Preoperative arterial embolization of large liver hemangiomas

PURPOSEWe aimed to investigate the efficacy and safety of preoperative selective intra-arterial embolization (PSIAE) in the surgical treatment of large liver hemangiomas.METHODSData of 22 patients who underwent resection of large liver hemangiomas were retrospectively analyzed. PSIAE was performed in cases having a high risk of severe blood loss during surgery (n=11), while it was not applied in cases with a low risk of blood loss (n=11).RESULTSA total of 19 enucleations and six anatomic resections were performed. Operative time, intraoperative bleeding amount, Pringle period, and blood transfusion were comparable between the two groups (P > 0.05, for all). The perioperative serum aspartate transaminase level was not different between groups (P = 1.000). Perioperative total bilirubin levels were significantly increased in the PSIAE group (P = 0.041). Postoperative hospital stay was longer in the PSIAE group. Surgical complications were comparable between groups (P = 0.476).CONCLUSIONPatients who underwent PSIAE due to a high risk of severe blood loss during resection of large liver hemangiomas had comparable operative success as patients with a low risk of blood loss who were operated without PSIAE. Hence, PSIAE can be used for the control of intraoperative blood loss, especially in surgically difficult cases

Firmalarda nakit yönetimi ve nakit yönetiminin banka karlılığı üzerindeki etkileri

Ülke ekonomisinde 1999 yılı sonundan itibaren yaşanan gelişmeler ve 3 yıllık stand-by anlaşması koşulları/öngörüleri gözönüne alındığı zaman görülmektedir ki; bankacılık sektörü açısından düşmekte olan faiz marjları daha da daralacaktır. Bu durumda bankaların nakit yönetimi işlemlerinden elde edecekleri gelirler belki de yukarıda verdiğimiz örnekteki durumdan da çok önem kazanacaktır. Bu şartlar altında 2000 yılının ilk aylarında bireysel kredilere yoğunlaşarak 2000 yılında kar hedeflerini tutturmayı amaçlayan bankalar, önümüzdeki dönemler için nakit yönetimi ürünlerine yoğunlaşacaktır. Çünkü bu ürülerin sağlamış olduğu katkı sayesinde pasif maliyeti düşmekte, bu durum da rekabet gücünü olumlu etkilemektedir. Nakit yönetimi ürünlerinin karlı bir şekilde satılabilmesi için öncelikli olarak personelin konu hakkında yeterli bilinç ve bilgi düzeyine getirlmesi gerekmektedir. Bu konuda kısa süreli eğitimler verilmesi ve düzenli toplantılar yapılması (aylık ve 3 aylık olabilir) gerekmektedir. Pazarlama/fiyatlama çalışmalarında personelin büyük pay alması nedeni ile eğitim ve bilinç eksikliği sonucu küçük küçük tutarlarda ama çok sayıda yanlış ile karşılaşılmaktadır. Bu yanlışlar üst üste toplanınca da Bankaların kaybettiği görünmeyen/ölçülemeyen kar tutarı belki de realize ettiği karı bile aşmaktadır. Bu varsayımımızı destekleyen en önemli göstergeler aktif büyüklüğü, şube sayısı, kredi plasmanı gibi kriterler açısından benzer büyüklükte olan bazı bankaların nakit yönetimi gelirlerinin birbirinden çok farklı tutarlarda gerçekleşmesidir. Son yıllarda birçok bankanın bünyesinde nakit yönetimi bölümlerinin kurulmasından sonra gösterilen performans da bu konudaki boşluğun bir dışavurumudur. İlgili tüm personelin istenen bilinç ve bilgi düzeyine ulaşmasından sonra nakit yönetimi ürünlerinden yaratılacak banka karı, mevcut karın çok daha üstünde gerçekleşecektir. Bir başka önemli sorun da nakit yönetimi ürünlerinin özelliği gereği operasyon yükünü arttırıcı bir etki yapmasıdır. Oysa ki düşen kar marjları nedeni ile sektör için maliyetlerin düşürülmesi büyük önem kazanmıştır. İşte bu noktada hesapların iyi yapılması ve nakit yönetimi politikaları ile kar peşinde koşulurken operasyon maliyetleri nedeni ile reel anlamda zarar edilmemesi gerekmektedir. Örnek verilecek olursa; yapılan her tahsilatın bankaya operasyon maliyeti 1-1.5 $arasında gerçekleşmektedir. Elektrik, su, doğalgaz vb. fatura tahsilatlarından yaratılan vadesiz kaynakların ortalama bankada kalma süresi 1 haftadan daha azdır. Piyasada faizlerin Tahsilat maliyetleri konusunda otomatik tahsilat sistemleri bankaların imdadına yetişmektedir. Bu sistemler ile yapılan tahsilatlarda maliyetler 0.1-0.3$ aralığına düşmekte ve tekrar karlı bir tablo ortaya çıkmaktadır. Bu nedenle bankaların yapması gereken en önemli çalışmalardan birisi de otomatik tahsilat sistemlerinin kullanımını (otomatik ödeme, telefon bankacılığı, internet bankacılığı gibi) müşterileri arasında hızla yaygınlaştırmaktır. Operasyon giderleri sadece tahsilatlarda sözkonusu olmamaktadır. Günlük işlemlerin takibinde de personelin zamanını efektif kullanamaması da banka açısından ciddi bir operasyon gideridir. Şöyle ki; mesainin önemli bir bölümünü müşterilere telefonda bilgi aktarmakla geçiren personel, alternatif bir işi tamamlamaktan mahrum kalmaktadır. Oysa ki alternatif işten kaynaklanan ciddi karlar elde edilemesi mümkün olabilir. Bu durumda bankanın görünmeyen zararları doğmaktadır. Bunun önüne geçmek için de teknolojinin devreye sokulması gerekmektedir. İnternet üzerinden hizmet vermek, müşterilerin kendi hesaplarını takip etmelerine ve bazı işlemlerini yapmalarına olanak sağlayan bilgi ekranlarını yaygınlaştırmak yapılması gereken en önemli işlerdendir. Nitekim son yıllarda sektörde bu konuda yoğun çalışmalar başlatılmış olup, şubelere bilgi ekranı hedefleri gibi hedefler verilmektedir. Son 1 yıl içerisinde yaygınlaşan bir başka uygulama da sürekli çek uygulamasıdır. Bu sayede banka çeklerinin kullanımının yaygınlaşması sağlanmaktadır. Diğer taraftan firmaların nakit akışının banka üzerinden geçirilmesi, bu sayede maliyetsiz kaynak yaratılması ve ücret/komisyon gelirlerinin arttırılması da tüm sektör tarafından uygulanan politikalardır. Bu kapsamda bir çok banka tarafından Doğrudan Borçlandırma Sistemi ve Doğrudan Ödeme Sistemi hizmetleri sunulmaktadır. Bu hizmetlerin yaygınlaştırılması, nakit yönetimi kaynaklı gelirlerin artmasını sağlayacaktır. Yeni nakit yönetimi ürünleri geliştirmek ve piyasaya sunmak ayakta kalmanın temel koşulları haline gelmiştir. Bunun için yeni ürün geliştirmeye yönelik çalışmalar arttırılmalıdır. Dünyada bazı gelişmiş bölgelerde uygulanmaya başlayan "smartcard" sistemleri de çok yakın bir dönemde nakit yönetimi politkalarının odak noktası olacaktır. Akıllı kartların doğrudan bireylere ulaşılmasını sağlaması ve tek tek alındığında önemsiz olan ama toplamda büyük rakamlar oluşturan kaynak yaratması nedeni ile bankalar açısından büyük önem taşımaktadır. Şu anda birçok banka bunun önemini kavramamış gözükmekle birlikte, bazı bankalar sistemi çalıştırmaya bile başlamıştır. Örneğin, Kentbank'ın son yıllarda bu alandaki çalışmaları dikkat çekmektedir. İzmir'de toplu ulaşım araçlarında geçerli olan "Kentkart" ile 700.000 kişiye ulaşılmıştır. Konya'da da benzer sistemin kurulması konusunda kesin anlaşma sağlanmıştır. Diğer büyük illerden de teklifler gelmekte ve çok yakın bir dönemde anlaşmalar imzalanması beklenmektedir. 2000/Ağustos dönemi itibarı ile Kentbank, en çok "smartcard" portföyüne sahip banka konumundadır. Smartcard uygulamasının firmaların (özellikle geniş bir dağıtım ağı olan) hizmetine sunulmasına başlanmıştır. Bu sistemde alıcı konumundaki kişilere/işletmelere akıllı kartlar verilmekte ve alıcıların ödemelerini verilen kartlarla yapması sağlanmaktadır. Yeterli koşulları sağlayan alıcıların kartlarına kredi limiti tanımlanmakta ve akıllı kartlar aynı zamanda kredi kartı gibi de kullanılabilmektedir. Bu durumda hem binlerce kart sahibi kişi/işletmeler mevduatlarını/işlemlerini bankaya yönelendirmekte hem de satıcı konumundaki büyük firmalar bankacılık ürünleri ihtiyaçlarını bankadan sağlamaktadır. Bu sistem, aynı zamanda maliyetsiz kaynak yaratma açısından büyük avantajlar içermektedir. Ayrıca, şu anda belli amaçlarla verilen kartlar (toplu ulaşım ücreti ödemesi veya bir firmanın malının alınması gibi) ileride diğer işlemlerde kullanıma da açılabilir. olarak; bankaların önümüzdeki dönemde yeni nakit yönetimi ürünleri geliştirerek karlılık oranlarını arttırmaya çalışmaları en önemli amaçlardan birisi olmalıdır. Türk Bankalarının nakit yönetimi uygulamalarının incelendiği 5.Bölüm'de de belirtildiği gibi; her ne kadar nakit yönetimi çalışmalarından elde edilen gelirlerin rakamsal olarak tespitinin güç olması ve bu nedenle sektörde birçok banka yönetimince gereken önemin verilmemesi sözkonusu olsa da nakit yönetimi çalışmaları ile sağlanacak kaynaklar sayesinde birçok bankanın karlılığı arzu edilen noktalara ulaşacak ve bankalar rekabet güçlerini koruyabilecektir. SUMMARY The aim of this thesis is to critisize cash management techniques in both firms and banks in Turkey, the USA and some European countries. Since cash management services&operations show the level of relations between banks and firms and have very important roles on the profitability of banks and firms, these operations and services are considered crucial implications in finance world. If we have a look at Turkish banking sector we understand that Turkish banking sector was dominant within the borders of Turkey until 1980's. As a result of openness policies of Özal governments and technological developments throughout the world after 1980's, Turkish banking sector has shown great improvement. When we come to 1990's, Turkish banks have reached a very good service quality and have had enough competition power among the banks in the international area. Having had increase in competition in Turkish banking sector, Turkish banks have started openning new branches abroad. On the other hand, interest revenues were almost all the incomes at the income sheets of the Turkish banks before 1980's. However, other revenues (mostly taken from customers as a service fee) have started taking an important share in income sheets especially at the 1990's. This trend has affected cash management policies. Therefore cash management policies have eventually gained importance for many banks in Turkey. The aim of of cash management policies is to create cheap or free source (money). In order to realize this, using time effectively is the essential rule. The circulation of cash especially in banking, food, tourism etc. sectors, is very dynamic. Thus, all market actors (banks, firms etc.) have to take care of their cash management policies under competitive market conditions. Almost in all sectors, the profit margins have been in a trend of decrease during recent years. So all financial enterprises have to control their income/expenditure positions properly. In other words, they have to carry out a very well operating cash management system. Some important cash management subjects and information related to these subjects are discussed at the first chapter of this thesis. The reason of handling cash by both people and firms, advantages of handling cash, advantages of cash management policies, and some cash management models for firms are also criticised in the above mentioned chapter. "Cash" is generally called as "asset with no return". Cash means "money or current accounts" in the financial markets. Although cash is called as "asset with no return", both people and enterprises need cash every time. Because of the importance of the cash in daily financial operations, harmonizing of cash inflows and cash outflows according to "time" is a must for both people and enterprises. There are three important reasons of handling cash; *Transactional reasons, *Precautinary reasons, *Speculational reasons, On the other hand, there is an asset that is not called as cash but "near cash instrument". As it is easily convertible to cash, it is called as "near cash instrument". For instance; bonds, stocks, foreign currency etc. Many of cash owners invest on near cash instruments for short term periods to maximize their income. There are two important reasons of investing on near cash instruments; *Financing daily and/or periodical operations, *Financing periodical payments such as tax payments, etc. Firms have to make the best cash planning schedule for themselves and according to their cash plan they have to leave no fund surples to maximize their income. Another important subject emphasized on at the first chapter is the importance of collection of claims for the firms. The firms that cannot collect their claims on due, can have some problems on payments. For example; supposedly the firm-ABC has such kind of collection problems. After some time, the suppliers of ABC can have some doubts on financial position of ABC. So the suppliers can hesitate on making forward sales to ABC. This can bring ABC with problems on demand side and can increase the costs of ABC. By the time, ABC begin to face matter of fact, some small cash management problems of today might be the huge problem of the near future for the firm. The first chapter of this thesis is also concentrated on such cases. Besides, some cash management models, which are stated below, are studied at the last of first chapter : *Baumol Model, *Miller-Orr Model, *Beranek Model, *Stone Model, Examples, graphics and tables related to these models are given and also the strengthnesses and weaknesses of these models are evaluated at this part of the thesis. Cash management tecniques and financial sources of firms are examined at the second chapter. Harmonizing cash inflows and cash outflows, collection of checks and payments of checks, clearing system, collection techniques, acceleration tecniques of collections, evaluation tecniques of payments, and evaluation techniques of differences are explained in details. Financial and industrial market conditions of United States and European countries at the two decades are studied at the second chapter. Development in financial markets -especially changes in interest rate- and its effects on cash management are discussed. The firms that have reached a proper financial volume begin to operate in the international markets in developed countries. Parallel to increase in the financial volume of the firms, they need to operate in many cities even in different countries. Therefore such kind of changes in the firms force them to adopt to new markets all over the world. Because the international firms have to work in very different markets with variety of customers, their cash management systems show important differences compare to each other. The banks also have to operate in the international area after reaching enough financial volume in their original local area or country like the firms. International banks, like international firms, have to operate in very different areas/countries compare to each other so that the cash management systems of the international banks differs from one to another. The most suitable cash management systems for international firms and international banks is studied at the second chapter of the thesis. At the beginning of the second chapter, it is given a questionnaire that has been made for some firms operating in European countries. Some questions asked at this questionnaire ; *What kind of changes will be in money transfers within 2 years , *According to which critics the European firms choose their banks, *What kind of newness the Eropean firms plan to make in their structure within 2 years. By the help of the answers in questionnaire, important consequences are obtained related to study. Evaluations on this consequences are given in second chapter. Another important information given in second chapter is about the basic cash management operations. In this part, some subjects related to the topics below are studied; *Basic information about check collections and check payments, *Clearing house system, *Differences between urban/rural checks (in Turkey), *Accounting technics of yield from disbursement checks, *Barter system, *Collection with POS (point-of-sale) system, *Collection systems throughout the money order system, *Collection systems throughout the EFT (electornic fund transmission) system, *EFT system in Turkey, USA, Japan, Switzerland, England and France, *Collection with mail system, *Collection with electronic banking system, Apart from that, techniques used in different countries to accelarate collection system are searched and detailed information about research results are given. In this sense, safe-deposit box system, automatic payment systems, concentration on special banks, rewarding early payments, assigning credit limit, fine for delays in payments, direct lending systems are examined. Like collection systems, payment systems are also studied in second chapter. In this part; important payment systems, payment services of banks, techniques that can be used to delay payments, controlling of payments, centralising of payments, zero-sum accounting system, and direct payment systems are discussed. The evaluation of differences is examined at the last phase of second chapter and information is given about the evaluation of differences between collections and payments. At the third chapter, information about cash management in international firms is considered. Some of important subjects explained are; cash management in international firms, cash management with foreign currency, defencing from potential parity and interest changes, forward, futures, options, swaps, currency market operations, future market agreements, active cash management, structure of international cash management system, and examples from real world. One of the most important developments of the 1980's is that; the diffrence between the national and international markets have lost their importance. Especially in the financial markets, this became more fasten with related to other markets. Technological developments have also affected it in a positive way. The integration process of markets bring together international banks and international firms; however, this situation has created new risks for all sides. As a result of globalization in the international markets, many new financial products have been innovated and have begun to be sold. The most important examples of new financial products are futures, forwards, swaps, and options. Parallel to these developments, money transfer between the countries has become easier and it has been fastened. Firms have started operating in many countries to increase their competition power. Consequently, the importance of cash management has recently increased as compared to previous time. Cash management in international firms has been studied in details at the third chapter. As a result, it has been seen that use of cash management instruments, mentioned in the second chapter, has been changing radically in terms of firms, sectors and countries. However, it has been also understood that in spite of all disorders of cash management operations from country to country, international firms have more advantages in cash management operations in regard to national or local firms. Another important consequence we have reached is that; all international firms, have centralised cash management system or local/area/country oriented cash management system, have to have a very effective payment and collection system. If we concentrate on more details, our first research subject in cash management systems of international firms is on the cash management system operating with foreign currency. Under this topic; additional account, synchronization of cash balances of enterprises in different countries, receiving help from group funds in the need for international cash management operations subjects have been examined. Another important characteristic of cash management is; the protection from potential parity and interest changes are very important. There are many alternative methods for defencing potential risks, but especially forward and future operations are used. Futures operations can be used for protection from risks, speculation, and arbitrage. Information about future tecniques has been given in the third chapter. Forward is a buying/selling agreement and it is based on the fixation of different currencies on a future value. When the agreement due, the currencies are changed between sides according to agreement conditions. Forward is an important standard financial product that is bought/sold in the organized markets. The main function of forward is to prevent the value of a currency according to other currency for a time defined by agreement. So forward can be defined as an important cash management tool. Options is used in both financial markets and real markets. The main function of options agreement is to prevent the owner of agreement from risks. Options agreement has an important difference from other agreements; because the owner of options agreement has a right rooting from agreement, but has no obligation. The detailed information is given about options in this section. Swap is an agreement between two sides that guarantees changing of cash flows at a defined date between sides. Swap agreements can be agreed as two or more forward agreements within one agreement. At the last phase of this chapter, foreign exchange markets operations and arbitrage operations are concerned. At the foreign currency operations part; important information has been given about the risks that come out while making operations with foreign currencies, protection tecniques from currency rates, operation tecniques with currency in future markets. Subjects are also supported by some useful examples related to the issue. Arbitrage is also one of the cash managent tecniques. Arbitrage is used for gaining profit from time, amount, and currency differences. Detailed information about arbitrage techniques has been given at this chapter. Cash management tecniques in banks have been studied at the fourth chapter of thesis. Choice of banks in colloborating cash management, reasons of chosing of local banks, reasons of preference of foreign banks, marketing of cash management services, critics of decisional process in buying services, and cash management policies in some countries are emphasized in this chapter. There are so many useful information about "banks and cash management operations in this part. This information is very helpful to understand the market operations. Especially, the information about bank preferences shows how important the quality of service is and how large branch networks are affected in bank preferences. Banking facilities in East Europe countries after 1990's and reasons of bank preferences between local and international banks

Firmalarda nakit yönetimi ve nakit yönetiminin banka karlılığı üzerindeki etkileri

ÖZETÜlke ekonomisinde 1999 yılı sonundan itibaren yaşanan gelişmeler ve 3 yıllık stand-by anlaşması koşulları/öngörüleri gözönüne alındığı zaman görülmektedir ki; bankacılık sektörü açısından düşmekte olan faiz marjları daha da daralacaktır. Bu durumda bankaların nakit yönetimi işlemlerinden elde edecekleri gelirler belki de yukarıda verdiğimiz örnekteki durumdan da çok önem kazanacaktır. Bu şartlar altında 2000 yılının ilk aylarında bireysel kredilere yoğunlaşarak 2000 yılında kar hedeflerini tutturmayı amaçlayan bankalar, önümüzdeki dönemler için nakit yönetimi ürünlerine yoğunlaşacaktır. Çünkü bu ürülerin sağlamış olduğu katkı sayesinde pasif maliyeti düşmekte, bu durum da rekabet gücünü olumlu etkilemektedir.Nakit yönetimi ürünlerinin karlı bir şekilde satılabilmesi için öncelikli olarak personelin konu hakkında yeterli bilinç ve bilgi düzeyine getirlmesi gerekmektedir. Bu konuda kısa süreli eğitimler verilmesi ve düzenli toplantılar yapılması (aylık ve 3 aylık olabilir) gerekmektedir. Pazarlama/fiyatlama çalışmalarında personelin büyük pay alması nedeni ile eğitim ve bilinç eksikliği sonucu küçük küçük tutarlarda ama çok sayıda yanlış ile karşılaşılmaktadır. Bu yanlışlar üst üste toplanınca da Bankaların kaybettiği görünmeyen/ölçülemeyen kar tutarı belki de realize ettiği karı bile aşmaktadır. Bu varsayımımızı destekleyen en önemli göstergeler aktif büyüklüğü, şube sayısı, kredi plasmanı gibi kriterler açısından benzer büyüklükte olan bazı bankaların nakit yönetimi gelirlerinin birbirinden çok farklı tutarlarda gerçekleşmesidir. Son yıllarda birçok bankanın bünyesinde nakit yönetimi bölümlerinin kurulmasından sonra gösterilen performans da bu konudaki boşluğun bir dışavurumudur. İlgili tüm personelin istenen bilinç ve bilgi düzeyine ulaşmasından sonra nakit yönetimi ürünlerinden yaratılacak banka karı, mevcut karın çok daha üstünde gerçekleşecektir.Bir başka önemli sorun da nakit yönetimi ürünlerinin özelliği gereği operasyon yükünü arttırıcı bir etki yapmasıdır. Oysa ki düşen kar marjları nedeni ile sektör için maliyetlerin düşürülmesi büyük önem kazanmıştır. İşte bu noktada hesapların iyi yapılması ve nakit yönetimi politikaları ile kar peşinde koşulurken operasyon maliyetleri nedeni ile reel anlamda zarar edilmemesi gerekmektedir. Örnek verilecek olursa; yapılan her tahsilatın bankaya operasyon maliyeti 1-1.5 $arasında gerçekleşmektedir. Elektrik, su, doğalgaz vb. fatura tahsilatlarından yaratılan vadesiz kaynakların ortalama bankada kalma süresi 1 haftadan daha azdır. Piyasada faizlerin$ aralığına düşmekte ve tekrar karlı bir tablo ortaya çıkmaktadır. Bu nedenle bankaların yapması gereken en önemli çalışmalardan birisi de otomatik tahsilat sistemlerinin kullanımını (otomatik ödeme, telefon bankacılığı, internet bankacılığı gibi) müşterileri arasında hızla yaygınlaştırmaktır.Operasyon giderleri sadece tahsilatlarda sözkonusu olmamaktadır. Günlük işlemlerin takibinde de personelin zamanını efektif kullanamaması da banka açısından ciddi bir operasyon gideridir. Şöyle ki; mesainin önemli bir bölümünü müşterilere telefonda bilgi aktarmakla geçiren personel, alternatif bir işi tamamlamaktan mahrum kalmaktadır. Oysa ki alternatif işten kaynaklanan ciddi karlar elde edilemesi mümkün olabilir. Bu durumda bankanın görünmeyen zararları doğmaktadır. Bunun önüne geçmek için de teknolojinin devreye sokulması gerekmektedir. İnternet üzerinden hizmet vermek, müşterilerin kendi hesaplarını takip etmelerine ve bazı işlemlerini yapmalarına olanak sağlayan bilgi ekranlarını yaygınlaştırmak yapılması gereken en önemli işlerdendir. Nitekim son yıllarda sektörde bu konuda yoğun çalışmalar başlatılmış olup, şubelere bilgi ekranı hedefleri gibi hedefler verilmektedir. Son 1 yıl içerisinde yaygınlaşan bir başka uygulama da sürekli çek uygulamasıdır. Bu sayede banka çeklerinin kullanımının yaygınlaşması sağlanmaktadır. Diğer taraftan firmaların nakit akışının banka üzerinden geçirilmesi, bu sayede maliyetsiz kaynak yaratılması ve ücret/komisyon gelirlerinin arttırılması da tüm sektör tarafından uygulanan politikalardır. Bu kapsamda bir çok banka tarafından Doğrudan Borçlandırma Sistemi ve Doğrudan Ödeme Sistemi hizmetleri sunulmaktadır. Bu hizmetlerin yaygınlaştırılması, nakit yönetimi kaynaklı gelirlerin artmasını sağlayacaktır.Yeni nakit yönetimi ürünleri geliştirmek ve piyasaya sunmak ayakta kalmanın temel koşulları haline gelmiştir. Bunun için yeni ürün geliştirmeye yönelik çalışmalar arttırılmalıdır. Dünyada bazı gelişmiş bölgelerde uygulanmaya başlayan "smartcard" sistemleri de çok yakın bir dönemde nakit yönetimi politkalarının odak noktası olacaktır. Akıllı kartların doğrudan bireylere ulaşılmasını sağlaması ve tek tek alındığında önemsiz olan ama toplamda büyük rakamlar oluşturan kaynak yaratması nedeni ile bankalar açısından büyük önem taşımaktadır. Şu anda birçok banka bunun önemini kavramamış gözükmekle birlikte, bazı bankalar sistemi çalıştırmaya bile başlamıştır. Örneğin, Kentbank'ın son yıllarda bu alandaki çalışmaları dikkat çekmektedir. İzmir'de toplu ulaşım araçlarında geçerli olan "Kentkart" ile 700.000 kişiye ulaşılmıştır. Konya'da da benzer sistemin kurulması konusunda kesin anlaşma sağlanmıştır. Diğer büyük illerden de teklifler gelmekte ve çok yakın bir dönemde anlaşmalar imzalanması beklenmektedir. 2000/Ağustos dönemi itibarı ile Kentbank, en çok "smartcard" portföyüne sahip banka konumundadır.Smartcard uygulamasının firmaların (özellikle geniş bir dağıtım ağı olan) hizmetine sunulmasına başlanmıştır. Bu sistemde alıcı konumundaki kişilere/işletmelere akıllı kartlar verilmekte ve alıcıların ödemelerini verilen kartlarla yapması sağlanmaktadır. Yeterli koşulları sağlayan alıcıların kartlarına kredi limiti tanımlanmakta ve akıllı kartlar aynı zamanda kredi kartı gibi de kullanılabilmektedir. Bu durumda hem binlerce kart sahibi kişi/işletmeler mevduatlarını/işlemlerini bankaya yönelendirmekte hem de satıcı konumundaki büyük firmalar bankacılık ürünleri ihtiyaçlarını bankadan sağlamaktadır. Bu sistem, aynı zamanda maliyetsiz kaynak yaratma açısından büyük avantajlar içermektedir. Ayrıca, şu anda belli amaçlarla verilen kartlar (toplu ulaşım ücreti ödemesi veya bir firmanın malının alınması gibi) ileride diğer işlemlerde kullanıma da açılabilir. Özet olarak; bankaların önümüzdeki dönemde yeni nakit yönetimi ürünleri geliştirerek karlılık oranlarını arttırmaya çalışmaları en önemli amaçlardan birisi olmalıdır. Türk Bankalarının nakit yönetimi uygulamalarının incelendiği 5.Bölüm'de de belirtildiği gibi; her ne kadar nakit yönetimi çalışmalarından elde edilen gelirlerin rakamsal olarak tespitinin güç olması ve bu nedenle sektörde birçok banka yönetimince gereken önemin verilmemesi sözkonusu olsa da nakit yönetimi çalışmaları ile sağlanacak kaynaklar sayesinde birçok bankanın karlılığı arzu edilen noktalara ulaşacak ve bankalar rekabet güçlerini koruyabilecektir.SUMMARYThe aim of this thesis is to critisize cash management techniques in both firms and banks in Turkey, the USA and some European countries. Since cash management services&operations show the level of relations between banks and firms and have very important roles on the profitability of banks and firms, these operations and services are considered crucial implications in finance world.If we have a look at Turkish banking sector we understand that Turkish banking sector was dominant within the borders of Turkey until 1980's. As a result of openness policies of Özal governments and technological developments throughout the world after 1980's, Turkish banking sector has shown great improvement. When we come to 1990's, Turkish banks have reached a very good service quality and have had enough competition power among the banks in the international area.Having had increase in competition in Turkish banking sector, Turkish banks have started openning new branches abroad. On the other hand, interest revenues were almost all the incomes at the income sheets of the Turkish banks before 1980's. However, other revenues (mostly taken from customers as a service fee) have started taking an important share in income sheets especially at the 1990's. This trend has affected cash management policies. Therefore cash management policies have eventually gained importance for many banks in Turkey.The aim of of cash management policies is to create cheap or free source (money). In order to realize this, using time effectively is the essential rule.The circulation of cash especially in banking, food, tourism etc. sectors, is very dynamic. Thus, all market actors (banks, firms etc.) have to take care of their cash management policies under competitive market conditions. Almost in all sectors, the profit margins have been in a trend of decrease during recent years. So all financial enterprises have to control their income/expenditure positions properly. In other words, they have to carry out a very well operating cash management system. Some important cash management subjects and information related to these subjects are discussed at the first chapter of this thesis. The reason of handling cash by both people and firms, advantages of handling cash, advantages of cash management policies, and some cash management models for firms are also criticised in the above mentioned chapter."Cash" is generally called as "asset with no return". Cash means "money or current accounts" in the financial markets. Although cash is called as "asset with no return", both people and enterprises need cash every time. Because of the importance of the cash in daily financial operations, harmonizing of cash inflows and cash outflows according to "time" is a must for both people and enterprises. There are three important reasons of handling cash;*Transactional reasons,*Precautinary reasons,*Speculational reasons,On the other hand, there is an asset that is not called as cash but "near cash instrument". As it is easily convertible to cash, it is called as "near cash instrument". For instance; bonds, stocks, foreign currency etc. Many of cash owners invest on near cash instruments for short term periods to maximize their income. There are two important reasons of investing on near cash instruments;*Financing daily and/or periodical operations,*Financing periodical payments such as tax payments, etc.Firms have to make the best cash planning schedule for themselves and according to their cash plan they have to leave no fund surples to maximize their income.Another important subject emphasized on at the first chapter is the importance of collection of claims for the firms. The firms that cannot collect their claims on due, can have some problems on payments. For example; supposedly the firm-ABC has such kind of collection problems. After some time, the suppliers of ABC can have some doubts on financial position of ABC. So the suppliers can hesitate on making forward sales to ABC. This can bring ABC with problems on demand side and can increase the costs of ABC. By the time, ABC begin to face matter of fact, some small cash management problems of today might be the huge problem of the near future for the firm. The first chapter of this thesis is also concentrated on such cases.Besides, some cash management models, which are stated below, are studied at the last of first chapter :*Baumol Model,*Miller-Orr Model,*Beranek Model,*Stone Model,Examples, graphics and tables related to these models are given and also the strengthnesses and weaknesses of these models are evaluated at this part of the thesis.Cash management tecniques and financial sources of firms are examined at the second chapter. Harmonizing cash inflows and cash outflows, collection of checks and payments of checks, clearing system, collection techniques, acceleration tecniques of collections, evaluation tecniques of payments, and evaluation techniques of differences are explained in details.Financial and industrial market conditions of United States and European countries at the two decades are studied at the second chapter. Development in financial markets -especially changes in interest rate- and its effects on cash management are discussed. The firms that have reached a proper financial volume begin to operate in the international markets in developed countries. Parallel to increase in the financial volume of the firms, they need to operate in many cities even in different countries. Therefore such kind of changes in the firms force them to adopt to new markets all over the world.Because the international firms have to work in very different markets with variety of customers, their cash management systems show important differences compare to each other. The banks also have to operate in the international area after reaching enough financial volume in their original local area or country like the firms. International banks, like international firms, have to operate in very different areas/countries compare to each other so that the cash management systems of the international banks differs from one to another. The most suitable cash management systems for international firms and international banks is studied at the second chapter of the thesis.At the beginning of the second chapter, it is given a questionnaire that has been made for some firms operating in European countries. Some questions asked at this questionnaire ; *What kind of changes will be in money transfers within 2 years ,*According to which critics the European firms choose their banks,*What kind of newness the Eropean firms plan to make in their structure within 2 years.By the help of the answers in questionnaire, important consequences are obtained related to study. Evaluations on this consequences are given in second chapter.Another important information given in second chapter is about the basic cash management operations. In this part, some subjects related to the topics below are studied;*Basic information about check collections and check payments,*Clearing house system,*Differences between urban/rural checks (in Turkey),*Accounting technics of yield from disbursement checks,*Barter system,*Collection with POS (point-of-sale) system,*Collection systems throughout the money order system,*Collection systems throughout the EFT (electornic fund transmission) system,*EFT system in Turkey, USA, Japan, Switzerland, England and France,*Collection with mail system,*Collection with electronic banking system,Apart from that, techniques used in different countries to accelarate collection system are searched and detailed information about research results are given. In this sense, safe-deposit box system, automatic payment systems, concentration on special banks, rewarding early payments, assigning credit limit, fine for delays in payments, direct lending systems are examined.Like collection systems, payment systems are also studied in second chapter. In this part; important payment systems, payment services of banks, techniques that can be used to delay payments, controlling of payments, centralising of payments, zero-sum accounting system, and direct payment systems are discussed.The evaluation of differences is examined at the last phase of second chapter and information is given about the evaluation of differences between collections and payments.At the third chapter, information about cash management in international firms is considered. Some of important subjects explained are; cash management in international firms, cash management with foreign currency, defencing from potential parity and interest changes, forward, futures, options, swaps, currency market operations, future market agreements, active cash management, structure of international cash management system, and examples from real world.One of the most important developments of the 1980's is that; the diffrence between the national and international markets have lost their importance. Especially in the financial markets, this became more fasten with related to other markets. Technological developments have also affected it in a positive way. The integration process of markets bring together international banks and international firms; however, this situation has created new risks for all sides.As a result of globalization in the international markets, many new financial products have been innovated and have begun to be sold. The most important examples of new financial products are futures, forwards, swaps, and options. Parallel to these developments, money transfer between the countries has become easier and it has been fastened. Firms have started operating in many countries to increase their competition power. Consequently, the importance of cash management has recently increased as compared to previous time.Cash management in international firms has been studied in details at the third chapter. As a result, it has been seen that use of cash management instruments, mentioned in the second chapter, has been changing radically in terms of firms, sectors and countries. However, it has been also understood that in spite of all disorders of cash management operations from country to country, international firms have more advantages in cash management operations in regard to national or local firms. Another important consequence we have reached is that; all international firms, have centralised cash management system or local/area/country oriented cash management system, have to have a very effective payment and collection system.If we concentrate on more details, our first research subject in cash management systems of international firms is on the cash management system operating with foreign currency. Under this topic; additional account, synchronization of cash balances of enterprises in different countries, receiving help from group funds in the need for international cash management operations subjects have been examined. Another important characteristic of cash management is; the protection from potential parity and interest changes are very important. There are many alternative methods for defencing potential risks, but especially forward and future operations are used. Futures operations can be used for protection from risks, speculation, and arbitrage. Information about future tecniques has been given in the third chapter.Forward is a buying/selling agreement and it is based on the fixation of different currencies on a future value. When the agreement due, the currencies are changed between sides according to agreement conditions. Forward is an important standard financial product that is bought/sold in the organized markets. The main function of forward is to prevent the value of a currency according to other currency for a time defined by agreement. So forward can be defined as an important cash management tool.Options is used in both financial markets and real markets. The main function of options agreement is to prevent the owner of agreement from risks. Options agreement has an important difference from other agreements; because the owner of options agreement has a right rooting from agreement, but has no obligation. The detailed information is given about options in this section.Swap is an agreement between two sides that guarantees changing of cash flows at a defined date between sides. Swap agreements can be agreed as two or more forward agreements within one agreement.At the last phase of this chapter, foreign exchange markets operations and arbitrage operations are concerned. At the foreign currency operations part; important information has been given about the risks that come out while making operations with foreign currencies, protection tecniques from currency rates, operation tecniques with currency in future markets. Subjects are also supported by some useful examples related to the issue.Arbitrage is also one of the cash managent tecniques. Arbitrage is used for gaining profit from time, amount, and currency differences. Detailed information about arbitrage techniques has been given at this chapter.Cash management tecniques in banks have been studied at the fourth chapter of thesis. Choice of banks in colloborating cash management, reasons of chosing of local banks, reasons of preference of foreign banks, marketing of cash management services, critics of decisional process in buying services, and cash management policies in some countries are emphasized in this chapter.There are so many useful information about "banks and cash management operations in this part. This information is very helpful to understand the market operations. Especially, the information about bank preferences shows how important the quality of service is and how large branch networks are affected in bank preferences. Banking facilities in East Europe countries after 1990's and reasons of bank preferences between local and international banks in East Europe countries are examined in this part of study.On the other hand, marketing facilities of banks in

Effect of pack-boriding on the tribological behavior of Hardox 450 and HiTuf Steels

In this study, Hardox 450 and HiTuf steels were boronized by pack-boriding method at 800, 900, and 1000∘C for 5 h. The phases, microstructure, hardness, and wear behavior of boride layers formed on the surface of samples were investigated using XRD, SEM, Micro-Vickers hardness testers, and a pin-on-disc tribotester, respectively. XRD analysis showed that both FeB and Fe2B phases were formed in the borided area of Hardox 450 steel, but only Fe2B phase occurred in the boride layer of the HiTuf steel. Micro-Vickers hardness results indicated that the hardness values of the boride layer decreased from the column-shaped structure to towards the matrix in both of Hardox 450 and HiTuf steels. Furthermore, the wear test results showed the coefficients of friction (COF) decreased significantly in the borided samples. The COF of the unborided Hardox 450 steel was reduced considerably from 0.29 to 0.02 by boriding treatment. Similarly, the COF of unborided HiTuf steel was significantly diminished from 0.16 to 0.04 by boriding treatment. In conclusion, the results of this study have indicated that the wear resistance of Hardox 450 and HiTuf steels can be improved by pack-boriding

Intensive Pulmonary Care After Liver Surgery: A Retrospective Survey From a Single Center

https://doi.org/10.1016/j.transproceed.2013.04.002</a

Surgical Trends in Breast Cancer in Turkey: An Increase in Breast-Conserving Surgery

PURPOSEBreast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018.PATIENTS AND METHODSBetween January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients' choices, surgical approaches, and academic institutions.RESULTSAll surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery.CONCLUSIONIncreasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey

Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study

WOS: 000384041400052PubMed ID: 27583892This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance 50mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of 3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients