ISSN: 2630-5720 | E-ISSN: 2687-346X
HAYDARPAŞA NUMUNE MEDICAL JOURNAL - Haydarpasa Numune Med J: 56 (2)
Volume: 56  Issue: 2 - 2016
RESEARCH ARTICLE
1. The Comparison Of Fine Needle Aspiration Biopsy And Histopathologş Results In Thyroid Lesions
Ayşe Nur İhvan, Aslı Mutlu
Pages 67 - 70
INTRODUCTION: To determine the utility of fine needle aspiration biopsy (FNAB) in Uskudar State Hospital by comparing pathology results.
METHODS: We compared the cytologic and histopathologic resultsof 56 patients who underwent thyroidectomies after FNAB at Uskudar State Hospital between 2012- 2016. The cytological results were classified as inadequate material, benign, follicular neoplasm, suspicious for malignancy/ malign.
RESULTS: Sensitivity, specificity, positive predictive value, negative prediktive value, effectiveness were %87,5, %92, %70, %97, %91,1 respectively.
DISCUSSION AND CONCLUSION: FNAB is an effficient and simple diagnostic method in thyroid nodules.

2. Sleep Habits In Children And Adolescent Diagnosed With Attention Deficit Hyperactivity Disorder
Mahmut Cem Tarakçıoğlu, Muhammed Tayyib Kadak, H. Gözde Akkın Gürbüz, Erkan Doğan, Fırat Erdoğan
Pages 71 - 77
INTRODUCTION: Sleep problems are reported quite often in children with ADHD.
METHODS: It is shown that sleep problems in ADHD occurs in approximately 50-70%. Aim of study was to to investigate the sleep habits of children and adolescents with ADHD who had no medical treatment.
RESULTS: 6-16 year old 70 ADHD and 54 healthy children and adolescents were included in the study as a control group in this study. There were there were significant differences statistically significant in mean bedtime and nigh- twakings between groups (p <.05). Bedtime resistant, delay in asleep, sleep anxiety, nightwakings, parasomnia and total sleep scores were signicantly different between groups (p <.05). In spearman correlation analysis between ADHD symptoms and sleep habits, there were significant correlation between hyperactivity scores and bedtime resistancy (r=.407, p<.001), sleep anxiety (r=.372, p<.001), parasomnia (r=.459, p<.001) and total sleep duration (r=.547, p<.001).
DISCUSSION AND CONCLUSION: However, there was not found correlation between inattention and sleep habits. In conclusion, our findings were consistent with literature showing frequent sleep problems in ADHD.

3. Suda Boğulma İle Çocuk Acil Kliniğine Başvuran Hastaların Değerlendirilmesi
Ayhan Erdem, Mustafa Özgür Toklucu, Caner Araz, Mehmet Nizamoğlu, Emin Pala, Ruhan Özer, Şirin Güven
Pages 78 - 80
INTRODUCTION: Bu çalışmada, Ümraniye Eğitim ve Araştırma Hastanesi Acil kliniğine suda boğulma nedeniyle başvuran hastaların epidemiyolojik ve klinik seyir açısından incelenmesi amaçlandı.
METHODS: Suda boğulma sonucu Acil servisimize başvuran veya 112 ambulans servisi ile getirilen çocuk hastaların dosya kayıtları geriye dönük olarak incelendi. Bu çalışmaya toplam 11 hasta dahil edildi. Olguların 4’ü kız, 7’si erkek, yaş dağılımı 1-13 yaş (ortalama yaş 5,9±4,8 yıl) arasındaydı. Boğulmaların %73’ü tatlı suda, %27’si tuzlu suda olmuştu.
RESULTS: Başvuru anındaki Glaskow skoru ortalama 12,2±3,4 olarak bulundu. Hastaların %36’sında akciğer bulgusu vardı, %27’sine ise resüsitasyon uygulandı. Hastaların %9,1’i acil serviste takip edilirken, %36,4’ü çocuk servisinde, %54,6’sı yoğun bakımda izlendi.
DISCUSSION AND CONCLUSION: Suda boğulma çocukluk çağındaki sık ölüm nedenlerinden birisidir. Özellikle bölgede deniz, su birikintisi, akarsu ve yüzme havuzları gibi ortamlar olduğunda bu risk daha da artar. Gerekli güvenlik önlemlerinin alınması ve ailelere temel ilk yardım eğitimi verilmesi bu riskleri azaltmak açısından önemlidir.

4. A Retrospective Analysis of Partial and Complete Mole Hydatiform Cases Diagnosed in our Clinic
Mehmet Şükrü Budak, Cihan Kaya, Mehmet Baki Şentürk, Sedat Akgol, Mine Kanat Pektaş, Senem Yaman Tunç, Mehmet Rıfat Göklü
Pages 81 - 86
INTRODUCTION: The present study aims to conduct an epidemiological and clinical assessment of mole hydatiform cases in our hospi- tal within the last two years.
METHODS: This is a retrospective analysis of 87 subjects who were diagnosed with mole hydatiform in our hospital during the time period between 1 January 2012 and 1 January 2014.
RESULTS: Partial mole hydatiform was diag- nosed in 52 cases (59.8 %) whereas complete mol hydatiform was specified in 35 cases (40.2 %). When compared to women with partial mole, women with complete mole had significantly higher concentrations of beta-human chorionic gonadotropin (β-HCG) (p=0.017). The clinical and pathological diagnoses of mole hydatiform did not correlate (χ2=4.490, p=0.213). Similarly, ultrasonographic and pathological diagnoses of mole hydatiform were statistically unassociated (χ2 = 4.663, p=0.198). There were no statistically significant correlations among serum β-HCG concentrations, patient age, gravi- dity, parity and abortus number.
DISCUSSION AND CONCLUSION: There are different results in different studies about incidence of mole hydatiform for our country in the literature. Effective contraceptive methods should be expanded to diminish incidence of molar pregnancy, especially in elderly women.

5. Serum Eosinophil Cationic Protein Levels In Asthmatic Children
Mehmet Cengiz, Aysun Boğa, Sadık Sami Hati&775;poğlu
Pages 87 - 92
INTRODUCTION: Bronchial asthma is an airway disease that commonly related with allergy in children.
METHODS: Because of the routine tests tho- se used in the diagnosis of bronchial asthma could be inadequate at times, evaluation of eosinophils and eosinophil products gained importance nowadays. Eosinophil cationic protein (ECP) is a cytotoxic product of eosinophil granulocytes which has ribonuclease activity. In this study, we aimed to investigate the importance of serum ECP levels in diagnosis and follow-up of asthmatic children. Fortynine asthmatic children and 40 healthy children are included to study. Average of serum ECP levels in asthmatic children and control group was 21,45±18,7 mcg / L and 8,4 ± 7,5 mcg / L, respectively. There was a significant difference in serum ECP levels when compared astmatic children with control group (p < 0,05). Sex distribution was equal in between two groups. Children in control group has a lower age than patient group (p < 0,05).
RESULTS: There was a elevation in serum ECP levels with severity of asthma. However this elevation was not statistically significant (p > 0,05). Serum ECP levels was increasing with older age and longer therapy duration in asthmatic children(p < 0,05).
DISCUSSION AND CONCLUSION: There was no effect of therapy duration on serum ECP levels when patient’s age was fixed (p > 0,05). In conclusion we think that serum ECP level can have an important role in diagnosis of asthma and follow up in therapy in children.

6. Retrospective Analysis Of 23 Cases With Borderline Overian Tumors
Nurettin Aka, Cemile Kanlıkama, Durdu Akarsu, Gültekin Köse, Deniz Azkan
Pages 93 - 98
INTRODUCTION: Twentythree patients who had been operated and diagnosed with borderline ovarian tumors were reviewed retrospectively.
METHODS: Laparoscopy in 5 (%22) patients,18 (%78) patients underwent laparotomy. 5(%21,7) case scystectomy, 18 (%78,3) patients under went total abdominal hysterectomy and bilateralsalpingooferectomy (TAH + BSO) with bilateral lymphadenectomy. Lymphnode invasion was not detected in any of the patients who had performed lymphadenectomy. 22 (%95,6) of the patients underwent frozen. The accuracy rate of frozen section for the diagnosis of malignancy was determined as 100% according to the absolute pat- hology results. The difference in histologic types was observed in only 5 cases.
RESULTS: Histologically these roustypein 9 patients, the mucinoustypein 10 patients, mixed type in 4 patients were revealed. The average diameter of mucinous borderline tumors (17,7±66,67), were larger than the average diameter of serous borderline tumors (12±10,9) and also this was found statistically insignificant (p=0,0937).
DISCUSSION AND CONCLUSION: As a result, the ideal method for the treatment of borderline ovarian tumors are not clear. Recurrence in cystectomy or oophorectomy for the protection of fertility, appears to be more frequent than those treated with hysterectomy and bilateralsalpingooferectomy (TAH + BSO). The patients who underwent fertility-sparing surgery, should be informed about recurrence and should be under close follow up.

7. The Result Of Early Laparoscopic Cholecystectomy In Acute Pancreatitis
Öztekin Çıkman, Şükrü Taş, Hasan Ali Kiraz, Berkin Şekerci, Muammer Karaayvaz, Yılmaz Akgün
Pages 99 - 103
INTRODUCTION: The aim of this study is to evaluate the results for early laparoscopic cholecycstectomy in patients who were treated for acute biliary pancreatitis without discharge of patients.
METHODS: Between january 2012 and july 2015, the data of 37 patients who were hospitailzed for acute biliary pancreatitis, were evaluated retrospectively, in whom laparoscopic cholecyctectomy were performed before discharged after ob- taining normal clinical and laboratory results. Age, sex, laboratory findings, ultrasonography, MRCP, and ERCP results, operation time, open convertion, morbidity, mortality, post operative care were recorded.
RESULTS: Of 37 acute pancreatitis patients; 16 was male, 21 female and the mean age was 58,1. The average ranson score was 1,38. As examined sonographically; 26 patients had multiple calcules(70,27%),5 had sludge(13,51%),6 had single calcule(16,22%). 19 patients suspicious for bile duct disease according to laboratory and clinical findings were examined by MRCP. ERCP was performed for 6 patients in whom calcule detected in MRCP. In all patients the standart laparoscopic cholesistectomy prosedure was done by using 4 ports. In only one patient the prosedure was continued by open conversion because of cholecystodudenal fistule which did not diagnosed preo- peratively. Calculated average hospitalization time was 2,08 days.
DISCUSSION AND CONCLUSION: Despite the diffuculties as bringing up the anatomic structures and delayed operation time in early period laparoscopic cholecystectomies; we believe that early laparoscopic cholecyctectomy is an ef- fective choice of management and prevents the recurrent acute pancreatit attacks.

8. The IncIdence of anemIa and the effect of TNF-α InhIbItors on anemIa In patIents wIth ankylosIng spondylItIs
Seher Tanrıkulu, Hatice Seval Pehlevan, Gül Babacan Abanonu, Yasemin Özgür, Zeynep Ece Demirbaş, İbrahim Taycı, Şevki Konür, Ozan Durmaz, Mehmet Fatih Akdoğan, Refik Demirtunç
Pages 104 - 112
INTRODUCTION: Anemia is one of the complications of chronic inflammatory diseases that can often accompany them. The prevalence of anemia in Ankylosing spondylitis (AS) is not known precisely. In this study, we aimed to investigate the prevalence of anemia and to investigate the effects of TNF-α inhibitors on anemia.
METHODS: This study was carried out in our hospital outpatient clinics of Internal Medicine and Rheumatology; 142 patients with AS (Group I) and 80 healthy volunteers with similar demographic features were included in. Forty two patients (of Group II) which have been using TNF-α inhibitors were selected from those who began this treatment in the last one year; clinical and laboratory findings at the beginning and the sixth months of the treatment were obtained from hospital records.
RESULTS: In addition to the routine physical examination, BASDAI scores, BASFI scores, modified Schober, chest expansion, tragus wall clearances were measured and recorded. Blood samples were taken from all individuals to measure blood count, serum iron, total iron binding capacity (TIBC), ferritin, folate, vitamin B12, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The rate of anemia was 23.2% in Group I, 27.5% in Group II (p: 0.480). Forty two patients which have been using TNF-α inhibitors, have showed significant reductions in terms of ESR, CRP, platelet count, white blood cell count (WBC) (p <0.05) and showed signifi- cant increases in terms of hemoglobin and hematocrit levels; whereas MCV, RDW, MPV haven’t changed significantly (p>0.05). While at the beginning anemia prevalence was 26.19%, after 6th months of treatment it decreases 7.14% (p: 0.008).
DISCUSSION AND CONCLUSION: In this study we showed that, the treatment of TNF-α inhibi- tors in ankylosing spondylitis can cause significant increase in hemoglobin levels and can reduce the incidence of anemia.

REVIEW
9. Adneksiyal Kitlelerin Preoperatif Öngrüsünde Malignite Risk İndeksi Hesaplamaları Ve Iota Kuralları
Sinem Ertaş, Fisun Vural, Nurettin Akarsu
Pages 113 - 121
Ovarian cancer is the fifth reason of women death because of cancer. According to World Health Organization criteria, ovarian cancer is in group of cancers which can not benefit from screening tests. Unfortunately because of nonspecific clinical findings, ovarian cancer can be diagnosed in late stages. For the purpose of early diagnosis and true triage of the patients to the right centers, clinicians had worked on different diagnostic methods. Today, for evaluation of the premenopausal patients IOTA group defends models that based on ultrasonografic findings; on the other hand Risk Of Malignancy Indices (RMI 1,2,3,4) are thought to have diagnostic accurancy in postmenopausal group. With this review,we up to date developments in the diagnosis and triage of adnexal masses which frequently encountered in daily practice and we aimed to evaluate dilemmas in the literature.

CASE REPORT
10. Our Anesthetic Experience with Capto- melic Dysplasia: Case Report
Arzu Yıldırım Ar, Güldem Turan, Ceren Şanlı Karip, Ceren Köksal, Hakan Arslan, Nur Akgün
Pages 122 - 124
Camptomelic dysplasia is a disease which is a subgroup of skeletal dysplasias. Curvature in the lower limb bones; thoracic deformities, micrognathia, microcephaly, heart, kidney abnormalities are some of the major problems in this disease. Bone and cartilage anomalies that can cause tracheomalacia can occur in this disease eigther. In the early periods of childhood disease can be mortal but if patients can deal with respiratory problems further medical intervention can be neccesary. In this cases, patients might have need orthopedic operations. Because of the abnormalities in the structure of the ribcage and tracheomalacia this patients have high risk of postoperative respiratory failure and need special anesthetic consiredation. In this case we want to share our clinic ex- perience because of respiratory failure in a 4 year old female patient with the diagnosis of Camptomelic dysplasia whom is having an operation for her pes equinovarus.

11. After Circumcision Resulting With Advanced Degrees Adhesion İn Glans Penis: A Case Report
Caner Ediz
Pages 125 - 127
Circumcision is described the removal of part of the male genital skin called preputial. One of the most commonly performed surgery in pediatric age group is circumcision on the world. The possibility of complications may occur during the operation of circumcision like any surgical procedures. Complication rates of circumcision may change with surgical operation experience of the person, the application conditions and varies with patient related factors. Circumcision complications can be classified as early and late complications. In the early period of pain, bleeding, swelling, as can be seen from minor complications such as inadequate skin excision is rarely death, serious complications may also occur, such as amputation of the glans. In the late period, pain, infection of the glans penis shaft skin bridge formation, severe adhesions, urinary retention, meatal stenosis, meatal ulcers and fistulas can be seen.In this case report, on a 6-month old boy, we discussed severe glandular adhesion and urinary retention after the circumcision performed by a mohel.

12. Scrotal Kaposi’s Sarcoma
Ayşe Nur İhvan, Caner Ediz, Muzaffer İlkay Tosun
Pages 128 - 130
Kaposi Sarcoma (KS), first described by Moritz Kaposi in 1872, is a vascular neoplasm. Distinguishing KS from other benign or malign vascular tumors, as well as other nonvascular spindle cell soft-tissue neoplasms can be challenging. Case; 86 year-old man who has a palpable nodule thats periodically hemorrhagic in the scrotum in recent months. Scrotal lesions were surgically excised.Isolated scrotal Kaposi’s sarcoma was reported in histopathological examination. A rare scrotal pathology which has HIV negative (-), HHV-8 positive (+) skrotal KS is presented in this article.

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