REMOVAL OF SEPARATED INSTRUMENTS WITH MASSERANN TECHNIQUES: TWO CASE REPORTS

Instrument fracture is a procedural mishap that prevents efficient cleaning and shaping of the root canal. When bypassing the fracture fails, the fragment must be removed. Many techniques and devices have been described to remove fragments from the root canal. The Masserann Kit is a widely used instrument for the removal of fragments. These clinical cases describe use of the Masserann Kit to remove separated instruments blocking the entire canal in posterior teeth

Evaluation of conventional imaging techniques on preoperative localization in primary hyperparathyroidism

We aimed to evaluate the diagnostic and preoperative localization capacity of Tc-99m methoxyisobutylnitrile (MIBI) parathyroid scintigraphy and ultrasonography (USG) in enlarged parathyroid glands in the primary hyperparathyroidism (pH PT), as well as the relationship between the success rate of these techniques and biochemical values. We retrospectively evaluated 39 patients with clinical and biological evidence of pHPT who referred to the university hospital for MIBI parathyroid scintigraphy. Patients were examined with USG and double-phase MIBI parathyroid scintigraphy for the detection of enlarged parathyroid glands. Preoperative serum intact parathyroid hormone (iPTH) levels, calcium (Ca), phosphate and alkaline phosphatase measurements were obtained. A total of 45 parathyroid lesions in 39 patients were reviewed. Thirty-four patients had a single adenoma and five patients with multi-gland disease had 11 abnormal parathyroid glands including three adenomas, whereas the remaining 8 glands showed hyperplasia. The overall sensitivities of MIBI parathyroid scintigraphy, USG, and combined techniques were 85.3%, 72.5% and 90.4%, respectively; the positive predictive values (PPV) were 89.7%, 85.2%, and 92.6%, respectively. The most successful approach for detection of enlarged parathyroid glands in hyperparathyroidism is the concurrent application of USG and MIBI parathyroid scintigraphy modalities. The concomitance of thyroid diseases decreases the sensitivity of both MIBI parathyroid scintigraphy and USG in enlarged parathyroid glands

AMYAND HERNIA AND SURGERY: IS APPENDECTOMY NECESSARY? HOW SHOULD HERNIA REPAIR BE DONE?

Amaç: Amyand herni, kasık fıtığı kesesi içinde normal veya inflame appendiks vermiformisin bulunmasıdır. Amyand hernili olguların çoğunluğu erişkinler, geri kalan kısmı ise 0-1 yaş arası çocuklardır. Klinik olarak Amyand hernili hasta serimizi sunarak cerrahi tedavi protokolünü literatür eşliğinde tartışmayı amaçladık. Yöntemler: 1974 - 2010 yılları arasında Dışkapı Yıldırım Beyazıt Eğitim Araştırma Hastanesi genel cerrahi polikliniği ve acil servise kasıkta şişlik ve ağrı şikayeti ile başvuran ve inguinal herni tanısıyla operasyona alınan, fıtık kesesi içinde appendiks saptanarak apendektomi yapılan 15 hasta tedavi edilmiştir. Bulgular: On beş hastanın yaş ortalaması 40,36 ± 21,82 idi. Kadın /erkek oranı ¼ idi. Hastaların 14'ünde sağ inguinal bölgede, birinde situs inversus nedeniyle sol inguinal bölgede Amyand herni olgusu saptandı. On bir hasta elektif şartlarda opere olurken, 4 hasta irredükte inguinal herni nedeniyle ameliyata alındı. İntraoperatif 4 olguda akut apandisit hali saptandı. Hastaların tamamına apendektomi uygulanırken ve 3 hastaya mesh herniorafi, 12 hastaya da anatomik onarım yapıldı. Sonuç: Amyand herni tanısı genellikle intraoperatif olarak konur. Fıtık kesesi içinde inflame olmayan apendiks saptanmasında tedavi tartışmalıdır ama apandisit saptanan durumlarda apendektomi yapılmalıdır. Apandisit saptanması durumunda da fıtık onarım tipi tartışma konusudur. Genelde mesh herniorafi uygulanırken, peritonit hali mevcutsa anatomik onarım tercih edilmelidir Objective: Amyand hernia is determined as the presence of normal or inflamed appendix in the hernia sac. It is commonly encountered in adult patients or in children up to 1 year of age. We aimed to discuss the treatment protocol of Amyand hernia cases under the light of the literature. Methods: There were 15 patients included the study in 1974 - 2010. They were admitted to Dışkapı Yıldırım Beyazıt Teaching and Researsh Hospital for elective or incarcerated inguinal hernia repair and appendix was found incidentally in hernia sacs, so appendectomy operations were performed additional procedure to hernioraphy. Results: The mean age was 40.36 (std dev 21.823), female/male ratio was ¼. Fourteen patients had right, one had left inguinal hernia but also situs inversus. Eleven cases were operated in elective condition, four patients for incarcerated hernia. We found acute appendicitis findings intra operatively in four patients. Appendectomies were done for all of the patients. Hernia repairing were performed with mesh in 3 cases, but with anatomic repairing were done in 12 patients. Conclusion: Amyand hernia is generally diagnosed intra operatively. Operation in the presence of non-inflamed appendix in the sac is controversial but inflamed appendix undoubtedly should be operated. This time, in these cases mesh usage is controversial due to the risk of infection. Generally m

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Soda kireç silika camlarda geçiş metallerinin elektron spin rezonans (ESR) spektroskopisi kullanılarak ölçülmesi

Thesis (Master)--Izmir Institute of Technology, Materials Science and Engineering, Izmir, 2017Includes bibliographical references (leaves: 50-52)Text in English; Abstract: Turkish and EnglishElectron spin resonance (ESR) spectroscopy does not appear to have found a wide use when compared with other structural analysis methods, especially spectroscopy techniques, utilized in the glass industry. The method, however, provides a good means for supporting the structural information obtained from other spectroscopic methods. Because of its ability to detect and differentiate the paramagnetic ions at low concentrations, ESR spectroscopy is commonly used as a quantitative and qualitative analysis method for evaluating transition metals. This study showed the behavior and interaction of paramagnetic 3d transition metal ions using ESR spectroscopy for the soda-lime-silicate based glasses. For this reason, it revealed the existence of paramagnetic (Fe3+, Cr3+, Mn2+ and Cu2+) transition metal ions in soda-lime-silicate glass and their spectral trends studied at addition levels up to 2.0% mol. Additionally, ESR spectra of Fe3+-Cr3+, Fe3+-Mn2+ and Fe3+-Cu2+ added soda-lime-silicate glass samples were studied to show the effects of the different transition metals on Fe3+ containing glasses. The final point of study is that the approach to quantify the ESR spectra with the concentration of paramagnetic metal ions in glass. In this way, this study gives structural information about the used glass and so lightens the locations of used metal ions.Elektron spin rezonans (ESR) spektroskopisi, cam endüstrisinde kullanılan diğer spektroskopik yapısal analiz metotları ile kıyaslandığında geniş alan bulamamıştır. Fakat bu metot diğer spektroskopik tekniklerden elde edilen yapısal bilgileri desteklemede iyi bir araçtır. Paramanyetik iyonları düşük konsantrasyonlarda bile saptayabilmesi ve araştırabilmesi sayesinde ESR spektroskopisi geçiş metallerini değerlendirmede kantitatif ve kalitatif analiz metodu olarak yaygınca kullanılmaktadır. Bu çalışma ESR spektroskopisinin paramanyetik 3d geçiş metal iyonlarının davranış ve etkileşimlerini soda kireç silika camlar için göstermiştir. Bu sebeple, soda kireç silika camların içinde paramanyetik (Fe+3, Cr+3, Mn+2 ve Cu+2) geçiş metal iyonlarının molce %2.0’ın altında katkılandığındaki spektral yönelimleri ortaya çıkartılmıştır. Buna ek olarak, farklı geçiş metallerinin Fe+3 içeren cam örneklere olan tesirlerini ve etkileşimlerini göstermek için Fe+3-Cr+3, Fe+3-Mn+2 ve Fe+3-Cu+2 eklenmiş soda kireç silika cam örneklerinin ESR spektrumları çalışılmıştır. Çalışmanın son noktası da, cam içerisindeki paramanyetik geçiş metali iyonlarının ESR spektrumlarına olan kantitatif yaklaşımdır. Bu sayede, çalışma kullanılan camın yapısal bilgisi hakkında bilgi vermiştir ve metal iyonlarının cam içerisindeki lokasyonlarını aydınlatmıştır

Soda kireç silika camlarda geçiş metallerinin elektron spin rezonans (ESR) spektroskopisi kullanılarak ölçülmesi

Thesis (Master)--Izmir Institute of Technology, Materials Science and Engineering, Izmir, 2017Includes bibliographical references (leaves: 50-52)Text in English; Abstract: Turkish and EnglishElectron spin resonance (ESR) spectroscopy does not appear to have found a wide use when compared with other structural analysis methods, especially spectroscopy techniques, utilized in the glass industry. The method, however, provides a good means for supporting the structural information obtained from other spectroscopic methods. Because of its ability to detect and differentiate the paramagnetic ions at low concentrations, ESR spectroscopy is commonly used as a quantitative and qualitative analysis method for evaluating transition metals. This study showed the behavior and interaction of paramagnetic 3d transition metal ions using ESR spectroscopy for the soda-lime-silicate based glasses. For this reason, it revealed the existence of paramagnetic (Fe3+, Cr3+, Mn2+ and Cu2+) transition metal ions in soda-lime-silicate glass and their spectral trends studied at addition levels up to 2.0% mol. Additionally, ESR spectra of Fe3+-Cr3+, Fe3+-Mn2+ and Fe3+-Cu2+ added soda-lime-silicate glass samples were studied to show the effects of the different transition metals on Fe3+ containing glasses. The final point of study is that the approach to quantify the ESR spectra with the concentration of paramagnetic metal ions in glass. In this way, this study gives structural information about the used glass and so lightens the locations of used metal ions.Elektron spin rezonans (ESR) spektroskopisi, cam endüstrisinde kullanılan diğer spektroskopik yapısal analiz metotları ile kıyaslandığında geniş alan bulamamıştır. Fakat bu metot diğer spektroskopik tekniklerden elde edilen yapısal bilgileri desteklemede iyi bir araçtır. Paramanyetik iyonları düşük konsantrasyonlarda bile saptayabilmesi ve araştırabilmesi sayesinde ESR spektroskopisi geçiş metallerini değerlendirmede kantitatif ve kalitatif analiz metodu olarak yaygınca kullanılmaktadır. Bu çalışma ESR spektroskopisinin paramanyetik 3d geçiş metal iyonlarının davranış ve etkileşimlerini soda kireç silika camlar için göstermiştir. Bu sebeple, soda kireç silika camların içinde paramanyetik (Fe+3, Cr+3, Mn+2 ve Cu+2) geçiş metal iyonlarının molce %2.0’ın altında katkılandığındaki spektral yönelimleri ortaya çıkartılmıştır. Buna ek olarak, farklı geçiş metallerinin Fe+3 içeren cam örneklere olan tesirlerini ve etkileşimlerini göstermek için Fe+3-Cr+3, Fe+3-Mn+2 ve Fe+3-Cu+2 eklenmiş soda kireç silika cam örneklerinin ESR spektrumları çalışılmıştır. Çalışmanın son noktası da, cam içerisindeki paramanyetik geçiş metali iyonlarının ESR spektrumlarına olan kantitatif yaklaşımdır. Bu sayede, çalışma kullanılan camın yapısal bilgisi hakkında bilgi vermiştir ve metal iyonlarının cam içerisindeki lokasyonlarını aydınlatmıştır