Cost-Effectiveness of Online Hemodiafiltration

Care of patients with end-stage renal disease (ESRD) is essential but also resource intense. We review several studies on online hemodiafiltration (OL-HDF), which concluded that high-volume OL-HDF is associated with better outcome compared to conventional hemodialysis. The cost-effectiveness of OL-HDF was shown in many studies. For example, in the Canadian setting of the Convective Transport Study (CONTRAST), the high-efficiency OL-HDF was shown to be cost-effective compared with low-flux hemodialysis (LF-HD) for patients with ESRD. In our study (Al Saran et al.), it was shown that the cost of hemodialysis was quite less in Saudi Arabia than in other industrialized countries while maintaining a high standard of care. In our retrospective analysis of the cost of OL-HDF in the same center, it was only 3% higher than the conventional HD, which indicates that it is cost-effective considering the improved hospitalization rate, the mortality rates, and the likely better quality of life associated with it. The trend of increased practice of OL-HDF may encourage the practice of home OL-HDF as well. It has been shown that home HD is more cost-effective than in-center HD and we presume that the same results will be applied to home OL-HDF as well

Sapanca Gölü’nde yaşayan sazan balığının (cyprinus carpio) biyolojisi ve hematolojik parametrelerinin belirlenmesi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Bu çalışmada Sapanca Gölü'nden yakalanan Sazan balıklarının (Cyprinus carpio) biyolojileri ve hematolojik parametreleri incelenerek aylık olarak hematolojik analizleri, balıkların uzunluk, ağırlık, yaş ve cinsiyet gibi metrik ve biyolojik özellikleri tespit edilip, çevresel faktörlerden etkilenip etkilenmediği belirlenmeye çalışılmıştır. Buna bağlı olarak Sazan Balığı (Cyprinus carpio) örnekleri biyolojileri ve hematolojik parametreler yönünden incelenerek aylık olarak hematolojik analizlerin, balıkların uzunluk, ağırlık, yaş ve cinsiyet gibi metrik ve biyolojik özellikleri tespit edilip, balıkların kan örneklerinden eritrosit, lökosit ve trombosit sayıları, hematokrit, hemoglobin miktarı, ortalama eritrosit hacmi (MCV), ortalama eritrosit hemoglobini (MCH) ve ortalama eritrosit hemoglobini konsantrasyonu (MCHC) değerleri tespit edilerek, elde edilen kan parametrelerinin uzunluk ve ağırlık grupları ile cinsiyete ve yaşa göre dağılımları belirlenmiştir. Bulunan değerlere göre eritrosit miktarı, hemoglobin miktarı ve hematokrit değeri ocak ve mart aylarında diğer aylara göre daha düşük, ortalama eritrosit hemoglobini (MCH) ve ortalama eritrosit hacmi (MCV) değerlerinin mayıs ayında daha yüksek, ortalama eritrosit hemoglobini konsantrasyonu (MCHC) değerinin ise mart ayında diğer aylara göre artış miktarının daha az olduğu saptanmıştır. Yakalanan balıkları ağırlıklarına göre minimum ve maksimum değerlerine bakıldığında sadece lökosit miktarının değişmediği gözlenmiştir. Boylarına göre karşılaştırıldığında ise eritrosit miktarı, hemoglobin, hematokrit ve ortalama eritrosit hemoglobini (MCH) değerlerinde artış gözlenmiştir. Yaşlarına göre kıyaslandığında ise eritrosit hematokrit, hemoglobin miktarı, ortalama eritrosit hacmi (MCV), ortalama eritrosit hemoglobini (MCH) ve ortalama eritrosit hemoglobin konsantrasyonu (MCHC) değerlerinde artış gözlenmiştir. Anahtar kelimeler: Sapanca Gölü, Sazan Balığı, Su Kirliliği, Hematolojik parametrelerIn this study, the carp fish (Cyprinus carpio), catched from Sapanca Lake, examined its biology and hematologic parameters monthly, its metric and biologic properties such as; leghth weight, age, and gender determined and within these datas tried to determine whether they are effected by the environmental factors. Correspondingly, carp (Cyprinus carpio), samples were studied based on their biology and hematalogic parameters monthly, their biologic and metric properties such as; legth, weight, age and gender determined and their hematologic analyses, from fish blood samples; count of erythrocyte, leukocyte, and thrombocyte, amounth of hemoglobin and hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) values determined and these blood parameters' distrubution in between legth and weight groups and according to age and gender determined. According to the found datas, amount of hemoglobin and hematocrit values of January and March were found lower, mean corpuscular hemoglobin (MCH) and hematocrit, mean corpuscular volume (MCV) values for May were found higher, on the other hand, mean corpuscular hemoglobin concentration (MCHC) for March was found lower compared to the other months. Based on the catched fish' minimum and maximum weight values, it was observed that only amount of leukocyte didn't alterded. Based on the lenght comparision, amount of erythrocyte, hemoglobin, hematocrit and mean corpuscular hemoglobin (MCH) values were observerd as increased. Based on the age comparision, amount of erythrocyte, hemoglobin, hematocrit and mean corpuscular hemoglobin (MCH) and corpuscular hemoglobin concentration (MCHC) observed that they were increased. Keywords: Sapanca lake, carp fish, water pollution, haematological parameter

THE INVESTIGATION OF THE EFFECT OF GAS MIXTURES ON ION NITRIDING

Bu çalışmada, AISI 8620 çeliği farklı gaz karışımlarında sertleştirilerek, optimum sertlik değerleri, difüzyon tabakası derinliği ve beyaz tabaka değişimleri incelenmiştir. Karışım gazları olarak azot, hidrojen ve argon seçilmiştir. Belirli oranlarda ikili ve üçlü karışım oluşturularak deneyler yapılmıştır. Deneysel sonuçlar X-Ray difraktometre, optik mikroskop ve mikro sertlik cihazları ile incelenmiştir. In this study, optimum hardness values, case depth, and change in the white layer thickness were investigated by hardening AISI 8620 steel using different gas mixtures. Nitrogen, hydrogen and argon were selected as mixture gases. Forming the double and ternary mixtures at certain ratios, the tests were carried out. Experimental results were examined by using X-Ray Diffraction, optical microscopy, and microhardness equipment

Functional characterization of cancer-related mutations of ERK3

Extracellular signal-regulated kinase 3 (ERK3) is an atypical member of the mitogen-activated protein kinase (MAPK) family. Recent studies have shown that ERK3 is highly upregulated in multiple cancers, such as lung cancer and colon cancer. Importantly, ERK3 promotes cancer cell migration and invasion by phosphorylating steroid receptor activator 3 (SRC-3), hence upregulating pro-invasive matrix metalloproteinase genes. While the link between ERK3 and cancers has been recognized, little is known about ERK3 mutations in cancer progression. In this study, we have investigated ERK3 mutations on arginine 64 (arginine 64 mutated to cysteine or histidine, R64C or R64H) and leucine 290 (leucine 290 mutated to proline or valine, L290P or L290V) that are found in cancers of lung, large intestine and skin (COSMIC database). Interestingly, both R64 and L290 residues are located in the kinase domain of ERK3 and are conserved in all ERK isoforms (ERKs1-4). In order to characterize these mutations, we generated expression vectors coating plasmids of ERK3 and each ERK3 constructs containing point mutation, and then overexpressed them in HeLa cells and lung cancer cell lines with or without stable knockdown of endogenous ERK3. Notably, we found that all of these cancer-related mutations lead to reduction of ERK3 phosphorylation at S189 within the activation loop. To study the functional impact of these ERK3 mutations on cancer cell invasiveness, we expressed each of these mutants or the wild type (WT) ERK3 in HeLa cells and lung cancer cell lines with or without stable knockdown of endogenous ERK3 and performed trans-well migration and invasion assays. Interestingly, we found that in comparison with WT ERK3, both L290P and L290V mutations significantly increased ERK3’s ability in promoting cell migration and invasion, whereas R64C and R64H mutations resulted in a decrease in cell migration. Given that all these cancer-related mutations led to reduction of ERK3 phosphorylation at S189, these results suggest that S189 phosphorylation within the activation loop is not associated with ERK3’s function in promoting cancer cell motility. To elucidate the underlying mechanism by which ERK3 L290 mutants increase cancer cell invasiveness, we examined the kinase activity of WT and mutant ERK3 in vitro by assessing the phosphorylation of SRC-3, a substrate for ERK3. We found that ERK3 L290P and L290V mutants have similar kinase activity to that of WT ERK3. ERK3 protein is known to shuttle between the nucleus and the cytoplasm, which may alter its function. Interestingly, by immunofluorescent staining, we found that both L290P and L290V mutations greatly increased the cytoplasmic localization of ERK3 proteins, whereas WT ERK3 is mostly nuclear. In conclusion, this study demonstrates that cancer-related L290P and L290V mutations lead to increased ability of ERK3 to promote cancer cell migration and invasion, possibly through their increased cytoplasmic localization

Monthly Administration Of Darbepoetin Alpha In Saudi Hemodialysis Patients: Is It A Practical Regimen?

Aim : In this study, we investigated the efficacy and safety of conversion stable hemodialysis patients from the current short-acting r-HuEPO (EPO beta) to the long-acting darbepoetin. Method : The study included 12 months of darbepoetin administration. The mean initial conversion ratio was 350 IU of short acting r-HuEPO to 1 microgram of darbepoetin. We adjusted the dose of darbepoetin to maintain hemoglobin levels between 11-12 g/dL. The study was carried out on 2 consecutive phases of 12 weeks each. Success with the extended dosing interval was defined as maintenance of mean hemoglobin> 10.0 g/dl during each phase.Result : There were 26 patients who fulfilled the entry criteria. Their mean age was 47.0 ± 17.13 years, and the mean duration on hemodialysis was 55.8 ± 14.0 months. The mean weekly dose increased from 28.75 ± 4.2 μg in the biweekly frequency of dosing to 38.5±3.9 μg after switching to the monthly protocol. The hemoglobin levels were maintained at therapeutic range without statistically significant change throughout the study; the mean hemoglobin levels was 10.81± .86 g/L at start of the study and 10.86 ± .76 g/L at the end of 6 months. Continuing the darbepoetin in 12 patients for one year disclosed no significant change of the conversion ratio of the drug, and the mean hemoglobin levels remained within the targeted limits.Conclusion: Darbepoetin alpha is effective and safe for the treatment anemia in hemodialysis patients even at monthly dose intervals and for long-term. With the the above mentioned conversion ratio and current prices, darbepoetin seems more expensive than the short acting erythropoetin beta by 15%, 58 % for the biweekly and monthly doses respectively. However, the longer dosing intervals are certainly much better convenience to patients and care takers in comparison with the currently used short acting ESAs

A NEW APPROACH AT SURFACE ENGINEERING; DUPLEX SURFACE TREATMENT

Duplex surface process was developed to deposite thin ceramic film coating on commonly manufacturing used low alloy steels. Low alloy steel having low strength by this process was first plasma nitrided with purpose enhancing load bearing capacity and then deposited with such ceramic coating. In this study, the duplex surface treatment was deal with main lines and informed about advantage and disadvantage