Search

Ebru Apaydin Doğan,1 Umuttan Doğan,2 Emine Genç,3 Çağla Erdoğan,1 Bülent Oğuz Genç3 1Department of Neurology, School of Medicine, Akdeniz University, Antalya, Turkey; 2Department of Cardiology, School of Medicine, Akdeniz University, Antalya, Turkey; 3Department of Neurology, School of Medicine, Necmettin Erbakan University, Konya, Turkey Background: Data regarding lacosamide treatment as an adjunctive therapy in patients representative of a focal-onset epilepsy population including those with and without intellectual/developmental disorders (IDDs) are limited. Purpose: To evaluate the retention rates of lacosamide in focal-onset epilepsy patients with and without IDD. Patients and methods: We retrospectively reviewed all consecutive electronic and paper medical records of patients diagnosed with focal-onset epilepsy who were treated with lacosamide in two tertiary epilepsy centers. Results: One hundred and thirty-six patients who met the inclusion criteria were studied. Number of patients with IDD was 46 (33.8%). Median lacosamide dose was 300 mg/day. A total of 39 patients (28.7%) experienced side effects, and 22 of them (16.2%) discontinued lacosamide. The 1-, 2-, and 3-year retention rates of lacosamide in patients with IDD were 68%, 62%, and 53%, respectively. Kaplan–Meier survival analysis showed that the retention rates were significantly lower in patients with IDD when compared to patients without IDD (P=0.04). Cox regression analysis showed that concomitant use of sodium channel blocker antiepileptic drugs (AEDs) was the only independent predictor of retention rate of lacosamide treatment (P=0.03). In the subgroup of patients with IDD, the analysis was performed again and the number of background AEDs was the only predictor for the retention rate of lacosamide (P=0.04). Conclusion: When compared to patients without IDD, retention rates of lacosamide adjunctive therapy were lower in patients with IDD. However, these rates were higher than the rates suggested with previously registered AEDs including lamotrigine, levetiracetam, and topiramate. Therefore, irrespective of having comorbid IDD, we might suggest that lacosamide is a well-retained drug with a high efficacy profile in patients with focal-onset epilepsy. Keywords: lacosamide, focal-onset epilepsy, intellectual/developmental disorders

The Global Navigation Satellite System (GNSS) signal experiences delays caused by the atmosphere, leading to the lengthening of the geometric path of the ray, commonly referred to as tropospheric delay. This delay is a significant source of error in GNSS positioning, contributing to a bias in the height component of several centimeters, even when meteorological data are simultaneously recorded and used in tropospheric models. In this study, considering seasonal variations, we investigated the impact of tropospheric delay on the GNSS height component. GNSS stations, part of the Turkish RTK CORS Network known as TUSAGA-Active (Turkish National Permanent GNSS Network Active), covered different heights over the 2014–2019 period. Daily coordinates of GNSS stations and tropospheric zenith delay were obtained through the GAMIT/GLOBK software solution.In the study, temperature, pressure, and relative humidity data of meteorological stations at different heights were converted to mean sea level. By using these values, interpolation estimates were made for the continuous GNSS stations in the same region with the IDW method. The most significant delay in GNSS signals occurs in July and August. This effect, which causes periodic changes in the zenith delay, varies inversely with the station's height. With the increase in the amount of water vapor in the atmosphere in parallel with the rise in the temperature in the summer months, it is seen that the stations at a low height are more exposed to the tropospheric effect than the stations at higher heights. In addition, GNSS stations' reduced meteorological values (temperature, pressure and relative humidity) show that the zenith delay values changed directly proportional to the temperature and inversely proportional to the pressure and relative humidity. [ABSTRACT FROM AUTHOR]

This study aims to determine the datum definition for the geodetic vertical velocity field derived from temporary and continuous GNSS observations. The observations have been analysed to investigate how the effect of vertical velocity for GNSS stations depends on the reference station selection. For this purpose, a network consisting of 26 GNSS stations has been designed. The GNSS observations have been processed using Bernese GNSS software v5.2 according to the different strategies. The strategies have been generated from ten different datum definitions of one to ten continuous GNSS stations within the IGS network in the Eurasia region, which is thought to be the least affected by tectonic movements. The vertical velocities of our solution derived from four reference stations concur within 0.4 mm/yr with those of the IGS/EUREF/NGL solution. It has been determined that the vertical velocities obtained based on the four reference stations proposed within the scope of the study are equal to the vertical velocities obtained from the ten stations distributed over the European region. The usability of these outcomes has been investigated in the studies to be carried out on Turkey's west and south coasts. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of our study is to compare the results of robotic surgery-assisted Low Anterior Resection (LAR) and Natural Orifice Specimen Extraction (NOSE) for Rectal Cancer (RC). PATIENTS AND METHODS: From November 2015 to June 2021, patients receiving robotic NOSES and robotic surgery assisted resection (RSAR) were retrospectively enrolled in the study. All robotic-assisted LAR of the rectum, NOSE, colorectal anastomosis and loop ileostomies were performed using the Da Vinci Xi system. RESULTS: A total of 57 patients with robotic NOSES and 93 with robotic RC resection were enrolled. Total mesorectal excision of the rectum, trans-anal or transvaginal specimen extraction (TVSE), anastomoses and protective ileostomy were conducted in all patients. ASA, BMI, tumor histology, stage, nodal stage, mean operative time, estimated blood loss, tumor size, lymph nodes removal, hospital stay morbidity and mortality were evaluated. No patient required conversion to conventional surgery. NOSE has less morbidity and significantly reduces postoperative pain and hospital stay (5.0 vs. 5.5). The two groups were similar in long-term survival. CONCLUSIONS: According to our literature search, this is the first study to compare RSAR and NOSE for RC using the Da Vinci Xi system. NOSE can be performed safely and successfully on selected patients, providing excellent good results. [ABSTRACT FROM AUTHOR]

Abstract Background Bladder cancer surgery is critical for treatment, and systemic treatment before or after cystectomy may be necessary. We aimed to investigate the efficacy and response to neoadjuvant and adjuvant treatments. Methods Data on 93 patients with resectable muscle-invasive bladder cancer were analyzed retrospectively. Patients who received neoadjuvant and adjuvant chemotherapies were included. The neoadjuvant treatment group was divided into pathological responders and non-responders. Overall survival and disease-free survival were calculated. Results The median age was 61.5 years; there were 6 female and 87 male patients. Baseline characteristics were similar between the groups. While there was no difference in OS between the neoadjuvant and adjuvant treatment groups (20 months vs. not reached), DFS was significantly higher in the adjuvant group (20.6 vs. 25.3 months). While there was no significant difference in DFS between the responders and non-responders to neoadjuvant treatment (20.6 vs. 19.1 months), OS was significantly longer in the responders (Not reached vs. 12.3 months). Conclusions Our results concluded that neoadjuvant and adjuvant chemotherapies have similar survival rates, but no response was associated with poor outcomes. Determining the group for patient selection may be helpful for optimal management.

ÖZ: Bu çalışmada M. Friedman’ın vergi-harcama hipotezi Türkiye (2006-2022) örneği üzerinden araştırılmıştır. Araştırmanın uygulaması iki aşamada gerçekleştirilmiştir. İlk olarak araştırmanın değişkenleri geleneksel birim kök testlerine (Augmented Dickey-Fuller ve Phillips-Perron testlerine) tabi tutulmuş ve ardından Engel-Granger koentegrasyon analizi yapılmıştır. İkinci aşamada değişkenler yapısal kırılmalı birim kök testlerine (Zivot-Andrews ve Lee-Strazicich testlerine) tabi tutulmuş ve yapısal kırılmayı dikkate alan Gregory-Hansen koentegrasyon analizi yapılmıştır. Sonuç olarak her iki yöntem benzer sonuçlar vermiş ve vergi-harcama hipotezinin Türkiye (2006-2022) için geçerli olduğunu sonucuna ulaşılmıştır. ABSTRACT: In this study, M. Friedman’s tax-expenditure hypothesis was investigated through the example of Turkey (2006-2022). The implementation of the research was carried out in two stages. First, the variables of the research were subjected to traditional unit root tests (Augmented Dickey-Fuller test and Phillips-Perron test) and then the Engel-Granger cointegration analysis was performed. In the second stage, the variables were subjected to unit root tests with structural break (Zivot-Andrews test and Lee-Strazicich test) and Gregory-Hansen cointegration analysis, which took into account the structural break, was performed. As a result, both methods gave similar results and it was concluded that the tax-expenditure hypothesis is valid for Turkey (2006-2022).

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.

An integrated energy system (IES) is a regional energy system incorporating distributed multi-energy systems to serve various energy demands such as electricity, heating, cooling, and gas. The reliability analysis plays a key role in guaranteeing the safety and adequacy of an IES. This paper aims to build a capacity reliability model of an IES. The multi-energy correlation in the IES can generate the dependent capacity outage states, which is the distinguished reliability feature of an IES from a generation system. To address this issue, this paper presents a novel analytical method to model the dependent multi-energy capacity outage states and their joint outage probabilities of an IES for its reliability assessment. To model the dependent multi-energy capacity outage states, a new multi-dimen-sional matrix method is presented in the capacity outage probability table (COPT) model of the generation system. Furthermore., a customized multi-dimensional discrete convolution algorithm is proposed to compute the reliability model, and the adequacy indices are calculated in an accurate and efficient way. Case studies demonstrate the correctness and efficiency of the proposed method. The capacity value of multi-energy conversion facilities is also quantified by the proposed method.

Objective: The aim of this study was to explore the relationship between health literacy and self-report medication adherence of Turkish cancer patients receiving oral chemotherapy. Methods: The present research was a descriptive and cross-sectional study and conducted with 100 voluntary cancer patients who were admitted to the medical oncology outpatient clinic and received oral chemotherapy. The data were collected through a questionnaire form consisting of the Oral Chemotherapy Adherence Scale and the Turkish Health Literacy Scale (TSOY-32). The collected data were analyzed using descriptive statistics, one-way ANOVA, and Pearson's correlation coefficient.Results: The results revealed that 57% of the patients were female, 35% were primary school graduates, 51% were breast cancer, and 36% took capecitabine. The mean index scores of the participants on both scales were calculated as 12.39 ± 1.51 and 73.25 ± 6.18, respectively. Overall, a positive and strong correlation was found between oral chemotherapy adherence and health literacy of the participants (r = 0.707, P = 0.000). Conclusions: Medication adherence and health literacy levels among the cancer patients in Turkey are alarming so that patient-centered interventions and training are required to overcome the barriers to medication adherence.

Background: Kaposi's sarcoma (KS) is a reactive, multifocal, multicentric, angiogenic neoplastic proliferation that is thought to originate from endothelial cells that are infected with human herpesvirus-8 (HHV-8). This report examines a cohort of patients with classic Kaposi's sarcoma (KS) evaluated at the national institute of oncology over the 13-year period. Methods: A retrospective analysis of 156 patients with classic KS, between January 2000 and November 2013, was performed. This study focused on the clinical presentation, staging, diagnosis, and treatment of classic KS. Results: One hundred fifty-six patients (median age 69 and 115 male) were enrolled into the study. Median age at diagnosis was 69 (range: 32–95 years). Male/female ratio was 2.80. The most common location was the lower limbs. There were 75 stage I patients (48.1%), 8 stage II patients (22.4%), 31 stage III patients (19.9%) and 15 stage IV patients (9.6%). Surgery was the most common local treatment method (43%). 44 patients (28.2%) received radiotherapy (RT) at diagnosis. Cytotoxic treatment with chemotherapy or interferon-α was administered in 57 patients. Visceral involvement was observed in 10 patients (lung: nine patients, liver: one patient) and bone metastasis occurred in two patients at relapse. Conclusion: This study is one of the largest reported series. Further studies are required and it will be important to standardize the assessment of disease activity and clinical response. Keywords: Classic Kaposi's sarcoma, Radiotherapy, Surgery, Chemotherapy

The aim of this study is to compare optical coherence tomography (OCT) findings of retinal thickness (RT) and retinal nerve fiber layer thickness (RNFLT) of idiopathic Parkinson's disease (IPD) patients to those of healthy subjects, and to investigate whether there is any relationship between the severity of the disease and the RNFLT values. This prospective study was included 25 IPD patients and 29 healthy controls. In the IPD group, the Hoehn and Yahr (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Exam (MMSE) were performed. Intraocular pressure (IOP), visual acuity (VA), spherical equivalent, axial length (AL), and central corneal thickness (CCT) were measured using OCT in both groups. The RT was measured in the central retinal (RTc), nasal (RTn), and temporal (RTt) segments. Nasal (RNFLTn), nasal superior (RNFLTns), nasal inferior (RNFLTni), temporal (RNFLTt), temporal superior (RNFLTts), and temporal inferior (RNFLTti) measurements were made and mean RTFLT was calculated (RNFLTg) for each individual. In the patient group, IOP and VA values were statistically significantly lower The RTn and RNFLTg were significantly thinner in the patient group. There was no statistically significant relationship between the severity of IPD and these findings. In our study, RNFLTg and RTn were found to be thinner in the IPD group, which may have caused lower VA scores. The effects of retinal dopamine depletion on RT and RNFLT, and lower IOP values in the non-glaucomatous IPD patients should be further investigated.

Abstract: Gravimetry has the potential to provide important data, in combination with GPS, for detecting vertical surface motions and subsurface mass changes. Here, we focus on the first results of joint gravity and GPS studies in order to understand better the vertical component of the postseismic deformations of the 1999 earthquakes along the western North Anatolian Fault. We investigate the relationship between gravity changes and GPS motions during the period 2003–2005. The changes in this period constitute a snapshot of the nonlinear movements that were not studied before in the Marmara Region. The first observations evaluated here demonstrate that the joint analysis of GPS and gravity data help to constrain the 3D postseismic deformations and hence expand our knowledge of the geophysical process in the Marmara Region. We identify what appear to be different crustal properties in the western and eastern parts of the region. Furthermore, the GPS results indicate that the western extension of the 1999 İzmit rupture area presently has low strain accumulation. To the extent that this behaviour continues through the earthquake cycle, it reduces the moment release of the expected future earthquake in the eastern Marmara seismic gap. In contrast, the western part of Marmara region has important strain loading. While our results are not sufficiently accurate for detailed interpretation, the observed strain accumulation implies the potential for a significant earthquake in the western Marmara region. Generally, possible fault creep extending west of the İzmit fault break following the İzmit earthquake is very important to understand the future seismic hazard in the Marmara region because it reduces the amount of strain accumulation during the earthquake cycle which will either delay the onset of future events or produce smaller future earthquakes. [Copyright &y& Elsevier]

Dünya nüfusundaki artışa paralel olarak artan enerji tüketimi de hızla artmaktadır. Artan enerji tüketiminin ise çevresel faktörlerle olan ilişkisi CO2 salınımı yoluyla her geçen gün daha fazla artmaktadır. Çevresel faktörlerle ekonomi arasında ilişki ise 1990’lı yılların başından itibarenele alınmaya başlanmıştır. Bu ilişkiye temel olan teori ise gelir eşitsizliği ile büyüme arasındaki ilişkiyi inceleyen Kuznets’in (1955), ekonomik büyüme ve gelir eşitsizliği arasında ters-U şeklinde bir ilişki olduğunu ileri sürdüğü hipotezinden türetilmiştir. Kuznets bu ilişki ile ilgili olarak, gelişmişlik düzeyinin ilk evresi ve sonraki evreleri hakkında farklı yorumlarda bulunmuştur. Başlangıç itibari ile gelişmekte olan ülkelerde sanayileşme ile birlikte gelir eşitsizliğinin ortaya çıkacağını belirtmiş, fakat bu olumsuzluğun ülkenin gelişimini tamamladıktan sonra telafi edileceği sonucuna ulaşmıştır. Bu hipotezden yola çıkılarak 1990’lı yıllarda Grossman veKrueger (1991, 1995) ekonomik büyümenin ilk yıllarında çevresel kirliliğin artacağını ancak büyümenin ilerlemesiyle çevresel kirliliğin azalacağını savunmuşlardır. Başka bir ifade ile başlangıç itibariyle gelişmekte olan ülkelerde kalkınmanın ilk hamlelerinin yapılmaya başlaması ile birlikte çevresel faktörlerin olumsuz etkilenme oranının yüksek olacağını fakat bu olumsuzluğun ülkenin gelişimini tamamladıktan sonra telafi edileceğini değerlendirmektedir. Türkiye’nin 1968 – 2011 yılları arasındaki verilerini ele alarak yapılan bu çalışmada, ülkelerin gelişmişlik düzeyini gösterenmakroekonomik değişkenlerin başında gelenkişi başına düşen milli gelir, çevre kirliliğinde etkili olan tüm sera gazlarının yüzde 58.8’ini oluşturan karbondioksit emisyonu (CO2) ve kişi başına düşen enerji tüketimi değişkenleri kullanılarak uzun dönemli bir analiz yapılmıştır. Analizde yapısal kırılmaları dikkate alan Hatemi-J (2008) eşbütünleşme testi uygulanmış ve uzun dönemde ülkelerin büyümeleri için gereklilik arz eden enerji tüketimindeki artış, tüketim neticesinde ortaya çıkan karbondioksit salınımını yükseltmiştir. Bununla birlikte gelir düzeyindeki artışların ise karbondioksit salınımını azalttığı sonucuna ulaşılmıştır.Ulaşılan sonuçlar gelişmekte olan ülkelerde olduğu gibi Türkiye’de de yatırım ve büyümenin en önemli faktörü olan enerji tüketiminin daha fazla çevresel kirlenmeye yol açacağı, artan gelir düzeyi ile birlikte ise bu olumsuz neticenin düzelme yolunda bir seyir izleyeceği görülmüştür.

Aim of the study : Data are available indicating that red blood cell distribution width (RDW) is higher in cancer patients compared to healthy individuals or benign events. In our study, we aimed to investigate the influence of different RDW levels on survival in lung cancer patients. Material and methods: Clinical and laboratory data from 146 patients with lung cancer and 40 healthy subjects were retrospectively studied. RDW was recorded before the application of any treatment. Patients were categorised according to four different RDW cut-off values (median RDW, RDW determined by ROC curve analysis, the upper limit at the automatic blood count device, and RDW cut of value which used in previous studies). Kaplan-Meier survival analysis was used to examine the effect of RDW on survival for each cut-off level. Results : The median age of patients was 56.5 years (range: 26–83 years). The difference in median RDW between patients and the control group was statistically significant (14.0 and 13.8, respectively, p = 0.04). There was no difference with regard to overall survival when patients with RDW ≥ 14.0 were compared to those with RDW < 14.0 (p = 0.70); however, overall survival was 3.0 months shorter in low values of its own group in each of the following cut-off values: ≥ 14.2 (p = 0.34), ≥ 14.5 (p = 0.25), ≥ 15 (p = 0.59), although no results were statistically significant. Discussion : We consider that the difference between low and high RDW values according to certain cut-off values may reflect the statistics of larger studies although there is a statistically negative correlation between RDW level and survival.

1905 RUS DEVRİMİ ve SULTAN ABDÜLHAMİDYazar: Hasip SAYGILIİstanbul: Ötüken Neşriyat, 2016, 312 s.ISBN: 978-605-1553-51-1

Bu çalışmada eğitimin ve dolayısıyla beşeri sermayenin önemi üzerine durulmuş, yükseköğretim kavramı incelenmiş, bireylerin eğitim seviyesinin artışıyla istihdam edilebilirliklerinin analizi yapılmıştır. Şimdiye kadar beşeri sermaye ile ilgili yapılan çalışmalarda beşeri sermayenin eğitim düzeyinin artışıyla ekonomik etkinliğinin arttığı yönünde sonuçlara ulaşılmıştır. Konunun önemine istinaden çalışmamızda eğitim sisteminin önemli bir yapı taşı olan yükseköğretim sistemi incelenmiştir. Bilimsel bilginin üretildiği ve bilgi maliyetinin yüksek olduğu yerlerden birinin üniversiteler olduğu göz önüne alınırsa üniversitelerin bilimsel bilginin önemi ve toplum dinamikleri için vazgeçilmez bir unsur olduğu gerçeği de daha iyi anlaşılacaktır. Eğitim sektörünün geliştirilmesi, kalitesinin arttırılması insan sermayesinin kalitesinin de yükseltilmesini gerektirecektir. İnsan sermayesinin kalitesinin arttırılması için bir takım yatırımların yapılması ve maliyetlere katlanılması gerekmektedir. Bu yatırımlarla toplum bir sonraki aşamaya ilerleyebilecek, ekonomik ve sosyal alanlarda birçok yeni ve iyi gelişmeler ortaya çıkabilecektir. Eğitim yatırımlarının topluma olan faydaları yanında bireylere olan faydaları da önemlidir. Bu faydaların başında bireyin aldığı eğitim düzeyi arttıkça istihdam edilebilirliği ve elde ettiği gelirin de artması gelmektedir. Kişinin eğitim düzeyini arttırabilmesi için katlanacağı maliyetle, gelecekte elde edeceği gelir karşılaştırılması yapılmaktadır. Lise mezunu bireyle üniversite mezunu bireyin gelecekte yakalayacağı iş imkânları, çalışacağı kurumlar ve elde edeceği gelirler farklı olmaktadır. Eğitimin bireysel faydalarının başında maddi ve manevi ömür boyu kazancın artması gelmektedir. Bu amaçlarla çalışmamızda yükseköğretimin gerekliliği, oluşturulma dinamikleri ve gelişim aşamaları, yükseköğretimin küresel gelişmeleri ifade edilmeye çalışılmış, ardından kısaca eğitimin işlevselliği ve üniversite mezunu olmanın bireysel ve sosyal kazançlara etkisi üzerinde durulmuştur. Son bölümde ise 1994-2014 yıllık verileri kullanılarak genel lise mezunu, meslek lisesi mezunu ve üniversite mezunu bireylerin istihdam üzerine etkisi Türkiye ekonomisi çerçevesinde incelenmeye çalışılmıştır. Veriler Türkiye İstatistik Kurumu, Yüksek Öğretim Kurumu ve Milli Eğitim Bakanlığı istatistikler veri tabanlarından elde edilmiş ve Eviews 8 programıyla modelleme yapılmıştır. Çalışmada öncelikle veri setleri için Augmented Dickey Fuller birim kök testi uygulanmış, En Küçük Kareler Yöntemine göre modelleme yapılmış ve Granger nedensellik testiyle değişkenlerin istihdam üzerine etkisi belirlenmeye çalışılmıştır.

Background: Primary tumor resection (PTR) in metastatic colorectal cancer (mCRC) has not been suggested by guidelines, since new systemic chemotherapy options have improved overall survival. However, the effect of PTR is still controversial in mCRC. In this study, we aimed to evaluate the effect of PTR on survival in unresectable mCRC. Materials and Methods: Two hundred and fifty-two patients with unresectable mCRC were screened retrospectively between January 2007 and December 2017 and a total of 147 patients who met inclusion criteria were included. The patients with emergency or elective PTR and the patients without surgery were compared for baseline features and overall survival. Results: The median follow-up time was 15.6 months (range; 1.2–78.9) in whole patients. There were 91 patients in nonsurgical (NS) group and 56 patients in PTR group. The median overall survival was significantly longer in PTR group compared NS group (21.8 vs. 17.0 months, P = 0.01), but it was not associated to better overall survival in multivariate Cox analysis (hazard ratio: 0.65, 95% confidence interval: 0.41–1.02, P = 0.06). There was no significant difference in overall survival between emergency and elective surgery subgroups (22.9 vs. 16.1 months, respectively, P = 0.9). Conclusion: PTR did not offer an overall survival benefit in this study. Although it is debated, we think that it is better to start treatment with chemotherapy and biological agent combinations in patients with asymptomatic mCRC. Thus, the patients can be protected from the morbidity and mortality of the surgery.

Globalleşme süreci ile global pazarlar, global tüketiciler, global markalar ortaya çıkarken, rekabetin boyutu da değişerek global hale gelmiştir. Ülkelerin sahip oldukları, ekonomik, sosyal ve kültürel değerler yanında, sahip oldukları teknoloji ve bilgi düzeyi ile bunlardan yararlanılması, ülkelerin global rekabet içinde ki yerini belirlemektedir.Çünkü günümüzde rekabetin boyutu değişerek faktör güdümlü rekabetten, teknoloji ve bilgiye dayalı rekabete yönelinmiştir. Bu çalışmanın kapsamı içinde, rekabet, rekabet sürecinin değişimi ve teknolojik gelişmeler bağlamında global rekabet ele alınıp incelenmiştir.

Bu çalışmada, Türkiye ve dünya buğday fiyatlarındaki 1996:06-2007:10 dönemine ait nedensellik ilişkisi araştırılmıştır. Zaman serilerinde geleneksel birim kök testinin (Augmented Dickey Fuller) yanı sıra, yapısal kırılmanın varlığının tespiti için, Tekrarlı Tahmin Yöntemi ve Philips Perron birim kök testi kullanılmış ve Türkiye ve Dünya buğday fiyatları arasında Granger nedensellik analizi yapılmıştır. Philips Perron ve ADF testi sonuçları benzer şekilde verilerin fark durağan olduğunu göstermiştir. Standart Granger nedensellik testi sonuçlarına göre %90 güven sınırında dünya buğday fiyatlarının, Türkiye buğday fiyatlarının oluşumunda etkili olduğu sonucuna varılmıştır. Ancak bu durum, daha yüksek güven düzeylerinde Türkiye’de buğday fiyatlarının oluşumunu dış şartlardan daha çok içsel ekonomik, siyasi ve buğday arz durumu gibi faktörlere bağlı olduğunu göstermektedir.