Granüloza hücreli over tümörlerinin yönetimi: Tersiyer bir merkeze ait 10 yıllık deneyim

Objective: Granulosa cell tumors (GCT) arise from the mesenchymal cells and sex cords of the ovaries and can be observed in women of all age groups. This study presented our 10 year-long gynecology oncology experience on the clinical course and outcome of GCT cases. Methods: Thirty-one patients who were operated due to suspicious adnexal masses in our hospital between January 2011 and January 2018 and whose final pathology report confirmed the diagnosis of GCT was included in the study. The data of the patients were evaluated. Preoperative ultrasound findings and serum tumor marker results are noted. Results: Twenty-nine (94%) patients were diagnosed with AGCS and only two (6%) patients were diagnosed with JGCS. The mean age of the study population was 47.74 14.47 years and the mean body mass index was 32.51 7.1. Most patients presented with heavy menstrual bleeding (29%). 48.4% of the patients underwent hysterectomy with bilateral salpingo-oophorectomy, and complete lymph-node dissection, whereas 22.6% of them had hysterectomy with bilateral salpingo-oophorectomy, and 29% of them had oophorectomy only. Three patients (9.3%) had a disease recurrence. The overall survival was 54.4 29.3 months and disease free survival was 49.6 24.2 months. Conclusion: The most important predictor of survival among patients with GCT is a disease stage at the time of initial diagnosis. Long-term surveillance, including routine clinical follow-up and evaluation of tumor markers is mandatory.Amaç: Granüloza hücreli tümörler (GCT) yumurtalıkların mezenkimal hücrelerinden ve cinsiyet kordonlarından ortaya çıkar ve her yaş grubundaki kadınlarda görülebilir. Bu çalışma, GCT olgularının klinik seyri ve sonuçları hakkında 10 yıllık jinekoloji onkoloji deneyimimizi sunmayı amaçladı. Yöntem: Ocak 2011-Ocak 2018 tarihleri arasında hastanemizde şüpheli adneksiyal kitle nedeniyle ameliyat edilen ve son patoloji raporu GHT tanısı ile doğrulanan 31 hasta çalışmaya dahil edildi. Hastaların verileri değerlendirildi. Preoperatif ultrason bulguları ve serum tümör belirteç sonuçları not edildi. Bulgular: Yirmi dokuz (%94) hastaya AGCS tanısı kondu ve sadece iki (%6) hastaya JGCS tanısı kondu. Çalışma popülasyonunun ortalama yaşı 47,74 14,47 yıl ve ortalama vücut kitle indeksi: 32,51 7,1 idi. Hastaların çoğu ağır adet kanaması (%29) ile başvurdu. Hastaların %48,4’üne bilateral salpingo-ooferektomi ve tam lenf nodu diseksiyonu ile histerektomi, %22,6’sına bilateral salpingo-ooferektomi ile histerektomi, %29’una sadece ooferektomi yapıldı. Üç hastada (%9,3) hastalık nüksü vardı. Genel sağkalım 54,4 29,3 aydı ve hastalıksız sağkalım 49,6 24,2 aydı. Sonuç: GCT’li hastalar arasında sağkalımın en önemli prediktörü, ilk tanı anındaki hastalık evresidir. Tümör belirteçlerinin rutin klinik takibi ve değerlendirmesini içeren uzun vadeli sürveyans zorunludur

Üstbiliş, Zeka ve Metinden Öğrenme Performansı Arasındaki İlişkiler

The main aim of this study was to investigate the relations among text learning performance, general intelligence and the three components of metacognition; namely metacognitive knowledge, metacognitive monitoring and metacognitive control. The participants were 91 fifth graders. The results of the study indicated no significant correlations among metacognitive knowledge, metacognitive control and general intelligence. On the other hand, metacognitive monitoring and general intelligence correlated significantly. The results of the regression analysis showed that metacognitive knowledge did not contribute to students’ text-learning performance whereas metacognitive monitoring and metacognitive control, together with general intelligence, were found to be significant predictors in explaining students’ text-learning performance.Araştırmanın amacı üstbilişin üç farklı boyutu olan üstbilişsel bilgi, üstbilişsel izleme ve üstbilişsel denetleme ile genel zekâ ve metinden öğrenme performansı arasındaki ilişkilerin incelenmesidir. Araştırmaya 91 ilköğretim beşinci sınıf öğrencileri katılmıştır. Araştırmanın sonucunda üstbilişsel bilgi ve üstbilişsel denetleme ile genel zekâ arasında anlamlı ilişki olmadığı görülürken üstbilişsel izleme ile genel zekâ arasında istatistiki olarak anlamlı ilişki olduğu görülmüştür. Regresyon analizi sonuçları; üstbilişsel bilginin metinden öğrenme performansındaki değişkenliğe katkı sağlamadığına, üstbilişsel izleme ve üstbilişsel denetlemenin ise genel zekâ ile birlikte metinden öğrenme performansındaki değişkenliğe anlamlı katkı sağladığına işaret etmektedir

Effects of Aminoguanidine on Glomerular Basement Membrane Thickness and Anionic Charge in a Diabetic Rat Model

We investigated the effect of aminoguanidine (AG) administration on GBM thickness, glomerular heparan sulfate (HS) content, and urinary albumin and HS excretion in diabetic rats. After induction of diabetes, female Wistar rats were divided into 2 groups: Group AGDM (n=11) received 1g/L aminoguanidine bicarbonate in drinking water, group DC (n=12) was given only tap water. Control rats received AG (group AGH, n=8) or tap water (group HC, n=8). At the end of a period of 8 weeks, urinary albumin and glycosaminoglycan (GAG) excretion was detected. GBM heparan sulfate distribution and count was determined under the electron microscope. The AGDM group had lower urinary albumin and GAG excretion than diabetic controls. GBM thickness was increased in diabetic rats compared to groups of AGDM and HC. In AGDM group alcian blue stained particle distribution and count in the GBM was similar to healthy controls. In conclusion AG prevents the decrease of anionic charged molecules in the GBM and GBM thickening. This can be one of the mechanisms by which AG decreases albuminuria in diabetic rats

The Effect of Nasal Functions on the Integrity of Grafts after Myringoplasty

Objective:We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplasty.Methods:In our study 78 patients who underwent myringoplasty operation between 2011-2013 were included. Group I was defined as the group with an intact tympanic membrane following surgery. Group II was defined as the group with a tympanic membrane perforation following surgery. Group I consisted of 44 and Group II consisted of 34 patients. Subjective and objective measurements of nasal functions, Eustachian tube function (ETF), and allergic status were performed using nasal obstruction symptom evaluation (NOSE) scale, visual analog scale (VAS), and the score for allergic rhinitis (SFAR) questionnaires and acoustic rhinometry and saccharin test. It was investigated whether there was any difference between these two groups in terms of these parameters.Results:There was statistically no significant difference between groups according to the age, sex and the presence of tubal dysfunction and allergic rhinitis (p>0.05). In the group of intact tympanic membranes, the likelihood of right ear being the operated one was significantly higher compared to the group of myringoplasty failures (p=0.037). The VAS and NOSE scales did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05). The nasal congestion index (NCI) and the mucociliary clearance (MCC) did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05).Conclusion:This study has shown that nasal functions measured by objective and subjective methods had no effects on the success of myringoplasty

COVID-19 in pediatric nephrology centers in Turkey

Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage

Measuring Service Quality and An Assessment In The Context of Public Relations: Türk Telekomünikasyon A.Ş.Ankara Implementation

Son yıllarda dünyada ve ülkemizde istihdam içerisindeki payını giderek artıran hizmet sektöründe rekabet de yogunlasmakta, müsterileri memnun edebilmek amacıyla hizmet kalitesinin saglanması çabaları önem kazanmaktadır. Heterojenlik, soyutluk gibi çesitli özellikleriyle mamullerden ayrılan hizmetlerde kalite algısının anlasılabilmesi için, mamullere kıyasla daha farklı yöntemler gelistirilmis ve hizmet kalitesi algısını etkileyen faktörler, çesitli yaklasımlar altında incelenmistir. Hazırlanan çalısmanın amacı, Türk Telekomünikasyon A.. müsterilerinin, sirketin sunmakta oldugu hizmetlerden bekledigi ve algıladıgı kalite düzeylerini belirlemek ve arada olusan farkın nedenlerini halkla iliskiler faaliyetleri baglamında degerlendirmektir. Ankara'da bulunan dokuz adet Telekom Müdürlügü'nde 687 kisinin katılımıyla gerçeklestirilen arastırma kapsamında, mükemmel telekomünikasyon sirketinden beklenen hizmet kalitesi düzeyi, Türk Telekomünikasyon A.Ş. hizmetlerinden algılanan kalite düzeyi ve Türk Telekomünikasyon A.Ş.'nin yürütmekte oldugu halkla iliskiler çalısmalarının farkındalık düzeyi anlasılmaya çalısılmıstır. Ayrıca halkla iliskiler farkındalık düzeyi ve müsteri yogunluk seviyesi ile algılanan hizmet kalitesi düzeyi arasında iliski bulunup bulunmadıgı da incelenmistir.Arastırma kapsamında anket uygulaması gerçeklestirilmistir. Demografik bilgiler ölçülmüs; beklenen ve algılanan hizmet kalitesini ölçmek amacıyla 5'li Likert ölçegine göre hazırlanmıs ifadeler kullanılarak anket uygulanmıs ve sonuçlar SPSS.15 programında egerlendirilmistir. Ayrıca halkla iliskiler faaliyetlerinin farkındalık düzeyini ölçmek amacıyla ankette 5'li Likert tipinde hazırlanmıs ifadelere yer verilmistir. Anketlerin degerlendirilmesi sürecinin sonucunda, müsterilerin kalite boyutlarını olusturan özelliklerden en çok güven, cevap verme hızı ve güvenilirlik boyutlarını önemsedikleri görülmüstür. Müdürlükler bazında elde edilen Servqual skorları karsılastırılmıs, Bahçelievler ve Dikmen Telekom Müdürlüklerinin sundugu hizmetin kalite algısının diger müdürlüklere göre daha yüksek çıktıgı görüsmüstür. Halkla iliskiler faaliyetlerinin farkındalıgı yüksek olan müsteriler, hizmet kalitesini boyutlarını olusturan özelikler konusunda daha yüksek kalite algısına sahip olmaktadırlar. Bu da halkla iliskiler ve algılanan hizmet kalitesi arasında iliski oldugunu göstermektedir. Müsteri yogunluk seviyesi ile algılanan hizmet kalitesi düzeyi arasında ise bir iliski bulunmadıgı tespit edilmistir.Elde edilen bulgular dogrultusunda, basta Türk Telekomünikasyon A.ş. olmak üzere sektörde rekabet eden isletmelerin önem vermesi ve gelistirmesi gereken hizmet kalitesi özellikleri belirtilmis ve bu konuda önerilerde bulunulmustur.In recent years competition in the service sector, the recruitment proportion of which is increasing day by day, is intensifying and efforts for obtaining the service quality is becoming important. In order to understand the quality perception in services, which is differenciating from goods by various features such as heterogenity, intangibility etc., different manners are developed. Service quality is analysed under these various methods. The aim of the thesis is to determine the exceptions and perceptions of the customers, to who are served by Türk Telekomünikasyon A.İ. in Ankara, and assessing the gap between exceptions and perceptions through public relations context. The research was implemented with participation of 687 customers of 9 Telekom Directorates in Ankara. It is aimed to understand both the expected service quality level of the ideal telecommunications company, and the perceived service quality level of Türk Telekomünikasyon A.İ. The research also aimed to measure the awareness level of customers from public relations acitivities of Türk Telekominkasyon A.İ. Finally, the relation between public relations awareness level and perceived service quality level is investigated together with the relation between the perceived service quality level and customer intensity of 9 Telekom Directorates. A questionnaire was prepared and implemented during the research. Firstly demographical information was measured. Expected and perceived service quality levels were measured by assessing the answers of the questionnaire, which is prepared through 5-Likert measure. Results were analysed by using SPSS v.15. in order to measure the awareness of public relations activities, 5-Likert measure was also used ın the last part of the questionnaire. As result of the evalution of the questionnaires, it is seen that trust, answering speed and reliability dimensions are evaluated as the most important quality dimensions. Servqual results are also compared among Telekom Directorates and it is seen that the service quality perceptions of Bahçelievler and Dikmen Directorates are higher than the rest of the Directorates. Customers, having high public relations awareness level have a high service quality perception level. That shows us the relation between public relations and service quality perception. On the contrary, there is no determination about the customer intendity and the perceived service quality level. According to the findings, comments about the most important service quality dimensions and features for competing telecommunication companies, especially for Türk Telekomünikasyon A.İ. are emphasized and advices are recommended for those companies

THE DECISION-MAKING PROCESS ON POLICY TRANSFER

Kamu yönetimleri açısından, geniş ve karmaşık ilişki ağlarını bünyesinde barındıran karar verme olgusu önem arz etmekte; kamu yönetiminin kalbinin attığı yerde gerçekleşmektedir. Siyasi sürecin çıktılarından olan ve son dönemde Türkçe literatürde kamu politikası olarak çalışılmaya başlanan kamu siyasasının oluşum süreci; problemi tanımlayarak gündem oluşturma, siyasa formülasyonu, siyasa tasarımı, siyasanın eyleme dönüştürülmesi ve son olarak siyasanın değerlendirilmesi aşamalarını içermektedir. Gündem oluşturma aşamasında hızlı karar verme gereği; uluslararası topluluktaki yerini meşrulaştırma, perçinleme gayreti; alınan kararlara ve benimsenen politikalara meşruluk sağlama isteği ya da direkt olarak başka bir ülkenin zorlaması gibi nedenlerle transfer olgusu gündeme gelebilmektedir. Ancak politika transferine karar verme süreci de siyasa oluşturma süreci gibi birden çok konuda karar vermeyi içeren ayrıntılı bir süreçtir. Bu doğrultuda çalışmanın amacı ülkelerin politika transferi sürecinde hangi konularda karar vermeleri gerektiğinin ve bu kararları alırken hangi adımları atmaları gerektiğinin açıklığa kavuşturulmasıdır.In terms of public administration, decision making that incorporates large and complex relationship network is important and it takes place at the heart of public administration. The formation process of public policies which is one of the outcomes of the political process and worked as politics in the recent Turkish literature comprises the steps such as creating agenda by defining the problem; formulation of policy, policy-design, transformation of policy to action and finally assessing the policy. Policy transfer can come up with reasons such as obligation of rapid decision-making on step of creating agenda, effort to legitimate of position in international community, request of providing legitimacy to decisions that were made and policy that were adopted or forcing by another country directly. However, the decision-making process of policy transfer is a detailed process that includes multiple issues such as the formation process of public policies. In this context, the * Prof. Dr., Necmettin Erbakan Üniversitesi Sosyal ve Beşeri Bilimler Fakültesi Siyaset Bilimi ve Kamu Yönetimi Bölümü Öğretim Üyesi, [email protected] ** Arş. Gör., Selçuk Üniversitesi İktisadi ve İdari Bilimler Fakültesi Siyaset Bilimi ve Kamu Yönetimi Bölümü, [email protected] of the study is to clarify the necessity of that which decisions are made and which steps are taken about these decisions in the process of policy transfer for countries