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Laparoendoscopic Single-Site Combined Hysterectomy and Nephrectomy in Deep Infiltrating Endometriosis  [PDF]
Merve Bi?er, Murat Arslan, Vedat Ulug, Zekeriya Güner, Suleyman Akarsu, Mert Gol
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.612123
Abstract: Within the advance ports and instruments, laparoendoscopic single-site (LESS) surgery has been increasingly used among gynaecologic surgeons. In addition, advanced port systems have enabled to perform concomitant surgical procedures via transumbilical incision. However, combined surgical operations are rarely reported in the literature, particularly in gynaecology. This case report presents a 42-year-old woman who undergo concomitant LESS hysterectomy and nephrectomy due to deep infiltrating endometriosis (DIE) and end stage renal disease. The operation is performed in approximately 3 hours without any complications, and the patient is discharged on postoperative third day. This case demonstrates that complex concomitant operations even in a patient with DIE can be performed using a LESS surgical approach.
Cardiovascular Risk Assesment at the Personnel of Turkish Armed Forces
Zekeriya Arslan,Mustafa Aparci,Ejder Kardesoglu,Atila Iyisoy
TAF Preventive Medicine Bulletin , 2009,
Abstract: AIM: In this study we aimed to evaluate the cardiovascular risk profile of Turkish Armed Forces (TSK) personnel and also to determine the ones at high risk. METHOD: Totally, 1311 individuals were participated in a questionnaire. Smoking, hypertension, diabetes, hyperlipidemia, family history, physical activity, previous cardiovascular disease or symptoms were interrogated. Of the 249 individuals with ≥2 risk factors or even not exist risk factors but having active cardiac complaint; 176 volunteers (%71) were performed physical examination, ECG, echocardiography, and biochemical tests (fasting glucose, lipid profiles etc) and the ones with high risk (n=14) were performed exercise stress test. Statistical analysis was performed by Chi-Square test, Fisher s exact test and Student t test using SPSS 11.0 for Windows. RESULTS: Of 1311 subjects (age 32.6 ± 6.7, %98.7 male), 24.3 % had no risk factors. Rate of Smoking, hypertension, hyperlipidemia, family history, overweight (BMI>25 kg/m2), and inactivity were 43.0%, 5.2%, 2.7%, 17.5%, 28.8%, 20.8% and 20%, respectively. Rate of overweight, inactivitiy, and typical chest discomfort were significantly increased with age (p<0.001). Smoking was similar in all age groups. While the the ten year-Framingham risk score was %1.6 before 40 years old, it was significantly increased then. Of 176 subjects, when rated general poll population, cardiovascular diseases rate was 2.7% (coronary 0.6%, valvular 1.1%, rhytm-conductance 0.8%, and other -congenital, peripheral vascular etc. 0.2%) compared to whole group. 22 patient had left ventricular hypertrophy due to valvular diseases or hypertension. Newly diagnosed 15 patients were started on medication, and three subjects referred advanced medical center. CONLUSION: Risk stratification and modification gain importance for an earlier diagnosis and treatment of cardiovascular diseases worldwide. Similar society based projects could also reduce the morbidity and mortality of cardiovascular disease in our country. [TAF Prev Med Bull. 2009; 8(5): 373-380]
Variability of Carotid Intima Media Thickness in Youth According to the Geographic Region
Mustafa Aparci,Zekeriya Arslan,Ejder Kardesoglu,Eyup Buyukkaya
TAF Preventive Medicine Bulletin , 2009,
Abstract: AIM: Carotid intima media thickness (IMT) is proposed to be an earlier predictor of subclinical atherosclerosis. Currently risk management of atherosclerosis at earlier ages gains importance. In this study we evaluated the carotid intima media thickness of young individuals and any possible changes due to the geographic region in which the individuals lived in. METHOD: Totally, 164 young individuals (age 21.14± 2.06) were enrolled to the study. Geographic regions in which they have been living for at least 10 years were documented. Measurements of IMT were performed by Logic5 Pro Color Doppler Device using transverse probe. Measurements of IMT, systolic and diastolic blood pressures, and levels of total cholesterol, HDL, LDL, and triglyceride were compared between the groups designed according to the geographic regions. Statistical analysis was performed by Oneway ANOVA test using SPSS 11.0 for Windows. RESULTS: Carotid IMT was significantly lower in subjects living in Mediterranean (0.416±0.02 mm) and South East Region (0.428±0.04), whereas it increased in subjects living in Marmara Region (0.468±0.06 mm) and Mid-Anatolian Region (0.473±0.04). CONCLUSION: We can propose that individual changes in carotid intima media thickness may develop at younger ages. Differences in dietary habits and its content, also cultural, and environmental differences due to geographic region in which the individuals lived in may contribute those changes. Measurement of IMT could be used as a screening test to detect young individuals with subclinical atherosclerosis in geographic region at risk for atherosclerosis in the future. [TAF Prev Med Bull. 2009; 8(2): 119-124]
Unfavorable Effects of Smoking on Atherosclerotic Risk Factors of Young Individuals
Mustafa Aparci,Zekeriya Arslan,Zafer Isilak,Ejder Kardesoglu
TAF Preventive Medicine Bulletin , 2009,
Abstract: AIM: It was documented that smoking was a significant atherosclerotic risk factor for adults. However reality of the initiation of atherosclerosis at childhood guided us to evaluate the probable effects of smoking on other atherosclerotic risk factors at young ages. METHODS: One hundred sixty four young subjects (age 21.14± 2.06) were enrolled. Participants were grouped as not smoking (n=48), ex-smoking (n=30), 1-3 cigarettes/day (n=26), a half package/day (n=26), a package/day (n=34). Body mass index (BMI) of subjects were calculated. Systolic and diastolic blood pressures (SBP, DBP) were measured. Carotid intima media thickness (IMT) was measured by Logic5 pro Colour Doppler Device. Total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels of subjects were measured from the serum obtained at 12 hour fasting state. IMT and IVSd were measured by transverse and 3S probes using. Statistical analysis was performed by One-way ANOVA test using SPSS 11.0 for Windows. RESULTS: BMI, SBP, and DBP were not different between groups (p=0.16). HDL cholesterol was significantly lowered whereas LDL cholesterol was significantly increased in group smoking one package/day. Also carotid IMT was increased in patients smoking one package/day compared to others but data was not statistically significant. Triglyceride level group. CONCLUSION: Smoking effects atherosclerotic risk factors unfavorably even at young ages. Thus smoking should be eradicated since earlier ages in order to reduce the prevalence of cardiovascular diseases. [TAF Prev Med Bull. 2009; 8(3): 193-198]
A parachute mitral valve accompanying persistent left superior vena cava: assessment by three-dimensional transthoracic echocardiography
Sait Demirkol,Zekeriya Arslan,?evket Balta,U?ur Kü?ük
Anadolu Kardiyoloji Dergisi , 2012,
Assessment of right ventricular systolic function with dP/dt in healthy subjects: an observational study
Sait Demirkol,Murat ünlü,Zekeriya Arslan,Turgay ?elik
Anadolu Kardiyoloji Dergisi , 2013,
Abstract: Objective: The objective of our study is to determine the mean values of right ventricular (RV) dP/dt and to compare it with other right ventricular function parameters by echocardiography.Methods: This observational study consisted of 112 healthy subjects who had trivial tricuspid regurgitation. Full echocardiographic examination was performed. RV systolic function was assessed by using myocardial performance index (RV MPI), tricuspid annular plane systolic excursion (TAPSE), myocardial acceleration during isovolumic contraction (RV IVA), RV fractional area change (RV FAC), tissue Doppler–derived tricuspid lateral annular systolic velocity (Tri S`) and RV dP/dt (dP/dt). Pearson correlation test was used in examining the correlation between parameters. Differences between correlations were compared with Fisher’s z transformation. Results: The mean of RV dP/dt (0.5-2) was 1016±421 mmHg/s (95% CI=891-1142) and the mean of RV dP/dt (1-2) was 1524±573 mmHg/s (95% CI=1354-1694). RV pulse Doppler MPI and RV tissue Doppler imaging MPI were negatively correlated with RV dP/dt (0.5-2) (r=-0.482 and r=-0.504, p<0.01). Tri S’ was positively correlated with RV dP/dt (0.5-2) (r=0.667, p<0.01) and with the RV dP/dt (1-2) (r=0.312, p<0.05). TAPSE was positively correlated with RV dP/dt (0.5-2) (r=0.585, p<0.01) and with the RV dP/dt (1-2) (r=0.323, p<0.05). RV IVA was positively correlated with RV dP/dt (0.5-2) (r=0.512, p<0.01). FAC (%) was not correlated with both RV dP/dt (0.5-2) and RV dP/dt (1-2).Conclusion: The results of our study were as follows: 1) we described the mean of RV dP/dt (0.5-2) and RV dP/dt (1-2) in healthy population; 2) the correlation between dP/dt (0.5-2) and RV function parameters was better than between dP/dt (1-2) and RV function parameters.
(Co)-Induced Two Crossed Modules
Ummahan Ege Arslan,Zekeriya Arvasi,Gülümsen Onarl?
Mathematics , 2011,
Abstract: We introduce the notion of an induced 2-crossed module, which extends the notion of an induced crossed module (Brown and Higgins).
Total Ischemic Time as an Independent Predictor of Response to Stem Cell Therapy in Patients with ST Segment Elevation Myocardial Infarction
Mary Lim,Zekeriya Arslan,Chunyan Cai,Christopher Y. Kim,Yong-Jian Geng,Ali E. Denktas
ISRN Stem Cells , 2014, DOI: 10.1155/2014/293967
Abstract: The selection criteria for bone marrow stem cell (BMSC) therapy are not well established for ST segment elevation myocardial infarction (STEMI) patients. This investigation seeks to utilize total ischemic time (TIT), time of symptom onset to percutaneous coronary intervention (PCI), as a criterion for giving BMSC to STEMI patients. A meta-analysis and metaregression were conducted to evaluate improvement of LVEF with BMSC and its association with TIT (<6 and ≥6 hours) and baseline LVEF (<45% and ≥45%) at short (3–6 months) and long term (>6 months) followup. At short term, BMSC allowed improvement of LVEF with prolonged TIT (6.62%, 95% CI, 2.26 to 10.98 for <45%; 6.13%, 95% CI, 2.59 to 9.67 for ≥45%). Similarly, for long term, receiving BMSC allowed significant improvement of LVEF for prolonged TIT (9.19%, 95% CI, 2.34 to 16.05 for <45%; 7.64%, 95% CI, 3.72 to 11.56 for ≥45%). Additionally, TIT was a significant predictor of LVEF improvement independent of baseline LVEF in both short (4.96%, 95% CI, 0.72 to 9.19, ) and long term (6.24%, 95% CI, 0.46 to 12.02, ) followup. Consequently, BMSC therapy allows LVEF improvement in prolonged TIT and future studies for BMSC should include TIT ≥ 6 hours as an inclusion criterion. 1. Introduction Autologous bone marrow stem cell (BMSC) injection in patients with ST segment elevation myocardial infarction (STEMI) has been investigated as a new treatment strategy for the past decade. After the first encouraging pilot study [1] in 2002, many trials have since been published. Although several studies failed to show any favorable outcomes from BMSC [2–5], there have been many trials which demonstrated the beneficial effects of BMSC [6–12]. Several meta-analyses have confirmed that BMSC injections improved left ventricular systolic function, on average, by 3% [13–15]. Despite the promising results in these studies, there were many inconsistencies in the selection criteria; incongruent cell types, varying administration time, and variable injection routes are a few examples. Selected patients were also heterogeneous in terms of baseline left ventricular ejection fraction (LVEF) and time from symptom onset to reperfusion. Unfortunately, it is still difficult to identify the best model to demonstrate the effectiveness of stem cell therapy. In this study, we attempted to define an independent parameter which can increase the efficacy of BMSC: we focused on whether the total ischemic time (TIT), defined by the time of symptom onset to the time of percutaneous coronary intervention (PCI), was associated with LVEF improvement
The Transformation of the Higher Education System in Turkey after 2002: A Game Theoretic Analysis  [PDF]
Zekeriya Tuzen, Caglar Yurtseven
Theoretical Economics Letters (TEL) , 2016, DOI: 10.4236/tel.2016.61012
Abstract: The higher education system in Turkey suffered from capacity problem during the 1980s and the 1990s. After the election in 2002, to solve the problem, the Justice and Development Party governments have invested in higher education through opening new universities, increasing the total capacity in higher education, and sending more students abroad especially for graduate studies. In this paper, noting the conservative structure of the Justice and Development Party, we determine whether a dilemma exists between these liberal practices and the party’s conservatism. By constructing a one-period sequential game, we show that heavy investment in higher education by the Justice and Development Party is not contradictory and, in fact, inevitable, as long as it tries to maximize its vote in the short-medium run.
Effects of GA3 and Kinetin Pre-Sowing Treatments on Seedling Emergence and Seedling Growth in Wheat under Saline Conditions
Zekeriya Akman
Journal of Animal and Veterinary Advances , 2012,
Abstract: his study was conducted to evaluate the effect of NaCl salinity and Gibberellic Acid (GA3) and Kinetin (KIN) pre-sowing treatments on the germination and emergence of 3 winter-wheat cultivars. Thus, the seeds soaked with GA3 and kinetin were germinated using 0, 94, 164 and 240 mM NaCl solutions in pod soil. The percentage seedling emergence of wheat genotypes decreased and delayed with salinity stress conditions. The pre-treatments of hormones, especially GA3, not only hastened seedling emergence but also overcame the germination-delaying effect of the high concentrations of NaCl in all investigated wheat genotypes except for initial germination of Kisla domestic variety. Exogenous kinetin treatment was not as effective as GA3. Seedling growth parameters under salt-stress conditions decreased with increased salt stress. Under salinity conditions, GA3 was significantly stimulated root length and shoot height in Kisla domestic variety and B-22 line, respectively.
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