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Bu çalışma farklı düzeylerdeki teknoloji ithalatının ekonomik büyümeyi ne ölçüde etkilediği sorusuna yanıt aramaktadır. Çalışmanın amacı 1992-2021 dönemi için yıllık verilerle gelişmekte olan 18 ülkenin düşük, orta ve yüksek düzey teknoloji ithalatının ekonomik büyüme üzerine etkisini tespit etmektir. Söz konusu etkiyi belirlemek üzere kullanılan granger panel nedensellik analizi sonuçlarına göre orta ve yüksek düzey teknoloji ithalatı ile büyüme arasında çift yönlü nedensellik ilişkisi varken düşük düzey teknoloji ithalatından büyümeye doğru tek yönlü nedensellik ilişkisi tespit edilmiştir. Bu durum yüksek ve orta düzey teknoloji ithalatı ile büyüme arasında Geribesleme Hipotezinin geçerli olduğu, düşük düzey teknoloji ithalatı ile büyüme arasında ise ithalata dayalı büyümenin varlığını desteklemektedir. Ayrıca ekonomik büyümenin sürdürülebilirliği için her dört yılın sonunda orta ve yüksek düzey teknoloji ile her üç yılın sonunda düşük düzey yenileme ithalatı yapılmalıdır. This research aims to answer the question of how varied amounts of technology imports effect economic growth. The study's goal is to assess the impact of 18 developing nations' low, medium, and high level technology imports on economic development from 1992 through 2021. According to the research results of the granger panel causality analysis used to determine the effect, there is a bidirectional causality relationship between medium and high level technology imports and growth, while there is a unidirectional causality relationship between low level technology imports and growth. This situation supports the existence of the Feedback Hypothesis between high and medium-level technology imports and growth, and the existence of import-led growth between low-level technology imports and growth. Furthermore, for the long-term sustainability of economic growth, medium and high-level technology should be imported every four years, and low-level replacement imports every three years.

Aim: Pain after thoracotomy is one of the most severe in clinical practice and more effective analgesia can be achieved by combining systemic and regional techniques. Though thoracic epidural analgesia (TEA) is the gold standard in the treatment, its application can be restricted due to side effects and contraindications. We investigated the hypothesis that thoracic paravertebral block (TPVB) reduced morphine consumption, pain scores, and side effects as much as TEA after thoracotomy. Material and Method: Fifty patients who underwent elective posterolateral thoracotomy were included in this study. Patients were randomly allocated into two groups as TEA (group I, n = 25) and TPVB (group II, n = 25). Postoperative consumption of patient-controlled morphine, visual analog scores (VAS), hemodynamic parameters, and side effects were collected in 72 hours. Additionally, pulmonary function tests (PFT) values were recorded. Results: Postoperative VAS values during rest were comparable between the groups (p > 0.005) and they did not have significantly difference postoperative VAS values during coughing (p > 0.005). The cumulative morphine consumption was higher in Group 2 (p < 0.05). Side effects were comparable between the groups II (p > 0.05). Conclusion: We conclude that TEA provided more effective analgesia than TPVB in thoracotomy patients in the early postoperative period with comparable side effects.

Vallecular cyst (VC) can cause difficult intubation. If a double-lumentube (DLT) has to be placed, difficulty in tracheal intubation becomes more complicated. The gum elastic bougie (GEB) is a widely used device for facilitating tracheal intubation.However, there is not enough study with DLT to make a predictionfor success of GEB-guided intubation. Here, we aimed to describe our approach during unexpected difficult intubation due to VC in a patient required DLT insertion. We emphasize that, in case of confronting a patient with asymptomatic VC as a cause of difficult intubation, a successful DLT intubation is possible by sliding endobronchial lumen of DLT over pediatric GEB.

Background/aim The aim of this study is to evaluate the effects of preemptive oral pregabalin on hemodynamic response, anxiety, sedation, and recovery in patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under sedation with intravenous ketamine-propofol combination. Materials and methods Sixty patients were included in this study, and patients were randomly divided into two equal groups to receive the placebo (Group 1) versus pregabalin 150 mg (Group 2) one hour prior to EBUS- TBNA procedure. Patients received 0.25 mg kg-1 ketamine and 0.25 mg kg-1 propofol mixture (ketofol) for sedation. Timing of the parameters was defined as follows; T0: in hospital ward before pregabalin or placebo administration, T1: premedication, T2: in operating room, T3: before the procedure, T4: initiation, T5: 3 min after induction, T6: 6 min after induction, T7: 9 min after induction, and T8: 12 min after induction. Hemodynamic parameters, severity of coughing, sedation and anxiety scores, and complications were recorded. The level of satisfaction of the bronchoscopist and the patients were evaluated at the end of the procedure. Results The heart rate and mean arterial pressure were significantly higher in Group 1 (P = 0.008, P = 0.04). Total doses of anesthetics, recovery time, and desaturation rate were significantly higher in Group 1 (P = 0.014, P = 0.001, P = 0.045). In Group 2, SpO2 level was significantly higher at various time periods (T1; P = 0.025, T4; P =0.043, T6; P = 0.001, T7; P = 0.003, T8; P < 0.001). The severity of coughing was found significantly lower in Group 2 (T4; P = 0.011, T5; P = 0.01, T6; P = 0.02, T7; P = 0.03, T8; P < 0.01). Anxiety scores were significantly lower in Group 2 (P < 0.001). Conclusion Preemptive oral pregabalin, in addition to sedation with ketamine-propofol combination, was effective in providing limited hemodynamic response, restricted coughing reflex, and lower anxiety during EBUS-TBNA. Besides, with pregabalin usage, decreased anesthetics consumption, lower complication rate, and shorter recovery time might have contributed to safety of the procedure and comfort of the bronchoscopist.

In this study, the causal relationship between global steel prices and demolition prices in five developing countries (Bangladesh, China, India, Pakistan, and Turkey) that host five main ship scrap centers in the world are examined. The bootstrap panel Granger causality analysis is employed to take heterogeneity and cross-sectional dependence into account. The data set used in this study consists of 289 weekly observations from January 8, 2013 to July 16, 2018. As a result of the study, a collective causality relationship from steel price to demolition prices is determined and individual causality relationships for all countries except Bangladesh are identified.

Fizikisermayenin yanı sıra insan sermayesi, büyüme ve kalkınma sürecini etkileyenönemli bir unsurdur. 1980’li yılların sonuna doğru neo-klasik iktisatçılartarafından ileri sürülen yakınsama teorisinin reddedilmesiyle içsel büyümekuramları doğru ortaya çıkmıştır. İçsel büyüme kuramları iktisadi büyümeye etkieden faktörlerden biri olarak kabul edilen insan sermayesi değişkenini dikkatealmaktadır. Bu doğrultu da yapılan çalışmalarda insana yatırım düzeyinietkileyen eğitim, sağlık, ar-ge harcamaları gibi faktörlere yapılanyatırımların iktisadi büyümeyi etkilediği sonucuna ulaşılmıştır. Bu çalışmada,eğitim harcamalarında meydana gelen değişimin ülkelerin uluslararası alandakatıldığı sınavlardan olan TIMMS ve PISA sınavı puanları ile arasındakiilişkinin belirlenmesi amacıyla sınava katılan ülkeler üzerinden analizyapılmıştır. Ülkelerin orta öğretime yaptığı eğitim yatırımları ve TIMMS sınavı1995-2015 yıllarında matematik ve fen puanları alınmıştır. Ayrıca, PISA sınavı 2000-2015 yılları arasında okuma,fen ve matematik sınavı puanları ele alınarak rassal etki panel veri modeliyapısında genelleştirilmiş en küçük kareler yöntemi kullanılmıştır. Elde edilenbulgular doğrultusunda PISA ve TIMMS sınavında ülkelerin iktisadi büyümeleriile eğitim kalitesi arasındaki istatistiksel olarak anlamsız olduğu, ülkebazında incelendiğinde ise bazı ülkelerin istatistiksel olarak anlamlı olduğu sonuçlarıelde edilmiştir., In addition to physical capital, human capital is an important factoraffecting growth and development process. Towards the end of the 1980s, thetheory of internal growth emerged as a result of the rejection of the theory ofconvergence proposed by neo-classical economists. The internal growth theoriestake into account the human capital variable, which is considered to be one ofthe factors affecting economic growth. In this study, it has been concluded thatinvestments in factors such as education, health and R & D expendituresaffecting the level of investment in human affect the economic growth. In thisstudy, an analysis was conducted on the countries participating in the exam inorder to determine the relationship between the TIMMS and PISA test scores,which are the exams of the countries where the change in education expenditurestook place internationally. Maths and science scores were taken from theeducational investments of the countries for secondary education and for theTIMMS exam in 1995-2015. In addition, PISA exam, 2000-2015 years, reading,science and math exam scores were taken in the generalized least-squares methodof random effect panel data model was used. In the PISA and TIMMS examinations,it was found that the countries were statistically insignificant between theeconomic growth and the quality of education and the results were statisticallysignificant.

Background/aim: This study aims to investigate the effects of thoracic epidural analgesia, before and after surgical incision and in the postoperative period, on thoracotomy pain and stress response. Materials and methods: A total of 45 patients who were scheduled for posterolateral thoracotomy were included in this study. A combination of epidural levobupivacaine and morphine was administered as a bolus before incision (Group 1; n=15), after incision (Group 2; n=15), or at the end of surgery (Group 3; n=15). Additionally, infusion was used in Group 1 and Group 2 during operation. Postoperative patient-controlled epidural analgesia infusion pumps were connected to all patients. Visual analog scale (VAS) scores and morphine consumption were recorded during the postoperative 48 h. Glucose, insulin, cortisol, and C-reactive protein (CRP) levels were compared before surgery and at 4, 24, and 48 h after the operation. Results: There were no differences in the morphine consumption and VAS scores for all measurements among the groups (P > 0.05). Both blood glucose levels at 4 h and CRP values at 48 h were higher in Group 2 than Group 1 (P < 0.05). Cortisol levels at 4, 24, and 48 h after the operation were similar to baseline values in all groups (P > 0.05). Conclusion: The application of thoracic epidural analgesia before and after surgical incision and in the postoperative period did not result in a significant difference in the severity of the postthoracotomy pain and stress response in all groups. Based on our results, we suggest that epidural levobupivacaine combined with morphine provides an effective and safe analgesia and can partially suppress surgical stress response.

ResumoJustificativa e objetivosEsclarecer a importância do ano de residência e outros fatores que influenciam o sucesso do cateterismo epidural torácico (CET) em pacientes submetidos à toracotomia.MétodosApós a aprovação do Comitê de Ética, os dados foram retrospectivamente analisados a partir dos prontuários de 415 pacientes. Todos os pacientes assinaram os termos de consentimento informado. As tentativas de CET foram divididas em dois grupos: segundo‐terceiro ano (Grupo I) e quarto ano (Grupo II), de acordo com o ano de residência. Dados demográficos, características das tentativas de CET e todas as dificuldades e complicações durante o CET foram registrados retrospectivamente.ResultadosA taxa de sucesso global de CET foi semelhante entre os grupos. Os níveis de colocação do cateter, o número e a duração das tentativas não foram diferentes entre os grupos (p>0,05). A alteração do nível de inserção da agulha foi estatisticamente maior no Grupo II (p=0,008), enquanto que a parestesia foi significativamente maior no Grupo I (p=0,007). As taxas de cefaleia durante e após punção dural foram maiores no Grupo I. Um índice de massa corporal (IMC) maior e o nível do local de inserção foram fatores significativos para o fracasso do CET e para as taxas de complicações no pós‐operatório, mas independentes da experiência dos residentes (p0.05). Change of needle insertion level was statistically higher in Group II (p=0.008), whereas paresthesia was significantly higher in Group I (p=0.007). Dural puncture and postdural puncture headache rates were higher in Group I. Higher body mass index and level of the insertion site were significant factors for thoracic epidural catheterization failure and postoperative complication rate and those were independence from residents’ experience (p

Cannulation of the internal jugular vein (IJV) may be diffucult because of anatomical variations. A 66-year-old female patient, who was in the intensive care unit, underwent ultrasound-guided cannulation of the right IJV. The right IJV could not be visualized by ultrasonography despite positional changes of the patient and Valsalva maneuvre. The left IJV was easily determined by ultrasonography and cannulated. Although the landmark technique may be sufficient for most of the central vein cannulations, the rate of anatomical variations and related complications is quite high. We point out that even if ultrasound cannot be used in real-time, the ultrasonographic confirmation during the pre-insertion period may be crucial for successful central vein cannulation.

Kartagener sendromu bronsektazi, sinuzit ve situs inversusla karakterize otozomal resesif gecisli bir hastaliktir. Bu yazida kombine genel ve torakal epidural anestezi altinda pulmoner rezeksiyon yapilan Kartagener send- romu ve bronsektazisi olan hastamiz sunuldu. Bu nadir hastalikta akciger izolasyon teknikleri; hastaya ve anesteziste gore degismektedir. Olgumuz- da; sol orta ve alt lobektomi icin sag ana bronsa, sol cift lumenli tupun bronsiyal lumeni sagda olacak sekilde yerlestirildi. Toraks cerrahisi geciren KGS'li hastada sevofluran ile kombine genel ve torakal epidural anestezi- nin avantajlari ve uygun anestezik yaklasimlar tartisildi.

ABS TRACT We pre sent fo ur ca ses in cri ti cal con di ti on di ag no sed as inf lu en za A (H1N1) in fec ti on with sig ni fi cant risk fac tors and se ve re hypo xe mi a. The ir chest X-rays sho wed bi la te ral ex ten si ve in fil tra ti ve le si ons. The ra ti o of par ti al ar te ri al oxy gen pres su re to ins pi red frac ti on of oxy gen (Pa O2/Fi O2) of the pa ti ents was be low 200. Thre e of the pa ti ents we re gi ven osel ta mi vir be fo re la bo ra tory con fir ma ti on of di ag no sis. Inf lu en za A vi rus in fec ti ons we re con fir med by re al-ti me re ver se trans crip ta se-poly me ra se cha in re ac ti on (RT-PCR) test from na sop hary nge al swabs. Lung pro tec ti ve in va si ve ven ti la ti on and po si ti ve end-ex pi ra tory pres su re (PE EP) tit ra ti on we re per for med in early pe ri od. Thre e pa ti ents we re ven ti la ted 5-7 days and disc har ged to ward une vent fully. In conc lu si on, we want to emp ha si ze that an ti vi ral tre at ment, in ten si ve ca re and in va si ve mec ha ni cal ven ti la ti on in early pe ri od can dec re a se mor ta lity and intensive care unit stay in pa ti ents with se ve re hypo xe mi a.

Background and objectives: In this study, we aimed to clarify the importance of residency grade and other factors which influence the success of thoracic epidural catheterization in thoracotomy patients. Methods: After the ethical committee approval, data were recorded retrospectively from the charts of 415 patients. All patients had given written informed consent. The thoracic epidural catheterization attempts were divided into two groups as second–third year (Group I) and fourth year (Group II) according to residency grade. We retrospectively collected demographic data, characteristics of thoracic epidural catheterization attempts, and all difficulties and complications during thoracic epidural catheterization. Results: Overall success rate of thoracic epidural catheterization was similar between the groups. Levels of catheter placement, number and duration of thoracic epidural catheterization attempts were not different between the groups (p > 0.05). Change of needle insertion level was statistically higher in Group II (p = 0.008), whereas paresthesia was significantly higher in Group I (p = 0.007). Dural puncture and postdural puncture headache rates were higher in Group I. Higher body mass index and level of the insertion site were significant factors for thoracic epidural catheterization failure and postoperative complication rate and those were independence from residents’ experience (p 0,05). A alteração do nível de inserção da agulha foi estatisticamente maior no Grupo II (p = 0,008), enquanto que a parestesia foi significativamente maior no Grupo I (p = 0,007). As taxas de cefaléia durante e após punção dural foram maiores no Grupo I. Um índice de massa corporal (IMC) maior e o nível do local de inserção foram fatores significativos para o fracasso do CET e para as taxas de complicações no pós-operatório, mas independentes da experiência dos residentes (p

BACKGROUND: Transbronchial needle aspiration using endobronchial ultrasonography (EBUS-TBNA), a new minimally invasive diagnostic procedure, has been used to evaluate intrathoracic lymph nodes. It has been reported that EBUS-TBNA can be performed safely under sedation and provides a high level of patient satisfaction. We aimed to describe perianesthetic data, and compare results regarding the agents of subjects undergoing EBUS-TBNA under deep sedation. METHODS: After ethics committee approval, perianesthetic data of 571 subjects undergoing EBUS-TBNA were analyzed retrospectively. Data were collected from anesthesia evaluation and observation forms. Four groups received anesthesia in the operating room as follows: propofol-midazolam (group PM), propofol-ketamine (group PK), propofol-ketamine-midazolam (group PKM), or propofol (group P). Dosage, number of anesthetic injection, hemodynamic variables, recovery time, complications, and patient satisfaction were also recorded. RESULTS: Propofol consumption was higher in groups P and PM compared with groups PK and PKM. Midazolam requirement was higher in group PM than in group PKM. Recovery time was shorter in group P compared with groups PK, PM, and PKM. It was also shorter in groups PK and PM compared with group PKM. All of these differences were statistically significant. Temporary desaturation ( n = 41; 7%) and increased blood pressure (n = 78; 14%) were predominant complications. In groups PK and PKM, risk of developing hypertension was higher than in groups PM and P ( P < .001). The percentage of subjects satisfied with the procedure was 99%. CONCLUSIONS: Independent from the sedative agent, deep sedation can be safe, and provide high patient satisfaction during EBUS-TBNA. The combination of ketamine with propofol or midazolam required lower doses of these anesthetics. However, the incidence of increased blood pressure was higher in groups administered ketamine. Recovery time was the shortest in group P, and the longest in group PKM. There was no relation between recovery time and total dose of anesthetics or presence of chronic disease.

Complex forming conditions of Penicillamine di sulfide with 99mTc have been specified. Labeling of penicillamine di sulfide with 99mTc by direct reduction with SnCl2 did not give favorable good results while the 99mTc complex of penicillamine can be easily obtained. Ligand exchange reaction with 99mTc-gluconate was attempted and a 95% labeling efficiency was obtained. Radiopharmaceutical potential of 99mTc-PADS (99mTc-Penicillamine di sulfide) has been investigated with a gamma camera in rabbits and the complex was found to be uptaken mostly by the liver and kidneys.

We aimed to compare the effectiveness and safety of ketamine-midazolam and ketamine-propofol combinations for procedural sedation in endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA).Sixty patients who were undergoing EBUS-TBNA were included in this study. Patients were randomly divided into two groups. Group 1 was given 0.25 mg/kg intravenous (iv) ketamine, 2 min later than 0.05 mg/kg iv midazolam. Group 2 received 0.125 mg/kg ketamine-propofol mixture (ketofol), 2 min subsequent to injection of 0.25 mg/kg each. Sedation was maintained with additional doses of ketamine 0.25 mg/kg, and ketofol 0.125 mg/kg each in Group 1 and Group 2, respectively. Blood pressure, heart rate (HR), peripheral oxygen saturation, respiratory rate (RR), Ramsay Sedation Score (RSS), and severity of cough were recorded prior to and after administration of sedation agent in the beginning of fiberoptic bronchoscopy (FOB) and every 5 min of the procedure. The consumption of the agents, the satisfactions of the bronchoscopist and the patients, and the recovery time were also recorded.HR in the 10(th) min and RSS value in the 35(th) min of induction in Group 1 were higher than the other group (P0.05). The recovery time in Group 1 was statistically longer than Group 2 (P0.05). There was no statistically significant difference between groups with respect to other parameters (P0.05).It was concluded that both ketamine-midazolam and ketamine-propofol combinations for sedation during EBUS-TBNA were similarly effective and safe without remarkable side effects.