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Jet tipi savaş uçağı ile taşınan bir faydalı yükün içindeki ekipmanların yapısal cevabı deneysel olarak çalışılmış, yapay sinir ağları(YSA) ile tahmin edilmiş ve askeri şartnamelerin önerdiği değerler ile karşılaştırılmıştır. Çalışmanın asıl amacı askeri şartnamelerin önerdiği cevap limitlerini, deneysel çalışmalar ile beraber değerlendirmek ve YSA temelli yeni bir yaklaşım önermektir. Çalışmada güdüm kitine sahip kütle ve geometri eşdeğer Mk-83 harp başlığı kullanılmıştır. Yetmiş beş farklı uçuş koşulu YSA eğitimleri için kullanılmıştır. Bu durumlardan ayrı olarak 8 adet uçuş koşulu ise eğitilen ağın testine yönelik kullanılmıştır. İvme verileri uçuş esnasında veri toplama sistemi ile toplanmıştır. Yapısal cevaplar ivme-güç spektrum yoğunluğu(İGTY) olarak frekans bandında işlenmiştir. Ölçümlerden alınan en yüksek yapısal cevap tahmininde normal tolerans limiti yöntemi kullanılmıştır. Yapısal tasarımlarda kullanılan rastgele titreşim tabanlı yükler, frekans-İGSY grafiklerinden üç-sigma kuralı ile 20-300Hz arası veriler dikkate alınarak çıkarılmıştır. Taşıyıcı bir yapısal parça üzerinde YSA tahmini yükleri, test yükleri ve askeri şartname yükleri uygulanarak topoloji eniyilemesi gerçekleştirilmiştir. Eniyileme sonucuna göre YSA tahmini ile elde edilen tasarım, askeri şartnamelerin önerdiği yük ile elde edilen tasarıma göre daha hafif olurken, aynı zamanda yeterli emniyet faktörüne de sahip olduğu gözlenmiştir.

Experimental structural response of equipment mounted in store carried externally by jet type aircraft is investigated, predicted and compared with responses suggested by military standards in this study. A representative store which is similar to Mark-83 warhead with guidance units in terms of mass and geometry is used in this study. The main scope of this study is to evaluate the structural response proposed by military standards with real test conditions and also suggest a new method with an artificial neural network to predict the maximum response. Seventy-five different flight conditions are used to train the network for low and high frequency components. Also, eight flight conditions apart from the training set of flight conditions are used to test the approach. Acceleration levels are collected in real flight conditions by the data storage system. In signal processing, vibration response is expressed as power spectral density functions in the frequency domain. Procedures to predict the maximum response from measurements are determined with statistical limits in the literature. Besides the well-known limits in literature, third-order polynomial normal and logarithmic transform is used, and the performance of the different limits is compared. It is found that the military standard vibration spectrum is conservative. Distribution-free and normal tolerance limits predicted low frequency acceleration spectral density magnitudes more accurately. Their prediction performances were better than those of the other tolerance limits and that of the military standard. Third-order polynomial transform predictions are found to be reasonable with respect to normal prediction limit and envelope approach. Finally, it can be concluded that the response prediction method proposed in this article works well for Mark-83 warheads with guidance unit carried externally by jet fighter.

Bu araştırmanın amacı, çalışmaya tutkunluk ve algılanan aşırı nitelikliliğin örgütsel vatandaşlık davranışı üzerindeki etkisini analiz etmektir. Araştırmanın örneklemi Nevşehir Belediyesinde 700 çalışan oluşturmaktadır. Regresyon analizi sonuçlarına göre; çalışmaya tutkunluğun örgütsel vatandaşlık davranışı üzerinde pozitif yönlü ve anlamlı etkiye sahip olduğu tespit edilmiştir. Çalışmaya tutkunluğun alt boyutları olan dinçlik, adanmışlık ve yoğunlaşmanın övd üzerinde pozitif yönlü ve anlamlı etkiye sahip olduğu ortaya konulmuştur. Algılanan aşırı niteliklilik ve algılanan aşırı nitelikliliğin alt boyutu olan kendini üstün görme örgütsel vatandaşlık davranışı üzerinde pozitif yönlü ve anlamlı etkiye sahip olduğu tespit edilmiştir. Diğer yandan algılanan aşırı nitelikliliğin alt boyutu olan kendini küçük görmenin övd üzerinde anlamlı bir etkiye sahip olmadığı tespit edilmiştir., The purpose of this research is to analyze the impact of passion for the study and perceived overqualification on organizational citizenship behavior. The research's sample accounts for 700 employees in Nevşehir Municipality. According to the regression analysis results; passion for the study has been found to have positive and meaningful impact on organizational citizenship behavior. It was revealed that vigorousness, dedication and concentration, which are sub-dimensions of passion in the study, have positive faceted and meaningful impact on organizational citizenship behavior. Perceived overqualification and superior self-vision, the lower dimension of perceived overqualification, have been found to have positive and meaningful impact on organizational citizenship behavior. On the other hand, self-deprecation, the lower dimension of perceived overqualification, has been found to have no meaningful impact on organizational citizenship behavior.

To demonstrate the effectiveness and safety of the defined manual vacuum aspiration (MVA) technique for treatment of type 2 cesarean scar pregnancies (CSPs).We treated 40 patients with CSP by MVA at the Early Pregnancy Clinic of our hospital between 1 January 2012 and 31 December 2014. The files of patients were reviewed and evaluated retrospectively. Eligibility criteria were hemodynamic stability and at least 2 mm myometrial thickness at the anterior part of the CSP. The key-point of successful MVA procedure is to keep away from entering the cesarean scar cavity directly; instead, CSP is displaced from the implantation site by applying vacuum, only while the cannula is passing near.During the study period, the ratio of CSP to total pregnancies was 1/1000. The ratio of CSP to cesarean delivery (CD) was 1/372. In that time period, CSPs were constituted 4.41% of all ectopic pregnancies. Total of 40 patients were treated with dilatation and MVA. Complications such as excessive hemorrhage, persistence of CSP, and any need of extra intervention were not observed. The beta-hCG values of 21 patients (52.5%) decreased below 10 mIU/mL after the first 15 days, and the rest decreased below 10 mIU/mL after 3 weeks following MVA.This MVA technique for treatment of CSP is easily applicable and effective method with high success and low complication rates. For appropriately selected patients, we think that this method can be considered as the first- line treatment.

Objective: To evaluate the histopathological findings of cystic endometrial morphology based on ultrasonographic imaging in premenopausal women.Study Design: The medical records of 3607 premenopausal women that underwent ultrasonographic examination at a tertiary care center were reviewed, as were endometrial biopsy findings in 816 of the women. These 816 women were divided in 2 groups according to ultrasonographic endometrial findings: the cystic group and the non-cystic group. Clinical and histopathological findings in the 2 groups were compared. Statistical analysis was performed using independent samples t test, chi-square test, and binary logistic regression analysis.Results: Three hundred and eighty one (46.7%) of the women that underwent endometrial biopsy had cystic endometrium, whereas 435 (53.3%) had non-cystic endometrium. The most common histopathological finding in the cystic group was endometrial hyperplasia without atypia (44.6%). Cystic morphology was nearly 8-fold more common in the women with endometrial hyperplasia without atypia (95% CI: 5.43-11.67). The premalignant and malignant pathology rates in the cystic group and non-cystic group were similar (1.1% vs. 0.5% [p=0.426] and 0.8% vs. 0.5% [p=0.669], respectively). Secretory endometrium was less common in the cystic group than in the non-cystic group (5.0% vs. 37.9% [p< 0.001])Conclusion: Cystic endometrial morphology based on ultrasonographic imaging was more common in women with endometrial hyperplasia without atypia. There wasn’t an association between cystic endometrium and other endometrial pathologies or functional endometrium. Keywords: Cystic endometrium, Endometrium, Endometrial hyperplasia, Premenopausal, Ultrasonography

Purpose: Hydrocephalus is a common comorbidity among the newborns, with myelomeningocele (MMC) and ventriculoperitoneal (VP) shunts being frequently used for the treatment of such patients. In this study, we aimed to compare the effectiveness of antibiotic-free and antibiotic-coated shunts to reduce the rate of shunt infection in patients with hydrocephalus and accompanying MMC. Methods: 116 patients with hydrocephalus and MMC who were treated with VP shunts were included in the study. Shunt infection rates among antibiotic-free and antibiotic-coated shunts were compared. Results: Of the 116 patients included in the study, 39 had antibiotic-coated shunts and 77 had antibiotic-free shunts. Shunt infection developed in 4 of the 39 cases treated with antibiotic-coated shunts and in 5 of the 77 cases treated with shunts without antibiotics. No significant statistical difference was found between antibiotic-coated and antibiotic-free VP shunts in terms of shunt infection (p = 0.450, p > 0.05). Conclusion: In patients with MMC, using VP shunts containing antibiotics was found not to have a protective effect in preventing shunt infection. Whether the sac is intact or ruptured does not affect this result.

İş erteleme, işleri yarına kadar erteleme, daha sonraya bırakma, ağırdan alma ve geciktirme anlamına gelmektedir. Bu çalışmanın amacı, demografik özellikler açısından çalışanların iş erteleme davranışları arasında anlamlı bir farklılık olup olmadığını ortaya koymaktır. Bu çalışmada bağımsız değişken demografik özellikler, bağımlı değişken ise iş ertelemedir. Veri toplama tekniği olarak anket tekniği kullanılmış olup, anket iki bölümden oluşmaktadır. Birinci bölümde iş erteleme, ikinci bölümde ise demografik özellikler ile ilgili sorular yer almaktadır. Araştırmanın örneklemini, Nevşehir ilinde faaliyet gösteren bankalarda çalışan 218 iş gören oluşturmaktadır. Verilerin normal dağılım gösterip göstermediğini tespit etmek içi K-S testi uygulanmıştır. Veriler normal dağılım göstermediği için, parametrik olmayan testler; Mann-Whitney U” ve “Kruskall Wallis" testleri uygulanmıştır. Araştırma bulgularına göre, çalışanların eğitim düzeyi değişkeni açısından iş erteleme davranışı arasında anlamlı bir farklılık olduğu tespit edilmiştir. Ancak çalışanların cinsiyet, medeni durum, yaş, iş deneyimi ve konum değişkenleri açısından iş erteleme davranışı arasında anlamlı bir farklılık olmadığı ortaya konulmuştur.

Foramen magnum meningiomas cause different symptoms based on the size and the location of the tumor. They often present with involvement of the long tracts and of the lower cranial nerves. Ataxia and occipitocervical headache are other common symptoms. In the present study, we report a case of foramen magnum meningioma presenting with cough syncope. A mass lesion located anterolateral to the foramen magnum was detected in a 38-year-old man during a magnetic resonance imaging (MRI) exam; the lesion extended from the inferior clivus to the level of the C2 vertebra. The neural axis has pushed towards posterior and contralateral side by the mass. We think that syncope occurred due to the encasement of the vertebral arteries by the tumor in addition to the compression of the neural axis. The posterolateral approach without condylar resection provides a safe surgical plane for total excision of these tumors. In our case, the tumor was totally removed and the syncope episodes were resolved.

The purpose of this study was to compare type IX collagen levels in the intervertebral disc (IVD) materials of diabetic and non-diabetic patients with lumbar disc herniation and to determine whether there is a relationship between diabetes mellitus (DM) and type IX collagen levels in degenerated discs. Overall, 30 non-diabetic patients and 30 type II diabetic patients who underwent lumbar microdiscectomy were included in this study. All patients underwent lumbar microdiscectomy, and IVD samples were obtained during the surgery. Deparaffinization, macroscopic digestion, and staining procedures were performed immunohistochemically. Fractional area stained, staining intensity, and total staining score were graded semi-quantitatively. The results were evaluated within a 95% confidence interval, and significance was evaluated as bidirectional at 0.05 and 0.01 significance levels. The type IX collagen staining intensities and fractional area stained were lower in the diabetic group than those in the non-diabetic group (p = 0.001). The total immunoreactivity staining scores of type IX collagen in the diabetic group were statistically lower at higher significance levels than the total immunoreactivity staining scores of type IX collagen in the non-diabetic group (p = 0.001). The duration of DM of the patients with DM was increased, the total immunoreactivity staining score of type IX collagen was decreased (p = 0.001). Diabetes reduces the type IX collagen level in the intervertebral disc and the duration of diabetes is the most important factor for this reduction. Diabetes may play a role in the development of disc herniation by reducing type IX collagen levels in the intervertebral disc. However, the causes of increased herniation in diabetic patients still have to be determined.

Our aim was to evaluate the presentation and diagnostic evaluation of patients with isolated tubal torsion and to evaluate the surgical approach to these patients. We also aimed to define the ultrasonographic diagnostic criteria. Five patients with isolated tubal torsion who were admitted to our gynecology department between January 2014 and January 2017 were evaluated and included in this study. All cases were diagnosed through ultrasonographic imaging alone. The preoperative findings of the patients were similar to those described in the literature. No further imaging modality was used for diagnosis and all patients were managed with laparoscopy. The clinical findings and ultrasonographic findings were consistent with literature. It may be difficult to preoperatively diagnose isolated tubal torsion, which is a rare clinical entity. Evaluation of these patients by an experienced sonographer and knowledge of the ultrasonographic findings of isolated tubal torsion may have vital preventive measures.

Background: Radiotherapy causes injury in the endothelial cells of blood vessels and the production of vasoactive amines such as endothelin-1 (ET-1). ET-1 is an important peptide in cancer development. In this study, the effects of radiation on brain tissue ET-1 level were evaluated. Is it possible to suggest a mechanism using ET-1 level in the production of this adverse effect? In this paper, the relationship between the development of brain tumors and the ET-1 level has been discussed. Materials and Methods: Twenty-eight adult Sprague Dawley rats were used in the experiments. The rats were divided into four groups (n = 7) as follows: control group: radiation was not applied during the experiment; Group 1: Decapitated on the 1st day following radiation; Group 2: Decapitated on the 7th day following radiation; and Group 3: Decapitated on the 30th day following radiation. ET-1 levels were measured with enzyme-linked immunosorbent assay (ELISA) method. The t-test, variance analysis, and Tukey honestly significant difference (HSD) tests were used in the statistical analysis. A value of P < 0.05 was accepted as significant. Results: No statistical differences were observed in the tissue ET-1 levels between the control group and other groups. According to the variance analysis and Tukey test, the differences between the groups were not significant. Conclusion: We observed in this study that the effects of radiation on brain tumor development or malignant transformation are not mediated by ET-1 levels. In addition, these results support the hypothesis of the fact that medical treatment with ET-1 antagonists in clinical cases receiving radiotheraphy is unnecessary.

Objective This study aimed to determine whether smartphones affect programmable shunts. Methods iPhone 5S (Apple Inc., Cupertino, CA, USA) and Samsung Galaxy S5 (Samsung Electronics, Gumi, South Korea) smartphones were chosen for this study. For both phones, magnetic field mapping was performed with 3-dimensional magnetic scanning systems constructed with high-precision motorized stages, and a Hall effect sensor was used to measure the flux density on the smartphone surface. The distance (h) between the distal outlet of the reservoir and the rugby ball of the Strata valve (Medtronic Inc., Minneapolis, MN, USA) was measured using highly sensitive microanalysis optical method. During optical microanalysis, while keeping a 3-cm distance between the valve and the magnetic generator, the h value (μm) was recorded for different magnetic flux densities (MFDs). Then, direct x-ray radiography was performed for radiologic assessment after each process under different magnetic fields. For analysis of the Codman Certas valve (Codman Neuro, Raynham, MA, USA), the magnet orientation and the angle between the magnet with the tantalum ball were measured with the same optical analysis. Results Maximum MFDs found 62 G for iPhone 5S and 61 G for Samsung Galaxy S5. When the magnetic generator formed a current at 0, 30, 60, and 90 G, the h values of the Strata valve adjusted to 100 mm H2O opening pressure were 320, 280, 190, and 175 μm, respectively. When the magnetic generator was removed from the environment, the h value returned to 320 μm. In direct graphs taken after each optical analysis at different Gauss values, substitution was not observed at the indicator. The angle in the Codman Certas valve was 123.9°, 112.5°, and 103.6° at the magnetic flux densities of 0, 60, and 90 G, respectively. When the magnetic field was removed (0 G), the angle was still 103.6°, suggesting an irreversible effect in the shunt construct. Conclusions Smartphones exert reversible effects on Strata programmable valves without producing remarkable radiologic findings and irreversible effects on Codman Certas valves.

Bu çalışmanın amacı, psikolojik sermayenin iş erteleme üzerindeki etkisinde psikolojik iyi oluşun düzenleyici rolünü analiz etmektir. Araştırmanın örneklemini, 2019 Nisan ayı içinde Kayseri ilinin merkezinde bulunan banka çalışanları oluşturmaktadır (n= 393). Psikolojik iyi oluşun psikolojik sermaye ve iş erteleme üzerindeki etkisini analiz etmek amacıyla veriler moderatör (düzenleyici) değişkenli regresyon analizi yardımıyla analiz edilmiştir. Araştırma sonuçlarına göre psikolojik sermayenin iş erteleme üzerinde negatif ve anlamlı bir etkiye sahip olduğu tespit edilmiştir. Araştırmanın bulgularına göre, psikolojik sermaye boyutlarından öz yeterlilik ve umut, iş erteleme üzerinde anlamlı olmayan bir etkiye sahiptir. Öte yandan psikolojik sermayenin boyutlarından dayanıklılık ve iyimserlik, iş erteleme üzerinde negatif ve anlamlı bir etkiye sahip olduğu tespit edilmiştir. Psikolojik sermaye ve iş erteleme ilişkisinde psikolojik iyi oluşun hem düşük, hem orta hem de yüksek düzeyde düzenleyici etkiye sahip olduğu gözlenmiştir. The aim of this study is to analyze the moderating role of psychological well-being in the effect of psychological capital on procrastination of work. The sample of the study consists of bank employees in the center of Kayseri in April 2019 (n= 393). In order to analyze the effect of psychological well-being on psychological capital and procrastination, the data were analyzed with the help of moderator regression analysis. According to the results of the research, psychological capital has a negative and significant effect on procrastination of work. According to the findings of the study, self efficacy and hope from the dimensions of psychological capital, have a non-significant effect on procrastination of work. On the other hand, it was found that there was a negative and significant relationship between resiliency and optimism and procrastination of work. It has been observed that psychological well-being has a low, medium and high level of moderating role on the relationship between psychological capital and work procrastination.

Background Although neurofibromatosis type 1 (NF1) is a common genetical disorder, symptoms due to neural involvement are rare among infants and children. Ganglioneuromas are slow-growing tumors and can be seen in patients with NF1. However, bilateral symmetrical involvement is very rarely reported in the literature. We present a rare pediatric case with NF1 who presented with upper cervical bilateral symmetrical ganglioneuroma. Case presentation A 7-year-old male presented with progressive gait disturbance, falls, and bilateral limb and trunk numbness that started several weeks ago. Physical examination revealed generalized café au lait spots, neurofibromas, and axillary and inguinal freckling. Family history for NF1 was positive. Neurological examination showed slight paraparesis and hypoesthesia of the upper extremities with C4–C5 dermatomas being more distinct. Cervical magnetic resonance imaging (MRI) revealed contrast enhancing dumbbell-shaped symmetrical lesions originating from both C3 nerve roots extending to C2–C5 vertebral body levels. There was a significant spinal cord compression causing myelopathy as well as dystrophic changes and kyphotic deformity at those levels. The patient was operated and the lesions were totally excised via C2–3–4 laminoplasty. Histopathological evaluation reported the lesion as ganglioneuroma. Following the surgery for excision of the lesions, the patient presented with rapidly progressing kyphotic deformity and underwent rigid craniocervical fusion. Conclusion Ganglioneuromas are seen among children, tend to occur in the mediastinum, abdomen, and retroperitoneal area, and may accompany NF1. Cervical spinal ganglioneuroma, however, is a very rare entity. Co-existence of NF1 and bilateral symmetrical cervical ganglioneuroma is highly unusual. Like neurofibromas, ganglioneuromas are slow-growing tumors and therefore they are not expected to cause myelopathy and related symptoms during childhood. Symmetrical nature of the lesions results in myelopathy and early onset of symptoms. Due to the risk of postoperative increase of kyphotic angulation, laminoplasty should be considered. Although laminoplasty alone does not prevent the progression of kyphotic changes, the procedure may allow the use of sublaminar wires and laminar hooks for future surgeries to correct the deformity.

Objective/Aim: The aim of this report was to investigate the effect of ventriculoperitoneal shunt insertion for the treatment of hydrocephalus on thyroid hormones in the first 3 months of life. Methods: Thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) levels were compared at 7 days (preoperatively) and at 30 and 90 days (postoperatively) after birth between 25 ventriculoperitoneal shunt-inserted hydrocephalic newborns and 20 healthy newborns. Results: The TSH level at 7 days was higher in the hydrocephalic patient group (6.33 µIU) compared to the control group (3.76 µIU). This value was significantly decreased at 90 days in the ventriculoperitoneal shunt-inserted newborns (2.35 µIU) compared to the control group (3.33 µIU; p < 0.05). There were no significant differences between time points for fT4 and fT3 values in the patient group or for TSH, fT4, and fT3 values in the control group. Conclusion: We propose that a ventriculoperitoneal shunt inserted in the early period of life may have beneficial effects on thyroid hormones.

OBJECTIVES Far lateral lumbar disc herniations (FLLDHs) can cause difficulty and differences in diagnosis and treatment compared with intraspinal herniation. We have aimed to analyze the efficacy of gabapentin as a noninvasive treatment of pain in patients with isolated FLLDH. METHODS Thirteen patients with isolated FLLDH were evaluated for the study prospectively. All of the cases were diagnosed by lumbar magnetic resonance imaging. The previously prescribed medical therapy of the patients was not changed and gabapentin (3 × 600 mg/d) was added. For each patient, visual analog scale and Odom criteria were administered and recorded at 4 time points as follows: pretreatment and days 1, 7, and 30 posttreatment. Paired t test was used to examine scores of the cases before and after gabapentin treatment. Results were considered significant at P < 0.05, and 95% confidence interval was calculated. RESULTS Mean visual analog scale score was 9.3 in the pretreatment period, and reduced to 5, 2.6, and 1.3 on posttreatment days 1, 7, and 30, respectively (P < 0.05). Mean Odom criteria score was 4 before gabapentin treatment. It decreased to 2.3 at posttreatment day 1 and 1.5 at day 7. At the end of 1 month, symptoms had resolved completely in all cases (P < 0.05). CONCLUSIONS Gabapentin provided fast and effective relief of pain caused by FLLDH. We advise that the gabapentin should be kept in mind in the first-step medication of pain for such patients. Direct compression of the dorsal root ganglion or its distal part may be related to the intense pain-relief effect provided by gabapentin.

Objectives: To evaluate the impact of the uterine artery Doppler values and the change of β-Human chorionic gonadotropin (β-HCG) levels from day 0 to day 4 for prediction of the success of single dose methotrexate treatment in tubal pregnancy cases. Study Design: 50 patients with tubal pregnancy were included the prospective study. The location and size of ectopic pregnancy, bilateral uterine artery pulsed color doppler imaging was examined by ultrasonography and serum β-HCG levels were measured on day 0, 4, 7 of treatment. Success was defined as decrease of β-HCG level 15.04% on day 4, single-dose methotrexate therapy were 3.82 times more successful than the group without > 15.04% β-HCG decrease. However, no significant alteration of uterine artery Doppler measurements was determined on the same days.Conclusion: Reduction rate in the β-HCG level on day 4 of treatment can be used in determination the success of single-dose methotrexate therapy.

Purpose: The goal of this research was to evaluate the effectiveness of burr hole drainage under local anesthesia in geriatric patients with chronic subdural hematoma.Material and Methods: This retrospective study involved 21 geriatric patients with chronic subdural hematoma who applied to the department of neurosurgery in an education and research hospital between 2011 and 2014. Sedoanalgesia was performed on 21 patients, then awake burr hole drainage was performed after scalp and periosteal local anesthesia with bupivacaine HCI 5mg/ml (Marcaine %0,5enj. Astrazeneca). Cranial motor perforator was used for burr hole trepanation. Age, sex, trauma history, examination findings, site of the pathology, systemic disease, ASA risk, glasgow coma scale, modified rankin scale, mortality and morbidity were evaluated. Results: The youngest patient was 68-year-old, the oldest was 90-year-old. The average age was 72.9 years. Eleven of the cases were male and 10 were female. Head trauma was the etiology in 20 cases. 2 burr hole drainages were performed in 18 cases and 1 burr hole drainage was performed in 3 cases under local anesthesia. 3 cases were re-operated. No mortality was seen in the early post-operative period. Cases were kept in the intensive care unit for 1 day. The average hospital stay was 7 days.Conclusion: Surgical interventions under local anesthesia in geriatric patients with chronic subdural hematoma can provide short operation time, early mobilization, early oral intake, avoidance of possible general anesthesia complications. Herewith, this intervention decrease mortality and morbidity in this age group., Amaç: Bu araştırmanın amacı kronik subdural hematomu bulunan ileri yaş hastalarda lokal anestezi altında burr hole drenajın etkinliğini değerlendirmektir.Gereç ve Yöntem: Bu retrospektif çalışma 2011-2014 yılları arasında bir eğitim ve araştırma hastanesinin beyin cerrahisi kliniğinde kronik subdural hematom nedeniyle değerlendirilen 21 ileri yaşlı hastayı içermektedir. Sedoaneljezi 21 hastaya uygulandı. Sonrasında bupivacaine HCI 5mg/ml (Marcaine %0,5enj. Astrazeneca) ile yapılan scalp ve periostal lokal anesteziyi takiben hastalara uyanık burr hole drenaj uygulandı. Burr hole açılırken kranial motor perforatör kullanıldı. Yaş, cinsiyet, travma hikayesi, fizik muayene bulguları, patolojinin yeri, sistemik hastalık, ASA, glasgow koma skalası, modifiye rankin skalası, mortalite ve morbidite değerlendirildi.Bulgular: En genç hasta 68, en yaşlı hasta 90 yaşındaydı. Ortalama yaş 72.9’ du. 11 hasta erkek, 10 hasta bayandı. 20 hastada etyoloji kafa travmasıydı. 18 hastada 2 burr hole ile drenaj, 3 hastada tek burr hole ile drenaj lokal anestezi altında uygulandı. 3 olgu tekrar opere edildi. Erken postoperatif periyotta mortalite görülmedi. Olgular yoğun bakım ünitesinde 1 gün tutuldular. Ortalama hastanede kalma süresi 7 gündü.Sonuç: Kronik subdural hematomlu ileri yaş hastalarda lokal anestezi altında yapılan cerrahi girişim kısa operasyon zamanı, erken mobilizasyon, erken oral alım, genel anestezinin olası risklerinden kaçınmayı sağlar. Bu sebeple, yöntem bu yaş grubunda mortalite ve morbiditeyi azaltır.

Background/Aim: There is currently no objective evaluation of hearing in patients with hydrocephalus (HCP), and we could not find any study in the literature comprising a sufficient number of patients with a high level of scientific evidence. In the current study, we used the auditory brainstem response (ABR) test to assess whether hearing function in patients with HCP is altered after ventriculoperitoneal shunt surgery. Methods: In total, 20 newborn patients with HCP (13 female, 7 male) were enrolled in this study. For each patient, ABR testing was performed at three time points: 1 day prior to the operation and on days 7 and 90 after the operation. ABRs using click stimuli of 90, 70, 50 and 30 dB nHL (normal hearing level) were achieved for V-wave latency, and I-III and I-IV interpeak latencies for both ears were recorded. Variance analysis for parametric data and Tukey's post hoc honest significant difference test were used to demonstrate the relationship between the results obtained from the different recording periods. Results were considered significant at p < 0.05, and 95% confidence intervals were calculated. Results: The mean values of the ABR tests were compared between the pre- and postoperative results, which showed an increase (faster transmission) of nerve conduction velocity of 0.2 ms. The results were not statistically significant for 50 and 90 dB (p > 0.05) but were significant for 30 and 70 dB (p < 0.05). Conclusion: Diagnosis in hydrocephalic patients is important not only for the treatment but also for the prevention of HCP-associated complications. Early treatment appears to be promising in terms of auditory benefit. Prompt diagnosis and treatment are therefore essential as soon as possible.

Bu çalışmanın amacı, örgütsel özdeşleşmesinin bireysel yaratıcılık üzerindeki etkisini analiz etmektir. Bu araştırmanın örneklemini, Nevşehir ilinde faaliyet gösteren bankalarda çalışan iş görenler oluşturmaktadır ( n=237). Örgütsel özdeşleşmenin bireysel yaratıcılık üzerindeki etkisini analiz etmek için bahsedilen örneklemden elde edilen veriler basit doğrusal regresyon analizi yardımıyla test edilmiştir.Araştırma bulgularına göre örgütsel özdeşleşmesinin bireysel yaratıcılık üzerinde pozitif bir etkiye sahip olduğu belirlenmiştir. Son olarak bu çalışmanın bazı kısıtlarına yer verilmiş ve gelecekte yapılacak çalışmalara yol gösterici öneriler sunulmuştur.

Aim To evaluate postoperative clinical outcome and recurrence rates in cases with ventrally located spinal meningiomas who underwent Simpson grade 2 resection. Material and methods We evaluated eight cases (six females and two males; age, 28?86 years; mean age, 60 years) with ventrally located spinal meningioma that underwent surgical treatment in our clinic. The tumors were located in the thoracic region in seven cases and in the cervical region in one case. All cases underwent surgery, which was performed using a traditional posterior midline approach. Laminectomy was unilaterally extended. The case with cervically located tumor differed from the other cases in that a skull clamp was used and laminoplasty was performed. Results The tumor was completely resected in all cases. Furthermore, in all cases, the tumor nidus that caused the thickening of the dura was cauterized using bipolar cautery and peeled off (Simpson grade 2). The pathological examination of the tumor specimens revealed typical grade 1 meningioma in all cases (fibropsammomatous type, n=1; meningothelial type, n=3; and psammomatous type, n=4). Recurrence was not observed in any of the cases during the follow-up. None of the cases demonstrated postoperative neurological deterioration. At 1 month postoperatively, pain and motor deficit completely improved in all cases, with remarkable improvements of motor deficits in the early postoperative period. Conclusion Simpson grade 2 resection in ventrally located spinal meningiomas results in low complication rates and is satisfactory in terms of recurrence.