Veri güdümlü yöntemler ile uydu yağış verileri kullanılarak aylık akarsu debisi tahmini.

Predictability of stream flow has been the focus of many studies involving water resources management and hydroelectric energy production. Many hydrologic models have been developed to predict future and current streamflow at various time lags and locations. However, these physically-based models require reanalyzed future data sets (particularly precipitation forcing data) to predict future streamflow. Alternatively, data driven models can also provide predictions without the need of future projections by relying on the strong seasonality and autocorrelation that exist in the streamflow data. In this study, a data driven approach has been taken to predict monthly streamflow data sets utilizing precipitation data sets and using various linear and non-linear methods. Streamflow predictions of Coruh Basin have been performed using both the Tropical Rainfall Measurement Mission (TRMM) and the ground-based station precipitation (MGM) data sets between years 2000 – 2011. Predictions are validated using independent streamflow measurements acquired from General Directorate of State Hydraulic Works (DSI). A Simple Linear Regression Model (SLR), a Multiple Linear Regression Model (MLR), an Artificial Neural Network Model (MLP), and two Copula Models (Normal Copula and Frank Copula) are constructed and their predictions are cross-compared with the climatology- and persistence-based predictions. To further investigate the source of the predictive skills of these methods, separate predictions are made using the standardized anomaly components of data sets [after climatology (long year monthly mean) components are removed and standardized by dividing by the standard deviation of the data] and complete data sets (normal/non-standardized data sets retaining both anomaly and climatology components). Results show the best predictions are obtained from the climatology-based predictions of the stations for the complete data sets while persistence-based predictions are also strong. Predictions using standardized anomaly data sets are improved when long-term climatology values added. These climatology added predictions show above 0.90 correlations, showing heavy majority of the predictive skill and the relation between the precipitation and the streamflow data sets are due to the strong seasonality impacting both variables.M.S. - Master of Scienc

Does the Change in the Indications of Endoscopic Sinonasal Surgery Continue? Data between 1994-2018

Objective: Endoscopic sinonasal surgery (ESS) has changing over the years in parallel with the developments in endoscopy devices, video-imaging techniques, and surgical instruments. In the present study we investigated whether the indications of patients who underwent surgery over a period of 25 years have accommodated to these changes.Methods: We retrospectively evaluated 1173 patients who underwent surgery in our clinic from 1994 through 2007, and 954 patients who underwent surgery from 2008 through 2018. The patients were divided into three groups as follows: chronic rhinosinusitis with polyps (CRSwNP), chronic rhinosinusitis without polyps (CRSsNP), and others. The changes in the indications during the first 14 years and the following 11 years were compared, and the results were statistically evaluated.Results: A significant decrease was observed in the number of patients who underwent surgery following the diagnosis of CRSsNP (p<0.001). In addition, a statistically significant increase was found in CRSwNP (p<0.001) and other (p<0.001) indications.Conclusion: When ESS indications identified in our clinic were reviewed, it was observed that the increasing trend in CRSwNP rate in the first 14 years continued, there was a significant increase in non-CRS indications in the last 11 years, and there has been an increase in patients with fungal sinusitis, especially in this group

Role of inferior pulmonary ligament at obliteration of apical dead space occuring following upper lobectomies

Giriş ve amaç: Üst lobektomisonrası yapılan pulmoner ligament diseksiyonunun postoperatif akciğer ekspansiyonu ve space üzerine olan etkisini göstermeyi amaçladık. Materyal ve metod: Kliniğimizde 23 Ocak 2011-26 Şubat 2013 tarihleri arasında üst lobektomi yapılan tüm hastalar retrospektif olarak inceledik. Her iki grupta 20 hasta, toplamda 40 hasta olacak şekilde inferior pulmoner ligament diseksiyonu yapılan ve yapılmayan hastalardaniki grup oluşturduk. Postoperatif çekilen akciğer grafisinde %20 den veya üç cm fazla olan hava boşluklarını space, postoperatif beşinci günden fazla devam eden hava kaçağını ise uzamış hava kaçağı olarak kabul ettik.Hastaların gelişen komplikasyonları, negatif aspirasyon ihtiyacı, ilave tüp torakostomi, dren çekilme zamanı, hastanede kalış süresini kaydettik. Her bir hastanın postoperatif birinci, üçüncü, beşinci, yedinci, 30., ve 90. gün çekilen akciğer grafilerini inceledik ve pnömotoraks yüzdelerini hesapladık. Tüm verileri Statistical Packageforthe Social Sciences (SPSS-22.0) istatistik paket programı kullanılarak karşılaştırdık. Bulgular: Çalışmaya dahil edilen hastaların %40'ında (n=16) postoperatif komplikasyon saptandı [grup 1 (n=9), grup 2 (n=7)]. En sık görülen komplikasyon 8 (%20) hasta ile uzamış hava kaçağı ve space idi. Yedi hastaya ilave tüp torakostomi uygulandı [grup 1 (n=3), grup 2 (n=4). Hastaların tamamında üçüncü ay akciğer grafilerinde akciğerin tam ekspanse olduğu görüldü. Komplikasyon sıklığı, space varlığı ve pnömotoraksdeğişim değerleri karşılaştırıldığında iki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuç: Çalışmamız sonucunda inferior pulmoner ligament diseksiyonunun olumlu ya da olumsuz sonuçlarını gösteren ikna edici kanıta ulaşılamamıştır. Geleneksel olarak uygulanan inferior pulmoner ligament diseksiyonun anlamlığını gösterebilmek için daha çok hasta sayısı içeren çok merkezli çalışmalara ihtiyaç vardır.Introduction and objective: We aimed to evaluate the effects of pulmonary ligament dissection following upper lobectomy on postoperative lung expansion and space. Material and method: We retrospectively assessed the patients who underwent upper lobectomy surgery between 23 January 2011 and 26 February 2013 in our clinic. We organized two groups of 20 patients due to undergoing inferior pulmonary ligament dissection or not undergoing this procedure, totally 40 patients were evaluated. If more than %20 or 3 cm space occurred in postoperative chest radiogram, we defined it as 'space'. If the air leak had still persisted after postoperative 5th day, we accepted it as prolonged air leak. Postoperative complications, requirement of negative aspiration, additional tube thoracostomy, drain removal time and hospitalization time was recorded. Chest radiograms of each patient were inspected on postoperative 1st, 3rd, 5th, 7th, 30th and 90th days and percentage of pneumothorax was calculated. All data has been compared with the use of Statistical Package for the Social Sciences (SPSS 22.0) pack programme. Results: %40 (n=16) of included patients had postoperative complications (group1:9, group 2: 7). The most frequent complication was prolonged air leak and space which was observed in 8 (%20) of patients. 7 patients underwent additional tube thoracostomy (group 1=3 and group 2=4). All of the patients had full pulmonary expansion at postoperative 3rd month. Complication frequency, presence of space and pneumothorax resolution time of two groups were compared and no statistically significant difference was observed. Conclusion: We could not obtain convincing evidence that indicates the favorable or unfavorable effects of inferior pulmonary ligament dissection as a result of our study. Multicenter studies that evaluate more cases are needed to assess the significance of inferior pulmonary ligament dissection

The Review of Our Chronic Osteomyelitis Cases

In this study, we have presented the laboratory and clinical findings, and treatment and follow-up results of 32 patients with osteomyelitis treated in both Infectious Disease Clinics and Orthopaedics & Traumatology departments of our university hospital between January 1999 and December 2001. Eleven female patients with a mean age of 45.9 ± 20.0 (15-80), and twenty-one male patients with a mean age of 53.4 ± 15.5 (28-82) were included in this study. The patients have had several risk factors rendering them predisposed to osteomyelitis. Staphylococcus aureus was the most frequently isolated microorganism (%46). The mean pretreatment and posttreatment C-reactive protein levels and sedimentation rates were different and the difference was statistically significant; but we could not find any difference between the white blood cell counts (p= 0.000, p= 0.022, p= 0.258 respectively). Despite of the medical and surgical treatment modalities, recurrence of the disease was detected in 6 patients. The mean time of treatment was 10.2 ± 9.3 (5-24) weeks and the mean follow up was 15.5 ± 7.5 (6-27) months. In conclusion, chronic osteomyelitis needs long term follow-up because of high rate of recurrence and resistance to treatment

Koroner baypas cerrahisi ve çıplak metal stent uygulanan hastaların klinik sonlanımlarının karşılaştırılması

Giriş: Biz bu çalışmamızda, koroner baypas greftleme cerrahisi ile çıplak metal stent uygulanmış hastalarda SYNTAX (Sx) skoru ile değerlendirilen koroner lezyon kompleksitelerinin klinik sonlanımlar üzerine etkisini incelemeyi amaçladık.Hastalar ve Yöntem: Çalışma grubumuz çıplak metal stent uygulanmış (n= 265) ve koroner baypas cerrahisine giden (n= 294) 459 hastadan oluşmaktadır. Koroner arter hastalığı kompleksitesi Sx skoru ile değerlendirilmiştir. Sx skoru, hafi f Sx skoru (= 33) olmak üzere üç gruba ayrılmıştır.Bulgular: Çalışma süresince orta dönem takipte herhangi bir nedenle revaskülarizasyon sıklığı hem tüm grupta hem de Sx alt gruplarında perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Orta dönem takipte herhangi bir nedenden ölüm sıklığı düşük ve orta Sx gruplarında tedavi grupları arasında benzer bulunmuştur. Ancak yüksek Sx skoru grubunda orta dönem takipte herhangi bir nedenden ölüm sıklığı perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Tüm popülasyonda herhangi bir nedenden dolayı ölüm için düzeltilmiş risk perkütan koroner girişim ve koroner baypas cerrahisi arasında benzerken [hazard ratio, %95 GA: 0.88 (0.38-2.05), p= 0.780], herhangi bir nedenle revaskülarizasyon için düzeltilmiş risk koroner baypas cerrahisi grubuna göre perkütan koroner girişim grubunda belirgin olarak daha fazlaydı [hazard ratio, %95 GA: 0.12 (0.05-0.30), p< 0.001].Sonuç: Sx skoru ile değerlendirilen koroner lezyon kompleksitesi herhangi bir nedenle revaskülarizasyon sıklığı ile daha yakın ilişkilidir. Yüksek Sx skoru gubunda herhangi bir nedenden ölüm çıplak metal stent uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazlaydıIntroduction: We aimed to compare the effects of coronary lesion complexity assessed by SYNTAX (Sx) score on the clinical outcomes in patients who have received BMS versus undergone coronary bypass grafting.Patients and Methods: Our study population consisted of 459 consecutive patients received bare metal stents (n= 265) or coronary bypass grafting (n= 294). The complexity of coronary artery disease was assessed by Sx score. Sx score was classifi ed as tertiles, as follows: low Sx score (? 22), intermediate Sx score and high Sx score (? 33).Results: Throughout the study, the intermediate-term incidence of any revascularization was signifi cantly higher in the percutaneous coronary intervention group compared with the coronary bypass grafting group for both overall group and Sx tertiles. The intermediate-term incidence of death from any cause was comparable between the treatment groups in patients with low and intermediate Sx tertiles. However, in patients with high Sx tertile, the intermediate-term incidence of death from any cause was signifi cantly higher in percutaneous coronary intervention group compared with coronary bypass grafting group. In the overall population, adjusted [hazard ratio, 95% CI: 0.88 (0.38-2.05), p= 0.780) risks for death from any cause were consistently comparable between percutaneous coronary intervention and coronary bypass grafting, whereas adjusted [hazard ratio, 95% CI: 0.12 (0.05-0.30), p< 0.001] risks for any revascularization were consistently signifi cantly higher in the percutaneous coronary intervention group compared with coronary bypass grafting group. Conclusion: Coronary lesion complexity assessed by SYNTAX score was closely associated with the higher incidence of any revascularization and in high SYNTAX score, with higher incidence of death from any cause in patients received bare metal stents than coronary artery bypass graftin

Assessment of Spectral-Domain Optical Coherence Tomography Findings in Three Cases of X-Linked Juvenile Retinoschisis in the Same Family

X-linked juvenile retinoschisis (XLRS) is an X-linked hereditary retinal dystrophy characterized by splitting of the neurosensory retina. On fundus examination, the macula often has a spoke wheel appearance with foveal cystic lesions, and separation of the retinal layers is typical on spectral-domain optical coherence tomography (SD-OCT). Patients with XLRS can exhibit different clinical courses, stages, and SD-OCT findings, even among members of the same family. SD-OCT is an important imaging method that allows us to achieve more detailed information about XLRS. In this study, we report three patients in the same family who have different clinical features and SD-OCT findings

Böbrek nakli yapılan hastalarda hiperürisemi ve gut hastalığı sıklığı

Amaç: Böbrek nakli sonrası hiperürisemi sık görülmesine rağmen gut hastalığı nadirdir. Ancak bu konu ile ilgili böbrek nakli yapılmış Türk hasta grubunda yayınlanmış makale mevcut değildir. Bu çalışmanın amacı böbrek nakli yapılmış hastalarda hiperürisemi ve gut hastalığı görülme sıklığını belir-lemektir. Gereç ve Yöntem: Başkent Üniversitesi Hastanesi Transplantasyon Ünitesinde 2000 ve 2002 yılları arasında böbrek nakli yapılmış 155 hasta (E/K, 119/36; ortalama yaş 34,7±9,7 yıl) retrospektif olarak araştırıldı. Çalışmaya en az 2 yıl süresince normal böbrek fonksiyonlarına sahip olan hastalar dahil edildi. Hastaların nakil olduktan sonra rutin poliklinik kontrollerindeki laboratuvar değerleri kayıt edildi. Ayrıca hastaların demografik özellikleri ve kullandığı ilaçlar kayıt edildi. Serum ürik asid seviyesi kadınlarda 6 mg/dl erkeklerde 7 mg/dl üzerinde ise hiperürisemi olarak kabul edildi. Klinik olarak gut hastalığı hiperürisemi ile birlikte gut artritinin ve tofüsün olmasıyla tanımlandı. Bulgular: Hiperürisemi 95 hastada, gut hastalığı ise 13 hastada saptandı. Serum ürik asid seviyelerinin hastaların yaşından, cinsiyetinden, donörün canlı veya kadavra olmasından ve aldıkları ilaç rejimin-den bağımsız olduğu saptandı. Sonuç: Böbrek transplantasyonu yapılan hastalarda hiperürisemi yaygın olarak görülmesine rağmen gut hastalığı bu hasta grubunda nadirdir. Aim: Although the prevalence of hyperuricemia is high after renal transplantation, investigation has shown that gout occurs rarely in these patients. The present study was designed to investigate the preva-lence of hyperuricemia and gout in renal transplant patients. Materials and methods: The records of 155 patients (M/F, 119/36, mean age 34.7 9.7 years) who under-went renal transplantation in between 2000 and 2002 were retrospectively reevaluated. Patients with at least 2 years stable graft survival duration were included. For each individual, mean value of serum uric acid levels that were repeated in each routine visits approximately every 6 months in transplanta-tion outpatient clinic were used. Patient demograph-ics, immunosuppressive drug regimens and other medications were also recorded. Hyperuricemia was defined as serum uric acid level of >6 mg/dl in females and 7 mg/dl in males. Clinical gout was defined as hyperuricemia with gouty arthritis and tophi. Results: Hyperuricemia and gout were seen in 95 patients, and 13 patients, respectively. Mean serum uric acid levels were found to be independent from patients' age, sex, donor type, and immunosuppres-sive drug regimen. Conclusion: Our study confirmed that although hyperuricemia is a common complication in renal transplant recipients, gout is not seen often in these populations