Makale Arama

Aim: Brucellosis, a zoonotic disease, may affect several body systems and cause various clinical manifestations considering the infection sites. Diagnosis of brucellosis is mainly based on culture and serological methods, specifically Rose Bengal agglutination (RBT) and standard tube agglutination tests (STA). When RBT, which is usually used as a screening method, is positive for Brucella antigens, STA is prefered to detect an agglutination titre by using serial dilutons of serum sample. On the otherhand, false negative results can be obtained by STA due to the presence of blocking antibodies. The refore, these two methods may be in adequate for diagnosis of Brucellosis. The aim of this study is to compare a novel method, Brucella Coombs gel test (BCGT) with other four serological methods, RBT, STA, Brucella immune-capture agglutination test (BCAP), and Brucella ELISA IgG, IgM tests. Patients and Methods: Serum samples taken from 100 patients, admitted from various clinics at Konya Training and Research Hospital were sent to the Medical Microbiology Laboratory with a clinical diagnosis of Brucellosis. Each serum sample was studied with RBT (Seromed Laboratory Products, Turkey), STA (Biomedica, Canada), BCAP (Brucellacapt, Vircell SD Spain), BCGT (ODAK, ISLAB, Turkey), and ELISA Brucella IgG, IgM (Euroimmune, Germany) methods. All procedures were carried out in accordance with the manufacturer’s recommendations. Results: The rates of positive results for each method were as follows: BCGT 88 (88.0%), RBT 74 (74.0%), STA 56 (56.0%), BCAP 84 (84.0%) and Brucella IgG, IgM test 92 (92.0%). Conclusion: Statistical analysis could not be executed due to lack of a gold standard method in the study. Yet, BCGT provided faster results than STA and BCAP methods because it does not require a 24-hourincubation. This novel test, BCGT, also showed an advantagein the diagnosis of Brucellosis because of detecting blocking antibodies. More comprehensive studies are needed to be performed to confirm the results.

In the Human Skin The efficacy of antimicrobial agents applied to-pically to the skin surface in eradicating coagulase-negative staphylococci (ENS) residing in the skin surface. Five antiseptic solutions (10 % povidone iodine, 2 % iodine, 2 % tincture of iodine, 70 % ethanol, and 0.5 % Chlorhexidine) were applied for 15s with a gauze sponge. The antimicrobial ointments (po-vidone-iodine. silver sulfadiazine, mupirocin, so-dium fucidate, and a double-antibiotic ointment con-taining neomycine, and bacitracin) were applied and covered for 6 th with gauze. After treatment. the surface was sampled. All agents were effective in eradicating ENS from the surface. The antiseptic solutions povidone-iodine. chlor-hexidine and tincture of iodine eradicated surface bacteria in every trial (10 of 10 each), and 2 % io-dine and 70 % ethanol eradicated bacteria from the surface in 9 and 7 of 10 trials, respectively. Four of the five antimicrobial ointments were also effective in the sterilization of the skin sur-face: 1 % silver sulfadiazine was the exception.

In this article, results of 750 cases who underwent choledochus exploration with cholecystectomy or cholecystectomy in our clinic are presented. In 549 (73.2%) of our cases, chronic cholecystitis, 150 (O 20) acute cholecystitis, 34 (4.5%) had gallbladder injury, 9 (1.2%) were due to gallbladder cancer and 8 (1%) , 1) cholecystectomy was performed for other reasons. Common bile duct exploration was performed in 150 cases (20%) for various reasons. Various postoperative complications were detected in 80 (11.1%) of 720 surviving patients who recovered with medical or surgical treatment. 30 of 750 patients died in the postoperative period, with a mortality rate of 4%. 7 (1.2%) of 556 patients who underwent cholecystectomy for chronic cholecystitis with and without stones died.

In this in vitro study performed in the rat gastro-esophageal sphincter, the relaxing effects of verapamil, nifedipine and nitrendipine, which are Ca2 + channel blockers, on contractions due to carbachol were investigated. When the% relaxations obtained with the said antagonists were compared, it was seen that verapamil and nitrendipine relaxed at the same rate, whereas the relaxation achieved with nitrendipine was lower than the other two drugs.

Aim: Gallbladder cancer is an uncommon, but aggressive tumor. Its prognosis is poor and the most cases are incidentally detected in histopathological examinations of cholecystectomies due to benign diseases. With the era of laparoscopic cholecystectomy, the number of cases detected in early stage is increasing. In this study, we aimed to evaluate the rate of cancer encountered and the distribution of non-cancer diagnoses in cholecystectomy materials sent to our department, together with the literature findings.

Materials and Methods: The results of the cholecystectomy materials sent to the pathology laboratory and examined routinely in 2016-2017 were retrospectively evaluated by forming diagnostic groups. Clinical preliminary diagnoses, demographic informations (age, sex), and pathology reports of the patients were reviewed.

Results: We included a total of 1000 cholecystectomy materials into the study. Two of the 7 patients who presented with malignancy were incidentally diagnosed and underwent laparoscopic cholecystectomy with the preliminary diagnosis of cholelithiasis, with the primary focus was gallbladder in one patient, and the other was compatible with colonic adenocarcinoma infiltration. Preoperative and / or perioperative malignancy was detected in the remaining 5 patients. A large proportion (> 90%) of the other cases had chronic or chronic active cholecystitis and low rate of acute cholecystitis included gastric heterotopia found in 2 (0.2%), tubular adenoma in 1 (0.1%), tubulovillous adenoma in 1 (0.1%), adenomyoma / adenomyomatosis in 4 (0.4%), polyp in 6 (0,6%) and dysplasia (Biliary intraepithelial neoplasia, BilIN) in 5 (0.5%) patients.

The contraction responses induced with serotonin (5-M) irz a medium without Ca2 + showed a dese-dependent increase by acicling Ca2+ into the extracellular mediutn. This contraction due to external Ca2+ used has significantly been inhibited by verapamil and diltiazem added into the extracellular medium. Similarly, in an isolated gastro-oesophageal sphincter, in a medium containing no Ca2+ the contraction induced with acetylcholine (ACh) has alsa been increased with Ca2+ used at a cumulative concentration and significantly inhibited by either calcium antagonists. Findings indicate that veraparnil and diltiazem have inhibited the eniry of extracellular Ca2+ intr. the tissues.

Sena were öbtained from 109 mothers who were in kibar and from the wnblical cord of the- ir newborn babies. CMV antibodies of the samples were deterrnined by ELLSA teehnique, These findings revealed that the serum of 32 (29,3%) and 13 (11,9%) mothers were CMV IgG- and 1gM pozilive, respectively.4-The serum of 25 (22.9%) newborn babies showed CMV IgG positive responses. Although, CMV specıfic 1gM response was not found in the serum of the newborn babies, but 11.9% CMV specific 1gM positive response of the »tothers implied health risk for the babies.

Purpose: The aim of this study is the documentation of characteristics of cases diagnosed and followed as cholelithiasis which is quite rare in childhood period. Material and method: Data of 23 cases diagnosed as cholelithiasis in ourclinic between June 1998 and June 2005 were evaluated. Result: Fifteen of cases were female (65.2%) and eight were male (mean age: 8.3±4.7 year). The most important reason of stone formation was hemolytic diseases (43.5%). No underlying reason could be found in 30.4% of cases. About 39% of all cases and 80% of cases with hemolytic diseases (43.5%). No underlying reason could be found in 30.4% of cases. About 39% of all cases and 80% of cases with hemolytic diseases were asymptomatic. Cholecystectomy was performed in nine of 23 cases (39.1%). Multiple stones were detected in 78% of all cases while all patients with hemolytic disease had multiple stones. Stone analysis was not performed in any of patients. Conclusion: Knowledge about cholelithiasis which rarely detected in children is insufficient. Most of cases with hemolytic disease are asymptomatic and gall bladder Stones were detected accidentally. Periodic follow up of these patients is very important. Laparoscopic cholecystectomy must be performed in all symptomatic patients and in patients having Stones larger than 2 cm diameter. Needed significance to stone analysis must be given in our country.

The aim of the study is determine the incidence of pathologies detected by abdominal ultrasonography in Konya. Screening has begun in 2011 after the necessary permissions from local ethical committee. Participators’ identity, age, gender, history and family history has been recorded. Abdominal ultrasonography has been performed in supine position. Hepatobiliary, genitourinary systems, spleen, midline structures and anterior abdominal wall has been evaluated. The mean age of 2010 participants was 46 (18-94). There were 1071 (53.3%) female and 939 (46.7%) male. In abdominal ultrasonography; hepatosteatosis in 371 (18.5%), liver hemangioma in 14 (0.7%), hidatic cyst of liver in 11 (0.5%), cholelithiasis in 60 (3%), splenomegaly in 13 (0.6%), simple cyst of spleen in 3 (0.1%), aortic aneurism in 4 (0.2%) participants were detected. In renal evaluation; nephrolithiasis in 34 (1.7%) and simple cyst in 145 (7.2%) participants were detected. In pelvic evaluation; prostatic hypertrophy in 4 (0.4%) males and myoma uteri in 8 (0.7%) females were detected. In Konya population most common pathologies at abdominal ultrasonography were hepatosteatosis, renal cyst, cholelithiasis and nephrolithiasis.

Nineteen cases were exarnined by computed tomography (CT) and ultrasonography (US). Gallstones were diagnosed in all of the cases (%100) with US. 14 oul of nineteen cases. were ,diagnosed by CT (%73,6). Common bile duci stone was diagnosed in three cases with CT and in one case with US. All of the cases had obstructive jaundiced. As a result, US is more sensitive !han CT in the diagnosis of the gallbladder stones. However, CT is more effective method than US in the diagnosis of the comrnon bile duct stones.

In ofr 30 cases, which were treated with ketoconazole, an antifungal agent, 90.48 perceni of :kese cases, clinical remissions ha ve been obiained. All !hese remissions, have been confirrned by cytological diagnosis which have been done by native preparation,y. Also, it's advantages were related with taking this drog orally and wilhout any adverse effects.

Aim: To identify the effects of sex hormones on inflammation and fibrosis on and around gall bladder. Material and method: In this study 48 rabbit (24 male, 24 female) was used. Acute cholecysstitis was achived by cystic canal ligature (SCL) except control groups. Female (DI, DII, DIII, DIV) and male (EI, EII, EIII, EIV) groups had 4 subgroups, each consist of 6 members. Macroscopic findings of acute cholecystitis were evoluated. Adhesive bands around gall bladder and biopsies from gall bladder were protected in deep freezer. Fibrotic bands and gall bladder were analyzed for hidroxyprolin (HP) and collagen. Results: Acute cholecystitis was developed in all subjects macroscopically. On male subjects adhesions around gall bladder were seen more intensively. Result of subjects with ooferectomy were close to male subjects. On castrated male subjects adhesions were similar to female subjects. The adhessons were less at female subjects with ooferectomy with external estrogen use. The lesions were more at castrated male subjects with external testosteron use. These findings were relevant with quantitative values of HP. Collagen were found more in male subjects compored to female subjects. Conclusion: The results is castrated males were similar to those in females and with usage of external testosteron male type results were achieved. And the similarity of results in female subjects with ooferectomy to males achivement of female type results with usage of external estrogens clearly shows us inflammation and fibrosis increasing effect of male sex hormones in acute cholecystitis.

Selection of primary mode of therapy for lower ureteral stones is stili controversial, should it be ESVVL (Extracorporeal shock wave lithotripsy) or ureteroscopic approach? ESVVL therapies were applied to 321 patients. Ultrasonographic targetings were used when stones could be localised by ultrasound in 131 patients (Group I), fluoroscopic targetings were used in 186 patients (Group II) during ESVVL treatment. Uretroscopic approach was selected in 121 patients as a primary treatment of lower ureteral stones. (Group III) Total success rates were 85% for ESVVL treatment and 94.4% for ureteroscopic approach. (P=0.015) Success rates were 91.1% and 80.6% in Group 1 and 2 subsequently. (P=0.015) Retreatment rate was clearly lower in group I (11.8%)than the group II (26.3%). (P=0.001) Success rate of ureteroscopic approach was compared to ESVVL groups, vvhile there was no d if ference with group I, (P=0.048) success rate of grup III was higher than group ll.(P=0.002) Complication rates showed significant difference between ESVVL and ureteroscopy groups.(13.2% versus 3.7%)(P=0.004) VVe concluded that ESVVL should be selected as a primary therapy of lower ureteral stones that can be seen by ultrasound due to its the higher success and lower complication rates than the ureteroscopic approach.

Congenital Leukemia is rare disease seen at birth or in the first 4 weeks of life . The incidence of Congenital Leukemia is 1 over 4.7 million live births. Most of the cases are myeloblastic leukemia. Usually symptoms like leukocytosis, petechia, echymosis, cutaneous nodules, hepatosplenomegaly and central nervous system involvement are seen. Two newborns with Down syndrome which were septic at application and diagnosed as congenital leukemia are presented in this article. The early recognition of such cases and finding opportunity to treat before the appearance of secondary complications such as sepsis play an essential role for saving life.

Invasive candidiasis is responsible for about 10% of nosocomial sepsis and it continues to be significant cause of serious morbidity and mortality in very low birth weight infants. Alhough the informations about the antifungal drugs which used for Candida species are increasing, studies and conclusions about the efficacy and safety are still insufficient. Most of the studies have focused on the pharmacokinetic and pharmacodynamic evaluations and obtained from adult patients. However, efectiveness of the therapy can not be same in newborns due to the different pathophysiology of neonatal candidiasis in newborn, the inferences can not be considered from adult studies. Until now, amphotericin B deoxycholate, fluconazole and micafungin seems to be effectivev therapy for the treatment of neonatal invasive candidiasis. Herein, the medical literature has been scanned and compiled with the latest information about the use of antifungal agents in newborn.

Purpose: V/e evaluated clinical features, diagnosis and characteristic findings in a cases of pigmented pa­ ravenous retinochoroidal atrophy. Case: Best corrected visual acuity of a 58 year old vvoman who was diagnosed on routine examination as pigmented paravenous retinochoroidal atrophy was 20/30 in the right eye and 20/50 in the left eye. No other family members are knovvn to have eye disease. Anterior segments and intraocular pres- sures were normal. İn ali qudrants, bilaterally, there was striking paravenous pigmentary retinal pigment epithelial atrophy vvith dense black bone-spicule pigmentation. The optic discs, maculas and retinal vessels outside of the pigmentary regions appeared normal. The fluorescein angiogram revealed areas of hyperfluorescence in- terspreaded vvith pigment clumps. There was no leakage from the retinal vessels. Conclusions: Pigmented pa­ ravenous retinochoroidal atrophy is a rare disorder that is not we understood or classified. The diagnosis of pig­ mented paravenous retinochoroidal atrophy is established on the opthalmoscopic appearence of a striking disturbance of the retinal pigment epithelium in a distinctly perivascular distribution vvith or vvithout bone spicule pigmentation.

Demonstrating the imaging findings of asymptomatic giant thymolipoma mimicking cardiomegaly is aimed. A paracardiac mass was detected with 32-year-old male patient afterwards demonstration of cardiomegaly on a posterior-anterior (PA) chest x-ray examination taken for a routine control. Computed tomography (CT) showed a mass, localized in the anterior mediastinum, with smooth margins, showing no significant invasion of adjacent structures, and including fat density with fibrous component. The diagnosis was reported as thymolipoma histopathologically after transthoracic biopsy. On a preoperative magnetic resonance (MR) examination, taken for detailing the limits of the lesion, the mass showed hyperintensity on both T1 and T2 weighted images, and suppression on fat saturated T2 weighted images. No invasion of adjacent structures was detected. A thymolipoma may reach a large size without symptoms due to its great pliability. It can mimic cardiomegaly on x-ray images. Adipose tissue on CT is helpful in the diagnosis. MRI gives valuable information in determining the exact boundaries of the lesion.

268 cases on which laparoscopic cho-lecystectomy was treated in General Surgical De-partment at the University of Selcuk, Faculty of Me-dical Science between 1994 th January-1995 th June were taken into consideration. 236 patients have de-veloped gallbladder stone which moves along with bilecholic, 32 patients have developed acute cho-lecystitis and 4 patients, because of having de-veloped splenic abcess, splenic eccinococcous cyst, simple cyst at left lobes of the liver, simple cyst at right over were taken into operation. Despite the successful application of la-paroscopic cholecystectomy at 252 patients, 16 pa-tient had necessarly been take into laparotomy. Mortality rate is nil. The operation approximately takes 50 minutes and patients are kept at our hos-pital for nearl 2 days and the patient's recoveries takes a week. Serious complications was observed at 6 patients. We come to the conclusion that the reason for the complications peeing high is that this kind of surgical attempts are very recently applied in our clinic.

Brucellosis is a zoonotic disease caused by bacteria of the Brucella subspecies from the gram-negative bacteria family. Brucellosis continues to be a public health problem worldwide, especially in developing countries. The bacteria can involve the reticuloendothelial system foremost, and many systems such as joints, the heart and the kidneys. Despite the respiratory system involvement being known, lung involvement is rare. Non-specific findings and complications in the patients with lung involvement makes the diagnosis difficult. In this case report, a 6-year-old male patient, presenting with the complaints of fever, cough, expectoration, hemoptysis, exhaustion, anorexia and knee ache, was hospitalized with the diagnosis of pneumonia and pleural effusion. On the performed examinations, hepatosplenomegaly and bicytopenia were detected. The Rose-Bengal test was (+++) and the Wright agglutination test was 1/1280 (+) in the blood and pleural effusion fluids of the case. The case was considered to be a pneumonia and pleural effusion due to brucella. The case has been presented since it is rarely seen, and in order to emphasize that in countries such as ours, in which brucella is endemic, complications due to brucella show a wide spectrum.

\r\n 1p36 Deletion Syndrome is a rare disease characterized by a partial deletion in the short arm of chromosome 1. The first reports of cases with microdeletion of chromosome 1p36 were published in 1980s, beginning with a report by Hain et al. The first pure case of 1p36 Deletion Syndrome was identified in the 1987 by Magenis et al. Its incidence is presumed as 1:5000 to 1:10000 and prevalence among men/women is 1/2. Characteristic signs are dysmorphic facial features, developmental delay, feeding difficulties, central nervous system anomalies, seizures, microcephaly, intellectual disability, vision problems, sensorineural deafness, congenital heart defects, skeletal and renal anomalies. Congenital Cytomegalovirus infection is an intrauterine disease with persistent effects on the fetus with no specific treatment. Common clinical findings are petechiae, jaundice at birth, hepatosplenomegaly, microcephaly, hypotonia, poor suck, sensorineural hearing loss, vision abnormalities, seizures, developmental cerebral anomalies, intrauterine development delay, prematurity and stillbirth. This case has been reported due to being a unique case having both such a rare disease like 1p36 Deletion Syndrome and a corresponding clinical picture to congenital Cytomegalovirus infection which she has firstly been determined with a positive CMV-DNA level when she was 7 months old.

\r\n

Chronlc myeloid leukemia accounts for 2-5% of cases of childhood leukemia. There are two types: adult type (A-CML) and juvenile type (J-CML). Juvenile type accounts for 18% of cases of the childhood myelodysplastic syndrome. Adult type is seen in the childhood period two fold of juvenile type. Leucocytosis, splenomegaly, lymphadenopathy, bone marrow elements in the periferic smear are the common findings. Skin rash, monocytosis, fetal hemoglobin above 10% and absence of Philadelphia (Ph) chromosome are the typical findings of J-CML and increase in the number of the megakaryocytic and eosinofilic series in the bone marrow, leucocytosis above 100.000/mm 3 and existence of Ph chromosome are the typical findings of A-CML. Since the chronic leukemia cases are rarely seen in the childhood period, we aimed to present two cases having mentioned symptoms, one of which is a 3 years old boy diagnosed as J-CML, the other is 4 years old boy diagnosed as A-CML.

This study was caried out to determine the intrahepatic distributıon of the proper hepatit artery by using plastic enjection and corrosion casting methods. It was observed that the main lobar fissure, whic functional divided the liver int() right and left lobes, didn't correspond to the line that is defined based on the surface features and the main lobar fıssure correspond to the line extendıng from gal! bladcler to the fossa for the inferior vena cava. At the origin of the caudate lobe arteries and in seven fifteen casis (46.66%) of arterıal systems, which could be evaluated at the segmentation level, slight and marked size variations were observed. This results showed that it will be useful to establish the necessary precautions preoperatively because there might be subsegmental variations.

391 cases were examined by US (Ultrasonography) at the department of Radiology of Medical Faculty of Selçuk University, between May 25, 1985 and December 30, 1985. Hydatid csyt to have localized in the liver in twenty three cases, in the liver and abdomen in one case, in the liver and left kidney in one case, liver ci.rrhose characteriezd by splenomegaly, acsites and the increase of connective tissue in twenty cases and solid (tumour) lesion in eight cases were determined in the liver. US findings were compared wi.th operation findigns. The diagnosed csyt. US has become a guide for clinical diagnostic studies and to determine operation indication.

This study is performed in 57 renal transplant recipients and 57 hemodialysis patients with chronic renal failure in the Nephrology Division of the Department of Internal Mek-lif-...ine, University of Hacettepe School of Medicine and llemodialysis Unit (4- the Department of Internal Medicine, University of Selçuk School of Medicine_ Cytornegalovirus (CMV) IgM and 1gG antibodies were deterrnined in blood sarnples by enzyme-linked immunosorbent assay (ELISA) rnethod in the Microbiology Laboratory of Selçuk University. 1,Ve compared the results with control including 50 healty individuals. We fourıd CMV-IgM seropositivity 56.14%, CMV- IgG seropositivity 100% in the renal transplant recipients and CMV-IgM seropositivity 24.56%, CM11-IgG se.ropotisivity 91.23% in the hernoclialysis patients. In control group, CMV-IgM seropositivity was 2% and CMV-IgG seropositivity 50%. The rates of CMV-1gM and Ig G seropositivity in the renal transplant recipients and hemodialysis patients with chronic renal failure were high and significant according ta the control group (p<0.01).

Aim: Patients who diagnosed acute viral hepatitis between 1990-2004 were avaluated for etiological, epidemiological, clinical and laboratory characteristics, retrospectively. Material and method: Patients who had acute symptoms and physical examination findings suggesting acute viral hepatitis were evaluated by ELISA and PCR methods. Results: Mean age of the patient group was 26.76±14.51 years (7-77). 297 of the patient groups were male, 270 of them were female. Acute viral hepatitis A, B, C, D, E were diagnosed in 270 (48.2%), 233 (41.5%), 18 (3.2%), 3 (0.5%), 1 (0.2%) patients respectively. Hepatitis A + B coinfection were diagnosed in 4 (0.7%) patients whereas; in 29 patients (5.2%) diagnosis remained obscured. Acute viral hepatitis A was tend to occur in students during autumn and winter. Route of infection could not be identified in 377 (67.2%) patients. Weakness (73.8%), jaundice (67%), nausea (66.1%) and dark urine (56.9%) are the most frequent complaints whereas; jaundice (85%), hepatomegaly (44%) and splenomegaly (8.2%) were the most common signs noted during physical examination. Mean AST, ALT, total bilurubin values were 1433.38 (106-7963), 1951.96 (218-15596), 9.13 (1.3-35) respectively. Conclusion: Value of anti-hepatitis A and B virus vaccination is underlined because of lackness of any transmission-associated risk factors in majority of acute viral hepatitis patients.

On a group of patients which were sended la aur laboratories and swpected of having brucellosis who were admitted to our hospital's iR patieni and out paıient Wright aggluiination tesis (WAT), Rose Bengal Tesis (RBT), and SİR, tesis (ST) were performed and evrıluaıed fr r Bruce11a abor While ST and RIIT were negative, WAT was 1140 positive, in a patient's serum. RBT was posi-tive, and WAT was 1140 positive, ha ve heen found, in anoıher serum. ST and RBT were positively correlated with 1180 and higher dilutions of WAT (100 per ccnt).

Laparoscopic cholecystectomy (LC) was first introduced in 1987 by Du Bois (1). However, the first publication in literature belongs to Langenbuch from 1882 (2). It became the preferred method in America and Europe after 1990. It has been widely used in our country since 1992-1993. LC has advantages that cause less discomfort to the patient, short hospital stay, no wound problem or minimal, and bring the patient to society and business life in a short time. Cosmetic results are excellent. However, despite these advantages, there are also risks. These are: - The extension of the bile duct combined with the upward traction of the gallbladder can be perceived as a "long cystic duct" as a false impression. - Wound care and labor is less. - The surgeon's eye (ie camera) is at the level of the portal hepatis. - There is no need to retract the liver, colon and edion as in the open. The upper third of the hepatic canal and the liver hilum sometimes cannot be visualized very well. Because there is no "perception of depth". - It is difficult to perceive the distance between the right hepatic canal and the cystic canal. - In open cholecystectomy, we can clearly reveal the intersection of the bile duct associated with the cystic duct. In laparoscopic cholestectomy: the view of the bile duct combined with the camera in the umbilicus is tangential. This should be borne in mind during LC. If necessary, if we turn the lower right trocar to 10 by umbilical laaroscopy and reveal it, the vision becomes more perfect.

Aınong the 17.793 cases that have applied to our rlinir,, only 2061 of the rrtirolir, dermatomyco-sis have been processed (The %11.58 of the whole). The clinic figures according to the age and 5.ex have been shown on table 1-11 and 111.

İn this descriptive study, determining the demographic features, death causes and death origins of medicolegal deaths which vvere occured betvveen the years of 1991 and 2000 in Konya was aimed. Totally 4281 death cases to vvhom forensic examination and autopsy vvere performed vvere taken for evaluation. İt was observed that death cases vvere more dense in summer months. Male / female ratio was 3.32/ 1 in forensic deaths. The cases vvere cumulated betvveen the ages of 20 and 29. Deaths due to accidents was the main death origin with 75.3 % and it was follovved by homicides (8.0 %) and suicides (5.9 %). İt was stated that the ratio of the deaths due to traffic accidents was 53.5 % of the total deaths and was 71.1 % of the accident originated deaths. The cause of death in 69.5 % of the cases was blunt trauma and it was follovved by pathological deaths with 6.8 % and asphyxic deaths vvith 5.8 %. İt was concluded that causes and origins of the deaths vvere varied by gender and age differences.

Tonsillectomy (with or without adenoidectomy) continious to be a commonly peıformed operation in the practice of otorhinolaryngology. Although the incidance of postonsillectomy haemorrhage has been decreased it is serious problem for surgeons. Bizmut Subgallate is an effective agent in pre-venting hemorrhage after adenotonsillectomy. It is shortened the clotting time of whole blood an activation of coagulation in assays of the partial thromboplastin time. The action of Bizmut Subgallate was localized to an effect on Ilageman Factor. In this report; control of bleding using topical Bismut Subgalltıte in the operation of 39 patients was discussed.

This study included 102 leukemic and lympho,rıa patients tit ho were ıreated in Internal Medicine pediatric Clinic of Selçuk University Medical Faculty and Ilematology Clinic of İbn-İ Sina Hospital of Ankara University. CMV-IgM and 1gG antibodies were investigated with the enzyrne-linked immunosorbent assay (ELİSA) rnethod on the blood saınples, The serologic examinations were made in Alicrobiology ELİSA taboratory of Selçuk University Medical Faculty. The finding.s- in 69 leukernic and 33 iyınphoma patients compared tere control group. CA1V-IgM seropositivity was found in 7 lebtkernic palienis (10.15%) and 1 lyınphoırıa patienı (3,03%). CMV-1gG seropositivity waz found in 35 leukeınic patients (50,72%) and 13 lymphoına patients (39,39%). CMV-IgM sero-positivily of control group was found in 1 patient (2';;> and CMV-1gC sepropositivity was found in 25 patients (50%, seropositivity wa? Pyr,nd in 2 paıienis (6.25[70) and CMV-IgG in 13 pa-tients (40.63%) 'vere not (reale(' with cyto(atic ::-1ceıno0;crapy. scropositivily was

The advantages of laparoscopic surgery are similar for pregnant and nonpregnant women; nevertheless, this procedure was avoided during pregnancy because of concerns that it may be harmful to the fetus. Within the last decade, however, multiple case reports and case series describing the safe performance of laparoscopic procedures in pregnant patients have been published, resulting in a paradigm shift. Appendicitis, gallbladder disease, mesenteric cysts, and adnexal masses/torsion have been successfully managed laparoscopically during pregnancy. More advanced laparoscopic procedures, such as radical nephrectomy, splenectomy, salpingectomy, adrenalectomy, retroperitoneal lymphadenectomy, and ventral hernia repair, have also been reported in gravid patients. This topic will discuss issues specific to laparoscopic surgery during pregnancy. Discussions of laparoscopic surgery in the general population and specific laparoscopic procedures can be found separately.

This study was constructed on 103 middle ear drainage of 90 suppurative chronic otitis media patients who app-lied to the outpatient clinics of the Selçuk University Faculty af Medicine. Aerobic bacteria and mycatic cultures of middle ear discharges were taken from patients. Standart therapeutic regime (daily care and topical drops with an-tibiotics) was applied ta MI of the patients according to their culture-antibiogram. Some of the patients who are re-sistant this medication were undertakerı to combirıed otomycotic therapy. The results showed that suppurative chro-nic otitis media was a risk factor for otomycosis. It was indicated that the addition of antifungal drugs ta the conventional treatment protocol increased the recovery chance of patients who resistant to conventional therapy.

In the 4th article of the deontology charter, it is stated that the physician and the dentist cannot perform the secrets of the patient that he / she has taken while performing his profession, unless there is a legal obligation, that the identity of the patient cannot be disclosed in cases that are presented at medical meetings or are mentioned in publications.

Milk is an ideal and natural drink that contains all the vital nutrient flour-wastes necessary for the organism to grow and survive.

Intraventricular hemorrhage (IVH) is a common complication associated with delivery in preterm neonates. Germinal matrix, subependymal layer of lateral ventricle is the most occurring site of intraventricular hemorrhage. IVH is imaged as a hyperechogenic area and ventriculomegaly on ultrasonography, but it is detected easily by fetal magnetic resonance imaging (MRI). The present case was referred to our clinic due to ventriculomegaly on ultrasonography. Germinal matrix was determined on the fetal cranium with ultrasonography and intrauterine MRI at 30th weeks of gestation. The pregnancy was terminated by cesarean section due to severe preclampsia. Fetal MRI should be performed to confirm the diagnosis on the cases with suspect ventriculomegaly.

In this study, the clinical and laboratory findings of 539 anemic patients who were hospitalized between 1996 and 2003 in Hematology inpatient clinics of Internal Medicine Department in Selçuk University Meram Medical Faculty, were evaluated. In our study the most common anemia was Fe deficiency anemia, there were 280 patients, it was seen three-fold more in women. In premenapausal period, menomethrorhagea was the most common cause (48%) in women. Among postmenapausal women and men, the most gastrointestinal hemorrhageas. In our patients, the rate of lesions which might bleed observed in colonoscopy. The second common cause of anemias was vit B12 deficiency causing megaloblastic anemias. In our study, cobalamine deficiency was detected in 115 patients.Thirty two patients had both Fe and vit B12 deficiencies. Twenty one patients had folic acid deficiency anemia. In our study, 28 patients had hemolytic. Twentysix patients had aplastic anemia. Twenty seven patients had chronic disease anemias. Four female patients had myelodysplastic syndrome with refractory anemia and 6 patients had anemia due to chronic kidney failure. Our study was carried out in inpatient clinics. Anemia, affecting all systems, makes many diseases worse. That’s why, it’s an important health problem.

Title : A case of cytomegalovirus infection mimicking total parenteral nutrition associated cholestasis.\r\n\r\nCongenital cytomegalovirus (CMV) infection is the most common infection that passes trough transplacentally in the early infancy period and is the most common infectious cause of the nonhereditary sensorineural hearing loss. We know that most of these cases were asymptomatic in the neonatal period. Especially among the extremely low birth weight infants, CMV prevalence is not known. We present a 29 weeks old 460 gr extremely low birth weight (ELBW) infant with congenital CMV infection mimicking total parenteral nutrition (TPN) associated cholestasis. Usually, when we see the cholestasis in the extremely low birth weight infant feeding with long time TPN, we think that it is associated with TPN. Direct hyperbilirubinemia and cholestasis are the common situations in the newborn period. Especially this is considered to be associated with sepsis, TPN, galactosemia, inborn errors of metabolism and other causes. CMV- associated cholestasis should be kept in mind, especially in cases of premature infants with cholestasis and extremely low birth weight infants have been fed for a long time TPN.

Objective: Mucormycosis is an infrequent opportunistic fungal infection which may cause an aggressive and invasive soft tissue necrosis. It is usually developed in patients with immune system deficiency, and rarely seen in immunocompetant patients.  We report prognosis and treatment of the immunocompetant patients that developed facial cutaneous mucormycosis after short term corticosteroid therapy.

Material and Method: The patients who were admitted to Manisa Celal Bayar University Hospital after multitrauma and given short term corticosteroids due to cranial and spinal injuries and became immuncompromised and diagnosed as facial cutaneous mucormycosis between 2016 and 2018 were included in the study. Prognosis, medical and surgical treatment outcomes of therapy is reported.

Results: One patient with malar and maxillary involvement was treated with medical therapy and serial debridements and infection was cured. Reconstruction with free flaps were done, acceptable functional and aesthetic results were achieved. Two patients had adequate therapy and reconstructed with local flaps.   One patient was not operated due to recurrent fungal osteomyelitis and intracranial inflammatory findings, and regression in MRI was seen.

Conclusion: Mucormycosis should be kept in mind in contaminated wound infections in patients who have been treated with corticosteroids even for a short time after multitrauma. Rapid, repetitive and aggressive debridemants should be performed and reconstruction should be planned after cure of the fungi.

Tuberculosis remains to be a serious public health problem in our country and all over the world. Extrapulmonary tuberculosis causes major clinical problems because of difficulties encountered in the differential diagnosis. In this case report, we aimed to discuss a case of tuberculous lymphadenitis mimicking mediastinal tumor in chest CT and PET-CT examination. Eighty years old female patient with right paratracheal enlargement in the chest radiography was admitted to our hospital. Thorax CT and MR imaging was supporting this expansion as concordant with the mediastinal tumor. The PETCT showed increased FDG uptake in favor of malignant masses. However, mediastinoscopic biopsy was reported as tuberculous lymphadenitis and antituberculous therapy was started. It should be kept in mind that even in adults patients, tuberculous lymphadenitis should be thought in differential diagnosis of mediastinal masses suspecting malignancy with imaging techniques and also it should not be forgotten that tuberculous lymphadenitis may be presented with elevated FDG uptake at PET-BT.

The body's defense against foreign microorganisms such as viruses and bacteria is provided by natural and acquired immunity. The activity of this immune system is regulated by protein hormones called cytokines.

Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. In this report, we present a rare case of Langerhans cell histiocytosis with CT and MRI in a 2 yearold-boy who developed symptomatic diabetes insipidus and multiple bone ,cranial, lung and spleen metastases during the disease course. A 2-year-old male patient was hospitalized due to complaints of cough, fever, vomitting, diarrhea, achromasia, weakness and rash. Chest X-ray revealed reticulonodular infiltration in both lung fields. Thorax CT revealed diffuse micro and macro nodular type infiltration in both lung parenchyma. On CT and MRI revealed common lytic lesion of skull, vertebra and iliac bone. There are infundibular thickening and absence of posterior pituitary intensity on MRI of pituitary gland. The spleen involvoment is determined by abdominal CT. The diagnosis is confirmed with biopsy of iliac bone. Langerhans cell histiocytosis should be in the differential diagnosis in children having widespread lung, bone, pituitary gland, and spleen involvement on MRI and CT.

A rare cause of acute abdomen; appendiceal neuroma. Case report

\r\n

 

\r\n

ABSTRACT

\r\n

 

\r\n

    Acute abdomen refers to nontraumatic pathologies of abdominal origin which are characterized by sudden-onset abdominal pain. In most cases the cause of pain is a pathological condition requiring urgent surgical intervention. Acute appendicitis is the most common indication for surgical intervention in patients presenting to emergency department with acute abdomen. Obstruction of appendiceal lumen has been widely accepted as the precipitating factor in the pathophysiology of acute appendicitis. It usually develops as a result of food or feces particles entering into and obstructing appendiceal lumen, leading to inflammation and swelling of regional lymph nodes. Luminal obstruction results in overproduction of bacteria, excessive mucus secretion, and increased intraluminal pressure. Some studies in recent years have suggested a neural component in the pathophysiology of this condition. Such cases may present with various diagnoses such as obliterated appendix, fibrous obliteration, appendiceal neuroma, and neurogenic appendicitis. In this paper we present a case operated with the initial diagnosis of appendicitis and histopathologically diagnosed with appendiceal neuroma, a rare cause of acute abdomen.

Pilonidal sinus is a chronic inflammatory disease which is seen in interglutal area and frequently affects young population. Studies done in relation to the frequency of the disease are not capable of representing the whole community and they are based on military personnel or hospital data. Therefore, it was aimed to do this epidemiologic screening study in order to determine the actual frequency of the disease and its distribution according to age. After taking the permit and legal consent of ethic committee, With population weighted systematic clump sampling which will represent Konya’s provincial population, 49 locations were selected from Konya city centre, districts and villages. It was intended to have 100 person as the clump volume in each location in the screening. In the locations determined, written consents of 18 year-old and older and those accepting the screening were taken. Giving the results in general and in percentage in accordance with age distribution was planned. The ongoing screening was performed in 20 regions and 2000 people were evaluated. Age average of people involved in the screening is 45(18-94) 936 of who (46,8%) are male and 1064 of who were (53,2%) were female. Among 2000 people evaluated, total 39 (1.95%) cases were determined 22 of which were operated, 16 of which were primary cases and 1 of which was relapse pilonidal sinus. The age range in which it is most frequently seen is 4,1% and between 18-30. Pilonidal disease was determined in only two women and man/woman ratio was 19/1 in the screening. In this communitybased study, pilonidal disease prevalence was determined as 1,95%. The disease is seen most frequently in men and at 4,1% rate in 18-30 year-old population. Its general frequency in men is 3,9%.

The bacterial and fungal colonisation of the hands flora of the 50 medical doctors working at the hospital of faculty of medicine and 50 dentists wor-king at the hopsital of faculty of dentist were in-vestigated.From the hands of the 7 (14%) medical doctors we determined gram negative bacterial co-lonisation but no fungus. We determined gram ne-gative colonisation from only one (2%) of the hands of the dentists who were using glovws while working and also from the hands of the dentists we could`nt derirmine fungal colonisation. We had been de-termined 20.4% gram negative and 8.6% fungal co-lonisation from the hands of the nurses that worked at the same hospital in our previous investigation. We thought that using gloves and washing hands had been decreased gram negative and fungal co-lonisation and this is very important for preventing nosocomial infections.

The purpose of this study was to designate the prevalences of Toxoplasma, Rubella, Cytomegalovirus, HBV, anti-HBs, HCV, HIV among first trimester pregnant women and investigate the relationship between age groups, parity. This study included 2900, under 12 gestational weeks pregnant women, ages ranging from 16 to 45 admitted to Bayrampasa State Hospital obstetrics and gynecology outpatient department between November 2011 and February 2013. Toxoplasmosis, rubella, cytomegalovirus, HBV, hepatitis B infection, HCV, HIV was studied in suitable pregnant women and results were analyzed. Age groups, gravida, parity number were questioned. The mean age of the pregnant women participating in the study was 27.78±5.57 (16-45), mean gestation was 2.21±1.39 (1-8), mean parity was 0.78±0.89 (0-5), mean gestational age on admission was 8±3 (5-12). Toxoplasma IgG, Rubella IgG, Cytomegalovirus IgG, HBsAg, antiHBs, HCV, antiHİV seropositivity were respectively 31.2%, 95.7%, 99.2%, 2.4%, 22.1%, 0.1%, 0%; and Toxoplasma IgM, Rubella IgM, cytomegalovirus IgM seropositivity percentages, were respectively 0.9%, 0.15%, 0.7%. Toxoplasma seropositivity rate is similar to Turkey data. Rubella seronegativity was found lower then the data of Turkey and with the prepregnancy vaccination this value can be pulled the level of European countries. The high level of CMV seropositivity in our study indicates the low socioeconomic status. HBsAg, anti-HBs, anti-HCV and anti-HIV levels were close to the average of Turkey. According to them, in addition to routine screening of TORCH, screening for HBsAg and anti-HBs appears appropriate, anti-HCV and anti-HIV screening is not cost effective.

Aim: Many serological tests are used in the diagnosis and follow-up of Brucellosis. Those routinely used in laboratories are Rose Bengal Aglutination, Standart Tube Aglutination and ELISA anti-Brucella tests. In addition to these tests, available Brucellacapt (immuncapture) aglutination and coombs tests are also used in the diagnosis. In this study, Rose Bengal Aglutination, Standart Tube Aglutination, Brucellacapt and ELISA tests were aimed to be compared. Method: Sent from various clinics with the prediagnosis of Brucellosis, the samples of 71 patients were investigated in the study. These samples were investigated using Rose Bengal, Standart Tube Aglutination, Brucellacapt and ELISA (Brucella-IgM, Brucella-IgG) tests. Results: Fifty six positivity rates were determined with Rose Bengal Aglutination test (78.8 %), 30 with STA (42.2 %), 52 with Brucellacapt (73.2 %) and 58 with ELISA (81.6 %). Conclusion: It was considered that STA is unsatisfactory in the diagnosis of Brucellosis in the patients for whom no culture could be performed, when performed alone, and that Brucellacapt and/or ELISA tests are necessary to be used combinedly. However, in the follow-up of Brucellosis, it was also concluded that Brucellacapt is inappropriate; instead, the use of ELISA (IgM and IgG) tests will be more appopriate in the diagnosis of Brucellosis.

Agenesis of the gallbladder is a rare congenital anomaly occurring in 1 to 4 people of a population of 10000. It may present with biliary type symptoms such as upper abdominal pain requiring further investigation. Ultrasound is the first choice of imaging for biliary symptoms but is frequently misleading in the context of Gallbladder Agenesis. We report a case of congenital Gallbladder Agenesis and a biliary tract abnormality diagnosed by laparoscopy. As a result most patients are diagnosed following conversion of laparoscopic to open cholecystectomy and subsequent failure to identify the gallbladder. Failure to suspect Gallbladder Agenesis at laparoscopy can result in unnecessary open surgery and a high risk of bile duct damage with corresponding postoperative morbidity and mortality.

Konya is the capital of the Anatolian Seljuk State; Seljuk is the leading city in the medical world. Just like Sivas, Kayseri and Çankırı, which have an important place in the S21çuklu medicine, Konya has brought famous personalities and made important contributions to the history of Turkish medicine. Among the institutions operating in the field of medicine in the capital city of Konya, we know especially Kemaliyye and Şadi Bey Dar'uş - Healing. It is certain that there are other large and small institutions. With the exception of Kemaliyye, who can only show his existence with his "iwan" today, all of them have disappeared. The excavation to be made after the determination of the location will provide information, documents and support suitable for restoration. Medical establishments have immunities today, even during war days. They are immune and immune from all kinds of rape and attack. But this principle has been abandoned from time to time in history. As a matter of fact, despite all humanitarian principles and agreements, in distant and recent conflicts, medical institutions, albeit from time to time, could not save themselves from various rape and assault. We are of the opinion that such attacks and rapes suffered in their past of seven hundred years had a great effect when the Seljuk medical institutions in the capital Konya were destroyed and could not survive today. Because Konya has a very important and key position in both the capital and Anatolian strategy. It is the crossroads of Anatolia's political, military and commercial roads. Throne and crown fights, religion and sect conflicts, rebellions, internal rebellions, siege and rape of Mongols and Beyliks were staged in Konya and its vicinity for this reason.

Sociodemographic and clinical features of 226 children, who were admitted to the outpatient clinic of psychiatry department of Selcuk University for the first time, between september 1993-and september 1994. were analyzed retrospectively. The purpose of this study is to reveal the problems of an adult psychiatrist when he come face to face with the children in a condition where female. Most of the children were between 12-14 years old and were the first child of the family. The patients admitted to the clinic mostly because of their parents regrests. The second reason of admittance was other physicians consultation request for female, and legal report for male. The differance was significant (p<0.05). Main complaints were enuresis, mental retardation, con-duct disorder, developmental articulation disorder for males, and somatic. depressive and conversive for females_ The differents was statistically sig-nificantly (p<0.05). As a result, 226 first admissions to a clinic in-dicates the need to a child psychiatrist in this dist-rict.

A case of clinically silent pheochromocytoma is presented.7lıe right adı-enal mass incidentally found by abdominal ultrasonography and computed tomog-raphy. The patient was normotansive and asympio-matic. Urinary levels of catecholamine and metabol-its vere elevated than expected normal levels. Mass was excised surgically. Palhological examination verified that ille nıass was a pheochromocytoma. The diagnosis of silent pheochromocytoma can be re-vealed by usiııg modern imaging techniques such as ulfi-asonograplıy and computed tomography.

in this study, the risks of emergency surgical procedures in elderly patients and the effect of surgery on the morbidity and mortality were investigated. The records of 884 patients, those who were 65 years old or elder, and who were operated on in the Department of Surgery, University of Selçuk beetwen May 1991 and April 1997 were analyzed, retrospectively. One hundred eighty three patients (20.7%) were operated on urgently and 701 patients (79.3%) were elective. The ratio of male ifemale was 1.9 (120M/63F) and the mean age was 72.3 (range 65-95) in the emergency operations. Most frequent reason for the emergency operations were intestinal obstruction (49 cases), acute mesenteric ischemia (24 cases) and pepic ulcer perforation (23 cases). Mean hospital stay was 10.8 days (3-51 days) in the emergency and 7.2 days (1-41 days) in the elective operation (p<0.0001). The mor-tality was 18.6% in the emergency and 3.4% in the elective operations (p<0.0001). There was no correlation bet-ween mortality rates in different age groups (p>0.05). The highest mortality was observed in intraabdominal abs-cess and in perforated gallbladder disease. Intestinal resection and anastomosis was performed in 55.9% of expired cases. The majority of the patients (70.6%), who had died, had coexisting cardiopulmonary diseases. The main causes of death in alt patients were sepsis and cordio-pulmonary diseases. The main causes of death in all patients were sepsis and cardio-pulmonary failure. In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the di-sease and to the coexisting cordio-pulmonary diseases. For this reason, timing is very important in the operations of elderly patients, and it is wise to perform the most conservative operation in some severe surgical conditions.

Initially extracmporeal shock wave lithotripsy (ESWL) was used for mechanical stimulation of asy-stolic heart and was larer to be used routinelv for urinary and gall bladder stone extraction. Soıne re-ported preliminary studies imply that ESWL can be used to treatment pseucloarthrosis, delayed union. epicondilitis, tendinosis calcarea and prostetic re-vision. Between July 1994- October 1995, in de-partment of Orthopedics and Traumatology, Me-dical Faculty, Selçuk University a study was undertaken for 5 patients with tihial pseudoarthrosis. For this purpose Dornier MFL 9000 lithotripter was used. An intensity of 20-22 kV. totalling 3000 pul ses were applied to the end of each fracture. Solid ttili011 was achieved on an average of 4 months (ranging 3-6 months). As a result of Iliis study, the technique ofkrs a potantial altrenative rreatment modality for cases for whom other techniques can be used with difficulty and for pseudoarthrosis which mav develop after opeıı fractures.

Fungal bloodstream infections are a leading cause of morbidity and mortalite in the immunosuppressed patients. While Candida albicans remains the predominant pathogen, the proportion of invasive candidiasis caused by other species of Candida continues to increase. In this study the identification of the Candida species isolated from blood cultures and investigation of their susceptibilities against amphotericin B and fluconazole was aimed. Candida strains isolated from 97 patients blood cultures within the time period of July 2009-2011 were included in the study. Identification of the strains, germ tube test, morphological appearance of corn meal-Tween 80 agar medium and API 20C AUX (Biomeriux, France) were used. The most common Candida form was C. albicans (68 %) followed by C. parapsilosis (14.5 %) and C. glabrata (9.3 %). Amphotericin B, fluconazole susceptibilities and Minimum Inhibitory Concentrations (MIC) values were measured with E-test method. All Candida strains were susceptible to amphotericin B. Except the flukonazole resistant one and dose-dependent susceptible six C.glabrata isolates, non of Candida isolates were resistant to fluconazole.

Castleman’s disease is a rare lymphoproliferative disorder of unknown etiology exactly. Although the disease most commonly appears in the mediastinal lymph nodes, it can be occur in cervical, retroperitoneal, axillary and other regions lymph nodes. There is no gender predominance and often occurs in young adults. Two histological variants as hyaline-vascular and plasma cell type have been described. Clinically it is also divided in two types: a localized type, which is usually asymtomatic and presented as a mass or swelling. Systemic (multicentric) type is characterized nonspecific symptoms such as fever, anaemia, generalized lymphadenopathy and hepatosplenomegaly Complete surgical excision is curative for localized form. Although systemic type is usually treated with radiation therapy, corticosteroids and chemotherapy, there is no certain treatment. We herein reported a neck mass diagnosed as hyaline vascular type Castleman’s disease.

In this study, 23 chronic myelotic leukemia (CIVIL) cases evaluated retrospectively between 1990 and 1993 in Selcuk University Department of Internal Medicine. The incidence of leukaemia were found 16.11 percent in all malign (435 patients) cases. The incidence of CML were found 5 27 per-cent in only leukemia. Femalelmale ratio were found 1.13. Age of women in our study were 45.6 ± 4.6 and age of man were 58.30 ± 3.7. CML appeared earlier in women_ The major complaints of our pa-tients were referred to hyper metabolism and sple-nomgaly. 5 of our the patients changed in to acute myeloblastic leukemia and all of them diet. 5 of our patients did not come for follow-up. The other 13 patients continue to come for regularly controls.

A twelve years old virgin patient who was menstruating regularly for one year presented with severe pelvic pain associating with her menstruation. She was diagnosed to have right renal agenesis before 4 months. In her physical examination she had annular hymen and normal external genital organs. Vaginal depth was 6 cm. In her pelvic ultrasonography, the endometrial thickness was 8 mm on left side uterus and 8x10 cm hematometra appearance was seen on right side. Laparotomy was planned for the patient. During the operation double uterus and double endometrial cavities were seen with fusion line in the middle. Double cervices were palpated by hand. Hematometra was seen on right side. Bilateral ovaries were normal. Uterus was incised from the middle the separating fibrous tissue was removed, hematoma was evacuated and the two cavities united. The patient was discharged on the 2nd postoperative day without complications. After two weeks she presented with severe vaginal bleeding for which laparotomy was done. The metroplasty line was opened. A bleeding arterial end was noticed on left lateral isthmic wall and it was not related to the incision line. The vessel was sutured and the patient was discharged on the 4th postoperative day without complication.

The technic for the producrion of immortal clones of cells making single antibody specificities by fating normal antibody-forming B lymphoblasts with an appropriate myeloma cells are achived by Kale,. and Milstein in 1975. These cells so celled "hibridornas" are selcted out iım a tissue cıdıure medimın. Monoclonal antibody and hibridoına technology are used in the speration of individual cell types with specific surfaces markers, diagnosis of lyrnphoid and myeloid ?nalignancies, tissue typing. And also yfr,ill be used in tufnour therapy (magic bullet) with cytotocric agents coupled to antiturnour-specific antibodies.

Brucellosis is a bacterial zoonotic disease with the major symptoms such as fever, joint and muscle pain generally caused by consumption of meat and milk of infected animals. Serological test methods such as Rose Bengal plate agglutination (RBPA) and standart tube agglutination test, are used in the diagnosis of brucellosis because of the lack of availability of blood culture in several laboratories, the low growth rate and ease to be effected by antimicrobials of the bacteria. Variations in biochemical parameters could be seen in the course of infection. In this study, seroprevalence of brucellosis in our region was determined by Rose Bengal and standart tube agglutination tests, and variations in biochemical parameters of the sera defined as positive for brucellosis were also evaluated. Rose Bengal test was found to be positive for 144 out of 4041 patient sera send to Microbiology Laboratory with the initial diagnosis of brucellosis. Among these sera, agglutination titer of 1/160 and over was detected in 121 samples. Seroprevalence for brucellosis was 3.56% for our study group. Among patient sera found to be positive in STA, 98 (81%) showed increase in C-reaktif protein (CRP) level, 66 (54.5%) in erytrocyte sedimantation rate (ESR), 29(24%) in alanin aminotransferase (ALT) and aspartat aminotransferase (AST). Additionally, leucocytosis was seen in 11 (9.1%), leucopenia in 12 (9.9%), anemia in 46 (36%) and thrombocytopenia in 53 (43.8%) patient sera. As STA titer increased CRP level had a paralel rise, but the platelet and leukocyte number decreased. In conclusion, especially serum CRP level could be a useful biochemical test parameter for the diagnosis and follow-up of brucellosis.

Bathing with the water containing suiphure has succesful effects in pruritic dermal lesions. Being ex-posed to its vapour or ingestion may cause collaps, coma and death. Even in low doses of sulphure may cause irritation in mucosa and adverse effects. The acidic characteristic of this water is the main cause of the irritation in mucosa. High levels of organic substance and ammonium show discontinued nit-rification of the water. The water containing organic substances may cause intestinal infections. The absence of protective area may increase ammonium concentration and total organic substance. High chlorine con-centration confirms that the water is contaminated with the urine of human beings or animals.

Scientific experiments are needed to see the natural course of the disease in living (human or animal) individuals and to develop treatment for this. For centuries, human beings have been studying human-like organisms and have been using an animal experiments in order to advance in science and health. Researchers who work in in the field of physiotherapy that is the main philosophy of which is to plan and apply the appropriate program by the teamwork into each patient under the clinical and experimental knowledge, must have knowledge of the design, methodology, analysis and interpretation of the study in order to be able to effectively evaluate the results of research on animal experiments. This paper aims to introduce the basic principles of experimental animal studies used in the field of physiotherapy and to give the necessary information to choose the appropriate experimental model.

Labor pain, which causes intolerable pain in some mothers, is one of the most severe and difficult to control pains known. Despite the false belief that this pain is natural and that every mother should suffer from this pain, labor pain should definitely be controlled. Because, like other acute pains, the respiratory system has negative effects on the cardiovascular system, neuroendocrine and limbic systems. It is an event that exhausts the mother, causes stress and anxiety, and increases the need for oxygen by hyperventilation.

Pneumomediastinum can develop spontaneously or in the setting of trauma. Spontaneous pneumomediastinum (SPM) is a rare condition and treatment of these patients is generally limited to observation. We discovered SPM in 15-year- old male patient, who had been wrestling, admitted to our emergency service with chest pain and shortness of breath. In this case report we discussed that in a patient without trauma, medical intervention for developing pneumomediastinum, the increased vagal maneuver may lead to SPM.

Risk factors and encountered problems during follow-up in babies with low birth weight (SGA) were investigated. 108 babies with SGA and who were follovved by our pediatrics department vvere evaluated. 52cases vvere male (48.2%) and 56 cases vvere female (51.8%) .40.7% of ali cases vvere prematüre and others (59.3%) vvere term babies. 53.7% of ali cases vvere applied from the city çenter. Low socioeconomic level, mother’s age lovver than 18 years, and preeclampsia vvere the most freguent risk factors. Infections (32.4%) , asphyxia (25.9%), hypoglysemia (21.3%) and polycythemia (19.4%) vvere the freguent problems. Important causes for mortality vvere infections, congenital abnormalities, and asphxy.

Amaç: Çocukluk döneminde Epstein-Barr virüsüne (EBV) nedenli enfeksiyöz mononükleoz olguları yüksek sıklıkta görülmektedir. Akut EBV enfeksiyonu belirti ve bulguları farklı klinik tablolarla kendini gösterebilmektedir. Çalışmamızda çocuklar arasında yaş ve yüksek riskli yaş gruplarına göre akut EBV enfeksiyonlarının klinik sunumunun incelenmesi amaçlandı.

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children.

Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively.

Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups.

Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.

in this manuscript a cervical vagal schwannomo is reported. Von Reckiirzklıausen disease was associated to the schwannoma. The relationship between two entilles is discussed. The imporiance of the vagal schwannoma in the dillerantial diagnosis of the head-neck massed rs impressed and the pertinent literature reviewed.

Bezoars are concretions in the gastrointestinal tract that increase in size by continuous accumulation of non-absorbable food or fibers. Most bezoars in children are trichobezoars from swallowed hair from the dolls or brushers. Trichobezoars typically cause abdominal pain and nausia, but can also present as an asymptomatic abdominal mass, progressing to intestinal obstruction and perforation. It is predominantly found in emotionally disturbed or mentally retarded youngers. We report a case of an unusual giant trichobezoar in 8-year-old girl. It was not extracted endoscopically, because it was huge and passed into the duodenum. Attempts at dissolving the bezoar with enzymes (papain) or meat tenderizers have not been efficacious. The abdomen was explored through a supraumblical median incision, an approximately 15X3 cm trichobezoar in diameter was identified in 50 cm distance from ileocecal segment, and was removed. In addition, ischemic and rupture 10 cm jejunal segment was repaired. These two rupture segments were repaired using Heineke Mikulicz procedure.

In ibis study the outcomes of paraplegic patients that we rehabilitated in our clinic were evaluated and compared to previous studies. Six women and nine men, totally 15 patients were included. Beside their demographic cha-racteristics the patients were assessed according to their lesion level. cause of injury, transfer activities in bed, walking activities, bladder and bowel con-ditions and functional status. At the end of the study the results were found comparable to previous ones and factors which take primarily part in i►e etiology of paraplegia like traf-fic accident, fall from height and gunshot wounding are still thought to be an important national pmb-lent.

Aim: We used Ligasure vessel sealing system in order to lessen the bleeding while cutting the parenchyma or to have a non-bleeding resection at 15 patients with mass at the liver. We aimed to present the data of the 15 patients where we applied hepatectomy and pericystectomy by the help of Ligasure, as a preliminary study. Material and Method: The records of 15 liver patients for whom we applied hepatectomy and pericystectomy by the help of Ligasure at Selcuk University Meram Medical Faculty of General Surgery Department during 2005-2007, were examined retrospectively. 10 of the patients were liver tumors (4 of them were hemangiomas, 2 were an adenoma and 4 were hepatocellular carsinoma), 3 of them were liver cyst hydatid, one of them was gall bladder Ca and the other was hepatolithiazis. Ligasure vessel sealing system (Ligasure Valleylab®) was used for all cases. Hepatectomy and pericystectomy by the help of Ligasure were applied to the patients. During parenchyma transection, sutures were used for great vessels a one patient. Result: The mean age of the patients was 53.7(32-65) and male/female ratio was 15/17. Mean blood loss was 217(30-700)cc and blood transfusion was not needed accept one case. Mean transection time was 48.93(25-85) minutes. There were no significant increases at biochemical parameters at the postoperative period. There was no morbidity at the late postoperative period. Conclusion: Ligasure application seems to be the precursor of a non-bleeding period at liver transection at them treatment of benign and malignant diseases of the liver

İn this study the antifungal susceptibility patterns of 63 clinical isolates of Candida albicans isolated from from hospitalized patiens vvere studied against amphotericin B, ketoconazole fluconazole and itraconazole using the Epsilometer test (E-test). Most of the isolates vvere isolated from urine samples (76.1%). The MIC ranges determined at 24 h incubation for amphotericin B, ketoconazole fluconazole and itraconazole vvere: <0.002-0.38. 0.004->32, 0.25->256, 0.008->32 respectively. The MIC50 and MIC90 (mg/l) for each antifungal vvere; amphotericin B 0.032, 0.125, ketoconazole 0.38, 4, fluconazole 2, 64 and itraconazole 0.094, 3. Ali strains vvere susceptible to amphotericin B, the resistance rates vvere 19.2% for fluconazole and 17.8% for itraconazole. Five İsolates shovved >32mg/l MIC values for ketoconazole. The results indicate that there is resistance against antifungal agents and this increases the importance of antifungal susceptibility tests.

Le mangue de Vitamin B12 se produisent surtout dans mes cas suivants; Mangue de nourriture, action de manger de folat rnsuffisamment, du N.70tarien et celui des autres alimentations, le d«ant de l'estomac caus6par le bouillonnement des legumes aux feuilles vertes et celui de l'absorption d6rivant de l'intestin grle, le mangue du facteur intrinsque l'&troitement de la surface de l'absorption, les dUauts mfrtaboliques. A la fin de tous ces cas, rtıgaloblastique se produit, commoneus en avons mentionne" les preuves cidessus.

Portal veins are the veins that carry the venous blood of the splacnic area in the abdomen to the liver (KC) sinusoids. Stomach, intestine, gallbladder, spleen, and pancreatic veins join the portal venous system. The largest vein of this system is the vena portal. It occurs by the union of the veria porta v.lialis (splenic vein) and the v. Mesenterica superior at the level of the L2 vertebra and the race of the pancreatic head. The v.porta, which has no valve inside, branches into the KC and opens to the sinusoids and central vein. Central hepatic veins unite and make v. Hepatic. Any reason that disrupts or prevents the blood flow in this system increases the blood pressure in the portal venous system and leads to portal hypertension (PH). To overcome the resistance of the sinusoidal system, the pressure in the portal system is normally 5-10 mm Hg higher than the venous pressure in other systems. With this increase in height, PH occurs. It is PH when the blood pressure in the portal venous system is higher than = 20 mm Hg (1) and, according to some authors, 10-12 mm Hg (17-20 cm water pressure) (2).

In Selok University. Faculty of Medicine, Cli-nical Bacteriology and Infectious Diseases de-partment. 136 patients had treated via hos-pitalization as infectious bowel disease (1BD)from 1 janua•y 1994 to 30 june 1995. 81 % of the patients (59.6 %) were female. 5.1 % of the patients were 18 and below 18. 43.4 % were between 19-39. 28.7 % were between 40-59. 22.8 % were 60 and above. by age. 80 of the 136 patients were diagnosed as Acute gastroenteritis and remaining were Ameobiasis (12), Salnionellosis (14), Shigellosis (18), Salmonella pa-ratyphi (6). Cholera (1), Giardiasis (3) and Chronic gastroenteritis (2). Among all of the cases, 99 pa-tients were determined in first year and 38 patients were determined in last 6 months. Of 37 cases di-agnosed and treated in 1995. 11 cases were fol-lowed in march and 10 cases were followed in june. 83 (f the cases of 1994 and 31 of the cases of 1995 had been lived in the vicinity of the town, Konya. Mean hospitalization time in 1994 was 7.7±0.5 days, and in 1995 was 6.0 ±0.8 days. The longest du-ration of hospitalization time was belonged to the Salmonella inji•ction as 11.4 days. The cost of the ill-ness per patient in 1994 was 95 $ and was 115 $ in 1994.

Context: Alcohol dependence syndrome is a major problem affecting both individuals and their family. Children of alcohol dependent parents are vulnerable to a host of behavioural problems. Studies in the west have shown both internalizing and externalizing symptoms in these children.

Aims: To assess the psychological functioning in offspring of alcohol dependent parents and its association with severity of alcohol dependence.

Settings and Design: This study was conducted at the Department of Psychiatry of a Tertiary hospital in Bangalore spanning a period of one year. Eighty children aged 11 years - 18 years, along with their alcohol dependent fathers were included.

Methods and Material: Socio demographic details of the parent and the child were collected by a semi structured Performa along with informed consent. Alcohol dependence was diagnosed based on ICD 10 criteria. Severity of Alcohol dependence was assessed using Severity of Alcohol Dependence Questionnaire (SADQ). Psychological functioning of the children was assessed using Youth Self Report Scale (YSR).

Statistical analysis used: descriptive statistics, and Chi-square test

Results: Among 80 children assessed 41 were males and 39 were females. 47.5% of them showed significant internalizing symptoms and 48.7% significant externalizing symptoms. Internalizing scores had higher correlation with girls (P – 0.004) and externalizing symptoms in boys (P – 0.008). However no correlation was found with severity of dependence in the father.

Conclusions: It was found that there was high prevalence of psychiatric morbidity in terms of externalizing and internalizing behaviours in children of alcohol dependent fathers. Thus early detection of these problems and intervention would ensure improved functioning in this group.

Sexually transmitted diseases being the most common communicable ones all over the world have steadily increased in incidence for the past two dec-ades. The causative agents are able to spread not only by sexual but indirect contact as well. In Konya, we searched for serological markers of Ilerpes genitalis, CMV, 11BV, AIDS, Syphilis and investigated pathogen microorganisms isolated from vaginal specimens of 95 prostitues and 71 women consisting up the control group. Despite no signıficancy established between anti 111V-1, RPR, 11BeAg, CMV-IgM and IISV-IgM lev-els, we established a significant correlation between the levels of 1lBsAg, anti-118s, anti-IIBe, CMV-IgG and 11SV-IgG. Microorganisms isolated from vaginal specimens of prostitues were as follows; S.aureus 34.78%, E.coli 20.29%, Enterococci 17.39%, Lactobacilli 15.94%, C.albicans 4.35%, enterobacteria 2.90%, Corynebacteria 2.90% and Klebsialk spp. bacteria 1.45%.

Towards the end of 2019, new coronavirus causing acute respiratory distress syndrome in patients was detected in Wuhan Province, China . This virus was called serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Virus Taxonomy Committee. The disease caused by this new coronavirus was called coronavirus disease-2019 (COVID-19) by the World Health Organization. This virus was found to be in the subclass of Betakoronavirus caused by bats. The role of viral proteins such as envelopes, membranes, nucleocapsids and spike proteins responsible for viral infectivity in immunopathogenesis is being investigated in studies. It has been emphasized in studies in which multiple organ failure develops due to the development of cytokine storm, especially in the advanced stages of the disease. An effective host immune response, including natural and adaptive immunity to SARS-Cov-2, is essential for controlling and treating viral infection. Although there is no effective treatment for the disease today, the benefits of various immunosuppressive and immunomodulatory drugs have been shown in studies. In this article, the immunopathogenesis of SARS-CoV-2 and the treatment models that can be effective on immunopathogenesis are reviewed in the light of current literature.

A calcified gallbladder case was operated in Septernber 1989, cholecysiectorny was performed. As this is very rare and demonstrative we presented the case and explained the subject briefly.

Tracheobronchomegaly is a rare condition with dilatation of trachea and central bronchi. It is en-countered more commonly in men and middle aged persons. Bronchiectasis and bronchopulmonary in-fections is common in this disorder. The diagnosis is established if the dilatatiton of trachea is de-monstrated by either bronchography or com-puterised tomography. In this article, we present a case of tracheobronchomegaly established in our clinic.

Detection of antihlarnydial IgG antibody prevalance by ELISA in pritnary enfertile women who dwell in Konya Chlamydia trachomatis plays in important role as an etiologic agent ,of genital tract infections causing infertility in women. In order to detect 1gG antibodies against this pathogenis agent rapidly, sera of 84 women of whom 42 were infertile and 42 had normal delivery were assayed by ELISA. Mean age of women involved in (his study performed in routin laboratory of Microbiology and Clinic Microbiology Departmant of Selcuk Univercity Medical School was 30. Antichlamydial IgG antibodies found to be negative in control group and positive in 12% of patients (5 of 42). We observed that ELISA had both reliable sensitivity and specifity in this study.

The patient has blunt abdominal pain and asyptomatic. The diagnosis of morgagni hernia is X-Ray pnemoperiteneum and CT. The patiend was re-pair surgical treatment. THe diagnosis of silent mor-gagni hernia can he revealed bly using modern ima-ging techniques such as CT or MRI.

Divorce is the legal end of the marriage union. The divorcee is the one who could not make a good marriage and maintain a bad marriage. It reveals that in societies where the family, which forms the basis of the society, continues its existence as an institution, sleep and nutritional disorders occur in people in the divorce process, which is defined negatively, increased drinking and smoking, decreased work efficiency, negative moods such as finding themselves incompetent, feeling lonely and anxiety increase.

Gallstone in the newborn period is rare and usually other pathological causes precede. in this report a gallstone case diagnosed in the ııewborn period is presented. By using ıdtrasorwgraphic technique, a gallstone was diagn.osed in a newborn with hemolitic jaundice caused by Rh incompatibi-lity and having phototheraphy. Six ınonths Inter it was observed that the gallstone had resoluted spontaneously when ultrason.ography repeated.

Purpose:

Primary and metastatic digestive system malignant melanomas are extremely rare. In our study, we aimed to compare lymph node metastasis with clinical and pathological parameters in gallbladder, stomach, small intestine and anorectal region malignant melanomas.

Materials and methods:

This retrospective study included 20 cases diagnosed with malignant melanoma in the gastrointestinal tract organs between January 2010 and January 2020 at XXXXXXXXXXXX. In our study, we wanted to evaluate the relationship between regional lymph node metastasis and age, gender, tumor localization, tumor size, extraintestinal melanoma history, melanin pigment, neutrophil-lymphocyte ratio and post-diagnosis life span in primary and metastatic malignant melanoma cases. We also reviewed the origin and literature of the cells from which melanoma originates in the digestive system.

Results:

There was a statistical relationship between tumor diameter and regional lymph node metastasis (p =0.000). As the tumor diameter increased, the lymph node metastasis rate increased. There was a relationship between survival and gender, tumor localization, distant metastasis, primary and metastatic digestive system melanoma (all p <0.05). Most of the men and those who did not metastasize away from the digestive system were alive. All patients with melanoma metastases to the digestive system and all patients with gallbladder and small intestine localization were alive. Our 70 year old patient with gallbladder primary malignant melanoma was the oldest patient we could identify in the literature.

Conclusions:

Regardless of cutaneous or origin, all melanomas originate from melanocytes, cells derived from embryological nerve crest. Malignant melanoma can be primary in every region, more frequently in the anorectal region in the gastrointestinal tract. The most common metastasis is to the small intestine. Accurate diagnosis is vital in places where it is rarely seen, such as the digestive system. Recently, in metastatic melanoma, immuno-oncological agents are used in adjuvant therapy to help prevent metastatic spread of the disease. Thanks to these treatments, it is reported that more than half of patients with melanoma who have the risk of metastasis after surgical resection provide recurrence-free survival. Although it is very rare, it should be kept in mind that there may be primary or metastatic malignant melanoma in the evaluation of digestive system biopsies.

In this study, the clinicopathologic cha-racteristics of 17 cases of carcinoma of the gall bladder was presented. The relationship between. histological types, gallstones, liver invasion and lymph node metastasis were investigated. Frequent lymph node metastasis and invasion of the liver, was encountered in the poor differentiated ade-nocarcinoma The presence of gallstones were fre-quent in papillary adenocarcinoma.

Objective: ıt was aimed to retrospectively evaluate the sociodemographic characteristics, anxiety and depression levels of adolescent mothers who were referred for marriage leave. Material and methods: 65 adolescent cases who became mother when they applied to the outpatient clinic for marriage permission between 2018-2020. Hospital records, sociodemographic data and edited forensic reports including psychiatric evaluations of the cases were reviewed retrospectively. In order to determine their depression and anxiety levels during the evaluation period, they were asked to fill in the anxiety and depression scale-revised self-report scale and kent e-g-y and porteus labyrinths intelligence tests applied by the psychologist were applied to evaluate the cognitive development.

Results: The mean age of the subjects included in the study was 16.33±0.307 years. It was determined that the mean age at which they were married unofficially was 15.44±0.499 years. It was observed that the average education period was 5.08±1.461 years. Before the unofficial marriage, 70.8% of the cases lived in the village and 29.2% in the city, after the marriage, 53.8% of the cases lived in the village and 46.2% in the city. It has been determined that 27.7% of unofficial marriages are consanguineous marriages. It was determined that the mean age of the children of the patients when they applied to the clinic was 4.05±3,701 months.

Conclusion: Girls who married early and gave birth before the age of 18, ıt reveals that their education period is short, their socioeconomic level is low, the age gap with their spouses is high, and their spouses' job opportunities are limited. The development of intervention programs and legal regulations aimed at preventing early marriages may contribute to the prevention of both adolescent marriages and the negative consequences of being an adolescent mother.

Sport has been adopted by many people around the world and has been accepted as a way of life. It not only contributes to the consciousness of exercise required for healthy life, but also contributes to the solution of many problems that people face in their daily lives thanks to the principles such as brotherhood, interlocking and justice. The practice of sports medicine has some differences in terms of ethical conflicts compared to other medicine practices. In addition to the classical physician-patient relationship, managing the physician-patient-team relationship, especially sports team physicians, forms the basis of these differences. During the management of this relationship, sports physicians may face some ethical conflicts. The physician must act in an honest and conscientious manner in his approach to the athlete and in his decisions. However, it is another important ethical behavior that the physician provides sufficient information to the athlete and enables the athlete to decide on his own body and act freely. Particularly financial pressures on teams and athletes, as well as the competition and ambition of success that are at the core of sports, can create dilemmas that can affect sports physicians' decision making processes. However, sports physicians are people who are expected to comply with ethical principles without losing their professionalism. If these ethical principles are not followed, malpractice situations may arise and physicians may encounter judicial processes. With the development of technology, many innovations in the field of sports medicine, as in every field, come into practical use. The role of these innovations in the development of sports medicine practices is very important. However, it is important to keep professional information up-to-date in the process of possible ethical problems and optimal decision making that these developments can create. Sports physicians have a great role in dealing with ethical and legally inappropriate situations, especially the use of doping. This review will review possible ethical problems and malpractice situations that sports physicians may encounter.

Cancer is a serious genetic disease caused by a series of disorders in the genome. Development of hightroughput sequencing approaches as well as the publication of large-scale projects have enabled the identification of several non-coding RNA molecules that are differentially expressed in various types of cancer. It has been reported that ncRNA transcripts such as long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have critical roles in the development and progression of cancer and can be used in the diagnosis/treatment of cancer. In particular, miRNAs are small RNA molecules which control gene expression at the post-transcriptional level and play critical roles in the important hallmark capabilities of cancers such as metastasis, invasion, cell proliferation, differentiation, and angiogenesis. Similarly, lncRNAs have also been identified as RNA transcripts that have important roles in the understanding of the molecular mechanism of cancer. Accordingly, in this comprehensive review, functional ncRNA molecules without protein coding capacity such as miRNAs, lncRNAs, and T-UCRs and the hallmarks of cancer were discussed together with a current perspective. 

This study was performed retrospectively by eı'a-luating the 200 cases. Of cases 130 was male ( 65%, mean ages 50), of them 70 was female (35%, mean ages 55 ). The ratio male/female was 1,8 (p<0,005). In the Ethiologic distribution; HBV(36%) was the striking cause where as HCV (33%) was second and alcohol consumption was the third causal factor. Alt-hough there are some differences in ı-atio, this dist-ribıttion was consistent with the results of other studies in Turkey. On the other hand, while the leading cause of chronic paranchimal liver disease is alcohol con-sumption in Europe and USA, it is HBV, an infectious agent, in developping countries. Weakness and fa-inting, abdominal swelling and loss of appetite and body weight at-e the most prominent svrnptoms. The connnonest abnormality and phvsical exa-mination was hepatomegaly which was followed bı-ascites and splenomegaly. The distribution of symptorns and physical findings were consistent with those in the literature published in Turkeı•. In over study easophagial bleeding to varies was the leading conıplication while hepatic en-cephaloapthy was reported as the comınonest one of chronic liver disease in Istanbul.

In this in vitro study, the dilatory effects of felodipine, verapamile, nimodipine and nicardipine on the contractile response to acetylcholine in isolated rat esophageal splıincter were investigated. The ga,s-tro-esophageal sphincters, obtained from rats, were suspended in Krebs-lIenseleit solution and were contracted with 10-4 M acetylcholine. In this part of investigation, cumulative concentrations (10-9-10-4M) of one of the antagonists were added in the medium. Then the responses were observed. tn the other part of investigation, cumulative concentrations of the same antagonist were applied on the preparation, which was contracted with acetylcholine in the Ca2+ -free medium. The maximuın contraction response induced by acetylcholine in Ca2+ -free medium was simi lar ta the response, obtained in medium with Ca2 . It was showed that, acetylcholine used both intra-and extracellular Ca2+. The poıency of the inhibitory effects of these calcium channel blockers was felodipine>verapamile>nimodipine=nicardipine. In Ca2+-free medium, there was no inhibition. The re,s-ults suggest that, these calcium channel blockers are effective on gastro-esophageal sphincter contractions and may be tıseful in the treatment of esophageal spasm.

In recent years, after it became clear that smoking poses a threat to human health by causing cancer and some other diseases, anti-smoking campaigns have intensified in many countries and the smoking rate has decreased significantly in these countries. Unfortunately, the amount of cigarettes consumed and imported in our country is gradually increasing. This means the number of people who will be harmed by smoking. Those who will suffer are not only actively smoking adults, but also the fetus, babies, and children in the mother's abdomen. In this article, some of the effects of smoking on child health will be discussed. This article has been prepared as part of a booklet that will also include other effects of smoking.

Acute pancıeatitis is the inflanırnation of this retcoperitoneal organ with various etiological factors varying in severity from slight edema tn peripancreatic necrosis that may deteriorate ta death. In this actiele, we eı'aluated the recolyis of 28 pa-tients with acute pancreatitis ı-etrospectively who adrnitted ta University of Selçuk. General Surgery Department, hetween .lanuaty 1992 and Novembeı-1995. Etiological factoı-s weı-e gallstone in 15, al-cohol in 2. lipe•lipidemia in one and pancreas head cancer in one. There was no identifiable cause in 9 patients. Six patients died of disease_ Three patients underwent lapaı-atomy. FollovıLtıp of the casus sho-wed good correlation with the lmrie prognosticcriterias tiCcriterias criteılas

In this study, in the TA. dominant ego states with effects adjustment and assertiveness of students have been examined. The dominant ego states of students was effective on their adjustement. The students with dominant Free Child have the least adjustment. all groups. The students with dominant Adult are the most adjusted. The dominant ego satates of the students effect their assertivenes. The students with dominant adap-ted Child had the least assertiveness in all groups. On theother hand, the students with dominant adult were the most assertive of all group.

In this study brainstem auditory evoked potential (BAEP) responses were obtained from 45 migraine patients (consisting of 8 males and 37 females) and a sufficient number of control cases. Peak latencies (I, II, III, IV and -V) and interpeak latencies (1411, I-V) were calculated and analysed statistically. Latency values of the tıvo group (migraine pa-tients and controls) were compared. We found no sta-tistically signıficant difference between the values of migraine patients (in painless and painful periods) and the controls. In unilateral headaches comparing BAEP latency values of painful and painless sides of head was of no statistically dillerence. Our results were evaluated in the light of the relevant literature

Otoacoustic emulsions are the amount of energy in the auditory frequency that originates from the cochlea, carried to the external auditory canal via the inner ear fluids, the small chain and the tympanic membrane. In other words, it is the cochlear energy release recorded from the external auditory canal. Views about cochlear function have changed enormously over the past 10 years. Morphological, physiological, psychoacoustical and experimental studies on this subject have contributed to this change. The most important contribution to the views on cochlear function is the fact that the cochlea is a structure that not only receives sounds but also produces acoustic energy. As it is known, auditory sensory cells are a meta-canoreceptor that converts mechanical stimulus to electrical impulse. Due to the mechanical function of the middle ear, the fluctuation that starts in the inner ear fluids causes excitatory and inhibitory action in the ciliary de-metes of the sensory cells in the corti organ, while this movement is in the excitatory direction, it initiates the release of afferent neurotrans ilter agent in the synaptic space, resulting in a neural impulse.

(VET Acute inferior (AIM!) And inferoposterior myocard infarction (AIPA41), atrioentricphs were examined in 247 cases to determine the intra-hospital mortality of cases with complete block (AV). Tarn block was 18% in proportion to development of AV block. Those who did not develop AV complete block: angina pectoris, hy-pertension, smoking and diabetes mellitiis increased compared to increased (P> 0.05) m, ventricular fibrillation (VF), yentricular tachycardia (VT) Complications such as paroxysmal atrial fibrillation (PAF), congestive heart failure (CHF), cardiomegaly, pulmolar bdem, and cadiogenic seal when compared to actsan attlanilt bultinmuour (p <0.05), enzyme values ​​in AV complete blockade are increased CPK: 1491 ± 202 UIL, LDH: 1493 ± 559 IUIL. SGOT was found to be 301 ± 24 UIL, CPK 12714 UI L, CDH 785 ± 51 U1IL SCOT 280 ± 17 UIL for those who did not come. In the majority of colleges, AV full block lasts for the first 24 hours. is in ge-1411. AV complete block poise ranged between 1-13 grams, while the density of the people between 1-8 grams was nimble from block to ctlai. In 17 of 55 Yak'anut with AIPMP, the ratio of AV complete block and AV complete block was 31%. Yaks with and without AV complete block; Oink findings such as angina pec-toris, diabetes mellitus were significant when compared to age (P> 0.05), while complications such as hypertension, smoking and VF, VT, PAF, CHF, car-diontegaly, pulmonary edema and a cardiogenic seal were significant. -lamh hulundu (P <0.05). Enzyme values ​​CPK I237 ± 112 UIL in those with complete AV block. LDH 672-145 ILIIL SCOT 211 ± I7 UIL, CPK 1121-1-128 UIL in gelipneyets. The LDH was 573 ± 34 SGOT 211 ± .30 UIL, and the difference between them was anlandzych. (P <0.05). Full AV block developed in 1-2 days in the foggy majority of our cases with AIPMI. While the number of AV complete block varied between 1-12 days, the cn-grat of the caught took off the block between 1-6 and turned into sitzis rhythm. We used the controversial a-pacemaker pacemaker to treat pain and ileum disturbances that occur during the course of AMtsfin. In-hospital mortality is 14% in cases with AIMP and complete AV block. 7% of those who did not come. AIPMI and AV were found to be 28% in those with complete block and 13% in those who did not. Results were significant when compared (P <0.05). As a result, we can divide that in patients with complete AV block and AIPMI valeas, complications are higher, those with higher enzyme values ​​and necrosis are more advanced than those with advanced complications. It is not the complete AV block itself, but the hemodynamic basucolic Blood diffuse myocardial necrosis that affects hospital mortality.