Konvansiyonel Tedavilere ve Splenektomiye Refrakter Primer Myelofibrozisli Olguda Ruxolitinib Deneyimi

A 67-year-old male patient who was diagnosed with primary myelofibrosis 4 years ago did not respond to conventional therapies. The splenomegaly progressively increased, which caused spleen infarctions and led to the decision to perform a splenectomy procedure. After splenectomy, the patient started treatment with ruxolitinib. In the first month of ruxolitinib treatment, the patient became transfusion-free and all constitutional symptoms disappeared. However, in the sixth month of ruxolitinib treatment, the disease transformed to acute myeloblastic leukemia, and the patient died 1 month later. This is the first case report that shows the effects of ruxolitinib in a splenectomized patient

Çokal Barajı (Çanakkale) çökme modeli ve taşkın risk analizi

The source of the hazard which is the main factor of disasters can be made by naturally or man. These are generally independent sources, but sometimes reason of one hazard such as flood can be both naturally and man-made. Certainly, all examples in our country and the world show that, the fail of constructed structures on the rivers (e.g. dam, embankment) produce a very large amount of water and damage more than the normal river floods. In this study, based on cofferdam of Çokal Dam breaching which occurred in 16 November 2007 on the Kavak River (Çanakkale), 1D modeling of probable Çokal Dam break take in the account tectonic properties of the area and analyzing of the flood risk have been done. For these purposes, Digital Elevation Model (DEM) gathered contours from 1:25000 scaled topographic maps and GPS points, high and medium resolution satellite images, hydrological soil data gathered from soil maps scaled 1:25000, precipitation and discharge data in 30 years, technical properties of structures on the Kavak River and field measurement have been used as a database. All these data is processed and analyzed using Geographic Information System (GIS), Hec-GeoRAS and HEC-RAS hydraulic models and hydrologic model. Hence, Çokal Dam break modeling based on cofferdam breach modeling reveals that probable flood after the dam-break will affect Evreşe Plain and the people which get livelihood from the plain. General probable lost in agricultural product after probable flood reaches TL 12 million. Thus, as a result of human interventions to the nature will cause great harm to himself again.   Afetlerin oluşmasında önemli etkiye sahip tehlikeler, doğa kaynaklı olabildikleri gibi insan kaynaklı da olabilmektedir. Bunlar genelde birbirinden bağımsız tehlike türleri iken bazen taşkınlar gibi kaynağını hem doğadan hem insandan alan tehlikeler olarak da karşımıza çıkmaktadır. Şüphesiz ki ülkemizdeki ve dünyadaki örneklerin tamamı ortaya koymuştur ki, insan kaynaklı olarak akarsular üzerine inşaa edilen yapıların (baraj, set vb.) bir şekilde zarar görmesiyle sonuçları normal taşkınlardan da fazla olmuştur. Bu çalışmada, 16 Kasım 2007'de Kavak Deresi (Çanakkale) üzerindeki Çokal Barajı menba batardosunda meydana gelen çökmenin oluşturduğu taşkına bağlı olarak, günümüz itibariyle halen yapımına devam edilen Çokal Barajı'nın sahanın tektonik özellikleri de gözönünde tutularak, olası çökmesinin tek boyutlu (1D) hidrolik modellemesi yapılmış ve buna bağlı taşkın risk analizi gerçekleştirilmiştir. Çalışmada altlık verileri, 1:25000 ölçekli topografik eşyükselti eğrisi ve saha GPS verileriyle üretilmiş Sayısal Yükselti Modeli (SYM), yüksek ve orta çözünürlüklü uydu görüntüleri, hidrolojik toprak  verileri, 30 yıllık yağış ve akım verileri, Kavak Dere üzerindeki yapılara ait teknik özellikler ve arazi ölçümleri oluşturmaktadır. Bütün bu altlık veriler Coğrafi Bilgi Sistemleri (CBS), Hec-GeoRAS ve HECRAS hidrolik modelleri  ve hidrolojik modellerde kullanılmış ve analiz edilmiştir. Sonuç olarak, menba batardosu çökme modeli temelinde oluşturulan Çokal Barajı çökme modeli göstermiştirki, olası baraj çökmesi sonucunda oluşacak taşkın, Evreşe Ovası ve buradan geçimini sağlayan insanlar için büyük zararlar ortaya çıkartacaktır. Sadece tarım ürünleri üzerindeki genel tahmini kayıplar 12 milyon TL yi bulmaktadır. Böylelikle insanın doğaya yapmış olduğu müdahale sonucunda yine insanın kendisi büyük zararlar görecektir.     &nbsp

Öğrencilerin ortaöğretim kurumu tercihinde okullarla ilgili faktörlerin etkisi

It is studied that to determine the school related factors which affects the students’ choices of the high school, according to the type of the schools. This is a survey study. The participants are 523  9 th grade students in 21 secondary schools in Adapazarı. SPSS is used for analyzing data. Kay-Kare Test is used to determine the demografic differences due to the type of the school. To analyze the data for the school related factors, Kruskal Wallis is used. As a result, it is expressed that in the choices of the schools, similar factors are important. On the other hand, the most important factors are; the fame of the school due to its succesful education, the easiness of entering the university after completing the school and the teachers of the school, who are talented and famous with their successBu araştırma ile öğrencilerin orta öğretim kurumu tercihlerinde etkili olan okullarla ilgili faktörler incelenmiştir. Bu amaçla Adapazarı’nda 21 ortaöğretim kurumundaki 9. sınıf öğrencilerinden 523 kişi ile anket çalışması yapılmıştır. Veriler SPSS paket programı ile analiz edilmiştir. Okul türüne göre demografik farklılıkları belirlemek için iki değişkenli Kay-Kare testi kullanılmıştır. Okul tercihine etki eden okullara ait faktörlerle ilgili verilerin analizi için Kruskal Wallis kullanılmıştır. Yapılan çalışma sonucunda okul tercihinde tüm okul türlerine göre benzer faktörlerin etkisi olduğu, en etkili faktörlerin okulun çevrede iyi eğitim veren başarılı bir okul olarak tanınmış olması, bu okuldan mezun olmanın üniversiteye girişte sağladığı kolaylık (ek puan, sınavsız geçiş hakkı gibi.) ve okulun öğretmen kadrosunun deneyimli ve tanınmış öğretmenlerden oluşması olduğu saptanmıştı

Treatment of Otomycosis in Ears with Tympanic Membrane Perforation is Easier with Paper Patch

Objective:To assess the effectiveness of paper patch closure of tympanic membrane perforation in patients with otomycosis and tympanic membrane perforation.Methods:Fifty-six otomycosis patients with central tympanic membrane perforations were included in the study. Patients were randomized into two groups as patched (PG) and non-patched (NPG) groups. In both groups, Castellani’s solution was applied to the external auditory canal. In PG patients, the perforated tympanic membrane was covered with carbon paper patch soaked in Castellani’s solution to reduce ear canal humidity and to prevent fungi from passing from the ear canal to the middle ear mucosa. Paper patch was not used in NPG patients.Results:There were statistically significant differences between the two groups in terms of severity scores in the first, second, third, fourth and sixth weeks of admission (p=0.004, p=0.018, p=0.001, p=0.009, and p<0.001, respectively). Time to complete recovery was statistically shorter in PG patients (p<0.001). Disease recurrence was statistically less among PG patients compared to NPG patients (p=0.025).Conclusion:Closing of perforation with paper patch and topical application of Castellani’s solution was found to be an effective and safe method. The method eliminated otomycosis in a shorter period and reduced recurrence rate in patients with eardrum perforation

The Danish Heart Registry

AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR and WDHR). For each type of procedure, up to 70 variables are registered in the DHR. Since 2010, the data quality protocol encompasses fulfillment of web-based validation rules of daily-submitted records and yearly approval of the data by the EDHR and WDHR. DESCRIPTIVE DATA: The data collection on procedure has been complete for PCI and surgery since 2000, and for CAG as of 2006. From 2000 to 2014, the number of CAG, PCI, and surgical procedures changed by 231%, 193%, and 99%, respectively. Until the end of 2014, a total of 357,476 CAG, 131,309 PCI, and 60,831 surgical procedures had been performed, corresponding to 249,445, 100,609, and 55,539 first-time patients, respectively. The DHR generally has a high level of completeness (1–missing) of each procedure (>90%) when compared to the National Patient Registry. Variables important for assessing the quality of care have a high level of completeness for surgery since 2000, and for CAG and PCI since 2010. CONCLUSION: The DHR contains valuable data on cardiac invasive procedures, which makes it an important national monitoring and quality system and at the same time serves as a platform for research projects in the cardiovascular field

Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retrospective Analysis of 30 Patients

Objective: Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department.Methods: The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed.Results: The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler–Weber–Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period.Conclusion: TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure

False-Positive Laryngeal FDG Uptake During PET/CT Imaging: Reinke’s Edema

Positron emission tomography/computed tomography (PET/CT) is frequently used for diagnosing, staging, and following-up various malignancy types because it provides information on the site and metabolic activity of the tumor. Fluorodeoxyglucose (FDG) uptake by the normal laryngeal tissue is symmetric and low, whereas that under some non-malignant conditions of the larynx, such as vocal cord paralysis and Teflon granuloma, is asymmetrically increased. We reported the first case of histologically proven Reinke’s edema causing false-positive laryngeal FDG uptake on PET/CT imaging. A clinician must be aware of these rare benign lesions in the case of increased FDG uptake, and histopathological investigation is mandatory to rule out malignancy for suspicious cases

The marine arthropods of Turkey

This recent checklist of marine arthropods found on the coasts of Turkey represents a total of 1531 species belonging to 7 classes: Malacostraca (766 species), Maxillopoda (437 species), Ostracoda (263 species), Pycnogonida (27 species), Arachnida (26 species), Branchiopoda (7 species), and Insecta (5 species). Seventy-fve species were classifed as alien species in the region. Tis paper also includes the frst record of the amphipod Melita valesi from the Levantine coast of Turkey (Kaş, Gulf of Antalya).This recent checklist of marine arthropods found on the coasts of Turkey represents a total of 1531 species belonging to 7 classes: Malacostraca (766 species), Maxillopoda (437 species), Ostracoda (263 species), Pycnogonida (27 species), Arachnida (26 species), Branchiopoda (7 species), and Insecta (5 species). Seventy-fve species were classifed as alien species in the region. Tis paper also includes the frst record of the amphipod Melita valesi from the Levantine coast of Turkey (Kaş, Gulf of Antalya)