GÝRÝÞ ve AMAÇ: Araþtýrmamýzýn amacý trans özefagial ekokardiyografi kýlavuzluðunda ciddi aort darlýðý nedeniyle transaortik kapak replasmaný yapýlan hastalardaki sonuçlarýmýzý sunmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya Kasým 2014 ve Haziran 2016 tarihleri arasýnda yüksek riskli ciddi aort darlýðý tanýsý konulup perkütan transaortik kapak deðiþimi kararý verilen hastalar alýndý. Ýþlem öncesi hastalarýn trans özefagial ekokardiyografi ve kardiyak tomografisi elde edildi. Tüm hastalarda Edwards Saphien XT balon expandable biyolojik kapak kullanýldý. Kapak boyutunu belirlemede trans özefagial ekokardiyografi ana ölçüm metodu olarak kullanýldý. Kardiyak tomografi ile trans özefagial ekokardiyografi ölçümlerine göre seçilecek kapak boyutu korelasyonuna bakýldý. Ýþlem baþarýsý, hastane içi ve 30 gün sonundaki istenmeyen olay geliþimi açýsýndan hastalar takip edildi.
BULGULAR: Çalýþmaya dahil edilen 33 hastanýn (18 erkek, 15 kadýn) yaþ ortalamasý 78.2 ( yaþ aralýðý 62 ile 92) idi. Hastalarýn hepsine kapak implantasyonu iþlemi baþarý ile uygulandý. trans özefagial ekokardiyografi ile seçilen kapak boyutu yalnýzca 1 hastada kardiyak tomografi deðerlendirmesinden sonra 1 numara büyük kapak ile deðiþtirildi. Hastane içi dönemde 3 hasta kaybedildi, 30 günlük takipte baþka ölüm yoktu.
TARTIÞMA ve SONUÇ: Yüksek riskli aort darlýðý hastalarýnda transaortik kapak replasmaný iþlemi etkin ve güvenilir bir tedavi biçimidir. Kapak boyutu ve iþlem stratejisinin belirlenmesinde trans özefagial ekokardiyografi, kardiyak tomografiyi tamamlayýcý vazgeçilmez bir görüntüleme yöntemidir.

INTRODUCTION: This study aimed to assess the procedural success and early term outcomes of percutaneous aortic valve replacement in patients with critical aortic stenosis.
METHODS: This study included patients with severe high-risk aortic stenosis who underwent transcatheter aortic valve replacement between November 2014 and June 2016. All patients underwent transesophageal echocardiography and cardiac tomography prior to the procedure. The Edwards Sapien XT balloon-expandable transcatheter aortic valve was used in all patients. The valve size was selected according to measurements obtained from cardiac tomography and transesophageal echocardiography. Patients were evaluated for procedural success and adverse effects during hospitalization and a 30-day follow-up period.
RESULTS: This study included a total of 33 patients (18 males, 15 females) with a median age of 78.2 (range: 62–92) years. Valve implantation was successfully performed in all patients. The valve size, which was selected according to transesophageal echocardiography, was increased in only one patient following cardiac tomography. Three patients died during the hospitalization period. No further deaths occurred during the 30-day observation period.
DISCUSSION AND CONCLUSION: Percutaneous transaortic valve replacement treatment for patients with high-risk aortic stenosis is an efficient and reliable treatment modality. Transesophageal echocardiography is a complementary and irreplaceable element for cardiac tomography when determining the valve size and operation strategy.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Tek port kolesistektomi operasyonlarýnda transvers kas fasya onarýmý için kullanýlan sütur materyallerine karþý dokularda oluþan enflamatuar reaksiyonunu deðerlendirmek.
YÖNTEM ve GEREÇLER: Bir Devlet Hastanesi genel cerrahi kliniðinde Aralýk 2013 - Ocak 2015 arasýnda tek port kolesistektomi ameliyatý yapýlan 65 hasta retrospektif olarak incelendi. Tek kutuplu kolesistektomi ameliyatlarýnda yapýlan 2 cmlik fasya insizyonunu tamir için kullanýlan dikiþ materyallerine doku reaksiyonu deðerlendirildi. Ameliyat dikiþ materyaline emici olmayan örgülü polyester, emilebilir olmayan monofilament polipropilen, emilebilir polifilament poliglaktin ve fasya defektinin onarýmý için kullanýlan emilebilir monofilaman poldioksanonun doku reaksiyonu analiz edildi.
BULGULAR: Bu çalýþmada, 14 hastada absorbe edilemeyen örgülü polyester, 25 hastada absorbe edilemeyen monofilament polipropilen, 10 hastada emilen polifilament poliglaktin ve 16 hastada emilebilir monofilament poldioksanon kullanýldý. Hastalar en az 6 ay takip edildi. Yabancý cisim reaksiyonu gören 14 hasta antibiyotik tedavisine yanýt alýnamadý ve bu nedenle reaksiyon oluþturan dikiþlerin alýnmasý için tekrar opere edildi.
TARTIÞMA ve SONUÇ: Emici olmayan örgülü polyester doku reaksiyonuna neden olmuþ ve bu reaksiyon antibiyoterapi ve týbbi tedavi ile giderilememiþtir. Bu dikiþin kullanýldýðý tüm hastalar, dikiþ materyalinin eksizyonu için ikinci kez ameliyat edildi. Diðer sütür materyalleri kullanýlan hastalarda yumuþak doku reaksiyonu görülmedi.

INTRODUCTION: This study aimed to evaluate the tissue inflammatory response to suture materials used for fascia repair in single-port laparoscopic cholecystectomy.
METHODS: The medical records of 65 patients who underwent single-port laparoscopic cholecystectomy in general surgery clinics at state hospitals between December 2013 and January 2015 were retrospectively analyzed. Tissue reaction to the suture materials used for repairing a 2-cm fascia incision in single-port laparoscopic cholecystectomy was evaluated. Tissue reaction to the following suture materials used for repairing the fascia defect was analyzed: non-absorbable braided polyester, non-absorbable monofilament polypropylene, absorbable polyfilament polyglactin, and absorbable monofilament poldioxanone.
RESULTS: Non-absorbable braided polyester was used in 14 patients, non-absorbable monofilament polypropylene in 25 patients, absorbable polyfilament polyglactin in 10 patients, and absorbable monofilament poldioxanone in 16 patients. Patients were followed up for at least 6 months. Fourteen patients who had a foreign body reaction could not be treated by antibiotherapy and therefore underwent surgery to excise the sutures responsible for inducing the reaction.
DISCUSSION AND CONCLUSION: Non-absorbable braided polyester caused tissue reaction, which could not be treated by antibiotherapy and medical treatment. All the patients who underwent surgery with this suture material had to be reoperated to excise the suture material. The patients who underwent surgery with other suture materials did not exhibit soft tissue reaction.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Obstrüktif uyku apne sendromunun (OSAS) iþitsel fonksiyon üzerindeki etkisini araþtýrmak.
YÖNTEM ve GEREÇLER: OSAS tanýlý 120 hasta (Apne-hipopne indeksi (AHI)> 5) çalýþmaya alýndý. 35 hafif (AHÝ: 5-15), 20 Orta (AHI: 15-30) OSAS tanýsý alan hastalar çalýþma dýþý býrakýldý. Geçirilmiþ kulak operasyonunu, merkezi ve periferik iþitme sistemini etkileyebilecek hastalýðý, akut ve kronik otit, sistemik hastalýk ve týbbi tedavi öyküsü olan 5 aðýr OSAS hastasý çalýþma dýþý býrakýldý. 60 aðýr OSAS tanýsý alan hasta çalýþmaya dahil edildi. 60 aðýr OSAS tanýsý alan hastalar 30-40 yaþ aðýr OSAS ve 40-60 yaþ aðýr OSAS olmak üzere iki gruba ayrýldý. Çalýþmaya toplam 60 saðlýklý kontrol grubu dahil edildi. 60 saðlýklý kontrol grubu 30-40 yaþ ve 40-60 yaþ saðlýklý kontrol grubu olarak iki gruba ayrýldý. Çalýþmaya toplam 120 hasta dahil edildi. Çalýþmaya dahil edilen kontrol grubu ve hasta grubu için saf ses odyometrisi ve distorsiyon product otoakustik emisyon (DPOAE) testi yapýldý. Saf ses odyometri testi ve DPOAE deðerleri tüm gruplar arasýnda karþýlaþtýrýldý.
BULGULAR: Ýþitsel fonksiyonlarýn deðerlendirilmesinde 30-40 yaþ arasýndaki kontrol grubu ile 40-60 yaþ arasýndaki kontrol grubu arasýnda farklýlýk saptandý. 30-40 yaþ arasýndaki hasta grubu ile 40-60 yaþ hasta grubu arasýnda farklýlýk saptandý. Diðer gruplar arasýnda anlamlý bir fark saptanamadý.
TARTIÞMA ve SONUÇ: Bizim çalýþmamýzda OSAS hastalarýndaki iþitme kaybýnýn OSAS' tan ziyade ileri yaþtan dolayý ortaya çýktýðý gösterilmiþtir. Literatürde OSAS ' ýn iþitsel fonksiyonlar üzerine etkisi hakkýnda bir belirsizlik olduðu için daha fazla çalýþma yapýlmasý gerekebilir.

INTRODUCTION: To investigate the effect of obstructive sleep apnea syndrome (OSAS) on auditory function.
METHODS: We included 120 patients with OSAS [Apnea–hypopnea index (AHI) >5]. We excluded 35 patients with 35 mild OSAS (AHI: 5–15) and 20 with moderate OSAS (AHI: 15–30). Five patients with severe OSAS along with acute and chronic otitis, systemic disease, and medical treatment history that may affect past ear operation and central and peripheral auditory system were also excluded. Finally, we included 60 patients with severe OSAS and 60 healthy controls. Both patients and controls were divided into two groups based on age: 30–40-years group and 40–60-years group. A total of 120 patients were included. Pure-tone audiometry (PTA) and distortion product otoacoustic emission (DPOAE) tests were performed at a frequency range of 250–8000 Hz for both controls and patients, and their values were compared between all the groups.
RESULTS: In the evaluation of auditory functions, there was a difference between the 30–40-years and 40–60-years control groups. There was a difference between the patient age group of 30–40 years and the patient age group of 40–60 years. There was no significant difference between other groups.
DISCUSSION AND CONCLUSION: Hearing loss, which is not influenced by auditory functions in patients with OSAS, arises due to advanced age. Since there is uncertainty about the effect of auditory functions on patients with OSAS in the literature, further studies may be needed.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Burunda yabancý cisim olan olgularýn demografik özellikleri, tedavi yönetimi ve çýkarýlan yabancý cisimlerin özelliklerini deðerlendirmek.
YÖNTEM ve GEREÇLER: Çalýþmaya burunda yabancý cisim olan 243 olgu ( 138 kadýn 105 erkek; ort.yaþ 2.78±1.33 yýl,daðýlým: 1 yýl- 8 yýl) dahil edildi. Tüm olgularýn dosyalarý, yaþ, cinsiyet, yabancý cismin cinsi, rengi, hangi tarafta olduðu ve uygulanan tedavi açýsýndan deðerlendirildi.
BULGULAR: Yabancý cisimler olgularýn 86 'sýnda (%35.4) sol taraf, 155 'inde (%63.8) sað taraf ve 2 'sinde (%0.8) her iki nazal kavitede saptandý. En sýk saptanan yabancý cisimler, 78 olguda (%32.1) boncuk, 67 olguda (%27.6) bitki türleri, 34 olguda (%14.0) kaðýt ve sünger parçacýklarý idi. Erkek olgularýn mavi ve kahverengi renkli, kadýn olgularýn ise kýrmýzý ve beyaz renkli yabancý cisimleri burunlarýna daha çok soktuklarý saptandý. Yabancý cisimler 14 olguda (%5.8) ameliyathane þartlarýnda genel anestezi altýnda çýkartýldý.
TARTIÞMA ve SONUÇ: Burunda yabancý cisimler, kulak burun boðaz (KBB) acilleri arasýnda en sýk görülen acillerdendir. Yabancý cisim özelliklerinin, çocuklarda burnuna sokmalarýnda etkisi olup olmadýðý bilinmemektedir. Bu konuda, daha fazla olgu sayýsýyla yapýlacak çalýþmalara ihtiyaç duyulmaktadýr.

INTRODUCTION: To evaluate the demographic data and treatment methods for patients with nasal foreign bodies and properties of foreign bodies.
METHODS: In total, 243 patients (138 female; 105 male; mean age, 2.78±1.33 years; range, 1–8 years) who were diagnosed with nasal foreign bodies were included in the study. All patient records were evaluated in terms of age, sex, type and color of foreign bodies, side of presentation, and treatment protocols.
RESULTS: Foreign bodies were detected in the left nasal cavity in 86 patients (35.4%), right nasal cavity in 155 (63.8%), and bilaterally in 2 (0.8%). The most common nasal foreign bodies were beads in 78 patients (32.1%), plant species in 67 (27.6%), and paper-sponge particles in 34 (14%). The most common colors of the foreign bodies were blue and brown in males and red and white in females. Fourteen (5.8%) patients required general anesthesia for the extraction of the foreign body in an operating room.
DISCUSSION AND CONCLUSION: Nasal foreign bodies are a common emergency in the field of otorhinolaryngology. It is not known whether the properties of foreign bodies affect children’s ability to nudge foreign objects. Further studies with greater number of patients are needed on this topic.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Üst gastrointestinal sistemde malign ve benign darlýklarýn palyasyonunda, postoperatif anastomoz kaçaðý ve fistüllerin tedavisinde kaplý ve kapsýz kendiliðinden geniþleyebilen stentler (SEMS) giderek artan yaygýnlýkta kullanýlmaktadýr. Biz bu çalýþmada kliniðimizde uygulanan üst gastrointestinal sistem stentleri ile ilgili deneyimimizi paylaþmayý amaçladýk.
YÖNTEM ve GEREÇLER: Kliniðimizde 2009 ile 2017 yýllarý arasýnda üst gastrointestinal sistem SEMS uygulanan hastalar belirlenerek dosyalarý retrospektif olarak incelendi. Hastalarýn demografik verileri, takýlan stent tipi, stent takýlma sebepleri, stent baþarýsý, tekrar stent uygulama gereksinimi, iþleme baðlý komplikasyon geliþimi ve mortalite deðerlendirilmiþtir.
BULGULAR: Ortanca yaþý 57,5 (32- 80) olan hastalarýn %58.62’si erkekti. Toplamda 9 hastada altta yatan benign bir sebep mevcuttu. Malignitesi olan hastalarýn 9’u (%45) primer özofagus kanseriyken; geri kalanlar (%55) mide ve özofagogastrik bileþke kanseriydi. Stent takýlma endikasyonlarý sýrasýyla; anastomoz kaçaðý (%41.37), özofageal darlýk palyasyonu (%37.94), obezite cerrahisi sonrasý kaçak (%10.35), özofagus perforasyonu (%6.89) ve trakea-özofageal fistül (%3.45) idi. Stent iliþkili majör morbidite geliþmezken mortalite oraný %20,68’idi.
TARTIÞMA ve SONUÇ: SEMS kullanýmý üst GIS darlýklarýnýn palyasyonu ve cerrahi komplikasyonlarýnýn tedavisinde kullanýlan etkin, güvenli ve minimal invaziv bir yöntemdir. Bizim serimizde özellikle cerrahi komplikasyon olan anastomoz kaçaklarýnýn tedavisinde stent uygulanan hastalarda mortalitenin daha yüksek olduðu saptandý.

INTRODUCTION: Coated and uncoated self-expandable metal stents (SEMS) are increasingly used in the palliation of malignant and benign strictures in the upper gastrointestinal (GI) tract and in the treatment of postoperative anastomotic leakage and fistulas. The objective of this study was to share the experience of one clinic with upper gastrointestinal tract stent placement.
METHODS: Patients who underwent upper GI tract SEMS placement between 2009 and 2017 were identified, and patient charts were retrospectively reviewed. The details of patient demographic data, stent type, indication for stent placement, success of stenting, need for stent replacement, morbidity, and mortality were documented.
RESULTS: In total, there were 29 patients with a median age of 57.5 years (min-max: 32-80 years), and 58.62% were male. There were benign problems in 9 patients. Nine (45%) of the patients with malignancy had esophageal carcinoma, while the remainder (55%) had gastric or esophagogastric junction carcinoma. Indications for stent placement were anastomotic leak (41.37%), esophageal stricture (37.94%), leak after obesity surgery (10.35%), esophageal perforation (6.89%), and tracheoesophageal fistula (3.45%).
DISCUSSION AND CONCLUSION: SEMS placement is an effective, safe, and minimally invasive method for the palliation of upper GI tract strictures and the treatment of surgical complications. In this series, the mortality rate in patients who underwent SEMS placement for the treatment of anastomotic leak was high.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Kadýnlar menopozdan sonra fiziksel fonksiyonlarda bir düþüþ yaþarlar. Bu çalýþmada premenopozal ve postmeopozal kadýnlarda el fonksiyonu, kavrama gücü ve kemik kalitesi arasýndaki iliþkiyi deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Metabolik, endokrinolojik ve nöromüsküler problemleri olmayan, 35-65 yaþ arasýndaki 81premenopozal ve 81 postmenopozal kadýn deðerlendirildi. Kavrama gücü (dominant el) JAMAR el dinamometresi ile ölçüldü. El fonksiyonunu deðerlendirmek için kavrama kabiliyeti testi (GAT) kullanýldý. Radius kemik mineral yoðunluðu ve ses hýzý (SOS), kantitatif ultrasonografi (QUS) (Sunlight Omnisense 7000S/8000S) ile ölçüldü.
BULGULAR: Postmenopozal kadýnlarýn premenopozal kadýnlara göre daha düþük T skorlarý ve SOS deðerleri, daha zayýf kavrama kuvveti ve daha yüksek GAT skorlarý vardý. Premenopozal ve postmenopozal kadýnlarda GAT skorlarý ile radius T skorlarý, SOS deðerleri arasýnda zayýf, GAT skorlarý ile kavrama gücü arasýnda orta derecede negatif korelasyon vardý. Premenopozal ve postmenopozal kadýnlarda kavrama gücü ile radius T, Z skorlarý ve SOS deðerleri arasýnda zayýf pozitif korelasyon vardý (p <0.05).
TARTIÞMA ve SONUÇ: Premenopozal kadýnlarýn postmenopozal kadýnlardan daha iyi el fonksiyonu, daha yüksek kavrama gücü, radius T, Z skorlarý ve SOS deðerleri vardý.

INTRODUCTION: Women experience a decline in physical function after menopause. In this study, we aimed to assess the relationship between hand function, grip strength, and bone status in premenopausal versus postmenopausal women.
METHODS: Eighty-one premenopausal and 81 postmenopausal women aged 35–65 years who did not have metabolic, endocrine, and neuromuscular problems were evaluated. Grip strength (of dominant hand) was measured using Jamar hand-held dynamometer. Grip ability test (GAT) was used to evaluate the hand function. Radius bone mineral density and speed of sound (SOS) were measured using quantitative ultrasonography (Sunlight Omnisense 7000S/8000S).
RESULTS: Postmenopausal women had significantly lower radius T-scores and SOS values, weaker grip strength, and higher GAT scores than premenopausal women. There was a weak negative correlation between GAT scores, radius T-scores, and SOS values and a moderate negative correlation between GAT scores and grip strength in both premenopausal and postmenopausal women. There was a weak positive correlation between grip strength, radius T- and Z-scores, and SOS values in both premenopausal and postmenopausal women (p<0.05).
DISCUSSION AND CONCLUSION: Premenopausal women had a better hand function and higher grip strength, radius T- and Z-scores, and SOS values than postmenopausal women.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Primer komplike olmayan nazolakrimal kanal týkanýklýðý cerrahisinde bikanaliküler silikon tüp entüpasyonu uygulanan ve uygulanmayan hastalarda cerrahinin sonuçlarýný karþýlaþtýrmak.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþma, komplike olmayan primer nazolakrimal kanal týkanýklýðýna sahip 61 hastadan oluþmaktadýr. Çalýþmada hastalar iki gruba ayrýldý; Grup 1: bikanaliküler silikon tüp entüpasyonu ile transkanaliküler diyot laser dakriyosistorinostomi ameliyatý yapýlan hastalar ve Grup 2: bikanaliküler silikon tüp entüpasyonu yapýlmaksýzýn transkanaliküler diyod laser dakriyosistorinostomi ameliyatý yapýlan hastalar. Takip süresi, Grup 1 için ortalama 13±0,6 ay, Grup 2 için 13±0,4 aydý.
BULGULAR: Baþarý, lakrimal lavajda suyun geri gelmemesi ve epifora yokluðu ile tanýmlandý. Baþarý oranlarý ameliyat sonrasý birinci yýlda Grup 1'de (24/30) %80.0, Grup 2'de (20/31)%64.5 idi. Ýstatistiksel olarak iki grup arasýnda anlamlý fark bulundu (p=0,03).
TARTIÞMA ve SONUÇ: Bikanaliküler silikon tüp entübasyonu uygulanan transanaliküler diyod laser dakriyosistorinostomi sonuçlarý silikon tüp uygulanmayan hastalara oranla daha baþarýlý bulunmuþtur.

INTRODUCTION: To compare surgical outcomes with and without bicanalicular silicon tube intubation for the treatment of patients with primary uncomplicated nasolacrimal duct obstruction.
METHODS: This retrospective study included 61 patients with uncomplicated primary nasolacrimal duct obstruction, who were divided into two groups: Group 1 underwent transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation and Group 2 underwent transcanalicular diode laser dacryocystorhinostomy surgery without bicanalicular silicon tube intubation. The mean follow-up periods were 13±0.6 months for Group 1 and 13±0.6 months for Group 2.
RESULTS: Success was defined as irrigation of the lacrimal system without regurgitation and the absence of epiphora. Success rates were 80.0% (24/30) for Group 1 and 64.5% (20/31) for Group 2 in the first year after operation. A statistically significant difference was found between the two groups (p=0.03).
DISCUSSION AND CONCLUSION: Transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation was more successful than that without bicanalicular silicon tube intubation.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Prostatik kalküller genellikle benign prostat hiperplazisi (BPH) veya kronik inflamasyonla iliþkilidir. Bununla birlikte birçok çalýþmada prostat kanseri (PCa) patogenezisinde, prostatik kalsifikasyon (PK) ve inflamasyon varlýðý gösterilmiþtir. Biz bu çalýþmada transrektal ultrasonda (TRUS) saptanan prostat periferal zondaki PK sýklýðý ile biyopsi sonuçlarýndaki histolojik bulgularýn iliþkisini inceledik.
YÖNTEM ve GEREÇLER: Baðcýlar Eðitim ve Araþtýrma Hastanesin Üroloji Polikliniðine baþvuran, parmakla rektal muayenede (PRM) anormal bulgu saptanan ve/veya prostat spesifik antijen (PSA) deðeri 2,5 ng/ml’nin üzerinde olan 156 hastaya TRUS eþliðinde prostat iðne biyopsisi yapýldý. PK; periferik zonda, birden fazla, en büyük çapý 3 mm’den büyük hiperekoik odaðýn varlýðý olarak kabul edildi. TRUS için BK Medical Ultrasound Pro Focus 2202 Color (Herlev, Denmark) marka biplane 8818 (4-12MHz) probe kullanýldý. Bütün TRUS eþliðindeki biyopsiler tek doktor tarafýndan yapýldý.
BULGULAR: Çalýþmaya alýnan 156 hastanýn 41 tanesinde PK saptandý. PK saptanan ve saptanmayan hastalar arasýnda PSA deðerleri, prostat volümleri ve hasta yaþlarý arasýnda anlamlý farklýlýk saptanmadý. PCa sýklýðýnýn; PK saptanan hastalarda %41,4, PK saptanmayan hastalarda %15,6 olduðu görüldü (p= 0,001). PCa saptanan hastalarda Gleason skorlarýna göre yapýlan deðerlendirmede de Gleason skor≥8 olan tüm hastalarda eþ zamanlý PK varlýðýnýn anlamlý olduðu gösterildi (p<0,05). Ayný zamanda Gleason skoru deðerleri arttýkça ona eþlik eden PK varlýðýnda da artýþ gözlendi.
TARTIÞMA ve SONUÇ: Çalýþmamýzda; PCa patogenezinde kronik inflamasyonun rol oynadýðýný ve bununla beraber PK varlýðýný gösterdik. Ayný zamanda Gleason skoru yüksekliði ile PK varlýðý arasýnda anlamlý iliþki olduðunu tespit ettik. Ancak bu iliþkinin daha iyi anlaþýlabilmesi için kapsamlý prospektif çalýþmalara ihtiyaç olduðu aþikârdýr.

INTRODUCTION: Prostatic calculi are generally associated with benign prostatic hyperplasia and chronic inflammation of the gland. Many studies have reported that prostatic calcifications (PCs) and inflammatory processes are involved in the pathogenesis of prostate cancer (PCa). In the present study, we evaluated the frequency of finding PCs in the peripheral prostatic zone during transrectal ultrasound (TRUS) and its relationship with histologic results of the biopsy.
METHODS: In total, 156 patients with prostate-specific antigen (PSA) levels >2.5 ng/ml and/or abnormal digital rectal examination findings who presented in the urology policlinics of the Baðcýlar Training and Research Hospital underwent TRUS-guided prostate needle biopsy. PCs were considered to be positive in patients with the presence of more than one hyperechoic foci in the peripheral zone with their largest diameter >3 mm. All TRUS biopsies were performed by the same physician.
RESULTS: Of 156 patients, PCs were observed in 41 patients. Between patient groups with and without concomitant PCs, there was no significant difference in PSA levels, prostate volume, and patient age. PCa frequency was 41.4% among PC-positive patients and 15.6% among PC-negative patients (p=0.001). Patients diagnosed with PCa were also categorized according to Gleason score, and PCs were observed in all the patients with Gleason score ≥8 without any exception (p<0.05). Higher Gleason scores showed positive correlation with the presence of PCs.
DISCUSSION AND CONCLUSION: In the present study, we revealed the involvement of chronic inflammation and PCs in the pathogenesis of PCa. At the same time, we found a positive relationship between higher Gleason scores and the presence of PCs. Further high-volume prospective studies are needed to confirm this hypothesis.

Makale Özeti | Tam Metin PDF

Saç dökülmesi oldukça sýk rastlanýlan bir saðlýk sorunudur. Hastalarda ciddi anksiyete ve emosyonel strese yol açmaktadýr. Kýl siklusundaki deðiþiklikler diffüz alopesilerin patogenezinden sorumludur. Diffüz alopesiler etkilenen saça göre anagen effluvium ve telogeneffluvium olmak üzere iki grupta incelenmektedir. Ayrýntýlý anamnez, dermatolojik muayene ve gerekli durumlarda kan tahlilleri tanýnýn konulmasýnda önem taþýmaktadýr. Bu derlemede diffüz alopesilerden, taný ve tedavi yöntemleriyle birlikte bahsedilmiþtir.

Hair loss is a common health problem. It leads to serious anxiety and emotional stress in patients. Changes in hair cycle are responsible for the pathogenesis of diffuse alopecia. Diffuse alopecia is categorized into two groups, namely anagen effluvium and telogen effluvium, according to affected hair. Detailed history, dermatological examination, and laboratory investigations, if needed, are important for diagnosis. In this review, diffuse alopecia has been discussed, along with its diagnosis and treatment.

Makale Özeti | Tam Metin PDF

Lactobacillus casei, probiyotik grubundan olup aðýz ve baðýrsak florasýnda bulunan bir bakteri türüdür. Aðýz içi enfeksiyonlarýný kontrol altýna almada etkili olduklarý ve gastrointestinal hastalýklarýn önlenmesinde ve tedavisinde faydalý olduklarý bilinen bu mikroorganizmalar saðlýklý insanlarda nadiren enfeksiyona neden olurlar. Bu olguda yoðun bakým ünitesinde yatan bir çocukta beyin omurilik sývýsý kültürü incelemesinde Lactobacillus casei gösterilmiþtir. Gastrostomisi bulunan ve tekrarlayan menenjit geçiren olgularda Lactobacillus casei, etken olarak düþünülmesi gereken bir patojendir.

Lactobacillus casei is a probiotic bacteria found in the human mouth and intestine. These microorganisms, which are known to be effective in controlling oral infections and in the prevention and treatment of gastrointestinal diseases, rarely cause infection in healthy people. Here, Lactobacillus casei was observed in the cerebrospinal fluid culture of a child who was hospitalized in the intensive care unit. In cases with gastrostomy and recurrent meningitis, Lactobacillus casei should be considered as a pathogenic cause.

Makale Özeti | Tam Metin PDF

Böbrek onkositomlarý benign lezyonlardýr ve tüm primer böbrek tümörlerinin % 3-7' sini oluþtururlar. Böbrek hücreli karsinomanýn (RCC) ayný böbrekte onkositom ile bir arada bulunmasý nadir görülen bir durumdur. Bu çalýþmada, ayný böbrekte RCC ve böbrek onkositomu olmak üzere iki farklý lezyonu olan ve sol radikal nefrektomi ile tedavi edilen 74 yaþýndaki bir erkek hasta sunuldu.

Renal oncocytomas (ROs) are benign lesions and account for 3%–7% of all primary renal tumors. The coexistence of renal cell carcinoma (RCC) with RO in the same kidney is a rare situation. Here, we report the case of a 74-year-old man with RCC and RO (two different lesions) in the same kidney, which were managed with left radical nephrectomy.

Makale Özeti | Tam Metin PDF

Liken slerosus (LS) benin, kronik, progresif, inflamatuar ve epitel incelmesi ile karakterize bir hastalýktýr. Kaþýntý ve aðrý eþlik eden semptomlardýr. LS sýklýkla (%85) anogenital bölgeyi tutar. 81 yaþýnda bayan hasta 3 yýldýr idrar yaparken zorlanma þikayeti ile polikliniðimize baþvurmuþtur.
Jinekolojik muayenede vulvada beyaz alanlar mevcuttu. Vaginal füzyondan dolayý vaginal muayene yapýlamadý. Labiumlarýn silinmiþ olduðu, üretra ve vajen oblitere olup yaklaþýk 2mmlik açýklýk olduðu görüldü. Üretra giriþi gözlenememiþtir. Sonda yerleþtirilmiþtir ve sondanýn vajende olduðu gözlenmiþtir. Transrektal ultrason muayenesine göre ise uterus 40*50mm endometrium çizgi halinde olup içinde sývý koleksiyonu mevcuttur. Bilateral overler izlenememiþtir. Mons pubis ve labia minörlerden alýnan patoloji sonuçlarý da liken sklerozus ve liken simpleks kronikus ile uyumlu gelmiþtir. Hastaya tedavi olarak topikal Klobetazol propionat merhem (2x1) ve topikal östrojen tedavisine baþlanmýþtýr. Hastanýn birinci ay takibinde idrarýný daha rahat yapabildiði gözlenmiþtir. Vajendeki dilatasyon ise yaklaþýk 0.5 cm kadardýr ve vulvanýn sulkuslarý belirginleþmeye baþlamýþtýr. Hastanýn 3. ay takibinde vajenin yaklaþýk 1.5 cm dilate olduðu olduðu görülmüþtür (Resim 2). Düzenli dilatasyon yapýlmasýna gerek kalmamýþtýr. Bu hastalarýn düzenli aralýklarla vulvar kanser geliþimi açýsýndan takip altýnda olmalarý gereliliði de unutulmamalýdýr.

Lichen sclerosus (LS) is a benign, progressive, inflammatory disease characterized by epithelial thinning. An 81-year-old woman presented to our clinic with the complaint of difficulty in urination. There were whitish lesions on her vulva. Also, her urethra and vagina were obliterated with an approximately 2 mm opening. The diagnosis of LS was confirmed with pathological examination. Topical clobetasol propionate and estrogen treatment were prescribed. Three months later, the vagina had an approximately 1.5-cm diameter opening and there was no difficulty in urination. Such cases should be followed up concerning the progression of vulvar cancer.

Makale Özeti | Tam Metin PDF