Acquired Epidermolysis Bullosa and Linear Immunoglobulin A Bullous Dermatosis

Acquired epidermolysis bullosa is a rare subepidermal bullous disease characterized by autoantibodies to type VII collagen, the major component of anchoring fibrils. Although the exact pathophysiologic mechanism remains unclear, reduction or perturbation of the anchoring fibrils results subepidermal blister formation and clinical features such as skin fragility, blisters, erosions, scars, milia and nail loss. Acquired epidermolysis bullosa includes various clinical manifestations resembling genetic epidermolysis bullosa, bullous pemphigoid, cicatricial pemphigoid, Brunsting-Perry pemphigoid and linear immunoglobulin A bullous dermatosis. Numerous treatment options are available but patients are often refractory to treatment. Linear immunoglobulin A bullous dermatosis is another subepidermal bullous disease characterized by the accumulation of IgA antibodies in lamina densa or sublamina densa region of the basement membrane and neutrophil-rich infiltrates in histopathology. It can be seen both in children and adults. The form seen in children usually begins under the age of 5 and it is called chronic bullous disease of childhood. The classical presentation is annular/polycyclic plaques and papules with blistering on perioral and perineal regions, giving a “cluster of jewels” appearance. The adult form is often seen after the fourth decade and clinical features are similar to those of dermatitis herpetiformis, bullous pemphigoid or cicatricial pemphigoid

Bullous Systemic Lupus Erythematosus and Cicatricial Pemphigoid

Bullous systemic lupus erythematosus is a rare distinctive subepidermal bullous disease seen in patients with systemic lupus erythematosus (SLE). It has characteristical clinic, pathologic, and immunologic findings including antibodies to type VII collagen, laminin 332, laminin 331, and bullous pemphigoid antigen 230. Clinical presentation combined with histopathology, immunological testing, and concomitant diagnosis of SLE according to the criteria of American College of Rheumatology, are required to distinguish bullous SLE from these bullous diseases. In patients with bullous SLE, SLE disease progression and complications may be worse. Cicatricial pemphigoid is a chronic subepidermal blistering disease which is characterized by erosive lesions of mucous membranes and skin. Pathogenesis of cicatricial pemphigoid is characterized by linear deposition of Immunoglobulin G, A, or complement 3 along the epithelial basement membrane zone. The main target antigens are bullous pemphigoid antigens 180–230, laminin 331–332, type VII collagen, and β-4 integrin subunit. Cicatricial pemphigoid may lead to serious complications such as blindness and airway obstruction. Herein, clinical, histological, immunopathological features, the diagnosis and treatment of bullous SLE and cicatricial pemphigoid diseases are mentioned to raise awareness among the dermatologists about this important but rare heterogeneous bullous disease

2008 global crisis: Simulation of a game theory

1960 ve sonrası yıllarda etkinliği fark edilen küreselleşme ile ekonomik bağımlılıklar ve ülkeler arasında etkileşimlerin arttığı görülmüştür. Küreselleşmenin bir sonucu olan 2008 Küresel Krizi; her ülke ekonomisinde farklı oluşumlara sebep olmuştur. Bu çalışmanın amacı; 2008 Global çıkmazının getiri ve götürülerini incelerken Oyun Teorisi'nden yararlanmak, ülke ekonomileri ve ortak pazar için hangi hamlelerin nelere sebebiyet vereceğini analiz etmektir. Çalışmada; Oyun Teorisi'nin Mahkumlar Çıkmazı tekniği olan şeytanın çocukları-Kızgın melekler kurgusu üzerinden ABD, AB, Yunanistan, Türkiye oyuncuları ile simülasyon gerçekleştirilmiştir. Çalışmanın sonucunda; ekonomilerin ani bir sıkıntı anında ekonomilerinin birbirleri ile ilişkili olduğu anlaşılmış ve söz konusu ülkelerin 2008 Krizi karşısında gerçekleştirdiği hamlelerin kendi ekonomileri ve ortak pazar için olumlu stratejiler olduğu saptanmıştır. Anahtar Kelimeler: Küreselleşme, Küresel Ekonomi, Kriz, 2008 Küresel Krizi, Oyun Teorisi, Mahkumlar Çıkmazı, Üstünlük Sağlama OyunuIn the 1960s and onward, global dependence and interactions between countries increased. The 2008 Global Crisis, as a result of globalization; each country emerged as different formations in the economy. The aim of this study is to take advantage of the Game Theory in analyzing the returns and benefits of the 2008 global deadlock what moves would lead to the country's economies and the common market. In the study; Game Theory of Prisoners Dilemma techniques children of the devil-Fi hot angels out of the US, EU, Greece, Turkey conducted a simulation with the players. As a result of the study, in the event of a sudden hardship of the economies, it is understood that their economies are related to each other and it is determined that the moves of these countries against the 2008 crisis have positive strategies for their economies and common market Keywords: Globalization, Global Economy, Crisis, 2008 Global Crisis, Game Theory, Prisoners' Dilemma, Superiority Gam

Invasiv Meme Kanseri Hücresi Tayini İçin Kuvars Kristal Mikroterazi Sensörlerin Hazırlanması

The aim of this study is to prepare a quartz crystal microbalance (QCM) biosensor for the detection of high-invasive breast cancer cells. For the selectivity of the sensor, the interaction between transferrin receptors overexpressed on the surface of breast cancer cells and transferrin was used. The QCM biosensor was prepared by modifiying poly(HEMA) particles which, along with transferrin, attached on the gold surface of the QCM sensor. In the first step, nanoparticles were prepared by a miniemulsion polymerization reaction of 2-hydroxyethyl methacrylate HEMA and ethylene glycol dimethacrylate (EGMA). The nanoparticles were characterized by zeta-sizer measurements. After that, the nanoparticles were immobilized by dropping a small amount of nanoparticle solution onto the gold surface and then drying at 37 Co for 6 hours. P(HEMA) particles which attached on the surface of the QCM sensor were modified with transferrin. Carbodiimide was used as an activation agent for modification. For the modification of p(HEMA) particles that attached on the surface of the sensor with transferrin, a QCM chip with p(HEMA) particles, transferrin and carbodiimide were put into pH 7.4 phophate buffer solution and kept in an agitated incubator, at room temperature for 24 hours. When preparing the QCM sensor without transferrin, p(HEMA) particles were unmodified. The prepared QCM sensor was characterized with atomic force microscopy (AFM), elipsometer, fourier transform infrared spectro- photometry (FTRI) and contact angle measurement. The thickness measurement and AFM observation indicated that the nanoparticle thin films were almost monolayer. After the characterization studies, the sensors with and without transferrin were connected to a QCM system to carry out kinetic and affinity studies on the high-invasive breast cancer cells. A cell solution of human breast cancer cell line MDA-MB-231 with diffirent concentrations were applied to the QCM system to determine the adsorption kinetics. The Langmuir- Freundlich adsorpsiton model was found as the most suitable model for this affinity system. In order to show the selectivity of the modified sensor with transferrin, competitive adsorption of MDA-MB-231 (high invasive), MCF-7 (low invasive) and serum and medium starved MDA-MB-231 was investigated. The results showed that the nanosensor with transferrin had high selectivity and sensitivity for cells which belong to high invasive human breast cancer cell line MDA-MB-231.Yapılan çalışmanın amacı yüksek oranda invaziv insan meme kanseri hücresi tayinine yönelik kuvars kristal mikroterazi sensör hazırlanmasıdır. Sensörün seçiciliği için meme kanseri hücresi yüzeyindeki aşırı eksprese olmuş transferrin reseptörü ile transferrin etkileşiminden faydalanılmıştır. QCM biyosensör, QCM çipin altın yüzeyine tutturulan Poly(2-hidroksietil metakrilat) (pHEMA) partiküllerin transferrin ile modifiye edilmesiyle hazırlanmıştır. Nanopartiküller etilen glikol dimetakrilat (EDMA) ve 2-hidroksietil metakrilat (HEMA)' nın miniemülsiyon polimerizasyon reaksiyonu ile hazırlanmıştır. Nanopartiküller zeta boyut analizi ile karakterize edilmiştir. Daha sonra hazırlanan nanopartiküller, az miktarda nanopartikül çözeltisinin altın yüzeye damlatılmasıyla ve sonra 37°C'da 6 saat kurutulmasıyla tutturulmuştur. QCM çipin yüzeyine yerleştirilen p(HEMA) partiküller transferrin ile modifiye edilmiştir. Bunun için, aktivasyon ajanı olarak karbodiimit kullanılmıştır. pH' sı 7.4'e ayarlanmış fosfat tamponu içine yüzeyinde p(HEMA) partikül bulunan çip, karbodiimit ve transferrin konulmuştur. QCM çip yüzeyindeki p(HEMA) partiküllerin transferrin ile modifiye olması için 24 saat çalkalamalı etüvde, oda sıcaklığında bekletilmiştir. Transferrinsiz QCM sensör hazırlanırken p(HEMA) partiküller modifiye edilmemiştir. Hazırlanan QCM sensörler atomik kuvvet mikroskobu (AFM), elipsometre, FTIR-ATR ve temas açısı ölçümleri ile karakterize edilmiştir. Kalınlık ölçümleri ve AFM görüntüleri, nanopartiküllerden oluşan ince filmlerin hemen hemen tek tabakalı olduğunu göstermektedir. Karakterizasyon çalışmaları ardından hazırlanan transferrinli ve transferrinsiz sensörler QCM sistemine bağlanarak yüksek oranda invaziv meme kanseri hücresine ait kinetik ve afinite bağlanma çalışmaları yapılmıştır. Adsorbsiyon kinetikleri farklı derişimlerdeki insan meme kanseri hücre hattı olan MDA-MB-231 'den hazırlanan hücre çözeltisinin QCM sisteminden geçirilmesi ile belirlenmiştir. Langmuir- Freundlich adsorbsiyon modeli, bu afinite sistemi için en uygun model olarak bulunmuştur. Transferrin modifiyeli sensörün seçiciliğini göstermek için insan meme kanseri hücre hatlarından olan MDA-MB-231(Yüksek oranda invaziv), MCF-7 ( daha az oranda invaziv) ve serum ve medyumdan yoksun bırakılmış MDA-MB-231 (hücre yüzey yapısı bozulmuş) hücrelerinin yarışmalı adsorbsiyonu araştırılmıştır. Sonuçlar sensörün, yüksek oranda invaziv olan MDA-MB-231 hücre soyu için yüksek seçiciliğe ve duyarlılığa sahip olduğunu göstermektedir

Transurethral Prostate Resection (TURP) Effect of Anxiety Before Surgery, Pain After Surgery and Sleep Quality

Bu çalışma, TURP ameliyatı olacak hastalarda anksiyetenin, ameliyat sonrası ağrı ve uyku kalitesine etkisini belirlemek amacıyla planlanıp uygulanan, tanımlayıcı ve kesitsel tipte bir araştırmadır. Araştırmanın evreni Haziran 2018-Aralık 2018 tarihleri arasında Kırklareli Devlet Hastanesi Üroloji Kliniği?nde TURP ameliyatı olan bireyler, örneklemi ise araştırma kriterlerini karşılayan ve bilgilendirilip izin alınan 85 hasta birey oluşturdu. Verilerin toplanmasında demografik bilgilerin yer aldığı Hasta Tanıtım Formu, ameliyat öncesi anksiyetenin belirlenmesi için Ameliyata Özgü Kaygı Ölçeği (AÖKÖ), ameliyat sonrası ağrı düzeylerini belirlemek için Sayısal Ağrı Ölçeği (VAS) ve ameliyat sonrası uyku kalitesini ölçmek için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanıldı. Verilerin analizi için NCSS 2007 programı ile tanımlayıcı istatiksel metodlar ve parametrik testler kullanıldı. TURP uygulanan hastaların yaş ortalaması 70,79±7,40 yıl olduğu, hastaların AÖKÖ ortalaması 19,79±3,72 olduğu, ameliyat sonrası VAS skoru ortalaması 4,65±1,91 ve PUKİ ortalaması 6,75±3,21 olduğu saptandı. Hastaların AÖKÖ toplam puanı ile ameliyat sonrası VAS skoru arasında pozitif yönlü istatiksel anlamlı ilişki saptandı (p=0.008; p0.05). Sonuç olarak, TURP uygulanacak hastalarda ameliyat öncesi anksiyete düzeyinin ameliyat sonrası dönemde ağrıyı pozitif yönlü etkilediği, uyku kalitesi üzerinde ise etkili olmadığı bulundu.This study is a descriptive and cross-sectional type of research that is planned and applied to determine the effect of anxiety on pain and sleep quality after surgery in patients who will have radish surgery. The universe of the study consisted of individuals who had radish surgery at Kırklareli State Hospital Urology Clinic between June 2018 and December 2018, and 85 patient individuals whose samples met the research criteria and were informed and received permission. The patient identification form, which includes demographic information, was used to determine preoperative anxiety, the operation-specific Anxiety Scale (PAO), the numerical Pain Scale (VAS) to determine postoperative pain levels, and the Pittsburgh Sleep Quality Index (PUKI) to measure postoperative sleep quality. Descriptive statistical methods and parametric tests were used with the NCSS 2007 program for the analysis of the data. The mean age of patients undergoing TURP was 70.79±7.40 years, the mean of the patients was 19.79±3.72, the mean of the VAS score after surgery was 4.65±1.91 and the mean of PUKI was 6.75±3.21. There was a positive statistically significant correlation between the total score of the patients and Vas pain score after the surgery (p=0.008; p0.05). As a result, it was found that the level of anxiety before surgery positively affected pain in the postoperative period and was not effective on sleep quality in patients undergoing radish

Pre-transurethral prostate resection anxiety on postoperative pain and sleep quality: A correlational study

Does pre-transurethral prostate resection (TURP) anxiety have any effect on postoperative pain and sleep quality? This descriptive, cross-sectional study was planned to determine the effect of pre-TURP anxiety on postoperative pain and sleep quality in adult male inpatients scheduled for TURP surgery in a urology clinic. Studies investigating the relationship between preoperative anxiety and TURP have reported side-effect-related quality of sleep impairment and higher pain levels in patients. The study was completely conducted from June to December 2018. Eighty-five participants meeting the inclusion criteria were involved. Informed consent was provided before the study outset. A patient identification form, the Surgery-Specific Anxiety Scale (SSAS), a numerical pain scale (Visual Analog Scale, VAS) and the Pittsburgh Sleep Quality Index (PSQI) were employed. Descriptive statistical methods and parametric tests were used with NCSS 2007 software for data analysis. Significance was set at P .05). Preoperative anxiety levels in patients undergoing TURP surgery positively affected pain during the post-operative period but had no effect on sleep quality. The limitations of the present study include the time restriction in the sample selection, and the fact that the results are specific to the group involved in the research. Another limitation was the research design that obviated any conclusion being drawn concerning the cause and effect relationship between anxiety and pain and sleep quality. The effect of preventing anxiety before surgery on pain and sleep quality can be investigated in future studies.WOS:0006653873000042-s2.0-8509672460