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BACKGROUND/AIMS The aim of this study was to investigate the effects of Nigella sativa (NS) oil form on reducing the damage caused by indomethacin in the stomach and duodenum of rats owing to their antioxidant and anti-inflammatory properties. MATERIAL and METHODS The rats were divided into 4 groups: group 1, saline-treated control group; group 2, NS-treated control group; group 3, saline-treated ulcer group and ulcers caused by indomethacin (30 mg/kg) and administration of physiological serum; group 4, NS-treated ulcer group, which is the group receiving NS oil after administration of indomethacin. At the end of the study, blood samples collected from animals were examined for tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and glutathione (GSH), malondialdehyde (MDA) levels and myeloperoxidase (MPO),and Na+/K+-ATPase activities in gastric and intestinal tissue samples. RESULTS Levels of TNF-alpha and IL-1 beta in serum and MDA and MPO values in tissue were found to be higher in the saline-treated ulcer group than in the saline-treated control group. In addition, tissue GSH and Na+/K+-ATPase levels were found to be lower. These values were found to be reversed when comparing NS-treated ulcer group to saline-treated ulcer group. Histopathological findings showed epithelial regeneration and improvement instead of dense tissue damage. CONCLUSION The strong antioxidant and anti-inflammatory effects of NS against potential small intestine and gastric damage were shown using an experimental indomethacin-induced ulcer model in rats. Hence, our study suggests that NS used together with indomethacin can prevent gastrointestinal damage; thus, this agent can create a new clinical therapeutic principle.

We aim to classify acoustic events recorded by a fiber optic distributed acoustic sensor (DAS). We derived the information from probing the fiber with light pulses and analyzing the Rayleigh backscatter. Then, we processed this data by a pipeline of processing algorithms to form the input for our machine learning classification model. We put random matrix theory to the test to distinguish the acoustic event of interest from the noise. We conditioned the raw trace using moving average and wavelet-based filtering algorithms to improve the signal-to-noise ratio. For raw, low pass, and wavelet-based filtered signals that we inject into a convolutional neural network, we rely on the magnitude of their complex coefficients to categorize the nature of the event. We also investigate Mel-Frequency Cepstral coefficients specific to the event as an input for the classifier and compare their performance to other signal representations. We run the experiments on the CNN for two-class and three-class classification using datasets from a DAS that is deployed for perimeter security and pipeline monitoring. We obtained the best results when using the MFCCs paired with wavelet denoising, achieving accuracies of 96.4% for the \"event\" class and 99.7% for the \"no event\" class when it comes to the two-class process. The three-class process yielded optimal accuracies of 83.3%, 81.3%, and 96.7% for the \"digging,\" \"walking,\" and \"excavation\" classes, respectively. Finally, the training execution time is exceptionally long because the extensive dataset and the model\"s architecture are complex. As a result, we make efficient use of the CPU and GPU to maximize our machine\"s power using the Keras API\"s sequence data generator. Compared with the serial implementation, we report an improvement of up to 4.87 times. (c) 2022 Society of Photo-Optical Instrumentation Engineers (SPIE)

This study investigated optimal combinations of parameters to improve the production performance and product quality in milling limestones on a computer numerical control (CNC) machine. Experiments were performed on four types of limestone rocks of sedimentary origin. The experiments were conducted using a Taguchi L9 orthogonal array design on a 6-mm carbide cutting tool on the CNC. The signal/noise (S/N) ratio was determined using the Taguchi method for the optimal machining parameters of limestones. The effects of the parameters on surface roughness were determined using analysis of variance. It is time-consuming and expensive to determine surface characteristics that appeal to customers. The optimal machining parameters depend on the heterogeneous structure and characteristics of the limestone, such as crack width and grain size. This, in turn, affects the surface quality due to insert cutting or breaking instead of insert cutting. Confirmation tests were conducted to select the optimal machining parameters for milling heterogeneous limestones. The optimal machining parameters were determined using carbide end milling to help both manufacturers to produce new tools and operators to improve product quality and reduce machining costs.

Determining cutting parameters in marble machining based on computer-controlled machine (CNC) is important for product quality. The aim of this study was to use the Taguchi experiment design method to select machining parameters to improve product surface quality in CNC milling of marbles. Experimental studies were conducted with a 6-mm-diameter cutting edge on six metamorphic rocks. Experiments were performed using the Taguchi experimental design method (L9 orthogonal array). The S/N (signal/noise) ratio based on “the lower the better” approach was calculated separately for each marble sample to determine appropriate machining parameters. Statistically significant and effective machining parameters were determined using variance analysis depending on the lowest roughness value. Results show that the parameters of depth and feed rate have the greatest effect on surface roughness in the machining of marbles.

Bu calismada, Sivas yoresinde sigir ve kenelerde Theileria, Babesia ve Anaplasma turlerinin varligi ve yayginliginin arastirilmasi amaclandi. Sigirlardan toplanan 314 EDTAli kan ve 610 kene ornegi analiz edildi. Kan ve kenelerden elde edilen genomic DNA’lardan polimeraz zincir reaksiyonu (PZR) ile Theileria, Babesia ve Anaplasma turlerinin 18S ve 16S rRNA parsiyal gen bolgeleri amplifiye edildi. Bir membran uzerine toplam 14 prob (iki cathall/genel, iki soy ve on tur) baglandi ve PZR urunleri reverse line blotting (RLB) ile analiz edildi. Pozitif orneklerin 18S ve 16S rRNA genlerinin kismi dizileri belirlendi. RLB ve sekans analizi ile Sivas yoresinde sigir ve kenelerde; T. buffeli (KJ183080), A. centrale (KJ183082), A. marginale (KJ183083), A. bovis (KJ183084) ve bir Babesia genotipi (Babesia sp. Sivas, KJ183081) ile bir Anaplasma genotipi (Anaplasma sp. Sivas, KJ210855) tespit edildi. Babesia sp. Sivas izolatinin, B. occultans, Babesia sp. Kashi ve Babesia sp. Kayseri izolatlari ile %99, Anaplasma sp. Sivas izolatinin ise Anaplasma sp. Clone 7 ile %99 ve A. bovis ile %98 benzerlige sahip oldugu belirlendi. Sigirlarda Theileria ve Anaplasma enfeksiyonlarinin genel prevalansi, RLB'de sirasiyla %5.10 ve %11.15 olarak bulundu. Bu calisma Sivas yoresinde sigirlarda ve kenelerde Theileria, Babesia ve Anaplasma turlerinin belirlendigi ilk molekuler calisma niteligindedir.

Noise is the most persistent physical contaminant in the environment. In this study, noise level and noise propagation were investigated during the working of natural stone cutting–processing machines used in the natural stone workshops. For this purpose, emerged noise was recorded and analyzed while cutting and processing of marble samples in a workshop where side cutting machine (cross-cutting), portable sawing machine and vibratory tumbling machine are used. Noise level maps were prepared by using equivalent noise data obtained from 110 regular points in the natural stone workshop. They were created by building grids using noise propagation variogram models, and plotting contour maps with Surfer version 10.2 software using kriging method. Risky areas were determined using noise propagation maps and also daily noise exposure limit values and working time. For risky areas in which a high level of noise was detected; the working time restriction, use of personal protective equipment or both are required.

Conventional geostatistical prediction methods can be used to carry out resource classification in ore beds and for reliability measurements. A field investigation based on lignite thickness data was conducted for resource classification in Eskisehir-Mihaliccik-Koyunagili coal basin. Moreover, a fuzzy logic-based resource classification method has been recently proposed to eliminate the uncertainties encountered in the conduct of conventional resource classification procedure. Fuzzy logic-based classification provides gradual transitions between two adjacent resource classes. In addition, the proposed method can classify each block by assigning a membership degree for handling decision-making problems encountered in conventional resource classification methods.

Bu çalışmada, mermerlerin bilgisayar kontrollü makine (CNC) ile işlenmesinde kesme kuvvetleri ve spesifik kesme enerjisinin istatistiksel analizi yapılmıştır. Deneysel çalışmalarda, 7 tür mermer, 6.0 mm çapında parmak frezeli kesici uç, 1.2, 1.6 ve 2.0 mm kesme derinliği, 2000, 2500 ve 3000 mm/dk ilerleme hızı parametreleri seçilmiştir. CNC makinesi ile yapılan işlenebilirlik deneylerinde kesme derinliği ve ilerleme hızına göre teğetsel kesme kuvveti (Fc), radyal kesme kuvveti (Ft) ve spesifik kesme enerji değerlerinin istatistiksel analizi (ANOVA) yapılmıştır. Mermerlerin fiziksel ve mekanik özelliklerinin kesme kuvvetleri ve spesifik kesme enerjisine olan etkileri doğrusal regresyon analizi ile incelenmiştir. Mermerlerin kesme kuvvet değerleri ve spesifik kesme enerji değerleri bakımından p, In the study, statistical analysis of the cutting forces and specific cutting energy with the pocessing of marbles by computer numerical controlled (CNC) machine has been performed. In test study, 7 type marble, 6.0 mm diameter end mill cutting tool with external lines and linear processing type, 1.2, 1.6 and 2.0 mm depth of cut and 2000, 2500 and 3000 mm/min feed speed parameters were selected. The effects of depth of cut and feed Properties speed of processing equipment of CNC Machine on the processability of marbles were diagnosed cutting force (Fc), radial cutting force (Ft), and specific cutting energy values were analyzed statistically. In terms of cutting forces and specific energy values, a statistically significant difference (P

WOS: 000435033100005, In this research, we investigate the prevalence of Dirofilaria immitis infection in dogs using microscopical, serological, and molecular methods from the Central Anatolia Region (Sivas) of Turkey and reveal the associated risk factors. Whole blood and serum samples were obtained from 306 dogs older than 7 months. Polymerase chain reaction (PCR) and the modified Knott's method (Knott) were used for detecting the microfilaria and enzyme-linked immunosorbent assay (ELISA) was applied for the presence of D. immitis antigens. The prevalence of D. immitis in dogs was detected as 2.9% (9/306) by PCR and ELISA and as 1.3% (4/306) by Knott. All Knottpositive samples were also found positive by both PCR and ELISA. According to ELISA and PCR results, no statistically significant difference was found between the prevalence in males (4.2%) and females (1.5%); dogs 0.7-2 years old (2.5%), 3-5 years old (2.2%); and more than 6 years old (7.1%); or stray (3.7%) and owned (1.7%) dogs (P > 0.05). One of the PCR products was selected for sequence analyses of the 16S small subunit rRNA gene and the obtained sequence was submitted to GenBank (KJ183078). The 16S rRNA sequence exhibited 100% identity to other D. immitis sequences available in GenBank (FJ799911, FJ799917, FJ799916). This research provides the first data on D. immitis infections in dogs from Sivas Province by using the combined identification techniques., Scientific Research Project Fund of Cumhuriyet University [V-011], The authors would like to thank all veterinarians and technicians for their kind help during sample collection, Dr Alparslan Yildirim for control samples, and Dr Yusuf Ziya Ograk for statistical estimation. This work was supported by the Scientific Research Project Fund of Cumhuriyet University under project number V-011.

This study used a four-axis machine to investigate the processability of natural rocks and parameters affecting cutting forces (Cf), specific energy (Se) and specific cutting energy (Sc). A total of 12 types of natural rocks (7 marbles, 3 travertines, and 2 limestones) were categorized according to their geological formations and subjected to various characterization tests (petrographic characteristics, chemical properties, and physical and mechanical properties). This study consisted of three parts: (1) experimental measurement of cutting forces resulting from processing natural rocks using a 6.0-mm-diameter end mill cutting tool and a four-axis machine; (2) calculation of tangential cutting force (Fc), radial cutting force (Ft), specific energy (Se) and specific cutting energy (Sc) values; and (3) statistical analysis of parameters. For processability, cutting parameters at different levels (depth of cut and feed rate) were used to mill samples of different natural rocks. Statistical analysis (ANOVA) was performed on Cf, Se, and Sc values depending on the depth of cut and feed rate. Results indicate that depth of cut (1.2, 1.6, 2.0 mm) and feed rate (2000, 2500, 3000 mm/min) are important cutting parameters in the processability of rocks. A simple linear regression was performed to examine the relationship between physical and mechanical properties, and between Cf, Se, and Sc values. The coefficient of determination value (R2) is ≥ 0.821. The physical and mechanical properties of natural rocks are important parameters in the estimation of Cf, Se, and Sc values.

WOS: 000413908600009, Machining has considerably increased with evolving technology and increasing demand in natural stone production facilities. Different types of accidents may occur in natural stone facilities during movement, dimensioning, cutting of blocks and surface processing. These accidents may be due to physical, chemical, ergonomic and mechanical conditions. Therefore, possible work accidents and occupational diseases should be investigated. In this study, an L-matrix analysis is conducted to analyze hazards and forecast risks in natural stone facilities. According to the L-matrix results, three major initiating events are identified. For each of these initiating events, event tree analysis is used to calculate risk scores. These initiating events are hoist rope fatigue and breaking, diamond wire fatigue and breaking, and electrical leakage due to old systems. These events and their results are classified according to the probabilities using event tree analysis.

Many techniques are described for the ligation of a difficult cystic duct (CD). The aim of this study is to assess the effectiveness and safety of stapling of a difficult CD in acute cholecystitis using Endo-GIA. From January 2008 to June 2012, 1441 patients with cholelithiasis underwent laparoscopic cholecystectomy (LC) at the Department of General Surgery, Haydarpasa Numune Education and Research Hospital. Of these, 19 (0.62%) were identified as having a difficult CD and were ligated using an Endo-GIA stapler. All patients were successfully treated with a laparoscopic approach. The length of hospital stay was 3.4 days. There were umbilical wound infections in 4 patients (21%). The length of follow-up ranged from 1.0 to 50.4 months. In conclusion, Endo-GIA is a safe and easy treatment method for patients with a dilated and difficult CD. The cystic artery should be isolated and ligated if possible before firing the Endo-GIA stapler. If isolation and stapling are not possible, fibrin sealant can be applied to avoid bleeding. The vascular Endo-GIA can be applied in a large CD, but for acute cholecystitis with an edematous CD, the Endo-GIA roticulator 4.8 or 3.5 stapler is preferred.

Short gastric vessels are divided during the laparoscopic Nissen fundoplication resulting in splenic infarct in some cases. We report a case of laparoscopic floppy Nissen fundoplication with splenic infarct that was recognized during the procedure and provide a brief literature review. The patient underwent a laparoscopic floppy Nissen fundoplication. We observed a partial infarction of the spleen. She reported no pain. A follow-up computed tomography scan showed an infarct, and a 3-month abdominal ultrasound showed complete resolution. Peripheral splenic arterial branches have very little collateral circulation. When these vessels are occluded or injured, an area of infarction will occur immediately. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from splenic infarct. In conclusion, we believe that the real incidence is probably much higher because many cases of SI may have gone undiagnosed during or following an operation, because some patients are asymptomatic. We propose to check spleen carefully for the possibility of splenic infarct.

Channel opening methods (V and U) are used in natural stone quarries with the aim of designing and planning benches. A channel opening method (V-shape) is widely used in natural stone quarries where a quarry face is plain and continuous, in order to form a new bench. The most important shortcomings of this method are high production losses, long preparation process to form a bench, and failure to control the progress in the quarry. Providing that the topography and geological structure of the quarry are appropriate, the U-shape channel opening method can be applied using armed chained cutting machines. However, the channel opening equipment is operated in an integrated way with diamond-wire cutting machine, which can perform a back-cut directly in natural stone quarries; this equipment has high initial investment cost and limited application. A series of characterization tests were conducted on two different commonly used natural stone types which were categorized according their formation. This study investigates a recently developed hole design that enables a diamond-wire cutting machine to produce a U-shape cut, and compares the efficiency of this method with the V-shape method. With the U-channel opening method, production losses decrease and quarry benches can be formed in 60 % less time. The recently developed channel opening method is being applied in natural stone quarries. At these sites, productivity has increased threefold with respect to V-channel opening method. It was observed of the U-channel opening method, resulted in production of blocks at a lower cost per unit time. It was calculated that block efficiency in natural stone quarries increased to 12–15 % values with use of the U-channel opening method.

Objective: The purpose of this article is to examine the correlation between information obtained from patients before endoscopy and histopathological findings. Material and Methods: One thousand, five hundred and thirty-six patients underwent upper GI endoscopy between January 2011-September 2012, without distinction of age and sex were included in the study. Patients with alarm symptoms, dyspepsia, epigastric pain, gastroesophageal reflux were recorded. Tissue samples taken for histopathological examination and H. pylori screening were evaluated by Giemsa stain. The information given by the patients and histopathological findings were comparatively evaluated. Results: Six hundred and twenty-four patients (40.6%) were male and 912 (59.4%) were female. Mean age was 45 years (18-90). H. pylori was positive in 416 patients with dyspepsia (58.8%), 172 patients with epigastric pain (54.4%), 52 patients with GER symptoms (28.3%) and 128 patients with alarm symptoms (50.8%). Four patients with dyspepsia (0.6%) and 20 patients with alarm symptoms (7.9%) were diagnosed with stomach cancer. Conclusion: The main factor should be considered as the presence of at least one of the alarm symptoms when planning an upper GI endoscopy in a patient. In the presence of at least one of the alarm symptoms, an upper GI endoscopy should be performed regardless of age. Under the age of 50 and for patients without alarm symptoms, medical treatment can be tried before performing upper GI endoscopy. Patients with GER symptoms but not diagnosed as reflux esophagitis, should be treated long-term even when symptoms decline with initial treatment.

BACKGROUND: To investigate the effects of curcumin, an antioxidant and anti-inflammatory agent, on free oxygen radicals and lipid peroxidation in an experimental sepsis model, as well as to determine the role of curcumin in preventing hepatorenal tissue damage caused by sepsis. METHODS: The rats were randomly divided into three groups (n=8) as follows: control group (group 1); sepsis group (group 2); and sepsis + curcumin group (group 3). Sepsis was created using the cecal ligation and perforation (CLP) method. Curcumin was administered intraperitoneally (200 mg/kg) in two equal doses just after the perforation and at twelve hours post-perforation. RESULTS: Serum TNF-alpha and IL-1 beta, and tissue MDA and MPO values were higher, whereas tissue GSH and Na+/K+-ATPase values were lower, in group 2 as compared to group 1. These values in group 3 were the inverse of those in group 2. As compared to group 1, histopathological evaluation of group 2 showed damaged hepatocytes, glomeruli, and tubules, whereas the damage was significantly reduced in group 3 as compared to group 2. CONCLUSION: The strong antioxidant and anti-inflammatory effects of curcumin against potential hepatorenal damage were shown using an experimental sepsis model in rats.

Bu çalışmada, bilgisayar kontrollü makine (CNC) ile mermerlerin işlenebilirliğinde kesme kuvveti ve spesifik enerjisi belirlenmiştir. Piyasada yaygın olarak kullanılan ve oluşumlarına göre sınıflandırılmış, 5 farklı tür mermer üzerine araştırma yapılmıştır. Deneysel çalışmalarda, parmak frezeli kesici uç (6.0 mm) ile farklı işleme türü (dış hatlar ve çizgisel), kesme derinliği (1.2, 1.6 ve 2.0 mm), ilerleme hızı (2000, 2500 ve 3000 mm/dk) parametreleri seçilmiştir. Bilgisayar kontrollü makine ile yapılan işlenebilirlik deneylerinde işleme türü, kesme derinliği ve ilerleme hızına göre Fz, Fc ve Ft kuvvetleri ve spesifik enerji değerlerinin istatistiksel analizi yapılmıştır. Mermerlerin kuvvet değerleri ve spesifik enerji değerleri bakımından p

This study used various test methods to analyze the impact resistance of marble, limestone, and travertine to determine their breaking potential when they are used for interior and exterior floor covering. A total of 17 kinds of natural rocks (7 marbles, 5 travertines, and 5 limestones) were categorized according to their commonly used geological formations and were subjected to various characterization tests (mineralogical and petrographic characteristics, chemical properties, as well as physical and mechanical properties). The rupture energy caused by an impact on natural rocks was determined according to the BS EN 14158 standard, whereas restitution coefficients were determined according to the BS EN ISO 10545-5 standard. The impact resistance, rupture energy, and restitution coefficient of polished natural stone plates that were used in the tests were statistically analyzed. The parameters that affected these variables of natural rocks were plate thickness, mineralogical and petrographic characteristics, and physical and mechanical properties. Finally, the potential fractures of the specimens were classified based on impact resistance, rupture energy, and restitution coefficient.

BACKGROUND The aim of the present study was to investigate morbidity and mortality-related risk factors in patients undergoing surgery due to incarcerated abdominal wall hernia. METHODS The patients were grouped according to the type of hernia (inguinal, umbilical, incisional, femoral), and these groups were evaluated in terms of risk factors affecting morbidity and mortality such as age, gender, American Society of Anesthesiologists (ASA) score, type of anesthesia, concomitant diseases, and the presence of intestinal strangulation and necrosis. RESULTS Inguinal hernia was frequent in males, whereas femoral hernia was frequent in females (p

Objectives This study aimed to investigate the antioxidant and anti-inflammatory effects of caffeic acid phenethyl ester (CAPE) on the methotrexate (MTX)-induced hepatorenal oxidative damage in rats. Methods Following a single dose of methotrexate (20 mg/kg), either vehicle (MTX group) or CAPE (10 µmol/kg, MTX + CAPE group) was administered for five days. In other rats, vehicle (control group) or CAPE was injected for five days, following a single dose of saline injection. After decapitation of the rats, trunk blood was obtained, and the liver and kidney tissues were removed for histological examination and for the measurement of malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) and sodium potassium-adenosine triphosphatase (Na+/K+-ATPase) activity. TNF-α and IL-1β levels were measured in the blood. Key findings Methotrexate administration increased the tissue MDA levels, MPO activity and decreased GSH levels and Na+/K+-ATPase activity, while these alterations were reversed in the CAPE-treated MTX group. Elevated TNF-α and IL-1β levels were also reduced with CAPE treatment. Conclusions The results of this study revealed that CAPE, through its anti-inflammatory and antioxidant actions, alleviates methotrexate-induced oxidative damage, which suggests that CAPE may be of therapeutic benefit when used with methotrexate.

Aim Our aim in this study was to evaluate patient outcomes resulting from the follow-up and treatment of pelvic cavity fractures and their common accompanying organ injuries.

INTRODUCTIONAtypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation.PRESENTATION OF CASEA 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation of epigastric region. There was a left subcostal incision with the history of diaphragmatic hernia repair when the patient was 3 days old. He had an intestinal malrotation with the cecum fixed at the epigastric region and the inflamed appendix extending beside the left lobe of liver.DISCUSSIONWhile appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality.CONCLUSIONAtypical presentations of acute appendicitis should be kept in mind in patients with abdominal pain in emergency room especially in patients with previous childhood operation for diaphragmatic hernia.

Objectives: This study was designed to evaluate the protective effect of the cysteinyl leukotriene receptor antagonist montelukast against pancreatic injury during acute pancreatitis. Methods: Acute pancreatitis was induced in rats by 20-μg/kg (intraperitoneal) cerulein given at 1-hour intervals within 4 hours. Montelukast was administered intraperitoneally at a dose of 10 mg/kg 15 minutes before the first cerulein injection. Six hours after the cerulein or saline injections, the animals were killed by decapitation. Blood samples were collected to analyze amylase, lipase, and the proinflammatory cytokines tumor necrosis factor α and interleukin 1β. Pancreas tissues were taken for the determination of tissue glutathione and malondialdehyde levels and Na+,K+-adenosine triphosphatase and myeloperoxidase activities. The extent of tissue injury was analyzed microscopically. Results: Acute pancreatitis caused significant decreases in tissue glutathione level and Na+,K+-adenosine triphosphatase activity, which were accompanied with significant increases in the pancreatic malondialdehyde level, myeloperoxidase activity, and plasma cytokine level. On the other hand, montelukast treatment reversed all these biochemical indices and histopathological alterations that were induced by cerulein. Conclusions: These results suggest that cysteinyl leukotrienes may be involved in the pathogenesis of acute pancreatitis and that the cysteinyl leukotriene receptor antagonist, montelukast, might be of therapeutic value for treatment of acute pancreatitis.

INTRODUCTIONHere, we present a case of gastric outlet obstruction due to focal nodular hyperplasia of the liver.PRESENTATION OF CASEA 23-year-old female presented to our emergency clinic with nausea, vomiting, and abdominal pain. Endoscopy showed that the prepyloric region of the stomach was externally compressed by a lesion. Computed tomography and magnetic resonance imaging revealed a 70mm solid mass originating from the liver, extending caudally in an exophytic manner, and compressing the stomach. Laparotomy revealed an irregular and exophytic mass originating from the liver, which caused gastric outlet obstruction. The mass was resected with a 10mm safety margin. The histopathology report of the mass returned as focal nodular hyperplasia.DISCUSSIONGastric outlet obstruction is a clinical syndrome characterized by abdominal pain, nausea, and postprandial vomiting. This clinical condition frequently develops as a result of peptic ulcer disease, pyloric stenosis, and obstruction of pylorus by foreign bodies including phytobezoars, congenital duodenal webs, malignant disorders, and various lesions externally compressing the stomach. Gastric outlet obstruction due to hepatic lesions is extremely rare; few cases have been reported.CONCLUSIONThis is the first reported case of gastric outlet obstruction that developed due to focal nodular hyperplasia of the liver.

Bu çalışmada, Ankara İli 112 Komuta Kontrol Merkezi'ne 2013 yılında zehirlenme nedeni ile başvuran vakaların formları geriye dönük olarak incelenmiş ve olguların epidemiyolojik ve demografik özellikleri yaş, cinsiyet, zehirlenme, çağrı nedeni, zehirlenme etkeni, vakanın sonucu, zehirlenmenin bölgesel durumu ve başvuru zamanı (mevsim, ay, gün, saat) açısından değerlendirilmiştir. Araştırmada 01.01.2013 ve 31.12.2013 tarihleri arasında Ankara 112 Komuta Kontrol Merkezi'ne başvuran ICD10 koduna göre 1889 zehirlenme olgu formu incelenmiştir. Bu formlardan `hastaneler arası nakil'', `görev iptali'', `tıbbi tetkik için nakil'', `olay yeri bekleme'', `başka araçla nakil`, `nakil reddi`, `eve nakil` çıkış kodlular tekrarları önlemek için dışarıda bırakılmış ve toplam 1349 olgu formu araştırmaya dahil edilerek tamamı incelenmiştir. Ankara İl Ambulans Servisi Başhekimliği veri hazırlama ve istatistik arşivinden elde edilen vaka çalışma ve kayıt formlarındaki veriler SPSS 15.00 programına kaydedilmiştir. Araştırma döneminde ICD10 koduna göre tüm başvurular içinde zehirlenmeler %0,9 sıklıkla saptanmıştır. Değerlendirmeye alınan olguların 672'si (%49,9) kadın, %64,3'ü 20–64 yaş grubundadır. Olguların %5,6'sı 0–2 yaş, %9,4'ü 3–10 yaş, %25,0'ı 11–19 yaş, %5,7'si 65 yaş üzeri yaş grubundadır. Vakaların 413'ünü (%30,6) `ilaç ve opioid` zehirlenmeleri, 238'ini (%17,6) `kimyasal, koroziv ve pestisidler`, 232'sini (%17,2) `CO ve diğer gazlar`, 165'ini (%12,2) `besin`, 161'ini (%11,9) `alkol ve madde`, 140'ını (%10,4) `hayvan ısırık ve sokmaları` zehirlenmelerinin oluşturduğu saptanmıştır. Erkeklerde (%43,8) ve kadınlarda (%56,2) en fazla görülen zehirlenme türü `ilaç ve opioid` kullanımına bağlıdır. Zehirlenmeler en fazla %12,3 ile Mayıs ayında, % 19 ile cuma gününde, % 37,2 ile 12.00–17.59 saat diliminde ve %27,7 ile İlkbahar mevsiminde meydana gelmiştir. Olguların % 52,9'unun medikal, % 21,7'sinin kaza sonucu, % 6,4'ünün `intihar ve intihar girişimi` amaçlı zehirlendiği tespit edilmiştir. Araştırmada incelenen olguların %88,4'ü kentsel, %11,6'sı kırsal bölgede gerçekleşmiştir. Zehirlenmeler tüm acil başvurular içinde nispeten düşük sıklıkta görülmekle birlikte, neden olabilecekleri sağlık sonuçları açısından önemlidir. Acil sağlık hizmetleri kapsamında zehirlenme etkenleri dağılımının bilinmesi bundan sonraki hizmet düzenlemeleri ve eğitim gereksiniminin saptanması konularında fayda sağlayacaktır. In this study, Ankara 112 Emergency Call Center admitted forms which are caused by poisonings were investigated as retrospectively and epidemiologic and demographic fcharacteristics of cases, age, gender, poisonings call reason, poisoning factor, result of case, result of poisoning regional status and application time (ex: seasons, months, days, hours) were evaluated. In this research 1889 poisoning case forms all were investigated which attended to Chief of Staff in Ankara Ambulance Service 112 Emergency Call Center between 01.01.2013 and 31.12.2013. From these forms total 1349 case forms were throwed in research and `inter-hospital transport`, `cancellation task`, `transport for medical inspection`, `wait for scene`, `transport with another vehicle`, `rejection of transport`, `transport to home` code were excluded to prevent repetition. Case studies and registration forms data which were obtained from Ankara Provincial Ambulance Service Chief of Staff data preparation and statistics archive saved in SPSS 15.00 computer software. According to ICD10 code in research period 0,9% poisonings were often found in all applications. Under consideration cases, 672 female (49,9%), 64,3% 20-64 age groups. 5,6 % of cases were 0-2 ages, 9,4% 3-10 ages, 25 % 11-19 ages, 5,7% were over 65 ages groups. Poisoning cases consist of 413 (30,6% ) drugs and opioids, 238 (17,6%) chemical, corrosive and pesticides,232(17,2%) CO and other gases, 165(12,2%) food, 161 (11,9%) alcohol and drug, 140(10,4%) animal bites and stings were determined. Most prevalent type of poisoning for male(43,8%) and female(56,2%) depends on drugs and opioids using. Poisonings are happened mostly in May with 12,3%, 19% on Friday, 32,7% 12.00 pm-5.59 pm time interval and 27,7 % in spring season. Poisoning cases are identified with 52,9% medical, 21,7% accident, 6,4% suicide and suicide attempts. In addition to cases which are composes in this study, cases based on region are determined 88,4% in urban areas, 11,6 % in rural areas. Poisonings in all emergency admissions are seen at relatively low frequency, they are important as they can cause health results. Knowledge of the distribution of poisoning agents within the scope of emergency medical services would benefit about next service arrangements and determination of training requirements. 130

Patient: Female, 45 Final Diagnosis: Neuroendocrine tumor Symptoms: Abdominal pain Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Unusual setting of medical care Background: Neuroendocrine tumor of the ampulla of Vater is extremely rare and is generally a low-grade endocrine cell tumor. The merits of radical vs. local resection remain uncertain. Case Report: A 45-year-old female patient presented with abdominal pain lasting for 2 months. Papilla that was tumor-like macroscopically was seen in the second part of the duodenum in endoscopic retrograde cholangiopancreatography. Biopsy was histologically confirmed as a low-grade neuroendocrine tumor. No lymphadenopathy or visceral metastasis was found on an abdominal CT scan, In-111 octreotide scan, and EUS. The ampulla was removed by endoscopic snare papillectomy. All margins of resection were negative for tumor. Conclusions: Endoscopic snare papillectomy may be the first step in the management of neuroendocrine tumors of the ampulla of Vater in high-risk surgical candidates and selected patients such as those with a well differentiated, low-grade, small tumor without regional/ distant metastasis. However, it can also be used in younger patients who wish to avoid surgical resection.

Bu çalışmada, Sivas yöresindeki sahipli ve sokak köpeklerinde Toxoplasma gondii’nin seroprevalansının araştırılması amaçlanmıştır. Bu amaçla, Sivas yöresinden (Sivas, Hafik, Kangal, Suşehri, Ulaş, Yıldızeli) 60’ı sahipli ve 60’ı sokak köpeği olmak üzere toplam 120 köpekten serum örneği toplanmıştır. Bu örnekler Sabin Feldman Boya Testi ile anti-T.gondii antikorlarının varlığı yönünden incelenmiştir. İncelenen 120 köpek serumunun 115 (%95,8)’inde anti-T. gondii antikorları belirlenmiştir. T.gondii seropozitifliği erkek köpeklerde %95,6, dişilerde %96,2 (p?0,05), sahipli köpeklerde %96,7, sokak köpeklerinde %95,0 (p?0,05), 0-2 yaş grubunda %93,9, 3-5 yaş grubunda %95,4, 6 yaş ve üstü grupta %100 (p?0,05) olarak tespit edilmiştir. Sonuç olarak, Sivas yöresindeki köpeklerde T.gondii’nin oldukça yüksek bir seroprevalansa sahip olduğu ortaya çıkmıştır. Elde edilen sonuçlar, köpeklerin T.gondii’nin epidemiyolojisinde önemli bir rol oynadıklarını gösterdiğinden, gerek veteriner ve gerekse halk sağlığı bakımından dikkate alınmalıdır., study was carried out to investigate the seroprevalence of Toxoplasma gondii in dogs in province of Sivas. For this aim, a total of 120 sera samples, which are 60 from owned dogs and 60 from stray dogs, were collected in the region (Sivas, Hafik, Kangal, Suşehri, Ulaş, Yıldızeli). Anti-T.gondii antibodies were investigated using Sabin- Feldman Dye Test in the sera samples. The antibodies were detected in the 115 (95.8%) of 120 sera samples. The seroprevalence of T.gondii was 95.6% in male dogs, 96.2% in female dogs (p˃0.05), 96.7% in owned dogs, 95.0% in stray dogs (p˃0.05), 93.9% in 0-2 age group, 95.4% in 3-5 age group and 100% in over 6 age group (p˃0.05). The results of the study revealed that T.gondii has a high prevalence in dogs in Sivas region. It show that dogs play an important role in the epidemiology of T.gondii and this situation should be taken into consideration in veterinary and human medicine.

The benefits and risks of surgery for splenic hydatid cyst (SHC) remain controversial. We aimed to share our experience about a surgical approach for SHC. Sixteen consecutive patients with SHC disease who underwent open splenectomy at our hospital between January 2006 and July 2012 were retrospectively evaluated. Data on the patients' demographic features, clinical findings, radiological and serological diagnostic methods, and surgical and medicinal treatment options were collected and used to generate descriptive profiles of diagnosis, treatment course, and outcome. The patient population was composed of 6 females and 10 males, with an age range of 18 to 79 years (mean age: 47.0 ± 18.0). Radiological examinations detected hydatid cysts in spleen alone (n = 7) or both spleen and liver (n = 9). Preoperative serological testing identified 13 of the patients as IHA positive. All except 1 patient received a 10- to 21-day preoperative course of albendazole therapy and all patients received vaccination 1 week prior to surgery. Seven patients underwent splenectomy. The remaining patients underwent splenectomy with partial cystectomy and omentopexy (n = 6), partial cystectomy and unroofing (n = 1), pericystectomy (n = 1), or pericystectomy with partial nephrectomy (n = 1). All except one patient received a 10- to 45-day postoperative course of albendazole. No patients developed serious complications or signs of recurrence during the follow-up. The clinical profile of SHC disease at our hospital includes diagnosis by radiological methods, splenectomy treatment by simple or concomitant procedures according to the patient's symptoms, cyst size, number and localization, and compression of adjacent organs, and adjunct vaccination to decrease risk of postoperative septic complications. This profile is associated with low risk of complications and high therapeutic efficacy.

WOS: 000305210100042, PubMed: 22079843, Background. The purpose of our study was to evaluate the protective effect of the strong antioxidant and anti-inflammatory agent, lycopene, on oxidative stress in a rat model of cerulein-induced acute edematous pancreatitis. Methods. Sprague-Dawley rats were pretreated with lycopene (50 mg/kg, i.p.) or saline 15 min before cerulein was given 20 mu g/kg (i.p.) at 1-h intervals within 4 h. Twelve hours after cerulein or saline injections, the animals were killed by decapitation. Blood samples were collected to analyze amylase, lipase, and proinflammatory cytokines (TNF-alpha and IL-1 beta). Pancreatic tissues were taken for the determination of tissue glutathione (GSH) and malondialdehyde (MDA) levels, Na+/K+-ATPase, and myeloperoxidase (MPO) activities. Tissue samples were also examined histologically. Results. Acute pancreatitis caused significant decrease in tissue GSH levels and Na+/K+-ATPase activity, while pancreatic MDA levels and MPO activity were increased. Furthermore, TNF-alpha, IL-1 beta, and amylase lipase levels were also significantly increased. On the other hand, lycopene pretreatment reserved all these biochemical indices as well as histopathologic alterations that were induced by cerulein. Conclusions. According to the results, lycopene protects the pancreatic tissues from oxidative damage induced by cerulein, and this effect possibly involves the inhibition of neutrophil infiltration and lipid peroxidation. These results suggest that high dietary intake of tomatoes may have protective effects against acute pancreatitis. (C) 2012 Elsevier Inc. All rights reserved.

Ischemia and reperfusion (I/R) injury is characterized by significant oxidative stress, characteristic changes in the antioxidant system and organ injury leading to significant morbidity and mortality. This study was designed to assess the possible protective effect of montelukast, a selective antagonist of cysteinyl leukotriene receptor 1 (CysLT1), on hepatic I/R injury in rats. Wistar albino rats through clamping hepatic artery, portal vein, and bile duct, were subjected to 45 min of hepatic ischemia followed by 60 min reperfusion period. Montelukast (10 mg/kg; i.p.) was administered 15 min prior to ischemia and immediately before reperfusion period. At the end of the reperfusion period, the rats were killed by decapitation. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) activity, and proinflammatory cytokines (TNF-α and IL-1β) were determined in blood samples. Malondialdehyde (MDA), and glutathione (GSH) levels and myeloperoxidase (MPO) and Na + , K + -ATPase activities were determined in the liver tissue samples while formation of reactive oxygen species was monitored by using chemiluminescence (CL) technique with luminol and lucigenin probes. Tissues were also analyzed histologically. Serum ALT, AST, and LDH activities were elevated in the I/R group, while this increase was significantly decreased by montelukast treatment. Hepatic GSH levels and Na + , K + -ATPase activity, significantly depressed by I/R, were elevated back to control levels in montelukast-treated I/R group. Furthermore, increases in tissue luminol and lucigenin CL, MDA levels, and MPO activity due to I/R injury were reduced back to control levels with montelukast treatment. Since montelukast administration alleviated the I/R-induced liver injury and improved the hepatic structure and function, it seems likely that montelukast with its anti-inflammatory and antioxidant properties may be of potential therapeutic value in protecting the liver against oxidative injury due to ischemia-reperfusion.

To postoperative endoscopic retrograde cholangiopancreatography (ERCP) failure, we describe a modified Rendezvous technique for an ERCP in patients operated on for common bile duct stone (CBDS) having a T-tube with retained CBDSs.Five cases operated on for CBDSs and having retained stones with a T-tube were referred from other hospitals located in or around Istanbul city to the ERCP unit at the Haydarpasa Numune Education and Research Hospital. Under sedation anesthesia, a sterile guide-wire was inserted via the T-tube into the common bile duct (CBD) then to the papilla. A guide-wire was held by a loop snare and removed through the mouth. The guide-wire was inserted into the sphincterotome via the duodenoscope from the tip to the handle. The duodenoscope was inserted down to the duodenum with a sphincterotome and a guide-wire in the working channel. With the guidance of a guide-wire, the ERCP and sphincterotomy were successfully performed, the guide-wire was removed from the T-tube, the stones were removed and the CBD was reexamined for retained stones by contrast.An ERCP can be used either preoperatively or postoperatively. Although the success rate in an isolated ERCP treatment ranges from up to 87%-97%, 5%-10% of the patients require two or more ERCP treatments. If a secondary ERCP fails, the clinicians must be ready for a laparoscopic or open exploration. A duodenal diverticulum is one of the most common failures in an ERCP, especially in patients with an intradiverticular papilla. For this small group of patients, an antegrade cannulation via a T-tube can improve the success rate up to nearly 100%.The modified Rendezvous technique is a very easy method and increases the success of postoperative ERCP, especially in patients with large duodenal diverticula and with intradiverticular papilla.

GIRIS Kolelitiazisin insidansi yasla artar. 70 yas ustu populasyonda yapilan otopsi calismalarinda kolelitiazisin insidansi 1/3 oraninda bulunmustur (1). Gunumuzde kolelitiazisin tedavisinde laparoskopik kolesistektomi (LK) altin standarttir (2,3). LK’nin acik kolesistektomiye gore; daha az agri, erken taburcu olma suresi, normal yasama erken donus, daha iyi kozmetik sonuclar ve dusuk maliyet gibi avantajlari vardir (4). Eslik eden hastaliklar ve sinirli fonksiyonel rezerv yasli hastalarda perioperatif ve postoperatif seyirde komplikasyon yapabilecek onemli faktorlerdir (5). Hastalar dikkatli secildiginde geriatrik populasyonda LK ile ilgili iyi sonuclar yayinlanmistir (6,7). Calismamizdaki amac cerrahi servisimizde 65 yas ve uzeri LK yapilmis hastalarda postoperatif mortalite ve morbidite sonuclarini bildirmektir. HASTA VE YONTEM Genel Cerrahi Klinigimizde Aralik 2003 –Mayis 2011 tarihleri arasinda LK uygulanmis 65 yas ve uzeri 420 hasta; yas, cinsiyet, ek hastaliklar, ameliyat endikasyonlari, yas dagilimina gore Amerikan Anestezistler Dernegi (ASA) skoru, uygulanan radyolojik goruntuleme yontemleri, peroperatif anatomik varyasyon, acik kolesistektomiye gecis sebepleri ve orani, ortalama ameliyat suresi, dren konulma orani ve cekilme suresi, oral beslenmeye gecis zamani, ASA degerlendirilmesiyle kiyasli postoperatif komplikasyonlar ve taburcu olma suresi yonunden retrospektif olarak degerlendirilmistir.