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Bu çalışmanın amacı, translüsent monolitik ve çift tabakalı zirkonya restorasyonların klinik başarılarını değerlendirmektir.Çalışmaya posteriorda her iki yarım çenede simetrik 3 üyeli, tek molar gövdeli sabit protetik tedavi gereksinimi olan 18 hasta dahil edildi. Bu ağız içi simetrik (split-mouth) randomize kontrollü klinik çalışmada, posterior bölgede iki farklı yöntemle hazırlanan zirkonya restorasyonların 2 yıl izlemi monolitik zirkonya köprü restorasyon (ZenoStar, Wieland, Pforzheim, Almanya) uygulanırken, diğer yarım çeneye ise çift tabakalı yöntem ile zirkonya köprü restorasyon uygulandı. Hastalara toplam 40 adet (n=40) köprü restorasyon uygulandı. Restorasyonlar adeziv rezin bir siman ile (Multilink Speed, IvoclarVivadent) yapıştırıldı. Silikon-replika yöntemi ile restorasyonların iç ve kenar uyumları belirlendi. Replikaların kesitleri elde edilerek ışık mikroskobu ile (Leica Cambridge Ltd., Cambridge, England) görüntüleri alındı ve çeşitli noktalardan ölçüm yapıldı. 0, 6 ay, 12 ay, 24 aylık klinik izlem periyotlarında, restorasyonların klinik başarısı modifiye USPHS kriterleri kullanılarak değerlendirildi. Restorasyonların aşınma ve karşıt dentisyonu aşındırmasının incelenmesi için 1. Hafta ve 24 aylarda Ivoclar Wear Protokolü esas alınarak alçı modelleri elde edildi. Modeller üç boyutlu dijital tarayıcıyla (Omnicam, Sirona Dental Systems, GmbH, Bensheim, Almanya) taranarak dijital ortama aktarıldı. CAD-CAM yazılım programındaki (Cerec 4.4, Sirona) çakışan modeller üzerinde ölçümler yapıldı.Tüm zirkonya restorasyonlar 2 yıllık klinik izlemde, klinik olarak kabul edilebilir başarıda bulunmuştur. Translüsent monolitik ve çift tabakalı restorasyonların klinik performansları arasında anlamlı fark bulunmamıştır. (p>0.05). Restorasyonların kenar ve iç uyumları karşılaştırıldığında çift tabakalı zirkonya restorasyonların uyumu anlamlı olarak daha iyi bulunmuştur. (p0.05). Double-layered restorations yielded significantly better marjinal and internal fit (p

We present a patient with a solitary cerebral metastasis from a transitional cell carcinoma of the right renal pelvis in the right occipital lobe with intratumoral hemorrhage. Despite aggressive multimodality management the patient died within 3 months of presentation due to widespread systemic disease.

Chronic viral hepatitis B, chronic viral hepatitis C, non-alcoholic steatohepatitis, alcoholic liver disease, autoimmune hepatitis, primary biliary cirrhosis, and secondary biliary cirrhosis are important health issues worldwide. While an association between angiotensin-converting enzyme gene insertion/deletion (ACE gene I/D) polymorphism and liver fibrosis has been demonstrated in rat studies, the results of clinical studies area have been contradictory. The aim of this study was to assess the possible association between ACE gene I/D polymorphism and liver fibrosis in a large group of Turkish patients from the western Black Sea region. In 418 patients with different etiologies, ACE gene I/D polymorphism and serum ACE levels were investigated. The distribution of the “DD”, “ID”, “II” genotypes of the ACE gene were 32.5, 48.8, and 18.7% in the mild to moderate fibrosis group (N = 246, F:1-3 according to Ishak’s score) and 39.0, 44.2, and 16.9% in the advanced fibrosis group (N = 172, F:4-6 according to Ishak’s score). A significant correlation between serum ACE levels and ACE gene alleles was identified (P < 0.001): serum ACE levels of patients with D alleles were higher than those of patients with I alleles [44 (min 7-max 101) versus 29 (min 7-max 96)]. Patients with advanced fibrosis were also found to be older than those with mild to moderate fibrosis (P < 0.001). No significant association was noted between the patient gender and fibrosis severity. We conclude that ACE I/D polymorphism is not associated with the degree of liver fibrosis. © FUNPEC-RP.

Örneklem büyüklüğü, yapısal kırılmanın varlığı, potansiyel kırılmanın yeri ve büyüklüğü ve birim köke yakın prosese sahip olmak Eşbütünleşme testlerinin performanslarını etkileyebilir. Engle-Granger (EG) ve Johansen eşbütünleşme testleri, Gregory – Hansen (GH) eşbütünleşme testinden farklı olarak, olası kırılmaları dikkate almadığından hatalı sonuçlar verebilmektedir. Sözü geçen testlerin çıktıları bu özelliklerin yapısına çok duyarlı olduğundan, bu çalışmada uygun eşbütünleşme testinin seçilmesinin oldukça karmaşık olduğu tartışılmıştır.Eşbütünleşme testlerinin performansları belirtilen özellikler altında karşılaştırıldı. Bu çalışma, standart hata terimi tabanlı testlerin - Engle-Granger ve Gregory-Hansen- serilerin yüksek iç bağımlılığa (birim köke yakın süreçlere) sahip olduğunda nasıl uygulanabileceğini göstermektedir. Testlerin sonlu örneklem performansları değerlendirildiğinde, Monte Carlo deney sonuçları, her iki testin de kırılma noktası, kırılmanın büyüklüğü, serinin genişliği ve AR(1) parametresi değerleri için anlamlılık düzeyi ve güç değerleri açısından iyi sonuçlar verdiğini göstermiştir. Çalışmanın bulguları finansal veri ile de analiz edilmiştir. Araştırmacılar AR(1) modelin iç bağımlılığını gösteren parametrenin değerini test ederken dikkatli olmalıdırlar. Otoregresif modelin parametresinin bire çok yakın çıktığı ve yapısal kırılmanın büyüklüğünün yüksek olduğu durumda her iki test de büyük örneklem genişliği altında uygulanabilir. Ancak testlerin daha iyi güç değerlerine ve nominal anlamlılık düzeylerine sahip olması için çok büyük örneklemlere ihtiyaç vardır. Ek olarak yapısal kırılmanın büyüklüğü arttıkça Gregory – Hansen testi Engle Granger testine göre daha liberal davranışlar sergilemektedir., Sample size of data, presence of structural break, location and magnitude of potential break, and having with near integrated process might affect the performance of cointegration tests. Engle-Granger (EG) and Johansen Cointegration tests may have erroneous results since they do not take into account possible structural break unlike Gregory – Hansen (GH) cointegration test. In this study, it is argued that the suitable choice of cointegration tests is quite complex, since outcomes of these tests are very sensitive to specifying these properties.The performance of cointegration tests is compared to each other underlying properties. This study presents how standard residual based tests- Engle-Granger and Gregory-Hansen- for cointegration can be implemented if series is near integrated, that is close to a unit root process. For assessing the finite sample performance of these tests, a Monte-Carlo experiment showed that both cointegration tests have relatively better size and power properties depend on break point, break magnitude, sample size of time series and the hypothesized value of AR(1) parameter. To illustrate the findings of the paper, a financial data is analyzed. The practitioners should be careful about the hypothesized value of AR(1) parameter which represents dependency degree of the data. If the autoregressive parameters is very close to one and the break magnitude is high, any test is acceptable for moderate to large sample size. However, one might need very large sample size to have a good power and actual size of the test. Additionally, GH test becomes liberal test unlike EG test as the magnitude of structural break increases.

Background Myeloperoxidase (MPO) is a lysosomal hemoprotein found in the azurophilic granules in neutrophils. Myeloperoxidase plays an important role in oxygen-dependent killing of bacteria, fungi, virus and malignant cells. Diabetes mellitus (DM) is listed among conditions that may lead to secondary MPO deficiency in neutrophils but inconsistent results concerning MPO activity in diabetic patients have been reported in the literature. In this study, we aimed to evaluate the relationship between glycemic control in patients with type 2 DM and MPO activity in neutrophils from a histochemical perspective. Methods The study included 40 patients with type 2 DM with poor glycemic control, 30 patients with type 2 DM with good glycemic control and 31 healthy controls. Peripheral blood smears were analyzed for each patient included in the study. Myeloperoxidase dye was used for staining. Myeloperoxidase ratios in neutrophil were evaluated for proportions of staining with MPO in 100 neutrophils in each smear. SPSS 16.0 version was used for statistical analyses. Results Myeloperoxidase ratios in neutrophils were 70 (58.5–80) in type 2 DM patients with poor glycemic control compared to 80 (73.75–90) in those with good glycemic control and 88 (78–92) in healthy controls. The DM group with poor glycemic control was statistically significantly different from the other groups (p

Çalışmada tam zamanında üretim sisteminin uygulanma potansiyelini araştırmak üzere hazırlanan anket formu ile elde edilen sonuçlar ve bu sonuçlarla ilgili değerlendirmeler yer almaktadır. Araştırmanın amacı, İzmir ve çevresinde büyük ölçekli işletmelerde (ana sanayide) TZÜ sistemini uygulayan firmaların hangi düzeyde olduğunu, otomotiv sektörünün TZÜ sistemini uygulamak için yeterli alt yapıya sahip olup olmadıklarını, TZÜ sisteminin elemanlarından yararlanıp yararlanamadıklarını , TZÜ sistemini uygulayan firmalar ile diğer firmalar arasındaki farklılıkları belirleyerek genel bir yargıya varmaktır. Bu amaç doğrultusunda, 102 ana sanayi kuruluşuna uygulanan soru formları yardımıyla firmaların kullandıkları üretim sistemleri ile ilgili bilgiler elde edilmiştir. Bu incelemeler sonucunda elde edilen veriler uygun istatistiksel teknikler kullanılarak değerlendirilmiş ve çalışmanın amacına sistematik bir biçimde ulaşılmaya çalışılmıştır., In this study, there are results from survey which was prepared to search for JIT applications and assessment related with this results. The aim of the study is to be reached the decision that, the common usage of JIT in fırms around IZMIR and whether automotive sector has an enough conditions for used JIT or not, and differences between fırms which use JIT and not . Survey was applicated 102 fırms and tried to obtained knowledge about their production system. As a result of this investigation, data were assessed with convenient statistical methods. Survey has four parts. In the fırst part, there are questions about general knowledge about fırms, in the second part, there are questions about properties of fırms, in the third part, there are questions about only fırms which use JIT can answer.

Aim: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease mainly caused by tobacco smoke inhalation. We aimed to evaluate antiinflamatory and antioxidant effect of mepenzolate bromide which is a muscarinic antagonist in subacute cigarette exposure mice model. Method: Forty seven healthy 25-40 gram male mices were categorized into 4 groups: (A) control group (n=7), (B) exposed to cigarette smoke (CS) (n=18), and (C) exposed to CS treated with 400 mikrogram/kg/ day mepenzolate group(n=14),( D) treated with 400 mikrogram/kg/ day mepenzolate group (n=8). After 5 weeks, mepenzolate or saline was given to mices during two weeks by inhalation. Mices were anesthetized, broncoalveolar lavage (BAL) was performed, lung tissues was removed. Interleukin-1β (IL1β), macrophage inflammatory protein-1 (MIP 1), tumor necrosis factor alpha (TNF α) measurements were evaluated in BAL fluid and total oxidant and antioxsidant status (TAS-TOS) were measured in lung tissues. Results: We found that cigarettes exposure significantly decreased TAS and increased TOS (p Conclusions: Mepenzolate may be a promising therapeutic choice to reduce oxidative effect and to control inflammation due to cigarette exposure.

Aim: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease mainly caused by tobacco smoke inhalation. We aimed to evaluate antiinflamatory and antioxidant effect of tiotropium bromide which is an anticholinergic bronchodilator in subacute cigarette exposure mice model. Method: Thirtyfive healthy 25-40 gram male balb-c mices were categorized into 3 groups: (A) control group (n=7), (B) exposed to cigarette smoke (CS) (n=18), and (C) exposed to CS treated with tiotropium group(n=10. After 5 weeks, tiotropium or saline was given to mices during two weeks by inhalation. Mices were anestetized, broncoalveolar lavage was performed and lung tissues removed. Interleukin-1β (IL1β), macrophage inflammatory protein-1 (MIP 1), tumor necrosis factor alpha (TNF α) measurements were evaluated in BAL fluid. Total oxidant and antioxsidant status (TAS-TOS) measurements were evaluated in lung tissue. Results: We found that cigarette exposure significantly decreased TAS and increased TOS (p

Türkiye’ de genç nüfus oranı oldukça fazla olduğundan gençlerin görüşlerinin belirlenmesi, Türkiye’ deki birçok farklı problemin çözülmesi açısından büyük önem taşımaktadır. Bu çalışmanın amacı; İzmir’ de lisans eğitimi gören öğrencilerin Türkiye-Avrupa Birliği ilişkileri, Türkiye’nin temel problemleri ve üniversite öğrencilerinin alışkanlıkları ile ilgili görüşlerinin belirlenmesiydi. Bu çalışmada, İzmir’ de bulunan beş farklı üniversiteden 1036 lisans öğrencisi seçildi ve hazırlanan anket formları 2004-2005 bahar dönemi ve 2006-2007 güz dönemi boyunca bu çalışma grubu üzerinde uygulandı. İki farklı dönemde elde edilen sonuçlar arasındaki farkların belirlenmesi amacı ile Tabakalı Küme Örneklemesi Yöntemi ve Neyman Dağıtımı Yaklaşımı kullanıldı. Veri çözümlemesi sonrası dönemler arasında çeşitli istatistiksel sonuçlar gözlemlendi

Tek değişkenli otoregresif sürecin genelleştirilmiş hali olan vektör otoregresif süreç değişkenler arasında otokorelasyon örneklerini modelleyerek yaygınca kullanılan bir süre çtir.Çalışmamızda ikideğişkenli birinci dereceden vektör otoregresif süreç göz önüne alınmıştır. Monte Carlo simulasyonu yardımıylaˆ nın sonlu örneklem tahmin edicilerinin asismptotik özellikleri MATLABR2011A programı kullanılarak incelenmiştir.

To investigate the effect of resin cement color on the post-cementation shade of thin laminate veneers milled from multilayered glass ceramic blocks for each layer.Thin slices (N = 180) with two thicknesses (A: 8 × 8×0.55 mm and B: 8×8×0.8 mm; n = 90/group) were obtained from multilayered glass ceramic blocks using a diamond saw. Resin die specimens were prepared (8 × 8 × 4 mm) (n = 180) and divided into two resin cement colors (D: -3. L: +3) and one control group (C: translucent). Each slice was luted to the composite specimens using a dual-curing resin cement under a constant load of 250 g and light-polymerized for 120 seconds. Specimens were placed on a white background and CIELab values for each layer of the blank slices (incisal [In], body [Bo], and cervical [Ce]) were recorded using a dental contact spectrophotometer. The values were calculated as ΔE, and the data were statistically analyzed (one-way ANOVA, Shapiro-Wilk).Mean ΔE values for A and B were significant (p0.05) for In (A: 6.2 ± 1.1; B: 6.6 ± 1.2), Bo (A: 5.1 ± 2.6; B: 3.9 ± 1), and Ce (A: 5.3 ± 2.7; B: 3.8 ± 1.2). Mean ΔE values for In for D and L for A and B groups were significantly higher (6.3 ± 1.2; 6.6 ± 1.2) than Bo and Ce for D (4.4 ± 2.4; 4.6 ± 2.6) and L (4.6 ± 1.4; 4.5 ± 1.7) groups (p0.05), respectively. Mean differences between Bo and Ce for A and B groups were insignificant (p ≥ 0.05), while for In the differences were significant. Mean differences between Bo and Ce for A (5.1 ± 2.6; 5.3 ± 2.7) and for B (3.9 ± 1; 3.5 ± 1.2) groups were insignificant (p ≥ 0.05), while for In the differences were significant (6.2 ± 1.1 for A and 6.6 ± 1.2 for B).The color changes for body and cervical regions of multilayered ceramic veneers were not affected by resin color or ceramic thickness, but the incisal area was affected. The translucency of each layer in ceramic veneer fabricated with multilayered blanks should be considered for clinical situations.

Antidepressants inhibiting the reuptake of both serotonin and norepinephrine may exhibit efficacy superior to that of selective serotonin reuptake inhibitors (SSRIs). Since the clinical effects of antidepressants appear gradually following weeks of treatment, the present study was designed to investigate if there is a benefit to long-term administration of the SSRI, fluoxetine, in comparison with venlafaxine, a 5-HT/norepinephrine (5-HT/NE) reuptake inhibitor (SNRI; both 20 mg/kg ip, once a day for 14 days) in a one-trial step-through passive avoidance task in rats. Locomotor activity was evaluated to assess the effects of the drugs on the motility of the animals. The comparison of training latencies versus test latencies showed inhibition of passive avoidance learning in fluoxetine- or venlafaxine-treated rats (e.g., no significant difference between training and test latencies) in a step-through test. There was no significant difference between fluoxetine- and venlafaxine-induced reduction of latency in rats in this test. Drug Dev. Res. 67:456–461, 2006. © 2006 Wiley-Liss, Inc.

Macroglossia has been very rarely reported as a first clinical sign of multiple myeloma.

Today, one of the most important sector in an economy is the production sector, the importance of goods and services sectors are increasing at a fastly every day. Until today, competitive conditions, efficiency, productivity and quality of production, forced to the firms to put more emphasis on production systems. Therefore, the firms are more interested in scientific analysis, planning and controllingof the their production systems. As a result, one of the newest approaches is ‘Just in Time (JIT)’ production system which emerged after WWII in Japan and aims to decrease the inventory cost and maximize the quality. The philosophy of this approach is to produce the necessary amount of production, when and where needed at the required quality. The aims of JIT is to improve the product and the process continously. The aim of this study is to investigate JIT as a new approach for Turkey in all aspects and analyze its applicability for firms.

Primary splenic tumors in children are rare and usually benign. We report the case of a 7-year-old boy with a splenic mass that initially resembled an infectious process. Histopathologic examination of a specimen obtained using sonographically guided Tru-cut needle biopsy, performed after angiography, revealed an inflammatory pseudotumor of the spleen, an extremely rare benign lesion. The lesion has been managed conservatively with clinical and sonographic follow-up. This case shows that benign lesions of the spleen can easily be diagnosed using current radiologic and histopathologic techniques without the need for surgery, thus allowing total or even partial splenectomy to be reserved for patients in whom a mass cannot be diagnosed or in whom clinical progression is evident. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:335–338, 2003

© 2015 Elsevier Inc. All rights reserved.Objective Surgical site infection (SSI) is the most common infection after liver transplantation in our hospital. In this study, the effect of microorganisms isolated in liver transplant recipients' (LTRs') culture with SSI on antibiotic treatment has been investigated. Method Between January 2003 and December 2013, microbiological data and antibiotic management of LTRs were examined from laboratory and patients' records retrospectively. For diagnosis of SSI, the Centers for Disease Control and Prevention criteria were used. Infections have been classified into 3 groups according to agent existence (culture negative, monomicrobial, or polymicrobial). The data were analyzed with the SPSS 17 program. Results In the study period, 457 liver transplantations were performed. The study included 412 adult LTRs. In 122 (29.6%) of these patients, at least 1 infection was detected within 30 days after transplantation. Seventy-one (17.2%) were SSI. Of LTRs with SSI, there were 36 (50.7%) with blood stream infection, 16 (22.5%) with pneumonia, and 10 (14.0%) with urinary tract infection together. Eighteen (25.4%) cases were polymicrobial (especially Acinetobacter baumannii and Enterococcus species), 35 (49.2%) cases were monomicrobial (firstly methicilline resistant Staphylococcus aureus), and 18 (25.4%) cases were culture negative SSI. In 60 (84%) cases, combined antibiotic treatment was used. Mortality rate was 14.0%. Conclusion In LTRs with SSI, the impact of the isolation of an infectious agent on antibiotic selection could not be determined. Whether or not there are bacteria, on the basis of the local epidemiological data and patient characteristics, at least 2 or more antibiotics were combined for treatment. According to the resistance of the isolated microorganisms prior antibiotics have been changed.

OBJECTIVES This study aimed to investigate the occurrence of low back pain in hospital employees during the previous year and its correlation with demographic data, occupational factors and chronic fatigue syndrome. METHODS All participants provided information on their socio-demographic background, occupational characteristics, their experience of low back pain during the previous year, and chronic fatigue syndrome. RESULTS The study included 365 volunteers (221 male and 144 female). The mean age was 33.1 ± 7.2. Of the 365 participants, 218 (59.7%) had experienced low back pain in the last year. No statistically significant difference was detected in age, height, weight, level of education, smoking habits, occupation, professional working hours, shift work or levels of income between the groups with and without low back pain. Low back pain was more frequent (p

31st International Epilepsy Congress -- September 05-09, 2015 -- Istanbul, Turkey WOS: 000365756500642 Purpose: Several studies have reported that commonly used antiepileptic drugs such as phenytoin, phenobarbital and carbamazepine increase low density lipoprotein-cholesterol profile, but others couldn’t find any relationship between antiepileptic drug usage and hyperlipidemia.

Amaç: Amacımız; hastane çalışanlarında son bir yılda geçirilmiş bel ağrısının; demografik veriler, mesleki özellikler ve kronik yorgunluk sendromu ile olan ilişkisini araştırmaktır. Gereç ve Yöntem: Tüm katılımcılar sosyodemografik veriler, mesleki özellikler, son bir yılda geçirilmiş bel ağrıları ve kronik yorgunluk sendromu semptomları yönünden sorgulandılar. Bulgular: Çalışmamıza 144’ü kadın 221’i erkek olmak üzere 365 gönüllü katıldı. Yaş ortalaması 33.1±7.2 idi. İki yüz on sekiz (%59.7) kişide son bir yılda geçirilmiş bel ağrısı vardı. Bel ağrısı olan ve olmayan grup arasında yaş, kilo, boy, medeni durum, eğitim durumu, sigara alışkanlığı, meslek, mesleki çalışma süresi, vardiyalı çalışma, gelir düzeyi, iş memnuniyeti açısından istatistiksel fark bulunmadı. Erkek cinsiyette bel ağrısı istatistiksel oranda fazla görülmekteydi (p

This paper proposes a radical change in industry practice that will improve the quality of the construction process and the levels of customer satisfaction derived from it by evaluating the quality performance of the contractor. An alternative theory is developed of what constitutes quality, client satisfaction, performance, and their interrelationships in the context of the construction industry. It should be noted here that the term construction client includes both the owner (i.e. the agency or organization funding the project) and the end-user of the construction (i.e. the general public). A comprehensive view of construction quality is proposed that deals with both the service (as received by the owner) and product (as received by the end-user) aspects of the construction project as well as the corporate quality culture. Such a dissection of construction activity facilitates developing strategies to define, operationalize, measure and improve construction quality. A frame4 work for the assessment of ...

Son yıllarda süreçlerin mükemmelleştirilmesi hedefiyle ortaya çıkan Altı Sigma kavramı ilk olarak 1980’liyıllarda Motorola tarafından dünyaya tanıtılmıştır. O zamandan günümüze, Altı Sigma felsefesini takip edenler, süreç yeterliliğini tahmin etmeden önce süreç ortalamasına belirli bir kaymanın neden eklenmesi gerektiği konusunu sorgulamaktadır. Altı Sigma literatürüne göre süreç ortalamasına eklenmesi gereken bu değer 1.4 ile 1.6 sigma arasında olup, birçok süreç için genellikle 1.5 sigma olarak kabul edilir. Böyle bir düzeltmeye neden ihtiyaç olduğu ve hata oranının tahmini için süreç ortalamasının neden farklı bir değer değilde 1.5 sigma kadar kaydırıldığı sorularının cevabı bu çalışmanın amacını oluşturmaktadır.

Objective One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula. Methods 40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale. Results Inflammatory infiltration was found to be higher in “platelet-rich plasma” group than “fibrin tissue adhesive” and “synthetic tissue adhesive” groups. The fibroblastic activity of “platelet-rich plasma”, “fibrin tissue adhesive” and “protein-based albumin glutaraldehyde” groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments. Conclusion These results shed light on the suggestion that platelet-rich plasma and fibrin tissue adhesive can be used in clinical studies to prevent pharyngocutaneous fistula.

Nowadays many companies focus on various kinds of quality improvement techniques to carry the service quality beyond costumer expectations. The selected quality technique should be appropriate to the company's culture and should be sufficient for carry out targeted improvement; this will enhance the company’s superiority in market place. For this purpose, Lean Six Sigma methods are one of the important methods being used today as an intensive use of statistical tools and techniques. Lean Six Sigma methods can be implemented in almost all sectors and successful gains can be obtained. Lean Six Sigma has wide range application in the world. Most applications are successful, while some of them are failed. In this study, reasons for unsuccessful Lean Six Sigma projects are examined. The way to convert unsuccessful project into successful project are suggested. Some solutions are carried out for this purpose., Günümüzde kaliteli ürün ya da hizmet üretmek, ürünün sadece sağlam olması ya da standartlara uygunluğu ile değil aynı zamanda müşteri beklentilerinin aşılması olarak da ifade edilmektedir. Firmalar, ürün ve hizmet kalitelerini müşteri beklentilerinin ötesine taşıyabilmek için çeşitli kalite geliştirme teknikleri üzerine odaklanmaktadırlar. Seçilecek kalite tekniğin firmanın kültürüne uygun olması ve hedeflenen iyileştirmeleri gerçekleştirecek yeterlilikte olması, rekabet açısından önemli bir avantaj sağlayacaktır. Bu amaçla günümüzde kullanılmakta olan önemli yöntemlerden biri Yalın Altı Sigma’dır. Yalın Altı Sigma yöntemi hemen hemen tüm sektörlerde uygulanmakta ve başarılı kazanımlar elde edilebilmektedir. Ancak Yalın Altı Sigma yönteminin dünyada yaygın bir şekilde kullanılmasına ve pek çok başarılı uygulama örneğine rastlanılıyor olmasına rağmen projelerinin bir kısmı başarısız olmaktadır. Bu çalışma ile Yalın Altı Sigma projelerinin başarısızlığa uğrama nedenleri incelenmiş, projelerin başarısız olmaması için çözüm önerileri getirilmiştir.