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Öğe Association between drug resistant hypertension and increased osteoprotegerin levels in hypertensive male patients with non obstructive sleep apnea(Carbone Editore, 2014) Akyüz, Aydın; Oran, Mustafa; Alpsoy, Şeref; Mutlu, Levent Cem; Değirmenci, Hasan; Küçükyalçın, Volkan; Alp, RecepObjectives: Increased carotid intima-media thickness (IMT) reflects subclinical vascular damage and is related to obstructive sleep apnea (OSA) syndrome and hypertension. Osteoprotegerin OPG is a member of the tumor necrosis factor superfamily and increases leukocyte adhesion. The relationship between increased OPG and atherosclerosis is Well known, but there is still no evidence whether there is an association between OPG and resistant hypertension. This study investigated the association between OPG and drug resistant hypertension in patients With OSA and non-OSA. Patients and methods: We investigated the association between serum OPG levels and carotid IMT in patients With drug resistant hypertensive OSA (ODR) patients (n= 39) and drug resistant hypertensive non-OSA(NODR) patients (n=34) and drug-responsive hypertensive non-OSA controls (n=36). Results: OPG levels and carotid IMT were found to be higher in the ODR [12.4(5.9-19.5) and 0.89 +/- 0.51 and in the NODR group [11.9(5.7-17.6) and 0.88 +/- 0.6] compared with the controls [8.4(4.8-16.5) pmollL and 0.73 +/- 0.8 um], (p= 0.01 and p=0.01 for OPG and p<0.01 and p<0.01 for carotid IMT). The carotid IMT was positively correlated with OPG levels in the ODR. group (r=0.412, p=0.016) and in the NODR group(r=0.321, p=0.024) and with apnea hypopnea index (r=0.462, p<0.001) in the ODR. There was no correlation between OPG and apnea-hypopnea index (r=0.07, p=0.564) in the ODR group. Conclusions: Increased serum OPG levels were associated with subclinical carotid atherosclerosis in patients with ODR and NODR, but not with drug-response non-OSA controls.Öğe Association Between Serum Fetuin-A levels, Carotid Artery Stiffness, and Intima-Media Thickness in Patients With Normotensive Obstructive Sleep Apnea Syndrome(Sage Publications Inc, 2014) Akyüz, Aydın; Oran, Mustafa; Alpsoy, Şeref; Mutlu, Levent Cem; Akkoyun, Dursun Çayan; Güzel, Savaş; Alp, RecepIncreased carotid intima-media thickness (cIMT) and stiffness, reflecting subclinical atherosclerosis, are associated with obstructive sleep apnea syndrome (OSAS). The relationship between serum fetuin-A, which inhibits ectopic calcification, and atherosclerosis is unclear. Therefore, we investigated the association between serum fetuin-A levels and carotid artery stiffness and cIMT in patients with normotensive OSAS (n = 50) and non-OSAS controls (n = 38). Compared with controls, there were lower fetuin-A levels (59.4 +/- 6.5 vs 68.2 +/- 5.8 ng/mL, P = .029), higher mean cIMT (0.73 +/- 0.2 vs 0.63 +/- 0.3 mm, P < .001), and greater stiffness (beta) index (7.45 +/- 0.9 vs 5.2 +/- 0.7, P = .001) in the OSAS group. The cIMT and stiffness (beta) index were inversely correlated with fetuin-A levels (r = -.324, P = .033; r = -.466, P < .001, respectively) and positively correlated with apnea hypopnea index (r = .498, P < .001; r = .422, P = .001, respectively) in the OSAS group. Decreased serum fetuin-A levels were associated with subclinical carotid atherosclerosis in patients with normotensive OSAS.Öğe Atrial Fibrillation Is Associated With Increased Mean Platelet Volume and Apnea Hypopnea Index in Patients With Obstructive Sleep Apnea(Sage Publications Inc, 2015) Akyüz, Aydın; Akkoyun, Dursun Çayan; Değirmenci, Hasan; Alp, RecepThis study investigated whether there is a relationship between atrial fibrillation (AF), mean platelet volume (MPV), and apnea hypopnea index (AHI) in patients who have obstructive sleep apnea syndrome (OSAS). We enrolled patients who had OSAS with either AF or normal sinus rhythm (NSR). We divided 90 patients (aged 50-80 years) into 2 groups: group 1 consisted of 40 patients with OSAS having AF and group 2 of 50 patients with OSAS having NSR. Mean platelet volume was higher in patients with AF than in those with NSR (9.8 +/- 0.6 vs 8.4 +/- 0.6 fL; P < .001). The MPV and AHI were substantial variables associated with AF (odds ratio [OR] = 2.41; 95% confidence interval [CI], 1.36-5.26; P < .004 and OR = 1.91; 95% CI, 1.26-3.32; P = .02). Elevated MPV value of 9.4 fL is associated with AF (70% sensitivity and 63% specificity). More research is needed to establish the clinical relevance of this association.Öğe Bortezomib-induced peripheral neuropathy and neuronopathy in patients with multiple myeloma(Springer Heidelberg, 2013) Turgut, Nilda; Turgut, Burhan; Oran, Musatfa; Yetişyiğit, Tarkan; Alp, Recep; Ünal, A.[No Abstract Available]Öğe Circadian Distribution of Epileptic Seizures(Wiley-Blackwell, 2015) Alp, Selen İlhan; Alp, Recep; Baklan, B.[No Abstract Available]Öğe Clinical and genetic features of PKAN patients in a tertiary centre in Turkey(Elsevier Science Bv, 2017) Akçakaya, Nihan Hande; Uğur İşeri, Sibel; Bilir, Birdal; Battaloğlu, Esra; Tektürk, Pınar; Gültekin, Murat; Yapıcı, Zuhal; Alp, RecepObjective: Pantothenate kinase-associated neurodegeneration (PKAN) is caused by mutations of the pantothenate kinase 2 (PANK2) gene. The major clinical sign of PKAN is dystonia and the eye-of-the-tiger pattern on the MRI has been a clue for the diagnosis. We aim to discuss clinical and genetic findings of 22 PKAN patients from 13 families. Methods: Twenty-two patients were clinically diagnosed with PKAN and screened for PANK2 mutations. The patients were classified according to their onset age and progression rate. Results: Mutation screening revealed 5 novel and 7 previously reported sequence variants in PANK2. The variants identified were in the form of missense changes, small exonic deletions and intronic mutations with a probable splicing effect. The presenting features were dystonia and gait disturbance in early onset patients, whereas the presenting symptoms were variable for the late onset group. The progression rate of the disease was not uniform. Conclusion: The current report is the first patient series of PI(AN from Turkey that expands the clinical and genetic spectrum of the disease. (C) 2017 Elsevier B.V. All rights reserved.Öğe Is it only a sleeping disorder or more? Restless legs syndrome and erectile function(Taylor & Francis Ltd, 2016) Kurt, Ömer; Yazıcı, Cenk Murat; Alp, Recep; Sancak, Eyüp Burak; Topçu, BirolObjective: Sexual dysfunction and restless legs syndrome (RLS) have similar pathophysiological properties. This study evaluated the presence of erectile dysfunction (ED) and premature ejaculation (PE) in patients with RLS. Materials and methods: Fifty patients in the RLS group and 50 in the control group were included in the study. The International Restless Legs Syndrome Study Group rating scale, the five-item International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool were used to define the RLS and erectile function of both the study and control groups. A stopwatch technique was used to evaluate the intravaginal ejaculatory latency time of patients in the study. Results: The mean age of patients in the RLS and control groups was 53.5 +/- 9.9 and 53.2 +/- 8.8 years, respectively (p = 0.527). None of the patients in either group had diabetes mellitus. There was no difference between the groups in terms of history of hypertension, body mass index and total testosterone level. There were 27 patients (54%) in the RLS group and 17 patients (34%) in the control group with PE (p = 0.008). There were 26 patients (52%) with ED in the RLS group and 17 (34%) in the control group (p = 0.069). The prevalence of moderate and severe ED was significantly higher in the RLS group (p = 0.045). Conclusions: PE was more prevalent in RLS than in control patients. On the other hand, the rate of ED did not differ between the groups. In addition to receiving a neurological evaluation, RLS patients must be evaluated for sexual function.Öğe Leukocytoclastic vasculitis due to duloxetine(John Libbey Eurotext Ltd, 2015) Erfan, Gamze; Alp, Recep; Albayrak, Şule; Oğuz, Keriman; Kalayci, Serkan; Öznur, Meltem; Kulaç, Mustafa[No Abstract Available]Öğe Mean Platelet Volume in Patients with Obstructive Sleep Apnea and Its Relationship with Simpler Heart Rate Derivatives(Hindawi Ltd, 2014) Akyüz, Aydın; Akkoyun, Dursun Çayan; Oran, Mustafa; Değirmenci, Hasan; Alp, RecepSome studies show increased mean platelet volume (MPV) in obstructive sleep apnea (OSA). The aim of this study was to evaluate MPV in OSA patients without cardiovascular risk factors and the possible association of heart rate derivatives with MPV. A total of 82 patients (aged 30-70 years) were divided into 2 groups according to the presence of either OSA or non-OSA as the control group. The OSA group consisted of 52 patients and the control group consisted of 30 subjects. Neither group was significantly different in terms of MPV values as well as heart rate (HR) derivatives such as minimum HR, maximum HR, the difference between maximum HR and minimum HR, mean HR, and heart rate performance index (HRPI) [(HR max. -HR min.)/HR mean] (P > 0.05 for all variables). In multivariate analysis, platelet count and percentages of recording time spent at arterial oxygen saturation < 90% significant variables are associated with MPV (beta +/- SE: -0.004 +/- 0.002, 95% CI, -0.008 to -0.001; P = 0.034) and (beta +/- SE: 2.93 +/- 1.93, 95% CI, 0.167 to 5.69; P = 0.038). Consequently, our findings predominantly suggest that there is a casual and reciprocal interaction between MPV and autonomic activation.Öğe Mezuniyet ve profesyonel sağlık personeli olarak çalışmanın hasta güvenliği bilinci üzerine etkileri(2012) Yıldız, Tülin; Eriten, Gülşah; Erdem, İlknur; Gökay, Nevzat Selim; Kulaç, Mustafa; Alp, RecepAmaç Bu çalışmanın amacı mezuniyet ve profesyonel sağlık personeli olarak çalışmanın hasta güvenliği üzerine etkinliğini belirlemektir. Yöntem Bu prospektif tanımlayıcı çalışma Namık Kemal Üniversitesi Sağlık Yüksek Okulu Hemşirelik bölümünde yapıldı. Çalışmada Sağlık Yüksek Okulu son sınıf öğrencileri (n=44)ve aynı okuldan mezun olmuş, çalışan yeni mezun hemşireler (n=35) yer aldı. Sosyo-demografik özellikler ve hasta güvenliği ile ilgili bilinçle ilgili veriler, yüzyüze görüşme sonrası özel olarak hazırlanmış veri formuyla toplandı. Toplanan veriler SPSS for Windows 17.0 istatistik program kullanılarak analiz edildi. Pearson Ki-kare ve Fisher kesinlik testleri gruplar arası karşılaştırılmada kullanıldı. Bulgular Yeni mezun hemşireler öğrencilerle kıyaslandığında tıbbi hataları tanımada ve tıbbi hataya sebep olan özellikleri tanımada daha bilinçlidirler (p<0.05). Sonuç Okuldan mezuniyet ve profesyonel sağlık personeli olarak çalışmak bir hemşirenin hasta güvenliği üzerine bilincini arttırır.Öğe Nasal mucociliary clearance in obstructive sleep apnea syndrome patients(Ocean Side Publications Inc, 2014) Deniz, Mahmut; Gültekin, Erdoğan; Çiftçi, Zafer; Alp, Recep; Özdemir, Damla Nihan; Işık, Aklime; Demirel, Oral BurakBackground: The main objective of this study was to investigate the correlation between the level of mucociliary dysfunction and severity of obstructive sleep apnea syndrome (OSAS). The effect of smoking in OSAS patients on mucociliary dysfunction was also assessed. Methods: It is a descriptive study that compares variables between groups (univariate analysis). In this clinical trial 122 patients with varying degrees of OSAS and 49 healthy volunteers were included (n = 171). Patients were divided into three groups as having mild, moderate, and severe OSAS, according to their apnea hypopnea index (AHI) values. (AHI values are typically categorized as 5-15/hr, mild OSAS; 15-30/hr, moderate OSAS; and >30/hr, severe OSAS.) The control group was comprised of healthy subjects. Each group was divided into smoking and nonsmoking subgroups. The mucociliary rates of the subjects were measured using the saccharin test. Statistical analysis was performed with the GraphPad Prism Version 3 pocket program. Results: Mild and moderate OSAS groups showed similar results with control group (p = 0.869), but severe OSAS patients showed a statistically significant difference with control group (Kruskal-Wallis [KW] = 32.28; p = 0.0032 and p < 0.05). Although in the moderate OSAS group the mucociliary clearance rates showed a tendency to decrease, this decrease was not significant (p = 0.453). A statistically significant difference was observed between smokers and nonsmokers in terms of mucociliary clearance times in all groups (KW = 18.24; p = 0.001). Conclusion: The nasal mucociliary system is significantly deteriorated in severe OSAS patients and they should be meticulously observed to prevent sinonasal infections. Measures to enhance mucociliary activity in these patients should be taken. Smoking, a well-known inhibitor of mucociliary activity, also has a negative impact on the mucociliary function of OSAS patients and quitting smoking would be of benefit for these patients.Öğe Nursing Students Exposed to Domestic Violence and Their Perspectives on Violence(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Yıldız, Tülin; Önler, Ebru; Malak, Arzu; Avcıbaşı, İlker Murat; Baç, Adnan; Alp, RecepAim The study was performed in order to evaluate the domestic violence that the nursing students exposed and their perspectives on violence. Materials and Methods The sample was consisted of 229 students who were selected by simple random sampling method. Percentage, Pearson's chi-square and Fisher's exact tests were used in order to perform statistical analysis by the SPSS 17.0. Results 26.6% of students were exposed to domestic violence, 34.4% of these students were exposed to psychological violence, 26.2% of them were exposed to physical violence, 39.3% of them were exposed to both psychological and physical violence. Among the students who were exposed to domestic violence, the violence application rate was significantly high (p<0.01). Conclusion Our results has showed, predisposition to violent tendencies of the individuals who are personally exposed to domestic violence or any member of their family is exposed to domestic violence increase in a way that cannot be overlooked.Öğe Planimetry investigation of the corpus callosum in temporal lobe epilepsy patients(Riyadh Armed Forces Hospital, 2016) Çağlar, Veli; Alp, Selen İlhan; Demir, Berrin T.; Şener, Ümit; Özen, Oğuz Aslan; Alp, RecepObjective: To evaluate the effects of temporal lobe epilepsy (TLE) on corpus callosum (CC) morphometry in patients with TLE. Methods: This retrospective study was conducted at the Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey between November 2010 and December 2013. The epileptic syndrome diagnosis was based on International League Against Epilepsy criteria, and this study was conducted on the MRIs of 25 epilepsy patients and 25 control subjects. We classified the patients according to their duration of epilepsy: < 10 and >= 10 years. The projection area length (PAL) of the CC was also estimated. Total brain volumes (TBV) were measured on CT images. Results: The mean values of TBV for patients with TLE and the control group were not statistically different, but the CC PAL values were statistically different. The mean CC PAL values of under and over 25 years of age in patients with TLE were statistically different. The mean values of TBV of under and over 10 years duration of TLE were small statistically, but the CC PAL values were statistically different. Conclusion: The results indicate a clear influence of TLE on the structure of the CC rather than TBV.Öğe Serum level of vitamin D in obstructive sleep apnea patients with fibromyalgia syndrome(2021) Dumur, Seyma; Yıldırım, Tülay; Kucur, Mine; Alp, Recep; Aydın, MuratObjectives: The aim of this study was to investigate the serum concentration of vitamin D in patients with obstructivesleep apnea syndrome (OSAS) alone and with coexisting fibromyalgia syndrome (FMS) and to assess the relationshipto pain.Methods: A total of 60 patients diagnosed with OSAS and 40 healthy individuals whose age and sex were analogousto the patient group were included in this study. The OSAS patients were examined for FMS according to the AmericanCollege of Rheumatology criteria, and 27 cases were identified. Group 1 consisted of patients with OSAS alone (n=33)and Group 2 comprised patients with FMS+OSAS (n=27). Serum samples were analyzed using an ultra-performanceliquid chromatography analyzer (Thermo Dionex Ultimate 3000; Thermo Fisher Scientific, Inc., Waltham, MA, USA).Results: A comparison of the OSAS and FMS+OSAS groups with the healthy individuals revealed that the vitamin Dlevel was significantly lower in the patient groups (Group 1: p=0.001, Group 2: p=0.038). No statistically significant difference was found in the vitamin D level between the subgroups of OSAS and FMS+OSAS. A weak negative correlationwas determined between the number of the tender points (r=-0.428) and the vitamin D level in the subjects with FMS(p=0.013). In addition, the oxygen desaturation values of the FMS+OSAS and OSAS patient groups were significantlydifferent (p=0.001).Conclusion: Patients with OSAS and FMS+OSAS had a low vitamin D level, which should be considered when planningtreatment strategiesÖğe Serum YKL-40 level is correlated with apnea hypopnea index in patients with obstructive sleep apnea syndrome(Verduci Publisher, 2017) Mutlu, Levent Cem; Tülübaş, Feti; Alp, Recep; Kaplan, Gökhan; Yıldız, Zeynep Deniz; Gürel, A.OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) has been associated with elevated biochemical markers of inflammation. Although the exact mechanism is unknown, both sleep deprivation and hypoxemia are believed to be important causative factors. YKL-40, also known as chitinase-like protein, has been shown to be related to various inflammatory conditions including atherosclerosis, diabetes, cancer and asthma. The present study aimed to evaluate the relationship between YKL-40 levels and the Apnea Hypopnea Index (AHI) in patients with obstructive sleep apnea syndrome. PATIENTS AND METHODS: The study was conducted at the Sleep Unit of the Namik Kemal University Research Center. From January 2013 to December 2013, 120 patients diagnosed with OSAS by polysomnography and 40 subjects without OSAS were recruited. Patients in both groups were matched by age, sex, and body mass index (BM!). They were further divided into groups of mild, moderate and severe OSAS based on their AHI value. Serum YKL-40 concentrations were measured by the enzyme linked immunosorbent assay (ELISA). RESULTS: OSAS patients showed significantly elevated YKL-40 levels compared to the control group; 102,05 (23.14) pg/ml in the control group vs. 144.81 (65.53) pg/ml in the OSAS group. A Spearman correlation analysis showed that serum YKL-40 levels were significantly and positively correlated with AHI (r = 0.434, p < 0.001) and oxygen desaturation index (r = 0.374, p < 0.001). CONCLUSIONS: The study demonstrated that high serum YKL-40 levels correlated with the severity of OSAS and might serve as a nonspecific biomarker for prediction and progression of the disease.Öğe Sleep and Epilepsy(Kare Publ, 2014) Alp, Recep; Altındağ, EbruIt is well known that clinical and EEG manifestations of many epilepsy syndromes are related to sleep-and-waking cycles. Epilepsies are thought as disorders reflecting abnormalities in neuronal networks underlying sleep process. Patients with epilepsy, on the other hand, are generally reported to have poor sleep quality when compared with healthy controls. Furthermore, poor sleep quality or sleep-deprivation may worsen seizure control and set a vicious cycle. Anti-epileptic drugs may also affect sleep architecture. Here, we aim to review the complex relationship of sleep and epilepsy in the light of relevant literature.Öğe Supraorbital and infraorbital nerve blockade in migraine patients: results of 6-month clinical follow-up(Verduci Publisher, 2013) Alp, Selen İlhan; Alp, RecepBACKGROUND: Nerve blockades are used for the treatment of acute migraine episodes in emergency room conditions and beneficial results are obtained from this clinical use. Although this is the case, there are limited numbers of studies investigating the long-term effects of such an approach. PATIENTS AND METHODS: In this investigation, we had 26 patients diagnosed as migraine based on the ICHD II criteria, these were injected with 1% lidocaine at supraorbital and infraorbital nerve localizations and clinical results were evaluated after 6 months of follow-up. All patients received 1.5 ml of 1% lidocaine bilaterally for supraorbital and infraorbital nerves with three day intervals for three times. Clinical evaluation was conducted by recording the number of migraine episodes per month together with migraine disability assessment scale (MIDAS) and visual analog scale (VAS) scores before and six months after the treatment. RESULTS: Mean age of the patients recruited in the study was 31.1 +/- 10.2 years. Disease duration was 8.1 +/- 5.4 years, the duration of the headache was 28.4 +/- 18.4 hours, mean number of episodes before treatment was 9.9 +/- 5.2, mean MIDAS was calculated as 3.2 +/- 0.8, and VAS as 9.0 +/- 1.0. Six months after the treatment, mean number of attacks was 2.0 +/- 3.0, MIDAS was 1.4 +/- 0.9 and VAS was 3.5 +/- 3.6. There was a statistically significant difference between the results obtained before and after the treatment. CONCLUSIONS: Injecting 1% of lidocaine to supraorbital and infraorbital nerve for three times prevents the acute migraine episodes effectively during the 6-months of follow-up without having any significant side effectsÖğe The evaluation of auditory system in obstructive sleep apnea syndrome (OSAS) patients(W B Saunders Co-Elsevier Inc, 2016) Deniz, Mahmut; Çiftçi, Zafer; Ersözlü, Tolga; Gültekin, Erdoğan; Alp, RecepObjective: The authors of the present study aimed to investigate the impact of hypoxemia on the auditory functions of OSAS patients and discussed their findings under the scope of the existing literature. Materials and methods: 160 patients who underwent a polysomnographic analysis for the diagnosis of possible sleep disordered breathing between January 2015 and December 2015 were enrolled in this study. Polysomnography tests were conducted at the sleep laboratory of the department of neurology at the same institute. Comprehensive otorhinolaryngological examinations of all participants were conducted by the same senior otorhinolaryngologist. Three study groups and a control group were designated in the study. Each study group was designated according to the severity of the apnea hypopnea index (AHI) and blood oxygen saturation values of the participants. All participants underwent pure tone auditometry and otoacoustic emission testing (OAE). Statistical data analysis was performed using SPSS for Windows, version 17 (SPSS Inc., Chicago, IL, USA). Results: Audiological assessment of the patients revealed that all patients in the control group and in mild OSAS group had normal hearing thresholds (lower than 26 dB). However, the patients who had moderate and severe OSAS had varying degrees of sensorineural hearing losses. As far as body mass indexes are concerned, statistically significant differences were observed among the groups (p = 0.038). Conclusion: There is convincing evidence that the risk of progressive dysfunction in vascular and neural structures of the body is inevitable for the Patients who suffer from a chronic hypoxemic condition secondary to OSAS. The findings of the present study indicated auditory transduction and transmission mechanisms may also be affected in moderate and severe OSAS patients. Therefore, via taking necessary steps in preventing hypoxemia at the outset, OSAS patients may be protected from the long term detrimental effects of chronic hypoxemia on the auditory system. (C) 2016 Elsevier Inc. All rights reserved.Öğe The Prevalence of Multiple Sclerosis in the North Caucasus Region of Turkey: Door-to-Door Epidemiological Field Study(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2012) Alp, Recep; Alp, Selen İlhan; Planci, Yılmaz; Yapıcı, Zuhal; Boru, Ülkü TürkBackground: The prevalence rate of multiple sclerosis (MS) might differ between countries depending on whether the data is obtained from hospital-based or population-based studies. This study aimed at identifying the prevalence of MS with face-to-face interviews by door-to-door field visits in a population study conducted in the north-eastern (Caucasus) part of Turkey situated at high altitude, with long winters and with inhabitants having low socio-economical status. Method: In this cross-sectional field study, one of every three houses within the city proper were visited searching for MS cases. Results: 7249 subjects were included in face-to-face interviews. Five patients diagnosed as having MS were identified. The prevalence of MS was calculated as 68.97/100000, with a mean age of 35.1 +/- 10.2 years and female to male ratio of 4/1. Conclusion: This study, similar to the previous population-based study conducted in our country, demonstrated that the prevalence of MS in Turkey could be higher than expected. (Archives of Neuropsychiatry 2012; 49: 272-275)Öğe The role of the three phase bone scintigraphy in the evaluation of the patients with idiopatic carpal tunnel syndrome(Springer, 2016) Ceber, Mehmet; Şahin, E.; Topçu, Birol; Alp, Recep[No Abstract Available]
