Search

Shaped charges are unique and very effective warhead technology mostly applied to the rocket propelled grenades (RPGs) along with other applications (e.g. perforation of rocky formations in mining, rock drilling and other geological technics etc.). RPG's armour piercing and perforation performances originate from an explosively induced formation of a stretching metallic jet with very high velocities (hypervelocity). The hydrodynamic penetration mechanism of the stretching quasi-solid metallic jet is extremely complex and has not been fully understood. Both the jet with spout-like form and the target (i.e. RHA armour steel) behave hydrodynamically (i.e. incompressible fluid) and yet both solid strangely. The present study, as part of a large-scale customized R&D project, is stopping the penetration of the stretching jet of a RPG rocket within an "add-on" armour system. A series of experimental detonations and explosion of shaped charge munitions was conducted to elucidate the microstructural evolution and microstructural features of the metallic copper jet. Penetrating metallic spout-like jet forms were stopped and apprehended/caught within the inner layers of highly succesful composite based "add-on" armour designs. Structural evolution and microstructural analysis of the penetrating metallic jet were investigated to understand this extraordinary "solid-but behaving like fluid (quasi-solid)" metallic copper jet material. The findings obtained in this study suggest that the effective way of stopping the lethal effects of this weapon could be managed by diverting and/or twisting its linear stretching and penetration pathway. State Planning Organization of Turkish Republic Authors would like to thank to the State Planning Organization of Turkish Republic for the support of the Project. Authors would like to thank to the Tetra for their support for the SEM microstructural analysis and EDS studies. Authors would also thank to the researchers and technicians of the Materials Institute of TUBITAK Marmara Research Center for their support and work during the detonation-explosion experiments.

Gunay, Gurkan/0000-0003-0597-1511; GOKASAR, ILGIN/0000-0001-9896-9220 Mode choice of airport ground access has been covered by several studies, but there is a lack of research in the case of airport ground egress; that is, mode choices of inbound passengers for ground trips from the airport to the city center. This study aimed to cover this gap by modeling the ground egress mode choice of passengers, employing mixed logit and comparing it with the multinomial logit model. The data for this research was collected at Istanbul's Sabiha Gokcen International Airport (SAW) in 2015. Analyses included six modes, namely automobile, pick-up, public transit, taxi, shuttle and public transit (SP), and shuttle and taxi (ST). An important outcome was that a mixed logit model with error components outperformed the multinomial logit model. Results showed that significant variables affecting the ground egress mode choice included the income of the passenger, the cost of a ground trip from the airport, auto ownership status, number of luggage and trip purpose. Passengers are less constrained by ground travel time in their airport egress trips than in their airport access trips. By this, a significant finding was that prioritizing egress trip cost over travel time affected the mode choice.

OBJECTIVE To show the effect of potassium citrate treatment on overactive bladder disease in patients with kidney stone and overactive bladder symptoms. STUDY DESIGN Experimental study. PLACE AND DURATION OF STUDY Department of Urology, Alanya Alaaddin Keykubat University and Department of Urology, Suleyman Demirel University, Turkey, from October 2019 to July 2020. METHODOLOGY Patients with an indication for starting potassium citrate therapy because of kidney stone, and patients with symptoms of overactive bladder disease were included in the study. At the beginning of the treatment, the overactive bladder-version 8 form was filled and potassium citrate 10 meq 2x2 dose was started to the patients. The effect of potassium citrate on the symptoms of overactive bladder disease was demonstrated by filling the overactive bladder-version 8 form after one month of treatment. RESULTS A total of 82 people, 36 men and 46 women, participated in the study. Potassium citrate treatment caused a significant increase in urine pH levels (p

ETLI, MUSTAFA/0000-0001-9320-3971; Aslan, Ahmet/0000-0001-5797-1287; Gulcu, Anil/0000-0002-9012-8053 WOS: 000575112600001 PubMed: 33021061 Diabetic foot is challenging progressive disease which requires multisystemic control. Neuropathy, arteriopathy, and cellular responses should treated collaboratively. Despite all medical advances, diabetic foot can highly resulted with amputation and also re-amputation can be required because of failed wound healing. In this study, we aimed to investigate the relation between blood parameters and amputation events. Diabetic 323 patients include to the study who referred to orthopaedic clinic for amputation. Amputation levels (amputation levels phalanx, metatarsal, lisfranc, syme, below knee, knee-disarticulation, above-knee amputation) and re-amputations recorded and compared with routine blood parameters. Re-amputation was observed at 69 patients. The significant difference detected between lower albumin, higher HbA1c, higher CRP levels (P < 0.05) in regards to gross amputation levels, and increased wound depth. Furthermore, lower albumin levels and higher levels of WBC, HbA1c, CRP, and Creatinine were detected in re-amputation levels. Especially, HbA1c, CRP, and Creatinine levels were found as upper bound of reference line for re-amputation. The statistically optimal HbA1c cutoff point for diabetes was >= 7.05%, with a sensitivity of 86% and a specificity of 59%. In according to our results, simple blood parameters can be useful for observing the progress of amputation in diabetic foot. Particularly, lower albumin, and higher HbA1c, CRP, and Creatinine levels detected as related with poor prognosis. Besides, screening of HbA1c level seems to be highly sensitive for detecting of re-amputation possibility.

Background and Study Aim. The aim of this study is to determine the effect of e-sports on physical activity level and body composition. Material and Methods. The athletes who participated in the study were 19.92± 2.21 years of age, 1.73±0.04 m body height and 78.35±6.52 kg body weight. A total of 137 athletes participated in the study, including 27 from Turkey, 47 from South Korea and 63 from the United States (USA). The data was collected by e-mail from the sports clubs. The athletes who representing their country in international competitions involved in the study. The data obtained were evaluated in the SPSS program. Results. According to the findings of the study, the body mass index (BMI) of e-sport athletes is 26.03±1.85, the number of physical activity steps is 6646±3400 and the daily e-sport hours are 9.34±1.12. The BMI was determined as USA 26.12, South Korea 26.02 and Turkey 25.84 respectively. The number of physical activity steps was identified as 5255 steps in the US, 7785 steps in South Korea and 7909 steps in Turkey. The daily e-sports hour is set at US 9.63 hours, Turkey 9.29 hours and South Korea 8.97 hours. In comparison of country-based athletes, there was a significant difference between physical activity level and daily e-sports hours at p, Предпосылки и цель исследования. Цель данного исследования - определить влияние киберспорта на уровень физической активности и композицию тела.Материал и методы. Возраст спортсменов, принимавших участие в исследовании, составлял 19,92 ± 2,21 года, рост составлял 1,73 ± 0,04 м, масса тела - 78,35 ± 6,52 кг. Всего в исследовании приняли участие 137 спортсменов, в том числе 27 из Турции, 47 из Южной Кореи и 63 из США. Данные были получены от спортивных клубов по электронной почте. В исследовании участвовали спортсмены, представляющие свою страну на международных соревнованиях. Полученные данные оценивались в программе SPSS.Результаты. Согласно результатам исследования, индекс массы тела (ИМТ) спортсменов, занимающихся киберспортом, составляет 26,03 ± 1,85, количество шагов физической активности - 6646 ± 3400, а ежедневные часы киберспорта - 9,34 ± 1,12. ИМТ был определен как США 26,12, Южная Корея 26,02 и Турция 25,84 соответственно. Количество шагов физической активности было определено как 5255 шагов в США, 7785 шагов в Южной Корее и 7909 шагов в Турции. Ежедневное время занятий киберспортом установлено на уровне 9,63 часа в США, 9,29 часа в Турции и 8,97 часа в Южной Корее. По сравнению со спортсменами из страны была выявлена ​​значительная разница между уровнем физической активности и дневными часами занятий киберспортом при p, Передумови та мета дослідження. Мета даного дослідження - визначити вплив кіберспорту на рівень фізичної активності і композицію тіла.Матеріал і методи. Вік спортсменів, які брали участь в дослідженні, становив 19,92 ± 2,21 року, зрост становив 1,73 ± 0,04 м, маса тіла - 78,35 ± 6,52 кг. Всього в дослідженні взяли участь 137 спортсменів, в тому числі 27 з Туреччини, 47 з Південної Кореї і 63 з США. Дані були отримані від спортивних клубів по електронній пошті. У дослідженні брали участь спортсмени, що представляють свою країну на міжнародних змаганнях. Отримані дані оцінювалися в програмі SPSS.Результати. Згідно з результатами дослідження, індекс маси тіла (ІМТ) спортсменів, які займаються кіберспортом, становить 26,03 ± 1,85, кількість кроків фізичної активності - 6646 ± 3400, а щоденні заняття кіберспортом - 9,34 ± 1,12 годин. ІМТ був визначений як США 26,12, Південна Корея 26,02 і Туреччина 25,84 відповідно. Кількість кроків фізичної активності було визначено як 5255 кроків в США, 7785 кроків в Південній Кореї і 7909 кроків в Туреччині. Щоденний час занять кіберспортом встановлено на рівні 9,63 години в США, 9,29 години в Туреччині і 8,97 години в Південній Кореї. У порівнянні зі спортсменами з країни була виявлена ​​значна різниця між рівнем фізичної активності та денними годинами занять кіберспортом при p

Yesil, Abdullah/0000-0002-0607-8226 In this paper, two new complementary metal oxide semiconductor (CMOS) realizations for second-generation voltage conveyor (VCII) are presented. The first proposed VCII has a very simple structure employing only six transistors. The second proposed VCII employs 11 transistors, and none of the transistors at both proposed circuits suffer from the body effect. Small-signal analysis, parasitic elements, and input-referred noise of the proposed VCIIs are given. Moreover, a new active element called voltage controlled second-generation voltage conveyor (VC-VCII) is proposed as dual element of current controlled second-generation current conveyor (CCCII) active element. Its parasitic resistance at theYterminal can be controlled electronically. Two presented CMOS structures of VCII are worked as VC-VCII with slight modification. Proposed circuits are simulated in Cadence Analog environment using TSMC 0.18-mu m process parameters with +/- 0.9-V supply voltages. Both CMOS structures occupy a small chip area of 276.8 and 271 mu m(2), respectively. The bandwidth of the current follower stage of the proposed VCIIs is found as 794 MHz, whereas the bandwidth of the voltage follower stage for the first and second proposed VCIIs is found as 2.57 and 1.92 GHz, respectively. As an application example, voltage-mode first-order low-pass filter has been given with its tunable gain by using VC-VCII.

Candan, Busra/0000-0002-5138-5583; avnioglu, seda/0000-0003-1719-4190 WOS: 000555417100001 PubMed: 32748247 Tinnitus is a symptom in which the patient can hear ringing, buzzing and similar sounds in the ear for 3 months longer. In our study, we aimed to analyse the cerebellum volume and cerebellum connections in patients with chronic tinnitus using VolBrain program. A total number of 10 patients and 10 otherwise healthy peoples records were then enrolled. Volumetric analysis was performed with automated segmentation of the cerebellum and its lobules, using magnetic resonance imaging (MRI). The mean volumes of 10 cerebellar volume were compared between the tinnitus and control groups. Quadrangular lobular portion of the cerebellum, the flocculonodular part and the volume of the central cerebellar lobule were decreased in the tinnitus group. White and grey matter decreased and the amygdala size was increased. We found statistically important volumetric changes in our study. VolBrain can be used in the future for analysing, diagnosis and treatment tinnitus patients. We recommend to use this practical, free of charge and easy programme to analyse for tinnitus patients. This may provide us with practical and useful information about the disease. In patients with tinnitus, the volume loss was 17.48% in the quadrangular lobe, 21% in the central lobule, and 9.33% in the total cerebellum volume.

OBJECTIVE: Newborns in neonatal intensive care units (NICUs) are at high risk for developing nosocomial infections (NIs), which may result in morbidity and mortality. In this study, we aimed to ascertain the bacteriological profiles and their antimicrobial susceptibility patterns in NIs. METHODS: We conducted a cross-sectional study in the NICU. Late-onset sepsis (LOS) cases confirmed with blood cultures were evaluated retrospectively. Laboratory parameters, demographics, and clinical data were collected and analyzed from hospital records retrospectively. RESULTS: Of the 1210 infants in the NICU, 76 (6.3%) had LOS. A total of 86 episodes of LOS were documented; in 10 infants, two pathogens were identified. The mean gestational age (GA) of the infants with LOS was 33.2+-4.8 weeks (23 to 42 weeks). Gram-positive cocci (GPC) caused most of the LOS episodes (65.8%, 50/76), with coagulase-negative Staphylococcus (CoNS) as the most common cause of LOS (50%, 38/76). Gram-negative rod species (GNRs) accounted for 32.9% (25/76) of the LOS cases, and fungi accounted for 1.3% (1/76). The mortality rates for GNR and GPC were 17.9% and 6.4%, respectively (p>0.05). The mean CRP and conjugated bilirubin levels for the GPC and GNR groups were 37.5 vs. 29.5 mg/dl and 0.7 vs 1.5 mg/dl, respectively (p>0.05). GNRs had a 20–25% ceftriaxone resistance. Two (4%) GPC species were resistant to linezolid, while all were susceptible to vancomycin. All of the GNRs were susceptible to carbapenems. CONCLUSION: These results underscore the recent emergence of CoNS in NICUs. LOS due to GNRs seems to display higher C-reactive protein and conjugated bilirubin values than those due to GPC. Clinical monitoring of NIs and bacterial resistance profiles are required in all NICUs.

Basaran, Murat Alper/0000-0001-9887-5531 WOS: 000551478900021 PubMed: 31771037 BACKGROUND: Pain is a significant cause of disability in knee osteoarthritis. Conventional radiography is widely used in the assessment of knee osteoarthritis, however radiographic findings do not correlate well with pain. Ultrasonography can be used to evaluate the soft tissue structures of the knee that can be related to pain. OBJECTIVE: To evaluate pain-related soft tissue structures of the knee with ultrasonography. METHODS: This cross-sectional study included a total of 198 knees from 99 patients with knee osteoarthritis. Knee pain and functional status were evaluated by performing visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). On the ultrasound, cartilaginous thickness, knee effusion and presence of Baker's cyst were assessed and the correlation to pain was investigated. RESULTS: Baker's cyst was significantly more frequent in symptomatic knees (13.9%) compared to asymptomatic knees (2.5%). Patients with Baker's cyst had a significantly more limited degree of knee flexion, significantly higher resting VAS pain scores and worse WOMAC scores compared to patients without Baker's cyst. In log-linear analysis, presence of Baker's cyst increased the risk of pain by 2.94 times. CONCLUSION: Ultrasound as a modality that is easily accessible, inexpensive and without radiation exposure is helpful to demonstrate factors related to pain in knee osteoarthritis by allowing assessment of soft tissue structures.

Sharing content easily on social media has become an important communication choice in the world we live. However, in addition to the conveniences it provides, some problems have been emerged because content sharing is not bounded by predefined rules. Consequently, offensive language has become a big problem for both social media and its users. In this article, it is aimed to detect offensive language in short text messages on Twitter. Since short texts do not contain sufficient statistical information, they have some drawbacks. To cope with these drawbacks of the short texts, semantic word expansion based on concept and word-embedding vectors are proposed. Then for classification task, decision tree and decision tree based ensemble classifiers such as Adaptive Boosting, Bootstrap Aggregating, Random Forest, Extremely Randomized Decision Tree and Extreme Gradient Boosting algorithms are used. Also the imbalanced dataset problem is solved by oversampling. Experiments on datasets have shown that the extremely randomized trees which takes word-embedding vectors as input are the most successful with an F-score of 85.66%. © 2020, Ismail Saritas. All rights reserved.

Purpose Fuzzy rule-based system (FRBS), a soft computing method used for big data analysis, is used to determine which single hotel attribute or interrelated hotel attributes used in Travel 2.0 data play a role on price–performance (PP). Design/methodology/approach FRBS, based on fuzzy set theory, is used using the data set of four- and five-star hotels in the Alanya destination in Turkey collected from HolidayCheck.de website for the period between 2009 and 2016. Findings Single attributes do not have an impact on PP. At least two or more attributes are necessary to have an impact on PP. Compensations among attributes that are observed to be leading to PP not to change from their current level. Instead of assuming a linear relationship between hotel attributes and PP, non-linearity should often be assumed. In addition, some hotel attributes do not have an impact on PP until some other attribute reaches a certain level. Research limitations/implications The limitations of this research can be grouped under two topics. While the first is related to data, which is German-speaking tourists staying at four- and five-star hotels between 2009 and 2016, the second is the limitation on generalizability. By implementing other types of data related to hotel attributes, new insights can be generated to shed light on different aspects of the relationship between hotel attributes and PP or other measures such as overall evaluation. Originality/value A data-driven model called FRBS is constructed using original verbal statements. Novel insights pertinent to relations between hotel attributes and PP have been extracted.

Objective To investigate the effectiveness of tumor volume dependent mean diameter (Rmax) in determining axillary lymph node metastasis positivity instead of the largest diameter (Dmax) in breast cancer. Study design Descriptive study. Place and duration of study Department of General Surgery, Ankara Training and Reseach Hospital, Turkey, from January 2009 to December 2018. Methodology Patients with breast cancer, who underwent modified radical mastectomy and lumpectomy and axillary lymph node dissection due to invasive carcinoma, included in this study. Approximate vTm was calculated from the obtained tumor specimen dimensions using ellipsoid volume formula. From the sphere volume formula, Rmax, which gives the same vTm value, was reversely calculated. Efficacy and usability of Rmax value were evaluated on nomograms that are available online; and are used most frequently owing to its ease of use. Results In 305 patients, mean Dmax was 3.4 ±1.8 cm, mean vTm was 17.9 ±35.9 cm3, and mean Rmax was 2.6 ±1.4 cm. For the distinction of ALNM positive and negative patients, Dmax significant [Area Under Curve (AUC) 0.709], Rmax significant [AUC 0.748] and vTm significant [AUC 0.748] efficacy was considered. Conclusion When the relationships of Dmax and vTm with ALNM were compared in breast cancer cases, the efficacy of vTm is higher. It was found that vTm and Rmax can be used instead of Dmax. The relation of Rmax parameter with ALNM was found to be higher. When Rmax was used in nomogram samples, which are currently used in predicting ALNM positivity, it increased nomogram efficacy. Key Words: Breast neoplasm, Tumor burden, Tumor volume, Tumor diameter, Lymphatic metastasis.

WOS: 000524263800001 PubMed: 32266786 The aim of this study was to investigate the effects of laparoscopic and open surgery on the development of postoperative surgical wound infection and wound healing between complicated appendicitis patients. Patients with complicated appendicitis were divided into those underwent laparoscopic and open surgical procedures according to the surgical method. Patients were followed up with regard to development of any postoperative wound infection, and medical, radiological, and surgical treatment methods and results were recorded. A total of 363 patients who underwent appendectomy were examined, of which 103 (28.4%) had complicated appendicitis. Postoperative wound infection rate in patients who underwent open surgery was 15.9%, while it was 6.8% in the laparoscopic surgery group. There was no statistically significant difference between the two groups in terms of infection development rates (P > .05). The rate of surgical drainage use and rehospitalisation was significantly higher in the group with wound infection than in the group without wound infection. (P < .05). We suggest that in terms of wound infection and wound healing, laparoscopic surgery should be the method of choice for patients with complicated appendicitis. In order to reduce the frequency of wound infection, drains should not be kept for a long time in patients undergoing appendectomy.

The degeneration of the Lumbar Intervertebral Disc (LIVD) and the other elements of the spine are an inevitable result of aging. However, it is observed that the same degree of degenerative change does not occur in each individual. In the present study, the purpose was to compare the morphometric changes on the lumbar spine with or without intervertebral disc herniation in early period. Group 1 (the Patient Group) consisted of the patients who were diagnosed with lumbar intervertebral disc hernia and who were not operated at least one month clinical duration. Group 2 (the Control Group) consisted of individuals who were selected randomly, had only back pain, underwent magnetic resonance imaging (MRI), and were determined to have intact intervertebral disc. The sagittal and axial MRI sections of lumbar spine was used for measurements and statistical evaluation. There were no statistically significant differences between the intervertebral disc volumes, vertebral body volumes and intervertebral disc anterior and posterior heights of Group 1 and 2 (p>0.05). In terms of anterior-posterior length, the length of the L5 vertebral body was determined to be more in the Patient Group (p0.05). There were no apparent relations between the change on the lumbar vertebra corpus and intervertebral disc in early period. It was concluded that the intact intervertebral disc could protect the lower lumbar vertebra corpus from degenerative changes. Although the herniation of the intervertebral disc is newly formed, it is understood that the physiological process or morphometric changes started earlier. © 2020, Universidad de la Frontera. All rights reserved.

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique. RESUMO OBJETIVO O Refluxo Vesicoureteral (RVU) representa um dos mais importantes fatores de risco para pielonefrite aguda em crianças. Diversas técnicas intra e extravesicais já foram descritas para a correção cirúrgica do RVU. O objetivo do nosso estudo é comparar os resultados de procedimentos extravesicais e intravesicais abertos para o tratamento de RVU primário unilateral em crianças. METODOLOGIA Entre janeiro de 2012 e agosto de 2018, 38 crianças com RVU primário foram submetidas a cirurgia aberta de reimplante ureteral. Esses casos foram retrospectivamente revisados. As abordagens de Cohen (intravesical) e Lich-Gregoir (extravesical) foram agrupadas nos grupos A e B, respectivamente. Os grupos foram comparados quanto à idade, sexo, grau de refluxo pré-operatório, presença de sintomas no trato urinário inferior, tempo de operação, desconforto e dor, necessidade de analgésicos, duração de hematúria, complicações pós-operatórias e tempo de internação. Todos os parâmetros foram comparados estatisticamente. RESULTADOS No total, 38 pacientes foram incluídos neste estudo. O grupo A teve 18 pacientes e o grupo B, 20. O tempo médio de operação foi significativamente menor no grupo B do que no grupo A. O tempo médio de internação também foi menor no grupo B. O tempo de uso do foley uretral foi de 4,7 ± 0,9 dias e 2±0 dias (p = 0,000*) , respectivamente, para o grupo A e B. Hematúria macroscópica foi observada no grupo A. A pontuação na escala objetiva de dor foi pior após a cirurgia intravesical. A necessidade de analgésicos foi maior no grupo A (p = 0,131). CONCLUSÃO As técnicas extravesicais e intravesical de ureteroneocistostomia são igualmente bem-sucedidas e viáveis para o tratamento de RVU primário unilateral. A técnica de Cohen está associada a um período de internação mais longo e mais doloroso, hematúria e maior tempo operatório, em comparação com a técnica de Lich-Gregoir.

All healthcare workers (HCWs) encounter stress during in their working lives, and are constantly exposed to adverse conditions. The present study evaluates the relationship between burnout syndrome, anxiety levels and insomnia severity among healthcare workers, who mostly work in shifts. The Maslach Burnout Inventory, the Insomnia Severity Index and the Beck Anxiety Inventory were used to measure burnout, insomnia severity and anxiety status, respectively. This cross sectional study included a total of 1,011 HCWs and 679 (67.2%) of the study respondents were women. The respondents were aged 20-72, with a mean age of 35.67 +/- 8.61 years. Fifty-eight percent (n = 589) of the participants were rotating shift workers. Working on-call led to a significant difference in all burnout parameters (for each

Purpose: The aim of our study was to compare different techniques for the estimation of liver volume using cadaveric sample, magnetic resonance imaging (MRI) and ultrasonography (USG) images, and to measure errors associated with volume estimation techniques based on fluid displacement (the Archimedes' principle). Materials and Methods: Our study was formed of five newborn cadavers aged 39.7±1.5 weeks and weighted 2.220±1.056 g. We used three different methods for calculate the liver volume. Results: Liver volume (LV) measured by the Archimedes' principle was 70.00±49.96 cm3. There was no significant difference between the methods. Conclusion: MR and USG images provide easy, applicable and reproducible estimates in calculating volume of normal and anomalous liver with the Cavalieri’s principle. We think that our study may be a reference for similar studies to be done in the upcoming years., Amaç: Bu çalışmada yenidoğan kadavralarına ait karaciğerler üzerinde, Ultrasonografi (USG), Manyetik Rezonans Görüntüleme (MRG), Arşimet prensibi ve dilimleme yöntemleri kullanarak, bu yöntemler arasındaki farklılıkların ortaya çıkarılması amaçlanmıştır.Gereç ve Yöntem: Çalışmamız 39.7 ± 1.5 hafta yaşları ve 2.220 ± 1.056 g ağırlıklı beş yenidoğan kadavradan oluşmuştur. Karaciğer hacmini hesaplamak için üç farklı yöntem kullanılmıştır.Bulgular: Arşimed prensibi ile ölçülen karaciğer hacmi (LV) 70.00 ± 49.96 cm3 idi. Metodlar arasında anlamlı fark bulunmadı.Sonuç: MR ve USG görüntüleri, Cavalieri prensibi ile normal ve anormal karaciğer hacminin hesaplanmasında kolay, uygulanabilir ve tekrarlanabilir tahminler sağlar. Çalışmamızın önümüzdeki yıllarda yapılacak benzer çalışmalara referans olabileceğini düşünüyoruz.

Objective Due to the biomechanical importance of the meniscal root ligament, several surgical techniques have been defined in order to treat meniscal root tear. Different application techniques have different levels of difficulty. We aimed to find a stronger and simpler repair technique. Methods Sixteen bovine knee joints were prepared. The posterior root of the medial meniscus was dissected and repaired with one of two different techniques. The knees in group 1 ("knotted group") were repaired with the knotted suture anchor technique, and the knees in group 2 ("knotless group") were repaired using the knotless suture anchor technique. The strength of the repairs was tested biomechanically. Results Cyclic loading tests were done. On the 0-20 N one-cycle test, the knotted anchor group's equivalent stiffness average was 5.28 N/mm, and the knotless anchor group's equivalent stiffness average was 5.48 N/mm. The 5-20 N two-cycle test results were 8.29 N/mm for the knotted group and 8.66 N/mm for the knotless group. On the 5-20 N 100-cycle test, the equivalent stiffness averages were 8.59 N/mm for the knotted group and 10.18 N/mm for the knotless group. Elongation was 5.83 mm for the knotted group and 4.86 mm for the knotless group. After performing load-to-failure tests, the failure forces were recorded as 237.83 N for the knotted group and 204.90 N for the knotless group. The failure test elongation values were 26.83 mm for the knotted group and 18.70 mm for the knotless group. The failure energies were 3.87 J for the knotted group and 1.83 J for the knotless group. Except for elongation until failure (p=0.009), there were no significant differences between the two groups tested (p>0.05). The average elongation was significantly less in group 2, showing that the knotless anchor had an advantage, with less meniscal excursion compared to the sutured anchor. Conclusion Knotless anchors have a mechanical advantage over knotted anchors for preventing meniscal excursion. When thought together with technical simplicity during arthroscopic surgery, knotless anchors could be used safely for the fixation of the meniscal root ligament.

Liu, Xiaoping/0000-0003-1808-4233; Jing, Yuan Wei/0000-0002-3347-2448 This paper provides a new solution for the finite-time attitude maneuvers of rigid spacecraft. Uncertainties involving unknown inertial parameters, external disturbances and actuator failures are taken into account. With an effort to achieve attitude tracking despite the impact of uncertainties, a non-singular terminal sliding mode (NTSM) manifold consisting of attitude errors and angular velocity errors is first constructed. After that, a simple but efficient adaptive updating law is derived to estimate the upper bound of the lumped unknown function in the derivative of sliding surface. Combining NTSM technology and pure adaptive control, a chattering-free fault-tolerant controller is presented. The premise assumptions on uncertainties in most of the existing achievements are eliminated, which makes the controller less constrained and more practical. The rigorous proof of finite-time stability is provided and the convergent regions of tracking errors are explicitly expressed. Finally, numerical simulation is conducted to verify the effectiveness of the proposed control scheme and the comparison experiments with relevant literature demonstrate the satisfactory performances. NSERC of CanadaNatural Sciences and Engineering Research Council of Canada (NSERC); National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [61773108] NSERC of Canada; National Natural Science Foundation of China, Grant/Award Number: 61773108

Liu, Xiaoping/0000-0003-1808-4233 In this paper, the problem of finite-time attitude-tracking control for a rigid spacecraft is addressed. Uncertainties including unknown inertial parameters, external disturbances, actuator failures and saturation constraints are considered. Firstly, a smooth function which is different from the common saturation treatment is presented to deal with the actuator constraints. Secondly, a fast non-singular terminal sliding mode (FNTSM) manifold composed of tracking errors is constructed. To estimate the unknown function in the sliding surface derivative, Chebyshev neural network (CNN) is introduced and thus the strict assumptions on uncertainties in many related works are abolished. By designing the CNN adaptive laws, a new fault-tolerant control scheme is proposed such that the attitude tracking can be achieved within a limited time interval. Compared with the existing CNN-based achievements with finite-time convergence, the approximation errors are proved to be finite-time stable instead of uniformly ultimately bounded (UUB). Finally, simulation experiments are conducted to demonstrate the satisfactory tracking performance of the attitude controller. National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [61773108]; NSERC of CanadaNatural Sciences and Engineering Research Council of Canada (NSERC) This work was supported by the National Natural Science Foundation of China: [Grant Number 61773108]; the NSERC of Canada: [Grant Number Xiaoping Liu].

Objective: This study aimed to investigate the effect of platelet-rich plasma (PRP) and platelet-rich fibrin matrix (PRFM) on the healing of vertical medial meniscal tears in a rabbit model. Methods: The study was conducted on 72 New Zealand mature rabbits aged more than 6 months. Rabbits were randomly assigned to six groups: control (C) group, meniscal repair (MR) group, PRP group, PRFM group, MR+PRP group, and MR+PRFM group, with 12 rabbits in each group. A 5-mm full-thickness vertical tear was created in the avascular zone of the medial meniscus corpus in the right knee of all rabbits. The respective treatment for each group was given to the meniscal tear in each rabbit. Histological evaluation of healing was performed 6 and 12 weeks after surgery. Results: Defect filling and collagen formation remained low in the C group. However, in all other groups, there was no significant difference in the $6^{th}$ week. In the $12^{th}$ week, similar results as those obtained in the $6^{th}$ week were obtained. In the C group, there was a difference in defect filling and cell type. This difference was that the defect filling and collagen formation remained low in the $12^{th}$ week. No significant difference was observed between MR, MR + PRP and MR + PRFM groups. The MR group significantly differed from the other groups in the defect-filling rate and cell type; however, the use of PRP and PRFM did not provide an obvious benefit. Conclusion: The contradictory results obtained in previous studies emphasize the need for further research on the use of PRP in meniscal recovery and repair. We believe that if surgery is indicated, repair is absolutely necessary to improve the healing of the tissue in meniscal tears. Studies using human meniscal tissue for meniscal injury and those that evaluate clinical applications of PRP are warranted.

PubMed: 32061493 Background: Recent studies have been revealed that oxidative damage is the main cause of aging and age-related neurodegenerative diseases like Alzheimer's disease (AD). Melatonin is secreted from the pineal gland and its secretion has been found to be altered in AD. In the last decade the role of exosomes in spreading toxic proteins and inducing the propagation of diseases like AD has been discussed. However, it is not known how melatonin affects the amount of exosomes released from the cells and the content of the exosomes. Objective: Herein, we investigated the possible role of melatonin treatment in the releasing of exosomes and exosomal tau content in an in vitro A? toxicity model. Method: SH-SY5Y cell line was used. The optimum concentration of A? was determined by cell viability and cell proliferation tests. Melatonin (100 µM) was applied before and after A? application. Total exosomes isolated from cell culture media were immunoprecipitated. The amount of released exosomes and their tau content were analyzed by Western blots. Results: Our data demonstrated for the first time that melatonin treatment clearly affected the amount of released exosomes. It would decrease the amyloid beta load and toxicity by inhibiting exosome release. We also demonstated that melatonin also affected the level of tau carried by exosomes depending on whether melatonin was applied before or after A? application. Conclusion: It is considered that the effect of melatonin in the release of exosomes and exosomal tau content would contribute the development of therapeutic strategies in AD and related disorders. © 2019 Elsevier Ltd

WOS: 000510009200005 PubMed: 31077857 Pain control is achieved typically by means of injection of local anesthesia for invasive procedures to carry out procedures with as little pain or discomfort as possible. Although this method is highly effective, patients often fear more from the sight of a needle during administration of local anesthetic than from the treatment. Therefore, needleless local anesthesia with a jet injection device has been proposed. With the INJEX (R), anesthetic solution is forced under high pressure into the oral mucosa, leading to mechanical infiltration of the compound through the mucosa. With this study, we aimed to show the effectiveness of the needleless injection for infiltrative anesthesia and compare the acceptance and efficacy between jet injection with INJEX and local infiltration anesthesia. 28 adult patients admitted to our department for tooth extraction were included in the study. Two symmetrical teeth in the same jaw were extracted from each of the patients. Jet injection with the INJEX (R) was performed on one side and classical (needle) infiltration anesthesia on the other side with 0.3 cc Ultracain DS forte (Sanofi Aventis, Istanbul, Turkiye) on buccal and lingual aspects and 0.1 cc on palatal aspects of the teeth. The difference between pain and discomfort scores experienced during tooth extraction was statistically significant (P = 0.026). Accordingly, the pain or discomfort score of the INJEX (R) method during tooth extraction was significantly higher. Jet injection with the INJEX (R) was not found to be effective for local infiltrative anesthesia especially teeth extractions. It may be more acceptable when using for previously classical local infiltration anesthesia by patients. The main problem with jet injection was the "pop" sound when the INJEX (R) device was pressed, and also inadequate suppyling the anesthesia. (C) 2019 Elsevier Masson SAS. All rights reserved.

With the complexity of the network system rapidly increasing, network traffic prediction has great significance for the safety pre-warning of the network load, network management and control, and improvement of the quality of the network service. In this paper, the time series analysis is used for the network traffic prediction, and a prediction method combined with an optimized unscented Kalman filter (UKF) by an improved fruit fly algorithm (IFOA) and echo state network (ESN) is proposed, which is named by IFOA-UKF-ESN. The researches mainly solve the problem that the prediction accuracy might be greatly affected by the actual network traffic data with unknown and time-varying noises. UKF is used to train the best state vector (formed by spectral radius, scale of the reservoir, scale of the input units and connectivity rate) of ESN; and the proposed IFOA algorithm is proposed to optimize the weights of the predicted state value and the covariance in UKF, which makes UKF have adaptive ability for unknown and time-varying noise. Three actual network traffic data sets with different Gaussian white noise distributions are constructed for experiments, and the experimental results show that the proposed prediction method makes an average improvement by reducing at least 20.60%, 43.23% and 41.85% of RMSE, at least 23.66%, 52.38% and 47.50% of MAE, and at least 23.58%, 52.10% and 47.28% of MAPE, which verify the effectiveness of the proposed method. National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [61773108] The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors are grateful for financial support from the National Natural Science Foundation of China (Grant No.61773108).

KARA, TAYFUN/0000-0002-2156-3457; tarakcioglu, hatice nur/0000-0002-8611-4353; WOS: 000529689200013 PubMed: 31912403 Purpose To compare the retinal and choroidal microvasculature quantitatively via optical coherence angiography (OCTA) in children with attention deficit hyperactivity disorder (ADHD) who were under methylphenidate (MFD) treatment or newly diagnosed as ADHD and were not taking any medication. Methods This was a cross-sectional, comparative, and observational study. The children who were between 6 and 17 years old and previously diagnosed as ADHD and were under MFD treatment or who were newly diagnosed as ADHD were included in the study. Optical coherence tomography angiography imaging was performed via OCT RT XR Avanti with AngioVue software (Optivue Inc, Freemont, CA). The main outcome measure of the study was OCTA parameters of the children with ADHD. Results A total of 186 eyes of 186 patients were included in the study. There were 80 eyes in the control group (newly diagnosed) and 106 eyes in the treatment group (under MFD treatment). The mean duration of methylphenidate use in the treatment group was 33.9 +/- 20.1 months (between 6 and 84 months). The choriocapillary flow area (p = 0.03), superficial parafoveal thickness (p = 0.01), and deep parafoveal thickness (p = 0.01) were statistically greater in the treatment group than the control group. Conclusion Most of the important OCTA parameters especially foveal avascular zone (FAZ) area and FAZ perimeter were similar in the two groups. There was a significant difference between the two groups in parafoveal thickness values which might point to a slight effect of MFD on retinal circulation.

Kilimci, Zeynep Hilal/0000-0003-1497-305X; Akyokus, Selim/0000-0003-0793-1601; (Bilgin) Tukel, Dilek/0000-0001-5288-5996 Human activity recognition is a challenging problem with many applications including visual surveillance, human-computer interactions, autonomous driving and entertainment. In this study, we propose a hybrid deep model to understand and interpret videos focusing on human activity recognition. The proposed architecture is constructed combining dense optical flow approach and auxiliary movement information in video datasets using deep learning methodologies. To the best of our knowledge, this is the first study based on a novel combination of 3D-convolutional neural networks (3D-CNNs) fed by optical flow and long short-term memory networks (LSTM) fed by auxiliary information over video frames for the purpose of human activity recognition. The contributions of this paper are sixfold. First, a 3D-CNN, also called multiple frames is employed to determine the motion vectors. With the same purpose, the 3D-CNN is secondly used for dense optical flow, which is the distribution of apparent velocities of movement in captured imagery data in video frames. Third, the LSTM is employed as auxiliary information in video to recognize hand-tracking and objects. Fourth, the support vector machine algorithm is utilized for the task of classification of videos. Fifth, a wide range of comparative experiments are conducted on two newly generated chess datasets, namely the magnetic wall chess board video dataset (MCDS), and standard chess board video dataset (CDS) to demonstrate the contributions of the proposed study. Finally, the experimental results reveal that the proposed hybrid deep model exhibits remarkable performance compared to the state-of-the-art studies.

PubMed: 33035413 Acquired idiopathic generalised anhidrosis is an uncommon sweating disorder characterized by loss of sweating in the absence of any neurologic, metabolic or sweat gland abnormalities. Although some possible immunological and structural mechanisms have been proposed for this rare entity, the definitive pathophysiology is still unclear. Despite some successfully treated cases with systemic corticosteroid application, the dose and route of steroid application are controversial. Here, we present a 41-yearold man with lack of generalised sweating who has been successfully treated with high dose pulse intravenous prednisolone. We have discussed his clinical and histopathological findings as well as the treatment options in view of the current literature. © 2020 Ifjusagi Lap-es Konyvkiado Vallalat. All rights reserved.

Purpose – This paper aims to enhance sustainable development in the construction industry by presenting a literature review from the perspective of sustainable development goals (SDG) on marketing in the construction industry, its importance on management strategies, marketing capabilities, and the relationship between SDG and lean and green marketing (LGM) management in the construction industry. Design/methodology/approach – A structured literature review was used as the research methodology to find out how the determinant topics were addressed in state-of-the-art of the literature. A total of 21 combinations of different keywords were applied to the search engine in the title, abstract, and keywords to gather research and review articles published within a period of ten years. As a result, 114 academic papers were examined. Findings and implications – Articles were examined in three stages, focusing on: marketing and construction industry, marketing and its importance on management, and LGM. The gaps in the literature were identified and potential future research areas were highlighted. Limitation – Using Elsevier (www.sciencedirect.com) as the database and focusing on research and review articles written in English only are the limitations of this research. Originality – This research contributes to the construction industry marketing literature, green marketing, and LGM in the construction industry. This research reviews the literature based on a large sample of papers in three stages. It outlines the gaps in the literature and may serve as a guide for further research of marketing and LGM strategy implementation in the construction industry., Svrha – Cilj je rada unaprijediti održivi razvoj u građevinskoj industriji (CI) i predstaviti pregled literature iz perspektive ciljeva održivog razvoja (SDG) u marketingu u građevinskoj industriji (CI), njegovoj važnosti za strategije upravljanja, marketinške sposobnosti i odnos između održivoga razvoja (SDG) i upravljanja lean (agilnim) i zelenim marketingom (LGM) u građevinskoj industriji (CI). Metodološki pristup – Kao metodologija istraživanja korišten je strukturirani pregled literature kako bi se saznalo na koji način su adresirane najznačajnije teme u suvremenoj literaturi. Korištena je kombinacija 21 različite ključne riječi pomoću tražilice i pretraživanja po naslovu, sažetku i ključnim riječima radi prikupljanja istraživačkih i preglednih članaka objavljenih u vremenskom razdoblju od deset godina. Ispitano je 114 znanstvenih radova. Rezultati i implikacije – Članci su ispitivani u tri faze s naglaskom na marketingu i građevinskoj industriji (CI), marketingu i njegovoj važnosti za upravljanje te lean (agilni)i zeleni marketing (LGM). Utvrđene su jazovi u literaturi. Istaknuta su potencijalna buduća područja istraživanja. Ograničenje – Ograničenja istraživanja vezana su uz korištenje Elseviera (www.sciencedirect.com) kao baze podataka i fokusiranje na istraživanja i pregledne članke napisane na engleskom jeziku. Doprinos – Rad doprinosi marketinškoj literaturi u području građevinske industrije (CI), zelenom marketingu te lean (agilnom) marketingu u građevinskoj industriji (CI). Istraživanje daje pregled literature na temelju velikog uzorka radova u tri faze. Prikazuje jazove u literaturi te može služiti kao vodič za daljnja istraživanja u marketingu te provedbi strategije lean (agilnog) i zelenog marketinga (LGM) u području građevinske industrije (CI).

Purpose: To evaluate the retinal vascular structure in amblyopic eyes by optical coherence tomography angiography (OCTA). Methods: Thirty-seven eyes of 37 patients with anisometric amblyopia were compared with 37 eyes of 37 age- and gender-matched control subjects by OCTA in terms of superficial capillary plexus vessel density, deep capillary plexus vessel density, and foveal avascular zone. Results: The mean age was 12 ± 4.2 years in patients with amblyopia and 13 ± 6.1 years in individuals without amblyopia. Foveal superficial capillary plexus vessel densities were 20.49% ± 3.27%, 19.70% ± 3.82%, and 19.96% ± 3.84%, and parafoveal superficial capillary plexus vessel densities were 48.50% ± 3.64%, 49.01% ± 3.33%, and 48.9% ± 2.98% in amblyopic, fellow, and control eyes, respectively. The foveal deep capillary plexus vessel densities were 18.95% ± 3.76%, 18.6% ± 4.50%, and 19.29% ± 4.01%, and parafoveal deep capillary plexus vessel densities were 51.0% ± 4.21%, 51.85% ± 4.12%, and 52.03% ± 3.57% in amblyopic, fellow, and control eyes, respectively. Superficial and deep capillary plexus vessel densities in the foveal and parafoveal areas were not significantly different between the groups ( P > .05). The parafoveal area was evaluated in quadrants. In the superior quadrant, superficial and deep capillary plexus parafoveal densities were significantly lower in amblyopic eyes ( P < .05). No significant difference was observed in the foveal avascular zone between the groups ( P > .05). Conclusions: Although no significant vascular damage was demonstrated by OCTA in amblyopic eyes, localized defects may be specific for it. Additional studies are needed to evaluate any specific localization of vascular damage related to amblyopia. [ J Pediatr Ophthalmol Strabismus . 2020;57(1):48–53.]

Objective: The aim of this study is to evaluate the sociodemographic, injury and employment characteristics of the patients included in a physical medicine and rehabilitation program after an occupational accident (OA). Material and Methods: The study included 102 patients who were admitted to our clinic for a rehabilitation program after an OA between January 2012 and December 2018. Electronic media files in the hospital automation system were retrospectively scanned. We recorded the sociodemographic, injury and employment characteristics for each patient. Results: The mean age of 102 patients included in the study was 36.39±10.38 (min: 18, max: 59). One hundred (98%) of them were male, two (2%) were female. 18.6% of the patients are between the ages of 18-25; 42.2% were between the ages of 26-40 and 39.2% were over the age of 40. The mean number of physical therapy sessions was 42.89±25.53 (min: 15, max: 180). OAs mostly occurred in the construction industry, most frequently as a result of falling from a height, followed by sharp object injuries. Of all patients, 48% (n:49) were primary school graduates. It was found that most sequela was observed statistically significantly after upper limb injuries. The most common sequelae was contracture with 45.1% (n: 46). Conclusion: The results of our study showed that the primary school graduate young males working in the construction and metal industry sectors were mostly affected by OAs. It was found that many of the patients in need of physical therapy and rehabilitation programs recovered with sequelae despite all treatment applications. Amaç: Bu çalışmanın amacı iş kazası sonrası fizik tedavi ve rehabilitasyon programına alınan hastaların sosyodemografik özelliklerine ek olarak, yaralanma ve yaralanmanın gerçekleştiği iş koluna ait verilerin değerlendirilmesidir. Gereç ve Yöntemler: Çalışmaya Ocak 2012 ve Aralık 2018 tarihleri arasında kliniğimizce iş kazası sonrası rehabilitasyon için takip edilen 102 hasta dahil edildi. Hastane otomasyon sisteminde bulunan elektronik ortam dosyaları retrospektif olarak tarandı. Her hasta için sosyodemografik özellikleri, yaralanma ve yaralanmanın gerçekleştiği iş koluna ait veriler kayıt altına alındı. Bulgular: Çalışmaya dahil edilen 102 hastanın yaş ortalaması 36.39±10.38 (min: 18, maks: 59) idi. Hastaların 100 (%98) ü erkek, 2 (%2)’si kadındı. Hastaların %18,6’sı 18-25 yaş aralığında; %42,2’si 26-40 yaş aralığında ve %39,2’si ise 40 yaş ve üzerinde idi. Hastaların aldıkları ortalama fizik tedavi seans sayısı 42.89±25.53 (min: 15, maks: 180) idi. İş kazaları en fazla inşaat sektöründe görülürken; ilk sırada yüksekten düşme, ikinci sırada kesici-delici alet yaralanmaları yer alıyordu. Tüm kazazedelerin %48 (n:49)’i ilkokul mezunu idi. En çok sekelin istatiksel olarak anlamlı şekilde üst ekstremite yaralanmalarından sonra gözlendiği tespit edildi. En sık gözlenen sekel %45,1 (n:46) ile kontraktürdü. Sonuç: Çalışmamızın sonuçlarına göre iş kazalarından en çok inşaat ve metal sanayi iş kollarında çalışan, ilkokul mezunu genç erkeklerin etkilendiği görülmüştür. Fizik tedavi ve rehabilitasyon ihtiyacı olan hastaların birçoğunun tüm tedavi uygulamalarına rağmen sekelle iyileştiği tespit edilmiştir.

WOS: 000530579900004 PubMed: 32356430 AIM: Transient receptor potential (TRP) channels expression is enhanced significantly in colon cancer cells and Low Lever Laser Treatment (LLLT), is known to have effects and is used clinically in the treatment ofmany diseases, including colon cancer. We aimed to reveal the effects of (LLLT) on apoptosis of colon cancer and on the efficacy of cyclophosphamide via Transient receptor potential melastatin 2 (TRPM2) channels. METHOD: Human colon cancer cells (Caco-2) were cultured and cells were divided into seven main groups. Cells were incubated with cyclophosphamide, TRPM2 channel inhibitor, stimulator and low level laser exposure separately and together. The effects of cyclophosphamide and low level laser were investigated on apoptosis. RESULTS: It was found that the levels of apoptosis in cyclophosphamide group were significantly increased in cancer cells compared to the control group. TRPM2 channel stimulator administration resulted in significantly increased apoptosis levels compared to the control group, in cyclophosphamide + low level laser group the apoptosis level was significantly increased compared to the cyclophosphamide-only group. CONCLUSIONS: It has been shown that apoptotic effects of cyclophosphamide on colon cancer cells were directly related to TRPM2 channels, low level laser increased apoptosis in colon cancer cells through TRPM2 channels and induced apoptotic effect of cyclophosphamide (Fig. 5, Ref. 26).

Koronavirüsler insan ve hayvan patojenleridir. 2019’un sonunda Wuhan'da koronavirüs pnömoni vakaları görülmüş ve hızla dünyadaki diğer ülkelere yayılmıştır. Dünya Sağlık Örgütü, 2019 koronavirüs hastalığı anlamına gelen COVID-19 hastalığını tanımlamış, COVID-19’a neden olan virüs, ciddi akut solunum sendromu koronavirüs 2 (SARSCoV-2) olarak adlandırılmıştır. COVID-19 enfeksiyonunun semptomlarının başlangıç süresi demografik özelliklere bağlı olarak değişkenlik göstermektedir. Hafif düzeyden ağır düzeyde solunum yetmezliğine kadar değişen klinik bulgular görülebilmektedir. Bununla birlikte asemptomatik vakalar da tanımlanmıştır. İleri yaş ve eşlik eden komorbid hastalıkların olması kötü prognostik faktörlerdir. Bu hastalarda morbidite ve mortalite oranları daha yüksektir. Ateş, öksürük, boğaz ağrısı, miyalji, hâsizlik ve balgam çıkartma semptomları sıklıkla görülse de gastrointestinal ve dermatolojik bulgular da rapor edilmiştir. Tanıda reverse transkripsiyon polimeraz zincir reaksiyonu, hematolojik testler ve radyolojik görüntülemeler kullanılmıştır. Coronaviruses are human and animal pathogens. At the end of 2019, coronavirus pneumonia cases have been reported in Wuhan and disease rapidly spread to other countries throughout the world. The World Health Organization has identified the disease COVID-19. The virus that causes COVID-19 is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The variability in incubation period of symptoms of COVID-19 depends on demographic characteristics. Clinical findings can range from mild to severe respiratory failure. However, asymptomatic cases have also been described. Advanced age and coexist with concomitant comorbid diseases are poor prognostic factors. Morbidity and mortality rates are higher in these patients. Although symptoms of fever, cough, sore throat, myalgia, weakness and sputum removal are common, gastrointestinal and dermatological findings have also been reported. Reverse transcription polymerase chain reaction (RT-PCR), hematological tests and radiological imaging were used for diagnosis.

Objective: The aim of our study was to determine the demographic and clinical characteristics of the patients with complex regional pain syndrome (CRPS) and to reveal the epidemiological features of CRPS. Material and Methods: Eighty-eight patients with CRPS, admitting to our clinic between January 2010 and December 2018 were included in the study. Patients were evaluated retrospectively in terms of demographics, symptom characteristics (sensory, vasomotor, sudomotor/edema and motor/trophic), involved extremity and side; etiological factors (orthopedic surgery history, soft tissue trauma, stroke, immobilization, cast using), possible risk factors (smoking, menopause, migraine, osteoporosis, asthma and anxiety disorders) and used therapeutic modalities. Results: Mean age of the patients was 51.14±15.25 years (min:18, max: 82). In 60.2% (n: 53) of the patients, upper extremity was involved but there was no statistically significant difference in terms of the involved side (p: 0.754). Soft tissue traumas were the most common factor in etiology in both genders. Most of the patients presented with sensory symptoms. The most common risk factor was menopause in females and smoking in males. Fifty patients (56.8%) had a history of cast using and the mean duration of cast using was 41.60±11.33 days (min: 20 days; max: 70 days). While 63.6% (n: 56) of the patients were included in a physical therapy program; the mean number of the physical therapy sessions was 33.42±10.70 (min: 20 sessions; max: 60 sessions). There was a statistically significant positive correlation between the duration of cast using and the number of physical therapy sessions (r: 0.571, p

WOS: 000504628000001 PubMed: 31884720 Wound healing is a complex cellular and biochemical process and can be affected by several systemic and local factors. In this study, we aimed to discuss the aetiologic factors of non-healing wounds and the management of this complicated process with current information. The medical data of the patients who were admitted to our clinic due to non-healing or chronic wounds were analysed retrospectively. A total of 27 patients were evaluated retrospectively during the 14 months of the study. The data of 6 patients who were followed up for chronic wound that developed after abdominal incisional hernia repair and pilonidal sinus surgery were not included in the study as their data could not be reached. A total of 21 patients were included in the study. Malignancy was diagnosed in two patients and granulomatous disease was found in four patients. The aetiology of the other cases included foreign body reaction, infection, and mechanical causes. Non-healing wounds are a serious social and economic problem for patients. Further studies on the pathophysiology of various aetiologies in non-healing wounds in both clinical settings and experimental animal models would be a useful step in treatment.

WOS: 000552091700010 It is very important to make accurate and early diagnosis to reduce both the rate of negative laparotomy and the morbidity and mortality associated with acute appendicitis. Numerous scoring systems have been described in the diagnosis of acute appendicitis. We aimed to determine the accuracy rates of these scoring systems in the diagnosis of acute appendicitis by applying Alvarado, Eskelinen, and Ohmann clinical scoring systems to patients who underwent appendectomy. This study was performed on patients who underwent appendectomy for acute appendicitis at Baskent University Alanya Hospital and Alanya Alaaddin Keykubat University Education and Research Hospital between September 2017 and December 2018. The sensitivity and specificity of Alvarado, Eskelinen, and Ohmann scoring systems as well as the compatibility analysis of scoring systems with pathology results were investigated. A total of 554 patients undergoing appendectomy were included in the study. The sensitivity of Eskelinen scoring method was found to be 53.4%, the specificity was 68.1%; the sensitivity of Alvarado scoring method 41.6%, the specificity 79.7%; and the sensitivity of Ohmann scoring system 94.0%, the specificity was 8.7%. In conclusion, Ohmann scoring system has the highest sensitivity; it could be more efficient in exclusion of the appendicitis diagnosis due to its low specificity. It is also concluded that some clinical parameters that are scored in Eskelinen and Alvarado scoring systems may decrease the sensitivity and specificity of these methods depending on the patient population and atypical clinical presentations.

The aim of this study is to present the importance of systemic inflammatory markers in patients with malignant bowel obstruction (MBO) due to intra-abdominal tumor metastasis. Patients who developed MBO due to end-stage intra-abdominal metastatic tumoral disease between October 2010 and September 2018 were retrospectively investigated. Clinical data such as age, sex, histopathological diagnosis of primary tumor and the level of obstruction due to tumor metastasis were recorded. Patients who were still receiving chemotherapy and had no metastatic involvement in the abdomen were excluded from the study. Patients with MBO who developed intra-abdominal metastasis from non-abdominal tumors were included. In the determination of the patients, whether or not the patient had previously operated for primary tumor was not taken into consideration. Neutrophil, lymphocyte ratio (NLR) and lymphocyte CRP ratio (LCR) were determined using laboratory data including the results of neutrophil, lymphocyte, C-reactive protein (CRP) and other basic hematological parameters. The effect of these values on survival as a prognostic factor was compared with statistical methods. There were 74 patients (28 females, 46 males) aged 60.5 ± 12.8 years (27-88) who developed MBO due to tumor metastasis in the abdomen. It was detected that the diagnosis of MBO developed an average of 11±7.5 months after the primary diagnosis. As a result of statistical evaluations, we found a positive correlation between serum LCR and survival (r=0.433; p=0.001) and a negative correlation between serum NLR and survival (r=-0.202; p=0.085). According to the Cox regression analysis, high NLR increases mortality risk (p= 0.01, OR = 1.050 [CI: 1.020-1.081]) and LCR increases the survival rate (p=0.02, OR = 0.014 [ C: 0.000 to 0.503]). NLR and LCR in metastatic tumor patients are closely related to the prognosis of the disease. High NLR and low LCR values can be used as an indicator to determine the poor prognosis of malignant patients. NLR and LCR can be used as a simple, fast and cost-effective biomarker. For this, further studies are needed. [Med-Science 2019; 8(4.000): 927-30]

WOS: 000499130800004 PubMed: 30978396 Introduction: Although the adverse effects due to the use of bisphosphonates, such as bisphosphonate-induced osteonecrosis of the jaw, are reported previously, whether adverse events of the temporomandibular joint related with bisphosphonate treatment have been still unclear. Therefore, the aim of this study is to evaluate the effects of BP treatment on the condylar tissues of the temporomandibular joint due to fibrous cartilage, hyaline cartilage and bone-specific differences in rat animal models. Material and method: A total of 12 adult Wistar-Albino rats, weighing from 250 to 300 g were included to the study. The animals were randomly divided into two groups. 0.1 mg/kg Zoledronic Acid were administrated to the animals intraperitoneally in the experimental bisphosphonate group for 60 days. Rest of the animals left as healthy control. All the animals were sacrificed at the end of 60 days. Two condyles were obtained from each animal and total 12 condyles were included to histological analysis in each group. The fibrous cartilage volume, hyaline cartilage volume and bone volume of the condyle were calculated using Cavalieri method. Statistical analysis was performed with Turcosa software. Results: There is a statistically significant difference of fibrous cartilage (P = 0.003) and bone volume between groups (P = 0.002). However, mean hyaline cartilage volume does not statistically differ between groups (P = 0.47). Bone volume and firbrous cartilage volume were increased in bisphosphonate group than control. Conclusion: According to our study results Zoledronic Acid treatment did not affect the hyaline cartilage volume however fibrocartilage volume and bone volume were increased when the animals received ZA intraperitoneally for 60 days. (C) 2019 Published by Elsevier Masson SAS. Erciyes UniversityErciyes University This study was supported by Erciyes University, and the authors thank to Dr.Bilge for the preperation to the ethical approval.

Aim: To evaluate the choroidal thickness (CT) in patients with Parkinson’s disease (PD) compared to healthy individuals and to investigate the relationship between the disease duration and the CT. Materials and methods: The study group included 24 right eyes of 24 PD patients and the control group included 25 right eyes of 25 healthy individuals. The CT was measured in both groups using spectral domain optical coherence tomography (SD-OCT) at 6 points: The foveal centre and at 500-?m intervals temporal (3 points) and nasal (2 points) to the foveal centre. The groups were compared in terms of CT values and group analyses were performed. The correlation between the PD duration and the CT was also evaluated. Results: The mean age of the 24 PD patients (14 males) was 67.5 ± 12.8 years and the mean age of the 25 healthy individuals in the control group (13 males) was 66.1 ± 9.7 years. There were no significant differences between the groups in terms of age or gender (P = 0.59 and P = 0.768). The PD patients had significantly increased CT values subfoveal (P = 0.04), 500 ?m nasal (P = 0.03), and 500, 1,000 and 1,500 ?m temporal to the foveal centre (P = 0.02, P = 0.02, P = 0.02, resp.). No correlation was detected between the PD duration and the CT (P > 0.05). Conclusion: The choroidal thickness may increase in PD compared with healthy individuals. However, more studies are needed to corroborate our findings and to assess the underlying pathophysiology. © 2019, Czech Medical Association J.E. Purkyne. All rights reserved.

Background The mastoid emissary veins (MEVs) pass through the mastoid emissary canal-mastoid foramen (MEC-MF) in the mastoid region of the skull. MEVs can give rise to complications during surgical procedures. The purpose of our study was to investigate the morphological and morphometric characteristics of MECs of patients with clinical chronic otitis media (COM) using high-resolution computed tomography (HRCT). Methods Patients diagnosed with COM and undergoing temporal HRCT were identified by retrospectively scanning our hospital's automation system. Patients undergoing temporal HRCT for reasons other than COM, infection or tinnitus were identified for the control group by scanning the PACS archive. Sixty-two mastoid regions were examined in 38 unilateral and 12 bilateral COM patients, and 100 mastoid regions in the 50 patients in the control group. The presence of an accessory MEC-MF and MEC-MF diameters was evaluated in both groups. Results Main MEC diameters on the side of the ear with COM were 1.6 mm, and total accessory and main MEC diameters were 1.8 mm, both values being significantly higher than in the control group. Presence of accessory MEC on the side of the ear with COM was determined at 61.8%, significantly higher than in the control group. Conclusion Preoperative awareness of cranial venous drainage abnormalities is important to reduce surgical complications. Our study shows that MECs may be wider in diameter in patients with COM. MECs in COM patients must be identified before surgery to the mastoid region.

Çalışma genç çiftçi desteklemeleri hibe programına başvuru yapan üreticilerin sosyo-ekonomik özelliklerinin incelenerek, kırsal alandan göç eğilimlerinin belirlenmesi amacıyla yürütülmüştür. TR-83 bölgesinde (Tokat, Amasya, Çorum, Samsun) 2016 yılında Gıda, Tarım ve Hayvancılık Bakanlığı “Genç Çiftçi Projesi” Destek Programına başvurmuş olan üreticiler ana popülasyonu oluşturmuştur. Örnek hacminin belirlenmesinde Neyman yönteminden yararlanılmıştır. Çalışmada desteklemeden yararlanan 120 üretici ve yararlanamayan 140 üretici olmak üzere toplam 260 üretici ile görüşülmüştür. Veriler destelemeden yararlanma durumuna göre karşılaştırmalı olarak değerlendirilmiştir. Üreticilerin göç etme eğilimleri incelendiğinde, kent ortamında yaşamaya uygun imkân olsa göç ederim diyen üretici oranı yaklaşık %17’dir. Göç etmek isteyen üreticilerin yanı sıra kararsız olan üreticiler de (%4) bulunmaktadır. Üreticiler arasında yaklaşık %21 göç potansiyeli bulunmaktadır. Göç etme eğilimi olan üreticiler yaş grubu düşük olan gruplarda görülmektedir. Kırsaldaki genç nüfusun kırsaldan göç etme eğilimlerini etkileyen faktörleri belirlemek amacıyla yapılan Lojistik Regresyon sonucunda; eğitim seviyesi yüksek, tarım dışı alanlardan gelir sahibi, köy yaşantısının zorlukları olduğunu düşünen, köyde yaşam standardını düşük bulan ve burada kazandığıyla geçinemeyenlerin, diğerlerine göre göç etme eğiliminin daha fazla olduğu belirlenmiştir. The study was carried out with the aim of determining the tendencies to stay in agriculture by examining the socio-economic characteristics of the producers who applied to the supporting program of young farmers. In the TR-83 Region (Tokat, Amasya, Çorum, Samsun), have formed the main population the producers who applied to the Support Program (Young Farmer Project) of the Ministry of Food, Agriculture and Livestock. The Method of Neyman was used in the determination of sample size. A total of 260 producers were surveyed with 120 Producers who benefit from the support of young farmers and 140 producers who cannot benefit from the support of young farmers. The data were evaluated comparatively according to the utilization status of the support. The rate of the producer, who said would migrate when the migration tendency of producers were investigated was determined as 17%. As well as producers who are saying that they should migrate to the city if they have the possibility, there are unstable producers (4%). There is about 21% migration potential among producers. The migration tendency was seen in the producers in low age groups. It is determined that the tendency to migrate is higher, farmers who high levels of education, farmers who have not non-agricultural income, farmers who think that there are difficulties in village life, farmers who believe that low standard of living, farmers who can’t make a living with the income they earn in the village, according to others.

ZIRH, Ali/0000-0002-8811-2263 WOS: 000486093600010 PubMed: 31383472 Deep brain stimulation (DBS) is still a highly effective treatment option that significantly improves motor function in advanced PD. Moreover, previous findings have shown that Olfactory dysfunction (OD) has been found in a majority of patients with Parkinson's Disease (PD). Despite this, the effect of DBS on the olfactory function is not fully understood. Here we aimed to determine the effect of STN DBS on OD by evaluating the olfactory functions in the preoperative and postoperative early stages (1st and 3rd months) in forty-five PD patients and 40 healthy controls. The therapeutic effect of DBS on the improvement of motor functions was parallelly investigated. We have observed that there was a significant improvement in OI in the 1st month and in all olfactory parameters (OT, ODI, OI, and TDI) in the 3rd month. In evaluating the motor functional scores, we have revealed a statistically significant (p < 0.001) difference between preoperative UPDRS-motor score (23 +/- 7.3) and the postoperative 3rd month score (11.1 +/- 5.1). Although Beck Depression and Anxiety scores were improved to a certain level in the 3rd month, this improvement was not at a statistically significant level (p > 0.05). As a conclusion, we have shown that STN-DBS improves the smell functions in PD within three months suggesting that the therapeutic effects of DBS might have a wide range of therapeutic spectrum. Despite some limitations (i.e., short follow-up period) our study gives a critical message that future studies are needed to evaluate the functional correlates of STN-DBS treatment in PD patients. (C) 2019 Elsevier Ltd. All rights reserved.

Objective: This study aimed to evaluate the outcomes of maximal levator resection in cases of congenital myogenic ptosis with poor levator function. Method: Thirty-threeptotic eyelids of 30 cases undergoing maximal levator resection were retrospectively included. There were 18 male and 12 female cases. The mean age of the cases was 12.55±5.3 years (range, 4-26 years). For all eyes, vertical palpebral aperture, margin reflex distance, levator functions, and upper eyelid crease height were measured. Ptosisseverity was “mild” when the eyelid elevation was ≤2 mm; “moderate” when the eyelid elevation was 3 mm; and “severe” when the eyelid elevation was ≥4 mm. The mean age of the cases (18 males and 12 females) was 12.55±5.3 years (range, 4-26 years). Results and Conclusion: The mean ptosis severity (vertical palpebral aperture) was 5.136 mm preoperatively and 0.818 mm at the postoperative Month 3 (p

WOS: 000481087200001 PubMed: 31397077 The aim of this study was to determine whether the use of prophylactic antibiotics had any effects on the development of postoperative surgical wound infections between laparoscopic cholecystectomy patients. Patients who received a single dose of prophylactic antibiotics prior to surgery were included in the prophylaxis group, and those who did not receive preoperative and postoperative intravenous and/or oral antibiotics were included in the no prophylaxis group. A total of 206 patients who underwent laparoscopic cholecystectomy were examined; the infection rate in patients who received prophylaxis was 4.5%, while it was 4.2% in the non-prophylactic group. There was no statistically significant difference between the groups in terms of infection development rates (P > .05). We suggest that antibiotics should not be given for prophylaxis before low-risk laparoscopic cholecystectomy as there is no statistically significant difference in the rate of postoperative wound infection among patients who were either given or not given prophylaxis.

Sargın, Serdar (Balikesir Author), Objectives: This study aims to compare the radiological, clinical and patient-reported outcomes of patients with intra-articular calcaneus fractures treated conservatively or surgically. Patients and methods: Fifty-four patients (30 males, 24 females; mean age 41.0 years; range, 18 to 73 years) treated due to calcaneus fracture were included in the study. Twenty-nine patients underwent conservative treatment (group 1) and 25 patients underwent surgical treatment (group 2). The fractures were classified according to Sanders. At the final follow-up, patients' Bohler's angle, The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and Foot Function Index (FFI) were used to evaluate their radiological, clinical and patient-reported outcomes. Postoperative complications were also noted. Results: The fracture was at the right foot in 28 patients and the left foot in 26 patients. The mean follow-up duration was 41.1 +/- 23.2 months (range, 24 to 126 months). No statistically significant differences were found between the groups in terms of gender, fracture side, mean age, or follow-up duration (p=0.951, p=0.571, p=0.326, and p=0.620, respectively). According to Sanders classification, 18 patients were type 2 and 11 patients were type 3 in group 1, while 11 patients were type 2 and 14 patients were type 3 in group 2. However, there was no statistically significant difference between the groups in terms of the type of the fracture (p=0.184). On the other hand, the outcomes were significantly better for group 2 compared to group 1 in terms of the Bohler's angle, AOFAS and FFI scores (p=0.004, p=0.003 and p=0.006, respectively). In group 1, subtalar arthritis developed in three patients. In group 2, wound healing problems and superficial infection developed in three patients, while subtalar arthritis developed in two patients. Conclusion: Surgical treatment is more effective in intra-articular calcaneus fractures compared to conservative treatment according to clinical, radiological and patient-reported outcomes. In addition, wound problems should be considered in surgical management., Amaç: Bu çalışmada konservatif veya cerrahi olarak tedavi edilen eklem içi kalkaneus kırıklı hastaların radyolojik, klinik ve hasta raporlu sonuçları karşılaştırıldı. Hastalar ve yöntemler: Çalışmaya kalkaneus kırığı nedeni ile tedavi edilen 54 hasta (30 erkek, 24 kadın; ort. yaş 41.0 yıl; dağılım, 18-73 yıl) dahil edildi. Yirmi dokuz hastaya konservatif tedavi (grup 1) ve 25 hastaya cerrahi tedavi (grup 2) uygulandı. Kırıklar Sanders’e göre sınıflandırıldı. Son takipte hastaların radyolojik, klinik ve hasta raporlu sonuçlarını değerlendirmek için Bohler açısı, Amerikan Ortopedik Ayak-Ayak Bileği Derneği (AOFAS) Ayak Bileği ve Arka Ayak Skoru ve Ayak Fonksiyon İndeksi (AFİ) kullanıldı. Ameliyat sonrası komplikasyonlar da kaydedildi. Bulgular: Yirmi sekiz hastada kırık sağ ayakta ve 26 hastada sol ayakta idi. Ortalama takip süresi 41.1±23.2 ay (dağılım, 24-126 ay) idi. Gruplar arasında cinsiyet, kırık tarafı, ortalama yaş ve takip süresi bakımından istatistiksel olarak anlamlı farklılık bulunmadı (sırasıyla, p=0.951, p=0.571, p=0.326 ve p=0.620). Sanders sınıflandırmasına göre, grup 1’de 18 hasta tip 2 ve 11 hasta tip 3 iken grup 2’de 11 hasta tip 2 ve 14 hasta tip 3 idi. Ancak gruplar arasında kırık tipi açısından istatistiksel olarak anlamlı farklılık yoktu (p=0.184). Diğer yandan; Bohler açısı, AOFAS ve AFİ skorları bakımından sonuçlar grup 2 için grup 1’e kıyasla anlamlı olarak daha iyi idi (sırasıyla, p=0.004, p=0.003 ve p=0.006). Grup 1’de üç hastada subtalar artrit gelişti. Grup 2’de üç hastada yara iyileşme sorunları ve yüzeyel enfeksiyon gelişirken iki hastada subtalar artrit gelişti. Sonuç: Klinik, radyolojik ve hasta raporlu sonuçlara göre eklem içi kalkaneus kırıklarında cerrahi tedavi konservatif tedaviye kıyasla daha etkilidir. Bununla birlikte, cerrahi tedavide yara sorunlarına dikkat edilmelidir.

Objective: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) and dry needling (DN) combination to the trigger points in the forearm extensor muscles on pain, grip strength and functionality in patients diagnosed with lateral epicondylitis. Materials and Methods: Forty patients who were clinically diagnosed with lateral epicondylitis were included in the study. The patients were divided into two groups as ESWT and ESWT + DN. Patients in the ESWT and exercise group were applied 2.000 pulses, once a week, three sessions; in addition to that three sessions of DN therapy was applied to the other group. Also, stretching and eccentric strengthening exercises were applied to the patients in both groups. The pain severity of the patients which occured with palpation and grip was measured by Visual Analog Scale (VAS), lateral epicondyle sensitivity by an algometer, grip strength by dynamometer and functionality level by the patient-rated tennis elbow evaluation (PRTEE) pre-treatment and at the end of treatment (first month). Results: In both groups; there were statistically significant improvements in first month VAS scores of the pre- and post-treatment (morning, activity, and rest) (p

Objectives: This study was conducted to compare the breastfeeding outcomes and self-efficacy in the early postpartum period of women who had given birth by cesarean under general (GA) or spinal anesthesia (SA). Methods: This descriptive study was conducted with 190 women who had given birth under GA and SA at a training and research hospital. The data of the study were collected with the “Data Collection Form”, “LATCH Breastfeeding Assessment Tool” and the “Breastfeeding Self-Efficacy Scale- Short Form (BSES-SF)”. Results: The time to first breastfeeding of the newborns was 78.71 ± 126.9 min and 23.7% of the women breastfed within 30 min. Those who gave birth under SA breastfed their newborn infants statistically significantly earlier (p .05). Conclusion: The percentage of women breastfeeding their infants within the first half hour and the self-efficacy and success rate was higher among women who gave birth under SA than those who had cesarean under GA. However, breastfeeding behaviors were not at the desired level in either group. Health care professionals should therefore support women who undergo a cesarean and especially those who give birth under GA to increase their breastfeeding success and self-efficacy. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Background: In this study, we aimed to compare serum biochemical markers in patients with malignant pleural mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos. Methods: Between September 01, 2010 and March 31, 2011, a total of 540 participants (354 males, 186 females; mean age 61.4 years; range, 35 to 89 years) were included in the study. The participants were divided into four groups as follows: (1) patients with pleural plaques (n=277); (2) healthy individuals with normal chest X-rays who were exposed to environmental asbestos (n=121); (3) healthy individuals with normal chest X-rays who were not exposed to environmental asbestos (n=118); and (4) patients with malignant pleural mesothelioma (n=24). Serum levels of carcinoembryonic antigen, cancer antigen 125, 15-3, 19-9, free T3, free T4, thyroidstimulating hormone, vitamin B12, folate, and ferritin were measured. Results: Serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels were higher with lower free T3 levels in Group 4 than the other groups. The areas under the curve for cancer antigen 125 and 15-3 were 0.78 and 0.67, respectively in the differential diagnosis of mesothelioma from other pathologies (p < 0.001 for both). Optimal limits of these biomarkers were 13.63 and 18.43 ng/mL, respectively with 83% and 75% sensitivity and 69% and 48% specificity, respectively. Conclusion: The combination or individual use of serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels may be helpful for early diagnosis and treatment of malignant pleural mesothelioma. Amaç: Bu çalışmada mezotelyoma ve plevral plaklı hastaların çevresel asbest maruziyeti yaşamış sağlıklı bireylere kıyasla serum biyokimyasal belirteçleri karşılaştırıldı. Ça­lış­ma pla­nı: 01 Eylül 2010 - 31 Mart 2011 tarihleri arasında toplam 540 katılımcı (354 erkek, 186 kadın; ort. yaş 61.4 yıl; dağılım, 35-89 yıl) çalışmaya alındı. Katılımcılar dört gruba ayrıldı: (1) plevral plaklı hastalar (n=277); (2) çevresel asbeste maruz kalıp göğüs röntgenleri normal olan sağlıklı bireyler (n=121); (3) çevresel asbeste maruz kalmadan göğüs röntgenleri normal olan sağlıklı bireyler (n=118) ve (4) malign plevral mezotelyomalı hastalar (n=24). Serumda karsinoembriyonik antijen, kanser antijeni 125, 15-3, 19-9, serbest T3, serbest T4, tiroid stimülan hormon, B12 vitamini, folik asit ve ferritin düzeyleri ölçüldü. Bulgular: Diğer gruplara kıyasla, Grup 4’te serum kanser antijeni 125, 15-3, folik asit, B12 vitamini ve ferritin düzeyleri daha yüksek ve serbest T3 düzeyleri daha düşük idi. Mezotelyomanın diğer patolojilerden ayırıcı tanısında kanser antijeni 125 ve 15-3’ün eğri altında kalan alanı sırasıyla 0.78 ve 0.67 idi (her ikisi için de p

Topiramate acetate is a commonly used drug prescribed by neurologists and psychiatrists for the treatment of various diseases including migraine. Topiramate therapy can cause a forward displacement of the iris-lens diaphragm which can result in acute bilateral angle-closure glaucoma and myopia. Common complaints include visual disturbances and eye pain. In this case report, we offered a patient who had a sudden loss of vision and severe eye pain due to acute myopia and angle-closure glaucoma after the use of topiramate for migraine. This case report aimed to increase awareness among neurologists, psychiatrists and ophthalmologists about the side effects that may occur with the use of topiramate Topiramat asetat başta migren olmak üzere nörolog ve psikiyatristler tarafından çeşitli hastalıklarda kullanılır. Topiramat tedavisi iris-lens diyaframının ileri doğru hareketi sonucu akut bilateral açı-kapanması glokomu ve miyopiye neden olur. Görme bulanıklığı ve göz ağrısı başlıca şikayetlerdir. Bu olgu sunumunda migren nedeniyle topiramat kullanımı sonrası ani görme kaybı ve şiddetli göz ağrısı gelişen bir hastada tespit edilen akut miyopi ve açı kapanması glokomu sunulmuştur. Bu olgu sunumu ile topiramat kullanımı sonucu ortaya çıkabilecek yan etkiler konusunda nöroloji, psikiyatri ve göz hastalıkları uzmanlarının farkındalıklarını artırmak amaçlanmıştır

Background/aim: Validated measures in palliative cancer patients are very important in the evaluation and management of the disease. The Karnofsky Performance Scale (KPS) has been used for many years to assess the performance status of cancer patients. The aim of this study is to determine the validity and reliability of the KPS in cancer patients receiving palliative care in Turkey.Materials and methods: Eighty patients with a cancer diagnosis who were admitted to Gaziosmanpaşa University Medical Faculty Hospital Palliative Care Unit between 01.03.2016 and 01.03.2017 were included in the study. KPS, measurements from the Katz Activi-ties of Daily Living (ADL) scale, and Basic Activities of Daily Living (BADL) scale were recorded. The alpha coefficient (Cronbach) was calculated by using SPSS version 20.0. The P-value was accepted as P < 0.05 in the analysis of the data.Results: There was a positive and strong correlation between Katz ADL scale total score and KPS score (r = 0.895; P < 0.001). In ad-dition, there was a strong negative correlation between the total score of BADL scale and KPS score (r = -0.894; P < 0.001). As for the reliability of the scale scores, Cronbach's alpha coefficient found to be 0.720.Conclusion: KPS is a reliable scale for Turkish cancer patients in palliative care settings.

Objective: Rheumatoid arthritis (RA) is a chronic and inflammatory disease characterized by synovial inflammation that causes cartilage and bone destruction as well as systemic defects, including cardiovascular, pulmonary, psychological, and skeletal disorders. The etiology of RA is unclear. Evidence suggests that RA is influenced by both genetic and environmental factors and the inflammatory and autoimmune activities take important roles in the development of this disease. In the onset of RA, an interaction between the resident cells of synovium and cells of the innate and adaptive immune system reported. Fibroblast-like synoviocytes (FLS) are one of the resident cells and they play a central role, with a tumor-like behavior, in joint destruction and development of chronic inflammation. Toll-like receptors (TLRs) are transmembrane glycoproteins that are related to inflammation via synthesis of proinflammatory cytokines like TNF-α, IL-6, and IL-1β. Some studies report an association between the activation of FLS and the cytokine environment, cell-to-cell contacts, or the activation of TLR2, TLR4, and TLR3. TLRs and especially TLR4 is involved in the recognition of endogenous molecules released by injured tissues and necrotic cells. TLR4 gene involved in a wide variety of both infectious and non-infectious diseases and two polymorphisms of TLR4, Asp299Gly and Thr399Ile, changed the binding capacity and electrical charge of the protein. There are conflicting or even contradictory results about these polymorphisms and we aimed to determine the distribution of the allele frequencies of these polymorphisms and compare the result of RA patients with healthy subjects. Methods: DNA extraction was realized by salting out method from peripheral blood lymphocytes of RA patients and healthy controls. PCR amplification carried out with appropriate primer pairs against the related DNA sequences. Genotyping performed by the restriction fragment length polymorphism method. Results and Conclusion: According to the results obtained from RA patients and healthy controls, we have not found any statistical difference between both groups. Including the other polymorphisms of the TLR family into this type of studies, will give more information about the role of TLR family in rheumatoid arthritis. Amaç: Romatoid artrit (RA), kardiyovasküler, pulmoner, psikolojik ve iskelet bozuklukları dahil olmak üzere sistemik kusurların yanı sıra kıkırdak ve kemik tahribatına neden olan sinovyal enflamasyonla karakterize kronik ve enflamatuar bir hastalıktır. RA’nın etiyolojisi tam olarak bilinmemektedir. Kanıtlar RA'nın hem genetik hem de çevresel faktörlerden etkilendiğini ve enflamatuar ve otoimmün aktivitelerin bu hastalığın gelişiminde önemli rol aldığını göstermektedir. RA'nın başlangıcında, yerleşik sinovyum hücreleri ile doğal ve adaptif bağışıklık sisteminin hücreleri arasında bir etkileşim olduğu bildirilmektedir. Fibroblast benzeri sinoviyositler (FBS), yerleşik hücrelerdir ve eklem yıkımı ve kronik enflamasyonun gelişmesinde- tümör benzeri bir davranışla- merkezi rol oynarlar. Toll-like reseptörler (TLR'ler), TNF-a, IL-6 ve IL-1 gibi proenflamatuar sitokinlerin senteziyle ilişkili transmembran glikoproteinlerdir. Bazı çalışmalarda FLS aktivasyonu ile sitokin, hücre teması veya TLR2, TLR4 ve TLR3 aktivasyonu arasında bir ilişki olduğunu bildirmektedir. TLR'ler ve özellikle TLR4, yaralı dokular ve nekrotik hücreler tarafından salınan endojen moleküllerin tanınmasında rol oynar. TLR4 geni, hem enfeksiyöz hem de enfeksiyöz olmayan hastalıklarda rol almakta olup, bu gendeki iki polimorfizm, Asp299Gly ve Thr399Ile, TLR4 proteinin bağlanma kapasitesini ve elektrik yükünü değiştirir. Bu polimorfizmlerle ilgili çelişkili ve uyumsuz sonuçlar bulunmaktadır, biz bu çalışmamızda bu polimorfizmlerin allel sıklıklarını belirlemeyi ve RA hastalarının sonuçlarını sağlıklı deneklerle karşılaştırmayı amaçladık. Yöntemler: DNA ekstraksiyonu, RA hastaları ve sağlıklı kontrollerin periferik kanlarından 'salting out' metoduyla gerçekleştirildi. PCR amplifikasyonu, çalışılan DNA dizilerine uygun primer çifleri kullanılarak yapıldı. Genotip belirlenmesinde 'restriksiyon enzimi parça uzunluk polimorfizmi metodu' kullanıldı. Bulgular ve Sonuç: RA hastalarından ve sağlıklı kontrollerden elde edilen sonuçlara göre, her iki grup arasında istatistiksel bir fark bulamadık. TLR ailesinin diğer polimorfizmlerinin bu tür çalışmalara dahil edilmesi, TLR ailesinin romatoid artritteki rolü hakkında daha fazla bilgi verecektir.