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Aim: This study was planned to determine cut-off values of the Tinetti Performance Oriented Mobility Assessment (POMA) and the Self-Assessment Fall Risk Questionnaire (FRQ) in older adults with mild cognitive impairment.Material and Methods: This study included a total of 213 individuals aged 65 years and over in the study. These individuals were divided into two groups according to Mini Mental Test (MMT) scores: 116 individuals with an MMT score of 18-23 (mild cognitive impairment) and 97 individuals with an MMT score of 24 or more (normal cognitive function). Balance and gait performance was assessed by the POMA, the fall risk self-assessment by older adult susing a FRQ.Results: In Older Adults with mild cognitive function, the clinical cut-off points for the POMA and FRQ were determined according to ROC curve analysis. The clinical cut-off point for the POMA was determined as 15.5 points; and 15.5 points or more in the POMA were considered normal with a 95% confidence level. The clinical cut-off point for the FRQ was determined as 4.5 points; and 4.5 points or less in the FRQ were considered normal with a 95% confidence level.Conclusions: We think that it is important to take the values obtained in the present study into account in interpreting the above-mentioned commonly used tests when cognitive status is considered related to falling. Therefore, it is suggested that these tests used in the clinic should be examined considering the risk of falling in older adults with mild cognitive function.

Aim: The aim of this study was to investigate the relationship and difference between balance, physical fitness and the quality of lifein retired people living in different geographical regions of Turkey.Material and Methods: For balance evaluation Berg Balance Scale, for physical fitness evaluation Senior Fitness Test (Chair StandTest, Arm Curl Test, 2-Minute Step Test, Chair Sit-and-Reach Test, Back Scratch Test and 8-foot Up-and-Go Test) for quality of lifeevaluation Short Form (36) Health Survey were administered to 155 retired individuals from seven geographical regions of Turkey(Antalya, Gaziantep, Elazığ, Eskişehir, İstanbul, İzmir, Samsun) For statistical analysis, one-way analysis of variance and Spearman’scorrelation analysis were used.Results: A total of 155 individuals aged between 55 and over were included in the study. The mean age of the individuals was64.235.86 years. The results of Berg Balance Scale showed statistically significant differences (p0.05) both between balancescore and 8-foot Up-and-Go Test scores in Eskişehir and between the balance score and the results of the Arm Curl Test in Antalya(p0.05). There were no significant differences between regions in the results of the SF-36 assessment of quality of life. A significantpositive correlation between Berg Balance Scale score and the scores of Chair Stand, Arm Curl and 2-Minute Step Tests was recorded.Furthermore, Berg Balance Score and 8-foot Up-and-Go score were found to present a negative correlation.Conclusion: Aging and differences between geographic regions in which individuals live cause deterioration in balance and thissituation effects physical fitness. Although participants had different lifestyles, the fact that our evaluation indicated a lack ofdifference in the quality of life assessment results was pleasing.

Günümüzde ciddi bir küresel sorun haline gelen yasadışı maddelerin kullanımının izlenmesinde insan biyolojik materyalleri yanında son yıllarda su tabanlı (yüzey, atık su vb.) yapılan çalışmalar avantajları nedeniyle büyük önem kazanmaktadır. Su tabanlı yapılan çalışmalar; toplumda suistimal edilen, bağımlılık yapabilen maddelerin ve kullanımı ile oluşan metabolitlerinin, düzeylerinin ve türünün gerçekçi, tekrarlanabilir, nesnel olarak tespit edilebilmesine olanak sağlamaktadır. İzmir Küçük Menderes Nehri'nden belirlenen koordinatlardan alınan yüzey suyu örneklerinde yasadışı maddeler ve metabolitlerinden morfin, kokain, benzoilekgonin, 3,4-metilenedioksi-N-metilamfetamin (MDMA), esrar, amfetamin, 11-nor-Δ9-Tetrahydrocannabinol-9 karboksilik asit (THC-COOH) ve psikoaktif etki gösteren kodeinin tespitine yönelik kromatografik yöntem geliştirilmesi amaçlanmıştır. Ege Bölgesi'nin en verimli havzalarından biri olan Küçük Menderes Nehri etrafındaki Bayındır, Beydağ, Kiraz, Ödemiş, Selçuk, Tire ve Torbalı ilçelerinde yapılan tarım faaliyetlerine bakıldığında, bu bölgede yapılan tarımın Türkiye ortalamasının üzerinde olduğu görülmektedir. Bu çalışmada önemli bir bölgede sulama kaynağı olarak kullanılan İzmir Küçük Menderes Nehri'nden alınan yüzey sularında yasadışı maddelerin tespiti ve tanımlanması için yöntem geliştirilmiştir. Analitler bir katı faz ektraksiyonu (SPE) sorbenti kullanılarak konsantre edilip kromatografik sistemde analizlenmiştir. En yaygın kullanılan analitik yöntemlerin başında gelen son kromatografisi-kütle spektrometresi (LC-MS/MS) yöntemlerinin kullanımı son yıllarda hızla artmaktadır. Ekstraksiyon ve cihaz performansını etkileyen adımlar optimize edilerek valide edilen yöntem ile yüzey suyu örneklerinde suistimal edilen hedef maddeler analiz edilmiştir. Kalibrasyon çalışma lineer aralığımız 10-500 µg/L arası 6 noktalı olup R2 değerleri sırarıyla morfin için 0,9972, morfin-d3 0,9965, kodein 0,9957, amfetamin 0,9977, MDMA 0,9979, MDMA-d5 0,9954, benzoilekgonin 0,9989, benzoilekgonin-d3 0,9999, kokain 0,9963, THC-COOH 0,9976 olarak bulunmuştur. Bu yöntemin ortalama bağıl standart sapma (%RSD) değerleri 25 µg/L ve 100 µg/L konsantrasyonlar için sırasıyla amfetamin 3,95 ve 4,10, benzoilekgonin 2,79 ve 3,67, kodein 8,16 ve 5,81, kokain 11,99 ve 5,29, MDMA 8,9 ve 2,99, morfin 14,41 ve 7,39, THC-COOH 2,19 ve 6,18 olarak hesaplanmıştır. Bağıl standart sapmasının düşük olması gün içi ve günler arası değişimlerde sapmanın büyük değişiklikler göstermemesi, metodun güvenilirliğini ortaya koymaktadır. Yüzey suyu örnekleri alınan bölgelerde aldığımız tarihlerde validasyonu yapılan maddelere ilişkin tayin limitimiz 25 µg/L olup bu konsantrasyonun üzerinde herhangi bir sonuca ulaşılamamıştır. Ancak kromatografik sistemde LOQ değerimizin altında olsa da tespit limitimiz olan LOD değerlerimizin üzerinde kokain için 5 µg/L, benzoilekgonin için 7 µg/L, amfetamin için 9 µg/L seviyelerinde sonuçlar gözlenmiştir. Tez çalışmasında geliştirilen yöntemle bilgimiz dâhilinde İzmir Bölgesi nehir sularında ilk kez yasadışı madde analizi yapılmıştır. Bölgeye ait elde edilen verilerle; ulusal yasadışı madde ile mücadele politikaları için gerekli yasal ve sosyal tedbirlerin alınmasına katkı sağlanması hedeflenmektedir., Nowadays, water based (surface, wastewater, etc.) studies have been come into prominence for illicit substances monitoring, which have become a serious global problem, besides human biological materials. Water based studies provide realistic, reproducible, objective determination of the abused, addictive substances and their metabolites, levels and species. The aim of this study is to develop a chromatographic method for the detection of morphine, cocaine, benzoylegononine, 3,4-methylenedioxy-N-methylamphetamine (MDMA), cannabis, amphetamine, 11-nor-Δ9-tetrahydrocannabinol-9 carboxylic acid (THC-COOH) and codeine which has a psychoactive effect in surface waters samples taken from İzmir Küçük Menderes River. Aegean Region, which is one of the most prolific basin flourishing around Küçük Menderes River, Beydağ, Kirazlı, Ödemiş, Selçuk and Torbalı. The structures of agricultural activities in this area seem to be above the average in Turkey. In this study, a method has been developed for the identification and detection of illegal substances in surface waters taken from İzmir Küçük Menderes River, which is used as an irrigation source in an important region. The analytes were concentrated using a solid phase extraction (SPE) method and analyzed in the chromatographic system. The use of liquid chromatography tandem mass spectrometry (LC-MS/MS) methods, one of the most widely used analytical methods, has recently increased rapidly. Abused target substances in the surface water samples were analyzed with the method which was validated by optimizing the steps affecting the performance of the extraction and device. Calibration range is between 10-500 µg/L and R2 values are respectively 0,9972 for morphine, morphine-d3 0,9965, codeine 0,9957, amphetamine 0,9977, MDMA 0,9979, MDMA-d5 0, 9954, benzoylecgonine 0,9989, benzoylecgonine-d3 0.9999, cocaine 0,9963, THC-COOH 0,9976. The mean relative standard deviation (RSD) respectively for concentrations of 25 µg/L and 100 µg/L values of this method was calculated as; amphetamines 3,95 and 4,10, benzoylegononine 2,79 and 3,67, codeine 8,16 and 5,81, L. cocaine 11,99 and 5,29, MDMA 8,9 and 2,99, morphine 14,41 and 7,39, THC-COOH 2,19 and 6,19. The relative standard deviation is low and the deviation does not show great changes in the intraday and day shifts, indicating the reliability of the method. In the regions where surface water samples were taken, our determination limit for the substances that were validated was 25 µg/L and no result was reached above this concentration. However, the results were below our LOQ, above our detection limit and we observed 5 µg/L for cocaine, 7 µg/L for benzoylecgonine and 9 µg/L for amphetamine. In this study, illegal substance analysis was performed for the first time in the river waters of Izmir Region. It is aimed to contribute to taking necessary legal and social measures for the fight against national illicit substances with the data obtained from the region.

Aim: An increase in the elderly population owing to an extended average life expectancy leads to an increase in the geriatric patient admissions to the emergency departments (EDs). The aim of this study was to investigate the intensity of geriatric patients among all admissions to the emergency department and to determine the importance of these patients in hospitalizations from the EDs.Material and Methods: Geriatric patients aged over 65 years were retrospectively evaluated between 1 January 2017and 31 December 2018. The patients were divided into two groups by the age: 65–79 (group I) and ≥80 years (group II). The number of days of hospitalization and mortality in the intensive care units (ICUs) and clinics were examined.Results: Of 386.670 patients aged over 18 years who were admitted to the ED, 17% (n=65.907) were aged ≥65 years. 64.4% of the patients who were hospitalized in the ICU from the ED were aged ≥65 years. The sex distribution of the patients who were admitted to but died in the ED in both the groups was as follows: Of 62.1% (n=72) in Group II were females, and of 62.1% (n=82) in Group I were males.Conclusion: In parallel with the increase in the number of geriatric patients in ED, there is a crowding in both clinics and ICUs. This article highlights the importance of geriatric patients in emergency department admissions and their importance in hospitalizations. Hospitalization and mortality rates increase with age. Keywords: Emergency department; crowding; geriatric patients.

Aim: Congenital heart disease (CHD) is one of the most common congenital anomalies. It is known that early detection of the criticallesions without symtomatic improves the prognosis of patients in the long term. In our study, we aimed to evaluate the efficacy andcost of pulse oximetry screening for detection of CHD in Konya region.Material and Methods: In our study, we analyzed the results of pulse oximetry screening of infants born between 2016 and 2018in Selcuk University and Saglik Bilimleri University Konya Training and Research Hospital. Positive screening test results and theircosts was evaluated.Results: Pulse oximetry was performed on a total of 3440 infants for screening congenital heart disease at two different centers. 2003(58.2%) of the cases were female and 1437 (41.8%) were male. The mean timing of screening was 24.713.1 (4-100) hours (mean SD (min-max). 292 (8.48%) infants were tested positive. Echocardiographic examination was performed in the positive cases. Theprevalence of CHD was found to be 27.6 ‰. The prevalence of critical CHD was 1.16 per 1000 live births. The false-positive screenrate was found to be 197 (5.7%). Among the cases who were screened, the most common CHD was the secundum ASD. The totalcost of probes was 2622 (497.91). The cost of echocardiography for 292 babies was approximately 13181 (2503).Conclusion: Screening for heart disease can be used effectively in the early diagnosis of serious and life-threatening diseasesin newborn and the cost is unneglectable in the early screening of patients. This study, the total cost of each infant screening isapproximately 4.5 (0.85) which appears to be a quite cheap and effective screening compared to the other countries.

It was aimed to investigate the effects of lipoic acid (LA) on 3-nitrotyrosine (3-NT), interleukin-1? (IL-1?), tumor necrosis factor- ? (TNF-?), magnesium and trace elements levels in serum of rats with sepsis. Control group (n=10) received a single dose of saline, lipopolysaccharide (LPS) group ( n=10) was injected a single dose of 20 mg/kg LPS, and LA+LPS (n=10) group was injected a single dose of 20 mg/kg LPS at the end of third day of 10 mg/kg/day LA injection. The serum 3-NT levels were determined by a high performance liquid chromatography. The serum levels of IL-1? and TNF-? were measured by enzyme linked immunosorbent assay. Determination of magnesium and trace element levels were performed by inductively coupled plasma mass spectromet er. 3-NT, IL-1? and TNF-? levels in control and LA+LPS groups were not determined. However, observable levels of these parameters were detected in the LPS group. It was found that manganese levels were positively correlated with IL-1? and TNF-? in LPS group. LA increased the manganese levels, while it decreased magnesium and iron levels in LA+LPS group. Our results show that LA decreases serum levels of 3-NT, IL-1? and TNF-? in rats with sepsis, and it is also effective on trace element levels. Decreased levels of manganese and its association with IL-1? and TNF-? in the LPS group suggest that manganese may be associated with immune response. 2-s2.0-85071254770

Aim: To invastigate the inflammatory process and hormone parameters as a result of underlying cause of unexplained infertility (UI)Metarial and Methods: In total 153 patients with UI who underwent to intracytoplasmic sperm injection (ICSI) were included in the study. The blood hormones levels were obtained on the 2nd or 3rd day of the menstruation. Other blood count examinations were taken on the day of HCG administration. Relationship regarding embryo grade was also investigated.Results: Of those 153 patients, only 42 of them got pregnant. Mean maternal age was 29.08±3.5 and mean duration of the infertility was 8.19±3.1 years, respectively. There was no statistically significant difference between pregnancy rate, embriyo grade, and FSH, progesterone, fT3, fT4, TSH levels (p>0.05). Also no significant difference was found between pregnancy rate, embriyo grade and hemoglobin, hemotocrit, platelet, mean platelet volume, neutrophil, lymphocyte counts, neutrophil lymphocyte ratio and platelet lymphocyte ratio (PLR) (p>0.05). However, a significant difference was found between embriyo grade and estradiol values (p0.05). There was a negative correlation between hematocrit values and the oosit number collected with the number of embryos (p0.05). PLR was found to be 110.9 (63.6 - 313.2) in pregnant women and 110.5 (51.8 - 390) in nonpregnant patients and the correlation between the PRL measured on HCG day and pregnancy rate.was significant (p=0.002). LH median values measured on HCG day were significantly lower in pregnant group (p0.001). Conclusion: We found that inflammation does not affect on IVF result and estradiol levels significantly effects on embriyo quality. Also there was an inverse correlation between hematocrit levels and the number of oocyte- and number of embryos.Keywords: Infertility; blood cell count; inflammation; estrogen.

Aim: Preoperative biliary drainage is suggested for patients with jaundice, considering that surgical operations may increase postoperative complications in the presence of jaundice. The aim of this study was to test the effect of biliary drainage on possible serious complications, deaths, or period of hospital stay.Material and Methods: Between January 2012 and June 2016, 160 patients with operable and resectable periampullary tumors who were diagnosed with periampullary tumors underwent pancreaticoduodenectomy (Whipple’s procedure) in Marmara University Pendik Training and Research Hospital, Department of General Surgery. The patients’ demographics, accompanying comorbid diseases, type of biliary drainage, drainage duration, pre- and post-drainage laboratory data, emerging complications and need for re-hospitalization were recorded retrospectively from the accessible files and records.Results: It was observed that out of 158 patients with periampullary tumors, 116 that were operated with drainage had a higher occurrence of surgical site infections and anastomotic leaks, compared to the 42 patients that were operated without drainage. Similarly, when patient results were classified according to the Clavien-Dindo complication classification, the ratio was again against the patients that were operated with drainage. Drainage patients stayed in the hospital for a longer period; however, in terms of pancreatic fistula, re-hospitalization, need for intensive care and relaparotomy ratios, and especially in terms of mortality ratios, a difference between two patient groups was not observed. Conclusion: Investigating the data collected from patients that were operated without drainage, and specifically considering the bilirubin values of the patients who had complications, there was no threshold identified that contributed to a higher likeliness of complications. Consequently, even though there were no results to motivate recommending drainage, it was concluded that applying drainage does not create any difference in short-term prognosis, but drainage increases infectious complications.Keywords: Periampullary cancer; obstructive jaundice; preoperative biliary drainage; postoperative complication; hyperbilirubinemia.

Aim: The frequency of placenta previa (PP) is increasingly rising due to the increase in caesarean ratio. The aim of this study is to investigate the role of the white blood cell (WBC) in the preoperatively taken complete blood specimen in foreseeing whether hysterectomy will be performed or not in patients with placenta previa totalis.Materials and Methods:Two hundred fifty-seven (257) patients who experienced caesarean due to placenta previa totalis (PPT) in Ondokuz Mayis University between 2010 and 2018 had been surveyed retrospectively. The results of the preoperative Complete Blood Count (CBC) of the Placenta PreviaTotalis (PPT) patients in which either hysterectomy was applied or not, demographic characteristics, other follow-up and treatment results were accessed via system records and file surveys. The primary outcome is the role of preoperative White Blood Cell (WBC) levels in predicting hysterectomy, Results: WBC median values in the pre-operative complete blood specimen of the patients with placenta previa totalis demonstrate difference between the patients with hysterectomy and those without hysterectomy. While the median value was as 9.7 109/L in the patients who could be recovered with treatments apart from hysterectomy, this was obtained as 11.3109/L in the patients in which hysterectomy was applied (p=0.007).Conclusion: Increase in WBC in the pre-operative blood specimen of the patients with diagnosis of Placenta Previa Totalis may be guiding whether hysterectomy will be applied or not.Keywords: Placenta previa; hysterectomy; leukocytosis; caesarean.

Background: Biological control of pathogenic fungi is a possible alternate to the chemical control, which is harmful to humans and environment. Soil-borne Bacillus strains can be potential biocontrol agents and a source of lytic enzymes. Aim: This study aimed to examine biocontrol potential and lytic enzyme activities of a soil isolate Bacillus subtilis Ege-B-1.19. Materials and methods: Strain was identified by biochemical and 16S rRNA gene analysis and its biocontrol activity was investigated against Aspergillus niger EGE-K-213, Aspergillus foetidus EGE-K-211, Aspergillus ochraceus EGE-K-217, Fusarium solani KCTC6328, Rhizoctonia solani KACC40111 and Colletotrichum gloeosporioides KACC40689. Chitinase, chitosanase, N-acetyl-?-hexosaminidase and protease activities of B. subtilis Ege-B-1.19 were also determined. Chitosanase was purified using Sephadex G-150 column and its molecular weight was determined by SDS-PAGE. Chitooligosaccharides production using chitosanase was carried out and analysed by TLC and HPLC. Results: Results depicted that B. subtilis Ege-B-1.19 has shown inhibitory effects against all the test fungi. Chitinase, chitosanase, N-acetyl-?-hexosaminidase and protease activities were determined as 2.7 U mL?1, 7.2 U mL?1, 6.2 U mL?1 and 12.2 U mL?1, respectively. Molecular weight of purified chitosanase was 44 kDa. Chitosanase hydrolysed chitosan to glucosamine (GlcN), dimers (GlcN)2 and trimers (GlcN)3. Conclusion: Bacillus subtilis Ege-B-1.19 can be anticipated as useful biocontrol agent and its chitosanase can be utilized for enzymatic synthesis of chitooligosaccharides., Giriş: Patojenik küflerin biyolojik kontrolü, insanlara ve çevreye zararlı kimyasal kontrole olası bir alternatiftir. Amaç: Bu çalışmada toprak kaynaklı bir izolat olan Bacillus subtilis Ege-B-1.19’un litik enzim ve potansiyel biyokontrol aktivitesinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Suş biyokimyasal ve 16S rRNA gen analizi ile tanımlandı ve Aspergillus niger EGE-K-213, Aspergillus foetidus EGE-K-211, Aspergillus ochraceus EGE-K-217 ve Fusarium solani KCTC6328 Rhizoctonia solani KACC40111 ve Colletotrichum gloeosporioides KACC40689 karşı antifungal aktivitesi araştırıldı. B. Subtilis Ege-B- 1.19’un kitinaz, kitosanaz, n-asetil-?-hekzosaminidaz ve proteaz aktiviteleri de ayrıca belirlenmiştir. Kitosanaz Sephadex G-150 kolonu kullanılarak saflaştırıldı ve molekül ağırlığı SDS-PAGE ile belirlendi. Kitosanaz kullanılarak kitosan-glikozilazların üretimi TLC ve HPLC ile gerçekleştirildi ve analiz edildi. Bulgular: Elde edilen sonuçlar B. subtilis Ege-B-1.19’un tüm test küflerine karşı inhibitör etki gösterdiğini ortaya koymuştur. Kitinaz, kitosanaz, n-asetil-?-hekzosaminidaz ve proteaz aktiviteleri sırasıyla 2,7 U mL?1, 7,2 U mL?1, 6,2 U mL?1 ve 12,2 U mL?1 olarak belirlendi. Saflaştırılmış kitosanazın moleküler ağırlığı 44 kDa idi. Kitosanaz kitosanı glukozamin (GlcN), dimerlere (GlcN)2 and trimerlere (GlcN)3 kadar hidroliz etti. Sonuç: Bacillus subtilis Ege-B-1.19 faydalı bir biyo-kontrol ajanı olarak öngörülebilir ve kitosanaz kitooligosakkaridlerin enzimatik sentezi için kullanılabilir.

Aim: In this prospective study, we aimed to compare the patients scheduled for in vitro fertilization (IVF) with poor ovarian reserve to patients with unexplained infertility in the same age group in terms of sexual dysfunction.Material and Methods: In this prospective study, a total of 146 patients admitted to the IVF center of Ondokuz Mayis University between June 2018 and December 2018 were included in the study. Fourty-eight of these patients had poor ovarian reserve and 98 were scheduled for IVF due to unexplained infertility. In these patients, the female sexual function index (FSFI) scores were calculated for the diagnosis of sexual dysfunction prior to treatment. In addition, ovarian reserve tests such as cyclic follicle stimulating hormone (FSH) and anti mullerian hormone (AMH) at the beginning of the menstrual cycle were recorded.Results: The mean age of the female patients in the study was 30.2+-5 years. The mean FSFI score was 22.36 +-3.31 and 22.44+-3.53 in the group with poor ovarian reserve and with unexplained infertility, respectively. The prevalence of sexual dysfunction (FSFI score 26.55) in the poor ovarian reserve group was 89.6% (n=48) compared to the unexplained infertility group, which was 93.9% (n=98). The analysis of domains revealed no statistically significant difference between the two groups (p=0,356).Conclusion: Sexual dysfunction is frequently observed in patients scheduled for IVF. Our study showed that there was no difference in sexual dysfunction between the two groups. Interestingly, it was revealed that there was a correlation between FSH levels and satisfaction and pain.It was also interesting that the rate of sexual dysfunction was extremely high in both groups.Keywords: Decreased ovarian reserve; sexual dysfunction; unexplained infertility; ovarian reserve.

Aim: The large number and different varieties of cysts and cyst-like lesions around the knee joints are commonly encountered on the magnetic resonance scanning. We aimed to evaluate type, frequency, and size of cystic lesions observed around the knee joints and to find out its relationship with osteoarthritis.Material and Methods: 620 knee joints belonging to 545 patients were enrolled in the study. We retrospectively examined magnetic resonance images of the knee joints which were divided into three groups as non-degenerative, mild degenerative, and severe degenerative. The cysts have been classified according to count, type and size and their relationship with knee osteoarthritis was assessed.Results: Out of 620 knees, 248 knees (40%) had no degenerative arthritis, 178 knees (28.7 %) had mild, and 194 knees had severe (31.3 %) degenerative arthritis. Cystic lesions were identified in 411 knees (66.3%). One cyst in 261 knees, two cysts in 102 knees, three cysts in 40 knees, and four cysts in 8 knees were encountered. Increased number and average diameter of the cysts showed statistically significant relation with the degree of osteoarthritis (p0.001 and p0.04, respectively). Moreover, some types of cysts such as synovial cysts, intraarticular ganglion cysts, and intraosseous cysts were significantly increased with osteoarthritis (p0.001).Conclusion: There was significant increase in frequency, number, and average size of knee joint cysts in patients with degenerative arthritis findings. In addition, almost all cyst types except intrameniscal and parameniscal cysts, were found more frequently in the knees with degenerative arthritis.

Aim: To screen the symptoms of attention deficit and hyperactivity disorder in adult migraine patients. Material and Methods: Our study included 102 migraine patients and 93 sex- and age-matched healthy volunteers. Gender, age, level of education and duration of disease were recorded. We used the adult attention deficit/hyperactivity disorder self-report scale to evaluate the symptoms of adult attention deficit / hyperactivity disorder. In addition, the short form-36 and the hospital anxiety and depression scale were applied to the patients and the healthy controls. Results: The mean scores of attention deficit hyperactivity disorder were significantly higher in migraine patients compared to the control group. There was no significant relationship between the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores and the duration of the disease. There was a negative correlation between the SF-36 health questionnaire scores and the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. There was a positive correlation between the Migraine Disability Assessment scores, the number of migraine attacks and the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. Conclusion: Attention-deficit and hyperactivity symptoms can develop in adult migraine patients and cause psychosocial morbidity and poor quality of life.

Aim: The aim of this retrospective study was to evaluate the possible complications and the complication management of cervical anterior discectomies and fusions in light of the literature.Materials and Methods: The study population consisted of patients who presented to the clinic with neck pain and/or arm pain, loss of strength, and sensory disturbances who were operated on after a lack of response to conservative/medical treatment. This study included 200 cervical discopathy and/or cervical spondylosis cases. The literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‑analyses guidelines without language or country restrictions.Results: The most common complication was dysphagia. The complications also included dural tears, cerebrospinal fluid leakage, graft extrusions, neurological deterioration, postoperative hematomas, and recurrent laryngeal nerve injuries. These were found to be consistent with the literature.Conclusion: In order to minimize the incidence of complications, the preoperative clinical examinations and radiological imaging of each patient should be examined carefully, and the appropriate surgical planning should be performed. It is also important to comply with the rules of asepsis and antisepsis, make sure the surgical time is as short as possible, and perform a dissection based on the patient’s anatomy with the appropriate surgical equipment. In addition, it is important to wash the surgical area frequently, drain the system at the end of the operation, close the tissues in accordance with anatomical integrity, and perform close clinical follow-ups.Keywords: Anterior cervical discectomy and fusion; cervical degenerative disc disease; complications; management of complications.

Aim: Although tumor grade has no impact on endometrial cancer stage, it carries prognostic and therapeutic importance. Surgical management and adjuvant treatment following surgery in certain patients depends on a number of factors including tumor grade. Although grade 3 tumors are included in the high-intermediate risk group, there are data demonstrating that there is a slight difference in survival between patients with grade 1 and 2 tumors in early-stage disease. In this study, we aimed to investigate the association of grade with clinicopathological characteristics, recurrence-free and disease-specific survival in patients treated at our clinic and diagnosed with endometrioid endometrial cancer. Material and Methods: 279 patients with early FIGO Stage endometrioid endometrial cancer treated between 2009-2018 in a University hospital were included in the study. The associations between tumor grade with stage, lymphovascular space invasion (LVSI), myometrial invasion, tumor size, and survival were analyzed. Results: LVSI, ≥50% myometrial invasion, advanced stage and > 2 cm tumor size were significantly higher in grade 3 tumors compared to patients with grade 1 tumors. Recurrence-free and disease-specific survival were significantly lower in patients with grade 2 and 3 tumors compared to patients with grade 1 tumors. In multivariate analysis of RFS and DSS, tumor grade, LVSI and stage were independent prognostic factors. Conclusion: According to this study, grade 2 tumors may not differ significantly from grade 3 tumors in terms of survival. Therefore, due to the potential adverse prognosis associated with grade 2 and 3 tumors, vigilance for recurrence is warranted.

Phosphine gas is a gas that is frequently used as rodenticide and insecticide due to its high diffusion capacity and the absence of residues in agricultural products. Since this gas is highly toxic, it is found in our country as aluminum phosphite tablets impregnated with clay, these tablets emit phosphine gas when they meet with the moisture in the air or gastric hydrochloric acid. Mortality rates in aluminum phosphite intoxications are 40-80% depending on the exposure dose. There is no control mechanism in the supply of aluminum phosphide tablets which are so dangerous and no information is given about the serious conditions that may occur during the use of these tablets. A 2 month old baby, whose family practiced drying pepper-eggplant, was reported to have been exposed to phosphine gas by inhalation, admitted to hospital with vomiting and cyanosis and lost his life within 24 hours. We present our case, who lost his life due to erroneous usage of aluminum phosphite, with additional emphasis on early diagnosis, treatment and gathering sample for toxicologic analysis, with corresponding forensic and medical documents. Fosfin gazı difüzyon kapasitesinin yüksek olmasından ve tarımsal ürünlerde kalıntı bırakmamasından dolayı rodentisit ve insektisit olarak sıklıkla kullanılan bir gazdır. Bu gaz oldukça toksik olduğundan preparat olarak kile emdirilmiş alüminyum fosfit tabletleri olarak ülkemizde bulunmakta, bu tabletler havadaki nem ya da mide de hidroklorik asit ile karşılaştığında fosfin gazı ortaya çıkmaktadır. Maruz kalınan doza bağımlı olarak alüminyum fosfit intoksikasyonlarında mortalite oranları %40-80 olarak belirtilmiştir. Bu kadar tehlikeli olan alüminyum fosfit tabletlerinin temininde ülkemizde herhangi bir kontrol mekanizması olmadığı gibi bu tabletlerin kullanımı sırasında oluşabilecek ciddi durumlar hakkında herhangi bir bilgilendirme de yapılmamaktadır. Ailesi biber-patlıcan kurutuculuğu yapan 2 aylık bebeğin inhalasyon yoluyla fosfin gazına maruz kaldığı, kusma ve morarma şikayetleriyle hastaneye kaldırıldığı ve 24 saat içerisinde hayatını kaybettiği bildirilmiştir. Bilinçsiz kullanılan alüminyum fosfite bağlı gelişen intoksikasyon sonucu hayatını kaybeden olgumuzu erken tanı-tedavinin ve toksikolojik inceleme için örnek alımının önemi vurgulanarak adli ve tıbbi belgeler eşliğinde sunuldu

Limaniçi Sediment Örneklerinde Organokalay Bileşiklerinin SıvıKromatografisi/Kütle Spektrometresi Yöntemi ile AraştırılmasıÖğrencinin Adı: Nihan KöseDanışmanı: Prof. Dr. Türkan YurdunAnabilim Dalı: Farmasötik Toksikoloji Anabilim Dalı1.ÖZETAmaç: Çalışma ile Tuzla limanından alınan sediment örneklerinde organokalay (OT)bileşiklerinin LC-MS/MS ile analiz edilerek, sediment kalitesine ve OT bileşiklerininoluşturduğu kirlilik dağılımına ait kapsamlı veriler elde edilmesi amaçlanmıştır.Gereç ve Yöntem: Tuzla limanındaki benzer özellikteki toplam 29 noktadan sedimentörneği alındı ve örneklerde OT bileşikleri LC-MS/MS ile analiz edildi.Bulgular: Çalışmamızda elde edilen veriler sonucunda Tuzla Liman içi bölgesini temsileden sediment örneklerinde ölçülen fizikokimyasal parametreler ile bütil kalaybileşikleri (MBT, DBT, TBT) verileri arasında istatistiksel olarak anlamlılık bulunmadı.Sediment örneklerinde TBT 0,34-10,83 μg/g aralığında bulundu. En yüksek değerlerTZ-16; 22; 24; 26, ve 28 örnekleme noktaları 9,54; 7,60; 3.91; 10,83, ve 2,34 μg/golarak bulundu. MBT 0,07-5,59 μg/g, DBT 0,04-5,36 μg/g aralığındadır. TPrT, MPhT,TPhT eser miktarlarda bulunurken, DPhT tespit edilemedi.Sonuçlar: Bu çalışma, Tuzla deniz sedimentlerinde OT'lerin belirlenmesi için LCMS/MS analizi ile yapılan ilk çalışmadır. Analiz edilen bazı örneklerde, bütilkalaybileşikleri yüksek seviyelerde bulundu. Bu nedenle, deniz ortamından ekosisteminbozulmasına kadar biyolojik ve kimyasal kirlenmenin izlenmesi gerekmektedir.Anahtar Sözcükler: Sediment, Tribütil kalay, Antifouling boyalar, Toksisite,LCMSMS--------------------Determination of Organotin Compounds in Marine Sediment by LiquidChromatography/ Mass SpectrometryName of the Student: Nihan KöseSupervisor: Prof. Dr. Türkan YurdunDepartment: Department of Pharmaceutical Toxicology2. ABSTRACTPurpose: The aim of this study was to analyze the organotin (OT) compounds in thesediment samples taken from Tuzla marine by Liquid Chromatography/MassSpectrometry (LC-MS/MS) and to obtain comprehensive data on the sediment qualityand pollution distribution of OT compounds.Material and Methods: Sediment samples were collected from 29 similar points inTuzla marine and the OT compounds were analyzed by LC-MS/MS.Results: As a result of the data obtained in our study, no statistically significantdifference was found between physicochemical parameters measured in sedimentsamples representing the Tuzla marine and butyltins (MBT, DBT, TBT). In sedimentsamples, TBT is found in the range of 0,34-10,83 μg/g. The highest values are TZ-16;22; 24; 26, and 28 points 9,54; 7,60; 3.91; 10,83, and 2,34 μg/g respectively. It isobserved that MBT is in the range of 0.07-5.59 μg/g, DBT in the range of 0,04-5,36μg/g. While TPrT, MPhT and TPhT were found trace, DPhT was not detected.Conclusions: This study represents the first application with LC-MS/MS analysis for the determination of OTs in the Tuzla marine sediments. The highest value of butyltins was found in some of the analyzed samples. Therefore, biological and chemical contamination from the degradation of the marine environment to the degradation of the ecosystem needs to be monitored.Key words: Sediment, Tributyltin, Antifouling paints, Toxicity, LCMSMS

Aim: The aim of this study was to investigate the relationship between tinnitus and the factors that cause the tendency to thrombosis in terms of gender.Material and Methods: Fifty-five consecutive patients who admitted to our clinic with the complaint of idiopathic subjective tinnitus were included in this study. Routine ENT (ear nose throat) examinations and pure tone audiometry test were performed. Prothrombin time (PT), partial thromboplastin time (PTT), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, Triglycerides, antithrombin III (AT III), protein C, protein S, homocysteine, antiphospholipid and anticardiolipin antibodies were examined in blood samples of patients. Temporal bone magnetic resonance imaging (MRI) was performed all patients. The results of the patients were compared in terms of gender and age groups (40 age).Results: The study was completed with 47 patients. Twenty-four of the patients were female and 23 were male. Both genders groups were similar in terms of age and pure tone average. Antiphospholipid and anticardiyolipin antibodies (IgG and IgM) were found as negative in all patients. Homocysteine levels were found to be statistically significantly higher in males than females (p=0.015; respectively 13.38±5.98 µmol/L and 9.87±3.11 µmol/L). AT III and Protein S levels were lower in males than females although this difference was not statistically significant (respectively p=0.07 and p=0.08)Conclusion: In this study, an association was shown between hyperhomocysteinemia and tinnitus, especially in males. Keywords: Tinnitus; tinnitus of vascular origin; thrombosis; gender role.

YÖK Tez No: 607532 Klorprifos (KP; O, O-diethyl O-(3,5,6-trikloro- 2-piridinol) fosforotioat) yaygın olarak kullanılan organofosfatlı insektisittir. Organofosfatlar tarım, ormancılık alanında ve evlerde böceklerle mücadelede en sık kullanılan insektisit grubudur. Organofosfatlı bileşikler vücuda cilt, solunum veya oral yolla giriş yaparlar. Vücutta hızlıca dağılarak yağ dokusu başta olmak üzere böbrek dokusunda birikirler. Organofosfatlar etkilerini asetilkolinesterazın (AChE) inhibisyonu üzerinden göstermekle birlikte diğer nörotransmitterleri, enzimleri ve hücre sinyal yollarını da etkileyebilmektedirler. Ayrıca reaktif oksijen türleri (ROS) üretimi ve DNA kırıklarına yol açarak apoptoza neden olabilmektedir. Çalışmanın amacı, klorprifosun olası toksik etkisinin ve antioksidan özellikleri olduğu bilinen kurkumin ve selenyumun insan embriyonik böbrek hücresi olan HEK293 hücre hattında hücre canlılığı ve proliferasyonu üzerine etkilerini araştırmaktır. Sonuçlarımız incelendiğinde klorprifosun HEK293 hücre hattında orta derecede toksik etkiye neden olduğu gözlenmiştir. Antioksidan etkiye sahip selenyum ve kurkumin uygulanmasının ise hücre proliferasyonunu artırabildiği görülmüştür. Chlorpyrifos (CPF; O,O-diethyl O-(3, 5, 6-trichloro- 2-pyridinol) phosphorothioate) is a commonly used organophosphate insecticide. Organophosphates are the most frequently used insecticides in agriculture, forestry and domestic control of insects. Organophosphate compounds enter the body through the skin, respiratory or oral route. These chemicals quickly disperse in the body and accumulate in the kidney and especially in adipose tissue. Organophosphates show their toxic effects through inhibition of AChE but can also affect other neurotransmitters, enzymes, and cell signalling pathways. It may also cause apoptosis by producing reactive oxygen species (ROS) and DNA fracture. Purpose of the study is to investigate the possible toxic effects of chlorpyrifos, and effects of selenium and curcumin, known to have antioxidant properties, on cell viability and proliferation in human embryonic kidney cell HEK293. When our results were examined it was observed that chlorpyrifos has moderately toxic effect on the HEK293 cell line and that the application of selenium and curcumin can increase cell proliferation with their antioxidant effects.

Aim: The aim of this study was to compare the important parameters for life, such as sleep, fatigue and quality of life, between the asymptomatic and schizophrenic individuals.Material and Methods: The study included 38 individuals diagnosed with schizophrenia by the psychiatrist and 39 asymptomatic individuals.All participants of our study applied to the outpatient clinic of Kirikkale High Specialization Hospital, Community Mental Health Center. Sociodemographic information of the individuals was questioned by the evaluation form. Sleep qualities of the individuals were evaluated with Pittsburgh Sleep Quality Index (PSQI), fatigue scores were evaluated with Fatigue Severity Scale (FSS), and quality of life scores were evaluated with World Health Organization Quality of Life Scale Brief Turkish Version (WHOQOL-BREF-TR).Results: A total of 77 individuals aged between 20 and 71 were included in the study. The mean age of the individuals with schizophrenia was 40.07 12.14 years, whereas the mean age of the asymptomatic individuals was 43.61 12.19 years.When the quality of sleep and the sleeping medication use were examined between the two groups, it was found that there was a statistically significant difference (p0.05). When the total scores of the sleep quality questionnaires were evaluated between the two groups, it was detected that there was no statistical difference (p0.05).When the quality of life was evaluated between the two groups, it was seen that the physical and social sub-parameters of the patients with schizophrenia were worse (p0.05).It was detected that there was no statistically significant difference in evaluations of fatigue severity between the two groups (p0.05).Conclusion: It was found that individuals with schizophrenia had a lower quality of life than asymptomatic individuals.We think that the physiotherapy and rehabilitation approaches in addition to medical and psychotherapy should be applied to improve sleep quality and quality of life in individuals with schizophrenia.

Having access to health care services is the most primary of the basic human rights. It is vital that all citizens in a country are able to get these services equally and homogeneously. Despite its importance, providing health services vary from both country to country and between different provinces or states in country. Similarly, it may cause severe disparities and negative effects between individuals in the society. The primary concern of this study is to determine whether there is any difference between Turkey provinces in terms of accessing health care services, or not. Several clustering algorithms including hierarchical clustering, k-means and partitioning around medoids (pam) were applied to the data set including 31 health indicators of all provinces in Turkey. After comparing these algorithms via using some measures for determining the number of clusters and cluster validity, the findings showed that there were four distinct and significant clusters based on k-means clustering algorithm. It seemed that these clustering results were in a a close reciprocal relationship with the economic development and geographical location of provinces. Clustering results were evaluated and interpreted according to these two important findings.

Purpose: The present study was aimed to analyze morphometric measurements of lower extremity dimensions in healthy females wearing and non-wearing high heeled shoes with narrow toe box.Materials and Methods: Lower extremity length measurements were taken from 121 healthy adult females (64 females non-wearing high heel shoes with narrow toe box, 57 females wearing high heeled shoes with narrow toe box) aged 20 to 40 years using an anthropometer and caliper. Additionally, demographic data (age, height, weight and body mass index-BMI) were taken and tibia-femur ratio (the ratio between tibia length and femur length-T/F) were calculated. Results: The mean values of Tibia - femur length ratio were found as 0.9087±0.038 (right) and 0.9088±0.036 (left) in females wearing high heeled shoes with narrow toe box, whereas the same values were established as 0.9128±0.035 (right) and 0.9157±0.032 (left) in females non-wearing high heeled shoes with narrow toe box. Furthermore, 53.12% of females non-wearing high heeled shoes with narrow toe box suffer from foot, knee and back pain, whereas 78.94% of females wearing shoes with narrow toe box suffer from foot, knee and back pain. Conclusion: The observations presented in this report have defined anatomic parameters and morphometric changes that need to be taken into consideration when wearing narrow high heeled shoes and shoes having wide toe box in females., Amaç: Bu çalışma dar burunlu yüksek topuklu ayakkabı giyen ve giymeyen yetişkin sağlıklı kadınlarda alt ekstremite ile ilgili morfometrik ölçümleri analiz etmek için yapılmıştır. Gereç ve Yöntem: Alt ekstremite uzunluk ölçümleri yaşları 20 ile 40 arası 121 yetişkin sağlıklı (geniş burunlu ayakkabı giyen 64 kadın; dar yüksek topuklu ayakkabı giyen 57 kadın) kadından antropometre ve kaliper kullanılarak yapıldı. Ayrıca, demografik veriler (yaş, vücut ağırlığı, boy uzunluğu, vücut kitle indeksi-BKI) alındı ve tibia-femur oranı hesaplandı. Bulgular: Dar burunlu yüksek topuklu ayakkabı giyen kadınlarda tibia’nın femur uzunluğuna oranı 0.9087±0.038 (sağ) ve 0.9088±0.036 (sol) iken, dar burunlu yüksek topuklu ayakkabı giymeyen kadınlarda aynı ölçümler sırasıyla 0.9128±0.035 (sağ) ve 0.9157±0.032 (sol) olarak hesaplandı. Son olarak, dar burunlu yüksek topuklu ayakkabı giymeyen kadınların %53.12’i ayak, diz ve bel ağrısı çekerken, dar burunlu yüksek topuklu ayakkabı giyen kadınların %78.94’si ayak, diz ve bel ağrısı problemi yaşamaktadır.Sonuç: Çalışmada elde edilen değerler, kadın populasyonunda dar burunlu yüksek topuklu ayakkabı ve geniş burunlu ayakkabı giyildiğinde dikkat edilmesi gereken anatomik parametreleri ve morfometrik değişimleri içermektedir.

Purpose: The aim of this study is to investigate the test-retest reliability of muscles strength measurements performed with Nicholas Manual Muscle Tester (NMMT) in healthy ballet subjects.Materials and Methods: The study group consisted of 10 healthy ballet students aged between 10-11 years. Muscle strength evaluations of lower extremity were made to determine the physical performance level using NMMT. Moreover, every measurements were performed three times with NMMT. Results: NMMT measurements were found as reliable for lower extremity muscle strength in clinical measurements. These reliability of NMMT scores were found as between 0.634 and 0.991. Conclusion: In this paper, we think that NMMT measurements for lower extremity muscles can be used as reliable in clinical measurements and the identification of problems including lower extremity, evaluation of the training and treatment effectiveness of ballet students, Amaç: Bu çalışmanın amacı sağlıklı bale öğrencilerinde Nicholas Manual Muscle Test (NMMT) aleti ile yapılan kas kuvvet ölçümlerinin test-retest güvenilirliğini araştırmaktır.Gereç ve Yöntem: Çalışma grubu 10-11 yaş arası 10 sağlıklı bale öğrencilerinden oluşmaktadır. Alt ekstremitenin kas kuvvet değerlendirmeleri NMMT aleti kullanılarak fiziksel performans düzeyini belirlemek için yapıldı. Ayrıca, her ölçüm 3'er defa NMMT aleti ile yapıldı.Bulgular: NMMT alet ölçümleri alt ekstremite kas kuvvet ölçümleri için klinik ölçümlerde güvenilir bulundu. NMMT aletinin güven aralığı 0.634 ile 0.991 olarak bulundu.Sonuç: Bu çalışmada, alt ekstremite kasları için NMMT aletinin bale öğrencilerinin tedavi etkinliğinin ve eğitimin değerlendirilmesinde, alt ekstremiteyi içeren problemlerin belirlenmesinde ve klinik ölçümlerde güvenilir olarak kullanılabileceğini düşünmekteyiz.

Amaç: Bu çalışmanın amacı izole subskapularis yırtıklarında etiyolojik bir faktör olan subkorakoid sıkışmada korakoid taşmanın bir risk faktörü olarak geçerliliğini araştırmaktır.Gereç ve Yöntem: Omuz artroskopisi uygulanan hastalardan izole subskapularis ve izole tam kat supraspinatus yırtıklı hastalar randomize olarak seçilerek iki grup oluşturuldu. Manyetik rezonans görüntüleme ve ameliyat videoları retrospektif olarak tekrar incelenerek T1 aksiyel manyetik rezonans görüntüleme kesitlerinde korakoid taşma miktarı ve korakoid taşma/humerus başı çapı oranı hesaplandı ve ortalamaları karşılaştırıldı.Bulgular: Çalışmada her iki grupta 28’er hasta olmak üzere toplam 56 hasta vardı. Hastaların yaş ortalamaları Grup 1 ve 2’de sırasıyla 48.719.66 ve 64.856.1 olarak bulundu. Cinsiyet ve ameliyat olan taraf bakımından fark yoktu. Ortalama korakoid taşma değerleri Grup 1 ve 2’de sırasıyla 16.085.6 ve 14.655.92, korakoid taşma/humerus başı çapı oranı ise 0.330.11 ve 0.290.11 bulundu. Ortalama korakoid taşma ve korakoid taşma/humerus başı çapı değerleri bakımından iki grup arasında anlamlı fark saptanmadı.Sonuç: Korakoid taşma ile subkorakoid sıkışma arasında istatistiksel olarak gerçek anlamda bir ilişki yoktur. Subskapularis yırtıklarında varlığı hala tartışmalı olan subkorakoid sıkışmaya bu çalışma ile de kanıt bulunamamıştır., Purpose: The aim of this study was to investigate the validity of the coracoid overlap as a risk factor of the subcoracoid impingement which is an etiologic factor in isolated subscapularis tears.Materials and Methods: Two groups were constituted including isolated subscapularis and isolated full-thickness supraspinatus tears selected randomly from patients who underwent shoulder arthroscopy. The magnetic resonance imaging and surgery videos were reviewed retrospectively to calculate and compare the means of the coracoid overlap and coracoid overlap/humeral head diameter ratio measured on T1 transverse magnetic resonance imaging sections.Results: There were a total of 56 patients including 28 in each group. The mean age of the groups were found to be 48.719.66 and 64.856.1 in Group 1 and 2, respectively. There was no significant difference in terms of age and involved shoulder. The mean coracoid overlap values were found to be 16.085.6 and 14.655.92 and coracoid overlap/humeral head diameter ratios were found to be 0.330.11 and 0.290.11 in Groups 1 and 2, respectively. There was no significant difference in terms of coracoid overlap values and coracoid overlap/humeral head diameter ratiosConclusion: There is actually no statistically significant relationship between coracoid overlap and subcoracoid impingement. There could be found no evidence also with this study for subcoracoid impingement which is still controversial in subscapularis tears.

Alüminyum fosfit nemle teması halinde fosfin gazı oluşturan yüksek toksisiteye sahip bir insektisittir. Tarım ürünlerinde kalıntı bırakmaması ve difüzyon kapasitesinin çok yüksek olması nedeniyle uygulandığı ortamdaki tüm canlıları farklı gelişim evrelerinde öldürebilmesi nedeniyle sıkça kullanılmaktadır. Halen özgün bir antidotu bulunmayan alüminyum fosfit zehirlenmelerinde ölüm oranları alınan doza bağlı olarak %30 ile %100 arasında değişmektedir. Bu çalışmada; bir binanın zemin katında bulunan gıda deposunun fumigasyonu sonrasında, birinci kattaki evinde sıra dışı bir şekilde alüminyum fosfit zehirlenmesi sonucu ölen 13 yaşındaki kız olgu ele alınmıştır. Olgunun otopsi raporu, toksikoloji ve patoloji bulguları birlikte değerlendirilerek konunun literatür eşliğinde tartışılması, oral kullanımı ve inhalasyonu halinde yüksek ölüm riski taşıyan alüminyum fosfitin ülkemizde kontrolsüz satışının ve kullanımının sebep olabileceği bazı olumsuzluklarla birlikte bazı çözüm önerilerinin vurgulanması amaçlanmıştır.

Amaç: Elektif sezaryen operasyonlarında, spinal anestezide intratekal morfin eklenen ve eklenmeyen farklı levobupivakain dozlarının, randomize, çift kör olarak karşılaştırılması amaçlandı.Gereç ve Yöntem: Bu çalışma, ASA I-II grubu 37-42 haftalık miadında sezaryen operasyonu için spinal anestezi uygulanan 60 gebe kadında prospektif, randomize, çift-kör olarak planlandı. Hastalar randomize edilerek iki gruba ayrıldı. Grup L’ye 12,5 mg (3 ml) levobupivakain, Grup LM’ye ise 10 mg levobupivakain + 0.1 mg morfin (3 ml) intratekal uygulandı. Sensoryal ve motor blok süresi, postoperatif ilk 24 saatteki VAS ağrı skoru, ilk analjezi ihtiyacı süresi, hemodinamik ve solunumsal parametreler, sedasyon düzeyleri, Apgar skorları, hasta memnuniyeti ve komplikasyonlar kaydedildi.Bulgular: Gruplar arasında motor blok başlama ve sonlanma süresi, sensoryal bloğun başlama ve iki segment gerileme süresi ile hasta memnuniyeti açısından istatistiksel anlamlı fark yoktu. Grup L’de ilk analjezik ihtiyacı, Grup LM’ye göre daha erken ortaya çıktı (sırası ile; 158.6 ± 31.8 dakika, 176.6 ± 37.16 dakika). Sonuç: Levobupivakain dozunun azaltılmasına rağmen levobupivakaine düşük doz morfin eklenmesi ile, yan etki ve komplikasyon sıklığında belirgin artış olmadan benzer anestezi ve analjezi düzeylerine ulaşıldığı, ayrıca daha uzun süreli spinal analjezi sağlandığı sonucuna varıldı., Purpose: The object of this randomized and double-blinded study was to compare the efficacy of intrathecally applied levobupivacaine at different doses with or without morphine added in elective Cesarean section operations with spinal anesthesia.Materials and Methods: The study was planned as prospective, randomized and double-blinded in ASA I-II group of sixty women who were 37-42 weeks pregnant and applied spinal anesthesia for cesarean section. Patients were randomized into two groups. 12.5 mg (3 ml) levobupivacaine to group L, 10 mg levobupivacaine + 0.1 mg morphine (3 ml) to group LM were applied intrathecally. Sensory and motor block durations, postoperative immediate 24 hour VAS pain scores, time to the first need for analgesia, hemodynamic and respiratory parameters, sedation levels, APGAR scores, patients’ satisfaction and complications were recorded.Results: No significant difference was found between groups in terms of time to motor block formation and termination, time to sensory block formation and its two segment decline, and patients’ satisfaction. Rescue analgesic need for the first time in group L was earlier compare to group LM (158.6 ± 31.8 minutes and 176.6 ± 37.16 minutes respectively). Conclusion: Despite levobupivacaine dose reduction, its combination with low-dose morphine was resulted in prolongation of spinal analgesia without significant increase in the frequency of side effects and complications with similar anesthesia and analgesia levels.

research Axenfeld-Rieger syndrome (ARS) manifests varying degrees of anterior segment dysgenesis and carries a risk of resistant glaucoma. It can affect ocular and extraocular structures derived from the neural crest. A small part of the thyroid gland originates from the neural crest, and defects in thyroid origination can result in thyroid agenesis. Thyroid agenesis is a cause of congenital hypothyroidism. We have presented clinical features the first case of ARS associated with congenital hypothyroidism. Axenfeld-Rieger syndrome (ARS) manifests varying degrees of anterior segment dysgenesis and carries a risk of resistant glaucoma. It can affect ocular and extraocular structures derived from the neural crest. A small part of the thyroid gland originates from the neural crest, and defects in thyroid origination can result in thyroid agenesis. Thyroid agenesis is a cause of congenital hypothyroidism. We have presented clinical features the first case of ARS associated with congenital hypothyroidism.

Leptospirosis is a zoonosis transmitted through the urine of infected animals. Leptospira can be associated with respiratory, renal, hepatic and hematological complications and most importantly carries a high mortality when untreated. We present a rare cause of acute renal failure, acute hepatitis, hyperbilirubinemia and cold agglutinin disease occurring simultaneously, with leptospirosis., Leptospirosis, enfeksiyonlu hayvanların idrar yoluyla bulaşan bir zoonozdur. Leptospiroz; solunum, renal, hepatik ve hematolojik komplikasyonlar ile ilişkili olabilir ve tedavi edilmediğinde yüksek mortalite riski taşır. Bu yazıda leptospirozise bağlı akut böbrek yetmezliği, akut hepatit, hiperbilirubinemi ve soğuk aglutinin hastalığı gelişen nadir bir vaka sunulmuştur. .

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Amaç: Bu çalışmada myotonik distrofi tip 1 (DM1) olgularında kognitif bulgular ile pulmoner fonksiyonların ilişkisinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışma 2013-2015 yılları arasında Çukurova Üniversitesi Nöroloji ve Göğüs Hastalıkları kliniklerinde prospektif olarak yapılmıştır. DM1 olguları ve sağlıklı kontrol grubunda minimental durum testi, sayı menzili testi, sözel akıcılık (semantik ve leksikal), saat çizme testi, sözel ve görsel bellek testleri, solunum fonksiyon testi, arteriel kan gazı değerlendirilmiştir. Çalışma grupları arasında kognitif testler ile pulmoner fonksiyonlar arası ilişki incelenmiştir. Bulgular: DM1 (10 erkek,14 kadın) ve kontrol grubu (12 erkek, 9 kadın) arasında sözel akıcılık, saat çizme testi, sayı menzili testlerinde anlamlı farklılık saptanmıştır. Ayrıca DM1 olgularında total akciğer kapasitesi ve sözel akıcılık arasında pozitif korelasyon gözlenmiştir (p, Purpose: We aim to evaluate the correlation of neurocognitive findings with pulmonary functions in Myotonic dystrophy type 1 (DM1).Materials and Methods: This is an observational prospective (between 2013-2015 years) cross-sectional single center study at Neurology and Chest clinics of Cukurova University. Mini mental state examination, forward and backward digit span, verbal fluency (semantic and lexical), clock drawing, verbal and visual memory, pulmonar function tests, arterial blood gas samples were performed to DM1 patients and control group. The presence of correlation between neurocognitive tests and pulmonary function, arterial blood gas samples were researched in DM1. Results: There were significant differences between DM1 (10 male, 14 female) and control group (12 male, 9 female) on verbal fluency, clock drawing, forward and backward digit span tests. There was a positive correlation (p

Objective: the aim of this study was to determine the total protein amounts, protein profiles, in vitro cytotoxicities, antimicrobial activities and hemolytic effects of skin secretions of the Lissotriton vulgaris and Triturus ivanbureschi. Methods: Skin secretions were obtained, clarified, supernatants snap-frozen then lyophilized. Total protein amounts were determined by BCA assay kit. Protein profiles were revealed by the SDS-PAGE. the cytotoxicity and antimicrobial activity were determined by using MTT assay and minimum inhibitory concentration (MIC) method. Hemolytic effects were measured on rabbit red blood cells. Results: Lissotriton vulgaris and T. ivanbureschi skin secretions have totally 18 and 20 protein fractions. IC50 values were detected between 1.40 and 40.28 ?g/mL. the MIC results were found between 7.8 and 250 ?g/mL. Lissotriton vulgaris skin secretion showed low hemolytic effect while T. ivanbureschi skin secretion showed high hemolytic effect. Conclusion: This study is the first report showing the potential of L. vulgaris and T. ivanbureschi skin secretions for cytotoxicity, antimicrobial and hemolytic activity as an alternative therapeutic approach for traditional uses. Further studies need to focus on purification of the active components from these skin secretions and mode of action on cancer cell lines and microorganisms as anti-agents., Amaç: Bu çalışmanın amacı, Lissotriton vulgaris ve Triturus ivanbureschi deri salgılarının total protein miktarlarını, protein profillerini, in vitro sitotoksisitelerini, antimikrobiyal aktivitelerini ve hemolitik etkilerini belirlemektir. Metod: Ham deri salgıları, sağıldı, arındırıldı, supernatant kısımlar donduruldu ardından liyofilize edildi. Deri salgılarının total protein miktarları BCA kiti ile belirlendi. Protein profilleri SDS-PAGE ile ortaya koyuldu. Sitotoksik ve antimikrobiyal etkiler MTT testi ve MIC metodu kullanılarak belirlendi. Hemolitik etkiler, tavşan kırmızı kan hücreleri üzerinde hesaplandı. Bulgular: Lissotriton vulgaris deri salgısında 18, T. ivanbureschi deri salgısında 20 protein fraksiyonu bulunmaktadır. IC50 değerleri 1.40–40.28 ?g/mL arasında tespit edildi. MIC sonuçları 7.8–250 ?g/mL arasında bulundu. Lissotriton vulgaris deri salgısı tavşan kırmızı kan hücreleri üzerinde düşük hemolitik etki gösterirken, T. ivanbureschi deri salgısı yüksek hemolitik etki gösterdi. Sonuç: Bu çalışma, L. vulgaris ve T. ivanbureschi deri salgılarının geleneksel kullanımdaki alternatif terapötik potansiyellerini sitotoksisite, antimikrobiyal ve hemolitik aktivite bakımından ortaya koyan ilk rapor niteliğindedir. Gelecek çalışmalarda deri salgılarının anti-ajanlar olarak kullanılabilmesi için içeriğindeki aktif bileşenlerin saptanması, hücre hatları ve mikroorganizmalar üzerindeki etki mekanizmasının belirlenmesine odaklanılmalıdır.

Aim: Physical inactivity is associated with the increased incidence of hospitalizations, increased risk of mortality due to heart diseases in hemodialysis patients. The aim of study was to evaluate the functional and physical activity levels of chronic renal failure patients receiving hemodialysis treatment.Material and Methods: 96 of whom were hemodialysis patients (63,22 12,84 years) and 107 (51,07 8,33 years) healthy people, participated to the study. The functional activity level was assessed with the Human Activity Profile. The level of physical activity was determined with the Turkish version of the International Physical Activity Questionnaire Short Form.Results: When the hemodialysis patients and the control group were compared in terms of the functional activity and physical activity level after controlled the age variable, Maximum Activity Score (MAS) and the Adjusted Activity Score (AAS) values and Turkish version of the International Physical Activity Questionnaire (IPAQ) levels of the hemodialysis group were significantly lower (p0.05). When the activity levels of the hemodialysis group were compared by gender, the Adjusted Activity Score values of females were significantly lower (p0.05), and the Turkish version of the International Physical Activity Questionnaire Short Form daily activity levels and Maximum Activity Score values were similar (p 0.05).Conclusion: The functional and physical activity levels of chronic renal patients receiving hemodialysis treatment were significantly lower. We believe that the results of our study give a small idea of the possible functional limitations and physical inactivity of the dialysis patients in our country.

Nöroergonomi, insan beyninin iş performansı ve günlük yaşam sırasında karşılaşılan beyin fonksiyonu ve davranışları hakkında değerli bilgiler elde edebilme adına geliştirilen bir bilim dalıdır. Teori ve prensiplerini ergonomi, sinirbilim ve insan faktörlerinden alır. Nöroergonomi çalışmaları sırasında beyin yapılarını, mekanizmalarını ve işlevlerini anlamak için nörogörüntüleme teknikleri kullanılır. Nörogörüntüleme teknikleri, iki genel kategoriye ayrılır; bunlar, elektroensefalografi gibi (EEG) gibi uyaranlara cevapta nöronal aktivitenin direkt göstergeleri ve pozitron emisyon tomografisi - bilgisayarlı tomografi (PET-BT), fonksiyonel manyetik rezonans görüntüleme (fMRG), fonksiyonel yakın kızılötesi spektroskopi (fNIRS), fonksiyonel Transkranyal Doppler (fTCD) gibi nöronal aktivitenin endirekt metabolik göstergeleridir. Bu derlemede mental iş yükü ve uyanık olma durumunda kullanılan nöroergonomik yöntemler gözden geçirilmiştir Neuroergonomics is the study of the behavior of the human brain. Its theories and principles are based on ergonomics, neuroscience, and the extant literature on human beings. Neuroimaging studies use neuroimaging techniques to understand the structures, mechanisms, and functions of the brain. Neuroimaging techniques are divided into two general categories: direct displays of neuronal activity in response to stimuli, such as electroencephalography (EEG) and positron emission tomography-computed tomography (PET-CT), and indirect metabolic indicators of neuronal activity, such as functional magnetic resonance imaging (fMRG), functional near-infrared spectroscopy (fNIRS), and functional transcranial Doppler sonography (fTCD). This review outlines the techniques and current applications of neuroergonomic methods used in mental workload and vigilance.

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Amaç: D vitamini kalsiyum metabolizması ve iskelet sağlığında önemli rol oynayan bir hormondur. Ayrıca D vitamininin iskelet sağlığı dışı birçok fonksiyona sahip olduğu bilinmektedir. Karaciğer, vitamin D metabolizmasına katılan başlıca organlardan biridir. Son yıllarda yapılan çalışmalar kronik karaciğer hastalığına sahip hastalarda vitamin D eksikliğinin ve yetersizlik prevalansının yüksek olduğunu ortaya koymuştur. Ancak çocukluk çağında bu konuda az sayıda çalışma mevcuttur. Gereç ve Yöntem: Kronik karaciğer hastalığı tanısı ile izlenen çocukların vitamin D düzeyleri ve tedavi yanıtları geriye dönük olarak dosyalarından değerlendirilmiştir. Dört yıllık dönemde izlenen 17 (%34) kız, 33 (%66) erkek olmak üzere toplam 50 hastanın dosya kaydı verilerine ulaşıldı. Bulgular: Çalışmaya alınan 50 hastanın tanı anındaki yaş ortalamaları 7,83 (±3,70) yıl olup 29’unda (%48) D vitamin düzeylerinde eksiklik veya yetersizlik saptandı (ortalama 25-OH vitamin D: 12,79 (± 4,63) ng/ml). Tedavi sonrası vitamin D düzeyi eksik veya yetersiz olan hastaların %82,8’inde düzelme sağlanırken, 5 hastada (%17,2) yeterli cevap yoktu. Kolestaz durumunda tedaviye verilen cevabın azaldığı görüldü. Sonuç: Kronik karaciğer hastalığı nedeniyle izlenen hastalardaki vitamin D düzeyleri düşük olabileceğinden, bu açıdan hastaların incelenmesi ve tedavi edilmesi gerekmektedir. Bu durum mevcut hastalığı için de bir destek sağlamaktadır. Purpose: Vitamin D is a hormone that plays an important role in the regulation of calcium homeostasis and bone health. Vitamin D also has many functions other than skeletal health. The liver is one of the main organs involved in vitamin D metabolism. Recent studies have demonstrated a very high prevalence of vitamin D deficiency and/or insufficiency in patients with chronic liver disease. However, studies in this subject are scarce in children. Materials and Methods: Vitamin D levels and treatment response of children with chronic liver disease diagnosed were evaluated retrospectively. A total of 50 patients, including 17 (34%) female and 33 (66%) male patients, who were being followed for 4 years, were recruited. Results: Vitamin D deficiency or insufficiency was detected in 29 (48%) of 50 patients with a mean age of 7.83 (± 3.70) years at the time of diagnosis. Mean 25-OH vitamin D level was 12.79 (± 4.63) ng/ml ). In 24 (82.8%) patients with vitamin D deficiency or insufficiency vitamin D level was recovered after treatment, whereas in 5 patients (17.2%) there was insufficient response. In the presence of cholestasis, the response to treatment was observed to decrease. Conclusion: Since vitamin D levels in patients with chronic liver disease may be low, patients should be examined and treated in this respect. This would also provides support for the current disease.

The increase in the frequency of use of the Internet causes the attacks on computer networks to increase. Such phenomena also increase the importance of intrusion detection systems. In this paper, KDD Cup 99 dataset is used for the classification of the network attacks. Four different classification algorithms were used, and the results were compared. These algorithms were multilayer perceptron network, decision trees, fuzzy unordered rule induction algorithm (FURIA) and support vector machines. The most successful algorithm in this dataset found as FURIA. As the second part of this study, the most important feature sets were found by correlation-based feature selection and best first search algorithm. Then, the results of classification algorithms were compared with these new feature sets according to the performance of the algorithms.

Purpose: Here we cytogenetically investigated the chromosomal rearrangements in repeated cultures of six different cell lines over continuous passages. Materials and Methods: MCF7, HCT116, A549, SHSY5Y, HEPG2, and NIH3T3 cell lines were cultured in DMEM containing 10% FBS and 1% penicillin-streptomycin. GTG banding procedure was used for the analysis of metaphase chromosomes, at least 20 metaphases were analyzed per cell line. Results: We found chromosome number variations and structural changes in the all examined cell cultures as the passage numbers increase. Conclusion: Cell lines have long been used in research to test drugs, to delineate molecular mechanisms, to understand the environmental effects and so on. The most important feature of a cell line is its genotype and karyotype similarities with their host organism. Cancer Cell lines, possess genomic/chromosomal instability that also lead them to change their phenotype along with their karyotype from one passage to next. Therefore, it is always best to verify karyotype before employing a specific cell line in a research project. Amaç: İ Burada sitogenetik olarak, altı farklı hücre hattının tekrarlanan hücre kültürlerinde yeni kromozomal düzenlenmeleri araştırdık. Gereç ve Yöntem: MCF7, HCT116, A549, SHSY5Y, HEPG2 ve NIH3T3 hücre hatları, %10 FBS ve %1 penisilin-streptomisin içeren DMEM besiyerinde kültüre edildi. Metafaz kromozomlarının analizi için GTG bantlama prosedürü kullanıldı ve en az 20 metafaz analiz edildi. Bulgular: İncelenen hücre kültürlerinde pasaj sayısı artışıyla kromozom sayı varyasyonları ve yapısal değişiklikler tespit ettik. Sonuç: İlaçları test etmek, moleküler mekanizmaları tanımlamak, çevresel etkileri anlamak için hücre hatları uzun süredir araştırmalarda kullanılmaktadır. Bir hücre dizisinin en önemli özelliği, konak organizmasıyla olan genotip ve karyotip benzerlikleridir. Kanser Hücresi soyları, genomik/kromozomal dengesizliğe sahiptir ve bu da her pasajda fenotip değişimi ile birlikte karyotip değişimine neden olabilmaktedir. Bu nedenle, hücre kültürlerinin kullanılacağı bir araştırma projesine başlamadan muhakkak kullanılan hücre hattının karyotipini doğrulamak gerekmektedir.

Aim: The aim of this study was to evaluate the accompanied cervical injuries of the patients presenting to the emergency department (ED) because of penetrating, perforating or tangential cranial gunshot injuries (CGI). Material and Methods: The retrospective study included 137 patients that presented to the EDs at Mustafa Kemal and Ataturk University due to penetrating, perforating or tangential CGI between 2014 and 2018. Patients younger than 12 years old and had insufficient radiological records were excluded from the study and thus 115 patients were included in the study. Results: 115 patients included 105 (91%) men and 10 (9%) women with a mean age of 27 (range, 12-65) years. Of the 115 injuries, 84 (73%) were high-velocity and 31 (27%) were low-velocity gunshot injuries. The injuries included 92 (80%) penetrating or perforating and 23 (20%) tangential injuries. No cervical dislocation injury was accompanied by CGI in any patient. Unilateral lamina fracture of the cervical vertebra was observed in one patient. Conclusion: Our results support the opinion that isolated penetrating, perforating or tangential CGI did not cause to cervical spinal injuries, the intubation or tracheostomy procedures should not be postponed after radiological evaluation of cervical spinal stability.

Purpose: We aimed to compare the psychological profile and personality characteristics of mild-to-severe obstructive sleep apnea (OSA) groups and snorers. The other purpose of our study to assess the correlation of psychological profile and personality characteristics with sleep parameters. Materials and Methods: Patients with OSA symptoms were assessed using the Eysenck Personality Questionnaire-Revised Abbreviated form (EPQR-A), Type D personality scale, and the Hospital Anxiety and Depression Scale (HADS). In addition to PSG, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale were used for sleep parameters. Results: In the analysis of the EPQR-A of groups, neuroticism scores were significantly higher for the moderate OSA group than the snorer group, and the other EPQR-A parameters did not differ between the four groups. In the correlation analysis of the EPQR-A and PSQI parameters, there was a positive correlation between the neuroticism scale and PSQI scores. Conclusion: This study showed that the “neurotic” personality trait was higher in patients with moderate OSA. We also demonstrated a positive correlation between subjective sleep quality, sleep latency, sleep disturbances, PSQI global scores, and neuroticism., Amaç: Hafif-şiddetli obstrüktif uyku apne (OUA) gruplarının ve horlayanların psikolojik profili ve kişilik özelliklerini karşılaştırmayı amaçladık. Çalışmamızın diğer amacı, psikolojik profil ve kişilik özellikleri ile uyku parametreleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: OUA semptomları olan hastalar, Eysenck Kişilik Anketi-Gözden Geçirilmiş Kısaltılmış Formu (EKA-GGK), Tip D kişilik ölçeği ve Hastane Anksiyete ve Depresyon Ölçeği (HADS) kullanılarak değerlendirildi. Uyku parametreleri için PSG'ye ek olarak Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ve Epworth Uykuluk Ölçeği kullanıldı. Bulgular: Grupların EKA-GGK analizlerinde, nevrotiklik skorları orta düzeyde OUA grubunda horlayan gruba göre anlamlı derecede yüksekti ve diğer EKA-GGK parametreleri dört grup arasında farklı değildi. EKA-GGK ve PUKİ parametrelerinin korelasyon analizinde, nevrotiklik ölçeği ile PUKİ skorları arasında pozitif bir korelasyon vardı. Sonuç: Bu çalışma orta düzeyde OUA'lı hastalarda "nevrotik" kişilik özelliklerinin daha yüksek olduğunu ortaya koymuştur. Ayrıca, öznel uyku kalitesi, uyku latansı, uyku bozuklukları, PUKİ genel puanları ve nevrotiklik arasında pozitif bir korelasyon olduğunu gösterdik.

Purpose: The aim of this study was toexplore the histopathologic subtypes of pediatric lymphomas and their relation with Ebstein-Barr virus infection in our region. Materials and Methods: In this retrospective study, 87 children including 36 cases with Hodgkin lymphoma and 51 cases with non-Hodgkin lymphoma were included in the study. The pathologic slides were used to investigate immunohistochemical staining with ebstein-barr virüs latent membrane protein-1 and in-situ hybridization. Results: The most common histopathological subtype in hodgkin lymphoma cases was mixed cellular classical hodgkin lymphoma (55.6%). The most common histopathological subtype in Non-Hodgkin lymphoma cases was Burkitt lymphoma (51.0%). Ebstein-Barr virüs latent membrane protein-1 was positive in 29 Hodgkin lymphoma. All non-Hodgkin lymphoma cases were stained negative with ımmunohistochemical. The positive staining rate of Hodgkin lymphoma cases with in-situ hybridization was 83.3% and this rate was 27.5% in non-Hodgkin lymphoma cases. The differences between groups for both staining methods were significant. Conclusion: The results of this study show that the distribution of histopatholojik subtypes of pediatric lymphomas similar to in developing countries. And we have observed that in-situ hybridization is more specific than immunohistochemistry because Ebstein-Barr virus positivity is more detected in in-situ hybridization. Amaç: Bu çalışmanın amacı bölgemizdeki pediatrik lenfomaların histopatolojik alt tiplerinin oranını ve bunların Ebstein-Barr virüs enfeksiyonu ile olan ilişkisini incelemektir. Gereç ve Yöntem: Hodgkin lenfoma tanısı alan 36 olgu ve non-hodgkin lenfoma tanısı alan 51 olgu retrospektif arşiv taraması yapılarak çalışmaya dahil edildi. Olgulara immünohistokimyasal olarak Ebstein-Barr virüs latent membran proteini-1 ve in-situ hibridizasyon uygulandı. Bulgular: Hodgkin lenfoma olgularında; en sık rastlanan histopatolojik alt tipler sırası ile mikst sellüler klasik hodgkin lenfoma (%55,6) idi. Non-Hodgkin lenfoma olgularında en sık rastlanan histopatolojik alt tip Burkitt lenfoma (%51) idi. Ebstein-Barr virüs latent membran proteini-1 ile 29 hodgkin lenfoma olgusunda pozitif iken non-hodgkin lenfoma olgularında immünohistokimya ile pozitif boyanma saptanmadı. Hodgkin lenfoma olgularında in situ hibridizasyon ile boyanma oranı % 83.,3 iken non-Hodgkin lenfoma olgularında bu oran % 27.5 idi.. Her iki boyama yöntemi için gruplar arasındaki fark istatistiksel olarak anlamlıydı. Sonuç: Bu çalışmada, olgularımızın histopatolojik dağılımlarının gelişmekte olan ülkelerdeki pediatrik lenfoma olguları ile benzer olduğunu göstermektedir. Aynı zamanda in situ hibridizasyon’da Ebstein-Barr virüs pozitifliği daha fazla olması nedeniyle in situ hibridizasyonun ebstein barr virüs tespitinde immünohistokimyadan daha spesifik olduğunu düşünmekteyiz.

Aim: Patient education is important for patients with predialysis chronic renal disease (CKD)because it can delay the progression of the disease to end-stage renal failure.Anxiety and depression may also contribute to the progression of the disease in patients with CKD. We evaluated the influences of education on progression ofCKD, the Short Form 36 Health Survey (SF36), and the Beck Depression Inventory (BDI) in predialysis CKD patients. Material and Methods: 121 patients with nondialysis stage 2-5 CKD were involved in this study. At the start of the study, the SF36 and BDI scoring were performed in all patients and their creatinine clearances were calculated. 31 patients were given education on CKD by the dialysis specialist nurse once a month. At the end of the sixth month, SF36 and BDI were rescored, and their creatinine clearances were recalculated. Results: There were no significant differences between the two groups regarding age, gender, creatinine clearance, and duration of chronic kidney disease. At the end of the sixth month, when the educated and uneducated patients were compared, while the increase of the creatinine level was significant in the two groups, the SF36 and BDI scores were found to be improved significantly in the study group. Conclusion: The results of this study suggested that patient education may improve the SF36 and BDI scores, but it does not affect the progression of the disease for at least six months in duration.

Objective: Diabetes mellitus, a heteregenous metabolic and chronic disease, is a growing health problem especially in developing countries. It is claimed that diabetes associated with increased formation of free radicals and decrease in antioxidant potential and also alterations in lipid profile and enzyme levels. Ursolic acid is commonly used in traditional Chinese medicine due to its beneficial effects. The aim of this study was to investigate the effects of ursolic acid on streptozotocin-induced diabetes in Wistar albino rats. Methods: DNA damage was evaluated in the blood and liver cells of rats by alkaline comet assay. The activities of antioxidant enzymes, oxidative stress parameters, biochemical parameters, hepatic enzyme levels and lipid profile parameters were also evaluated. Results: The results of this study demonstrate that diabetes caused genotoxic damage, changes in hepatic enzyme and lipid profile, biochemical and antioxidant enzyme activities and oxidative stress parameters in rats. Ursolic acid was found to be protective against diabetes induced effects in blood and liver samples of rats. Conclusions: According to our results, it seems that ursolic acid may be beneficial against diabetes and its adverse effects in rats., Amaç: Karmaşık bir metabolik ve kronik hastalık olan diyabet özellikle gelişmekte olan ülkelerde büyüyen bir sağlık sorunudur. Diyabetin serbest radikal oluşumu ve antioksidan potansiyelde azalma ile birlikte lipit profili ve enzim düzeylerinde değişikliklerle ilişkili olduğu iddia edilmektedir. Ursolik asit yararlı etkileri nedeniyle geleneksel Çin tıbbında yaygın olarak kullanılmaktadır. Bu çalışmanın amacı, ursolik asidin Wistar albino sıçanlarda streptozotosin ile oluşturulan diyabete etkilerini değerlendirmektir. Metod: DNA hasarı sıçanların kan ve karaciğer hücrelerinde alkali comet yöntemiyle değerlendirilmiştir. Antioksidan enzimlerin aktiviteleri, oksidatif stres göstergeleri, biyokimyasal parametreler, hepatik enzim düzeyleri, lipit profil göstergeleri de değerlendirilmiştir. Bulgular: Bu çalışmanın sonuçları sıçanlarda diyabetin genotoksik hasara, hepatik enzimlerde ve lipit profilinde, biyokimyasal ve antioksidan enzim aktivitelerinde ve oksidatif stres parametrelerinde değişikliğe neden olduğunu göstermiştir. Ursolik asidin sıçanların kan ve karaciğer örneklerinde diyabetin neden olduğu etkilere karşı koruyucu olduğu bulunmuştur. Sonuç: Sonuçlarımıza göre, ursolik asidin sıçanlardaki diyabet ve diyabetin istenmeyen etkilerine karşı yararlı olabileceği görülmektedir.

Amaç: Bu çalışmada semptomatik ekstragenital yerleşimli intraabdominal endometriozis olgularıyla ilgili klinik deneyimimizi sunmayı amaçladık. Gereç ve Yöntem: Bu çalışmada değişik endikasyonlar sebebiyle opere edilen ve nihai histopatojik incelemesinde endometriozis olarak rapor edilen olgular değerlendirildi. Hastaların demografik özelliklerinin yanısıra klinik prezentasyonları, lokalizasyonları, yapılan cerrahiler ve takip süresi içindeki rekürens oranları değerlendirilmiştir. Bulgular: Çalışmamızda histopatolojik olarak konfirme edilmiş 778 endometriozis tanısı almış hastalar retrospektif olarak incelendi. 32 (%4.1) olguda ekstragenital abdominal yerleşim mevcut olup, hastaların tamamı semptomatik idi. Hastaların başvuru esnasındaki en sık semptomları karın ön duvarda ele gelen kitle (n:13 %40.6) ve kronik tekrarlayan abdominal/pelvik ağrı (n:9, %28.1) şeklindeydi. Abdominal ekstragenital endometriozisli olguların %22’sinde (n=7) klinik tanısı preoperatif dönemde konmuştu. Yapılan operasyonlar ise karın ön duvarından kitle eksizyonu, (n=14, %43.8), apendektomi (n=5,%15.7), pelvik kitle eksizyonu (n=6,%18.8), anterior rezeksiyon (n=3,%9.4), sağ hemikolektomi (n=2,%6,3), laparotomi ile birlikte üriner stentleme (n=2,%6,3) idi. Ortalama 42 aylık takip süresinin sonunda 6 olguda (%18.7) nüks izlendi. Sonuç: Endometriozis, ekstragenital tutulum sebebiyle reproduktif dönemde değişik nedenlere bağlı olarak abdominal cerrahi planlanan kadınlarda ayırıcı tanıda düşünülmelidir. Komplet cerrahi eksizyonun yansıra, endometrizis tanısının pre- veya intraoperatif dönemde konulması durumunda yara koruyucu kullanılması nüks oranlarının azalmasını sağlayabilir. Purpose: This study aimed to present our clinical experience on symptomatic intaabdominal extragenital endometriosis cases. Materials and Methods: In this study, patients undergoing surgery various indications and for which final histopathologic results reported as endometriosis were evaluated. Demographic characteristics, clinical presentations, localization of disease, surgical procedures and recurrence rates within follow-up period were presented. Results: Histopathologically confirmed 778 endometriosis patients were retrospectively analyzed. Extragenital abdominal endometriosis were present in 32 (4.1%) patients and all cases were symptomatic. The most common symptoms at index admission were mass detected within abdominal wall (n:13; 40.6%) and chronic recurrence abdominal/pelvic pain (n:9, 28.1%). 22% (n=7) of patients with abdominal extragenital endometriosis were diagnosed preoperatively. The operations performed were as follows: mass excision from the abdominal wall (n=14, 43.8%), appendectomy (n=5, 15.7%), pelvic mass excision(n=6, 18.8%), anterior resection (n=3, 9.4%), right hemicolectomy (n=2, 6,3%) , and laparotomy with urinary stenting (n=2, 6,3%). Recurrence is reported in 6 (18.7%) cases at median follow-up of 42 months. Conclusion: Due to extragenital involvement, endometriosis should be part of differential diagnosis in all women who are reserved for abdominal surgery during reproductive era. Along with the complete excision, wound protector use can potentially decrease recurrence rates in cases diagnosed pre- or intraoperatively as endometriosis.

Amaç: Herpetik infeksiyonların tanısında Tzanck yayması için en uygun lezyonların 1-3 günlük olduğu bildirilmiştir. Bu çalışmada, daha uzun süreli lezyonlardan yayma yapmanın ek yarar sağlayıp sağlamayacağını değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Hasta kayıtları geriye dönük olarak incelendi. Hasta dosyasında "Tzanck" sözcüğü geçen ve bu işlemin herpetik infeksiyon tanısı için yapıldığı hastalar seçildi. Lezyonların kaçıncı gününde yayma yapıldığı belirtilen hastalar çalışmaya dahil edildi. Bulgular: Yüzs eksen hastanın 65'inde bu işlem, herpetik infeksiyon tanısı için yapılmıştı. Ön tanı, hastaların 31 (%47.7)'inde herpes simpleks, 26 (%26.0)'sında herpes zoster ve 8 (%12.3)'inde varisella idi. Kesin tanı ise 16 (%34.8)'sında herpes simpleks, 26 (%56.5)'sında herpes zoster ve 4 (%8.7)'ünde varisella idi. Toplam 33 (10’u herpes simpleks, 20’si herpes zoster ve 3’ü varisella) hastada Tzanck yayma sonucu pozitif olarak kaydedilmişti. Yalnız kesin tanısı da herpetik infeksiyon olan 46 hasta ele alınacak olursa, 1-3 günlük lezyonlarda %75 (15/20), 4-6 günlük lezyonlarda %67 (10/15) ve 7-25 günlük lezyonlarda %73 (8/11) oranında pozitiflik elde edilmişti. Sonuç: Tzanck yaymasında pozitifliğin en çok veziküllerden elde edildiği, ancak püstül ve erozyon gibi öteki lezyonlardan elde edilen pozitifliğin de azımsanamayacağı, üstelik bir vezikülün üç günden uzun sürebileceği görüldü. Bu verilerin ışığında, Tzanck yaymasının daha eski lezyonlarda da yapılmasının tanıya katkı sağlayabileceği gösterilmiştir. Purpose: In the diagnosis of herpetic infections, lesions of 1 to 3 days' duration have been proposed to be the most suitable ones for Tzanck smear. In this study, it was aimed to evaluate whether or not a diagnostic yield is obtained when the smear is prepared from older lesions. Materials and Methods: Patients’ records were analyzed retrospectively. Patients whose records contain the word "Tzanck" and the smear had been done for herpetic infections were chosen. The patients who were stated their smears was done on which day of the lesions were included in the study. Results: The smear had been done for herpetic infections in 65 out of 180 patients. Preliminary diagnosis was herpes simplex in 31 (47.7%) patients, herpes zoster in 26 (26.0%) patients and varicella in 8 (12.3%) patients. Definitive diagnosis was herpes simplex in 16 (34.8%) patients, herpes zoster in 26 (56.5%) patients and varicella in 4 (8.7%) patients. In a total of 33 patients (10 with herpes simplex, 20 with herpes zoster and 3 with varicella), the smear had been found to be positive. If only the 46 patients with a definitive diagnosis of herpetic infections were taken into consideration, positivity had been obtained in 15 of 20 (75%) lesions of 1 to 3 days' duration, in 10 of 15 (67%) lesions of 4 to 6 days' duration and in 8 of 11 (73%) lesions of 7 to 25 days' duration. Conclusion: In Tzanck smear, positivity is obtained most commonly from vesicles; however, the positivity rate obtained from other lesions such as pustules and erosions should not be underestimated; and moreover, a vesicle may last more than three days. We have shown that doing Tzanck smear may contribute to the diagnosis even in older lesions.

Objectives: To determine the effect of royal jelly (RJ) on the oxidant-antioxidant balance in rats with N-methyl-Nnitrosourea (MNU) induced breast cancer and to compare this with the chemotherapeutic agent paclitaxel. Material and methods: Fifty-six female Sprague Dawley rats were divided into five groups. Except control group (n = 8, Group I) others received MNU (50 mg/kg, a single dose, i.p.) to develop breast cancer: Group II (n = 8) untreated, Group III (n = 7) treated with paclitaxel (15 mg/kg/week, 3 times, i.p.), Group IV (n = 7) with RJ (by oral gavage, 100 mg/kg/ day, for 30 days), and Group V (n = 7), with paclitaxel + RJ. At the end of 30 days, histopathological and biochemical parameters were evaluated in breast tissues. Results: Levels of protein carbonyl (PC) and 8-hydroxydeoxyguanosine (8-OHdG) were higher in Group V than in Group II while malondialdehyde (MDA) levels were lower in groups IV and V compared to Group II (p < 0.05). Levels of catalase (CAT) in Group V and glutathione (GSH) in Group III were higher than Group II (p < 0.05). Glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels did not significantly different. Decreasing effect of RJ on CA15-3 levels was relevant to histopathological results. Conclusion: Although RJ (with or without paclitaxel) had increasing effect of antioxidant status it was insufficient to reduce oxidative stress in breast cancer. Amaç: N-metil-N-nitrosourea (MNU) ile indüklenen meme kanserli sıçanlarda, arı sütünün oksidan-antioksidan denge üzerindeki etkisini belirlemek ve bunu kemoterapötik ajan olan paklitaksel ile karşılaştırmak. Gereç ve Yöntem: Elli altı dişi Sprague Dawley sıçan, beş gruba bölündü. Kontrol grubu Grup I (n = 8) hariç diğer dört grup MNU (50 mg/kg, tek, doz ip) ile meme kanseri oluşturuldu. Grup II (n = 8), tedavi edilmemiş, Grup III (n = 7), paklitaksel (15 mg/kg/hafta, 3 kez, ip) ile; Grup IV (n = 7) arı sütü (oral gavaj ile, 100 mg/kg/gün, 30 gün) ile ve Grup V (n = 7), paklitaksel ve arı sütü ile tedavi olmak üzere beş gruba ayrıldı. günün sonunda, meme dokularında histopatolojik inceleme ve biyokimyasal parametreler değerlendirildi. Bulgular: Protein karbonil (PC) ve 8-hidroksi deoksiguanozinin (8-OHdG) düzeyleri Grup V‘de Grup II‘ye göre yüksek, malondialdehit (MDA) düzeyleri grup IV ve V’de Grup II‘ye göre daha düşüktü (p < 0.05). Grup V‘de katalaz (CAT) ve Grup III’de glutatyon (GSH) seviyeleri Grup II’den daha yüksekti (p < 0.05). Glutatyon peroksidaz (GPx) ve süperoksit dismutaz (SOD) düzeyleri arasında anlamlı farklılık yoktu. Arı sütünün CA15-3 düzeyleri üzerine azaltıcı etkisi, histopatolojik sonuçlar ile uyumlu idi. Sonuç: Meme kanserinde arı sütü (paklitaksel ile veya paklitakselsiz) antioksidan durumu arttırıcı yönde etki göstermesine rağmen oksidatif stresi azaltmada yetersizdi.

Purpose: This study aims to analyze the effect of nail polish applied by operating room nurses on bacterial colonization after surgical hand washing. Materials and Methods: This is a self-controlled, experimental study in which the before and after values of the same group were analyzed. This study was conducted on 33 operating room nurses. The glove juice method was used to measure bacterial colonization on the nurses' hand flora. The data were collected using the Introductory Information Form for Nurses and the Data Recording Form. The data were analyzed using descriptive statistical methods along with the Wilcoxon test. Results: Of the nurses, 54.56% had a bachelor's degree, 78.8% had been working as a nurse for at least 11 years, and 63.7% had been working as an operating room nurse for at least 11 years. Of them, 66.7% had nails shorter than 2 mm. and 60.6% sometimes used moisturizer. No statistically significant difference was found between the amount of bacteria in the samples obtained from the nurses' hands with and without nail polish after surgical hand washing. Conclusion: The findings showed that freshly applied nail polish has no effect on bacterial colonization., Amaç: Araştırma ameliyathane hemşirelerinde oje kullanımının cerrahi el yıkama sonrası bakteriyel kolonizasyona etkisini incelemek amacıyla yapıldı. Gereç ve Yöntem: Bu araştırma, kendi kendisinin kontrolü olan ve aynı grupta önceki ve sonraki değerlerin karşılaştırıldığı, deneysel çalışma olarak gerçekleştirildi. Araştırma 33 ameliyathane hemşiresi ile yapıldı. Araştırmada hemşirelerin el florası üzerindeki bakteri kolonizasyonunu ölçmek için eldiven sıvı yöntemi (glove juice methodu) kullanıldı. Verilerin değerlendirilmesinde; tanımlayıcı istatistiksel yöntemlerin yanı sıra Wilcoxon testi kullanıldı. Bulgular: Hemşirelerin %54.56’ sının lisans mezunu olduğu, %78.8’ inin 11 yıl ve üzerinde hemşirelik yaptığı, %63.7’ sinin de 11 yıl ve üzerinde ameliyathanede hemşire olarak çalıştığı bulundu. Cerrahi el yıkamayı etkileyen bireysel faktörler incelendiğinde ise; hemşirelerin %66.7’ sinin tırnak uzunluğunun 2 mm’ den kısa olduğu, %60.6’ sının bazen nemlendirici kullandığı, saptandı Araştırmada, hemşirelerin cerrahi el yıkama sonrası oje sürülen ve oje sürülmeyen ellerinden alınan örneklerdeki bakteri sayıları arasında istatistiksel olarak anlamlı bir farklılık bulunmadı. Sonuç: Araştırma bulguları, taze sürülmüş ojenin bakteriyel kolonizasyonda etkisi olmadığını gösterdi.

A combination of attenuated total reflectance–Fourier transform infrared (ATR–FTIR) spectroscopy and chemometric techniques was used to classify different trademarks of edible oils available on the Turkish markets. A total of 144 spectra of edible oil samples, including extra virgin olive oil (VOO), hazelnut oil (HNO), cottonseed oil (CSO), sunflower oil (SFO) and soybean oil (SBO), was recorded. The feasibility of ATR–FTIR with multivariate data analysis for discrimination of extra VOOs from other edible oils was also evaluated. Classification of edible oils was performed using principal components analysis (PCA), hierarchical cluster analysis (HCA), linear discriminant analysis (LDA) and soft independent modeling of class analogies (SIMCA). The spectra collected from wavelength region of 4000–650 cm-1 and 28 different wavelength ranges selected from full spectra were evaluated for optimal classification models. All multivariate analysis provided excellent discriminations between the edible oil classes with low classification error. LDA models constructed with five predictors, and a total of 100% of edible oil samples from different trademarks were correctly classified. Furthermore, no misclassification was reported for the discriminant analysis in supervised SIMCA models with an accuracy of 95%. Consequently, ATR–FTIR spectroscopy combined with multivariate data analyses provides excellent illustrations of the relative positions of the different brands of commercial edible oils according to their quality and purity.

Aim: Sleeve gastrectomy has been used for the surgical treatment of morbid obesity. The aim of the present study was to determine the effects of triiodothyronine supplementation on oxidative stress parameters in anastomotic tissue level. Material and Methods: Twenty-four male Wistar albino rats were divided into control (n:12), and experimental (n:12) groups and underwent sleeve gastrectomy. Experimental group rats received a single dose of triiodothyronine (400 mg/100 g) in the operation day. Rats were sacrificed on postoperative day 7. Serum thyroid hormones were analysed. The supernatants were used to measure total oxidant status, total antioxidant status, nitric oxide and malondialdehyde levels. All tissue parameters were analysed by spectrophotometric methods. Oxidative stress index values were calculated. Results: Thyroid stimulating hormone levels in both the control and triiodothyronine group did not significantly change on the 7th postoperative day (p=0.663). Free triiodothyronine levels were significantly higher in triiodothyronine group rats than in control group rats (triiodothyronine vs control: p=0.004). Although total oxidant status levels did not altered by thyroid hormone treatment (p>0.05), total antioxidant status levels significantly decreased (p0.05). Tissue nitric oxide levels were also similar in both groups (p>0.05). Malondialdehyde levels increased in triiodothyronine given rats compared with the control group (p

Çalışmamız frontal kavernom cerrahisi sonrasında fizyoterapi ve rehabilitasyon programına alınan hastanın fonksiyonel sonuçlarını incelemek amacıyla yapılmıştır. Bu çalışmada sol frontal lobda kortikal yerleşimli kavernom sebebiyle cerrahi geçiren ve ardından fizyoterapi programına alınan 23 yaşındaki bir olgu sunulmuştur. Olgu cerrahi sonrasında beşincigünde ve üçüncü ayda değerlendirilmiştir. Bu süreçte el becerilerini arttırmaya yönelik olarak kavrama eğitimi, yürüme eğitimi, merdiven çıkma-inme ve denge egzersizlerini içeren fizyoterapi programı uygulanmış ve ev programı verilerek taburcu edilmiştir. Fizyoterapi programından sonra hasta önemli gelişme kaydetmiştir. Frontal kavernoma cerrahisi sonrası hastaya uygulanacak fizyoterapi ve rehabilitasyon programının hastanın fonksiyonel geri dönüşüne katkıda bulunacağı düşünülmektedir.