Search results for: Tumer Orhun Aykut
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20

Search results for: Tumer Orhun Aykut

20 Phytoplankton Structure and Invasive Cyanobacterial Species of Polish Temperate Lakes: Their Associations with Environmental Parameters and Findings About Their Toxic Properties

Authors: Tumer Orhun Aykut, Robin Michael Crucitti-Thoo, Agnieszka Rudak, Iwona Jasser

Abstract:

Due to eutrophication connected to the growing human population, intensive agriculture, industrialization, and reinforcement of global warming, freshwater resources are changing negatively in every region of the World. This change also concerns the replacement of native species by invasive ones that can spread in many ways. Biological invasions are a developing problem to ecosystem continuity and their presence is mostly common in freshwater bodies. The occurrence and potential invasion of the species depends on associations between abiotic and biotic variables. Due to climate change, many species can extend their range from low to high latitudes and differ in their geographic ranges. In addition, the hydrological issues strongly influence the physicochemical parameters and biological processes, especially the growth rates of species and bloom formation of Cyanobacteria. Among tropical invasive species noted in temperate Europe, Raphidiopsis raciborskii, Chrysosporum bergii, and Sphaerospermopsis aphanizomenoides are considered a serious threat. R. raciborskii being the most important one as it is already known as a highly invasive species in almost all around the World, is a freshwater, planktonic, filamentous, potentially toxic, and nitrogen-fixing Cyanobacteria. This study aimed to investigate the presence of invasive cyanobacterial species in temperate lakes in Northeastern Poland, reveal the composition of phytoplankton communities, determine the effect of environmental variables, and identify the toxic properties of invasive Cyanobacteria and other phytoplankton groups. Our study was conducted in twenty-five lakes in August 2023. The lakes represent a geographical gradient from central Poland to the Northeast and have different depths, sizes, and trophic statuses. According to performed analyses, the presence of R. raciborskii was recorded in five lakes: Szczęśliwickie (Warsaw), Mikołajskie, Rekąty, Sztynorckie (Masurian Lakeland), and further East, in Pobondzie (Suwałki Lakeland). On the other hand, C. bergii was found in three lakes: Rekąty (Masurian Lakeland), Żabinki, and Pobondzie (Suwałki Lakeland), while S. aphanizomenoides only in Pobondzie (Suwałki Lakeland). Maximum phytoplankton diversity was found in Lake Rekąty, a small and shallow lake mentioned above. The highest phytoplankton biomass was detected in highly eutrophic Lake Suskie, followed by Lake Sztynorckie. In this last lake, which is also strongly eutrophic, the highest biomass of R. raciborskii was found. Cyanophyceae had the highest biovolume and was followed by Chlorophyceae in the entire study. Numerous environmental parameters, including nutrients, were studied, and their relationships with the invasive species and the whole phytoplankton community will be presented. In addition, toxic properties of environmental DNA results from each lake will also be shown. In conclusion, investigated invasive cyanobacterial species were found in a few Northeastern Polish temperate lakes, but the number of individuals was quite low, so the biomass was quite low. It has been observed that the structure of phytoplankton changed based on lakes and environmental parameters.

Keywords: biological invasion, cyanobacteria, cyanotoxins, phytoplankton ecology, sanger sequencing

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19 Globalization and Foreign Bank Entry in Turkey

Authors: Eda Orhun

Abstract:

Turkey stayed as a closed economy until the beginning of 1980s. This changed with the de-regulation and the liberalization program that was adopted by the government at that time. This re-structuring program also affected the Turkish banking system by triggering more foreign bank entry. While the number of foreign banks have been increasing, the number of (local) private banks have been decreasing especially after the currency crisis of 2001. This outcome is largely due to increased acquisitions of (local) private banks by foreign entrants.

Keywords: acquisitions, de-regulation, foreign bank entry, globalization

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18 Investigation of Mutagenicity and DNA Binding Properties of Metal-Free and Metallophthalocyanines Containing α-Napththolbenzein Groups on the Peripheral Positions

Authors: Meltem Betül Sağlam, Halil İbrahim Güler, Aykut Sağlam

Abstract:

In this work, phthalocyanine compounds containing α-naphtholbenzeinunits have been synthesized. Mutagenicity and DNA binding properties of the compounds were investigated by Salmonella/Microsome Assay and spectrophotometer. According to the results of the preliminary range finding tests, the compounds gave no toxic effect to all tester strain S. typhimurium TA98 and TA100 at doses of 500, 1100, 350, 500 and 750 µg/plate in the presence and absence of S9, respectively. This study showed that all compounds exhibited efficient DNA-binding activity. In conclusion, these non-toxic compounds may be used as effective DNA dyes for molecular biology studies.

Keywords: dye, mutagenicity, phthalocyanine, toxicity

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17 The Role of Strategic Flexibility for Achieving Sustainable Competition Advantage and Its Effect on Business Performance

Authors: Kemalettin Eryesil, Osman Esmen, Aykut Beduk

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In this study, it has been studied to determine the relationship between business performance and strategic flexibility, which is defined to be the strategic choice that provides the ability of rapidly responding the changes of the dynamic environment of the companies, for having competitive advantages. In this context a field study has been conducted over 56 companies, which are active in informatics and electronics sectors in TEKNOKENT. As a result of the study it has been determined that; strategic flexibility has an effect on business performance and there is a positive and statistically significant relationship between strategic flexibility and business performance.

Keywords: sustainable competition advantage, strategic flexibility, firm performance, TEKNOKENT

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16 Inheritance of Protein Content and Grain Yield in Half Diallel Maize (Zea mays L.) Populations

Authors: Gül Ebru Orhun

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A half diallel crossing design was carried out during 2011 and 2012 growing seasons under Çanakkale-Turkey ecological conditions. In this research, 20 F1 maize hybrids obtained by 6x6 half diallel crossing were used. Gene action for protein content and grain yield traits were explored in half set involving six elite inbred lines. According to the results diallel analysis dominance and additive gene variances were determined for protein content. Variance/Co-variance graphs revealed for grain yield and protein content traits. In this study, inheritance of grain yield and protein content demonstrated over-dominance type of gene action.

Keywords: protein, maize, inheritance, gene action

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15 The Effect of Organizational Commitment and Burn out on Organizational Cynicism: A Field Study in the Healthcare Industry

Authors: Aykut Bedük, Kemalettin Eryeşil, Osman Eşmen

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The aim of this study is to examine the relationship between organizational commitment which is defined as a strong belief in and acceptance of the organization’s goals and values, and burnout syndrome and organizational cynicism. Accordingly, a field research based on survey method was conducted on the employees of a health institution operating in the province of Konya. The findings of the research show that there is a positive statistically significant relationship between organizational cynicism and burnout while there is a negative statistically significant relationship between organizational commitment and burnout. Furthermore, it has been also realized that there is a negative and statistically significant relationship between organizational commitment and organizational cynicism.

Keywords: burnout, organizational commitment, organizational cynicism, healthcare management

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14 Flowing Online Vehicle GPS Data Clustering Using a New Parallel K-Means Algorithm

Authors: Orhun Vural, Oguz Bayat, Rustu Akay, Osman N. Ucan

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This study presents a new parallel approach clustering of GPS data. Evaluation has been made by comparing execution time of various clustering algorithms on GPS data. This paper aims to propose a parallel based on neighborhood K-means algorithm to make it faster. The proposed parallelization approach assumes that each GPS data represents a vehicle and to communicate between vehicles close to each other after vehicles are clustered. This parallelization approach has been examined on different sized continuously changing GPS data and compared with serial K-means algorithm and other serial clustering algorithms. The results demonstrated that proposed parallel K-means algorithm has been shown to work much faster than other clustering algorithms.

Keywords: parallel k-means algorithm, parallel clustering, clustering algorithms, clustering on flowing data

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13 Photocatalytic Glucose Electrooxidation Applications of Titanium Dioxide Supported CD and CdTe Catalysts

Authors: Hilal Kivrak, Aykut ÇağLar, Nahit Aktaş, Ali Osman Solak

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At present, Cd/TiO₂ and CdTe/TiO₂ catalysts are prepared via sodium borohydride (NaBH4) reduction method. These catalysts are characterized by fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). These Cd/TiO₂ and CdTe/TiO₂ are employed as catalysts for the photocatalytic oxidation of glucose. Cyclic voltammetry (CV), chronoamperometry (CA), and electrochemical impedance spectroscopy (EIS) measurements are used to investigate their glucose electrooxidation activities of catalysts at long and under UV illumination (ʎ=354 nm). CdTe/TiO₂ catalyst is showed the best photocatalytic glucose electrooxidation activity compared to Cd/TiO₂ catalyst.

Keywords: cadmium, NaBH4 reduction method, photocatalytic glucose electrooxidation, Tellerium, TiO2

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12 Investigation of Compressive Strength of Fly Ash-Based Geopolymer Bricks with Hierarchical Bayesian Path Analysis

Authors: Ersin Sener, Ibrahim Demir, Hasan Aykut Karaboga, Kadir Kilinc

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Bayesian methods, which have very wide range of applications, are implemented to the data obtained from the production of F class fly ash-based geopolymer bricks’ experimental design. In this study, dependent variable is compressive strength, independent variables are treatment type (oven and steam), treatment time, molding time, temperature, water absorbtion ratio and density. The effect of independent variables on compressive strength is investigated. There is no difference among treatment types, but there is a correlation between independent variables. Therefore, hierarchical Bayesian path analysis is applied. In consequence of analysis we specified that treatment time, temperature and density effects on compressive strength is higher, molding time, and water absorbtion ratio is relatively low.

Keywords: experimental design, F class fly ash, geopolymer bricks, hierarchical Bayesian path analysis

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11 Tree-Based Inference for Regionalization: A Comparative Study of Global Topological Perturbation Methods

Authors: Orhun Aydin, Mark V. Janikas, Rodrigo Alves, Renato Assuncao

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In this paper, a tree-based perturbation methodology for regionalization inference is presented. Regionalization is a constrained optimization problem that aims to create groups with similar attributes while satisfying spatial contiguity constraints. Similar to any constrained optimization problem, the spatial constraint may hinder convergence to some global minima, resulting in spatially contiguous members of a group with dissimilar attributes. This paper presents a general methodology for rigorously perturbing spatial constraints through the use of random spanning trees. The general framework presented can be used to quantify the effect of the spatial constraints in the overall regionalization result. We compare several types of stochastic spanning trees used in inference problems such as fuzzy regionalization and determining the number of regions. Performance of stochastic spanning trees is juxtaposed against the traditional permutation-based hypothesis testing frequently used in spatial statistics. Inference results for fuzzy regionalization and determining the number of regions is presented on the Local Area Personal Incomes for Texas Counties provided by the Bureau of Economic Analysis.

Keywords: regionalization, constrained clustering, probabilistic inference, fuzzy clustering

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10 A Feminist Approach to the COVID-19 Lockdown Process in Turkey

Authors: Aykut Sigin

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In feminist theory, home is usually regarded as an unsafe place for women to be in, as it continually produces inequalities between men and women, favoring the former, and maintains the patriarchal status quo. The second-wave feminists argued that women need to raise their concerns regarding domestic problems and this eventually led to the emergence of the motto 'the personal is political', pointing out to the fact that the domestic problems one woman experienced were essentially the problems of women in general as the patriarchal ideology manifested itself at home. Although this motto was from the late 1960s, it still holds significance today. In the golden era of the Internet, women could use social media to voice their concerns more easily than ever. Following this line of thought, the aim of this study is to analyze the domestic problems of the women in Turkey during the lockdown caused by COVID-19 through social media as they find themselves at home with their fathers, husbands and/or brothers for longer periods of time than ever before. For this purpose, an investigation of the posts shared under '#EvdeKal' ('StayAtHome') was carried out. The results of the study made it clear that women find the lockdown process to be problematic, that they express their domestic concerns rather freely through social media, and that the inequalities caused by the patriarchal ideology persist in the 21st century.

Keywords: COVID-19, lockdown, home, feminism

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9 The Persistent English Language Gap between the Direct Entry and Foundation Program University Students: Empirical Evidence from the UAE

Authors: Eda Orhun

Abstract:

This paper studies the IELTS exit scores of Emirati university students before graduation and specifically compares the IELTS exit performance of the English foundation program (FP) students to direct entry (DE) students. Direct entry (DE) students are the students who were able to directly start with the undergraduate program without the need to attend English foundation program courses as they were able to prove a sufficient level of English at the university admittance. The results clearly show that the gap that existed already between these two groups of students at the start does not seem to disappear at the end of university studies, as DE students’ IELTS exit scores are significantly higher compared to FP students. Further work of a regression analysis exhibits that GPA and CMATH scores do have a positive and significant effect on IELTS exit scores. In addition, while the College of Education students are found to have the lowest performance in every sub-section of the IELTS exam across colleges, students of the College of Humanities and Social Sciences and the College of Natural and Health Sciences seem to have the best reading skills. Another important determinant of IELTS exit scores is found to be the English level of students at inception. With these results, the study offers important policy implications regarding the public education system of the UAE and sheds light on the main roots of the problem.

Keywords: English proficiency, higher education, IELTS exit scores, English foundation program, United Arab Emirates

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8 Public and Private Spaces Producing Social Connectedness in Traditional Environment: A Study on Old Medina District of Casablanca

Authors: Asmaa Sokrat, Aykut Karaman

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Public and private spaces are major components of the morphology of the city. This research aims to study the interactions between public and private domains in terms of urban space in Casablanca. The research focuses on a general vision of a socio-spatial issue. It plans to identify the public, private, and transition (semi-public, semi-private) spaces as the constituent of the urban space. Moreover, the study investigates the link between public and private spaces with the social dimensions. Additionally, the research argues that the public space is a place of social interaction; as a reflection, this interaction is the intersection between urban space and social connectedness. Besides, social interaction can be the key to distinguishing between the public and private spheres. The methodological approach of the research is based on the literature review and field study. The article is targeting a case study on the old Medina of Casablanca, from daily use of the public and private spaces, the urban tissue, and the urban space types. In conclusion, the research exhibits that a public space could influence the privacy of the residents of a local urban area; thus, this privacy is inverted on the social interaction. This social interaction is the link between the urban space and social connectedness. Hence, this equation affects the typology of the private space.

Keywords: public sphere, private sphere, social connectedness, old Medina of Casablanca

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7 Visual Analysis of Picturesque Urban Landscape Case of Sultanahmet, Istanbul

Authors: Saidu Dalhat Dansadau, Aykut Karaman

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The integration of photography into architecture was a pivotal point in the journey of architectural representation; photography proved itself useful for the betterment of architecture early on, as well as established itself as a necessary tool in the realm of architecture. The main study this paper was extracted from looked into the inquiry of knowing exactly what are the key picturesque locations/structures in Sultanahmet, Fatih-Istanbul, and how can their spatial distribution and cultural significance be characterized and mapped for urban design and development as well as the secondary objective, of which this paper focuses on, is to “Investigate the role of perception in urban environments and how photography serves as a tool for capturing and conveying the perception of Sultanahmet's picturesque structures/locations”. The study achieved these objectives by utilizing methodologies such as geo-tagged photography, sequential photography, social media metadata extraction, GIS mapping, spatial analysis, and visual analysis, focusing on the historically rich and culturally significant study area of Sultanahmet, Fatih-Istanbul. By looking at potential structures/locations and then dissecting their special distribution and cultural significance, the main study was able to achieve the main objective as well as unveil a more nuanced understanding of the dynamics between photography, architecture, and urban design with respect to perception using sequential photography.

Keywords: perception, architectural photography, picturesque, urban design, Sultanahmet, Istanbul

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6 Two-Sided Information Dissemination in Takeovers: Disclosure and Media

Authors: Eda Orhun

Abstract:

Purpose: This paper analyzes a target firm’s decision to voluntarily disclose information during a takeover event and the effect of such disclosures on the outcome of the takeover. Such voluntary disclosures especially in the form of earnings forecasts made around takeover events may affect shareholders’ decisions about the target firm’s value and in return takeover result. This study aims to shed light on this question. Design/methodology/approach: The paper tries to understand the role of voluntary disclosures by target firms during a takeover event in the likelihood of takeover success both theoretically and empirically. A game-theoretical model is set up to analyze the voluntary disclosure decision of a target firm to inform the shareholders about its real worth. The empirical implication of model is tested by employing binary outcome models where the disclosure variable is obtained by identifying the target firms in the sample that provide positive news by issuing increasing management earnings forecasts. Findings: The model predicts that a voluntary disclosure of positive information by the target decreases the likelihood that the takeover succeeds. The empirical analysis confirms this prediction by showing that positive earnings forecasts by target firms during takeover events increase the probability of takeover failure. Overall, it is shown that information dissemination through voluntary disclosures by target firms is an important factor affecting takeover outcomes. Originality/Value: This study is the first to the author's knowledge that studies the impact of voluntary disclosures by the target firm during a takeover event on the likelihood of takeover success. The results contribute to information economics, corporate finance and M&As literatures.

Keywords: takeovers, target firm, voluntary disclosures, earnings forecasts, takeover success

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5 Analysis of Thermal Effect on Functionally Graded Micro-Beam via Mixed Finite Element Method

Authors: Cagri Mollamahmutoglu, Ali Mercan, Aykut Levent

Abstract:

Studies concerning the microstructures are becoming more important as the utilization of various micro-electro mechanical systems (MEMS) are increasing. Thus in recent years, thermal buckling and vibration analysis of microstructures have been subject to many investigations that are utilizing different numerical methods. In this study, thermal effects on mechanical response of a functionally graded (FG) Timoshenko micro-beam are presented in the framework of a mixed finite element formulation. Size effects are taken into consideration via modified couple stress theory. The mixed formulation is based on a function which in turn is derived via Gateaux Differential scientifically. After the resolution of all field equations of the beam, a potential operator is carefully constructed. Then this operator is used for the manufacturing of the functional. Usual procedures of finite element approximation are utilized for the derivation of the mixed finite element equations once the potential is obtained. Resulting finite element formulation allows usage of C₀ type simple linear shape functions and avoids shear-locking phenomena, which is a common shortcoming of the displacement-based formulations of moderately thick beams. The developed numerical scheme is used to obtain the effects of thermal loads on the static bending, free vibration and buckling of FG Timoshenko micro-beams for different power-law parameters, aspect ratios and boundary conditions. The versatility of the mixed formulation is presented over other numerical methods such as generalized differential quadrature method (GDQM). Another attractive property of the formulation is that it allows direct calculation of the contribution of micro effects on the overall mechanical response.

Keywords: micro-beam, functionally graded materials, thermal effect, mixed finite element method

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4 Descriptive Assessment of Health and Safety Regulations and Its Current Situation in the Construction Industry of Pakistan

Authors: Khawaja A. Wahaj Wani, Aykut Erkal

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Pakistan's construction industry, a key player in economic development, has experienced remarkable growth. However, the surge in activities has been accompanied by dangerous working conditions, attributed to legislative gaps and flaws. Unhealthy construction practices, uncertain site conditions, and hazardous environments contribute to a concerning rate of injuries and fatalities. The principal aim of this research study is to undertake a thorough evaluation based on the assessment of the current situation of Health & Safety policies and the surveys performed by stakeholders of Pakistan with the aim of providing solution-centric methodologies for the enforcement of health and safety regulations within construction companies operating on project sites. Recognizing the pivotal role that the construction industry plays in bolstering a nation's economy, it is imperative to address the pressing need for heightened awareness among site engineers and laborers. The study adopts a robust approach, utilizing questionnaire surveys and interviews. As an exclusive investigative study, it encompasses all stakeholders: clients, consultants, contractors, and subcontractors. Targeting PEC-registered companies. Safety performance was assessed through the examination of sixty safety procedures using SPSS-18. A high Cronbach's alpha value of 0.958 ensures data reliability, and non-parametric tests were employed due to the non-normal distribution of data. The safety performance evaluation revealed significant insights. "Using Hoists and Cranes" and "Precautionary Measures (Shoring and Excavation)" exhibited commendable safety levels. Conversely, "Trainings on Safety" displayed a lower safety performance, alongside areas such as "Safety in Contract Documentation," "Meetings for Safety," and "Worker Participation," indicating room for improvement. These findings provide stakeholders with a detailed understanding of current safety measures within Pakistan's construction industry.

Keywords: construction industry, health and safety regulations, Pakistan, risk management

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3 Determination of the Vaccine Induced Immunodominant Regions of Nucleoprotein Crimean-Congo Hemorrhagic Fever Virus

Authors: Engin Berber, Nurettin Canakoglu, Ibrahim Sozdutmaz, Merve Caliskan, Shaikh Terkis Islam Pavel, Hazel Yetiskin, Aykut Ozdarendeli

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Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus in the family Bunyaviridae, genus Nairovirus. The CCHFV genome consists of three molecules of negative-sense single-stranded RNA, each encapsulated separately. The virion particle contains viral RNA polymerase (L segment), surface glycoproteins Gn and Gc (Msegment), and a nucleocapsid protein NP (S segment). CCHF is characterized by high case mortality, occurring in Asia, Africa, the Middle East and Eastern Europe. Clinical CCHF was first recognized in Turkey in 2002. The numbers of CCHF cases have gradually increased in Turkey making the virus a public health concern. Between 2002 and 2014, more than 8000 the CCHF cases have been reported in Turkey and mortality rate is around 5%. So, Turkey is one of the countries where the epidemy has become spread to the wider geography and the biggest outbreaks of CCHF have occurred in the world. We have recently developed an inactivated cell-culture based vaccine against CCHF. We have showed that the Balb/c mice immunized with the CCHF vaccine induced the high level of neutralizing antibodies. In this study, we aimed to determine the immunodominant regions of nucleoprotein (NP) CCHFV Kelkit06 strain which stimulate T cells. For this purpose, pools of overlapping NP were used for an IFN- γ ELISPOT assay. Balb/c mice were divided into two groups for the experiment. Two groups (n = 10 each) were immunized via the intraperitoneal route with 5, or 10μg of the cell culture-based vaccine. The control group (n = 6) was mock immunized with PBS. Booster injections with the same formulation were given on days 21 and 42 after the first immunization. The higher reactivity against the CCHFV NP pools 31-40 and 80-90 was determined in the two dose groups. In order to analyze the vaccine-induced T cell responses in Balb/c mice immunized with varying doses of the vaccine, we have been also currently working on CD4+, CD8+ and CD3 + T cells by flow cytometry.

Keywords: Crimean-Congo hemorrhagic fever virus, immunodominant regions of NP, T cell response, vaccine

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2 A Mixed Finite Element Formulation for Functionally Graded Micro-Beam Resting on Two-Parameter Elastic Foundation

Authors: Cagri Mollamahmutoglu, Aykut Levent, Ali Mercan

Abstract:

Micro-beams are one of the most common components of Nano-Electromechanical Systems (NEMS) and Micro Electromechanical Systems (MEMS). For this reason, static bending, buckling, and free vibration analysis of micro-beams have been the subject of many studies. In addition, micro-beams restrained with elastic type foundations have been of particular interest. In the analysis of microstructures, closed-form solutions are proposed when available, but most of the time solutions are based on numerical methods due to the complex nature of the resulting differential equations. Thus, a robust and efficient solution method has great importance. In this study, a mixed finite element formulation is obtained for a functionally graded Timoshenko micro-beam resting on two-parameter elastic foundation. In the formulation modified couple stress theory is utilized for the micro-scale effects. The equation of motion and boundary conditions are derived according to Hamilton’s principle. A functional, derived through a scientific procedure based on Gateaux Differential, is proposed for the bending and buckling analysis which is equivalent to the governing equations and boundary conditions. Most important advantage of the formulation is that the mixed finite element formulation allows usage of C₀ type continuous shape functions. Thus shear-locking is avoided in a built-in manner. Also, element matrices are sparsely populated and can be easily calculated with closed-form integration. In this framework results concerning the effects of micro-scale length parameter, power-law parameter, aspect ratio and coefficients of partially or fully continuous elastic foundation over the static bending, buckling, and free vibration response of FG-micro-beam under various boundary conditions are presented and compared with existing literature. Performance characteristics of the presented formulation were evaluated concerning other numerical methods such as generalized differential quadrature method (GDQM). It is found that with less computational burden similar convergence characteristics were obtained. Moreover, formulation also includes a direct calculation of the micro-scale related contributions to the structural response as well.

Keywords: micro-beam, functionally graded materials, two-paramater elastic foundation, mixed finite element method

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1 Epigastric Pain in Emergency Room: Median Arcuate Ligament Syndrome

Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

Abstract:

Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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