Comparison of the efficiency of anti-androgenic regimens consisting of spironolactone, Diane 35, and cyproterone acetate in hirsutism.

The aim of the present study was to evaluate the effects of three different anti-androgenic drug-therapy regimens, Diane 35 (cyproterone acetate (CPA) [2 mg] and ethinyl estradiol [35 microg]) plus CPA, Diane 35 plus spironolactone, and spironolactone alone, in patients with hirsutism. In this prospective, randomized clinical study, 79 subjects with idiopathic hirsutismus were studied. The patients were divided into 3 groups. Group I patients (n=32) were treated with Diane 35 plus CPA, group II patients (n=25) with Diane 35 plus spironolactone [100 mg], and group III patients (n=22) with spironolactone [100 mg] alone. Serum FSH, LH, testosterone (T), and DHEAS levels were analyzed before and after treatment at 6 and 12 months. Hirsutism scores were graded according to the Ferriman-Gallwey scoring system, and side effects were monitored. All treatment regimens were found to be efficient and well-tolerated, and none of the patients stopped therapy due to any adverse event. However, in hormone screening, only patients on the Diane 35 plus CPA regimen revealed a decrease in serum T levels after therapy. As such, treatment of each hirsute patient should be planned individually, but with regard to both cost-efficiency and potential side effects, we recommend spironolactone alone in the treatment of hirsutismus.</p

Kaynarca ilçesinin coğrafi etüdü

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Araştırma sahasını oluşturan Kaynarca İlçesi, Marmara Bölgesinde Sakarya ilinin kuzeybatısında yer alır. Yüz ölçümü 33 Km2 dir.İnceleme alanı ve konusuyla ilgili literatür taraması, gezi ve gözlemler ile mülakat çalışmasından elde edilen veriler, coğrafyanın prensipleri (dağılış, sebep-sonuç ve ilişki) göz önünde tutularak analiz edilmiştir. Elde sonuçlar bölgesel coğrafya anlayışına uygun olarak rapor haline getirilmiş ve sunulmuştur.Kocaeli platosunda yer alan araştırma alanı bulunduğu bölümün genel morfolojik karakterini yansıtır. Dolayısıyla hafif engebeli aşınım yüzeyleri ve tepeler topografik görünümde baskındır. Karadeniz iklimi ve bitki örtüsünün yayılış alanı içerisindedir. Ormanların büyük kısmı tarım arazisi ve iskan nedeniyle tahrip edilmiş olsa da % 27 lik oranı ile önemli bir yere sahiptir. Arazinin plato karakterinde oluşu ve kuzeydeki düzlüklerin genç kuaterner dolgularından oluşması nedeniyle 1. sınıf tarım arazileri bulunmaz. Kireçsiz kahverengi orman topraklarının yaygın olduğu görülür. İnceleme alanında akarsular (dereler) kuzey yönünde akışlıdır ve genel olarak Sakarya nehri havzası içerisindedir. Göller ise kıyı kesiminde yer alır ve deniz akıntıları ve dalgaların biriktirmesi ile oluşmuş dolguların gerisindeki çukurluklarda yer alır genel hatları ile lagünlere benzerlik gösterir.Bitinyalı'lardan beri yerleşme alanı olan Kaynarca ve çevresi bu özelliğini Roma, Bizans ve Osmanlı döneminde de sürdürmüştür. Bir nahiye olan Kaynarca cumhuriyet döneminde idari bakımdan ilçeye (1959) dönüştürülmüştür. Günümüzde (2008) toplam nüfusu 23.366 olan Kaynarca'nın 41 köyü bulunmakta ve kır nüfusu % 77 lik bir orana sahiptir.Kaynarca'da ekonomik yapının tarım ve hayvancılığa dayalı olduğu görülür. İlçe merkezinde ise idari fonksiyona bağlı olarak hizmet sektörü ve küçük sanayi gelişmiştir.Günümüzde Çatalca-Kocaeli Bölümü'ndeki hızlı kentleşme ve sanayileşme sonucunda yeni alanlara ihtiyaç duyulduğundan henüz çok yoğun bir yerleşme ve endüstriye sahip olmayan inceleme alanı bir cazibe merkezine dönüşebilir. Bu nedenle yapılacak planlamalarda ve yatırımlarda doğal ve beşeri coğrafya özelliklerine dikkat edilmesi gelecekte olası çevre sorunlarını azaltabilir.Anahtar Kelimeler: Kaynarca, Kocaeli Platosu, SakaryaThe territory of Kaynarca county covered in this study takes place in Marmara region along north-east of Sakarya province. Total area of the county is 33 square kilometers.Data obtained through compiling information by searching library documents, travelling, observations and interviews have been analised in accordance with geographical principles. The results of this survey are presented in a report form that complies to standing rules of regional geography.Survey area taking place in Kocaeli Plato reflects the general morphological characteristics of the area. Therefore slightly irregular erosion surfaces and hills are dominant figures along its topographical view. It is within the spread zone of the Black Sea climate and vegetation.Although great majority of the forests were destroyed for agriculture and settlement it still has 27% forestry that can said to be quite significant.Because the land shows plate characteristics and that flat territory on the north consisting of quaternary fills high quality agricultural soil does not exist in the area. Brown forest soil free of lime is widespread.All streams in the surveyed area generally take place in the Sakarya river basin and they flow north. Lakes take place in those trenches formed by waves and currents along the shore similar to lagoons.Kaynarca county and its vicinity had been a place of inhabitance since Bitinians. These aspects were carried on through the times of Romans, Byzantines and Ottomans. Kaynarca that used to be administered as a sub-district turned into a county in the republic era (1959).Today (2008) Kaynarca has a population of 23.366 and it has 41 villages. Rural population is 77%.Kaynarca?s economy is based on agriculture and livestock. In the town center administrative services and some small industries take place.Nowadays due to rising demand for urban land because of rapid industrialization and urbanization in Çatalca-Kocaeli zone it may have an impact on the area that this study is focused. This area may become a land of attraction because of its low inhabitance.Therefore potential environmental problems can be minimized by paying special attention to natural and anthrop geographical aspects planning and investing in the area.Key words: Kaynarca, Kocaeli Plato, Sakary

Review of Two Siblings with Werner's Syndrome: A Case Report

We report the clinical course of two siblings with Werner's syndrome (WS) who were diagnosed and followed at our clinics for 12 years. Initial diagnosis of the first sibling (sister) was at age 20, the second (brother) at 16. At the initial diagnosis, the sister had amenorrhea, muscle atrophy at arms and legs, diabetes mellitus (DM), short stature, bilateral cataracts, genital hypoplasia, osteoporosis, and gray hair. During 12 years follow-up period, high-pitched voice, hepatosteatosis, renal parenchymal disease, and urethral obstruction developed. Regarding the brother, DM, cataracts and genital hypoplasia were observed at the initial diagnosis. During the 12 years follow-up period, gray hair, high-pitched voice, steatohepatosis, and osteoporosis developed

Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom.

Despite the current diagnostic and serologic testing for SLE, the interval between the onset of symptoms and the diagnosis is still long. In this study, we aimed to show the interval between the initial symptoms and the diagnosis of SLE and to investigate the presence of any relationship between the interval and the initial symptoms. One hundred and thirty-six patients were diagnosed with SLE using the 1982 ARA criteria. The mean age of the patients at diagnosis was 29.9 +/- 10.5 years. The mean interval between the onset of symptoms and the diagnosis of SLE was 21.82 +/- 30.32 months. The subjects were evaluated twice, at intervals of &#60; or = 3 and &#60; or = 12 months after the onset of symptoms. Although arthritis and/or arthralgia were the most common initial symptoms (60.3%), only 26.8% of the patients with these symptoms were diagnosed earlier than 3 months after the onset. If the first initial symptoms were butterfly rash or pericarditis, pleuritis, spontaneous abortion or cognitive dysfunction, they led to early diagnosis. In conclusion, since arthritis and/or arthralgia are the most common initial symptoms of the disease, every young woman with these symptoms should be carefully evaluated for SLE.</p

Effect of surface treatments on wear and surface properties of different CAD-CAM materials and their enamel antagonists.

STATEMENT OF PROBLEM Which surface treatment provides optimal surface roughness, microhardness, and wear behavior for computer-aided design and computer-aided manufacturing (CAD-CAM) materials and their enamel antagonists is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of surface treatment on the surface roughness, microhardness, and 2-body wear of different CAD-CAM materials and their enamel antagonists. MATERIAL AND METHODS Monolithic zirconia, polymer-infiltrated ceramic network, lithium disilicate, leucite-reinforced ceramic, zirconia-reinforced lithium silicate, and feldspathic ceramic specimens were sliced into 2-mm-thick rectangular plates and divided into polished or glazed subgroups (n=6). After surface roughness and microhardness measurements, the specimens were loaded at 49 N for 250 000 cycles and simultaneously thermocycled (5 °C and 55 °C). All specimens were scanned before and after the wear test by using a scanner. The volumetric loss and wear depth of the materials and the volumetric and height loss of the enamel were calculated, and scanning electron microscope images of the specimens were made. Multiple 2-way ANOVAs and Tukey honestly significant difference tests were used to assess the effect of material and surface treatment on surface roughness, microhardness, and wear behavior of materials and enamel (α=.05). RESULTS Material and surface treatment interactions affected the surface roughness (P<.001), microhardness (P<.001), volumetric loss of materials (P=.044), and height loss of enamel (P<.001). CONCLUSIONS Polishing resulted in higher surface roughness and microhardness than glazing. Volumetric loss depended on the material, which affected the height loss of the antagonists. Glazing and polishing had similar effects on the volumetric loss of materials and antagonists. No correlation was found between the wear of materials and the antagonists, nor between the surface roughness of materials and the volumetric loss of materials or antagonists

STATISTICAL ANXIETY AND METACOGNITIVE AWARENESS LEVELS OF GRADUATE STUDENTS STUDYING IN MATHEMATICS EDUCATION PROGRAM

Graduate students are faced with some difficulties in determining statistical methods to be used in their assignments and researches and this leads to anxiety in them. In this study, it was aimed to examine the relationships between statistical anxiety and metacognitive awareness levels of graduate students studying in the field of mathematics education and to compare these levels in terms of some variables. The research study group consists of 101 students studying at the master's and doctorate levels in the department of mathematics education and participated in the research voluntarily. As a data collection tool in the research, Statistical Anxiety Scale (SAS) and Metacognitive Awareness Scale (MCAS) were used. In the analysis of the data, descriptive statistics, t-test, ANOVA and Correlation Coefficient were used. According to the research results, it was determined that there is a negative and moderately significant relationship between statistical anxiety and metacognitive awareness levels of graduate students studying in the field of mathematics education. As a result of the analyzes, it was observed that the statistical anxiety and metacognitive awareness of the students were high, the statistical anxiety and metacognitive awareness levels differed statistically according to the variables of graduate education level and stage of graduate education, but did not differ significantly according to the variables of gender and taking statistics course.   Article visualizations

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TÜBİTAK EEEAG01.01.201

Symmetric Teleparallel Gravity: Some exact solutions and spinor couplings

In this paper we elaborate on the symmetric teleparallel gravity (STPG) written in a non-Riemannian spacetime with nonzero nonmetricity, but zero torsion and zero curvature. Firstly we give a prescription for obtaining the nonmetricity from the metric in a peculiar gauge. Then we state that under a novel prescription of parallel transportation of a tangent vector in this non-Riemannian geometry the autoparallel curves coincides with those of the Riemannian spacetimes. Subsequently we represent the symmetric teleparallel theory of gravity by the most general quadratic and parity conserving lagrangian with lagrange multipliers for vanishing torsion and curvature. We show that our lagrangian is equivalent to the Einstein-Hilbert lagrangian for certain values of coupling coefficients. Thus we arrive at calculating the field equations via independent variations. Then we obtain in turn conformal, spherically symmetric static, cosmological and pp-wave solutions exactly. Finally we discuss a minimal coupling of a spin-1/2 field to STPG.Comment: Accepted for publication in the International Journal of Modern Physics

A Fusion-Based Framework for Wireless Multimedia Sensor Networks in Surveillance Applications

Multimedia sensors enable monitoring applications to obtain more accurate and detailed information. However, the development of efficient and lightweight solutions for managing data traffic over wireless multimedia sensor networks (WMSNs) has become vital because of the excessive volume of data produced by multimedia sensors. As part of this motivation, this paper proposes a fusion-based WMSN framework that reduces the amount of data to be transmitted over the network by intra-node processing. This framework explores three main issues: 1) the design of a wireless multimedia sensor (WMS) node to detect objects using machine learning techniques; 2) a method for increasing the accuracy while reducing the amount of information transmitted by the WMS nodes to the base station, and; 3) a new cluster-based routing algorithm for the WMSNs that consumes less power than the currently used algorithms. In this context, a WMS node is designed and implemented using commercially available components. In order to reduce the amount of information to be transmitted to the base station and thereby extend the lifetime of a WMSN, a method for detecting and classifying objects on three different layers has been developed. A new energy-efficient cluster-based routing algorithm is developed to transfer the collected information/data to the sink. The proposed framework and the cluster-based routing algorithm are applied to our WMS nodes and tested experimentally. The results of the experiments clearly demonstrate the feasibility of the proposed WMSN architecture in the real-world surveillance applications

Diltiazem Increases the Liver Regeneration in Rats by Inhibiting TGF-β1

Transforming growth factor beta-1 (TGF- β1) is the most important inhibitory cytokine during the hepatic regeneration process. Diltiazem is a Ltype calcium channel blocker that has inhibitory effect on TGF- β1. The aim of the present study was to determine the effect of diltiazem on hepatic regeneration. Sixty female Wistar Albino rats were used. Three groups were created; the control, low dose diltiazem and high dose diltiazem groups, each consisting of 20 rats. After partial liver resection (70% hepatectomy), saline was introduced to control group, 5 mg/kg diltiazem was introduced to low dose group and 15 mg/kg diltiazem to high dose group intraperitoneally. Ten rats in each group were sacrificed on the first postoperative day and the remaining rats on the fifth day. Liver weight, mitotic rate and the Ki-67 ratio were measured for determining hepatic regeneration. Liver regeneration rate on the fifth postoperative day was significantly higher both in the low dose and high dose diltiazem groups than the control group (Low diltiazem vs control: P&lt;0.001; High diltiazem vs control: P&lt;0.001). No significant difference was found between the groups regarding the number of mitoses on the first and fifth days following partial hepatectomy (P&gt;0.05). The Ki-67 ratio on the first postoperative day was significantly higher both in the low dose and high dose diltiazem groups than the control group (Low diltiazem vs control: P&lt;0.001; High diltiazem vs control: P&lt;0.001). Diltiazem increases liver regeneration by inhibiting TGF-β1