Anterior Herniation of Partially Calcified and Degenerated Cervical Disc Causing Dysphagia

We report a rare case of anterior cervical disc herniation associated with dysphagia. A 32-year-old man presented with complaints of dysphagia and concomitant pain in the right arm resistant to conservative therapy. On physical examination with respect to the muscle strength, the right shoulder abduction and flexion of the forearm were 3/5. Lateral X-ray revealed calcified osteophytes at the anterior C4-5 level. Magnetic resonance imaging showed soft disc herniation involving the right C6 root at the C5-6 level and anterior herniation of the C4-5 cervical disc. Anterior discectomies for C4-5 and C5-6 levels stabilized and ameliorated the dysphagia and pain. Cervical disc herniation usually presents with radicular findings. However, dysphagia may be an uncommon presentation. Anterior cervical disc herniation should be considered in a patient presenting with dysphagia

An Uncommon Intramedullary Tumor: Primary Spinal Cord Melanoma

A 47-year-old woman was admitted with complaints of progressive weakness in the lower extremities and pain in the back and left leg. Thoracic magnetic resonance imaging (MRI) revealed a spinal intramedullary tumor between the T9 and L1 levels, which were iso- to hypointense on T2 and slightly hyperintense on T1-weighted images. The tumor was resected as total, and the diagnosis was malignant melanoma confirmed with histopathology. Neurological findings improved at the postoperative period and no residual or recurrence was noted on postoperative MRI at the 9-month follow-up. Primary melanoma of the spinal cord, particularly intramedullar localization, is seldomly reported in the literature. We report a primary malignant melanoma of the spinal cord and emphasize the diagnostic and prognostic challenges

SİLLE, BİR KORUMA GELİŞTİRME PLANI VE SONRASI

Sille, which for some people it is a Byzantium village, for some other it is a Central Anatolian settlement dated to very old periods, where either Byzantines or Turks, as being Orthodox Christian and Muslim, lived together. Sille, which is known a very important centre up to the end of 19 Century, fell into a declining period at the end of that century, and accelerated its speed during the Post Exchanging period realized together with Lozan Agreement, and reached to the 21 Century. A slowly increasing  interest,  being  not  much  as  in  old  times,  by  Conservation  Development  Plan  (CDP), providing tourism attraction, and the positive process experienced during conservation implementations (after 2004) have led to a significant activities in Sille. In this study, starting with the Sille case, it is tried to take the picture of conservation implementations in Turkey within the framework experienced during the period of 10 years after the approval of the plan, by examining the investigations carried out before CDP and the plan decisions taken. Sille, kimine göre bir Rum köyü, kimine göre Anadolu’nun ortasında hem Rumların, hem Türklerin  Ortodoks  Hristiyan  ve  Müslüman  olarak  birlikte  yaşamış  oldukları,  tarihi  çok  eskilere dayanan bir Anadolu yerleşmesidir. 19. Yüzyılın sonlarına kadar önemli bir merkez olduğu bilinen Sille’nin, bu yüzyılın sonuna doğru yaşamaya başladığı bir gerileme dönemi hızını Lozan’la birlikte gerçekleşen Mübadele sonrası iyice arttırmış ve 21. Yüzyıla uzanabilmiştir. 2001 yılında onaylanan Koruma Amaçlı İmar Planı (KAİP) ile eskisi kadar olmasa da yavaş yavaş artan ilgi, turizm olgusunun isteklendirmesi  ve  koruma  uygulamasında  yaşanan  olumlu  süreç  (2004  sonrası)  Sille’de  bir hareketlenmeye  yol  açmıştır.  Bu  çalışma,  Sille  KAİP  öncesi  yapılan  araştırmalar  ve  alınan  plan kararlarını incelerken,  plan  onayını  izleyen  10  yıllık  süreçte yaşananlar  çerçevesinde ülkemizdeki koruma uygulamasının Sille örneğinden hareketle bir fotoğrafını çekmeye çalışmaktadır

Esnek ve Rijit Yol Üst Yapılarında Gürültü Seviyelerinin Eş Zamanlı Ölçümü ve Analizi

Beton yollar dünyada yaygın olarak kullanılmasına karşın ülkemizde gelişim gösterememiş, bu nedenle de genel olarak bitümlü sıcak karışım asfalt yollar tercih edilmiştir.Bu çalışmada, Türkiye'de yaygın olarak kullanılan bitümlü sıcak karışım asfalt yollar ve henüz yaygınlaşmamış olan beton yollar arasında gürültü seviyeleri yönünden bir karşılaştırma yapılmıştır. Bunun için Afyonkarahisar-Emirdağ arasında inşa edilmiş 2 km'lik beton yol ile bu yolun devamı olan bitümlü sıcak karışım asfalt yol arasındaki geçiş noktası çalışma koridoru olarak kullanılmıştır.Bu koridordaki beton yol ve bitümlü sıcak karışım asfalt yolun kenarlarına, ses girişimlerini en aza indirecek şekilde, ayrı ayrı gürültü ölçüm cihazı ve kamera düzenekleri yerleştirilmiş, yol yapım malzemesine bağlı olarak değişen gürültü seviyeleri eş zamanlı olarak kaydedilmiş, bulunan değerler analiz edilerek kaplama türleri ile gürültü seviyeleri arasındaki ilişki araştırılmıştır. Bu aşamada, kurulan düzenekler arasındaki mesafe trafik yoğunluğunun ve akış hızının değişimini engellemek için mümkün olduğunca kısa tutulmuştur.Yapılan ölçüm ve analizler sonunda beton yolların bitümlü sıcak karışım asfalt yollara göre ortalama gürültü seviyesinin aynı taşıt kompozisyonu ve trafik hacmi için yaklaşık 4 dB(A) daha düşük olduğu ortaya konmuş ve ülkemizde de beton yolların gelişim göstermesi gerektiği vurgulanmıştır

Clinical and hormonal characteristics of patients with different types of hypophysitis: a single-center experience

Objective: The inflammation of the pituitary gland is known as hypophysitis. It is a rare disease accounting for approximately 0.24%-0.88% of all pituitary diseases. The natural course of hypophysitis is variable. Main forms are histologically classified as lymphocytic, granulomatous, IgG4 related and xanthomatous. We aim to present our patients with hypophysitis and compare clinical, laboratory and radiological features. Subjects and methods: We retrospectively reviewed our database of 1.293 patients diagnosed with pituitary diseases between 2010 and 2017. Twelve patients with hypophysitis were identified. Demographical data, clinical features, endocrinological dysfunction, imaging findings, treatment courses and follow-up periods were evaluated. Results: The frequency of hypophysitis was found 0.93% in all cases of the pituitary disease. Twelve patients (nine females and three males), ages between 17-61 years, were evaluated. The characteristic features of our patients tended to be predominantly female and young. Diagnosis of hypophysitis was made after pituitary biopsy in four patients, and in eight patients after pituitary operation due to adenoma. Headache (67%) and visual problems (33%) were the most frequent nonendocrine symptoms. Anterior pituitary hormone deficiencies (63.7%) and/or diabetes insipidus (17%) were seen among patients. According to histopathological forms, four had lymphocytic, seven had granulomatous and one had xanthogranulomatous types. Contrast enhancement heterogeneous and thickened pituitary stalk were the most common radiological alterations. Conclusion: Hypophysitis should be considered in the differential diagnosis of sellar masses. It can mimic pituitary adenomas in radiological and endocrinological aspects. The different patterns of pituitary hormone deficiencies may be seen in the course of the disease

Endoscopic endonasal repair of spontaneous sphenoid sinus lateral wall meningocele presenting with cerebrospinal fluid leak

Spontaneous sphenoid sinus lateral wall meningoceles are rare lesions with an unknown etiology. Endoscopic endonasal technique is a considerable route in the treatment of this condition. The aim of this paper is to report the etiology, surgical technique, and outcome in a patient repaired via endoscopic endonasal approach. A 51-year-old male patient applied with rhinorrhea started three months ago after an upper respiratory infection. There were no history of trauma or sinus operation. Biochemical analysis of the fluid was positive for beta-2-transferrin. This asypthomatic patient had undergone for repairment of lateral sphenoid sinus meningocele with endoscopic endonasal transsphenoidal approach. After endoscopic endonasal meningocele closure procedure no complications occured and a quick recovery was observed. Endoscopic endonasal approach is an effective and safe treatment modality of spontaneous lateral sphenoid sinus meningoceles and efficient in anterior skull base reconstruction

AKILCI İLAÇ KULLANIMI

Akılcı ilaç kullanımı,DSÖ tarafından;kişilerin klinik bulgularına ve bireysel özelliklerine göre uygun ilaca,uygun süre ve dozda,en düşük maliyette ve kolayca ulaşabilmeleri olarak tanımlanmıştır.Bir endikasyon için uygun ilaç,etkililik,güvenlik,uygunluk ve maliyet kriterleri dikkate alınmışsa akılcı olarak seçilebilir.İlaç tedavisine karar vermeden önce mutlaka ilaç dışı tedavi seçenekleri gözden geçirilmeli özellikle diş hekimliğinde hastalığa neden olan etkeni ortadan kaldırmaya yönelik tedavi uygulamalrı yapılmalı ve hasta ağız hijyenini sağlama konusunda bilinçlendirilmelidir.Kullanılacak ilaçlar hastanın şikayeti, muayene bulguları göz önüne alınarak seçilmelidir.İlacın dozu ve kullanım süresi iyi ayarlanmalıdır

In vitro Effects of Chitosan on the Survival of Listeria monocytogenes

The nonlinear robust stability theory of Georgiou and Smith (IEEE Trans. Auto. Control, 42(9):1200--1229, 1997) is generalized to the case of notions of stability with bias terms. An example from adaptive control illustrates non trivial robust stability certificates for systems which the previous unbiased theory could not establish a non-zero robust stability margin. This treatment also shows that the BIBO robust stability results for adaptive controllers in French (IEEE Trans. Auto. Control, 53(2):461--478, 2008) can be refined to show preservation of biased forms of stability under gap perturbations. In the nonlinear setting, it also is shown that, in contrast to LTI systems, the problem of minimizing nominal performance is not equivalent to maximizing the robust stability margin

Clinical and hormonal characteristics of patients with different types of hypophysitis: a single-center experience

ABSTRACT Objective: The inflammation of the pituitary gland is known as hypophysitis. It is a rare disease accounting for approximately 0.24%-0.88% of all pituitary diseases. The natural course of hypophysitis is variable. Main forms are histologically classified as lymphocytic, granulomatous, IgG4 related and xanthomatous. We aim to present our patients with hypophysitis and compare clinical, laboratory and radiological features. Subjects and methods: We retrospectively reviewed our database of 1.293 patients diagnosed with pituitary diseases between 2010 and 2017. Twelve patients with hypophysitis were identified. Demographical data, clinical features, endocrinological dysfunction, imaging findings, treatment courses and follow-up periods were evaluated. Results: The frequency of hypophysitis was found 0.93% in all cases of the pituitary disease. Twelve patients (nine females and three males), ages between 17-61 years, were evaluated. The characteristic features of our patients tended to be predominantly female and young. Diagnosis of hypophysitis was made after pituitary biopsy in four patients, and in eight patients after pituitary operation due to adenoma. Headache (67%) and visual problems (33%) were the most frequent nonendocrine symptoms. Anterior pituitary hormone deficiencies (63.7%) and/or diabetes insipidus (17%) were seen among patients. According to histopathological forms, four had lymphocytic, seven had granulomatous and one had xanthogranulomatous types. Contrast enhancement heterogeneous and thickened pituitary stalk were the most common radiological alterations. Conclusion: Hypophysitis should be considered in the differential diagnosis of sellar masses. It can mimic pituitary adenomas in radiological and endocrinological aspects. The different patterns of pituitary hormone deficiencies may be seen in the course of the disease