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Aim: In this study, we aimed to investigate the effect of betahistine dihydrochloride (BD) use on positional nystagmus as an objective criterion for the diagnosis of benign paroxysmal positional vertigo (BPPV).Methods: The retrospective study included 59 patients (15 males, 44 females) who were aged between 18 and 80 years and referred with suspected BPPV to the otorhinolaryngology clinic of the Istanbul Training and Research Hospital. Only patients who had no central pathology on oculomotor tests were included. Of the patients included, those not using BD were classified as Group I and those using BD medication (24 mg/day) within the last 48 hours as Group II. The positional nystagmus latency, duration, and slow-phase velocity (SPV) values were compared using videonystagmography.Results: There was no significant difference between the two groups in terms of oculomotor gains (p>0.05). While there was no difference between the two groups in terms of positional nystagmus latency and SPV values, nystagmus duration was found to be significantly longer in Group II. Conclusion: Although the BD use appears to prolong the duration of nystagmus in BPPV, it does not affect the other parameters of nystagmus, including SPV, and the prolonged duration is still within normal limits. Positional nystagmus can be investigated in patients with a history of suspected BPPV and BD prescription.

In recent years, as a result of the rapid increase in population and industrial development, the need for energy has increased. Many investments are made especially for electrical energy which is an inevitable requirement for the industry. Most of these investments are made by using fossil resources in countries’ lands. Fossil sources are known to be consumable as well as too poisonous gases they give to the atmosphere during energy production. This situation causes global climate change. To prevent climate change, the carbon emitted to the atmosphere has to be brought under a certain control mechanism. In this context, the first Kyoto Protocol and then Paris Climate Agreement was signed. Under these agreements, countries will be responsible for the level of their greenhouse gases in the atmosphere. This situation led to the carbon trade among countries. This situation accelerated the transition of countries from fossil sources to renewable energy sources. In this study, the effect of hydroelectric power plants, one of the renewable energy sources, on carbon emissions was investigated. According to the results, based on fossil sources of 408,533.57 tCO2 per year from Turkey Gokcekaya dam has been shown to reduce the carbon footprint.

Nowadays, the continuity of all activities related to industrial production is essential for the sustainability of modern life. In order to achieve this, it is necessary to ensure the continuity of...

Stormwater, which cannot penetrate the soil surface due to the impermeable layer created by urbanization, inevitably causes floods. Therefore, the change in urban areas and calculation of flood siz...

Objective: The objective of this study is to evaluate the effect of diagnostic ureterorenoscopy (URS) prior to radical nephroureterectomy (RNU) on intravesical recurrence (IVR), in patients with primary upper urinary tract urothelial carcinoma (UTUC). Materials and Methods: Retrospective analysis of 354 patients, who underwent RNU for UTUC from 10 urology centers between 2005 and 2019, was performed. The primary endpoint was the occurrence of IVR after RNU. Patients were divided into URS prior to RNU (Group 1) and no URS prior to RNU (Group 2). Rates of IVR after RNU were compared, and a Cox proportional hazards model was used to evaluate potential predictors of IVR. Results: After exclusion, a total of 194 patients were analyzed: Group 1 n = 95 (49.0%) and Group 2 n = 99 (51.0%). In Group 1, a tumor biopsy and histopathological confirmation during URS were performed in 58 (61.1%). The mean follow-up was 39.17 ± 39.3 (range 12–250) months. In 54 (27.8%) patients, IVR was recorded after RNU, and the median recurrence time within the bladder was 10.0 (3–144) months. IVR rate was 38.9% in Group 1 versus 17.2% in Group 2 (p = 0.001). In Group 1, IVR rate was 43.1% in those undergoing intraoperative biopsy versus 32.4% of patients without biopsy during diagnostic URS (p =0.29). Intravesical recurrence-free survival (IRFS) was longer in Group 2 compared to Group 1 (median IRFS was 111 vs. 60 months in Groups 2 and 1, respectively (p< 0.001)). Univariate analysis revealed that IRFS was significantly associated with URS prior to RNU (HR: 2.9, 95% CI 1.65–5.41; p < 0.001). In multivariate analysis, URS prior to RNU (HR: 3.5, 95% CI 1.74–7.16; p < 0.001) was found to be an independent prognostic factor for IRFS. Conclusion: Diagnostic URS was associated with the poor IRFS following RNU for primary UTUC. The decision for a diagnostic URS with or without tumor biopsy should be reserved for cases where this information might influence further treatment decisions.

Objective:We aimed to investigate the factors affecting intravesical recurrence and survival in patients undergoing radical nephroureterectomy and bladder cuff excision due to primary upper urinary system urothelial tumor (UUST) in our clinic.Materials and Methods:The data of 52 patients who were operated for primary UUST between 2008 and 2018 were retrospectively evaluated. All patients underwent preoperative computed tomography and magnetic resonance urography. Tumor localizations were grouped according to the ureteropelvic compound. During the follow-up period after radical surgery, the patients underwent physical examination, routine blood tests and radiological evaluation. The patients were followed up quarterly in the first two years, every six months for the next two years and then yearly with cystoscopy.Results:Thirteen female and 39 male patients with an average age of 60.5±10.35 years were included in the study. Mean follow-up time was 66.8±38.2 months. Thirty (58%) patients had renal tumors, 13 (25%) patients had ureteral tumors and 9 (17%) patients had multifocal tumors. Intravesical recurrence was detected in 9 (69%) patients with ureteral tumor (p=0.047). Ten-year overall survival of patients with ureteral tumors was 50% (35.4% side effect) (Log rank test=0.012). Recurrent-free survival was significantly worse in ureteral tumors (Hazard ratio:3, p=0.04).Conclusion:The ureteral tumor group was significantly worse in terms of postoperative intravesical recurrence and overall survival and recurrence-free survival.

Adrenal gland surgery has been practiced by the urologists ever increasingly in line with their interest in this particular field. Total adrenalectomy which is the classical approach for adrenal masses, is replaced by the organ-sparing surgery as soon as the significance of the organ sparing approach is understood as in the case of the renal masses. The partial adrenalectomy which has been in use through open surgery method since 1950’s, was adapted to adrenal surgery by Gagner in 1991 and technical advancement was achieved since then with the introduction of the laparoscopic adrenalectomy by Janetschek six years later. Although it is increasingly being used, there still exist ambiguities concerning the technique and indications of the adrenal sparing surgery. In this review, the updated status of the adrenal sparing surgery is discussed with the current literature.

In recent years, it is known that Geographic Information Systems (GIS) provide fast and practical solutions in large research areas in the selection of dam locations. In the study, the dam points to be selected for the determination of the hydroelectric energy potential were determined by two different methods. In the first method, the head, precipitation, evaporation and flow characteristics of the basin were modeled by using Geographic Information System (GIS). This method, which provides a simple and fast solution, is based on the potential energy of water. The amount of potential energy to be produced in this method (100-200 kW; 200-400 kW, up to 0.5 MW) and its location, on main stream and on side stream in the basin is shown on the map. In the second method, the authors decided on the most suitable dam location from the points in the first method. While doing this, a model was used by considering factors such as flow potential, topography, valley status and geology, which are important in the choice of dam location. Then, the amount of annual energy to be produced from this dam, the cost of the dam and the self-amortization of the dam were calculated. As a result of the study, the cost of the dam is $ 2.39 million; annual energy production 2.17 GWH/year; the self-amortization time was calculated as 9.3 years.

Objective: To answer the question whether balance related systems have been affected in adults who recovered from Covid-19 disease. This is the first case-control study to assess balance objectively and quantitatively in Covid-19 disease.Methods: Thirty-seven patients who recovered from Covid-19 disease and 30 healthy controls were compared using Dizziness Handicap Inventory (DHI), Computerized Dynamic Posturography (CDP), Vestibular Evoked Myogenic Potentials(VEMP) and Video Head Impulse Test (v-HIT).Results: On CDP, the composite and visual general scores of the patients were significantly lower than controls (p < 0.01). The v-HIT gains of the patients significantly decreased in the vertical semicircular canals compared to controls (p < 0.01).There was a significant difference between the patients and controls regarding the absence of o-VEMPs (p < 0.01) while the amplitudes and latencies were similar between the groups (p > 0.05). Decreased P1/N1 amplitudes and elongated N1 latencies were found on c-VEMP testing (p < 0.05). Anosmia, taste disorder and gender were not associated with subjective and objective test results (p > 0.05).Conclusion: The Covid-19 disease can cause dizziness rather that incapacitating vertigo. Dizziness can be seen in almost one-fifth of the adult covid19 out-patients, which may be due to involvement of vestibular and visual systems,ortheir central connections. The squeals created in the balance related systems may be irreversible as they have persisted after the recovery of the patients. It is also plausible to anticipate more severe condition in the older patients who were treated in the intensive care units. In the long term follow up of the survivors, the need for balance rehabilitation programs should be remembered in order to minimize risks of falling down.

Objectives To investigate the predictors of acute kidney injury (AKI) after partial nephrectomy and the impact of AKI stage on long-term kidney function. Methods Data of 1055 patients who underwent partial nephrectomy between January 2008 and January 2018 at seven separate tertiary centres were analysed. AKI was defined according to AKI Network criteria. The association between pre-operative and perioperative factors and AKI was evaluated using logistic regression analysis. Recovery of at least 90% of baseline glomerular filtration rate 1 year after partial nephrectomy, change of 1 year glomerular filtration rate compared with baseline glomerular filtration rate and stage >= 3 chronic kidney disease (CKD) progression were assessed according to the stage of AKI. Results AKI was recorded in 281 (26.7%) of 1055 patients after partial nephrectomy, and of these patients, 197 (70.1%) had stage 1, 77 (27.4%) had stage 2 and 7 (2.5%) had stage 3. Higher tumour complexity and baseline glomerular filtration rate were independent predictors for AKI. The proportion of recovering 90% of baseline glomerular filtration rate at 1 year for any patient who had stage = 3 CKD progression for any patient who had stage

OBJECTIVE: This study aimed to evaluate the effects of repeated pressure alterations on cochlear structures in rats in an attempt to understand indirectly the inner ear status of flight crew who are repeatedly exposed to pressure alterations.METHODS: There were 12 adult Wistar albino rats equally divided into 2 groups: Group 1 (controls) and Group 2 (study group). The animals in Group 2 were exposed to repeated pressure changes in a pressure cabin which is regulated by manometers. The animals in Group 1 were placed in the cabin without being exposed to pressure changes. Auditory brainstem response (ABR) testing was performed in all animals at the beginning and at the end of the study. After 12 wk the animals were sacrificed and their cochleas were investigated using scanning electron microscopy (SEM).RESULTS: In the study group, hearing decreases at 2 kHz, 4 kHz, 6 dB at 8 kHz, and 32 kHz were encountered at the end of 3 mo. On SEM evaluation of the control group, the outer hair cells (OHC) and stereocilia were normal throughout the cochlea. In the study group, there were irregularities in lateral surface connections and separations, collapse, and adhesions in the basal segment of the cochlea and partial loss of stereocilia throughout the cochlea.CONCLUSION: Repeated alterations in the atmospheric pressure can lead to damage in the inner ear with subtle or evident hearing loss. Frequent flyers like air workers may be at risk of inner ear damage, which may be considered an occupational health problem.Eroglu S, Dizdar HT, Cevizci R, Cengiz AB, Ogreden S, Bulut E, Ilgezdi S, Dilci A, Ustun S, Sirvanci S, Cilingir-Kaya OT, Bayazit D, Caki BO, Oktay MF, Bayazit Y. Repeated atmospheric pressure alteration effect on the cochlea in rats: experimental animal study. Aerosp Med Hum Perform. 2021; 92(7):550555.

Objective:We aimed to compare the safety and efficacy of upper, middle and lower calyx accesses obtained as isolated and single access in percutaneous nephrolithotomy (PCNL) operation which is performed for treating renal stones.Materials and Methods:The records of patients who had undergone PCNL via isolated single pole access due to renal stone between September 2007 and June 2018 were retrospectively evaluated. The patients were divided into three groups as isolated single upper calyceal access patients (group 1), isolated single middle calyceal access patients (group 2) and isolated single lower calyceal access patients (group 3). The patient groups were compared in terms of patient characteristics, stone size and location, operative data, postoperative outcomes and complications.Results:Fifty-seven (2.8%) patients who underwent isolated single calyceal access PCNL were included in group 1 (upper calyx), 542 (26.9%) in group 2 (middle calyx) and 1427 (70.4%) were included in group 3 (lower calyx). The mean age of the patients in groups 1, 2 and 3 was 43.09±15.00, 38.23±22.47 and 39.40±19.93, respectively. A thousand hundred and seventy-six (58%) patients were male and 850 (42%) were female. The mean stone burden was 367.19±266.48, 335.7±301.85 and 353.73±346.47 mm2 in groups 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.45, p=0.77, p=0.29, respectively). The mean operative time, mean fluoroscopy time, and mean nephrostomy time, and the mean length of hospitalization were statistically significantly longer in group 2 than in group 3. Stone-free rates in patients with clinically insignificant stones (SF + CIRF) were 89.5%, 89.6% and 91.6% in group 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.25, p=0.43 and p=0.6 respectively). There was no significant difference between the three groups in terms of postoperative fever, blood transfusion and overall complications.Conclusion:As a result, different isolated single calyceal accesses do not have superiority over each other in terms of stone-free rate and complications. A proper access is required while performing PCNL to remove the stones, decrease the comorbidity rates and prevent complications and the ideal way is the way that provides the shortest and the smoothest reach all stones.

In this study, it is aimed to develop the flood risk analysis of Porsuk River, which is responsible for naming of the Porsuk Basin sub basin of Sakarya Basin, by utilizing the methods of Remote Sensing (RS) and Geographical Information Systems (GIS). In addition, flood elevation effects of Porsuk River in Eskisehir city and the regions around were investigated. Necessary data for study were obtained from Eskisehir 3. Regional Directorate of State Hydraulic Works archives. For analyses, the cross section of Porsuk River was defined in the Hydrologic Engineering Centers River Analysis System (HEC-RAS) software. Subsequently, recurring periods of 50, 100 and 1000 years discharge of Porsuk River which is calculated as 51.83 m3/s, 60.15 m3/s and 86.66 m3/s respectively were inputted in the software to obtain analysis results. Obtained results from the present study and topographic data were compared and interpreted. As a result, elevation of flood and its risks for urban regions were studied and presented.

In this study, trends of minimum, average and maximum flows were investigated in Porsuk basin, which is a sub-basin of Sakarya basin and then changes in flows were mapped using Geographical Information Systems (GIS). In the study, in 10 flow gauging stations across the Porsuk basin, monthly average, maximum and minimum flow data is used covering the period 1961-2013 (53 years). When analyzing the distribution of observed trends in the basin, a trend has been observed in most of the river flows. A decreasing trend has been observed overall in the basin. Trends are generally decreasing over time except for a few stations. As a result, increasing trends are observed in the west part of the basin; while in the east part of the basin decreasing trends are observed. When average and maximum monthly flows are investigated, decreasing trends are observed in the stations except DSI-12182. Trend analysis of 10 flow gauging stations across the Porsuk basin is investigated by Mann-Kendall method. Trend distribution was made according to flow trends of basin by transferring Z values to GIS.

Background: Epstein criteria based on sextant biopsy are assumed to be valid for 12-core biopsies. However, very scarce information is present in the current literature to support this view. Objectives: To investigate the validity of Epstein criteria for clinically insignificant prostate cancer (PCa) in a cohort of the currently utilized 12-core prostate biopsy (TRUS-Bx) scheme in patients with low-risk and intermediate-risk PCa. Method: Pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian) scheme and in all 12-core schemes. Patients were divided into 2 groups according to the final pathology report of RP as true clinically significant PCa (sPCa) and insignificant PCa (insPCa) groups. Predictive factors (including Epstein criteria) and cutoff values for the presence of insPCa were separately evaluated for 6- and 12-core TRUS-Bx schemes. Then, different predictive models based on Epstein criteria with or without additional biopsy findings were created. Results: A total of 442 patients were evaluated. PSA density, biopsy GS, percentage of tumor and number of positive cores, PNI, and HG-PIN were independent predictive factors for insPCa in both TRUS-Bx schemes. For the 12-core scheme, the best cutoff values of tumor percentage and number of positive cores were found to be ≤50% (OR: 3.662) and 1.5 cores (OR: 2.194), respectively. The best predictive model was found to be that which added 3 additional factors (PNI and HG-PIN absence and number of positive cores) to Epstein criteria (OR: 6.041). Conclusions: Using a cutoff value of “1” for the number of positive biopsy cores and absence of biopsy PNI and HG-PIN findings can be more useful for improving the prediction model of the Epstein criteria in the 12-core biopsy scheme.

Introduction: Tinnitus is a widely seen otological symptom that interferes with daily activities and causes discomfort. Tinnitus treatments can be classified into 4 main groups: pharmacological treatments, cognitive and behavioral therapy, psychological treatments, and combined treatment approaches made up of at least 2 of these 3 treatment methods. Objective: The aim of this study was to assess whether it would be possible to develop an individualized treatment method of tinnitus by application of a combined tinnitus signal and music during sleep. Methods: Forty-three ears of 30 patients who had subjective tinnitus were included. The patients were evaluated using Tinnitus Handicap Inventory, Visual Analogue Scale, and Beck Depression Inventory. The psychoacoustic parameters of tinnitus, such as tinnitus frequency and loudness, and minimal masking levels, were determined. The patients were asked to select musical melodies that they liked. The tinnitus frequency of each patient was taken as the central frequency according to ANSI 2004. All sound files were prepared as stereo channels, with 16-bit resolution and 44,100 Hz sampling rate. The root mean square power value of the music and the band noise’s average root mean square power value were equalized with the “Amplification” command, and 70% of the music and 30% of wide/narrow-band noise were mixed as a stereo channel by the “Mix Paste” command. The patients were instructed to listen to that individualized music/narrow-band noise (tinnitus signal) for 2 h during sleep for a duration of 6 months. Results: Tinnitus frequencies of the patients measured prior to treatment and at the second, fourth, and sixth months of follow-up were not significantly different. A statistically significant decrease was seen in tinnitus loudness, minimal masking levels, and residual inhibition during the follow-up. Tinnitus Handicap Inventory scores decreased significantly during follow-up, and the number of patients who complained of tinnitus decreased (p < 0.05). The Visual Analogue Scale scores significantly decreased during follow-up (p < 0.05). Beck Depression Inventory scores decreased significantly during follow-up (p < 0.05). Conclusion: Stimulation of the auditory and limbic systems during sleep by the tinnitus signal combined with individualized musical melodies seems an alternative, effective, and cheap method in the treatment of tinnitus.

To determine the efficiency of prostate health index (PHI) calculated simultaneously during an ultrasound-guided fine-needle prostate biopsy in prostate cancer diagnosis.The present study included 258 subsequent patients who underwent a TRUS-guided biopsy in our clinic between August 2015 and March 2016 due to elevated blood levels of PSA and suspicion of prostate cancer. The total PSA, free PSA and pro-PSA were analysed in all patients before the procedure.The average age of 258 patients was 63.5 (36-91) years, and the mean PSA level and mean PHI values were 40.1 (0.12-2170) and 118 (0.41-1308), respectively. According to the PSA data, the patients were divided into two groups: the low PSA (4 ng/mL) group containing ten patients with adenocancer (31.2%) and 22 patients with BPH (68.8%) and the high PSA (4 ng/mL) group consisting of 86 patients with adenocancer (42.2%) and 118 (57.8%) with BPH. The sensitivity and specificity of PSA in detecting prostate adenocancer were calculated as 89.6% and 15.7%, respectively. Similarly, when a PHI level below 55 was accepted as low, and a PHI level at or above 55 was accepted as high, PHI's sensitivity and specificity were determined as 71.9% and 67.9%, respectively.The overall findings indicate that the specificity of PHI is higher than PSA in terms of prostate cancer detection.

PURPOSE To compare the functional outcomes of patients who underwent partial (PN) or radical nephrectomy (RN) for clinical T1 (cT1) renal tumours using the Kidney Cancer Database of the Urooncology Association, Turkey. METHODS We retrospectively reviewed 1004 patients who underwent PN and RN for cT1 renal tumours at multiple academic tertiary centres between 2000 and 2018. Patients with preoperative end-stage chronic kidney disease and/or metastatic disease were excluded. RESULTS There were 452 patients in the PN group and 552 patients in the RN group. The median follow-ups were 74.9 and 83.7 months in RN and PN cohort. The eGFR was significantly reduced in both groups on postoperative day 1 (PN = 13.7 vs RN = 19.1 mL/min/1.73 m2 : P

Objective: We evaluated the influence of percutaneous nephrolithotomy (PCNL) on the estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD). Materials and Methods:...

Porsuk River Basin, located in the Central Anatolia, Turkey, has a drainage area of 10818.41 km2 and a total length of 460 km, which makes it a significant region for a variety of hydrological and hydropower studies. Therefore, it is necessary to determine the rainfall distribution over the basin so that related projects and processes, such as dam planning works, can be properly performed. To fulfil this aim, the meteorological data gauged between 1927-2015 by 15 different stations within and around the study area were used to perform interpolation functions with three widely known spatial distribution methods, namely Thiessen Polygons (TP), Spline (SP) and Inverse Distance Weighting (IDW), for the determination of the rainfall distribution. Moreover, the reliability of these methods was also evaluated and compared in terms of their Mean Absolute Error (MAE), Mean Square Error (MSE), Root Mean Square Error (RMSE) and Correlation Coefficient (R2) values. The results revealed that IDW method, in general, was the most appropriate option for Porsuk River Basin in comparison with SP and TP methods, as MAE, MSE, RMSE and R2 values of this method was found 33.359, 1710.385, 41.357 and 0.7118 respectively. However, TP displayed smoother results at the points where the rain gauges were closer to each other or dense., Porsuk River Basin, located in the central Anatolia, Turkey, has a drainage area of 10818.41 km2 and a total length of 460 km, which makes it a significant region for a variety of hydrological and hydropower studies. Therefore, it is necessary to determine the rainfall distribution over the basin so that related projects and processes, such as dam planning works, can be properly performed. To fulfill this aim, the meteorological data gauged between 1927-2015 by 15 different stations within and around the study area were used to perform interpolation functions with three widely known spatial distribution methods, namely Thiessen Polygons (TP), Spline (SP) and Inverse Distance Weighting (IDW), to estimate the rainfall distribution. Moreover, the reliability of these methods were also evaluated and compared in terms of their Mean Absolute Error (MAE), Mean Square Error (MSE), Root Mean Square Error (RMSE) and Correlation Coefficient (R2) values. The results revealed that IDW method, in general, was the most appropriate option for Porsuk River Basin comparison with methods of SP and TP, as it generated the MAE, MSE, RMSE and R2 values of 33.359, 1710.385, 41.357 and 0.7118 respectively. However, TP displayed a smoother result at the point, where the rain gauges are closer to each other or highly densed.

WOS: 000571741400004 PubMed ID: 32902699 In recent years, it has been difficult to establish a supply-demand balance between urban growth, increasing population, and existing water resources in many countries. In this study, the Bodrum Peninsula, which is an important tourism center for Turkey, was examined in terms of the relationship between the urban growth of the peninsula, population projections, the need for drinking and potable water, and the availability of the existing water resources. Using the Geographic Information System, it has been determined that the urban growth of the peninsula increased by 11.36% between 1985 and 2010. Urban growth is mostly concentrated in the coastal areas where 2 houses are densely built. The population is expected to increase approximately six times between 2010 and 2060. The amount of drinking and potable water required according to the population projection is 12.38, 26.50, 69.12, and 109.50 hm(3)/year for 2010, 2030, 2050, and 2060 respectively. The existing water resources of the peninsula will be able to meet the requirements until 2030. In order to meet the water needs of the peninsula until 2055, the Bozalan and Gokceler dams located nearby as well as the Namnam dam located at mid-range to the peninsular should be built. It is not possible to meet the water needs of the peninsula in 2060 with just the near and medium distance water resources. However, by supplying water from the Akkopru dam located at a further distance, it is possible that 2060 water needs can be met.

The combining of evaluation instruments into Geographic Information System (GIS) environments has caused an advancement in solidifying the evaluation and analysis of the hydropower potential existing for the streams in the case of the spatial variability of different factors affecting stream power. GIS spatial analyses are very useful for the development of various methodologies which can be used to calculate hydropower potentials. Geographic Information System based hydrological modeling is conducted on equiareal raster cells by utilizing topographical and meteorological datasets. The input data are then compiled and analyzed using GIS data layers, including topographic characteristics, monthly evaporation and precipitation data. This is essential as it allows for determination of water streams, which have sufficient or high amounts of water and also the potential for showing possible locations where hydropower plants can be constructed. This study aims to analyze the application of a Geographical Information System for computing the theoretical surface hydropower potential by taking Bilecik regional Sakarya Basin of Turkey as a case study. The study has shown that streams found in the Bilecik region have a good potential for hydropower production. In the study area, 85 possible designated locations of small hydropower plants (SHP) have been determined allowing for different annual energy production levels. The results of this study are very significant for the regional planning in collaboration with decision making authorities such as politicians and technical staff, so that hydropower plant construction and operations can be maximized in efficiency.

Geographical data are of great importance in meteorology and climate science. These data can create the areal distribution models analyzed by spatial interpolation methods. The values of the areas without measurement data are estimated with these distribution models. In this study, distribution of meteorological parameters such as precipitation, temperature and evaporation in Porsuk basin, which is determined as research area, was investigated by Inverse Distance Weighting (IDW) and Ordinary Kriging methods. Actual meteorological data analyzed of the basin do not show a normal distribution statistically. Therefore, the data were firstly subjected to normalization and then analyzed according to the IDW and Ordinary Kriging methods to create distribution maps of precipitation, temperature and evaporation data. Quadratic mean error values were compared to investigate the reliability of analyzes. In this study, the analysis results of precipitation, temperature and evaporation data have been calculated by two different methods. Ordinary Kriging method has been determined as the method making the most accurate estimation.

Background The management of adrenal incidentaloma is still a challenge with respect to determining its functionality (hormone secretion) and malignancy. In this light, we performed 18F-FDG PET/CT scan to assess the SUVmax values in different adrenal masses including Cushing syndrome, pheochromocytoma, primary hyperaldosteronism and non-functional adrenal adenomas. Methods Total 109 (73 F, 36 M) patients with adrenal mass (incidentaloma), mean age of 53.3 ± 10.2 years (range, 24–70) were screened by 18F-FDG PET/CT. Data of 18F-FDG PET/CT imaging of the patients were assessed by the same specialist. Adrenal masses were identified according to the calculated standardized uptake values (SUVs). Clinical examination, 24-h urine cortisol, catecholamine metabolites, 1-mg dexamethasone suppression test, aldosterone/renin ratio and serum electrolytes were analyzed. Results Based on the clinical and hormonal evaluations, there were 100 patients with non-functional adrenal mass, four with cortisol-secreting, four with pheochromocytomas and one with aldosterone-secreting adenoma. Mean adrenal mass diameter of 109 patients was 2.1 ± 4.3 (range, 1–6.5 cm). The 18F-FDG PET/CT imaging of the patients revealed that lower SUVmax values were found in non-functional adrenal masses (SUVmax 3.2) when compared to the functional adrenal masses including four with cortisol-secreting adenoma (SUVmax 10.1); four with pheochromcytoma (SUVmax 8.7) and one with aldosterone-secreting adenomas (SUVmax 3.30). Cortisol-secreting (Cushing syndrome) adrenal masses showed the highest SUVmax value (10.1), and a cut-off SUVmax of 4.135 was found with an 84.6% sensitivity and 75.6% specificity cortisol-secreting adrenal adenoma. Conclusions Consistent with the similar studies, non-functional adrenal adenomas typically do not show increased FDG uptake and a certain form of functional adenoma could present various FDG uptake in FDG PET/CT. Especially functional adrenal adenomas (cortisol secreting was the highest) showed increased FDG uptake in comparison to the non-functional adrenal masses. Therefore, setting a specific SUVmax value in the differentiation of malignant adrenal lesion from the benign one is risky and further studies, including a high number of functional adrenal mass are needed.

In this research, distributions of precipitation, temperature and evaporation in Seydisuyu basin were analyzed with the help of inverse distance weighted (IDW) method. Because real meteorological data of the basin (precipitation, temperature and evaporation) do not have normal distribution, precipitation, temperature and evaporation distribution maps are drawn after normalization process. The number of meteorological stations, in other words the number of samples, is low, so only IDW method is used in this research. In addition to the research, reliability of the results obtained with the help of inverse distance weighting method was examined with accuracy analysis. The purpose of this study, the spatial distribution of meteorological data on a basin or areas is to demonstrate the applicability of the statistical basis.

This study has been conducted with the purpose of determining the hydroelectric potential that can be utilized by Cine dam which will be constructed for irrigation, overflow control and for energy production purposes on the Cine stream (which is located as an important arm of Buyuk Menderes River in Turkey). The study will also compare other research conducted by various organizations. In order to determine the hydroelectric energy potential, the SIMAHPP 4 (Simulate and Assess the Feasibility of Hydropower Projects) professional software has been utilized. It has been observed that the calculated hydroelectric potential conforms to energy potential calculated by other organizations such as DSI (State Hydraulic Works). Especially the turbine power, installed power, turbine design flow rate and annual energy production values in the studies have been realized with close values to the real ones. The power plant which is planned to have an average of natural streams of the past 43 years has been designed with an annual power production capacity of 210.87 GWh/year (without regulation ratio) and with installed power of 48,144 MW along with a design flow rate of 35 m3/s. As a result, since these water structures have high costs associated with them and also since they will have to be functional for many years, it will be beneficial to use various different computational methods.

WOS: 000408247500032 PubMed ID: 28816700 We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after complete removal of intracranial portion of jugular foramen schwannoma via the retrosigmoid approach. The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after suboccipital craniectomy. The recovery of sensorineural hearing loss and tinnitus after release of arachnoid adhesions may indicate the clinical significance of these adhesions or arachnoiditis, which should also be considered and investigated in the etiology of other neurotological diseases.

Objective : In this study, we investigated the concordance between Gleason scores of transrectal ultrasound guided biopsy and radical prostatectomy specimens in patients diagnosed with prostate cancer via transrectal ultrasound guided biopsy and treated with radical prostatectomy in our clinic. Material and Method : 115 patients were included in our study treated with radical prostatectomy for organ-confined prostate cancer between the dates of November 2011 and December 2014. Data of these patients are reviewed retrospectively. Results : The average age of the patients was 61.8 ± 6.8 (43-76) years. The average body mass index of these patients were (BMI) 26.7 ± 3.34 (19.3 – 35.3) kg/m². Average PSA value was 6.6 ± 10.1 (1.4 – 80) ng/ml. Gleason scores of transrectal ultrasound guided biopsy and radical prostatectomy were observed concordant in 74 (64.3%) of 115 patients, while 41 (35.6%) were not concordant. Gleason score was decreased by 1 grade for 8.6% (10 patients) of patients, it was increased by 1 for 26.0% (30 patients) of patients and for 0.8% (1 patient) it was increased by 3. Discussion : These findings indicate indicate that Gleason scores of transrectal ultrasound guided biopsy and prostatectomy specimens may be discordant.

PubMedID: 30611260 Background: Optimal treatment of high-risk prostate cancer remains controversial. We aimed to compare treatment outcomes of prostate cancer patients treated with definitive external-beam radiotherapy (ExRT) or radical prostatectomy (RP). Methods: The records of 120 high-risk clinical stage T2b-T4 N0 M0 prostate cancer patients treated with definitive ExRT or RP were reviewed. Patients with pretreatment prostate-specific antigen (PSA) levels ?20 ng/mL or clinical ?T3 stage or Gleason score (GS) ?8 were included in the study. Biochemical failure free survival (BFFS), distant metastasis free survival (DMFS), cancer-specific survival (CSS) and overall survival (OS) were analyzed. Cox regression analysis was performed to determine predictors of BF. Results: Seventy-two patients received definitive ExRT with androgen-deprivation therapy in 95.8% and 48 patients underwent RP with pelvic lymph node dissection. Mean age (67.7 ± 6.6 vs 64.5 ± 7.6 year, p = 0.017) and the rate of patients with PSA levels ?20 ng/mL (69.4% vs 47.9%, p = 0.022) were higher in the definitive ExRT group than the RP group. Distributions of GS and clinical T stage were similar. Mean follow-up was 60.2 ± 30.3 months in the definitive ExRT group and 41.3 ± 21.5 months in the RP group (p < 0.001). Twenty-five % of the RP group received adjuvant ExRT and 41.7% received salvage ExRT. Biochemical failure was significantly higher (52.1% vs 21.4%, p < 0.001) and the mean BFFS was significantly lesser (34.4 ± 3.9 vs 97.8 ± 5.9 months, p < 0.001) in the RP group than the definitive ExRT group. However, DMFS, CSS and OS were similar in both groups. In multivariate analysis, being in the RP group significantly increased the risk of BF (p < 0.001). Furthermore, not receiving pelvic lymphatic irradiation in the definitive ExRT group (p = 0.048) and having positive surgical margin in the RP group (p = 0.050) increased the risk of BF. Conclusions: BF was significantly higher and the mean BFFS was significantly lesser in high-risk prostate cancer patients undergoing RP than definitive ExRT while DMFS, CSS and OS were similar in both treatment groups. © 2019 The Author(s).

Bu makalede, su kaynaklari ve hidroelektrik enerji potansiyeli bakimindan Seydisuyu havzasinin gelistirilmesi hedeflenmistir. Bu amacla, Seydisuyu uzerinde planlamasi yapilan bir adet barajdan uretilecek elektrik miktari arastirilmistir. Bu calismada, Cografi Bilgi Sistemleri (CBS) yazilimi ve havzaya ait sayisal haritalar kullanilmistir. Seydisuyu havzasindaki hazir kurulu barajlarin (Catoren ve Kunduzlar) mansabinda bulunan vadinin uygun olmasi nedeni ile elektrik uretmek icin bir adet yeni baraj planlamasi da yapilmistir. Butun Seydisuyu havzasinin su potansiyelini degerlendirmek icin Seydisuyu havzasinin daglik kesiminde en az bir adet yeni baraj insa edilmelidir. Seydisuyu havzasinin debi kapasitesi sadece Kucuk Hidroelektrik Santrallerin (KHS) kurulmasi icin uygundur. Bu amacla, ilk olarak, yeni rezervuarin tarihi akim verileri incelenmistir. Sonra, aylik bazdaki 21 yillik tarihi debiler analiz edilmistir. Bu yeni barajin su potansiyeli kullanilarak, 0,62 MW kurulu gucunde ve 2,17 GWh/yil elektrik uretilebilecegi hesaplanmistir.

This study is based on determination of the freeze-thaw resistance of air-entrained and non-air-entrained normal strength concrete (NC) and high strength concrete (HSC) produced with fly ash and silica fume according to surface scaling. The procedure allows us to measure the amount of scaling per unit surface area due to a number ofwell defined freezing and thawing cycles in the presence of deicing salt.Theweight loss, surface scaling, moisture uptake, and internal damage were measured after 0 and after every 4th freezethaw cycle. The test results showed that the freeze-thaw resistance is influenced directly by the compressive strength property of the concrete. Silica fume significantly reduced the resistance of normal strength concrete against freeze-thaw effect without plasticizing agent. The surface scaling of silica fume concrete without admixture was 22% higher than reference normal concrete. WOS:000362361600001 Q3

Since geodetic and fossil energy that Turkey owns is insufficient and do not meet the demand, evaluation of renewable energy resource is very important for Turkey. For this reason, tending towards hydro-electric power is an applicable option and hydroelectric power is one of the most important energy resource for the country. From the point of view of water resources, evaluation of water potential of large and small streams for the purpose of energy production is vital for the country. Thereby, the existing deficit gap relevant to the energy, is reduceable. Within this paper, Seydisuyu basin has been selected as the research area. Precipitation in the watershed is drained by Seydisuyu stream. Only two dams named as Kunduzlar and Çatören, were constructed and are currently in operation in the study area. These dams were built for the purposes of only irrigation and flood control, in the watershed. Water potential of the basin is very small, due to the slight amount of precipitation within that area. Accordingly, planning of only small-scale hydro-electric energy potential is considerable over these dams, for region/national economic advantage of the country. In this study, the hydro-electric power potential of these two existing dams, were investigated. For this purpose, using 19 years of monthly data obtained from six existing flow gauging stations in the basin, the amount of hydroelectric energy generation of these dams was analyzed individually. As the result of these analysis, the calculation of the annual energy production capacity, the installed power production, and the annual economic contribution for both Çatören and Kunduzlar dams were estimated as 4.14 GWh (2.15 GWh (Çatören) + 1.99 GWh (Kunduzlar)), 0.843 MW (0.273 MW (Çatören) + 0.57 MW (Kunduzlar)), and 495000 USD (257000 USD (Çatören) + 238000 USD (Kunduzlar)), respectively.

PubMedID: 29773452 Introduction: The aim of the study is to investigate the effect of Rolipram, a selective phosphodiesterase 4 inhibitor, on testicular torsion – detorsion injury. Methods: Sixty young male rats were divided into five groups. In each group, the right testes of six rats were removed four hours after detorsion for biochemical analysis, and the right testes of the remaining six rats were removed 24 h after detorsion for pathological analysis. In group 1 (sham-operated) right orchiectomy was performed without torsion, and right testes were sent to the laboratory for biochemical and pathologic analyses. In group 2 (control) torsion was applied to the right testes for 60 min, and detorsion was performed without the administration of Rolipram. In group 3 torsion was applied to the right testes for 60 min. 1 mg/kg Rolipram was administered 30 min before detorsion. In group 4 torsion was applied to the right testes for 60 min, and 1 mg/kg Rolipram was administered during detorsion. In group 5 torsion was applied to the right testes for 60 min. 1 mg/kg Rolipram was administered 30 min after detorsion. The malondialdehyde and nitric oxide levels were determined. The rates of necrosis and apoptosis were evaluated by histopathological examination. Results: The level of malondialdehyde was higher in the torsioned groups (Group 2, 3, 4, 5) than that in group 1 (p = 0.004). There was no statistically significant difference between the groups regarding the level of nitric oxide (p = 0.182). Apoptosis was higher in groups 2, 3 and 4 than in group 1; however, apoptosis was similar in group 1 and group 5 (p = 0.122). The level of necrosis in group 1 was similar to that in groups 4 and 5 (p = 0.194 and p = 0.847, respectively). Conclusion: We suggest that the administration of Rolipram can decrease the rate of necrosis and apoptosis in testicular ischaemia-reperfusion injury. © 2018 Elsevier Inc.

WOS: 000415085100079 PubMed ID: 28953158 Saddle nose deformity is a challenging complication of septoplasty or septorhinoplasty, characterized by underprojected cartilaginous dorsum. Nasal dorsal augmentation is a significant part of reconstructive surgery of saddle nose deformities. In this study, the authors aimed to discuss the results of using toothpick-shaped costal cartilage grafts in nasal dorsal augmentation of saddle nose deformity. Twelve patients who underwent nasal dorsal augmentation due to moderate to severe saddle nose deformity secondary to the previous septoplasty or septorhinoplasty were retrospectively reviewed. Costal cartilage grafts prepared in the shape of toothpicks were used in all patients. Costal cartilage was used as toothpick-shaped free grafts in 12 patients (female: 7, male: 5) with a mean age of 42 (range: 24-56) for dorsal augmentation in the secondary septorhinoplasty. All patients had a history of previous surgery (septoplasty, n=9; and septorhinoplasty, n=3). All patients were operated under general anesthesia with open technique septorhinoplasty. The mean follow-up was 18 (range: 9-48) months. In only 1 of the 12 patients, a postoperative complication was observed including an infection of the tip area in the second postoperative week. None of the patients experienced donor site complications or major graft resorption. All patients were satisfied with functional and esthetic outcomes. No revision surgery was needed in any patient. Toothpick-shaped costal cartilage grafts are useful in nasal dorsal augmentation of moderate to severe saddle nose deformity. This technique offers smooth camouflage, satisfactory accordance with the recipient region, and shorter operation time. In addition, it avoids the side effects from wrapping techniques such as foreign body reaction or additional donor site morbidities.

WOS: 000403984600002, The Bodrum peninsula is one of the more important tourist locations in Turkey. Due to an increasing population and tourism demand, water shortages have emerged as a significant problem during the summer months in recent years. It has now reached the point where the peninsula no longer has a sufficient, safe and continuous water supply to meet its needs. In this study, population projections of the peninsula until the year 2060 are provided along with estimates of the water needs of the population, the amount of water resources available and the resources that need to be developed to supply water of the required quality. It is concluded that, given population growth and tourist demands, in each of 2020, 2030, 2040, 2050 and 2060 water needs will be 23.47; 32.46; 45.52; 60,76 and 83.18 hm(3)/year

WOS: 000402750600071 PubMed ID: 28277485 Objectives: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. Methods: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center. All demographic and clinical data were collected, radiologic and endoscopic evaluations were performed to assess the characteristics of stenosis. Myer-Cotton grading scale was used for classification of stenotic area. Results: All patients have subglottic stenosis due to intubation-related causes and inappropriate tracheostomy procedure. The duration of intubation period ranged from 15 days to 4 years; 11 patients have grade III stenosis according to Myer-Cotton system and there was cricoid involvement in 2 patients. The mean follow-up period was 5.2 months and postoperative decannulation was achieved in 10 patients (71.4%). Conclusions: Subglottic stenosis is the difficult situation to manage minimal invasively. Flexible fiber CO2 laser surgery is safe and effective in the management of properly selected patients and can be used as a first option for patients.

Objective : To assess the relationship between the immunohistochemical expression of vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule (VCAM) with the clinical feature of laryngeal squamous cell carcinoma (LSCC). Study Design and Methods : Twenty-nine patients with LSCC were examined as the LSCC group. Twenty-one healthy people who showed no signs of regional or systemic disorders were used as the control group. The staging system for LSCC was determined using American Joint Committee on Cancer (AJCC) 2010 criteria. A quantitative enzyme-linked immunosorbent assay (ELISA) was performed to measure the concentration of soluble serum VEGF and VCAM-1. Results : VEGF levels were higher in the LSCC group compared to the control group (p = 0.001). VCAM levels were not significantly different (p = 0.617). VEGF levels were not correlated to the T and N stage in the LSCC group (p = 0.402). VCAM levels were significantly correlated with the T and N stage (p < 0.0001). Conclusions : VCAM levels could not be used as a tumor marker for diagnosis but were correlated with the stage and, therefore, the aggressivity of the cancer disease.

Objectives This study aims to report our experience on endoscope-assisted microvascular decompression experiences performed due to vascular compression syndromes such as hemifacial spasm, trigeminal neuralgia, and cochleovestibular nerve compression. Patients and methods Between March 1999 and June 2013, 55 patients (34 females, 21 males; mean age 44 years; range 24 to 77 years) underwent endoscope-assisted microvascular decompression surgery through a retrosigmoid approach due to vascular compression syndromes in our clinic. The diagnosis was based on history, neurological examination, magnetic resonance imaging findings and audio-vestibular tests. Results A total of 49 patients (89.1%) had complete relief of the symptoms and two had (3.6%) a partial relief, while four had (7.3%) no relief of the symptoms. Only two patients had (3.6%) cerebrospinal fluid leakages as a perioperative complication. The major offending vessels were anterior and inferior cerebellar arteries in 14 patients. Four patients with essential hypertension became normotensive after decompression of the left medulla oblongata as well. Conclusion Microvascular decompression surgery provides a significant relief of the symptoms in patients with vascular compression syndromes. An angled endoscope as an adjunct to microscope contributes to the diagnosis of the offending vessel in the root entry zone of the cranial nerve.

Dis kulak yolu atrezisi, dis kulak yolunun kismi veya tam gelisim defekti ile karakterize bir konjenital malformasyonudur. Calismamizdaki amacimiz MET Fully-Implantable Ossicular Stimulator (FIMOS) Carina® ile tadavi edilen bilateral aural atrezi olgusunun sonuclarini tartismaktir. Bilateral konjenital aural atrezisi olan isitme kayipli hasta tamami implante edilebilen MET Fully-Implantable Ossicular Stimulator (FIMOS) Carina® ile tedavi edilmistir. Hastanin postoperatif 6. ay odyolojik degerlendirilmesinde saf ses odyometrisinde ortalama 39 dB HL kazanci saptanmistir. Carina® MET kemikcik zincir uyarimi ile yeteri kadar isitme kazanci saglamis olup, bilateral aural atrezisi olan kisilerde tedavi amacli kullanilabilinir.

To assess expression of three main inflammatory genes, COX-II, ALOX-12 and i-NOS, quantitatively at transcriptional level in cholesteatoma matrix tissue. Ten patients who have chronic otitis media with primary acquired cholesteatoma were included in this study. Tissue samples obtained from cholesteatoma matrix and external ear canal skin (control tissue). Expression of the targeted genes (COX-II, i-NOS and LOX-12) was assessed using real-time quantitative polymerase chain reaction (RT-PCR) technique. The amount of COX2 mRNA was significantly higher in cholesteatoma matrix at transcriptional level (p = 0.038). There was no statistically significant difference regarding expression of iNOS and LOX12 mRNA levels (p > 0.05). There is a significant overexpression of the mRNA of COX-II in cholesteatoma matrix, which indicates a difference between the normal skin and cholesteatoma matrix at molecular level. COX-II gene overexpression seems to be associated with pathogenesis of cholesteatoma. This molecular change is similar to the molecular abnormalities observed in some benign and malignant neoplasms. Invasive and locally destructive nature of cholesteatoma may be due to COX-II overexpression. Absence of an increase in the gene expressions of i-NOS and LOX-12 in cholesteatoma matrix suggests that these mediators may not be related with the pathogenesis and evolution of cholesteatoma.