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In today?s world, all the higher education institutions across the world are trying to keep and improve their educational standards in order to respond to the ever-changing needs and expectations of all their stakeholders and to survive under great environmental pressure resulting from the stiff global and local competition. To this end, they need to plan, control and improve their own educational quality on a regular and continuous basis. However, if there is a considerable gap between the internationally agreed-upon quality standards and the quality offered within the institutional framework, it will be very difficult to claim objectively that the educational services provided are of the highest achievable quality. Thus, obtaining international quality accreditation is of crucial importance both in proving the educational quality offered institutionally and persuading all the stakeholders that the education provided is planned, monitored, evaluated and improved in line with the predefined and preset international quality standards. On the other hand, having an international quality accreditation as a higher education institution might not always guarantee a positive quality perception on the students? part, who are the actual consumers of the quality. The main purpose of this study is to analyze the relationship between the internationally accredited educational quality and the quality perception of the students studying at an English preparatory school of a foundation university in Turkey.

Marble excavation and processing are the most risky endeavors of the mining industry. Many precautions are taken to determine or prevent occupational accidents. Failure Mode and Effect Analysis (FMEA) is a risk assessment tool that can be easily applied to an occupational health and safety (OHS)-based improvement process. In this paper, marble processing techniques and failure mode effect analysis method were summarized, and a case study was performed in the marble processing plants of Afyonkarahisar, Turkey. The study tried to eliminate or improve primary risks by preparing an improvement program. The theoretical improvement was realized as 50.08% for the first period.

This paper discusses how Turkish Cypriot orthopedically impaired learners who are living in North Cyprus use social networking as a tool for leisure and education, and to what extent they satisfy their personal development needs by means of these digital platforms. The case study described, conducted in North Cyprus in 2015 followed a qualitative research methodology: semi-structured interviews and document analysis were used for data collection. The study sample of 20 orthopedically impaired participants was selected from among members of the Cyprus Turkish Association for the Orthopedically Disabled which asked for volunteers. The study concluded that impaired learners typically satisfy their social and learning needs, or their need for excitement and relaxation, through social media. It is clear that the use of social networking only satisfies individual needs and does not contribute to group interdependence: if orthopedically impaired learners actively directed themselves to communicating more effectively among themselves and creating groups, they could solve personal problems through group solidarity. Social networks contribute to orthopedically impaired learners’ lifelong education process: in addition to providing them with positive gratification, they also “informally” contribute to their personal education. Although the individuals who participated in this study do use social networks, more effort needs to be made within the context of North Cyprus to make use of social networks for formal education purposes. The file in this item is the publisher version (published version) of the article.

In this case report, we aimed to discuss a patient presenting with convulsion and respiratory depression after interscalene brachial plexus blockade (ISB) was performed with ropivacaine 0.5%. A 35 years old man, 70 kg in weight and 174 cm in height was taken to operation for right radial nerve repair. ISB was done with 40mL of ropivacaine 0.5% using peripheral nerve stimulator. Clonic convulsions at the face muscles and respiratory depression occurred 3 min later than ISB. Convulsions and hypotension improved without any intervention, bradycardia was not seen. As a result, slow injection should be performed having continuous dialogue with the patient during the ISB procedure. We hold the opinion that even if the aspiration and test dose are negative, physician should be aware to the cardiovascular and central nervous system complications after the local anesthetic injection. Key words: Regional anesthesia, Brachial plexus block, Ropivacaine, Convulsion, Respiratory depression, Bu olgu sunumunda %0.5 ropivakain ile yapılan interskalen brakiyal pleksus bloğu (ISB) sonrası konvülsiyon ve solunum depresyonu meydana gelen bir olguyu tartışmayı amaçladık. 35 yaşında, 70 kg ağırlığında, 174 cm boyundaki erkek olgu sağ radiyal sinir onarımı için operasyona alındı. Periferik sinir sitümülatörü kullanılarak 40 mL %0.5 ropivakain ile interskalen blokaj yapıldı. ISB yapıldıktan 3 dk sonra yüz kaslarında klonik kasılmalar ve solunum depresyonu meydana geldi. Konvülsiyon ve hipotansiyon herhangi bir müdahaleye gerek kalmadan kendiliğinden düzeldi, bradikardi görülmedi. Sonuç olarak; ISB işlemi sırasında hasta ile sürekli diyalog halinde olunarak yavaş enjeksiyon yapılmalıdır. Ayrıca, aspirasyon ve test dozu negatif olsa bile lokal anestezik enjeksiyonu sonrası kardiyovasküler ve santral sinir sistemi komplikasyonlarına karşı hazırlıklı olunması gerektiğini düşünüyoruz. Anahtar kelimeler: Rejyonel anestezi, Brakiyal pleksus bloğu, Ropivakain, Konvülsiyon, Solunum depresyonu

Acutely developing atelectasis causes disrupted gas exchange, increases risk of infection and resultantly increases the rate of mortality and morbidity if it's not treated urgently. Today flexible fiberoptic broncoscopy (FFB) is a common method in diagnosis and treatment of atelectasis. It has a major role, especially in treatment of mucous related atelectasis.A case report with acutely developed intraoperative atelectasis and rapid recovery. After FFP is presented Key words: Atelectasis, General Anaesthesia, Flexible Fiberoptic Broncoscopy., Akut gelişen atelektazi acil tedavi edilmediğinde gaz değişimini bozup, enfeksiyon riskini arttırarak mortalite ve morbiditede artışa sebep olur. Fleksibl fiberoptik bronkoskopi (FFB) son zamanlarda atelektazinin tanı ve tedavisinde yaygın kullanılan bir metod olup, özellikle hava yolundaki mukusa sekonder atelektazilerin tedavisinde önemli bir role sahiptir. Bu nedenle intraoperatif akut gelişen ve FFB sonrası hızla düzelen bir atelektazi olgusunu sunmayı uygun bulduk. Anahtar kelimeler: Atelektazi, Genel Anestezi, Fleksibl Fiberoptik Bronkoskopi.

Aim: ProSeal LMA (LMA) was developed on the basis of the classic LMA is a supraglottic airway device. In this study, anesthesia records of 428 pediatric patients who PLMA were inserted after induction of general anesthesia in pediatric surgery between May 2009 and June 2011 were reviewed retrospectively. Material-Methods: Demographic characteristics, ASA score, type of surgery and anesthesia time, the premeditation, induction agents, positions of patients, PLMA placement technique, the number of attempts, the practitioners' experience of anesthesia and complications encountered were recorded retrospectively. Results: Anesthesia was induced intravenously or inhalationally in 355 and 73 patients, respectively. PLMA was placed at the first trial to 411 patients and at the second trial to 14 patients. 342 patients who PLMA were inserted underwent to the operation in the supine position, 86 patients had the operation in lithotomy position. PLMA was placed with digital technique to 355 patients, introducer was used in 73 patients. After PLMA was placed, in 4 patients laryngospasm, in 3 patients bronchospasm, in one patient gastric distension, in two patients hiccup developed. After placement of PLMA two patients vomited. After removal of PLMA laryngospasm developed in three patients, blood transmission at PLMA has been found in 2 patients. Conclusion: In children, PLMA with allowing high leak pressures than the classic LMA and separating glottis to esophagus, high placement success and low complication rate is an effective airway device. Key words: Proseal LMA; Children; Complication., Amaç: ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411'ine birinci denemede, 14'üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342'si supin pozisyonda, 86'sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA'da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA'ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır. Anahtar kelimeler: Proseal Laringeal Maske; Çocuklar; Komplikasyon.

Heparin resistance with an unknown mechanism is observed in a wide range of clinical severity. In this report, we aimed to present a case with heparin resistance who had to receive high dose heparin (15 mg/kg) before CPB despite intraoperatively normal levels of antitrombin III and platelet count. Keywords: Anticoagulant, Heparin, Antitrombin III, Surgery, Cardiac., Mekanizması tam olarak bilinmeyen heparin direnci, klinikte değişkenlik gösteren şiddetlerde karşımıza çıkmaktadır. Bu sunuda, intraoperatif dönemde normal antitrombin III düzeyi ve trombosit sayısına rağmen kardiyopulmoner bypass öncesinde yüksek doz heparin (15 mg/kg) verilen heparin direncine sahip bir olguyu sunmayı amaçladık Anahtar kelimeler: Antikoagülan, Heparin, Antitrombin III, Cerrahi, Kardiyak

Ankylosing spondilitis is a chronic, painful, autoimmune seronegative spondyloarthropaty. Both airway management and neuroaxial block of patients with ankylosing spondilitis may have difficulties for anaesthetist. We aimed to present a patient with ankylosing spondilitis that was applied to spinal anaesthesia with lateral approach for total hip replacement surgery. Key words: Ankylosing Spondylitis; Spinal; Anaesthesia., Ankilozan spondilit, kronik, ağrılı, inflamatuar bir seronegatif otoimmün spondiloartropatidir. Anestezistler için ankilozan spondilitte hem hava yolunun yönetimi hem de nöroaksiyel blok uygulamalarında zorluklar olabilir. Total kalça protezi operasyonu geçirecek ankilozan spondilitli hastaya lateral yaklaşımla başarılı spinal anestezi uygulamasını sunmayı amaçladık. Anahtar kelimeler: Ankilozan Spondilit; Spinal; Anestezi.

After adrenalectomy and thyroidectomy which performed as a therapy of multiple endocrine neoplasia II (MEN II), adrenal insufficiency and hypothyroidism may occur. However in response to surgery, both cortisol and thyroid hormones are essential and should be replaced. For any reason if an anaesthesia method will be applied to these cases, regional block is more suitable which causes decreased metabolic and endocrine response. Therefore we aimed to discuss anaesthetic management of a case who underwent vaginal hysterectomy with adrenal insufficiency and hypothyroidism and receives hormonal replacement therapy, first planned to perform epidural anaesthesia but because of the technical difficulties general anaesthesia was attempted. Key words: Anaesthetic Management: Multiple Endocrine Neoplasia II (MEN II), Adrenal İnsufficiency, Hypothyroidism, Hormone Replacement., Multipl Endokrin Neoplazi II (MEN II) nedeniyle yapılan sürrenalektomi ve tiroidektomiyi takiben adrenal yetmezlik ve hipotiroidi gelişebilir. Oysa cerrahiye stres yanıtta gerek kortizol gerekse tiroid hormonları ana unsurlar olup; replasmanları gerekmektedir. Herhangi bir nedenle bu tür vakalara anestezi uygulaması gerektiğinde cerrahiye metabolik ve endokrin yanıtı azalttığı bilinen rejyonal bloklar daha uygun olacaktır. Bu nedenle vajinal histerektomi geçirecek olan, öncelikle epidural anestezi planladığımız ancak uygulama zorluğu nedeniyle genel anestezi vermek zorunda kaldığımız, adrenal yetmezlik ve hipotiroidi replasman tedavisi alan bir olguyu sunmayı amaçladık. Anahtar kelimeler: Anestezi Uygulaması: Multipl Endokrin Neoplazi II (MEN II), Adrenal Yetmezlik, Hipotiroidizm, Hormon Replasmanı.

Beckwith-Wiedemann sendromu; eksofalos, makroglossi, hipoglisemi, organomegali, omfalosel ve gigantizim gibi çeşitli anomalileri içerir. Beckwith-Wiedemann sendromlu olgular sıklıkla infant dönemde cerrahiye gereksinim duyarlar. Anestezi yönetimindeki temel problemler sıklıkla; zor hava yolu ve hipoglisemidir. Makroglossinin maske ventilasyonu ve entübasyonu zorlaştırabileceği akılda tutularak indüksiyondan önce zor hava yolu hazırlığı yapılmalıdır. Dikkatli intraoperatif glukoz takibi hipogliseminin neden olacağı nörolojik sekelleri önlemede oldukça önemlidir. Bu sunuda laringeal maskenin potansiyel zor hava yolu anatomisine sahip Beckwith-Wiedemann sendromlu olguda endotrakael tüpe alternatif olarak kullanılabileceğine değindik. Anahtar kelimeler: Beckwith-Wiedemann Sendromu; Anestezi; Zor Hava Yolu; Laringeal Maske., Beckwith-Wiedemann syndrome consists of various abnormalities, such as exomphalos, macroglossia, hypoglcemia, visceromegaly, omphalocele, gigantism. Patients with Beckwith-Wiedemann syndrome frequently require surgical intervention during infant period. Common problems associated with anesthetic management of Beckwith-Wiedemann syndrome are difficult airway and hypoglycemia. Macroglossia might cause difficult ventilation and intubation for that reason preparation for airway difficulty should be made before induction. Intraoperative plasma glucose monitoring is particularly important to prevent the neurologic sequelae. In this presentation, we addressed the use of laryngeal mask may be an alternation to the endotracheal tube patients with Beckwith-Wiedemann which consist potentially difficult airway anatomy. Key words: Beckwith-Wiedemann Syndrome; Anesthesia, Difficult Airway; Laryngeal Mask.

Neuroleptic malignant syndrome often occurs as a side effect of antipsychotic drugs. The syndrome is characterized by altered consciousness, hemodynamic instability, fever, muscle rigidity and susceptibility to malignant hyperthermia therefore anesthetic management is important. Electroconvulsive therapy used to in the treatment of psychotic symptoms with neuroleptic malignant syndrome. Succinylcholine is used as a muscle relaxant in the electroconvulsive therapy. Succinylcholine should be used cautiously in patients with suspected malignant hyperthermia. Suggammadex that antagonized of non-depolarizing muscle relaxants is used as easy and safe increasingly in recent years. This case report describes the use of rocuronium-sugammadex accompanied with literature for the anesthetic management of neuroleptic malignant syndrome. Key words: Neuroleptic Malignant Syndrome; Electroconvulsive Therapy; Malignant Hyperthermia; Suggammadex, Nöroleptik malign sendrom, sıklıkla antipsikotik ilaçların yan etkisi olarak ortaya çıkan klinik bir durumdur. Bu nadir görülen sendromun, bilinç değişiklikleri, hemodinamik instabilite, ateş ve kaslarda rijidite gibi bulguları olması nedeniyle malign hipertermiye benzemesi nedeniyle anestezi yönetimi özellik arz eder. Nöroleptik malign sendromda, psikotik semptomların tedavisinde elektrokonvülzif tedavi kullanılan bir tedavi yöntemidir. Elektrokonvülzif tedavide kas gevşetici olarak kullanılan süksinilkolin, malign hipertermi şüphesi olan hastalarda dikkatli kullanılması gereken bir ajandır. Son yıllarda suggammadeksin kullanıma girmesiyle nondepolarizan kas gevşeticiler antagonize edilme kolaylığı ile güvenle kullanılmaya başlanmıştır. Bu olgu sunumunda nöroleptik malign sendromlu hastanın elektrokonvülzif tedavisi için anestezi yönetiminde rokuronyum-suggammadeks kullanılmasını literatür ışığında tartışmayı amaçladık. Anahtar kelimeler: Nöroleptik Malign Sendrom; Elektrokonvülzif Tedavi; Malign Hipertermi; Suggammadeks.

Due to the recent improvements in technologic and pharmacologic fields, invasive and non-invasive diagnostic and/or therapeutic approaches are increasingly used outside the operative rooms. The anesthetists should be incorporated and share the responsibility in order to increase the success rates and patient safety, on performing these procedures. In this study, we aimed to present the used anesthetic techniques and the resultant complications, during October 2002-December 2006 in MR scanning unit for the pediatric cases by our clinic. 1458 pediatric cases were included in the study. We experienced cardiac arrest in three and minor complications such as bradycardia (45), desaturation (98), and prolonged sedation (22) in 168 of these cases. The anesthetists must be more careful when working outside the operating room. In addition, we believe that the anesthetists should be more active in regulating the physical and technical infrastructure, for patients who will receive anesthesia outside the operating room in order to maintain the safety of the patient and the medical personnel. Key words: Anesthesia, Magnetic Resonance Imaging, Pediatric Cases, Günümüzde, teknolojik ve farmakolojik gelişmeler sayesinde, hastalara tanı ve tedavi amacıyla ameliyathane dışı ortamlarda invaziv ve invaziv olmayan girişimler artarak uygulanmaya başlanmıştır. Bu girişimlerde başarı oranının artırılması ve hasta güvenliğinin sağlanması için anestezistlere görev düşmektedir. Bu çalışmada Ekim 2002-Aralık 2006 tarihleri arasında manyetik rezonans görüntüleme ünitesinde kliniğimizce pediyatrik olgulara uygulanan anestezi tekniklerini ve ortaya çıkan komplikasyonları sunmayı amaçladık. Çalışmaya 1458 pediyatrik olgu dahil edildi. Bu olgulardan üçünde kardiyak arrest sonucu eksitus, 168 olguda ise minör komplikasyonlar ile karşılaşıldı bunlar; bradikardi, (45) desatürasyon (98) ve uzamış sedasyon (22) şeklindeydi. Anestezistler ameliyathane dışı ortamlarda görev yaparken komplikasyonlardan kaçınılması için normalden daha dikkatli olmak zorundadır. Ayrıca anestezi verilecek ameliyathane dışı ortamlarda hasta ve personel güvenliğini sağlamak için gereken fiziki ve teknik altyapının düzenlenmesinde anestezistlerin aktif görev almaları gerektiği kanısındayız. Anahtar kelimeler: Anestezi, Manyetik Rezonans Görüntüleme ve Pediyatrik Olgular.

Pulmonary arterial hypertension (PAH) is increasing of mean arterial pressures of pulmonary vessels more than 25-30 mmHg. Pulmonary hypertension is essential or secandary to congenital heart deffect. Down's syndrome is the most common congenital anomaly. It is special for the anesthesiologists because of respiratuar, cardiovascular and other sistemic anomalities and may be associated with Morgagni hernia that should be repaired when detected. A 2.5 year-old female pediatric patient with Down's syndrome (6 kg) and Morgagni hernia accompained secondary PAH was planned to repairing of diaphragmatic deffect. We aimed to investigate anesthetic management of this patient with litarature. Key words: Pulmonary Arterial Hypertension; Morgagni Hernia; Down's Syndrome; Anesthesia Management., Pulmoner arter hipertansiyonu (PAH) pulmoner damarların ortalama arter basıncının 25-30 mmHg'yı aşmasıdır. Esansiyel olabileceği gibi konjenital kalp defektlerine sekonder olarak da görülebilir. Down sendromu en sık görülen konjenital anomalidir. Solunumsal, kardiyovasküler ve diğer sistemik anomaliler nedeniyle anestezist için özellik arz eder. Down senromuna Morgagni hernisi eşlik edebilir. Saptandığında olası akciğer komplikasyonlarını engellemek için düzeltilmelidir. Down sendromlu 2.5 yaşında (6 kg), Morgagni hernisi ve buna sekonder PAH'nın eşlik ettiği diafragmatik defekt için operasyon planlanan kız çocuğunun anestezi yönetimindeki özellikleri literatür eşliğinde gözden geçirmeyi amaçladık. Anahtar kelimeler: Pulmoner Arteriyel Hipertansiyon; Morgagni Hernisi; Down Sendromu; Anestezi Yönetimi.

Amyotrophic lateral sclerosis (ALS) is a progressive, neurodegenerative disease caused by the degeneration of motor neurons, including medulla spinalis, cerebellum and motor cortex of central nervous system that control voluntary muscle movement. The disease usually does not affect cognitive abilities, but makes muscle weakness, difficulty in swallowing and chewing especially breathing. Here in, we report the critical care management of three ALS case with pneumonia and severe respiratory distress. Key words: Amyotrophic Lateral Sclerosis, Motor Neuron Disease, Critical Care, Pneumonia, Amyotrofik lateral skleroz (ALS) medülla spinalis, beyin sapı ve beynin motor korteksindeki motor nöronların ilerleyici dejeneratif bir hastalığıdır. Bilinç bozukluğu yapmadan yaygın kas güçsüzlüğü, yutma güçlüğü ve özellikle solunum güçlüğü yaratan bir hastalıktır. Bu yazıda ağır solunum yetmezliği ve pnömoniyle yoğun bakımda takip ve tedavi edilen üç ALS tanısı almış olgunun takip ve tedavisi sunulmuştur. Anahtar kelimeler: Amyotrofik Lateral Skleroz, Motor Nöron Hastalığı, Yoğun Bakım, Pnömoni

%30 of deaths in anesthesia occur during the intubation. Intubation can be achieved during deep anesthesia with spontaneous respiration or awaken if there is an expected intubation difficulty. Usage of propofol and shorteffective opioid provides acceptable conditions for laringoscopy and tracheal intubation without a muscle relaxant. Remifentanil is an ideal agent for its short narcotic effect and for returning spontaneous respiration rapidly. Induction without using a muscle relaxant can be practiced before invasive intubation procedures. For this reason; we aimed to report our method for this patient with thyroid leiomyosarcoma and tracheal stenosis. Key words: Difficult Intubation, Propofol, Remifentanil., Anestezi uygulamalarındaki ölümlerin %30'u entübasyon sırasında görülmektedir. Entübasyon güçlüğü riski söz konusuysa, uyanık entübasyon veya derin anestezi altında spontan solunum korunarak entübasyon denenebilir. Propofol ve kısa etkili bir opioidin birlikte kullanılması, kas gevşetici kullanmaksızın laringoskopi ve trakeal entübasyon için yeterli şartları sağlar. Remifentanil spontan solunumun hızlı dönmesi ve kısa süreli opioid etkisi istendiği durumlarda ideal bir ajandır. Kas gevşetici kullanmaksızın yapılan indüksiyon invazif entübasyon yöntemlerden önce uygulanabilir. Bu nedenle tiroid leiomyosarkomu ve trakeal stenozu olan ventilasyon ve entübasyon güçlüğü beklediğimiz olguda yöntemimizi tartışmayı amaçladık. Anahtar kelimeler: Zor Entübasyon, Propofol, Remifentanil

Objectives: The aim of rapid sequence intubation is to create fast and satisfactory intubation conditions to decrease risk of aspiration with anesthetic and muscle relaxant drugs. In our study, we compared the effects of rocuronium bromide (0.6 mg.kg-1), a fast and short effective non-depolarizing muscle relaxant with addition of alfentanyl (10 µg. kg-1) and thiopental (5 mg.kg-1) or propofol (2.5 mg.kg-1) for rapid sequence intubation on hemodynamics and intubation conditions at 60 to 90 seconds. Material and Methods: 80 cases in ASA I-II classification undergoing elective surgery were divided into four groups. After slow administration of alfentanyl, all of the patients were preoxygenated with spontaneous breathing. The intubation had been performed at 60 s after administration of thiopental and rocuronium bromide in group I, at 90 s after administration of thiopental and rocuronium bromide in group II, at 60 s after administration of propofol and rocuronium bromide in group III and at 90 s after administration of propofol and rocuronium bromide in group IV. The patients continued to receive 100% oxygen by mask before intubation. After the administration of neuromuscular relaxant the blood pressure, heart rate, peripheral oxygen saturation at 1, 2, 5 and 15 minutes were recorded. The intubation state evaluated as excellent, good, poor and impossible, excellent and good were considered to be satisfactory. Results were compared with One-Way analysis and Chi-Square tests. p, Amaç: Hızlı entübasyonun amacı, aspirasyon riskini azaltmak için, anestezik ve kas gevşetici ilaçların birlikte uygulanarak, hızlı ve uygun entübasyon koşulları sağlamaktır. Çalışmamızda, hızlı ve kısa etkili bir nondepolarizan kas gevşetici olan roküronyum bromürün (0.6 mg.kg-1), alfentanil (10 mg.kg-1) ilavesi ve tiyopental (5 mg.kg-1) veya propofol (2.5 mg.kg-1) ile birlikte hemodinami ve 60.- 90. saniyelerdeki (sn) entübasyon koşulları üzerine etkileri karşılaştırıldı. Materyal ve metot: ASA I-II risk grubu, elektif cerrahi girişim geçirecek 80 olgu, dört gruba ayrıldı. Yavaş hızla alfentanil verilmesini takiben tüm olgulara, spontan solunumla preoksijenasyon yapıldı. Grup I'de tiyopental ve roküronyum bromür verilip 60. sn'de, Grup II'de tiyopental ve roküronyum bromür verilip 90.sn'de, Grup III'te propofol ve roküronyum bromür verilip 60. sn'de ve Grup IV'te propofol ve roküronyum bromür verilip 90. sn'de entübasyon yapıldı. Olgular entübasyon öncesi maske ile %100 oksijen almaya devam etti. Kas gevşetici verilmesini takiben 1, 2, 5 ve 15. dakikalarda (dk) kan basıncı, kalp atım hızı, periferik oksijen saturasyonları kaydedildi. Entübasyon durumu, mükemmel, iyi, zayıf ve yetersiz olarak değerlendirilip, mükemmel ve iyi, uygun entübasyon koşulları olarak kabul edildi. Sonuçlar One-Way Analiz ve Chi-square testleri ile karşılaştırıldı. p

The use of diagnostic colonoscopy has increased recently. Colonic perforation is a rare complication during diagnostic colonoscopic procedures. This case report evaluates diagnosis, treatment and clinical presentation of a 77 year old man patient with pneumomediastinum, pneumoperitoneum, pneumothorax and cervical subcutaneous emphysema who experienced colonic perforation after diagnostic colonoscopy. Key words: Diagnostic Colonoscopy, Colonic Perforation, Pneumomediastinum, Pnömoperitoneum, Subcutaneous Emphysema, Özet: Tanısal kolonoskopinin günümüzde kullanım sıklığı artmıştır. Ancak tanısal kolonoskopinin uygulanması sırasında kolon perforasyonuna neden olması nadir bir komplikasyonudur. Bu olgu raporu 77 yaşında diagnostik kolonoskopi sonrası iatrojenik oluşan sigmoid kolon perforasyonlu erkek hastanın klinik prezentasyonu, tanı ve tedavisini anlatmaktadır. Anahtar kelimeler: Tanısal Kolonoskopi, Kolon Perforasyonu, Pnömomediastinum, Pnömoperitonyum, Ciltaltı Amfizem

Spinal anestezi altında transüretral rezeksiyon planlanan ağır astımlı bir hastada gelişen akut kardiyojenik pulmoner ödemin non invaziv ventilasyon ile tedavisi anlatılmaktadır. Literatürde ciddi astım sonrası non invaziv ventilasyon ile ilgili bilgi bulunmamaktadır. Biz bu nadir uygulanan tedaviye dikkat çekilmesinin önemli olduğuna inanıyoruz. Anahtar kelimeler: Astım; Akut Kardiyojenik Pulmoner Ödem; Non-invaziv Mekanik Ventilasyon., This is case of a non-invasive ventilation treatment of severe asthma with acute cardiogenic pulmonary edema, who underwent transurethral resection of the prostate under subarachnoid anesthesia. There is no sufficient data in literature about the occurence of non-invasive ventilation after severe asthma. We believed it is important to call attention to this unusual treatment. Key words: Asthma; Acute Cardiogenic Pulmonary Edema; Non-invasive Mechanical Ventilation.

Objective: There has been no study evaluating sevoflurane minimum alveolar concentration for the laryngeal mask airway (LMA) removal (MAC-LMA removal) in children whom caudal anesthesia was performed. The aim of this study is to determine the MAC-LMA removal of sevoflurane in children caudal anesthesia was performed. Materials and Methods: Fifty-six children undergoing elective urologic surgery for, Amaç: Kaudal anestezi uygulanan çocuklarda laringeal maske (LMA) çıkarılması için gerekli sevofluran minimum alveolar konsantrasyonunu (MAK) değerlendiren bir çalışma bulunmamaktadır. Çalışmanın amacı kaudal anestezi uygulanmış çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ını belirlemektir. Materyal ve Metod: Genel anestezi ile ürolojik cerrahiye giden (

The increase in negative intrathoracic pressure due to upper airway obstruction after postextubation laryngospasm may cause pulmonary edema. The probable mechanism is pulmonary edema and alveolar hemorrhage related laryngospasm and high negative pressure during respiratory effort due to glottic obstruction. This presentation concludes a case of pulmonary edema following acute upper airway obstruction in a young patient. Key words: Pulmonary Edema, Airway Obstruction, Laryngospasm, Ekstübasyon sonrası laringospazmın neden olduğu üst havayolu obstrüksiyonuna karşı yapılan zorlu inspirasyona bağlı negatif intratorasik basınçtaki belirgin artış pulmoner ödeme yol açabilir. Olası mekanizma; pulmoner ödem ve alveoler hemorajiye neden olan laringospazm ve kapalı glottis ile birlikte solunum eforu sırasında akciğerlerde yüksek negatif basıncın oluşmasıdır. Bu sunuda ekstübasyonu takiben üst hava yolu tıkanıklığının neden olduğu negatif basınçlı pulmoner ödem gelişen olgunun tanı ve tedavisi irdelenmiştir. Anahtar kelimeler: Pulmoner Ödem, Havayolu Obstrüksiyonu, Laringospazm

Objective: In this study we aimed to present the procedure time and early complications of the percutaneous tracheotomies with Griggs technique in our intensive care unit. Material and methods: 115 adult patients were included the study and assessed retrospectively. Before the procedure, the primary diagnosis, age, sex and intubation time of the patients were recorded. The procedure was performed with ‘Percutaneous tracheostomy kit' (Portex, Hythe, Kent, UK). The procedure time, the early complications (minor bleeding, surgical bleeding, subcutaneous emphysema, pneumothorax, false passage, hypoxia and mortality), mechanical ventilation time, intensive care unit stay time and the patient status at the hospital discharge were recorded. Results: The mean procedure time was 5.77 min. The early complications of the procedure were found as minor bleeding in three patients (2.6%), surgical bleeding in one patient (0.86%), and false passage in one patient (0.86%). Conclusion: We conclude that percutaneous tracheostomy with Griggs technique is performed in a short time at the bedside and i has a low complication ratio. Key words: Intensive care unit, Complication, Percutaneous, Tracheostomy, Griggs technique, Amaç: Bu çalışmada, yoğun bakım ünitemizde Griggs tekniği ile açılan perkütan trakeostomilerin işlem süresini ve erken komplikasyonları sunmayı amaçladık. Gereç ve Yöntem: Çalışmaya alınan 115 erişkin hasta retrospektif olarak değerlendirildi. İşlem öncesi hastaların birincil tanıları, yaş, cinsiyet ve entübasyon süresi kaydedildi. İşlem “Percutaneous tracheostomy kit” (Portex, Hythe, Kent, İngiltere) ile gerçekleştirildi. İşlem süresi, hastalarda gelişen erken komplikasyonlar (minör kanama, cerrahi kanama, subkutan amfizem, pnömotoraks, yanlış pasaj, hipoksi ve mortalite), mekanik ventilasyon süresi, yoğun bakım yatış süresi ve hastaneden çıkış durumu kaydedildi. Bulgular: İşlem süresinin ortalama 5.77 dk olduğu tespit edildi. Perkütan trakeostomiye bağlı erken komplikasyon olarak 3 (%2.6) hastada minör kanama, 1 (%0.86) hastada cerrahi kanama ve 1 (%0.86) hastada yanlış pasaj gelişti. Sonuç: Griggs tekniği ile perkütan trakeostomi açılmasının yatak başında kısa sürede uygulanan, düşük komplikasyon oranına sahip bir yöntem olduğu kanaatine varıldı. Anahtar kelimeler: Yoğun bakım ünitesi, Komplikasyon, Perkütan, Trakeostomi, Griggs tekniği

Single umbilical artery is associated with multiple organ malformations, fetoplacental insufficiency and intrauterine fetal growth retardation. During anaesthesia severe hypotension can cause decrease of uteroplacental blood flow and fetal distress. Herpes Simplex (HSV) infection is activated by exogeneous factors such as sunlight, wind, trauma and fever or endogenous physcological factors such as stress especially in immune deficiency. The choice of anaesthetic technique for HSV infected obstetric patient with single umbilical artery requires both uteroplacental blood flow sufficiency and prevention of HSV activation. For these reasons we aimed to report the anaesthetic method that we performed for a caesarean section of single umbilical artery and HSV type 1 positive obstetric patient. Key words: Obstetric Anaesthesia; Umbilical Cord Abnormality: Single Umbilical Artery, Herpes Simplex Virus Type 1 Infection., Tek umbilikal arter multipl organ malfarmasyonu, plasental yetmezlik ve intrauterin fetal gelişme geriliğiyle birliktedir. Anestezi esnasında ciddi hipotansiyon gelişecek olursa uteroplasental kan akımında azalma ve fetal distrese neden olabilir.Herpes Simplex enfeksiyonu (HSV) güneş ışığı, rüzgar, travma, ateş gibi eksojen faktörlerle immun yetmezlikli hastalarda stres gibi endojen faktörlerle aktive olabilir.Tek umblikal arterli HSV infekte hastalarda hem uteroplasental kan akımını koruyacak hemde HSV aktivasyonunu önleyecek bir anestezik tekniğin seçilmesi gerekir. Bu nedenle tek umblikal arterli HSV Tip1 pozitif obstetrik olgudaki anestezi uygulamasını sunmayı amaçladık. Anahtar kelimeler: Obstetrik Anestezi, Tek Umblikal Kord Anomalisi, Herpes simplex Virus Tip1 Enfeksiyon

This study investigated the polymerization shrinkage of restorative materials and microleakage in the proximal box of Class II restorations. Twenty caries free extracted human molars were prepared on the mesial and distal, making 40 slot cavities. Groups (n=10) were classified as: Group 1: Single bond/Filtek Z-250; Group 2: Single Bond/Filtek Flow/Filtek Z-250; Group 3: Admira Bond/Admira; Group 4: Ariston Liner/Ariston. Dentin bonding systems and resin composites were applied according to the manufacturer's instructions. The specimens were stored in distilled water for one week at 37°C, thermocycled (5°-55°C x 2000), stained with 50% aqueous silver nitrate, immersed in a diluted developer solution (24 hours), rinsed and sectioned in two pieces with a low speed saw (Isomet). Dye penetration (Score 0-4) was determined separately at the occlusal enamel margin and cementoenamel junction. The volumetric polymerization shrinkage of materials was determined with the apparatus of Watts and Cash (Watts & Cash, 1991) for 300 seconds. Polymerization shrinkage results were as follows: Filtek Flow (3.5%±0.1) > Admira (2.1%±0.1) = Ariston AT (2.3%±0.1) > Filtek Z-250 (1.8%±0.1) (One-way Anova, post hoc Bonferroni test at p=0.05 level). No statistical difference was found at the enamel margins for any of the materials (Score 0-1). At the cemento-enamel junction, all test groups showed significantly higher microleakage when compared to the enamel margins (Kruskal-Wallis test, Mann-Whitney U). Dye penetration results at dentin were as follows: Filtek Flow + Filtek Z-250= Admira < Ariston AT=Filtek Z-250. It was concluded that enamel showed no high dye penetration scores and microleakage was not influenced by the material. Microleakage at dentin could not be eliminated with any adhesive restoration. The ormocer and bonding-flowablehybrid composite restorations showed less microleakage than the ion-releasing and hybrid composites lined only with bonding agent at the cementoenamel junction in Class II cavities.

This study determined the three-body abrasive wear resistance of two packable composites (P-60; Solitaire 2), an ion-releasing composite (Ariston AT), a hybrid composite (Tetric Ceram) and an ormocer (Admira). The study also looked at the correlation between wear resistance and hardness of the composites. Three-body wear testing was performed using an ACTA wear machine with 15 N contact force using millet seed as the third body. Wear depth (µm) was measured by profilometry after 200,000 cycles. The hardness test was performed using a digital microhardness tester (load: 500 g; dwell time: 15 seconds). The data were analyzed by using Kruskal Wallis (p AristonAT=Tetric Ceram= Solitaire 2= Admira). The results of this study indicate that there are significant differences in the wear resistance of the resin composites. The correlation between hardness and wear was significant with a correlation coefficient of r:-0.91. A significant negative correlation exists between hardness and three-body wear of resin composites.

… Int Assoc Dent Res

Moyamoya disease is an entity, which is caused by obstruction or stenosis in the area between the internal carotid artery, and anterior and middle cerebral arteries, identified angiographically, and does not have an exactly known etiology. The most frequent symptoms of onset are hemorrhage in adults and ischemia in children. In the treatment of moyamoya disease revascularization surgery is performed in order to decrease the vascular fragility. A specialized care is required in the perioperative period since surgery is often complicated by cerebral ischemia or cerebral hemorrhage. Aim in the perioperative anesthetic management is to provide the balance between oxygen supply to and use in the brain. In this case report we aimed to discuss the anesthetic management in a 22-year-old male patient with moyamoya disease in whom a multipl burr hole surgery was performed. © Gülhane Askeri Ti{dotless}p Akademisi 2010.

It is mostly believed by the foreign language learners that writing is not of crucial importance when compared to other language skills. Almost all language learners want to spend their time reading, listening, practicing grammar, or speaking. When they are asked to write something, either they show a very little interest in what they are supposed to write or try to do everything they can to avoid it. Thinkabout your own past experiences related to writing for a while. Actually, there is a very little possibility that you remember them in a positive mood. Let' s suppose that you are asked which language skill you like most; it is, to a great degree, certain that the answer to be given will not be the answer expected. In short, we neither like nor want to write in any way. Language learning, on the other hand, isa multi-dimensional process in which you master all the skills that make up a language. Reading and listening are regarded as receptive skills; whereas writing and speaking are productive or creative skills. In the course of language learning, it is impossible to ignore even one of these dimensions that are of the same importance as each other. Writing requires creativity; that' s why, generally this skill is perceived as more difficult than the others, and it is also thought that the lack of enough creativity hinders efficient writing. Then, the question is what will happen if you are not a very creative person. There is no need to worry; in fact, everybody has creativity to a certain degree to write. Of course, some people are better at expressing themselves and their ideas in writing; but academic writing - with its strategies, techniques, and rules - does not necessarily need this special talent. Academic writing is a collection of strategies, techniques, and rules which can be learned. When you learn all these effectively, you can get ri d of the phobia, fear of writing. It is a proven fact that motivation plays a very critical role in learning. Learning how to write, particularly in an academic context, is not independent of general learning concept. When the nature of writing and its basic principles are not known or understood, it is virtually impossible to raise the motivation level towards writing and cope with the fear of writing. Writing is like looking into a mirror. When wntıng, you concentrate on yourself and your own potential. You are all alone with your paper. This situation can be considered to be one of the sources of fear about writing; but in my opinion, it is a great opportunity for you to face yourself, discover your potential, and learn your limits. 'Write Now!' is basically designed to take intermediate levellanguage learners from paragraph writing to essay writing. In this book, above all, you will be able to feel that you are not al one. You are go ing to find whatever you need in terms of basic academic writing skills. The book is organized from the basic academic writing subjects towards the more complicated ones. 'Write Now!' teaches writing as a process, but at the same time focuses on the product, as well. In-depth explanations can be found for all the subjects in the book, and these explanations are clarified throughout the book with various tables, shapes, graphs, and illustrations. Every subject in the book is supported with a wealth of examples and exercises for you to practice. The general layout and organization of the book will help you leam the subjects in an order. With the aid of this clear and easy-to-follow organization, you will be able to reach the level you need step by step and without having much diffıculty. As I have mentioned above, motivation is a significant factor in leaming and should not be ignored in any way. In this context, the exercises and examples used are organized around the topics that are very likely to draw interest. The book, also, contains a very comprehensive glossary for the words that are likely to arise problems in understanding the subjects. By means of this glossary your attention will not shift from the content to the words you do not know. 'Write Now!', with its exceptional features, is very appropriate for both class use and self-study. I strongly hope and believe that this book will help you in your academic writing studies, bring the barriers down in front of your success in writing; and of course, give you the pleasure of writing as a who le. At this point, I would like to express my deepest gratitude to the Rector of Istanbul Commerce University, Prof. Ateş Vuran, to the General Coordinator of English Preparatory School, Zeynep Sevgener, to Banu Koçaş from Material Office, and to my colleagues for their canfidence in this book and for their great support.

WOS: 000228764800006 PubMed: 15832354 The aim of this study was to assess the anatomical variations, especially the anomalous muscles passing through Guyon's canal and the fibrous arch forming the piso-hamate hiatus, which may play a role in ulnar tunnel syndrome. We have also focused on the relation of these structures with specific concern to the ulnar nerve. Nineteen embalmed cadavers (37 hands and forearms) were dissected. A fibrous arch extending between the pisiform and the hook of the hamate was observed in 21 hands. In majority of the cases flexor digiti minimi muscle was found to originate only from this arch. An anomalous muscle was disclosed in six hands with four of them passing through the piso-hamate hiatus with the deep branch of the ulnar nerve. In two of four cases, the superficial branch of the ulnar nerve was also accompanying the deep branch of the ulnar nerve beneath the anomalous muscle and through the piso-hamate hiatus. Because these anomalous muscles were generally found to course through the piso-hamate hiatus with the branches of the ulnar nerve, we conclude that the distal portion of the Guyon's canal has a relatively higher risk for ulnar nerve entrapment. We believe that surgeons operating on this region should take into account these various anatomic structures. (c) 2005 Wiley-Liss, Inc.

Management Information System (MIS), is a system using formalised procedures to provide management with appropriate information to make timely and effective decisions. Before developing MIS, first functions of the organisation should be defined and grouped into subsystems. After determining the information required and produced by each system and interaction between subsystems, the related data resources should be structured into a series of databases and files. In this study, the MIS developed for Soma Open Pit Mines, Turkey is described in this respect. First, analyses of the existing system including user requirements and scope of the system are given. Then the designed information system, its subsystems, interaction between subsystems and system structure are presented in detail.

Tuccar, Eray/0000-0002-1137-1961 WOS: 000170301000014 PubMed: 11437579 The microsurgical anatomy of the jugular foramen was studied in 12 formalin preserved cadavers (24 foramina) and 40 dry-skulls (80 foramina). The jugular foramen was exposed by microsurgical dissection with drilling from a superior to inferior direction. Observations regarding dural architecture of the jugular foramen and relationships between neurovascular structures passing through the foramen were noted in cadavers. Normal bony construction of the foramen and its variational anatomy were examined in dry-skull specimens. Using photographs and drawings, the anatomy of the jugular foramen is presented and related terminology is discussed in the light of a literature review. (C) 2001 Harcourt Publishers Ltd.

Management information System (MIS) is the combination of human and computer based resources that result in the collection, storage, retrieval, communication and use of data for the purpose of efficient management operation and for business planning. MIS facilitates management by producing structured and summarised reports on a regular and recurring basis. They are used in decision making. Today, without the application of computer, and MIS based on computer network, it is impossible to modernise mining enterprise management. In this study, a Milling Management Information System (MMIS) named SOMMIS developed for Soma Open Pit Mines is described. The development life cycle approach of MIS is followed and each of the preliminary investigation, the detailed investigation, the logical design, the physical design and the implementation phases are explained for SOMMIS. The system is tested using real and artificial data and it is found as suitable for application.

Purpose: To evaluate acid-etching effects prior to the application of self-etching primer and the effect of different primer application techniques on dentin shear bond strength (SBS). Materials and Methods: Forty human third molar cervical regions were used in this study. The teeth were randomly divided into four groups (n = 10) of different tooth surface conditions: group A: Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group B: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group C: Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond; group D: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond. The SBS test was performed with a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with one-way ANOVA and Tukey HSD tests. Results: The mean SBS values (MPa) and standard deviations are as follows: group A: 36.0 ± 8.3; group B: 24.0 ± 3.9; group C: 35.0 ± 3.3; group D: 30.6 ± 6.7. Conclusion: Acid etching decreased the SBS of the self-etching bonding system to dentin. Active primer application increased the SBS only in acid-etched groups.

Bu araştırma da bireyin kişilik gelişiminde aile nin bir başka deyişla anababa çocuk ilişkilerinin önemi dikkate alınarak, anababaların çocuklarının davranışları karşısında ne tür disiplin teknikleri kullandıkları araştırmaya çalışılmıştır. Çeşitli araştırma bulgularından yola çıkılarak, anne ve babaların uyguladıkları disiplin tekniklerinin cinsiyet ve sosyoekonomik düzey değişikliklerinden etki lenip etkilenmediğini sınamak amacıyla araştırma bu değişkenler dikkate alınarak yapılmıştır. Ayrıca anne ve babaların uyguladıkları disiplin tekniklerinin çocuklar tarafından nasıl algılandığı önemli bulunduğundan araş- tınmada çocuklardan bilgi alma yoluna gidilmiştir. Bu çerçevede alt ve üst sosyoekonomik düzeyden gelen kız ve erkek çocuklar tarafından anne ve babalarının beğendikleri ve beğenmedikleri davranışların ve> bu davranışlar karşısında kendilerine uygulanan disiplin tekniklerinin nasıl algılandığının araştıılması amaç lanmıştır. Çocukların algılarının. incelenmesi planlandığı -88-için, veriler çocukların topluca bulunduğu okullardan toplanmıştır. Bu amaçla, örneklem olarak üst sosyoekono mik düzeyi temsil eden Özel Amerikan Lisesi ve alt sosyoekonomik düzeyi temsil eden Sıdıka Rodop Lisesi' nin orta bölümlerinde okuyan (12-13 yaş arasında) toplam 120 çocuk seçilmiştir. Bilgi toplama aracı olarak açık- uçlu sorulardan oluşan bir anket hazırlanmıştır. Daha önce de belirtildiği gibi, araştırma sonuçlarının konuyu yerel hatlarıyla aydınlatmaya ve bu konuda ileride kul lanılabilecek standart bir ölçme aracının oluşturulabil mesi ne katkıda bulunabileceği düşünülmüştür. Elde edilen araştırma bulgularına göre,her iki sosyoekonomik düzeydeki anne ve babaların hem kız hem de erkek çocuklarında saygı, itaat, ana babaya sorumluluk ve bağımlılık davranışlarını beğendikleri; bu davranışın erkeklere göre kızlardan daha çok beklenildiği söylene bilir. Çocuklarda beğenilen davranışlara anne ve baba ların genellikle sevgi gösterme tepkisini verdikleri, ancak her iki sosyoekonomik düzeyde de annelerin babalara göre daha çok sevgi gösteren olarak algılandığı yine annelerin sevgi göstermeyi daha çok erkek çocuklarında kullandıkları bulunmuştur. Çocuklar ise ana babalarının kullandıkları bu tepkiler karşısında genellikle kendiyle ilgili olumlu duygular hissetmektedir. Çocuklarda beğenilmeyen davranışlara ann* ve baba ların ilk tepkilerinde genellikle sözel cezaya, daha sonra da açıklama yöntemine başvurdukları, davranış devam ettiği -89-taktirde alt sosyoekonomik düzey annelerin cinsiyet ay rıma yapmaksızın ham kız ham da erkek çocuklarında fiziksel cezayı uyguladıkları, bu gruptaki babaların İse fiziksel cezayı genellikle erkek çocuklarına uyguladıkları bulunmuştur. Yine de fiziksel cezanın alt sosyoekonomik düzeyde de yaygın olarak kullanılmadığı görülmektedir. Buna karşılık her iki sosyoekonomik düzeyde de yaygın olarak sözlü gazanın uygulandığı belirtilmiştir.Çocuk- ların tepkiler karşısında genellikle kendiyle ilgili olumsuz duygular hissettikleri görülmektedir. Ayrıca her iki sosyoekonomik düzeyde de gocuklar kendilerine ana baba lan dışında da disiplin uygulayan kişiler bulunduğunu belirtmişlerdir. Alt sosyoekonomik düzeyde bu kişilerin daha çok büyük ağabey* -ye` ablalar oldukları, üst sosyoekonomik düzeyde ise büyükanne ve büyük babalar oldukları anlaşılmıştır. Türkiyede çocuk disiplini konusunda yapılacak ileriki araştırmalarda bu durumun dikkate alınmasının ve ayrıca ailede herhangi bir bireyin çocuğa uyguladığı disiplin karşısında diğer lerinin de tepkilerinin, yeni bireyler arası etkileş-, melerin, incelenmesinin uygun olacağı belirtilmiştir. 102

Bu araştırmada, Hacettepe üniversitesi Matematik Bölümü öğrencilerinin 1986-1987 öğretim yılındaki I. yarıyıl akademik başarı ortalamaları ile bu bölümü kazandıkları 1986 yılı ÖYS matematik fen puanları arasındaki ilişki incelenmiştir. Ayrıca, 1986-1987 öğretim yılında matematik bölümü öğrencilerinin I. yarıyıl akademik başarılarının cinsiyet, tercih sıralaması ve mezun oldukları ortaöğretim türü gibi değişik faktörlere göre fark gösterip göstermediği araştırılmıştır. Araştırmada, 1986-1987 öğretim yılında H.ü matematik bölümüne alınan öğrencilerden 95 öğrenci örneklem grubunu teşkil etmektedir. Araştırmanın alt problemlerine cevap bulunabilmesi için toplanan bilgilere çeşitli istatistiksel yöntemler uygulanmış tır. Araştırmada elde edilen bulgulara göre ; 1- 1986 ÖYS matematik fen ağırlıklı puanların, matematik bölümü I. yarıyıl başarısını yordamadaki gücünün zayıf olduğu, 2- 1986-1987 öğretim yılı H.ü matematik bölümü öğrencilerinin I. yarıyıl akademik başarı ortalamalarının cinsiyete, mezun oldukları ortaöğretim kurumuna ve tercin sıralamasına iigöre fark göstermediği, 3-öğrencilerin lise son sınıftaki matematik dersi başarısının, matematik bölümü I. yarıyıl başarısını yordamada güçlü olduğu, 4-öğrencilerin lise son sınıftaki fen dersleri başarı sının, matematik bölümü I. yarıyıl başarısını yordamada zayıf olduğu, 5-1986 ÖYS matematik fen ağırlıklı puanları ile öğren- çilerin lise son sınıftaki matematik ve fen derslerindeki başarıları arasındaki ilişkinin beklenen düzeyde olmadığı, saptanmıştır. iii In this research, the relationship between the I.half tern academic accomplishment averages in the academic year 1986-1987 of the students who attended the Matheaatics Depart» meat of Hacettepe university and the points in aatheaatics science they got in the ÖYS (student placement examination ) they passed in 1986» In addition to the above, research was extended to find out whether such differing factors as sex, order of preference and the middle educational institutions fro» which such students graduated played a role in the degree of achlvement in the first half term of such students attending the aatheaa- tics departaent during the academic year 1986-1987. In the research, the sample consisted of 95 first year students who entered the ®athenatics department of H.Ü in the acadesic year of 1986-1987. Various statistical aetbods were applied to the data collected in order to find the answers to the sub-proble»s of the study. In accordance with the results obtained froo the present research it was seen that, 1- The 19S6 Student Flaceaent Examination »atfaena-» tics science gravity points held only minor inportaac® in in terpreting the 1. half tens achievements ©f the ®at!te®aticsdepartment during the I. half terra. 2- The academic achieveaents of the Hacettepe Uni versity mathematics department students during the X. half ter» of the acadeoic year 1986-1987 did not differ according to such factors as sex, order of preference or the »ladle- educational institution the students concerned graduated from. 3- the achievenents in Mathematics in the last class of the.Lycâe of the students had a high effect on interpreting their success during the I. half ter» in the Mathematics Department » 4- The achievements of the sane students' in lessons of science in the last class of the Lycâe played only a low role in interpreting their accomplishments during the x. half term in the Mathematics Department. 5- The relationship between the ®athe»atics science gravity points received hj the said students in the 1986 Student Placement Examination and the ©arks they received in mathematics and sciences in the last class of the Ljcâe was not as strong as expected. 64

WOS: 000403448200013 Objectives: It was aimed to evaluate histological effects of different doses of dexmedetomidine on lung injury induced by liver ischemia-reperfusion in rats. Materials and methods: Forty rats were included into the study in Inonu University Animal laboratory at 2013, In Group 1, the liver was manipulated and no occlusion of the vessels of the liver was performed. In IR Group 2, 60 min of ischemia and 60 min of reperfusion were applied. In Group 3, 10 mu g/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. In Group 4, 100 mu g/kg of dexmedetomidine was administered via intraperitoneal route 30 min before ischemia. Further procedures in groups 3 and 4 were the same as those of group 2. After the experiment was completed, the rats were killed and then histologic assessments were performed to the lung tissues. Results: Histopathological damage score in group 2 was higher than in group 1. Although lung damage was recognized as alleviated in group 3, the lesions did not completely improve. However, treatment with 100 mu g/kg of dexmedetomidine was more effective than 10 mu g/kg of dexmedetomidine injection in respect to protection of alveolar structures. The difference was found to be statistically significant between group 3 and group 4 in terms of histopathological damage score. Conclusions: The present study suggests that dexmedetomidine administration may be beneficial for preventing lung injury induced by hepatic IR.

This paper aims to investigate the relationship between tourism and planning in UNESCO World Heritage List (WHL) sites, with special reference to the relation between Management Plans and other (local and regional) planning instruments and policies able to influence the promotion of sustainable and responsible development. This will be explored through a confrontation between two important tourist locations in Sicily: Agrigento (the Valley of the Temples) and the Aeolian Islands, which have both been recognized as World Heritage Sites by UNESCO. The analysis of these case studies will point out the challenge of integrating different management and planning regimes – which mainly refer to a performative model – in a (still) very conformative planning system. The article will show how supranational policies often lose their efficacy in relation to regional and local planning systems, being in opposition to such systems. The selection of the two Sicilian case studies is particularly appropriate under this perspective, as they represent significant or even extreme examples of the gap between the supranational performative approach of the UNESCO WHL MP model and the conformative nature of the Sicilian planning system; this is due to the different nature and characteristics of the Sicilian planning law and regulations and the UNESCO WHL MP guidelines. The comparison, proposed in the paper, will explore the influence and mutual relationships between the two UNESCO sites and the planning instruments and policies. The main questions of the paper are: In which way the above mentioned framework of planning instruments takes into account the UNESCO sites? What is the role of planning instruments and policies to facilitate integration and reconciliation? Which are the strategies implemented by the planning system and its regulations in order to manage and improve the tourist flows, according to a sustainable planning approach? On the other hand, does the UNESCO heritage label (and its related policies and management plans) guarantee international and global control over local changes and planning decisions? The paper will underline how the interrelation among the WHL MP and other (local and regional) plans is on the one hand necessary and on the other hand problematic, due to the diversity of planning systems in each country. Consequently, the paper will consider the legal implications for local planning systems due to the fact that each national and local reality has to spot the most adequate configuration for WHL MP, in the light of existing laws and specific cases. The paper will also show the difficult integration between planning instruments operating in the same area, but managed by different actors, with different time schedules, resources and law effectiveness.

This paper considers the usefulness, and limitations, of codes of research ethics for the planning researcher. Formal ethical approval of planning research, and explicit agreement to adhere to specified codes of ethics, is required for research by planning academics in more and more countries. What might those promoting these processes be hoping to achieve, and how do they think the codes will help? There has been discussion of codes of professional ethics in planning for some decades (Hendler,1990; Taylor,1992), and the paper considers whether these contain arguments which could also justify codes of research ethics. The fact that planning research is undertaken both outside and inside universities, and typically aims to inform planning, or at least inform debates on planning (ie it is often action-oriented) makes professional codes more pertinent a starting point than they might be in, say, history or philosophy. The paper argues that the significance of, and hopes pinned upon, codes of ethics, whether professional or related to research, will depend upon how one understands moral behaviour, moral deliberation, and – crucially – the relationship of scholarly inquiry to moral frameworks. Analyzing the specific issue of codes of research ethics, the paper will consider the political implications of planning research in the face of several actors in the field, including the researcher him/herself (with his/her political ideas and values) on one side, and on the other side institutions which - in our research.

Vulnerability is widely recognized, both in scientific literature and institutional documents, as a key-component of risk, crucial for improving risk knowledge, assessment and management. In the last decades, vulnerability has been largely investigated according to different aims and disciplinary perspectives: nevertheless, the challenge for integrating current approaches has to be still faced and many gaps related to vulnerability understanding and measuring have still to be bridged. Despite some scholars have clearly outlined that “vulnerability rests in a multi-faceted coupled system with connections operating at different spatio-temporal scales” (Turner et al. 2003), till now vulnerability is often represented as a static and crystallized feature of elements/systems or, according to Roberts et al. (2009), “as a static factor” rather than a process, neglecting in such a way the significant changes affecting both its facets and the relationships among them over time and across space. Hence, a clear idea of the path to be followed for analyzing and measuring the time and spatial dependency of vulnerability (Birkmann, 2006) and for grasping its dynamic nature is still missing. For long, vulnerability has been associated, up to an absolute identification, to the concept of damage even though, according to a shared interpretation, it can be more precisely defined as “the characteristics and circumstances of a community, system or asset that make it susceptible to the damaging effects of a hazard” (UNISDR, 2009). The UNISDR glossary (2009) highlights that vulnerability concept includes numerous aspects - arising from physical, social, economic and environmental factors - and that it significantly varies over time, but does not emphasize the variability of vulnerability, and of its different aspects, across space despite the entity and the far-reaching dimensions of the consequences produced by such a variability, as largely shown by recent disasters. Even if different from each other, the concepts of vulnerability and damage are closely related and the recognition of damage patterns may represent one of the key-tool for in-depth analyzing some aspects of vulnerability not sufficiently investigated up to now. Accordingly, Cochrane (2004) states that “damages are displaced geographically and temporally”. Therefore, looking at the different phases following the impact of a hazardous event, might the analysis of the spatial distribution of damage help us to better understand factors and mechanisms able to induce a displacement of vulnerabilities across space? The present work aims at answering this question; in detail, grounding on some case studies, an overview of the main spatial mechanisms that can favor the displacement and the change of vulnerability across space and some hints devoted to an in-depth conceptualization of the spatial dynamics of vulnerabilities will be provided.

Thirty seven strains of Lactococcus laths subsp. locus and 5 strains of L. locus subsp. cremoris isolated from White Pickled and Kashar cheeses were identified according to phenotypic and molecular techniques using subspecies specific primers. Then, acidification, proteolysis and autolysis of strains were assessed in order to select bacteria for starter development. The strains were divided into slow, moderate and rapid acidifying groups according to their acidifications (P < 0.05) in reconstituted skim milk (RSM). Acidification of strains from White Pickled cheese was significantly higher (P < 0.05) compared to those of Kashar. Majority (86%) of the isolates exhibited Prt(+) phenotype. Bacterial autolysis which was tested under starvation conditions evidenced that strains have an autolytic extent at the end of 24 h ranging from 37 to 70%. The results of this study showed a large diversity among the isolates and provide criteria for choosing strains to be tested as starters in cheesemaking. experimentation.