Novel Tb³âº-Doped LaAl2B4O10 phosphors: Structural analysis, luminescent properties, and energy transfer mechanism.

This study explores the structural and luminescent properties of terbium (Tb³âº)-doped lanthanum aluminium borate (LaAl2B4O10, abbreviated as LAB) phosphors, a novel host lattice for Tb³âº doping. LAB:Tb³âº phosphors, with varying dopant concentrations, were synthesized using a microwave-assisted combustion synthesis approach and characterized using X-ray diffraction (XRD), Rietveld refinement, and photoluminescence spectroscopy at both room and low temperatures. The structural analysis confirmed the hexagonal crystal structure of LAB and revealed successful incorporation of Tb³âº ions without altering the fundamental lattice. Luminescence studies demonstrated that the LAB:Tb³âº phosphors show strong green emission primarily attributed to the 5D4→7F5 transition of Tb³âº. The optimal doping concentration was determined to be 5 wt% Tb³âº, which provided maximum luminescence efficiency. This concentration also allowed for a critical study of energy transfer mechanisms within the phosphor, revealing dipole-dipole interactions with a critical distance of 9.80 Å between Tb³âº ions. Additionally, the CIE chromaticity coordinates of LAB:0.05 Tb³âº were precisely determined to be (0.289, 0.4460), indicating the potential for high-quality green emission suitable for solid-state lighting and display technologies. This work not only demonstrates the potential of LAB:Tb3+ as a highly efficient green luminescent material, but also sheds light on the mechanisms responsible for energy transfer and concentration quenching.

Enhanced luminescence of Eu3+ in LaAl2B4O10 via energy transfer from Dy3+ doping.

In this study, an investigation was conducted on the structural and photoluminescence (PL) characteristics of LaAl2B4O10 (LAB) phosphors initially incorporated with Dy3+ and Eu3+ ions. Subsequently, the impact of varying Eu3+ concentration while maintaining a constant Dy3+ concentration was examined. Structural characterization was performed using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and energy-dispersive X-ray spectroscopy (EDS). XRD analysis confirmed the effective embedding of both dopants into the hexagonal framework of the LAB. The PL emission spectra revealed characteristic emissions of Dy3+ (blue and yellow) and Eu3+ (red) ions. The optimized dopant concentrations of both Dy3+ and Eu3+ were observed to be 3 wt%. The dominant mechanism for concentration quenching in doped LAB phosphors was determined to be the electric dipole-dipole interaction. Co-doping with Eu3+ led to a substantial decrease in Dy3+ emission intensity (∼0.18-fold) while enhancing Eu3+ emission intensity (∼3.72-fold). The critical energy transfer distance (RC = 11.64 Å) and the analysis based on the Dexter theory confirmed that the energy transfer mechanism corresponds to dipole-dipole interaction. The color purities and correlated color temperatures (CCT) were estimated, suggesting the potential of these phosphors for warm white and red lighting applications, respectively. The observed energy transfer and luminescence properties, along with the structural and compositional characterization, highlight the promising potential of LAB:Dy3+/Eu3+ co-doped phosphors for advanced lighting and display technologies.

Tailoring the phase composition of carbon-coated nickel sulfides to achieve a high specific capacitance.

As significant transition metal sulfides, nickel sulfides integrated with carbon were successfully synthesized in the presence of polyethylenimine and glutaraldehyde with a solvothermal route at 180 °C followed by carbonization. Glutaraldehyde prevented complete sulfur loss and allowed the formation of a mixed phase of nickel sulfide. The electrochemical performances of pure NiS2, NiS@C0, NiS2/NiS@C1, and NiS2/NiS@C2 electrodes were tested by a series of measurements. The specific capacitances obtained from GCD analysis were 698, 1160, 1484, and 908 F g-1 at 1 A g-1 for NiS2, NiS@C0, NiS2/NiS@C1, and NiS2/NiS@C2 electrodes, respectively. The results implied that the NiS2/NiS@C1 electrode possessed the highest specific capacitances and this study can be a good reference for the preparation of other hybrid metal sulfides as pseudocapacitive electrode materials.

Prognostic significance of low basal serum creatinine levels in internal intensive care unit patients.

OBJECTIVE: This study aimed to show the relationship between low creatinine level and mortality in the internal Intensive Care Unit (ICU) based on the view that there may be a relationship between low creatinine level and mortality in patients admitted to the ICU. PATIENTS AND METHODS: This retrospective, single center study was performed in the ICU. Patients older than 18 years who stayed in the ICU for more than 24 hours were included in the study. Patients were evaluated for age, gender, albumin, creatinine levels and length of hospital stay in the analysis. Patients were divided into 7 groups according to serum creatinine levels: group 1: creatinine ≤ 0.4; group 2: 0.4 < creatinine ≤ 0.6; group 3: 0.6 < creatinine ≤ 0.8; group 4: 0.8 < creatinine ≤ 1.0; group 5: 1.0 < creatinine ≤ 1.2; group 6: 1.2 < creatinine ≤ 1.4; group 7: creatinine > 1.4 mg/dL. Creatinine level of 0.7-0.8 mg/dL was considered as reference and cox regression analysis was performed. RESULTS: Of 2,359 patients admitted to the ICU, 699 died (29.6%). Mortality relationship according to the accepted creatinine levels of the patients showed a U-shaped distribution, and ICU mortality increased in both low and high creatinine levels. At low creatinine levels (creatinine ≤ 0.4 mg/dl), the mortality rate was 71.4% for men and 10.7% for female (p < 0.001). Cox regression analysis showed that group 1 and group 2 increased mortality (HR: 0.721, 95% CI; 0.555-0.936, HR: 0.509, 95% CI; 0.285-0.909, respectively). CONCLUSIONS: In patients admitted to ICU, lower creatinine acceptance is associated with increased ICU mortality and reduced survival.

Comparison of Mortality Rates in Patients Waiting for Liver Transplant and Patients With Colorectal Metastatic Tumors.

OBJECTIVES: We aimed to identify outcomes of liver surgery in patients with hepatocellular carcinoma and colorectal cancer, which result in primary and secondary liver tumors. MATERIALS AND METHODS: Our study included 51 patients with colorectal cancer and liver metastases and 63 patients with hepatocellular carcinoma who were prepared for liver transplant due to cirrhosis who underwent hepatic resection or local ablation treatments; patients were seen between January 2011 and December 2021. RESULTS: Most patients with colorectal cancer were men (58.8%). Mean age was 65.76 ± 13.818 years (range, 27-88 y). Most patients had planned, elective surgery (86.3%). Neoadjuvant chemotherapy was administered to 58.8% of patients. The most common location of metastasis in the liver was in the right lobe (43.1%), and the most common surgery was low anterior resection (17 patients). During simultaneous liver surgery, 31 patients required metastasectomy and 7 patients required radiofrequency ablation plus metastasectomy. No deaths occurred in the early posttransplant period, and cumulative survival was 82.624 ± 7.962 months. Disease-free survival was 45.2 ± 7.495 months. Most patients with hepatocellular carcinoma were men (82.5%). Mean age was 58.73 ± 17.428 years. Hepatocellular carcinoma lesions were mostly located in both the right and left lobes (23.8%). In the hepatocellular cancer group, 60.3% had transarterial chemoembolization and 42.9% had radiofrequency ablation. The primary surgical resection was metastasectomy (17.9%) because of multiple localized lesions. Median follow-up was 22 months (range, 1-126 mo). Overall survival was 101.898 ± 7.169 months, with 10-year overall survival of 38%. Disease-free survival was 74.081 ± 8.732 months, with 1-year and 5-year disease-free survival of 90.5% and 54%. CONCLUSIONS: Better survival was shown in patients with hepatocellular carcinoma than in patients with colorectal cancer.Therefore, more aggressive treatment options, as used in hepatocellular carcinoma, including liver transplant, may be options for patients with colorectal cancer.

Technological Advances Have Improved Surgical Outcome in Thyroid Surgery: Myth or Reality?

AIM: In this study, we aimed to investigate the effects of Ultrasonic Coagulation (UC), Bipolar Energy Sealing System (BESS), Intra Operative Nerve Monitoring (IONM) and surgical experience on the complications of thyroid surgery. METHOD: The data of 1627 patients who underwent thyroid surgery for various indications in our department between 2009 and 2018 were analyzed retrospectively and the effects of different technological devices on complications were investigated. RESULTS: Transient recurrent laryngeal nerve (RLN) palsy was higher between 2009 and 2013, when IONM was not in routine use (p=0.029). There were no significant differences between two energy devices (UC and BESS) in terms of transient or permanent RLN palsy, bleeding, and transient or permanent hypocalcemia. Multivariate analysis showed that young age (0.006), female gender (0.016), surgery type (p<0.001), and lateral neck dissection (p=0.026) are independent risk factors for transient hypocalcemia. CONCLUSION: The results indicate that there is no superior hemostatic device. IONM and specific branching decrease transient RLN palsy. Female gender, young age, completion thyroidectomy, and lateral neck dissection were independent risk factors for the development of transient hypocalcemia.

Analysis of root and canal morphology of fused and separate rooted maxillary molar teeth in Turkish population.

AIMS: To investigate the root canal anatomy and the incidence of fused roots in maxillary first molar (MFM) and maxillary second molar (MSM) teeth in the Turkish population and compare them to teeth with separate roots using cone-beam computed tomography (CBCT). METHODS: CBCT images of 616 MFMs and 703 MSMs were analyzed from 402 patients for the number of roots and the presence of fusion. The canal configuration of teeth with separate and fused roots was compared. Type of fusion and canal merging positions were determined. A P value of less than 0.05 was considered significant. RESULTS: Five hundred and seventy-one (92.69%) MFMs had three separate roots, one (0.16%) had four roots and the incidence of root fusion was 7.14%. An additional mesiobuccal (MB) canal was present in 79.34% of the teeth with three separate roots. There was no merging of canals in 36 of 44 teeth with fused roots. The prevalence of fusion was higher in the MSMs (23.47%). The incidence of three and four separate roots in MSM teeth was 74.68% and 1.85%, respectively. The prevalence of additional MB canals in teeth with three separate roots was 53.14%. There was no canal merging in 60% of the fused rooted teeth. There were two-merged canals in 31.52% and multiple merged canals in 8.48% of the MSMs. CONCLUSIONS: In the Turkish population, the incidence of root fusion in the MFMs and MSMs was 7.14% and 23.47%, respectively, with more canal merging in the MSMs.

Fructanogenic traits in halotolerant Bacillus licheniformis OK12 and their predicted functional significance.

AIMS: Isolating a novel bacterial source of fructan from a saltern and analysis of its genome to better understand the possible roles of fructans in hypersaline environments. METHODS AND RESULTS: Bacteria were isolated from crude salt samples originating from Çamalti Saltern in Western Turkey and screened for fructanogenic traits in high-salt and sucrose-rich selective medium. Exopolysaccharide accumulated in the presence of sucrose by isolate OK12 was purified and chemically characterized via HPLC, FT-IR and NMR, which revealed that it was a levan-type fructan (ß-2,6 linked homopolymer of fructose). The isolate was taxonomically classified as Bacillus licheniformis OK12 through 16S rRNA gene and whole-genome sequencing methods. Strain OK12 harbours one levansucrase and two different levanase genes, which altogether were predicted to significantly contribute to intracellular glucose and fructose pools. The isolate could withstand 15% NaCl, and thus classified as a halotolerant. CONCLUSIONS: Fructanogenic traits in halotolerant B. licheniformis OK12 are significant due to predicted influx of glucose and fructose as a result of levan biosynthesis and levan hydrolysis, respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: Fructans from the residents of hypersaline habitats are underexplored compounds and are expected to demonstrate physicochemical properties different from their non-halophilic counterparts. Revealing fructanogenic traits in the genome of a halotolerant bacterium brings up a new perspective in physiological roles of fructans.

Analysis of general surgery outpatient clinic admissions and operations during COVID-19 pandemic in Turkey: Reactions of 12728 patients.

Covid-19 pandemic is spreading rapidly in Turkey. We aimed to examine the numbers and demographic data of patients who applied to the general surgery outpatient clinics and operated in this process. Our primary outcome is to reveal the response of general surgery patients to the Covid-19 pandemic.The first Covid-19 case in Turkey has appeared in March 11, 2020. Patients who were operated on due to a surgical emergency or trauma were evaluated separately. Patients in 3 periods were compared with each other. A total of 12728 patients were examined in general surgery outpatient clinics in 26 working days. It is seen that patients come to the outpatient clinic after the first time the Covid-19 patient is seen. All patients reduced hospitalization after the first death due to Covid-19. Women had reduced going to the hospital earlier than men. There was no change in the number of emergency surgeries. Rapid decrease was observed in the number of elective surgeries.It is not easy to control the entrance and exit of these busy hospitals. The remote diagnosis (mail, phone or video-call) and treatment methods that can be expected in the near future may be even closer with the Corona virus (Tab. 3, Fig. 4, Ref. 15). Keywords: general surgery, Covid-19, outpatient clinics, operation, reaction of patients.

The development of a delirium knowledge test for intensive care nurses: A validity and reliability study.

OBJECTIVES: This study aimed to determine the validity and reliability of the Delirium Knowledge Test for the Intensive Care Nurse. METHOD: The item analysis and reliability of the test was assessed in a sample of 274 nurses working in the internal and surgical adult intensive care units of one public and three university hospitals in Turkey between 15 May and 15 August 2017. Content and face validity, item analysis and reliability coefficients were used to evaluate the psychometric properties of the test. RESULTS: The item difficulty index and item discrimination index of the questions included in the draft form of the 40-item test were found to range from 0.22 to 0.93 and from 0.06 to 0.51, respectively. At the end of the analyses, 14 items were excluded from the draft test, 11 according to the item difficulty index and 3 according to the item discrimination index. Correspondingly, the final version of the test consisted of 26 questions. The item difficulty index of the final test was 0.22 to 0.79, and the item discrimination index was 0.20 to 0.51. The difficulty level of the final test was found to be 59%, and the Cronbach's alpha reliability coefficient was 0.83. CONCLUSION: The results of the study showed that the test had good content and face validity and reliability for measuring the delirium knowledge of intensive care nurses.

Intraneural angioleiomyoma of the median nerve presenting as a forearm mass: A case report.

Angioleiomyoma is a solitary form of leiomyoma which is typically encountered in the subcutis. They are mostly seen in lower extremities, and the upper extremity is the second most common location for these lesions. There are only a few reports about the presence of an angioleiomyoma within a peripheral nerve in the upper extremity. Here we report a 56-year-old male patient who was referred to our clinic after an attempt was made for removal of a forearm mass at another institution. The lesion was encased within the median nerve and there was an unusual hypervascularity around the tumor with numerous vessels entering the lesion. Removal of the tumor without apparent damage to nerve fascicles was possible. Histopathological examination of the excision material revealed an intraneural angioleiomyoma. Following surgery, the patient was free of any functional deficits and no evidence of recurrence was observed at one year follow-up. There is no data regarding recurrence in intraneural lesions due to the lack of a large series. It would not be wrong to recommend spare grossly uninvolved fascicles if the nerve in question is not expendable.

Pregnancy after renal transplantation.

OBJECTIVE: A well-functioning renal transplant usually reverses ESRD-related infertility and allows the reproductive function to improve. In this study, we wanted to emphasize that women who have renal transplantation can live healthy pregnancies with a careful follow-up. BACKGROUND: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies. METHOD: All of these patients were evaluated according to the criteria by the organ transplant team and perinatologist before the pregnancy planning and during the pregnancy processes. RESULTS: The mean age of the patients was 22.5 ± 4.5 (18-29) years. The creatinine level was below in 1.5 mg/dl in all patients in the pre-pregnancy period, and 1 + proteinuria was found in only two of them. Pregnancy periods varied between 31 weeks and 38 weeks. All births were performed by cesarean section and birth weight in babies ranged between 1650 and 3190 gram. CONCLUSION: Pregnancy in the renal transplant recipient is high-risk and should be managed by a multidisciplinary team of high-risk obstetricians, perinatalogists and transplant nephrologists. It should be closely monitored in terms of complications during pregnancy (Tab. 5, Ref. 16).

Posterior tibial slope measurement on lateral knee radiographs as a risk factor of anterior cruciate ligament injury: A cross-sectional study.

INTRODUCTION: The posterior tibial slope (PTS) is believed to be a risk factor for anterior cruciate ligament (ACL) injury. The aim of this study was to reveal the differences in terms of PTS measurements on lateral knee radiographs between ruptured and non-injured cases as well as between males and females in regard to ACL alignment. METHODS: The study cohort included 92 patients (61 males and 31 females) with ACL rupture and 101 individuals (59 males and 42 females) who visited the Orthopedics Department but had no ACL injury. PTS measurements on lateral knee radiographs were compared by two blinded reviewers. The results were analyzed in terms of ACL injury and sex differences. The intraclass correlation coefficient was used to calculate interobserver agreements. RESULTS: Notably, there was an excellent agreement between the reviewers with regard to PTS measurements. In addition, although a statistically significant difference existed in terms of PTS measurements between the patient and control groups (p < 0.0001), a significant difference was not observed between males and females (p = 0.179). CONCLUSION: Lateral knee radiographs are useful for PTS measurements to estimate the risk of ACL injury.

Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective study.

AIM: Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. METHODS: We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. RESULTS: The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 ± 5 vs. 28 ± 5 years, P < 0.001) and heavier (mean BMI: 27.2 ± 5.1 vs. 24.7 ± 4.7 kg/m2 , P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m2 , no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). CONCLUSION: The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.

Serotonin transporter (5-HTTLPR) genotypes and trinucleotide repeats of androgen receptor exert a combinatorial effect on hormonal milieu in patients with lifelong premature ejaculation.

Premature ejaculation is one of the most common sexual disorders in men due to uncontrolled modulation of spinal reflexes controlled by cortico-limbic centers in the brain. In this study, we investigate the combinatorial effects of trinucleotide repeats of androgen receptor and allelic variants of the 5-HTTLPR gene on sex steroids, hypophyseal hormones, sexual performance, and premature ejaculation assessment parameters among evidence-based lifelong premature ejaculation subjects. A total of 271 outpatients (age 26.6 ± 1.9) consulting for evidence-based lifelong premature ejaculatory dysfunction were selected in this study. The control group consists of 155 men with normal IELT (>4 min). The study revealed that the subjects who have the highest (≥26) CAG stretches depicted a significantly higher serum oxytocin levels (102.1 pg/ml; n = 126, p < 0.001) compared with the control group (71.2 pg/ml; n = 75, p = <0.001) and patients which have medium (22-25) and short (≤21) CAG stretches (76.63 ng/ml; n = 64, p < 0.001 vs. 77.4 ng/ml; n = 81, p < 0.001). Almost 33 (26.1%) lifelong premature ejaculatory patients had AR variant of longer (≥26) CAG repeats was homozygous for S alleles (SS), 45 (35.7%) was homozygous for L allele (LL), and 48 (38%) had the L/S or S/L genotype of 5-HTTLPR gene. Homozygous (SS) alleles have a significant positive correlation (r = 0.44, p < 0.0001) with the high score of BDI-II (39.1, n = 126, p < 0.001). However, LL alleles have shown a significant positive correlation with PEDT (r = 0.46, p < 0.001) and negative correlation with self-estimated IELT and intercourse satisfaction (r = -0.35, p < 0.001). The innovative study design elaborates that androgen receptor trinucleotide repeats and 5-HTTLPR genotypes have combinatorial impact on hormonal milieu and sexual function regarding evidence-based lifelong premature ejaculatory dysfunction patients.

P3HT-graphene bilayer electrode for Schottky junction photodetectors.

We have investigated the effect of a poly (3-hexylthiophene-2.5-diyl)(P3HT)-graphene bilayer electrode on the photoresponsivity characteristics of Si-based Schottky photodetectors. P3HT, which is known to be an electron donor and absorb light in the visible spectrum, was placed on CVD grown graphene by dip-coating method. The results of the UV-vis and Raman spectroscopy measurements have been evaluated to confirm the optical and electronic modification of graphene by the P3HT thin film. Current-voltage measurements of graphene/Si and P3HT-graphene/Si revealed rectification behavior confirming a Schottky junction formation at the graphene/Si interface. Time-resolved photocurrent spectroscopy measurements showed the devices had excellent durability and a fast response speed. We found that the maximum spectral photoresponsivity of the P3HT-graphene/Si photodetector increased more than three orders of magnitude compared to that of the bare graphene/Si photodetector. The observed increment in the photoresponsivity of the P3HT-graphene/Si samples was attributed to the charge transfer doping from P3HT to graphene within the spectral range between near-ultraviolet and near-infrared. Furthermore, the P3HT-graphene electrode was found to improve the specific detectivity and noise equivalent power of graphene/Si photodetectors. The obtained results showed that the P3HT-graphene bilayer electrodes significantly improved the photoresponsivity characteristics of our samples and thus can be used as a functional component in Si-based optoelectronic device applications.

Acoustic Radiation Force Impulse Quantification in the Evaluation of Thyroid Elasticity in Pediatric Patients With Hashimoto Thyroiditis.

OBJECTIVES: To evaluate the parenchymal elasticity of the thyroid gland with acoustic radiation force impulse imaging in pediatric patients with Hashimoto thyroiditis and to compare it with healthy volunteers. METHODS: Twenty-six patients with Hashimoto thyroiditis and 26 healthy volunteers between 6 and 17 years were included. The shear wave velocity (SWV) values of both thyroid lobes in both groups were evaluated. RESULTS: The age and sex characteristics of the controls and patients with Hashimoto thyroiditis were similar. The SWV of the thyroid gland in patients with Hashimoto thyroiditis (mean ± SD, 1.67 ± 0.63 m/s) was significantly higher than that in the control group (1.30 ± 0.13 m/s; P < .001). There was no significant difference between the thyroid lobes in both groups. A receiver operating characteristic curve analyses showed an optimal cutoff value of 1.41 m/s, with 73.1% sensitivity, 80.8% specificity, a 79.2 % positive predictive value, and a 75.0% negative predictive value (area under the curve, 0.806; P < .001). In patients with Hashimoto thyroiditis, there was a positive correlation between the SWV values versus anti-thyroperoxidase (Pearson r = 0.46; P = .038). There were no correlations between age, body mass index, thyroid function test results, and anti-thyroglobulin values and versus SWV values. Also, no significant differences were seen between the groups for gland size, gland vascularity, and l-thyroxine treatment. CONCLUSIONS: Acoustic radiation force impulse elastography showed a significant difference in the stiffness of the thyroid gland between children with Hashimoto thyroiditis and the healthy group. Using acoustic radiation force impulse elastography immediately after a standard ultrasound evaluation may predict chronic autoimmune thyroiditis.

Detection of cholesteatoma: High-resolution DWI using RS-EPI and parallel imaging at 3 tesla.

The purpose of this study is to evaluate the impact of RS-EPI-DWI in the detection of cholesteatoma and to compare with single-shot echo-planar DWI (SS-EPI-DWI). Diffusion-weighted and apparent diffusion-coefficient (ADC) images were obtained using RS-EPI and SS-EPI techniques in 30 patients. Presence of cholesteatoma (3 point scale), amount of artefacts (4 point scale), visibility (4 point scale), and ADC values of the lesions were assessed. The results of both techniques were compared with each other and gold-standard (GS) test results. Lesion visibility and presence of artefact scores of RS-EPI-DWI group were significantly different from those of the SS-EPI group. RS-EPI-DWI images had fewer artefacts and higher visibility scores. The sensitivity, specificity, negative/positive-predictive, and overall-agreement values of RS-EPI-DWI technique were 100%, 78%, 100%, 74%, and 87%; respectively. These values for SS-EPI-DWI technique were 91%, 60%, 88%, 67%, and 75%; respectively. Also, these values were higher on axial plane than coronal plane images for ADC measurements. Based on gold-standard test findings, agreement values were good (κ=0.74) for RS-EPI-DWI and moderate for SS-EP-DWI (κ=0.50) techniques (P<0.001 for both). The RS-EPI-DWI technique allows a higher spatial-resolution and this technique is less susceptible to artefacts when compared with SS-EPI technique.

SERUM IRISIN LEVEL INCREASES THROUGHOUT THE GESTATIONAL PERIOD AND IT DOES NOT PLAY A ROLE IN DEVELOPMENT OF GESTATIONAL DIABETES MELLITUS.

INTRODUCTION: Irisin is a recently discovered novel adipomyokine that induces an increase in total body energy expenditure, improves insulin sensitivity and glucose tolerance. It has been shown that circulating levels of irisin are low in patients with obesity, diabetes mellitus and impaired glucose tolerance. However, the information about the level of circulating irisin in gestational diabetes mellitus (GDM) is controversial. MATERIAL AND METHODS: Serum irisin was measured by an ELISA in a longitudinal prospective cohort study in 221 women. There were 156 healthy pregnant and 65 women with GDM. RESULTS: Circulating irisin levels were significantlly higher in the middle pregnancy compared with early pregnancy levels in healthy pregnant women and in women with GDM. Serum irisin levels were found to be lower in GDM compared to healthy pregnant women during first trimester but the difference was not observed throughout the pregnancy and it was comparable in middle pregnancy. There was a significant inverse correlation of BMI with serum irisin (r = -0.193, p = 0.004) and between HbA1c and mean glucose of OGTT with serum irisin (r =-0.377, p =0.0001) and (r = -0.147, p:0.03) in the early pregnancy of pregnant women repectively. CONCLUSIONS: The present study shows that serum irisin level increases throughout the gestational period from early to middle pregnancy in women with GDM, but there is no effect of irisin on the development of GDM.

MUSCULAR HYPERTROPHY AS ATYPICAL INITIAL PRESENTATION OF HYPOTHYROIDISM.

Hypothyroidism is a common endocrine disease with characteristic symptoms and signs such as fatigue, weight gain, intolerance of cold, constipation, depression, mental slowdown and muscle cramps. Myopathic changes are observed in 30-80% of patients with hypothyroidism, but muscular hypertrophy with muscle stiffness has been reported in less than 10% of patients. Hoffmann's syndrome is a specific form of the hypothyroid-associated myopathy, rarely seen. Symptoms of this syndrome include proximal muscle weakness, hypertrophies in extremities, stiffness, muscle cramps, spontaneous muscle pain; and are associated with increased muscle enzymes. These findings can be seen at any time during hypothyroidism. Hofmann's syndrome has a very good prognosis. Its response to hormone replacement therapy is very good. Therefore, in patients with myopathy-like symptoms, considering in the differential diagnosis that the myopathy may be a reflection of hypothyroidism will facilitate the diagnosis and treatment. In this case, we aimed to present together Hashimoto thyroiditis and muscular hypertrophy, which is an atypical presentation of hypothyroidism and rarely seen in the literature, namely Hoffmann's syndrome.