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Purpose: Measurement Uncertainty (MU) is a valuable tool for evaluating analytical performance and interpreting results in clinical laboratories. The International Organization for Standardization (ISO) has proposed a practical approach for MU calculation in its ISO/TS 20914:2019 guide. This study aimed to calculate the MU values of 20 clinical chemistry analyses per the ISO guideline and compare them with the Maximum expanded allowable measurement uncertainty (MAU) values. Methods: The study was performed using 6-month internal quality control (IQC) values (uRw) and calibrator uncertainty (ucal) in line with the recommendations of the ISO/TS 20914:2019 guideline. The common MU value was calculated for 20 clinical chemistry tests on two identical devices, Roche Cobas 6000 c501 (Roche Diagnostics, Mannheim, Germany) analyzers. The calculated MU values for the tests were compared with the current MAU values in the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Biological Variation database (the current Clinical Laboratory Improvement Amendments/CLIA recommendation for Ethanol has been selected). Results: MU values for Alanine aminotransferase, C-reactive Protein, Iron, Ethanol, Total Bilirubin, Triglyceride, and Blood urea nitrogen remained within the MAU limits. The MU values of the other 13 tests (excluding Aspartate aminotransferase, Glucose, and Potassium Level 2 IQC) exceeded the MAU values. Conclusion: It was observed that the uRw value affected the MU value the most. Close monitoring and evaluation of uRw and thus IQC and implementation of corrective and preventive actions may reduce MU.

OBJECTİVES: To evaluate the morphological characteristics, immunophenotypic features, osteogenic, adipogenic, and chondrogenic differentiation capacities of in-vitro cultured amniotic cells during the culture process based on mesenchymal stem cell (MSC). MATERİAL/METHOD: This study used waste cells remaining after fetal karyotype determination with second-trimester amniotic cell culture. Cultured cells were morphologically evaluated daily. Selective subculture (SSC) was produced by the scraping method. Immunophenotypic features of primary and subculture amniotic cells were evaluated based on specific surface antigens. Specific growth mediums were used to assess their osteogenic, adipogenic, and chondrogenic differentiation abilities. Differentiation was confirmed using specific staining. RESULTS: Fifteen cases with 46,XY fetal cytogenetic analyses at 16+3-19+5 gestational weeks were included in the study. Amniotic fluid cells were evaluated morphologically in three classes as Amniotic fluid specific cell-type(AF), Fibroblastoid cell-type(FB1, FB2), and Epithelioid cell-type(E). The first cell adhesions occurred in the first 24-48 hours(36%) of cell culture, while the first colonies within three days(82%). SSC was produced in AF-SSC(n=4) and FB2-SSC(n=6) directions by mechanical scraping. Primary amniotic fluid cells and AF/FB-SSCs were positive for MSC immunophenotypic markers CD29,CD73,CD166,CD44,CD49e,CD90, while negative for CD34,CD45, and HLA-DR. Cells were shown to have osteogenic (Alizarin Red-S) and chondrogenic (Alcian Blue) differentiation potentials based on histochemical staining, while adipogenic (Oil Red-O) differentiation was not obtained. CONCLUSION: We believe that preliminary protocols and experiences to obtain MSCs from amniotic fluid-derived cells produced under routine prenatal diagnosis cell culture conditions can enable many promising pre-clinical/clinical studies and be the pioneer of "stem cell therapy applications" in many "incurable" diseases in the clinic.

Conventionaldiagnostic methods have been used successfully for a long time in infectiousdiseases. Besides conventional microbiologic diagnosis methods, new methods arebeing developed for advanced accuracy, cost-effectiveness and ease ofapplication. Prokaryotic immune system has defense types of innate, adaptiveand cell suicide (programmed death). A part of prokaryotic adaptive immunesystem named CRISPR-Cas is under intensive research recently as a novelbacterial diagnostic system. CRISPR-Cas system can be used as abiotechnological method and can be classified in genetic based bacterialdiagnostic methods. CRISPR-Cas system classification is based on included Casprotein type and the target nucleic acid type (DNA or RNA). CRISPR-Cas locus inprokaryotic cells consists of two main parts which are repeat sequences andspacer sequences. Sequences which constitutes the adaptive immunity are spacersequences that are acquired from invading agents after survival of the prokaryotefrom the attack. In CRISPR-Cas system cas genes are in charge ofcleaving foreign nucleic acid to defense prokaryotic cell itself. Currently newsystems like SHERLOCK, DETECTR and HUDSON are developed as variations of CRISPR-Cassystem by different research groups. Also, as a gene editing tool CRISPR-Cassystem is highly effective in setting up knock-out and knock-in systems and inexperiments which require gene regulation either in the transcriptional andpost-transcriptional level. CRISPR-Cas system is planned to be used inproducing therapeutic antiviral drugs. Considering current data, CRISPR-Cas isa promising bacterial diagnostic system with all its advantages of rapidity,lower cost, accuracy and simple application protocol., Bulaşıcı hastalıklarda geleneksel tanı yöntemleri uzunzamandır başarıyla kullanılmaktadır. Geleneksel mikrobiyolojik tanıyöntemlerinin yanı sıra, gelişmiş doğruluk, maliyet etkinliği ve uygulamakolaylığı için yeni yöntemler geliştirilmektedir. Prokaryotik bağışıklıksistemi tipleri doğuştan gelen, adaptif ve programlı hücre ölümüdür. Sonzamanlarda yeni bir bakteriyel tanı sistemi olarak CRISPR-Cas adlı system prokaryotikadaptif bağışıklık sisteminin bir parçasıdır ve yoğun olarak araştırılmaktadır.CRISPR-Cas sistemi, genetik tabanlı bakteriyel tanı yöntemlerindesınıflandırılabilir ve aynı zamanda biyoteknolojik bir yöntem olarak da kullanılmaktadır.CRISPR-Cas sisteminin sınıflandırılması, Cas protein tipine ve hedef nükleikasit tipine (DNA veya RNA) göre yapılmaktadır. Prokaryotik hücrelerdeCRISPR-Cas lokusu, tekrarlayan diziler ve spacer diziler olarak iki anabölümden oluşur. Spacer diziler prokaryotun saldırıdan sağkalımından sonraistilacı ajanların genomundan bakteriye geçen dizilerdir. CRISPR-Cas sistemindecas genleri prokaryotik hücrenin kendisini korumak için yabancı nükleikasidi parçalayan enzimlerdir. CRISPR-Cas sisteminin varyasyonları olarak Şuanda SHERLOCK, DETECTR ve HUDSON gibi yeni sistemler, farklı araştırma gruplarıtarafından geliştirilmektedir. Ayrıca CRISPR-Cas sistemi, knock-out ve knock-insistemlerinin oluşturulmasında, transkripsiyon ve transkripsiyon sonrasıseviyede gen regülasyonu gerektiren deneylerde oldukça etkilidir. CRISPR-Cassisteminin terapötik antiviral ilaçların üretilmesinde kullanılması da planlanmaktadır.Mevcut veriler göz önüne alındığında, CRISPR-Cas, hız, düşük maliyet, yüksekdoğruluk ve basit uygulama protokolü avantajları ile umut verici bir bakteriyeltanı sistemidir.

The aim of this study was to assess vitamin D serum levels in autoimmune thyroid disease, Hashimato thyroiditis in the Turkish population. the subjects with Hashimato thyroiditis (HT, n=67, mean age 45.1±10.9,F/M-61/6), control subjects (mean age 42.1±15.7, n=29, F/M-26/3) were recruited for the study. Thyroid function tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultrasound features, demographic and antropometric variables were recorded. Vitamin D level was not different between the HT and the control groups (53.1±24.7 nmol/L and 54.1±19.8 nmol/L, as mean, respectively, p = 0.482) in the HT group, 35.8% of subjects had vitamin D insufficiency, only 16.4% of subjects with HT were vitamin D sufficient. There was no significant difference between the HT and the control groups according to the vitamin D classification status (p = 0.666). Vitamin D levels were significantly higher in the subjects who were taking replacement compared to subjects who were not (58.7 ± 26.0 vs. 46.0 ± 23.3, as mean, respectively, p = 0.033). There was no significant correlation between vitamin D levels and TgAb and TPOAb levels in HT group (p = 0.754 r = -0.039, p = 0.134 r = -0.290, respectively). in both HT and control groups, vitamin D levels were significantly correlated only with the fT4 levels (p

The achievement of euthyroid state has been suggested in patients with thyrotoxicosis undergoing surgery to reduce the risk of thyroid storm. However, euthyroid state could not always be achieved by antithyroid drugs. Therefore, therapeutic plasma exchange (TPE) is an option in this condition. A 58-year-old male patient with a history of type-2 diabetes using 200 mg amiodarone per day, admitted for diabetic ketoacidosis (DKA), induced by thyrotoxicosis. with palpitation, sweating, polyuria, and polydipsia. Euthyroid state could not be achieved, despite all apropriate treatments for thyrotoxicosis. Therefore, preparation with TPE followed by total thyroidectomy was planned. A 35% decrease in fT3 (free T3) and fT4 (free T4) levels were achieved, after two sessions of TPE. A 74-year-old male patient, admitted for acute anterior myocardial infarction (AMI) induced by thyrotoxicosis due to Graves disease. Multiple vessel disease was detected on primer percutanous coronary angiography, and an emergency coronary artery bypass grafting (CABG) was planned. Therefore, preperation with TPE was planned before surgery. A substential decrease in fT4 and fT3 levels (45% and 72%, respectively) levels were achieved, after one session of TPE. Most of the studies evaluating the efficacy of TPE in patients with thyrotoxicosis are including patients with Graves disease and toxic multinodular goiter, and TPE was indicated as an effective option for preparation of these patients for surgery. However, as presented in case 1, TPE may not be effective in amiodarone induced thyrotoxicosis (AIT) as in cases with thyrotoxicosis due to Graves disease. [Med-Science 2019; 8(1.000): 233-6]

Gastric cancer comprises 10% of all cancers in the world and is rarely seen before the age of 30. Different genetic interactions or molecular changes like e-cadherin, P16, APC, c-erb B2, c-met, ras, or c-myc have been described in the pathogenesis of the disease. MiRNAs play critical roles in various biological processes such as cell proliferation, cell differentiation, apoptosis, repairing of DNA damage, angiogenesis, stress response, and stem cell division. The aim of this study is to investigate the relationship between miRNA gene expressions and gastric cancer. Method: Sixty-four patients with gastric cancer diagnosed consecutively in our pathology laboratory and 30 consecutive participants with normal gastric tissue, as a control group, were included in our study between 2011 and 2013. Total miRNAs were obtained by using genomic miRNA extraction kit (QIAGEN Sample & Assay Technologies, Hilden, Germany) after the samples had been deparaffinized. MiR-21, 107, 141, 150, 192, 202, 218, 331 gene expressions were evaluated by using real time-PCR (RT-PCR) from the whole miRNA. Results: MiR-331 was downregulated in the stage 2 patients and the rest of the miRNAs were significantly upregulated (p < 0.001). All miRNAs were significantly upregulated in the stage 3a patients (p < 0.001). In the antrum localized tumors, miR-107, -150, -202, -218, and -331 were significantly upregulated, whereas miR-21, -192 were statistically downregulated (p < 0.05). In the cardia localized tumors, miR-21 (p > 0.05) was downregulated and miR-107, -150, -202, -218, and -331 were upregulated (p < 0.05) Different gene expressions of miRNAs according to the different localizations of gastric cancer and different stages suggest that it can be tumor marker to predict the stage and localization of gastric cancer. [Med-Science 2019; 8(1.000): 255-9]

Chest pain (CP) is the major presenting symptom of coronary artery disease (CAD) wherein history remains to be a fundamental and challenging diagnostic step. Despite the clarity of typical CP characteristics in guidelines; interpretation and description of CP by patients are open to wide variations. The aim of this study was to define the components of CP that most closely associate to presence of obstructive CAD and determine the influence of gender on CP features. Herein, consecutive patients with suspected stable CAD who were scheduled for a coronary angiography(CAG) were prospectively enrolled. The data on demographic and pain characteristics were collected by a questionnaire. Patients were categorized into CAD and Normal groups with respect to presence of obstructive CAD in CAG. Among 402 patients, 86 had chest discomfort or equivalent symptoms but denied CP. Patients with CAD were more commonly male; with older age, lower BMI, more frequent prior revascularization, clopidogrel use, higher creatinine and lower HDL levels. When classical features of CP such as quality; location, duration, relationship to exertion were compared; stabbing/sharp pain, CP related to cold or emotional stress and CP that radiates to back were significant factors against CAD; while absence of precipitating factors was related to CAD. Yet, none of the features of typical angina pectoris were significantly related to presence of CAD. Determinants of CAD were; prior revascularization (OR= 22.7, p=0.021), body mass index (OR=1.4, p=0.007), clopidogrel use(OR=55.5, p=0.018) and blood glucose (OR=1.02, p=0.046) in women; and age (OR=1.2, p=0.029) was the single predictor of CAD in men. This study demonstrated no association between classical features of typical CP and presence of CAD in patients with stable angina pectoris. Clinical factors that influenced presence of CAD in different genders were also different. [Med-Science 2019; 8(1.000): 88-92]

HHV-8 is associated with Kaposi sarcoma, multicentric Castleman disease and primary effusion lymphoma mostly in immunocompromised patients. in this report, we describe a female patient without any immunosuppressive state, encountering those three malignancies throughout her lifetime. A-69-year-old female patient was diagnosed with Kaposi sarcoma in 2009 and multicentric Castleman disease in 2011. She received several chemotherapy regimens during 4 years and stayed in remission during following 5 years. Then, she was diagnosed with primary effusion lymphoma, extracavitary/solitary variant on excisional biopsy of her cervical lymphadenopathy. Despite having 5 different lines of chemotherapy protocols, including autologous stem cell transplantation, and systemic cidofovir treatment, she died because of progressive disease. HHV-8 associated malignancies are not prevalent in immunocompetent patients. Our patient, who has suffered from all three malignancies related to HHV-8, is the only HIV negative patient in the literature with primary effusion lymphoma, extracavitary/solitary variant.

Endometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n = 27) of the women included in the study, while 82.6% (n = 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p = 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p = 0.03, p = 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n = 1), benign ovarian tumor in 25.9% (n = 7) and malignant ovarian tumor in 11.1% (n = 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models. [Med-Science 2018; 7(4.000): 848-51]

Objective: Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associated with liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was to assess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and OSAS and its severity. Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May 2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index were analyzed. The data were analyzed using the Student t-test, ANOVA, Chi-square test, and Pearson's correlation coefficient. Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Of the patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. There was a statistically significant difference in ALT and AST levels between the OSAS and control groups (p < 0.001 and p < 0.001, respectively). In the OSAS group, there was a statistically significant positive relationship between serum ALT and AST levels and apnea-hypopnea index (AHI), apnea index, oxygen desaturation index. Both AST and ALT levels were statistically significantly higher in obese patients than in non-obese patients (p < 0.001 and p < 0.001, respectively). ALT level was statistically significantly higher in patients without hypertension than in patients with hypertension (p < 0.001). In OSAS patients without hypertension, there was a statistically significant relationship between serum ALT and AST levels and AHI (r = 0.223, p < 0.001 and r = 0.142, p = 0.007; respectively). Conclusion: OSAS is a risk factor for elevated liver enzyme levels. Hypoxia plays an important role on liver enzymes in OSAS patients.

Aim: In this study, we aimed to investigate the potential role of lung mast cells in migraine by using a nitroglycerin-induced migraine model in rats. Materials and Methods: Thirty-five adult male Wistar rats were divided into five groups. Each treatment being performed intraperitoneally, the NS group received 0.2 ml normal saline, the NTG group 10 mg/kg nitroglycerin, the NTG vehicle group 0.2 ml 0.1% ethanol in normal saline, the L-NAME+NTG group 50 mg/kg L-NAME + nitroglycerin, and the NS+NTG group normal saline + nitroglycerin. Two hours after the nitroglycerin and other treatments, the rats under anesthesia were intracardially perfused with a solution of 150 ml 4% paraformaldehyde. The lungs were harvested and stained with toluidine blue to observe mast cells. The data were analyzed by using one-way ANOVA. Results: Nitroglycerin increased significantly both number (from 94±3.8 to 131±6.7, p=0.0035) and percent of degranulation (from 11.8±1.3% to 35.5±5.7%, p=0.003) of lung mast cells. However, L-NAME prevented the effects of nitroglycerin on the number and degranulation of lung mast cells, attenuating the increase in both number (from 136±5.1 to 93±2.5, p=0.0011) and degranulation percentage of lung mast cells (from 37.3±1.0% to 13.6±3.1%, p=0.001) induced by nitroglycerin. Discussion and Conclusion: Our findings demonstrate that nitroglycerin treatment leads to an increase in the number and degranulation of lung mast cells in a rat model of migraine induced by nitroglycerin. Moreover, L-NAME prevented these effects, suggesting that nitric oxide released from nitroglycerin directly or indirectly leads to the activation of lung mast cells. The results obtained in the current study can pioneer new research on the role of lung mast cells in migraine. Amaç: Bu çalışmada sıçanlarda nitrogliserin ile oluşturulan migren modeli kullanılarak akciğer mast hücrelerinin migrendeki muhtemel rolünü araştırmak amaçlanmıştır. Gereç ve Yöntemler: Otuz beş yetişkin erkek Wistar sıçan beş gruba bölündü. Tüm uygulamalar intraperitoneal yoldan olmak üzere; NS grubuna 0,2 ml normal salin (serum fizyolojik), NTG grubuna 10 mg/kg nitrogliserin, vehikül NTG grubuna 0,2 ml normal salin içinde %0,1’lik etanol, L-NAME+NTG grubuna 50 mg/kg L-NAME + nitrogliserin, NS+NTG grubuna ise 0,2 ml normal salin + nitrogliserin uygulandı. Nitrogliserin ve diğer uygulamalardan iki saat sonra sıçanlar anestezi altında 150 ml %4’lük paraformaldehit ile intrakardiyak olarak perfüze edildi. Akciğerler alındı ve mast hücrelerini gözlemlemek için toluidin mavisi ile boyandı. Veriler tek yönlü varyans analizi ile incelendi. Bulgular: Nitrogliserin akciğer mast hücrelerinin hem sayısında (94±3,8’den 131±6,7’ye; p=0,0035) hem de degranülasyon yüzdesinde (%11,8±1,3’ten %35,5±5,7’ye; p=0,003) anlamlı bir artış sağladı. L-NAME ise akciğer mast hücrelerinin sayı ve degranülasyonu üzerinde nitrogliserinin yol açtığı bu etkileri önledi, böylece akciğer mast hücrelerinin nitrogliserin ile tetiklenerek artan sayısını ve degranülasyon yüzdesini ayrı ayrı azalttı. Tartışma ve Sonuç: Bulgularımız nitrogliserin ile oluşturulan migren sıçan modelinde nitrogliserin uygulamasının akciğer mast hücrelerinin sayısında ve degranülasyonunda bir artışa yol açtığını göstermiştir. Ayrıca L-NAME’nin bu etkileri önlemiş olması, nitrogliserin kaynaklı nitrik oksidin direkt veya indirekt olarak akciğer mast hücrelerinin aktivasyonuna yol açtığını düşündürmektedir. Bu çalışmada elde edilen sonuçlar akciğer mast hücrelerinin migrendeki rolü üzerine yapılacak yeni araştırmalara öncülük edebilir.

Amaç: Bu çalışmada, Istranca meşesi (Quercus hartwissiana Steven) kabuğu ekstraktlarının bakteriyelve fungal patojenlere karşı antimikrobiyal aktivitesini araştırmak amaçlanmıştır.Gereç ve Yöntemler: Istranca meşesinin, etanol, formaldehit, aseton, etil asetat ve metanol çözücüleriile ekstraksiyonu gerçekleştirilmiştir. Bu ekstraktlardan 50 µl alınarak steril disklere emdirildiktensonra ekstraktlarda bulunan çözücülerin sonucu etkilememesi amacıyla diskler 24 saat steril ortamdakurutulmuştur. Disk difüzyon yöntemiyle Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichiacoli, Klebsiella pneumoniae, Salmonella spp., metisilin dirençli Staphylococcus aureus, metisilinduyarlı Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus spp., Candida albicans,Candida glabrata ve Candida tropicalis türlerine karşı antimikrobiyal aktivite araştırılmıştır.Bulgular: En geniş zon çapının etanolle hazırlanan ekstraktta Enterococcus spp. (8 mm) ve S. epidermidis(8 mm) suşlarına, formaldehit ve etil asetatla hazırlanan ekstraktlarda E. Coli suşuna (16 mm,28 mm), asetonla hazırlanan ekstraktta Enterococcus spp. suşuna (21 mm), metanolle hazırlananekstraktta ise metisilin duyarlı S. aureus suşuna (28 mm) karşı oluştuğu görülmüştür. Mayalarda iseen geniş zon çapının etanolle hazırlanan ekstraktta C. glabrata suşuna (12 mm), formaldehitle hazırlananekstraktta C. albicans (28 mm) ve C. tropicalis (28 mm) suşlarına, aseton, etil asetat ve metanollehazırlanan ekstraktlarda C. albicans suşuna (19 mm, 30 mm, 22 mm) karşı oluştuğu saptanmıştır.Tartışma ve Sonuç: Etil asetat ile hazırlanan ekstraktın diğer çözücülerle hazırlanan ekstraktlara kıyaslaçalışılan suşlara karşı daha geniş zon çapı oluşturduğu saptanmıştır. En geniş zon çapı E. coli, S. aureusve C. albicans türlerinde oluştuğundan, ülkemizde doğal olarak yetişen Istranca meşesinin inhibeedici etkilerine yönelik in vivo antimikrobiyal çalışmalar yapılmasının önemli olduğunu düşünmekteyiz. Aim: This study aimed to investigate the antimicrobial activity of extracts from the Istranca oak (Quercushartwissiana Steven) against bacterial and fungal pathogens.Materials and Methods: Extraction of the Istranca oak was carried out with ethanol, formaldehyde,acetone, ethyl acetate, and methanol solvents. After injecting 50 ?l of these extracts into sterile discs,the discs were dried in a sterile environment for 24 hours in order for the results not to be affected bythe solvents present in the extracts. Antimicrobial activity against the species Pseudomonas aeruginosa,Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Salmonella spp., methicillin-resistantStaphylococcus aureus, methicillin-susceptible Staphylococcus aureus, Staphylococcusepidermidis, Enterococcus spp., Candida albicans, Candida glabrata and Candida tropicalis was investigatedby disc diffusion method.Results: It was observed that the extract prepared with ethanol showed the widest zone diameteragainst Enterococcus spp. (8mm) and S. epidermidis (8mm), the extracts with formaldehyde and ethylacetate against E. coli (16mm, 28mm), the extract with acetone against Enterococcus spp. (21mm),and the extract with methanol against methicillin-susceptible S. aureus (28mm). For the yeasts, theextract prepared with ethanol showed the widest zone diameter against C. glabrata (12mm), the extractwith formaldehyde against C. albicans (28mm) and C. tropicalis (28mm), and the extracts preparedwith acetone, ethyl acetate, and methanol against C. albicans (19mm, 30mm, 22mm).Discussion and Conclusion: It was determined that the extract prepared with ethyl acetate showedwider zone diameter against the strains studied, compared to extracts prepared with the other solvents.Given that the widest zone diameters were observed against the strains E. coli, S. aureus and C.albicans, we think that it is important to conduct in vivo antimicrobial studies on the inhibitory effectsof the Istranca oak indigenous to our country.

Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.

Ortodontik tedavinin amacı; bireyin dentofasiyal fonksiyonlarını ve estetiğini geliştirerek yaşam kalitesini artırmaktır. Başarılı bir tedavinin kriterleri; en az histolojik hasar ve ağrı, hızlı diş hareketi, kısa tedavi süresi ve stabil sonuçlardır. Son yıllarda ortodontik tedavi talebi giderek artmaktadır. Ortodontik tedavi sürelerinin uzun olması, hem hastaların psikolojik motivasyonlarını etkilemekte, hem de çürük, dişeti çekilmesi ve kök rezorpsiyonu gibi birçok istenmeyen duruma yol açmaktadır. Bu sebeple son yıllarda araştırıcılar ortodontik diş hareketinin hızlandırılması üzerine çalışmalar yapmaktadır. Ancak daha hızlı diş hareketi elde etmek için laboratuvar ve klinik olarak birçok girişimde bulunulmasına rağmen, bu tekniklerle ilgili belirsizlikler ve cevaplanmamış sorular halen mevcuttur. Literatürde ortodontik diş hareketini hızlandırmak amacıyla çoğu henüz hayvanlar üzerinde denenmiş ve insanlar üzerinde uygulanabilirliği kuşkulu olan cerrahi teknikler, fiziksel ve kimyasal uygulamalar bildirilmiştir. Ancak diş hareketi multifaktöriyel bir olgu olduğu için konu hakkında gelecekte daha fazla araştırma yapılması gerekmektedir. Bu derlemede literatürde şu anda var olan ortodontik diş hareketi hızlandırma yöntemlerinden bahsedilecektir., The purpose of orthodontic treatment is to enhance patients’ life quality by improving their dentofacial functions and aesthetics. Minimal histological damage and pain, rapid tooth movement, short treatment duration, and stability of results are the major criteria for successful treatment. In recent years, the demand for orthodontic treatment has been increasing gradually. Prolonged duration of orthodontic treatment affects the psychological motivation of the patients and leads to several undesirable situations, such as caries, gingival recession, and root resorption. Thus, in recent years, related research has investigated the acceleration of orthodontic tooth movement. However, despite the various laboratory and clinical interventions designed to achieve faster tooth movement, uncertainties and unanswered questions about these techniques persist and warrant further investigation. Several surgical techniques as well as physical and chemical applications have been reported by previous studies to accelerate orthodontic tooth movement, most of which have been conducted on animals, with debatable applicability on humans. However, as tooth movement is a multifactorial phenomenon, further research is needed in the future. In this review, we describe the orthodontic tooth movement acceleration methods reported thus far.

We sought to investigate the prevalence of skin tumors in Muğla, which has a Mediterranean climate and a high population of elderly people. This was a cross-sectional study conducted on patients, 65 years old and older, who consulted at our dermatology outpatient clinics between January 2014 and January 2015. Diagnoses of the patients were obtained and retrospectively evaluated from the electronic medical records of the hospital. Of 2297 geriatric patients, 50.8% were females and 49.2% were males. Of these patients, 12% had actinic keratosis, 5.4% had seborrheic keratosis, 2.1% had basal cell carcinoma, 0.8% had squamous cell carcinoma, and 0.1% had malignant melanoma. In patients

Depression is a major mental health issue worldwide, and university students with heavy burdens of study are at a high risk for depression. The purpose of this study was to determine the prevalence of depressive symptoms among nursing students, and to explore the association between socio-demographic factors, health-related quality of life and depressive symptoms. This study adopted a cross-sectional design. A total of 345 nursing students from a Faculty of Health Sciences were assessed by the questionnaire consisted of demographic information, Beck Depression Inventory (BDI), a 12-item Short Form Health Survey. SPSS software, version 16, was used to analyze the data. Pearson Chi-Square, Fishers Exact Test and Independent-Samples T-Test were used to compare different categorical variables. A total of 345 nursing students participated in the study (282 females and 63 males). Overall, 92 (26.7%) of the participants had depression of various grades based on the BDI diagnostic criteria using a cut point of more than 17. The depressive symptoms were statistically associated with gender and the parental attitudes. BDI score at the cut point of 17 was statistically associated with the Physical and Mental Health Composite Scores. This study seems to indicate an alarming rate of depressive symptoms. Female gender, non-democratic parental attitude have the highest association with depressive symptoms. The findings suggested that in order to prevent depression among undergraduate nursing students, school-and family based strategies should be developed and implemented. [Med-Science 2018; 7(1.000): 154-157]

Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age- and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy. [Med-Science 2018; 7(1.000): 106-109]

The incidents of hip fractures rise as the population gets older. Weakness of bones cause fractures easily due to falling, which can occur by balance deficiency, side effects of medications and maneuvering difficulties through environmental hazards. Patients with hip fractures are cared by clinicians in different specialties who should be familiar with the management of these injuries. The fascia iliaca compartment block, an easy to perform and low-cost procedure, provides efficient perioperative analgesia for patients who suffer from hip or femur fractures. Increased success rates are due to the facilitation of the block via ultrasound which is easily accessible in many operation theaters and emergency services. Anterior thigh and knee surgery as well as analgesia following hip and knee procedures are the basic indications for this block. In this case, we performed an ultrasound guided fascia iliaca compartment block for postoperative analgesia after a hip fracture surgery. [Med-Science 2019; 8(1.000): 239-41]

Amaç: Son yıllarda inflamasyon göstergesi olarak değerlendirilen C-reaktif proteinin (CRP)/ortalama trombosit hacmi (OTH) oranı ve beyaz küre sayısı (BKS)/ortalama trombosit hacmi (OTH) oranının toplum kökenli pnömonili (TKP) çocuklarda tanı ve hastalık şiddeti ile ilişkisini araştırmaktır.Gereç ve Yöntem: Çalışma TKP tanısı alan 3 ay ile 18 yaş arasında 60 hasta ve 30 sağlıklı çocuktan oluşturuldu. Hasta ve kontrol grubunda CRP, BKS, OTH, nötrofil/lenfosit oranı (NLO) değerleri ile birlikte CRP/OTH ve BKS/OTH değerleri incelendi.Bulgular: Hasta ve kontrol grubu arasında OTH düzeyleri açısından anlamlı fark saptanmazken, CRP/OTH, BKS/OTH, NLO ve plateletkrit düzeyleri hasta grubunda anlamlı olarak yüksek bulundu. Ciddi pnömonili hasta grubunda (n=27) BKS, NLO, BKS/OTH, CRP/OTH ve CRP düzeyleri hafif-ılımlı pnömonili gruba (n=33) göre anlamlı olarak yüksek saptandı. CRP/OTH ve BKS/OTH oranlarının hastalık belirtilerinin süresiyle arasında pozitif korelasyon gösterildi. Receiver Operating Characteric (ROC) analizinde CRP (Eğri altındaki alan (EAA)=0.801), BKS (EAA=0.761) ve BKS/OTH (EAA=0.731) düzeylerinin TKP’nin tanısında yeterliliği anlamlı bulundu. Ciddi TKP’li hastaların ayrımında ise CRP/OTH (EAA=0.733) ve CRP (EAA=0.708) düzeyleri anlamlı bulundu.Sonuç: CRP/OTH ve BKS/OTH oranları TKP tanısının değerlendirilmesinde ve CRP/OTH oranı hastalık aktivitesinin belirlenmesinde iyi bir belirteç olabileceğini göstermektedir. Purpose: Our aim is to evaluate the relationship between C-reactive protein (CRP)/mean platelet volume (MPV) ratio and white blood cell (WBC)/mean platelet volume (MPV) ratio and diagnosis and disease severity in children with community-acquired pneumonia (CAP). Material and Methods: 60 patients with CAP including 33 mild-moderate (Group 1) and 27 severe pneumonia (Group 2) and 30 healthy children were examined for routine blood test. WBC, MPV, neuotrophile/lymhocyte ratio (NLR), CRP, WBC/MPV, CRP/MPV values were recorded on each patient and healthy groups. Result: CRP/MPV, WBC/MPV, NLR and plateletcrit values were significantly higher in patients group than controls, while MPV value is not correlated between patient and control groups. WBC, NLR, WBC/MPV, CRP/MPV and CRP values were higher in the Group 2 compared to Group 1. CRP/MPV and WBC/MPV were positively correlated with duration of symptoms in the CAP. The area under ROC curve of CRP, WBC and WBC/MPV in diagnosing CAP was significant (0.801, 0.761 and 0.731). Also the area under ROC curve of Group 2 in CRP/MPV and CRP in diagnosing CAP was significant (0.733, 0.708). Conclusion: CRP/MPV and WBC/MPV ratio may be used a marker in the evaluation of CAP diagnosis and CRP/MPV ratio can be good marker prediction of disease activity.

Celiac disease is an autoimmune disease of the small intestine, resulted from villusdamage and malabsorbtion due to ingestion of gluten; and production of antibodies to gliadin. Thedisease can manifest with various presentations. Celiac crisis was described as an acute, serious,life-threatening form of celiac disease about sixty years ago with a higher incidence among pediatric patients than adults. It is characterized by gastrointestinal symptoms like profuse diarrhea andsevere metabolic distubances like hyponatremia and hypoproteinemia. Early suspicion and detection is important. This case report presents a 54-year-old female patient who died from celiac crisis and sepsis.

Harlequin ichthyosis (HI) is a rare and severe form of congenital ichthyosis caused by truncating mutations in the ABCA12 gene. Although it has many distinctive signs on perinatal sonography such as short limbs, wide gaping mouth, joint contractures, edema of the hands and feet and cloudy amniotic fluids, it usually can not be diagnosed until birth. Herein, we report a case of recurrent HI, which remained undiagnosed until labor at 38 weeks of gestational age. A multiparous woman presented to hospital at 38th weeks of gestation. There were no personal or family history. Vaginal delivery was performed and a 3300 gram baby was delivered. The body of the neonate was covered with thick, armor like skin, have generalized edema and erythematous fissures, scanty hair, everted eyelids with exposed swollen conjunctiva, open mouth were noted at the first examination. Newborn was diagnosed to be having Harlequin ichthyosis and was given to neonatal intensive care unit (NICU) for supportive care and additional examination. Genetic counseling is important and should be recommended to affected families. With the growing technology electron microscopes, invasive prenatal diagnostic tools and 3D sonography may reveal suggestive features of the disease. In addition, new treatment regimens, experienced and competent NICU facilities may increase survival rates.

Distant metastasis of breast carcinoma frequently occurs within five years after the diagnosis of the primary tumor. A 58-year-old female sharing a history of mastectomy for invasiveductal carcinoma six years previously admitted to our clinic with dyspnea progressively ongoing forpast two weeks. A right-sided massive pleural effusion was diagnosed and also pleural catheterdrained. Radiologic studies and cytological examination of the fluid did not introduce any evidenceof malignancy while she lately underwent thoracoscopy for the residuary effusion and atelectasis.Pathological study of the punch biopsies through the parietal pleura reported the pleural metastasis of the breast carcinoma but still negative evidence of malignancy for the pleural fluid. After discharge, evaluation with positron emission tomography also did not verify an uptake in any of thepleura, lungs or primary malignancy site. This event is of importance revealing that the patientssharing a past of malignancy should be approached with more caution and suspicion since the routine diagnostic algorithms pending to be reliable may not be applicable for all patients.

Dieulafoy lesion (DL) is an important cause of acute gastrointestinal hemorrhage (GIH) because endoscopic diagnosis is very difficult. We report an ileal DL in a patient with Glanzmann Thrombasthenia (GT). A forty-year old female presented with bloody stool. Records showed that she was diagnosed with GT at 3 years of age. Physical examination on admission, she was clinically stable, except for tachycardia (110 bpm). Rectal examination revealed bright red blood. Her haemoglobin level was 8.7 g/dl. Colonoscopy revealed a DL at the terminal ileum. It was treated with combined endoscopic therapy of epinephrine injection followed by two clips application. Haemoglobin values were stable in the post-procedural period. DL in the terminal ileum is very rare. There have been fewer than 20 cases reported in the literature to date. Also GT is a rare congenital bleeding disorder. This case report revealed the coincidence of two rare disorders.

In this study; we tried to compile risk scoring systems (Original EuroSCORE, EuroSCORE II and STS) used in robotic surgery, minimally invasive cardiac surgery and open-heart surgery in the context of the literature.As a result, literature study of risk scoring systems in the robotic surgery was not found. In minimally invasive cardiac surgery, few studies are available. The effectiveness of existing risk scoring systems has not been established in these studies. Therefore, further investigations are required for developing risk scoring systems in robotic surgery and minimally invasive cardiac surgery. In open heart surgery, there is still no gold standard scoring system in all populations. Due to the increased case diversity, we believe that the commonly used risk scoring systems must be updated. Widely used risk-scoring systems are not effective in minimally invasive cardiac surgery and this is supporting our idea. Each clinic should choose the appropriate risk scoring system according to their own experience and case diversity. [Med-Science 2018; 7(4.000): 959-61]

To test the null hypothesis that bony pelvis dimensions are different in women with and without polycystic ovarian syndrome (PCOS). In this case-control study all subjects underwent hysterosalphingography examination. The interspinous, intertuberous diameters and subpubic angle were measured from the images independently by author blinded to the clinical and laboratory data of the patients. Women with PCOS had shorter interspinous diameter. There was no significant differences in the length of intertuberous diameters and subpubic angles between the two groups. Significant difference in interspinous diameter was identified when comparing reproductive-aged women with PCO and their similar aged controls. [Med-Science 2018; 7(3.000): 681-3]

In recent years, medication-related diseases have become a major concern in elderly care. Elderly people tend to experience more negative drug events than younger patients due to accompanying diseases, multiple drug use, and age-related changes in pharmacodynamics and pharmacokinetics of drugs. Vancomycin is a nephrotoxic and ototoxic antibiotic commonly used in gram (+) bacterial infections, especially in Methicillin-resistant Staphylococcus aureus (MRSA), which can cause important problems such as flushing, muscle spasm, redman syndrome. It was aimed to report vancomycin drug reaction, which emerges of elevated eosinophilia. [Med-Science 2018; 7(2.000): 453-5]

Although the main interest of artificial intelligence in medicine seems to be to develop methods that can offer diagnostic and therapeutic recommendations, it includes numerous areas suchas physician and nurse clinical decision support systems, pharmacy decision support systems, patient care, clinical data pooling, data sharing between units and institutions, storage, interp-retation, business intelligence and machine learning. In addition to having a strong orientation towards automation, expert systems and artificial intelligence, medical laboratories have anincreasing need especially for expert systems. Clinical microbiology laboratories are a central element in the identification of data chains that may be involved in the fight against antimicrobialresistance. By the integration of artificial intelligence to clinical microbiology laboratory use, it is aimed to provide detailed support to individual epidemiological surveillance, research appli-cations and to improve individual patient care quality. In our study, the principles and methods of the study of artificial intelligence in clinical microbiology and antibiotic resistance processingwere reviewed and important clinical studies were examined., Yapayzekanın tıp alanındaki ana ilgi alanı, teşhis ve tedavi önerileri sunabilecekyöntemler geliştirmek gibi görünse de hekim ve hemşire klinik karar destek sistemleri, eczane karar desteksistemleri, hasta bakımı, klinik veri havuzu oluşturulması, birimler vekurumlar arası veri paylaşımı, depolama, yorumlayabilmeye sürecine katkı ileberaber olarak iş zekası ve makine öğrenmesi gibi sayısız alanı kapsar. Tıbbi laboratuvarlarotomasyon, uzman sistemler ve yapay zekaya doğru güçlü bir yönelimle karşı karşıyaolmanın yanısıra uzman sistemlere yönelik artan bir ihtiyaç yaşamaktadır. Klinikmikrobiyoloji laboratuvarları antimikrobiyal dirence karşı mücadelede yeralabilecek veri zincirlerinin tespitinde merkezi bir unsurdur. Yapay zekanın klinik mikrobiyoloji laboratuvar kullanımına entegrasyonunamaçları arasında bireysel epidemiyolojik sürveyans, araştırma uygulamalarınaayrıntılı destek sağlamanın yanı sıra bireysel hasta bakım kalitesini artırmakyer alır. Çalışmamızda klinik mikrobiyoloji ve antibiyotikdirencinin işlenmesi konusunda farklıyapay zeka çalışma prensip ve yöntemleri gözden geçirilerek, bu yöntemleriirdeleyen önemli klinik çalışmalar incelenmiştir.

Kablosuz algılayıcı ağlar birçok alanda yaygınolarak kullanılan kablosuz ağ teknolojisidir. Yeraltı, karasal, sualtı veendüstriyel algılayıcı ağlar olmak üzere farklı kullanım alanlarıbulunmaktadır. Kablosuz algılayıcı ağlardaki en önemli sorunlardan birisi, algılayıcıdüğümlerin mekanik nedenlerden dolayı arızaya meyilli olmasıdır. Diğer birsorun ise, kablosuz algılayıcı düğümlerin sınırlı enerjiye sahip olmasıdır. Bubağlamda, hata sezme mekanizmaları bulunan ve enerji verimli olarak çalışanalgılayıcı ağ tasarımları büyük önem taşımaktadır. Bunun yanında, maliyetaçısından algılayıcı düğümlerin yerleştirildiği konumları belirleme tekniğioldukça önemlidir. Düğümlerin yerleştirildiği konumlar, hedef bölgenin birdüğümün algılama alanı içinde olma olasılığını ve bu düğümün baz istasyonu ileolan bağlantısını etkilemektedir. Bu makale çalışmasında, çok sayıda algılayıcıdüğümün geniş bir alana yerleştirildiği farklı bir yaklaşım önerilmektedir. Algılayıcıdüğümler; belirli bir bölgedeki sıcaklık, nem, basınç vb. parametrelerialgılamak için tüm bölgeyi kapsayacak şekilde yerleştirilmektedir. Düğümlertarafından algılanan değerler, merkezde sabit olarak bulunan baz istasyonutarafından toplanmaktadır. Önerilen yaklaşımın benzetim modeli, RiverbedModeler yazılımı kullanılarak gerçekleştirilmiştir. Önerilen yaklaşımsayesinde, belirli bir bölgenin en az sayıda kablosuz algılayıcı düğüm ilesezilmesi sağlanmaktadır., Wireless sensor networks are widelyused wireless network technology in many areas. There are different usage areassuch as underground, terrestrial, underwater and industrial sensor networks. Oneof the most important problems in wireless sensor networks is that the sensornodes are prone to malfunction due to mechanical reasons. Another problem isthat the wireless sensor nodes have limited energy. In this context, sensornetwork designs with error sensing mechanisms and energy efficient operationsare of great importance. In addition, the technique of determining thelocations where the sensor nodes are placed is very important in terms of cost.The locations where the nodes are placed affect the probability that the targetregion is within the detection area of ​​a node and its connection with thebase station. In this paper, a different approach is proposed in which a largenumber of sensor nodes are placed on a large area. Sensor nodes are placed tocover the entire region in a specific area in order to detect the parameterssuch as temperature, humidity, pressure, etc. The values ​​detected by thenodes are collected by the base station which is fixed at the center. Thesimulation model of the proposed approach was performed by using RiverbedModeler software. Thanks to the proposed approach, it is ensured that a certainregion is sensed by the minimum number of wireless sensor nodes.

Amaç: Sferoid kültürleri, hücrelerin kendi iç dinamikleri ve diğer hücrelerle olan etkileşimleri açısından tek tabakalı kültürlere kıyasla tümör dokusunun özelliklerini daha iyi yansıtmaktadır. Bu çalışmanın amacı, üç boyutlu (3D) ve iki boyutlu (2D) kültür ortamlarında üretilen CD133+/CD44+ prostat kanser kök hücrelerinin (KKH) makromoleküllerindeki benzerlik ve farklılıklarının araştırılmasıdır. Gereç ve Yöntem: DU-145 prostat kanser hücre hattı içerisindeki CD133+/CD44+ yüzey belirteç özelliklerine sahip KKH’leri akış sitometrisi (FACS) kullanılarak izole edilmiştir. Agarla kaplı kültür kapları ile sferoid yapıları oluşturulmuştur. 2D ve 3D kültür ortamlarındaki KHK hücreleri Fourier dönüşümü kızılötesi (FTIR) spektroskopisi ile karşılaştırılmıştır. Bulgular: CD133+/CD44+ hücrelerin birinci haftada agarlı kültür ortamlarında mikro-agregatlar oluşturduğu gözlenmiştir. İkinci haftada ise, olgun sferoid yapıların oluştuğu saptanmıştır. 2D ve 3D (multisellüler tümör sferoidleri) kültür ortamlarında üretilen hücreler ile yapılan FTIR analizleri KHK hücre yapısındaki proteinler, lipitler, karbonhidratlar ve nükleik asitlerde (DNA, RNA) önemli derecede farklanmalar olduğunu göstermiştir. Membran lipit açil zincir uzunluğu ve hücre zarı kalınlığı, proteinlerin sekonder yapıları ve DNA oligonükleotitlerin baz sekanslarında veya fonksiyonel gruplarında önemli farklanmaların olduğu tespit edilmiştir. Elde edilen sonuçlar, 3D kültür ortamında üretilen sfreoid yapılarının in vivo tümör dokusu ile benzer özellikler sergilediğini göstermiştir. Sonuç: Hücre ortam koşulları ile yaratılmış olan fiziksel, kimyasal ve biyolojik özellikler hücrelerin kendi iç dinamiğini ve mikroçevresi içerisindeki etkileşimlerini önemli derecede etkilemektedir. 2D kültür ortamları ile hücreleri tek boyutta indirgemek hücrelerin gerçek özelliklerini yansıtmamaktadır. Bu nedenle, 3D kültür ortamları ile hücre dinamiklerinin incelenmesi gerekmektedir. Bu çalışmadan elde edilen sonuçlar, kanserde önemli bir hücre popülasyonunu oluşturan KKH’lerin membran yapısı, lipitler, proteinlerin sekonder yapıları ve DNA oligonükleotit yapılarının terapötik hedef olabileceğini göstermektedir., Objective: Spheroid cultures reflect properties of tumor tissue better than monolayer cultures in terms of internal dynamics and interaction with other cells. the aim of this study is to investigate the similarities and differences in CD133+/CD44+ prostate cancer stem cells (CSCs) produced in threedimensional (3D) and two-dimensional (2D) culture media. Material and Method: CSCs with CD133+/CD44+ surface marker properties in the DU-145 prostate cancer cell lines were isolated using flow cytometry (FACS). Spheroid structures were formed with agar-coated culture vessels. CSCs in 2D and 3D cultures were compared with Fourier transform infrared (FTIR) spectroscopy. Results: CD133+/CD44+ cells were observed to form micro-aggregates in cultured media in the first week. in the second week, mature spheroid structures were formed. FTIR analysis revealed that the 2D and 3D (multicellular tumor spheroids) models of CSCs exhibit significant differences in proteins, lipids and nucleic acids. Significant differences were detected in membrane lipid acyl chain length, membrane thickness, protein secondary structures and DNA oligonucleotides. the results showed that spheroids in 3D culture medium exhibit similar properties to in vivo tumor tissue. Conclusion: Physical, chemical and biological properties generated by environmental conditions significantly affect internal dynamics of cells and their interactions within the microenvironment. Reducing the cells in one dimension through the 2D culture medium does not reflect actual properties of cells. Therefore, cell dynamics in 3D culture media should be investigated. This study demonstrates that cellular lipids, membrane structure, protein secondary structures and nucleic acids of CSCs constituting an important cell population in cancer may be therapeutic targets.

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.

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, 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

Mushroom poisoning has an important place in thepoisonings applied to emergency department (ED).Patients may present with different toxoids according tothe fungus and toxin fecalin. Pantherina syndrome is atablature that can interfere with cerebrovascular diseasesdue to clinical presentation. Three patients from thesame family were admitted to our ED with newlydeveloped symptoms of confusion, aphasia andmydriasis. When the first patient was evaluated, thediagnosis of hypertensive encephalopathy was firstconsidered with the current symptoms. However, afterthe application of the second and third patients withsimilar symptoms, the anamnesis was deepened and thestory of eating a mushroom was questioned. Patients aretreated in the emergency ICU. Two patients recoveredwithin 24 hours, and the symptoms of one patientcontinued for up to 72 hours. Pantherina syndrome is atoxicoma characterized by early onset, confusion,neurological symptoms such as aphasia and mydriasis.Treatment is generally supportive treatment. Stomachlavage and activated charcoal will be useful in the earlyperiod. Benzodiazepines can be used in extremeagitation. Pantherina syndrome is one of the diagnosesthat clinicians should actually have in patients presentingwith an acute confusional condition. Mantar zehirlenmeleri günlük acil servis pratikuygulamasında zehirlenmeler içinde önemli bir yeresahiptir. Hastalar mantara ve toksinin türüne göre farklıklinik tablolar ile hastaneye başvurabilirler. Pantherinasendromu, serebrovasküler hastalıklarla k arışabilen birklinik tablodur. Aynı aileden üç hasta, yeni gelişen bilinçbulanıklığı, afazi ve midriyazis belirtileri ile acil servisebaşvurdu. İlk hasta değerlendirildiğinde, mevcutsemptomlarla birlikte hipertansif ensefalopati tanısıkonuldu. Bununla birlikte, benzer semptomlara sahipikinci ve üçüncü hastada anamnezin derinleştirilmesi ilemantar yemekten kuşkulanıldı. Hastalar acil yoğun bakımünitesinde tedavi edildi. İki hasta 24 saat içinde düzeldive bir hastanın semptomları 72 saate kadar devam etti.Pantherina sendromu erken başlangıçlı, konfüzyon, afazive midriyaz gibi nörolojik semptomlarla karakterize birklinik durumdur. Tedavi genellikle destek tedavisidir.Mide yıkama ve aktif kömür erken dönemde faydalıolacaktır. Benzodiazepinler aşırı ajitasyon durumundakullanılabilir. Pantherina sendromu, akut konfüzyonel birdurumla başvuran hastalarda klinisyenlerin düşünmesigereken tanılardan biridir.

Cystic echinococcosis is a zoonotic disease with worldwide distribution caused by Echinococcus granulosus,represents a substantial global health problem. Hydatid cyst (Echinococcus) has a remarkable negative effect on thehealth of people and the economic development of the country. The objective of this study was to investigate the CD68,nicotinamide nucleotide adenylyltransferase 3 (NMNAT 3), Neuregulin 1 (NRG1) and Neuregulin 2 (NRG2) expres-sions in bovine lungs infected with E. granulosus and to identify whether they have any correlation with pulmonarypathology. For this purpose, 30 bovine lung tissues were used between January 2016 and December 2016 collected inKırıkkale slaughterhouse. In histopathologic examinations, proliferation of fibrous connective tissue and infiltrationof mononuclear cells were detected in the lung tissues of the bovine. Most of the cysts were seen to be quite thickcapsule. There was also a cellular line rich in abundant fibroblasts and mononuclear cells. The cyst wall was found tobe an eosinophilic laminar structure. There was infiltration with lymphocytes and macrophages, especially eosinophilsand giant cells. Immunohistochemically, CD68 positivity was seen around the bronchi, bronchioles and cystic matter.However; NMNAT 3, NRG1 and NRG2 showed no positive reactions in macrophages, bronchi, bronchioles and alveo-lar epithelium. These results indicate that NMNAT 3, NRG1 and NRG2 pathways were not used in pulmonary pathol-ogy. Therefore, it is the most important result of the study that the adhesion molecules in pulmonary pathology are notoriginating from NMNAT 3, NRG1 and NRG2., Kistik ekinokokkozis, dünya çapında Echinococcus granulosus’un neden olduğu geniş dağılımı olan zoonotikbir hastalıktır ve önemli bir küresel sağlık sorunudur. Kist hidatid (Echinococcus), insan sağlığı ve ülkenin ekonomikgelişimi üzerinde dikkate değer bir olumsuz etkiye sahiptir. Bu çalışmanın amacı E. granulosus ile enfekte olmuş sığırakciğerlerinde CD68, nikotinamid nükleotid adenililtransferaz 3 (NMNAT 3), Neuregulin 1 (NRG1) ve Neuregulin2 (NRG2) ekspresyonlarını araştırmak ve pulmoner patoloji ile herhangi bir korelasyon olup olmadığını saptamaktır.Bu amaçla Kırıkkale kesimhanesinde Ocak 2016 ile Aralık 2016 arasında toplanan 30 adet büyükbaş akciğer dokusukullanıldı. Histopatolojik incelemede, sığırların akciğer dokularında fibröz bağ dokusu proliferasyonu ve mononükleerhücrelerin infiltrasyonu saptandı. Kistlerin çoğunun oldukça kalın bir kapsülü olduğu görüldü. Ayrıca fibroblastlar vemononüklear hücreler bakımından zengin bir hücresel hat vardı. Kist duvarının eozinofilik bir laminar yapı gösterdiğitespit edildi. Lenfosit, makrofaj, özellikle eozinofil infiltrasyonları ve dev hücrelerinin de görüldüğü yangısal alanlardikkati çekti. İmmünhistokimyasal olarak, CD68 ekspresyonları bronş, bronşiyol ve kistik yapının etrafında gözlendi.NMNAT 3, NRG1 ve NRG2 makrofajlarda, bronş, bronşiyol ve alveolar epitellerinde hiçbir pozitif reaksiyon göster-memiştir. Bu sonuçlar, pulmoner patolojide NMNAT 3, NRG1 ve NRG2 yollarının kullanılmadığını göstermektedir.Bu nedenle, çalışmanın en önemli sonucu, pulmoner patolojide adezyon moleküllerinin NMNAT 3, Neuregulin 1 veNeuregulin 2’den kaynaklanmadığıdır.

Objectives: Bleeding control is crucial in preventing negative consequences by reducing blood loss in surgical operations. The aim of this study is to evaluate the hemostatic effect of a new herbal hemostatic agent called Algan Hemostatic Agent (AHA) in an uncontrolled bleeding model made by liver laceration.Methods: In these study 5–7 weeks-old 64 rats were used. Rats were randomly divided into 8 groups each consistingof eight rats (4 groups heparinize and 4 groups non-heparinize). The experimental liver laceration was performed, andphysiological serum impregnated gauze was applied to the control group for hemorrhage control, AHA liquid formimpregnated gauze, AHA gel, and AHA powder form were applied to experimental groups, respectively.Results: The shortest bleeding time was found in the AHA powder group. The AHA powder form stopped the bleedingin the heparinize group for a mean of 4 s, the non-heparinized group for 2 s. This was followed by the gel group and theliquid group. The bleeding time was significantly shorter in the all AHA group compared to the control group.Conclusion: This study showed that AHA is a highly effective hemostatic agent in controlling bleeding compared tothe control group.

Objectives:psychometric properties of the Turkish version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the sensitivity tochanges in clinical indicators.Patients and Methods:This study was conducted within the framework of a national multicentre project. Patients with either stage IIIB or IV primary lungcancer diagnosed after April 2010were included in thisstudy. A classical confirmatory approach was used for both the reliability and validity analyses.Internal consistency was tested using Cronbach’s α value, and the validity analysis was performed using construct validity and clinical validity.Results:276 (92.3%) patients were male and the average age was 60.8 ± 9.4 years. The most frequently observed histological type was squamous cellcarcinoma (36.8%), and 61.5% of these stage IV tumours. Cronbachs α values for the subscales ranged from 0.60 to 0.84. The majority of the FACT-Lsubscales revealed inter-scale correlation coefficients greater than 0.35. All sub-dimensions, except that of the social/family well-being scale, are ableto significantly discriminate between stages IIIB and IV. Significantly lower scale scores were detected in patients with stage IV than stage IIIB. Thecomparative fit index was 0.917, and the root mean square error of approximation was 0.091. Dyspnoea, haemoptysis, chest pain, weight loss, anorexia,localised pain, and fever symptoms had a significant correlation with the FACT-L, trial outcome index, and lung cancer subscale.Conclusion:Turkish version of the psychometric properties of the original FACT-L scale is regarded as a valid and reliable tool and can be used safely ina clinical context when managing patients with lung cancer in Turkey.

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Amaç: Antitrombotik ilaçlar birçok farklı hastalığın tedavisinde kullanılan yüksek riskli ilaçlardır. Bu çalışmanın amacı, Türkiye’deki serbest eczacıların antitrombotik tedavi ile ilişkili faaliyetlerinin nitelik ve içeriğinin belirlenmesi ve serbest eczacıların antitrombotik tedavi yönetimine katkıda bulunabilecek farmasötik bakım aktivitelerine yaklaşımlarının belirlenmesidir. Gereç ve Yöntem: Web ortamında hazırlanan kesitsel anket çalışmasına Türkiye’de 53 ilden 321 eczacı kendi kendine uygulama yöntemiyle katılmıştır. Ankette evet/hayır soruları, kapalı uçlu çoktan seçmeli sorular, yarı kapalı uçlu çoktan seçmeli sorular, 0-100 arası derecelendirme ve 5 noktalı Likert ölçeği kullanılmıştır. Bulgular: Eczacılar verdikleri farmasötik bakım hizmetlerinin %21,84 ± 1,05’inin antitrombotik tedavi görmekte olan hastalara yönelik olduğunu bildirmiştir. Eczacıların %99,1’inin birden fazla antitrombotik ilaç hakkında bilgi verdiği belirlenmiştir. Eczacıların sadece %33,0’ü antitrombotik ilaçların kullanıldıkları tıbbi durumlar ve ilgili tedavi protokolleri ile ilgili bilgi düzeylerinin yeterli olduğunu düşündüğünü bildirmiştir. Verilen çeşitli farmasötik bakım hizmetleri ile eczacıların bilgi düzeyi arasında zayıf pozitif korelasyon bulunmaktadır. Eczacılar hastaların %82,2’sinin ilaçları/tedavileri konusunda bilgisinin yeterli olmadığını düşünmesine rağmen %85,7’si hastalara yazılı bilgilendirme materyali vermemektedir. Eczacıların farmasötik bakım hizmeti sağlarken hastalar ile ilgili faktörlerden en çok kullandığı diğer ilaçlar (%88,8), yaş (%78,8), sağlık okuryazarlığı (%72,9) ve eğitim durumunu (%71,7) dikkate aldığı belirlenmiştir. Eczacıların diğer sağlık profesyonellerinin eczacı hizmetlerine verdikleri öneme ilişkin öz değerlendirme sonucu ile olası tedavi sorunları için hekimle iletişime geçme sıklığı arasında istatistiksel olarak anlamlı zayıf pozitif korelasyon bulunmuştur. Sonuç: Bu çalışmanın sonuçları Türkiye’de antitrombotik tedavi yönetiminde serbest eczacıların sundukları farmasötik bakım hizmetleri ile ilgili bir çerçeve sunmaktadır. Sonuçlar doğrultusunda serbest eczacılık hizmetlerin geliştirilmesi ülkemizde güvenli ve etkin antitrombotik ilaç kullanımının artışına katkı sağlayabilir., Objective: Antithrombotic drugs are high risk drugs used in treatment of various conditions. the purpose of this study was to determine the nature of pharmaceutical care activities related to antithrombotic therapy management and the attitudes of community pharmacists in this area. Material and Method: 321 pharmacists from 53 provinces of Turkey completed this cross-sectional self-administered web-based survey. the questionnaire consisted of yes/no, closed-ended multiple choice, semi-closed multiple choice, 0-100 rating and 5-point Likert scale questions. Results: 21.84 ± 1.05% of the pharmaceutical care services provided by pharmacists were directed toward patients using antithrombotic drugs. 99.1% of pharmacists provided information on more than one antithrombotic drug. Only 33.0% of the pharmacists reported that their knowledge on antithrombotic drugs was adequate. There was a weak positive correlation between the pharmacists’ level of knowledge and various pharmaceutical care services provided. Although pharmacists don’t think that 82.2% of patients have enough knowledge about treatments, 85.7% don’t hand out written information to patients. Other drugs (88.8%), age (78.8%), health literacy (72.9%) and education status (71.7%) were the most frequently considered factors while providing pharmaceutical care services. There was a weak positive correlation between pharmacist's perceived value for pharmacy services by other healthcare professionals and frequency of communication with physicians for possible treatment problems. Conclusion: the results of this study provide a framework for pharmaceutical care services provided by community pharmacists in the management of antithrombotic therapy in Turkey. the improvement of community pharmacy services may contribute to the increase of safe and effective antithrombotic drug use in our country.

Objective: Foreign body aspiration is a potentially life-threatening emer-gency in children. Urgent rigid bronchoscopy should be performed when presentation includes severe respiratory failure with suspicion for FBA. To the best of the knowledge, this is the first study that evaluates URB in English literature.Methods: Forty-eight patients who underwent urgent rigid bronchoscopy were included in this study. From the medical records, the patients’ demo-graphic characteristics, hospital arrival time, endotracheal intubation status, peripheral oxygen saturation, bronchoscopy results, type and location of for-eign body , intraoperative and postoperative complications, mortality, X-ray results, length of hospital stay were evaluated. Results: Twenty-four of the 48 patients were non-intubated. Peripheral oxy-gen saturation values were 60±14.40 in the preoperative period. There was not any statistically significant difference between intubated and non-intu-bated patients in terms of intraoperative and postoperative complications. There was not any statistically significant difference between patients with negative and positive results for bronchoscopy in terms of intraoperative and postoperative complications. Conclusions: Bronchoscopy is not without risk; however, it is a life-sav-ing procedure. Despite negative foreign body results, urgent bronchoscopy should be performed in suspicious cases.

Güneş enerjisinden elektrik üretmekte kullanılan PV panellerin verim artırma çalışmaları devametmektedir. Verimi etkileyen unsurların başında MGNT algoritmaları gelmektedir. Bu çalışmada sezgisel(BM, YSA) ve D&G tabanlı MGNT algoritmaları incelenmiştir. Sezgisel algoritmaların uygulanabilmesi içinCuk dönüştürücüye ait denetleç tasarımı Matlab aracılığıyla yapılmıştır. Yapılan benzetim çalışmaları sonucunda, üçfarklı MGNT algoritmasının performans analizleri gösterilmişti Efforts to increase the efficiency of PV panels used in electricity generation from solar energycontinue. MPPT algorithms are at the forefront of the factors affecting efficiency. In this work, heuristic(FL, ANN) and P&O based MPPT algorithms have been investigated. In order to apply heuristicalgorithms, controller design of Cuk converter have been done by using Matlab. As a result of thesimulation studies, performance analyzes of three different MGNT algorithms have been shown.

Aim: Thyroidal incidentalomas (Tis) detected by F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18FDG PET/CT) may be associated with three different causes that include metastasis of another malignancy, primary thyroid gland malignancies and lastly benign thyroidal nodules, all require different clinical approaches. For appropriate treatment, quick characterization of the Ti is important, preferably with a lesser invasive method. Our aim was to determine whether the characterization of TIs can be performed with FDG-PET/CT, due to contribute faster diagnosis, and initiation of the therapy.Material and Methods: Forty-four patients with detected TIs in FDG-PET/CT were included in the study. The relationship between metabolically/morphological parameters and pathology results were evaluated statistically. If two subsequent cytology were negative, nodule accepted as benign. If cytology result was suspected or malignant, histopathological confirmation was made. For these patients, histopathological results were accepted as definite diagnosis. Results: Malignant thyroidal pathologies were detected in 29.5% of patients. We could not find any significant relationship between age, nodule size and SUVmax value and pathology results. According to ROC analysis, there were not any cut-off value for nodule size and SUVmax. Similar results were also obtained for papillary carcinoma as a special subgroup.Conclusion: Characterisation of TIs could not be performed by using age, nodule size and SUVmax. Therefore, TIs which detected by FDG-PET/CT should be examined pathologically due to high risk of malignancy.Keywords: Thyroidal incidentalomas; FDG-PET/CT; malignant; characterization.

Aim: The aim was to analyze the outcome of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vinblastine,and dacarbazine (ABVD) chemotherapy adjuvant radiotherapy according to the risk groups and determine the adverse prognosticfactors affecting survival in Hodgkin lymphoma.Material and Methods: A retrospective study was performed on 52 pediatric patients with Hodgkin lymphoma who were treated withABVD between 1997 and 2018. Patients with early-stage favorable disease received 4 cycles of ABVD radiotherapy. Early-stageunfavorable and advanced-stage patients received 6 cycles of ABVD radiotherapy.Results: Thirty (57.7%) boys and 22 (42.3%) girls were included in the study. The median age of the patients was 9 years and 3months (1 year and 10 month – 17 years and 7 months). Overall survival rate was 94.2% and the mean survival time was 19.50.70(95% CI, 18.1 - 20.9) years. The mean event-free survival time was 9.56.5 years. Overall survival rate was 90%, and the meanevent-free survival time was 8.26.1 years in early-stage favorable disease. Overall survival rate was 100%, and the mean eventfreesurvival time was 1.97.0 years in early-stage unfavorable disease. Overall survival rate was 94.1 %, and the mean event-freesurvival time was 8.96.3 years in advanced-stage disease. Presence of bulky disease, nodular sclerosing histologic subtype andleukocytosis had a negative prognostic effect on relapse and bulky disease had adverse effect on overall survival (p0.05).Conclusion: Four courses of ABVD chemotherapy radiotherapy (IFRT or ISRT) in early-stage favorable patients and 6 courses ofABVD chemotherapy radiotherapy (IFRT or ISRT) in both early-stage unfavorable and advanced-stage Hodgkin lymphoma patientsbenefited from promising outcomes in terms of OS and FFS.Presence of bulky disease, nodular sclerosing histologic subtype and leukocytosis have adverse prognostic effects on relapse andpresence of bulky disease have adverse effect on OS.

Aim: Cutaneous lupus erythematosus (CLE) has a multifactorial pathogenesis involving genetic and environmental triggers and congenital and acquired immune response. The aim of this study was to investigate the effects of Glutathione S-Transferases (GST) isoenzymes including GSTT1, GSTM1, and GSTP1 in the CLE patients with an etiology of solar radiation exposure. Material and Methods: Paraffin-embedded skin biopsy sections from the patients were stained by immunohistochemical methods. The results were evaluated under a light microscope by a pathologist. The pattern, localization, and distribution of the immunohistochemical staining were recorded for each patient. Staining of the nucleus or cytoplasm was considered as positive staining. The accuracy of staining was determined based on the intensity and percentage of staining. Results: No significant difference was found between the patient and control groups regarding staining intensity. In terms of staining percentage, the prevalence of GSTP1-3 genotype was significantly lower in the patient group compared to the control group (25% vs. 63.33%) (p=0.002). Conclusion: No significant difference was observed in the staining intensity of GSTP1, GSTT1, and GSTM1 between the patient and control groups and the staining percentage in some genotypes was even higher in the control group compared to the patient group.

Cryptococcus neoformans is an opportunistic fungal agent, which may cause infectiondepending on the state of immunity. The agent is especially prone to be localized in the centralnervous system. Fingolimod is an immunomodulatory drug that is used in the treatment of Multiple Sclerosis (MS). The use of this drug leads to a decrease in lymphocyte count and thus might result in the occurrence of the opportunistic infections like Cryptococcosis. In this article, we presenta MS patient that underwent fingolimod treatment and developed Cryptococcus meningoencephalitis.

Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptides that play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was to determine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormal uterine bleeding. According to the pathology results, patients were identified as polyp group (n=38) (endometrial polyps) and control group (n=50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained from venous blood. Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the number of living children were compared (p>0.05). There was no statistically significant difference between the groups in terms of follicle stimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p>0.05). Plasma kisspeptin (1.84±0.93 ng/dL and 1.32±0.47 ng/dL, p= 0.008) and estradiol (90.34±13.02 pg/mL and 81.75±12.36 pg/mL, p=0.002) levels were significantly higher in the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve (AUC) was 1.26 (p= 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.Keywords: Abnormal uterine bleeding; endometrial polyps; kisspeptin.

Aim: Alopecia areata is an auto-immune skin disease characterized by non-scarring hair loss. Nail changes are strongly associatedwith prognosis. In patients with Alopecia areata, the nail examination should not be neglected for an optimal follow-up.Material and Methods: A retrospective study involving 207 patients with Alopecia areata was undertaken in a tertiary hospitalbetween April 2016 and May 2017. Patients whose nail changes were registered in the database were included in the study. Gender,age, disease severity, sites affected, and nail changes of those patients were noted.Results: 114 patients (55%) had nail involvement. The most common nail finding was leukonychia (n 84). Nail pitting was detectedin 29 patients.11 patients had both leukonychia and nail pitting. The mean age of the patients with leukonychia was 23.3, while themean age of nail pitting patients was 31.7 and the mean age of the patients without nail change was 34.1.Conclusion: Leukonychia is the most common nail change in this study, as a different finding from all previous studies

Objectives: Lung cancer accounts for 20% of cancer-related deaths worldwide. Several studies have shown that Vitamin D levels at the time of diagnosis are prognostic in lung cancer. In this study, we evaluated the relationship between pre-diagnosis Vitamin D replacement levels and platinum-based chemotherapy results. Methods: In this cross-sectional study, we retrospectively analyzed archive records of all 247 patients diagnosed with lung cancer from an oncology center in Turkey, between 2012-2018. The chemotherapy outcomes, Vitamin D levels and replacement doses of these patients up to 6 months ago were recorded. Results: Vitamin D levels of 153 patients were below 15 ng/mL, 65 patients had a level of 15-30 ng/mL, and 29 patients had a vitamin D level higher than 30 ng/mL. In the study population, 215 had a replacement below 300.000 IU whereas 32 had a replacement above 300.000 IU. When the patients were evaluated based on their chemotherapy responses, no difference was observed between the patients with below and above 300.000 IU. In our study, Vitamin D and replacement level at the time of diagnosis did not change the chemotherapy response. Conclusion: Vitamin D replacement levels were not significantly associated with chemotherapy outcomes in our study.

Günümüzde genel anestezinin santral sinir sistemine etkisi sağlıklı genç yetişkinlerde önemli bir sorun olarak karşımıza çıkmazken, yapılan bir çok hayvan deneyi yanında az ama önemli klinik çalışmalar, yaşamın erken veya geç dönemlerinde santral sinir sistemi üzerine anestezik toksisite kuşkusunu güçlendirmektedir., Nowadays, while the effects of general anesthesia on central nervous system is not considered to be an important problem on healthy young adults, alongside many experiments on animals, few but significant clinical studies strengthenthe suspicion of anesthetic toxicity on the central nervous system in early or late ages

Objectives: Lung cancer has been the leading cause of cancer mortality, and its incidence is growing throughout the world. This study aims to compare the distribution of the six World Health Organization by configural frequency analysis (CFA). Methods: The National data (GLOBOCAN 2012) were included in the analysis. Data were analyzed by CFA which is used for the analysis of multiway contingency tables. Results: In Africa, East Mediterranean, Europe, and Southeast Asia, lung cancer incident cases were observed to be higher than expected. Under the years

Aim: We aimed to determine whether Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), D-dimer, and troponin values were correlated with the simplified Pulmonary Embolism Severity Index (sPESI) in patients diagnosed as having Pulmonary Embolism (PE) in the emergency room. Material and Methods: Forty-three patients diagnosed as having PE in the emergency departmentwere divided into low and high-risk groups according to the sPESI. We investigated whether NLR, MLR, and PLR, d-dimer, troponin-I, and Pulmonary Artery Pressure (PAP) had any effect in determining the severity of PE. Also, patients were divided into groups as those with PAP ≤20 or >20 mm Hg, Systolic Blood Pressure (SBP) ≤100 or >100 mm Hg, and those receiving or not receiving thrombolytic treatment, and compared. Results: There was a statistically significant difference between patients with low sPESI (n=10) and those with high sPESI (n=33) in terms of age (p=0.001), pulse (p=0.016), oxygen saturation (p=0.039), troponin-I (p=0.029) and PAP (p=0.032), but there was no difference between the groups in terms of NLR (p=0.796), MLR (p=0.656), PLR (p=0.863), and d-dimer (p=0.343). There was a statistically significant difference between patients who did (n=6) and did not (n=37) receive thrombolytic treatment in terms of troponin-I (p=0.012), but there was no difference between the groups in terms of NLR (p=0.861), MLR (p=0.335), and PLR (p=0.277). Conclusion: NLR, MLR, PLR and d-dimer levels were found not to be effective in determining the severity of PE. Troponin-I was associated with sPESI and was considered as an effective marker in determining the thrombolytic treatment.

Aim: This study was planned to determine cut-off values of the Tinetti Performance Oriented Mobility Assessment (POMA) and the Self-Assessment Fall Risk Questionnaire (FRQ) in older adults with mild cognitive impairment.Material and Methods: This study included a total of 213 individuals aged 65 years and over in the study. These individuals were divided into two groups according to Mini Mental Test (MMT) scores: 116 individuals with an MMT score of 18-23 (mild cognitive impairment) and 97 individuals with an MMT score of 24 or more (normal cognitive function). Balance and gait performance was assessed by the POMA, the fall risk self-assessment by older adult susing a FRQ.Results: In Older Adults with mild cognitive function, the clinical cut-off points for the POMA and FRQ were determined according to ROC curve analysis. The clinical cut-off point for the POMA was determined as 15.5 points; and 15.5 points or more in the POMA were considered normal with a 95% confidence level. The clinical cut-off point for the FRQ was determined as 4.5 points; and 4.5 points or less in the FRQ were considered normal with a 95% confidence level.Conclusions: We think that it is important to take the values obtained in the present study into account in interpreting the above-mentioned commonly used tests when cognitive status is considered related to falling. Therefore, it is suggested that these tests used in the clinic should be examined considering the risk of falling in older adults with mild cognitive function.