The causality analysis of relationship between financial development and economic growth in Turkey

Türkiye ekonomisi için büyüme ve finansal gelişme arasındaki nedensellik ilişkisinin yönünü tespit etmeyi amaçlayan bu çalışmada 1989-2011 dönemine ait yıllık veriler kullanılarak Toda-Yamamoto testi uygulanmıştır. Ayrıca, temel bileşenler analizi yöntemi ile Türkiye ekonomisinin özgün koşullarını yansıtan ve finansal gelişmişlik düzeyini en kapsamlı biçiminde ölçmeyi mümkün kılacak bir finansal gelişme endeksi oluşturulmuştur. Ampirik bulgular, ‘89 sonrası dönemde ağırlıklı olarak ‘büyüme’den ‘finansal gelişme’ye doğru işleyen tek yönlü nedensellik ilişkisi söz konusu olduğunu ortaya koymaktadır. Bir başka ifadeyle finansal gelişme ve ekonomik büyüme arasında ‘talep takipli’ bir nedensellik ilişkisi söz konusudur.In this study Toda-Yamamoto test was applied by using annual data between 1989-2011 to determine the direction of causality relationship between growth and financial development for the Turkish economy. Also, by principal components analysis a financial development index which reflects original conditions of Turkish economy and makes it possible to measure financial development level widely was constituted. Empirical evidence has shown that there is a unidirectional causal relationship from economic growth to financial development in the period after 1989. In other words, there is a causal relationship called 'demand following' between financial development and economic growth

The Use of Human Epididymis 4 and Cancer Antigen 125 Tumor Markers in the Benign or Malignant Differential Diagnosis of Pelvic or Adnexal Masses

Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumour marker, thus some unnecessary, highly morbid operations can be performed. Aims: To explore the efficacy of human epididymis 4 (HE 4) and cancer antigen 125 (CA 125) markers in differentiating malignant and benign pelvic masses of ovarian origin and to identify the cut-off points for those markers. Study Design: Prospective study. Methods: Fifty-one patients who were diagnosed and planned to undergo surgery for ovarian mass between June 2008 and December 2008 were enrolled into this study. Preoperative venous blood samples were taken and frozen for marker investigation and final diagnoses were concluded by histopathological examination. After recruitment of all cases CA 125 and HE 4 levels were evaluated. Results: The statistical analysis did not indicate any statistically significant difference between the CA 125 levels of the patients with malignant and benign adnexal masses (p=0.105). The HE 4 levels of the patients with malignant adnexal masses were higher at a statistically significant level compared to the patients with benign adnexal masses (p=0.002). For HE 4 tumour marker and at the cut-off point of >25 pM, sensitivity was 1, specificity 0.40, positive cut-off value 0.19, negative cut-off value 1, accuracy 0.47 and positive likelihood ratio 1.65. Conclusion: Human epididymis 4 is a better diagnostic tool than CA 125 in benign-malignant discrimination of adnexal masses. The cut-off value of 25 pmol/L for human epididymis 4 will contribute to providing proper guidance to patients with adnexal masses and applying the proper treatment method

The comparison of preoprative magnetic resonance imaging results with postoperative pathologic results in early stage cervical cancer

Tıpta Uzmanlık TeziDünyada meme kanserinden sonra kadınlarda ikinci sıklıkta saptanan malign neoplazm serviks kanseridir. Bu nedenle serviks kanserinin tanı ve tadavisi her geçen gün daha da önem kazanmaktadır. Manyetik rezonans ile serviks kanserinin evrelemesinde tümör boyutu, parametrium invazyonu, pelvik duvar ve komşu organlar ile uzak metastazların değerlendirilmesi önemlidir. Serviks kanserinin evrelemesinde ve tedavinin yönlenmesinde en önemli parametre parametrial tutulumdur. Günümüzde parametrial tutulumu olan ve olmayan hastalara yaklaşım merkezlere göre değişse de genel olarak tedavinin cerrahi mi yoksa radyoterapi mi olacağını parametrial tutulum göstermektedir. Retrospektif olarak yapılan bu çalışmada ise erken evre serviks kanseri incelemeleri manyetik rezonans görüntüleme yöntemiyle yapılan hastaların, operasyon sonrasındaki histopatolojik sonuçlarının karşılaştırılması amaçlanmıştır. Çalışmamızda 01 Temmuz 2006 - 19 Ağustos 2011 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi`nde tanısı konmuş, cerrahi tedavisi yapılmış olan ve preoperatif görüntülemelerine ulaşılabilen 30 hastanın onkoloji dosyaları retrospektif olarak taranmıştır. Çalışmaya alınan 30 hastanın MRG ile evrelemesinde 9 hasta evre IBI, 2 hasta evre IBII, 7 hasta evre IIA, 4 hasta evre IA ve 8 hasta evre IIB olarak izlenmiştir. Genel toplama bakıldığında 30 hastadan klinik evreleme 7 tanesini doğru evrelemişken MRG ile 20 hasta doğru evrelenmiştir. Çalışmamızda 17 hastanın tümör çapı 4 cm'den küçük, 13 hastanın ise 4 cm'den büyük saptanmıştır. Ancak tümör çapı 4 cm'den küçük olan hastaların MRG incelemesinde 8 hastanın tümör boyutu patolojik boyut ile uyumlu ,9'u ise uyumsuz saptanmıştır. Çalışmamıza alınan 30 hastanın 20 tanesinde patolojik değerlendirme ile servikal ring tutulumu saptanmış, 10 hastada tutulum saptanmamıştır. Patolojide tutulum izlenen 20 hastanın 13 tanesinde MRG'de servikal ring tutulumu göstermiştir. Servikal tutulumu olmayan 10 hastanın 6 tanesinde MRG'de de tutulum saptanmamıştır. Çalışmamızda 11 hastada parametrial tutulum saptanmış 19 hastada saptanmamıştır. Manyetik rezonans görüntüleme ile bu 11 hastanın 7 tanesinde parametrial tutulum izlenmiştir. Çalışmamızda MRG'nin serviks kanserinin evrelemesindeki başarısını da değerlendirdik. Buna göre MRG'nin evrelemede sensitivitesi %66 bulunmuş olup patoloji ile anlamlı bir korelasyon saptanmıştır. Preoperatif MRG evreleme doğruluğu, parametrial invazyonu değerlendirmedeki başarısı, servikal ring tutulum göstermedeki uygunluğu ve tümör boyutu tahmin yeteneği ile operasyon ve tedavi yönlendirmesinde kullanılabilecek uygun bir araçtır.Anahtar Kelimeler: Serviks kanseri, manyetik rezonans görüntülemeAbstractCervical cancer is the second most detected neoplasm world wide after breast cancer. Therefore diognosis and treatment of cervical cancer gets more important everyday. Evaluating tumor size, parametrial invasion, pelvic wall, adjacent and distant metastasis with magnetic resonance imaging is important in staging of servical cancer. The most crucial parameter in staging and treatment management of cervical cancer is parametrial invasion. Although the treatment approaches may show a variety in different centers, determining if it will be a radioteraphy or surgery is based on parametrial invasion. The aim of this retrospective study is to compare the preoperative magnetic resonance imaging findings of an early stage cervical cancer patient with histopathologic outcomes after surgery. Our study includes retrospective evaluation of oncology charts of 30 patients with preoperative magnetic resonance imaging who were diagnosed servical cancer and undergone surgery between July 01 2006 and August 19 2011 at Trakya Univercity Faculty of Medicine Department Of Obstetric And Gynecology. In magnetic resonance imaging staging among all 30 patients: 9 were stage 1b1, 2 were stage 1b2, 7 were stage 2a, 4 were stage 1a and 8 were stage 2b. Regarding all 30 patients, clinical staging of 7 were staged correctly and 20 of them staged correctly by magnetic resonance imaging (MRI). In our study 17 patients has tumor diameter less than 4 cm and 13 had diameter more than 4. However, among all patients whose tumor diameter is less than 4 cm, magnetic resonance imaging results of 8 patients correlates with pathologic evaluation whereas 9 is not. Cervical ring invasion was found in 20 of all patients pathologic examination whereas was not seen in the other 10. Among all the 20 patients who had ring invasion, 13 of them showed servical ring invasion in MRI evaluation. Among 10 patients who had no servical ring invasion, 6 of them were evaluated correctly by magnetic resonance imaging. In our study parametrial invasion was detected in 11 patients and was not in 9 patients. Parametrial invasion was detected by MRI in 7 of those 11 patients. We also analyzed the success of magnetic resonance imaging in cervical cancer staging in our study. We found out that the MRI staging shows 66% sensitivity and is strongly correlated with pathologic staging. Preoperative magnetic resonance imaging staging may be an appropriate tool to evaluate tumor diameter, parametrial and cervical ring invasion in guidance of surgery and treatment.Key Words: Cervical cancer, magnetic resonance imagin

Macroscopic Portal Vein Thrombosis in Hcc Patients

Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD 10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.PubMedWoSScopu