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This research addresses the issue of how we can benefit from school culture and school principals' leadership styles in order to reach schools that respond to the needs of the 21st century and to create dynamic schools and to provide school dynamism to meet the current and possible needs of their students both today and in the future. In this direction, seeking an answer to the question in the research, "Do the leadership styles of school principals and school culture significantly predict school dynamism?". The research is a descriptive study in survey method with relational approach. Within the scope of the research, data were collected from 747 teachers working in secondary schools located within the borders of İzmir province, using multi-stage stratified proportional cluster sampling. The relationship between school principals' level of realization of leadership styles, school culture and school dynamism was analyzed using hierarchical multiple regression. The independent variables of the research are school principals' leadership styles and school culture; The dependent variable is school dynamism. The results obtained from the research explain how we can benefit from the school principals' leadership styles and school culture to ensure school dynamism. In the research, it has been concluded that the highest contribution to school dynamism is made by the transformational leadership in schools where the culture of duty, success and bureaucracy is dominant, and the leadership that allows freedom, being negative in schools where the support culture is dominant. According to partial correlations and explained variance values in the study, it was seen that the effect of task and success culture on school dynamism was higher than support culture and bureaucratic culture. The research offers suggestions for school principals to think and act on their leadership behaviors and school culture in order to ensure school dynamism.

Background: Peptic ulcer perforation is a complication of peptic ulcer disease frequently encountered in the emergency departments. Although there are many treatment options ranging from nonoperative treatment to wide resections, surgery is the first treatment option in peptic ulcer perforations. In this article, we aimed to present the feasibility of nonoperative treatment in appropriate and selected cases.Materials and Methods: The data of the patients who were not operated but provided with medical treatment in our clinic between January 2016 and July 2018 were evaluated retrospectively. Results: Three of the patients were male, one of them was female, and the mean age was 58 years (range, 35-79). On physical examination, there were no signs of acute abdomen, only tenderness was observed in the right upper quadrant and epigastric region. Standing direct abdominal radiography revealed free air under the diaphragm in three patients. The diagnosis was made with tomographic findings in one patient. No contrast agent extravasation was observed in any patient. The patients were examined intermittently by a specialist surgeon, oral intake was permitted on the 4th day of hospitalization, and they were discharged on the 7th day on average.Conclusion: Peptic ulcer perforation is a condition, which is still common and requires emergency surgery in case of acute abdomen development. Although the time elapsed after perforation is a factor affecting mortality and morbidity, nonoperative treatment is a method that can be successfully applied under strict physical examination and laboratory follow-up in appropriate and selected patients without diffuse peritonitis and extravasation on CT with water-soluble contrast agent., Amaç: Peptik ülser perforasyonu acil servislerde sık karşılaşılan peptik ülser hastalığının bir komplikasyonudur. Peptik ülser perforasyonlarında non-operatif tedaviden geniş rezeksiyonlara kadar pek çok tedavi seçeneği olmasına rağmen ilk tedavi seçeneği cerrahidir. Bu makalede uygun ve seçilmiş olgularda non-operatif tedavinin uygulanabilirliğini sunmayı amaçladık.Gereç ve Yöntemler: Kliniğimizde Ocak 2016 – Temmuz 2018 tarihleri arasında cerrahi uygulanmayıp medikal tedavi edilen hastaların verileri retrospektif olarak değerlendirilmiştir.Bulgular: Hastaların üçü erkek biri kadın ve ortalama yaşları 58 (35-79) idi. Hastaların fizik muayenesinde akut karın bulguları yok sadece sağ üst kadranda ve epigastrik bölgede hassasiyet vardı. Üç hastada ayakta direkt karın grafisinde diyafragma altında serbest hava vardı. Bir hastada ise tanı tomografik bulgularla konuldu. Hiçbir hastada kontrast madde ekstravazasyonu görülmedi. Hastalar uzman bir cerrah tarafından aralıklı muayene edildi ve yatışının 4. Günü orali açılıp ortalama 7. günde hastalar taburcu edilmiştir.Sonuç: Peptik ülser perforasyonu halen sık karşılaşılan ve akut karın tablosu gelişmiş ise acil cerrahi gerektiren bir durumdur. Her ne kadar perforasyon sonrası geçen süre mortalite ve morbitideyi etkileyen bir faktör olsa da seçilmiş uygun vakalarda suda çözünen kontrast madde ile çekilen BT de ekstravazasyon yoksa ve yaygın peritonit halinin olmadığı, uygun ve seçilmiş hastalarda sıkı fizik muayene ve laboratuar takibi altında başarıyla uygulanabilir bir yöntemdir.

Bu çalışma okul müdürlerinin göstermiş oldukları karanlık liderlik davranışlarına yönelik öğretmen algılarını saptamak üzere geçerli ve güvenilir bir ölçme aracı geliştirmeyi amaçlamaktadır. Alanyazın incelemesi ve alan uzmanlarının görüşleri sonucunda oluşturulan Karanlık Liderliği Ölçeği; Kesinlikle Katılıyorum, Katılıyorum, Kararsızım, Katılmıyorum, Kesinlikle Katılmıyorum olmak üzere 5’li Likert tipindedir. Karanlık Liderlik Ölçeğinin yapı geçerliğini test etmek amacıyla Açımlayıcı Faktör Analizi ve Doğrulayıcı Faktör Analizi yapılmıştır. Açımlayıcı faktör analizi sonucunda 15 madde ve 3 boyuttan oluşan bir ölçme aracı elde edilmiştir. Ölçeğin birinci alt boyutu “Sorumsuz Davranışlar”, ikinci alt boyutu “Büyüklenmeci Davranışlar” ve üçüncü alt boyutu “Uyumsuz Davranışlar” olarak isimlendirilmiştir. Ölçeğin geneli için Cronbach Alpha Katsayısı 0,93 olarak belirlenmiştir. Ölçekte, özdeğerler için birikimli varyans miktarının toplam varyansın %74,35’ini açıkladığı görülmektedir. Doğrulayıcı faktör analizi sonuçları ise standart uyum indekslerini karşılamaktadır (χ2/sd = 3,04, GFI = ,90, AGFI = .86, CFI =,95, NFI = .93). Ölçeğin S-RMR= ,044 değeri de sıfıra yakındır. RMSEA= ,079 değerinde ve uyum indekslerinin hepsi kabul edilir düzeydedir. Bu doğrultuda, sonuçlar bu ölçme aracının geçerli ve güvenilir olduğunu doğrulamaktadır.

Background: Sclerosing encapsulating peritonitis (SEP) is a rare cause of acute abdomen and can be easily misdiagnosed. Preoperative diagnosis of the SEP can be performed with preoperative imaging studies. We aimed to evaluate the clinical features of ileus cases who were diagnosed with primary or secondary SEP in the last five years. Methods: This retrospective cohort study evaluated the patients who were admitted with ileus or acute abdomen symptoms to the Emergency Department of Elazig Training and Research Hospital and underwent surgery by the same surgical team of General Surgery Department between January 2014 and January 2019. Patients who were diagnosed with primary or secondary SEP were included. The demographic data, clinical presentation, whether the disease was primary or secondary, the treatment options performed and mortality rates were evaluated. Results: SEP was observed in 11 of the patients. Ten patients underwent surgery (90.9%), and one patient (9.1%) was treated conservatively. Of the patients, six had secondary SEP (54.5%) and five had primary SEP (45.5%). In total, five patients were female (45.5%) and six were male (54.5%). The median age of the patients was 35 years (24–69). The median age of the patients with primary disease was 48 (29–69) years, while the median age of patients with secondary disease was 34.5 (24–64) years. One patient expired in the postoperative 8th hour. Conclusion: SEP should be considered in the case of recurrent abdominal pain attacks, especially in patients undergoing peritoneal dialysis, and it should be known that the mortality rate is high when misdiagnosed.

Background: Morbid obesity surgery and related complications have increased with time. Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy. Method: 1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score. Results: Complications were seen in 40 patients (2.5%) and mortality wasn’t seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15-64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40-57) kg/m2 and 44.8±3.49 (35-67) kg/m2 respectively. According to BMI groups 40-45 kg/m2, 45-50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score. Conclusion: There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores. RESUMO Racional: A cirurgia da obesidade mórbida e complicações relacionadas aumentaram com o tempo. Objetivo: Avaliar a relação entre as complicações perioperatórias antes da alta e o índice de massa corporal pré-operatório e o escore de mortalidade da cirurgia de obesidade na gastrectomia vertical laparoscópica. Método: 1.617 pacientes que atenderam aos critérios de inclusão foram avaliados retrospectivamente. Os pacientes foram examinados quanto aos dados demográficos, presença de comorbidades, ocorrência ou não de complicações, tipo de complicações e escore de mortalidade cirúrgico da obesidade. Resultados: Complicações foram observadas em 40 pacientes (2,5%) e mortalidade não foi observada no período pós-operatório imediato antes da alta. A média de idade dos pacientes com complicações foi de 36,3±10,02 anos (19-57) e sem complicações de 34,12±9,54 (15-64) anos. Os valores médios de IMC pré-operatórios dos pacientes com e sem complicações foram 45,05±3,93 (40-57) kg/m2 e 44,8±3,49 (35-67) kg/m2, respectivamente. De acordo com os grupos de IMC 40-45 kg/m2, 45-50 kg/m2 e 50 e mais, não houve qualquer significância estatística observada em três grupos em termos de positividade de complicações e taxas de complicações maiores-menores. Não houve significância estatística entre os pacientes com e sem complicações maiores e menores e o escore de mortalidade da cirurgia de obesidade. Conclusão: Não houve qualquer relação entre as taxas de complicações da gastrectomia vertical laparoscópica perioperatória antes da alta e os escores de mortalidade da cirurgia de obesidade e IMC.

Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy. Material and methods: The patients who underwent laparoscopic appen dectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation tech niques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracor poreal knotting – loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference be tween the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump liga tion techniques reduces the cost, is a safe method and shortens the opera tive time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treat ment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other tech niques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.

The aim of the study was to investigate secondary school students’ and teachers’ access to information technologies in Turkey by making interregional comparisons. Document analysis of the qualitative research methods was employed to analyze the reports issued by the Turkish Ministry of National Education, the Turkish Statistical Institute (TUIK), and the Programme for International Student Assessment (PISA). The results of the research revealed the importance of access to information and communication technologies for both students and teachers: 67.9% of the participating students were found to have Internet connection and 69.1% a computer in their homes, while 80.3% of the students were observed to use a computer outside the school, but 19.7% were not. The results also showed that 64.6% of the students have Internet connection in their classrooms, but 29.2% of these students do not use the Internet in the classroom, whereas 8.9% use it in the classroom all the time. The rate of students using a digital device for reading is 38.1%, while that of those not using one is 61.9%. Some 32.1% of secondary school students were revealed not to have Internet connection at home. Additionally, 77% of teachers were not trained in online teaching prior to the COVID-19 pandemic. Based on the findings, teachers can be suggested to develop projects – i.e., of TUBITAK, E-twinning, and Erasmus – which potentially encourage students to use information and communication technologies so that both teachers and students can benefit from them. It is also suggested that the Ministry of National Education should work on improving the information communication technology competencies of teachers and students. Besides, policies should be developed to eliminate regional differences in terms of access to digital resources and technology in terms of equal opportunities and opportunities.

Bu araştırmada, İzmir, Bayraklı ilçesindeki okullardagörev yapan ilkokul öğretmenlerinin çalışma arkadaşlarına yönelik algılanansosyal kaytarma davranışı düzeylerinin belirlenmesi ve bu düzeylerin çeşitlideğişkenler bakımından incelenerek okullarda yapılan çeşitli grupçalışmalarının etkililiği kapsamında değerlendirilmesi amaçlanmaktadır. Araştırmanın çalışma evrenini, 2017-2018eğitim-öğretim yılı Güz döneminde, İzmir ili Bayraklı ilçesinde bulunan 31ilkokul ve bu okullarda görev yapan 2000 ilkokul öğretmeni oluşturmaktadır. Araştırmanınörneklemi tabakalı örnekleme tekniği kullanılarak belirlenmiştir. Araştırmanınörneklemini ulaşılabilen ve anket formunu yanıtlayan 293 öğretmenoluşturmaktadır. Araştırma verilerine, Liden, Wayne, Jaworski ve Bennett (2004) tarafındangeliştirilmiş ve Ülke (2006) tarafından Türkçeye uyarlaması yapılmış olan ölçekkullanılarak ulaşılmıştır. Ölçek, 5’li Likert tipinde olup, öğretmenlerinbirlikte çalıştıkları çalışma arkadaşlarını sosyal kaytarma davranışlarınailişkin değerlendirmeye yönelik 11 ifadeden oluşmaktadır. Kişisel BilgiFormu’nda ise, öğretmenlerin cinsiyeti, yaşı, medeni durumu, çocuk lisansüstüeğitim durumu, kıdemi, çalıştıkları okuldaki kıdemi, okul müdürü ile çalışmayılı ve görev aldıkları zümrede yer alan öğretmen sayısı ile ilgili sorular yeralmaktadır. Elde edilen veriler, IBM SPSS Statistics 21 programında analizedilmiş analiz sonuçlarına göre ilkokul öğretmenlerinin çalışma arkadaşlarınayönelik algılanan sosyal kaytarma düzeylerinin çalıştığı okuldaki müdürle olançalışma süresi, zümrede yer alan öğretmen sayısı ve okulun başarı düzeyideğişkenleri açısından anlamlı farklılık gösterdiği tespit edilmiştir. Bireyleri kaytarma davranışındancaydıracağı düşüncesiyle okullarda yürütülen grup çalışmalarının en fazla 6mümkün ise 3-4 kişilik gruplarla yapılması, kaytarmanın önüne geçebilecek grupiçi bir iç denetim mekanizmasının kurulması ve okul müdürlerinin birlikte çalıştığı öğretmenlerin kişisel vemesleki uygunluğu ve yeteneklerini bilerek onlara verilecek görevleri daha iyi planlaması için aynıokulda en az 4-5 yıl görev yapmasının daha uygun olacağı getirilen önerilerdenbirkaçıdır., In this study, itis aimed to investigate the levels of perceived coworker social loafingbehaviors of primary school teachers working at schools in İzmir, Bayraklıprovince. It is also aimed to determine whether these levels are significantlydifferent according to gender, age, marital status, having children, level ofeducation, seniority, seniority with the school principal in the school incharge, the size of the working group and the academic success of the schools.In addition, these levels are intended to be evaluated within the scope of theeffectiveness of group work done in schools. The population of the study consists of 31 primaryschools and 2000 primary school teachers working in Bayraklı district of İzmirprovince during fall 2017-2018 academic year.Stratified sampling method is used and the sample of the study isconsisted of 293 teachers who could be reached and answered the questionnaire. Perceived Coworker Social Loafing Scaledeveloped by Liden, Wayne,Jaworski ve Bennett (2004) and adapted into Turkish by Ülke (2006) was used to collect data. The scale is a 5-point Likert type and consists of11 expressions for teachers to evaluate their coworkers on social loafingbehaviors. In the Personal Information Form, there are questions about gender,age, post graduate education, seniority, and seniority with the schoolprincipal in the school in charge, the size of the working group and theirhometown. The data obtained were analyzed in the IBM SPSS Statistics 21 programand the results of the analysis showed that the level of perceived socialloafing behaviors of the primary school teachers was significantly different interms of seniority with the school principal in the school in charge, size ofthe working group and academic success of the school.

Bu calismanin amaci, okul mudurlerinin liderlik stilleri ile Avrupa Birligi projelerinin okula katki duzeyi arasindaki iliskinin Ankara Ili ortaokul ogretmenlerinin algilarina gore incelenmesidir. Arastirma iliskisel tarama modelinde betimsel bir calismadir. Arastirmanin orneklemini 2016-2017 egitim ve ogretim yilinda Ankara Ilinde yer alan en az bir AB projesi yurutmus ortaokullarda calisan ogretmenler olusturmaktadir. Bu arastirma kapsaminda “Cok Faktorlu Liderlik Olcegi” ve “AB Projeleri Katkilari Degerlendirme Olcegi” kullanilmistir. Okul mudurlerinin liderlik stillerine iliskin sonuclar incelendiginde ogretmenlerin en yuksek duzeyde katilim gosterdikleri boyutun donusumcu liderlik oldugu, en dusuk ortalamanin ise serbestlik taniyan liderlik boyutunda gerceklestigi gorulmustur. Arastirma sonucunda AB projesi yurutulen okullardaki ogretmenlerin bu projelerin katkilarina iliskin algilarinin olumlu oldugu gorulmustur. Ote yandan bu algilarin ogretmenlerin cinsiyetine ve ogrenim duzeyine gore farklilik gostermedigi gozlenmistir. Arastirma kapsaminda yapilan coklu dogrusal regresyon analizi sonucunda donusumcu liderlik ve serbestlik taniyan liderlik alt boyutlarinin AB projelerinin okula katki duzeyini anlamli bicimde yordadigi gorulmustur.

Aim:In this paper, we aimed to evaluate the patients who underwent trephine stoma with sedoanalgesia in addition to local anesthesia and to share the results.Method:The patients who underwent trephine stoma with sedoanalgesia in addition to local anesthesia for fecal diversion in our general surgery clinic between June 2012 and June 2017 were evaluated retrospectively. The patients were evaluated in terms of demographic characteristics, diagnosis of primary disease and complications.Results:A total of 11 patients (F/M: 4/7) were evaluated. The mean age was 54 (±4) years. The mean follow-up period was 18 months (range 2-30). Primary disease was rectal cancer in seven patients (63.6%), Fournier’s disease in two patients (18.2%), genital cancer in one patient (9.1%), and rectovaginal fistula in one patient (9.1%). Only one patient underwent transverse colostomy and 10 patients underwent sigmoid colostomy. There were no complications related to surgical procedures. One patient died on the 14th postoperative day because of complications secondary to metastasis.Conclusion:Trephine stoma technique, which does not require laparotomy, is a fast, reliable, and easy to use method especially in high-risk patients with poor general condition.

Aim: The effects of preoperative radiotherapy and emergent surgery on conversion in laparoscopic colorectal surgery is not clear. We therefore aimed to determine the effects of neoadjuvant radiotherapy and emergent surgery on conversion. Methods: The data of 67 patients, who were operated for familial adenomatosis polyposis coli, colon, and rectum malignant neoplasms by the same surgical team between October 2016 and January 2018 were evaluated retrospectively. Among them, fifty-five laparoscopically finished or converted to open surgery cases were included in the study. The exclusion criteria included cases which began as open surgery, history of previous colorectal surgery for benign or malignant diseases, morbid obesity (body mass index >40 kg/m2) and missing data. Demographic values (age, gender), localization of tumor, whether it was an emergent or elective surgery, history of preoperative chemotherapy and radiotherapy, and causes of conversion were evaluated. Results: Among 55 patients, 35 were male (63.6%) and 20 were female 20 (36.4%), with a mean age of 58.4 (13.4) (22 – 80) years. Mean ages of conversion and laparoscopically finished cases were 62.86 (8.91) (53 – 73) and 57.71 (13.84) (22 – 80) years, respectively (P=0,216). The reason for operation was right colon cancer in three patients (5.5%), left colon cancer in six (10.9%), rectum cancer in thirty-seven (67.3%), rectosigmoid junction cancer in five (9.1%) and adenocancer due to familial adenomatous polyposis coli in four patients (7.3%). In seven patients (12.7%), the need for conversion to open surgery arose. Among 55 patients, 47 patients were operated electively (85.5%) and 8 were operated under emergent conditions (14.5%). Of the 7 conversion patients, 5 were operated under emergent conditions and 2 were operated electively (P, Amaç: Laparoskopik kolorektal kanserlerde açığa geçiş üzerinde neoadjuvan radyoterapi uygulanmasının ve acil şartlarda operasyon yapılmasının etkisi açık değildir. Bu nedenle Neoadjuvan radyoterapi alınması ve acil cerrahinin preoperatif açık cerrahiye geçiş üzerine etkilerini değerlendirmek amaçlandı. Yöntemler: Ekim 2016 – Ocak 2018 tarihleri arasında aynı cerrahi ekip tarafından ailesel polipozis koli, kolon malign neoplazisi ve rektum malign neoplazisi nedeniyle aynı cerrahi ekip tarafından opere edilen 67 hastanın dosyaları retrospektif olarak incelendi. Laparoskopik tamamlanan veya laparoskopik başlanıp açık cerrahiye geçilen 55 hasta çalışmaya dahil edildi. Çalışmadan çıkarılma kriterleri; direk açık cerrahi uygulanmak, benign veya malign sebeplerle daha önce kolorektal cerrahi uygulanmış olmak, morbid obezite (vücut kitle indeksi >40 kg/m2) ve verilere ulaşılamamaktır. Hastalar demografik özellikleri (yaş, cinsiyet), tümör lokalizasyonu, cerrahinin acil ya da elektif olarak yapılması, preoperatif kemoterapi ve radyoterapi uygulanması, açığa geçiş nedenleri açısından değerlendirildi. Bulgular: Çalışmaya dahil edilen 55 hastanın 35’i erkek (%63,6), 20’si kadın (%36,4) hastaydı. Hastaların yaş ortalaması 58,4 (13,4) (22 – 80) yaştı. Açığa geçilen hastaların yaş ortalaması 62,86 (8,91) (53 – 73) ve laparoskopik tamamlanan hastaların yaş ortalaması 57,71 (13,84) (22 – 80) yaştı (P=0,216). Hastaların operasyon nedenleri; 3 sağ kolon kanseri (%5,5), 6 sol kolon kanseri (%10.9), 37 rektum kanseri (%67,3), 5 rektosigmoid bölge tümörü (%9,1) ve 4 familiyal polipozis koli sendromu zemininde gelişen adenokarsinomdu (%7,3). 7 hastada cerrahiye laparoskopik başlandı ancak açık cerrahiye geçilmek zorunda kalındı (%12,7). 47 hasta elektif şartlarda (%85,5) opere edilirken 8 hasta acil şartlarda (%14,5) opere edildi. Açığa geçilen 7 hastanın 5’i acil şartlarda opere olurken 2 hasta elektif şartlarda opere edildi (P

BACKGROUND: The present study aims to evaluate the use of the chlorhexidine gluconate and metronidazole impregnated compresses concerning anastomosis safety in the left colonic anastomosis in the presence of peritonitis. METHODS: This study was conducted on 21 Wistar-Albino-rats divided into three equal groups. After median laparotomy, the whole layer of the left colon was cut 2 cm over the pelvic peritoneum. The faeces were spread around the injury for fecal contamination. Then, fasia and skin were closed with 3/0 silk. After one day period, relaparatomy was performed. The abdomen was cleared isotonic sodium chloride with impregnated material before starting colonic anastomosis in the first group and then double layer colonic anastomosis was performed. In the second Group-II, abdomen was cleared with the metronidazole impregnated compresses then double layer colonic anastomosis was performed. In the group-III, abdomen was cleared with the chlorhexidine gluconate impregnated compresses then double layer colonic anastomosis was performed. Tissue hydroksiproline levels and anastomosis bursting pressures were measured and histopathologic findings on the anastomosis line were evaluated on the postoperative tenth day by performing relaparatomy. RESULTS: The highest anastomosis bursting pressure was found in Group-III (p

Cerrahi kliniklerde sık rastlanılan durumların başında Akut apandisit gelmekle birlikte Klasik tedavisi cerrahidir. Bu klasik tedavi son yıllara damgasını vuran laparoskopik cerrahiden de etkilenmiştir. Laparoskopik apendektominin açık apendektomiye göre en önemli avantajı ‘tanısal laparoskopi’ yapılarak tanısı arada kalan hastalara doğru yaklaşım sağlanmış olunur. Bunun yanı sıra diğer avantajları olarak da; yara enfeksiyonu ve fıtık riskinin daha düşük olması, kozmetik olarak daha iyi yara yeri görünümü elde edilmesi, ameliyat sonrası ağrının daha az olması, günlük hayat aktivitelerine ve işe daha hızlı dönüşün sağlanabilmesi olarak sıralanabilir. Biz de bu yazımızda iki adet 5 mm'lik port kullanarak laparoskopik yardımlı minimal invaziv apendektomiyi sunmayı amaçladık.

Foreign body ingestion is a frequent cause of emergency service admission. Although frequent in children, it can be seen in alcoholics and adults with psychiatric distress or mental retardation. Most of these patients do not require any intervention, however only a few have surgery or endoscopic procedures. Surgery is mostly performed in cases such as obstruction, perforation or hemorrhage. In this article, we present a case along with literature which was evaluated as acute abdomen in the emergency department. Theetiology explaining the case was not found in the test sand perforation wasd etermined due to a foreign body after laparotomy.

Aim: Benign anorectal diseases are common surgical procedures in general surgery. Various anesthetic techniques are utilized during surgical procedures. In this study, postoperative headache, urinary retention, and back pain were evaluated in patients operated under spinal anesthesia. Method: The incidence of postoperative headache, urinary retention and back pain was evaluated in patients operated under spinal anesthesia for benign anorectal disease (hemorrhoidal disease, pilonidal cyst, anal abscess, anal polyps, anal fissure, and anal fistulas) between January 1, 2016 and January 1, 2017. Patients for whom data was not available or who were operated under general or local anesthesia were excluded from the study. Results: Of the 302 patients whose data could be reached, 242 (80.1%) were operated under spinal anesthesia, 56 (18.5%) were operated under local anesthesia, and 4 (1.3%) were operated under general anesthesia within the 1-year period evaluated. Patients operated under spinal anesthesia included 152 (62.8%) patients with pilonidal cyst, 29 (12%) with hemorrhoidal disease, 41 (16.9%) with anal fistulas, 13 (5.4%) with anal abscess, 5 (2.1%) with anal fissures, and 2 (0.8%) with anal polyps. Postoperative headache was seen in 6 (2.5%) of the patients operated under spinal anesthesia, 3 (50%) of whom required rehospitalization for headache. The patients were treated conservatively with fluid replacement, caffeine, and nonsteroidal anti-inflammatory therapy. Urinary retention was seen in 6 (2.5%) patients and treated with temporary urinary catheterization. Permanent urinary retention was not seen any of the patients. None (0%) of the patients had back pain. Conclusion: Spinal anesthesia has low complication rates and can be a preferred anesthetic technique for benign anorectal disease surgery.

Organizational deviant behaviors can be defined as behaviors that have deviated from standards and uncongenial to organization's expectations. When such behaviors have been thought to damage the organization, it can be said that reducing the deviation behaviors at minimum level is necessary for a healthy organization. The aim of this research is to determine the level of teachers' organizational deviant behaviors to show the relationship between deviant behavior level and principal's leadership styles. Research's data were collected from 557 secondary school teachers working in Izmir province by using scales named as “Organizational Deviance Scale for Schools” and “Multifactor Leadership Questionnaire”. According to the findings, teachers have displayed organizational deviant behaviors at low level and principals have absorbed transformational and interactional leadership. According to correlation analysis, there has been a negative relationship between organizational deviant behaviors and transformational and interactional leadership styles, and a positive relationship between organizational deviant behaviors and laissez-faire leadership. Findings have explained the effect of principals' leadership styles on deviant behavior. As a recommendation, to decrease these deviant behaviors, principals who tend to show transactional and transformational leadership behaviors can be guided and trained about the reasons of deviant behaviors, and how to reduce these deviant behaviors. Key words: Organizational deviance, multi-factor leadership, education.

Amaç Çalışmamızda hastanemiz genel cerrahi kliniğinde yapmış olduğumuz İnkarse Karın Ön Duvarı Fıtıklarında Laparaskopik Tedavi Deneyimlerimizi sunmayı amaçladık. Materyal – Metod Kliniğimizde Ocak 2017 - Ocak 2018 tarihleri arasında Karın Ön Duvarı hernilerden laparoskopik yaklaşımla tedavi edilen hastalar retrospektif olarak incelendi. Hasta verileri bilgisayar kayıtlarından elde edildi. Verilerine tam olarak ulaşılamayan hastalar çalışma dışına alındı. Çalışmaya alınan tüm hastalara Laparoskopik intraperitoneal mesh tekniği uygulandı. Bulgular Çalışmaya 13 hasta dahil edildi. Hastaların tamamı kadın hastaydı. Yaş ortalaması 55,8 (38-70) yıl, cerrahi süreleri 60,4 (30 - 85) dakikaydı. Defekt çapı ortalama 4,7 (3-6) cm olup postoperatif hastanede yatış süreleri 2,1 (1 - 4) gündü. komplikasyon olarak 3 hastada seroma izlendi. Sonuç Sonuç olarak; kliniğimizde acil servise başvuran ön karın hernisi tanısı almış olan hastalara Dual Mesh kullanarak laparoskopik intraperitoneal onarım tekniğini kullanmanın güvenilir ve kolaylık sağladığını göstermeyi amaçladık.

This research examines supervisional deviant behaviours depending on the primary school teachers’ view in Izmir, Turkey. Organizational or workplace deviant behaviours have been studied in number of studies and these types of behaviours are determined. It is obvious that solving the problems of orgaizational deviance contribute to meet organizational objectives. Since the supervision process which aims at revealing the realization level of organizational goals is one of the important part of organizations, determining and solving the problems of supervisional deviant behaviours can also contribute to meet the targets. Therefore this study is organized to determine supervisional deviant behaviours in supervision process depending on the primary school teachers’ opinions. Qualitative research was conducted in this study. Extreme-end sampling was used as a procedure of data collection. MAXQDA10.1 data analysis programme is used to anlayze the data. According to research findings supervisional deviant behaviours are observed in Turkish primary schools and supervisional deviance is influenced by three themes namely “supervisors’ individual deviant behaviours”, “deviant behaviours resulted from supervisors inabilities” and “supervisors unethical deviant behaviours”. Consequently, educational system should take some measures to overcome the negative effects of supervisional deviant behaviours for better learning outcomes. Key words: Organizational deviance, supervisioanl deviance, primary school teachers’ views.