases while 28 stents were observed in fifteen cases. In cases with by-pass graft, artifacts due to clips did not hinder the examination. In conjunction with technological advances, CAs can be non-invasively examined using new generation multi-dimensional computerized tomography. Clips artifacts in coronary stents and by-pass grafts do not hinder CA examination due to high spatial and temporal resolution of MDCT devices. more...

Congenital short colon, more commonly known as pouch colon, is a rare anomaly that can be encountered with anorectal malformations (ARM). The colon is shorter than normal and the distal end is dilated like a pouch. We report the case of a newborn with a Type 2 pouch colon. A female newborn was brought to our clinic with a diagnosis of cloaca anomaly. Her physical examination revealed a single canal introitus and flat perineum. In the abdominal x-ray taken in the upright position, a prominent air sac was noticed at the left side. A laparotomy was performed and exploration demonstrated that the colon was like a pouch. The pouch terminated in the upper part of the vagina with a wide canal. A genitogram displayed the presence of double uteri and double vaginas. One month after the operation we performed a cystoscopy, which showed the urethral meatus to be more proximal than normal (female type hypospadias). When the patient was 8 months old she was re-operated and anterior-abdomino-posterior sagittal anorectoplasty plus tube coloplasty were performed. She is now 4 years old and has a stool discharge of 2-3 times a day. Her physical and psychosocial development is in concordance with her age. Congenital pouch colon is a very rare anomaly, which has to be considered especially during the clinical evaluation of children with cloacal malformations and high type anorectal anomalies. more...

The exact mechanisms behind the association between atherosclerosis and gamma-glutamyltransferase (GGT) are unclear. Coronary artery calcification (CAC) detected by computerized tomography is an important marker of atherosclerosis and its severity correlates with coronary plaque burden. The aim of this study was to investigate if serum GGT levels are associated with CAC in patients without known coronary heart disease (CHD) who had low-intermediate risk for CHD.Two hundred and seventy two patients who had low-intermediate risk for coronary artery disease were included in the study. Serum GGT levels were measured spectrophotometrically. CACS (Agatston method) were performed using a 64-slice computerized tomography scanner. The patients were grouped according to their GGT values in four quartiles.Patients in higher GGT quartiles had elevated CAC score (P0.001). Patients in higher GGT quartiles were predominantly males (P0.001) and were more likely to be smoking (P=0.004), and have elevated uric acid (P0.001), fasting blood glucose (P0.001), CRP levels (P=0.003) and 10-year total cardiovascular risk (P=0.007) and low HDL levels (P0.001). Positive correlations were found between log GGT and CAC (r=0.233, P0.001). In the multivariate analysis GGT, age, smoking and serum uric acid levels appeared as independent factors predictive of presence of CAC.We demonstrated a significant correlation between serum GGT levels and CAC and CHD risk factors. Serum GGT level was an independent marker of CAC. more...

Objectives ACC/AHA/ESC guidelines recommend sublingual nitroglycerin (SNG) in patients with stable angina pectoris and coronary artery disease (CAD). However, the shelf life of SNG following first use is six months for SNG tablets and two years for SNG sprays. We investigated the frequency of prescription of SNG tablets/sprays in patients having anginal symptoms and documented CAD and the awareness levels of patients about appropriate use of SNG. Study design Three hundred patients (201 men, 99 women; mean age 61.7±10.8 years) with documented CAD and angina were enrolled into this study. Angina pectoris was categorized according to the functional classification system of the Canadian Cardiovascular Society. Data on cardiovascular past histories, risk factors, medications, and the use of SNG were recorded. Results At least one risk factor was present in 96% of the patients. Only 46% of the patients had a prescription for SNG. Of those with a prescription of SNG tablet and spray, 91.8% and 84.4% did not know the shelf life of the product, respectively. Of those who were routinely carrying SNG, 35.6% had an expired product. Of those with a prescription of SNG, only 65.9% were informed by the physician on the proper use of SNG. Conclusion Our results show that, despite recommendations of the guidelines, SNG is not prescribed to a substantial percentage of patients with CAD and angina, a considerable fraction of patients carry an expired product, and that patients are not adequately informed by the physicians on the use of SNG. These problems will certainly affect the optimal medical management of CAD and its efficacy. more...

Objective Behcet disease is a systemic disease with protean manifestations. Vasculitis is a hallmark of the disease and may involve arteries, veins, and capillaries. Varicocele is dilatation of the pampiniform plexus veins. We aimed to investigate the incidence of varicocele in patients with Behcet disease. Methods The study included 47 male patients with Behcet disease and 31 healthy control participants. All underwent a clinical evaluation including a medical history and systemic and scrotal examinations. Subsequently, 2 investigators blinded to the clinical data performed sonographic examinations and measured pampiniform plexus vein diameters. Results The mean age of the patients ± SD was 23.4 ± 3.2 years; disease durations ranged from 3 to 120 months (46 ± 31 months). Scrotal pain or a palpable mass was detected by clinical examination in 24 patients with Behcet disease (51.1%) and 5 healthy participants (16.1%; P = .002). By color Doppler examination, left varicocele was diagnosed in 26 patients with Behcet disease (55.3%) and 9 healthy participants (29%; P = .02). All patients with right varicocele also had left varicocele; that condition was detected in 10.6% (5 patients) of the Behcet disease group and 6.4% (2 patients) of the control group (P > .05). Eight patients with Behcet disease (17%) had epididymitis, whereas none of the healthy participants did (P = .019, Fisher exact test). Genital ulcers and erythema nodosum lesions were more common among patients with varicocele (P = .034 and .058, respectively). There were no differences in smoking, epididymitis, arthritis, uveitis, or other clinical parameters for distinguishing varicocele in patients with Behcet disease. Conclusions The incidence of varicocele was increased in Behcet disease. Whether varicocele confers fertility problems in patients with Behcet disease and the underlying mechanism for a possible association are yet to be determined. more...

Background. Polycystic ovary syndrome (PCOS) is independently associated with the major cardiovascular risk factors. The aim of this study was to examine the echocardiographic profiles of patients with PCOS using conventional echocardiographic methods and tissue Doppler imaging.Methods. For this study, we have registered 48 women with PCOS and 21 healthy control subjects who were mathced with respect to age and body mass index. Standard two-dimensional and M-mode measurement, transmitral valve flows and tissue Doppler imaging of mitral and tricuspid anulus were recorded.Results. In PCOS and control groups, left ventricular and atrium diameters, ejection fraction, mitral E/A ratio, deceleration time and isovolumic relaxation time were similar. There were no significant differences between patients with PCOS and control subjects with respect to tissue Doppler profiles.Conclusion. Patients with PCOS execute echocardiographic measures of cardiac function that are similar to those of healthy women. more...

In Behcet’s disease, deep venous thrombosis occurs primarily in the lower extremities. Total recanalization rate is low, so thrombotic segment could be detected by imaging afterward. For disclosing vein involvement, leg swelling is commonly queried in the history taking in those patients. However, there are no data about the presence of “silent” thrombosis in patients with BD. We aimed at investigating the integrity of venous vessels in BD, without any known vascular event by using Doppler ultrasonography (DU). Patients having past events revealed in the vascular questionnaire or physical findings attributable to vascular disease were excluded. Various degree of venous insufficiency was detected in 74 patients in BD (74%), 24 out of 33 patients (72%) in AS and in 8 out of 34 (25%) in HC group. All were at the lower extremities, and there is no difference in the frequency between BD and AS, while both were significantly higher than in HC (P = 0.001, and 0.004, respectively). Six patients with BD (6%) have chronic venous thrombi at the lower extremities and none in either AS and HC. As a non-invasive method, DU of lower extremities may disclose “silent” thrombosis. Venous insufficiency in those patients should be considered cautiously as an indicator of vein involvement. more...

The purpose of our study was to research the applicability of measuring serum pepsinogen I (PG I) and PG I/pepsinogen II (PG II) ratios as screening tests for atrophic gastritis, which is the most important predisposition for stomach cancer.We measured serum pepsinogen levels in non-specific gastritis, atrophic gastritis and gastric cancer using a radioimmunoassay method. We included in this study 30 healthy control, 30 nonspecific gastritis, 30 atrophic gastritis and 50 gastric cancer cases.The serum PG I level was statistically higher in the control group and in the patient group with chronic nonspecific gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p0.05). The best cutoff values for diagnosing stomach cancer using serum PG I and PG I / PG II ratios were found to be25 ng/ml for PG I and3.0 for PG I / PG II. The same cut-off values were also most effective for the patients with atrophic gastritis.Serum pepsinogen screening was shown to be a practical predictor of stomach cancer and atrophic gastritis, the most important predisposing lesion for stomach cancer. Although the diagnosis of stomach cancers localized in the pylorus and cardia via this method is difficult, we believe that the detection of early-stage cancers that develop following chronic atrophic gastritis in particular will be possible, and therefore the morbidity and mortality of stomach cancer will be decreased.Bu çalışmada amacımız serum pepsinojen I (PG I) ve PG I / pepsinojen II (PG II) düzeylerinin mide kanseri ve onun en önemli predispozan faktörü olan atrofik gastrit ile ilişkisini incelemekti.Çalışmamızda sağlıklı kontrol 30, nonspesifik gastritli 30, atrofik gastritli 30 ve mide kanserli 50 hastada serum pepsinojen düzeylerini radioimmunoassay yöntemi ile ölçtük.Çalışmamızın sonucunda serum PG I düzeyleri atrofik gastrit ve mide kanserli olgularda sağlıklı kontrollere göre düşük bulduk. Mide kanseri ve atrofik gastrit tanısı için kullanılabilecek en iyi sınır değerler PG I için25 ng/ml, PG I / II için3.0 olarak tespit ettik.Serum pepsinojen taramasının, mide kanserinin en önemli predispoze lezyonu olan atrofik gastrit ve mide kanserinin pratik bir göstergesi olduğu gösterildi. Her ne kadar pilor ve kardiyada lokalize mide kanserlerinin tanısı bu yöntemle zor olsa dahi, özellikle atrofik gastriti izleyen mide kanserlerinin erken dönemde tespiti mümkün olabilecektir ve böylece mide kanserlerinin mortalite ve morbiditesinin azaltacağını düşünmekteyiz. more...

This study aimed to investigate the apoptotic mechanisms, oxidative stress, and mechanisms of effect of antibiotics and ursodeoxycholic acid (UDCA) in total parenteral nutrition (TPN)-associated liver injury.Four groups of young rabbits were used in the study as follows: Group 1 (n: 7): TPN + Metronidazole (30 mg/kg IV) + Gentamicin (6 mg/kg IV); Group 2 (n: 7): TPN + UDCA (15 mg/kg per oral); Group 3 (n: 6): TPN only; and Group 4 (n: 7): Control group. After 10 days, the animals were killed and livers were removed. Hepatic apoptosis, apoptotic proteins, malondialdehyde (MDA) and myeloperoxidase (MPO) levels were studied in liver, and direct bilirubin values were assessed in the blood samples.Direct bilirubin increased with TPN, and antibiotic combination, as the most effective group, significantly lowered its levels (p0.01). MDA values also showed significant differences in comparisons between G1 and G3 (p0.05) and G1-G4 (p0.01). An increased number of apoptotic cells was detected particularly in G2 and G3, whereas the lowest levels, other than in the control group, were found in G1. All TUNEL-positive cell number data were statistically significant except between G2 and G3(p0.05). Caspase-3 and Bax immunoreactivities were greatest in G2. Significant differences were shown in caspase-3 immunoreactivity between the groups (p0.01), except between G1 and G3 (p0.05). All comparisons between the groups were significant for Bax (p0.01). In contrast, Bcl-2 immunoreactivity was moderate and highest in G1: comparisons between G1 and the other groups demonstrated statistically significant differences (p0.01). Fas-L immunoreactivity was greatest in G2, and all comparisons between the groups were statistically significant (p0.01).Metronidazole and gentamicin combination is effective on TPN-induced liver injury by the Bcl-2 anti-apoptotic pathway, total anti-apoptotic effect and by decreasing bilirubin levels. Oxidative injury in the liver increased with therapy. UDCA seems less effective on TPN-associated liver injury. more...

The Eocene marine sequence in the southern part of the Thrace Basin (NW Turkey) involves a variety of platform and deep-marine olistostromal units, the stratigraphy of which have been vigorously debated in the past. A detailed analysis of larger foraminifera in these either foraminifera or foraminifera-coral-coralline algae-dominated platform and associated comparatively deeper-marine units permits us to establish a high-resolution biostratigraphy in the context of shallow benthic zonation (with SBZ zones) of Tethyan Paleogene. The oldest zone (SBZ 5, corresponding to the basal Ypresian) was observed only in olistoliths. An old erosional remnant of a transgressive shallow-marine to basinal sequence (Dişbudak series; late Ypresian−? middle Eocene) was recognized below the regionally most widespread carbonate platform unit, the Soğucak Formation. The Dişbudak sequence, previously considered to belong to the Soğucak Formation and formally introduced recently, contains larger foraminifera, such as orthophragmines, nummulitids and alveolinids in its shallow-marine package referred to SBZ 10 (late Ypresian). The Soğucak Formation, which often exhibits patch reef developments, contains a rich and diverse assemblage of orthophragmines (Discocyclina, Orbitoclypeus and Asterocyclina), nummulitids (reticulate and other Nummulites, Assilina, Operculina, Heterostegina and Spiroclypeus), and other benthic taxa (Silvestriella, Pellatispira, Chapmanina, Orbitolina, Linderina, Gyroidinella, Fabiania, Halkyardia, Eoannularia, Sphaerogypsina, Asterigerina, Planorbulina and Peneroplis). Their assemblages, referred to SBZ 15/16, 17, 18, 19 and 20 Zones, provide a precise tool for recording the history of marine events which resulted in the deposition of the Soğucak Formation during four main periods. Their spatial distribution, recorded as late Lutetian, early Bartonian, late Bartonian and Priabonian, suggests a marine transgression from WSW to ENE. The Çengelli flysch sequence overlying the Soğucak Formation in a limited area to the east of the Gelibolu Peninsula, contains benthic foraminifera, mainly from limestone olistoliths mostly derived from the Soğucak Formation, and also in the turbiditic strata. The assemblages in the olistoliths reveal the existence of various shallow marine limestone sequences ranging in age from late Bartonian to early Priabonian. more...

Behcet’s disease is a systemic disease characterized by oral aphthosis, genital ulcers, ocular lesions, gastrointestinal, musculoskeletal, neurological and major vessel involvement. Arterial involvement, aneurysms and arterial thrombosis have been reported in 1.5–3% of patients. In this case report, we present a patient with ulnar arterial aneurysm associated with Behcet’s disease. more...

To observe early renal parenchymal cellular changes in an experimental model of vesico-ureteral reflux (VUR) and to show whether the apoptotic pathway plays a role in these cellular changes.Fourteen New Zealand breed rabbits were used and were divided into two equal groups (control and experimental groups). Urine samples were obtained in a sterile manner and cultured. In the study group, reflux was created in the right kidneys surgically. Renal scintigraphy and voiding cystourethrography (VCUG) were performed in both groups on Day 17. The kidneys were examined in terms of histology, apoptotic activity and caspase activity.No growth was observed in urine cultures in either group. VUR was manifested in only two rabbits in the experimental group on VCUG. On renal scintigraphy, no renal scarring was observed in either of the groups and renal uptake values were in the normal range. There was a greater increase in collagen in the right kidneys in the experimental group than in the control group and apoptotic activity was significantly increased in the study group: 0% in the control group, 10.8%+/-0.7% in the experimental group (p0.001). Caspase-6 activity was strongly positive and caspase-8 and -9 activities were moderately positive in the right kidneys of the experimental group. Caspase-6 activity was moderately positive, and caspase-8 and -9 activities were weakly positive in the contralateral kidneys of the experimental group. Caspase activities in the control group were negative (p0.001).In this experimental model of VUR, apoptotic activity was initiated via the caspase-8 and -9 pathway and collagen tissue increased in the renal parenchyma where reflux occurred. The balance of apoptotic activity may play a key role in the occurrence of reflux nephropathy. more...

A wandering spleen is a rare anomaly and its association with omphalocele has been reported in the literature only once. We present a female infant that has a wandering spleen associated with omphalocele. The patient was admitted with the diagnosis of omphalocele. Primary repair was performed and the patient was discharged on the 6th postoperative day. Nine months later, the girl was referred to our emergency unit with complaints about abdominal distention and restlessness. After 2 days of clinical observation, an immobile, firm abdominal mass was palpated. Ultrasonographic evaluation revealed that the mass was the spleen and it was found exactly under the left side of the umbilicus, instead of its original location. During the operation, the spleen was beneath the left side of the umbilicus, with its upper surface completely adhered to the peritoneum, and it was rotated 180° clockwise. Then the spleen was rotated back and placed in its normal anatomic location. At 1 month postoperatively, a radionuclide scan was performed and splenic perfusion was evaluated to be normal. In conclusion, herniations and eventrations of organs through defects on the abdominal wall may either result in restriction of normal rotations of the stomach and the spleen or in inefficient fusion after the rotation has been completed. more...

Bu calismada, reel doviz kuruyla ihracat ve ithalat arasindaki iliskiler, 1990:1–2004:6 donemi icin aylik veriler kullanilarak VAR modeli yardimiyla arastirilmistir. Bulgular Granger nedensellik, varyans ayrimlastirma ve etki-tepki fonksiyonlarindan hareketle yorumlanmistir. Granger nedensellik sinamasina gore, Ithalat ve ihracat arasinda karsilikli bir nedensellik iliskisi vardir. Varyans ayrimlastirma ve etki-tepki fonksiyonlarina ait bulgular, reel kurdaki herhangi bir degismenin dis ticaret dengesi uzerinde anlamli bir etki yapmadigini gostermistir. Sonuclar, reel doviz kurunun dis ticaret dengesini saglamada etkin bir sekilde kullanilamayacagini gostermistir. Ayrica, ithalattan ihracata yonelik kuvvetli nedensellik iliskisi, Turkiye ornekleminde, ithalat kisitlamalarinin ihracati olumsuz yonde etkileyecegini gostermistir. Sonuc olarak, Turkiye icin ornek doneminde J Egrisi etkisi gecerli degildir. more...

Politik istikrarsizlik ve yolsuzluk arasindaki iliskiyi tespit etmeyi amaclayan bu calismada 1995–2013 doneminde 31’i az gelismis, 91’i gelismekte olan ve 51’i gelismis olmak uzere toplam 173 ulke icin panel veri analizleri kullanilmistir. Pedroni, Kao ve Johansen-Fisher panel es-butunlesme testi sonuclarina gore politik istikrarsizlik ve yolsuzluk arasinda uzun donemli iliski tespit edilmistir. Ayrica Granger nedensellik analizi bulgulari ise politik istikrarsizligin, yolsuzlugun nedeni oldugunu gostermistir. Sabit etkili model tahmin sonuclarina gore politik istikrarsizlikta meydana gelecek %1’lik bir artis, yolsuzlukta %0,0603’luk bir azalma meydana getirmektedir. Dolayisiyla, 1995-2013 doneminde ele alinan 173 ulkede politik istikrarsizliktaki artisin yolsuzlugu arttirdigi sonucuna varilmistir more...

Bu makale bolgesel enflasyon ve bolgesel ekonomik buyume arasindaki iliskiyi arastirir. Calismada bolgesel enflasyon ve bolgesel buyume degiskenleri kullanilmistir. Calisma 1983–2001 donemine ait yedi cografi bolgeyi kapsamaktadir. Uygulama bulgularini elde etmek icin hem zaman serisi hem de panel veri analizleri kullanilmistir. Calismada ozellikle 1990’li yillarin sonlarina dogru kullanilmaya baslanan panel veri birim kok, es-butunlesme ve nedensellik testlerine de yer verilmistir. Zaman serisi analizleri sonucunda Marmara Bolgesi disindaki bolgelerde enflasyonun buyumeyi negatif ve istatistiksel olarak anlamli bir sekilde etkiledigi gorulmustur. Panel veri analizlerde ise enflasyon ve buyume arasinda es-butunlesme ve nedensellik bulunmus ve enflasyonun buyumeyi negatif ve istatistiksel olarak anlamli bir sekilde etkiledigi gorulmustur. more...

During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate (Seprafilm; Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed; JohnsonJohnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection.In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm, and in group 2 with Interceed. But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination.When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p=0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p=0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus.Seprafilm and Interceed had no effect on esophagus dissection. Although Seprafilm had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa. more...