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Purpose: To compare white matter (WM) structural alterations between the subjects with amnestic mild cognitive impairment (MCI) which is a transitional state to Alzheimer's Disease (AD) and healthy elderly controls.Methods: Diffusion tensor imaging (DTI) scans of 20 subjects with amnestic MCI and 20 healthy control groups who are matched by age, gender, and education with the MCI group between 2011 and 2016 were examined by in this retrospective study. WM structural integrity was analyzed using tract based spatial statistics (TBSS) for voxel-based differences in fractional anisotropy (FA) between the two groups. Results: Fractional anisotropy was found significantly lower in the forceps minor, the body and genu of the corpus callosum, the right anterior thalamic radiation, the right cingulum, the right inferior fronto-occipital fasciculus, the right superior longitudinal fasciculus, and the right superior corona radiata in the MCI group than the control group. Conclusion: TBSS analysis is a promising method to examine structural WM integrity. These findings suggested that the DTI measurements may be useful for the detection of preclinical changes in AD., Amaç: Alzheimer Hastalığı’na geçiş durumu olan amnestik hafif kognitif bozukluğu (HKB) olan olgular ile sağlıklı yaşlı kontroller arasındaki beyaz cevher yapısal değişikliklerini karşılaştırmaktır.Gereç ve Yöntem: Bu retrospektif çalışmada, 20 amnestik HKB ile yaş, cinsiyet ve eğitim açısından HKB grubu ile eşleştirilmiş 20 sağlıklı kontrol grubunun 2011-2016 arasındaki difüzyon tensör görüntüleme (DTG) taramaları incelendi. Beyaz cevher yapısal bütünlüğü, iki grup arasındaki fraksiyonel anizotropide (FA) voksel bazlı farklılıklar için yolak tabanlı uzamsal istatistik (TBSS) kullanılarak analiz edildi.Bulgular: Forseps minör, korpus kallozumun genu ve gövdesi, sağ anterior talamik radyasyon, sağ singulum, sağ inferior fronto oksipital fasikül, sağ superior longitudinal fasikül ve sağ üst korona radiatada FA değerleri kontrol grubuna göre HKB grubunda istatistiksel olarak düşük bulundu.Sonuç: TBSS analizi, yapısal beyaz cevher bütünlüğünü incelemek için umut verici bir yöntemdir. Bu bulgular, DTG ölçümlerinin Alzheimer'daki klinik öncesi değişikliklerin saptanması için yararlı olabileceğini düşündürdü.

Objective: Intracerebral haemorrhages account for approximately 20% of all strokes and have higher morbidity and mortality, nearly 60% of patients die within a year, and 20% of the survivors live disabled. The volume of intracerebral haemorrhage has a strong association with the unfavourable outcome; therefore, fast and accurate measurement of the volume is crucial for clinical decision making. This study aimed to compare the ellipsoid methods and the Cavalieri method for calculating intracerebral hematoma volumes by physicians without special education on computed tomography assessment.Methods: The hematoma volumes in the computed tomography images of 30 consecutive patients were measured via ellipsoid methods and the Cavalieri method. The calculated volumes of hematoma by the four methods were compared statistically. Results: The median haematoma volumes (interquartile ranges) for ‘Cavalieri’, ‘prolate ellipse (abc)’, ‘prolate sphere (aac)’ and ‘sphere (aaa)’ methods were 23.2 (27.4), 37.2 (45.8), 22.1 (30.75), and 14.4 (31.87) respectively. A Friedman repeated measures ANOVA test determined that the results of the four methods to evaluate the haematoma volume differ significantly (p, Amaç: İntraserebral kanamalar tüm inmelerin yaklaşık %20'sini oluşturur ve yüksek morbidite ile mortaliteye sahiptir, hastaların yaklaşık %60'ı bir yıl içinde ölür ve hayatta kalanların ise %20'si engelli yaşar. İntraserebral kanama hacminin olumsuz sonuç ile güçlü bir ilişkisi vardır; bu nedenle, hacmin hızlı ve doğru bir şekilde ölçülmesi klinik karar verme için çok önemlidir. Bu çalışmada bilgisayarlı tomografi değerlendirmesinde özel eğitim almamış hekimler tarafından intraserebral hematom hacimlerini hesaplamak için elipsoid yöntemlerle Cavalieri yönteminin karşılaştırılması amaçlanmıştır.Yöntem: Ardışık 30 hastanın bilgisayarlı tomografi görüntülerindeki hematom hacimleri elipsoid yöntemleri ve Cavalieri yöntemi ile ölçüldü. Dört yöntemle hesaplanan hematom hacimleri istatistiksel olarak karşılaştırıldı. Bulgular: 'Cavalieri', 'yayvan elips (abc)', 'yayvan küre (aac)' ve 'küre (aaa)' yöntemleri için medyan hematom hacimleri (çeyrekler arası aralık) sırasıyla 23,2 (27,4), 37,2 (45,8), 22,1 (30,75) ve 14,4 (31,87) idi. Friedman tekrarlanan ölçümler ANOVA testi, hematom hacmini değerlendirmek için dört yöntemin sonuçlarının önemli ölçüde farklı olduğunu belirledi (p

Posterior spinal enstrümantasyon, dejeneratif omurga patolojilerinin tedavisi için oldukça yaygın uygulanan cerrahi bir prosedürdür. Spinal enstrümantasyon sonrası komşu segment dejenerasyonu (KSD) gelişimi önemli bir problem olarak karşımıza çıkmaktadır. Bu çalışmanın amacı KSD gelişimi için risk faktörlerinin değerlendirilmesidir. Bu çalışmada posterior segmental enstrümantasyon uygulanan ve cerrahi işlemi üzerinden 4 yıldan fazla geçen 126 hasta retrospektif olarak incelenmiştir. Bu hastalar KSD ve n-KSD olarak iki gruba ayrılmıştır. İki grubun hasta karakteristikleri, preoperatif ve postoperatif radyolojik parametreleri ve cerrahi farklılıkları karşılaştırılarak KSD gelişimi için prediktif faktörler ortaya konulmaya çalışıldı. Çalışmaya dahil edilen hastaların on beşinde (%11.9) KSD geliştiği görüldü. Her iki grup arasında cinsiyet, diyabetes mellitus, sigara kullanımı ve osteoporoz açısından anlamlı farklılık yok idi (p>0.05). Lojistik regresyon analizine göre preoperatif yüksek vücut kitle indeksi, preoperatif komşu segmentteki faset dejenerasyonu varlığı, postoperatif lomber lordozda azalma ve 4 seviyeden daha fazla posterior enstürman uygulanması KSD gelişimi için bağımsız risk faktörleridir. Spinal enstrümantasyon cerrahisi öncesi yukarıda bahsedilen risk faktörlerinin bilinmesi, cerrahi açıdan daha uygun sonuçlar alınabilmesi için önlem almaya imkan tanımaktadır. Hastaların ve işlemi uygulayacak cerrahların modifiye edilebilecek risk faktörleri açısından gerekli önlemleri almaları uzun dönem komplikasyonları azaltabileceğini düşünmekteyiz., Posterior spinal instrumentation is a fairly common surgical procedure for the treatment of degenerative spine pathologies. The development of adjacent segment degeneration (ASD) after spinal instrumentation is an important problem. The aim of this study is to evaluate the risk factors for the development of ASD. In this study, 126 patients who underwent posterior segmental instrumentation and who had undergone surgery for more than 4 years were reviewed retrospectively. These patients were divided into two groups as ASD and non-ASD. By comparing the patient characteristics, preoperative and postoperative radiological parameters and surgical differences of the two groups, predictive factors for the development of ASD were tried to be revealed. Fifteen of the patients (11.9%) included in the study had ASD. There was no significant difference between the two groups in terms of gender, diabetes mellitus, smoking and osteoporosis (p>0.05). According to logistic regression analysis, preoperative high body mass index, presence of facet degeneration in the preoperative adjacent segment, decrease in postoperative lumbar lordosis, and posterior instrumentation of more than 4 levels are independent risk factors for the development of ASD. Knowing the above-mentioned risk factors before spinal instrumentation surgery allows taking precautions to obtain more appropriate surgical results. We think that taking the necessary precautions in terms of risk factors that can be modified by the patients and the surgeons who will perform the procedure can reduce long-term complications.

Internal carotid artery agenesis is usually an asymptomatic condition. It is detected incidentally by radiological imaging performed for other reasons. It may rarely present with clinical manifestations such as subarachnoid hemorrhage associated with aneurysm, transient ischemic attack, or stroke. Agenesis can be erroneously interpreted as occlusion in case of insufficient clinical experience. The absence of the carotid canal on the bone window in the computed tomography scan of the brain helps confirm the diagnosis. The well-developed collateral circulation in patients with internal carotid artery agenesis is an effective factor in recovering from cerebrovascular diseases with less damage. Here, a rare case of agenesis of the right internal carotid artery and contralateral middle cerebral artery infarction is presented.

Amaç: Septum pellucidum (SP), lateral ventrikülün medial duvarını meydana getiren iki laminanın oluşturduğu ince tabakadır. Laminalar birleşmediğinde cavum septum pellucidum (CSP) veya Cavum Vergae (CV) adı verilen bir kavite oluşur. CSP patolojik önemi tam olarak aydınlatılamamış, gelişimsel bir anomalidir. CSP nöropsikiyatrik hastalıklarla, özellikle şizofreni ile ayrıca post-travmatik stres bozukluğu, Tourette hastalığı ile tekrarlayan ve ciddi kafa travmasına maruz kalan kişilerde sık görülmektedir. Ancak literatürde CSP morfolojisini sağlıklı bireylerde inceleyen çalışma sayısı çok azdır. Bu nedenle çalışmamızda septum pellucidum morfolojisini ve varyasyonlarını değerlendirmeyi amaçladık.Yöntem: Sakarya Üniversitesi Tıp Fakültesi/Sakarya Eğitim Araştırma Hastanesine başvuran ve Magnetik Resonans Görüntüleme (MRG) ile beyin görüntülemesi gerçekleştirilen 509 hastada septum pellucidum morfolojik açıdan retrospektif olarak değerlendirilmiştir.Bulgular: Olguların %11,98’inde CSP, %1,38’inde CV saptanmıştır. CSP saptanan bireylerin %55,74’ü erkek iken %44,26’sı kadındı. Çalışmada CSP uzunluğu ortalama 7.71±2,95 mm iken yüksekliği 2.80±1,12 mm olarak ölçüldü. SP uzunluğu ise ortalama 30.98±7,36 iken yüksekliği 11.89±3,32 mm olarak ölçüldü.Sonuç: Septum pellucidum varyasyonlarından olan CSP varlığının bilinmesi orta hat yerleşimli kistik kitle lezyonlarının ayrıcı tanısında oldukça önemlidir. Hacimsel değişikliklerinin çocukluk ve erişkinlikte psikiyatrik bozuklukların gelişimi ile ilişkili olabileceği düşünülmektedir., Background/Aim: The septum pellucidum (SP) is the thin layer formed by the two laminas that form the medial wall of the lateral ventricle. When the laminas do not fuse, a cavity called cavum septum pellucidum (CSP) or Cavum Vergae (CV) forms. CSP is a developmental anomaly with unclear pathological significance and is common in people with neuropsychiatric diseases, especially schizophrenia, as well as post-traumatic stress disorder, Tourette's disease, and patients who suffer from recurrent and severe head trauma. However, few studies in the literature examine the CSP morphology among healthy individuals. Therefore, we aimed to evaluate the morphology and variations of septum pellucidum in healthy individuals.Methods: In this retrospective cohort study, the septum pellucidum was morphologically evaluated in 509 patients who underwent brain Magnetic Resonance Imaging (MRI) at Sakarya University Faculty of Medicine, Sakarya Training and Research Hospital. We classified the anatomical variations of the septum pellucidum as CSP, CV, CVI and evaluated their dimensions.Results: CSP was detected in 11.98% of the cases, and CV, in 1.38%. While 55.74% of individuals with CSP were male, 44.26 % were female. The mean CSP length and height were 7.71 (2.95) mm (P=0.103), and 2.80 (1.12) mm (P=0.649), respectively, and the mean length and height of the SP were 30.98 (7.36) mm (P=0.001), and 11.89 (3.32) mm (P=0.042), respectively. Conclusion: Knowledge of CSP, one of the septum pellucidum variations, is of great importance in the differential diagnosis of midline cystic mass lesions. Its volumetric changes may be related to the development of psychiatric disorders in childhood and adulthood.

Background/Aim: A subarachnoid hemorrhage (SAH) usually occurs between the ages of 45-60 years and its prevalence is 2-32 per hundred thousand. Approximately 70-80% of SAHs develop as a result of aneurismal hemorrhage. Studies examining the two methods in the literature are insufficient. The goal of this study was to compare CT angiography (CTA) and digital subtraction angiography (DSA) in the management of patients with aneurysmal subarachnoid hemorrhage (ASH). Method: In this retrospective cohort study, the CTA and DSA records of patients who were followed up due to aneurysmal SAH were retrospectively examined. The location and size of the aneurysm were measured. The patients were transported to the DSA unit within 1-12 hours once they stabilized and the records of the patients who underwent DSA for Anterior Communicating Artery (Ant.Com.A), Basilar Artery (BA), MCA and Posterior Communicating Artery (Post.Com.A.) for diagnostic purposes were assessed. Results: Our study included a total of 69 aneurysm cases complying with our criteria. Twenty-four (34.8%) were at the Ant.Com.A, 6 (8.7%) were at the BA, 32 (46.4%) were at the MCA and 7 (10.1%) were at the Post.Com.A. When the alignment between DSA and CTA results was examined according to the location, eighteen cases with Ant.Com.A aneurysm, and eighteen cases with MCA aneurysm were coherent, while six and fourteen cases of Ant.Com.A and MCA aneurysm, respectively, were not (p>0,05). An analysis in terms of size revealed that DSA was more sensitive in patients with aneurysms 1 cm. Overall, no significant difference was found (Ҡ=-0.075, -0.120; π= -0.107, -0.200; P=0.600) between DSA and CTA in terms of accuracy of showing aneurysmal location (Ҡ=-0.050, π= -0.076; P=0.650). Conclusion: In SAH due to aneurysms, CTA can be preferred, and treatment can be planned based on its results because it is more accessible and cheaper, does not require specially trained physicians and technicians, enables easier control of post-operative brain CT, and reduces patient referrals between health institutions for diagnostic purposes.

Amaç: Karpal tünel sendromu(KTS) tanılı olgularda real -time strain elastografisinin tanısal değerini ve median sinire yönelik EMG (elektromiyografi) bulguları ile sonografik parametrelerin (sinir kesit alanı ölçümü) arasındaki korelasyonu göstermeyi amaçladık. Gereç ve Yöntem: Çalışmaya median sinirin trasesinde en az 3 ay süren parestezisi olan hastalar dahil edildi. KTS tespit edilen toplam 23 kadın hasta ve 25 sağlıklı kadın kontrol gruplarının el bileği incelenirken bifid median sinir ekarte edilerek toplamda 36 KTS ve 46 sağlıklı median sinire el bileği trasesinde 3 farklı noktada; radyoulnar eklem, skafoidpsiform bileşke ve hamat kemik olmak üzere real time strain elastografisi uygulandı. Hastaların klinik belirtileri vardı ve EMG testleri tanıyı doğruladıBulgular: KTS mevcut olgularda EMG bulguları ile sonografik median sinir kesit alanı ölçümü ve strain elastografi oran değerleri korele olarak tespit edildi. KTS olgularında median sinir elastografi strain oran değeri kontrol grubuna göre anlamlı olarak artmıştı .Sonuç: Sonoelastografi KTS tanısı için yararlı bir yöntem olarak umut verici sonuçlar vermektedir., elastography in relation to carpal tunnel syndrome (CTS) and to show the relationship between electromyography (EMG) and sonographic cross-sectional area measurements.Materials and Methods: The patients with paresthesia of the median nerve distrubition lasting at least for 3 months were included. A total of 23 female patients’s of CTS and 25 healthy female volunteers’ wrist in which one median nerve existed included that of 36 CTS and 46 healthy wrists. The patients had clinical signs and their EMG test confirmed the diagnosis. The patients median nerve along its course on the wrist was applied strain elastography at three points of the radioulnar joint, scaphoidpsiform junction and hamate bone. Results: The EMG findings, strain elastogragraphy ratios and the CSA of the median nerve were found to be correlated significantly. The median nerve strain ratio in elastography was significantly increased in the CTS patients compared to the control group. Conclusion: Sonoelastography promises to be a useful method for the diagnosis of CTS.

Karotiko-kavernöz fistül, karotis sistemi ile kavernöz sinüs arasındaki anormal arteriyovenöz bağlantıdır. Görüntüleme yöntemleri tanıda en önemli basamağı oluşturmaktadır. Karotiko-kavernöz fistülü olan 50 yaşındaki kadın hastayı sunmaktayız. Hastanın çift görmesi, sağda göz kapağı düşüklüğü ve sağ göz çevresinde ağrısı mevcuttu. Yapılan diğer görüntüleme yöntemleri normal saptanan hastanın dijital subtraksiyon anjiografisinde sağ internal karotis arterin meningohipofisyal arterinden, internal maksiller arterden ve orta meningeal arterden köken alan karotiko-kavernöz fistülü tespit edildi. Hastanın fistülünün koillenmesinin ardından kişi eski sağlığına kavuştu. Nadir durumlarda, karotiko-kavernöz fistül manyetik rezonans görüntüleme ya da bilgisayarlı tomografi ile tespit edilemeyebilmektedir. Eğer hastada fistül olduğuna dair kuvvetli şüphe var ise, dijital subtraksiyon anjiografi yapılması konusunda ısrarcı olunmalıdır., Carotid-cavernous fistula is an abnormal arteriovenous communication between the carotid arteries and the cavernous sinus. Imaging studies are the most important step of diagnosis. We herein report a 50-year-old woman with a carotid cavernous fistula, who presented with double vision, right ptosis and ipsilateral pain. All imaging studies were normal except digital subtraction angiography, which revealed a carotid cavernous fistula arising from the meningohypophyseal trunk of right internal carotid artery, internal maxillary artery and middle meningeal artery. The patient underwent endovascular coiling of the fistula. She had an excellent recovery after intervention. In rare situations, carotid cavernous fistula can not be revealed by computerized brain tomography or magnetic resonance imaging. If there is a strong suspicion of carotid cavernous fistula, digital subtraction angiography must be obtained for diagnosis and treatment.

Histopathologically, calvarial lesions are congenital, inflammatory, neoplastic and traumatic origin and these are rarely seen. The calvarial lesions most commonly manifest as palpable mass on physical examination or they are diagnosed incidentally during a radiological test. Defect, lysis and sclerosis in the bony structure are evaluated with radiography and computed tomography (CT) and relationships of the lesions with the soft tissue components and surrounding soft tissue are evaluated with CT and magnetic resonance imaging (MRI) and especially with MRI. Based on the radiological findings, benign-malignant discrimination of the calvarial lesions can be made and it may be possible to estimate their histopathological diagnoses., Kalvarial lezyonlar histopatolojik olarak, kongenital, enflamatuar, neoplastik ve travmatik kökenli olup, nadir olarak izlenmektedir. Kalvarial lezyonlar en sık klinik muayenede ele gelen kitle şeklinde ya da radyolojik bir tetkikde insidental olarak tanı konur. Kemik yapıdaki defekt, lizis ve skleroz radyografi ve bilgisayarlı tomografi (BT) ile, lezyonların yumuşak doku komponentleri ve çevre yumuşak doku ile ilişkisi, BT ve manyetik rezonans görüntüleme (MRG) ile ve özelikle MRG ile değerlendirilir. Radyolojik değerlendirme sonucu, radyolojik bulgulara göre kalvarial lezyonların benignmalign ayrımı ve histopatolojik tanısını tahmin etmek mümkün olmaktadır.

Aim: This study was conducted to evaluate the knowledge, use and views of health school nursing students about complementary and alternative medicine (CAM) practices.Materials and Methods: In this descriptive study, the questionnaire was distributed to every student who was studying on the days when the research was applied. The study was conducted with 489 volunteer students who agreed to fill out the questionnaire. The obtained data were recorded in SPSS packaged software and statistical analyzes were done through this software. Results: The CAM methods that are most known by the students who participated in the research are respectively, (82.6%) exercise, (79.6%) vitamins, (74.0%) diet, (73.0%) vegetable products and (71.3%) massage. The frequency of using CAM was found to be 51.3%. CAM usage rate in males is higher than females (p

Aim: The aim of this study was to evaluate the accompanied cervical injuries of the patients presenting to the emergency department (ED) because of penetrating, perforating or tangential cranial gunshot injuries (CGI). Material and Methods: The retrospective study included 137 patients that presented to the EDs at Mustafa Kemal and Ataturk University due to penetrating, perforating or tangential CGI between 2014 and 2018. Patients younger than 12 years old and had insufficient radiological records were excluded from the study and thus 115 patients were included in the study. Results: 115 patients included 105 (91%) men and 10 (9%) women with a mean age of 27 (range, 12-65) years. Of the 115 injuries, 84 (73%) were high-velocity and 31 (27%) were low-velocity gunshot injuries. The injuries included 92 (80%) penetrating or perforating and 23 (20%) tangential injuries. No cervical dislocation injury was accompanied by CGI in any patient. Unilateral lamina fracture of the cervical vertebra was observed in one patient. Conclusion: Our results support the opinion that isolated penetrating, perforating or tangential CGI did not cause to cervical spinal injuries, the intubation or tracheostomy procedures should not be postponed after radiological evaluation of cervical spinal stability.

Amaç: Yapısal olmayan bir amino asit olan antioksidan etkili taurinin kırık iyileşmesi üzerine etkilerinin araştırılması Gereç ve Yöntem: Kontrol grubunda dokuz, taurin grubunda yedi tane Yeni Zelanda tipi tavşana açık tibial osteotomi uygulandı. Radyolojik kırık iyileşmesi, 21. günde çekilen direk grafi ve bilgisayarlı tomografi (BT) kesitleri üzerinde Goldberg skoru ile değerlendirildi. Histoloik olarak iyileşme Huo skoruna göre derecelendirildi. Sıfırıncı, yedinci, 14. ve 21. günlerde serumda malondialdehit (MDA) ve alkalen fosfataz (ALP) düzeyleri ölçüldü. Bulgular: Direk grafi ve BT kesitlerine göre kırık iyileşmesinin ortanca evresi taurin grubunda radyolojik kaynamayken kontrol grubunda olası kaynama olarak bulundu. Histolojik olarak, kallus taurin grubunda esas olarak kemik dokusundan oluşurken (ortanca Huo skoru 8), kontrol grubunda baskın doku kıkırdaktı (ortanca Huo skoru 6). MDA düzeyindeki değişimler oksidatif stresin kırık iyileşmesinin enflamatuvar fazında en yüksek olduğunu göstermekteydi. Her iki grupta da ALP düzeyleri önce azalmış, 21. Günde yeni kemik oluşumuyla yeniden yükselmiş olarak bulundu. Sonuç: Bu çalışmanın sonuçları deneysel osteotomi modelinde taurinin erken evre kırık iyileşmesi üzerinde olumlu etkileri olduğunu desteklemektedir. Bu etki tarunin antioksidan özelliği ile ilişkilendirilebilir., Objective: To evaluate the influence of taurine, a non-structural amino acid with antioxidant effects, on fracture healing. Materials and Methods: Open tibial osteotomy was performed on nine New Zealand rabbits in the control group and seven in the taurine group. Radiologic fracture healing was assesed using the Goldberg score on x-rays and computed tomography (CT) sections on the 21st day. Healing was graded histologically using the Huo score. Serum malondialdehyde (MDA) and alkaline phosphatase (ALP) levels were measured, at days zero, seven, 14 and 21. Results: Upon completion of the study, in the taurine group, the median stage of healing was recorded as “radiologic union”, whereas it was “probable union” in the control group with respect to x-ray and CT sections. In the taurine group, callus was mainly composed of osteoid tissue (median Huo score 8); in the control group the predominant tissue was chondroid (median Huo score 6). Changes in MDA levels revealed that oxidative stress was greatest in the inflammatory phase. In both groups, the ALP levels first decreased, and then increased ,with new bone formation on the 21st day. Conclusion: Taurine improved early bone healing in an experimental animal osteotomy model. This influence might be related to its antioxidant properties.

Vatansever, Alper (Balikesir Author), Çalışmamız, tıp fakültesi öğrencilerinin, anatomi pratik eğitimi sırasında karşılaştıkları zorlukların belirlenebilmesi ve çözümlenmesi ile birlikte anatomi pratik derslerinin daha etkili bir yönteme dönüştürülmesini amaçlamaktadır. Bu noktadan yola çıkılarak, anatomi eğitimine yeni başlamış ve anatomi eğitimini bitirmek üzere olan toplam 226 öğrenci çalışmamıza dahil edilmiştir. Bu öğrencilere, açık uçlu ve çoktan seçmeli sorulardan oluşan 30 soruluk anket uygulaması yapılmıştır. Anket uygulaması tamamlandıktan sonra elde edilen yanıtlar, SPSS 21 paket programı ile değerlendirilmiştir. Çalışmamıza katılan öğrencilerden 225’i (%99,6), anatomi dersinin işlenişi hakkında kendilerinin de fikirlerinin alınması gerektiğini belirtmişlerdir. Bunun yanında, anatomi eğitimi için vazgeçilmez olan kadavra gösteriminin yanı sıra, radyo-lojik görüntülerin de yardımcı eğitim aracı olarak kullanılması gerektiğini düşünmektedirler (%72,6). Elde edilen bulgular, anatomi pratik eğitiminin daha etkili bir yöntemle ilerleyebilmesi için tıp fakültesi öğrencilerinin fikirlerinin alınmasının gerekliliğini ortaya koymaktadır., Aim of our study was detection of medical students’ difficulties during anatomy practical education and creating more effective anatomy practical education by resolving their problems. For this purpose, a total of 226 medical students who had just started and were about to complete anatomy lectures were included. A questionnaire consisting of 30 questions including of open-ended and multiple choice questions was given to these students. After the questionnaire was completed, the responses were evaluated using the SPSS 21 software. 225 (99.6%) of the students participating in this study stated that it was necessary to ask their ideas about the anatomy courses. Furthermore, besides the cadaver demonstration which is indispensable for anatomy education, radiological images should be used as an auxiliary educational tool (72.6%). Our results revealed that it was necessary to ask the medical students’ ideas for proceeding the anatomy practical courses with a more effective method.

Amaç: Mortalite ve morbidite oranı oldukça yüksek olan intraserebral hemorajinin(İSH) prognozunda inflamatuar süreç oldukça önemli bir yer tutar. İnflamatuar bir gösterge olarak kabul edilen platelet/lenfosit oranının(PLO); son yapılan çalışmalarla özellikle akut koroner sendrom, kalp kapak hastalıkları, çeşitli onkolojik hastalıklar ve serebral infarktüste prognozla ilişkili olduğu ortaya konmuştur. Ancak akut dönem İSH’li hastaların prognozunu göstermedeki yeri henüz bilinmemektedir. Gereç ve Yöntemler: Çalışmamıza retrospekif olarak Ocak 2008- Haziran 2016 tarihleri arasında kliniğimize şikayetlerinin başladığı ilk 24 saat içinde başvuran, İSH tanısı kesinleşmiş 296 hasta ile benzer yaş ve cinsiyete sahip 180 kontrol dahil edildi. 296 hastanın 120 tanesi 30 günlük hastane yatışı sırasında hayatını kaybetmişti. Hastalarla kontrollerin ve ölenlerle sağ kalan hastaların nötrofil/lenfosit oranları(NLO) ile PLO değerleri karşılaştırılarak 30 günlük mortaliteyi saptamada NLO ve PLO’nun rolü değerlendirildi. Bulgular: Hasta grubu kontrollerle, ölen hastalar sağ kalan hastalarla kıyaslandığında nötrofil ve platelet sayıları ile NLO ve PLO değerleri hasta grubunda ve özellikle de ölen hastalarda daha yüksekti. Yapılan tek ve çok değişkenli lojistik regresyon analizlerinde, NLO ve PLO değerlerindeki yüksekliğin akut dönem İSH’li hastalardaki kısa dönem mortaliteyi saptamada anlamlı bağımsız değişkenler olduğu saptandı(p= 0.014,p=0.024).Ek olarak yapılan ROC analizi ile PLO için 261.7, NLO için ise 9.5 üzerindeki değerlerin İSH’ye bağlı 30 günlük mortaliteyi saptamada kullanılabileceği gösterildi. Sonuç: Bu sonuçlarla akut dönem İSH’lı hastalarda NLO ve PLO değerlerinin arttığı ve mekanizması tam olarak bilinmese de NLO ve PLO değerlerindeki yüksekliğin İSH’li hastalarda kısa dönem mortalite ile yakından ilişkili olduğu söylenebilir., Aim: Inflammation plays an important role in the prognosis of intracerebral hemorrhage(ICH), which has high mortality and morbidity rates. Platelet to lymphocyte ratio(PLR), which was accepted as an indicator of inflammation, have been increasingly demonstrated a prognostic factor, particularly in acute coronary syndrome, various oncological diseases, and in cerebral infarction in recent studies. Nonetheless, its significance regarding the determination of prognosis in patients with ICH has not yet been clarified. Materials and Methods: This is a retrospective study including 296 patients who presented to our clinic within 24 hours of the onset of symptoms and who were diagnosed with ICH between January 2008 and June 2016, along with 180 age and sex-matched controls. During their 30 day-hospitalization, 120 of these 296 patients died. Patients and controls were compared in terms of neutrophil to lymphocyte ratio(NLR) and PLR values; these were also compared between died and surviving patients. The significance of NLR and PLR in predicting mortality was also evaluated. Results: Patients had significantly higher neutrophil and platelet counts and NLR and PLR values than controls; these results were similar between died and surviving patients. Univariate and multivariate logistic regression analyses indicated that NLR and PLR were independent predictors of short term mortality in ICH (p= 0.014, p=0.024). In addition, ROC analysis showed that cut-off values of 261.7 for PLR and 9.5 for NLR may be used to determine 30-day mortality due to ICH. Conclusion: These results indicate that NLR and PLR can increase in patients with ICH, and that although the mechanism is unclear, the increase of NLR and PLR is closely associated with short term mortality in patients with ICH.

Amaç: Bu araştırma, Ahi Evran Üniversitesi, Sağlık Yüksekokulu, hemşirelik öğrencilerinin HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) hakkındaki bilgi ve tutumlarını belirlemek amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı tipte olan bu araştırma, Mart-Nisan 2015 tarihleri arasında yapılmıştır. Anket uygulaması sırasında sınıfta bulunan ve araştırmaya katılmayı kabul eden 351 öğrenci (%80.1) araştırmanın evrenini oluşturmuştur. Araştırmanın verileri literatür taranarak hazırlanan anket formu aracılığı ile toplanmıştır. Anket formu öğrencilerin sosyo-demografik özellikleri ile 23 maddeden oluşan HIV/AIDS bilgi düzeyi soruları ve 9 maddeden oluşan AIDS’e karşı tutum ifadelerini içermektedir. Tanımlayıcı verilerde yüzde ve sayı, istatistiki analizlerde Mann-whitney U ve Kruskal Wallis testleri kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 21.17±2.24 olup, %71.8’ikız öğrenciydi. Öğrencilerin %18.5’i 1. sınıf öğrencisidir. Öğrencilerin %65’i AIDS’li olduğunu bildiği kişilerden uzak duracağını ve %17.9’u AIDS’li hastaların toplumdan uzak tutulması gerektiğini bildirmişlerdir. Ayrıca öğrencilerin %83.2’si mesleki olarak AIDS konusunda riskli olduklarını düşünmektedirler. Öğrencilerin yaş grubu, bulundukları sınıf ile HIV/AIDS bilgi düzeyi puan ortalamaları arasında istatistiksel olarak anlamlı fark saptanmıştır (p

Objective: The aim of the study was to investigate the prophylactic effects of acetyl L-carnitine against to uterus induced by cisplatin. Methods: Twenty-four female Wistar albino rats were divided into four groups: group I (control) was administered with saline; group II was administered with acetyl L-carnitine; group III was administered with cisplatin; group IV was pretreated with acetyl L-carnitine before cisplatin intraperitoneal injection. After 72h of cisplatin injection uterine tissue was removed. Histological and immunohistochemical investigations were performed, respectively. Results: We found that the number of TUNEL and caspases positive cells were increased in the endometrial epithelium, subepithelial connective tissue, endometrial glands and stroma in group III compare to the other groups. Furthermore inflammation and edema were observed in uterus of rats in group III. Conclusion: We can concluded that pretreatment of acetyl L-carnitine administration has protective effect on histological alteration of uterus caused by cisplatin. Amaç: Bu çalışmanın amacı, asetil L-karnitinin, sisplatinin neden olduğu uterus hasarına karşı profilaktik etkilerini araştırmaktır. Yöntem: Yirmi dört adet Wistar albino cinsi dişi sıçanlar dört gruba ayrıldı: 1. gruba (kontrol) salin uygulaması yapıldı; 2. gruba asetil L-karnitin uygulaması yapıldı; 3. gruba sisplatin uygulaması yapıldı; 4. grup ise sisplatinin intraperitoneal enjeksiyonu öncesinde asetil L-karnitin ile ön tedaviye tabi tutuldu. Sisplatin enjeksiyonundan 72 saat sonra uterus dokusu çıkarıldı. Histolojik ve immünohistokimyasal incelemeler yapıldı. Bulgular: TUNEL ve kaspaz pozitif hücre sayılarının, diğer gruplara göre 3. grupta endometriyal epitelde, subepitelyal bağ dokusunda, endometriyal bezlerde ve stromada arttığını bulduk. Ayrıca 3. Gruptaki ratların uterusunda inflamasyon ve ödem gözlenmiştir. Sonuç: Asetil L-karnitin ön tedavi uygulamasının, sisplatin kaynaklı uterus histolojisinin değişikliği üzerinde koruyucu etkisi olduğu sonucuna vardık.

Amaç: Bu çalışmanın amacı, inme sonrası hemipleji hastalarında glenohumeral subluksasyonun klinik değişkenlerle ilişkisinin değerlendirilmesidir. “Hemiplejik hastalardaki omuz subluksasyonu; spastisite, motor iyileşme ve ambulatuvar durum ile ilişkilidir” hipotezinin değerlendirilmesi amaçlanmaktadır. Yöntemler: İnme sonrası hemipleji tanılı hastalardan, omuz ağrısı nedeniyle anteroposterior omuz radyografisi çekilmiş olanlar çalışmaya dahil edildi. Retrospektif olarak dizayn edilen bu çalışmada, hastaların elektronik veri tabanındaki ve dosyalarındaki verilerinden demografik özellikleri (yaş, cinsiyet), hastalık süreleri, fonksiyonel ambulasyon skalaları (FAS), üst ekstremite için Brunnstrom motor iyileşme seviyeleri ve Modifiye Ashworth Skalası'na (MAS) göre spastisite evreleri kaydedildi. Muayene verilerinden klinik GHS tanısı alıp almadıkları not edildi. GHS saptanan hastalarda, muayeneleri ile eş zamanlı çekilmiş olan anteroposterior omuz radyografilerinde vertikal ve horizontal mesafeler ölçüldü. Klinik değişkenler ile GHS arasındaki ilişki değerlendirildi. Bulgular: Omuz ağrısı nedeniyle anteroposterior omuz grafisi çekilmiş olan, toplam 47 hemipleji hastasının sistem verisine ulaşıldı. Dışlama kriterlerinden sonra, yaş ortalaması 66,2±12,1 yıl olan 41 hasta istatistiksel analize dahil edildi. Hastaların 22’sinde (%53,7) GHS mevcuttu. Subluksasyon oranı Brunnstrom kategori I’de (Brunnstrom 1-3), kategori II’deki (Brunnstrom 4-6) hastalara göre anlamlı olarak daha fazlaydı (p0,05). Non-fonksiyonel (FAS 0-2) ve fonksiyonel (FAS 3-5) ambulasyona sahip hastalarda subluksasyon oranları benzerdi (p>0,05). GHS'li hastalarda, vertikal ve horizontal mesafeler, FAS ve MAS kategorisine göre değişim göstermezken (p>0,05), Brunnstrom kategori II’de, istatistiksel analiz için yeterli hasta sayısına ulaşılamadığından karşılaştırmalı analiz yapılamadı. Sonuç: İnme sonrası hemipleji hastalarında, GHS varlığı, motor iyileşme seviyesiyle ilişkili olmakla birlikte, ambulasyon ve spastisite düzeyinden bağımsızdır. Subluksasyon olan hastalarda, ambulasyon ve spastisite düzeyinin subluksasyonun kantitatif ölçümleri üzerine etkisi olduğu gösterilememiştir. Objective: The objective of the present study was to evaluate the relationship between glenohumeral subluxation (GHS) and the clinical variables in patients with post-stroke hemiplegia. The hypothesis, “Spasticity, motor recovery and ambulatory status are associated with GHS in hemiplegic patients” was tested. Methods: Post-stroke hemiplegic patients who had undergone anteroposterior shoulder radiography with a complaint of shoulder pain were included in the study. In this retrospectively designed study, demographic features (age, sex), disease duration, Functional Ambulation Scale (FAC) score, upper extremity Brunnstrom’s motor recovery stage, spasticity grade of the affected upper limb according to the Modified Ashworth Scale (MAS) were recorded from the electronic medical database. It was also noted whether the patients were diagnosed with GHS or not. In patients with GHS, vertical and horizontal distances were measured on anteroposterior shoulder radiographs, which were taken at the time of physical examination. Results: Data of 47 hemiplegic patients underwent anteroposterior shoulder radiographs due to shoulder pain was obtained. Following the application of exclusion criteria, 41 patients with a mean age of 66.2±12.1 were analysed. Of them, 22 (53.7%) had GHS. Subluxation rate was significantly higher among patients in Brunnstrom category I (Brunnstrom 1-3) than those in category II (Brunnstrom 4-6) (p0.05). Subluxation frequency was also similar between patients with non-functional (FAC 0-2) and functional ambulation (FAC 3-5) (p>0.05). In patients with GHS, vertical and horizontal distances did not differ by FAC and MAS category (p>0.05). Since Brunnstrom category II did not have enough number of patients for statistical tests, comparative analysis could not be applied. Conclusion: Among patients with post-stroke hemiplegia, presence of GHS is related to the motor recovery stage, but is regardless of ambulation and spasticity level. In patients with GHS, level of ambulation and spasticity had no impact on the quantitative measures of subluxation.

Amaç: Bu çalışmada, koroner arter hastalığı olan tip 2 diyabetik hastalar ile nefropatisi olan tip 2 diyabetik hastaları ana karotis intima–media kalınlığı açısından karşılaştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya koroner arter hastalığı olan tip 2 diyabetik hastalar (n=36) ve koroner arter hastalığı olmayan, nefropati ile komplike tip 2 diyabetik hastalar (n=31) alındı. Sağ ve sol ana karotis arter intima–media kalınlığı B-mod ultrasonografi ile değerlendirildi. Hastalarda kardiyovasküler hastalık açısından diğer geleneksel risk faktörleri de değerlendirildi. Bulgular: Koroner arter hastalığının eşlik ettiği diyabet hastalarında hem sağ hem de sol ana karotis arter intima–media kalınlığı, sadece nefropatinin eşlik ettiği diyabet hastalarına göre anlamlı derecede fazla bulundu (sağ ana karotis için 0,99 mm’ye 0,82 mm, sol ana karotis için 1,07 mm’ye 0,92 mm; her ikisi için de p0,05). Tartışma ve Sonuç: Koroner arter hastalığı varlığı tip 2 diyabette eşlik eden serebrovasküler hastalık için önemli bir göstergedir., Aim: This study aims to compare type 2 diabetic patients with coronary artery disease and type 2 diabetic patients with nephropathy in terms of common carotid artery intima–media thickness. Materials and Methods: The study included type 2 diabetics with coronary artery disease (n=36) and type 2 diabetics without coronary artery disease but with complicating nephropathy (n=31). The right and left common carotid arteries were evaluated in terms of intima–media thickness by using B-mode ultrasonography. Other traditional risk factors for cardiovascular disease were also evaluated. Results: Both right and left common carotid artery intima–media thicknesses were found to be significantly greater for the diabetics with concomitant coronary artery disease than for the diabetics with concomitant nephropathy only (0.99 mm vs 0.82 mm for the right and 1.07 mm vs. 0.92 mm for the left common carotid artery; p0.05 for all). Discussion and Conclusion: Presence of coronary artery disease is an important indicator for concomitant cerebrovascular disease in type 2 diabetics.

Objectives. The aim of this retrospective study was to report the treatment results obtained with the ankle- spanning Ilizarov fixator technique in the treatment of complex OTA/AO type 43C3 open tibial pilon fractures. Methods. A total of 14 patients with open OTA/AO type 43C3 tibial pilon fractures were evaluated. The demographics and fracture characteristics, preoperative and postoperative radiological evaluations, duration of follow-up (months), time to union (months) and complications were recorded. After collection of operative data, patients were invited for functional and radiological outcome evaluation. American Orthopaedic Foot and Ankle Society (AOFAS) scores and range of movement (ROM) of the ankle joint were investigated. Also radiologically the ankle osteoarthritis level according to the Bargon et al. criteria was noted. Results. The mean age of the patients was 48.7 years (range, 26-72 years). The mean follow-up period was 32 months (range, 25- 46 months). The clinical and radiological time to union was mean 6.5 months (range, 5-11 months). On the postoperative ankle CT images, the separation within the ankle was measured as < 2mm in all patients and in 3 patients, stepping was measured as > 2mm. Following removal of the external fixator, dorsiflexion was measured as mean 15.5° (range, 0°-23°) and plantar flexion as mean 26.14° (range, 13°-36°). The mean AOFAS was 80.35 (range, 56-92). Conclusion. Satisfactory results can be obtained with the Ilizarov external fixator passing the ankle in the permanent treatment of AO-43C3 type open tibial pilon fractures.

Aim: Papillary thyroid carcinoma (PTC) is the most common primary thyroid malignancy. It is called papillary thyroid microcarcinoma (PTMC) if the nodule is less than 10 mm in diameter. It has been shown that platelets may play an essential role during chronic inflammation, cancer progression, and metastasis. The aim of this study was to examine the value of platelet indices including platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) in PTC. Material and Methods: 26 patients (19 female, 7 male) with PTC diagnosis were included in the study. The patients were divided into two groups: papillary thyroid microcarcinoma (PTMC) and PTC. All patients who were included in the study were examined for complete blood count parameters. Results: There was no significant difference between the groups in terms of age and gender. Leukocyte count, neutrophil count and percentage, lymphocyte count and percentage, platelet count, plateletcrit, and MPV were not statistically different between groups. PDW were significantly higher in patients with PTC than in those with PTMC. Conclusion: Our results show that patients with PTC have higher PDW levels compared to patients with PTMC. Elevated PDW in PTC may be useful in diagnosis of the disease and for better understanding of its pathogenesis.

Aim: To evaluate and compare the mRNA expression of antioxidant genes between the cervical and lumbar degenerated disc tissues. Material and Methods: Obtained degenerated Nucleus Pulposus (DNP) materials were divided into two groups, which were cervical DNP (Group I) (n=20) and lumbar DNP (Group II) (n=20). There are 6 men and 14 women in group I with a mean age of 43.8 years and 13 men and 7 women in group II with the mean age of 40.3 years (28 to 54). All cervical DNP materials were obtained between C5 and C6 and all lumbar DNP materials were obtained between L4 and L5 levels. The TGF?1, bFGF, IGF-1, NGF and Matrix metalloprotease III (MMP III) gene expressions of DNP materials were determined by polymerase chain reaction, Real-time polymerase chain reaction and western blotting techniques.Results: When the results of the two groups were compared by polymerase chain reaction, the expressions of TGF?1, bFGF, IGF-1, NGF and MMP III was found lower in lumbar DNP group. Also the TGF?1, bFGF, IGF-1, NGF, and Matrix metalloprotease III genes showed a decrease in gene expression levels when they were analyzed by Real-time polymerase chain reaction. Conclusion: These data showed that; decrease of the TGF?1, bFGF, IGF-1, NGF and MMP III genes in the degenerated lumbar disc tissues, may related with the possibility of molecular background of the disease pathogenesis.

research Amaç: Çocukluk çağında solunum sistemi hastalıklarına ve anomalilerine sık rastlanılmaktadır. Solunum yolu problemlerinde fleksibl fiberoptik bronkoskopi (FOB) kullanımın, tanı ve tedavideki etkinliğini ve çocukluk çağında güvenle kullanımını göstermek amaçlanmıştır. Gereç ve Yöntem: Şubat 2011- Haziran 2012 tarihleri arasında, Dr. Lütfü Kırdar Kartal Eğitim ve Araştırma Hastanesi Çocuk Göğüs Hastalıkları bronkoskopi ünitesinde yapılan 116 FOB işlemi retrospektif olarak değerlendirildi. Bulgular: Fleksibl fiberoptik bronkoskopi yapılan 77’si erkek, 39‘u kız toplam 116 hasta değerlendirmeye alındı. Bronkoskopi endikasyonlarının dağılımı; olgularda görülen stridor, kronik öksürük, persistan wheezing, tekrarlayan krup, hemoptizi, postero anterior akciğer (PAAC) grafisinde persistan infiltrasyon, lokalize bronşektazi, lokalize havalanma artışı, yabancı cisim şüphesi, atelektazi ve akciğer tüberkülozunun tanı ve değerlendirilmesi idi. Sonuç: Bronkoskopi tekrarlayan, persiste eden ve tanısında zorlanılan üst ve alt havayolu semptomları olan hastalarda güvenle yapılan, önemli bir tanı ve tedavi aracıdır. Objective: Respiratory system disorders and anomalies are common in the childhood. In this study, our objective was to demonstrate the effective use of the flexible fiberoptic bronchoscopy (FOB) in the respiratory system disorders and its safety in the childhood. Materials and Methods: 116 FOB interventions, which were carried out in the bronchoscopy unit of the Dr. Lütfü Kırdar Kartal Training and Research Hospital Pediatric Pneumology Department, were retrospectively evaluated. Results: 77 of the 116 evaluated FOB patients were boys and 39 were girls. The most common indication for bronchoscopy was stridor (33.6%) and the most common diagnosis after the bronchoscopy was laryngomalacia (27.59%). Bronchoscopy was completed successfully in 112 patients (96.55%) and it was discontinued in 4 patients (3.5%). Conclusion: Bronchoscopy is an important diagnosis and treatment tool, which can be safely carried out in the recurrent, persistent and hard-to-diagnose upper and lower respiratory disorders in the childhood.

research Amaç: Akciğer kanseri kötü prognozlu ve tedavi yanıtı sınırlı olan bir kanser türüdür. Galektin akciğer kanseri patogenezinde rol alabildiği düşünülen fakat akciğer kanseri ile ilişkisinin yeterli düzeyde gösterilemediği potansiyel bir belirteçtir. Amacımız serumda basit bir yöntem olan galektin 1 ve 3 ölçümünün, akciğer kanseri tanısal ya da prognostik belirteci olup olamayacağını araştırmaktır. Yöntem: Çalışmaya 49 akciğer kanseri ve 30 sağlıklı kontrol hastası alındı. Serumlarında galektin 1 ve 3 düzeyleri galektin ölçüm kiti ile çalışıldı. Akciğer kanserli olgular ve sağlıklı kontrol hastaları galektin 1 ve 3’ün tanısal ve prognostik belirteç olup olmayacağı ile ilgili parametreler istatistiksel olarak incelendi. Bulgular: Akciğer kanserli hastada galektin 1 ve 3 değeri, kontrol grubuna göre daha düşüktü. Galektin 1 ve 3 düzeyleri ile sağ kalım, evre ve tümör çapı arasında ilişki saptanmazken, metastaz ve tümör tipi ile negatif ilişkisi saptandı. Sonuç: Galektin 1 ve 3 değeri akciğer kanseri hastalarında sağlıklı olgulara göre daha düşüktür fakat sensitivite ve spesifitesi kısıtlıdır. Literatürde yüksek galektin düzeyi ile akciğer kanseri arasında pozitif saptanan ilişkinin daha geniş hasta gruplarında çalışılmasının uygun olacağı görüşündeyiz. Basit bir tanısal belirteç olarak serum düzeyinin kullanımı umut vaat etmektedir. Objective: Lung cancer is a cancer type with poor prognosis and limited treatment response. Galectin is a potential marker of lung cancer, which is suggested to be involved in the pathogenesis of lung cancer although its association with lung cancer was not accurately demonstrated. Our aim was to investigate whether the simple method of serum galectin 1 and 3 measurements could be diagnostic or prognostic markers of lung cancer. Methods: Forty-nine lung cancer patients and 30 healthy controls were included in the study. The serum galectin 1 and 3 levels were measured using a Galectin assay kit, provided by contribution of the Hitit University Scientific Research Project (SRP). Lung cancer patients and healthy controls were categorized by galectin 1 and 3 levels, either as high or low, and were evaluated statistically for parameters related to diagnostic and prognostic markers. Results: Galectin 1 and 3 values were lower in lung cancer patients compared to the control group (p= 0.015, p= 0.001, respectively). No significant difference was detected for survival and size of tumor between Galectin 1 and 3 groups. Significant difference was detected for metastasis and type of tumor between Galectin 1 and 3 groups. Conclusion: Galectin 1 and 3 values were lower in lung cancer patients compared to healthy subjects but sensitivity and spesifity were not satisfactory. We believe that, the positive relationship between high galectin levels and lung cancer reported in the literature should be assessed further in larger patient populations. Galectin 1 and 3 were not found associated with survival. Measurement of serum galectin-1 and galectin-3 levels as a diagnostic marker is a simple but promising method.

Amaç: Çalışmamızda non-alkolik yağlı karaciğer (NAYK) hastalığında ilgili biyokimyasal belirteçleri ve bunlar arasındaki ilişkileri incelemeyi amaçladık. Gereç ve Yöntemler: Herhangi bir yakınması olmayıp hastanemize kontrol amacıyla başvurmuş olan bireylerin dosyaları retrospektif olarak incelendi. Ultrasonografide (USG) karaciğerde değişik derecelerde NAYK tespit edilen 148 (94 kadın, 54 erkek) birey vaka grubu olarak, USG’de NAYK tespit edilmeyen 149 (76 kadın, 73 erkek) birey ise sağlıklı kontrol grubu olarak çalışmaya dahil edildi. Toplamda 297 hastanın açlık kan glukozu, insülin, HOMA-IR, ürik asit, C-reaktif protein (CRP), trigliserit, LDL, HDL, TSH, D vitamini, AST, ALT, GGT, ALP değerleri ve USG ile belirlenmiş olan NAYK dereceleri incelendi. Bulgular: Cinsiyet karşılaştırılmasında erkeklerde, NAYK prevalansı vaka grubunda sağlıklı gruptakine göre anlamlı biçimde daha yüksek bulundu (p=0,029). Benzer şekilde serum açlık kan glukozu, insülin, HOMA-IR, ürik asit, trigliserit, HDL, ALT, AST, GGT, CRP değerleri de vaka grubunda anlamlı biçimde daha yüksekti. HDL, D vitamini düşüklüklerinin NAYK derecesine etkisi saptanmadı. Vaka grubunda NAYK derecesine göre yapılan analizler açlık kan şekeri (AKŞ), HOMA-IR, ALT, AST ve GGT ortalamaları açısından NAYK dereceleri arasında istatistiksel olarak anlamlı fark olduğunu gösterdi. NAYK derecesi 2 ve 3 olan gruplar birleştirilerek analizler tekrarlandığında NAYK derecesi 1 ve 2 olan iki yeni grup arasında AKŞ, insülin, HOMA-IR, ALT, GGT ortalamaları açısından istatistiksel olarak anlamlı bir fark bulundu. Bu kez AST’deki farklılık azalırken, insülin değeri ortalaması açısından da istatistiksel olarak anlamlı fark olduğu gözlendi. Tartışma ve Sonuç: Çalışmamız görünürde sağlıklı olan bireylerde de NAYK’nin araştırılması gerektiğini, erken tanı ve uygun yönetim ile siroz ve hepatoselüler karsinom gibi komplikasyonların önüne geçilebileceğini düşündürmektedir., Aim: In this study, we aimed to investigate the related biochemical markers and their correlations in non-alcoholic fatty liver (NAFL) disease. Materials and Methods: Patient files of individuals who came to our hospital for routine controls without any complaints were reviewed retrospectively. One hundred and forty-eight individuals (94 females; 54 males) whose ultrasonographic examination revealed varying degrees of NAFL disease constituted the patients group and 149 individuals (76 females; 73 males) whose results were clear the healthy controls group. We reviewed the ultrasonographically determined NAFL disease grades and fasting blood glucose, insulin, HOMA-IR, uric acid, C-reactive protein (CRP), triglyceride, LDL, HDL, TSH, vitamin D, AST, ALT, GGT and ALP values of a total of 297 patients. Results: With respect to sex, NAFL prevalence was significantly higher in the patients group than in the healthy controls for males (p=0.029). Similarly, fasting blood glucose, insulin, HOMA-IR, uric acid, triglyceride, HDL, ALT, AST, GGT and CRP levels were also significantly higher in the patients group. No effect of low HDL and vitamin D levels on NAFL disease grade was observed. Analyses based on NAFL disease grade showed statistically significant difference between the subgroups of disease grade of the patients group in terms of fasting blood glucose, HOMA-IR, ALT, AST and GGT mean values. When the analyses were repeated after the grade 2 and 3 subgroups were combined, there was statistically significant difference between the new grade 1 and 2 subgroups in terms of fasting blood glucose, insulin, HOMA-IR, ALT and GGT mean values. This time there was statistically significant difference in terms of mean insulin levels also, while the difference between the AST levels decreased. Discussion and Conclusion: Our study suggests that apparently healthy individuals also be examined for presence of NAFL disease because timely diagnosis and appropriate management could significantly help prevent complications such as cirrhosis and hepatocellular carcinoma.

Jejunal divertikülozis nadir görülen bir hastalıktır. Prevalansı yaşla doğru orantılı olarak artmakta, 6. ve 7. dekadlarda en üst düzeye ulaşmaktadır. Jejunal divertiküller genellikle asemptomatik seyirlidir ancak, perforasyon geliştiğinde ciddi morbidite ve hatta mortaliteye neden olabilir. Acil servise karın ağrısı ile başvuran, ilk muayenede ve görüntülemede anormal bulgu saptanmayan, yatışının 48. Saatinde akut karın nedeniyle ameliyata alınan ve jejunal divertikül perforasyonu saptanan, intraoperatif arrest nedeniyle exitus gelişen hasta ile ilgili deneyimimizi paylaşmak istedik. Jejunal diverticulosis is a rare disease. The prevalence increases with age, reaching the highest level in the 6th and 7th decades. Jejunal diverticulum is usually asymptomatic but may cause serious morbidity and even mortality when perforation develops. We wanted to share our experience with the patient who presented with an emergency department abdominal pain, who had no abnormal findings on the first examination and imaging, who was operated on due to acute abdomen at the 48th hour of hospitalization and who developed jejunal diverticulum perforation and developed exitus due to intraoperative arrest. © Copyright 2018 by Gazi University Medical Faculty

Aim: Music’s rehabilitative effects are clear in the literature, but the effect of the music type on the post-stroke patients is not clear. The aim of the present study was to investigate the effects of listening different types of music on depression, sleep quality, mental state and anxiety in post-stroke patients. Material and Methods: The study was conducted prospectively. Thirty post-stroke pateints admitted to Department of Neurology, Faculty of Medicine at Mustafa Kemal University, were considered for the study. The patients’ depression level, sleep quality, anxiety and cognitive status were evaluated. Subjects were listening music during the rehabilitation program. Subjects were separated as the Eastern Music group (n=10), western music group (n=10) and control group (n=10). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Standardized Mini Mental Test (SMMS), and Pittsburgh Sleep Quality Index (PSQI) tests were performed for all subjects twice pre and post- treatment. Results: There was a significant difference in SMMT and BDI within the eastern and Western Music groups (p

Objective: Carpal tunnel syndrome (CTS) is the most common peripheral trap neuropathy resulting from compression of the median nerve in the carpal tunnel of the wrist. Open release of the transverse carpal ligament is now the most commonly used method. New techniques are being developed to avoid complications of standard long curvilinear incision. Methods: Between March 2010 and January 2016, carpal tunnel release was performed by the same surgeon with 110 minimally invasive techniques in 96 patients due to CTS. Complaints and physical examination findings were compatible with CTS and mid- to severe-severity CTS cases supported by EMG were included in the study. Results: Complaints and examination findings were recorded at the post- operative 1 st year outpatient clinics of the patients. Of the110 carpal tunnel release, in 50 patients (%45,5) total, in 45 patients (%40.9) significant, in 13 patients (%11,8) slight improvement were recorded, while no improvement was recorded in 2 patients (%1,8). They stated that 88% of the patients were satisfied with the operation and 12% were not satisfied. Visual Analog Scale (VAS) was used to evaluate pain complaints. The mean VAS score was 7,5 pre- operatively and 3,2 at post-operatively 1 year follow-up. Conclusion: In patients with CTS, median nerve decompression with minimal wrist incision is an effective and reliable surgical procedure., Amaç: Karpal tünel sendromu (KTS), median sinirin el bileğindeki karpal tünelde sıkışması sonucu ortaya çıkan en sık periferik tuzak nöropatidir. Transvers karpal ligamanın açık serbestleştirilmesi günümüzde en yaygın kullanılan yöntemdir. Standart uzun kurvilinear insizyonun komplikasyonlarından sakınmak için yeni teknikler geliştirilmektedir. Yöntem: Mart 2010- Ocak 2016 yılları arasında KTS nedeniyle 96 hastaya 110 minimal invazif teknik ile aynı cerrah tarafından karpal tünel serbestleştirilmesi yapıldı. Şikayet ve fizik muayene bulguları KTS ile uyumlu olup EMG ile ön tanısı desteklenmiş orta ve ağır derece KTS olguları çalışmaya alındı. Bulgular: Hastaların post-operatif 1. yıl poliklinik kontrollerindeki şikayet ve muayene bulguları kaydedildi. 110 karpal tünel serbestleştirilmesi sonrası 1. yılda, 50’sinde (%45,5) tam, 45’ inde (%40.9) belirgin, 13’ ünde (%11,8) hafif düzelme kaydedilirken 2 (%1,8) hastada düzelme olmadı. Hastaların %88’ i olduklarını ameliyattan memnun olduklarını, %12’ si memnun olmadıklarını belirtti. Hastaların ağrı değerlendirmeleri için Görsel Analog Ağrı Skalası kullanıldı. Bu değer ameliyat öncesi 7,5 iken ameliyat sonrası 1. yılda 3,2 olarak kaydedildi. Sonuç: KTS hastalarında, minimal el bileği insizyonu ile median sinirin dekompresyonu, etkin ve güvenilir bir cerrahi prosedürdür.

Yorgunluk, multiple sklerozlu bireylerde en sık rastlanan semptomlardan biridir. Multiple skleroz ile ilişkili yorgunluğun değerlendirildiği çalışmalarda; çoğu yorgunluk vakasının çevresel ve vücut içi sıcaklığının yükselmesi ile arttığı belirlenmiştir. Multiple sklerozlu bireylerde vücut sıcaklığı düşürülerek sinir iletisinin hızlandırılması ve semptomların giderilmesi amacıyla çeşitli soğutma tedavisi yöntemleri kullanılmakta ve yorgunluk düzeyinde azalmalar olduğu bildirilmektedir. MS hastalarında soğutma tedavisi; soğuk su içme, soğuk duş alma, deriye soğuk ped uygulama veya soğutucu giysi gibi yapay soğutma sistemlerinin kullanımı ile sağlanmaktadır. Bu derleme, MS hastalarında yorgunluk yönetiminde soğutucu giysi uygulaması ile ilgili literatür bilgisini paylaşmak amacıyla yazılmıştır., Fatigue is one of the most common symptoms in individuals with multiple sclerosis. In the studies evaluating the fatigue associated with multiple sclerosis, it was determined that fatigue increased with the elevation of body and environmental temperature in most of the cases. Various cooling methods are being used to accelerate nerve conduction and eliminate symptoms by reducing body temperature in the individuals with multiple sclerosis and it is reported that level of fatigue decreased with cooling therapies. In MS patients cooling treatment is provided by use of artificial cooling systems, such as drinking cold water, taking a cold shower, applying cold pad or cooling suits. This review aims to share knowledge about the application of cooling clothing in fatigue management in MS patients.

Amaç: Onkolojik hastalarda uzun süreli kemoterapi, total parenteral beslenme ve sıvı replasmanı amacıyla kullanılan ve total olarak yerleştirilebilen venöz kateterler, yaşam kalitesini artırırlar. Bununla birlikte, çok faydalı olmalarına rağmen bu kateterlerin yerleştirilmesinde ve idamesinde tromboz, enfeksiyon, perforasyon, pnömotoraks, kopma, yer değiştirme ve fistülizasyon gibi ciddi komplikasyonlar meydana gelebilir. Retrospektif çalışmamızın amacı, klinik deneyimlerimizi okuyucularla paylaşmak ve gelişen erken ve geç dönem komplikasyonları literatür eşliğinde değerlendirildi. Gereç ve Yöntemler: Şubat 2008-Aralık 2014 tarihleri arasında İzmir Bozyaka Eğitim Araştırma Hastanesi 3.Genel Cerrahi kliniğinde total implante edilebilir kalıcı venöz port katater takılan 130 kanser hastasına ait klinik ve demografik veriler retrospektif olarak incelendi. Bulgular: Toplam 130 hastaya kemoterapi amaçlı port kateter takıldı. Hastaların ortalama yaşı 54,1 yıl, 75’ü kadın 55’i ise erkekti. Bütün hastalarda malinite mevcuttu. Port kataterler hastalara kemoterapi amaçlı yerleştirildi. Komplikasyonlar olarak bir hastada pnömotoraks, bir hastada malpozisyon, 8 hastada port yerinde enfeksiyon, bir hastada cilt nekrozu, bir hastada da derin ven trombozu gelişti. Sonuç: Kalıcı venöz port kateter takılması için perkutan teknik ile santral venlerin kullanımı, deneyimli ellerde güvenle uygulanabilen, komplikasyon oranı düşük, başarı oranı yüksek ve hastalar için çok konforlu bir tekniktir. Objective: Totally placed venous catheters for long-term chemotherapy, total parenteral nutrition and fluid replacement in oncologic patients improve quality of life. However, despite their usefulness, serious complications such as thrombosis, infection, perforation, pneumothorax, rupture, displacement and fistulization may occur in the placement and management of these catheters. The aim of our retrospective study was to share our clinical experience with the readers and to evaluate the early and late complications in the light of the literature. Material and Methods: Between February 2008 and December 2014, clinical and demographic data of 130 cancer patients with total implantable permanent venous port catheter in İzmir Bozyaka Training and Research Hospital 3rd General Surgery Clinic were retrospectively reviewed. Results: A total of 130 patients had a port catheter for chemotherapy. The average age of the patients is 54.1 years, 75 is female and 55 is female. All patients had malignancy. Port catheters were placed for disease chemotherapy. Complications included pneumothorax in one patient, malposition in one patient, infection at the port site in 8 patients, skin necrosis in one patient, and venous thrombosis in one patient. Conclusion: The use of central venules with percutaneous technique for permanent venous port catheter insertion is a technique that can be applied safely in experienced hands, has low complication rate, high success rate and is very comfortable for patients.

Aim: This study aims to determine the knowledge, and behavior of patients at a university hospital’s family practice outpatient clinic regarding blood donation. Material and method: In this cross-sectional study, the authors administered a questionnaire to patients (400 people) at the university hospital’s family practice outpatient clinic for three months. The study data were entered into the SPSS package program, and the author performed the statistical analyses using this program. Results: The mean age of the participants was 28.70±10.81. Of them, 86% knew their blood type, and 53.8% had a document showing their blood type. Only 21.8% of the participants had previously donated blood. Blood donation was evaluated according to gender; men had offered to donate blood more than women; when evaluated according to marital status those who were married were found to donate blood more than singles. 63.3% of the participants who donated blood said they did so to help other people. Of those who did not donate blood before, 29.1% now consider donating?? In response to the question, how much a person is supposed to weigh in order to donate blood, 47.0% said a person should weigh at least 50 kilograms. When asked how often you could donate blood, 23.8% said every three months. Conclusion: The participants’ attitudes and behavior regarding blood donation were positive. Knowledge of participants is not enough. They are moderately well informed about this issue. People should be continuously provided with training about blood donation to increase their awareness.

Yazıcı, Haşmet (Balikesir Author), Objectives. The aim of the present study was to investigate the protective role of selenium against cisplatininduced oral mucositis in rats. Methods. Healthy wistar albino rats (n=21) were randomly divided into threegroups: Cisplatin (Cis), cisplatin and selenium (Cis+Se) and control (C). Cisplatin was administered for 3 daysto Cis and Cis+Se groups. Cis+Se group received selenium 5 days before cisplatin injection and continued for11 consecutive days. Malondialdehyde (MDA) levels of the rats were determined before and at the end ofexperimental protocol. The tongues of rats were harvested for immunuhistochemical examinations. Results.In biochemichal analysis, MDA levels significantly increased in the Cis group (p=0.018). On the contrary,there was no significant difference between pretreatment and posttreatment MDA levels in Cis+Se group(p=0.128). In the immunohistochemical examinations of lingual tissues stained with anti-caspase-3, when theCis and Cis+Se groups were compared, there were significantly more immunopositivity in the Cis group andsignificantly less immunopositivity in the Cis+Se group (p

Aim: Glutathione, which is known to be the main antioxidant, is the foremost redox regulator in the control of inflammatory processes. The goal of this study was to investigate the levels of total glutathione, which plays a central role in cellular antioxidant defense, in the gingival crevicular fluid (GCF) and plasma of individuals with gingivitis and periodontally healthy. Materials and Methods: Fifteen periodontally healthy subjects and 15 individuals with gingivitis were enrolled in the study. Samples of GCF, plasma, and clinical measurements were attained before and one month after non-surgical periodontal therapy. GCF and plasma levels of total glutathione were analyzed using spectrophotometric assay. Results: It was found that the levels of total glutathione in GCF were lower in gingivitis group than those in the periodontally healthy group (P0.05). Also, a statistically significant rise in GCF and plasma total glutathione levels in gingivitis group was found after periodontal therapy compared to baseline (P

Globus sensation is a somatoform disease, defined as an intermittent feeling of a lump or foreign body in the throat that occurs between meals, and is not associated with gastroesophageal reflux or esophageal motility disorders. Although common in adults, globus sensation is rare in children. A 9 years old girl was referred to our hospital because of sore throat, cough, vomiting, anorexia, weight loss. Hematologic and gastroenterologic pathology were excluded. Anxiety was notable. She witnessed the killing of his cousin. Diazapam was started and dramatic response was taken in one day. Heal without treatment, lack of other accompanying pathologies, rapid response to diazepam was thought to be responsible for globus. Her tuberculin skin test was positive and thorax computed tomography that performed for the reasons of anorexia of weight loss and chronic cough revealed tuberculoma. Globus is a rare condition in children because of describing and diagnosis difficulties. Organic pathologies should be excluded., Somatoform bir hastalık olan globus histerikus, özofagus motilite bozuklukları ve gastroözofageal reflü ile ilişkili olmayan, yemekler arasında, boğazda yabancı cisim hissidir. Yetişkinlerde daha sık olmakla birlikte çocuklarda nadirdir. Dokuz yaşında kız hasta boğaz ağrısı, öksürük, kusma, iştahsızlık ve kilo kaybı ile başvurdu. Hematolojik ve gastroözofageal patolojiler dışlandı. Anksiyetesi olan hastanın kuzeninin öldürülüşünü gördüğü öğrenildi. Tedavi yapılmadan diazepama bir günde dramatik yanıt veren olgu globus olarak değerlendirildi. Öksürük ve kilo kaybı olan hastanın, tüberkülin deri testi pozitif ve kilo kaybı ve anoreksia nedenine yönelik yapılan torakal tomografisinde tüberkülom saptandı. Globus çocuklarda nadir görülen ve altında yatan patolojiler açısından tetkik edilmesi gereken bir durumdur.

Aim: Diabetes mellitus (DM) is a chronic metabolic disorder principally characterized by an elevation in oxidative stress levels. Ischaemia-reperfusion (IR) injury starts a cascade of events that lead to tissue ischaemia and cellular damage produced by reperfusion causing an inflammatory like response. Erythrocyte deformability and plasma viscosity are important clinical implications for organ and tissue perfusion. Recent studies have found that picroside-2 has antioxidant, neuroprotective and anti-inflamatory effects. The aim of our study was to investigate the effects of picroside-2 on erythrocyte deformability and lipid peroxidation in streptozotocin-induced diabetic rats subjected to left anterior descending (LAD) artery IR. Methods: The animals were randomly assigned to one of five experimental groups. In Group (control) C, DC (diabetes-control group), and DP (diabetespicroside-2 group) neither coronary artery occlusion nor reperfusion were performed in the control rats. In Group DIR, a branch of the LAD artery was occluded for 45 minutes followed by 90 minutes of reperfusion to produce IR. In Group DIRP, picroside-2 was administrated via 10 mg.kg-1 inraperitoneal (IP) route 30 minutes before ligating the LAD artery. Serum malondialdehyde and nitric oxide activities were investigated to document lipid peroxidation and erythrocyte deformability index. Results: Deformability index was notably increased in diabetic rats (p, Amaç: Diyabetes mellitus (DM), özellikle oksidatif stres seviyelerinde yükselme ile karakterize edilen kronik bir metabolik bozukluktur. İskemi-reperfüzyon (İR) hasarı, doku iskemisi ve reperfüzyonla üretilen hücresel hasara yol açan, bir dizi inflamatuar cevap benzeri olay sonucunda başlar. Eritrosit deformabilitesi ve plazma viskozitesi, organ ve doku perfüzyonu için önemli klinik belirteçlerdir. Son yıllardaki araştırmalar, pikrozid-2'nin antioksidan, nöroprotektif ve antiinflamatuar etkilere sahip olduğunu bulmuştur. Çalışmamızın amacı, streptozosin ile diyabet oluşturulan, sol ön inen (LAD) arter için İR uygulanan ratlarda pikrozid-2'nin eritrosit deformabilitesi ve lipid peroksidasyonu üzerine etkilerini araştırmaktı. Yöntem: Hayvanlar rasgele beş gruba ayrıldı. Grup K, DK (diyabet kontrol grubu) ve DP (diyabet-pikrozid-2 grubu) ratlarında koroner arter oklüzyonu veya reperfüzyon uygulanmadı. Grup DİR'de LAD arterinin bir dalı 45 dakika boyunca kapatıldı, bunu takiben İR hasarına neden olmak için 90 dakika reperfüzyon uygulandı. Grup DİRP'de LAD arterinin bağlanmasından 30 dakika önce 10 mg.kg-1 intraperitoneal (IP) yolu ile pikrozid-2 uygulandı. Serum malondialdehit ve nitrik oksit aktiviteleri, lipid peroksidasyonu ve eritrosit deformabilite indeksi değerlendirildi. Bulgular: Deformabilite indeksi diyabetik ratlarda belirgin şekilde arttı (p

Aim: Gynecological cancers are among the most important health problems of women, with high rates of morbidity and mortality.These patients also have high rates of anxiety and depression symptoms which can affect the quality of life, self-care, self-esteem,body image, adherence, response to treatment and prognosis of the cancer. This study aimed to investigate the anxiety and depression symptoms, self-esteem and body image among patients with gynecological cancers. Material and Method: In this study, anxiety and depression symptoms, self-esteem, body image satisfaction, and the effect of canceron these parameters were investigated in eighty-one patients with gynaecological cancer who underwent surgery and have been taking chemotherapy currently. After obtaining the informed consent, a socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Body Image Scale (BIS) and Coopersmith Self- Esteem Scale (CSES) were applied to all participants.Results: HADS-anxiety score was positively correlated with HAD depression score (p, Amaç: Jinekolojik kanserler yüksek morbidite ve mortalite ile kadınların en önemli sağlık sorunlarından biridir. Bu hastalar aynı zamanda hayat kalitelerini, öz bakımlarını, benlik saygılarını, beden algılarını uyumlarını, tedaviye yanıtlarını ve kanser prognozlarınıetkileyebilen yüksek oranlarda anksiyete ve depresyon semptomlarına sahiptirler. Bu çalışma jinekolojik kanserli hastalarda anksiyete ve depresyon semptomlarını, benlik saygısını ve beden algısını araştırmayı amaçlamıştır.Materyal ve Metot: Bu çalışmada cerrahi operasyon geçiren ve halen kemoterapi almakta olan 81 jinekolojik kanserli hastada anksiyete ve depresyon semptomları, benlik saygısı, beden algısı memnuniyeti ve kanserin bu parametreler üzerine etkisi araştırıldı. Aydınlatılmış onam formu alındıktan sonra tüm katılanlara birer sosyodemografik bilgi formu, Hastane Anksiyete ve Depresyon Ölçeği (HAD), Beden Algısı Ölçeği (BAÖ) ve Coopersmith Benlik Saygısı Ölçeği uygulandı (CBSÖ).Bulgular: HAD Anksiyete skoru, HAD Depresyon skoru ile pozitif yönde (p

Aim: Complementary and alternative medicine (CAM) usage has increased among the elderly. To promote comprehensive quality care, health professionals should assess for CAM usage. This study was planned to determine the CAM usage among elderly living in nursing homes in Istanbul. Material and Method: This study was made in two nursing homes in Istanbul between December 2012 and May 2013. The study sample consisted of 230 elderly. Results: A percentage of 59.1 of elderly (n=136) used CAM. Herbs (55.2%) and non-herbal supplements (53.5%) were the most frequently used therapies. CAM usage rate was higher among elderly who graduated from secondary school, had chronic disorder, and used medicine regularly (p, Amaç: Tamamlayıcı ve alternatif tıp (TAT) yöntemlerinin kullanımı yaşlılar arasında artmıştır. Bakım kalitesini yükseltmek için sağlık profesyonelleri TAT yöntemlerinin kullanımını değerlendirmelidir. Bu çalışma İstanbul’da iki huzurevinde kalan yaşlılarda TAT yöntemlerini kullanma durumunu saptamak amacıyla yapıldı. Materyal ve Metot: Bu çalışma Aralık 2012 ve Mayıs 2013 tarihleri arasında İstanbul’da iki huzurevinde yapıldı. Çalışmanın örneklemini 230 yaşlı birey oluşturdu. Bulgular: Yaşlıların %59,1’i TAT yöntemlerinden birini kullanıyordu. Bitkiler (%55,2) ve bitkisel olmayan destekler (%53,5) en çok kullanılan TAT yöntemleriydi. Ortaokul mezunu, kronik bir hastalığı olan ve düzenli tıbbi tedavi alan yaşlılar arasında TAT kullanım oranı yüksekti (p

Amaç: Bebeklerin her hangi bir nedenle annelerinin sütü ile beslenemediği durumlarda kullanılabilecek en ideal kaynaklardan birisi banka sütü olup, anne sütü ile beslenmenin sürdürülmesinde sağlık personelinin bilgi ve görüşleri önemlidir. Bu nedenle çalışma, Doğum-Kadın Sağlığı ve Çocuk Sağlığı alanlarında çalışan hemşire, ebe ve hekimlerin anne sütü bankalarına ilişkin bilgi ve görüşlerinin belirlenmesi amaçlanmaktadır. Gereç ve Yöntem: Tanımlayıcı olarak Ankara ve Malatya’da yapılmıştır. Örneklem, uygulamanın yapıldığı birimlerde görevli, çalışma hakkında aydınlatılmış onamları alınmış toplam 344 hemşire, ebe ve hekiminden oluşmuştur. Veriler, araştırmacılar tarafından geliştirilen form kullanılarak, Şubat-Ekim 2014 tarihleri arasında toplanmıştır. Bulgular: Katılımcıların % 49,7’si 21-30 yaş arasında, % 64,5’i lisans mezunu, %50,3’ü hemşire, %23.0’ı hekimdir. Anne sütü bankalarına ilişkin hemşirelerin bilgi puan ortalaması 3.39±2.40, ebelerin 3.33±1.84, hekimlerin 5.50±2.56 olup, hekimlerin bilgi puan ortalaması hemşireler ve ebelerin puan ortalamasından anlamlı düzeyde yüksektir (p, Objective: One of the most ideal source that can be used are milk banks in the absence of infants fed with breast milk for any reasons. Health care staff’s knowledge and views are essential for the continuation of breastfeeding. Therefore, the study was determination of nurse, midwife and physicians’ knowledge and views to breast milk banks who works in the area of women’s health and children’s health. Methods: The descriptive study conducted in Ankara and Malatya. The sample consists of 344 nurses, midwives and physicians who worked in clinical practice and obtained informed consent about the study. The data collected using a form which was developed by researchers in February and October 2014. Results: A 49.7% of participants were between 21-30 years of age, 64.5% had bachelor's degree, 50.3% were nurses, 23.0% were physicians. The mean knowledge score of nurses about breastmilk banks was 3.39±2.40, midwifes’ score was 3.33±1.84, physicians’ score was 5.50±2.56. The mean knowledge score of physicians was significantly higher than the mean knowledge score of nurses and midwives (p

Objective: Diabates mellitus, is a chronic metabolic disorder accompanied by an increase in oxidative stress. Ischemia-reperfusion injury is a cascade of events initiated by tissue ischemia. The cellular damage produced by reperfusion leads to an active inflammatory response. This study was performed to investigate the effect of picroside II on myocardial ischemiareperfusion injury in rats with streptozotocin-induced diabetes. Methods: Animals were equally (n:6) divided for five groups as follows; Control (C), diabetes [D], diabetes+picroside II [DP], diabetes+I/R [DIR], and diabetes+I/R+ picroside II [DIRP]. In DIR group, a left anterior descending artery branch was occluded for 60 minutes, the reperfused for 120 minutes. In DIRP group, picroside II was administrated via 10 mg/kg intraperitoneal route 30 minutes before ligating the left anterior descending artery. At the end of the study, myocardial tissues were taken for total oxidant status and total antioxidant status level determinations. Results: Total oxidant status levels were significantly higher in DIR group, when compared with C, DP, and DIRP groups (p:0.001, p:0.019, and p:0.031, respectively). Total antioxidant status levels were significantly higher in DIR group, when compared with C, DP, and DIRP groups (p:0.006, p:0.024, and p:0.007, respectively). Conclusion: These results indicate that administration of picroside II may have protective effects against I/R injury., Amaç: Diyabetes mellitus, oksidatif stres artışının eşlik ettiği kronik metabolik bir hastalıktır. İskemi-reperfüzyon (İ/R) hasarı doku iskemisi tarafından başlatılan olayların bir kaskadıdır. Reperfüzyon sonucunda oluşan hücre hasarı inflamatuar yanıtı aktive eder. Bu çalışma, Streptozosin kaynaklı diyabeti olan ratlarda miyokard İ/R hasarı üzerine Pikrozid II’nin etkisini araştırmak amacıyla yapıldı. Yöntem: Hayvanlar, beş gruba (n=6) olacak şekilde ayrıldı; Kontrol grubu (K), Diyabet grubu [D], Diyabet + Pikrozid II grubu [DP], Diyabet + İ/R grubu [DİR] ve Diyabet + İ/R + Pikrozid II grubu [DİRP]. DİR grubunda, sol ön inen arter dalı iskemi amaçlı 60 dakika süre ile kapatılmış ardından reperfüzyon için akım sağlanarak 120 dakika beklenmiştir. DİRP grubuna sol ön inen arter dalı kapatılmadan 30 dakika önce Pikrozid II, 10 mg/kg olmak üzere intraperitoneal olarak verildi. Çalışmanın sonunda, miyokard doku örnekleri total oksidan durum ve total antioksidan durum seviyesinin ölçülmesi için alındı. Bulgular: Toplam oksidan durum seviyeleri DİR grubunda, diğer gruplarla karşılaştırıldığında (K, DP, DİRP) anlamlı yüksek bulunmuştur (sırasıyla p:0.001, p:0.019, ve p:0.031). Total antioksidan durum seviyeleri DİR grubunda, diğer gruplarla karşılaştırıldığında (K, DP, DİRP ) anlamlı olarak yüksek bulunmuştur (sırasıyla p:0.006, p:0.024, ve p:0.007). Sonuç: Bu bulgular Pikrozid II’nin İ/R hasarına karşı koruyucu etkiye sahip olabileceğini göstermektedir.

Yüzeyel (servikovajinal ) miyofibroblastom, nadir görülen ve klinikopatolojik özellikleri yeni tanımlanmış bir yumuşak doku tümörüdür. Alt kadın genital sistemin, hormona duyarlı özelleşmiş subepitelyal stromasından köken aldığı düşünülmektedir. Orta-ileri yaştaki kadınlarda serviks, vajen ve vulvada polipoid veya nodüler kitleler oluşturmaktadırlar. Benign davranışa sahip bu lezyonların tanısında en önemli tuzak, belirsiz veya malign davranış gösteren diğer yumuşak doku lezyonları ile karışabilmesidir. Histopatolojik olarak fibromiksoid stromada yer alan iğsi-yıldız şekilli tümör hücrelerinde CD34, östrojen ve progesteron reseptörü immünpozitivitesinin gösterilmesi tanı için gereklidir. Bu çalışmada, 49 yaşındaki kadın olguda servikal leiomiyomu taklit eden yüzeyel (servikovajinal) miyofibroblastom, bu tümörlerin histogenezi ve klinikopatolojik ayırıcı tanısı açısından literatür bilgileri eşliğinde tartışılmıştır., Superficial (cervicovaginal) myofibroblastoma is a rare soft tissue tumor whose clinicopathological properties have been newly defined. It is considered to originate from the hormonesensitive specialized subepithelial stroma of the lower female genital system. It forms polypoid or nodular mass lesions in the cervix, vagina, and vulva of middle-aged or elderly women. The main obstacle in the diagnosis of this benignly behaving lesion is that it may be confused with other soft Superficial (cervicovaginal) myofibroblastoma is a rare soft tissue tumor whose clinicopathological properties have been newly defined. It is considered to originate from the hormonesensitive specialized subepithelial stroma of the lower female genital system. It forms polypoid or nodular mass lesions in the cervix, vagina, and vulva of middle-aged or elderly women. The main obstacle in the diagnosis of this benignly behaving lesion is that it may be confused with other soft tissue lesions with indeterminate or malignant behavior. It is necessary to demonstrate CD34, estrogen, and progesterone receptor positivity in spindle- or star- shaped tumor cells found in a fibromyxoid stroma for a histopathological diagnosis. Herein, we report a case of a superficial (cervicovaginal) myofibroblastoma mimicking cervical leiomyoma in a 49-years-old woman under the light of the existing literature to provide a detailed discussion about the histogenesis and clinicopathological differential diagnosis of this lesion. tissue lesions with indeterminate or malignant behavior. It is necessary to demonstrate CD34, estrogen, and progesterone receptor positivity in spindle- or star- shaped tumor cells found in a fibromyxoid stroma for a histopathological diagnosis. Herein, we report a case of a superficial (cervicovaginal) myofibroblastoma mimicking cervical leiomyoma in a 49-years-old woman under the light of the existing literature to provide a detailed discussion about the histogenesis and clinicopathological differential diagnosis of this lesion.

Aim: The present study investigated the changes in the liver tissues of rats with experimentally fractured mandible following the use of Grape Extract (GSE) and Low Level Laser Therapy (LLLT) in healing the fracture in dentistry. Materials and Methods: 60 adult male Wistar Albino rats were randomly assigned to 5 main groups (Control, Fractured Mandible (FM), FM + GSE, FM + LLLT, FM + LLLT + GSE), and then these groups were divided into two groups of 7 and 21 days (n = 6). A vertical fracture line passing through the molar teeth was formed in the right mandibles of all subjects except for these in the control group, and the fracture was internally fixed with a four-hole microplate and four micro-screws. Malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) activities were analyzed to determine the changes caused by GSE and LLLT administration in rat liver tissues in fractured mandibles. Results: It was determined that MDA and SOD levels in FM group and GSH and CAT activity levels in FM + GSE group and MDA levels in FM + LLLT group and GSH and CAT levels in FM + GSE + LLLT group increased statistically significantly to the control group on days 7 and 21. Conclusion: Biochemical parameters were investigated on the 7th and the 21st days, and it was determined that the oxidative damage caused by mandibular defects could be eliminated substantially in the rat liver especially with the administration of grapeseed that has antioxidant capacity.

Aim: Nutritional deficiencies and metabolic syndrome (MS) is challenge in chronic kidney disease patients with peritoneal dialysis(PD). This study was planned in order to assess the nutritional status and metabolic syndrome in PD patients. Methods:This study was performed on clinically stable patients that were undergoing PD therapy. Energy and nutrient intakes were determined with consequently three days dietary record. The statement of MS was identified according to MS criteria adopted for PD patients. Results:The prevalence of MS was found 64.3%. The mean duration of PD in with-MS(35.4±25.23mo.) was lower than without-MS(44.3±30.99mo.) (p>0.05). Patients with MS had significantly greater systolic/diastolic blood pressure and lower high-density-lypoprotein cholesterol levels (HDL-C) (p, Amaç: Beslenme yetersizlikleri ve metabolik sendrom (MS), peritoneal diyaliz (PD) alan, kronik böbrek hastalarında ciddi sorunlardır. Bu çalışma PD hastalarında beslenme ve metabolik sendromu durumunu değerlendirmek amacıyla planlanmış ve yürütülmştür. Yöntem: Bu çalışma, PD tedavisi gören klinik olarak stabil hastalar üzerinde gerçekleştirildi. Enerji ve besin öğesi alımları ardışık üç günlük besin tüketim kaydı alınarak belirlendi. MS durumu, PD hastaları için uyarlanan MS kriterlerine göre tanımlandı. Bulgular: MS prevelansı %64.3 bulundu. Ortalama PD süresi MS'li hastalarda (35.4 ± 25.23 ay), MS olmayanlardan (44.3 ± 30.99 ay) daha kısaydı (p> 0.05). MS hastalarında sistolik / diyastolik kan basıncı ve HDL-C düzeyleri anlamlı derecede daha yüksekti (p

Pilomatricoma is a benign skin tumor of hair matrix cells. The head and neck is the most commonly affected site of the body. This article describes 41 year-old man who referred to our clinic with an asymptomatic, slow-growing mass on the right retroauricular, suboccipital region. The tumor was excised and histopathologically diagnosed as pilomatricoma. Because of its frequency and predilection of head and neck region, otolaryngologists should be familiar of this tumor. Pilomatrikoma, kıl folliküllerinin matriks hücrelerinden köken alan benign deri tümörleridir. Bu tümörün en sık görüldüğü yerleşim yeri baş ve boyun bölgesidir. Bu yazıda, 41 yaşında sağ retroauriküler, suboccipital bölgede semptomsuz, yavaş büyüyen kitle ile başvuran bir hasta tarif edilmektedir. Bu tümör çıkarılarak histopatolojik incelemeye gönderilmiş ve pilomatrikoma tanısı almıştır. Baş ve boyun bölgesinde sık görülme eğilimi nedeniyle kulak burun boğaz hekimlerinin bu tümörün klinik sunumunun bilincinde olması ve baş boyun kitlelerinin ayırıcı tanısında bu tümörleri akla getirmesi önerilmektedir.

Aim: Interleukin (IL)-32, a recently discovered proinflammatory cytokine, is demonstrated in several infectious diseases. The goal of this study is to investigate the levels of IL-6, IL-10 and IL-32 in gingival tissue and serum of rats with experimental periodontitis. Material and Methods: Experimental periodontitis was induced by placing a silk ligature around the cervix of both sides of mandibular first molars in each male rat except for control group (Group 1). Thirty male Wistar albino rats were randomly divided into three groups of ten animals each as experimental periodontitis groups (Group 2, ligated for seven days; Group 3, ligated for fourteen days) and periodontally healthy control group (Group 1). At the end of experimental period, rats were sacrificed, and histomorphometric analyses were performed on the mandibles. IL-32, IL-10 and IL-6 levels were measured in gingival tissue and serum samples by ELISA. Results: Alveolar bone and attachment loss were statistically higher in all experimental groups than those in control group (P

Objectives. M any studies have demonstrated a significant association between cardiovascular disease and neutrophil to lymphocyte ratio (NLR). To our knowledge, no study has been reported in patients with deep venous thrombosis (DVT) which affecting proximal or distal leg. In this study we analyzed proximal and distal DVT according to the NLR. Methods. This retrospective study was obtained from patients’ records of a tertiary university hospital between May 2011 to January 2014. A total of 57 patients with the diagnosis of acute primary DVT and 30 patients as control group included in the study. All of them were confirmed with lower extremity venous duplex examinations. Of these, 37 examinations with the diagnosis of proximal DVT were compared to 20 examinations with distal DVT. The groups compared regarding to complete blood counter values. Results. Mean eosinophil level was higher in the distal DVT group (0.28±0.24 vs. 0.12±0.01, p =0.001), whereas median NLR were higher in the proximal DVT group than the distal DVT group (3.5 [0.5-4.3] vs. 2.3 [1.2-9.7], respectively; p =0.002). In addition, median NLR, leukocyte and neutrophil counts were statistically lower in the control group than the others ( p =0.014, p =0.027 and p =0.004, respectively). Conclusion. NLR, an inexpensive and easily measurable laboratory variable, was independently and significantly associated with the presence and severity of DVT, especially acute proximal DVT.

Amaç: Tanımlayıcı tipteki bu araştırma, yetişkin yataklı servislerde çalışan hemşirelerin maneviyat ve manevi bakıma ilişkin algılarının belirlenmesi amacıyla yapılmıştır. Yöntem: Araştırmanın örneklemini bir üniversite hastanesinde çalışan 132 hemşire oluşturmuştur. Veriler Hemşire Bilgi Formu, Maneviyat ve Manevi Bakım Dereceleme Ölçeği (MMBÖ) ile Şubat-Eylül 2015 tarihleri arasında toplanmıştır. Bulgular: Hemşirelerin yaş ortalaması 30.65±6.00 (min=19; max=55), %90.2’si kadın, %62.1’i evli ve %84.9’u lisans mezunudur. Hemşirelerin %46.2’si dahili birimlerde, %91.7’si servis hemşiresi olarak ve %34.8’i 4 yıl ya da daha az süredir çalışmaktadır. Hemşirelerin %68.9’u manevi bakım hakkında bilgi sahibidir; %51.6’sı bu bilgiyi yeterli bulmaktadır. Hemşirelerin %46.2’si manevi bakım vermediğini ve zaman, personel ve bilgi eksikliğinin manevi bakımın verilmesini engellediğini bildirmiştir. Hemşirelerin %90.2’si manevi boyutları fark etmek için eğitimin gerekli olduğunu belirtmiştir. Hemşirelerin MMBÖ puan ortalaması 3.69±0.40 (min=2.76;max=4.59)’dır. Manevi bakım bilgisini yeterli bulan hemşirelerin MMBÖ puan ortalaması daha yüksektir. Çalışma yılı arttıkça dinsellik alt boyutuna ilişkin maneviyat ve manevi bakım algısı da artmaktadır. Sonuç: Bu bulgular hemşirelerin manevi bakıma ilişkin bilgilerinin yetersizliği, bu konuda eğitime gereksinim duyulduğunu ve klinikte personel sayısının arttırılmasının manevi bakım açısından önemli olduğunu göstermektedir. Objective: The aim of this descriptive study was to determine the spirituality and spiritual care related perceptions of nurses working in adult’s inpatient units. Methods: The study sample consisted of 132 nurses working in adult’s inpatient units of a university hospital. The data were collected between February and September 2015 using the Nurse Information Form and the Spirituality and Spiritual Care Rating Scale (SSCRS). Results: The mean age was 30.65±6.00 (min=19; max=55) years. Females made up 90.2% of the group; married nurses constituted 62.1% while 84.9% were at the undergraduate degree level. Internal medicine nurses constituted 46.2%, inpatient service nurses 91.7% and 34.8% are employed for 4 years or less. We found that 68.9% of the nurses had information on spiritual care and 51.6% finding their current knowledge adequate. 46.2% of the nurses reported that they did not give spiritual care and that lack of time, personnel and information prevented spiritual care. 90.2% of nurses stated that education is necessary to recognize spiritual dimensions. The mean SSCRS scale score was 3.69±0.40 (min=2.76; max=4.59). The mean SSCRS scale score was higher in nurses who found their spiritual care knowledge adequate. As the number of years of work increases, the perception of spiritual and spiritual care related to the subscale of "Religiousity" also increases. Conclusion: These findings indicate that the knowledge of the nurses' spiritual care is inadequate, that training is needed and that increasing the number of staff in the clinic is important for spiritual care.

Tedavi alanındaki tüm gelişmelere rağmen, akciğer kanseri halatüm dünyada kanserle ilişkili ölüm nedenlerinin başında gelmektedir.Etyolojisinde sigaranın yanı sıra çevresel, mesleksel ve genetikfaktörler rol oynamaktadır. Akciğer kanserleri genellikle kü-çük hücreli akciğer kanseri (KHAK) ve küçük hücreli dışı akciğerkanseri (KHDAK) olmak üzere iki ana histolojik tipe ayrılır. Tümakciğer kanserlerinin yaklaşık %85’ini oluşturan KHDAK’inde bir-çok gen anomalisi saptanır. Anaplastik lenfoma kinaz (ALK) geniinsülin reseptör tirozin kinaz süper ailesinin bir üyesidir. ALK geniakciğer kanseri, lenfoma gibi çeşitli malignitelerde füsyon proteinoluşumuna yol açan translokasyonlara dahil olur. Bu derlemedeKHDAK’inde görülen ALK yeniden düzenlenmelerine ait son literatürgözden geçirilecektir., Despite all improvements in treatment modalities, lung canceris the leading cause of death related to cancers worldwide.Environmental, occupational and genetic factors, as well as smokingplay role in the etiology. Lung cancers are generally dividedinto two main histologic categories: small cell lung cancer (SCLC)and non-small cell lung cancer (NSCLC). Several gene aberrationsare detected in NSCLC, which constitute approximately 85% ofall lung cancers. The Anaplastic lymphoma kinase (ALK) gene is amember of insulin receptor tyrosine kinase super family. ALK geneinvolves with translocation those results in formation of fusion proteinin various malignancies such as lung cancer and lymphoma. Inthis article, latest literature regarding re-arrangement of ALK seenin NSCLC will be reviewed.

Objectives. Nora’s disease is a mesenchymal bone tumor with controversial diagnosis and treatment due to the benign but locally aggressive course and high recurrence rates. Methods. A retrospective analysis was made of patients diagnosed with Nora’s Disease at Ankara University Orthopedics and Traumatology Clinic. The evaluation was made of the age of the patient, gender, symptoms, lesion location, trauma history, treatment choice and recurrence rates during follow-up. Results. Excision was applied to 6 patients diagnosed with Nora’s disease, and in 1 patient an additional autograft and internal fixation were required. Recurrence was observed in 3 patients, 2 of whom underwent revision surgery and one who did not as there no patient complaints. Conclusions . Nora’s disease is problematic for orthopedic surgeons as there are difficulties in diagnosis, there is no absolute treatment algorithm, recurrence potential is high, and there are limited additional treatment choices. Therefore, treatment and follow-up at clinical center’s dealing with orthopedic tumor surgery can be considered appropriate.

Aim: Aim of the study was to examine the relationship between pain and quality of life in adult patients with sickle cell disease (SCD) and to examine complications of SCD on pulmonary system. Material and Methods: A total of 25 individuals (19 male, 6 female) diagnosed with SCD were included in the study. Pulmonary system, quality of life and pain was measured. Pain in rest and activity was questioned with Visual Analog Scale. The quality of life was assessed by the Short Form-36 (SF-36) Scale. Results: It was determined that the individuals experienced an important level of pain in rest and activity levels, however it was seen that the pain level in activity was higher. It was determined that the oxygen saturation average was 91% and incidence of secretion and the number of coughing individuals was 6 and that 2 individuals used accessory respiration muscles. It was also found out that the SF-36 Scale’s parameters’ scores were low and that the quality of life of individuals were negatively affected. There was a moderate, negative and significant correlation between pain in rest and SF-36 Scale’s physical function, pain, general health, mental health parameters. Conclusion: It has been concluded that in the treatment of patients with SCD, although it is not mentioned in patient history, pain related problems should be taken into consideration. We believe that pulmonary and pain rehabilitation to patients with SCD will support their wellbeing.

Aim: The most important way for children to communicate with their surroundings is to take every substance that they keep in hand to their mouths. Foreign bodies that are ingested can be found anywhere in the gastrointestinal tract. Especially foreign bodies in esophagus may be the cause of morbidity and mortality. For this reason, the ingestion of foreign bodies in children is one of the most important health problems. Material and Methods: Between January 2014 and June 2017, 119 patients, admitted to Mustafa Kemal University [MKÜ] Faculty of Medicine, Department of Pediatric Surgery with foreign body ingestion diagnosis, were retrospectively studied. Patients were evaluated in terms of age, gender, complaints of arrival, ingested foreign body quality, location in the gastrointestinal tract and treatment approaches. Results: Of the patients, 74 were males [62%] and 45 were females [38%]. The mean age of the patients was 4.3 years [6 months-15 years]. Foreign bodies most commonly seen in the esophagus first stenosis in 73 patients [61%].Most commonly complaint at presentation was parental recognition of the ingested object and hypersalivation. The most commonly ingested foreign bodies included coins. Conclusion: Esophagoscopy must be performed foreign bodies in the esophagus should be treated conservatively, in case of clinical suspicion, the possibility of foreign body ingestion must be kept in mind. Education of the parents and taking some precautions where the children play are the most important protective factors.