Search

Background and objectives: The development of new therapeutic options to treat leukemia (therapies targeting chimeric antigen receptor [CAR] T cells) down-regulates markers expressed on the cell surface. Therefore, conventional immunophenotyping panels no longer make these antigens unreliable for identifying a B cell immunophenotype. In our study, we methodically compared multiparametric flow cytometry (FC) in bone marrow aspiration and immunohistochemical (IHC) analysis in bone marrow biopsy in childhood acute lymphoblastic leukemia (ALL). We sought to answer whether these two methods could be alternatives to each other in the diagnosis of leukemia. Material-Method: Twenty-eight patients diagnosed with ALL were included in the study. A Kappa test was performed between the expression rates of the antibodies studied in simultaneous FC and IHC studies in bone marrow aspiration and biopsy samples performed at the initial diagnosis. Results: Twenty-three of the patients were precursor B-ALL (BCP-ALL) and 5 were T-ALL. In the immunophenotyping of patients with BCP-ALL using FC and IHC, MPO, CD79A, CD14, CD3 expressions were the same, while CD19, CD7, CD117, CD33, CD 56, CD34 expressions were very good, good concordance for CD20 expressions and moderate for CD10 expressions. In immunophenotyping of patients diagnosed with T-ALL using FC and IHC, CD20, CD19, CD14, CD79a, MPO, CD22 expressions were the same and excellent agreement was found in terms of CD2, CD10, CD34 expressions. Conclusion: In cases where there are treatments that affect immunophenotyping, costly methods such as FC are not available, or bone marrow aspiration cannot be taken adequately, immunophenotyping with IHC can be safely performed in the diagnosis of pediatric ALL in bone marrow biopsy.

Objectives: Our aim in this study is to investigate the effect of fibrosis at diagnosis on treatment and survival in childhood acute lymphoblastic leukemia (ALL). Methods: This study is retrospective. We evaluated the relationship between patients' age, white blood cell count at diagnosis, morphological blast percentage and flow cytometric blast percentage at diagnosis, day 15th and day 33th, absolute blast count in peripheral smear on day 8th, and the degree of fibrosis in bone marrow biopsy at diagnosis in 36 pediatric patients. The fibrosis degree in biopsy on the thirty-third day after induction therapy was measured. Results: Twenty-eight (77.8%) cases were diagnosed B-ALL and 8 T-ALL (22.2%). There was no statistically significant difference between the groups with and without fibrosis in terms of any parameter measured at the time of diagnosis, 8th day, 15th day, and 33th day. No significant difference was found between the groups according to overall survival (OS): the mean OS was 50.22 ± 5.44 months in the fibrosis group and 49.70 ± 3.96 months in the non-fibrosis group (p = 0.557). Conclusions: There is a high detection rate of bone marrow fibrosis in ALL pediatric cases at the time of diagnosis. Nevertheless, fibrosis does not affect survival.

Objectives: According to estimates, cancer of unknown primary origin (CUP) accounts for approximately 3 to 5% of new cancer cases annually in the United States. With early diagnosis, many CUP patients can achieve long-term remission. The aim of this study was to document the organ tropism for metastasis for tumors with a definite primary cancer. In addition, we sought to contribute to understanding organ tropism in tumors of unknown origin. Methods: Retrospectively, biopsies of 492 metastatic cancers were evaluated. The required immunohistochemical panel was applied to determine the tumors’ origins. Results: A total of 492 patients with metastases were included in the study. The most common origins of metastasizing tumors were lung (25.4%), colon (18.9%), breast (15.4%) and stomach cancers (10.6%). The least metastatic tumors were the salivary gland, neuroendocrine, adrenal, tubal, nasopharynx, rectum and esophagus cancers (0.22% for all). The most common cancers that metastasized to the liver were colon cancer (29.0%), stomach cancer (18.6%) and pancreatic cancer (18.6%). The most common cancers that metastasized to the bone were lung cancer (58.0%), breast cancer (29.0%), and prostate cancer (13.9%). The most common types of tumors that metastasized to the lungs, the kidney (35.1%), colon (29.7%), and breast cancers (16.2%), were the most common. The most common tumors that metastasized to the brain were the lung (61.1%), the breast (16.7%), and kidney cancers (8.7%). The most common tumors metastasizing to the skin were lung (31.0%), breast (27.6%), and colon (13.8%) cancers. Conclusions: Primary cancers have different metastatic patterns, which may help determine their causes. By involving distant anatomical structures and disrupting their function, tumor metastases increase the morbidity and mortality associated with the disease; thus, they affect staging, prognosis, and treatment. Metastases (or cancers from unknown primary sites) usually require extensive investigation to determine their primary source. Whether the cancer is tracked prospectively or retrospectively, a detailed observational template highlighting expected metastatic patterns would greatly assist in diagnosis and treatment.

Introduction: The diagnosis of chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL), which also includes atypical forms, can be very difficult. The aim of this study is to compare immunohistochemical (IHC) and flow cytometric (FC) immunophenotyping methods in the CLL/SLL, the most common mature B-cell leukemia/lymphoma of adults, in bone marrow biopsy. In these two methods, it is to determine the minimum panels that can differentiate CLL/SLL from other mature B-cell leukemia/lymphomas. Material and Method: The study included 68 adult patients diagnosed with mature B cell leukemia/lymphoma. Final diagnoses were made on the basis of peripheral smear, bone marrow aspirate, bone marrow biopsy, IHC and FC analysis, clinical and genetic studies. Cell counts, final diagnosis and immunophenotyping were compared with both methods. Cytogenic findings were evaluated. The sensitivity, specificity, positive and negative predictive values of IHC and FC results for CLL/SLL were calculated. Results: CLL/SLL was diagnosed in 64.7% of the cases and non- CLL/SLL in 35.29% of the cases. The median age was 66.50 years, 69.18% male and 30.82% female. The diagnosis compatibility in FC and IHC was found to be highest in hairy cell leukemia/lymphoma with 100%, and in CLL/SLL with 90%. In other lymphomas, a definitive diagnosis could only be made with biopsy. Immunophenotyping made with CD23+CD43+CD5+LEF-1 in the bone marrow biopsy showed a sensitivity of 95.45% (range, 84.53-99.44%) and a specificity of 100.00% (range, 85.75-100.00%) for CLL/SLL. Immunophenotyping made with CD23+CD43+CD5+CD200+ in FC showed a sensitivity of 100.00% (range, 91.96-100.00%) and a specificity of 82.61% (range, 61.22-95.05%) for CLL/SLL. Conclusion: This was the most extensive study to have compared immunophenotyping in IHC and FC in bone marrow biopsies of mature B cell leukemia/lymphoma. The addition of LEF-1 to the CD23(+), CD43(+), CD5(+) panel in IHC and the addition of CD200 to the same panel in FC will be extremely helpful in the differential diagnosis of typical/atypical CLL/SLL from mature B cell leukemia/lymphoma.

Son dönem böbrek yetmezliği, dünyada ve ülkemizde görülme sıklığı giderek artan önemli bir halk sağlığı sorunudur. Son dönem böbrek yetmezliğinde en yaygın kullanılan renal replasman tedavi yöntemi hemodiyalizdir. Hemodiyaliz tedavisi karmaşık bir süreçtir ve tedavinin başarılı bir şekilde sürdürülebilmesinde en önemli etken hastanın tedaviye uyumudur. Bireyin uyumunu artırmak için farklı birçok yöntem bulunmaktadır. Motivasyonel görüşme tekniği de bu yöntemlerden biridir. Bu olgu sunumunun amacı; rutin hemodiyaliz tedavisi alan hastada uygulanan motivasyonel görüşme yöntemini sunmaktır., End-stage renal disease is an important public health problem with an increasing incidence in the world and in our country. Hemodialysis is the most widely used renal replacement therapy for end-stage renal disease. Hemodialysis treatment is a complex process and the most important factor in the successful continuation of the treatment is the patient's compliance with the treatment. There are many different methods to increase the harmony of the individual. Motivational interview technique is one of these methods. The aim of this case report is; to present the motivational interview method applied to a patient receiving routine hemodialysis treatment.

Introduction Lower limb stiffness has been shown to be associated with running economy (RE) in adults, but this relationship in children remains unclear. Objectives The purpose of this study was to investigate the relationship between lower limb stiffness, RE, and repeated-sprint ability in child soccer players. Methods Twenty-eight male child soccer players (mean age 11.8 ± 0.9 years) participated in the study. RE was determined by measuring the steady-state oxygen uptake (ml/min/kg) at submaximal running speeds of 8 and 9 km/h. Vertical and leg stiffness were calculated from the flight and contact time data obtained during two submaximal running tests. Additionally, vertical stiffness was measured during the maximal and submaximal hopping tests. All participants performed the repeated sprint test consisting of 10 × 20-m all-out sprints interspersed with 20-s active recovery. Results During both submaximal running tests, vertical (r= –0.505 to –0.472) and leg stiffness (r= –0.484 to –0.459) were significantly correlated with RE (p< 0.05). Maximal (r= –0.450) and submaximal hopping stiffness (r= –0.404) were significantly correlated with RE at 8 km/h (p< 0.05). Maximal hopping stiffness was significantly correlated with the best sprint time (r= –0.439) and mean sprint time (r= –0.496) (p< 0.05). Vertical (r= –0.592 to –0.433) and leg stiffness (r= –0.612 to –0.429) at 8 and 9 km/h and submaximal hopping stiffness (r= –0.394) were significantly correlated with the fatigue index (p< 0.05). Conclusions Current findings indicate that the lower limb stiffness may be an important determinant of both RE and repeated-sprint ability in child soccer players. Level of Evidence II; Diagnostic Studies - Investigating a Diagnostic Test.

Kist hidatik, vücudun neredeyse her yerinde görülebilen parazitik bir hastalıktır. Vücuttaki tutulum yerlerine göre farklı semptomlar ve bulgular verebilirler. Hastalığın etkenleri ise echinococcus granulosus, echinococcus multilocularis, echinococcus oligarthrus, daha nadir olarak da echinococcus vogeli adlarındaki sestodlardır. Ülkemizde genel cerrahi uzmanlarının çok iyi bildiği bu hastalık, ülkemizin gelişen ve değişen sosyal yapısından ve zaman zaman klinik ve radyolojik olarak malignitelerle karışabileceğinden hala sorun teşkil etmektedir. 55 yaşındaki bir kadın hasta karın ağrısı şikayetiyle, kadın doğum ve hastalıkları polikliniğine başvurdu. Özgeçmişinde kist hidatik öyküsü bulunmayan hastanın uterusunda, görüntüleme yöntemleri ile kitle saptandı. Kadın doğum ve hastalıkları servisinde malignite ön tanısıyla histerektomi ve bilateral salpingooeferektomi uygulandı. Mikroskobik olarak yapılan histopatolojik incelemede ise kist hidatik tanısı konuldu. Çalışmamızda nadir görülen primer uterin kist hidatik vakasını sunacağız.

The aim of this study is to determine the metaphorical perceptions of students who studies in the field of fashion design and graphic design towards the concept of "Design" and to reveal the similarities and differences between the metaphorical perceptions of these two departments students. The research was carried out with 100 students studying at Giresun University Technical Sciences Vocational School Design Department. These 100 students consist of 50 Fashion Design and 50 Graphic Design students. The data of the study were obtained by completing the blanks in the students' sentence “Design is like ………… because ………………………………” In the study, in which the phenomenology design was used, one of the qualitative research methods, the data obtained were analyzed by content analysis and explained the support of the literature with expert opinions. As a result of the research, total of 44 different metaphors for the concept of "Design" were obtained from Graphic and Fashion Design students, and they were discussed in 5 different categories as "Individual, Spirituality, Life, Object and Aesthetics" with expert opinions. It was concluded that there were both similarities and differences between the metaphors of the two groups. The research is considered important in terms of contributing to researches to be conducted on the subject and setting an example for researchers in the relevant field., Bu araştırmanın amacı moda tasarım ve grafik tasarım alanlarında öğrenim gören öğrencilerin “Tasarım” kavramına yönelik metaforik algılarını belirlemek ve bu iki bölüm öğrencilerinin metaforik algıları arasındaki benzerlik ile farklılıkları ortaya koymaktır. Araştırma, Giresun Üniversitesi Teknik Bilimler Meslek Yüksekokulu Tasarım Bölümü’nde okuyan 100 öğrenci ile gerçekleştirilmiştir. Bu 100 öğrenci 50 Moda Tasarım ve 50 Grafik Tasarım öğrencisinden oluşmaktadır. Araştırmanın verileri öğrencilerin “Tasarım………… gibidir, çünkü………………………………” cümlesindeki boşlukların tamamlanmasıyla elde edilmiştir. Nitel araştırma yöntemlerinden olgu bilim deseni kullanılan araştırmada, elde edilen veriler içerik analizine tabi tutularak incelenmiş ve uzman görüşleriyle birlikte literatür desteklenerek açıklanmıştır. Araştırma sonucunda Grafik ve Moda Tasarım öğrencilerinden “Tasarım” kavramı için toplam 44 farklı metafor elde edilmiş, uzman görüşleri ile “Birey, Maneviyat, Yaşam, Nesne ve Estetik” olmak üzere 5 farklı kategorilerinde ele alınmıştır. İki grubun metaforları arasında hem benzerlik hem de farklılıklar olduğu sonucuna ulaşılmıştır. Araştırma konu ile ilgili yapılan araştırmalara katkı sağlaması ve ilgili alandaki araştırmacılara örnek teşkil etmesi yönünden önemli görülmektedir.

BACKGROUND: Sprint drills are part of the soccer training routine for their resemblance to match activities. There is a lack of information in the literature about the changes in isokinetic skeletal muscle strength in response to sprint training. OBJECTIVE: This study evaluates the effects of eight weeks, on-season repeated sprint training with a change of direction on isokinetic strength parameters in well-trained youth soccer players. METHODS: Nineteen well-trained youth soccer players volunteered to participate in the study. The training program included three sets of six, 40 m (20 + 20 m) shuttle sprints twice a week for eight weeks. Isokinetic peak moment, work, and power of knee extensors and flexors were measured at angular velocities of 60, 180 and 240∘/s. Pre- and post-training valid isokinetic sector data were compared. RESULTS: Following the training period, dominant and non-dominant legs’ peak moment, work, and power values for both extensor and flexor muscle groups improved significantly at various angular velocities. CONCLUSIONS: Isokinetic strength enhancement may be explained with the induction of muscle hypertrophy following a prolonged period of sprint training.

In this study, the effect of high-calorie feeding and aerobic exercise on skeletal and cardiac muscle citrate synthase (CS), carnitine palmitoyltransferase-I (CPT-I), and -II (CPT-II) mRNA expressions were evaluated. Genetically non-obese rats were grouped as normal-high calorie and sedentary-exercising. Gastrocnemius-soleus and heart muscles' CS, CPT-I, and CPT-II expressions and skeletal muscles' histopathological characteristics were evaluated. High-fat diet had increased body weight by 10% and aerobic exercise did not make any difference. Skeletal muscle CS expression was increased significantly in normal-calorie exercising group. Exercise and high-fat diet did not change CPT-I and CPT-II expressions in both heart and skeletal muscle. Histopathological evaluations demonstrated increased cytoplasmic lipid droplets in high-calorie fed sedentary rats, and exercise had reduced lipid droplets in skeletal muscle. Also, both mitochondria and nuclei distribution were impaired in high-calorie groups. In conclusion, aerobic exercise without food restriction was not enough to make significant changes in fat transportation mechanism into skeletal and heart muscle.

Comorbidity of "blue" nevi of the uterine cervix and leiomyosarcoma of the bladder: a rare case report, Uterin serviksin “blue’’ nevüsü ve mesane leiomyosarkomu birlikteliği: nadir bir olgu sunumu

Fallop tüpünün primer benign tümörleri nadirdir. Lipom, tüm vücutta görülen çok yaygın benign bir tümör olmasına rağmen fallop tüpünde oldukça nadir görülür. Derin yerleşimli lipomatöz tümörler genellikle liposarkom özelliğinde olduğudan ayrıcı tanısı dikkatlice yapılmalıdır. Fallop tüpünün lipomu genellikle başka hastalıklara bağlı histerektomi sonrasında raslantısal olarak görülmektedir. Bu nedenle tuba ve çevresindeki yağlı doku dikkatlice incelenmelidir. Bu yazıda akut batın tablosu ile acil servise başvuran, overde 25 cm kitle nedeniyle opere edilen ancak biyopsi materyalinin histopatolojik incelemesi sonucunda torsiyone over dokusu ve fallop tüpünün lipomu olduğu saptanan 45 yaşındaki kadın hasta sunuldu., Primary benign tumors of the fallopian tube are rare. Lipoma is a very common benign tumor that occurs throughout the body but it is extremely rare in the fallopian tube. Since deeply located lipomatous tumors are usually liposarcoma, their differential diagnosis should be made carefully. Lipoma of the fallopian tube is usually seen incidentally after hysterectomy due to other diseases. Therefore, the tube and surrounding fatty tissue should be carefully examined. In this article, a 45-year-old female patient who was admitted to the emergency department with acute abdomen, was operated due to a mass of 25 cm in the ovary, but was found to have torsioned ovarian tissue and fallopian tube lipoma as a result of histopathological examination of the biopsy material.

Amaç: Hemodiyaliz tedavisi alan hastalarda konfor düzeyinin incelenmesidir. Gereç ve Yöntem: Tanımlayıcı olarak yapılan araştırma, Ekim-Aralık 2018 tarihleri arasında, hemodiyaliz tedavisi alan 262 hasta ile yapılmıştır. Veriler “Hasta Tanıtım Formu” ve “Hemodiyaliz Konfor Ölçeği kullanılarak toplanmıştır. Araştırmadan elde edilen veriler SPSS (Statistical Package For Social Sciences) 25 programı kullanılarak; sayı, yüzde ve frekans dağılımları ile değerlendirilmiştir. Analizlerde bağımsız gruplarda t testi ve tek yönlü varyans analizinden yararlanılmıştır. Çalışmada kullanılan ölçeğin iç tutarlığını değerlendirmek için Cronbach alfa katsayısı 0.75 olarak bulunmuştur. Çalışmada anlamlılık düzeyi p

Amaç: Hemodiyaliz tedavisi alan hastalara uygulanan progresif gevşemeegzersizinin konfor düzeyine etkisini değerlendirmektir.Gereç ve Yöntem: Bu araştırma, ön test-son test kontrol gruplu yarı deneyselolarak, 15 Nisan- 30 Mayıs 2019 tarihleri arasında bir diyaliz merkezinde, kontrolgrubu 20 ve girişim grubu 20 hasta ile yapılmıştır. Araştırma verileri, “HastaTanıtım Formu” ve “Hemodiyaliz Konfor Ölçeği (HDKÖ)” kullanılaraktoplanmıştır. Frekans dağılımı, ortalama, standart sapma ile veriler sunulmuşistatistiksel analizlerde, bağımsız gruplarda t testi kullanılmıştır. Çalışmadaanlamlılık düzeyi p, Objectıve: The aim of this study was to evaluate the effect of progressiverelaxation exercise on comfort level of hemodialysis patients.Materıal and Methods: This study was carried out with the control group 20 andexperimental group 20 patients in a dialysis center between April 15 and May 30,2019. The research data were collected using the "Patient Information Form" and"Hemodialysis Comfort Scale (HDSP)".Data were presented with frequencydistribution, mean, standard deviation and t test was used for independent groups.In the study, the significance level was accepted as p

Diffuse Large B-cell lymphoma is a subgroup of nonHodgkin's lymphoma. Lymphoma with endobronchial pulmonary involvement is a rarely reported condition. A 64-year-old male patient was admitted to our clinic with complaints of swellings in the neck and in the bilateral upper limbs, along with shortness of breath. A computed tomography of the thorax revealed diffuse mediastinal enlargement with a superior vena cava obstruction, and a huge right hilar mass formation obliterating the anterior segment of the right upper lobe. A diagnostic fiberoptic bronchoscopy showed mucosal irregularity and an endobronchial lesion on the anterior segment of the right upper lobe. A diagnosis of endobronchial lymphoma was made following bronchial biopsies. Diffüz büyük B hücreli lenfomalar non-Hodgkin lenfomaların subtipini oluştururlar. Lenfomaların endobronşial invazyonu oldukça nadirdir. Nefes darlığı, boyun ve üst ekstremitede şişlik şikayeti olan 64 yaşında erkek hasta kliniğimize başvurdu. Toraks tomografisinde üst mediastende büyümüş lenf nodları, vena cava süperiorda daralma ve sağ hiler büyümüş lenf nodları izlendi. Fiberoptik bronkoskopisinde sağ akciğer üst lob anterior segmentte endobronşiyal lezyon izlendi. Fiberoptik bronkoskopik biyopsi ile endobronşiyal lenfoma tanısı doğrulandı.

Solid tümörlerin kemik iliğinde tutulum yaptığı bilinmektedir. Ancak kemik iliği tutulumu ile tanı alması nadirdir. Klinik ve laboratuvar bulguları karakteristik değildir ve farklı ön tanıların düşünülmesine yol açabilmektedir. Kemik iliğinde tutulum saptandığı zaman tedavi yaklaşımını da etkilemekte ve kötü prognozla ilişkilidir. AMAÇ: Kemik iliği tutulumu ile tanı alan solid tümörlü hastalarımızın klinik ve laboratuvar özelliklerini anlatmayı amaçladık. MATERYAL- METOD: Hematolojik malignite ön tanısı ile kemik iliği biyopsisi yapılan ve karsinom metastazı tanısı alan 7 hasta retrospektif olarak değerlendirildi. 3’ü erkek, 4’ü kadın hastanın median tanı yaşı 71 idi. Ortalama tanı yaşı 61,2±19,9 idi. 6 hasta halsizlik, 2 hasta nefes darlığı, 1 hasta da iştahsızlık şikayeti ile başvurmuştu. Hastaların hepsinde anemi, 6 hastada trombositopeni, 6 hastada eritrosit sedimentasyon hızı (ESH) yüksekliği, 3 hastada lökositoz mevcut idi. 4 hastada meme kanseri, 2 hastada mide, 1 hastada prostat karsinom tutulumu saptandı. Tanı konan hastaların median sağ kalım süreleri 20 ay (2-33 ay) olarak saptanmıştır. 2 meme kanseri ve 1 prostat kanserli hasta hormonoterapi ile yaşamlarını sürdürmektedirler. SONUÇ: Kemik iliği biyopsisi; kemik iliğinde tutulum yapan hastalıkları saptamada ucuz, kolay uygulanabilen ve etkin bir yöntemdir. It is known that solid tumors are involved in the bone marrow. However, it is rare to be diagnosed with bone marrow involvement. Clinical and laboratory findings are not characteristic and may lead to the consideration of different prediagnoses. When bone marrow involvement is detected, it also affects the treatment approach and is associated with a poor prognosis. We aimed to describe the clinical and laboratory characteristics of our patients with solid tumors diagnosed with bone marrow involvement. Seven patients who underwent bone marrow biopsy with the pre-diagnosis of hematological malignancy and were diagnosed with carcinoma metastasis were evaluated retrospectively. The median age at diagnosis of 3 male and 4 female patients was 71. The mean age at diagnosis was 61,2±19,9. 6 patients presented with fatigue, 2 patients with shortness of breath, and 1 patient with anorexia. All patients had anemia, 6 patients had thrombocytopenia, 6 patients had increased sedimentation, and 3 patients had leukocytosis. Breast cancer in 4 patients, gastric carcinoma in 2 patients, and prostate carcinoma in 1 patient were detected. The median survival time of the diagnosed patients was 20 months (2-33 months). 2 breast cancer and 1 prostate cancer patients continue their lives with hormone therapy. Bone marrow biopsy; is a cheap, easily applicable and effective method for detecting diseases involving the bone marrow.

The purpose of this study was to examine and comparethe occurrence of exercise-induced arterial hypoxemia (EIAH) in aerobic andanaerobic trained young female athletes during a maximal exercise test. Internationallevel young female skiers including eight cross-country skiers (17±1.4 years)and seven alpine skiers (16.1±1.2 years) took part in the study. Maximal oxygenuptake (VO2max: ml/kg/min) was determined using an incrementaltreadmill exercise test. Oxyhemoglobin saturation (SaO2%) was continuously measured using a Pulse oximetry atrest and during the test. EIAH was assumed to have developed when SaO2decreased by at least 4% (ΔSaO2≤ −4%) from the baseline values. VO2max,maximal minute ventilation (L/min), maximal running speed, test duration andmaximal heart rate values were higher in the cross-country skiers than in thealpine skiers (p< 0.05). All theathletes in both groups exhibited EIAH. SaO2 was significantlydecreased from 97.7±1.3% at rest to 87±3.4% at exhaustion in alpine skiers andfrom 98.1±0.3% at rest to 88±2.8% at exhaustion in cross-country skiers (p< 0.01). It has been found thatthere is no statistically significant difference between the resting and lowestSaO2% values of the two groups (p>0.05). It was determined that arterial hypoxemia occurred during exercise inanaerobic and aerobic trained athletes. Well-trained young female athletes whohave different aerobic fitness levels may exhibit similar EIAH during theincremental maximal exercise., Buçalışma ile, aerobik ve anaerobik antrenmanlar yapan genç kadın sporcularda maksimalegzersiz sırasında egzersizle oluşan arteriyel hipoksemi (EOAH) düzeylerinitespit amaçlandı. Araştırmaya, uluslararası düzeyde yarışmalara katılan sekizgenç kadın kros kayakçısı (17±1.4 yaş) ve yedi genç kadın alp kayakçısı (16.1±1.2yaş) katıldı. Maksimal oksijen alımı (VO2max: ml/kg/dak) koşubandında şiddeti giderek artan egzersiz protokolü uygulanarak tespitedilmiştir. Oksijen saturasyonu (%SaO2) istirahatte ve testsüresince sürekli olarak Pulse oksimetre kullanılarak ölçülmüştür. EOAH, SaO2’ninistirahat düzeyinden en az % 4 (ΔSaO2≤–%4) azalması şeklinde tanımlanmıştır. Kroskayakçılarının VO2max, maksimal dakika ventilasyonu (L/dak),maksimal koşu hızı, test süresi ve maksimal kalp atım hızı değerleri alpkayakçılarına göre yüksek düzeyde anlamlı bulundu (p< 0.05). Her iki gruptaki tüm sporcularda EOAH görüldü. SaO2değerlerinin Alp kayakçılarında % 97.7±1.3 dinlenim düzeyinden % 87±3.4’edüştüğü, kros kayakçıların ise % 98.1±0.3 dinlenim düzeyinden % 88±2.8’edüştüğü tespit edildi (p< 0.01).İki grubun dinlenim ve en düşük % SaO2 değerleri arasında anlamlıfark olmadığı tespit edildi (p>0.05). Anaerobik ve aerobik antrenmanlar yapan sporcularda egzersiz sırasındaarteriyel hipoksemi ortaya çıktığı tespit edildi. Bu çalışmanın sonuçlarıfarklıaerobik uygunluk düzeylerine sahip iyi antrenmanlı genç kadın sporcuların,maksimal egzersiz sırasında benzer EOAH sergileyebileceğini göstermiştir.

Amaç: Bu çalışmada sporcu ve sedanter bireylerin performans testleri sonucunda tespit edilen en yüksek yağ yakım aralıkları ve substrat kesişim noktalarındaki metabolik değişkenlerin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmaya 10 sedanter (22,1 ± 0,5 yıl) ve 11 sporcu (22,3 ± 0,6 yıl) olmak üzere toplam 21 erkek gönüllü katılmıştır. Katılımcıların egzersiz testleri yürüme bandında indirekt kalorimetre kullanılarak yapılmıştır (Cosmed Quark CPET). Uygulanan iki farklı egzersiz testi sonucunda katılımcıların performans düzeylerine ve yağ oksidasyon hızlarına ait veriler elde edilmiştir.Bulgular: Beden kitle indekslerine göre sporcular normal, sedanter bireyler ise fazla kilolu sınıfında yer almışlar ve sedanter bireylerin vücut yüzde yağ oranları sporculara kıyasla istatistiksel olarak anlamlı düzeyde yüksek bulunmuştur. Sporcuların pik oksijen alım seviyeleri anlamlı düzeyde yüksek olmasına karşın, en yüksek yağ oksidasyon hızları sedanter bireylere benzer seviyede tespit edilmiştir. Karbonhidratların baskın enerji kaynağı haline gelmeye başladığı kesişim noktasında, sporcu ve sedanter bireylerin oksijen alım miktarları arasında istatistiksel fark olmamasına karşın, bu değerin maksimal oksijen alım kapasitelerine oranı değerlendirildiğinde sporcu grupta istatistiksel olarak anlamlı düzeyde düşük bulunmuştur. Sonuç: Oksijen alım kapasitesi yüksek olan sporcu bireylerin hem en yüksek yağ yakım hızlarının hem de kesişim noktasındaki yağ yakım hızlarının sedanter gruba kıyasla istatistiksel farklılık göstermemesi, yağ oksidasyonunu belirleyen tek faktörün maksimal aerobik kapasite olmayabileceğini düşündürmektedir., Purpose: The aim of this study was to evaluate metabolic responses of athletic and sedentary men at maximal fat oxidation and crossover points that were determined by performance tests. Materials and Methods: 10 sedentary (22.1 ± 0.5 years) and 11 athletic (22.3 ± 0.6 years) volunteers participated in this study. Participants’ exercise tests were performed on a treadmill. Maximal fat oxidation rates and metabolic responses at cross over point (COP) were measured by indirect calorimeter (Cosmed Quark CPET). Results: Sedentary individuals were classified as overweight whereas athletic individuals were classified as normal according to their body mass indices and sedentary individuals’ body fat percentage were significantly higher than athletic participants. Although athletic participants’ peak oxygen uptakes were significantly higher, maximal fat oxidation rates were similar at both groups. At COP where oxidation of carbohydrates predominate fat oxidation, both group’s oxygen consumption rates were found to be similar. On the other hand, the ratio of oxygen consumption to maximal oxygen uptake at COP was significantly lower in athletic group.Conclusion: Athletic individuals’, whom had higher oxygen uptake capacities, maximal fat oxidation rates and fat oxidation rates at COP were not significantly higher than sedentary individuals. This finding indicates that maximal aerobic capacity might not be the only determinant of fat oxidation.

WOS: 000496520600012, Introduction: There is no previous study examining muscle damage responses from training load changes in individuals trained exclusively with repeated sprint exercise. Objectives: The purpose of this study was to examine the effect of training load changes on physical performance and exercise-induced muscle damage in male college athletes who were trained using a 30m repeated sprint protocol. Methods: Twelve participants completed the 6-week training period (three sessions/week), which consisted of progressively increasing intensity training in the first 5 weeks. On the first day of the training period, all sprints were performed at 70-80% of maximum effort. In the first session of the 5th week (Maximal intensity training; MIT), all sprints (10x30m sprints) were performed at maximal speed. The sets (10 sprints at maximal speed in each set) were repeated until exhaustion (Exhaustive training; ET) in the first training session of the 6th week, followed by two sessions of the normal training. Isometric strength, 30m sprint performance, flexibility, serum creatine kinase (CK) and cortisol were measured periodically during the examination period. Results: Isometric strength, 30m sprint performance, and flexibility were significantly decreased following the ET, and did not recover during the following 9-day period, which consisted of two training sessions and 6 days of recovery. Cortisol was significantly elevated immediately after the ET but was not changed after training on first day and during MIT. CK was significantly elevated after training every week, but the increase at 24 hours after ET was significantly higher than after the first day and MIT. Conclusions: Dramatically increasing the volume of maximal intensity repeated sprint exercise results in greater relative muscle damage even in trained individuals, which will significantly limit their performance. Further training sessions, even at normal intensity and volume with insufficient time for muscle recovery, may prolong the duration of fatigue.

This study aimed to compare the maximal fat oxidation (MFO) rates obtained from the stage average, last 2 min average, and highest value in the Fatmax stage determined with a 6 min step protocol. A total of 35 overweight, sedentary healthy men (age: 25.4 ± 0.7 years, body mass index: 26.0 ± 0.6 kg/m2) participated in the study. Substrate oxidation was calculated using breath-by-breath gas exchange data for each stage. When the change in the fat oxidation rate for every min throughout the Fatmax stage was evaluated, the average value of the 4th min was significantly lower than that of the 2nd and 3rd min (p < 0.01). In addition, the 5th and 6th min fat oxidation rates were significantly lower than the rates of the 1st, 2nd, 3rd, and 4th min (0.30 ± 0.01 and 0.29 ± 0.01 g/min for the 5th and 6th min, respectively, vs. 0.35 ± 0.02, 0.34 ± 0.02, 0.33 ± 0.02, and 0.31 ± 0.01 g/min for the 1st, 2nd, 3rd, and 4th min, respectively; p < 0.01). Most of the participants had MFO rates in the 1st min of the stage (16/35 participants), and the MFO rates of the remaining participants were observed in the 2nd, 3rd, and 4th min (7/35, 4/35, and 8/35 participants, respectively). None of the participants had MFO rates in the 5th or 6th min. The individual MFO rate (highest fat oxidation rate during Fatmax) was significantly higher than the fat oxidation rate calculated with the last 2 min average values (0.36 ± 0.02 and 0.30 ± 0.01 g/min, respectively; p < 0.05). In conclusion, the calculation of the fat oxidation rate by averaging the last portion of the Fatmax stage data may cause the underestimation of the MFO rate, which probably occurs earlier in the Fatmax stage.

WOS: 000488819900002, Study aim: The purpose of this study was to examine the effects of a repeated sprint exercise protocol on muscle damage indicators. serum IGF-I and cortisol levels. Material and methods: Nine trained male subjects (age 23.3 +/- 3.6 years) completed a repeated sprint protocol consisting of two sets of 10 x 30-in maximal sprints with 30 s of active recovery between sprints and 5 min of passive recovery between sets. The isometric strength and flexibility were measured before, immediately after and 24 hours after exercise. 30-m maximal sprint time was measured before and 24 hours after exercise. Blood samples were taken before, immediately after and 24 hours after exercise. Results: Isometric strength and flexibility were significantly decreased after exercise and 24 hours after exercise (p < 0.05). 30-in sprint time was significantly increased 24 hours after exercise (p < 0.05). A significant increase in serum lactate dehydrogenase, IGF-I and cortisol were found after exercise (p < 0.05). Serum creatine kinase increased significantly immediately after and 24 hours after exercise compared to pre-exercise values (p < 0.05). Conclusion: Our data show that due to increased scrum IGF-I level, repeated sprint exercise may have anabolic effects as well as traumatic effects on the muscles.

Nekrobiyozis lipoidika, etyolojisi ve patogenezi henüz net olarak bilinmeyen granülomatöz bir deri hastalığıdır. Diyabetes mellitus ve nekrobiyozis lipoidika komorbiditesi literatürde sıkça tartışılmakta olup mikroanjiyopatinin bu komorbiditede önemli bir role sahip olduğu düşünülmektedir. Nekrobiyozis lipoidika, diyabetes mellitus ile eş zamanlı ortaya çıkabilmekle beraber diyabetes mellitus tanısından önce veya sonra da ortaya çıkabilmektedir. Nekrobiyozis lipoidikanın kanıtlanmış etkin bir tedavisi bulunmamaktadır. Köbnerizasyon nedeniyle cerrahi tedavi önerilmemektedir. Burada yaklaşık 2 yıldır her iki alt ekstremitede multiple lezyonları olan ve yapılan punch biyopsi ile histopatolojik olarak nekrobiyozis lipoidika tanısı konulan 15 yaşında kız hasta sunuldu. Olgumuz ile nekrobiyozis lipoidika etyolojisi, kliniği ve tedavisi literatür ışığında değerlendirildi., Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology and pathogenesis. The comorbidity of diabetes mellitus and necrobiosis lipoidica is frequently discussed in the literature and it is thought that microangiopathy has an important role in this comorbidity. Although necrobiosis lipoidica may occur at the same time as diabetes mellitus, it may occur before or after the diagnosis of diabetes mellitus. There is no proven effective treatment for necrobiosis lipoidica. Surgical treatment is not recommended due to koebnerization. Here, we present a 15-year-old female patient who had multiple lesions in both lower extremities for about 2 years and was diagnosed histopathologically with necrobiosis lipoidica by punch biopsy. In this case report, the etiology, clinic and treatment of necrobiosis lipoidica were evaluated in the light of the literature.

Background. Psoriasis is an inflammatory skin disease in which the cells and molecules of innate and adaptive immunity are involved in the pathogenesis. Aplastic anemia is a bone marrow deficiency syndrome that is characterized by an extreme reduction in the number of blood cells as a result of failure in hematopoiesis. Allogenic hematopoietic stem cell transplantation is a promising treatment for Aplastic Anemia and it is important to note that other comorbid diseases like psoriasis- since both have some common pathogenetic mechanisims- might achieve remission after treatment. Case. We present a 12-years-old male patient who underwent bone marrow transplantation for aplastic anemia and his psoriasis vulgaris lesions completely regressed. The final follow-up visit on day 150 also revealed no sign of the pre-transplantation skin and scalp lesions. Conclusions. This is the first case of pediatric psoriasis together with aplastic anemia that achieved complete remission of psoriasis after bone marrow transplantation. Our case report needs to be supported by prospective studies involving larger patient populations

Objective The most common primary malignant tumors of the lung are squamous cell carcinoma, small cell carcinoma and adenocarcinoma. However, some rare malignant primary lung tumors can also affect the lung and cause difficulties in diagnosis and treatment. Conventional imaging methods do not help the diagnosis in most cases, and moreover, preoperative tissue samples may fail to establish a diagnosis. In cases with endobronchial lesions, small samples or lack of transthoracic biopsy in central tumors without endobronchial lesions can make diagnosis difficult. The definitive diagnosis can only be made after larger examinations with larger tissue samples taken after the operation. In addition, failure to differentiate benign- malignant in frozen examination may negatively affect the resection of the surgeon. It can cause incomplete or unnecessary resection. The aim of this study was to evaluate the clinical radiological and histopathological features of these tumors, which have been rarely reported in the literature, and to contribute to the diagnosis and treatment of these tumors. Material and Methods The study included 10 patients with rare malignant primary lung tumor who were operated on in our clinic between 2010 and 2019. All patients were retrospectively evaluated in respect of age, gender, symptoms, preoperative imaging methods and invasive diagnostic methods. Tumor localization, tumor size, type of surgical operation and survival were recorded. Results The 10 patients included in the study comprised 6 males and 4 females. Postoperative histopathological diagnoses of the patients were reported as 2 carcinosarcomas, 2 large cell carcinomas, 2 epithelioid hemangioendothelioma, 1 glomangiosarcoma, 1 primary pulmonary leiomyosarcoma, 1 mucoepidermoid carcinoma, and 1 synovial sarcoma. Conclusion It can be difficult to diagnose in rare primary malignant lung tumors by preoperative imaging and preoperative invasive diagnostic methods. CT-guided fine needle biopsy and tru-cut biopsy, endobronchial biopsy and frozen samples performed before surgery may be insufficient in diagnosis, which may mislead the surgeon about lung resection. Amaç Akciğerin en sık görülen primer malign tümörlerini yassı hücreli karsinom, küçük hücreli karsinom ve adenokarsinom oluşturur. Ancak, nadir görülen bazı malign primer akciğer tümörleri de akciğeri etkileyebilir, tanı ve tedavide zorluklara neden olabilir. Geleneksel görüntüleme yöntemleri olguların birçoğunda tanıda yeterince yardımcı olmaz hatta preoperatif alınan doku örnekleri tanı koymada yetersiz kalabilir. Endobronşial lezyonu olan vakalarda örneklerin küçük olması veya endobronşial lezyon olmayan santral tümörlerde transtorasik biyopsi yapılamaması tanıyı zorlaştırabilir. Kesin tanı ancak operasyon sonrası alınan daha büyük doku örnekleri ile ayrıntılı incelemeler sonunda konabilir. Ayrıca frozen incelemesinde benign-malign ayrımı yapılamaması cerrahın yapacağı rezeksiyonu olumsuz yönde etkileyebilir. Eksik ya da gereksiz rezeksiyona neden olabilir. Çalışmamızın amacı literatürde çok az bildirilen bu tümörlerin klinik radyolojik ve histopatolojik görünümlerini değerlendirerek tanı ve tedavilerine katkıda bulunmaktır. Gereç ve Yöntem 2010-2019 yılları arasında kliniğimizde opere edilen oldukça nadir 10 malign primer akciğer tümörü hasta çalışmaya dahil edildi. Tüm hastalar, yaş, cinsiyet, semptomlar, preoperatif görüntüleme yöntemleri ve invazif tanı yöntemleri ile retrospektif olarak incelendi. Tümör lokalizasyonu, tümör boyutları, yapılan cerrahi operasyon tipi ve yaşam süreleri kaydedildi. Bulgular Çalışmamıza 10 hasta dahil edildi. Hastaların 6 tanesi erkek, 4 tanesi kadındı. Yaş ortalamaları 53.4 idi. 3 hastaya sol alt lobektomi, 2 hastaya sol pnömonektomi, 3 hastaya wedge rezeksiyon, 1 hastaya sol üst lobektomi, 1 hastaya orta lobektomi yapıldı. Hastaların postoperatif histopatolojik tanıları 2 hastada karsinosarkom, 2 hastada büyük hücreli nöroendokrin karsinom, 2 hastada epiteloid hemanjioendotelyoma, 1 hastada glomanjiosarkom, 1 hastada primer pulmoner leiomyosarkom, 1 hastada mukoepidermoid karsinom, 1 hastada sinovyal sarkom olarak raporlandı. Sonuç Akciğerin nadir görülen primer malign tümörlerine preoperatif görüntüleme ve invaziv yöntemler ile tanı koymak zor olabilir. Ameliyat öncesi yapılan tomografi eşliğinde ince iğne biyopsi, tru-cut biyopsi, bronkoskopik biyopsi örnekleri ve frozen incelemeleri tanı koymakta yetersiz kalabilir. Bu durum, operasyonu yapacak cerrahı yapılacak akciğer rezeksiyonu konusunda yanlış yönlendirebilir.