Yüksek enerjili travma nedeni ile oluşmuş ekstremite defektlerinin tedavisinde negatif basınçlı terapi kullanılması]

Aim: Defects of the extremities due to high-energy trauma are common and it is necessary to repair these defects. Reconstruction is possible with simple surgeries using skin grafts and negative pressure therapy (NPT). In this study, we present our results of the reconstruction of extremity defects caused by high-energy trauma with a simple surgical procedure using NPT. Methods: Patients with soft tissue defects of the upper and lower extremities caused by high energy trauma, who were treated with NPT between November 2009 and June 2015, were included in the study. Results: NPT was performed in 63 patients. The average defect size was 60 cm(2). The patients underwent an average of nine sessions. The average length of hospital stay was 26 days. The defects were reconstructed using skin grafts and local flaps in 58 and two patients, respectively. None of the patients required free flaps. Conclusion: Extremity defects occurring due to high energy trauma can be closed by simple surgical techniques using NPT, patients can be protected from the complications of free tissue transfer, and also treatment is possible at much lower costs

Hydrogeochemistry of the region between Çorlu-Çerkezköy of Ergene basin

Ergene Havzası, Çerkezköy ve Çorlu kesiminde sanayi kuruluşları ve nüfusun fazlalaşması ile artan su gereksinimi ve proses sularının Ergene ve Çorlu Derelerine bırakılması ana akifer olan Ergene Formasyonu için kirlenme riski oluşturmuştur. Ergene Formasyonundan su alan 9 adet gözlem kuyusundan örnekleme yapılarak, iyon ve ağır metal analizleri yapılmıştır. Bölgedeki yeraltısuları Schoeller’in içilebilirlik diyagramına göre, 1. 2. ve 3. kalite sular sınıfındadır. ABD Tuzluluk diyagramına göre C2-S1 ve C3-S1 grubunda bulunan sular, Wilcox diyagramına göre çok iyi-iyi ve iyi-kullanılabilir sular grubuna girer. Yeraltısularında ağır metal kirliliği olduğu akiferin dinamik rezervinin azaldığı yağışa rağmen bu azalmanın sürdüğü tespit edilmiştir.Anahtar Kelimeler: Hidrojeokimya, hidrojeolojik, Ergene Havzası, yeraltısuyu, kirlilik. Irrigational lands and industrial zones cover most of the area between Çorlu and Çerkezköy. Groundwater is the only major source of water for agricultural, industrial and domestic purposes. The main aquifer in the study area is the Ergene Formation. Çorlu creek, which is contaminated by the process waters of factories, flows on Ergene Formation and has become a contamination source for the groundwater. Main ion and heavy metal investigations are carried out from 9 sampling wells selected on the basis of well inventory survey to reveal the hydrogeochemistry and contamination status of the aquifer in the study area. Also three surface water samples are being analyzed from Çorlu and Ergene creeks. Results of the analysis are plotted on diagrams and interpreted. All waters are classified as first, second and third quality water according to Schoeller's drinking diagram. However, they are in the groups of C2-S1 and C3-S1 on US Salinity Lab. Diagram. According to Wilcox diagram all groundwaters are in the groups of very good to good and good to permissible but surface waters from Ergene creek is classified as suspicious non permissible, and Çorlu creek is classified as non permissible. High heavy metal concentrations are also being observed in the groundwater as an indicator of the contamination of the aquifer. The static water levels also fall down although precipitation has increased in recent years. Keywords: Hydrogeochemistry, hydrogeology, Ergene Basin, groundwater, contamination.

Magnetization mechanism in amorphous ferromagnetic wires

Çiftekararlılık için sınır uzunluğun üzerindeki bir amorf ferromanyetik telin üzerinde yaratılan eziğin ve küçük bobinler ile tele uygulanan yerel manyetik alanların telin DC manyetik histeresisine etkisi, deneysel olarak incelenmiş, sonuçlar bir model ile yorumlanmıştır. Bir grup amorf tel, ölçümden önce 0.75mm çaplı sert çelik iğneyle tele dik olarak ortadan değişik miktarlarda ezilmiştir. Diğer bir grup ölçüm de ortasından kesilip çeşitli aralıklar bırakılmış örneklerle yapılmıştır. Üçüncü bir grup deney de, tele 1.5mm uzunluğunda bobin(ler) sarılarak uygulanan manyetik alan(lar)ın telin manyetik histeresisi üzerindeki etkilerini incelemek üzere yapılmıştır. Birinci grup ölçümlerde kullanılan teller çiftekararlılık için sınır uzunluktan kısa olduğu halde ezik 20µm’yi aştıktan sonra histeresis döngülerinde iki aşamalı büyük Barkhausen sıçraması ile kademeli düşüş görülmüştür. İkinci grup deneylerden elde edilen histeresis döngüleri fark olarak birinci gruptakilerden sadece basamaklı gevşeyen kısımlarında daha büyük bir eğim göstermiştir. Aynı yerde tele sarılı küçük bir bobin ile tele artı yönlü manyetik alan uygulandığında ise, mıknatıslanma histeresis döngüsünde uzun, basamaklı bir gevşemeden sonra büyük bir Barkhausen sıçraması ile ters yönde doyuma gitmiştir. Döngünün çıkıcı kısmında ise ters mıknatıslanmanın, eksi bir dış alan değerinde büyük bir Barkhausen sıçraması ile başlayıp küçük basamaklarla doyuma gittiği görülmüştür. Bu çalışmada sunulan model, telin iç çekirdeğindeki manyetik bölge duvarı hareketi ve kapanma bölgelerindeki parçalanma sonucunda ortaya çıkan manyetik moment dağılımının bilgisayar yazılımları ile hesaplanması temeline dayanmaktadır. Hesap sonucu elde edilen histeresis döngüleri deneysel sonuçlarla uyum içindedir. Anahtar Kelimeler: Amorf tel, ezik, histeresis, ferromanyetik.Hysteresis loops in a ferromagnetic amorphous wire longer than the critical length are studied. Wires with a deformation in the middle are considered. Both theoretical and experimental studies using DC vibrating sample magnetometer were performed. Amorphous wires with compositions Fe-Si-B and with diameter 125µm of positive magnetostriction coefficient are used in the experiments. Samples have been deformed at the middle by pressing with a hard steel needle of 0.75mm diameter, perpendicular to the axis of the wire. Another group of measurements was carried out of the samples cut at the middle. A third group of experiments was intended to be a bridge to the hysteresis model proposed. 1.5mm coils were wound up at the middle of the wire under investigation to apply a local magnetic bias. An oppositely directed pair of local fields is applied with a pair of identical coils reversely connected is employed to investigate its effect on the hysteresis loop. The DC hysteresis loops were measured with a home made vibrating sample magnetometer. The sample vibrates sinusoidally along the axis of a long solenoid at the frequency of 23 Hz. The pick-up coils have been particularly designed to measure long samples. Magnetic field has been changed with a step of 0.3 A/m, and measured with a sensitivity of 0.01 A/m. In the first group of experiments, although the length of the wire is greater than the critical length for bistable behavior, after a threshold value of increasing, the hysteresis loop starts to narrow keeping its rectangular shape. Furthermore deformations more than 20 µm lead to two large Barkhausen jumps separated by a staircase relaxation. The only difference of the hysteresis loops yielded by the second group of experiments from the first is that the slope of the inclined parts is bigger than those in the first group. The unidirectional magnetic bias gave rise to a staircase relaxation, followed by a long Barkhausen jump in the descending branch of the loop. In the ascending branch, the domain wall completes its almost entire motion in a negative external field and the magnetization approaches saturation with staircase movements. As the current through the reversely connected pair of coils is increased, the hysteresis loop starts developing nearly horizontal tails first at the up right, and then at the bottom left corners. The model proposed in this work is based on the calculation of the magnetic moment distribution in the core of the wire by means of computer simulations. To simulate the magnetization process of the deformed wire, the total energy is taken as a function of five variables. Three of these correspond to the nucleation at two ends and at the middle of the wire while the remaining two represent the domain wall locations in the two regions. The simulation traces the gradient in the six dimensional energy landscape to find the set of coordinates, which, for a given value of external field, minimizes the total energy. Magnetization makes a jump to another stable position when the total energy loses its local minimum in the landscape. Since in general there are more than one energy minima along the entire process, a magnetic hysteresis occures. The total energy of the system is taken as the summation of mutual magnetostatic interactions along all the domains, Zeeman energy, and the anisotropy energies. Exchange interactions are taken into accound by assuming the domain wall motions along the wire. When the deformation created in the middle of the wire is represented by just an anisotropy field, but no nucleation allowed, the upper and lower halves of the calculated loop is shifted symmetrically to the right and to the left respectively, with horizontal stretch lines in the two directions. The horizontal lines result from the energy barrier created by the local anisotropy field in the middle. Although the great simplicity of this structure, it reveals the response mechanism of the wire beyond a certain threshold of deformation; no change in the hysteresis occurs before the threshold is reached. When the wall motion starts at a point around the deformation, and nucleation mechanism occurring at the deformed part and at the ends is taken into account, the same staircase character in the hysteresis loops is obtained as the experimental ones. The ends and the deformed part of the wire act as pinning sites.    Keywords: Amorphous wire, deformation, hysteresis, ferromagnetic

Akut allerjik rinitli hastalarda lokal sempatik sistem disfonksiyonunu gösteren lokal sempatik deri yanıtları testi’nin elektrofizyolojik çalışması

Introduction: In this study, we aimed to investigate sympathetic nervous system functions by local sympathetic skin responses of the nasal septum in patients with acute allergic rhinitis.Material and Methods: Eighty-five patients who were diagnosed as acute allergic rhinitis according to medical history and otorhinolaryngological examination with positive allergy evaluations via skin prick testing and 50 healthy subjects were included to the study. Sympathetic skin responses of the nasal septum were recorded in patients and in the control groups, and sympathetic skin response latencies and amplitudes were compared between groups.Results: The mean value of sympathetic skin response latencies was significantly longer in the patient group than that of the control group (p<0.001). In addition, mean value of sympathetic skin response amplitudes was significantly lower in the patient group than the control group (p<0.001).Conclusion: Our study is the first which electrophysiologically evaluated the local sympathetic nervous functions that shows objective evidence of local sympathetic nervous system dysfunction. This way to access local sympathetic nervous system dysfunction would be helpful in deciding patients' treatment

GIANT CERVICAL LIPOMA, RARE BENIGN TUMOR OF CERVICAL REGION: TWO CASE REPORTS

Lipomlar, en sık saptanan mezenşimal orjinli benign tümörlerdir. Vücutta herhangi bir yerde izlenebilirler, servikal bölgede ise oldukça nadir olarak karşımıza çıkarlar ve posterior cilt altı düzeyde daha sık rastlanırlar. Asemptomatik yavaş büyüyen yumuşak doku kitlesi olarak karşımıza çıkan lipomlar, dev boyutlara ulaşabilirler. Bu olgu bildirisinde nadir rastlanmaları nedeniyle anterior ve posterior servikal bölgede yerleşimli histopatolojik olarak tanısı doğrulanmış iki dev lipom olgusunun radyolojik bulguları literatür eşliğinde tartışılmıştır. Lipomas are the most frequent benign tumors of mesencymal origin. Even though they can be viewed anywhere in the body, come as quite rare in the cervical region and can be seen more common in the posterior cervical region subcutaneously. Lipomas which appear as asymptomatic, slow growing soft tissue masses can reach giant proportions. In this case report, due to seeing rarely, two cases of giant lipomas in the anterior and posterior servical region are discussed by radiologic findings; the diagnosis was histopathologically confirmed

Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

Purpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole +/- beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible

İncisional endometrioma mimicking a malignant mass: report of two cases

Endometriozis dogurganlık çagındaki kadınlarda sık görülen klinik bir problemdir. Insizyon yerlesimli endometriomaya ise nadir rastlanır. Hastalarda genellikle sezaryen veya histerektomi gibi ameliyat öyküsü vardır. Endometriomayı olusturan dokudan malignite gelisebildigi bildirilmistir. Jinekolojik bir patoloji olmasına ragmen insizyonel herni ya da karın duvarı tümörleri gibi bulgu verebilmekte ve bu nedenle hastalar genellikle genel cerrahi polikliniklerine basvurmaktadırlar. Biz bu çalısmada dogurganlık çagında olan ve daha önce sezaryen ameliyatı öyküsü bulunan, klinik ve laboratuar olarak malignite süphesi tasıyan iki olguyu sunduk. Tedavide sezaryen skarındaki kitlelere genis eksizyon yapıldı ve olusan fasya defekti primer onarıldı. Patolojik inceleme sonucu kitlelerin endometrium dokusuna sahip endometrioma oldugu saptandı.Endometriosis is a common clinical problem of the child-bearing women. Incisional endometrioma is very rare. Patients frequently presented with a history of previous gynecological surgery such as cesarean section or hysterectomy. Although being a gynecological disorder, it may seem like an incisional hernia or abdominal wall tumor. Therefore, it is frequently referred to general surgery outpatient clinics. Here, we report two cases with previous histories of cesarean sections and questinable clinical and laboratory findings of malignancy. The masses located on the previous incision scars were excised widely, and pathological examination of surgical specimens revealed the diagnosis of endometrioma in both cases

Determination of population parameters of alburnus chalcoides (Güldenstädt, 1772) from Ayvacik Dam Lake (Çanakkale)

Bu çalışma, Ayvacık Barajı Alburnus chalcoides populasyonuna ait parametrelerin belirlenmesi amacıyla Ağustos-Kasım 2014 tarihleri arasında gerçekleştirilmiş olup toplam 726 birey incelenmiştir. İncelenen bireylerin yaşlarının 0-IV'üncü yaş grubu arasında olduğu; örneklenen bireylerin boy değerlerinin 6,0 ile 21,7 cm (10,63±2,43 cm) ve ağırlıklarının ise 1,58 ile 90,20 g (11,63±9,47 g) arasında değişim gösterdiği belirlenmiştir. Boy-ağırlık ilişkisi ise W=0,00705L3,0528 olarak belirlenmiştir. Populasyon parametreleri akarsular için L∞: 32,81 cm, k: 0,140, t0: -1,38, Φꞌ: 2,18 ve K: 0,76 olarak hesaplanmıştır. Ölüm oranları ve stoktan yararlanma düzeyi ise Z: 0,646, M: 0,325, F: 0,321 ve E: 0,497 olarak tahmin edilmiştir. Tahmin edilen bu değerler ışığında popülasyon üzerinde aşırı avcılık baskısının bulunmadığı ve stoktan optimum düzeyde yararlanıldığı söylenebilir.This study was carried out in order to determine population parameters of Alburnus chalcoides between August and November 2014 in Ayvacık Dam Lake and a total of 727 specimens analyzed. Age of the specimens ranged from 0 to IV. age groups. Total length and total weight varied from 6.0 to 21.7 cm (10.63±2.43 cm) and 1.58 to 90.20 g (11.63±9.47 g), respectively. Length-weight relationship were estimated W=0.00705L3.0528. Estimated population parameters were calculated as L∞: 32.81 cm, k: 0.140, t0: -1.38, Φꞌ: 2.18 and K: 0.76 for the population. Mortality and exploitation rates also estimated as Z: 0.646, M: 0.325, F: 0.321 and E: 0.497, respectively. In the light of these values have been estimated there were not any over fishing pressure on the population which is exploited optimally