Purpose: The aim of this study was to examine the normal values of the cervical spinal cord, spinal canal, and intervertebral disc morphometry of healthy subjects in this study Materials and Methods: Cervical magnetic resonance imaging of 83 healthy subjects were examined retrospectively. The anterior and posterior height of each cervical vertebra body, anterior and posterior height of each intervertebral disc between C3-T1, and spinal canal and cord diameters were measured. Additionally, the height ratios of the cervical vertebra body and intervertebral disc were calculated. Results: There was no significant difference between genders in spinal cord diameters from C1 to C7, whereas there was a significant difference between genders in spinal canal diameters from C1 to C4. There were significant differences between genders in terms of anterior and posterior vertebral body height from C3 to C7 level. Moreover, significant differences between genders in terms of anterior and posterior intervertebral height from C3-4 to C7-T1 level (except C6-7 intervertebral anterior height) were found. Conclusion: We would like to stress that the cervical region is a clinically important structure because of its location, surgical importance, its exposure to a large number of injuries, Gender plays the most important role in spinal canal morphometry, following vertebral body heights and intervertebral heights.

Bu çalışmanın amacı; Citrobacter izolatlarına karşı laktik asit bakterilerinin antimikrobiyal ve antibiyofilm aktivitelerini belirlemektir. Bu çalışmada kullanılan Citrobacter izolatları (C1, C2, C3) BD PhoenixTM otomasyon sistemi ile Citrobacter braakii olarak tanımlanmıştır. Biyofilm oluşumu Kongo kırmızılı agar ve mikrotitrasyon plak metodu kullanılarak incelenmiştir. Antibiyogram test sonuçlarına göre, tüm izolatlar amfisilin ve amoksilin-klavulanata karşı dirençli bulunmuştur. Antimikrobiyal aktivite test sonuçları laktik asit bakterilerinden elde edilen ekstraktların (Lactococcus lactis (L1), Lactobacillus fermentum (L2), Enterococcus faecalis (L3), Lactobacillus casei (L4), Lactobacillus plantarum (L5), Enterococcus faecium (L6), Lactobacillus curvatus (L7), Enterococcus durans (L8) Lactococcus garviae (L9), Enterococcus faecalis (L10)) Citrobacter braakii üzerinde antimikrobiyal ve antibiyofilm etkinliğinin olduğu saptanmıştır. En yüksek antimikrobiyal etki C2 izolatı üzerinde ve en düşük etki C3 izolatı üzerinde belirlenmiştir. Antibiyofilm test sonuçlarına göre L1, L2, L4, L6, L7, L8 ekstraktlarının en yüksek dozlarının tüm Citrobacter izolatlarında biyofilm oluşumunu engellendiği görülmüştür.

In Türkiye, the general name for aromatic plant species belonging to the Lamiaceae family is “thyme”. However, species containing thymol/carvacrol type essential oil are considered “thyme”. Origanum acutidens is one of the thyme species that grows endemic in the Northeastern Anatolia Region of Türkiye. The low germination rate of its seeds is one of the factors limiting the studies conducted on this plant. This study was conducted to investigate the effects of different doses of colchicine and gibberellic acid on germination in O. acutident seeds. Seeds collected from the plant’s natural habitat at the end of the flowering period were used as plant material. The experiment was planned as control (only distilled water) and treatments consisting of three different gibberellic acid (GA3) [100 ppm (GA1), 200 ppm (GA2) and 300 ppm (GA3)] and four different colchicine doses [0.01 mM (C1), 0.02 mM (C2), 0.04 mM (C3) and 0.08 mM (C4)]. The applications were kept at 25±1 ⁰C for 12 hours. After the waiting period, all seeds were filtered and placed, 50 seeds each, in 9 cm diameter petri dishes between two layers of sterile filter paper sheets. The experiment was carried out in 4 replications. Some parameters of the germination (Germination rate (GR), Germination time (GT), Average germination time (AGT)) and early seedling period (Embryonal root length (ERL), Number of embryonal roots (NER), Root fresh weight (RFW), Root dry weight (RDW), Grass sheath length (GSH)) were measured and the results were statistically evaluated. In general, the highest values obtained from all evaluated germination (92.0% GR and 1.7 day AGT) and early seedling parameters (10.4 cm ERL, 4.6 NER, 0.095 g RFW, 0.028 g RDW and 3.6 cm GSL) were found to belong to the GA3 application. The lowest values obtained from the relevant parameters were obtained with the C4 application. In our study, it was observed that gibberellic acid applications significantly increased germination in this plant and positively increased the parameters related to germination. Based on the study results, we think that colchicine stimulates germination at certain rates, but causes death by having a toxic effect in increasing doses.

The aim of this study was to determine the hepatocarcinogenic effect of diethylnitrosamine in rainbow trout (Oncorhynchus mykiss), the most cultivated and consumed fresh water fish. In this study, 120 fish weighing 50-70 g each were used. Randomly selected fish were divided into 3 dosage groups and a control group that contained 30 fish per group. Diethylnitrosaminewas dissolved in 0.1 ml of dimethylsulfoxideat 50 mg/kg, 100 mg/kg and 150 mg/kg, and respectively administered to each of the dosage groups intraperitoneally. On the 15th, 30th and 45th days of the study, 10 fish from each study group were euthanised while under sedation, and necropsies were performed. For histopathological and immunohistochemical examinations, tissues were routinely processed and sections were stained with haematoxylin-eosin and examined by light microscopy. Histology revealed hyperaemia, parenchymal degeneration, mononuclear cell infusion, necrosis, bile ducts hyperplasia, cholangiofibrosis and fatty degeneration of the liver. In immunohistochemical staining, CYP1A was slightly positive in the bile duct epithelium in the C2, A3, B3 and C3 groups, and negative in the other groups. Cytokeratin 18 showed negative staining in all groups. Mild positive staining in the bile duct epithelium, A3, B3 and C3 and negative staining in other groups for glutathione-S-transferase. It was concluded that diethylnitrosamine causes significant damage to liver tissuein fish, even in short-term applications, and may cause neoplastic changes in liver cells over the long term.

Background: Several nomenclatures have been defined for easier understanding of cardiovascular anatomical structures. The “Erin commissure and annulus nomenclature” we have developed, aims to name the commissures and annulus of the valves in a certain order. Methods: We renamed the commissures and parts of annulus in a clockwise fashion. We named the commissure, closest to the first surgeon as C1 in all heart valves. Latter commissures are named as C2 and C3 in clockwise fashion. In our naming system, the commissures in aortic, pulmonary and tricuspid valves are named as C1, C2 and C3 and the commissures in mitral valve are named as C1 and C2. We divide the annulus into zones. Each zone is the part of the annulus between two commisures. Zones are named clockwise with reference to C1 commissure as the starting point. These zones are defined as Z1, Z2 and Z3 in aortic, pulmonary and tricuspid valves and Z1 and Z2 in mitral valve. Results: All of the heart valvular commisures and parts of the annulus even the congenital valves are named. Conclusion: The new nomenclature will facilitate learning of topographic anatomy in surgical training.It will provide technical convenience in communication during valve surgery.

Bu çalışmada, 3D yazıcı ile üretilen PLA numunelerin çoklu yazdırma parametrelerinin vida tutma kuvveti üzerindeki etkileri istatistiksel olarak araştırılmıştır. Taguchi L27 Ortogonal dizi esas alınarak, yazdırma hızı, yazdırma sıcaklığı, doluluk oranı, tabla sıcaklığı ve dolgu deseni faktörlerinin farklı seviyelerinde testler gerçekleştirilmiştir. Test sonuçları, varyans analizi, ana etkiler ve etkileşim grafikleri ile % 95 güven seviyesinde değerlendirilmiştir. Böylece faktörlerin ve bazı etkileşimlerin vida tutma kuvveti üzerindeki etkileri ve optimum cevabı veren seviyeler belirlenmiştir. Buna göre sadece yazdırma sıcaklığı, doluluk oranı, dolgu deseni ve yazdırma sıcaklığı-doluluk oranı faktör ve etkileşimlerinin anlamlı olduğu belirlenmiştir. Ayrıca, doluluk oranının % 55.08’lik oranla tutma kuvveti üzerinde en yüksek etkiye sahip olduğu ve bunu sırasıyla yazdırma sıcaklığı (% 18.62), doluluk oranı (% 12.19) ve dolgu deseni (% 4.03) faktör ve etkileşimlerinin izlediği gözlemlenmiştir. Son olarak, optimum tutma kuvveti yazdırma hızının ikinci (A2= 50 mm/s), yazdırma sıcaklığının üçüncü (B3= 230 °C), doluluk oranının üçüncü (C3= % 100), tabla sıcaklığının üçüncü (D3= 80 °C) ve dolgu deseninin birinci seviyesinde (E1= Grid) 1885.89 N olarak tahmin edilmiştir. Bu seviyelerde gerçekleştirilen 3 adet doğrulama deneyinde, ortalama 1993.33 N’luk tutma kuvveti elde edilmiş olup, sonucun belirlenen güven aralığında olduğu tespit edilmiştir. Böylece yapılan optimizasyonun yeterli doğrulukta olduğu söylenebilir.

Objective: The aim of this study was to investigate whether there is subtle cardiac dysfunction in patients with chronic venous insufficiency. Methods: Age and sex matched 56 patients with a score of C3 and above in the Clinical, Etiological, Anatomical, Pathophysiological classification and 56 healthy volunteers were included in the study. All subjects were evaluated by detailed echocardiographic examination, including two-dimensional strain echocardiographic analysis by speckle tracking method. Results: Mitral E wave deceleration time (EDT), E and A wave velocity, E/e' ratio for left ventricle, tricuspid EDT, E/e’ ratio for right ventricle and systolic pulmonary artery pressure were found high as significant statistically in patients groups (p < 0.05). But no any statistically significant difference was observed in other parameters between two groups. Conclusions: There may be an increase in diastolic filling pressures in patients with chronic venous insufficiency due to the increased preload in the supine position. This condition seems to be clinically important in patients at high risk for heart failure due to the presumption of the early treatment of chronic venous insufficiency may reduce the risk of heart failure evolvement.

In this study, 1,3,4-thiadiazole derivatives were obtained from the reaction of benzophenone-4,4'-dicarboxylic acid and N-substitute-thiosemicarbazide compounds with each other. After the synthesis of the final products, some biological properties of these compounds such as antibiofilm, antimicrobial and efflux pump inhibiting efficiencies were evaluated. According to the MBC/MFC test, all the activities were found to be bacteriostatic, also, especially the biofilm inhibition activity of C1 against K. pneumoniae is noteworthy. In addition, C4 was observed to exhibit efflux pump inhibition activity in E. coli, whereas C2 and C3 in K. pneumoniae. The absorption and emission values of the molecules were obtained and electrochemical studies were performed. In addition; absorption, metabolism, distribution, excretion and toxicity (ADMET) scores were predicted using the pharmacokinetic properties of all 1,3,4-thiadiazole compounds. Finally, the electrochemical stabilities of the synthesized molecules have been analyzed by using cyclic voltammetry in 0.1 M TBAPF6 in DMSO as a supporting electrolyte.

Smallholder farmers commonly practise intercropping to improve crop yield per unit land area. Proper combination of plant population and row orientation of the component crops needs to be established and this prompted this investigation. A 2x7 factorial experiment was laid in a RCBD with three replications, at Matopos Research Station in Natural Region IV of Zimbabwe. Treatments consisted of sorghum planted at a constant population of 55556plants/ha intercropped with cowpea (C) simultaneously planted at varying populations of 111111plants/ha (C1), 166667plants/ha (C3) and 222222plants/ha (C3) in East-West (EW) and North-South (NS) row orientation. Interaction of cowpea population density and row orientation significantly (p<0.05) influenced crop yield and its attributes. Treatment NS-SC3 produced lowest number of pods/plant and grains/pod of 2.6 and 6.1 respectively. Highest cowpea grain yield (637.2kg/ha) was obtained in EW-C3 and lowest (92.4kg/ha) in EW-SC3. Sorghum yield was highest in NS-S (1296.5kg/ha) and lowest in EW-SC3 (491.9kg/ha). LER showed that intercropping performed better than sole crops except for EW-SC3 and NS-SC3 which had LER of 0.800 and 0.905 respectively. Highest LER of 1.312 was obtained in EW-C2. Farmers should plant sorghum-cowpea intercrops in EW row orientation for increased cowpea grain yield but NS row orientation for sole sorghum.

Bu çalışmada temel iki amaç gözetilmektedir. Bunlardan birincisi Türkiye ekonomisinde açık enflasyon hedeflemesi rejiminin benimsendiği dönemde döviz kuru yansıma etkisinin ARDL sınır testi yaklaşımıyla kısa ve uzun dönem değerlerini tespit etmektir. İkincisi FMOLS, DOLS ve CCR tahmin yöntemleri ile uzun dönem yansıma etkisinin tespit edilerek sonuçların güvenirliliğinin ortaya konulmasıdır. Bu amaçlar doğrultusunda Türkiye ekonomisine ait 2006:Ç1-2022:Ç3 dönemi çeyreklik enflasyon ve nominal döviz kuru verileri ile döviz kuru yansıma etkisi incelenmektedir. Ampirik bulgular kısa dönemde döviz kuru yansıma etkisinin %7 seviyelerinde, uzun dönemde ise yaklaşık %22 seviyelerinde gerçekleştiğini göstermektedir. Uzun dönem tahmininde hem ARDL hem de FMOLS, DOLS ve CCR yöntemlerinin benzer sonuçlar ortaya koyduğu elde edilmektedir. Bu sonuç, elde edilen etkinin güvenirliliğini artırmaktadır. Türkiye ekonomisi için elde edilen bulgular, döviz kuru yansıma etkisinin uzun dönemde kısa döneme kıyasla daha yüksek olduğunu göstermektedir. Ara malı ve yatırım malında yüksek ithal girdi oranlarına sahip olan Türkiye’nin sürdürülebilir makroekonomik denge için döviz kuru oynaklığını giderici politikalar uygulaması ve yansıma etkisinin olumsuz etkilerini en aza indirmesi gerekmektedir.

This report identifies clinical, Magnetic Resonance Imaging (MRI), surgical and histological findings of recurrent solitary spinal meningothelial meningioma in a dog. Five-year-old female Pomeranian dog with a history of severe cervicalgia was subjected. A solitary mass between C3-C4 vertebras were diagnosed by MRI, and surgery was carried out with successful results; however, clinical signs reappeared one year after surgery. Control MRI revealed the recurrence of the mass at the same location. Patient reoperated and it was histopathologically reconfirmed as meningothelial meningioma. In conclusion, reoperation of the recurrence of spinal meningioma can be suggested for the practitioners.

Objective: Kidney biopsy may unusually show non-lupus nephritis (LN) causes in patients with systemic lupus erythematosus (SLE). This study aimed to reveal the causes of non-LN and to compare the clinical and laboratory features of LN and non-lupus renal disease in patients with SLE. Methods: Patients with SLE followed between 2014 and 2020 at Hacettepe University Hospitals and who had kidney biopsy were the subject of the study. One hundred thirty four patients’ kidney biopsies were evaluated retrospectively and grouped as LN and non-LN. Clinical characteristics, laboratory values at the time of kidney biopsy, and renal outcome were recorded. Results: Of 134 (107 females, 27 males) patients, 116 (86.6%) were in the LN group, and 18 (13.4%) were in the non-LN group. The most common diagnosis was focal segmental glomerulosclerosis (n=6) in the non-LN group. The median (interquartile range) biopsy age of LN patients was young [21 (17.7) vs. 36.5 (17), p<0.001], and high titer antinuclear antibody positivity over 1/320 at SLE diagnosis was more frequent in this group (50.9% vs 22.2%, p=0.02). Non-renal SLE involvement was similar in both groups. Anti-dsDNA positivity, low C3- 4, and presence of active urinary sediment were significantly higher in LN patients, while serum creatinine, albumin, and proteinuria were not different between the groups at the time of kidney biopsy. Additionally, median renal SLEDAI was more elevated in LN patients. Conclusion: Anti-dsDNA positivity, low C3-C4, active urinary sediment, and high renal SLEDAI scores may give us some clues regarding renal disease in patients with SLE. However, it should be kept in mind that these serological abnormalities may also occur in non-lupus renal disease.

Background. Antiphospholipid syndrome (APS), particularly the catastrophic antiphospholipid syndrome (CAPS), is one of the rare causes of thrombotic microangiopathy (TMA). CAPS is the most severe form of APS, especially when accompanied by complement dysregulation, causes progressive microvascular thrombosis and failure in multiple organs. In this report, a case of CAPS with TMA accompanied by a genetic defect in the complement system is presented. Case. A 13-year-old girl was admitted to the hospital with oliguric acute kidney injury, nephrotic range proteinuria, Coombs positive hemolysis, refractory thrombocytopenia, a low serum complement C3 level and anti-nuclear antibody (ANA) positivity. The kidney biopsy was consistent with TMA. She was first diagnosed with primary APS with clinical and pathological findings and double antibody positivity. As initial treatments, plasmapheresis (PE) was performed and eculizumab was also administered following pulsesteroid and intravenous immunoglobulin treatments. Her renal functions recovered and she was followed up with mycophenolate mofetil, hydroxychloroquine, low dose prednisolone and low molecular weight heparin treatments. The patient presented with severe chest pain, vomiting and acute deterioration of renal functions a few months after the diagnosis of TMA. A CAPS attack was considered due to radiological findings consistent with multiple organ thrombosis and intravenous cyclophosphamide (CYC) was given subsequent to PE. After pulse CYC and PE treatments, her renal functions recovered, she is still being followed for stage-3 chronic kidney disease. Complement factor H-related protein I gene deletion was detected in the genetic study. Conclusions. The clinical course of complement mediated CAPS tends to be worse. Complement system dysregulation should be investigated in all CAPS patients, and eculizumab treatment should be kept in mind if detected.

Passiflora incarnata L. (Passifloraceae) has been traditionally used to treat ailments such as dysmenorrhoea, insomnia, epilepsy and neuralgia. In this study, qualitative and quantitative analyses of P. incarnata products in the Turkish market were studied via High-Performance Thin-Layer Chromatography (HPTLC) and High-Performance Liquid Chromatography (HPLC) and vitexin, isovitexin, orientin and isoorientin were used as bioactive marker compounds. Seven herbal tea samples (T1-7) composing P. incarnata herb, eighteen capsules/tablets/powders (C1-18) and four syrups (S1-4) containing P. incarnata extract were purchased from pharmacies, markets, herbalists or e- commerce websites in Turkey. Comparing HPTLC fingerprinting profiles of the reference plant (P. incarnata) with the samples indicated that only T1, C1-C3, C5, C7, C11, C12, C14, C15 and S1 showed similar chemical fingerprints with the reference plant material. On the HPLC analysis, the total ratio of investigated compounds was 6.33% and 2.08% in hydroalcoholic (70% EtOH) and aqueous extracts of reference P. incarnata, respectively. Furthermore, hydroalcoholic extract of T1 was found to possess higher content (6.40%) than other tested tea samples (T2-6). However, based on the morphological characteristics, the tea sample (T7) was identified as Jerusalem thorn (Paliurus spina-christi) fruits. Among the food supplements (C1-18), only nine were determined to contain the reference molecules (3.301-0.827%), consistent with HPTLC results, and C1 exerted the highest total percentage. To conclude, most of the marketing P. incarnata products in Turkey were adulterated or contained lower amounts of bioactive components.

Cervical myelopathy is a condition that is rarely reported in pediatric patients who have movement or neuromuscular disorders. We, herein, present a rare case of cervical myelopathy observed in a 14-year-old patient, who was previously a healthy boy treated with cervical laminoplasty, which was caused by cervical spinal canal stenosis based on multiple level disc herniation. The patient presented to the clinic with spastic and ataxic gait with previous diagnostic challenges. Magnetic resonance imaging showed cervical degenerative changes mainly marked at the C3–C4 and C4–C5 levels, along with canal narrowing and a central high signal cord abnormality on T2-weighted images. A C3–C4 open-door laminoplasty surgery technique was performed. The neurological symptoms and signs improved dramatically following surgery. Subsequently, cervical computed tomography and magnetic resonance imaging showed good decompression of the cervical spinal cord during the 5 years of follow-up with the preservation of the range of movement. We concluded that though it is pretty rare, cervical myelopathy should be considered in diagnosing adolescent patients with gait and balance disorders.

Amaç: Bu çalışmanın amacı, 2 farklı kompozit rezin örneklerinin 3 farklı zaman diliminde farklı içeceklerde bekletilmesiyle kompozit rezinlerde meydana gelen renk ve translusenstlik değişimin değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmada, 2 farklı kompozit rezin kullanıldı: Universal nanohibrit kompozit Palfique Omnichroma (OMN) ve nanohibrit kompozit Estelite Sigma Quick (ESQ). Kompozitlerin renk stabilitesini değerlendirmek için A1, B2 ve C3 olmak üzere 3 farklı renkte ESQ kompozit ve tek renkli OMN kompozit kullanıldı. Her materyal için 90 adet silindirik örnek (2 mm kalınlık, 6 mm çap) hazırlandı. Başlangıç renk ölçümleri alındıktan sonra örnekler distile su, kırmızı şarap ve kahve gibi farklı içeceklerde bekletildi. Devamında sırasıyla 24 saat, 1 hafta ve 1 ay sonra ölçümler yapıldı. Tüm renk ölçümleri, klinik bir spektrofotometre ile CIEDE2000 renk koordinatlarına göre yapıldı. Translusentlikte meydana gelen değişiklikleri değerlendirmek için translusentlik parametresi (TP) kullanıldı. Verilerin normalliğini analiz etmek için Kolmogorov-Smirnov testi kullanıldı. Farklı solüsyonlara daldırılan örneklerin ΔE00 ve ΔTP değerleri arasındaki farklar bağımsız örneklem t-testi, tek yönlü varyans analizi ve Tukey dürüst anlamlı fark post-hoc testleri ile analiz edildi. ΔE00 ve TP değerlerinin zamana bağlı değişimlerini belirlemek için tekrarlı varyans analizi testi kullanıldı. Bulgular: Her iki kompozitin A1 ve B2 renkli örneklerinin distile su ve diğer renklendirici sıvılarda aynı süre bekletilmesi sonucunda ΔE değerleri arasında istatistiksel olarak anlamlı fark tespit edildi (p<0,05). Sonuç: Renklendirici içecekler, kompozitlerin fizikokimyasal özelliklerinden bağımsız olarak her iki kompozit rezinde de renklenmeye neden olmuştur. Her iki nanohibrit kompozitte de tüm zaman dilimlerinde renklendirme sıvılarında meydana gelen renk değişimi arasında fark yoktur.

Aim: This study investigates serum interleukin(IL)-37 levels in patients with systemic sclerosis (SS) and assesses its relationship with clinical findings. Methods: This study included 35 patients with SS and 30 healthy control subjects. The demographic and clinical characteristics of the patients, such as the presence of Raynaud’s phenomenon, SS subtype, digital ulcers, gastrointestinal and lung involvement, and disease activity, were recorded. The medications used by the patients were recorded, and Serum IL-37 levels were measured using an enzyme-linked immunosorbent assay. The United Kingdom Functional Scoring system was used to evaluate the functional status of the patients, while the Valentini criteria were used to evaluate disease activity. Skin involvement was evaluated based on the modified Rodnan skin score. Results: Although serum IL-37 levels were found to be lower in patients with SS than in the control group, the difference was not statistically significant (p= 0.078). A negative correlation was identified between serum IL-37 levels and C3 levels in patients with SS (p= 0.046). No significant relationship was found between IL-37 levels and other clinical and laboratory parameters. Conclusion: Unlike in patients with autoimmune disorders, serum IL-37 levels were found to be lower in patients with SS than in the control subjects, and IL-37 demonstrated a negative correlation with C3 levels.

Q ateşi, hücre içi gram-negatif bakteri olan Coxiella burnetii’nin etken olduğu bir zoonozdur. Enfeksiyon asemptomatik geçirilebildiği gibi, akut veya kronik hastalığa da neden olabilmektedir. Kronik hastalık en çok enfektif endokardit (EE) tablosu ile ortaya çıkmaktadır. Etkenin standart kan kültürlerinde kolay ürememesi ve kapak vejetasyonlarının zor görülmesi nedeniyle EE tanısı oldukça güçtür. Q ateşi endokarditi olan hastalarda glomerüler tutulum literatürde olgu sunumları ile sınırlıdır. Günümüze kadar Türkiye’den Q ateşi endokarditi saptanan toplam üç olgu yayımlanmıştır. Bu olgu raporunda immün kompleks aracılı glomerülonefritin eşlik ettiği, Türkiye’den dördüncü Q ateşi endokarditi olgusu sunulmuştur. Mitral ve aortik kalp kapak replasmanı öyküleri olan 35 yaşında erkek hasta ateş, gece terlemesi ve istemsiz kilo kaybı şikayetleri ile başvurmuştur. Muayenede servikal lenfadenopati ve hepatosplenomegali saptanan hastanın laboratuvar incelemelerinde enflamasyon anemisi, akut böbrek hasarı (ABH), hematüri ve proteinüri görülmüştür. Kan ve idrar kültürlerinde etken saptanmazken, kemik iliği ve servikal lenf bezi biyopsileri sonucu tanı konulamamıştır. Ateş etiyolojisine yönelik yapılan transözefageal ekokardiyografide (TÖE) prostetik mitral kapakta 7 mm vejetasyon tespit edilmiştir. İndirekt immünfloresan antikor yöntemiyle bakılan C.burnetii faz 1 IgG 1/16384 titrede pozitif tespit edilen hastada doksisiklin ve hidroksiklorokin tedavileri başlanmıştır. ABH etiyolojisine yönelik yapılan böbrek biyopsisinde ise C3, C1q ve IgM immünkompleks birikimi ile seyreden fokal segmental endokapiller proliferatif glomerülonefrit saptanmıştır. Tedavisine metilprednizolon (MPZ) eklenen hastanın semptomlarında iyileşme gözlenirken, kreatinin ve proteinüri düzeylerinde dramatik düşüş izlenmiştir. Q ateşi, ülkemizde endemik olmasına rağmen, tahmin edilenden düşük seviyede olgu saptanmaktadır. Mikrobiyolojik ve klinik tanıdaki zorlukların yanı sıra, hekimlerin hastalık hakkında farkındalığının az olması bu durumun önemli sebeplerinden birisidir. Hastalık akla getirildiğinde ise serolojik yöntemlerle kolayca tanıya ulaşılabilmektedir. Bu nedenle, lenfoproliferatif hastalık benzeri bulgular, nedeni bilinmeyen ateş ve kültür negatif endokardit varlığında Q ateşi mutlaka araştırılmalıdır.

C3 glomerulopathy is a newly defined glomerular disease dominated by C3 complement storage and uncertain C1, C4, and immunoglobin accumulations. Hereditary mutations associated with Complement Factor H (CFH) causing hyperactivation of the alternative complement pathway were identified. Most mutations associated with C3 glomerulopathy are associated with the N-terminal end. Whether mutations are pathogenic or not will direct diagnosis and treatment. We present 2 cases, one 61-year-old and one 24-year-old attending our clinic at different times with hematuria, proteinuria, edema, and kidney failure. Both patients had C3 glomerulopathy diagnosed based on the results of kidney biopsy and were treated with eculi- zumab. Both cases had CFH-associated mutations.

Aim: Deep venous insufficiency is an important health issue affecting the population worldwide. In this study we aimed to assess the effectiveness and safety of a novel antireflux treatment procedure in patients with primary deep vein insufficiency. Material and Methods: Between October 2016 and December 2018, 81 valvular leak operations consisting of perivenous hard gel injection were performed in 81 patients with primary deep venous insufficiency. The clinical symptoms of the patients were between C3-C6 according to the CEAP clinical classification. Venous insufficiency associated with only one deep venous valve was verified with Doppler ultrasonography. Patients were assessed with physical and ultrasound examination on the follow-up visits, which were achieved on the third day and at the first, sixth, and twelfth months. The nonexistence of reflux in the treated valve level was defined as the success of the procedure. Any reflux, which lasted 0.5 seconds or more, was regarded as a lack of success. Results: The ages of the patients ranged between 32 and 78. All the patients had deep venous insufficiency. The follow- up could be achieved in all the patients. The mean volume of the gel administered was 2.4±0.9 ml. The mean procedure duration was 22.3±8.9 (range 14–42) minutes. The procedures could be performed successfully in all of the patients confirmed perioperatively and on the third day of follow-up with the elimination of reflux. The sixth-month follow-up, with the same vein diameter after the treatment without any reflux, revealed the same findings as to the first-month follow-up. The treatment was not associated with any significant morbidity or mortality. The VCSS decreased significantly when preprocedural and twelfth-month VCSS were compared as 21.8 ± 4.8 and 3.8±0.7, respectively (p<0.001). Conclusions: Treatment of venous insufficiency with the novel hard gel injections of hyaluronic acid and n-butyl- cyanoacrylate seems safe, effective, and feasible confirmed with early and midterm follow up results.