Idiopathic granulomatous mastitis (IGM) is a rare, heterogeneous inflammatory breast disease lacking a universally accepted classification or a standardized management pathway. To provide a comprehensive narrative synthesis of the current literature on IGM and to contextualize the Turkish IGM clinical classification and treatment algorithm in relation to existing global evidence. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar (2000-2025). Clinical, radiological, pathological, and therapeutic studies were examined. Previously published Turkish national consensus studies based on a modified Delphi process were incorporated into the synthesis. IGM remains diagnostically challenging due to its diverse presentations and overlap with malignancy. Existing global classification attempts are inconsistent and lack clinical practicality. The Turkish IGM clinical classification addresses these gaps by integrating lesion size, skin involvement, pregnancy/lactation categories, and extramammary findings. Treatment outcomes demonstrate the high efficacy of topical and intralesional steroids, the selective use of systemic immunosuppression, and the limited indications for surgery. The Turkish IGM classification and its associated treatment algorithm provide a practical, standardized framework that aligns with current evidence and may reduce overtreatment and mismanagement in IGM.

Background:Radioiodine (RAI) therapy is frequently used to treat suspected or documented cervical lymph node metastases in papillary thyroid carcinoma (PTC), although its effectiveness for structurally documented residual nodal disease remains uncertain. Methods:This retrospective analysis of a prospectively followed cohort included RAI-naïve patients with PTC who had structurally confirmed cervical nodal metastases identified after surgery. Patients with documented metastatic lymph nodes in recently operated compartments, or those declining immediate reoperation, received upfront RAI therapy. Treatment response was evaluated at both lymph-node and patient levels using serial ultrasonography and biochemical follow-up. Results:A total of 146 cervical lymph node metastases in 71 patients were analyzed. Of these, 39 (26.7%) were RAI-avid, 89 (61%) were RAI-non-avid, and 18 (12.3%) were indeterminate due to remnant interference. Among RAI-avid nodes, complete and partial responses were observed in 38.5% and 20.5%, respectively. Across all nodes, complete and partial responses were seen in 10.3% and 6.2%, while no objective response occurred in 83.5%. RAI-non-avid disease was frequent among aggressive histologic subtypes; however, most non-avid metastases arose from tumors with otherwise indolent histology. At the patient level, a complete response was achieved in 11% (8/71). All responders remained in the excellent response category at a median follow-up of 77 months (range 32-156), indicating a durable treatment effect. Conclusion:RAI-non-avid nodal metastases were common and represented the primary determinant of treatment failure. Even among RAI-avid lesions, response rates were modest. These findings suggest that lesion-level RAI-avidity is the principal determinant of therapeutic benefit and support a more selective, biology-guided approach to RAI therapy in patients with residual nodal disease.

Objective:The aim of this study was to evaluate the diagnostic value of preoperative hemogram parameters —platelet count (PLT), plateletcrit (PCT), platelet distribution width (PDW), mean platelet volume (MPV), and red cell distribution width (RDW)— in differentiating papillary thyroid carcinoma (PTC) from benign thyroid pathology in an age- and sex-matched patient series. Material and Methods:A total of 2.080 patients who underwent total thyroidectomy at the Gazi University Faculty of Medicine, Department of General Surgery between January 2015 and January 2023 were retrospectively reviewed. After applying exclusion criteria and removing outliers, 1.955 patients were identified. Cases with a histopathological diagnosis of PTC were matched 1:1 with patients with benign thyroid pathology based on sex and 10-year age groups. The final analysis included 348 PTC patients and 348 benign patients (n=696). Preoperative hemogram parameters were compared between the groups using the Mann-Whitney U test, and the diagnostic value was assessed using receiver operating characteristic (ROC) curve analysis. Results:After matching, no significant difference was found between groups in terms of age (48.0±12.7 vs. 48.3±12.9 years; p=0.754) or sex distribution (p=0.930). None of the parameters —PLT (277.0±70.4 vs. 275.7±69.1 ×109/L; p=0.723), PCT (0.270±0.072 vs. 0.270±0.075; p=0.680), PDW (14.1±2.9 vs. 13.8±2.8; p=0.300), MPV (9.54±1.33 vs. 9.42±1.14 fL; p=0.591), or RDW (13.8±1.4 vs. 14.1±1.5; p=0.053)— showed a statistically significant difference between groups. ROC analysis confirmed that none of the parameters demonstrated meaningful diagnostic value (AUC: PLT 0.508, PCT 0.510, PDW 0.473, MPV 0.488, RDW 0.543). Conclusion:When age- and sex-matching are applied, preoperative PLT, PCT, PDW, MPV, and RDW values do not provide meaningful discrimination between PTC and benign thyroid pathology. Positive findings reported in the literature may be partly attributable to demographic confounding. The potential diagnostic value of combined indices or integration with other complete blood count parameters warrants investigation in prospective studies.

Objective: Esophageal cancer lacks a standard surgical approach, and opinions differ regarding the extent of lymphadenectomy. This study aimed to assess the correlation between the extent of lymphadenectomy, patient and tumor characteristics, and survival of esophageal cancer. Methods: Data of 101 patients who underwent surgery for esophageal cancer between 1990 and 2022 were retrospectively analyzed. The mean survival and 1, 3, 5, and 10 year overall survival (OS) rates were examined. Overall survival rates for adenocarcinoma and squamous cell carcinoma were separately evaluated. The relationships among gender, age, tumor size, stage, total number of harvested lymph nodes, and survival were analyzed. Results: Among 101 patients, 34 (33.7%) were female, and 67 (66.3%) were male, with a mean age of 61.01 +/- 12.01 years. Among the included patients, 82 (81.2%) had squamous cell carcinoma and 16 (15.8%) had adenocarcinoma. The mean follow-up was 61.2 months, and the OS averaged 61.01 +/- 12.01 months. Only the total harvested lymph node count had a statistically significant impact on survival (p=0.17). Conclusion: There was a clear association between the total number of harvested lymph nodes and OS. In squamous cell cancers, the extent of lymph node dissection improves long-term survival. However, the routine use of extended lymphadenectomy for distal cancer remains a topic of debate.

Objective:This study aimed to compare preoperative, intraoperative, and tumor characteristics between patients undergoing emergency and elective surgery for right-sided colon cancer. Despite the worsened prognosis of emergency colorectal cancer cases, studies on right colon cancer remain limited. Material and Methods:This retrospective study included 356 patients who underwent surgery for right-sided colon cancer between January 2015 and April 2023. Patients were categorized into emergency (n=93) and elective (n=263) groups. Demographic data, tumor characteristics, and surgical details were analyzed. Binary logistic regression was applied to identify independent predictors of emergency surgery. Results:Age (p=0.435) and gender distribution (p=0.853) were similar between groups. However, American Society of Anesthesiologists (ASA) scores were higher in the emergency group (p=0.001), while Charlson comorbidity index (CCI) scores showed no significant difference (p=0.169). T4 (p<0.001), N1 (p=0.008), and M1 stages (p<0.001) were significantly more frequent in the emergency group, along with higher tumor perforation rates (34.4% vs. 1.9%, p<0.001). Open surgery was more common in the emergency group (p=0.005). While total lymph node yield was similar (p=0.501), the number of metastatic lymph nodes was higher in the emergency group (p=0.008). Logistic regression identified higher ASA score, advanced T, N, M stages, tumor perforation, and tumor size as predictors of emergency surgery. Conclusion:Patients undergoing emergency surgery for right colon cancer have more advanced disease, higher tumor perforation rates, and poorer prognostic factors. Laparoscopic surgery was less utilized, which indicates technical challenges. Early diagnosis and screening strategies may reduce emergency interventions and improve outcomes.

Papillary thyroid cancer (PTC) is the most common malignancy of the thyroid gland. This study aimed to evaluate the potential biomarker effect of ABO blood group and Rhesus factor in PTC. In this retrospective study, data from patients who underwent thyroid surgery at our center were analyzed. Patients operated for benign thyroid disease (Group I, n = 955) and those operated for PTC (Group II, n = 656) were included. Demographic data, histopathological characteristics of thyroid nodules, ABO blood group, and Rhesus factor were evaluated, and statistical analyses were performed. No significant difference was found in ABO blood group distribution between Group I and Group II (p = 0.340). Similarly, Rhesus factor showed no statistically significant association with PTC (p = 0.579). The nodule diameter was significantly smaller in the malignant group (p < 0.001). Preoperative Free T3, TSH, and thyroglobulin levels differed significantly between the two groups (p < 0.001). No statistically significant relationship was observed between ABO blood groups and histopathological characteristics, including extrathyroidal extension, lymphatic invasion, vascular invasion, and capsular invasion. ABO blood group and Rhesus factor do not appear to be independent biomarkers in papillary thyroid cancer. Our study presents findings that do not support a relationship between ABO blood group, Rhesus factor, and PTC. However, further studies with larger patient cohorts are needed to reach more definitive conclusions.

Primary hyperparathyroidism (PHPT) is caused by excessive parathormone secretion from one or more parathyroid glands. The primary treatment for PHPT is surgery. Due to anatomical variations in the parathyroid glands, preoperative localization, surgical approaches, and success rates can vary. With the development of advanced imaging techniques and the introduction of intraoperative intact PTH (i-PTH) measurement, traditional extended surgical approaches have increasingly been replaced by focused surgeries. Intraoperative i-PTH measurement has been applied by different surgeons using various criteria. This study aims to evaluate the effectiveness of intraoperative i-PTH measurement in improving surgical success, particularly in cases with inconclusive preoperative imaging results. Between January 2010 and September 2020, 203 adult patients who underwent surgery for PHPT in our clinic were included in the study. Patients were categorized into two groups: Group A (with intraoperative i-PTH measurement) and Group B (without i-PTH measurement). Persistent hyperparathyroidism was defined as elevated calcium levels occurring shortly after surgery, whereas recurrence was defined as calcium elevation after the 6th postoperative month. The absence of recurrence or persistent hypercalcemia was considered an indicator of surgical success. The mean age of the patients was 54.6 ± 12.7 years. Of the 203 patients, 40 (19.7

Doğal afetler, can ve mal kaybına yol açabilen yıkıcı olaylardır. Deprem, sel, yangın gibi afetlerin yarattığı tahribat, insan hayatının kurtarılması ve maddi zararların önlenmesi için acil durum planlaması ve koordinasyon gerektirir. Afet bölgesindeki insanların güvenli tahliyesi ve acil durum araçlarının etkin yönlendirilmesi hayati bir öneme sahiptir. Bu çalışmada, Türkiye’nin özgün trafik koşulları ve acil durum araçlarının gereksinimleri dikkate alınarak ambulanslar için bir rota optimizasyon modeli geliştirilmiştir. Bu model, mevcut yol ağlarının ambulansların kullanımına uygun hale getirilmesini ve acil durum müdahale sürelerinin iyileştirilmesini hedeflemektedir. Yenilikçi çözümler arasında trafik ışıklarında ambulanslara öncelik verilmesi, gerektiğinde ters yönde seyahat edebilme senaryoları ve zorlu trafik koşullarında etkili rotaların belirlenmesi yer almaktadır. Bu sayede ambulans hizmetlerinin iyileştirilmesi ve müdahale sürelerinin kısaltılmasıyla hasta ve yaralıların hayatta kalma oranlarının artırılması amaçlanmaktadır. Sonuçlar, ambulans hizmetlerinin verimliliğini artırdığını ve müdahale sürelerini azalttığını göstermektedir. Çalışma, Türkiye için ambulans rotası optimizasyonu ve acil durum yönetimi alanında önemli bir adım olarak değerlendirilmektedir

Travmaya Metabolik, Endokrin ve İmmün-İnflamatuar Yanıt Aydın YAVUZ Sıvı ve Elektrolit Metabolizması Ramazan KOZAN Asit- Baz Dengesi ve Bozuklukları Saygın ALTINER Şok Hakan SÖZEN Cerrahi Hastada Beslenme Kürşat DİKMEN Cerrahi Alan Enfeksiyonları Kürşat DİKMEN Cerrahi Hastanın Monitörizasyonu Murat AKIN Yara İyileşmesi Çağrı BÜYÜKKASAP Benign Tiroid Hastalıkları, Tiroid Nodüllerine Yaklaşım ve Tiroidektomi Komplikasyonları Hüseyin GÖBÜT Malign Tiroid Hastalıkları Hüseyin GÖBÜT Paratiroid Bezinin Cerrahi Hastalıkları Murat AKIN Meme Kanserı Rölatif Risk Faktörleri Osman KURUKAHVECİOĞLU Memenin Benign Hastalıkları Osman KURUKAHVECİOĞLU Memede Kitleye Yaklaşım Ekmel TEZEL Meme Kanseri Ekmel TEZEL Adrenal Bez Hastalıkları Murat AKIN Karın Duvarı Anatomisi Ziya ANADOL Fıtıklar Ziya ANADOL Karın Travmaları Osman YÜKSEL Akut Karın Sendromu Akif TÜRKOĞLU Akut Apandisit Hasan BOSTANCI Akut Pankreatit Çağrı BÜYÜKKASAP Bağırsak Obstrüksiyonu Hakan SÖZEN Gastrointestinal Kanamalar Aydın YAVUZ Mezenterik Vasküler Hastalıklar Abdülkadir BEDİRLİ Özofagus Tümörleri Aydın YAVUZ Mide Tümörleri Osman YÜKSEL Morbid Obezite Abdülkadir BEDİRLİ Kolorektal Anatomi ve Anorektal Muayene Sezai LEVENTOĞLU Kolorektal Polipler ve Prekanseröz Lezyonlar Sezai LEVENTOĞLU Benign Anorektal Hastalıklar Sezai LEVENTOĞLU Pelvik Taban Hastalıkları Sezai LEVENTOĞLU Kolorektal Tümörler Ahmet KARAMERCAN Karaciğer Tümörleri Mustafa ŞARE Karaciğer Apseleri Akif TÜRKOĞLU Kist Hidatik Hasan BOSTANCI Safra Kesesi ve Safra Yollarının Hastalıkları Aydın DALGIÇ Pankreatik Kistler ve Pankreasın Premalign Lezyonları Mustafa KEREM Pankreas Kanseri ve Periampuller Tümörler Mustafa KEREM Portal Hipertansiyon ve Cerrahi Tedavisi Aydın DALGIÇ Organ Transplantasyonu Aydın DALGIÇ Cerrahide Onkolojik Tedavi İlkeleri Ekmel TEZEL Klinikte Sık Kullanılan Ameliyat ve Girişim Adları Ekmel TEZEL Cerrahi Terimler Kılavuzu Ekmel TEZEL

Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory lesion of the breast. Immunoglobulin G4 (IgG4) associated disease is rare in the breast. In our study, we aimed to evaluate the efficacy of steroid treatment on IgG4 levels in tissue in patients diagnosed with IGM. Between 2008 and 2017, 55 patients diagnosed with IGM in our clinic were included in the study. Demographic, clinical, microbiologic and histopathologic characteristics, treatment modality and recovery time were evaluated retrospectively. Patients were divided into 3 groups according to tissue IgG4 levels: negative (Group I), infrequently and slightly positive (Group II), and highly positive (Group III). Group I patients had a complete response rate of 77.8%. In the rest of the patients (22.2%), insufficient response was detected from the beginning of the treatment. In Group II, the response rate was 91.3% and the permanent success rate after treatment was 87.0%. Although group III patients had a complete response at the beginning (95.65%), they relapsed in a short period of time (26.1%) after discontinuation of steroid treatment. At least one steroid-related side effect was observed in 47 (85.8%) patients in all groups. There is no consensus on the dose and duration of immunosuppressive treatment in IGM. In this study, responses to steroid treatment according to IgG4 concentration in pathologic breast tissue and recurrences after the end of treatment were determined. We think that high IgG4 concentration in the tissue is associated with recurrence and other immunosuppressive drugs should be added as maintenance after steroid treatment.

Objectives:Ultrasonography and fine-needle aspiration biopsy (FNAB) are the gold standard methods in the prediction of benign and malignant thyroid nodules. However, despite being easily applicable, FNAB is an invasive procedure. Less invasive biomarkers should be utilized in the diagnosis of thyroid malignancies. In this study, we aimed to determine the parameters that can be used in the diagnosis of differentiated thyroid cancer (DTC) based on the serum thyroid and thyroglobulin (TG) levels which are routinely checked in patients followed up for thyroid nodules.Methods:In the study, we evaluated patients who underwent thyroid surgery for nodular diseases between January 2015 and June 2022. Of the 1444 patients evaluated, 919 patients who met the inclusion criteria (normothyroid benign nodular disease or normothyroid DTC) were included in the study. Patients were divided into two groups as benign group (BG) and DTC group (DTCG). We compared patients' pre-operative serum thyroid and TG values and the diagnostic properties of their ratios.Results:Of the 919 patients included, 517 (56.3%) were in BG and 402 (43.7%) were in DTCG. In DTCG, 318 patients were female and 84 patients were male. The mean age in the DTCG was 47.8 years. Comparison of DTCG and BG revealed a significant difference between T3/T4 ratio (p=0.002), T3/TSH ratio (p≤0.001), T4/TSH ratio (p≤0.001), TG/TSH ratio (p≤0.001), and TSH/TG ratio (p≤0.001). However, evaluation of the specified values by ROC analysis showed that the T3/T4 ratio did not make a significant difference between the two groups (p=0.1), whereas the other values displayed a significant difference (p≤0.001 for T3/TSH, p=0.001 for T4/TSH, p≤0.001 for TG/TSH, and p<0.001 for TSH/TG).Conclusion:T3/TSH (cutoff =2.183), T4/TSH (cutoff=0.6), and TG/TSH (cutoff=29.67) values were found to be significant tumor markers for the prediction of malignancy in thyroid nodules, and low values were found to be associated with malignancy. TSH/TG (cutoff=0.031) value was also significant in predicting malignancy while high values were found to be associated with malignancy. Thyroid hormone and TG ratios may alter the preferred treatment method for thyroid nodules.

Aims: Adhesion is the pathological connections that occur during the healing with scar formation of peritoneal surface defects. CO2 is used the most frequently in laparoscopic operations for insufflation. It is believed that it causes to changes in the inflammatory reply of the pneumo-peritoneum, defects in acid-base balance and decrease in peritoneal macrophage functions. CO2 is the only gas whose immunologic effects have been shown. It has been proven in experimental studies that the CO2 insufflation causes to local peritoneal acidosis without affecting the systemic status. Moreover, it has also been shown that it decreases the pneumo-peritoneum TNF-α and IL-6 production; however, increases the IL-10 production which is an anti-inflammatory cytokine. In the literature, the relation between the laparoscopy and the postoperative adhesions has always been explained by taking the suggestion of its causing to less tissue trauma as a basis when compared with the open surgery. The inflammatory reply of the CO2 has been less dealt with. In this study, we wanted to find the answer to the question whether the capno-peritoneum has a role in preventing the postoperative adhesion formation only by using CO2 without a a laparoscopic operation. Methods: 30 female Wistar Albino type rats whose weights varied between 250±20 were used in the study. The rats were divided into 5 groups. Each group had 6 rats. Rats were placed in standard polycarbon cages in groups of 6. The room temperature was kept in 21°C. The rats were fed with standard pellet food during the study and tap water was provided to them. The operational anesthesia was performed by injecting intramuscular Ketamine Hydrochloride (Ketalar, Parke Davis and Eczacıbaşı, İstanbul) 50 mg/kg and Xylazine hydrochloride (Rompun, Bayer HealthCare) 5 mg/kg. Results: A meaningful difference (p

In the modern marketing world, where data as a source is very important, businesses use many different methods with the help of technology to obtain various data about consumers' purchasing behavior and to reach detailed information about their consumption habits. Businesses are able to identify the weak points of the consumer, manipulate them, and enable the consumer to buy more and more often than they need, thanks to the information they have obtained from the analyzes they have made. At this point, we come across manipulative techniques that businesses use in various sizes and types. Businesses use the act of manipulation, to attract the attention of consumers or to encourage them to buy their products by trying to change their purchasing behavior and consumption habits with different stimuli. In the study, it was aimed to determine the extent of the effects of the manipulative sales techniques used by mobile phone companies on the behavioral intentions and consumption habits of the consumers in the generation z. For this, a conceptual model has been developed and the hypotheses created for the research have been tested through the analysis. The sample of the research focused on individuals who studying at university in Turkey, and the online survey method with Google Forms was used to collect the data. In line with the purpose of the research, exploratory and confirmatory factor analysis and structural equation model analyzes were performed on the data obtained. Keywords: Manipulative Marketing, Generation Z, Consumption Habit, Behavioral Intention

6102 sayılı Türk Ticaret Kanunu’nun (“TTK”) 600. maddesi ile limited şirket esas sermaye payının rehni ilk defa açıkça düzenlenmiştir. Ancak rehin hakkının rehin alacaklısına sağladığı hakların kısıtlılığı uygulamada esas sermaye payının inançlı temlike konu edilmesini doğurmuştur. Bu noktada inançlı temlikin, kanun koyucu tarafından düzenlenmemiş olup doktrin ve uygulama tarafından geliştirilmiş olması esas sermaye payının inançlı işlemle devredilmesi sonucu tarafların hukuki konumu hakkında belirsizliğe yol açmaktadır. Alacağını teminat altına almak isteyen alacaklı için hem avantajları hem de dezavantajları bulunan bu kurum, beraberinde bilhassa tarafların yetkisine ilişkin birtakım sorunları getirmektedir. Bu çalışmada söz konusu olabilecek sorunlara değinilerek doktrinin görüşleri çerçevesinde çözüm getirilmeye çalışılmıştır.

Sınavları hele sözlü olanlarını kimse sevmez. Bütün bir staj boyunca veya bir yıl boyunca ve hatta yıllar boyunca çalışıp girilen sözlü sınavlarda, ne sorulacağını ve nasıl yanıtlayacağını bilmemenin yarattığı belirsizlik duygusu ve yüksek katekolamin salgısına bağlı heyecan içinde insan çoğu kez en iyi bildiklerini bile söyleyemez olur. Öte yandan sınavda yanıtlanamayan soruları, sınavı yapanhoca ya da sınav sonrası bir arkadaşınız yanıtladığında “ne kadar kolaymış” duygusuna kapılır ve çoğunu hayat boyu unutmazsınız.

The aim of this paper is to develop a new approach for a solution of the model following control (MFC) problem with a dynamic compensator by using linear matrix inequalities (LMIs). TheH1 model following control problem is derived following LMI formulation. First, the H1 optimal control problem is revisited by referring to Lemmas assuring all admissible controllers minimizing the H1 norm of the transfer function between the exogenous inputs and the outputs. Then, the solvability condition and a design procedure for a two degrees of freedom (2 DOF) dynamic feedback control law is introduced. The existence of a 2 DOF dynamic output feedback controller for the model following control is proven and the stability of the closed-loop system is satisfied by assuring the Hurwitz condition. The benchmark thermal process (PT-326) as the first order process with timedelay is regulated by the presented 2 DOF dynamic output feedback controller. The simulation results illustrate that the presented controller regulates a system with dead-time as a large set of generic industrial systems and the H1 norm of the closed-loop system is assured less than the H1 norm of the desired model system.

Şirket menfaati kavramı, 6102 sayılı Türk Ticaret Kanunu’nda tanımlanmamıştır. Bununla birlikte, bu kavrama kanunun pek çok yerinde bazen açıkça bazen de örtülü olarak değinildiği görülmektedir. Bu kavram, şirket eksenli çatışan tüm menfaatlerin ortak paydasıdır. Herhangi bir menfaat çatışmasında şirket menfaatinin tercih edilmesi, orta ve uzun vadede tüm menfaatlerin yararınadır. Bazı hallerde yönetim kurulu üyelerinin kendi menfaatlerini şirketin menfaatinin önünde tutarak şirket menfaatini zarara uğratması neticesinde hukukumuzdaki sorumluluk rejimi çerçevesinde hangi hukuki adımların atılacağı bu çalışmanın konusudur. Şirket menfaatini koruyucu esaslı bir rejimin hukukumuzda bulunmayışı, şirket menfaatine aykırı hareket eden yönetim kurulu üyelerinin aleyhine işletilecek sorumluluk hükümlerinin önemini artırmaktadır.