Značilnosti kanalskega in razpoklinskega toka izvira Pinarbaşi, Centralni Taurus, Seydişehir, Turčija

This study was conducted to investigate the flow and storage mechanisms of a karst aquifer located at the central Taurus Mountains, Turkey. As the biggest discharge point of the aquifer system, the flow characteristics are investigated at Pinarbaşi spring by using recession and time-series analyses. Continuous water level measurements are taken from the spring and are converted to flow rate by using a rating curve. The spring flows for 7 months (December 2014 – July 2015) and dries up for the rest of the year. Six individual recession periods are investigated and analyzed in the discharge time series. The recession coefficients (between 0.029 day-1 and 0.695 day-1) show that the flow within the aquifer system is mainly controlled by large open conduit and partly fracture porosity. The peak discharge is measured as 7.08 m3/s, and the maximum storage within the aquifer is calculated as 3.15 million m3. The continuous discharge data of the spring were evaluated combined with daily rainfall, temperature, electrical conductivity, and amount of suspended sediment in the water. Also a dye-tracing test was also applied to obtain the recharge-discharge relationship and porosity type of the aquifer system. Statistical tests on discharge hydrograph and tracer test showed that the memory of the karst aquifer was found to be about 3 days in the DJF period and about 15 days in the MAM period. The average elevation of the recharge area of the spring was determined to be 1,490 m by using stable isotope data of snow samples and was validated by dye tracer test made via the swallow hole in the recharge area. The total discharge for the year 2015 is estimated at 16.2 million m3 that approximately 25% of the total discharge is caused by snowmelt.Raziskovali smo dinamiko toka in skladiščenja v kraškem vodonosnika v Centralnem Taurusu v Turčiji. Z recesijsko analizo in analizo časovnih vrst pretoka smo raziskovali značilnosti največjega izvira vodonosnika, izvira Pinarbaşi. Časovno vrsto pretoka smo izračunali iz podatkov zveznih meritev nivoja in pretočne krivulje. Izvir je bil aktiven med decembrom 2014 in julijem 2015, preostali del leta je bil suh. Analizirali šest recesijskih obdobij. Koeficienti recesije, ki so med 0.029 dan-1 in 0,695 dan-1, kažejo na kanalsko in razpoklinsko poroznost. Največji izmerjeni pretok je bil 7,08 m3/s, največji izračunani volumen uskladiščene vode pa 3,15 milijona m3. Z analizo časovnih vrst smo raziskovali korelacijo med pretokom ter padavinami, temperaturo, električno prevodnostjo in motnostjo. Polnjenje in praznjenje ter strukturo vodonosnika smo določali tudi z sledilnim poskusom. Statistična analiza in rezultati sledenja so pokazali, da je spominski čas vodonosnika 3 dni v obdobju od decembra do februarja in 15 dni v obdobju od marca do maja. Z analizo stabilnih izotopov v vzorcih snega smo ugotovili, da je povprečna nadmorska višina prispevnega območja 1490 m. To potrjuje tudi sledilni poskus z vnosom sledila v enega od ponorov, ki jih najdemo na tej nadmorski višini. Celoten odtok izvira v letu 2015 ocenjujemo na 16,2 milijona m3, pri čemer je približno 25 % prispevalo taljenje snega

Hayat dolu kalbi 23.30'da durdu

Taha Toros Arşivi, Dosya No: 67-Barış MançoUnutma İstanbul projesi İstanbul Kalkınma Ajansı'nın 2016 yılı "Yenilikçi ve Yaratıcı İstanbul Mali Destek Programı" kapsamında desteklenmiştir. Proje No: TR10/16/YNY/010

İnsizyonel Herni Onarımının Nadir Komplikasyonu: Gastroenterostomi Hattına Mesh Migrasyonuna Bağlı Gastrik Obstruksiyon

Hernia repair is one of the most common elective procedures in general surgery. Agreement has been achieved that tension-free hernia repair using prostheses reducesrecurrence rates significantly. Approximately 60% of prosthetic repairs of the inguinal flor are believed to use a flat mesh of some type, and 90% of incisional and ventral herniarepairs incorporate the use of a synthetic prosthesis. However, the use of prosthetic mesh for hernia repair can cause serious complicationssuch as infection, seroma formation, fistulae formation, adhesion, biomaterial-related intestinal obstructions, and other miscellaneous complications. Mesh migration is dangerous and rare complication after hernia repair. Hereby, reporting a rare case of intra-peritoneal migration of polypropylene mesh and its adhesion to stomach wall following onlay mesh repair of incisional hernia.Fıtık tamiri genel cerrahide en fazla yapılan ameliyatlardan birisidir. Protez kullanılarak yapılacak gerginliği azaltıcı tamirlerin etkinliği konusunda bir fikir birliği oluştu. Bugün, inguinal fıtıkların %60’ında flat mesh, insizyonel fıtıkların %90’ında prosthetic mesh kullanıldığı sanılmaktadır. Bununla birlikte, mesh kullanımı enfeksiyon, seroma, fistül, barsak fistülü, yapışıklık, barsak tıkanmaları ve diğer nadir görülen komplikasyonlara yol açabilir. Mesh migrasyonu tehlikeli ve nadir bir komplikasyondur. Burada, insizyonel herni nedeniyle onlay olarak uygulanan polipropilen meshin intraperitoneal olarak migrasyonu ve mide duvarına yapıştığı nadir bir vaka sunulmuştur

Follow-Up During Early Infancy of Newborns Diagnosed with Subcutaneous Fat Necrosis

Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon condition caused by generalized and/or local tissue hypoperfusion. The skin lesions of ScFN tend to improve spontaneously. However, ScFN may also lead to complications which cause serious problems. The severity of the etiologic factors contributing to the development of the disease determines the severity of complications. Therefore, these patients should be closely monitored for complications, especially for hypercalcemia which may be life-threatening. The severity and duration of hypercalcemia are associated with the extensity of skin lesions

Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

OBJECTIVE: Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus. MATERIALS AND METHODS: This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935. RESULTS: The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (

Roux-en-Y rekonstrüksiyonlu pankreatikoduodenektomi sonrası izole pankreatikojejunostomi pankreas fistülünü azaltabilir mi?

Amaç: Pankreatikoduodenektomi ampulla Vateri, pankreas başı, distal koledok tümörleri ve bazı kronik pankreatit olgularında yaygın kabul gören cerrahi prosedürdür. Rekonstrüksiyon sonrası pankreatik fistül halen ciddi bir problemdir. Rekonstrüksiyon yöntemleri hususunda üzerinde fikir birliği sağlanmış bir yöntem henüz yoktur.Gereç ve Yöntemler: Pankreas tümörü nedeniyle pankreatikoduodenektomi uygulanan hastalarda yapılan rekonstrüksiyon yöntemleri ve sonuçları retrospektif olarak araştırılmıştır. Tüm hastalardaki anastomoz Roux-en-Y şeklinde yapılmış olup birbirinden farkları ise şöyledir; Tip 1: Y bacağı ile sadece pankreatik anastomoz, Tip 2: Y bacağı ile pankreas ve hepatik kanal anastomozu birlikte yapılmıştır.Bulgular: Çalışmaya 31 hasta dahil edilmiştir. Hastaların 21'i erkek, 10'u kadındı. Çalışmamızda pankreatik fistül, kanama, abse, yara yeri enfeksiyonu ve akciğer enfeksiyonu postoperatif dönemde gözlenen komplikasyonlardı. Her ne kadar grup 2'de komplikasyonların sayısı grup 1'e kıyasla daha fazla gözlense de istatistiksel olarak anlamlı fark tespit edilmedi. Mortalite her iki grupta da birer hastada gelişti.Sonuç: Kaçağın sebeplerinden birinin aynı ans üzerine yapılan pankreas ve safra kanalı anastomozlarının birlikte debiyi yükseltmesi ve anastomoz basıncını arttırarak fistül oluşumuna neden olması olduğunu düşünüyoruz. Çalışmamızın dezavantajı ise hasta sayısının az olmasıdır. Pankreatik sıvı ile safranın ayrı anastomozlarla rekonstüksiyonu kronik pankreatik fistülleri azaltabilir.Objective: Pancreaticoduodenectomy is a surgical procedure which is commonly accepted in cases of ampulla of Vater, head of pancreas, distal common bile duct neoplasms and severe chronic pancreatitis. Pancreatic fistula is still a serious problem after reconstruction. Yet, there is no consensus on a single reconstruction method. Material and Methods: The reconstruction methods on patients who had pancreaticoduodenectomy due to pancreatic tumor, and results of these reconstruction methods were retrospectively analyzed. Anastomosis was performed on all patients in the form of Roux-en-Y, but they varied as follows; Type 1: Only pancreatic anastomosis to the Y limb, Type 2: Pancreas and hepatic canal anastomosis together to the Y limb.Results: 31 patients participated in the study. 21 of them were male, and 10 were female. In our study, postoperative complications included pancreatic fistula, hemorrhage, abscess, wound site infection, and pulmonary infection. Although more complications were observed in group 2 than in group 1, there was no statistically significant difference. There was one mortality in each group.Conclusion: In our opinion, one of the reasons of leakage is that anastomosis of both the biliary and pancreatic ducts to the same loop increases anastomotic pressure due to the raised output thus leading to fistula formation. A limitation of our study was the low number of patients. Reconstruction of the pancreas and bile secretions through separate anastomosis may reduce the rate of pancreatic fistulas

Firm Size and Financing Behavior during the COVID-19 Pandemic: Evidence from SMEs in Istanbul

This paper examines how small and medium-size enterprises (SMEs) in Istanbul managed their financial needs during the COVID-19 pandemic. A unique survey was conducted in May–June 2021 to analyze the effect of the pandemic on financial conditions and access to finance. The paper maps the differences between firms in terms of their financing conditions and behavior based on their size during the pandemic. The novel data set helps to conceptualize the impact of the COVID-19 pandemic on SMEs. The paper makes a contribution to the literature through using a large number of variables related to firms’ financial conditions and opportunities (e.g., credit restructuring, debt postponing, capital injection). The paper hypothesizes that SMEs are less likely than large firms to access formal finance opportunities, but they tend to rely more on informal financing. The empirical findings suggest that, during the pandemic, micro and small firms tend to borrow more from their acquaintances, such as relatives and friends. Micro firms are less likely to restructure their outstanding loans, borrow from banks, or inject capital. Furthermore, micro firms tend to cut their costs more to avoid further difficulty in their financial positions. Micro and small firms tend to apply for bank loans less than large firms, while medium-size firms are more likely to apply. Micro and small firms are more inclined to report difficulty in accessing credit

Surgical approach in adrenal incidentalomas: Report of thirteen cases and review of the literature

Amaç: Adrenal insidentalomalar rutin görüntüleme tekniklerinde yaklaşık %4-7 oranında tespit edilirler. Çoğunlukla benign olmakla birlikte dikkatli klinik ve laboratuvar incelemeleri sonrasında karsinom veya fonksiyonel adenomlar belirlenebilir.Gereç ve Yöntemler: Ocak 2010-Haziran 2014 tarihleri arasında adrenal kitle tespit edilerek cerrahi tedavi uygulanan 13 hastanın bulguları retrospektif olarak incelendi.Bulgular: Olgulardan 7'si (%54) erkek, 6'sı (%46) kadın, ortalama yaş 38,2 idi. Klinik tanılarda 5 hastada (%38,4) feokromasitoma, 5 hastada (%38,4) nonfonksiyone adenom, 1 hastada (%7,6) metastatik lezyon, 1 hastada (%7,6) Cushing sendromu, 1 hastada (%7,6) sürrenal karsinom tespit edilmiştir. Cerrahi tedavi uygulanan hastaların 8'ine laparotomi ile, 52'sine de laparoskopik adrenalektomi uygulanmıştır.Sonuç: Adrenal insidentaloma saptanan olgular asemptomatik olsa dahi hormonal yönden detaylı olarak incelenmeli, non-fonksiyone kitlelere ise malignite kuşkulu lezyonlar olarak bakılmalıdır. Kitle boyutu 6 cm'den küçük ve komşu organ infiltrasyonu bulunmayan hastalarda laparoskopik adrenalektomi altın standart haline gelmektedir.Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation.Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively.Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy.Conclusion: Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs

Gastric Trichobezoar: Case Report

Bezoar, sindirilemeyen maddelerin gastrointestinal sistem içinde birikmesiyle oluşan kitlelere verilen isimdir. Bu yazıda, bulantı, kusma, karın ağrısı, anemi ve epigastrik kitle nedeni ile opere edilen, 28 yaşındaki bir kadın hasta sunuldu. Laparotomi ile hastanın midesini tamamen dolduran ve mide şeklini almış olan trikobezoar çıkarıldı. Ameliyat sonrası dönemde sorunsuz iyileşen hastada, psikiyatrik değerlendirmede, dürtüsel saç çekme (trikotillomani) ve depresyon olduğu tespit edildi.Bezoar is a mass that cannot be digested and that is collected in the gastrointestinal system. A 28-year-old girl, underwent an operation for abdominal pain, nausea, vomiting, anemia and epigatsric mass, was presented in this study. A mass which took the shape of the stomach was removed out of her stomach by laparatomy. Postoperative period was uneventful. A subsequent psychiatric consultation revealed trichotillomania and depression