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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Erken, İpek Elif;

    Dikkat eksikliği hiperaktivite bozukluğu (DEHB), dikkatsizlik, aşırı hareketlilik ve dürtüsellik belirtileri ile seyreden ve büyük oranda yaşam boyu devam eden nörogelişimsel bir bozukluktur. Genetik ve epigenetik faktörlerin DEHB etiyolojisinde önemli bir rol oynadığı düşünülmektedir. Epigenetik alanında DNA metilasyonunun DEHB etiyolojisindeki yerini inceleyen çalışmaların sayısı oldukça azdır. Bu çalışmada, DEHB etiyopatogenezindeki rolünü araştırmak amacıyla 30 DEHB tanılı hasta ve 30 sağlıklı gönüllü sağlam çocuğun DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri incelenmiştir. Çalışmaya dahil edilmiş katılımcılar 6-17 yaş aralığında, başka herhangi bir fiziksel veya psikiyatrik ek tanısı ve psikotrop ilaç kullanım öyküsü olmayan çocuk ve ergenler arasından seçilmiştir. Periferik kan örneklerinden ticari kit kullanılarak DNA izolasyonu yapılmış ve PyroMark Q24 pyrodizileme sistemi kullanılarak DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri kantitatif olarak ölçülmüştür. Katılımcıların belirti düzeyleri, Çocuk ve Ergenlerde Yıkıcı Davranım Bozuklukları İçin DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği ve DEHB Çocuk Değerlendirme yarı yapılandırılmış görüşme ile değerlendirilmiştir. DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri açısından olgu ve kontrol grupları arasında istatistiksel olarak anlamlı bir fark bulunamamıştır (p>0.05). Tüm katılımcılar değerlendirildiğinde bu parametrelerin cinsiyet veya yaş ile ilişkisi olmadığı bulunmuştur (p>0.05). DAT1, 5-HT1B, BDNF ve VIPR2 genlerinin total metilasyon veya CpG adacıklarının metilasyon düzeyleri ile dikkat eksikliği ve hiperaktivite/impulsivite semptom şiddeti arasında istatistiksel olarak anlamlı düzeyde korelasyonlar olduğu saptanmıştır (p<0.05). DNA metilasyonunun DEHB etyopatogenezindeki rolünün anlaşılması için daha geniş örneklemde, genetik, nörogörüntüleme ve nörokimyasal değerlendirmelerin birlikte yapılacağı çalışmalara ihtiyaç vardır. Attention deficit hyperactivity disorder (ADHD) is a life-long neurodevelopmental disorder which is characterized by inattention, hyperactivity, and impulsivity. Genetic and epigenetic factors are thought to play an important role in the etiology of ADHD. Regarding the epigenetics area, there is quite a little number of studies which investigated the role of DNA methylation in the ADHD etiopathogenesis. In this study, DNA methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF genes were investigated in 30 ADHD patients and 30 healthy volunteer healthy children with the aim to find out their role in ADHD etiopathogenesis. The participants of the study were selected among children and adolescents aged 6-17 years, who have no other physical or psychiatric condition and no psychotropic drug use history. DNA was isolated from peripheral blood samples using commercial kit. Methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF genes were quantitatively measured using the PyroMark Q24 pyrolysis system. Participants' symptom levels were assessed by the DSM-IV Screening and Assessment Scale for Disruptive Behavioral Disorders in Children and Adolescents and by a semi-structured interview-ADHD Child Assessment. Any statistically significant difference regarding DNA methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF was not found between the case and control groups (p>0.05). The methylation levels of the selected genes were not found to be related to gender or age (p>0.05) in the analysis of whole study participants. Some statistically significant correlations were detected between the methylation levels of DAT1, 5-HT1B, BDNF and VIPR2 genes (either total methylation or CpG islands’ methylation levels) and inattention and hyperactivity/impulsivity symptom severity (p<0.05). There is a need for future studies that assess genetic, neuroimaging and neurochemical factors in larger samples to understand the role of DNA methylation in the etiopathogenesis of ADHD.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Pamukkale GCRIS Data...arrow_drop_down
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    Other ORP type . 2017
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Pamukkale GCRIS Data...arrow_drop_down
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Tarhan, Ceyda;

    GIRIŞ VE AMAÇ: Nazal fizyolojide önemli bir rol oynayan ve tüm solunum yollarının en dar kısmı olan nazal valvin dinamik bir elemanı olan alt konkaya ait patolojiler burun tıkanıklığının önde gelen nedenlerini oluşturmaktadırlar. Burun boşluğunun lateral duvarında yer alan bu erektil yapıların histolojisi, anatomik varyasyonları, glanduler paterni ve damarlanması birçok bilimsel araştırmaya konu olmuştur. Erektil yapıların ve konka kanlanmasının değerlendirildiği bu çalışmalarda alt konka başından itibaren posteriora doğru kanlanmanın arttığı gösterilmiştir. Ancak çalışmaların çoğunda konka cerrahisi sonrası elde edilen materyallerin değerlendirilmesine ait veriler bulunmaktadır. Çalışmamızın ana amacı alt konkanın bir bütün olarak ele alınarak önden arkaya doğru vasküler yapılarının histolojik olarak incelenmesi ve varsa bölgesel farklılıklarının tespit edilmesidir. GEREÇ VE YÖNTEM: Ege Üniversitesi Anatomi Anabilim Dalı'ndan temin edilen 8 adet taze donmuş kadavranın alt konkaları rezeke edildikten sonra, histolojik preparasyona uygun olan 13 adet konka, 7 sağ ve 6 sol alt konka olmak üzere iki gruba ayrılmıştır. Alt konkalar asit ve alkol ile prepare edildikten sonra parafın bloklara yatırılmıştır. Her konka önden arkaya doğru ön, orta ve arka 1/3'ü olmak üzere 3 ana parçaya ayırıldıktan sonra 0,5 micron'luk seri kesitler alınmıştır. Toplamda tek konka için 30 kesit olmak üzere her 1/3'lük kısımdan ayrı olarak randomize 10 kesit elde edildikten sonra bu kesitler Hematoksilen;Eozin, Masson Trichrome ve PAS ile boyanmıştır. Işık mikroskobunda büyük büyütmede arter ve ven yapıları sayılarak ön, orta ve arka gruptakiler kendi aralarında toplanmış ve SPSS 21 programında One Way ANOVA testi uygulanmıştır. Ayrıca kemiğin laterali ve mediali için ayrı 2 grup oluşturularak buradaki arter ve yen sayıları tüm kesitlerde sayılarak toplanmıştır. Ek olarak arter çapları ölçülerek ön, orta ve arka olmak üzere gruplara ayrılıp ortalamaları hesaplanarak SPSS 21 programında One Way ANOVA ile istatistiksel analiz uygulanmıştır. BULGULAR: Ön 1/3'te arter kesitleri için ortalama değer 33,25 (Min: 9, Max: 105; SD:33,24; IR: 41), yen kesitleri için ortalama değer 308 (Min: 124; Max: 674; SD: 181,347; IR: 255) idi. Orta 1/3'te arter kesitleri için ortalama değer 56,13 (Min: 16, Max: 158; SD:52,179; IR: 79), yen kesitleri için ortalama değer 663,63 (Min: 179; Max: 1906; SD: 584,502; IR: 702) idi. Arka 1/3'te arter kesitleri için ortalama değer 35,63 (Min: 1, Max: 88; SD:27,045; IR: 37), ven kesitleri için ortalama değer 445,88 (Min: 88; Max: 819; SD: 269,683; IR: 546) idi. One way ANOVA ile yapılan istatistiksel analiz sonucu olarak sırasıyla ön, orta ve arka 1/3'lük kısımlarda venöz yapılar için bölgeler arasındaki farklılık p>0,05 (=0,202) ve arteriyel yapılar için p>0,05 (=0,449) olarak hesaplandı. TARTIŞMA VE SONUÇ: Nazal fizyolojide temel taşlardan biri olan alt konkaya yönelik araştırmalar 1940'lı yıllara kadar dayanmaktadır. Bu erektil yapının işlevini nasıl gerçekleştirdiğine dair yapılan çalışmalar, özellikle glanduler epitel ve vasküler yapılar üzerinde yoğunlaşmıştır. Bu anatomik çalışmalarda vaskülaritenin posteriora doğru belirginleştiği, alt konka kuyruğunda vaskülaritenin en fazla olduğu vurgulanmıştır. Ancak 2004 yılında Philpott ve arkadaşlarının yaptığı çalışmada endoskopik sinüs cerrahisi uygulanan hastalardan bölgesel olarak alınan doku biyopsilerinde CD34 immünohistokimyasal olarak çalışılmış ve mikrovasküler yapılarda bölgesel olarak bir farklılık saptanmamıştır. Bizim çalışmamızda randomize biyopsiler ile değil; konkanın tamamından elde edilen tam kat seri kesitlerde arter ve ven yapıları ayrı ayrı ışık mikroskopisinde değerlendirilerek ön, orta ve arka gruplar ve kemiğin laterali ve medialinde vasküler yapı açısından fark olup olmadığı karşılaştırılmıştır. Yapılan analiz sonucu alt konka vasküler yapılarının dağılımı ön, orta ya da arka kısımda istatistiksel olarak anlamlı farklılık göstermediği bulunmuştur. Burun tıkanıklığının önde gelen nedenlerinden olan alt konka hipertrofılerinde uygulanan cerrahi tekniklerde daha önce bilinenin aksine, konkada vaskülaritenin konka başı, orta kısmı ve kuyruğunda farklı olmamasından dolayı, bu cerrahilerde en sık karşılaşılan komplikasyon olan kanamanın konkanın hangi kısmına müdahale edilirse edilsin ortaya çıkabileceği düşünülebilir. Ancak daha fazla konkanın dahil edildiği, yüzey alanı ve damar çapının hesaplanarak yapıldığı çalışmalar ile vasküler patern daha detaylı incelenebilir ve ileride yapılacak cerrahi girişimlerde yol gösterici olabilir. BACKGROUND: The inferior turbinate which plays an important role in nazal physiology and it consists dynamic component of the nazal valve that is the narrowest part of the upper aerodigestive tract, and its pathologies are the common cause of the nazal obstruction. The histology, anatomical variations, glandular pattern and vascularity of these erectile structures on the lateral wall of the nazal cavity had been the subject of many investigations. In these studies, in which erectile structures and vascularity were evaluated, it was shown that blood flow in the posterior one-third of the turbinate increased. Majority of these datas are obtained from the evaluation of the materials which was gathered from nazal surgeries. The aim of this study is to evaluate the whole turbinate in the terms of the vascular structures histologically from the anterior to posterior and to determine regional differences, if any. MATERIALS AND METHODS: 13 inferior turbinates those were resected from 8 fresh frozen cadavers which gathered from Ege University Anatomy Department. Inferior turbinates are included those are suitable for histological preparation. Turbinates were separated into two groups; 7 right and 8 left turbinate. The resected turbinates are prepareted acid and alcohol and than were embedded in paraffin blocks. Each turbinate was divided into 3 main parts, anterior to posterior, 0.5 micron serial sections were evaluated. 10 sections were obtained from each one third of the turbinate, anterior, posterior and middle of the turbinate, and 30 sections in total were evaluated and these were stained with Hematoxylin ; Eozin, Masson Trichrome and PAS. On the light microscope, large and enlarged arteries and veins were counted and the anterior, middle and posterior groups were collected. One way ANOVA test was applied in SPSS 21 software. In addition, two separate groups were created for the lateral and medial sides of the bone, and the arterial and venous structures were counted in all sections. Diameters of arteries were measured and the mean diameter in the each turbinate section were calculated by x10 magnification. RESULTS: In the anterior 1/3, the mean value for arterial sections was 33.25 (Min: 9, Max: 105, SD: 33.24, IR: 41), the mean value for venous sections were 308 (Min: 124; Max: 674; SD: 181,347; IR: 255). in the middle 1/3, mean values for arterial sections were 56,13 (Min: 16, Max: 158, SD: 52,179, IR: 79), mean values for the venous sections were 663,63 (Min: 179, Max: 1906; SD: 584,502; IR: 702). In the posterior 1/3, mean values for arterial sections were 35.63 (Min: 1, Max: 88, SD: 27.045, IR: 37), mean values for venous sections were 445.88 (Min: 88, Max: 819, SD : 269,683; IR: 546). Statistical analysis with one way ANOVA showed that the difference between the regions for venous structures in the anterior, middle and posterior 1/3 regions was p> 0.05 (= 0.202) and for arterial structures was p> 0.05 (= 0.449) DISCUSSION: Since 1940s, researches about the inferior turbinate, which is one of the corner stone in nazal physiology, still continue. Particularly, studies on how this erectile structure performs its function have been focused on glandular epithelium and vascular structures. In these anatomical studies, it was emphasized that vascularisation of posterior one-third is much more than anterior part of the turbinate and vascularisation is the most pronounced within the tail of the turbinate. However, in 2004, Philpott et al. conducted a CD34 immunohistochemistry study on tissue biopsies that different regions of the nazal cavity were taken from patients who underwent endoscopic sinus surgery. In this study, regional differences in microvascular structures was not seen. In our study, in the full-layer serial sections obtained from the whole turbinate, the arterial and venous structures were evaluated by light microscopy and it was compared whether there was any difference in the vascular structure in the anterior, middle and posterior groups. There has not been found any statistical differences between the distribution of the vascular structures of the inferior turbinate in the anterior, middle or posterior part. Unlike what is known about turbinate surgery complications, according to our study, it can be considered that bleeding can occur whichever part of the turbinate is operated. Further studies including surface area and vessel diameters are needed to evaluate the vascular pattern and to guide future surgical procedures, however.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Ege University Insti...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Ege University Insti...arrow_drop_down
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    Authors: Özcan, Muhammed Furkan;

    Introduction: Dental treatments increase the level of anxiety and fear in many people. Developing anxiety and fear may cause delays in appointments and inability to receive treatments in some patients. In this case, it becomes important for the physician to be able to detect and manage the patient's anxiety. Pharmacological and/or psychological interventions are applied to control anxiety. Psychological/behavioral approach is more preferred by patients with high anxiety values for dental treatment. Since music therapy is a non-invasive method with an anxiolytic effect, it is preferred in the management of anxiety and fear. The aim of this study is to investigate the effect of music therapy on dental anxiety in patients who will undergo periodontal surgery. Material and Method: A total of 46 patients, 23 patients in the test group and 23 patients in the control group, who will undergo periodontal surgery were included in this study. During the procedure, the patients in the test group listened to music from in-ear headphones isolated from ambient sounds. The patients in the control group, on the other hand, were only isolated from the ambient sounds by wearing in-ear headphones, but no music was played. All patients were asked to complete the Modified Dentistry Anxiety Scale (MDAS), State Anxiety Scale (STAI-S), and Fear of Dentistry Scale (DFS) before and after the surgical procedure. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured as vital signs before and after the surgical procedure. Visual Analogue Scale (VAS) values were recorded twice at the end of the surgical procedure and afterwards. For statistical analysis, Chi-square test, Fisher exact test, Student's test, Shapiro Wilk test, Mann Whitney U test, Paired t-test, Wilcoxon signed rank test, Two way mixed ANOVA, Levene test, Box's M test, Pillai's Trace test and Bonferroni-adjusted in-group and between-group comparisons were used. (P<0.05). Results: While MDAS, STAI-S and DFS post-test measurement values showed a statistically significant decrease in the test group compared to the pre-test measurement values (Respectively; P<0,001; P=0,009; P<0,001), no statistically significant difference was found in the control group (Respectively: P=0,093; P=0,923; P=0,460). In both test and control groups, VAS post-test measurement values showed a statistically significant decrease compared to pre-test measurement values (Respectively; P=0,002; P=0,019). While SBP post-test measurement values decreased statistically significantly in the test group compared to the pre-test measurement values (P=0,020), no statistically significant difference was found in the control group (P=0,705). There was no statistically significant difference between DBP pre-test and post-test measurement values in both the test and control groups (Respectively; P=0,083; P=0,160). Conclusion: Music therapy was found to be effective in reducing dental anxiety and fear values during periodontal surgery. Giriş: Dental tedaviler birçok kişide anksiyete ve korku düzeyini artırmaktadır. Gelişen anksiyete ve korku bazı hastalarda randevuların aksatılmasına ve tedavilerin yaptırılamamasına neden olabilmektedir. Bu durumda hekimin hastadaki anksiyeteyi tespit edebilmesi ve yönetebilmesi önem kazanmaktadır. Anksiyeteyi kontrol edebilmek için farmakolojik ve/veya psikolojik girişimler uygulanmaktadır. Dental tedavi yapılacak anksiyete değerleri yüksek hastalarda psikolojik/ davranışsal yaklaşım hastalar tarafından daha çok tercih edilmektedir. Müzik terapi anksiyolitik etkili ve non-invaziv bir yöntem olduğundan anksiyete ve korku yönetiminde tercih edilmektedir. Bu çalışmanın amacı, periodontal cerrahi işlem yapılacak hastalarda müzik terapinin dental anksiyete üzerine etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışmaya, periodontal cerrahi işlem yapılacak 23 hasta çalışma grubu, 23 hasta kontrol grubu olmak üzere toplam 46 hasta dahil edilmiştir. Çalışma grubunda olan hastalara işlem esnasında ortam seslerinden izole kulak içi kulaklıktan müzik dinletilmiştir. Kontrol grubundaki hastalar ise sadece kulak içi kulaklık takarak ortam seslerinden izole edilmiş, müzik dinletilmemiştir. Tüm hastalardan cerrahi işlem öncesinde ve sonrasında Modifiye Diş Hekimliği Anksiyete Ölçeği (MDAS), Durumluluk Anksiyete Ölçeği (STAI-S) ve Diş Hekimliği Korkusu Ölçeği (DKS)'ni doldurmaları istenmiştir. Cerrahi işlem öncesi ve sonrasında vital bulgu olarak sistolik kan basıncı (SKB) ve diastolik kan basıncı (DKB) ölçümü ile cerrahi işlem bitimi ve sonrasında Görsel Analog Skala (VAS) değerleri iki kez kaydedilmiştir. İstatistiksel analiz için Ki-kare testi, Fisher exact testi, Student's testi, Shapiro Wilk testi, Mann Whitney U testi, Paired t-test, Wilcoxon signed rank testi, Two way mixed ANOVA, Levene testi, Box's M testi, Pillai's Trace testi ve Bonferroni düzeltmeli grup içi ve gruplar arası karşılaştırmaları kullanılmıştır. (P<0,05). Bulgular: MDAS, STAI-S ve DKS son-test ölçüm değerleri, ön-test ölçüm değerlerine göre çalışma grubunda istatistiksel olarak anlamlı azalma gösterirken (Sırasıyla; P<0,001; P=0,009; P<0,001), kontrol grubunda istatistiksel olarak anlamlı fark bulunamamıştır (Sırasıyla; P=0,093; P=0,923; P=0,460). Hem çalışma hem de kontrol grubunda VAS son-test ölçüm değerleri, ön-test ölçüm değerlerine göre istatistiksel olarak anlamlı azalma göstermiştir (Sırasıyla; P=0,002; P=0,019). Çalışma grubunda SKB son-test ölçüm değerleri ön-test ölçüm değerlerine göre istatistiksel anlamlı azalırken (P=0,020), kontrol grubunda istatistiksel anlamlı fark bulunamamıştır (P=0,705). DKB ön-test son-test ölçüm değerleri arasında hem çalışma hem de kontrol grubunda istatistiksel olarak anlamlı fark bulunamamıştır (Sırasıyla; P=0,083; P=0,160). Sonuç: Müzik terapi periodontal cerrahi işlem sırasında dental anksiyete ve korku değerleri üzerinde azaltıcı yönde etkili bulunmuştur.

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    Authors: Çavuşoğlu, Güneş Dorukhan;

    New biomarkers that will guide the diagnosis of rheumatoid arthritis are being studied and early diagnosis and treatment of the disease is aimed. Similar pathogenetic mechanisms of periodontitis and RA have been demonstrated. Disease activities of patients with RA who have periodontal disease tend to be worse. Previous studies suggest that calprotectin may be a valuable biomarker for the diagnosis and prognosis of RA. The relationship between calprotectin and disease activity in patients with periodontitis is known. In addition, several studies have shown that the salivary calprotectin level is high in patients with chronic periodontitis. A study showing the relationship between salivary calprotectin levels and disease activity in patients with RA has not been found in the literature so far. In this study, our aim is to evaluate the disease activity with serum and salivary calprotectin levels in patients with RA, and secondly, to evaluate periodontitis in these patients and to reveal whether serum and salivary calprotectin levels are related to periodontitis. 76 patients diagnosed with RA (Female/Male: 59/17) according to the 2010 ACR/EULAR classification criteria, 24 patients diagnosed with SS (F/M: 24/0) according to the 2016 ACR-EULAR classification criteria as the patient control group, and 40 healthy adults (F/M: 24/0) as healthy control group, who applied to the Medipol University Faculty of Medicine Rheumatology Department outpatient clinic, were included in the study. Demographic, clinical and laboratory data of the cases were recorded in the patient follow-up form, and periodontitis examination was performed after taking serum and saliva samples to measure the calprotectin levels simultaneously. Intergroup analyzes were evaluated with Student-T test and Mann-Whitney U test. The correlations between patient and physician-derived scales were evaluated with the Spearman correlation test. In patients with RA, serum calprotectin value was found to be higher in the group with high disease activity than in the group with low disease activity [HDA and LDA: 11.5 (0.78-38.23); 8.3 (1.6-24.4) (p:0.02)]. Mean serum calprotectin values were found to be higher in the RA group than in the other two groups, and there was a statistical difference between the RA group and the SS group, but no statistical difference was found between the RA group and the healthy control group [RA, SS, and HC, respectively: 13.6 (9.8); 8.1 (7.5) and 10.9 (6.02) (p:0.01)]. Median salivary calprotectin levels in patients with RA were found to be higher in patients with periodontitis than in patients without periodontitis [Periodontitis stage I and Periodontitis stage II-IV, respectively: 27.3 (1.6-40.74); 31.7 (0.64-75.85) (p:0.04)]. Serum calprotectin levels were found to be higher in the rheumatoid arthritis patient group than in the healthy and patient control group, and were correlated with disease activity. On the other hand, salivary calprotectin values in patients with rheumatoid arthritis were found to be lower than those of the healthy and patient control group. While periodontal inflammation was correlated with salivary calprotectin values in patients with rheumatoid arthritis, no such relationship was found in the other two groups. Similar to other studies, this study showed that serum calprotectin levels were positively correlated with disease activity markers. Romatoid artrit hastalığının tanısında yol gösterecek yeni biyobelirteçler üzerinde çalışılmakta ve hastalığın erken teşhisi ve tedavisi hedeflenmektedir. Periodontit ve RA'nın benzer patogenetik mekanizmaları gösterilmiştir. Periodontal hastalığı olan RA'lı hastaların hastalık aktiviteleri daha kötü seyretmektedir. Önceki çalışmalar kalprotektinin RA tanısı ve prognozu için değerli bir biyobelirteç olabileceğini göstermektedir. Periodontiti olan hastalarda kalprotektinle hastalık aktivitesi arasındaki ilişki bilinmektedir. Ayrıca kronik periodontiti olan hastalarda tükürük kalprotektin düzeyinin de yüksek olduğu birkaç çalışmada gösterilmiştir. RA tanılı hastalarda tükürükteki kalprotektin düzeyleriyle hastalık aktivitesinin ilişkisini gösteren bir çalışma şu ana dek literatürde bulunmamaktadır. Bu çalışmada amacımız RA tanılı hastalarda serum ve tükürük kalprotektin düzeyleriyle hastalık aktivitesini değerlendirmek, ikincil olarak da bu hastalarda periodontiti değerlendirerek serum ve tükürük kalprotektin düzeylerinin periodontitle ilişkisi olup olmadığını ortaya koymaktır. Medipol Üniversitesi Tıp Fakültesi Romatoloji Bilim Dalı polikliniğine başvuran, 2010 ACR/EULAR sınıflandırma kriterlerine göre RA tanısı almış 76 hasta (K/E: 59/17), hasta kontrol grubu olarak 2016 ACR-EULAR sınıflandırma kriterlerine göre Sjögren sendromu tanısı almış 24 hasta (K/E: 24/0) ve sağlıklı kontrol grubu olarak 40 yetişkin (K/E: 25/15) çalışmaya dahil edildi. Olguların demografik, klinik ve laboratuvar verileri hasta takip formuna kaydedildi ve eş zamanlı olarak kalprotektin için serum ve tükürük örneği alındıktan sonra periodontit muayenesi yapıldı. Gruplar arası analizler Student-T testi, Mann-Whitney U testi; hasta ve doktor kökenli ölçekler arası korelasyonlar Spearman korelasyon testiyle değerlendirildi. RA'lı hastalarda serum kalprotektin değeri, yüksek hastalık aktivitesi olan grupta, düşük hastalık aktivitesi olan gruba göre daha yüksek saptandı [YHA ve DHA: 11,5 (0,78-38,23); 8,3 (1,6-24,4) (p:0,02)]. Ortalama serum kalprotektin değerleri RA grubunda diğer iki gruba göre daha yüksek saptandı ve RA grubuyla SS grubu arasında istatistiksel fark saptanırken, RA grubu ile sağlıklı kontrol grubu arasında istatistiksel fark saptanmadı [RA, SS ve SK sırasıyla: 13,6 (9,8); 8,1 (7,5) ve 10,9 (6,02) (p:0,01)]. RA tanılı hastalarda ortanca tükürük kalprotektin düzeyleri, periodontiti olan hastalarda periodontiti olmayanlara göre daha yüksek saptandı [Periodontit evre I ve Periodontit evre II-IV sırasıyla: 27,3 (1,6-40,74); 31,7 (0,64-75,85) (p:0,04)]. Romatoid artrit hasta grubunda serum kalprotektin değerleri sağlıklı ve hasta kontrol grubuna göre yüksek saptanmış ve hastalık aktivitesiyle korele bulunmuştur. Buna karşılık romatoid artritli hastalarda tükürük kalprotektin değerleri sağlıklı ve hasta kontrol grubuna göre düşük saptanmıştır. Romatoid artritli hastalarda periodontal enflamasyon tükürük kalprotektin değerleri ile korele çıkarken, diğer iki grupta böyle bir ilişki saptanmamıştır. Bu çalışma diğer çalışmalara benzer şekilde serum kalprotektin düzeylerinin hastalık aktivite belirteçleriyle pozitif yönde korele olduğunu göstermiştir.

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    Authors: Öner Özer; Ayhan Tokbaş;

    Thirty methicillin- and cephalothin-sensitive Staphvlococcus aureus strains isolated from blood cultures between January 1993 and January 1994 in the Department of Microbiology and Clinical Microbiology, Medical Faculty, Ege University, were investigated for cephalothin tolerance with tube dilution and time-kill curve method and Eagle phenomenon. Cephalothin tolerance was found in 20 of 30 ( 66.6 %) strains with tube dilution and 10 of 30 { 33.3 %) strains with time-kill curve. None of the strains showed Eagle phenomenon. Ege Üniversitesi Tıp Fakültesi Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı Ocak 1993 - Ocak 1994 tarihleri arasında kan kültürlerinden soyutlanan metisilin ve sefalotin duyarlı 30 Staphvlococcus aureus kökeninde tüp diiüsyon ve zaman ölüm eğrisi ile sefalotin toleransı ve Eagle fenomoni varlığı araştırıldı. İncelenen 30 kökenin tüp diiüsyon yöntemi ile 20'sinde (% 66.6), zaman ölüm eğrisi ile 10'unda (% 33.3) sefalotin toleransı saptanırken hiçbir kökende Eagle fenomeni görülmedi.

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    Authors: Bülent KARABULUT;Fatih KIRÇELLİ;Veliddin C. SEZGİN;Gamze G. MÜEZZİNOĞLU;Ulus A. ŞANLI;Rüçhan USLU;Erhan GÖKMEN;Erdem GÖKER;

    Nekrotising myofasciitis (NMF) is a rare infection that involves subcutaneus tissues, especially fascia and the muscular tissues. It can happen on the basis of immunosupression, tumour, surgery and injection which impair tissue integrity in cancer patients. A 37 year old male, diagnosed as nasopharyngeal carcinoma was accepted to the emergency servise 15 days after chemotherapy with pain in his gluteal region, that later turned to a necrotising lesion involving proximal left lower limb, left lower part of the abdomen and distal right lower limb. No etiological factor was found although all microbiological, pathological and rheumatological tests were done. NMF was taken under control with broad spectrum antibiotics and prompt surgical exploration and removal. Nekrotizan miyofasitis (NMF) subkutan dokuları, özellikle fasya ve kas tabakasını içine alan, sık olmayan bir enfeksiyon tablosudur. Kanser hastalarında ise zemindeki immunsüpresyon ve tümöre, cerrahi müdahalelere veya enjeksiyonlara bağlı doku bütünlüğünün bozulması nedeni ile görülebilmektedir. Otuzyedi yaşında, nazofarinks kanseri tanılı erkek hasta, kemoterapiden 15 gün sonra gelişen NMF tablosu nedeniyle acil serviste hospitalize edilmiştir. Yapılan mikrobiyolojik, patolojik ve romatolojik testlere rağmen etiyoloji belirlenememiştir. NMF geniş spektrumlu antibiyoterapi ve debritman ile kontrol altına alınmıştır.

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    Authors: Melek Ergin; Gülfiliz Gönlüşen; Suzan Zorludemir; İlhan Tuncer; +1 Authors

    Enterojenöz kistler (EK), santral sinir sisteminin nadir gelişimsel lezyonlarıdır. Kistler sıklıkla alt servikal ve torakal kanal yerleşimli olabilir.Olgumuz; 42 yaşında kadın hasta olup, bir aydır bacaklarında kuvvetsizlik, yürüyememe, idrar ve gaita kaçırma şikayeti ile Çukurova Üniversitesi Tıp Fakültesi Beyin Cerrahi kliniğine başvurdu. BT'de L1-L2 mesafesinde intradural, intramedüller kitle saptandı. L1-L2 mesafesindeki kistik kitle total olarak eksize edildi. Bu olgu nedeni ile enterojenöz kistler literatür bilgileri ışığında tartışılmıştır. Enterogenous, cysts are rare developmental lesins of the central nervous system. The cysts occur mainly in the lower cervical and thoracic canal but also within the cranium.A 42 years old woman was admitted to Neurosurgery clinic for urinary and bowel incontinence, weakness in the lower extremities and walking disability for one month. Computed Tomography (CT) seans, disclosed intramedullary, intradural cystic mass at L1-L2 level.The cystic mass was excised totally. Enterogenous cysts of the spinal cord are discussed.

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    Authors: Ratıu, V. Andrei; Deniz, Ali;

    3-boyutlu hiperbolik uzayda, hacim hesabında sıkça kullanılan Lobachevsky fonksiyonu $JI :Bbb {R} rightarrow Bbb {R}}$ $JI(theta)=-int_0^theta log|2 sin x|dx$ şeklinde tanımlanır. Hiperbolik uzayda düzgün, ideal dörtyüzlünün hacminin $3JI (frac{pi}{3})$ olduğu ve tüm hiperbolik dörtyüzlüler arasında maksimum hacimli dörtyüzlünün düzgün, ideal dörtyüzlü olduğu Lobachevsky'den beri bilinmektedir. (Milnor, 1982; Ratcliffe, 1994). İdeal düzgün altıyüzlü, sekizyüzlü ve yirmiyüzlünün hacimleri (Deniz, 2001)'de hesaplanmıştır. Bu çalışmada bazı hiperbolik çokyüzlülerin (altıyüzlü, sekizyüzlü, yirmiyüzlü) hacimlerinin maksimum olabilmesi için düzgün ve ideal olmaları gerektiği gösterilmiştir. The Lobachevsky function, frequently used in calculation of volume in 3-dimensional hyperbolic space, is denned by JI :Bbb{R}rightarrowBbb{R} $JI(theta)=-int_0^theta log|2 sin x|dx$ It is known since Lobachevsky that the tetrahedron which has maximal volume among all tetrahedra is regular and ideal tetrahedron and its volume is $3JI (frac{pi}{3})$. (Milnor, 1982; Ratcliffe, 1994). The volumes of regular, ideal hexahedron, octahedron; dodecahedron and icosahedron are calculated in (Deniz, 2001). In this work, we have shown that some polytopes (hexahedron, octahedron, icosahedron) must be regular and ideal for maximality of their volumes.

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    Authors: Erdemir, Zehra;

    The susceptibility of patients with hematological malignancies to infections is increased due to several reasons including disease itself, neutropenia and the applied chemotherapy protocols. Since fever may be the only symptom in neutropenic patients, it is presumed to be associated with infection until otherwise proven. The standard approach is the rapid evaluation of FEN (febrile neutropenic) episodes and initiation of appropriate antibiotic treatment. Between January 2012 and January 2016, we studied 155 adult patients with AML who were treated at the Adult Hematology Clinic of Ege University Medical Faculty Hospital. In our study, we retrospectively evaluated 337 chemotherapy-related FEN episodes in terms of infection categories, isolated pathogenic microorganisms and mortality rates. 84.52% (131 patients) of our cases were diagnosed with AML and 12.90% (20 patients) were diagnosed with MDS to AML transformation and 2.58% (4 patients) with biphenotypic leukemia. 43.92% (148 patients) of the patients had pathological examination findings accompanying the fever. The most frequent examination findings were found to be rale-rhonchus-hypoxia with a rate of 26.35% (39 patients). 73.89% (249 subjects) of the FEN episodes had clinically and / or microbiologically proven infection centers. The most frequent infection center was found to be lungs (41.5%). There were also central venous catheters in 63.5% of the patients (214 patients) and 38.78% (83 patients) of these patients had positive growth in catheter culture. Culture positivity was detected in 54.90% (185 patients) of the FEN episodes. Blood culture positivity ratio was 31.4% (106 samples). No agent has been isolated in 45.10% of the patients. 48.66% of the isolated agents were bacteria and 2.67% were fungus. 62.16% of the bacteria isolated were gram-negative and 54.05% were gram-positive bacteria. The most frequently isolated microorganisms were found to be coagulase negative staphylococcus with 37.30% and E. coli with 36.21%. 32.94% of the patients (111 patients) were recorded as smokers. When the correlation between smoking status and presence of lung infection was studied, it was found statistically significant that the incidence of lung infection was higher in smokers according to the analysis made (p: 0.007). In our hospital, 27% of the FEN episodes (91 people) died (exitus). Of the total 155 patients, 91 were exitus (58.70%). 72 of the patients diagnosed with AML (24.8%) and 19 of the patients diagnosed with MDS to AML transformation (40.4%) died. There was a statistically significant correlation between diagnosis and mortality (p: 0.033). The presence of additional diseases of the patients and the mortality cases were compared. Mortality was higher in patients with additional diseases. There was a statistically significant correlation in the analysis (p: 0.018). The correlation between age and mortality has been studied and mortality was found to increase as the age increased, statistically significant in the analysis performed (p: 0.000). The correlation between the detected infection site and mortality was studied; according to which most frequently the patients with the lung infection were found to be exitus with 40.71%. When we take a look at our study and the similar studies in the literature, we can reach the conclusion that each clinic may contribute to the more accurate management of the FEN episode process by examining its own infectious agents, identifying empirical antibiotic treatment policies and taking the necessary infection control measures. Hematolojik malignitelerde; hastalığın kendisi, nötropenik süreç ve uygulanan kemoterapi protokolleri nedeni ile bu hastaların enfeksiyonlara duyarlılıkları artmaktadır. Bu hastalarda tek semptom ateş olabildiği için nötropenik hastalarda ateş aksi ispat edilene kadar enfeksiyon ile ilişkili kabul edilir. FEN ataklarının acil olarak değerlendirilip uygun antibiyotik tedavisinin hızlıca başlanması standart yaklaşımdır. Araştırmamıza Ocak 2012 ve Ocak 2016 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Hastanesi erişkin Hematoloji Kliniğinde yatarak tedavi gören 155 erişkin AML tanılı hasta alındı. Çalışmamızda bu hastalarda kemoterapiye bağlı gelişen 337 FEN atağı; infeksiyon kategorileri, izole edilen patojen mikroorganizmalar, mortalite oranları açısından geriye dönük olarak değerlendirildi. Olgularımızın %84.52'si (131 kişi) AML, %12.90'ı (20 kişi) MDS'den AML'ye dönüşüm ve %2.58'i (4 kişi) bifenotipik lösemi tanılıdır. Hastaların %43.92'sinde (148 kişi) ateşe eşlik eden patolojik muayene bulgusuna rastlanmıştır. En sık muayene bulgusunun %26.35 (39 kişi) ile ral-ronküs-hipoksi olduğu görülmüştür. FEN ataklarının %73.89'unda (249 kişi) klinik ve/veya mikrobiyolojik olarak kanıtlanmış enfeksiyon odağı saptanmıştır. En sık saptanan enfeksiyon odağının akciğer olduğu görülmüştür (%41.5). Ayrıca hastaların %63.5'inde (214 kişi) santral venöz kateter mevcuttu. Bunların %38.78'inde (83 tanesinde) kateter kültürlerinde üreme saptanmıştır. FEN ataklarının %54.90'ında (185 kişi) kültür pozitifliği saptanmıştır. Kan kx pozitifliği % 31.4 (106 adet) olarak saptanmıştır. Hastaların %45.10'unda herhangi bir etken izole edilememiştir. Etken izole edilenlerin %48.66'sı bakteri, %2.67'si mantardır. Bakteri izole edilenlerin %62.16'sı gram-negatif, %54.05'i gram-pozitif bakteridir. İzole edilen mikroorganizmaların en sık %37.30 ile KNS ve %36.21 ile E.coli olduğu görülmüştür. Hastaların %32.94'ü (111 kişi) sigara kullandığı kaydedilmiştir. Sigara içilme durumuna göre akciğer enfeksiyonu varlığı arasındaki ilişki incelendiğinde, yapılan analize göre sigara içenlerde akciğer enfeksiyon sıklığının daha fazla olduğu istatistiksel olarak anlamlı bulunmuştur (p: 0.007). Hastanemizde FEN ataklarının %27'si (91 kişi) exitusla (ex) sonuçlanmıştır. Toplam 155 hastanın 91'i ex olmuştur (%58.70). AML tanısı olanların 72'si (%24.8'i) ex olmuşken MDS'den AML'ye dönüşüm olan hastaların 19'u (%40.4'ü) ex olmuştur. Tanı ile mortalite arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır (p: 0.033). Hastaların ek hastalıklarının varlığı ile mortalite durumları kıyaslanmıştır. Ek hastlıkları bulunan hastalarda mortalite daha yüksek saptanmıştır. Yapılan analizde istatistiksel olarak anlamlı bir ilişki söz konusudur (p: 0.018). Yaş ile mortalite arasındaki ilişki incelenmiş ve yaş arttıkça mortalitede artış olduğu, yapılan analizde istatistiksel olarak anlamlı bulunmuştur (p: 0.000). Saptanan enfeksiyon alanı ile mortalite arasındaki ilişki incelenmiş; buna göre %40.71 ile en çok akciğer enfeksiyonu görülen hastaların ex oldukları görülmüştür. Sonuç olarak, her kliniğin kendi enfeksiyon etkenlerini inceleyerek; ampirik antibiyotik tedavi politiklarını belirlemeleri, gerekli enfeksiyon kontrol önlemlerini almaları ve FEN ataklarında sürecin daha doğru yönetilmesine katkı sağlayabilir.

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    Authors: Yüksel Gökel; Salim Satar; Güven Kuvandık; Zikret Köseoğlu; +1 Authors

    Şiddetli organofosfat zehirlenmesinde akut pankreatit olguları bildirilmiştir. Amilaz ve lipaz organofosfat zehirlenmesine bağlı gelişen akut pankreatit teşhisinde güvenilir parametreler değildir. Bundan dolayı organofosfat zehirlenmelerinde Ultrasonografi (USG) veya bilgisayarlı tomografi (BT) gibi görüntüleme yöntemleri de yapılmalıdır. Bu çalışmada, organofosfat zehirlenmesi ile acil servise başvuran ve hiperamilazemi ve hiperlipazemi tespit edilen hır olgu sunulmuştur. 21 yaşındaki bayan hasta intihar amaçlı parathion içeren tarım ilacı aldıktan 10 saat sonra acil servise başvurdu. Hastanın şuuru kapalı idi, pin-point pupilleri, fasikülasyonları vardı, bronşial sekresyonu artmıştı. Konvülzyon gelişen hastada aynı zamanda solunum arresti gelişti. Laboratuvar değerlerinde amilaz ve lipaz değeri yüksek bulundu. Batın BT normal bulundu. Amylase and lipase are not reliable parameters in the diagnosis of organophosphate - induced pancreatitis. Therefore, imaging procedures such as ultrasound or computed tomography (CT) should be performed in cases of organophosphate intoxications. In this study, a case with acute organophosphate poisoning with hyperamylasemia and hyperlipasemia is presented. The patient applied to Emergency Department 10 hours after administering parathion. She was unconscious, had fasciculations and pin-point pupils. Respiratory arrest developed after a grand mal convulsion. Amylase and lipase values were found to be high. CT of abdomen was normal.

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Erken, İpek Elif;

    Dikkat eksikliği hiperaktivite bozukluğu (DEHB), dikkatsizlik, aşırı hareketlilik ve dürtüsellik belirtileri ile seyreden ve büyük oranda yaşam boyu devam eden nörogelişimsel bir bozukluktur. Genetik ve epigenetik faktörlerin DEHB etiyolojisinde önemli bir rol oynadığı düşünülmektedir. Epigenetik alanında DNA metilasyonunun DEHB etiyolojisindeki yerini inceleyen çalışmaların sayısı oldukça azdır. Bu çalışmada, DEHB etiyopatogenezindeki rolünü araştırmak amacıyla 30 DEHB tanılı hasta ve 30 sağlıklı gönüllü sağlam çocuğun DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri incelenmiştir. Çalışmaya dahil edilmiş katılımcılar 6-17 yaş aralığında, başka herhangi bir fiziksel veya psikiyatrik ek tanısı ve psikotrop ilaç kullanım öyküsü olmayan çocuk ve ergenler arasından seçilmiştir. Periferik kan örneklerinden ticari kit kullanılarak DNA izolasyonu yapılmış ve PyroMark Q24 pyrodizileme sistemi kullanılarak DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri kantitatif olarak ölçülmüştür. Katılımcıların belirti düzeyleri, Çocuk ve Ergenlerde Yıkıcı Davranım Bozuklukları İçin DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği ve DEHB Çocuk Değerlendirme yarı yapılandırılmış görüşme ile değerlendirilmiştir. DRD4, DAT1, VIPR2, 5-HT1B ve BDNF genlerinin DNA metilasyon düzeyleri açısından olgu ve kontrol grupları arasında istatistiksel olarak anlamlı bir fark bulunamamıştır (p>0.05). Tüm katılımcılar değerlendirildiğinde bu parametrelerin cinsiyet veya yaş ile ilişkisi olmadığı bulunmuştur (p>0.05). DAT1, 5-HT1B, BDNF ve VIPR2 genlerinin total metilasyon veya CpG adacıklarının metilasyon düzeyleri ile dikkat eksikliği ve hiperaktivite/impulsivite semptom şiddeti arasında istatistiksel olarak anlamlı düzeyde korelasyonlar olduğu saptanmıştır (p<0.05). DNA metilasyonunun DEHB etyopatogenezindeki rolünün anlaşılması için daha geniş örneklemde, genetik, nörogörüntüleme ve nörokimyasal değerlendirmelerin birlikte yapılacağı çalışmalara ihtiyaç vardır. Attention deficit hyperactivity disorder (ADHD) is a life-long neurodevelopmental disorder which is characterized by inattention, hyperactivity, and impulsivity. Genetic and epigenetic factors are thought to play an important role in the etiology of ADHD. Regarding the epigenetics area, there is quite a little number of studies which investigated the role of DNA methylation in the ADHD etiopathogenesis. In this study, DNA methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF genes were investigated in 30 ADHD patients and 30 healthy volunteer healthy children with the aim to find out their role in ADHD etiopathogenesis. The participants of the study were selected among children and adolescents aged 6-17 years, who have no other physical or psychiatric condition and no psychotropic drug use history. DNA was isolated from peripheral blood samples using commercial kit. Methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF genes were quantitatively measured using the PyroMark Q24 pyrolysis system. Participants' symptom levels were assessed by the DSM-IV Screening and Assessment Scale for Disruptive Behavioral Disorders in Children and Adolescents and by a semi-structured interview-ADHD Child Assessment. Any statistically significant difference regarding DNA methylation levels of DRD4, DAT1, VIPR2, 5-HT1B and BDNF was not found between the case and control groups (p>0.05). The methylation levels of the selected genes were not found to be related to gender or age (p>0.05) in the analysis of whole study participants. Some statistically significant correlations were detected between the methylation levels of DAT1, 5-HT1B, BDNF and VIPR2 genes (either total methylation or CpG islands’ methylation levels) and inattention and hyperactivity/impulsivity symptom severity (p<0.05). There is a need for future studies that assess genetic, neuroimaging and neurochemical factors in larger samples to understand the role of DNA methylation in the etiopathogenesis of ADHD.

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    Authors: Tarhan, Ceyda;

    GIRIŞ VE AMAÇ: Nazal fizyolojide önemli bir rol oynayan ve tüm solunum yollarının en dar kısmı olan nazal valvin dinamik bir elemanı olan alt konkaya ait patolojiler burun tıkanıklığının önde gelen nedenlerini oluşturmaktadırlar. Burun boşluğunun lateral duvarında yer alan bu erektil yapıların histolojisi, anatomik varyasyonları, glanduler paterni ve damarlanması birçok bilimsel araştırmaya konu olmuştur. Erektil yapıların ve konka kanlanmasının değerlendirildiği bu çalışmalarda alt konka başından itibaren posteriora doğru kanlanmanın arttığı gösterilmiştir. Ancak çalışmaların çoğunda konka cerrahisi sonrası elde edilen materyallerin değerlendirilmesine ait veriler bulunmaktadır. Çalışmamızın ana amacı alt konkanın bir bütün olarak ele alınarak önden arkaya doğru vasküler yapılarının histolojik olarak incelenmesi ve varsa bölgesel farklılıklarının tespit edilmesidir. GEREÇ VE YÖNTEM: Ege Üniversitesi Anatomi Anabilim Dalı'ndan temin edilen 8 adet taze donmuş kadavranın alt konkaları rezeke edildikten sonra, histolojik preparasyona uygun olan 13 adet konka, 7 sağ ve 6 sol alt konka olmak üzere iki gruba ayrılmıştır. Alt konkalar asit ve alkol ile prepare edildikten sonra parafın bloklara yatırılmıştır. Her konka önden arkaya doğru ön, orta ve arka 1/3'ü olmak üzere 3 ana parçaya ayırıldıktan sonra 0,5 micron'luk seri kesitler alınmıştır. Toplamda tek konka için 30 kesit olmak üzere her 1/3'lük kısımdan ayrı olarak randomize 10 kesit elde edildikten sonra bu kesitler Hematoksilen;Eozin, Masson Trichrome ve PAS ile boyanmıştır. Işık mikroskobunda büyük büyütmede arter ve ven yapıları sayılarak ön, orta ve arka gruptakiler kendi aralarında toplanmış ve SPSS 21 programında One Way ANOVA testi uygulanmıştır. Ayrıca kemiğin laterali ve mediali için ayrı 2 grup oluşturularak buradaki arter ve yen sayıları tüm kesitlerde sayılarak toplanmıştır. Ek olarak arter çapları ölçülerek ön, orta ve arka olmak üzere gruplara ayrılıp ortalamaları hesaplanarak SPSS 21 programında One Way ANOVA ile istatistiksel analiz uygulanmıştır. BULGULAR: Ön 1/3'te arter kesitleri için ortalama değer 33,25 (Min: 9, Max: 105; SD:33,24; IR: 41), yen kesitleri için ortalama değer 308 (Min: 124; Max: 674; SD: 181,347; IR: 255) idi. Orta 1/3'te arter kesitleri için ortalama değer 56,13 (Min: 16, Max: 158; SD:52,179; IR: 79), yen kesitleri için ortalama değer 663,63 (Min: 179; Max: 1906; SD: 584,502; IR: 702) idi. Arka 1/3'te arter kesitleri için ortalama değer 35,63 (Min: 1, Max: 88; SD:27,045; IR: 37), ven kesitleri için ortalama değer 445,88 (Min: 88; Max: 819; SD: 269,683; IR: 546) idi. One way ANOVA ile yapılan istatistiksel analiz sonucu olarak sırasıyla ön, orta ve arka 1/3'lük kısımlarda venöz yapılar için bölgeler arasındaki farklılık p>0,05 (=0,202) ve arteriyel yapılar için p>0,05 (=0,449) olarak hesaplandı. TARTIŞMA VE SONUÇ: Nazal fizyolojide temel taşlardan biri olan alt konkaya yönelik araştırmalar 1940'lı yıllara kadar dayanmaktadır. Bu erektil yapının işlevini nasıl gerçekleştirdiğine dair yapılan çalışmalar, özellikle glanduler epitel ve vasküler yapılar üzerinde yoğunlaşmıştır. Bu anatomik çalışmalarda vaskülaritenin posteriora doğru belirginleştiği, alt konka kuyruğunda vaskülaritenin en fazla olduğu vurgulanmıştır. Ancak 2004 yılında Philpott ve arkadaşlarının yaptığı çalışmada endoskopik sinüs cerrahisi uygulanan hastalardan bölgesel olarak alınan doku biyopsilerinde CD34 immünohistokimyasal olarak çalışılmış ve mikrovasküler yapılarda bölgesel olarak bir farklılık saptanmamıştır. Bizim çalışmamızda randomize biyopsiler ile değil; konkanın tamamından elde edilen tam kat seri kesitlerde arter ve ven yapıları ayrı ayrı ışık mikroskopisinde değerlendirilerek ön, orta ve arka gruplar ve kemiğin laterali ve medialinde vasküler yapı açısından fark olup olmadığı karşılaştırılmıştır. Yapılan analiz sonucu alt konka vasküler yapılarının dağılımı ön, orta ya da arka kısımda istatistiksel olarak anlamlı farklılık göstermediği bulunmuştur. Burun tıkanıklığının önde gelen nedenlerinden olan alt konka hipertrofılerinde uygulanan cerrahi tekniklerde daha önce bilinenin aksine, konkada vaskülaritenin konka başı, orta kısmı ve kuyruğunda farklı olmamasından dolayı, bu cerrahilerde en sık karşılaşılan komplikasyon olan kanamanın konkanın hangi kısmına müdahale edilirse edilsin ortaya çıkabileceği düşünülebilir. Ancak daha fazla konkanın dahil edildiği, yüzey alanı ve damar çapının hesaplanarak yapıldığı çalışmalar ile vasküler patern daha detaylı incelenebilir ve ileride yapılacak cerrahi girişimlerde yol gösterici olabilir. BACKGROUND: The inferior turbinate which plays an important role in nazal physiology and it consists dynamic component of the nazal valve that is the narrowest part of the upper aerodigestive tract, and its pathologies are the common cause of the nazal obstruction. The histology, anatomical variations, glandular pattern and vascularity of these erectile structures on the lateral wall of the nazal cavity had been the subject of many investigations. In these studies, in which erectile structures and vascularity were evaluated, it was shown that blood flow in the posterior one-third of the turbinate increased. Majority of these datas are obtained from the evaluation of the materials which was gathered from nazal surgeries. The aim of this study is to evaluate the whole turbinate in the terms of the vascular structures histologically from the anterior to posterior and to determine regional differences, if any. MATERIALS AND METHODS: 13 inferior turbinates those were resected from 8 fresh frozen cadavers which gathered from Ege University Anatomy Department. Inferior turbinates are included those are suitable for histological preparation. Turbinates were separated into two groups; 7 right and 8 left turbinate. The resected turbinates are prepareted acid and alcohol and than were embedded in paraffin blocks. Each turbinate was divided into 3 main parts, anterior to posterior, 0.5 micron serial sections were evaluated. 10 sections were obtained from each one third of the turbinate, anterior, posterior and middle of the turbinate, and 30 sections in total were evaluated and these were stained with Hematoxylin ; Eozin, Masson Trichrome and PAS. On the light microscope, large and enlarged arteries and veins were counted and the anterior, middle and posterior groups were collected. One way ANOVA test was applied in SPSS 21 software. In addition, two separate groups were created for the lateral and medial sides of the bone, and the arterial and venous structures were counted in all sections. Diameters of arteries were measured and the mean diameter in the each turbinate section were calculated by x10 magnification. RESULTS: In the anterior 1/3, the mean value for arterial sections was 33.25 (Min: 9, Max: 105, SD: 33.24, IR: 41), the mean value for venous sections were 308 (Min: 124; Max: 674; SD: 181,347; IR: 255). in the middle 1/3, mean values for arterial sections were 56,13 (Min: 16, Max: 158, SD: 52,179, IR: 79), mean values for the venous sections were 663,63 (Min: 179, Max: 1906; SD: 584,502; IR: 702). In the posterior 1/3, mean values for arterial sections were 35.63 (Min: 1, Max: 88, SD: 27.045, IR: 37), mean values for venous sections were 445.88 (Min: 88, Max: 819, SD : 269,683; IR: 546). Statistical analysis with one way ANOVA showed that the difference between the regions for venous structures in the anterior, middle and posterior 1/3 regions was p> 0.05 (= 0.202) and for arterial structures was p> 0.05 (= 0.449) DISCUSSION: Since 1940s, researches about the inferior turbinate, which is one of the corner stone in nazal physiology, still continue. Particularly, studies on how this erectile structure performs its function have been focused on glandular epithelium and vascular structures. In these anatomical studies, it was emphasized that vascularisation of posterior one-third is much more than anterior part of the turbinate and vascularisation is the most pronounced within the tail of the turbinate. However, in 2004, Philpott et al. conducted a CD34 immunohistochemistry study on tissue biopsies that different regions of the nazal cavity were taken from patients who underwent endoscopic sinus surgery. In this study, regional differences in microvascular structures was not seen. In our study, in the full-layer serial sections obtained from the whole turbinate, the arterial and venous structures were evaluated by light microscopy and it was compared whether there was any difference in the vascular structure in the anterior, middle and posterior groups. There has not been found any statistical differences between the distribution of the vascular structures of the inferior turbinate in the anterior, middle or posterior part. Unlike what is known about turbinate surgery complications, according to our study, it can be considered that bleeding can occur whichever part of the turbinate is operated. Further studies including surface area and vessel diameters are needed to evaluate the vascular pattern and to guide future surgical procedures, however.

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    Authors: Özcan, Muhammed Furkan;

    Introduction: Dental treatments increase the level of anxiety and fear in many people. Developing anxiety and fear may cause delays in appointments and inability to receive treatments in some patients. In this case, it becomes important for the physician to be able to detect and manage the patient's anxiety. Pharmacological and/or psychological interventions are applied to control anxiety. Psychological/behavioral approach is more preferred by patients with high anxiety values for dental treatment. Since music therapy is a non-invasive method with an anxiolytic effect, it is preferred in the management of anxiety and fear. The aim of this study is to investigate the effect of music therapy on dental anxiety in patients who will undergo periodontal surgery. Material and Method: A total of 46 patients, 23 patients in the test group and 23 patients in the control group, who will undergo periodontal surgery were included in this study. During the procedure, the patients in the test group listened to music from in-ear headphones isolated from ambient sounds. The patients in the control group, on the other hand, were only isolated from the ambient sounds by wearing in-ear headphones, but no music was played. All patients were asked to complete the Modified Dentistry Anxiety Scale (MDAS), State Anxiety Scale (STAI-S), and Fear of Dentistry Scale (DFS) before and after the surgical procedure. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured as vital signs before and after the surgical procedure. Visual Analogue Scale (VAS) values were recorded twice at the end of the surgical procedure and afterwards. For statistical analysis, Chi-square test, Fisher exact test, Student's test, Shapiro Wilk test, Mann Whitney U test, Paired t-test, Wilcoxon signed rank test, Two way mixed ANOVA, Levene test, Box's M test, Pillai's Trace test and Bonferroni-adjusted in-group and between-group comparisons were used. (P<0.05). Results: While MDAS, STAI-S and DFS post-test measurement values showed a statistically significant decrease in the test group compared to the pre-test measurement values (Respectively; P<0,001; P=0,009; P<0,001), no statistically significant difference was found in the control group (Respectively: P=0,093; P=0,923; P=0,460). In both test and control groups, VAS post-test measurement values showed a statistically significant decrease compared to pre-test measurement values (Respectively; P=0,002; P=0,019). While SBP post-test measurement values decreased statistically significantly in the test group compared to the pre-test measurement values (P=0,020), no statistically significant difference was found in the control group (P=0,705). There was no statistically significant difference between DBP pre-test and post-test measurement values in both the test and control groups (Respectively; P=0,083; P=0,160). Conclusion: Music therapy was found to be effective in reducing dental anxiety and fear values during periodontal surgery. Giriş: Dental tedaviler birçok kişide anksiyete ve korku düzeyini artırmaktadır. Gelişen anksiyete ve korku bazı hastalarda randevuların aksatılmasına ve tedavilerin yaptırılamamasına neden olabilmektedir. Bu durumda hekimin hastadaki anksiyeteyi tespit edebilmesi ve yönetebilmesi önem kazanmaktadır. Anksiyeteyi kontrol edebilmek için farmakolojik ve/veya psikolojik girişimler uygulanmaktadır. Dental tedavi yapılacak anksiyete değerleri yüksek hastalarda psikolojik/ davranışsal yaklaşım hastalar tarafından daha çok tercih edilmektedir. Müzik terapi anksiyolitik etkili ve non-invaziv bir yöntem olduğundan anksiyete ve korku yönetiminde tercih edilmektedir. Bu çalışmanın amacı, periodontal cerrahi işlem yapılacak hastalarda müzik terapinin dental anksiyete üzerine etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışmaya, periodontal cerrahi işlem yapılacak 23 hasta çalışma grubu, 23 hasta kontrol grubu olmak üzere toplam 46 hasta dahil edilmiştir. Çalışma grubunda olan hastalara işlem esnasında ortam seslerinden izole kulak içi kulaklıktan müzik dinletilmiştir. Kontrol grubundaki hastalar ise sadece kulak içi kulaklık takarak ortam seslerinden izole edilmiş, müzik dinletilmemiştir. Tüm hastalardan cerrahi işlem öncesinde ve sonrasında Modifiye Diş Hekimliği Anksiyete Ölçeği (MDAS), Durumluluk Anksiyete Ölçeği (STAI-S) ve Diş Hekimliği Korkusu Ölçeği (DKS)'ni doldurmaları istenmiştir. Cerrahi işlem öncesi ve sonrasında vital bulgu olarak sistolik kan basıncı (SKB) ve diastolik kan basıncı (DKB) ölçümü ile cerrahi işlem bitimi ve sonrasında Görsel Analog Skala (VAS) değerleri iki kez kaydedilmiştir. İstatistiksel analiz için Ki-kare testi, Fisher exact testi, Student's testi, Shapiro Wilk testi, Mann Whitney U testi, Paired t-test, Wilcoxon signed rank testi, Two way mixed ANOVA, Levene testi, Box's M testi, Pillai's Trace testi ve Bonferroni düzeltmeli grup içi ve gruplar arası karşılaştırmaları kullanılmıştır. (P<0,05). Bulgular: MDAS, STAI-S ve DKS son-test ölçüm değerleri, ön-test ölçüm değerlerine göre çalışma grubunda istatistiksel olarak anlamlı azalma gösterirken (Sırasıyla; P<0,001; P=0,009; P<0,001), kontrol grubunda istatistiksel olarak anlamlı fark bulunamamıştır (Sırasıyla; P=0,093; P=0,923; P=0,460). Hem çalışma hem de kontrol grubunda VAS son-test ölçüm değerleri, ön-test ölçüm değerlerine göre istatistiksel olarak anlamlı azalma göstermiştir (Sırasıyla; P=0,002; P=0,019). Çalışma grubunda SKB son-test ölçüm değerleri ön-test ölçüm değerlerine göre istatistiksel anlamlı azalırken (P=0,020), kontrol grubunda istatistiksel anlamlı fark bulunamamıştır (P=0,705). DKB ön-test son-test ölçüm değerleri arasında hem çalışma hem de kontrol grubunda istatistiksel olarak anlamlı fark bulunamamıştır (Sırasıyla; P=0,083; P=0,160). Sonuç: Müzik terapi periodontal cerrahi işlem sırasında dental anksiyete ve korku değerleri üzerinde azaltıcı yönde etkili bulunmuştur.

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    Authors: Çavuşoğlu, Güneş Dorukhan;

    New biomarkers that will guide the diagnosis of rheumatoid arthritis are being studied and early diagnosis and treatment of the disease is aimed. Similar pathogenetic mechanisms of periodontitis and RA have been demonstrated. Disease activities of patients with RA who have periodontal disease tend to be worse. Previous studies suggest that calprotectin may be a valuable biomarker for the diagnosis and prognosis of RA. The relationship between calprotectin and disease activity in patients with periodontitis is known. In addition, several studies have shown that the salivary calprotectin level is high in patients with chronic periodontitis. A study showing the relationship between salivary calprotectin levels and disease activity in patients with RA has not been found in the literature so far. In this study, our aim is to evaluate the disease activity with serum and salivary calprotectin levels in patients with RA, and secondly, to evaluate periodontitis in these patients and to reveal whether serum and salivary calprotectin levels are related to periodontitis. 76 patients diagnosed with RA (Female/Male: 59/17) according to the 2010 ACR/EULAR classification criteria, 24 patients diagnosed with SS (F/M: 24/0) according to the 2016 ACR-EULAR classification criteria as the patient control group, and 40 healthy adults (F/M: 24/0) as healthy control group, who applied to the Medipol University Faculty of Medicine Rheumatology Department outpatient clinic, were included in the study. Demographic, clinical and laboratory data of the cases were recorded in the patient follow-up form, and periodontitis examination was performed after taking serum and saliva samples to measure the calprotectin levels simultaneously. Intergroup analyzes were evaluated with Student-T test and Mann-Whitney U test. The correlations between patient and physician-derived scales were evaluated with the Spearman correlation test. In patients with RA, serum calprotectin value was found to be higher in the group with high disease activity than in the group with low disease activity [HDA and LDA: 11.5 (0.78-38.23); 8.3 (1.6-24.4) (p:0.02)]. Mean serum calprotectin values were found to be higher in the RA group than in the other two groups, and there was a statistical difference between the RA group and the SS group, but no statistical difference was found between the RA group and the healthy control group [RA, SS, and HC, respectively: 13.6 (9.8); 8.1 (7.5) and 10.9 (6.02) (p:0.01)]. Median salivary calprotectin levels in patients with RA were found to be higher in patients with periodontitis than in patients without periodontitis [Periodontitis stage I and Periodontitis stage II-IV, respectively: 27.3 (1.6-40.74); 31.7 (0.64-75.85) (p:0.04)]. Serum calprotectin levels were found to be higher in the rheumatoid arthritis patient group than in the healthy and patient control group, and were correlated with disease activity. On the other hand, salivary calprotectin values in patients with rheumatoid arthritis were found to be lower than those of the healthy and patient control group. While periodontal inflammation was correlated with salivary calprotectin values in patients with rheumatoid arthritis, no such relationship was found in the other two groups. Similar to other studies, this study showed that serum calprotectin levels were positively correlated with disease activity markers. Romatoid artrit hastalığının tanısında yol gösterecek yeni biyobelirteçler üzerinde çalışılmakta ve hastalığın erken teşhisi ve tedavisi hedeflenmektedir. Periodontit ve RA'nın benzer patogenetik mekanizmaları gösterilmiştir. Periodontal hastalığı olan RA'lı hastaların hastalık aktiviteleri daha kötü seyretmektedir. Önceki çalışmalar kalprotektinin RA tanısı ve prognozu için değerli bir biyobelirteç olabileceğini göstermektedir. Periodontiti olan hastalarda kalprotektinle hastalık aktivitesi arasındaki ilişki bilinmektedir. Ayrıca kronik periodontiti olan hastalarda tükürük kalprotektin düzeyinin de yüksek olduğu birkaç çalışmada gösterilmiştir. RA tanılı hastalarda tükürükteki kalprotektin düzeyleriyle hastalık aktivitesinin ilişkisini gösteren bir çalışma şu ana dek literatürde bulunmamaktadır. Bu çalışmada amacımız RA tanılı hastalarda serum ve tükürük kalprotektin düzeyleriyle hastalık aktivitesini değerlendirmek, ikincil olarak da bu hastalarda periodontiti değerlendirerek serum ve tükürük kalprotektin düzeylerinin periodontitle ilişkisi olup olmadığını ortaya koymaktır. Medipol Üniversitesi Tıp Fakültesi Romatoloji Bilim Dalı polikliniğine başvuran, 2010 ACR/EULAR sınıflandırma kriterlerine göre RA tanısı almış 76 hasta (K/E: 59/17), hasta kontrol grubu olarak 2016 ACR-EULAR sınıflandırma kriterlerine göre Sjögren sendromu tanısı almış 24 hasta (K/E: 24/0) ve sağlıklı kontrol grubu olarak 40 yetişkin (K/E: 25/15) çalışmaya dahil edildi. Olguların demografik, klinik ve laboratuvar verileri hasta takip formuna kaydedildi ve eş zamanlı olarak kalprotektin için serum ve tükürük örneği alındıktan sonra periodontit muayenesi yapıldı. Gruplar arası analizler Student-T testi, Mann-Whitney U testi; hasta ve doktor kökenli ölçekler arası korelasyonlar Spearman korelasyon testiyle değerlendirildi. RA'lı hastalarda serum kalprotektin değeri, yüksek hastalık aktivitesi olan grupta, düşük hastalık aktivitesi olan gruba göre daha yüksek saptandı [YHA ve DHA: 11,5 (0,78-38,23); 8,3 (1,6-24,4) (p:0,02)]. Ortalama serum kalprotektin değerleri RA grubunda diğer iki gruba göre daha yüksek saptandı ve RA grubuyla SS grubu arasında istatistiksel fark saptanırken, RA grubu ile sağlıklı kontrol grubu arasında istatistiksel fark saptanmadı [RA, SS ve SK sırasıyla: 13,6 (9,8); 8,1 (7,5) ve 10,9 (6,02) (p:0,01)]. RA tanılı hastalarda ortanca tükürük kalprotektin düzeyleri, periodontiti olan hastalarda periodontiti olmayanlara göre daha yüksek saptandı [Periodontit evre I ve Periodontit evre II-IV sırasıyla: 27,3 (1,6-40,74); 31,7 (0,64-75,85) (p:0,04)]. Romatoid artrit hasta grubunda serum kalprotektin değerleri sağlıklı ve hasta kontrol grubuna göre yüksek saptanmış ve hastalık aktivitesiyle korele bulunmuştur. Buna karşılık romatoid artritli hastalarda tükürük kalprotektin değerleri sağlıklı ve hasta kontrol grubuna göre düşük saptanmıştır. Romatoid artritli hastalarda periodontal enflamasyon tükürük kalprotektin değerleri ile korele çıkarken, diğer iki grupta böyle bir ilişki saptanmamıştır. Bu çalışma diğer çalışmalara benzer şekilde serum kalprotektin düzeylerinin hastalık aktivite belirteçleriyle pozitif yönde korele olduğunu göstermiştir.

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    Authors: Öner Özer; Ayhan Tokbaş;

    Thirty methicillin- and cephalothin-sensitive Staphvlococcus aureus strains isolated from blood cultures between January 1993 and January 1994 in the Department of Microbiology and Clinical Microbiology, Medical Faculty, Ege University, were investigated for cephalothin tolerance with tube dilution and time-kill curve method and Eagle phenomenon. Cephalothin tolerance was found in 20 of 30 ( 66.6 %) strains with tube dilution and 10 of 30 { 33.3 %) strains with time-kill curve. None of the strains showed Eagle phenomenon. Ege Üniversitesi Tıp Fakültesi Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı Ocak 1993 - Ocak 1994 tarihleri arasında kan kültürlerinden soyutlanan metisilin ve sefalotin duyarlı 30 Staphvlococcus aureus kökeninde tüp diiüsyon ve zaman ölüm eğrisi ile sefalotin toleransı ve Eagle fenomoni varlığı araştırıldı. İncelenen 30 kökenin tüp diiüsyon yöntemi ile 20'sinde (% 66.6), zaman ölüm eğrisi ile 10'unda (% 33.3) sefalotin toleransı saptanırken hiçbir kökende Eagle fenomeni görülmedi.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Ege University Insti...arrow_drop_down
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    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Ege University Insti...arrow_drop_down
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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