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To evaluate several lymphocyte subtypes with various parameters that can be applied easily and give fast results for their roles in evaluating the stage and prognosis of acute biliary pancreatitis.Case-control study.The Emergency Department of Istanbul Training and Research Hospital, and Gaziosmanpasa Research and Training Hospital, Turkey, between June 2020 and April 2021.Patients, who admitted to the Emergency Department with acute pancreatitis and treated after hospitalisation, were included in the study. The patients were divided into three groups; mild, moderately severe and severe, according to the 2012 revised Atlanta classification. Hematocrit, creatinine, potassium, sodium values, and flow cytometry ratios of lymphocyte, monocyte, CD4+, CD8+, and regulatory T cells were measured and the difference between the groups were evaluated. Their results were compared with healthy volunteers.A total of 53 persons including 40 with acute pancreatitis (14 mild, 14 moderately severe, and 12 in the severe pancreatitis groups) and 13 healthy volunteers, were included in the study. The average age of the studied participants was 50.9 ±13.42 years, 43.3% males and 56.7% females. Leukocyte values, lymphocyte rates, hematocrit rates, age, hospital staying duration, creatinine, potassium values, CD4+, and CD3+ lymphocyte rates were found to be different at a statistically significant level between the groups.High leukocyte, low lymphocyte, high hematocrit, advanced age, elevated creatinine, elevated potassium, low CD4+ T lymphocyte, low CD3+ T lymphocyte, and low lymphocyte/monocyte ratio were identified as poor prognostic indicators.Acute pancreatitis, Flow cytometry, Regulatory T cell, Atlanta.

Background: The most effective treatment for permanent weight loss is bariatric surgery. The present study aimed to evaluate the early period effects of laparoscopic Roux-en-Y gastric bypass (LRYGB...

Background: Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. Materials and methods: This study was performed in 16 adult male rats who underwent hemithyroidectomy in the right lobe and randomized into two experimental groups: Group I (control group) was given any substance and Group II (NCHA group) received NCHA spray into their perithyroidal area. The rats were sacrificed after three weeks of thyroidectomy for assessment. Results: Gross adhesions score (x = 2.500) was significantly higher in Group I than Group II (x=1.750; P = 0.031). Group II showed significantly less fibrosis compared to the Group I (P = 0.002). The rate of inflammation was found to be significantly higher in group I (P = 0.008). Vascular proliferation was not different between two groups (p=0.083). Conclusions: Our study showed that NCHA can reduce postoperative adhesion and might be effective in preventing fibrosis after the thyroidectomy. Although this study could not demonstrate that application of NCHA is able to reduce complication rate in revision neck surgery, it could be safely used after thyroidectomy and neck surgeries to prevent adhesions.

Acute mesenteric ischemia (AMI) has very high mortality and morbidity rates, and the most important factor in the prognosis of AMI is the duration of ischemia. This study aims to evaluate the changes of these markers according to the ischemia duration and possible use of cytokines and chemokines in the early diagnosis of AMI.Twenty-one male Sprague-Dawley rats were divided into three equal groups. The Superior Mesenteric Artery and Superior Mesenteric Vein were tied tightly and exposed to ischemia for 2 h for Group 1 and 6 h for Group 2. There was no intervention for Group 3, and it was selected as a control group. Intracardiac blood samples were collected after 2 h in Group 1 and 6 h in Groups 2 and 3. The IL-1α, 1β, 6, 10, 12p70, 17A, 18, 33, CXCL1/KC, CCL2/MCP-1, GM-CSF, IFN-γ, and TNF-α were measured using flow cytometry.Significant differences were observed between the groups in IFN-γ, CXCL1, MCP1, TNF-α, and IL-6 parameters. In the correlation analyses performed according to the mesenteric ischemia time, a very strong correlation was observed in CXCL1, as well as a strong level for MCP-1, TNF-α, and IL-6. Furthermore, a moderate level of correlation was found in IFN-γ, IL-10, and IL-18.The increased levels of CXCL1, MCP-1, TNF-α, and IL-6, which had a high correlation with the duration of ischemia in patients with intestinal ischemia, may help clinicians with diagnoses and treatment decision-making.

To determine the location of thyroid-related nerves by nerve monitoring and demonstrate the usefulness of Nerve Integrity Monitor in thyroid surgery.Descriptive study.Department of General Surgery, University of Health Sciences, Istanbul Training and Research Hospital, Turkey, from February 2017 to January 2020.Patients, who underwent thyroid surgery, were evaluated for age, gender, preoperative diagnosis, type of surgery, histopathological result, postoperative hoarseness, and postoperative vocal cord examinations. The vagus nerve, recurrent laryngeal nerve (RLN), and superior laryngeal nerve (SLN) were mapped by nerve monitoring.A total of 328 patients were included in this study. On both sides, the vagus nerve was most often located in the posterior of the internal carotid artery and internal jugular vein and less frequently anterior to this vein. A total of 303 right RLNs and 305 left RLNs were verified. The SLN was visualised or motor activity was verified by nerve monitoring on the right side in 181 patients and on the left side in 179 patients. The SLN's location was classified most frequently as type I and least frequently as type IIb on the right and left sides.The reported variations, the experience of the surgeon, and these anatomical markers cannot be adequate in preventing nerve injuries. Furthermore, the variations can be identified more clearly peroperatively with the use of nerve monitoring.Laryngeal nerves, Nerve mapping, Nerve monitoring, Nervus vagus, Thyroid surgery, Zuckerkandl tubercles.

OBJECTIVES: Over the last decade, surgeons have started to think of the ways in which to further reduce the trauma of surgery and improve cosmesis. Consequently, many surgeons have yielded to single incision laparoscopic surgeries (SILS) in order to maximize operative and postoperative outcomes. This study aimed to highlight the feasibility and challenges of different procedures by presenting our data about different fields of abdominal SILS practices with long term follow-up. MATERIAL AND METHODS: We retrospectively analysed an observational cohort of 155 patients who underwent surgery for different indications using the SILS technique. RESULTS: Of the 155 SILS procedures: 75 (48.4%) were cholecystectomies; 22 (14.2%) were splenectomies; 17 (11%) were hernia repairs; 11 (7.1%) were appendectomies; 8 (5.2%) were partial colon resections; 8 (5.2%) were adrenalectomies; 6 (3.8%) were distal pancreatectomy & splenectomies; 3 (1.9%) were subtotal gastrectomies; 3 (1.9%) were partial liver resections; and 2 (1.3%) were Nissen fundoplications. Ten (6.5%) early and 3 (1.9%) late postoperative complications were detected. No mortality or late morbidity (> 30 days) was detected due to SILS procedures. CONCLUSION: SILS is a feasible technique in experienced hands for specific procedures. Meticulous patient selection is also important for good cosmetic results and outcomes.

WOS: 000463210100003, The present study explores the applicability of response surface methodology (RSM) in conjunction with central composite design (CCD) matrix to statistically optimize ettringite crystallization process for the removal of sulphate from landfill leachate. A three factor-five coded level CCD with 20 runs, was performed to estimate the best fitted model. The RSM results indicated that the fitted quadratic regression model could be appropriate to predict sulfate removal efficiency. The pH was identified as the most dominant parameter affecting sulphate removal. 61.6% of maximum sulphate removal efficiency was obtained at pH of 11.06 for a 1.87 of Ca/SO4 and 0.51 of Al/SO4 molar ratios. The operating cost for ettringite crystallization at optimized conditions was calculated to be 0.52 $/m(3 ). The significance of independent variables and their interactions were tested by analysis of variance. Scanning electron microscope (SEM) and SEM coupled with energy dispersive X-Ray spectroscopy results confirmed the formation of ettringite crystal and were used to describe its morphology features., Scientific and Technological Research Council of Turkey, TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [115Y031], This study was funded by the The Scientific and Technological Research Council of Turkey, TUBITAK (Grant No.: 115Y031).

Evsel kati atiklarin bertarafinda duzenli depolama yontemi siklikla tercih edilmektedir. Cok kirli sizinti suyu olusumu, duzenli depolama tesislerinin en onemli dezavantajidir. Bu calismada, Cevap Yuzey Yontemi ve Merkezi Kompozit Tasarimi kullanilarak sizinti suyundan amonyum giderimine yonelik struvit cokturme optimizasyonu yapilmistir. Optimum struvit cokturme sartlarinin belirlenmesi icin 11 adet deneysel calisma yapilmistir. Sonuclar ikinci dereceden polinom fonksiyonel model ile iyi uyum gostermistir. Istatistiki analizler, Mg/N ve N/P molar orani bagimsiz degiskenlerinin amonyum giderim verimi uzerine onemli etkisinin oldugunu ortaya koymustur. En yuksek amonyum giderim verimine %99,8 olarak; 9,2 sabit pH degerinde, Mg/N icin 1,2 ve N/P icin 1,27 molar oranlarinda ulasilmistir. Elde edilen sonuclar, anaerobik proseste on aritim olarak kullanilan struvitin Cevap Yuzey Yontemi kullanilarak modellenebildigini ortaya koymustur. Ayrica Cevap Yuzey Yontemi; KOI/N/P icin 300:5:1 oranina sahip bir anaerobik proses icin tasarlanmis olan on aritim performansini etkileyen daha dusuk Mg/N ve N/P molar orani icin gerekli amonyum giderme verimliligini optimize etmek icin kullanilabilir.

The purpose of this study was to inquire how patients’ quality of life is affected after thyroid surgery and the factors involved. A semi-structured questionnaire and the World Health Organization Quality of Life Scale (WHOQOL-BREF) were applied to 101 patients prior to surgery. Thereafter data was collected in the early and again in the late post-operative period. Mean general health score for pre-operative quality of life was 6.72 ± 1.53 (3–10), mean physical field score was 22.81 ± 2.77 (17–31), mean psychological field score was 21.69 ± 2.78 (15–28), mean social field score was 11.10 ± 1.94 (5–15) and mean environmental field score was 27.86 ± 4.30 (18–39). In the early post-operative period, mean general health score was 7.05 ± 1.45 (4–10), mean physical field score was 22.84 ± 2.83 (14–29), mean psychological field score was 21.67 ± 2.32 (16–27), mean social field score was 10.89 ± 1.96 (5–15) and mean environmental field score was 28.56 ± 4.18 (18–40). In the late post-operative period, the general health score for quality of life was 7.43 ± 1.34 (4–10), mean physical field score was 23.59 ± 2.70 (17–35), mean psychological field score was 21.75 ± 2.34 (14–29), mean social field score was 11.23 ± 1.94 (6–15) and mean on-field environment score was 29.30 ± 3.96 (16–40). The pre-operative levels of symptoms were found to be higher than early and late post-operative periods. Quality of life increased after total thyroidectomy and statistically significant improvement was observed in late post-operative stage.

Objectives: single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy. Methods: this study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology. Results: there were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p, NA

Ancient Karez has a history of millennium. Karez is underground tunnel which is constructed in ground by digging the main well of the system and extending underground tunnel in foothills of the mountains. This system extracts groundwater to surface by gravity without using any pumping equipment. Ancient Karez system is viable in hot, arid and semi-arid climate regions. These systems are one of the best ways of extracting groundwater by gravity in such poor regions. Minimum slope is vital for extracting groundwater to the surface in Karez system. In this study, the perspective of construction and maintenance of Karez system in Afghanistan is assessed. Information related to Karez construction and maintenance is provided in order to improve the quality of work during these processes. The Karez system cannot be used effectively if construction and maintenance processes are not carried out properly. This will affect agricultural productions, water supply and social life in the region. Some possible solutions are suggested for the mitigation of the risk of collapsing and extinction of Karez systems. Some recommendations are provided to encourage the associated organizations in Afghanistan for rehabilitation of Karez irrigation and water supply system.

WOS:000456271000012 In the present study, experiments were conducted to optimize sulfate removal efficiency with ettringite precipitation from landfill leachate using Response Surface Methodology (RSM) and Central Composite Design (CCD). The statistical analysis of the results showed that the operating parameters such as molar rates of Ca/SO4 and Al/SO4, and pH had a significant effect on sulfate removal efficiency. Aluminum hydroxide and calcium hydroxide were used for external sources of aluminum and calcium. The goodness of the model was checked by different criteria including the coefficient of determination (R-2 = 0.94), p value (

Background: Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe–guided excision of nonpalpable neck lesions in patients with previously operated neck compartments. Methods: This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised. Result: All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P < .001). During follow-up, all patients had negative ultrasonography. Conclusion: Magnetic probe–guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.

Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe-guided excision of nonpalpable neck lesions in patients with previously operated neck compartments.This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised.All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P.001). During follow-up, all patients had negative ultrasonography.Magnetic probe-guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.

BACKGROUND: Although, there are studies in the literature having shown the feasibility and safety of laparoscopic adrenalectomy, there are still debates for tumour size and the requirement of the minimal invasive approach. Our hypothesis was that the use of laparoscopy facilitates minimally invasive resection of large adrenal tumours regardless of tumour size. Materials and Methods: Within 7 years, 149 patients underwent laparoscopic adrenalectomy at one institution. The patients were divided into two study groups according to tumour size. Group 1 included patients with adrenal tumours smaller than 5 cm and group 2 included larger than 5 cm. Patient demographics and clinical parameters, operative time, complications, hospital stay and final pathology were analysed. Statistical analyses of clinical and perioperative parameters were performed using Student's t-test and Chi-square tests. RESULTS: There were 88 patients in group 1 and 70 in group 2. There were no significant differences between study groups regarding patient demographics, operative time, hospital stay, and complications. Estimated blood loss was significantly higher in group 2 (P = 0.002). The conversion to open rate was similar between study groups with 5.6% versus 4.2%, respectively. Pathology was similar between groups. CONCLUSION: Our study shows that the use laparoscopy for adrenal tumours larger than 5 cm is a safe and feasible technique. Laparoscopic adrenalectomy is our preferred minimally invasive surgical approach for removing large adrenal tumours.

Summary Many drought indices (DIs) have been introduced to monitor drought conditions. This study compares Percent of Normal (PN), Rainfall Decile based Drought Index (RDDI), statistical Z-Score, China-Z Index (CZI), Standardized Precipitation Index (SPI), and Effective Drought Index (EDI) to identify droughts in a semi-arid closed basin (Konya), Turkey. Comparison studies of DIs under different climatic conditions is always interesting and may be insightful. Employing and comparing 18 different timesteps, the objective of comparison is twofold: (1) to determine the effect of timestep for choosing an appropriate value, and (2) to determine the sensitivity of DI to timestep and the choice of a DI. Monthly rainfall data obtained from twelve spatially distributed stations was used to compare DIs for timesteps ranging from 1 month to 48 months. These DIs were evaluated through correlations for various timesteps. Surprisingly, in many earlier studies, only 1-month time step has been used. Results showed that the employment of median timesteps was essential for future studies, since 1-month timestep DIs were found as irrelevant to those for other timesteps in arid/semi-arid regions because seasonal rainfall deficiencies are common there. Comparing time series of various DI values (numerical values of drought severity) instead of drought classes was advantageous for drought monitoring. EDI was found to be best correlated with other DIs when considering all timesteps. Therefore, drought classes discerned by DIs were compared with EDI. PN and RDDI provided different results than did others. PN detected a decrease in drought percentage for increasing timestep, while RDDI overestimated droughts for all timesteps. SPI and CZI were more consistent in detecting droughts for different timesteps. The response of DI and timestep combination to the change of monthly and multi-monthly rainfall for a qualitative comparison of severities (drought classes) was investigated. Analyzing the 1973–1974 dry spell at Beysehir station, EDI was found sensitive to monthly rainfall changes with respect to cumulative rainfall changes, especially more sensitive than other DIs for shorter timesteps. Overall, EDI was consistent with DIs for various timesteps and was preferable for monitoring long-term droughts in arid/semi-arid regions. The use of various DIs for timesteps of 6, 9, and 12 months is essential for long term drought studies. 1-month DIs should not be used solely in comparison studies to present a DI, unless there is a specific reason. This investigation showed that the use of an appropriate timestep is as important as the type of DI used to identify drought severities.

Thanks to the proliferation of internet, a lot of data are produced by both websites and personal users. The documents are required to be classified in terms of their content in order to reach the necessary information fast and correctly from produced data. One of the biggest difficulties in document classification systems is detection of attribute that represent the classes in best way. In this research, a new attribute method is presented by using a Genetic Algorithm for document classification problem. This proposed method is tested on 450 documents that are from 6 different categories collected from a news portal that broadcasts online. According to experimental results 93% of success is achieved with the proposed method.

WOS: 000367229000001, The aim of this study was to evaluate the effects of premating ewe weight and age on ewe reproductive performance, lamb growth and survival in Central Anatolian Merino (CAM) sheep. The trial included 4935 ewes and 5548 lambs from 23 breeder flocks in Eskisehir Province. The live weights (LWs) and ages of the ewes were recorded 1 week before the mating season. The number of lambs born, fertility rate, multiple birth rate (MBR), and lamb survival rate (SR) at days 75 and 120 were determined. The effects of the LW and age of the ewe were found to be important for the reproductive performance of ewes and for the lamb's growth rate (P < 0.05-0.001). Ewe MBRs and the birth weight (BW) and LW of the lambs at days 75 and 120 increased proportionally with the increase in LW in ewes prior to mating. The fertility rate and MBR were lower (P < 0.05-0.001) in 1.5-year-old ewes than in older ewes. However, lambs' SR at days 75 and 120 were not affected by the premating LW and age of the ewe. In summary, a better reproductive performance and lamb growth rate in CAM flocks may be achieved by the selection of breeding ewes from ewes weighing more than 60 kg., General Directorate of Agricultural Research and Policy in Turkey, through the project called "Improvement of Central Anatolian Merino sheep under breeder conditions in Eskisehir Province" [TAGEM-HAYSUD-06/08/01/01], This study was supported by the General Directorate of Agricultural Research and Policy in Turkey, through the project called "Improvement of Central Anatolian Merino sheep under breeder conditions in Eskisehir Province" (TAGEM-HAYSUD-06/08/01/01). This is one of the many projects under the main project called "National Genetic Improvement Project for Small Ruminants at Breeders' Conditions".

Removal of nickel ions from aqueous solutions containing 1-100 mg l(-1), using pine tree (Pinus nigra) materials modified with HCl, was investigated on a laboratory scale. For this purpose, two natural adsorbents such as the modified pine bark (MPB) and the modified pine cone (MPC) materials with HCl solution were studied. At first, the required concentration level of the HCl solution for the modification was observed, and then this was followed by the determinations of optimum levels of adsorbent amount, stirring rate, contact time and pH values. Various adsorption isotherms were also obtained by using different concentrations of the heavy metal cations tested in the experiment. As a result, the maximum removal efficiency levels obtained were as follows; 97% for the modified pine bark at pH 8 and 80% for the modified pine cone at pH 8.

Chromium (VI) is one of the heavy metals in water and wastewater that has the most toxic characteristic. Consequently, it is dangerous for human and environmental health. Various methods are used for removal of the chromium from wastewater, and new methods have been developed in recent years. Recent studies and investigations on the removal of environmental pollution selected methods that were economical, of optimum efficiently and could be carried out easily. In this study, the removal of Cr6+ in the leather industry wastewater is investigated using MnSO4 that was used easily and economically. Experimental studies are performed in two phases. In the first phase, the optimum MnSO4 dose for removal of Cr6+ was determined. In the second phase, the optimum pH was studied. About 96% removal of chromium was launched with 530 mg l(-1) MnSO4 dose at pH value 9 in the wastewater sample.