GÝRÝÞ ve AMAÇ: Sürdürülen sayýsýz araþtýrmaya ve geliþtirilen ilaçlara raðmen günümüzde kanser hala milyonlarca insanýn ölümüne neden olan hastalýklarýn baþýnda gelmektedir. Over kanseri en ölümcül kanserlerden biri olup kadýnlarda en çok görülen beþinci kanser türüdür. Uygulanan tedavi yöntemleri arasýndan kemoterapiye nispeten daha iyi yanýt alýnmasýna raðmen over kanseri halen tam olarak tedavi edilememektedir. Bu nedenle geleneksel tedavi yöntemlerinin aðýr yan etkilerinden sýyrýlmýþ, kanser hücresine karþý seçicilik gösteren etkili yöntemlerin geliþtirilmesi ve/veya var olan yöntemlerin birleþtirilerek özgün tedavilerin geliþtirilmesi gerekmektedir. Fotodinamik Terapi (FDT), ýþýkla aktive olan molekül (fotosensitizer), oksijen ve uygun dalga boyundaki ýþýðýn birleþmesi sonucu ortaya çýkan bir dizi fotokimyasal/fotofiziksel reaksiyonlar sonucu hücrenin ölümü prensibine dayanýr. Özgün, suda çözünürlüðü yüksek fotosensitizerin SKOV-3 over kanser hattýnda FDT çalýþmalarý yapýldý. 100 µM konsantrasyona kadar karanlýk toksisite görülmezken, ayný deðerde ýþýkla aktivasyonu sonucu fotosensitizerin reaktif oksijen türleri üreterek yüksek fototoksisiteye sebep olduðu görüldü. SKOV-3 over kanseri hücre hattýnda IC50 deðeri 79 µM olarak belirlendi.
YÖNTEM ve GEREÇLER:
BULGULAR:
TARTIÞMA ve SONUÇ:

INTRODUCTION: Cancer is a leading cause of death of millions of people, in spite of countless studies and drugs developed. Ovarian cancer is one of the deadliest cancer types, and it is the fifth most common in women. Despite the relatively better response to chemotherapy among treatment modalities, ovarian cancer still cannot be fully treated. For this reason, it is necessary to develop effective methods that are selective against cancer cells and/or to combine existing methods to develop original therapies that are free of the side effects of traditional treatment methods. Photodynamic therapy (PDT) involves a series of photochemical/photophysical reactions caused by the combination of a photosensitizer (a molecule activated by light), oxygen, and light of a specific wavelength, which leads to cell death. PDT has been performed with a novel, water-soluble photosensitizer in the SKOV-3 ovarian cancer cell line. While the photosensitizer did not show any toxicity up to a concentration of 100 µM, upon activation with light, significant toxicity was created via the generation of highly reactive oxygen species. The IC50 value was determined to be 79 µM in the SKOV-3 ovarian cancer cell line.
METHODS:
RESULTS:
DISCUSSION AND CONCLUSION:

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GÝRÝÞ ve AMAÇ: Rejenerasyon, fonksiyonel bir kayýp yaþamadan hasarlý dokunun, organýn ya da uzvun restore edilmesi iþlemidir. Su semenderlerinden olan Aksolotl kendisini öldürmeyecek iç organ, merkezi sinir sistemi ve uzuv hasarlarýný baþarý ile tamir edebilmektedir. miRNA’lar hedef mRNA’larýn translasyon düzeyini düþürerek yazýlým sonrasý gen ifadesinin kontrolünde önemli roller üstlenirler. Biz de bu çalýþmada Aksolotl’un kuyruk rejenerasyonu sýrasýnda deðiþen miRNA profilini ve bu miRNA’larýn moleküler yolaklara olasý etkilerini araþtýrdýk.
YÖNTEM ve GEREÇLER: 6-8 aylýk 60 adet Aksolotl’un kuyruk bölgesinden ampütasyon yapýlmýþ ve hayvanlar 4 gruba ayrýlmýþtýr. Ampütasyondan hemen sonra (0. gün) ve rejenerasyonun 1., 4. ve 7. günü örnek toplanmýþtýr. Toplanan örneklerden yeni nesil dizileme yöntemi ile miRNA tespiti yapýlmýþtýr. Bulunan miRNA’lar içinde rejenerasyonun farklý evrelerinde miktarý anlamlý olarak deðiþenlerin hangi yolaklarý regüle ettiði analiz edilmiþtir.
BULGULAR: Bulunan miRNA’lar içinden 52 tanesinin miktarý 1.5 kat ve üzeri deðiþtiði (arttýðý veya azaldýðý) için bu miRNA’lar yolak analizlerinde kullanýlmýþtýr. Rejenerasyon ile birlikte artýþ gösteren miRNA’larýn hemostazla iliþkili yolaklarý regüle ettiði görülmüþtür. Rejenerasyon sürecinde azalýþ gösteren miRNA’larýn ise hücre bölünmesi ve hücre bölünmesinin kontrolü ile ilgili yolaklarý regüle ettiði bulunmuþtur.
TARTIÞMA ve SONUÇ: miRNA’lar canlýlýkta birçok görev (hemostaz, geliþim, büyüme ve hastalýk durumunun regülasyonu vb.) üstlenirler. miRNA profilinin deðiþmesi rejenerasyonun baþarý ile sürmesi ve tamamlanmasý için gerekli bir mekanizmadýr. Biz de bu çalýþmada Aksolotl’un kuyruk rejenerasyonu sürecinde miktarý artan ve azalan miRNA’larýnýn dinamik deðiþimini tanýmlayýp, bu deðiþimin moleküler yolaklar üzerine etkisini araþtýrdýk.

INTRODUCTION: Regeneration is the process of the restoration of an injured organ, extremity, or tissue without functional loss. Axolotl, a species of aquatic salamander, can perform successful regeneration after a non-lethal injury to internal organs, the central nervous system, and extremities. miRNAs targeting mRNAs have essential roles in post-transcriptional regulation by decreasing the translational level. This study was an investigation of changes in the miRNA profile and the effect of miRNAs on molecular pathways during tail regeneration.
METHODS: 60 axolotls 6 to 8 cm in length was amputated and the animals were randomly divided into 4 groups. Tissue samples were taken just after amputation (day 0 sample), and on the first, fourth, and seventh day of regeneration. miRNAs were identified in the collected samples using next generation sequencing. Among the identified miRNAs, those demonstrating significant change at different stages of regeneration were analyzed to explore the pathways regulated.
RESULTS: Of the identified miRNAs, 52 that changed (increased or decreased) by 1.5 times or more were used in molecular pathway analysis. It was found that miRNAs upregulated during regeneration controlled homeostatic pathways, while downregulated miRNAs controlled the cell cycle and cell cycle regulating pathways.
DISCUSSION AND CONCLUSION: miRNAs act in fundamental processes, such as homeostasis, development, growth, and regulation of disease. A shift in the miRNA profile is necessary to achieve progress and the successful accomplishment of regeneration. In this study, the dynamic alterations of increased and decreased miRNAs levels were identified and the putative effects on molecular pathways were examined.

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GÝRÝÞ ve AMAÇ: Hemodiyaliz ve periton diyalizi hastalarýnda uyku bozukluklarý sýkça rapor edilmekte olup, bu hastalarýn rüyalarýný araþtýran çalýþma bulunmamaktadýr. Biz hemodiyaliz ve periton diyalizi hastalarýnda rüya bunaltýsý düzeyindeki farklýlýklarý araþtýrmayý planladýk. Bu iki grup arasýnda depresyon ve anksiyete semptomlarý,uyku kalitesi ve uykusuzluk düzeylerini de karþýlaþtýrmayý planladýk.
YÖNTEM ve GEREÇLER: Bu gözlemsel kesitsel çalýþmaya nefroloji kliniðinde ayaktan takip edilen 49 hemodiyaliz hastasý ve 29 peritoneal diyaliz hastasý alýndý. Gerekli özelliklerin deðerlendirilmesi için Sosyodemografik Veri Toplama Formu, Van Rüya Bunaltýsý Ölçeði (VDAS), Pittsburg Uyku Kalitesi Ýndeksi (PSQI), Uykusuzluk Þiddet Ýndeksi (ISI), Beck Depresyon ve Anksiyete Envanteri kullanýldý. Hemoglobin (Hb), Kt / V üre indeksi ölçüldü.
BULGULAR: Rüya bunaltýsý (p=0.517), depresyon (p = 0,889), uyku kalitesi (p = 0,221), uykusuzluk þiddeti (p = 0,152) ve hb (p = 0,505) açýsýndan gruplar arasýnda anlamlý farklýlýk yoktu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda hemodiyaliz ve periton diyalizi hastalarý arasýnda depreyon, anksiyete, uyku kalitesi ve uykusuzluk þiddeti düzeyleri açýlarýndan anlamlý fark bulmadýk. Benzer þekilde rüya bunaltýsý düzeyi de bu bulgularla tutarlý bulundu.

INTRODUCTION: Sleep disorders are frequently reported in hemodialysis and peritoneal dialysis patients, but there are no studies investigating the dreams of these patients. This study was an examination of differences in the level of dream anxiety between hemodialysis patients and peritoneal dialysis patients. A comparison of depression and anxiety symptoms, sleep quality, and sleepiness between these 2 groups was also performed.
METHODS: In this observational, cross-sectional study, 49 hemodialysis patients and 29 peritoneal dialysis patients treated at an outpatient nephrology clinic were enrolled. A sociodemographic data collection form, the Van Dream Anxiety Scale, the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Beck Depression and Anxiety Inventories were administered, and hemoglobin level and fractional clearance of body water by dialysis (Kt/V urea) were measured.
RESULTS: There were no significant differences between the groups in terms of dream anxiety (p=0.517), depression (p=0.889), sleep quality (p=0.221), insomnia severity (p=0.152) or hemoglobin level (p=0.505).
DISCUSSION AND CONCLUSION: We did not find any significant difference in the level of depression, anxiety, sleep quality, or insomnia severity between hemodialysis and peritoneal dialysis patients in our study. Similarly, the level of dream anxiety was consistent with these findings.

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GÝRÝÞ ve AMAÇ: Böbrek tümörü nedeniyle yapýlan nefron koruyucu cerrahi yöntemlerin, radikal nefrektomi olgularý ile benzer onkolojik sonuçlara ve uzun dönemde daha iyi fonksiyonel sonuçlara sahip olduðu bilinmektedir. Deneyimli merkezlerde minimal invaziv cerrahi yöntemlerle yapýlan nefron koruyucu operasyonlar (Laparoskopik Parsiyel Nefrektomi, LPN) radikal nefrektomiye karþý güvenli ve etkin bir alternatif olarak kabul görmüþtür. Bu çalýþma ile laparoskopik operasyonlarda kendinden dikenli dikiþ materyalinin (KDDM) kullanýlmasýnýn perioperatif parametreler ve postoperatif fonksiyonel sonuçlar üzerindeki etkilerinin deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Baðcýlar Eðitim ve Araþtýrma Hastanesi, Üroloji Kliniði’nde Kasým 2008 ile Aralýk 2016 tarihleri arasýnda, renal kitle nedeni ile tek cerrah tarafýndan LPN yapýlan 83 hastanýn verileri retrospektif olarak incelenmiþtir. Hastalar operasyonlarda kullanýlan dikiþ materyalinin türüne göre iki gruba ayrýlmýþtýr. Birinci grupta; renorafi ve/veya toplayýcý sistem onarýmýnýn 3/0 emilebilen polyglactin dikiþ materyali ile yapýldýðý 38 hasta, ikinci grupta; renorafi ve/veya toplayýcý sistem onarýmýnýn KDDM (V-Loc) ile yapýldýðý 45 hasta bulunmaktadýr. Ýki grup arasýnda; demografik özellikler, radyolojik bulgular, tahmini kan kaybý miktarý ve sýcak iskemi süresi (SÝS) gibi perioperatif deðerler, onkolojik sonuçlar, komplikasyonlar ve postoperatif fonksiyonel deðerler karþýlaþtýrýlmýþtýr.
BULGULAR: Yaþ, Vücut kitle indeksi (VKÝ), ASA (American Society of Anesthesiologists) skoru, tümör boyut ve taraflarý, PADUA skoru, operasyon süresi, komplikasyon oraný ve hastanede kalýþ süresi gibi temel özelliklerin gruplar arasýnda benzer olduðu görülmüþtür. Ýkinci grupta birinci gruba göre tahmini kan kaybý miktarý daha az olarak saptanmýþtýr (grup I: 202,1 cc; grup II: 179,77 cc, p=0,001). Ýkinci grupta SÝS daha kýsa olarak saptanmýþtýr (grup I: 23,81 dk.; grup II: 16,42 dk. p=0,001). Operasyon sonrasý takiplerde böbrek fonksiyonlarý ikinci grupta daha iyi olarak saptanmýþtýr (p=0,003).
TARTIÞMA ve SONUÇ: Böbrek tümörü tedavisinde uygulanan LPN’de kullanýlan KDDM’nin sýcak iskemi süresi, tahmini kan kaybý ve postoperatif fonksiyonel sonuçlarda olumlu kazanýmlar saðladýðý görülmüþtür. Laparoskopik parsiyel nefrektomi operasyonlarýnda KDDM’nin kullanýlmasý etkin ve güvenilir bir seçenek olarak deðerlendirilmiþtir.

INTRODUCTION: It is acknowledged that nephron-sparing surgery has similar oncological results to radical nephrectomy and better long-term functional outcomes. In experienced centers, minimally invasive nephron-sparing surgery is a strong alternative to radical nephrectomy. The aim of this study was to determine the effects of V-Loc (Covidien, Ltd., Dublin, Ireland) suture use on perioperative parameters in laparoscopic partial nephrectomy (LPN) and postoperative renal function.
METHODS: The data of 83 patients who underwent LPN performed by a single surgeon between November 2008 and December 2016 were evaluated retrospectively. Renorrhaphy and collecting system repair was performed for 38 patients in Group 1 using 3/0 polyglactin suture, and V-Loc suture was used for 45 patients in Group 2. Perioperative variables of demographic characteristics, radiological features, estimated blood loss, and warm ischemia time were compared, as well as oncological and postoperative functional outcomes of the 2 groups.
RESULTS: The basic features of age, body mass index, American Society of Anesthesiologists score, tumor size and laterality, Padua score, and operative time did not differ significantly between the 2 groups. Estimated blood loss was less in Group 2 (Group 1: 202.1 cc, Group 2: 179.77 cc; p=0.001). Warm ischemia time was shorter for Group 2 (Group 1: 23.81 minutes, Group 2: 16.42 minutes; p=0.001). Postoperative renal function was significantly better in Group 2 (p=0.003).
DISCUSSION AND CONCLUSION: The study results indicated that renorrhaphy and collecting system repair with V-Loc suture had significant benefits for warm ischemia time, estimated blood loss, and postoperative renal function, and that it is efficient and safe for use in LPN.

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GÝRÝÞ ve AMAÇ: Kanser geliþimi ve kansere baðlý ölümde yakýn iliþkisi birçok çalýþmada gösterilen metabolik sendromun dünya genelinde olduðu gibi ülkemizde de insidansý her geçen gün artmaktadýr. Kliniðimizde mesane tümörü nedeniyle deðerlendirdiðimiz hastalarda; metabolik sendrom ve metabolik sendrom bileþenlerinin; mesane kanserinin evresi, derecesi, CIS (Carsinoma Ýn Situ) varlýðý ve nüks sayýsýna olan etkilerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Üroloji Kliniði’nde, Temmuz 2010 – Temmuz 2013 tarihleri arasýnda mesane kanseri ön tanýsý ile sistoskopi ve doku rezeksiyonu yapýlan hastalar deðerlendirildi. Ýlk kez kliniðimizde mesane kanseri tanýsý alan, 100’ü metabolik sendromlu ve 100’ü metabolik sendromlu olmayan toplam 200 hasta çalýþmaya dahil edildi. Hastalar yaþ, cinsiyet, sigara kullanýmý, ailede kanser öyküsü, HT, metabolik sendrom, metabolik sendrom bileþenleri (bel çevresi, trigliserid, HDL ( High Density Lipoprotein), kan basýncý, açlýk kan þekeri), BMI (Body Mass Ýndex) parametrelerinin; mesane kanseri evresi, derecesi, CIS varlýðý ve nüks sayýlarý ile iliþkisi retrospektif olarak deðerlendirildi.
BULGULAR: Metabolik sendrom ve metabolik sendrom bileþenlerinin mesane kanseri evresi, derecesi, CIS varlýðý ve nüks sayýsýna olan etkilerini istatistiksel olarak deðerlendirdiðimiz çalýþmaya katýlan hastalarýn 25’i kadýn 175’i erkek olup yarýsýnda metabolik sendrom tanýsý mevcuttu. Yaþ ortalamasý 63±12 yýl olan hastalarýn 40’ýnda diyabet, 70’inde hipertansiyon, 49’unda ailede kanser öyküsü, 125’inde sigara kullaným hikayesi mevcuttu. Hastalarýn ortalama; sistolik kan basýncý 127±10 mmHg, diastolik kan basýncý 82±8 mmHg, Bel çevresi 97±10 cm, BMI 25,5±2,3 kg/m2, açlýk kan þekeri 104±24 mg/dl, HDL 47±9 mg/dl, trigliserid 163±64 mg/dl olarak saptandý. Mesane tümörü patolojisi; 24 hastada Ta, 135 hastada T1 ve 41 hastada T2 iken tümör derecesi; 125 hastada düþük grade, 75 hastada yüksek grade saptandý. CIS (+)’liði 58 hastada saptandý. Ortalama 18±4,2 aylýk takipte; 55 hastada mesane tümör nüksü gerçekleþmezken, 87 hastada 1 kez, 49 hastada 2 kez ve 9 hastada ise 3 kez nüks gerçekleþti.
TARTIÞMA ve SONUÇ: Mesane kanseri evresi için, 40 paket/yýl üzeri sigara kullanýmý (p=0,001) ve 60 üstü yaþ (p=0,024) baðýmsýz risk faktörleri olarak belirlenirken; mesane kanseri derecesi için ise aile öyküsü (p=0,003) ve 40 paket/yýl üzeri sigara kullanýmý (p=0,012), baðýmsýz risk faktörleri olarak belirlendi. 18±4,2 aylýk takipte metabolik sendromun tüm taný kriterleri ile bir bütün olarak, mesane kanseri parametreleri ile iliþkisi saptanmamýþtýr. Fakat sistolik kan basýncý yükseklikleri, düþük trigliserid ve HbA1c düzeyleri, mesane kanseri seyrini olumsuz yönde etkilemektedir.

INTRODUCTION: Metabolic syndrome is associated with a rising incidence of cancer and cancer-specific mortality. At the same time, the incidence of metabolic syndrome is increasing in our country and worldwide, as can be seen in recent studies. In this study, patients diagnosed with bladder cancer were retrospectively evaluated to assess the correlation of bladder cancer with metabolic syndrome and the effect on cancer stage, grade, presence of carcinoma in situ (CIS), and disease recurrence.
METHODS: Patients with suspected bladder neoplasm who underwent cystoscopy and bladder tumor resection between July 2010 and July 2013 were analyzed. A total of 200 patients who were newly diagnosed with bladder cancer were included in the study. Two groups were created: 100 patients who had concomitant metabolic syndrome and 100 who did not. Patient age, sex, tobacco use, family cancer history, hypertension, presence of metabolic syndrome, metabolic syndrome components (waist circumference, triglycerides, high-density lipoprotein [HDL], blood pressure, and fasting glucose level), body mass index (BMI) parameters, and bladder cancer stage, grade, incidence of CIS, and recurrence rate were evaluated.
RESULTS: Of the total, 25 patients were female and 175 were male. Metabolic syndrome was present in 50%. The average age was 63±12 years. In all, 40 patients had diabetes mellitus, 70 had hypertension, 49 had a positive family history of malignancy, and 125 had a positive history of tobacco use. The mean systolic blood pressure was 127±10 mmHg, diastolic pressure was 82±8 mmHg, waist circumference was 97±10 cm, BMI was 25.5±2.3 kg/m2, fasting blood glucose level was 104±24 mg/dL, HDL was 47±9 mg/dL, and triglyceride level was 163±64 mg/dL. Bladder cancer pathological stage reported was: 24 patients with Ta, 135 with T1, and 41 patients with T2 tumor; 125 patients had low-grade and 75 had high-grade tumors. CIS was determined in 58 patients. In a mean follow-up of 18±4.2 months, no tumor recurrence was seen in 55 patients, 87 patients had 1 recurrence, 49 had 2 instances of tumor recurrence, and 9 patients had 3 instances of recurrence.
DISCUSSION AND CONCLUSION: Tobacco use of >40 pack/years (p=0.001) and age over 60 years (p=0.024) were independent risk factors for bladder cancer stage, and positive family history of cancer (p=0.003) and tobacco use >40 pack/years (p=0.012) were independent risk factors for bladder cancer grade. In follow-up of 18±4.2 months, no correlation was found between metabolic syndrome criteria and bladder cancer parameters; however, high systolic blood pressure rate, and high triglyceride and glycated hemoglobin levels can negatively affect bladder cancer outcomes.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý çocukluk çaðý nörofibromatosis tip 1 olgularýnýn klinik bulgularýnýn deðerlendirilmesi.
YÖNTEM ve GEREÇLER: 2010-2017 yýllarý arasýnda Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Çocuk Nöroloji Bilim Dalý tarafýndan takip ve tedavileri yapýlan çocukluk hastalarýn klinik özellikleri retrospektif olarak deðerlendirildi.
BULGULAR: Çalýþmaya 49 çocuk alýndý. Olgularýn 23’ü erkek, 26’sý kýzdý. Yaþ ortalamasý 11.71 ± 4.05 yýl saptandý 14 (%28.6) olgunun ailesinde nörofibromatosis öyküsü mevcuttu. Lisch nodülü 20 hastada, koltukaltý çillenmesi 15 hastada görüldü. Olgularýn 10’nunda nörofibrom vardý. Pleksiform nörofibrom hiçbir olguda yoktu. Dört çocukta skolyoz, bir çocukta tibiada psödoartroz mevcuttu. Olgularýn onunda öðrenme güçlüðü vardý.
TARTIÞMA ve SONUÇ: Çalýþmamýzdaki olgularýn semptom, bulgu ve komplikasyonlarý literatürle uygun¬luk göstermektedir. Komplikasyonlarýn az olmasýnýn olgularýn yaþlarýnýn küçük olmasýna baðlý olduðu düþünüldü. Bu çalýþmada NF-l’in erken tanýnmasýnýn ailelerin hastalýk hakkýnda bilgilen¬dirilmesi ve bu çocuklarýn düzenli klinik takibiyle tedavi edilebilir komplikasyonlarýn önlenmesi açýsýndan önemini vurguladýk.

INTRODUCTION: The aim of the present study was to analyze the clinical features of children with neurofibromatosis type 1.
METHODS: Neurofibromatosis cases admitted to the Eskisehir Osmangazi University Child Neurology unit from 2010 through 2017 were evaluated retrospectively.
RESULTS: The research group consisted of 49 patients. Of those, 23 were boys and 26 were girls. The mean age of the children was 11.71±4.05 years. Lisch nodules were observed in 20 patients, and axillary freckling in 15 patients. Neurofibroma was present in 10 cases. No plexiform neurofibroma was detected. Scoliosis was seen in 10 patients and tibial pseudoarthrosis was observed in 1. Ten children were evaluated for learning difficulty.
DISCUSSION AND CONCLUSION: The results of the present study were consistent with the lit¬erature. The low number of complications seen in our study is thought to be related to the young age of the patients. Early diagnosis of NF-1 is very important to inform families about the disease and prevent treatable complications with regular follow-up of these children.

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GÝRÝÞ ve AMAÇ: Bu çalýþmamýzdaki amaç iyot eksikliðine baðlý endemik bir bölgede yapýlan guatr ameliyatlarýndan sonra tiroid kanser oranýný saptamak ve histopatolojik hücre tiplerini belirlemektir.
YÖNTEM ve GEREÇLER: Çalýþtýðýmýz endemik bir bölgede ameliyat edilen 332 guatr olgusu deðerlendirmeye alýnmýþtýr. Tüm olgular fizik muayene, tiroid hormon seviyeleri (sTSH,FT3,FT4 ) ve tiroid ultrasonografisi (USG) ile deðerlendirildi. Bazý olgulara ince iðne aspirasyon biyopsisi (ÝÝAB) ve tiroid sintigrafisi uygulanarak preoperatif tanýlara ulaþýldý. Postoperatif histopatolojik incelemelere göre tiroid kanser oraný ve hücre tipleri ortaya kondu.
BULGULAR: Ardýþýk olarak tiroidektomi yapýlan hastalarýn yaþ ortalamasý 43.6 + 13.7 (17-67), Kadýn/Erkek daðýlýmý ise sýrasýyla %84 (n=279) ve %16 (n=53) olarak saptandý. Olgularýmýzýn preoperatif tanýlarý multinodüler guatr %77.4 (n=257), soliter tiroid nodülü %20.8 (n=69), toksik diffüz guatr %1.8 (n=6) olarak belirlendi. Hastalara cerrahi prosedürler % 80.4 (n=267) total tiroidektomi, % 6 (n= 20) unilateral total kontrlateral totale yakýn tiroidektomi, %3 (n=10) unilateral total tiroidektomi, istmektomi, % 10.6 (n=35) bilateral subtotal tiroidektomi þeklinde uygulandý. Postoperatif histopatolojik deðerlendirmeye göre papiller karsinom oraný %77.8 (n=21), Folliküler karsinom oraný %7.4 (n=2), diðer karsinom oranlarý %14.8 (2 olgu malign potansiyeli belirsiz folliküler tümör, 1 olgu malignite potansiyeli belirsiz iyi differansiye tümör, 1 olgu iyi differansiye karsinom –NOS grubu) saptandý.
TARTIÞMA ve SONUÇ: Ýyot eksikliðine baðlý endemik bir bölgede yapýlan bu çalýþmada guatr nedeni ile ameliyat edilen hastalarda tiroid karsinom oraný %8.1 olarak bulunmuþtur. Kontrolsüz iyot profilaksisi uygulanmakta olan endemik bu bölgemizdeki çalýþmada, tiroid kanser histopatolojik hücre oranlarýndaki deðiþiklik literatür ile uyumlu olarak; papiller karsinom oranýnýn arttýðý, folliküler karsinom oranýnýn azaldýðý yönündedir.

INTRODUCTION: The aim of this study was to determine the incidence of thyroid cancer and the histopathological cell type of goiters operated on in an area of endemic iodine deficiency.
METHODS: A total of 332 goiter cases that were operated on were evaluated. All of the patients underwent a physical examination, test of thyroid hormone levels (sensitive thyroid stimulating hormone, free triodothyronine, free thyroxine) and thyroid ultrasonography. Some of the patients were diagnosed preoperatively by fine needle aspiration biopsy and thyroid scintigraphy. The thyroid cancer rate and cell types were defined by postoperative histopathological evaluation.
RESULTS: The mean age of consecutive thyroid surgery patients was 43.6±13.7 years (range: 17-67 years); 84% (n=279) of them were female. The preoperative diagnostic distribution of cases was 77.4% multinodular goiter (n=257), 20.8% solitary thyroid nodule (n=69) and 1.8% toxic diffuse goiter (n=6). Surgical procedures performed were total thyroidectomy in 80.4% (n=267), total unilateral thyroidectomy and near total on the contralateral side in 6% (n=20), total thyroidectomy and unilateral isthmectomy in 3% (n=10), and bilateral subtotal thyroidectomy in 10.6% (n=35). The postoperative histopathological results revealed papillary carcinoma in 77.8% (n=21), follicular carcinoma in 7.4% (n=2), and other carcinomas in 14.8% (2 cases with follicular tumor of uncertain malignant potential, 1 case with well-differentiated tumor of uncertain malignant potential, and 1 case with well-differentiated carcinoma-not otherwise specified).
DISCUSSION AND CONCLUSION: The rate of thyroid carcinoma in patients operated on for a goiter in an area of endemic iodine deficiency and where uncontrolled iodine prophylaxis is being performed was determined to be 8.1%. The change in thyroid cancer histopathological cell ratios found was consistent with the literature: an increased proportion of papillary carcinoma was seen, and a decrease was observed in follicular carcinoma.

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GÝRÝÞ ve AMAÇ: Hemodiyaliz hastalarýnda üst gastrointestinal sistem yakýnmalarý sýk görülmektedir ve ülkemizde diyaliz hastalarýnda gastroözefageal reflü hastalýðý (GÖRH) prevelansý araþtýrýlmamýþtýr. Bu çalýþmada hemodiyaliz hastalarýnda GÖRH sýklýðýný ve iliþkili olduðu faktörleri araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Kesitsel tipteki bu çalýþmaya 107 standart hemodiyaliz tedavisi uygulanan hasta dahil edildi. Hastalarýn gastrointestinal sistem þikayetleri, özgeçmiþ özellikleri ve kullandýklarý ilaçlar yüz yüze görüþme yöntemi ile elde edildi. Anket formu, bireylerin sosyodemografik özelliklerini, gastroözefageal reflü hastalýðý (GÖRH) ile iliþkili olduðu düþünülen bazý faktörler ile ilgili sorularý içermekteydi. Çalýþmada gastroözofageal reflü hastalýðýnýn deðerlendirilmesinde National Ýnstitutes of Health (NIH) PROMÝS GERD Ölçeði kullanýlmýþtýr.
BULGULAR: Çalýþmaya dahil edilen hastalarýn 59’u (%55.1) erkek, 48’i (%44.9) ise kadýndý. Hastalarýn yaþlarý 30-89 arasýnda deðiþmekte olup, yaþ ortalamalarý 61.3±12.2 yýl idi. Hastalarda GÖRH sýklýðý % 14,0 oranýnda tesbit edildi. Hastalarýn %72.9’u gastroprotektif ajan kullanmakta idi. GÖRH olanlarla olmayanlar arasýnda yaþ, cins, vücut kitle indeksi, sigara kullanýmý, medeni durum, gastroprotektif ilaç kullanýmý, nonsteroid antienflamatuar ilaç kullanýmý, diyaliz süresi açýsýndan fark bulunmadý. Eðitim düzeyi arttýkça gastroözofageal reflü hastalýðý sýklýðýnýn azaldýðý bulundu (p<0.05).
TARTIÞMA ve SONUÇ: Genel Türk popülasyonu ile karþýlaþtýrýldýðýnda (%33.9), hemodiyaliz hastalarýnda GÖRH sýklýðý daha az (%14) bulunmuþtur. Hemodiyaliz hastalarýnda yüksek gastroprotektif ilaç kullaným oraný daha az GÖRH sýklýðý ile iliþkili olabilir.

INTRODUCTION: Upper gastrointestinal system complaints are common in hemodialysis patients, yet the prevalence of gastroesophageal reflux disease (GERD) has not been investigated in dialysis patients in this country. The aim of this study was to investigate the frequency of GERD in hemodialysis patients and related factors.
METHODS: This cross-sectional study included 107 patients who underwent standard hemodialysis treatment. Face-to-face interviews were conducted to obtain details of gastrointestinal complaints, biographical data, and the drugs they used were obtained by. The questionnaire used included questions about socio-demographic characteristics and some factors thought to be related to GERD. The National Institutes of Health Patient-Reported Outcomes Measurement Information System GERD Scale was used to evaluate the presence of GERD in the patients.
RESULTS: Of the patients included in the study, 59 (55.1%) were male and 48 (44.9%) were female. The age of the patients ranged from 30 to 89 years, with a mean age of 61.3±12.2 years. The incidence of GERD was 14.0% in the study patients. In all, 72.9% of the patients were using a gastroprotective agent. There was no difference between patients with GERD and those without GERD in terms of age, sex, body mass index, smoking status, marital status, gastroprotective drug use, nonsteroidal anti-inflammatory drug use, or duration of dialysis. As the level of education increased, the frequency of GERD decreased.
DISCUSSION AND CONCLUSION: The frequency of GERD was lower in hemodialysis patients (14%) compared with the general Turkish population (33.9%). High gastroprotective drug use rates in hemodialysis patients may be associated with a lower GERD frequency.

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Piriformis sendromu (PS), siyatik sinirin piriformis kasý tarafýndan tuzaklanmasý ile oluþan bir klinik tablodur. Siyatik sinir ile piriformis kasýnýn anatomik iliþkisi ile ilgili çeþitli varyasyonlar görülebilir. Piriformis kasý kalça eklemine uyluk ekstansiyondayken dýþ rotasyon, kalça fleksiyondayken abduksiyon yaptýrýr. Piriformis kasýnda miyofasial tetik nokta, hipertrofi, inflamasyon, travmatik yaralanmalar, piriformis kasý ve/veya siyatik sinirin anatomik varyasyonlarý ve myositis ossifikans gibi nedenler PS’na yol açabilmektedir. Siyatik aðrýsý vakalarýnýn %5-6’sýnýn PS olduðu gösterilmiþtir. Ancak radiküler aðrý ile karýþtýðý için bu oranýn daha fazla olduðu düþünülmektedir. Bu derlemede nondiskojenik siyatalji ayýrýcý tanýsýnda düþünülmesi gereken PS ve ultrasonografinin PS taný ve tedavisindeki öneminden bahsedilmiþtir.

Piriformis syndrome (PS) is a clinical picture that develops when the sciatic nerve is trapped by the piriformis muscle. Several variations in the anatomical relationship of the sciatic nerve and the piriformis muscle may be seen. The piriformis muscle externally rotates the hip joint when the thigh is in extension and abducts when the hip is in flexion. Myofascial trigger points in the piriformis muscle, hypertrophy, inflammation, traumatic injury, anatomical variations of the piriformis muscle and/or the sciatic nerve, and myositis ossificans can cause PS. It has been reported that 5% to 6% of sciatic pain cases are PS. However, it is thought that this percentage may actually be higher because it can be confused with radicular pain. PS should be considered in the diagnosis of nondiscogenic sciatica, and the importance of ultrasonography in the diagnosis and treatment of PS are described in this review.

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Kolloidal bizmut subsitrat gastrit ve helikobakter pilori eradikasyonu tedavisinde sýk kullanýlan bir bileþiktir. Gastrointestinal emilimi az olmakla birlikte yüksek dozlarda alýndýðý zaman hepatik ensefalopati veya daha nadiren nefropati þeklinde yan etkiler geliþebilir. Bizmut intoksikasyonuna baðlý akut nefrotoksisite tedavisinde hemodiyaliz ve þelasyon tedavilerini erken uygulamak önemlidir. Bu vakada intihar giriþimi amaçlý yüksek doz bizmut alýmý sonrasý akut böbrek yetmezliði geliþen bir hasta sunuldu.

Colloidal bismuth subcitrate is a compound that is widely used to treat gastritis and Helicobacter pylori infection. Gastrointestinal absorption is low, but when it is consumed in large dosages, side effects such as hepatic encephalopathy, or more rarely, nephropathy can occur. Early treatment modalities of hemodialysis or chelation therapy are important in acute nephrotoxicity caused by bismuth intoxication. This report is a description of the case of a patient who had acute renal failure after ingestion of a large dose of bismuth in a suicide attempt.

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Temiz aralýklý kateterizasyon uygulayan hastalarda, katetere baðlý mesane perforasyonu nadir görülen bir komplikasyondur. Biz burada 6 ay önce geçirdiði ateþli silah yaralanmasý sonrasý (servikal spinal kord hasarý) tetraplejik olan ve nörojenik mesane nedeniyle kazadan bu yana sondalý olup; son 5 gündür hasta yakýný tarafýndan TAK yapýlan 40 yasýnda erkek hastada oluþan ve akut abdomen bulgularý ile acile baþvuran mesane perforasyonu olgusunu raporladýk.

Catheter-related bladder perforation is a very rare complication in patients undergoing clean intermittent catheterization (CIC). Presently described is the case of a 40-year-old man who had been diagnosed as tetraplegic after a firearm injury (cervical spinal cord injury) 6 months earlier. As a result of neurogenic bladder, he had been permanently catheterized after the accident. CIC treatment was initiated with the help of a relative of the patient. Five days after the initiation of treatment, the patient was admitted to the emergency room with an acute abdomen and an intraperitoneal bladder perforation was diagnosed.

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Kabuki make-up sendromu (KMS) multipl konjenital anomaliler ve mental retardasyonla seyreden, kalýtým þekli tam bilinmeyen ancak otozomal dominant bir mutasyonun sebep olduðu düþünülen nadir bir sendromdur. Bu yazýda, mental-motor retardasyon, geniþ alýn, yukarý doðru kavisli kaþ kemeri, lateral 2/3’si dökük kaþý, çekik ve ayrýk gözleri, alt göz kapak lateralinde dýþa dönüklüðü, basýk ve geniþ burun kökü, gaga burnu, bilateral geniþ ve düþük kulak sayvanlarý, seyrek ve kýrýlgan saçlarý, dar ve yüksek damaðý, dismorfik diþleri, belirgin el parmak pulpalarý, 5. parmak kýsalýðý ve karaciðer enzim yüksekliði saptanan 27 aylýk bir kýz çocuðu literatüre katkýda bulunmak amacýyla sunulmuþtur.

Kabuki make-up syndrome (KMS) is a rare syndrome characterized by multiple congenital anomalies and mental retardation. Its inheritance pattern is not precisely known, but it is thought to be caused by an autosomal dominant inheritance. Presently described is the case of a 27-month-old girl who had mental and motor retardation; frontal bossing; arched eyebrows that were sparse in the lateral two-thirds; long palpebral fissures with eversion of the lateral part of the lower eyelid; a broad, depressed nasal root; a beaked nose; large, protuberant, low-set ears; sparse and fragile hair; a high, arched palate; dysmorphic teeth; prominent finger pads; short fifth fingers; and hypertransaminasemia as a contribution to the literature.

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