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Objectives: This study aims to clinically evaluate the efficacy of pedicle bone flap treatment in stage II Kienböck's disease. Patients and methods: This retrospective study included 10 patients (8 males, 2 females; mean age 33.3 years; range, 23 to 46 years) treated with pedicle bone flap between January 2012 and June 2016. In all patients, a fourth extensor compartment artery (ECA) pedicle bone flap from the dorsal surface of the radius was prepared and placed through a window opened on the lunate bone. Clinical results of the patients were evaluated according to the Mayo wrist score. Results: All patients could return to their daily activities after surgery. No superficial or deep infection developed requiring debridement or antibiotic use other than prophylaxis. None of the patients required reoperation due to complications or the progression of the disease. The mean Mayo wrist score was measured as 81 (good). Conclusion: In this study, results of the fourth ECA pedicle bone flap application were found to be effective in the treatment of avascular necrosis of the lunate bone. Further comparative and long-term follow-up studies are required including large and homogeneous patient groups. © 2019 Turkish Joint Diseases Foundation.

OBJECTIVES: This study aims to clinically evaluate the efficacy of pedicle bone flap treatment in stage II Kienböck's disease. PATIENTS AND METHODS: This retrospective study included 10 patients (8 males, 2 females; mean age 33.3 years; range, 23 to 46 years) treated with pedicle bone flap between January 2012 and June 2016. In all patients, a fourth extensor compartment artery (ECA) pedicle bone flap from the dorsal surface of the radius was prepared and placed through a window opened on the lunate bone. Clinical results of the patients were evaluated according to the Mayo wrist score. RESULTS: All patients could return to their daily activities after surgery. No superficial or deep infection developed requiring debridement or antibiotic use other than prophylaxis. None of the patients required reoperation due to complications or the progression of the disease. The mean Mayo wrist score was measured as 81 (good). CONCLUSION: In this study, results of the fourth ECA pedicle bone flap application were found to be effective in the treatment of avascular necrosis of the lunate bone. Further comparative and long-term follow-up studies are required including large and homogeneous patient groups.

Objectives: This study aims to clinically evaluate the efficacy of pedicle bone flap treatment in stage II Kienböck's disease. Patients and methods: This retrospective study included 10 patients (8 males, 2 females; mean age 33.3 years; range, 23 to 46 years) treated with pedicle bone flap between January 2012 and June 2016. In all patients, a fourth extensor compartment artery (ECA) pedicle bone flap from the dorsal surface of the radius was prepared and placed through a window opened on the lunate bone. Clinical results of the patients were evaluated according to the Mayo wrist score. Results: All patients could return to their daily activities after surgery. No superficial or deep infection developed requiring debridement or antibiotic use other than prophylaxis. None of the patients required reoperation due to complications or the progression of the disease. The mean Mayo wrist score was measured as 81 (good). Conclusion: In this study, results of the fourth ECA pedicle bone flap application were found to be effective in the treatment of avascular necrosis of the lunate bone. Further comparative and long-term follow-up studies are required including large and homogeneous patient groups. © 2019 Turkish Joint Diseases Foundation.

Products of children literature should be able to create pleasure of reading in children and lead them creative thinking. So it is essential to pay attention to structure, content and illustration of children's books. In this research it is aimed to determine the situation of primary school students' children's picture books in terms of physical structure, content and illustration. In the study descriptive model was used and a qualitative research method was used to collect, analyze and interpret the research data. In order to collect data document analysis were conducted. The population of this research was the first grade students' children's picture books whose first editions were between the years 2005-2010. The sample of the research consists of 120 children's picture books which were chosen through random method. Data gathered from the research were analyzed through descriptive analysis techniques. As a result of research it is ascertained that in the books durable bindings weren't used, there aren't any subject variety, three out of four illustrations are consist of imaginary items, writing/illustration proportion is not at an adequate level. On the other hand in most of the books grammatical rules were followed correctly and writing/illustration were related to each other.

Primer hiperparatiroidizmin %8090 nedeni tek bezde görülen paratiroid adenomudur. Son yıllarda ultrasonografi, Tc 99 M sesta MIBI ve gama prob gibi paratiroidleri lokalize edici tekniklerin kullanılması ile primer hiperparatiroidi tedavisinde minimal invaziv paratiroidektomi (MIP) başarıyla uygulanmaya başlanmıştır. Bu çalışmada son 4 yılda Selçuk Üniversitesi Meram Tıp Fakültesi Genel Cerrahi Kliniğinde primer hiperparatiroidi nedeniyle gama prob eşliğinde işaretleme ile minimal invaziv paratiroidektomi yapılan 14 hastanın analizi ve klinik özellikleri değerlendirildi. Hastalardan 10u kadın, 4ü erkek ve yaş ortalamaları 54,6 (39-74) idi. Operasyon öncesi ortalama Ca seviyeleri 11,7 mg/dl (10,1 13,3, normali: 8,9-10,3), fosfor seviyeleri 2,7 mg/dl (1,6-3,9, normali: 2,4-4,7) ve PTH 260,3 pg/ml (74,94 - 990,8 normali: 12-88) olarak ölçüldü. Hastaların kliniğimize başvuru şikâyetleri arasında baş ağrısı ve yaygın kemik ağrısı ön plandaydı. Tüm hastalara lokal anestezi ile birlikte sedasyon uygulandı. Sınırlı flep diseksiyonundan sonra strep kasları vertikal olarak açılarak adenoma ulaşıldı. Vasküler yapıları bipolar koter eşliğinde kesildi ve kapsülü zedelenmeden adenom çıkarıldı. Post operatif dönemde hastaların hastanede kalış süresi ort. 1,5 (1 ile 3 gün) gündü. Ortalama Ca seviyeleri 9,1 mg/dl, fosfor seviyeleri 3,2 mg/dl ve PTH ise 63,8 pg/ml olarak ölçüldü. Gama prob eşliğinde minimal invaziv paratiroidektomi; operasyonunun lokal anestezi ile yapılabilmesi, operasyon sonrası ağrının daha az olması ve düşük komplikasyon oranı ile günümüzde paratiroid cerrahisinde sık tercih edilen yöntemlerdendir., Parathyroid adenoma seen in a single gland comprises 80-90% of the reasons for primary hyperparathyroidism. The recent use of parathyroid localizing techniques such as ultrasonography, Tc 99 M sesta MIBI, and gamma probe has made minimally invasive parathyroidectomy (MIP) a success in hyperparathyroidism therapy. This study evaluates the analyses and clinical characteristics of 14 patients with primary hyperparathyroidism who have undergone minimally invasive parathyroidectomy by gamma probe marking at Selçuk University, Meram Faculty of Medicine, General Surgery Clinic in the last four years. Ten of the patients were female while four were male, with a mean age of 54.6 (39-74). The patients preoperative mean Ca levels were 11.7 mg/dl (10.1 13.3, normal: 8.9-10.3), phosphorous levels were 2.7 mg/dl (1.6-3.9, normal: 2.4-4.7), and PTH levels were 260,3 pg/ml (74.94 990.8 normal: 12-88). Among the complaints the patients had when they presented to our clinic, headache and generalized bone pain were predominant. All the patients were sedated with local anesthesia. Following a bordered flap dissection the adenoma was reached through the vertical opening of the strap muscles. The vascular structures were cut by bipolar cautery and the adenoma was removed with no damage to its capsule. The mean period of hospitalization was 1.5 days (1 to 3 days) during the postoperative period. The patients postoperative mean Ca levels were 9.1 mg/dl while the levels of phosphorus and PTH were 3.2 mg/dl and 63.8 mg/dl respectively. Minimally invasive parathyroidectomy with a gamma probe is one of the most frequently used techniques in parathyroid surgery today because the procedure can be performed with local anesthesia, there is less postoperative pain, and a lower rate of complications.

Amaç: Kalp hızı değişkenliği (KHD) diyabetik hastalarda (DM) otonomik disfonksiyonu göstermede güvenilir parametrelerden biridir. Bu çalışmada DM'ta metabolik ve inflamatuvar parametreler ile KHD arasındaki ilişki gösterilmeye çalışıldı. Metod ve bulgular: Çalışmaya benzer yaş grubundan koroner arter hastalığı ve hipertansiyonu olmayan 40 sağlıklı birey (Grup 1, Ortalama yaş 46 13) ve 80 diyabetik hasta (Grup 2, Ortalama yaş 489) alındı. Tüm olguların 24 saatlik Holter monitörizasyonu ile KHD 'time-domain' parametreleri belirlendi. Grup 2'de açlık kan şekeri (AKŞ), tokluk kan şekeri (TKŞ), hemoglobin A1C (HbAlC), serum insülin düzeyi, idrar mikro-albumin düzeyi, fibrinojen ve C-reaktif protein (CRP) düzeyleri çalışıldı. DM'un süresi belirlendi. KHD'nin 'time domain' parametrelerinin tümü grup 2'de düşüktü (p0.05). Grup 2'de KHD ile AKŞ, TKŞ, HbAIC, insülin, idrar mikroalbumini, diyabetin süresi ve fibrinojen arasında korelasyon yoktu (p0.05). CRP ile KHD (pNN50) arasında negatif korelasyon mevcuttu (r-0.37, p0.05). Sonuç: Bu çalışmada KHD ile DM'un süresi ve metabolik parametreler arasında ilişki belirlenmemiştir. DM'ta KHD'ndeki azalmada inflamatuvar reaksiyonların rolü olabileceği sonucuna varılmıştır., Purpose: Heart rate variability (HRV) is one of the reliable parameters indicating autonomic dysfunction in diabetic patients. In this study, we investigated the relationship between metabolic and inflammatory param¬eters, and HRV in Diabetes Mellitus (DM). Method and Results: Forty subjects (mean age 46±13, 18 M) without coronary heart disease (CHD) and hypertension (group 1) and 80 diabetic patients (mean age 48±9, 42 M) without CHD and hypertension (group II) with similar age were included in this study. Twenty four hour Holter monitorization and HRV 'time-domain' parameters were calculated in all cases. Fasting blood glucose (FBG) level, postprandial blood glucose (PBG) level, serum insulin level, hemoglobin A1C (HbAlC) level, urine microalbumin level, fibrinogen level, C-reactive protein (CRP) levels were studied in group II. Duration of DM was recorded. All the 'time-domain' parameters were lower in group II than those of group I (p0.05); a negative correlation between HRV (pNN50) and CRP was detected. Conclusion; A relationship between HRV and duration of DM and metabolic parameters could not be detected in this study. It has been concluded that inflammatory reactions may have a role in the decreased HRV in DM.

Diabet ve komplikasyonları dünya genelinde morbidite ve mortalitenin önemli nedenleri arasında yer alır. Yaptığımız çalışmada, nüfusuyla bir milyona yaklaşan Konya metropolündeki diabet ve ilgili risk faktörlerinin sıklığını belirlemeyi amaçladık. Bu amaçla Konya'da farklı yerlerde bulunan üç büyük alışveriş merkezinde kurduğumuz standlarda toplum tabanlı tarama çalışması gerçekleştirdik. Bu çalışma Ramazan ayında gerçekleştirilmiştir ve bu sayede çok sayıda aç ve tok olgunun kısa zamanda taranması mümkün olmuştur. Çalışmada 3474 olgu tarandı. Bu olguların 255 adedi daha önceden bilinen diabet hastalarından oluşmakta idi. Olguların % 29.09'sında obezite izlendi. Abdominal obezite olguların % 33.48'sında var idi. Hastaların % 7.3'ü daha önceden bilinen diabetik, % 2.2'si yeni tanı diabetik, % 3.2'si IGT, % 8.3'ü IFG olarak saptandı. Olguların 32.85'inde arteryel hipertansiyon bulundu. Olguların yaş gruplarına göre dağılımı, 40 yaşından sonra diabet insidansinda istatistiksel olarak anlamlı artış olduğunu ve 80 yaşına kadar devam ettiğini gösterdi (pearson chi square: 210.91, df:4, p0.001) Ailede diabet, obezite, hipertansiyon ve viseral obezite olan grupta olmayan gruba göre diabet insidansının daha fazla olduğu izlendi (p0.001) Bu çalışma Konya'da gerçekleştirilen toplum tabanlı diabet ve ilgili risk faktörleri ile ilgili ilk taramadır. Türkiye'de, literatürde diabetle ilgili yapılmış olan toplum tabanlı tarama çalışmasına rastlayamadık. Çalışma sonucunda, diabet, obezite ve hipertansiyonun yüksek bulunmasının; Konya'nın coğrafik yapısı, beslenme alışkanlıkları ve toplumun daha hareketsiz bir yaşam tarzına sahip olması ile ilgili olabileceğini düşündük. Çalışmada taranan olgu sayısının fazla olması, toplumu temsil etme bakımından önemlidir. Bu nedenle, bulgularımızdan yola çıkarak, bu kadar yaygın olan diabet ve ilgili risk faktörlerinin önüne geçmek için halkın diabet konusunda bilinçlendirilmesi, yaşam tarzı değişikliğinin öneminin vurgulanması, akdeniz tipi beslenme şekli, fizik aktivitenin artırılması, kilo verme gibi bazı tedbirlerin alınması ve hızla hayata geçirilmesi gerekmektedir., Diabet and related risk factors are one of the most important cause of mortality and morbidity world wide. We aimed to determine the incidence of diabetes and related risk factors in Konya metropolis with a population aproaching to a million. So, we performed community based screening for diabetes and related rise factors in three shopping centers located in different parts of metropolis. This study was performed in holly month Ramadan and due to this we were able to screen enormous amount of fasting and postprandial in people. 3474 people were screened in this study. 255 of this people were previously known diabetics. Obesity and abdominal obesity were detected 29.09 % and 33.48 % of screened people, respectivelly. Screened people consist of 7.3 % previously known diabetes, 2.2 % new diagnosed diabetes, 3.2 % IGT, 8.3 % IFG. Arterial hypertension was detected in 32.85 % of screened people. The incidence of diabetes mellitus was increased significantly between age of 40 years and 80 (pearson chi square: 210.91, df:4, p