Taking initiative in educational organizations: A scale development studyEğitim örgütlerinde inisiyatif alma: Bir ölçek geliştirme çalışması

The purpose of the study is to develop a reliable and valid scale for individual initiative in educational organizations. The draft form to get experts’ opinion was presented. After getting feedback of experts, unsuitable items were removed from the scale. Pilot implementation showed that the language of the scale is suitable for the basic implementation. 39-item form was administrated to 370 volunteer inspectors, principals and teachers in different educational units. Confirmatory factor analysis, difference tests between %27, construct validity, reliability, item total, item removed and other tests were applied for developing the scale. All those statistical analysis showed that initiative of individuals can be assess into four dimensions. These dimensions are “self-starting”, ”overcoming the barriers”, “proactive action” and “self-investment”. The scale with 35-item that is shaped through experts’ opinion after statistical tests are developed as a valid and reliable scale for educational organizations. ÖzetBu çalışmanın amacı eğitim örgütlerinde kullanılabilecek bir inisiyatif alma ölçeğinin geliştirilmesidir. Bu amaçla taslak form oluşturulmuştur. Oluşturulan taslak form görüşlerinin alınması için uzmanlara sunulmuştur. Uzmanlardan alınan geri bildirimler ile ölçeğin yapısına uygun olmayan maddeler ölçekten çıkarılmıştır. Oluşan 39 maddelik nihai form kasıtlı örnekleme yöntemi ile seçilen 370 müfettiş, müdür, müdür yardımcısı ve öğretmene uygulanmış elde edilen veriler ölçek geliştirme sürecine uygun olarak analiz edilmiştir. Araştırma kapsamında inisiyatif alma ölçeğinin geliştirilmesi sürecinde madde toplam, madde kalan, alt ve üst %27’lik gruplar arasında fark testleri, doğrulayıcı faktör analizi, yapı geçerliliği ve güvenirlik analizleri yapılmıştır. Yapılan tüm bu istatistiki sınamalar, alan yazın ve uzman görüşleri doğrultusunda son şekli verilen,  “başlatıcılık”, “engelleri aşma”, “basiret gösterme” ve “öz-yatırım” boyutlarından oluşan,  eğitim örgütlerinde kullanılabilecek 35 maddelik geçerli ve güvenilir bir inisiyatif alma ölçeği geliştirilmiştir

A Novel Technique for Conjunctivoplasty in a Rabbit Model: Platelet-Rich Fibrin Membrane Grafting

Purpose. To investigate the effect of platelet-rich fibrin (PRF) membrane on wound healing. Methods. Twenty-four right eyes of 24 New Zealand rabbits equally divided into 2 groups for the study design. After the creation of 5 × 5 mm conjunctival damage, it was secured with PRF membrane, which was generated from the rabbit’s whole blood samples in PRF membrane group, whereas damage was left unsutured in the control group. Three animals were sacrificed in each group on the 1st, 3rd, 7th, and 28th postoperative days. Immunohistochemical (IHC) stainings and biomicroscopic evaluation were performed and compared between groups. Results. PRF membrane generated significant expressions of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and platelet-derived growth factor (PDGF) in the early postoperative period. However, the IHC evaluation allowed showing the excessive staining at day 28, in control group. Biomicroscopic evaluation revealed complete epithelialization in PRF membrane group, but none of the cases showed complete healing in the control group. Conclusions. This experimental study showed us the beneficial effects of the PRF membrane on conjunctival healing. Besides its chemical effects, it provides mechanical support as a scaffold for the migrating cells that are important for ocular surface regeneration. These overall results encourage us to apply autologous PRF membrane as a growth factor-enriched endogenous scaffold for ocular surface reconstruction

Collagen Cross-linking in Keratoconus Patients with Thin Corneas: Short-Term Results

Pur po se: To study the effectiveness and safety of corneal collagen cross-linking with hypoosmolar riboflavin solution applied to keratoconus patients with thin corneas. Ma te ri al and Met hod: In this retrospective study, medical records of keratoconus patients planned for cross-linking surgery and having thinnest corneal thickness (TCT) less than 400 μm after corneal epithelial removal were reviewed. There were 12 patients and 16 eyes in the study cohort. After the epithelium was removed, hypoosmolar solution was applied for 30 minutes and pachymetric measurements were taken. If corneal thickness became more than 400 μm, the cross-linking procedure was started; if not, hypoosmolar solution was continued until corneal thickness reached 400 μm. Maximum keratometry values (K Max), pachymetric measurements, uncorrected distance visual acuities (UDVA), and corrected distance visual acuities (CDVA) were recorded. Comparison between preoperative measurements and measurements taken in sixth postoperative month were performed. Re sults: The mean TCT was 422.75±26.98 μm preoperatively (max: 450, min: 360). The mean TCT was reduced to 373.63±22.41 μm after epithelium was removed (max: 398, min: 325). There was a statistically significant difference between preoperative K max (62.62±5.09) and postoperative K max (61.55±5.80), (p=0.03). On the other hand, the difference between preoperative-postoperative UDVA (p=0.29) and preoperative-postoperative CDVA was not significant (p=058). There were no cases with significant corneal opacity or with any other complication. Dis cus si on: Corneal collagen cross-linking with hypoosmolar riboflavin solution in keratoconus patients with thin corneas is an effective procedure and can be considered as safe regarding preservation of visual acuities and absence of significant corneal opacity. (Turk J Ophthalmol 2012; 42: 316-2

Investigation of the Pupil Diameter Differences in Anisometropic Amblyopia

Pur po se: To study pupil diameter differences between amblyopic and fellow eyes in anisometropic amblyopia. Ma te ri al and Met hod: This study was carried out from medical records of 412 candidates for refractive surgery with excimer laser. 69 patients (21 males and 48 females) with anisometropic amblyopia were enrolled in this study. Mean age of subjects was 33.07±9.07 years. Pupil size measurements were performed with an ocular wavefront analyzer. Amblyopic eyes and fellow eyes were compared with regard to pupil diameter, spherical refractive error, magnitude of astigmatism, spherical equivalent, and best-corrected visual acuity on Snellen chart. Also, correlation analyses were performed to determine correlation coefficients and their significance between selected variables. Re sults: Mean pupil diameter was 5.95±0.90 mm in amblyopic eyes and 6.15±0.90 mm in fellow eyes. Difference in mean pupil diameter between amblyopic and fellow eyes was statistically significant (p=0.01). Mean spherical refractive error (-2.96±6.21 D), mean astigmatic refractive error (-2.87±1.80 D), mean BCVA (0.44±0.19), and mean spherical equivalent (-4.40 ±2.92 D) in amblyopic eyes were statistically different from the values in fellow eyes (p=0.01). In addition, the analyses showed that the correlations between the magnitude of anisocoria and anisometropia, and between the magnitude of anisocoria and the depth of amblyopia were statistically insignificant. Dis cus si on: This study shows a relationship between anisocoria and amblyopia. The existence of such relationship helps both to diagnose amblyopia earlier and to unveil some hidden process in the pathophysiology of amblyopia. (Turk J Ophthalmol 2013; 43: 45-50

Long-Term Results of Punctal Plug Applied to Dry Eye Patients

Purpose: The evaluation of long-term results of punctal plugs applied to dry eye patients and the potential problems they may bring about. Material and Method: In this study, we retrospectively assessed 30 eyes of 15 patients with moderate to advanced dry eyes who were applied punctal plug (5 mm) for treatment purpose and were observed for 12 months. The patients’ Ocular Surface Disease Index (OSDI ) scoring, Schimer-1 test (without topical anesthesia), tear film break-up time (TBUT) and ocular surface staining with fluorescein results were evaluated and compared before and after 6- and 12-month use of punctal plug. The patients were started on topical antiinflammatory treatment and artificial tears two months before the application of the punctum plug. Results: The patients’ average age was 56.4±2.3 (range: 36-70) years, and the average follow-up period was 15 (12-30) months. The average OSDI score was statistically significantly decreased at 6 and 12 months when compared to the initial value (p<0.05). The average Schirmer-1 test values measured at 6 and 12 months were also statistically significantly increased compared with the initial value (p<0.05). The average Schirmer-1 test value at 12 months was considerably increased when compared with the 6th month’s value (p<0.05). The average TBUT was statistically significantly increased when compared to the values at 6 and 12 months (p<0.05). When the outcomes of ocular surface staining with fluorescein were evaluated, a significant decrease was seen at 6 and 12 months when compared to the initial value (p<0.05). Discussion: The punctal plug treatment associated with topical anti-inflammatory treatment for moderate and advanced dry eye patients is a reliable method. It decreases the dry eye symptoms and findings in the long term. (Turk J Ophthalmol 2011; 41: 225-9

The Effect of Cross-Linking Treatment on Conus Curvature and Higher Order Corneal Aberrations in Keratoconus

Objectives: To study the effect of corneal collagen cross-linking on conus curvature and corneal aberrations in keratoconus. Materials and Methods: The medical records of thirty-seven eyes of 32 progressive keratoconus patients (17 male, 15 female, mean age: 22.13±4.64 years) who had undergone corneal cross-linking were evaluated retrospectively. The change in refractive errors, visual acuity on Snellen charts, average keratometry, conus curvature, and corneal aberrations calculated at 6.00 mm pupil size throughout the follow-up time were compared with paired t-test. The correlation of the change in best-corrected visual acuity and in uncorrected visual acuity with the change of the parameters which had statistically significant difference at 18 months was studied with Pearson’s correlation analysis. Results: The best-corrected visual acuity, uncorrected visual acuity, spherical and cylindrical error, average keratometry, conus curvature, vertical coma, total corneal aberrations, total higher order aberrations had statistically significant difference at 18 postoperative months (p=0.001). Spherical aberration (p=0.95) and horizontal coma (p=0.78) did not show statistically significant difference at the end of follow-up. The change in uncorrected visual acuity correlated with change in conus curvature (r=-0.420, p=0.01) and change in cylindrical refraction (r=0.453, p=0.005) at 18 months. The change in best-corrected visual acuity correlated with change in total corneal aberrations (r=-0.490, p=0.002), vertical coma (r=0.408, p=0.01), average keratometry (r=-0.386, p=0.02), conus curvature (r=-0.381, p=0.02), and total higher order aberrations (r=-0.326, p=0.05) at 18 months. Conclusion: Corneal collagen cross-linking treatment applied to progressive keratoconus cases induces significant decrease in conus curvature, in total corneal aberrations, and in higher order aberrations, especially in vertical coma, and leads to a prominent visual acuity increase eventually. (Turk J Ophthalmol 2014; 44: 184-9

Gıdalarda antimikrobiyal madde olarak kullanılan sodyum metabisulfit'in Allium cepa L.7nin kök ucu hücrelerinde sitogenetik etkileri

The effects of sodium metabisulfite (SMB) on mitosis were investigated in Allium cepa L. The roots of A. cepa were treated with SMB concentrations of 7.5 mg/lt, 15 mg/lt and 30 mg/lt for 10- and 20-hour treatment periods. SMB significantly decreased the mitotic index (MI) at all concentrations and treatment periods. While the decreasing of the MI was dose-dependent at 10 hours treatment time, SMB increased the mitotic abnormalities dose dependently.The effects of sodium metabisulfite (SMB) on mitosis were investigated in Allium cepa L. The roots of A. cepa were treated with SMB concentrations of 7.5 mg/lt, 15 mg/lt and 30 mg/lt for 10- and 20-hour treatment periods. SMB significantly decreased the mitotic index (MI) at all concentrations and treatment periods. While the decreasing of the MI was dose-dependent at 10 hours treatment time, SMB increased the mitotic abnormalities dose dependently

Demokrat Parti döneminin toplumsal ve siyasal yapısının Zübük eseri merkezinde yorumlanması

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2012.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by İbrahim Mert Öztürk.Öztürk, İbrahim Mert. HIST 203-06ÖZTÜRK HIST 203-06/2 2011-1

Comparison of the efficiency of subconjunctival aflibercept ranibizumab and bevacizumab in corneal neovascularization in a rat model

Background: Corneal neovascularization (CN) might be a sight-threatening condition via reducing the corneal transparency. One of the most significant proangiogenic factors is vascular endothelial growth factor (VEGF) that is shown to be upregulated in CN. Accordingly, we aimed to evaluate and compare the effectiveness of aflibercept, ranibizumab, and bevacizumab in CN in a rat model. Material and methods: Twenty-eight male Wistar-Albino rats were administered general anesthesia. 2-mm-diameter central burns were formed on the corneas. Rats were divided into four groups randomly, and one group was administered subconjunctival saline solution as the control group. Subconjunctival aflibercept, bevacizumab, and ranibizumab were applied to the other three groups, respectively. Three rats from each group were randomly selected, and digital photographs of the corneas were taken under general anesthesia. Then, rats were euthanized, and eyes were enucleated one week and one month after the corneal injury. Three enucleated eyes from each group were prepared for histological evaluation with hematoxylin and eosin. Results: According to the first week results, there was no central CN in all groups except the control group. There was no statistically significant difference in total CN among the groups according to the Kruskal-Wallis test (p = 0.09). The control group had a higher inflammation score than the other groups in the central cornea. On the other hand, the control group had less intense fibrosis than the other groups in the central cornea. In the first month, there was a spontaneous regression in central CN in the control group. There was again no statistical difference among the groups regarding the CN (p = 0.46). There was no inflammation in the central cornea in any groups. Conclusion: single-dose subconjunctival injection of aflibercept, ranibizumab, and bevacizumab prevents thecentral CN and reduces the inflammation

NAK Koruyucu Mastektomi Ve Eşzamanlı İmplant İle Rekonstruksiyon Yapılan Hastalarda Önceki Skara Bağlı Seçilen İnsizyonun Nekroz Gelişimi Üzerine Etkisi

NAK Koruyucu Mastektomi Ve Eşzamanlıİmplant İle Rekonstruksiyon YapılanHastalarda Önceki Skara Bağlı Seçilenİnsizyonun Nekroz Gelişimi Üzerine EtkisiHasan Basri Çağlı, Haluk Vayvada, AdnanMenderes, Cenk Demirdöver, Süleyman Çakmak,Safa Eren AtalmışDokuz Eylül Üniversitesi Tıp Fakültesi, PlastikRekonstrüktif ve Estetik Cerrahi Ana Bilim Dalı, İzmirGiriş: Meme başı(NAK) koruyucu mastektomilerin enönemli komplikasyonu cilt ve meme başı ile çevresi(nippleareola kompleksi) nekrozlarıyken komorbid hastalıkların,sigara kullanımının, radyoterapi ve kemoterapi öyküsünün,cerrahi prosedürün nekroz oluşumuna etkisiyle ilgili farklısonuçlar literatürde bulunmaktadır. Bu çalışmada nipplekoruyucu mastektomi ve eşzamanlı implant ile memerekonstrüksiyonu yapılan hastalarda memeye yönelikgeçirilmiş cerrahinin, cerrahiye bağlı skarın memedenekroz gelişimi üzerine etkisi incelenmiştir. Bunun yanındaönceki skara bağlı olarak insizyon seçimi, nipple-areolakompleksinin dermal pedikülünün skara göre belirlenmesigibi cerrahi kaygıların nekroz üzerinde etkisi olup olmadığıortaya kondu.Gereç ve Yöntem: Dokuz Eylül Üniversitesi Tıp FakültesiPlastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalı’ndaOcak 2006 ile Temmuz 2020 arasında nipple koruyucu20mastektomi operasyonu ve eşzamanlı implant ilerekonstrüksiyon yapılan 129’u bilateral olmak üzere 152kadın hasta, 281 meme değerlendirildi. Hastaların komorbidhastalıkları, sigara kullanımı, radyoterapi ve kemoterapiöyküsü, memeye yönelik önceki cerrahi öyküsü, cerrahiprosedür ve operasyon sonrası komplikasyonlar kayıt altınaalındı. Operasyonlarda insizyon olarak inframammariyan,periareolar, wise pattern, eski cerrahi skar kullanıldı.Bulgular: Yaş ortalaması 46,21 olan 152 kadın hastanın54(%35,52)’üne komorbid hastalıklar eşlik ederken en sıkolarak hipotiroid hastalığının 23(%15,13) eşlik ettiği görüldü.Hastaların 67(%44,07)’si kemoterapi ya da radyoterapitedavisinin en az birini alırken, 40(%26,31) hastadasigara kullanım hikayesi mevcuttu.281 memeye yapılanmeme ucu koruyucu mastektomi ve eş zamanlı implantile meme rekonstrüksiyonu işlemi öncesinde 131(%46,61)memede geçirilmiş cerrahi ve cilt skarı vardı.41(%14,59)memede inframammariyan, 54(%19,21)’ünde periareolar,138(%49,11)’nde wise pattern, 44(%15,65)’ündeönce cerrahi skarından insizyon yapıldı. İşlem sonrası56(%19,57) memede çeşitli büyüklükte meme ucu ileçevresi, cilt nekrozu gelişti. Bazı nekroz komplikasyonlarıkonservatif olarak izlenirken bazıları için ek operasyonlaryapıldı. Nekroz gelişen olgularda hastaya ait özelliklerinebakıldığında 20(%35,71)’sinde sigara kullanım öyküsü,35(%62,5)’inde kemoterapi ya da radyoterapi öyküsündenen az birine sahip, 21(%37,5)’inde en az bir komorbidhastalık mevcuttu. Meme bazında değerlendirildiğindesigara kullanım ve KT-RT tedavisi olanların memelerindenekroz gelişiminin daha fazla olduğu görüldü. Nekrozgelişimi olan 56 memenin 47(%83,92)’sinde geçirilmişcerrahi ve skarı mevcuttu. Sadece ikisinde eski skarındaninsizyon seçimi yapılabilirken bu iki meme dışında beşmemede önceki skar insizyon ya da cilt eksizyon alanınadahil edilebildi. Bu açıdan bakıldığında önceki cerrahiöyküsü ve cerrahi prosedüre dahil edilemeyen önceki skarvarlığında memelerde nekroz komplikasyonunun dahafazla olduğu belirlendi.Sonuç: NAK koruyucu mastektomi operasyonlarındainsizyon seçimi hem estetik açıdan hem en önemlikomplikasyonlardan biri olan nekroz gelişimininengellenmesi açısından önemli bir aşamadır. Önceki skarabağlı insizyonun çeşitlendirilmesi, skarında insizyon yada cilt eksizyon alanına dahil edilmesi, nipple-areolakompleksinin dermal pedikülünün yakın bir skar varlığındazıt tarafa alınması olası nekroz gelişimini önleyebilir ya danekroz büyüklüğünü azaltılabilir. Bununla birlikte nipplekoruyucu mastektomi adayları olan hastalarda GenelCerrahi tarafından yapılan memede kitlenin eksizyonunayönelik işlemlerdeki insizyonların sonraki insizyonseçenekleri dahilinde yapılması, hem estetik olarak görünürek bir skarın oluşmasını engelleyebilir hem de cilt fleplerinindolaşımını azaltabilecek ek skarlar oluşturmayarak olasınekroz gelişimi azaltabilir.Anahtar Kelimeler: İmplant, Mastektomi, Nekroz, Skar</p