Turkish Tombul hazelnut (Corylus avellana L.) protein concentrates: functional and rheological properties.

Turkish Tombul hazelnut consumed as natural or processed forms were evaluated to obtain protein concentrate. Defatted hazelnut flour protein (DHFP) and defatted hazelnut cake protein (DHCP) were produced from defatted hazelnut flour (DHF) and defatted hazelnut cake (DHC), respectively. The functional properties (protein solubility, emulsifying properties, foaming capacity, and colour), and dynamic rheological characteristics of protein concentrates were measured. The protein contents of samples varied in the range of 35-48 % (w/w, db) and 91-92 % (w/w, db) for DHF/DHC and DHFP/DHCP samples, respectively. The significant difference for water/fat absorption capacity, emulsion stability between DHF and DHC were determined. On the other hand, the solubility and emulsion activity of DHF and DHC were not significantly different (p > 0.05). Emulsion stability of DHFP (%46) was higher than that of DHCP (%35) but other functional properties were found similar. According to these results, the DHCP could be used as DHFP in food product formulations. The DHFP and DHCP samples showed different apparent viscosity at the same temperature and concentration, the elastic modulus (G' value) of DHPC was also found higher than that of DHFP samples.

Dislocation of three segments of the liver due to hernia of the right diaphragm: report of a case and review of the literature.

Right diaphragmatic hernia is a rare injury (0.25-1%) following blunt abdominal trauma. The diagnosis may be delayed and achieved years after the trauma during laparotomies for other reasons. A 75-year-old male fell 6 years before, and was symptom-free since then. He was admitted to the hospital for abdominal pain, and chest X-rays revealed intestinal gas in the lower right thoracal region. Abdominal ultrasonography showed agenesis of the gallbladder, and computed tomography demonstrated that the right upper abdominal viscera were located in the vicinity of the heart. The patient underwent a laparotomy for right diaphragmatic hernia, and the right hepatic lobe and the medial segment of the left lobe, the gall bladder, the proximal part of the transverse colon, the omentum and some segments of the intestine were dislocated into the thoracal cavity by a tear in the right diaphragm. The organs were returned to the abdominal cavity uneventfully and the defect in the diaphragm, measuring 10 x 5 cm, was repaired by unabsorbable sutures. The diagnosis, surgical treatment and postoperative course of the right diaphragmatic hernia is discussed with a review of the literature.

Association between residual thyroid carcinoma and diffuse hepatic uptake of 131I following radioiodine ablation in postoperative total thyroidectomy patients.

In patients with differentiated thyroid cancer (DTC) total or near-total thyroidectomy, postoperative 131I ablation, and thyroid suppression therapy are reported to be associated with fewer recurrences than other treatments. Many patients with DTC after total thyroidectomy and radioablation therapy have diffuse hepatic uptake of radioiodine, and its clinical importance is debated. Some investigators report that diffuse liver uptake correlates with uptake in the thyroid bed or the presence of metastatic thyroid cancer somewhere in the body, whereas others note no such correlation. The purpose of this research was to determine the clinical importance of diffuse hepatic uptake of radioiodine after 131I ablative therapy in patients with DTC. We retrospectively reviewed 141 posttherapy scans done in 118 patients with DTC. Patients had had total thyroidectomy and were hypothyroid when serum thyroglobulin (Tg) levels were obtained, and they were treated with 30 to 200 mCi of 131I. Scans were performed 3 to 21 days after radioablation therapy. Information was collected regarding the patients' age and gender, the interval between the ablation therapy and scan, uptake of radioiodine, serum thyroglobulin level, thyroid-stimulating hormone (TSH) level, thyroglobulin antibodies, TNM classification, mortality, and recurrence. Diffuse liver uptake was classified from 0 to 4 depending on hepatic brightness. Radioiodine scans were done to determine whether there was uptake in the thyroid bed or elsewhere. Statistical analyses included analysis of variance and Kaplan-Meier survival analysis. Diffuse hepatic uptake was observed (grades 1-4) in 96.4% of the patients; thus 3.6% had no hepatic uptake. There was no significant association between liver uptake and the uptake in the thyroid bed, the dose of 131I administered for ablation therapy, thyroglobulin levels, age, stage of the disease, presence of local or distant metastases, recurrence, or survival. Diffuse hepatic uptake was therefore not associated with residual normal thyroid or metastases as suggested by some but not all previous investigators.

Turkish hospital management at a crossroads: prospects for the year 2000.

The Turkish health system has been undergoing a radical reform process since the early 1990s. Reform proposals, based on purchaser/provider split, self-governing hospitals (ultimately leading to full privatization), compulsory health insurance etc., are expected to have a profound effect on hospital management. In such an environment, hospital administrators' views on the domains and issues that will come to the fore in the year 2000 gain importance. In this paper, results of a study undertaken among hospital administrators are presented. The study aimed to find the views of hospital administrators on issues likely to gain prominence in the year 2000 and the skills, knowledge, and abilities required to tackle these issues. It was concluded the autonomous status of hospitals, privatization, competition, and health trusts will become the central domains in the year 2000 in hospital administration. Innovation and following technological developments were considered most critical.

Primary health care in Turkey: a passing fashion?

The Alma-Ata Declaration has long been regarded as a watershed in the health policy arena. The global goal of the World Health Organization, 'Health for All by the Year 2000' through primary health care, has attracted many countries both in the developed and the developing world and commitments to this end have been made at every level. However, albeit this consensus on the paper, a common and explicit definition of the concept has not been reached yet. This paper aims at discussing various definitions of primary health care that emerged after the Declaration and also presenting a case study from Turkey, a country that advocates primary health care in her recent health policy reform attempts. After setting the conceptual framework for discussion the Turkish case is presented by using research carried out among Turkish policy-makers at different levels of the State apparatus. It has been concluded that application of primary health care principles as defined in the broad definition of the concept requires major changes or rather shake-ups in Turkey. These areas are outlined briefly at the end of the paper.

PIP: The global goal of the World Health Organization stated at Alma-Ata in 1978 to achieve health for all by the year 2000 through primary health care (PHC) garnered commitments at all levels from developed and developing countries. Turkey signed the Alma-Ata conference document, declaring its commitment to the PHC approach. However, that commitment was largely ignored among policymakers until 1990 when the country's plan to establish a strong PHC service by 2000 was put back on track. The organization and finance of Turkey's health system is described. Results of a case study conducted in Turkey to explore the following are presented: Turkey's response to Alma-Ata, perceptions of Turkish health policymakers about PHC and related issues, and the prospects for PHC in Turkey. Major changes must occur in Turkey before the primary health care principles as defined in the broad definition of the concept can be applied.