Tıp Fakültesi / Faculty of Medicine
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Item A 10-Year Experience of Tuberculosis in Solid-Organ Transplant Recipients(2015) Ulubay, Gaye; Kupeli, Elif; Birben, Ozlem Duvenci; Seyfettin, Emine Pinar; Dogrul, Mustafa Ilgaz; Ugurlu, Aylin Ozsancak; Eyuboglu, Fusun Oner; Haberal, Mehmet; 0000-0002-5525-8207; 0000-0002-3462-7632; 0000-0003-2478-9985; 0000-0003-3598-3986; 0000-0002-5826-1997; 25894157; AAR-4338-2020; AAJ-8097-2021; AAB-5064-2021; AAA-2925-2020; AAB-5345-2021Objectives: Tuberculosis remains an important problem in solid-organ transplant patients due to their immunocompromised state. The objective of the present study was to report the incidence, demographic characteristics, and various presentations of tuberculosis in solid-organ transplant recipients. Materials and Methods: We evaluated a total of 999 patients (male/female = 665/334, 661 renal and 338 liver transplants) who underwent solid-organ transplant between 2003 and 2013. The medical records of all patients were retrospectively reviewed. Patients' demographics, transplant type, primary site of tuberculosis specimen culture and pathology results, chest radiograph, and thoracic computed tomography findings, total blood count and chemistry were all recorded. Results: Among the 999 subjects, 19 patients (1.9%) (male/female: 15/4, mean +/- SD age, 42 +/- 18.5 y) were diagnosed with tuberculosis. The majority of patients (85%) were diagnosed with tuberculosis within 6 months after transplant, and 15% were diagnosed within 3 months. Most diagnoses of tuberculosis were based on histopathologic examination of biopsy material. Of these patients, 9 were diagnosed with pulmonary tuberculosis, 8 had extrapulmonary tuberculosis, and 2 had both. Nontuberculosis mycobacteria infections were detected in 3 patients. Conclusions: Even with a negative exposure history, tuberculosis can manifest as different clinic presentations in solid-organ transplant patients on immunosuppressive drugs, particularly in the first 6 months after transplant. Therefore, clinicians should always consider tuberculosis as the potential cause of an infectious disease with unknown cause to successfully diagnose and manage solid-organ transplant recipients.Item A 10-year retrospective analysis of intimate partner violence patients in the emergency department(2022) Kavak, Nezih; Kavak, Rasime Pelin; Ozdemir, Meltem; Sever, Mustafa; Ertan, Nurcan; 35652880BACKGROUND: Intimate partner violence (IPV) is an important human rights problem faced by one in three women worldwide. The aim of this study is to evaluate the demographic, trauma, and radiological characteristics of patients admitted to a tertiary emergency department due to IPV. METHODS: Sociodemographic characteristics (age, gender, education level, and marital status), trauma characteristics (severity, type, and location), radiological imaging findings (radiography, computed tomography, and magnetic resonance imaging) of patients diagnosed with IPV were evaluated. RESULTS: In the study, 1225 patients were evaluated, and 98.7% of them were women (mean age 35 [IQR: 17] years). Of the patients, 63.1% were high school and university graduates. The rate of married women was 74.6%. No relationship was found between gender, age, educational status, and marital status (p>0.05). Most of the traumas were minor (85.4%) and blunt (81.9%) trauma, and the most common types of trauma were kicking (49.9%) and punching (47.3%). It was found that the most frequently affected areas of the patients were the head and neck (76.7%), and the frequency of pelvic trauma was high in male patients (p<0.05). The most common bone fracture was nasal (40.5%) followed by ulna fractures (14.5%). The left-sided diaphyseal fractures were the most common in patients exposed to IPV. In our study, the frequency of mortality was 12.9%, and it was found to be significantly higher in males (p<0.05). CONCLUSION: Female patients are more frequently exposed to IPV. Specific injury characteristics can be detected in patients diagnosed with IPV and old fractures detected in these patients should alert the clinician about IPV.Item The 2-Stage Liver Transplant: 3 Clinical Scenarios(2015) Gedik, Ender; Bicakcioglu, Murat; Otan, Emrah; Toprak, Huseyin Ilksen; Isik, Burak; Aydin, Cemalettin; Kayaalp, Cuneyt; Yilmaz, Sezai; 0000-0001-9293-8116; 0000-0002-2395-3985; 0000-0002-7175-207X; 0000-0003-4657-2998; 25894175; ABB-5579-2020; AAH-1764-2021; AAN-4023-2020; A-6657-2018; ABI-2971-2020The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We describe our experience of 3 patients with 3 different clinical conditions. A 57-year-old man was retransplanted successfully with this technique due to hepatic artery thrombosis. However, a 38-year-old woman with fulminant toxic hepatitis and a 5-year-old-boy with abdominal trauma had poor outcome. This technique could serve as a rescue therapy for liver transplant patients who have toxic liver syndrome or abdominal trauma. These patients required intensive support during long anhepatic states. The transplant team should decide early whether to use this technique before irreversible conditions develop.Item 2019 Expert opinion on biological treatment use in inflammatory bowel disease management(2019) Toruner, Murat; Akpinar, Hale; Akyuz, Filiz; Dagli, Ulku; Hamzaoglu, Hulya Over; Tezel, Ahmet; Unsal, Belkis; Yildirim, Suleyman; Celik, Aykut Ferhat; 32207688Item The 2100 Mhz Radiofrequency Radiation of A 3G-Mobile Phone and The DNA Oxidative Damage in Brain(2016) Sahin, Duygu; Ozgur, Elcin; Guler, Goknur; Tomruk, Arin; Unlu, Ilhan; Sepici-Dincel, Aylin; Seyhan, Nesrin; 26775761We aimed to evaluate the effect of 2100 MHz radiofrequency radiation emitted by a generator, simulating a 3G-mobile phone on the brain of rats during 10 and 40 days of exposure. The female rats were randomly divided into four groups. Group I; exposed to 3G modulated 2100 MHz RFR signal for 6 h/day, 5 consecutive days/wk for 2 weeks, group II; control 10 days, were kept in an inactive exposure set-up for 6 h/day, 5 consecutive days/wk for 2 weeks, group III; exposed to 3G modulated 2100 MHz RFR signal for 6 h/day, 5 consecutive days/wk for 8 weeks and group IV; control 40 days, were kept in an inactive exposure set-up for 6 h/day, 5 consecutive days/wk for 8 weeks. After the genomic DNA content of brain was extracted, oxidative DNA damage (8-hydroxy-2'deoxyguanosine, pg/mL) and malondialdehyde (MDA, nmoL/g tissue) levels were determined. Our main finding was the increased oxidative DNA damage to brain after 10 days of exposure with the decreased oxidative DNA damage following 40 days of exposure compared to their control groups. Besides decreased lipid peroxidation end product, MDA, was observed after 40 days of exposure. The measured decreased quantities of damage during the 40 days of exposure could be the means of adapted and increased DNA repair mechanisms. (C) 2016 Elsevier B.V. All rights reserved.Item 22q13.3 Deletion Syndrome: An Underdiagnosed Cause of Mental Retardation(2015) Erol, Ilknur; Onay, Ozge Surmeli; Yilmaz, Zerrin; Ozer, Ozge; Alehan, Fusun; Sahin, Feride IffetPhelan-McDermid syndrome, also known as 22q13.3 deletion syndrome, is characterized by global developmental delay, absent or delayed speech, generalized hypotonia, and minor physical anomalies. The deletion typically involves the terminal band 22q13.3 and has been associated with both familial and de-novo translocations. We report the case of an 11-year-old Turkish girl with 22q13.3 deletion syndrome presenting with repeated seizures during the course of a rubella infection. We also review the clinical features of 22q13.3 deletion syndrome and emphasize the importance of considering a rare microdeletion syndrome for idiopathic mental retardation when results of a routine karyotype analysis are normal. To the best of our knowledge, this is the first reported case of a Turkish patient with isolated 22q13.3 deletion syndrome.Item 3q29 Microdeletion Syndrome Associated with Developmental Delay and Pulmonary Stenosis: A Case Report(2022) Kaba, Duygu; celik, Zerrin Yilmaz; 36305444Background. 3q29 microdeletion syndrome (OMIM 609425), first described in 2005, is a rare copy number variation (CNV), accompanied by various neurodevelopmental and psychiatric problems. Phenotypic features of the syndrome have not been fully characterized due to the new definition and rarity. Facial dysmorphology, musculoskeletal anomalies, cardiovascular abnormalities, gastrointestinal abnormalities, and dental abnormalities can be seen.Case. A 28-month-old male patient was brought to the child and adolescent psychiatry clinic with a complaint of speech delay. He had mild dysmorphic symptoms. He was also sensitive to voice and often covered his ears. Balloon valvuloplasty was performed on the postnatal 28th day due to severe pulmonary stenosis. While karyotype was found to be normal, in array-Comparative genomic hybridization (aCGH), copy loss was detected in the long arm of chromosome 3 (arr[hg19] 3q29[196,209,689-197,601,344]x1), which contains approximately 1.4 Mb harboring 30 genes. Genetic counseling was given to the family of the patient who was diagnosed with 3q29 microdeletion syndrome.Conclusions. In conclusion, we present 3q29 microdeletion syndrome with global developmental delay (GDD), dysmorphic face, hyperacusis, scoliosis, and severe pulmonary stenosis. Performing genetic analysis in patients with developmental delay and congenital heart disease (CHD) for which the cause cannot be explained will prevent these rare diseases from being missed, and the characteristics of the diseases will be better characterized with the reported cases.Item ABDOMINAL BIOELECTRIC IMPEDANCE FOR FOLLOW-UP OF DIETERS: A PROSPECTIVE STUDY(2019) Bozkus, Y.; Mousa, U.; Demir, C. C.; Anil, C.; Kut, A.; Iyidir, O. Turhan; Kirnap, N. Gulsoy; Firat, S.; Nar, A.; Tutuncu, N. B.; 0000-0002-1816-3903; 31508169; ABG-5027-2020; K-7904-2019Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal follow-up studies. Objective. The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. Design. All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. Subjects and Methods. Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. Results. Mean loss of body weight was 3.4 +/- 2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p<0.001). Decreases in body weight, body mass index (BMI), and VAT level significantly correlated with decreases in fasting blood glucose, fasting insulin level, and HOMA-IR score (r=0.230-0.371). In multiple linear regression analysis changes in BMI and VAT significantly correlated with change in HOMA-IR score (F(7.93)=2.283, p=0.034, R2=0.147). Conclusion. Decreases in BMI and VAT, as determined by A-BIA, were predictors of changes in metabolic laboratory measures. A-BIA is useful for follow-up of patients receiving diet therapy for weight loss.Item Abdominal CT Findings in Patients with Primary Lymphoma Causing Small Bowel Obstruction(2017) Karadeli, Elif; Erbay, Gurcan; Parlakgumus, Alper; Yabanoglu, Hakan; 0000-0002-0352-8818; 0000-0002-1706-8680; 0000-0002-1161-3369; 29132484; AAK-5399-2021; AAK-5370-2021; AAJ-7865-2021The purpose of this study was to investigate retrospectively CT findings in patients with primary lymphoma causing small bowel obstruction. CT scans of 11 patients with small bowel lymphoma were separately analysed in terms of affected section of the small bowel, focality, wall thickness, pattern and degree of contrast enhancement, lymphadenopathy, organ involvement, perforation, and the presence of intraabdominal fluid. Eight patients had diffuse large B-cell lymphoma, and one patient each had marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT), T-cell lymphoma, and anaplastic T-cell lymphoma. Affected sections of the bowels involved were jejunum (n=5, 45.4%), ileum (n=2, 18.1%), and one case (9%) each of distal ileum, distal jejunum, distal jejunum and ileum, and distal jejunum and colon. Primary gastrointestinal (GI) lymphoma is an uncommon disease, that may lead to small bowel obstruction sometimes.Item Abdominal Ischemia-Reperfusion Induced Cardiac Dysfunction Can Be Prevented by MitoTEMPO(2021) Akkoca, Ahmet; Celen, Murat Cenk; Tuncer, Seckin; Dalkilic, Nizamettin; 33761811Background Cardiac dysfunction is secondary to acute mesenteric ischemia (AMI) and abdominal aortic aneurysms (AAA). The underlying cause of distant organ damage in the heart is the formation of oxidative stress caused by ischemia-reperfusion. In this study, we investigated the possible protective effects of a novel mitochondria-targeted antioxidant MitoTEMPO on contractile dysfunction and structural defects of the rat papillary muscle caused by abdominal ischemia-reperfusion (AIR). Methods and Results In the experiments, adult Wistar-Albino rats were used and animals were divided randomly into 3 groups; sham-operated group (SHAM), an IR group that had aortic cross-clamping for 1 h followed by 2 h reperfusion, and a third group that received protective 0.7 mg/kg/day MitoTEMPO injection for 28-day before IR. As a result, it was observed that MitoTEMPO injection had a protective effect on the mechanical activities and structural properties of the papillary muscle impaired by AIR. Our study also showed that AIR disrupted the contractile function of the papillary muscle for each stimulation frequency and post-potentiation responses tested. This is common for each measured and calculated mechanical parameter and MitoTEMPO injection showed its protective effects. Conclusion Consequently, calcium homeostasis seems to be impaired by AIR, and MitoTEMPO may exert its protective effect through energy metabolism by directly targeting the mitochondria.Item Abdominal Problems in Children with Congenital Cardiovascular Abnormalities(2015) Guney, Lutfi Hakan; Araz, Coskun; Beyazpinar, Deniz Sarp; Arda, Irfan Serdar; Arslan, Esra Elif; Hicsonmez, Akgun; 26185717Background: Congenital cardiovascular abnormality is an important cause of morbidity and mortality in childhood. Both the type of congenital cardiovascular abnormality and cardiopulmonary bypass are responsible for gastrointestinal system problems. Aims: Intra-abdominal problems, such as paralytic ileus, necrotizing enterocolitis, and intestinal perforation, are common in patients who have been operated or who are being followed for congenital cardiovascular abnormalities. Besides the primary congenital cardiovascular abnormalities, ischemia secondary to cardiac catheterization or surgery contributes to the incidence of these problems. Study Design: Cross-sectional study. Methods: In this study, we aimed to screen the intra-abdominal problems seen in patients with congenital cardiovascular abnormalities who had undergone surgical or angiographical intervention(s). Patients with congenital cardiovascular abnormalities who had been treated medically or surgically between 2000 and 2014 were analyzed retrospectively in terms of intra-abdominal problems. The patients' demographic data, type of congenital cardiovascular abnormalities, the intervention applied (surgical, angiographic), the incidence of intra-abdominal problem(s), the interventions applied for the intra-abdominal problems, and the results were evaluated. Results: Fourteen (Group I) of the 76 patients with congenital cardiovascular abnormalities diagnosis were operated due to intra-abdominal problems, and 62 (Group II) were followed-up clinically for intra-abdominal problems. In Group I (10 boys and 4 girls), 11 patients were aged between 0 and 12 months, and three patients were older than 12 months. Group II included 52 patients aged between 0 and 12 months and 10 patients older than 12 months. Cardiovascular surgical interventions had been applied to six patients in Group I and 40 patients in Group II. The most frequent intra-abdominal problems were necrotizing enterocolitis and intestinal perforation in Group I, and paralytic ileus in Group II. Seven of the Group I patients and 22 of the Group II patients died. The patients who died in both groups had more than three congenital cardiovascular abnormalities in the same patient, and 80% of these patients had been operated for congenital cardiovascular abnormalities. Conclusion: The gastrointestinal system is involved in important complications experienced by patients with congenital cardiovascular abnormalities. The mortality rate was higher in operated patients due to gastrointestinal complications. Gastrointestinal complications are more frequent in patients with cyanotic anomalies. The presence of more than one congenital cardiovascular abnormality in a patient increased the mortality rate.Item Ability of ESWL nomograms to predict stone-free rate in children(2021) Ceyhan, Erman; Ozer, Cevahir; Ozturk, Bulent; Tekin, Mehmet Ilteris; Aygun, Yuksel Cem; 0000-0001-8223-6399; 0000-0002-6232-4313; 0000-0002-7850-6912; 33867289; ABI-2513-2020; AAM-3015-2021; AAM-2222-2020Introduction We aimed to evaluate whether the pediatric extracorporeal shock wave lithotripsy (ESWL) nomograms can predict stone-free status in children effectively and whether they are applicable to our series. We hypothesize that two current nomograms predicting successful treatment with ESWL in pediatric patients are valid. Study design We evaluated 415 renal units (children <18 years) with eligible data who received ESWL treatment for upper urinary tract stones. Children's age, gender, stone size, stone surface area, stone location and history of previous intervention were recorded. Children with no residual fragments after ESWL treatment were designated as stone-free. The nomograms described by Dogan and Onal were implemented to our series for the prediction of stone-free status. Results Mean age of children was 64.7 +/- 57.2 months. Male to female ratio was 219:196.78.8% (327) of children had single stone. Mean stone size was 10.0 +/- 3.7 mm and mean stone surface area was 380.0 +/- 72.2 mm(2). Our stone-free rate after single ESWL session was 52.5% (218/415). Mean residual stone size and stone surface area after single session was 6.4 +/- 3.3 mm and 36.0 +/- 44.2 mm(2) respectively. There were no significant difference between stone-free children and children with residual fragments regarding gender, age and history of previous intervention. Mean stone size and stone surface area in stone-free children were lower and lower pole stones had the lowest stone-free rate (p < 0.05). Area under curve for Dogan and Onal nomogram were 0.628 and 0.580 respectively in ROC analysis (0.05). The agreement between Dogan and Onal score was moderate in our series. In multivariate analysis only stone surface area and Dogan score found to be independent predictors of stone-free status (p < 0.05). Discussion Only one study has assessed both nomograms in the literature. Both nomograms are reported to be independent predictors of stone free status. ROC analysis in our study revealed fair accuracy for both nomograms with higher area under curve for Dogan nomogram. Higher accuracy for both nomograms were reported by other authors. These nomograms offer practical data but more effective tools are needed to be developed for the prediction of stone-free status in pediatric ESWL. Conclusions Stone size and stone surface area are associated with stone clearance. Dogan and Onal nomograms can be useful in prediction of stone-free status in children. Dogan nomogram is superior to Onal nomogram. [GRAPHICS]Item Abnormal circadian blood pressure regulation in children with nocturnal enuresis(2016) Yuce, Ozge; Bayrakci, Umut Selda; Gulleroglu, Kaan; Baskin, Esra; 27056252Introduction: To investigate autonomic nervous system function in enuretic children by performing ambulatory blood pressure monitor (ABPM) for 24h. Methods: Twenty-eight children ranging in age from 6 to 15 years with primary nocturnal enuresis and 27 age-matched healthy controls were enrolled and they get 24h ABPM. Hypertension was defined as standard deviation score (SDS)>1.64 (i.e., >95th percentile) adjusted for gender and height. Urinalysis, urine electrolyte levels, urinary culture, and urinary system ultrasound were carried out in all children. They have also requested to have a diary about daily fluid intake and urine volume. Results: Although the mean 24-h and daytime diastolic blood pressure (BP) did not differ between the groups, systolic BP (SBP) was significantly higher in enuretic children (p<0.05). The mean night-time SBP, DBP values, SDS and BP loads were found to be significantly higher than those in the controls (p<0.01). A lack of nocturnal decrease was more prevalent in the enuretic children compared with the control subjects, the difference was statistically significant for DBP but not for SBP. Patients with elevated night-time BP load was found to have higher frequency of urinary incontinence per week as well as per night when compared with enuretic children with normal night-time BP load (r=0.72, r=0.69, p<0.01, respectively). Conclusion: Subtle abnormalities of circadian BP regulation in enuretic children indicated by a selective elevation of nocturnal SBP, DBP, and MAP, and attenuated nocturnal dipping may reflect sympathetic hyper activation and its possible role in pathogenesis of enuresis.Item ABO and Rh Blood Groups and Risk of Myelomeningocele(2020) Isik, Semra; Cevik, Serdar; Turhan, Ali Haydar; Baygul, Arzu; Hanimoglu, Hakan; 32239487AIM: To investigate the relationship between the distribution of ABO or Rhesus (Rh) blood group antigens and the incidence of myelomeningocele. MATERIAL and METHODS: A retrospective data was reviewed for all myelomeningocele patients operated at a tertiary academic hospital between years 2014 and 2019. Age, sex, delivery method, physical and neurological examination findings, and radiological findings alongside with blood type of each patient were recorded. The data of blood group distribution among the study patients was compared to the data of healthy individuals in the same region. RESULTS: Patients with group B and AB showed a higher chance of developing myelomeningocele. Rh-positive blood group was associated with high incidence of myelomeningocele (93.5%), whereas Rh-negative blood group showed least association (6.5%). Rh-positive blood group was also found to be more frequent in patients with myelomeningocele with hydrocephalus and Chiari malformation. CONCLUSION: The findings of this study show that ABO and Rh blood groups have an effect on the development of myelomeningocele under the influence of environmental or genetic factors.Item Absence of Luteal Phase Defect and Spontaneous Pregnancy in IVF Patients Despite Gnrh-Agonist Trigger and "Freeze All Policy'' without Luteal Phase Support: A Report Of Four Cases(2016) Gurbuz, Ali Sami; Deveer, Ruya; Ozcimen, Necati; Ozcimen, Emel Ebru; Lawrenz, Barbara; Banker, Manish; Antonio Garcia-Velasco, Juan; Fatemi, Human Mousavi; 26487486Human chorionic gonadotropin (hCG) is commonly used for final oocyte maturation in in vitro fertilization (IVF)-treatment cycles, however, the main important risk is development of severe ovarian hyperstimulation syndrome (OHSS). OHSS can almost be avoided by using gonadotrophin-releasing-hormone agonist for final oocyte maturation in an antagonist protocol. However, primarily this approach lead to a very poor reproductive outcome, despite the use of a standard luteal phase support. The reason seems to be severe luteolysis. Obviously, luteolysis post-gonadotropin-releasing-hormone-agonist (post-GnRH-a) trigger is individual specific, and not all patients will develop a complete luteolysis, as expected previously. Luteolysis can been reverted by the administration of hCG. Unprotected intercourse around the time of ovulation induction and oocyte retrieval can lead to a spontaneous conception in IVF treatment and, endogenous hCG, produced by the trophoblast, will rescue the corpora lutea. Therefore, one should not rely on complete luteolysis after GnRH-a triggering and, especially patients for egg donation and pre-implantation-genetic diagnosis for single gene disorder, have to be counselled to avoid unprotected intercourse.Item Abused-Abuser Dilemma in Sexual Abuse and Forensic Evaluation: a Case Report(2017) Kutuk, Meryem Ozlem; Guler, Gulen; Tufan, Ali Evren; Sanberk, Sati; 0000-0002-2918-7871; AAI-9626-2021The factors such as having family problems, growing up in a disintegrated family, having parents with personality disorders, expressing physical and mental deficiencies, history of alcohol and substance abuse, previous history of sexual abuse, and lack of social support may increase the risk of being exposed to sexual abuse. According to the previous studies about one-third of children who are subjected to abuse may become abusers in the future. In such a condition, a dilemma of abuse-abuser has been experienced. Importantly, additional medical mistakes and lack of experience in such cases make legal evaluation processes more complex. In this case report, we discussed a pediatric patient who was abused by a babysitter with a history of abuse in her adolescence. Early recognition of sexual abuse, treatment of developing psychiatric disorders, and a follow-up program are necessary to minimize the vicious cycle of abused-abuser.Item Acceptability, Reliability and Validity of The Turkish Version of The De Morton Mobility Index in Elderly Patients with Knee Osteoarthritis(2014) Yuruk, Zeliha Ozlem; Aytar, Aydan; Tuzun, Emine Handan; Eker, Levent; Yuksel, Inci; De Morton, Natalie A.; https://orcid.org/0000-0002-4408-6489Introduction: The de Morton Mobility Index is a newly developed instrument that assesses the mobility in elderly. The aim of the study was to translate the de Morton Mobility Index into Turkish and investigate its psychometric properties in elderly patients with knee osteoarthritis. Materials and Method: The Turkish version of the de Morton Mobility Index was developed using the forward-backward translation method. Patients (n= 100) were assessed using the Turkish version of the index, Western Ontario and McMaster Universities Osteoarthritis Index, and Timed Up and Go test. Acceptability was assessed in terms of refusal rate, and administration time. Floor and ceiling effects and skew of the distribution were measured. Intra-class correlation coefficients, standard error of measurement, and minimal detectable change scores were calculated. The Pearson's correlation coefficients were measured. Results: Average time to complete the index was 7.8 minutes. The response rate was 99%. The reliability analyses were conducted with 40 patients. The intra-class correlation coefficient( 2,1), standard error of measurement, minimal detectable change90, and minimal detectable change95 were 0.95, 3.15, 7.33, and 8.71, respectively. The de Morton Mobility Index scores were normally distributed, and had no floor or ceiling effects. Ninety-nine knee osteoarthritis patients were analyzed for validity. Correlation coefficients between the de Morton Mobility Index, Timed Up and Go test and the Western Ontario and McMaster Universities Osteoarthritis Index physical function, pain and stiffness subscales were -0.69, -0.70, -0.39, and -0.32, respectively. Conclusion: The Turkish version of the de Morton Mobility Index is an acceptable, reliable and valid measure for assessing mobility in elderly patients with knee osteoarthritis.Item Accidental Late PEG Dislodgment in 3 Cases with A Narrow Stoma: Bougie Dilatation Rescue(2023) Koker, Ibrahim Hakki; Yenidunya, Ozlem; Savas, Nurten Akyurek; Tosun, Serife Degirmencioglu; Davutoglu, Can; 0000-0001-5622-4378; 38073451; JAZ-1759-2023Percutaneous endoscopic gastrostomy (PEG) is a simple and effective method of enteral nutrition for many patients who cannot take oral food. The accidental dislodgment of the PEG tube after the maturation of the gastrocutaneous fistula (stoma) is called late dislodgment. If it is not detected early, the stoma lumen gets narrower and does not permit the passage of the replacement tube. In this case, the commonly followed method is to continue enteral nutrition by opening a new gastrocutaneous fistula after the complete closure of the original stoma. Here, we present a stoma-saving bougie dilatation method in 3 cases with severely narrowed stomas after late accidental dislodgment of the PEG tube.Item Accuracy of CBCT images in the volumetric assessment of residual root canal filling material: Effect of voxel size(2019) Yilmaz, F.; Sonmez, G.; Kamburoglu, K.; Koc, C.; Ocak, M.; Celik, H. H.; 31417052Aims: Our aim was to compare three different voxel sizes of CBCT images for the determination of residual filling material volume in root canals when compared with micro CT. Material and Methods: Forty-two root canals of 14 extracted human maxillary molar teeth were retreated by using ProFile((R)) instruments. Images were obtained after retreatment by using ProMax 3D Max CBCT at 3 different voxel sizes (1) High resolution (0.1 mm); (2) High definition (0.15 mm); and (3) Normal resolution (0.2 mm). Two observers measured volumes of residual filling materials in exported CBCT images by means of 3D Doctor Software. Micro CT measurements were served as gold standard. Mann-Whitney U test and Wilcoxon Test were used for the comparison of CBCT and micro CT measurements. Statistical significance was set at P < 0.05. Results: No statistically differences were found between the two observers for all measurements (P 0.05). There were no significant differences among different CBCT voxel sizes used (0.1 mm, 0.15 mm, and 0.2 mm) (P 0.05). The Spearman correlation coefficients between CBCT at different voxel sizes significantly highly correlated with micro CT measurements for each observer (P < 0.05). Furthermore, no significant differences were found between the measurements obtained by the two observers in consideration to root canal location (P 0.05). Conclusion: CBCT images may provide useful information in the volumetric assessment of the amount of residual filling material in root canals for retreatment procedures.