Ctp Atıklarının Kendiliğinden Yerleşen Tamir Harçlarının Özelliklerine Etkisi

Kendiliğinden yerleşen tamir harçları (KYTH) dar kesitlerden vibrasyon gerekmeksizin geçebilen ürünlerdir. Tamir ve güçlendirme işlerinde kullanılabilecek nitelikte olan bu harçların yüksek oranda toz içermesi atık değerlendirilmesi açısından fırsat olarak görülebilir. Çalışmada, gemi ve tekne onarımında kullanılan cam lifi takviyeli plastiklerin (CTP) uygulaması sırasında açığa çıkan tozların KYTH içerisinde kullanım potansiyeli araştırılmıştır. Çimento bağlayıcılı ve yüksek oranda (%50) öğütülmüş yüksek fırın cürufu (YFC) ikameli matrislere hacmen %1, %2, %3 CTP katılarak 6 farklı karışım oluşturulmuştur. CTP tozunun KYTH'nın işlenebilirliğini azalttığı, mekanik özelliklere etkisinin ise bağlayıcı matrise göre değiştiği görülmüştür. CTP dozajı arttıkça erken dönem bünyesel büzülmeler sırf çimentolu matriste artarken, cüruf ikameli matriste azalmıştır

Predictors of survival after surgery with curative intent for perihilar cholangiocarcinoma

BACKGROUND: Several clinicopathological predictors of survival after curative surgery for perihilar cholangiocarcinoma (pCCA) have been identified; however, conflicting reports remain. The aim was to analyse clinical and oncological outcomes after curative resection of pCCA and to determine prognostic factors. METHODS: Eighty-eight consecutive patients with pCCA underwent surgery with curative intent between 1998 and 2017. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Twenty-one prognostic factors were evaluated using multivariate Cox regression models. RESULTS: Postoperative complications were observed in 73 (83%) patients of which 41 (47%) were severe complications (therapy-oriented severity grading system (TOSGS) grade > 2), including a 90-day mortality of 9% (n = 8). Overall survival (OS) and disease-free survival (DFS) rates at 5 and 10 years after surgery were 33% and 19%, and 37% and 30%, respectively. Independent predictors of OS were locoregional lymph node metastasis (LNM) (risk ratio (RR) 2.12, confidence interval (CI) 1.19-3.81, p = 0.011), patient American Society of Anesthesiologists (ASA) physical status classification system > 2 (RR 2.10, CI 1.03-4.26, p = 0.043), and depth of tumour penetration (pT) > 2 (RR 2.58, CI 1.03-6.30, p = 0.043). The presence of locoregional LNM (RR 2.95, CI 1.51-5.90, p = 0.002) and caudate lobe resection (RR 2.19, CI 1.01-5.14, p = 0.048) were found as independent predictors of DFS. CONCLUSIONS: Curative surgery for pCCA carries high risks with poor long-term survival. Locoregional LNM was the only predictor for both OS and DFS.status: publishe

Cytoreductive surgery and Hyperthermic intra-operative peritoneal chemotherapy with Cisplatin for gastric peritoneal Carcinomatosis Monocentric phase-2 nonrandomized prospective clinical trial

Abstract Background Cytoreductive surgery (CRS) plus hyperthermic intra-operative peritoneal chemotherapy (HIPC) for gastric peritoneal carcinomatosis (PC) is controversial, and selection criteria for this treatment modality are lacking. Methods Thirty-two patients (F/M ratio 12/20; median (range) age 58 (32-75) years) underwent CRS + HIPC with cisplatin for PC from gastric adenocarcinoma in 2010-2014. This monocentric phase-2 nonrandomized prospective study with a power of 90% aimed to improve the 1-year overall survival (OS) rate with 40% (historical reference of 52% to 72%). Median PCI score was 8 (range 1-20), number of regions involved was 6 (range 1-11). The impact of 16 prognostic factors on survival was evaluated using univariable and multivariable Cox regression models. Follow-up was complete in all patients, and closed 2 years after patient inclusion. Results All patients had complete cytoreduction (CCR-0) and histopathological R0 resection. PCI </= 12 without PC on any small bowel region with 4 or more non-small bowel regions resulted in a median OS time of 24.7 months (15.6–29.4), and 1, 2, 5-year OS rates of 90%, 55%, 5.6%, respectively. Independent predictors of OS were PC on the small bowel combined with PC on 4 or more non-small bowel regions (p = 0.0004), number of regions involved (p = 0.0029), and overall PCI score (p = 0.0104). Conclusions CRS + HIPC with cisplatin to treat gastric PC, providing complete cytoreduction and R0 resection, should be restricted to patients with PCI of 12 or less. Patients having PC on any small bowel region with 4 or more non-small bowel regions should be refused for CRS + HIPC. Trial registration number Registration number: NCT01116791 . Registration date: May 5, 2010

Yaşlı hastalarda erken postoperatif kognitif fonksiyonlarda sevoflurayin ve desflurayinin etkisi

Genel anestezi altında, elektif cerrahi girişim geçirecek geriatrik olgularda desfluran ve sevofluranın erken postoperatif kogni- tif fonksiyonlar üzerine etkilerini karşılaştırmayı amaçladık. Ulusal etik kurul izni alındıktan sonra, yaşları 65-75 arasında olan 40 hasta çalışmaya dahil edildi. Hastalar desfluran (n20) ve sevofluran (n20) olarak iki gruba ayrıldı. Tüm hastaların anes- tezi indüksiyonunda propofol ve remifantil kullanılırken, anestezi idamesinde remifentanil ile birlikte desfluran veya sevofluran kullanıldı. Anesteziden uyanma zamanları ve Aldrete derlenme skorları kaydedildi. Hastaların kognitif fonksiyonları iki kognitif test; Kısa Blessed Oryantasyon Bellek Konsantrasyon Testi (BOMC) ve Standardize Mini Mental Test (SMMT) ile preoperatif ve post- operatif ekstübasyon sonrası 60. ve 180. dakikalarda değerlendirildi. Ortalama ekstübasyon süreleri, göz açma süreleri ve Aldrete skorları desfluran ve sevofluran grubunda benzerdi (p0,05). Preoperatif ve postoperatif 60. ile 180. dakikalarda BOMC ve MMST skorları karşılaştırıldığında sevofluran ve desfluran grupları arasında anlamlı fark yoktu (p0,05). Geriatrik hastalarda desfluran ve sevofluran anestezisinin erken postoperatif kognitif fonksiyonlar üzerine benzer etkilere sahip olduğu sonucuna varıldı.Our aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were en- rolled. Patients were allocated to either the desflurane (n20) or the sevoflurane (n20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p<0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p<0,05).The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly

Is pimecrolimus cream (1%) an appropriate therapeutic agent for the treatment of external ear atopic dermatitis?

Background: In recent years, pimecrolimus 1% cream has been demonstrated to reduce symptoms of atopic dermatitis in patients when applied topically. Material/Methods: In our study we compared the therapeutic effects of local 1% pimecrolimus to 1% hydrocortisone, and to a control group in a mouse model with atopic dermatitis in the external ear canals. Atopic dermatitis was created by application of Dinitrochlorobenzene in the external ear canals of mice. The development of atopic dermatitis was detected by clinical observation score and determination of total serum IgE levels. Pimecrolimus and hydrocortisone cream were topically applied to the external ear canal skin once a day for 14 days. Results: There was no significant difference between the hydrocortisone and the pimecrolimus therapy groups, while there was a statistically significant difference between these 2 groups and the control group (p<0.05) Assessment of the clinical observation scoring carried out on the 14th day of therapy revealed that there was no difference between the hydrocortisone and pimecrolimus groups. Biopsies were taken on the 14th day following treatment. Tissue samples were histologically evaluated; contact dermatitis was observed microscopically in the control group, but in the therapy groups only minimal evidence of contact dermatitis was found. Conclusions: The results of our study reveal that the therapeutic efficacy of 1% pimecrolimus was equivalent to 1% hydrocortisone treatment in the artificially developed atopic dermatitis model in external ear canals of mice. These results clearly demonstrate that 1% pimecrolimus cream can be an effective alternative therapeutic agent in cases where steroid treatment proves to be insufficient or in cases where treatment must be discontinued due to its adverse effects

Outcome in Caucasian patients with hepatitis B e antigen negative chronic infection:A long-term observational cohort study

Sensitive polymerase chain reaction assays to measure hepatitis B virus (HBV) DNA became only available the last decade. Hence, the long-term outcome of Caucasian patients in Western Europe with hepatitis B e antigen (HBeAg)-negative chronic infection, especially with a baseline HBV DNA level &gt; 2000 IU/mL, is still unclear. Out of a cohort of 1936 chronic HBV patients, 413 Caucasian individuals were identified with HBeAg-negative chronic infection, defined as persistently normal alanine aminotransferase (ALT) levels and HBV DNA levels 2 x upper limit of normal due to non-HBV-related causes. The cumulative probability of spontaneously developing CAH after 10 years was almost exclusively seen in patients with baseline HBV DNA level &gt; 2000 IU/mL (11.7% vs 1.2%; P &lt;.001). Advanced liver disease developed significantly more in patients with baseline HBV DNA level &gt; 2000 IU/mL (5.2% vs 1.5%; P = .018) and occurred especially in patients with obesity (16.7% vs 4.2%; P = .049). The incidence of hepatocellular carcinoma was 0.0%. Caucasian patients with HBeAg-negative chronic infection and baseline HBV DNA level 2000 IU/mL are at risk to develop advanced liver disease.</p