Comparison of Outcomes of Scrotal and Inguinal Incision Orchiopexy for Undescended Testis

Introduction: The aim of this study was to compare the results of treating undescended testis with conventional inguinal orchiopexy or by scrotal orchiopexy (in selected cases with undescended testis that can be rubbed up to the top of scrotum in their examination under general anesthesia). Materials and Methods:  Physical examination files of 66 palpable undescended testes patients performed by two pediatric surgeons at a 5th level hospital in Kenya/Kiambu within the scope of the program (29/09/2018-07/10/2018) were retrospectively reviewed. Result: There was a statistically significant difference between the groups in terms of surgery time (p = 0.001).  In both groups, there was no recurrence, testicular atrophy, and hernia or hydrocele formation complications. Scrotal hematoma was observed in one patient in each group. Conclusion:  Scrotal orchiopexy is a comfortable method that can be preferred in children because it requires less dissection, shorter operative time, no need analgesia, a single scrotal incision, and the fact that inguinal canal is not opened

The assessment of penetration cognitions and sexual functionality of women with sexual pain disorder in a Turkish sample: a comparative study

Amaç: Bu araştırmanın amacı vajinismuslu, disparonili ve sağlıklı kadınlarda vajinal penetrasyon bilişlerini ve genel cinsel işlevselliği karşılaştırmaktır. Yöntem: Toplam 210 kadın (yaşam boyu vajinismuslu 70 kadın, disparonili 70 kadın ve cinsel aktivitede ağrısı olmayan 70 kadın) bir dizi ölçeği tamamladı. Bütün katılımcılara Yapılandırılmış Bilgi Formu, Golombok-Rust Cinsel Doyum Ölçeği ve Vajinal Penetrasyon Biliş Ölçeği (VPBÖ) uygulandı. Bulgular: Disparoni ve kontrol grubuyla karşılaştırıldığında vajinismuslu kadınlarda penetrasyon sırasında VPBÖ kontrolünü kaybetme biliş puanlarının anlamlı olarak yüksek ve cinsel bilgi düzeylerinin daha düşük olduğu bulunmuştur. Ayrıca, vajinismuslu grubun parmaklarını vajinalarına sokamadığı ve tampon kullanmadığı saptanmıştır. Cinsel yakınması olmayan gruba göre hem vajinismuslu, hem de disparonili kadınlar daha fazla olumsuz benlik bilişleri, felaketleştirme/ağrı bilişleri, cinsel (genital) uyumsuzluk bilişlerine sahiptiler. Ek olarak, vajinismuslu ve disparonili kadınlarda orgazm zorluğu, duyusal-dokunma sorunları ve cinsel işlev bozuklukları kontrol grubuna göre daha fazlaydı. Tartışma: Sonuçlarımız, Türkiye'deki cinsel ağrı bozukluğu olan kadınlarda Batılı toplumlarda yaşayan kadınlarla benzer vajinal penetrasyon bilişleri olduğunu göstermiştir. Ayrıca, bulgularımıza göre vajinismus ve disparonili kadınlar arasında kayda değer farklılıklar bulunduğundan hiç cinsel birleşmede bulunamayan kadınların 'cinsel organlarda-pelviste ağrı/penetrasyon bozukluğu' başlığı altında ayrı bir alt grup olarak tanımlanması yararlı olacaktır.Objective: The aim of this investigation is to compare vaginal penetration cognitions and general sexual functionality in women with vaginismus and dyspareunia and healthy controls. Methods: A sample of 210 women (70 women with lifelong vaginismus, 70 women with dyspareunia and 70 women without painful sexual activity) completed a series of validated questionnaires. All participant received Structured Assessment Questionnaire, Golombok-Rust Sexual Satisfaction Scale, and Vaginal Penetration Cognition Questionnaire (VPCQ). Results: It was found that when compared to dyspareunia and control group, women with vaginismus have higher cognitive scores of loss of control during penetration in VPCQ. Moreover, vaginismus group havelower level of sexual knowledge, cannot penetrate their fingers into their vaginas, and do not use tampons. Both women with vaginismus and dyspareunia were reported to have more level of negative self-cognitions, catastrophe/pain and genital incompatibilitycognitions than those women with no sexual complaints. Moreover, women with vaginismus and women with dyspareunia have more anorgasmia, non-sensuality and sexual dysfunctions than the control group. Conclusion: Our results revealed that Turkish women with sexual pain disorder have similar vaginal penetration cognitions with women living in Western societies. In addition, according to our resultsit will be beneficial to define another sub group consisting of women who have never experienced sexual intercourse under the title of genito-pelvic pain/ penetration disorder because there are noteworthy differences between vaginismus and dyspareunia

Charlson comorbidity index (CCI) in diffuse large B-cell lymphoma: A new approach in a multicenter study

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of adult lymphomas. The incidence of DLBCL increases with age and has a fairly rapid fatal course without treatment. Patients often have difficulty tolerating standard chemotherapy regimens due to their comorbidities. Charlson Comorbidity Index (CCI), which is calculated by considering 19 different comorbidities, was developed in 1987 and is widely used for mortality prediction in cancer patients. Literature data on CCI and hematological malignancies are limited. Main aim in this study is to evaluate the effectiveness of CCI and compare to the International Prognostic Index (IPI) scoring system in the DLBCL patient group. Methods: A total of 170 patients diagnosed with DLBCL between 1.1.2002- 1.12.2020 were included in the study. Statistical analyzes were performed among patients whose IPI and CCI scores were recorded by considering baseline data. Results: The median age of patients was 58 (range: 17–84). Thirty-five (20.6%) patients had stage III and 76 (44.7%) had stage IV disease. When the CCI, IPI and ECOG scores were compared with the mortality status of the patients as a reference, AUCs were resulted as 0.628 (95% CI: 0.506–0.749), 0.563 (95% CI: 0.484–0.639) and 0.672 (95% CI: 0.596–0.743), respectively. There was no significant difference between the ROC curves of CCI, IPI and ECOG scores. Patients with a CCI score of ≥ 4 had shorter OS comperad to those with a score of < 4. Conclusion: Rather than claiming that CCI is superior to IPI, ECOG or another scoring system in a single-center patient population, it should be stated that CCI is also an effective scoring system in patients diagnosed with DLBCL

Thymic stromal lymphopoietin levels are increased in patients with celiac disease

Thymic stromal lymphopoietin (TSLP) is a cytokine produced by epithelial cells in the lungs, skin and intestinal mucosa, and is involved in several physiological and pathological processes. In this study, we evaluated serum TSLP levels in patients with celiac disease (CD). The prospective study was conducted at a gastroenterology outpatient clinic between March 2018 and August 2018. Eighty-nine participants aged between 18 and 75 years were classified into following groups: 22 patients with newly diagnosed CD; 20 patients with CD who were compliant with a gluten-free diet (GFD); 32 patients with CD who were not compliant with a GFD; and 15 healthy controls. Demographic characteristics, disease duration, and selected biochemical and hematologic parameters were recorded and compared between groups. Median serum TSLP levels were 1193.65 pg/mL (range: 480.1–1547.1) in newly diagnosed CD patients, 110.25 pg/mL (range: 60.3–216.7) in CD patients who were compliant with a GFD, 113.1 pg/mL (range: 76.3–303.4) in CD patients who were not compliant with a GFD, and 57 pg/mL (range: 49–67.8) in healthy controls. Overall, there was a significant difference in serum TSLP levels between groups (p = 0.001). Patients with newly diagnosed CD had the highest serum TSLP levels. There was no significant difference in serum TSLP levels between patients with CD who were or were not compliant with a GFD. TSLP appears to be involved in the pathogenesis of CD. Further studies are required to determine if the TSLP signaling pathway can be used in the treatment of CD

İdyopatik Hirşutizm Hastalarında QT Dispersiyonu

Amaç: Çalışmada idyopatik hirşutizm tanılı hastaların QT dispersiyonu açısından değerlendirilmesi amaçlanmıştır. Metod: 28 İH hastası ve kontrol grubu olarak 35 sağlıklı kadın çalışmaya dahil edildi. Hastaların hormonal incelemeleri ile birlikte elektrokardiyografi EKG analizleri yapılarak QT dispersiyonları QTd ile düzeltilmiş QT QTc değerleri kullanılarak düzeltilmiş QT dispersiyon QTcd değerleri elde edilmiştir. Bulgular: İH ve kontrol hastalarının minimum QT 336±30; 337±32 ms , maksimum QT 358±30; 358±34 ms , minimum QTc 391 ± 24; 399 ± 25 ms ; maksimum QTc 417 ± 24; 424 ± 26 ms , QTd 22±5; 21±7, P=0.6 ve QTcd 26 ± 6, 25 ± 9 ms, P= 0.7 değerleri arasındaki fark istatistiksel olarak anlamsızdı. Hirşutizm hastalarında açlık insülin, Homeostasis model assessment HOMA indeksi ve androjen düzeyleri anlamlı olarak yüksek saptandı. Sonuç: Hormonal ve metabolik bozukluklara rağmen İH hastalarında sağlıklı kadınlara göre anlamlı QT dispersiyonu saptanmamıştı

Sızdırma yataklı reaktörlerde organik bazlı evsel katı atıklardan organik asit elde edilmesi.

This study was carried out to evaluate the potential of high-rate anaerobic digestion of high-solids organic fraction of municipal solid waste (OFMSW) for the production of organic acids and alcohols in leaching bed reactors (LBRs). For this purpose, two different experimental set-ups, namely Set-1 and Set-2, were operated. In the Set-1, only OFMSW without paper was studied in two identical LBRs, whereas, four identical LBRs, fed with OFMSW with paper and cow manure in different proportions, were operated in the Set-2. In this study, 50-60% of hydrolysis efficiency was achieved in the LBRs of Set-1, whereas this value was decreased to 20-25% in the LBRs of Set-2; which was resulted from OFMSW containing cellulose and less volume of water addition in the Set-2. The mass of total volatile fatty acids (tVFA) production was found as 7000-9000 mg at the end of 80 days in the LBRs of Set-1, fed with OFMSW without paper, whereas it was 3000 mg at the end of 40 days in the LBR of Set-2, containing only OFMSW with paper. It was also observed that cow manure addition increased the amount of tVFA production in the LBR of Set-2. In conclusion, LBRs were found as alternative reactors for the degradation of OFMSW compared to completely stirred tank reactors (CSTRs) in terms of rapid hydrolysis and acidification, which can result in high hydrolysis yield and tVFA production.M.S. - Master of Scienc

The problems and their suggested solutions using particular methods in the practice of trombone playing

Trombon eğitiminde karşılaşılabilecek pek çok olası problem vardır. Bu çalışma, bütün bu problemleri saptama ve bunlara çözüm önerileri üretmekten ziyade, bedensel ve fiziksel problemler üzerinde yoğunlaşmıştır. Bedensel tanımı, gövdeden, ellerden, kollardan, omuzlardan ya da iç organlardan olaşabilecek problemlere işaret eder. Fiziksel problemler olarak tanımlanmak istenen ise embouchure (dudakları, bunları kontrol eden yüzdeki tüm kasları, dişleri ve alt çeneyi kapsayan çalma pozisyonuna denir) ile ilgili problemlerdir. Bu çalışmada problemlerin kaynağını daha iyi algılayabilmek için, trombonun ve insanın anatomik yapısı kısaca incelenmiştir. Trombonda sesin oluşması için gerekli olan çene, dişler ve dudakların, trombon öğrencisi seçerken hangi kıstaslara göre değerlendirilmesi gerektiği analiz edilmiştir. Tek tip bir pozisyon (embouchure) ile çalmak yerine, kişilerin fiziksel farklılıkları göz önünde bulundurularak, bunları sınıflandıran Reinhardt'ın ‘Pivot Sistemi', ‘trombon çalmayı etkileyen fiziksel faktörler' bölümünde açıklanmaya çalışılmıştır. Bu çalışma, trombonda ‘doğru' ya da ‘yanlış'ı anlatma gayretinden ziyade, doğal çalabilmenin yolunu sorgulamış, olası çalma problemlerine çözüm olabilme gayesiyle yazılmıştır. There may exist many obstacles to encounter within trombone education. This study does not have an approach to determine those obstacles with their probable solutions, yet does attempt to focus on the concepts related to physical and corporal complications in trombone playing. The term "corporal" refers to the problems that may occur from hands, arms, shoulders and internal organs. By "physical problems" difficulties connected to embouchure (lips, muscles that control the lips, teeth and lower jaw) are mentioned. This article introduces a brief examination of the anatomic structures of the trombone instrument and the human being with the aim of comprehending the origin of the existing problems. The jaw, the teeth and the lips which constitute the essential elements for the creation of the sound of the trombone and the criteria required in selecting the trombone student are analyzed. Reinhardt's "Pivot System" which establishes a classification of modifiable methods to fit the needs of each individual player considering the physical differences among players is stated in the section "the factors that effect trombone playing". This study does not bear the intention of clarifying the notions of right or wrong in trombone playing yet seeks the purpose of presenting the way to play the instrument naturally, suggesting solutions to possible problems that may consist within it

The Uses of Anachronism in Shakespeare’s Troilus and Cressida

Written at the turn of the century, Troilus and Cressida includes different codes of conduct in relation to those belonging to the past and the contemporary. In the play, the fading away ideals of the chivalric age are represented by the Trojan Hector and of the modern by the Greek Ulysses. William Shakespeare, by juxtaposing the medieval/feudal and the modern/capitalist in this play, employs an anachronistic approach to looking at the past and the present. In his version of the most famous story of war and valour in the Western tradition, Shakespeare problematizes the linear view of history and offers a kairotic understanding of historical difference not only by carrying contemporary forms of behavior and thought to the past but also by showing the anachronism of trying to be chivalric in the modern age. This necessary anachronism lets Shakespeare make a comment on the early modern ideology in his retelling of the seemingly Homeric tale that reached to the Renaissance in an altered form through the romance tradition

The Trauma of Time in Shakespeare’s The Winter’s Tale and Winterson’s The Gap of Time- Shakespeare’in The Winter’s Tale ve Winterson’ın The Gap of Time Eserlerinde Zamanın Travması

William Shakespeare’s The Winter’s Tale and its rewriting in the novel form by Jeanette Winterson both handle the concept of time traumatically. In the play, the traumatic events culminating into tragedy is linked to the second part of the play, after an interval of 16 years, with the help of the emblematic character “Time” that winds the play towards a seemingly happy ending. In the novel, on the other hand, the narrator takes up the role of Time and changes the setting in time and space. The change in temporality not only disrupts the flow of time signifying trauma, but also leads way to an otherwise impossible reconciliation entailing the trauma of forced compromise without a proper denouement. Trauma is attempted to be treated in Shakespeare’s The Winter’s Tale through miracle and forgiveness and in Winterson’s novel through forgiveness and in the belief that the next generation will not make the same mistakes as the old one. This paper evaluates the trauma of the gap of time in these two works through Cathy Caruth’s theory on the effects of forgetting the past trauma and Thomas de Quincey’s concept of being carried to the normal flow of time in Shakespearean dramatic action

TEMEL METAL VE KOR ALT YAPI ÜZERİNE FARKLI KALINLIKLARDA HAZIRLANAN DÜŞÜK ISI PORSELENİNİN RENK STABİLİTESİNİN ESKİTME SONRASI KARŞILAŞTIRILMASI

Bu çalışmanın amacı metal porselen ve fullporselen sistemlerin hızlandırılmış eskitme işlemisonrasında renk stabilitesini karşılaştırmaktır.Çalışmada 2 farklı porselen restorasyon incelenmiştir. Grup I: Temel metal kor+ Finesse düşük ısıporseleni, Grup II: Seramik kor+ Finesse düşük ısıporseleni, Örneklerdeki tam seramik kor finesseall ceramic kor materyalinden, metal kor Wiron99 temel metal alaşımından elde edildi. Örnekler0,6mm, 0,9mm, 1,2mm dentin kalınlıklarındahazırlandı. Korların üzerine farklı kalınlıklardadentin porseleni hazırlamak için 8mm çapında birkalıp kullanıldı. Her grup için 10 örnek hazırlandıve toplam 60 örnek incelendi. Bütün örnekler A2renginde hazırlandı. Örneklerin renk analiziMinolta CR 321 kolorimetre kullanılarak gerçekleştirildi. Örneklerin renkleri porselenlerin glazeişleminden sonra kaydedildi. Glazeden sonra örnekler h›zland›r›lm›ş eskitme siklusuna tabi tutuldu. 300 saatlik eskitmeden sonra renk ölçümleri tekrarland›. CIE Lab renk sistemine göre veriler al›nd› ve renk değişiminin hesaplanmas›nda ∆E= [ ∆L* 2+ ∆a* 2+ ∆b* 2]1/2 formülü kullan›ld›. İstatistiksel analiz sonucuna göre porselen tipi ve kal›nl›klara bağl› olarak her üç renk parametresinin L aç›kl›k- koyuluk, a k›rm›z›- yeşil, b sar›- mavi porselen gruplar›nda önemli farkl›l›klar gösterdiği bulundu **