[Erdheim-Chester disease presenting with bilateral orbital involvement: Report of three cases]. / La maladie d'Erdheim­Chester révélée par une atteinte orbitaire bilatérale : étude de trois cas.

PURPOSE: To report treatment outcomes of orbital tumors associated with Erdheim-Chester disease and to highlight the importance of systemic work-up in patients presenting with bilateral proptosis. PATIENTS AND METHODS: Three patients with Erdheim-Chester disease, whose initial manifestation was bilateral proptosis, were retrospectively studied. The course of onset, clinical, imaging and histopathological features, systemic associations and response to treatment were reviewed. The main outcome measures were Hertel measurements and orbital tumor regression on imaging studies. RESULTS: All patients presented with bilateral non-pulsatile proptosis resistant to retropulsion and headeache without specific localization. Magnetic resonance imaging studies showed bilateral intraconal orbital tumors. Incisional biopsy of these tumors demonstrated CD68+, CD1a-, and S100- histiocytic infiltrates consistent with the diagnosis of Erdheim-Chester disease. The BRAFV600E mutation was found in all cases. Systemic work-up revealed asymptomatic bony involvement in the lower extremities, perirenal fibrosis, central nervous system and cardiac involvement. All patients initially received pegylated interferon-α2a, which resulted in excellent responses except for the orbital tumors. Two patients were then treated with vemurafenib, which resulted in rapid regression of the orbital lesions. CONCLUSION: Pegylated interferon-α was highly effective in the control of cardiac, perirenal, skeletal and cerebral involvement but not the orbital tumors. The infiltrative orbital lesions of Erdheim-Chester disease would appear more responsive to vemurafenib.

Bilateral multiple pulmonary 18F-FDG microembolisms demonstrated on PET/CT / Múltiples microembolismos pulmonares bilaterales en 18F-FDG PET/TAC

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Identification of Differentially Expressed Genes in Chilling-Induced Potato (Solanum tuberosum L.); a Data Analysis Study.

Cold stress, as chilling (<20 °C) or freezing (<0 °C), is one of the frequently exposed stresses in cultivated plants like potato. Under cold stress, plants differentially modulate their gene expression to develop a cold tolerance/acclimation. In the present study, we aimed to identify the overall gene expression profile of chilling-stressed (+4 °C) potato at four time points (4, 8, 12, and 48 h), with a particular emphasis on the genes related with transcription factors (TFs), phytohormones, lipid metabolism, signaling pathway, and photosynthesis. A total of 3504 differentially expressed genes (DEGs) were identified at four time points of chilling-induced potato, of which 1397 were found to be up-regulated while 2107 were down-regulated. Heatmap showed that genes were mainly up-regulated at 4-, 8-, and 12-h time points; however, at 48-h time point, they inclined to down-regulate. Seventy five up-regulated TF genes were identified from 37 different families/groups, including mainly from bHLH, WRKY, CCAAT-binding, HAP3, and bZIP families. Protein kinases and calcium were major signaling molecules in cold-induced signaling pathway. A collaborated regulation of phytohormones was observed in chilling-stressed potato. Lipid metabolisms were regulated in a way, highly probably, to change membrane composition to avoid cold damage and render in signaling. A down-regulated gene expression profile was observed in photosynthesis pathway, probably resulting from chilling-induced reduced enzyme activity or light-triggered ROSs damage. The findings of this study will be a valuable theoretical knowledge in terms of understanding the chilling-induced tolerance mechanisms in cultivated potato plants as well as in other Solanum species.

Characterization of wound-induced serine protease inhibitor (wip1) genes and proteins in Turkish maize varieties.

Protease inhibitors (PIs) are generally small proteins that have been identified in plants. The wip1 gene codes for wound-induced protein, which is similar to serine PIs of the Bowman-Birk family (BBIs). In this study, we analyzed 10 wip1 genes of Turkish maize varieties to understand the structure and characteristics of the wip1 genes and proteins in maize. We found that genetic variability of wip1 genes was higher (π: 0.0173) than reported in previous studies. Tajima's D value was found to be positive (1.73), suggesting over-dominant selection in these loci. According to phylogenetic analysis of wip1 proteins, monocot and dicot BBIs were separated independently, and Turkish varieties were clustered with each other generally. The 3D structures of wip1 proteins indicated that several wip1 proteins had structural divergence in active loops, containing various numbers of cysteine residues ranging between 7 and 9. Particularly, Cys74 was identified in Kocbey and Gozdem varieties, whereas Cys98 was only in the Gozdem variety. Also, a critical serine residue (Ser98) was observed in two varieties - Antbey and Batem Efe. These results can contribute to understanding the role of wip1 genes and corresponding proteins in maize.

Electrocatalytic activity, methanol tolerance and stability of perfluoroalkyl-substituted mononuclear, and ball-type dinuclear cobalt phthalocyanines for oxygen reduction in acidic medium.

Electrocatalytic activity, methanol tolerance and stability of three phthalocyanine (Pc) complexes (a heptadecafluorononyl-substituted mononuclear CoPc 1, a pentaerythritol-bridged ball-type dinuclear Co2Pc2 2 and a heptadecafluorodecyl-substituted, pentaerythritol-bridged ball-type dinuclear Co2Pc2 3) and the performance of dual catalysts of 2/Pt and 3/Pt, dispersed on a high surface area carbon substrate, Vulcan XC-72 (VC) and Nafion (Nf), towards oxygen reduction (OR) were investigated and compared by surface cyclic voltammetry, rotating disk electrode, rotating ring-disk electrode and chronoamperometry experiments in acidic medium. The VC/Nf/3 modified glassy carbon electrode showed much higher catalytic performance, compared to VC/Nf/2 and VC/Nf/1 modified ones. The long term stability of the VC/Nf/3 catalyst in acidic medium was better than that of VC/Nf/2. It was found that the VC/Nf/1, VC/Nf/2 and VC/Nf/3 catalysts are nearly insensitive to the presence of methanol. In the presence of 1 M methanol in the electrolyte, the catalytic performances of 2- and 3-based catalysts were much better than that of the Pt-based one. Thus, it was shown that the VC/Nf/2-Pt and VC/Nf/3-Pt dual catalysts can be good alternatives to VC/Nf/Pt as cathode catalysts in direct methanol fuel cells. Moreover, in the absence of methanol, the mixing of 3 with Pt resulted in the enhancement of catalytic activity for OR, when compared to 3 and even Pt in the high overpotentials region.

Evaluation of activatory and inhibitory natural killer cell receptors in non-segmental vitiligo: a flow cytometric study.

BACKGROUND: Recent observations established the role of altered cellular immunity and autoimmune hypothesis in the pathogenesis of vitiligo. There have been several reports discussing T-cell and natural killer (NK) cell populations, but NK cell receptors were not evaluated in vitiligo. OBJECTIVE: The purpose of this investigation was to assess the role of T and NK cells as well as activatory and inhibitory NK cell receptor alterations in the pathogenesis of vitiligo and whether any aberrations were correlated with clinical findings of the disease. PATIENTS/METHODS: Fifty-three patients with non-segmental vitiligo and 45 age- and sex-matched healthy controls were enrolled in the study. The percentages of lymphocytes, granulocytes, monocytes and CD3, CD4, CD8, CD14, CD16, CD56, CD45, CD45RA, CD54RO, CD28, CD80, CD94, CD158a, KIR3DL-1 receptors as well as CD94, CD158a, KIR3DL-1 receptors on CD16(+) cells were detected by using flow cytometry. The patient and control groups were compared in terms of the results of flow cytometric analysis, and the results were assessed regarding the type and activity of vitiligo. RESULTS: The percentages of CD16(+)CD56(+), CD3(+)CD16(+)CD56(+), CD8(+) and CD45RO(+) cells were significantly increased in vitiligo group compared with the controls. No difference was detected between the patients and control groups in percentages of CD3(+), CD4(+), CD3(-)CD16(+)CD56(+), CD28(+), CD45(+), CD45RA(+), CD94(+), CD158a(+) and KIR3DL-1(+) cells. The percentage of CD16(+)CD158a(+) cells was significantly decreased in a randomized selected group of vitiligo patients. There were no differences in percentage expression of studied cell surface antigens between patients in the active or stable period. CD3(+) cells were significantly increased in generalized form, and CD45RO(+) cells were significantly increased in acral/acrofacial form when compared with the other types of vitiligo. CONCLUSIONS: These results indicate further evidence for T and NK cell abnormalities in non-segmental vitiligo. The present data show that NK cell activation may be responsible in the pathogenesis of vitiligo in conformity with decreased inhibitory and increased activatory NK cell receptors.

Toilet training in Turkey: the factors that affect timing and duration in different sociocultural groups.

BACKGROUND: The aim of the present study was to determine the patterns of toilet training and the factors that may be related to its timing and duration and the approaches of different sociocultural groups within a developing country. METHODS: This cross-sectional survey was performed on 745 children who live in three different sociocultural settlements. The factors that might have affected initiation and completion age and duration of toilet training were assessed with t-test, ANOVA and logistic regression analysis. RESULTS: Mean initiation and completion ages were 22.05 +/- 6.73, 28.05 +/- 8.40 months respectively. The families living in rural and semi-urban settlements, mothers educated for less than 5 years, unoccupied mothers, children living in houses which do not have a toilet inside, families who use washable diapers, who use Turkish style toilets and who use punishment methods started training earlier. In the infants whose mothers had an education over 12 years, completion age was later than others and the earliest completion age was seen in families who used punishment method. Mean duration needed to complete toilet training was 6.84 +/- 7.16 months. The duration of training was longer in families living in rural and semi-urban settlements, mothers educated for less than 5 years, unoccupied mothers, children living in houses which do not have a toilet inside, families who use washable diapers and when the initiation was before the child was 18 months old. CONCLUSION: Toilet training shows differences among cultures. The age of initiation may be increased as the parents are educated better and a child-orientated approach becomes more popular than the parent-orientated approach.

Near-irreversibility in a conservative linear structure with singularity points in its modal density.

Through two complementary approaches, using modal response and wave propagation, the analyses presented here show the conditions under which a decaying impulse response, or a nearly irreversible energy trapping, takes place in a linear conservative continuous system. The results show that the basic foundation of near-irreversibility or apparent damping rests upon the presence of singularity points in the modal density of dynamic systems or, analogously, in the wave-stopping properties associated with these singularities. To illustrate the concept of apparent damping in detail, a simple undamped beam is modified to introduce a singularity point in its modal density distribution. Simulations show that a suitable application of a compressive axial force to an undamped beam placed on an elastic foundation attenuates its impulse response with time and develops the characteristics of a nearly irreversible energy trap.

A closer look at traditional contraceptive use in Turkey.

Withdrawal is the main method used amongst couples in Turkey to prevent pregnancy. Discontinuation of use is most likely to be due to the desire to become pregnant or failure of the method. Withdrawal users are less likely to switch to another contraceptive method; however, among users who do switch, they will most likely switch to a modem method. The strongest three determinants that predict withdrawal use are using withdrawal as one's first method, the woman's age, and the husband's education. The woman's work status and the couple's ethnicity are also important predictors of withdrawal use. Family planning programs should target different segments of the population and focus on correct knowledge of all methods. Results indicate that men and women need to learn about family planning options earlier in their lives or prior to marriage.

Increased cesarean section rates in Turkey.

The aim of this study was to examine the trend in Cesarean section deliveries and the factors associated with Cesarean sections in Turkey. Data come from the ever-married women questionnaire of the 1998 Turkish Demographic and Health Survey (TDHS-98). During the decade preceding the TDHS-98, the proportion of deliveries by Cesarean section increased from 5.7% to 20.8%. When only hospital births were considered, the percentage of Cesarean deliveries for the year 1998 was found to be 26.1%. The estimated rate for the year 2001 was around 30% (i.e. double the maximum rate of Cesarean sections defined by the World Health Organization). Logistic regression analysis performed for the births occurring in the most recent period of 1993-98 revealed that the highest Cesarean section rate was strongly associated with maternal education, maternal age, place of delivery, number with prenatal care and household welfare. These findings imply that women with higher socioeconomic status are more likely to accept Cesarean section than women with lower socioeconomic status. The trend of increasing Cesarean section rates is a problem in itself, but more importantly it may indicate that Turkey is headed toward a more costly medical delivery system. For all of these reasons, the reduction of Cesarean section rates should be a priority for any reproductive health program in Turkey in order to improve the quality of prenatal care and to reduce the number of maternal deaths and morbidity.

Determinants of contraceptive use and method choice in Turkey.

In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple's living children, implying some preference for sons, although generally women prefer to have children of both sexes.

[The decision-making process in marriage formation in Turkey and factors affecting this process]. / Turkiye'de evlilige karar verme sureci ve bu surece etkide bulunan faktorler.

PIP: "The main objective of the study is to answer the question... How does [the] decision-making process in marriage formation work in Turkey? Data used in the study come from the 1993 Turkish Demographic and Health Survey.... Educational level of women...has [a] much more powerful effect on [the] decision-making process in marriage formation than the educational level of husbands. The role of women in the process of marriage formation increases as the educational level of women increases." (EXCERPT)^ieng

Female-headed households in Turkey and socio-demographic and economic characteristics of female household heads.

PIP: This study examines the welfare of female-headed households in Turkey during 1978-93. Data were obtained from the 1978 Turkish Fertility Survey, the 1987 Household Income and Consumption Expenditures Survey, the 1988 Turkish Population and Health Survey, and the 1993 Turkish Demographic and Health Survey. Duben and Behar (1996) report that female headship was 19.3% in 1885 and 14.7% in 1907 in Istanbul. About 40% of female heads of household were living alone in 1885 and 1907. In 1993, the percentage of female headship was 11.4% in Istanbul, with about 35% living alone. During 1950-93, the proportion of households headed by women increased by about 64%. Female headship peaked at 10.4% in 1978, declined during 1978-88, and increased again by 14% during 1988-93. High female headship during the 1970s may have been due to emigration of male labor, which swelled during the early 1960s and 1970s. A labor agreement with Libya in 1975 diverted migration to North Africa and then to the Middle East. After 1974, migration of Turkish workers was replaced by family reunification. The Turkish labor market changed markedly during 1973-80. Many of the families left behind due to migration joined extended families. During 1978-93, urban households were more likely to be headed by women. Female headship was lowest in the south in 1978 and in the north in 1993. Female household heads were more likely to be disadvantaged in both years. In 1993, over 50% of female household heads and only 11.3% of male household heads had no education. 20% of female household heads and 80% of male household heads were in the labor force in 1978 and 1993. Female household heads in the labor force were less likely to be covered by the social security system. 62% of female household heads and 38% of male household heads are in the low-income group. One in 10 households in Turkey is female-headed, and 1 in 6 low-income household heads is female.^ieng

Consanguineous marriage in Turkey and its impact on fertility and mortality.

Turkey has a high rate of consanguineous marriage (21.1%), indicating strong preference for this traditional form of marital union. Social and cultural factors are especially important in marriages between first and second cousins. Fertility is high, the closed birth interval is long, and the sterility rate is low among these couples. Post-neonatal, infant and under-5 mortalities are high in first cousin unions by comparison with non-consanguineous marriages. According to the results of the study, first cousin marriage is a significant determinant underlying the high total fertility and infant mortality rates in Turkey.

[Suicide in Turkey]. / Turkiye'de intihar olgusu.

"This paper mainly deals with the socio-demographic characteristics and sex differentials of persons [committing] suicide [in Turkey] on the basis of the 1990 Suicide Statistics.... Causes of suicide and suicide methods are also [discussed].... There is a strong relationship between socio-demographic factors, such as urbanization, aging and household patterns and suicide rates." The impact of sex roles and socialization is considered. (SUMMARY IN ENG)

[Sex ratios in Turkey]. / Turkiye'de cinsiyet oranlarinin belirlenmesi.

"The article [provides] examples of error in the censuses and surveys and questions the reliability of age specific sex ratios in the 1990 Census of Turkey...[and derives] sex ratio at birth from census and survey results as well as from hospital records. Finally the 1990 population is reconstructed by surviving birth cohorts [from] 1900 until 1990 using historical trends of birth rates and cohort, age and time specific survival rates using the East Family of Coale-Demeny Model Life Tables." (SUMMARY IN ENG)

[Ethnic structure in Turkey as implied by the analysis of census data on mother tongue]. / Turkiye' nin etnik yapisinin ana dil sorularina gore analizi.

The authors examine data on language from population censuses conducted in Turkey from 1927 until 1971. "The main objective of this paper is to draw some implications about the ethnic structure of Turkish citizens to the extent permitted by the available 'mother tongue' data. Turkish is the most commonly used language followed by Kurdish and Arabic. Census data carry evidence of differential mortality (as well as fertility) on growth rates of different sub-groups in Turkey. The paper sets 'reasonable' low and high estimates of major groups under different growth rate assumptions in Turkey." (SUMMARY IN ENG)