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The hydroxypropyl chitosan (HPCH) and hydroxyethyl chitosan (HECH) are multifunctional chitosan derivatives with biocompatible and biodegradable properties. Due to their hydroxypropyl and hydroxethyl groups, they have water solubility, moisture retention, and gelling properties. In this study, the chitosan derivatives HPCH and HECH were obtained in two steps alkalisation and etherification. For alkalisation, chitosan was kept in an alkaline medium at - hours by mixing alkaline chitosan with propylene oxide and ethylene oxide separately in a pressure reactor. The structures of the obtained HPCH and HECH were characterised by FT-IR, 1H(13C)-NMR, XRD, and TG analysis methods. Since the degree of deacetylation (DA) of chitosan is 75-85%, the chitosan units contain N-acetyl (-N-(CO)-CH3)) groups in addition to -NH2 functional groups. When the 1H(13C)-NMR spectrum of chitosan was examined, the peak value of these acetyl groups was observed at δ1.89 ppm. When the XRD spectra were examined, it was observed that the strong peak in chitosan at 2θ=20° was weakened in HPCH and HECH. In addition, the thermal stability of HPCH and HECH was found to be higher than chitosan in TG analysis.

Aim:Surgical methods are the most commonly used methods in the treatment of pilonidal sinus (PS) in the world but their recovery durations and return to work/school periods are long and the complication rates are high. Among minimally invasive methods, phenol therapy is frequently used in adults and successful results are reported. However, studies on phenol treatment in adolescents with PS are limited and their number of patients is small. Therefore, our study aims to determine whether 80% liquid phenol treatment can be used as first-line therapy in this age group.Materials and Methods:Primary and 9 between 14 and 19 years who were treated with 80% liquid phenol were included in this study. Patient data were obtained from their files retrospectively.Results:Of the patients, 69 (69.7%) were male and 30 (30.3%) were female. The mean age of the patients was 17.4±1.3 (minimum-maximum 14-19). The total recurrence and complication rates after phenol administration were 10.7% and 16.1%, respectively. According to the Likert-type questionnaire, the mean satisfaction rate was 8.7±1.7 (minimum-maximum 5-10).Conclusion:In our study, it has been shown that 80% liquid phenol treatment can be successfully applied in adolescents with PS with low recurrence and low major complication rates. In addition, we think that 80% liquid phenol treatment should be recommended as the first-line treatment option for both primary and postoperative recurrent adolescent patients with PS, as it ensures a quicker return to work/school and shows high satisfaction rates.

Purpose: The aim of this study is to evaluate clinical success rate of resin-based fissure sealants applied at Istanbul University, Department of Pediatric Dentistry after 1 year of application. Materials and methods: Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study. The ages of children ranged from 7-13 (mean age:9.2±1.22). Resin-based fissure sealant was applied to the 322 fissures of the first permanent molars in 100 children. 12 months after the application, children were recalled for examination. Recall examinations were carried out by the same dentist. Fissure sealants were evaluated at 12th month by using Ryge criteria: Retention (R), precence of caries (PC), marginal adaptation (MA), marginal discoloration (MD) and cracking (C). Results: 12 months after the application, all of the children were recalled and fissure sealants were examinated. Our findigs are: R: Alpha 95 (29.5%), Bravo: 143 (44.4%), Charlie: 84 (26%); PC: Alpha 274, Bravo 48 (14.9%); MD: Alpha 322; MA: Alpha 279, Bravo 43 (13.3%); C: Alpha 321, Bravo 1 (0.3%). Conclusion: The preventive effects of the sealant are only maintained as long as it remains completely intact and bonded in place. After applying fissure sealants, patients must be recalled and sealants must be checked to provide retention and marginal adaptation.

INTRODUCTION: Recently, minimally invasive methods have been used in surgical treatment of adult Sacrococcygeal pilonidal sinus (SPS) instead of classical wide excisions. However, there are fewer data about minimally invasive methods in the adolescent age group. Therefore, we aimed to compare our adolescent patients undergoing minimal excision and primary closure (MEPC) with the Limberg flap (LF) method. METHODS: In this study, the data of 80 patients who were operated for sacrococcygeal pilonidal sinus between July 2014 and December 2017 were retrospectively reviewed. Patients who underwent minimal excision with primary closure (MEPC) or Limberg flap (LF) were included in the study. Patients were evaluated in terms of age, sex, body mass index (BMI), length of hospital stay, time to return to work / school, time to complete healing, complication, recurrence and patient satisfaction levels. RESULTS: No significant difference was found between patient characteristics, complication, recurrence and patient satisfaction rates of these two groups. However, in terms of hospitalization and return to work / school, MEPC group was found to be statistically advantageous compared with LF group. DISCUSSION AND CONCLUSION: MEPC procedure has similar success in terms of recurrence, complications and patient satisfaction compared with LF. However, the MEPC procedure has advantages such as allowing faster return to work / school and not requiring hospitalization. Therefore, in adolescents with non-complex and uncommon SPS disease, MEPC procedure may be offered as an alternative treatment option to LF.

Non spesifik spontan ince bağırsak ülser perforasyonu akut karına neden olan ve çoğunlukla perioperatif olarak tanı alan, nadir görülen bir durumdur. Yetmiş iki yaşında kadın hasta karın ağrısı yakınması ile acil servise başvurdu. Yapılan fizik muayenesi akut batın ve peritonit ile uyumluydu. Çekilen abdomen bilgisayarlı tomografide sağ diyafram altında serbest hava saptandı. Hasta gastrointestinal perforasyon ön tanısı ile operasyona alındı. Operasyon sırasında jejunum ansında antimezenterik yüzde perforasyon alanı saptandı. Bu alandan biyopsi alındı ve perforasyon primer suturasyon ile onarıldı. Hasta pulmoner komplikasyonlar nedeniyle postoperatif beşinci gün yoğun bakım ünitesinde exitus oldu. Alınan biyopsi yüzeyel olmakla birlikte ülser tanısını desteklemekteydi. Non spesifik jejunal ülser perforasyonları gecikmiş tanı nedeniyle hayatı tehdit edici olabilir. Özellikle ileri yaş hastalarda bir akut karın nedeni olarak akılda tutulmalıdır.

The paper describes the synthesis of hydroxyethyl cellulose from industrial waste, namely, air particle vacuum dust (APVD). The selected reaction parameters were sodium hydroxide concentration, ethylene oxide proportion, reaction time, and reaction temperature in an attempt to understand their effects on the reaction. For this purpose, APVD was bleached and mercerized using sodium hydroxide and hydrogen peroxide solution to remove/dissolve non-cellulosic material. The modified waste material was then reacted with ethylene oxide under microwave irradiation to obtain hydroxyethyl cellulose. To determine the effect of each reaction parameter, the degree of substitution and viscosity were measured and compared in detail. The greatest values were achieved using 40% (w/v) sodium hydroxide, one gram ethylene oxide per gram of APVD, a 90 min reaction time, and a 70 °C reaction temperature. Process efficiency was evaluated by recording 1H-NMR (nuclear magnetic resonance), solid-13C-NMR, Fourier Transform Infrared Spectroscopy, Differential Thermal Analysis-Thermogravimetry, Differential Scanning Calorimetry and Scanning Electron Microscope of best samples. These helped elucidate the expected reaction. The proposed method, compared with the conventional method, was easy, fast, and straightforward. Keywords: Air particle vacuum dust, Synthesis, Microwave, Hydroxyethyl cellulose

This study provides a comparison between classic and modified (i.e., ultrasound) Fenton process on the industrial textile wastewater. For this purpose, the classic, and ultrasound Fenton process were investigated and compared using the following parameters: pH of solution, amount of ferrous ion (Fe(II)), and hydrogen peroxide as well as reaction time. With these parameters, degrading organic compounds (i.e., decolorization percentage) was calculated. The best decolorization percentage (95% for Pt-Co) was found using 0.10 g L−1 of Fe(II), and 2.20 g L−1 of H2O2 for 90 min at pH 3 for classic Fenton process. Similar experiments were carried out using 35 kHz ultrasonic irradiation, and the best decolorization percentage (99% for Pt-Co) was obtained via 0.05 g L−1 of Fe (II) and 1.65 g L−1 H2O2 for 60 min at pH 3 for ultrasound Fenton process. The results showed that decolorization increased with decreasing amount of chemical for the ultrasound Fenton process. Additionally, the contact time was decreased by comparing performance with classic Fenton process. In light of these results, the ultrasound Fenton process can be used for decolorization of textile wastewater to save reaction time and chemical costs. Also, the decolorized water (e.g., treated water) may be reused in the plant for washing the textile materials after applying ion exchange process.

Jejunal divertikulozis genellikle asemptomatik seyreden çok nadir görülen bir hastalıktır. Obstruksiyon, kanama ve perforasyon gibi divertikülite sekonder oluşan ciddi komplikasyonlar geç tanı konulduğunda yaşamı tehdit edici olabilir. Seksen iki yaşında erkek hasta acil servise karın ağrısı şikayetiyle başvurmuş olup, fizik muayenesi akut batın ve peritonit ile uyumlu idi. Bilgisayarlı abdomen tomografide serbest hava ve apse nedeniyle hastaya perforasyon tanısı konuldu. Eksploratif laparatomi yapılan hastaya ameliyat sırasında peroperatif jejunal divertikülit perforasyonu tanısı konuldu. Segmental ince bağırsak rezeksiyonu ve uçtan uca anastomoz uygulandı. Ameliyat sonrası 25. günde komplikasyonsuz olarak taburcu edildi. Bu olgu sunumunda, gecikmiş tanı nedeniyle jejunal divertikülit perforasyonu olan yaşlı bir hastada nadir bir akut karın nedeninin sunulması amaçlanmıştır.

Malignant fibrous histiocytoma is a type of soft tissue sarcoma that originates from mesenchymal tissues and that mostly affects extremities. Abdominal malignant fibrous histiocytoma usually has a poor prognosis and is rarely seen in the rectum. A 52-year-old female patient presented with rectal bleeding, tenesmus and anemia. She was operated for an obstructive rectal mass and postoperative pathology was reported as malignant fibrous histiocytoma. Herein, we aimed to report a case of malignant fibrous histiocytoma, a rare cause of rectal mass, who was treated with abdominoperineal resection + end colostomy.

Granüler hücreli tümör sıklıkla baş ve boyun bölgesini etkileyen, Schwann hücrelerinden kaynaklanan, nadir bir yumuşak doku tümörü tipidir. Vücutta pek çok farklı organ tutulumu olabilen granüler hücreli tümör, nadir de olsa memede de gözlenebilmektedir. Elli yedi yaşında postmenopozal kadın hastaya sol memede hızlı büyüyen ele gelen ağrısız palpabl kitle nedeniyle dış merkezde eksizyonel biyopsi uygulanmıştı. Biyopsisi memenin granüler hücreli tümörü olarak raporlanan ve cerrahi sınır pozitifliği olan hastaya, geniş sağlam cerrahi sınırlarla reeksizyon yapıldı. Postoperatif takiplerinde bir problem yaşanmayan hasta sorunsuz bir şekilde taburcu edildi. Klinik ve radyolojik olarak meme karsinomuna benzerlik gösteren granüler hücreli meme tümörünün cerrahi tedavisinde lokal nüksü engellemek amacıyla geniş lokal eksizyon yapılmalıdır. Bu olgu sunumunda, granüler hücreli tümörün tanı ve tedavisini güncel literatür bilgisi eşliğinde sunmayı amaçladık.

Objective: To evaluate the long-term results of tumorectomy and concomitant bilateral oncoplastic reduction mammoplasty (ORM) for early stage breast cancer patients with macromastia in terms of local disease control and long-term oncological results. Patients and method: Data of 82 patients with macromastia undergoing ORM for breast cancer between 1996 and 2011 were retrospectively examined and evaluated with regard to oncological results. Results: The median age was 50 years. The median follow-up was 121 months (range 28–212 months). The median breast volume was 1402 cm3 and the median weight of excised breast material was 679 g. The median surgical margin was 16 mm. Ten-year local recurrence rate was 8.7%. The 10-year overall survival rate was 82.2% and the disease-free survival rate was 73.2%. Early and late complication rates were 12.2% and 14.6%, respectively. Conclusions: From the standpoint of local disease control and long-term observation, ORM can be considered a very safe and acceptable treatment for early stage breast cancer in women with macromastia.

Aim: In this study, it was aimed to investigate the ethiology, surgical treatment approaches and complications in the patients who underwent the surgical treatment due to small intestine obstruction. Method: The data of patients who had surgical intervention in the general surgery department of our hospital due to small intestine obstruction between 2009 and 2015 was evaluated retrospectively. Demographics such as the age, additional morbidity, history of abdomen operation of the patients were recorded. During the operation, etiology was investigated and treatments were recorded. The patients’ postoperative follow-up data and complications were recorded. Results: In this study 121 patients were included. Hypertension was determined to be the most common additional comorbidity in the patients (28.9%). The most common complaint was abdomen ache and it was seen in 94.2% of the patients. The reasons of obstructions were adhesions in 57% of the patients, hernia in 27.3% of the patients, gallstones in 4.1% of the patients, cancers in 4.1% of the patients and phytobezoars in 3.3% of the patients. The patient group were applied these operations; separation of adhesions in 49.6% of patients, repair of the hernia in 19.8% of patients, repair of the hernia+resection in 7.4% of patients and separation of adhesions+resection in 5.8% of patients. Total complications rate was 26.5% and the most common complication was iatrogenic intestine injury in 9.1% of patients. Conclusion: The most common etiology of the patients who underwent small intestine obstruction operation were found as adhesions and hernias. These factors should be primarily considered as etiology during preoperative assessment. It was found that one out of the four patients had at least one complication after operation.

Objective:Metaplastic breast cancer (MBC) is a rare type of breast cancer that is considered to be clinically aggressive. The clinical significance and prognostic risk factors of MBC are limited. This study comprises a retrospective analysis of the clinical and pathologic findings of a series of patients treated for MBC.Materials and Methods:The files of 657 patients who underwent surgery because of breast cancer at our clinic were examined and the data found on 11 patients who were diagnosed as having MBC were analyzed.Results:With a median age of 56 years, all patients were postmenopausal and presented with a palpable mass on physical examination. Symptoms of ulceration and skin involvement were seen in only one patient. Eight patients were diagnosed as having squamous cell carcinoma (SCC), and 3 had both SCC and osseous differentiation. The median diameter was 3.8 cm (max. 14 cm; min. 1.5 cm). Lymph node metastasis was detected in 5 (45%) patients. Progesterone (PR) and estrogen (ER) were both negative in 11 (100%) patients and 10 (90.9%) patients, respectively, and CerbB2 was negative in 7 (63.6%) patients. Patients were followed up for a median period of 15 months (range, 6-40 months); at the end of which, 10 patients survived and one died of cardiac arrest at 7 months post-operatively. No instances of local recurrence or distant organ metastasis were found in any patients. The overall patient survival rate was 90%.Conclusion:There is no consensus on the clinical significance or best treatment approach for metaplastic carcinoma. In our study, patients with MBC were of advanced age, had tumors with large margins, high negativity for hormone receptors, and moderate- to well-differentiated histology.

Aim of the study : Despite the increase in studies concerning oncoplastic reduction mammoplasty (ORM), data showing long-term aesthetic and patient satisfaction for ORM in patients with macromastia remain limited. Therefore, this study evaluated the long-term results of tumorectomy and concomitant bilateral ORM for early-stage breast cancer patients with macromastia in terms of cosmesis, patient satisfaction, and functional outcomes. Material and methods : Retrospective data of patients with macromastia undergoing ORM for breast cancer between 1996 and 2011 were examined and evaluated regarding the aesthetic results, patient satisfaction, and functional outcomes. Results : The median age of the 82 patients was 50 years. The median follow-up was 120 months (range: 28–212 months). The median breast volume was 1402 cm 3 , and the median weight of the excised breast material was 679 g. A good or excellent evaluation of the cosmetic outcome was as follows: self-evaluation: 84.1% at the early-stage, 80.3% at the later stage; panel evaluation: 75.4% at the late-stage. Median patient satisfaction rates were 9.1% for early-stage disease and 8.8% for late-stage disease. Reduced mobility and intertrigo improved by three-fold during the post-operative period. Conclusions : ORM for early-stage breast cancer in women with macromastia results in good cosmesis in both the early-stage and long-term, and is quite acceptable for use in patients. Patients reacted favorably to the prospect of having their breast cancer and macromastia treated in a single session, and positive results continued over the long-term.

Objective: In this study, we aimed to evaluate the clinical, pathologic and management differences between breast cancer patients under 35 years of age and postmenopausal patients above 55 years of age.Materials and Methods: Patients who were operated on for breast cancer between November 2003 and March 2013 in our hospital were retrospectively analyzed. Patients were separated into two Groups according their age; Group 1 (55 years).Results: 94 patients with breast cancer, 45 patients in Group 1 and 49 patients in Group 2, were included in the study. The mean follow-up was 51 (19-121) months and 50 (19-120) months in Groups 1 and 2, respectively. Stages of breast cancer at the time of diagnosis were similar between the two groups. The groups were similar in terms of rates of re-excision (p=0.42), local recurrence (p=0.34) and solid organ metastases (p=0.182). The number of oncoplastic and reconstructive procedures were higher in Group 1 (p=0.04). Regarding pathological results, the rate of grade 3 tumors, those with Ki-67>12 and triple negative breast cancer were found to be higher in Group 1. In addition, the number of patients receiving chemotherapy was significantly higher in Group 1 (p=0.03).Conclusion: Oncologic results were similar between young patients and postmenopausal patients. Nevertheless, tumor biology was found to be worse in young patients. In addition, oncoplastic and reconstructive approaches were significantly higher in young patients.

Objective:General surgeons’ approaches to breast masses in their daily practices and their perspectives for issues on breast diseases and breast surgery are investigated through a survey.Materials and Methods:Answers of 524 general surgeons for the survey “Approach to breast diseases and breast surgery” between November 2012 and February 2013 were assessed. Demographic features, approaches to the breast masses, and answers for the clinical scenerios of surgeons were questioned. Surgeons were asked about management of breast cancer and the future role of surgeons for oncoplastic breast surgery and breast diseases.Results:Participants were representing 14.6% of all general surgeons in Turkey. The survey revealed that breast diseases are the most common cause for admission in general surgery outpatient clinics. Needle biopsies were employed by 241 (60%) respondents. Three hundred and seventy-one (71%) participants indicated that breast cancer management could be accurately conducted by the general surgeons. Two hundred and seventy-three (52%) respondents think that oncoplastic breast surgery should be performed by a general surgeon and 241 (41%) respondents predict that the role of general surgeons for breast diseases and breast surgery will decrease in the future.Conclusion:Basic approaches towards breast masses need to be improved in our country despite the highest frequency of breast diseases in outpatient admissions. The views and opinions of surgeons on breast diseases and the course of breast surgery in different regions and different communities need to be defined and clarified.

Background: Oncoplastic Breast Surgery (OBS), which is a combination of oncological procedures and plastic surgery techniques, has recently gained widespread use. Aims: To assess the experiences, practice patterns and preferred approaches to Oncoplastic and Reconstructive Breast Surgery (ORBS) undertaken by general surgeons specializing in breast surgery in Turkey. Study Design: Cross-sectional study. Methods: Between December 2013 and February 2014, an eleven-question survey was distributed among 208 general surgeons specializing in breast surgery. The questions focused on the attitudes of general surgeons toward performing oncoplastic breast surgery (OBS), the role of the general surgeon in OBS and their training for it as well as their approaches to evaluating cosmetic outcomes in Breast Conserving Surgery (BCS) and informing patients about ORBS preoperatively. Results: Responses from all 208 surgeons indicated that 79.8% evaluated the cosmetic outcomes of BCS, while 94.2% informed their patients preoperatively about ORBS. 52.5% performed BCS (31.3% themselves, 21.1% together with a plastic surgeon). 53.8% emphasized that general surgeons should carry out OBS themselves. 36.1% of respondents suggested that OBS training should be included within mainstream surgical training, whereas 27.4% believed this training should be conducted by specialised centres. Conclusion: Although OBS procedure rates are low in Turkey, it is encouraging to see general surgeons practicing ORBS themselves. The survey demonstrates that our general surgeons aspire to learn and utilize OBS techniques.

Bilgi artan bir biçimde rekabette üstünlük sağlayan kritik öneme sahip kurumsal kaynak olarak görülmektedir. Bununla birlikte stratejik bir kaynak olarak bil­ginin, bilgi kaynaklarının bilinçli bir şekilde yönetilmesi kurumsal başarıyı artıran en önemli faktördür. Bu çerçevede kurumsal bilgi kaynaklarının ne olduğunun tespit edilmesi, düzenlenmesi ve en önemlisi bir sistem dâhilinde yönetilmesi gerekmektedir. Bu çalışma bilgi yönetiminin başarıya ulaşması için en önemli unsur olan kurumsal bilgi kaynaklarının ortaya konulması ve yönetilmesi üzerinde durmaktadır.

Belgeler, bilgi teknolojilerinin kurumsal yapılarda yoğun bir şekilde kullanılmasıyla birlikte elektronik ortamda yönetilmeye başlanmıştır. Elektronik belgelerin kurumsal yapı içinde yoğun bir şekilde kullanılmaya başlanması sağlıklı bir arşivlemeyi ve buna bağlı olarak elektronik belgelerin gerçekliğini ve bütünlüğünü korumayı zorunlu hale getirmiştir. Buna yönelik sağlıklı çözümler geliştirmek elektronik belge yönetim sisteminin başarısı açısından büyük önem taşımaktadır. Bu makalede, elektronik belgelerin, bilgi teknolojileri bağlamında gerçekliğinden ve bütünlüğünden taviz vermeden uzun dönem arşivlenmesi için gereken hususlar ortaya konulmuştur.

Knowledge has been increasingly seen as a critical institutional source which provides superiority in rivalry. Moreover, the management of knowledge and knowledge sources as a strategic source is the most important factor that increases institutional success. In this framework, it is necessary to determine, arrange and most importantly manage these sources due to a systematic approach. This study focuses on the determination and management of knowledge sources which is the most important factor to achieve successful knowledge management.

More than 84 % of women with invasive breast cancer now survive more than five years. Chronic complications and disabilities such as lymphedema that occur as a result of therapeutic interventions became a major concern in those long-term survivors causing a significant decrease in their quality of life. In this review, we evaluate the impact of sentinel lymph node biopsy upon the prevention of lymphedema in light of both recently published studies and our own experience.

Information technologies have undergone rapid development in the last decade and these developments especially affected the information and records management profession. Developments in information technologies have caused changes in the way of creating, storing, sending and sharing records in organisational structures, and traditional record management has been replaced by a modern understanding of record management. In this respect, the management of electronic records let important problems arise. This study focuses on the effects of information technologies on records management, and thus on electronic record management.

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years. Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient’s postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups. Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.

Objectives. To investigate the effects of proton pump inhibitors (PPIs) and H2 receptor antagonists on ileum motility in rats with peritonitis and compare changes with control group rats. Methods. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another of 8 rats underwent a sham operation and were accepted as controls. Twenty-four hours later after the operation, the rats were killed, and their ileum smooth muscle was excised and placed in circular muscle direction in a 10 mL organ bath. Changes in amplitude and frequency of contractions were analyzed before and after PPIs and H2 receptor blockers. Results. PPI agents decreased the motility in a dose-dependent manner in ileum in both control and intraabdominal sepsis groups. While famotidine had no significant effect on ileum motility, ranitidine and nizatidine enhanced motility in ileum in both control and intraabdominal sepsis groups. This excitatory effect of H2 receptor antagonists and inhibitor effects of PPIs were significantly high in control group when compared to the peritonitis group. The inhibitor effect of pantoprazole on ileum motility was significantly higher than the other two PPI agents. Conclusions. It was concluded that H2 receptor antagonists may be more effective than PPIs for recovering the bowel motility in the intraabdominal sepsis situation.

Few existing efforts to predict childhood obesity have included risk factors across the prenatal and early infancy periods, despite evidence that the first 1000 days is critical for obesity prevention. In this study, we employed machine learning techniques to understand the influence of factors in the first 1000 days on body mass index (BMI) values during childhood. We used LASSO regression to identify 13 features in addition to historical weight, height, and BMI that were relevant to childhood obesity. We then developed prediction models based on support vector regression with fivefold cross validation, estimating BMI for three time periods: 30-36 (N = 4204), 36-42 (N = 4130), and 42-48 (N = 2880) months. Our models were developed using 80% of the patients from each period. When tested on the remaining 20% of the patients, the models predicted children's BMI with high accuracy (mean average error [standard deviation] = 0.96[0.02] at 30-36 months, 0.98 [0.03] at 36-42 months, and 1.00 [0.02] at 42-48 months) and can be used to support clinical and public health efforts focused on obesity prevention in early life., (© 2023. The Author(s).)

Intestinal malrotation is a developmental anomaly characterized by a midgut fixation disorder and failure to complete its normal fetal rotation around the superior mesenteric artery inside the peritoneal cavity. Malrotation is a rare cause of mechanical intestinal obstruction in adults. It may manifest as an emergency condition or with chronic abdominal symptoms. Although its diagnosis remains difficult, early diagnosis and treatment usually yield favorable outcomes. Intestinal malrotation rarely has an asymptomatic course, in which the diagnosis is usually made incidentally. Multislice computed tomography is quite helpful for making a correct diagnosis. In this study, we reported a 56-year-old patient incidentally who was detected to have intestinal malrotation and was managed symptomatically after presenting at our clinic with signs and symptoms of intestinal obstruction; we also provided a discussion of the relevant literature.

Objective: Fourteen brain death cases diagnosed in Mart 2012-May 2013 period in Tokat State Hospital were studied retrospectively. CT angiography experience about those cases was shared, and use of CT angiography in confirmation of brain death was discussed., Material and Methods: All 14 cases were patients on mechanical ventilator, who did not respond to medical and surgical treatments at intensive care unit and were diagnosed clinically with brain death. All of these patients had CT angiography as a confirmatory test using a 4-slice CT scanner in Radiology department in Tokat State Hospital., Findings: Six of the patients were female and eight were male. All of them were referred from intensive care unit and had clinical brain death diagnosis before CT angiography. In the evaluation of CTA, four-point scoring involving opacification loss in both ICVs and cortical segments of MCA was used. CTA examinations confirmed brain death diagnoses in all patients who had clinical brain death diagnoses, and no confliction between CTA findings and clinical diagnoses was observed., Conclusion: Demonstrating the lack of cerebral circulation is a necessity for confirmation of brain death diagnosis. While conventional angiography remains the standard method, CTA emerged as an alternative method. In parallel to increase in prevalence of organ implants, CTA, a fast and efficient method, has been increasingly used in confirmation of brain death diagnoses.

Purpose: The aim of this CT-based study was to investigate the frequency of splenic infarction (SI) following conventional open gastrectomy performed for gastric malignant neoplasms., Methods: 20 patients who underwent subtotal or total gastrectomy, omentectomy, and D2 lymph node dissections preserving the spleen for gastric malignant neoplasms were retrospectively reviewed. Patients with postoperative CT scans within 3 months were enrolled in this study. CT imaging was performed with a 64-row multidetector CT scanner. Abdominal CT scan with precontrast and postcontrast portal phase images was performed on 19 of the patients, while pulmonary CT angiography was performed on 1 patient for chest pain. Second postoperative control abdominal CT images were also present for 3 of the 5 patients with SI. These examinations were also reviewed for the evolution of the SI's., Results: SI was detected in 5 of the patients (25%) at a postoperative early stage. A single infarct area was detected in 4 of the 5 patients while two distinct infarct areas were present in one patient. The infarct areas in two patients disappeared on the second postoperative control CT. A decrease in the size of the SI area in 1 patient was also detected on the second postoperative control CT scan., Conclusion: The frequency of SI as a complication of abdominal surgeries tends to increase in CT-based studies. We have detected the highest frequency in the literature and suggest that SI, especially when accompanying D2 lymphadenectomy, should be included in the list of early stage gastrectomy complications.