Bu çalışmada, çerçeve konstrüksiyonlu mobilya birleştirmelerinde kullanılmak üzere auksetik kavelalar tasarlanmış, üç boyutlu (3B) yazıcı teknolojisiyle üretilmiş ve bu kavelaların Sarıçam (Pinus sylvestis L.) ve 20 mm kalınlığındaki kavak (Populus nigra L.) kontrplak (KKP) ile tutma mukavemetleri araştırılmıştır. Bu amaçla, auksetik özellikli enine kesit geometrisine sahip 4 farklı kavela tasarımı gerçekleştirilmiş ve 3B yazıcıyla Polilaktik Asit (PLA), Akrilonitril Butadiyen Stiren (ABS) ve Akrilonitril Stiren Akrilat (ASA) filamentlerinden üretilmiştir. Tasarlanan kavelalarda, birleştirme sırasında tutkal kullanımını elimine etmek amacıyla dış yüzeyler dişli olarak dübel şeklinde tasarlanmıştır. Çalışma kapsamında, 2 ağaç malzeme, 2 dış yüzey diş geometrisi, 2 auksetik desen tipi, 3 farklı filament ve her bir gruptan 5 yineleme olmak üzere toplam 120 adet liflere paralel (kenardan) çekme, 120 adette liflere dik (yüzeyden) çekme deney örneği hazırlanmış ve statik yük altında test edilmiştir. Deneyler sonucunda, ahşap malzemelerden KKP, filamentlerden de PLA en iyi tutma mukavemetini verirken; auksetik kavelalardan ise üçgen biçimli auksetik desene sahip ve ikizkenar üçgen dişli kavelalar ile en yüksek tutma mukavemeti elde edilmiştir.

According to the literature review, limited studies were performed related to the production of "without fastener and ready to assemble (RTA)" furniture made of wood-based panel materials with Computer Numerical Control (CNC) machines and the evaluation of their strength. The aim of this study was to evaluate the cyclic loading performance of different types of RTA chairs without fastener which produced with CNC machines by using engineering design approach and product engineering methods including performance tests. In the production of chairs, 18 mm thick oriented strand board, medium density fiberboard and Oriental beech plywood were utilized as wood-based panels. Within the scope of the study, 4 different chair types without fasteners were designed and produced, and performance tests were carried out in 3 different loading directions (front to back, back to front and side thrust) with cyclic stepped increasing loading method according to the principles of American Library Association specification. Totally, 108 real size chairs without fastener were prepared and tested. As a result of the study, it was concluded that the chairs produced from Oriental beech plywood gave the best performances, while the chairs produced from medium density fiberboard gave performance values close to Oriental beech plywood, except for the side thrust test. However, the mechanical performance values of the chairs constructed of oriented strand board were very low. In conclusion, it could be said that the chairs constructed of Oriental beech plywood and medium density fiberboard without fastener have been found to have sufficient mechanical performance.

In this study, the aim was to optimize the cross-sectional geometry of auxetic dowels for furniture joints. For this purpose, two different sizes of auxetic dowels were chosen, one for frame- and the other for panel-type furniture joints for designing the cross-sectional geometry. Auxetic patterns that are created on the cross-sectional area cause deficiency of the materials, and this phenomenon decreases the modulus of elasticity (MOE) and increases the member stress. Accordingly, maximum MOE values and minimum Poisson’s ratio levels were determined for the optimum strength-auxetic behavior relation by means of a Monte Carlo method. Furthermore, Poisson’s ratio of the optimized dowel’s cross-section was confirmed with experimental tests, numerical analyses and analytical calculations. As a result, Poisson’s ratio values were obtained as negative values and confirmed, which means the dowels designed in this study had auxetic behavior. In conclusion, it could be said that studies should be conducted on the performance of auxetic dowels in both frame and panel furniture joints.

Weight-strength optimization of wooden household chairs was performed based on the member section size in this study. Member section sizes of the Scotch pine (Pinus sylvestris) and Oriental beech (Fagus orientalis) chairs were optimized and resulting re-manufactured optimized chairs were tested under the cyclic "front to back", "back to front" and "backrest" loads according to American Library Association (ALA) specification. Finite element method (FEM) and MATLAB nonlinear programming were utilized for the optimization. Firstly, the internal forces and moments acting on each member were analyzed by FEM in order to obtain the maximum critical stresses in each type of member; then, optimized cross-sectional sizes of the members were determined by Gradient Descent method, and all constraints were treated with Logarithmic Barrier Functioning. As a result, the minimum section sizes of members were determined, and cyclic performance tests were performed to determine whether the optimized chairs were strong enough to carry the acceptable loads. According to the results, member section size of both beech and pine chairs could be significantly reduced. The reduction was 32 % in the total weight and volume for beech chairs while 16 % for pine chairs without sacrificing the performance required for domestic usage by ALA. In conclusion, the method used is suitable for the optimization of furniture frames, making it lighter and reducing the material costs.

Tests were carried out to investigate the cyclic loading performance of chairs constructed of Scotch pine (Pinus sylvestris) and Oriental beech (Fagus orientalis). Totally, 30 real size chairs were constructed and assembled with polyvinyl acetate adhesive. Chairs were tested under 3 cyclic loading directions; namely, front to back, back to front, and backrest according to American Library Association (ALA) specifications, and obtained loading performances of chairs were crosschecked with allowable design load levels. Additionally, specimens were analyzed as structures by using the finite element method in order to obtain axial, shear, and bending stresses acting on each member under loadings and compare these values with design stresses. As a result, it was concluded that finite element method analyses achieve reasonable estimates for strength performances and failure behaviors of chairs. Depending on allowable design loads by American Library Association; chairs constructed of beech could meet the medium service for front to back and back to front loading, while heavy service for backrest loading. In the case of pine chairs; they could meet the medium service for front to back and back to front loading, while light service for backrest loading.

PURPOSE: ICS are the most commonly used anti-inflammatory drugs in the treatment of asthma.There is no study evaluating corticophobia with likert type questionnaire among the asthmatic patients. In this study, it was aimed to evaluate the fear and beliefs of ICS in asthmatic patients. The effect of corticophobia on treatment compliance by questionnaire is also investigated. METHODS: Between December2017 and January2018, 150 stable asthmatic patients were included to the study. The treatments were reviewed 3 months after the ICS treatment. Demographic and asthma-related data were recorded. The questionnaire was composed of 5 questions about fear and 5 questions about beliefs of ICS. RESULTS: The rate of ICS maintain in stable asthmatic patients was found to be 66.6%. 68% of the patients believed that ICS gained weight, 52% believed that ICS caused infection, 73% believed that ICS circulate in the blood, and 67.3% believed that ICS damaged the lung, 90.7% needed to be informed about ICS. The mean ICS treatment duration of patients with corticophobia group was found to be significantly lower (4.5 months,9.4 months,p=0.005,respectively). The duration of use of ICS of Bliefs1 group was found significantly lower than the Bliefs2 group(4.7 months,8.3 months,p=0.039,respectively). The duration of use of ICS of Worries1 group was found significantly lower than the Worries2 group(5.9 months,9.2 months,p=0.02,respectively). CONCLUSIONS: We found that compliance with ICS treatment is low in asthmatic patients due to corticophobia. CLINICAL IMPLICATIONS: It is considered that treatment compliance may increase with allocate time to asthma patients to informed about ICS effects at the beginning of ICS treatment.

The effects of cross-sectional geometry and force direction on bending strength (MOR) and modulus of elasticity (MOE) were investigated in selected softwoods. The specimens were constructed of Scots pine (Pinus sylvestris), Black pine (Pin us nigra), Siberian pine (Pinus sibirica), Stone pine (Pinus pinea), Nordmann fir (Abies nordmanniana), Oriental spruce (Picea orientalis), and Lebanon cedar (Cedrus libani). A total of 280 specimens were prepared from these seven species in two different cross-sectional geometries (circular and square, equal in area) and tested in two characteristic force directions (tangential and radial) by 10 replications. They were subjected to three-point bending tests according to TS 2474 (2005) and TS 2478 (2005) to obtain the MOR and MOE. The results showed that the type of cross-sectional area and direction of applied force, individually or together, had considerable effects on the MOR and MOE. The MOR values of the circular-sectioned specimens were 5% greater than those of the square-sectioned specimens. The MOE values of the circular-sectioned specimens were on average 19% greater than those of the square-sectioned specimens. The MOR and MOE values were on average 7% and 17% greater, respectively, for the force applied in the tangential direction.

PURPOSE: Idiopathic Pulmonary Fibrosis (IPF) is a chronic progressive pulmonary disease with an average survival of 3-5 years from the time of diagnosis. We present a case of pifenidone-induced renal failure, an unusual complication due to treatment of IPF. METHODS: A 66-year-old male admitted to the hospital with the complaints of dyspnea and chest pain. There was no known disease or drug use except IPF disease 2 months earlier and had begun treatment with pirfenidone. Serum creatinine level found 3.1 mg/dl with low urine output. The patient reffered to the Nephrology Department with acute renal failure(ARF). Abdominal and pelvic ultrasonography was revealed as grade 2 increased cortex echoes (renal parenchymal disease) in both kidneys. The protein level was 2.65 gr / dl on 24 hour urine examination. Serum C3C4level were normal. ANA, c-ANCA and anti-GBMA levels were negative. Serum p-ANCA level were showed a weak positivity [5,61 U/ml(Normal range: 0-5 U/ml)]. No significant findings were found in terms of Microscopic PAN and Wegener granulomatosis. Bronchoscopic biopsy reviewed again which was performed for IPF diagnosis 2 months ago and there were no findings in terms of pulmonary vasculitis. Renal biopsy was reported as ‘Mesengioproliferative Glomerulonephritis’. Steroid therapy and hemodialysis responsive was positive; creatinine level was measured as 1,89 mg / dl. RESULTS: The patient was discharged with the recommendation 40 mg/dayprednisolone and not to use pirfenidone once again. CONCLUSIONS: Kidney damage due to Pirfenidone has been not reported. We wish to alert physicians to keep in mind that pirfenidone may cause kidney injury. CLINICAL IMPLICATIONS:.

Periodic leg movements (PLM) in sleep may reflect sympathetic hyperactivity in patients with OSAS patients. However, the association of PLM and cardiovascular disease (CVD) is unknown. Herein we aimed to investigate the relationships between OSAS, CVD and PLM index (PLMI). Overall, 745 participants who underwent polysomnography were recruited. An apnea-hypopnea index (AHI) <5 were recruited as a control group. PLMI was derived from standard overnight polysomnography in the sleep laboratory in all subjects. A total of 611 patients with varying severity of OSAS (mean age: 50±86 years, M/F: 539/196) and 134 controls without OSAS (mean age: 44±50 years, M/F:120/615) were enrolled. When the group distributions were analyzed, 257 cases were classified as severe, 185 as moderate, 169 as mild OSA and 134 cases as control group. PLMI levels increased in a stepwise fashion from controls to patients with more severe OSAS (3.8 ± 3.0; 5.1 ± 3.5; 6.6 ± 4.5 and 7.3 ± 5.1 respectively, p<0.001). When CVD prevalance was compared with controls and various degrees of severity of OSAS, a stepwise increase in CVD was observed [21(16); 46(27); 45 (24) and 90(35) % respectively, p=0.001)]. PLMI levels were found to be significantly associated with AHI (r=0.025, p<0.001)) in the study group. Also, PMLI levels were significantly associated with CVD in all subjects (6.68±4.28, 5.67±4.14 respectively, p=0.015). CVD prevalance levels were significantly increased in patients with OSAS and associated with the severity of OSAS and PLMI. Increased PLM activity may be related to increased CVD risk in patients with OSAS

The most common common risk factor for the development of Obstructive sleep apnoea (OSA) and cardiovascular disease (CVD) is central obesity. The neck circumference, waist circumference, waist / hip ratio, body mass index (BMI) and the ‘A Body Shape Index’ (ABSI) are the anthropometric measurements (APM) may use to determine OSA risk. The aim of this study is to investigate the value of anthropometric measurements in predicting CVD in cases with OSA. Overall, 745 participants who underwent polysomnography were recruited. Patients with an AHI < 5 were recruited as a control group. CVD defined as hypertension, aryithmia, cerebrovascular disease, and ischemic heart disease. Waist, waist / hip, BMI and ABSI measurements were recorded. A total of 611 patients with varying severity of OSAS (mean age: 50±86 years, M/F: 539/196) and 134 controls without OSAS (mean age: 44±50 years, M/F:120/615) were enrolled. When the group distributions were analyzed, 257 cases were classified as severe, 185 as moderate, 169 as mild OSA and 134 cases as control group. As the OSA severity increased, the incidence of CVD and Diabetes Mellitus was significantly increased (p=0.001 ve p=0,05). When compare neck circumference, waist circumference, waist / hip ratio, BMI and ABSI, significant differences were found in terms of severity of OSA (p<0.001, p< 0.001, p<0.001, p= 0.001 and p <0.001, respectively). In ROC curve analyses, for females the cut-off value to predict CVD is 0,079 and for males the cut-off value is 0,085. ABSI measurement is useful APM associated with the severity of OSA and CVD. ABSI should be routinely recorded as well as other APM.

Inhaler Corticosteroids (ICS) are essential agents of asthma treatment. Although ICS have very few systemic side effects patients do not continue treatment. There is no previous study evaluating corticophobia with likert type questionnaire among asthma patients. In this study, it was aimed to evaluate the fear of ICS and the effect of corticophobia on asthma treatment compliance. The Likert type questionnaire consisted of 10 questions in total. (Fear 5 and beliefs 5 about ICS). Between July 2017-October 2017, 80 stable asthmatic patients were included to the study. All patients were reassessed after 3 months starting ICS treatment. The rate of continuing ICS use was found 66.3%. It was found that 68% of the patients were thought that the ICS might get weight to them, 73% were believed that ICS might involve to blood and had systemic effects, 69% were believed ICS might damage the lungs. It was found that 90% wanted to inform deeply about ICS, 68% were wanted to terminate ICS treatment as soon as possible. It was found that duration of ICS use was significantly lower in patients whose questionnaire score had greater than 10 points (p= 0.005, r= -0.37). The duration of ICS use was found significantly lower in the group with more negative beliefs about ICS (p= 0.039). The duration of ICS use was found significantly lower in the group with more fear of ICS (p= 0.02). Patients whose questionnaire score was found greater than 10 points had significantly lower duration of ICS use. The results showed that, treatment compliance is very low due to incorrect thoughts. We emphasize that if patients are adequately informed about ICS they may be more successful in maintaining treatment.

Introduction: It is known that eosinophils play an important role in the pathophysiology of COPD in recent years. In this study, it was planned to investigate eosinophilia, eosinophil / neutrophil ratio (ENR), distribution of ENR according to GOLD groups, and ICS use rate in COPD. Patients with stable COPD who were applied to our polyclinic between July 2017-December 2017 were enrolled to the study. All COPD patients were divided into 2 groups as eosinophilic group and non-eosinophilic group. Results: A total of 205 COPD patients were included to the study. 126 patients were included in the eosinophilic group (114 males, mean age 63.1 ± 10.1) and 79 in the non-eosinophilic group (68 males, mean age 62.8 ± 10.0). Age, gender, BMI, smoking history, mMrc dyspnea score were statistically similar. Although the PFT findings were similar, the number of exacerbations in the last one year was significantly higher in the eosinophilic group (p <0.001). ENR was significantly higher in eosinophilic group (p <0.001). However, there was no significant relationship between ENR and GOLD stage groups (f = 0,84, p = 0, 47). When the treatments were compared, the use of ICS + LABA was lower in the eosinophilic group (p = 0.025). Conclusion: ENR was significantly higher in eosinophilic COPD patients (p <0.001). However, ENR was not associated with GOLD Stage in eosinophilic COPD. Although eosinophilic COPD has similar PFT findings, the use of inhaler CS was significantly lower and the number of exacerbations was significantly higher. In the light of these findings ICS should be given in patients with high ENR.

Spinal Tuberculosis (STB) is much rarer than pulmonary tuberculosis. It can cause neurological and orthopedic problems due to infiltration of vertebrae. Here we report a 27-year-old male patient who applied with cough and low back pain. The chest Xray was unremarkable. In thorax computer tomography there were consolidations at the left and right upper lobes, multiple lytic lesions in the spine, spinal cord compression and gibbous deformity in the thoracic vertebrae. The acid resistant bacteria (ARB) smear and Mycobacterium tuberculosis (MT) culture of bronchial lavage fluid were found to be negative. Due to appearing to be an epidural abscess in thoraco-lumbar magnetic resonance imaging (MRI), surgical drainage was performed. For lytic lesions on the spine, bone biopsy was performed. ARB smear of bone biopsies was positive and MT isolated in the Lowenstein-Jensen culture. The cytology of the biopsy showed necrotizing granulomatous inflammation. Back pain decreased with anti tuberculosis treatment and surgical stabilization. We emphasize that, STB, in MT endemic and other developing areas, is an important consideration the differential diagnosis of patients presenting with low back pain.

GİRİŞİnsan immun yetmezlik virüsü (HIV) ve tüberküloz (TB) dünyada sık görülen en önemli enfeksiyon hastalıklarındandır.HIV pozitif bireylerde TB görülme riski 26 ila 31 kat daha fazla olduğu bildirilmektedir 1 .TB, Tümör nekrozis faktör alfa (TNF α) üzerinden HIV replikasyonunu artırması nedeniyle HIV enfeksiyonunun progresyonunu hızlandırıp AIDS tablosunun gelişimine yol açabilmektedir.Çalışmamızda, HIV

Fusion of the ribs is one of the most frequent anomalies in rib pathologies. Anomalies of the ribs may be isolated or a component of a congenital syndrome or metabolic disease. It is usually asymptomatic and detected incidentally on a plain chest radiography. Presently described is a case of a patient with a rib fusion mimicking a cavitary lesion observed on a plain chest radiography. Rib anomalies, including rib fusion, are often undiagnosed during radiological evaluation; however, they may lead to unnecessary diagnostic tests and treatments. Thus, rib fusion should be considered in the differential diagnosis of cavitary lesions.

IntroductionObstructive sleep apnea (OSA) syndrome is closely associated with cardiovascular and metabolic disorders. Recent studies reported that osteoarthritis (OA) is associated with cardiovascular disease as well as inflammation defined as "metabolic disorder". Due to the strong association of metabolic disorders with both OA and OSA, we aimed to investigate the association between severity of OSA and osteoarthritis grade based on X-Ray.Materials and MethodsPatients who underwent polysomnography due to suspicion of OSA were recruited in a cross-sectional study. Included patients were grouped according to apnea-hypopnea index (AHI) as mild (AHI between 5 and 14.9), moderately (AHI between 15 and 29.9), and severe OSA (AHI ≥ 30). Patients with AHI p< 5 served as the control group. Kellgren-Lawrence scoring system was used to express OA severity, which was graded as Grade 0, 1, 2, 3 and 4.ResultOne hundred twenty patients were enrolled into the study. Mean age was 52.4 ± 11.5 years and 56% (68/120) of the patients were male. A strong correlation was present between severity of OSA and severity of OA. Among those with Grade 4 OA group (33 patients), all patients had severe OSA and this association was independent from body-mass index. In the Grade 1 OA group, none of the patients had severe OSA (p< 0.05). A positive correlation was also seen between severity of OSA, OA and hs-CRP.ConclusionsThere is a strong association between OSA and OA. OSA might be a novel risk factor for the development OA. Further studies should evaluate the effect of OSA treatment on OA.

Case Presentation: 28-year-old male patient was admitted to our hospital with nausea and vomiting due to accidental thinner drinking while painting 2 hours ago. On physical examination, fever was 38°C and on auscultation was listened to the left basal crackles. In chest radiography was seen infiltration on the left (Figure 1). In thorax CT was observed bilateral consolidation more pronounced on the left (Figure 2). With antibiotics, bronchodilators and support treatments, reduced symptoms. Thinner which contains aromatic hydrocarbons such as xylene, toluene and N-hexane is widely used [1]. Thinner drinking causes severe complications such as rhabdomyolysis, polyneuropathy, cerebellar dysfunction and coma [2-5]. In literature, chemical pneumonia due to thinner drinking was rarely presented. Our case is important in terms of represents bilateral pneumonia due to exposure to thinner

Obstructive sleep apnea syndrome (OSA) is an independent risk factor for endothelial dysfunction and cardiometabolic diseases. Plasma endocan levels are elevated in a large number of diseases, and is a novel surrogate endothelial cell dysfunction marker. We aimed to assess the role of serum endocan level as a potential mechanism of endothelial dysfunction in OSA patients.

This article was originally published online on 8 April 2015 Serum specific igE levels, serum total igE levels and serum total eosinophil counts in asthma bronchiale patients were compared with healthy controls and the relation between serum specific igE levels, serum total igE levels and serum total eosinophil counts were evaluated. 5 specific igE level measurements (weed, 2 different tree panels [mixture of 5], feathers mix and dermatophagoides pterosyninus[Dp] and dermatophagoides farinae[Df]) and serum total igE levels, serum total eosinophil counts of a total 60 patients with Asthma (21 of them with asthma and allergic rhinitis) aged 19 to 52 (41 female, 19 male) and 34 (20 female, 14 male) healthy persons were compared. 60 percent of patient study group was determined to have positive specific igE, it is obtained that 70 percent of this positive specific igE group has sensitiveness to house dust mite antigen. Asthma bronchiale cases have specific igE positiviness level and total igE level and total eosinophil counts were significantly higher than the control group. Patients with asthma and allergic rhinitis revealed significant correlation with specific igE Df, total igE and eosinophil counts, furthermore significant correlation was behold between specific igE Dp, total igE and eosinophil counts. In our study compared to other allergens, sensitivity against house dust was much more higher and it is coherent with other studies in literature.

Acute retinopathy and vitreous hemorrhage (VH) are very rare ocular manifestations of sarcoidosis. A 42-year-old male patient complained of blurred vision and floaters in his left eye for three weeks. On the ophthalmologic examination, bilateral acute retinopathy and VH were observed. Superotemporal branch retinal vein occlusion (BRVO), retinal fibrovascular membrane and VH in the left eye were noted via fundus fluorescein angiography. Mediastinal lymphadenopathies were detected during systemic evaluation of the patient. Transthoracic lymphoid biopsy from the mediastinal region, confirmed the diagnosis of sarcoidosis histologically. Although the patient was treated with oral steroids for sarcoidosis, he underwent pars plana vitrectomy and membranectomy due to progressive VH and tractional fibrovascular membrane. Sarcoidosis should be considered within the differential diagnosis list in patients with bilateral acute retinopathy, BRVO, and VH. Improved outcomes can be achieved through early recognition of the underlying disease and appropriate therapy.