Retraction to: Shear strength of extremely altered serpentinites based on degree of saturation (Ankara, Turkey)

The Editor in Chief has retracted this article.After publication,concerns were raised over potentially inconsistent data-for example,the author mentioned residual soil with silt fraction,but Fig.5 shows even the smallest grains are beyond silt grains.Further analysis showed that Fig.6 and Fig.9 show both loose and dense soils exhibiting very similar dilatance behaviour,which is not typical.The author shared raw data,but it was incomplete and could not be verified.The Editor in Chief,therefore,has lost confidence in the findings of this article.The author does not agree to this retraction.

Effect of gamification applications on success of dentistry students

BACKGROUND Gamification,the use of game materials in education,has been used in several scientific fields,and studies have demonstrated its effectiveness in student comprehension.AIM To evaluate whether the success of 4th-and 5th-grade dentistry students increases when using the gamification applications Kahoot!and Mentimeter.METHODS An experimental design was used to measure the effect of gamification applications on students who were taught using the traditional method.For this purpose,Mentimeter and Kahoot!applications were used in this experimental study.Three groups of 4th-and 5th-grade students were formed:Mentimeter,Kahoot!,and control groups.The effect of gamification applications on achievement was evaluated by administering a post-test to these groups after the instructional process.One-way analysis of variance and t-tests were used for statistical analyses.RESULTS A total of 35.5%of the students were in the Mentimeter group,29.8%in the Kahoot!group,and 34.6%in the control group.Of the total number of students,54.8%were female and 45.2%were male,while 52.2%were 5th-grade students and 47.8%were 4th-grade students.The overall grade point average was found to be 66.65(range,24-100).There was a statistically significant difference in average success scores between students of different groups(P=0.003<0.05)and grades(P=0.036<0.05).The average success score was the highest in the Mentimeter group(71.64)and the lowest in the Kahoot!group(62.15).In the control group,this score was 65.41.The average success score was higher for students in the 5thgrade(68.16)and for female students(68.84).CONCLUSION Gamification has a great potential in the education of dentomaxillofacial radiology students.Mentimeter outperformed both the Kahoot!and the traditional method in terms of average student success rates.

Daily Ambrosia Pollen Concentration in the Air of Ankara,Turkey (1990-1999)

The airborne ragweed pollen spectrum was investigated in the air of Ankara, Turkey for aperiod of ten years (1990-1999) using a Burkard seven-day volumetric recording trap. In our study period,long distance transported Ambrosia pollen has been registered. Daily pollen levels varied from low to highin Burge抯 system. In last three years, the pollen concentration of Ambrosia showed a clear increasingtendency. Our results prove that ragweed pollen may be an important threat for ragweed sensitive patientsin Ankara city in near future.

Shear strength of extremely altered serpentinites based on degree of saturation(Ankara, Turkey)

The term "mélange" has several definitions due to the origin, tectonic and petrographical features. The geotechnical engineering behaviors of mélanges are either dominated by different kinds of intact rock blocks or matrix material. Landslides were encountered within the serpentinite matrix of Ankara Mélange, which is a typical bimrock mass. The residual sections of the extremely altered serpentinites are sandy soils. Such soils undergo rapid change of saturation, leading to shear strength reduction. Undisturbed and disturbed samples were obtained from the outcrops for shear box tests. Geochemical and petrographical composition of the serpentinites were determined by XRF(X Ray Fluorescence), XRD(X-ray diffraction) and thin section inspections, in order to outline the alteration process. Based on field observations, physically decomposed core stones exist beneath 40-120 cm thick residual green and grey-dark grey residual sandy soil. Physical and mechanical properties of the soils were tested with particular emphasis on residual shear strength parameters. Disturbed samples were remolded by standard compaction. The field work was completed during both rainy and summer seasons. Disturbed samples were prepared using phase diagrams in order to attain varying saturation degree. Two distinct sandy soil groups were determined through classification tests. The volumetric compression and/or expansion of the loose and dense samples were also considered based on the angle of dilatancy. A series of consolidated and drained shear box tests were conducted with ascending degree of saturation. The reduction of effective apparent cohesion, internal friction angle and dilatancy angle were determined to obtain a threshold of the degree of saturation. All the sand samples had zero residual internal friction angle and/or apparent cohesion after reaching 70% degree of saturation.

Factors Controlling Low Uranium and Thorium Concentrations in the Cayirhan Bituminous Shales(CBS)in the Beypazari(Ankara)Area,Turkey

In this study uranium and thorium contents and depositional characteristics of ay rhan bituminous shales（ BS）, west of Ankara（central Anatolia）, are investigated. Samples used were collected from boreholes opened by Park Holding Ltd. A total of 25 samples were taken from bituminous shale levels in boreholes drilled at 6 different locations in the study area. The H rka formation which hosts bituminous shale deposits is a volcanosedimentary sequence and all lithofacies indicate that a lacustrine environment where the water level was continuously changed. In addition to hydrocarbon generation potential, bituminous shales also accumulate significant amount of radioactive elements such as uranium and thorium. The average uranium and thorium concentrations of BS（1.83/2.62 ppm） are much lower than averages of UC, NASK and PAAS（uranium： 2.70/2.66/3.10 ppm; thorium： 8.50/12.30/14.60 ppm）. Low uranium contents in comparison to those of similar lacustrine environments might be attributed to that waters of depositional environment of BS contain low concentration of dissolved uranium and redox conditions were of oxic and dioxic character. Correlation data indicate that U and Th have a similar source and are associated predominantly with clays and phosphates and dominantly with organic material. Radioactive elements in the basin might be derived from Paleozoic granites and metamorphites（e.g. gneiss, schist） which comprise the basement and volcanism which was active in the region throughout the Miocene period. These elements are probably associated with uraniferous phosphate minerals（e.g. autunite, torbernite） which occur in granite, gneiss and schist. BS with average TOC content of 10.96 % shows very good/perfect source rock potential. Positive correlations between Gamma-Ray values and U, Th and K concentrations imply that radioactivity might be originated from these three elements.

Organic Material and Trace Elements of Bituminous Rocks in the Ozank(?)y Field,Ankara,Turkey

Bituminous rocks in the Ozankoey （Ankara） field are different from those of the Paleocene- Eocene Mengen and Giineytepe （Bolu） regions in metal enrichment levels. Organic carbon （Corg） content of organic material-rich rocks in the Ozankoey （Ankara） field is 3.66-40.72% wt averaging 14.34%. The dominant organic materials are algae/amorphous accompanied by minor amount of herbaceous material （The dominant kerogen type is Type-I with a limited amount of Type-Ⅱ kerogen.）. The bituminous rocks in the Ozankoey field are enriched in heavy metals such as Ni, Mn, As and Cr. In comparison with the average enrichment values of dements, Ni, Mn, As and Cr in bituminous shales of the Ozankoey field are as about 4.38, 14.93, 10.90 and 5.58 times as average values. The average concentrations of these heavy metals are also as high as 215× 10^-6, 828 × 10^-6, 58.54 × 10^-6, and 148 × 10^-6 respectively. In addition, sorption properties of day and organic materials are also important for metal enrichments in the bituminous shales.

Demographic features and histopathological diagnosis in primary eyelid tumors: results over 19 years from a tertiary center in Ankara, Turkey

AIM:To evaluate the demographic features,location,and histopathologic results in primary eyelid tumors.METHODS:We retrospectively reviewed the records of patients with primary eyelid tumor diagnosed and treated between November 1997 and June 2016 on our service.RESULTS:Nine hundred and eleven lesions from 874 patients were included in this study.Four hundred and fortysix(51.0%)of the patients were females and 428(49.0%)were males.The mean age was 51.0y(range:3 mo-94 y).The lesions were located in the upper eyelid(418 cases,45.9%),lower eyelid(378 cases,41.5%),medial canthus(89 cases,9.8%),and lateral canthus(26 cases,2.8%).Four hundred and seventy(51.6%)lesions were located on the right side and 441(48.4%)on the left.Of the eyelid lesions,666(73.1%)were benign,230(25.2%)malignant,and 15(1.6%)premalignant.When the eyelid tumors were classified according to their tissue or cell of origin,527(57.8%)of the lesions were found to be epidermal,171(18.8%)adnexal,131(14.4%)inflammatory and infectious,and 65(7.1%)stromal.The most common benign lesions were squamous cell papilloma(139 lesions,15.2%),intradermal nevus(97 lesions,10.6%),epidermoid inclusion cysts(78 lesions,8.6%),seborrheic keratosis(60 lesions,6.6%),and inflammatory masses(59 lesions,6.5%).Basal cell carcinoma was the most common malignant tumor(191 lesions,21.0%)followed by squamous cell carcinoma(16 lesions,1.8%),sebaceous carcinoma(14 lesions,1.5%),and malignant melanoma(5 lesions,0.5%).CONCLUSION:In this study,73.1%of eyelid lesions are benign and the remaining 26.9%are premalignant and malignant.Basal cell carcinoma is the most common tumor among all histopathological diagnosis followed by squamous papilloma.

Dysregulation of RNA modification systems in clinical populations with neurocognitive disorders

The study of modified RNA known as epitranscriptomics has become increasingly relevant in our understanding of disease-modifying mechanisms.Methylation of N6 adenosine(m^(6)A)and C5 cytosine(m^(5)C)bases occur on mRNAs,tRNA,mt-tRNA,and rRNA species as well as non-coding RNAs.With emerging knowledge of RNA binding proteins that act as writer,reader,and eraser effector proteins,comes a new understanding of physiological processes controlled by these systems.Such processes when spatiotemporally disrupted within cellular nanodomains in highly specialized tissues such as the brain,give rise to different forms of disease.In this review,we discuss accumulating evidence that changes in the m^(6)A and m^(5)C methylation systems contribute to neurocognitive disorders.Early studies first identified mutations within FMR1 to cause intellectual disability Fragile X syndromes several years before FMR1 was identified as an m^(6)A RNA reader protein.Subsequently,familial mutations within the m^(6)A writer gene METTL5,m^(5)C writer genes NSUN2,NSUN3,NSUN5,and NSUN6,as well as THOC2 and THOC6 that form a protein complex with the m^(5)C reader protein ALYREF,were recognized to cause intellectual development disorders.Similarly,differences in expression of the m^(5)C writer and reader effector proteins,NSUN6,NSUN7,and ALYREF in brain tissue are indicated in individuals with Alzheimer's disease,individuals with a high neuropathological load or have suffered traumatic brain injury.Likewise,an abundance of m^(6)A reader and anti-reader proteins are reported to change across brain regions in Lewy bodies diseases,Alzheimer's disease,and individuals with high cognitive reserve.m^(6)A-modified RNAs are also reported significantly more abundant in dementia with Lewy bodies brain tissue but significantly reduced in Parkinson's disease tissue,whilst modified RNAs are misplaced within diseased cells,particularly where synapses are located.In parahippocampal brain tissue,m^(6)A modification is enriched in transcripts associated with psychiatric disorders including conditions with clear cognitive deficits.These findings indicate a diverse set of molecular mechanisms are influenced by RNA methylation systems that can cause neuronal and synaptic dysfunction underlying neurocognitive disorders.Targeting these RNA modification systems brings new prospects for neural regenerative therapies.

Personalized medicine and opioid use disorder

Opioid use disorder(OUD)is a major public health problem affecting millions of people worldwide.Although OUD is a chronic and relapsing disorder,a variety of pharmacological and non-pharmacological interventions are available.Medication-assisted treatment of OUD generally relies on competition for opioid receptors against the addictive substance.The mechanisms of this competition are to block or inactivate the opioid receptor or activate the receptor with a substance that is intermittent or long acting.Methadone and buprenorphine are two United States Food and Drug Administration-approved medications that have long-term positive effects on the health of opioid-dependent individuals.Although clinical studies of drugs generally demonstrate efficacy in thousands of people and toxicity is excluded,it cannot be predicted whether the given drug will cause side effects in one of the patients at the treatment dose.Individual differences can be explained by many biological and environmental factors.Variations in genes encoding drug metabolism or cellular drug targets significantly explain the variability in drug response between individuals.Therefore,for the effects of candidate genes to be accepted and included in individual treatment protocols,it is important to repeat studies on individuals of different ethnic backgrounds and prove a similar effect.

Surgical treatment of a rare brachial artery aneurysm postarteriovenous fistula closure after kidney transplant:A case report

BACKGROUND Brachial artery aneurysms are defined as dilations greater than 50%of the normal diameter,which are rare among all peripheral arterial aneurysms.While they are often present as pseudoaneurysms,true brachial artery aneurysms are also detected rarely.In this case report,the surgical repair method of true brachial artery aneurysms,which is a rare condition,is explained.CASE SUMMARY Herein,we present a 61-year-old male patient with complaints of swelling and pain in the right arm antecubital region that had been progressing over 6 mo.Upon the diagnosis of a true brachial artery aneurysm associated with arteriovenous fistula,the aneurysm was surgically repaired with an autologous saphenous vein graft.The patient was discharged without any neurovascular complications postoperatively.CONCLUSION True brachial artery aneurysms are rare and there are not any recommendations for their management in the current literature.Even though the treatment of true aneurysms in this artery is primarily based on a surgical treatment,endovascular repair also might be an option.

Inhibition of Ehrlich ascites carcinoma growth by melatonin:Studies with micro-CT

Melatonin is a versatile indolamine synthesized and secreted by the pineal gland in response to the photoperiodic information received by the retinohypothalamic signaling pathway.Melatonin has many benefits,such as organizing circadian rhythms and acting as a powerful hormone.We aimed to show the antitumor effects of melatonin in both in vivo and in vitro models through the mammalian target of rapamycin(mTOR)signaling pathway and the Argyrophilic Nucleolar Regulatory Region(AgNOR),using the Microcomputed Tomography(Micro CT).Ehrlich ascites carcinoma(EAC)cells were administered into the mice by subcutaneous injection.Animals with solid tumors were injected intraperitoneally with 50 and 100 mg/kg melatonin for 14 days.Volumetric measurements for the taken tumors were made with micro-CT imaging,immunohistochemistry(IHC),real-time polymerase chain reaction(PCR)and AgNOR.Statistically,the tumor tissue volume in the Tumor+100 mg/kg melatonin group was significantly lower than that in the other groups in the data obtained from micro-CT images.In the IHC analysis,the groups treated with Tumor+100 mg/kg melatonin were compared when the mTOR signaling pathway and factor 8(F8)expression were compared with the control group.It was determined that there was a significant decrease(p<0.05).Significant differences were found in the total AgNOR area/nuclear area(TAA/NA)ratio in the treatment groups(p<0.05).Furthermore,there were significant differences between the amount of mTOR mRNA for the phosphatidylinositol 3-kinase(PI3K),AKT Serine/Threonine Kinase(PKB/AKT)genes(p<0.05).Cell apoptosis was evaluated with Annexin V in an in vitro study with different doses of melatonin;It was observed that 100µg/mL melatonin dose caused an increase in the apoptotic cell death.In this study,we have reported anti-tumor effects of melatonin in cell culture studies as well as in mice models.Comprehensive characterization of the melatonin-mediated cancer inhibitory effects will be valuable in advancing our fundamental molecular understanding and translatability of pre-clinical findings to earlier phases of clinical trials.

Confirmation of a Sub-Saturn-size Transiting Exoplanet Orbiting a G Dwarf:TOI-1194 b and a Very Low Mass Companion Star: TOI-1251 B from TESS

We report the confirmation of a sub-Saturn-size exoplanet,TOI-1194 b,with a mass of about 0.456+0.055-0.051M_(J),and a very low mass companion star with a mass of about 96.5±1.5 MJ,TOI-1251 B.Exoplanet candidates provided by the Transiting Exoplanet Survey Satellite(TESS)are suitable for further follow-up observations by ground-based telescopes with small and medium apertures.The analysis is performed based on data from several telescopes worldwide,including telescopes in the Sino-German multiband photometric campaign,which aimed at confirming TESS Objects of Interest(TOIs)using ground-based small-aperture and medium-aperture telescopes,especially for long-period targets.TOI-1194 b is confirmed based on the consistent periodic transit depths from the multiband photometric data.We measure an orbital period of 2.310644±0.000001 days,the radius is 0.767+0.045-0.041RJ and the amplitude of the RV curve is 69.4_(-7.3)^(+7.9)m s^(-1).TOI-1251 B is confirmed based on the multiband photometric and high-resolution spectroscopic data,whose orbital period is 5.963054+0.000002-0.000001days,radius is 0.947+0.035-0.033 R_(J) and amplitude of the RV curve is 9849_(-40)^(+42)ms^(-1).

海鞘内生真菌焦曲霉Aspergillus ustus TK-5的化学成分研究

焦曲霉(Aspergillusustus)TK-5是分离自土耳其海域海鞘(Pyuramomus)新鲜组织中的一株内生真菌,利用正相与反相硅胶柱层析、葡聚糖凝胶Sephadex LH-20柱层析以及高效液相制备等色谱方法从其发酵产物中分离得到17个化合物,通过一维、二维核磁共振、质谱等技术鉴定了所有化合物的结构,分别为血苋烷型倍半萜类化合物strobilactone A(1), ustusolate E(2), ustusolate C(3), ustusolate D(4),11-hydroustusolate E(5), 11, 6’-hydroustusolate E(6),(2’E, 4’E, 6’E)-6-(1’-carboxyocta-2’, 4’, 6’-triene)-11,12-epoxy-9, 11-dihydroxydrim-7-ene(7), 12-hydroxy-6-epi-albrassitriol (8), ustusolate A (9), deoxyuvidin B(10)和二倍半萜类化合物6-epi-ophiobolinG(11),(6α)-21,21-O-dihydroophiobolinG(12),6-epi-ophiobolin K(13), ophiobolin P(14) ophiobolin H(15), ophiobolin Q(16)及ophiobolin R(17)。活性筛选表明化合物2、6、7、9、11和13对神经氨酸酶具有一定的抑制活性,其半数抑制浓度(IC50)分别为31.8、37.3、28.4、36.8、46.6和37.6μmol/L。

Liver histology according to the presence of metabolic syndrome in nonalcoholic fatty liver disease cases

AIM:To investigate the histologic features of the liver in nonalcoholic fatty liver disease (NAFLD) cases according to the presence of metabolic syndrome or its individual components. METHODS:We enrolled 81 patients (40 male,41 fe-male) who were diagnosed with fatty liver by ultraso-nographic scan and fulfi lled the inclusion criteria. First anamnesis,anthropometric,clinical,laboratory and imaging features of all participants were recorded and then liver biopsy was performed after gaining consent from patients. Diagnosis of metabolic syndrome was dependent on patients having 3 or more out of 5 risk criteria defined by the WHO. Biopsy specimens were assessed according to Brunt et al's classification. RESULTS:Sixty-nine of the 81 patients had nonalco-holic steatohepatitis (NASH),11 had simple fatty liver and 1 had cirrhosis according to histologic evaluation. Comparisons were made between two groups of NASH patients,those with and without metabolic syndrome. We did not detect statistically significant differences in liver histology between NASH patients with and wit-hout metabolic syndrome. CONCLUSION:NASH can progress without metabolic risk factors or the presence of metabolic syndrome.

Pegylated interferon-alpha plus taurine in treatment of rat liver fibrosis

AIM: To investigate the antif ibrotic effects of peginterferon- alpha 2b and taurine on oxidative stress markers and hepatocellular apoptosis. METHODS: Sixty rats with CCl4-induced liver fibrosis were divided into 4 groups (n = 15). Group 1 was left for spontaneous recovery (SR). Groups 2-4 received peginterferon-alpha 2b, taurine, and their combination, respectively, for four weeks. Histological f ibrosis scores, histomorphometric analysis, tissue hydroxyproline, tissue MDA, GPx and SOD activities were determined. Activated stellate cells and hepatocellular apoptosis were also evaluated. RESULTS: The degree of f ibrosis decreased in all treatment groups compared to spontaneous recovery group. Taurine alone and in combination with peginterferon-alpha 2b reduced oxidative stress markers, but peginterferon-alpha 2b alone did not. Apoptotic hepatocytes and activated stellate cells were higher in groups 2-4 than in group 1. Combined taurine and peginterferon-alpha 2b further reduced fibrosis and increased activated stellate cell apoptosis, but could not improve oxidative stress more than taurine alone.CONCLUSION: Peginterferon-alpha 2b exerts anti- f ibrotic effects on rat liver fibrosis. It seems ineffective against oxidative stress in vivo. Peginterferon-alpha 2b in combination with taurine seems to be an antif ibrotic strategy.

Examining the whole bowel, double balloon enteroscopy: Indications, diagnostic yield and complications

Double balloon enteroscopy(DBE) is an advanced type of endoscopic procedure which brings the advantage of reaching the whole small bowel using anterograde or the retrograde route. This procedure is both diagnostic and interventional for a variety of small intestinal diseases, such as vascular lesions, tumors, polyps and involvement of inflammatory bowel diseases.Main indication is the diagnosis and treatment of mid-gastrointestinal bleeding according to the recent published data all over the world. The complication rates seem to be higher than conventional procedures but growing experience is lowering them and improving the procedure to be safe and well tolerated. This review is about the technique, indications, diagnostic importance and complications of DBE according to the literature growing since 2001.

Catalytic performance of Cu-and Zr-modified beta zeolite catalysts in the methylation of 2-methylnaphthalene

2,6-Dimethylnaphthalene(2,6-DMN) is a commercially important chemical for the production of polyethylenenaphthalate and polybutylene naphthalate. However, its complex synthesis procedure and high production cost significantly reduce the use of 2,6-DMN. In this study, the synthesis of 2,6-DMN was investigated with methylation of 2-methylnaphthalene(2-MN) over metal-loaded beta zeolite catalysts including beta zeolite, Cu-impregnated beta zeolite and Zr-impregnated beta zeolite. The experiments were performed in a fixed-bed reactor at atmospheric pressure under a nitrogen atmosphere. The reactor was operated at a temperature range of 400–500 °C and varying weight hourly space velocity between 1 and 3 h^(-1).The results demonstrated that 2,6-DMN can be synthesized by methylation of 2-MN over beta type zeolite catalysts.Besides 2,6-DMN, the product stream also contained other DMN isomers such as 2,7-DMN, 1,3-DMN, 1,2-DMN and 2,3-DMN. The activity and selectivity of beta zeolite catalyst were remarkably enhanced by Zr impregnation, whereas Cu modification of beta zeolite catalyst had an insignificant effect on its selectivity. The highest conversion of 2-MN reached81%, the highest ratio of 2,6-DMN/2,7-DMN reached 2.6 and the highest selectivity of 2,6-DMN was found to be 20% by using Zr-modified beta zeolite catalyst.

Use of cone beam computed tomography in periodontology

Diagnosis of periodontal disease mainly depends on clinical signs and symptoms. However, in the case of bone destruction, radiographs are valuable diagnostic tools as an adjunct to the clinical examination. Two dimensional periapical and panoramic radiographs are routinely used for diagnosing periodontal bone levels. In two dimensional imaging, evaluation of bone craters, lamina dura and periodontal bone level is limited by projection geometry and superpositions of adjacent anatomical structures. Those limitations of 2D radiographs can be eliminated by three-dimensional imaging techniques such as computed tomography. Cone beam computed tomography(CBCT) generates 3D volumetric images and is also commonly used in dentistry. All CBCT units provide axial, coronal and sagittal multi-planar reconstructed images without magnification. Also, panoramic images without distortion and magnification can be generated with curved planar reformation. CBCT displays 3D images that are necessary for the diagnosis of intra bony defects, furcation involvements and buccal/lingual bone destructions. CBCT applications provide obvious benefits in periodontics, however; it should be used only in correctindications considering the necessity and the potential hazards of the examination.

Biliary fistula after treatment for hydatid disease of the liver:When to intervene

AIM:To determine the outcome of patients with biliary fistula(BF)after treatment for hydatid disease of the liver. METHODS:Between January 2000 and December 2010,out of 301 patients with a diagnosis of hydatid cyst of the liver,282 patients who underwent treatment [either surgery or puncture,aspiration,injection and reaspiration(PAIR)procedure]were analysed.Patients were grouped according to the presence or absence of postoperative biliary fistula(PBF)(PBF vs no-PBF groups,respectively).Preoperative clinical,radiological and laboratory characteristics,operative characteristics including type of surgery,peroperative detection of BF,postoperative drain output,morbidity,mortality and length of hospital stays of patients were compared amongst groups.Multivariate analysis was performed to detect factors predictive of PBF.Receiver operative characteristics(ROC)curve analysis were used to determine ideal cutoff values for those variables found to be significant.A comparison was also made between patients whose fistula closed spontaneously(CS)and those with intervention in order to find predictive fac-tors associated with spontaneous closure. RESULTS:Among 282 patients[median(range)age, 23(16-78)years;77.0%male];210(74.5%)were treated with conservative surgery,33(11.7%)radical surgery and 39(13.8%)underwent percutaneous drainage with PAIR procedure A PBF developed in 46(16.3%) patients,all within 5 d after operation.The maximum cyst diameter and preoperative alkaline phosphatase levels(U/L)were significantly higher in the PBF group than in the no-PBF group[10.5±3.7 U/L vs 8.4±3.5 U/L(P<0.001)and 40.0±235.1 U/Lvs 190.0±167.3 U/L(P=0.02),respectively].Hospitalization time was also significantly longer in the PBF group than in the no-PBF group[37.4±18.0 d vs 22.4±17.9 d(P< 0.001)].A preoperative high alanine aminotransferase level(>40 U/L)and a peroperative attempt for fistula closure were significant predictors of PBF development (P=0.02,95%CI:-0.03-0.5 and P=0.001,95%CI:0.1-0.4),respectively.Comparison of patients whose PBF CS or with biliary intervention(BI)revealed that the mean diameter of the cyst was not significantly different between CS and BI groups however maximum drain output was significantly higher in the BI group(81.6± 118.1 cm vs 423.9±298.4 cm,P<0.001).Time for fistula closure was significantly higher in the BI group(10.1 ±3.7 d vs 30.7±15.1 d,P<0.001).The ROC curve analysis revealed cut-off values of a maximum bilious drainage<102 mL and a waiting period of 5.5 postoperative days for spontaneous closure with the sensitivity and specificity values of(83.3%-91.1%,AUC:0.90)and (97%-91%,AUC:0.95),respectively.The multivariate analysis demonstrated a PBF drainage volume<102 mL to be the only statistically significant predictor of spontaneous closure(P<0.001,95%CI:0.5-1.0). CONCLUSION:Patients with PBF after hydatid surgery often have complicated postoperative course with serious morbidity.Patients who develop PBF with an output <102 mL might be managed expectantly.