BMP-9 ve TGF-ß3 eklenmiş kondrojenik farklılaşma medyumunun transwell ko-kültürde hipertrofi üzerine etkisi

Mesenchymal stem cells are widely used in the treatment of many diseases, including osteoarthritis, due to their ability to differentiate into cartilage. The high chondrogenic differentiation potential of synovial fluid-derived mesenchymal stem cells increases the importance of these cells in osteoarthritis treatments. Addition of BMP-9 and TGF-ß3 into chondrogenic differentiation medium, increases chondrogenic differentiation and they also cause hypertrophic effects on chondrocytes. In our study, it was aimed to demonstrate the effects of BMP-9 and TGF-ß3 on cell hypertrophy by adding them into the chondrogenic basal medium during in vitro chondrogenic differentiation. In the study, stem cells in passage 5 and chondrocytes in passage 1 were cultured in a transwell co-culture system and six experimental groups were formed. Cell hypertrophy was demonstrated by examining MMP-13 and RUNX-2 gene expressions, in stem cells where chondrogenesis were induced in transwell co-culture. Although the addition of BMP-9 and TGF-ß3 to the chondrogenic medium increased hypertrophic gene expressions in experimental groups compared to control, the results were not statistically significant. The addition of BMP-9 and TGF-ß3, separately or in combination, during the chondrogenic differentiation of stem cells does not cause significant chondrocyte hypertrophy.Mezenkimal kök hücreler, kıkırdağa farklılaşma yetenekleri nedeniyle osteoartrit dahil birçok hastalığın tedavisinde yaygın olarak kullanılmaktadır. Sinoviyal sıvı kökenli mezenkimal kök hücrelerinin kondrojenik farklılaşma potansiyellerinin fazla olması bu hücrelerin osteoartrit tedavilerindeki önemini artırmaktadır. Kondrojenik farklılaşma medyumuna ilave edilen BMP-9 ve TGF-ß3 büyüme faktörleri kondrojenik farklılaşmayı artırır ve aynı zamanda kondrositlerde hipertofik etkilere sebep olur. Çalışmamızda in vitro kondrojenik farklılaşma esnasında kondrojenik bazal medyuma ilave edilen BMP-9 ve TGF-ß3’ün hücre hipertrofisi üzerine etkilerinin gösterilmesi amaçlandı. Çalışmada transwell ko-kültür sisteminde 5. pasajdaki kök hücreler ve pasaj 1'deki kondrositler birlikte kültüre edildi ve altı deney grubu oluşturuldu. Hücre hipertrofisi, transwell ko-kültüründe kondrogenezin indüklendiği kök hücrelerde MMP-13 ve RUNX-2 gen ekspresyonları incelenerek gösterildi. BMP-9 ve TGF-ß3'ün kondrojenik ortama eklenmesi, kontrol grubuna göre deney gruplarında hipertrofik gen ekspresyonlarını artırmasına rağmen bu artış istatistiksel olarak anlamlı değildi. Kök hücrelerin kondrojenik farklılaşması esnasında BMP-9 ve TGF-ß3’ün ayrı ayrı veya birlikte kullanılması önemli derecede kıkırdak hücresi hipertrofisine neden olmamaktadır

Cardiovascular etiology with report of 3 cases in differential diagnosis of epilepsy

Epilepsi çocukluk çağında %0.5-1 oranında görülen, tekrarlayıcı nöbetlerden oluşan klinik bir tablodur. Çocukluk çağında senkop görülme insidansı %15 olup, acil servise nöbetle başvuruların%3-5'ine senkop neden olmaktadır. Genel populasyonda senkopun epilepsiden daha yaygın görülmesine rağmen, bilinç kaybı ve nöbetle başvuran hastalarda genellikle akla ilk olarak epilepsi gelmektedir. Ayrıntılı tetkikler basta senkop ve diğer kardiyojenik kökenli hastalıklar olmak üzere diğer non-epileptik paroksizmal olayların da bilinç kaybının nedeni olduğunu gösterebilir. Bu yazıda çocuk acil servisi ve çocuk nörolojisi polikliniğine bilinç kaybıyla başvuran ve tetkiklerinde kardiyovasküler nedenler saptanan üç olgu sunularak, epilepsi ayırıcı tanısında kardiyojenik kökenli senkopların mutlaka hatırlanması gerektiği vurgulandı.Epilepsy is a disorder with an incidence of 0.5-1.0% in childhood and characterized by recurrent seizures. The incidence of syncope in childhood is 15% and it causes 3-5% of admissions to the emergency department. Although syncope is more frequent than epilepsy in general population, usually epilepsy is the first pre-diagnosis in patients with loss of consciousness and seizures. Detailed investigations may show other reasons like syncope and cardiologic diseases as the cause of loss of consciousness. In this paper,we present 3 patients admitted to the pediatric emergency department and pediatric neurology clinic with cardiovascular reasons in the etiology of loss of consciousness and pointed out that cardiac syncope should be remembered in the differential diagnosis of epilepsy

The views of provincial educational supervisors on the fifth grade students’ obstacles for reaching to objectives and acquisition of Turkish courseİl eğitim denetmenlerinin gözünden 5. sınıf öğrencilerinin Türkçe dersi amaç ve kazanımlarına erişmesinin önündeki engeller

This study was carried out for the aim of determining the 5th grade students’ obstacles for reaching to objectives and acquisitions of Turkish courses, from the viewpoints of provincial educational supervisors. This study was practiced with 19 provincial educational supervisors working in Adıyaman, Elazığ and Malatya, who check Turkish courses. The data were gathered by qualitative inquiry and semi-structured interviews were adopted. The data were analyzed by content analysis. Supervisor views were sub-categorized by coding. They were handled with from the main themes such as teacher, student, material, school managing; and 16 sub-themes related to main themes. Results indicated that teacher factor was determined the most important obstacle for students to reach to objectives and acquisitions of Turkish courses. This is followed by problems arising from student, material, and school managing. Ignorance of existing students’ problems by teachers, writing problems of students, course book problems, these problems were determined other sub-themes for students not to reach to objectives and acquisitions of Turkish courses. ÖzetBu araştırma, 5. sınıf Türkçe dersinin amaç/kazanımlarına öğrencilerin erişmesinin önündeki engelleri il eğitim denetmenlerinin görüşlerine dayalı olarak belirlemek amacıyla yapılmıştır. Araştırma; Adıyaman, Elazığ ve Malatya illerinde görev yapan ve Türkçe derslerini denetleyen 19 il eğitim denetmeniyle yürütülmüştür. Araştırmaya ilişkin veriler, nitel araştırma yöntemiyle toplanmış ve denetmenlerle yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Yapılan görüşmelerden elde edilen veriler, içerik analizi tekniği ile incelenmiştir.  Denetmen görüşleri, kodlanarak alt kategorilere ayrılmış; öğretmen, öğrenci, materyal, okul idaresi ana temaları ve bu temalarla ilişkili 16 alt temaya göre ele alınmıştır. Araştırma sonuçlarına göre; öğretmen faktörü, öğrencilerin Türkçe dersinin amaç/ kazanımlarına erişmesinin önündeki en önemli engel olarak tespit edilmiştir. Bunu; öğrenci, materyal ve okul idaresinden kaynaklanan sorunlar takip etmektedir. Öğrencinin gelişim özelliklerinin öğretmen tarafından bilinmemesi, öğrencinin yazma sorunu, ders kitabı ve okul idaresi denetleme sorunu ise 5. sınıf Türkçe dersinin amaç/kazanımlarına öğrencilerin erişmesinin önündeki engelleri oluşturan diğer alt temalar olarak tespit edilmiştir

The association of silicosis severity with pectoralis major muscle and subcutaneous fat volumes and the pulmonary artery/aorta ratio evaluated by CT

PURPOSESilicosis is an incurable occupational disease that sometimes rapidly progresses with fatal outcomes. We aimed to evaluate the association between disease severity and the change in the pectoralis major muscle volume (PMV), subcutaneous fat volume (SFV), and the pulmonary artery/aorta (P/Ao) ratio in patients with silicosis using computed tomography (CT).METHODSThe study included 41 male silicosis patients and 41 control group subjects with available chest CT images. Using dedicated software, we measured PMV and SFV from the axial CT images. We calculated the P/Ao ratio and obtained body mass index (BMI) and forced expiratory volume/forced vital capacity (FEV1/FVC) results from hospital records. We used the chest X-ray profusion score according to the International Labor Organization (ILO) classification to evaluate the severity of the silicosis.RESULTSThe mean age was 33.5±4.4 and 34.7±4.7 years in the silicotic and control groups, respectively. The mean BMI, PMV, SFV, and P/Ao values significantly differed between the study and control groups (P = 0.0009, P < 0.0001, P < 0.0001, and P = 0.0029, respectively). According to the ILO classification, there were 12 silicosis patients in category 1, 13 in category 2, and 16 in category 3. A significant difference was found between disease categories in terms of PMV, SFV, P/Ao, BMI, and FEV1/FVC values (P = 0.0425, P = 0.0341, P = 0.0002, P = 0.0492, and P = 0.0004, respectively).CONCLUSIONDisease severity had a stronger association with decreased PMV and SFV and increased P/Ao ratios than BMI in patients with silicosis caused by denim sandblasting. Thus, CT evaluation might be a useful indicator of disease severity

Effectiveness of immediate appointment scheduling in smoking cessation clinics for patients with chronic airway diseases: Preliminary results from a randomized trial

INTRODUCTION Patients with airway diseases who bear the burden of smoking need access to smoking cessation support. We aimed to investigate the impact of immediately scheduled appointments on access to smoking cessation compared with usual care in this patient group. METHODS This multicenter, prospective, randomized, open-label study conducted between November 2022 and June 2023 at pulmonary outpatient clinics. The study included adult patients who were current smokers and diagnosis of asthma, COPD, or bronchiectasis for at least six months. Sequentially randomization was used for the allocation of patients in a 1:1 ratio to two arms: the usual support arm (representing the current standard care procedure) and the immediate support arm (involving intensive brief cessation advice followed by the immediate arrangement of an appointment at the same clinic's smoking cessation service). After one week, both patient groups were contacted by phone to assess their quit attempts and whether they had sought assistance from smoking cessation outpatient clinics (SCCs). RESULTS A total of 397 patients were enrolled in the study, with 199 allocated usual support arm and 198 allocated to the immediate support arm. Within first week, 18.1% of patients in the usual support arm and 77.3% of patients the immediate support arm sought assistance from the smoking cessation (p<0.001). The rate of smokers without an intention to quit was 56.7% usual support arm and 27.7% in the immediate support arm in the first of follow-up. Immediate appointment scheduling was significantly associated with a 13-fold (OR=13.38; 95% CI: 8.00-22.38) increase in referral rates multivariate logistic regression model. CONCLUSIONS Arranging instant appointments has increased access to SCCs times compared to the usual care, this group of patients should be given immediate appointment to SCCs

Post-covid interstitial lung disease: how do we deal with this new entity?

Background: In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease. Aims: To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD. Study design: Multicenter cross-sectional analysis of data from a randomized clinical study. Methods: In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT). Results: At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%). Conclusion: The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term “fibrosis” should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients

A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera

Introduction:Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV).Methods:A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: ≥35%) by imaging and control of hematocrit levels (≤45%) compared to baseline.Results:While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman’s rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman’s rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher’s exact test: p=0.033).Conclusion:This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups

Sermaye piyasası aracı kurumlarında muhasebe düzeni

ÖZETSERMAYE PİYASASI ARACI KURUMLARINDA MUHASEBE DÜZENİSermaye piyasası, orta ve uzun vadeli fon arz ve talebinin karşılaştığı piyasadır. Sermaye piyasası aracı kurumları, sermaye piyasasına fon arz edenler ile sermaye piyasasından fon talep edenleri buluşturan kurumlardır. Sermaye piyasası aracı kurumlarının muhasebe düzeni, faaliyet alanlarının diğer işletmelerden farklılığı nedeniyle, kendine has birtakım özelliklere sahiptir. Hesap planı, kayıt düzeni, muhasebe belgeleri ve muhasebe defterlerinde diğer işletmelerden önemli farklılıklar gözlenmektedir. Buna karşın sermaye piyasası aracı kurumlarının finansal tablolarının Uluslararası Muhasebe/Finansal Raporlama Standartlarına uygun şekilde düzenlenmesi muhasebede dil birliğinin oluşmasına katkı sağlamıştır. Bu çalışmada, sermaye piyasası aracı kurumlarının muhasebe düzeni derinlemesine incelenmiş ve konuyla ilgili bir uygulamaya yer verilmiştir. ABSTRACTACCOUNTING SYSTEM OF CAPITAL MARKET BROKERAGESMedium and long-term fund offer and fund demand encounters in capital markets. Brokerages get together fund offerers and fund demandants in capital markets. Brokerages accounting system includes some specific properties. Because field of activities of brokerages are different from other businesses. There are differences at chart of accounts, record order, accountable receipts and book of accounts of brokerages from other businesses. But brokerages financial statements are arranged according to International Accounting/Financial Reporting Standarts and this case has contributed to use same language in accounting. In this study brokerages accounting system is analyzed deeply and practise has been made related to the subject