Hashimoto tiroiditinde anti-BIP düzeyleri

Hashimoto tiroiditli hastalarda immün modülatör ve antiapoptotik etkileri olan endoplazmik retikulum şaperonu BIP’e karşı oluşan antikor varlığını araştırmak. Çalışmaya 20 ötiroid otoimmün tiroidit, 27 subklinik hipotiroidi, 15 hipotiroid hashimoto tiroiditi olmak üzere 62 otoimmün tiroiditli hasta ve 37 hastadan oluşan sağlıklı kontrol grubu alındı. Hashimoto tiroiditli hastaların alt gruplarıyla kontrol grubu arasında ve hashimoto tiroiditi alt gruplarının kendi aralarında Anti-BIP düzeyleri açısından kıyaslandığında herhangi bir istatistiksel fark saptanmadı (p=0,889). Tiroid hücrelerinde BIP aktivasyonu gösterilmesine rağmen bizim çalışmamızda hashimoto tiroiditli hasta alt gruplarında Anti-BIP düzeyi kontrol grubundan farklı bulunmamıştır. Bu durum hashimoto tiroiditinde apoptozis ve/veya T hücre cevabıyla BIP’e karşı oluşan antikorların ilişkisiz olduğu veya serumda tespit edilemeyecek düzeylerde olduğunu düşündürmektedir. To asses the presence of antibodies to BIP/GRP78, which is a chaperon of endoplasmic reticulum and has immune modulating and antiapoptotic effects in hashimoto’s thyroiditis. The study included 62 patients with autoimmune thyroiditis. Of these, 20 had euthyroid, 27 had subclinical hypothyroid, and 15 had hypothyroid hashimato’s thyroiditis. A control group including 37 healthy patients also participated in the study. There was no statistically significant difference between subgroups of hashimoto’s thyroiditis patients and control group, and between subgroups of hashimoto’s thyroiditis patients, individually; when comparison was made in respect of Anti-BIP levels (p=0,889). Although BIP activation has previously been shown, the Anti-BIP level was not different from the control group in subgroups of hashimoto’s thyroiditis patients in our study. This condition suggests that antibodies formed aganist BIP by apoptosis and/or T cell response are not associated with hashimoto’s thyroiditis or that it is at a level in serum that can not be measured

Teaching self-regulation through role modeling in K-12

For K-12 teachers to develop effective teaching skills, integration of role modeling strategies into teaching and learning process as a dimension of selfregulated learning is of the foremost value. Role modeling strategy training through a hybrid professional development model bears the potential to serve as a facilitating component in promoting K-12 teachers’ instructional competence. Conducted within the selfregulated learning framework, this study suggested findings of a teacher professional development training aimed at role modeling strategy implementation at K-12 level. Pursuing a mixed-method model, the current research was performed with 16 teachers who were trained and supervised to integrate role-modeling strategies into their teaching context. In this study, the data sources were role-modelingintegrated lesson plans, trainers’ feedback on these lesson plans, and online student products. The data collection methods included lesson plan evaluation through a role-modeling rubric in a quantitative fashion, whereas content analysis of trainer feedback on lesson plans, latterly revised lesson plans and online student products composed the qualitative aspect. Results revealed that this professional development training achieved significantly positive changes in teachers’ role modeling strategy implementation skills, particularly in terms of teachers’ role as agents in students’ self-regulated learning skills, promotion of student-centered learning and overall improvement in students’ self-regulated learning skills. Further, the integration of education technology tools into lessons was observed to have a positive impact on enhancing students’ self-regulated learning skills. This study could offer major contributions to designing teacher professional development training for researchers, practitioners, and teacher trainers, particularly in role modeling dimension of selfregulated learning

Comparison of Manual and Automated Scoring Techniques in Polysomnography

Objective:Polysomnography (PSG) scoring can be performed manually or with an automated programme. The purpose of this study is to compare two different scoring techniques in PSG.Methods:The sleep recordings of 120 patients with obstructive sleep apnoea (OSA) suspicion who underwent PSG at ear nose and throat clinic of Akdeniz University Hospital between January and June 2013 were retrospectively analysed. Patients were divided into 4 groups according to the apnoea-hypopnea index (AHI): AHI30 (severe OSA). There were 30 patients in each group. Manually scored recordings were reanalysed with an automated programme and the results, including sleep stages and respiratory events, were compared.Results:A total of 86.400 epochs of 120 patients were reanalysed. In all patients, the total sleep time and sleep efficiency were decreased with automated scoring by 29 min and 6%, respectively (p=0.001). The percentage of stage I sleep was higher and REM was lower, respectively (p=0.001 for both parameters). In automated scoring, the number of cases of obstructive and central apnoea were lower (p=0.001), and the number of cases of hypopnoea, mean apnoea duration and hypopnoea duration were higher (p=0.001, p=0.001 and p=0.039, respectively). There were no statistically significant differences in the total AHI and REM AHI between two scoring techniques (p=0.053 and p=0.319, respectively). However, NREM AHI was significantly higher in the automated scoring (p=0.002). Sensitivity, specificity, positive predictive value and negative predictive value of automated scoring were 98.88%, 93.33%, 97.80% and 95.55%, respectively.Conclusion:Automated scoring is not sufficiently accurate for many sleep parameters. Inconsistency between the two techniques is apparent, especially in patients with mild to moderate forms of OSA

Evaluation of the relationship between inflammation and bone turnover by sclerostin and Dickkopf-1 (DKK-1) levels in patients with SIRS

Introduction: In intensive care units (ICU), patients remain bedridden for a long time. In addition, severe infections are frequently seen in ICUs. Both prolonged immobilization and serious infections are associated with bone tissue loss. The Wnt pathway has recently been focused on evaluating bone tissue loss. The Wnt pathway participates in both infections and the formation of bone tissue. Wnt pathway inhibitors sclerostin and Dickkopf-1 (DKK-1) inhibit bone formation and increase osteoclastic activity. In this study, we aimed to examine bone turnover by the Wnt inhibitors sclerostin and DKK-1 and their possible associations with inflammation in SIRS patients.Methods: We included 30 patients diagnosed with systemic inflammatory response syndrome (SIRS) in the study group and 16 in the control group. Serum sclerostin, DKK-1, white blood cell (WBC), and C-Reactive Protein (CRP) levels on the day of SIRS diagnosis (basal), the 7th, 14th, and 21stdays were evaluated in the study group, and the results were compared with the control group.Results: When the control group was compared with the basal SIRS, there was a significant elevation in both sclerostin (p=0.003) and DKK-1 (p=0.001). Statistical analysis showed significant decreases in sclerostin levels between basal and the 7th, 14th, and 21st days (p=0.033, p=0.003, p=0.002, respectively). Similarly, significant decreases in DKK-1 levels between basal and the 7th and 21st days (p=0.015, p=0.001, respectively) and an insignificant decrease on the 14th day (p=0.191) was observed. Sclerostin was positively and significantly correlated with WBC and CRP in basal and 7th-day measurements and WBC in 7th and 14th days. DKK-1 is positively and significantly correlated with WBC in basal and 7th-daymeasurements, while DKK-1 negatively correlates with CRP in basal-7th-day measurements.Conclusion: In this study, it was shown for the first time that the Wnt antagonists sclerostin and DKK-1 values are high in SIRS patients in ICU. Both biomarker levels decreased in parallel with the treatment. However, it could not be associated with disease severity and inflammatory marker levels. We believe that monitoring the change of Wnt antagonists will be useful in demonstrating bone turnover in patients with SIRS.Keywords: Dickkopf-1, Intensive care unit, Sclerostin, Systemic inflammatory response syndrome, Wnt signaling pathway, Bone turnove

POLİKİSTİK OVER SENDROMLU HASTALARDA SERUM SKLEROSTİN VE DİCKKOPF-1 SEVİYELERİ

AMAÇ: Polikistik over sendromu (PKOS), premenopozal kadınlarda en sık görülen endokrin patolojidir ve çeşitli sistemleri etkileyen karmaşık bir sendromdur. PKOS'un kemik metabolizması üzerindeki etkileri hakkında çok sayıda çalışma yapılmıştır, ancak PKOS’da osteoporoz riski konusundaki veriler çelişkilidir. Wingless-type mouse mammary tumor virus integration site (Wnt) yolu, kemik metabolizmasının düzenlenmesinde önemli rol oynar. Bu yolun inhibitörleri olarak Sklerostin (Scl) ve Dickkopf-1 (DKK1) son zamanlarda osteoporozun terapötik tedavisiiçin hedefler haline gelmiştir. Bu çalışma, PKOS'lu kadınlarda Scl ve DKK1 düzeylerini belirlemeyi amaçlamıştır.GEREÇ VE YÖNTEM: Bu çalışmada PKOS tanısı konulmuş 36 kadın ve 35 sağlıklı gönüllü retrospektif olarak incelendi. Her iki grup, demografik, antropometrik, biyokimyasal parametrelerin yanı sıra Scl ve DKK1 seviyeleri açısından karşılaştırıldı.BULGULAR: Scl seviyesi, PKOS grubunda 42,68 ± 13,28 pg / mL ve kontrol grubunda 45,69 ± 11,79 pg / mL idi ve istatistiksel olarak benzerdi. DKK1 seviyesi, PKOS grubunda 1444,73 ± 611,30 pg / mL ve kontrol grubunda 1204,26 ± 660,88 pg / mL idi ve istatistiksel olarak benzerdi. PKOS grubunun vücut kitle indeksi (VKİ) ve bel/kalça oranı (BKO) değerleri, istatistiksel olarak anlamlı olmamasına rağmen, kontrol grubuna göre daha yüksekti.SONUÇ: Bu çalışma, PKOS'lu kadınlarla sağlıklı bireyler arasında, Scl ve DKK1 düzeyleri bakımından anlamlı bir fark olmadığını göstermiştir. Amenore PKOS olgularında kemik kaybına neden olsa da, hiperandrojenemi ve hiperöstrojeneminin kemik yoğunluğu üzerindeki olumlu etkileri dengeleyici bir unsur olarak kabul edilebilir

Crisis and crisis management in tourism businesses: A research of five star hotel businesses in Bodrum region

Yüksek Lisans Tezi.YÖK Tez No:454751Son yıllarda yaşanan krizler turizm sektörünü de olumsuz yönde etkilemiştir. Bu bağlamda otel yöneticileri de kriz yönetimine bağlı olarak yeni stratejiler geliştirmeli ve krizi yönetme konusunda daha bilgili ve donanımlı olmalıdırlar. Muğla ilinin Bodrum ilçesinde faaliyet gösteren beş yıldızlı otel işletmelerine yönelik yapılan bu çalışmada anket yöntemiyle elde edilen verilerin spss programında değerlendirilip sonuçları değerlendirilmiştir. Otel işletmelerin yaşamlarını devam ettirmelerin de önemli bir faktör haline gelen kriz. Krizin önlenmesi ya da en azından en az zararla geçmesini sağlamak amacıyla yapılan bu uygulama çalışması işletme yöneticilerinin krize yönelik yaklaşımlarını, krizin etkilerinin değerlendirilmesi, yönetim planının ve ekibinin önemini anlamaları bunun sonucunda işletmelerin uygulayacakları çözüm stratejilerini değerlendirip işletmelerine en uygun strateji bulmalarını hedefleyen bu çalışma üç ana bölümden oluşmaktadır. İlk bölümde kriz kavramı ve yapısı hakkındaki kavramsal açıklamalara yer verilmiştir. İkinci bölümde ise turizm sektöründe kriz yönetimi ve otel işletmelerinin krize karşı uyguladıkları stratejilere ve turizm de meydana gelen krizlerin sebeplerine yer verilmiştir. Üçüncü ve son bölümde ise Muğla ilinin Bodrum ilçesinde faaliyet gösteren beş yıldızlı otel işletmelerine yönelik anket yöntemiyle elde edilen verilerin değerlerine ve yorumlarına yer verilmiştir. Bunun sonucunda çıkan sonuçlara göre bazı demografik özellikler otelin genel düşüncesini etkilediğini diğer yandan bazı demografik özelliklerin ise sadece bazı alanlarda olumlu yönde etkilediği anlaşılmıştır. Bu uygulama çalışmasında otel işletme yöneticilerinin kriz öncesi, anında ve sonrasın da uyguladıkları kriz stratejileri incelenip krizlerin konaklama sektörü üzerine etkileri değerlendirilmiştir.Crises experienced in the recent years influenced tourism sector negatively. In this context, hotel managers should also develop new strategies depending on crisis management and be more knowledgeable and equipped about crises management. In this study that was performed for managements of five star hotels displaying activity in Bodrum County, Muğla City, data obtained by the means of survey method were assessed in SPSS program and results were evaluated. Crisis that became an important factor to survive for hotel managements. This application study which was done to prevent crisis or at least to provide it to be overcome with minimum damage consists of three main parts that aimed at evaluating approaches of hotel managers towards crises, assessment of effects of crisis, understanding the importance of management plan and team and as a consequence solution strategies which the managements shall apply and at finding optimum strategies. In the first part, the conceptual explanation about the concept and nature of crisis are included In the second part, crisis management and strategies applied by hotel managers towards crisis and reasons of crisis in tourism are included. In the third and last part, data values and comments obtained by the means of survey method for the managements of five star hotels displaying activity in Bodrum County, Muğla City are included. According to the consequences as a result of that, it is understood that some demographical features influence the concept of hotel, on the one hand, and that demographical features influence only in some areas positively, on the other hand. In this application study, strategies applied by hotel managers pre-crisis, in the time of crisis or post-crisis were examined and effects of crises on hospitality industry were evaluated

Mısırdaki dini eğitim kurumlarının, politikalarının ve dini eğitime ilişkin söylemlerin sosyolojik bir analizi.

In thesis, I intended to sociologically examine the perceptions and practices of the state and different Islamist groups about the religious education in Egypt from the 1970s onwards. I define the religious education as a religious course to which several hours a week are devoted in the curriculum of mass education, and which teaches moral instructions based on the Qur'an, and basic information about Islamic culture and history. Since the 1970s, the rise of Islamism in Egypt has created strife between the ruling elites and dissident Islamist groups to capture the religious discourse and control the religious socialization in the mass education. This strife has resulted in the emergence of alternative Islamic educational areas (private Islamic schools and Al-Azhar schools). In this context, I used hermeneutic method to analyze the religious educational discourses and institutions of these two main agents ruling elites and Islamist groups. The Mubarak regime in Egypt seeks to institutionalize a particular state discourse in religious education in accordance with its own interests. However, the important thing is the reactions of different Islamist (moderate and radical) groups to this state discourse and institutionalization; because, today, these reactions of opponent Islamist groups generates unintended consequences which are subversive to the legitimacy of the regime.M.S. - Master of Scienc

Retrospective evaluation of chemotherapy regimes administered to patients followed by Uludağ University Faculty Of Medicine, field of hematology due to diagnosis of mantle cell lymphoma

Mantle Hücreli Lenfoma (MHL) agresif seyirli bir B hücre kökenli non-hodgkin lenfoma (NHL) subtipidir. Toplumda görülme sıklığı %5-7 oranındadır. Tüm gelişmelere rağmen birinci basamak tedavide kabul görmüş standart bir tedavi şekli bulunmamaktadır. Her merkez deneyimi, teknik donanımı ve yatak sayısına göre pratikte tedavi seçimi yapmaktadır. Biz çalışmamızda MHL hastalara başlanan kemoterapi türlerini ve etkinliklerini değerlendirmeyi planladık. Çalışmamıza Ocak 2000 - Aralık 2014 tarihleri arasında MHL tanısı konmuş olup kemoterapi başlanan hastalar alındı. Toplamda 26 hasta bulundu ve bunlardan bir tanesi dış merkezden otolog kök hücre nakli (OKHN) açısından değerlendirilmek üzere gönderilmiş olup dosya bilgilerine tam ulaşılamadığı için çalışmaya dahil edilmedi. Toplam 25 hastanın tanıdaki yaşı, evresi, tüm basamaklarda aldıkları kemoterapiler ve tedavi yanıtları, tedaviyle ilişkili komplikasyonlar ve toksisiteler ve OKHN durumları kaydedildi. Ortalama takip süresi 37 (6-132) ay olan çalışmada medyan yaş ortalaması 54 yıldı. Kadın erkek oranı 1/5'ti. Hastaların %92'si ileri evreydi. Birinci basamakta 23 hastaya ayaktan kemoterapi uygulanmış olup en sık R-CHOP (Rituksimab- Siklofosfamid, Doksorubisin, Vinkristin, Prednisolon) rejimi kullanılmıştı. Yanıt oranları değerlendirildiğinde 9 (%36) tam yanıt, 9 (%36) kısmi yanıt, 1 (%6) stabil hastalık ve 6 (%24) progresyon saptandı. Progresyonsuz sağkalım (PFS) 17 (2-39) ay olarak bulundu. Medyan genel sağkalıma (OS) ise ulaşılamadı. 3. ve 5. yıllara ait OS sırasıyla %52 ve %28 saptandı. Oranların literatür ile benzer olduğu görüldü. İkinci basamakta yanıt değerlendirilen 10 hastanın 3 (%30) tam yanıt, 3 (%30) kısmi yanıt, 1 (%10) stabil hastalık ve 3 (%30) progresyon saptandı. Oranların literatür ile benzer olduğu görüldü. Toplam 7 hastaya OKHN yapılmıştı. OKHN yapılan hastalarda genel sağkalım oranları diğerlerine göre yüksek olarak bulundu. Bu durum yüksek riskli genç hastalarda ilk remisyondan sonra OKHN ile konsolidasyon yapılmasının önemini göstermiştir. MHL; kötü prognozlu ve kür şansı olmayan bir hastalıktır. Kemoterapi yanıtlarımıza bakıldığında literatür ile benzer olarak bulundu. Kemoterapi seçiminde hastanın yaşı ve performans durumu göz önüne alınarak tedavi seçimi yapılmalıdır.Retrospective Evaluation of Chemotherapy Regimes Administered to Patients Followed by Uludağ University Faculty of Medicine, Field of Hematology Due to Diagnosis of Mantle Cell Lymphoma Mantle cell lymphoma (MCL) is an aggressive B cell non-Hodgkin lymphoma (NHL) subtype. Its prevalence rate is 5-7% in society. Despite all the developments, a standard treatment method accepted in primary care is not available. Each center performs treatment selection in practice according to experience, technical equipment and number of beds. In our study, we aimed to evaluate the types and efficiencies of chemotherapy applied to the MCL patients. The patients who were diagnosed with MCL between January 2000 and December 2014 and applied with chemotherapy were included in our study. There were 26 patients in total and one of them was sent from the outside center to be evaluated in terms of autologous stem cell transplant (ASCT) and as the file information of this patient could not be obtained fully, the said patient was excluded from the study. The information such as age, stage, chemotherapies taken in all the stages and treatment responses, complications related to the treatment and toxicities, and ASCT conditions in diagnosis of a total of 25 patients were recorded. In the study where the average following period was 37 (6-132) months, the median average age was 54. Proportion of female to male patients was 1/5. 92% of the patients were in the advanced stage. In the first stage, 23 patients were applied with ambulatory chemotherapy, R-CHOP (Rituximab plus cyclophosphamide, Doxorubicin, Vincristin and Prednisolon) regimen was used most frequently. When response rates were evaluated, it was detected that 9 (36%) had complete response, 9 (36%) had partial response, 1 (6%) had stable disease and 6 (24%) had progression. PFS (progression-free survival) was found as 17 (2-39) months. Median OS (overall survival), however, was not found. OS belonging to 3rd and 5th years were detected as 52% and 28%, respectively. It was observed that the rates were similar to the literature. In the 10 patients whose responses were evaluated in the second stage, 3 (30%) had complete response, 3 (30%) had partial response, 1 (10%) had stable disease and 3 (30%) had progression. It was observed that the rates were similar to the literature. A total of 7 patients underwent ASCT. Overall survival rates were found higher in the patients who underwent ASCT than the others. This showed the significance of performing consolidation with ASCT after the first remission in the high risk young patients. MCL is a disease with poor prognosis which cannot be cured. Looking at the chemotherapy responses, they were similar to the literature. Chemotherapy treatment selection should be made by taking the age and performance condition of the patient into consideration