Search

Videoendoskopik yaklaşım yerini almaya başlamakla birlikte bazı durumlarda torakotomi halen standart uygulamadır. Bu durumların başında da çocukluk çağı cerrahi hastalıkları gelmektedir. Bu çalışmamızda 2015-2017 yılları arasında torasik patolojilerin tanı ve tedavisi amacıyla çocuk yaş gurubunda torakotomi tecrübemizi paylaşmayı amaçladık. Gereç ve Yöntem: Hastalar çocuk sağlığı ve hastalıkları anabilim dalının ilgili bilim dalları ile yapılan konsültasyonları ile değerlendirildi. Tanısal veya tedavi amaçlı cerrahi işlem kararı verilen hastalara cerrahi müdahalenin torakotomi ile yapılması kararı göğüs cerrahisi tarafından verildi. Otuzbeş hastaya torakotomi yapıldı. Veriler retrospektif olarak tarandı. Bulgular: Ortalama yaş 8.3 yıl (9 ay-15 yaş). Yirmiiki erkek (%62.8), 13 kız (%37.2). Onbeş sağ (%43 ),20 (%57) sol torakotomi yapıldı. Torakotomi ile 5 lobektomi (14,25%), 1 bilobektomi (2,8%), 5 pnömonektomi (14,25%), 7 wedge rezeksiyon (19,6%), 1 lobektomi+wedge rezeksiyon (2,8%), 2 göğüs duvarı rezeksiyonu (5,7%), 3 mediyastinal kitle eksizyonu (8,4%), 6 kist hidatik (17,1%), 1 diyafragma rüptürü tamiri (2,8%), 1 hemotoraks eksplorasyonu (2,8%), 1 duktus ligasyonu (2,8%), 1 apiyemektomi (2,8%), 1 metastazektomi (2,8%) yapıldı. Patolojiye materyal gönderilmiş olan vakaların içinde bronşiektazi ve kist hidatik en sık iki tanı idi (Tablo 1). Bronşiektazi nedeniyle opere edilen 3 hastada eşlik eden sendrom ve romatizmal hastalık mevcuttu. Hastaneden yatış süresi ortalama 10.2 gün (3- 40 gün). Postop mortalite olmadı. Üç hastaya sekresyon retansiyonuna bağlı atelektazi nedeniyle bronkoskopi yapıldı. Bir hastaya ekspansiyon kusuru nedeniyle postoperatif takipte toraks dreni takıldı. Tartışma-Sonuç: Videotorakoskopinin göğüs cerrahisi uygulamalarında kullanım sıklığı ve kulanıldığı durumların çeşitliliği giderek artmaktadır. Torakotomi ise göğüs cerrahisinin temel uygulama kesisi olarak günümüze kadar kullanılagelmiştir. Videotorakoskopinin göz ardı edilemeyecek avantajları olsa da pediyatrik vakalarda özellikle teknik gereklilik nedeniyle torakotomi halen güncelliğini korumaktadır. Gereklilik halinde çocukluk çağı vakalarında güvenle, düşük morbidite ile uygulanabilir ve uygulanmasından kaçınılmamalıdır. Anahtar Kelimeler: Videotorakoskopi, Çocuklarda Torakotomi, Torakotomi

An esophageal stricture refers to the abnormal narrowing of the esophageal lumen. It often presents as dysphagia commonly described by patients as difficulty in swallowing. It is a serious sequela to many different disease processes and underlying etiologies. Benign means that it is not caused by cancer of the esophagus, and subjects to inflammation, esophagitis, and scar tissue, which causes the esophagus to narrow. Its recognition and management should be prompt.These strictures have a negative impact on the quality of life of patients, mainly because of dysphagia and may lead to severe complications, such as malnutrition, weight loss and aspiration. Endoscopic dilation with bougies or balloons is initial standard treatment for such lesions.Esophagectomy is rarely needed for benign conditions. Usually reserved for end-stage disease, when the esophagus is either severely non-functional or when quality of life is very poor. In these circumstances esophagectomy is a good option to consider and it is associated with encouraging success rates and improved quality of life. Depending on the specific disease leading to organ failure, peculiar technical issues should be carefully evaluated in order to avoid complications and optimize results

35th European Photovoltaic Solar Energy Conference and Exhibition; 188-191, TiOx is an n-type semiconductor with a high dielectric constant, that has been frequently employed in photovoltaic solar cell applications. Thin films of TiOx have been recently demonstrated to act as an efficient electron selective and passivation layers for n-type crystalline silicon (c-Si) solar cells. In this study, optical and compositional characterizations of TiOx thin films deposited by thermal atomic layer (ALD) using tetrakis(dimethylamido)titanium (TDMAT) and H2O as precursors on n-type c-Si substrates, were investigated by using spectroscopic ellipsometry (SE) and x-ray photoelectron spectroscopy (XPS) techniques. Effects of substrate and precursor temperature as well as postdeposition annealing on the optical and compositional properties of ALD-grown TiOx thin films were investigated.

Presently described is case of a 42-year-old woman with eye injury that was result of gunshot fired by a man at a wedding celebration. Bullet penetrated inferior quadrant of nasal sclera of left eye 7–12 mm behind limbus. Choroid and vitreous were prolapsed around bullet. Hemorrhage, vitreous prolapse and lens subluxation were present in anterior chamber. Presenting visual acuity (VA) was hand motion. Bullet 14×5 mm in size was carefully extracted from the eye. Fifteen days later, argon laser photocoagulation was performed on retina in area of bullet entry point. VA was 20/25 (Snellen) at final visit. In this case, although foreign body was large, area of penetration was Zone III, and initial VA was poor, early and appropriate surgical repair achieved integrity of the globe and good vision prognosis. © 2017 TJTES.

Plevral boşluk temel olarak pariyetal ve viseral plevra yaprakları arasında kalan potansiyel boşluktur. Akciğerlerin çalışması ve solunum işinin optimum şekilde devam etmesi için plevral boşluğun normal fizyolojide olması son derece önemlidir. Enfeksiyonlar, maligniteler, travmalar gibi nedenlerle plevral boşlukta sıvı (ampiyem, malign plevral sıvı, hemotoraks vs.) ve hava (pnömotoraks) toplanması meydana gelebilir. Bu gibi etkenler plevral boşluk fizyolojisini bozarak solunum fonksiyonlarını etkilediğinden dolayı çözülmesi gereken sorunlar olarak karşımıza çıkmaktadır. Plevral boşluk problemlerinin çözülmesinde parenteral antibiyotik verilmesi gibi medikal tedaviler, plevral boşluğa katater/göğüs tüpü takılması veya Videotorakoskopi ya da torakotomi yapılması gibi cerrahi uygulamaları veya kateter/tüp takıldıktan sonra plevral boşluğa etyolojiye göre skatrizan yada fibrinolitik ajan verilmesi gibi cerrahi ve medikal yöntemlerin bir arada kullanıldığı tedavi alternatifleri vardır. Basicly, the pleural space is a potential space between the visceral and parietal pleura layers. It is so important that the pleural space is on normal physiology for working of the lungs and continueing respiration in optimum condition. Fluid (empyema, malign pleural effusions, haemothorax etc.) or air (pneumothorax) may be collected in the pleural space because of reasons like infections, malignancies and traumas. \"eese kind of factors are problems must be solved because of affecting the respiratoru functions by deteriorating the pleural space physiology. \"ere are many treatment alternatives to solve pleural space problems so medical methods like using antibiotics, surgical procedures like catheter/tube thoracosthomy applications or performing VATS/thoracotomy and using medical and surgical technics together like performing catheter/tube thoracostomi and giving a scatrisial or fibrinolitic agent via this drainage device.

Being a behaviorist aligned technique; drill and practice are still actively used in English vocabulary learning. The purpose of this study is to compare the effects of verification and elaborative feedback on students’ English vocabulary learning. The pre-test post-test with control group experimental research design was used in the study. Freshman prospective teachers participated in the study. Findings indicate that utilizing elaborative feedback improves prospective teachers’ vocabulary learning more than the verification feedback in computer-based vocabulary learning. Future research should investigate the effects of multimedia feedbacks on individuals’ English vocabulary learning. © The Turkish Online Journal of Educational Technology.

The implications of learning style in education have a huge potential to improve teaching and learning. The purpose of this study is to investigate the effects of matching and mismatching learning style of students and the lecturer on the students’ achievement. The casual comparison method (ex post facto design) was utilized in the study. The sample of the study included 258 prospective teachers. Participants’ demographic information, learning style and course grade lists were used as data. Results of the study indicated that majority of the patricipating students and the lecturer has the “assimilating” learning style. It was also found that matching and mismatching learning style of students and the lecturer did not affect the achievement of students in the Turkish Folk Literature course regardless of the gender. Besides students’ achievement, future studies should use students’ motivation towards the course, their attitudes and/or their course involvement variables to examine the effects of matching and mismatching. © The Turkish Online Journal of Educational Technology.

We report the case of 36-year-old woman who came to us with a history of recurrent miscarriages and who was later diagnosed as having primary antiphospholipid syndrome (PAPS) and chronic hepatitis C virus (HCV) infection. The patient was referred to us with generalised seizures; cranial MRI revealed multiple embolic infarcts in both frontal lobes and a focal cortical infarct in the left frontoparietal lobe. Her echocardiography showed mitral valve vegetation and insufficiency. The patient was put on oral anticoagulant therapy and during her 8-month follow-up period no thrombotic events occurred. We report this case because it was the first in which PAPS, valvular disease, a cerebral embolic event and HCV infection were coexistent in the same patient. We also review other cases in which there was valvular vegetation and a cerebral ischaemic event associated with PAPS.

To determine the maternal serum N-Terminal proBNP levels in predicting development of preeclampsia.

Background. Various caspases have been implicated in the development of secondary damage after spinal cord injury (SCI). Anticaspase therapy that targets only one caspase has been investigated in a variety of in vitro and in vivo studies. This study examined the neuroprotective effects of Q-VD-OPh, a pan-caspase inhibitor, in a rat model of SCI. Methods. Thirty Wistar albino rats were divided into 3 groups of 10 each: the sham-operated controls (group 1), the trauma-created controls (group 2), and the QVD-OPh"treated rats (group 3). An SCI (a trauma of 40 g-cm) was produced at the thoracic level (T8-T10) by the weight-drop technique. The response to injury and the neuroprotective effects of Q-VD-OPh were investigated by histopathologic examination and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) 24 hours and 5 days after trauma. The inclined plane technique of Rivlin and Tator and a modified version of Tarlov's grading scale were used to assess the functional status of the rats 24 hours, 3 days, and 5 days after injury. Results. Twenty-four hours after trauma, light microscopic examination of a specimen taken from group 2 rats revealed hemorrhage, necrosis, vascular thrombi, and edema. Group 3 tissue samples showed similar features at that time. Twenty-four hours after trauma, the mean apoptotic cell number was 4.47 ± 0.35 cells in group 2 and 1.58 ± 0.33 in group 3. Five days after injury, the mean apoptotic cell count was 4.35 ± 0.47 in group 2 and 1.25 ± 0.34 in group 3. Thus the number of TUNEL-positive cells in an injured spinal cord was greatly reduced by treatment with Q-VD-OPh. The neurologic function scores (both the inclined plane performance and motor grading scores) were significantly better in the Q-VD-OPh"treated group than in the trauma-created control group. Conclusion. The marked antiapoptotic properties of Q-VD-OPh due to the inhibition of all caspases render it a promising novel agent. A therapeutic strategy using Q-VD-OPh may eventually lead to the effective treatment of SCI in humans. Introducción. En el desarrollo de daño secundario tras lesión medular están implicadas diversas caspasas. La terapia anti-caspasas ha utilizado como diana una sola caspasa que ha sido investigada en una gran variedad de estudios tanto in-vitro como in-vivo. Estos estudios han examinado el efecto neuroprotector del Q-VD-PPh, un inhibidor pan-caspasa, en un modelo de lesión medular en rata. Material y métodos. Se dividieron 30 ratas Wistar en tres grupos de 10 ratas cada uno: una lesión medular traumática (con un trauma de 40 g-cm) se realizó a nivel torácico grupo control (grupo 1), grupo trauma control (grupo 2) y el grupo de ratas tratadas con Q-VD-OPh (grupo 3) se realizó a nivel torácico (T8-T10) mediante la técnica de caída de peso. La respuesta a la lesión y los efectos neuroprotectores de Q-VD-OPh se valoraron mediante el examen histopatológico y la técnica de TUNEL 24 horas y 5 días tras el traumatismo. Se usó la prueba del plano inclinado de Rivlin y Tator y una versión modificada de la escala de Tarlov para valorar el resultado funcional de las ratas 24 horas, 3 días y 5 días tras la lesión. Resultado. Veinticuatro horas tras la lesión, el estudio histopatológico de las secciones obtenidas del grupo 2 revelaron hemorragia, necrosis, trombos vasculares y edema. Las secciones obtenidos del grupo 3 mostraron hallazgos similares en ese momento. 24 horas tras la lesión el número de células apoptóticas fue 4.47 ± 0.35 en el grupo 2 y 1.58 ± 0.33 en el grupo 3. Cinco días tras la lesión el número medio de células apoptóticas fue de 4.35 ± 0.47 en el grupo 2 y de 1.25 ± 0.34 en el grupo 3. De esta forma el número de células TUNEL positivas en la médula dañada se redujo de forma considerable con el tratamiento con Q-VD-OPh. La función neurológica (tanto con el plano inclinado como con las escalas motoras) fueron significativamente mejores en el grupo de ratas tratadas mediante Q-VD-OPh que en el grupo control. Conclusión. Los marcados efectos antiapoptóticos de la Q-VD-OPh debido a la inhibición de todas las caspasas hace que sea un agente prometedor.

Background. An increase in the level of intracellular calcium activates the calcium-dependent neutral pro-tease calpain, which in turn leads to cellular dysfunction and cell death after an insult to the central nervous system. In this study, we evaluated the effect of a calpain inhibitor, AK 295, on spinal cord structure, neurologic function, and apoptosis after spinal cord injury (SCI) in a murine model. Methods. Thirty albino Wistar rats were divided into 3 groups of 10 each: the sham-operated control group (group 1), the spinal cord trauma group (group 2), and the spinal cord trauma plus AK 295 treatment group (group 3). After having received a combination of ketamine 60 mg/kg and xylazine 9 mg/kg to induce anesthesia, the rats in groups 2 and 3 were subjected to thoracic trauma by the weight drop technique (40 g-cm). One hour after having been subjected to that trauma, the rats in groups 2 and 3 were treated with an intraperitoneal injection of either dimethyl sulfoxide 2 mg/kg or AK 295 2 mg/kg. The effects of the injury and the efficacy of AK 295 were determined by an assessment of the TUNEL technique and the results of examination with a light microscope. The neurologic performance of 5 rats from group 2 and 5 from group 3 was assessed by means of the inclined plane technique and the modified Tarlov's motor grading scale 1, 3, and 5 days after spinal cord trauma. Findings. Light-microscopic examination of spinal cord specimens from group 2 revealed hemorrhage, edema, necrosis, and vascular thrombi 24 hours after trauma. Similar (but less prominent) features were seen in specimens obtained from group 3 rats. Twenty-four hours after injury, the mean apoptotic cell numbers in groups 1 and 2 were zero and 4.57 ± 0.37 cells, respectively. In group 3, the mean apoptotic cell number was2.30 ± 0.34 cells, a value significantly lower than that in group 2 (P < .05). Five days after trauma, the injured rats in group 2 demonstrated significant motor dysfunction (P < .05). In comparison, the motor scores exhibited by group 3 rats were markedly better (P < .05). Conclusions. AK 295 inhibited apoptosis via calpaindependent pathways and provided neuroprotection and improved neurologic function in a rat model of SCI. To our knowledge, this is the first study to evaluate the use of AK 295, a calpain inhibitor, after SCI. Our data suggest that AK 295 might be a novel therapeutic compound for the neuroprotection of tissue and the recovery of function in patients with a SCI. Introducción. Una lesión en el sistema nervioso central origina un incremento en los niveles de calcio intracelular que activa la proteasa neutral calcio-dependiente calpaina, que a su vez conduce a la producción de disfunción y muerte celular. En este estudio evaluamos el efecto de un inhibidor de la calpaina, AK 295, sobre la estructura de la médula espinal, la función neurológica y apoptosis tras lesión medular en un modelo murino. Métodos. Treinta ratas Wistar se dividieron en tres grupos de 10 ratas cada uno: Un grupo control (grupo 1), un grupo sometido a trauma espinal (grupo 2) y un grupo de ratas a las que se sometió a trauma medular y tratamiento con AK 295 (grupo 3). Después de recibir una combinación de ketamina 60mg/kg y xylazina 8mg/kg para la inducción anestésica, las ratas del grupo 2 y 3 fueron sometidas a trauma medular torácico mediante la técnica de caída de peso (40 g-cm). Una hora después de haber sufrido el traumatismo, las ratas del grupo 2 y 3 fueron tratadas mediante una inyección intraperitoneal bien de dimetil-sulfóxido 2mg/kg o de AK 295 2 mg/kg. Los efectos del traumatismo y la eficacia de AK 295 fueron determinados mediante la estimación de la técnica TUNEL y los resultados del examen del tejido mediante microscopía óptica. La función neurológica de 5 ratas del grupo 2 y 5 del grupo 3 fue estimada mediante la técnica del plano inclinado y la escala motora de Tarlov modificada a 1, 3 y 5 días desde el traumatismo medular. Resultados. El estudio mediante microscopía óptica de las preparaciones de médula espinal del grupo 2 demostró la existencia de hemorragia, edema, necrosis y trombosis vascular 24 horas tras el traumatismo. Hallazgos similares pero menos importantes se encontraron en las preparaciones procedentes del grupo 3. Veinticuatro horas tras el trauma, el número medio de células apoptóticas en los grupos 1 y 2 fueron cero y 4.57 ± 0.37 células respectivamente. En el grupo 3, el número medio de células apoptóticas fue de 2.30 ± 0.34 células, un valor significativamente menor que en el grupo 2 (p < 0.05). Cinco días tras el traumatismo, las ratas lesionadas en el grupo 2 demostraron una significativamente mayor disfunción neurológica (p

The Internet and computer technology have altered the education landscape. Online courses are offered throughout the world. Learning about the experiences of faculty members is important to guide practitioners and administrators. Using qualitative research methodology, this study investigated the experiences of faculty members teaching online courses. A convenience sampling was used to select the instructional technology faculty members to investigate their experiences in online courses. Semistructured interviews with faculty members teaching online courses were used as the primary source to collect data about the experiences of faculty members in online courses. Results of the study showed that faculty members' interest in using technology and the amount of time available to them for online course design affected the quality of online courses. The findings of this study also indicated that design quality of online courses is affected by the interest of faculty members to use the technology and the time that they can devote to planning, designing, and developing online courses. The poor design of existing online courses, high learning expectations of individuals from these courses, and the future of online courses are the concerns of faculty members. Higher education institutions should support workshops and trainings to increase the skills and interests of non-instructional design faculty members to design and develop online courses.