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Kazıklı temel sistemi uygulamaları son yıllarda giderek yaygınlaşmaktadır. Özellikle yüksek yapılarda çoğunlukla zorunluluk haline gelmektedir. Bu tez çalışmasında kazıklı sistemlerin dinamik yükler altındaki davranışları incelenmektedir. Çalışma üç aşamada yapılmıştır. Birinci aşamada eşdeğer lineer ve doğrusal olmayan zemin davranış analizleri bir ve üç boyutlu modeller üzerinde gerçekleştirilmiştir. İkinci aşamada doğrusal ve doğrusal olmayan model kazıklı sistemlerin statik ve dinamik yükler altındaki analizlerinin literatürdeki deneysel çalışma bulgularıyla kalibrasyonu yapılmıştır. Üçüncü aşamada ise literatürde kumlu zeminde bulunan tekil kazığın statik yatay yükler altında elde edilen P-Y eğrilerinin geliştirilen sayısal modellerden edinilen eğrilerle kalibrasyonu gerçekleştirilmiştir. Bu aşamada ayrıca farklı frekans ve genlikteki dinamik yükler altındaki tekil ve 3x3 grup kazık tepkilerinin irdelenmesi için sayısal modeller geliştirilmiş ve analizler gerçekleştirilmiştir. Eşdeğer lineer ve doğrusal olmayan zemin davranış analizlerinde izlenecek yol, kazıklı sistemlerde sayısal modelin oluşturulması için tanımlanabilecek etkileşim türleri ve grup kazıklarda kullanılan P-çarpanı parametresi ile ilgili kapsamlı açıklamalar tezde materyal ve yöntem bölümünde sunulmuştur. Üç boyutlu modellerin dinamik analizlerinde yansıtmayan sınırları temsil etmek için sonsuz elemanlar ve zeminin doğrusal olmayan davranışını tanımlamak için kinematik pekleşme modeli kullanılmıştır. Yapılan zemin davranış analizleri, statik ve dinamik etkiye maruz kazıklı sistem analizleri ışığında parametrelerin doğru kalibre edilmesi durumunda kinematik pekleşme modelinin zemin davranışını temsil edebildiği görülmüştür. Bunun yanında, kazık zemin arasında kullanılan etkileşim türünün yatay ve düşey taşıma kapasitesini olduğundan fazla veya az tahmin ettiği vurgulanmıştır. Son olarak, dinamik yükler altındaki 3x3 grup kazıklarda orta sıradaki kazıkların küçük genliklerde ön sıradakilere göre daha az yük aldığı ancak genlik arttıkça orta sıradaki kazıklara gelen yükün arttığı belirlenmiştir. Pile foundation system applications have become increasingly common in recent years. Especially in high-rise buildings, it often becomes a necessity. In this thesis, the behavior of piled systems under dynamic loads is examined. The study was carried out in three stages. In the first stage, equivalent linear and nonlinear site response analyzes were performed on one and three dimensional models. In the second stage, the analyzes of linear and non-linear model piled systems under static and dynamic loads were calibrated with the findings of experimental studies in the literature. In the third stage, the calibration of the P-Y curves obtained under static horizontal loads of single pile in sandy soil in the literature with the curves obtained from the developed numerical models was carried out. At this stage, numerical models were developed and analyzes were carried out to examine the response of single and 3x3 group piles under dynamic loads of different frequencies and amplitudes. Comprehensive explanations about the path to be followed in equivalent linear and non-linear site response analysis, the interaction types that can be defined for constructing the numerical model in pile systems, and the P-multiplier parameter used in group piles are presented in the material and method section of the thesis. In the dynamic analysis of the three-dimensional models, infinite elements are used to represent nonreflective boundaries and a kinematic hardening model is used to describe the nonlinear behavior of the soil. In the light of the site response analysis and pile system analysis subject to static and dynamic effects, it has been seen that the kinematic hardening model can represent the soil behavior if the parameters are correctly calibrated. In addition, it was emphasized that the type of interaction used between the pile-soil may over- or underestimate the horizontal and vertical bearing capacity. Finally, it was determined that in 3x3 group piles under dynamic loads, the middle row piles received less load than the front row piles at small amplitudes, but as the amplitude increased, the load on the middle row piles increased.

In the present study, the behaviour of infilled RC frames under earthquake loading is investigated numerically, and the influence of three different concrete material models on the in-plane behaviour of infilled RC frames is evaluated using the finite element analysis (FEA). For this reason, the efficiency of infilled walls is examined on full scale models. Finite element analysis results show that mathematical model of concrete may change behaviour of infilled RC frames. The post-peak behaviour is especially influenced.

Site response analysis is based on determining how strong ground motions occurring in bedrock are affected by local soils above the bedrock. Although the local ground response is determined as a result of simplified one-dimensional linear analysis of the system, which is actually three-dimensional, it is insufficient to represent the nonlinear behavior of soil which exhibiting plastic behavior under small deformations. The equivalent linear analysis method is more commonly used among other methods (linear or non-linear) to represent the nonlinear behavior of the soil. However, two or three dimensional analyzes are required in cases where the soil environment varies in all three dimensions or does not consist of horizontal layers, and especially when soil-structure interaction will be applied. In this study, threedimensional modeling strategies are dwelled on and the effects of nonreflective boundary element lengths, dimensions of the soil (system), finite element size and the frequency range selected for damping on the response of the three-dimensional system are investigated. Onedimensional and three-dimensional soil behavior analysis results are compared with the studies in the literature in terms of the maximum ground acceleration, maximum displacement and response spectrum. As a result of the comparisons, it is revealed that the correctly generated three-dimensional model can be applied in determining the ground behavior in cases where one-dimensional analysis cannot be used., Zemin davranış analizleri, anakayada meydana gelen kuvvetli yer hareketlerinin anakaya üzerinde bulunan yerel zeminler tarafından nasıl etkilendiğinin belirlenmesi esasına dayanmaktadır. Yerel zemin tepkisi, gerçekte üç boyutlu olan sistemin basitleştirilmiş bir boyutlu doğrusal analizler sonucunda belirlenmesine rağmen, küçük şekil değiştirmelerde plastik davranış sergileyen zeminin doğrusal olmayan davranışını temsil etmede yetersiz kalmaktadır. Eşdeğer doğrusal analiz yöntemi, zeminin doğrusal olmayan davranışını temsil etmek için diğer yöntemler (doğrusal ya da doğrusal olmayan) arasında daha yaygın bir şekilde kullanılmaktadır. Ancak, zemin ortamının her üç boyutta değişkenlik gösterdiği veya yatay tabakalardan oluşmadığı ve ayrıca özellikle yapı-zemin etkileşimi yapılacağı durumlarda iki veya üç boyutlu analizlere ihtiyaç duyulmaktadır. Bu çalışmada, üç boyutlu modelleme stratejileri üzerinde durulmakta ve yansıtmayan sınır eleman boyları, zeminin (sistemin) boyutları, sonlu eleman boyutu ve sönüm için seçilen frekans aralığının üç boyutlu sistemin tepkisi üzerindeki etkileri araştırılmaktadır. Bir boyutlu ve üç boyutlu zemin davranış analiz sonuçları maksimum yer ivmesi, maksimum deplasman ve tepki spektrumu dikkate alınarak literatürdeki çalışmalarla karşılaştırılmaktadır. Yapılan kıyaslamalar sonucunda, doğru bir şekilde oluşturulan üç boyutlu modelin, bir boyutlu analizlerin kullanılamayacağı durumlarda zemin davranışını belirlemede uygulanabileceğini ortaya koymaktadır

WOS: 000428480600001, On 6 February 2017 an earthquake swarm began at the western end of Turkey. This was the first recorded swarm in the Canakkale region since continuous seismic monitoring began in 1970. The number of earthquakes located increased during the following 10 days. This paper describes the output of a survey carried out in the earthquake-prone towns in the area of Ayvacik, Canakkale, Turkey, in February 2017 after the earthquakes. Observations of traditional buildings were made on site at the rural area of Ayvacik. A description of the main structural features and their effects on the most frequently viewed damage modes were made according to in-plane, out-of-plane behavior of the wall regarding construction practice, connection type, etc. It was found that there were no convenient connections like cavity ties or sufficient mortar strength resulting in decreased and/or lack of lateral load bearing capacity of the wall. Furthermore, distribution maps of damaged/undamaged buildings according to villages, damage ratios, structures and damage levels are generated. Distribution maps showed that damage ratio of structures is higher in villages close to epicenter and decrease away from epicenter except Gulpinar, where past experiences and development level affect the construction quality.

Heavy snowfall and frost are common phenomena in some areas of Turkey. Since it is an active seismic region, most engineering efforts focus on the impact of seismic loads. Meanwhile, the evaluation of structural and non-structural damages caused by snow loads are less of a concern. Depending on region geographical characteristics, snow is considered one of the most critical loads, especially in the case of large spans industrial structures, sport facilities and malls. This study investigates the snow induced failure of Bozuyuk Market in Turkey. An evaluation of the attributed reasons behind the reported collapse is provided. To investigate the critical regions of the structural systems, a finite element model has been generated, linear and nonlinear static push-down analysis are carried out for the collapsed portion of the structure of interest. The snow load calculations are compared in regard to national standards TS 498 and TS EN 1991–1-3. It has been found that the construction defects were the primary reason behind the partially failure of the investigated roof. The paper highlights the urgent need to upgrade the national standards regarding snow loads to go along with the changes in snowfall density and frequency due to accelerated climate change.

Stem Cell Transplantation is last chance for some patients and they enter the unit highly hopeful for their life. Although the physicians, medical director of unit are the observable part of iceberg, which is on the surface, nurses and the other members of team are like the huge invisible part of iceberg. If they are not educated well increased mortality rates are inevitable. This article summarises the role of nurses well to the fore and technicians.

On February 6, 2017 a swarm of earthquakes began at the western end of the Turkey. This has been the first recorded swarm at Çanakkale region since continuous seismic monitoring began in 1970. The number of located earthquakes increased during the next ten days. This paper describes the output of a survey carried out in the earthquake prone towns of Ayvacık, Çanakkale, Turkey, in February 2017 after the earthquakes. Observations collected on site regard traditional buildings at the rural area of Ayvacık. A description of the main structural features and their effects on the most frequently viewed damage modes are related in plane, out of plane behavior of the wall regarding construction practice, connection type etc. It was found that there were no convenient connection details like cavity-ties or sufficient mortar strength resulting in decreased and/or lack of lateral load bearing capacity of the wall.

Summary This phase II study explored the effects of bortezomib consolidation versus observation on myeloma-related bone disease in patients who had a partial response or better after frontline high-dose therapy and autologous stem cell transplantation. Patients were randomized to receive four 35-day cycles of bortezomib 1·6 mg/m2 intravenously on days 1, 8, 15 and 22, or an equivalent observation period, and followed up for disease status/survival. The modified intent-to-treat population included 104 patients (51 bortezomib, 53 observation). There were no meaningful differences in the primary endpoint of change from baseline to end of treatment in bone mineral density (BMD). End-of-treatment rates (bortezomib versus observation) of complete response/stringent complete response were 22% vs. 11% (P = 0·19), very good partial response or better of 80% vs. 68% (P = 0·17), and progressive disease of 8% vs. 23% (P = 0·06); median progression-free survival was 44·9 months vs. 21·8 months (P = 0·22). Adverse events observed ≥15% more frequently with bortezomib versus observation were diarrhoea (37% vs. 0), peripheral sensory neuropathy (20% vs. 4%), nausea (18% vs. 0) and vomiting (16% vs. 0). Compared with observation, bortezomib appeared to have little impact on bone metabolism/health, but was associated with trends for improved myeloma response and survival.

This phase II study explored the effects of bortezomib consolidation versus observation on myeloma-related bone disease in patients who had a partial response or better after frontline high-dose therapy and autologous stem cell transplantation. Patients were randomized to receive four 35-day cycles of bortezomib 1·6 mg/m2 intravenously on days 1, 8, 15 and 22, or an equivalent observation period, and followed up for disease status/survival. The modified intent-to-treat population included 104 patients (51 bortezomib, 53 observation). There were no meaningful differences in the primary endpoint of change from baseline to end of treatment in bone mineral density (BMD). End-of-treatment rates (bortezomib versus observation) of complete response/stringent complete response were 22% vs. 11% (P = 0·19), very good partial response or better of 80% vs. 68% (P = 0·17), and progressive disease of 8% vs. 23% (P = 0·06); median progression-free survival was 44·9 months vs. 21·8 months (P = 0·22). Adverse events observed ≥15% more frequently with bortezomib versus observation were diarrhoea (37% vs. 0), peripheral sensory neuropathy (20% vs. 4%), nausea (18% vs. 0) and vomiting (16% vs. 0). Compared with observation, bortezomib appeared to have little impact on bone metabolism/health, but was associated with trends for improved myeloma response and survival. © 2017 John Wiley & Sons Ltd

Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation, with a reported incidence between 0.8% to 32%. Herein we retrospectively analyzed the patients who diagnosed as PTLD in Akdeniz University. Within the 782 (773 renal and 9 heart) transplant recipients six patients were diagnosed as PTLD (diffuse large B-cell lymphoma). Five of them had renal, one had cardiac transplantation. Three patients were diagnosed within the first year of transplantation. Five patients had abdominal disease one had central nervous system involvement. All patients had positive Epstein-Barr virus (EBV) and cytomegalovirus (CMV) IgG at the time of diagnose. EBV-DNA with polymerase chain reaction (PCR) was found to be negative in five patients. Only one patient was survived after the diagnosis of PTLD. In conclusion, even with treatment the mortality rate is high in patients with PTLD. In order to decrease the incidence of PTLD and related mortality, the risk factors should be evaluated with multicenter studies.Transplantasyon sonrası gelişen lenfoproliferatif hastalık (PTLH) organ nakillerinin önemli bir komplikasyonu olup, %0.8 ile %32 oranında görülmektedir. Burada Akdeniz Üniversitesi`nde tespit edilen PTLH olgularını retrospektif olarak değerlendirmeyi amaçladık. Transplantasyon yapılmış olan 782 (773 böbrek, 9 kalp) hastanın altısında difüz büyük B-hücreli lenfoma gözlenmiştir. Olguların beşi böbrek, biri kalp nakli yapılmış hastalar olup, üç hastada ilk bir yıl içinde lenfoma geliştiği tespit edilmiştir. Olguların beşinde hastalık batından, birinde santral sinir sisteminden kaynaklanmıştır. Tüm hastalarda lenfoma tanısı aldıkları sırada Epstein-Barr virüs (EBV) ve sitomegalovirüs (CMV) ıgG pozitif, beş olguda polimeraz zincir reaksiyonu ile EBV-DNA negatif bulunmuştur. Tanıdan sonra yapılan tedaviler ile yalnızca bir olgu hayatta kalabilmiştir. Sonuç olarak, tedaviye rağmen mortalitesi yüksek olan PTLH sıklığını ve buna bağlı ölüm oranlarını azaltabilmek için risk faktörlerinin çok merkezli çalışmalarla tespit edilmesi gerekmektedir.

Serum soluble CD23 (sCD23) and soluble IL-2 receptor (sIL-2R) levels increase not only in disorders with immune system activation, but also in hematological malignancies. They have been used as markers of disease progression and/or the response to therapy in lymphoproliferative disorders (LPD). In this study, we investigated the serum sCD23 and sIL-2R levels of 21 patients with different hematological malignancies [10 LPD, 6 multiple myeloma (MM), and 5 myelodysplastic syndrome (MDS)] before treatment, and compared them with 19 age- and sex- matched healthy subjects. Median sIL-2R levels were found to be significantly elevated in both the overall patient group and each of the subgroups. Median sCD23 levels were significantly higher in the overall patient group and in patients with LPD and MM. A positive correlation was found between sIL-2R and sCD23 levels in LPD. Our preliminary findings suggest that elevated serum levels of these soluble factors are not only markers of LPD but might be also used for other hematologic malignancies, except for MDS. Further studies should be designed to find out if it might be the result of an overactive immune system or not.

Pneumocystis carinii (P. carinii) is an organism which was previously considered as a protozoan but recently it was shown to be more related to fungi. P. carinii increasingly causes opportunistic infections in immunocompromised patients. In this study, we detected P. carinii oocysts by indirect immunofluorescence test in 33 specimens obtained from 31 patients with haematological malignancies who had symptoms of pneumonia and investigated probable risk factors (corticosteroid usage, neutropenia duration, severe or mild neutropenia and type of haematological malignancy) for P. carinii pneumonia in P. carinii (+) patients. Although not statistically significant, PCP incidence was higher in relapsed acute leukemia (AL) patients (62.5%), patients with prolonged neutropenia (57.1%), and who received high dose ARA-C therapy (62.5%). P. carinii (+) patients were treated with trimethoprim-sulfamethoxazole. Six patients with PCP did not respond to therapy and died (50%). In conclusion PCP is not infrequent in AL (especially relapsed AL) and, indirectly we can suggest that chemoprophylaxis may be considered for these patients when they were in severe and prolonged neutropenia after high dose ARA-C therapy.

Amaç: Kistik fibrozis (KF) otozomal resesif geçiş gösteren, epitel hücre membranındaki Kistik Fibrozis Transmembran Regülator (KFTR) adlı klor kanalının defekti sonucu ortaya çıkan ter bezleri, solunum, pankreas, gastrointestinal ve genital sistemin müköz bezlerini tutan metabolik bir hastalıktır. Bu çalışmada KF tanısı almış hastaların klinik ve laboratuar özellikleri incelendi.Gereç ve Yöntemler: Bu çalışmada Dicle Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Göğüs Hastalıkları Ünitesinde Kistik Fibrozis tanısı almış hastaların klinik ve laboratuar özellikleri retrospektif olarak değerlendirildi. Bir veya daha fazla Kistik Fibrozis klinik bulgu taşıyan ve ter testi >90 mEq/L olan hastalar ile en az bir Kistik Fibrozis klinik bulgu taşıyan ter testi normal veya sınırda olan hastalar için iki mutasyon gösterilerek tanı alan hastalar çalışmaya dahil edilecekdi (Ter testi Macroduct yöntemi ile yapılmaktadır).Bulgular: Bu çalışma 22 kız (%45,8) ve 26 erkek (%54,2) Kistik Fibrozisli olgudan oluşturuldu. Olguların cinsiyet, yaşadığı yer, tanı yaşı, hastaneye başvuru şikayeti, ilk yıl hastaneye başvuru sayısı, son yıl hastaneye başvuru sayısı, hastaneye başvuru mevsimi, hastaneye yatış sayısı, anne baba akrabalığı, kistik fibrozis kardeş öyküsü, fizik muayene bulguları, laboratuvar özellikleri, akciğer tomografi bulguları ve elektrokardiyografi bulguları değerlendirildi. Ayrıca son kontrolde, hastaneye başvuru şikayeti, fizik muayene bulguları, laboratuar bulguları, beslenme durumu, son balgam kültürü, akciğer grafisi bulguları, KF'e bağlı gelişen komplikasyonlar ve aldıkları tedaviler değerlendirildi. Olgularımızın 31'i (%64,6) Diyarbakır'da ikamet etmekteydi. Hastalarımız en sık ilk bir yaş içinde tanı almıştı. En sık başvuru şikayeti akciğer enfeksiyonudur. 14 (%29,2) hastanın KF kardeş öyküsü olduğu saptandı. En sık rastlanılan laboratuvar bozukluğu transaminaz yüksekliği ve anemi idi. Olgularımızın 30'unda (%62,5) anne baba akrabalığı vardı. Tanı aldıktan sonraki yıl ortalama hastaneye başvuru sayısı 8,88±5,24, son bir yıl içinde ortalama hastaneye başvuru sayısı 4,58±2,99 olarak bulundu. Son kontrolde 21 olgunun (%43,8) öksürük şikayeti ile başvurduğu, 18 olgunun (%37,5) fizik muayenede sekretuar rallerinin olduğu, ideal vücut ağırlığı yüzdesine göre 20 olgunun (%40,1) yetersiz beslendiği, en sık gelişen komplikasyonun bronşektazi olduğu, balgamda en sık üreyen mikroorganizmanın pseudomonas aeruginosa olduğu ve hastalarımızın çoğunun insan deoksiribonükleazı ve pankreas enzim tedavisi aldığı saptandı.Sonuç: Günümüzde KF hastalığı çocukluk döneminde ciddi sağlık problemlerine neden olmaya devam etmektedir. KF'li hastalarda komplikasyonu gelişimini önlemek için erken tanı ve tedavide multidisipliner yaklaşım hastaların yaşam kalitesinin artması için büyük önem taşımaktadır.Anahtar Kelimeler: Kistik Fibrozis, çocuk, erken tanı ve tedavi Objective: Cystic Fibrosis (CF) is a autosomal recessive metabolic disorder with defect chloride channel in the epithelial cell membrane named Cystic Fibrosis Transmembrane Regulator (CFTR) that resulting sweat glands, pulmonary, pancreatic, gastrointestinal and genital tract mucous glands. In this stady were analyzed clinical and laboratory characteristic of patients diagnosed with CF.Material and Methods: In this study were evaluated retrospectively by clinical and laboratory characterictics of patients who were diagnosed with Cystic Fibrosis in the Dicle University Faculty Medicine, Department of Child Health and Disease, Pediatric Pulmonology Unit. This study one or more of the Cystic Fibrosis clinical features bearing and sweat chloride test >90mEq/L in patients with at least one Cystic Fibrosis clinical feature that sweat chloride test is normal or borderline for patients with two mutations showing the diagnosed patients will be included. (Sweat chloride test performed by the method of Macroduct)Result: This study consisted of 22 (45,8%) female and 26 (54,2%) male patients with Cystic Fibrosis. Cases' gender, where they live, diagnosis age, reason for hospital admission, number of hospital admissions in the firs year, number of hospital admissions in the last year, hospital admissions season, number of hospitalizations, relatedness parents, sister or brother history of Cystic Fibrosis, physical examination findings, lung tomography findings, elektrocardiocraphic findings were evaluated. Also due to last control were evaluated cases' reason for hospital admission, physical examination findings, labaratory findings, nutritional status, last sputum culture, chest X-ray findings, complications related CF and their treatment. 31 of our patients (64,6%) was living in Diyarbakır. Our patients were diagnosed most frequently in first year of age. Most commond initial complaints is a lung infection. Male patient more refers to hospitals during the winter season (p=0,02). 14 (29,2%) patients had a CF family history. Most frequent labaratory abnormalities were height transaminase and anemia was is. 30 patients (62,5%) had kinship parents. In the first year the average the number of applications to the hospital was found 8,88±5,24, and in the last year the average the number of applications was found 4,58±2,99. İn the last control; were fount that 21 patients (43,8%) had cough, 18 patients (37,5%) secretory crackles on physical examination, 20 patients (40,1%) were malnourished according to the percentage of ideal body weight, the most frequent complication was bronciectasis, the most common microorganism was Pseudomonas aeruginosa in sputum and many of our patients are being treated with pancreatic enzymes and human deoxyribonuclease.Conclusion: Today CF disease continues to cause serious health problems in the childhood. To prevent the development of complications in patients with CF, early diagnosis and multidisciplinary approach in the treatment of CF is of great importance to increase the quality of life of patients.Keywords: Cystic Fibrosis, child, early diagnosis and treatment 82