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INTRODUCTION: Ophtalmic pathologies may be seen in various liver diseases related to autoimmunity, complications, drugs and other treatment modalities. In this study we aimed to assess the ophtalmic findings in autoimmune liver diseases (AILD) including Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), Overlap Syndromes and Primary Sclerosing Cholangitis (PSC). METHODS: Patients with AILD under follow-up in gastroenterology department in a tertiary hospital (Istanbul Medeniyet University, Goztepe Education and Research Hospital) were examined by an ophtalmologist blind to the diagnosis. A detailed ophthalmic examination, including external inspection of eye and eye lids, visual acuity, pupillary reaction, ocular movements, and ophthalmoscopy were performed. The demographic data and ocular findings were statistically analysed. RESULTS: The total registered patients in a single center with AILD were 111 (101 female and 10 male; 55 PBC, 44 AIH, 10 Overlap and 2 PSC) fulfilling relevant criteria for diagnosis. The mean age of the patients were 56,4±13,6 (23–84). Of these 13 patients had died related to liver problems. Ophtalmic examination could be done in 156 eyes of 78 patients. with AILD. The prominent ocular findings of 156 eyes of 78 patients were cataract (12,8%) and dry eye (11,5%). corneal sensitivity, uveitis, diabetic retinopathy (2,56% each), corneal lesions, episcleritis, macular degeneration, blepharitis, arcus senilis, conjunctival nevi and floating specks (1,28% each). xanthelasma was present on eyelids only in 3 patients (3,8%) and all were female PBC patients. All cataract patients were female and the ages were less than 60 in 5 of them and the youngest was 38 years old. Remaining 90 eyes of 45 patients (57.6%) had no distinct pathological ocular finding. Also, no glaucoma was assessed in this cohort. CONCLUSION: In our AILD patients, ophtalmic findings were primarily cataract and dry eye. Xanthelasma which is closely related with high total cholesterol level was infrequent in our patients than some reports indicating it as 15–33% of PBC patients. Other findings were not seen in a high majority of AILD patients than other autoimmune diseases as rheumatoid arthritis, Reiters or SLE.

INTRODUCTION: Thyroid diseases may be seen in various autoimmune and viral liver diseases related to autoimmunity, complications, drugs and other treatment modalities. Revised International Autoimmune Hepatitis Group score adds 2 points for accompanying thyroiditis or another autoimmune disease presence (1,2,3). In this study we aimed to assess the thyroid findings in autoimmune liver diseases (AILD) patients including Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), Overlap Syndromes and Primary Sclerosing Cholangitis (PSC). We aimed to assess the thyroid pathologies in our AILD cohort. METHODS: Patients with AILD under follow-up in gastroenterology department of a tertiary hospital (Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey) were investigated with palpation, thyroid function tests, autoantibodies and thyroid ultrasonography. The demographic and laboratory data were statistically analysed. RESULTS: The total registered patients in a single center with AILD were 111 (101 female and 10 male; 55 PBC, 44 AIH, 10 Overlap and 2 PSC) fulfilling relevant criteria for their diagnosis. The mean age of the patients was 56,4±13,6 (23–84). Of these,13 patients had died previously related to liver problems. Of these 98 patients, Hashimoto thyroiditis (21.4%), Hypothyroidia (10%) and Basedow-Graves disease (3.0%) were assessed (Table 1). Thyroid ultrasonography revealed 74.3% had heterogenous parenchyma and 28% had thyroid nodüle(s). One patient had papillary carcinoma which later treated appropriately. Nineteen patients (19.4%) were receiving L-thyroxin. CONCLUSION: In our AILD patients, thyroid findings were primarily Hashimoto’s thyroiditis and heterogenous parenchyma. Incidentally a thyroid papillary carcinoma was detected and treated appropriately. There was no difference between subgroups by means of thyroiditis and parenchymal heterogenity. Treatment response and clinical severity were not related with thyroid manifestations. Intermittent controls of thyroid gland in AILD patients may be crucial to detect thyroid pathologies before advanced disease.

Background and Aims:Vitamin B12 and folate are two important vitamins necessary for cell division, proliferation and DNA synthesis. In this study, we aimed to evaluate the levels of B12 and folate as indicators of liver metastases of stomach and colon cancer. Materials and Methods: The study group consisted of 31 patients with colon cancer, 30 patients with gastric cancer and 30 healthy control subjects. Presence of liver metastases was evaluated by computerized tomography. Patients with or without liver metastases were compared with the control group in terms of vitamin B12 and folate levels. Results: Twelve (40%) patients with gastric cancer and 8 (25.8%) patients with colon cancer had liver metastases. Folate levels were significantly lower (p, Giriş ve Amaç:Vitamin B12 ve folat hücre bölünmesi ve çoğalması için gerekli olan DNA yapımında yer alan iki önemli vitamindir. Bu çalışmada vitamin B12 ve folat düzeylerinin mide ve kolon kanserinde karaciğer metastazı göstergesi olarak değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 30 mide kanserli ve 30 kolon kanserli hasta ile kontrol grubu olarak 30 sağlıklı kişi alındı. Hastaların karaciğer metastazları bilgisayarlı tomografi ile değerlendirildi. Metastatik olan ve olmayan gruplar vitamin B12 ve folat düzeyleri açısından karşılaştırıldı. Bulgular: Mide kanserli hastaların 12'sinde (%40), kolon kanserli hastaların 8'inde (%25.8) karaciğer metastazı saptandı. Folat değerleri, kanserli grupta kontrol grubuna göre anlamlı derecede düşük bulunurken (p

Altmış üç yaşında kadın hasta halsizlik nedeni ile doktora başvurmuş. Biyokimyasal tetkiklerinde demir eksikliği anemisi saptanmış. Bunun üzerine yapılan üst gastrointestinal endoskopisinde midede hareketli Ascaris lumbricoides izlendi. İşlem sırasında snare yardımı ile çıkarıldı (Resim-1 ve 2). Albendazol 400 mg/gün başlanan hastaya poliklinik kontrolü planlandı.

Nonalcoholic fatty liver (NAFL) has an extensive clinical spectrum ranging from simple fatty liver to steatohepatitis and cirrhosis. Its pathogenesis is multifactorial. The aim of our study was to measure the serum levels of some cytokines (IL-1b, IL-6, IL-8 and TNF-a), which are thought to play a role in the pathogenesis of NAFL. Thirty subjects (18 males, 12 females) with clinical and laboratory features of hepatosteatosis were enrolled in the study as the patient group (group 1) and 30 healthy subjects (21 males, 9 females) served as controls (group 2). The levels of hepatic transaminases, gamma-glutamyltransferase, alkaline phosphatase, total cholesterol, IL-1b, IL-6, IL-8 and TNF-a were studied in both patients and controls. Serum IL-1b, IL-6, and TNF-a levels did not display significant differences between the patients and the controls (P > 0.05). On the other hand, the IL-8 level was significantly elevated in the patient group (P < 0.05). This increased level may play a more active role in the pathogenesis of fatty liver than IL-1b, IL-6 and TNF-a. Further studies are needed to elucidate to what extent the proinflammatory cytokines (especially IL-8 and TNF-a) are involved in the pathogenesis of NAFL.

Background/Aims: To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C.Materials and Methods: A total of 104 chronic hepatitis C patients were included in this non-interventional, openlabel, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points. Results: The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.0210.607).Conclusion: Our findings revealed significant associations between insulin resistance and hepatic fibrosis.

The aim of this study was to determine clinical value of alone and combined use of serum cytokeratin (CK)-18, carcinoembryonic antigen (CEA) and CA 19-9 in esophageal squamous cell carcinoma and gastric adenocarcinoma. Serum tumor markers were measured in 60 patients who had esophageal squamous cell carcinoma or gastric adenocarcinoma. Thirty healthy subjects served as controls. In patients with gastric adecarcinoma serum CK-18 levels were significantly increased compared to both esophageal squamus cell carcinoma and control groups (p0.05). On the other hand, serum CEA and CA 19-9 levels did not differ between groups (p>0.05). The sensitivity of serum CK-18, CEA and CA19- 9 in esophageal squamous cell carcinoma were 53%, 70% and 66%, respectively. For gastric adenocarcinoma, the sensitivity of each tumor marker was similar 70%, 70% and 70%, respectively. CK-18/CA19-9 combination in the esophageal (83%) and gastric carcinomas (93%) were found to be more sensitive than other tumor markers when these markers were evaluated in combination.CEA exhibited the highest sensitivity for esophageal squamous cell carcinoma compared to CK-18, and CA19-9. However, the sensitivity of all tumor markers in gastric adenocarcinoma were similar. The combination of CK-18 and CA19-9 could increase the diagnostic sensitivity in esophageal and gastric carcinomas.Keywords: Esophageal carcinoma, gastric carcinoma, cytokeratin-18, CEA, CA19-9

Background Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome (MS). However, not all patients with the MS will develop NAFLD and not all patients with NAFLD have the MS. We sought to investigate the differences between patients with biopsy-proven NAFLD with and without the MS. Methods A total of 357 consecutive patients with biopsy-proven NAFLD were analysed. Of them, 216 patients had nonalcoholic steatohepatitis (NASH) and 96 a fibrosis score = 2. The MS was defined as = 3 of the ATP III criteria. Results A total of 214 patients with NAFLD met the criteria for the MS, while the remaining 143 did not. In NAFLD patients with the MS, homeostasis model of insulin resistance (P = 0.03; OR, 1.06; 95% CI, 1.0231.25 per unit increase) and diabetes (P = 0.01; OR, 1.2; 95% CI, 1.12.4) were independent predictors of NASH. In NAFLD patients without the MS, the only variable independently associated with NASH was haemoglobin (P = 0.007; OR, 1.9; 95% CI, 1.43.6 per 50 g/L increase). Alanine aminotransferase (P = 0.03; OR, 1.04; 95% CI, 1.0061.11 per 10 U/L increase) was an independent predictor of fibrosis = 2 in NAFLD patients with the MS, while haemoglobin (P = 0.02; OR, 1.4; 95% CI, 1.21.9 per 50 g/L increase) was the only variable significantly associated with fibrosis = 2 in NAFLD patients without the MS. Conclusions Increased haemoglobin in NAFLD subjects without MS should be considered in the selection of cases for histological assessment. Marmara University

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Nonalkolik karaciğer yağlanması (NAFLD), artık dünyada en yaygın karaciğer hastalığı olarak kabul edilmektedir. Bu, basit steatozdan steatohepatite, son dönem karaciğer hastalığına (siroz) ve hepatoselüler karsinoma kadar gidebilen farklı derecedeki durumlar için kullanılan genel bir isimdir. Bu durum sıklıkla metabolik sendromun özelliklerini gösterir ve insülin rezistansı ile ilişkilidir. Hastalık asemptomatik karaciğer enzim yüksekliğinden siroza ve karaciğer yetersizliğinin komplikasyonlarına kadar değişik şekillerde görünmektedir. Bu derlemede NAFLD etiyolojisi, patogenezi, tanısı ve tedavi yaklaşımları tartışılmıştır.

ÖZETBu araştırmada, çay yapraklarını sürekli akışla fabrikanın istenilenye/ine taşıyabilen sistemi geliştirmek amaçlanmıştır. Pnömatiktaşıma ve bandlı konveyörle taşıma prensipleriyle çalışan iki denememodeli yapılmıştır. Pnömatik taşıma için 'yaprağı zedelemeden sevk edebilecekhava hızları smıfları, hava hızı ile basınç kaybı ve ventüri datalmasıarasındaki ilişkiler ve yaprağın şekil katsayısı denemelerle saptanmıştır. Elde edilen optimal değerlerden faydalamlatak 7,5 ton/hkapasitelipnömatik taşıyıcı imal edilmiştir.Bandlı konveyör deneme modelinde taşıma mesafesi, meyil derece·recesi ııe güç ihtiyacı arasındaki bağıntılar saptanmıştır.Işçi eliyle taşıma, pnömatik taşıma ve bandiı konveyörle taşımaçeşitli yönleriyle biribi;/eri>;.le karşılaştırılmıştır.ZUSAMMENFASSUNGDie von Tag zu Tag grösser werdendenProbleme des türkischen Tees könnendUTch entspreehende ıu treffende Mass: "nahmen beim Teeanbau, Teeverarbeitungİn der Fabrik und Marketingge1öst werden.In türkischen Teefabriken werden sehrgrosse Mengen von Arbeitskraften zurTeeblaetterbeförderung benötigt. Diehohe Arbeiterbeschaftigung und derEnergieverbıauch der Verarbeitung desTees wİrkten sich um 60% auf dieHeı:.stellungskosten des Tees aus.Zwecks Mechanisierung der Blaetterbeförderungwurde eine pneumatischeund auch eine mechanische Förderanlageals Versuchsmodell gebaut.Diese beiden iFörderanlagen ermöglicheneine leiclıte und beschaedigungloseFörderung der Blatter in höher gelegeneStockwerke der Fabrik und einefast vÖllİge Abschaffung der dazu erfordedichenArbeitslCraefte.Durch Versuche wurden die optimatenLuftgeschwindigkeiten, die ökonomischenGrenzeıı der Masse, Bandgeschwindİgkeİtenu.a. ermittelt. Die vergleichendenUnteıschiede bei der Anwendungvon Arbeiters, der pneumatischenFörderung und der Bandförderanlagewurden ermittelt. Die pneumatischenund mechanischen Anlagen könnenvon jeder Fabrik ohne schwierigenAufwand gebaut werden und eine grosseKostensenkung der Teeherstellungermöglichen.

ÖZETDoğu Arıad.olu, özellikle Van yöresi çiftçisi asırların tecrilbesiylekazandığı özel ekim şeklini - Tir sabanıyla ekimi uygu~amaktadır. Yöreniniklim ve toprak şartlarında diğer ekim metodlarmdan istediği verimi a/amayançiftçi, tir sabanıyla ayni ekimi yapabilen fakat iş kapasitesibüyük tir ekim makina/arma gereksinme duymaktadır. Çiftçi bö/ge demircilerinewnar/ama olarak traktörle çekilen tir akim makinaları yaptırmaktadır.T. Z. D. Kurumu tarafindan 1976 yılında imal edilen traktöre asmatip tir ekim makinası, bu konuda labrikasyon tekniğiyle yapılan ilkmakina özelliğini taşımaktadır. Bu makine Erzurum toprak ve iklimşartlarında denenmiş'deneme sonuçlarıyla makinanın bu yörede kullanılabilmeolanakları saptanmıştır.ZusammenfassungDie Ermittlung der Testwerte und der Anwendungsmöglichkeit der "Tir" Sae-und Düngemasçhine, Bauart T.Z.D.K. unter Erzurumer Klima- und BodenverhaltnisseNach jahrhundertelangen Erfahrungender Ostanatolisehen Bauem wurdein diesem Gebiet ein Hakenpflug,den man aueh als Siivorbereitungsmaselıirıebezeiehnen kann und der einekanaliihnliche Furehe hinterIiiBt, entwiekelt.Die Samen für die Wintersaatwerden mit der Hand in die Kanalsohle- feuente Brdschicht - gesaet. Dasist die einzige Saemet~ode - genannt"Tir" -unter ariden Klirrlaverha'ltnissen,die eine Ernte risikofrei maeht.Die Bauem brauehen eine Saemasehine,die die Funktion eines Sapflugesersetzt und mit Traktorenzug und groBererArbeitsbreite grö~ere Kapazitatenerreicht. Die in den örtlichenSehmiedewerkstatten naeh BesteIlunggebauten Masehinen erfül1en diese Bedingungennieht ausreiehernd. Oeshalbwurde vom T.Z.O.K. die erste fabrikgebaute'Tir" Samasehine filreine Traktoren-Anhangevorriehtung he rgestetllt .Oiese Masehinewurdlbei ErzurumerBoden- und Klimaverha1t- nissengetestet, um die Anwendungsınöglickkeitenzu. ermitteln.

ÖZETTarım tekniğinde ürünlerin işlenmesi ve tarımsal işlemler esnasında çalışan ınsan veku/lamlan makinaların emniyetini tehlikeye sokac((lk oranlarda toz oluşmaktadır. Havanınfozla kirlenmesinde insan, hayvan ve makinaların zarar gördükleri toz konsantrasyonusınırlaruaptanmıştır. Sağlığı ve çalışma emniyetini koruyacak şfkilde havanın ·temitlenmesigerekmektedir.Toz ayırıcı aygıtlar tozları ağırlıkları ve merkezkaf kuvvet ekkisinde- bırakılmaları,statik elektrikle yüklenmeleri. dı:j sürtünme kuvvetinin artırılması ve benzeri fizikselkuvvetleıinin etkilerininin düzenlenmeleri prensipleriyle çalışmaktadırlar. Bu fiziksel kuvvetlerinetki tarzını ve bağıntılarını açıklayan teorik ve deneysel eşitlikler araştırıcılareliyle ortaya konulmuştur.

Background/Aims: The aim of this study is to observe the relationship between the expression of vascular endothelial growth factor (VEGF), microvascular density (MVD) and the pathological characteristics of gastric carcinoma.