GÝRÝÞ ve AMAÇ: Akut bronþiolit süt çocukluðunda ve 2 yaþýndan küçük çocuklarda, genellikle viral etkenlere baðlý geliþen ve hastaneye yatýþýn majör sebeplerinden olan bir alt solunum yolu enfeksiyonudur. Çalýþmamýzýn amacý akut bronþiolit nedeniyle hastanede yatan çocuklarda izole edilen laboratuvar bulgularý ve uygulanan tedavi yöntemlerinin hastalarýn yatýþ sürelerine etkisini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu amaçla Konya Eðitim ve Araþtýrma Hastanesi Çocuk Kliniðinde Aralýk 2013 – Mayýs 2014 tarihleri arasýnda bronþiolit tanýsýyla yatarak takip edilen 95 hastanýn dosyalarý retrospektif olarak incelendi.
BULGULAR: En fazla izole edilen viral patojenler respiratuvar sinsityal virüs (%21.8) ve rinovirüs idi (%21.8). Sadece rinovirüs üreyen grupla üreme olmayan grup arasýnda yatýþ süreleri açýsýndan anlamlý bir fark bulunamazken, sadece RSV-A üreyen ve RSV-A+Rinovirüs birlikte üreyen grupta hastanede yatýþ süreleri anlamlý derecede uzun bulundu. Ýnhale bronkodilatatör, ipratropium bromid, hipertonik salin tedavisi uygulanan ve uygulanmayan hasta gruplarý arasýnda yatýþ süreleri açýsýndan anlamlý fark saptanmazken, inhale streoid alan olgularýn yatýþ süresi almayanlara oranla daha uzun bulundu. Ýmmunglobulin E (Ig E) düzeyi yüksek ölçülen hastalarýn ortalama yatýþ süreleri, normal olanlara göre anlamlý olarak uzundu. Anne sütü alan ve almayan gruplar arasýnda ve sigara ile temas öyküsü olan ve olmayan gruplar arasýnda yatýþ süreleri açýsýndan anlamlý fark saptanmadý.
TARTIÞMA ve SONUÇ: Sonuç olarak, RSV ve rinovirüs hala akut bronþiolitin majör sebepleridir. Ýnhale steroid tedavisi almak, yüksek Ig E düzeyi ve bronþiolit sebebinin RSV olmasý hastanede yatýþ süresini uzatmaktadýr.

INTRODUCTION: Acute bronchiolitis, is a predominantly a viral disease, part of the spectrum of lower respiratory tract diseases, is a major cause of illness and hospitalization in infants and children younger than two years. The aim of the study was to determine the effects of treatment protocols, other laboratory results together with the isolated viral agents on the duration of hospitalization.
METHODS: Data of 95 children who were hospitalized with diagnosis of bronchiolitis in Konya Training and Research Hospital Pediatrics Clinic between October 2013 and May 2014 were reviewed retrospectively.
RESULTS: The most isolated agents were respiratory syncytial virus (RSV) and rhinovirus with an equal rate of 21.8%. When patients with no isolation were compared with patients only rhinovirus isolated no significant difference was found among hospitalization length. However hospitalization duration was significantly longer in patients with RSV-A infection and RSV-A + rhinovirus together, than patients with no virus isolation. While hospitalization length was not effected from receiving inhaled bronchodilator, ipratropium bromide or hypertonic saline, the duration was longer in patients receiving inhaled corticosteroid when compared with patients who didn’t receive inhaled corticosteroid. Mean hospitalization duration was significantly longer in patients with higher immunoglobuline E (IG E) levels. Smoke exposure and receiving breast milk in the first 6-months of life didn’t influence the length of stay in hospital.
DISCUSSION AND CONCLUSION: In conclusion, receiving inhaled corticosteroid, high Ig E levels and bronchiolitis due to RSV infection prolonges hospital stay.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý, trombotik trombositopenik purpura (TTP) ve hemolitik üremik sendrom (HÜS)’un tanýsý sýrasýnda, ADAMTS13 düzeylerini ve diðer hemoliz parametrelerini deðerlendirmek ve sonuçlarla ayýrýcý tanýya varabilmektedir.
YÖNTEM ve GEREÇLER: 2014-2016 yýllarý arasýnda Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Ýç Hastalýklarý Kliniðinde mikroanjiyopatik hemolitik anemi (MAHA) kliniði ile baþvuran ve tedavileri yapýlan hastalar retrospektif olarak deðerlendirildi. ADAMTS13 aktivitesi ve diðer laboratuvar testleri TTP (n=6), HÜS (n=5) ve diðer MAHA’li (n=8) hastalarda çalýþýldý.
BULGULAR: : HÜS ve diðer MAHA gruplarý ile karþýlaþtýrýldýðýnda TTP hastalarýnda, hem ADAMTS13 aktivitesi hem de trombosit sayýlarý istatistiksel açýdan anlamlý derecede düþük saptandý (p=0,014, p=0,028). ADAMTS13 aktivitesi ile taný öncesi trombosit sayýsý (p=0.001, r=0.693) ve serum kreatinin (p=0.008, r=0.589) düzeyleri arasýnda pozitif korelasyon saptandý. ADAMTS13 aktivitesi TTP grubunda en düþük düzeylerde, HÜS ve diðer grubunda ise orta-yüksek düzeylerde saptandý (p=0.048).
TARTIÞMA ve SONUÇ: MAHA tanýsý sýrasýnda ciddi trombositopeni ve çok düþük ADAMTS13 aktivite düzeylerinin varlýðý HÜS tanýsý için bir bulgu deðilken, TTP tanýsýný iþaret etmektedir. Ilýmlý bir trombositopeni, normal veya hafif/orta düzeyde azalmýþ ADAMTS13 aktivite düzeyleri ve artmýþ serum kreatinin düzeylerinin varlýðý ise HÜS tanýsýný desteklemektedir.

INTRODUCTION: The aim of this study was to analyze the value of ADAMTS13 measurements and the other hemolysis tests in the diagnosis of thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS).
METHODS: At presentation, we analyzed patients retrospectively with microangiopathic hemolytic anemia (MAHA) treated in Eskisehir Osmangazi University Faculty of Medicine, Internal Medicine Department from 2014 to 2016. ADAMTS13 activity and other laboratory tests were measured with TTP (n=6), HUS (n=5) and other MAHA (n=8) patients.
RESULTS: ADAMTS13 activitiy and platelets count levels was significantly lower in TTP patients compared with HUS and other MAHA patients group (p=0.014, p=0.028). There was a significant correlation between ADAMTS13 activitiy levels and platelets count levels (p=0.001, r=0.693) and serum creatinine levels (p=0.008, r=0.589) in diagnosis. Severe decreased ADAMTS13 activity levels was significantly found in TTP group compared with HUS and other MAHA patients group (p=0.048).
DISCUSSION AND CONCLUSION: Severe thrombocytopenia and severe ADAMTS13 activity deficiency at the diagnosis of MAHA is not present in the HUS disease, is present in the TTP disease. Mild thrombocytopenia, normal or mild/moderate decrease ADAMTS13 activity levels and increased serum creatinine levels is present in the HUS disease.

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GÝRÝÞ ve AMAÇ: Çalýþmanýn amacý sperm parametrelerinin yoðunluk gradyan yöntemi ile yýkanmasýnýn sperm sonuçlarýnýn etkisini araþtýrmak ve uzmanlara bu yöntem ile yýkama sonrasýnda sonuçlarý öngörme imkaný verebilmektir.
YÖNTEM ve GEREÇLER: 04.2011- 10.2016 tarihleri arasýnda Florence Nightingale Hastanesi, Yardýmla Üreme Merkezi’ne infertilite araþtýrmasý nedeniyle baþvuran 1402 erkek çalýþmaya alýnmýþtýr. Sperm hazýrlama öncesi ve sonrasýnda semen analizleri WHO 2010’ a göre yapýlmýþtýr. Sperm konsantrasyonu <1 mil/ ml nin altýndaki örnekler dansite gradyan yöntemiyle hazýrlanmýþ ve semen parametreleri (sperm konsantrasyonu, toplam motilite, progresif motilite, normal morfoloji ve normal akrozom yapýsý oranlarý analiz edilmiþtir.
BULGULAR: Yoðunluk gradyan yöntemi sonrasýnda sperm konsantrasyonu azalmasýna raðmen total motilite, progresif motilite, normal morfoloji ve normal akrozomal yapý oranlarý artmýþ olarak bulunmuþtur (p<0,05). Sperm konsantrasyonu parametresinde %37,49 lük anlamlý bir azalma belirlenmiþtir. Toplam motilite oranýnda %21,47 lik anlamlý bir artýþ (yýkama öncesi 66.1% ve yýkama sonrasý 87.57%) after semen preparation, progresif motilite oranýnda 28.12% lik bir artýþ (yýkama öncesi 11.45% ve yýkama sonrasý 39,57%), normal morfoloji oranýnda %5’lik bir artýþ (yýkama öncesi 3% ve yýkama sonrasý 8%), ve normal akrozomal yapý oranýnda %14’lük bir artýþ yýkama öncesi 62% ve yýkama sonrasý 76%), belirlenmiþtir (p<0,05).
TARTIÞMA ve SONUÇ: Çalýþmanýn bulgularý doðrultusunda yoðunluk gradyaný yöntemi sonrasýnda toplam motilite, progresif motilite, normal morfoloji ve normal akrozomal yapý oranlarý anlamlý derecede artmýþ ancak sperm konsantrasyonu anlamlý derecede azalmýþ olarak belirlenmiþtir p0,05). Bulgular, uzmanlara yöntem sonrasýnda parametreleri öngörme ve buna göre yardýmla üreme tekniklerinde sperm hazýrlama yöntemini seçmekte yardýmcý olacaktýr.

INTRODUCTION: The aim of this study is to observe the changes in the sperm parameters after density gradient sperm preparation. The data will help the specialist to decide the preparation technique and to predict the outcome of semen parameters after using this technique.
METHODS: One thousand four hundred two men screening for infertility were analyzed attending Florence Nightingale Hospital, IVF clinic for infertility investigation between 04.2011- 10.2016. Semen analysis were performed according to WHO 2010 before and after semen preparation. Samples having <1 mil/ ml sperm concentration were prepared by density gradient centrifugation technique and the semen parameters (sperm concentration, total motility, progressive motility, normal morphology rates and normal acrosomal status rates) were analyzed after the preparation.
RESULTS: Although the sperm concentrations were decreased, total motility, progressive motility and normal morphology rates were increased after density gradient semen preparation. The sperm concentrations were decreased by 37.49% after semen preparation (P= 0,01). Total motility rates were increased significantly by 21.47% (66.1% before and 87.57% after semen preparation), progressive motility rates were increased by 28.12% (11.45% before and 39.57% after semen preparation), normal morphology rates were increased by 5% (3% before and 8% after semen preparation), normal acrosomal status rates were increased by 14% (62% before and 76%)) after semen preparation (p<0,01).
DISCUSSION AND CONCLUSION: According to the results of this study, the sperm parameters including the total motility, progressive sperm motility, normal morphology and normal acrosomal status rates increased but the sperm concentration decreased after density gradient sperm preparation. The data will help the specialist to decide the sperm preparation technique for using in assisted reproductive techniques and to predict the outcome of semen parameters after using this technique.

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GÝRÝÞ ve AMAÇ: Romatoid artrit (RA) hastalarýnda serum D vitamini düzeylerinin hastalýk aktivitesi ile iliþkisini incelemektir.
YÖNTEM ve GEREÇLER: Çalýþmamýza kliniðimizin Romatoloji dal polikliniðinde RA tanýsý ile takip ve tedavi edilmekte olan hastalar alýndý. Bu hastalardan takipleri düzenli olarak yapýlmýþ, serum 25 hidroksi (OH) D vitamini seviyeleri ölçülmüþ ve D vitamini replasman tedavisi almamýþ olanlarýn dosyalarý retrospektif olarak tarandý. Hastalarýn yaþ, cinsiyet, boy, kilo gibi demografik özellikleri, hastalýk süresi, kullandýklarý ilaçlar ve serum 25(OH)D vitamini seviyelerinin ölçülmüþ olduðu tarihteki 1 saatlik eritrosit sedimantasyon hýzý (ESH), C-reaktif protein (CRP) düzeyleri, serum kalsiyum, fosfor, alkalen fosfataz, parathormon gibi laboratuar parametreleri kayýt edildi. Hastalýk aktivitesi, Disease Activity Score (DAS) 28 skorlarý hesaplanarak belirlendi.
BULGULAR: Çalýþmaya dahil edilen 34 RA tanýlý hastanýn yaþ ortalamasý 54.09±11.8 yýl idi. Hastalarýn 30’u kadýn, 4’ü erkekti. Hastalýk süreleri ortalama 8.38±6.87 yýldý. Ortalama DAS 28 skoru 4.59±2.07, CRP 0.92±1.12 mg/dL, ESH 27.79±18.57 mm/saat, 25(OH)D vitamini düzeyleri ise 19.87±13.22 ng/mL idi. Serum 25(OH)D vitamini düzeylerinin diðer parametrelerle korelasyonu incelendiðinde; yaþ, hastalýk süresi ve ESH ile pozitif yönde, hastalýk aktivitesi ve CRP düzeyi ile ise negatif yönde iliþki saptandý, ancak 25(OH)D vitamininin sadece hastalýk süresi ile olan pozitif korelasyonu ve CRP ile olan negatif korelasyonu istatistiksel olarak anlamlý idi (p<0.05).
TARTIÞMA ve SONUÇ: D vitamini eksikliðinin otoimmün hastalýklarla iliþkisinin saptanmasý ile D vitamininin immün modülatör bir rolü olduðu anlaþýlmýþtýr. Bu çalýþmada RA’lý hastalarda serum D vitamini düzeyi, hastalýk aktivitesi ve CRP ile negatif yönde iliþkili bulunmuþ olup tedavi planýnda D vitamini düzeylerini dikkate alan bir yaklaþýmýn gerekli olduðu düþünülmektedir.

INTRODUCTION: To investigate the relationship between serum vitamin D levels and disease activity in patients with rheumatoid arthritis (RA).
METHODS: Patients who were followed up and treated with RA diagnosis in the Rheumatology branch of our clinic were included. Serum 25 hydroxy (OH) D levels were measured regularly in these patients, and files of those who did not receive vitamin D replacement therapy were retrospectively screened. Demographic characteristics such as age, gender, height, weight, duration of illness, medications used and 1 hour serum erythrocyte sedimentation rate (ESR) which was measured at the same date with serum25 hydroxy (OH) D, C-reactive protein (CRP) levels, serum calcium, laboratory parameters such as phosphorus, alkaline phosphatase, parathormone were recorded. Disease activity was determined by calculating the Disease Activity Score (DAS) scores.
RESULTS: The mean age of 34 RA patients included in the study was 54.09 ± 11.8 years. 30 of the patients were female, 4 were male. The mean duration of illness was 8.38 ± 6.87 years. The mean DAS 28 score was 4.59 ± 2.07, CRP was 0.92 ± 1.12 mg/dL, ESH was 27.79 ± 18.57 mm/h and 25 (OH) D vitamine levels were 19.87 ± 13.22 ng/mL. When the correlation of serum 25 (OH) D vitamin levels with other parameters is examined; positive correlation was found with age, duration of disease and ESR, and negative correlation was found with disease activity and CRP level. However, only positive correlation of 25 (OH) D vitamin with disease duration and negative correlation with CRP was statistically significant (p <0.05 ).
DISCUSSION AND CONCLUSION: Vitamin D deficiency is associated with autoimmune diseases and vitamin D has an immunomodulatory role. In this study, serum vitamin D levels were correlated with disease activity and CRP in patients with RA, and it is considered that an approach considering the levels of vitamin D in the treatment plan is necessary.

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GÝRÝÞ ve AMAÇ: Bu çalýþmadaki amacýmýz kýzamýk hastalarýnýn demografik özellikleri ile morbidite ve mortalitelerinin deðerlendirilmesi, kýzamýk salgýnlarýnýn kontrol altýna alýnarak önlenmesidir.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmada, 0cak 2013 - Mayýs 2014 tarihleri arasýnda Saðlýk Bakanlýðý Ýstanbul Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi Çocuk Kliniði'ne baþvuran 20 kýzamýk olgusu retrospektif olarak incelendi.
BULGULAR: Çalýþmaya Kýzamýk, Kýzamýkçýk ve Konjenital Kýzamýkçýk Sendromu Sürveyansý Daimi Genelgesi'ne uygun olarak kesin vaka tanýmlamasýna uyan hastalar dahil edildi. Veriler kýzamýk teþhisi alan hastalarýn hasta dosyalarýndan, týbbi kayýtlarýndan ve Saðlýk Bakanlýðý Kýzamýk/Kýzamýkçýk Vaka Ýnceleme Formu verilerinden elde edildi. Kýzamýðýn doðal seyrinden farklý olarak vakalarýn çoðunun yaz aylarýnda kümelendiði görüldü. T.C. Saðlýk Bakanlýðý’nýn ve kliniðimizin önceki kayýtlarý ile karþýlaþtýrýldýðýnda 2013 yýklýnda Türkiye’de bir kýzamýk epidemisinin var olduðu kesinlik kazandý. Çalýþmamýzda vakalarýn %70’inin (14 hasta) komplikasyonlu kýzamýk vakalarý olduðu ve en sýk rastlanan komplikasyonun bronkopnömoni olduðu görüldü.
TARTIÞMA ve SONUÇ: Komþu ülkelerdeki siyasi istikrarsýzlýk nedeniyle yeni aþý kampanyalarýna ihtiyaç doðduðu, enfeksiyon hastalýklarýnýn bildirimi için ulusal ve online bir bilgi aðýnýn oluþturulmasý ve bu sayede bildirimlerin kolay ve hýzlý bir biçimde yapýlabilmesi gerektiði kanýsýna varýldý. Yüksek komplikasyon oraný göz önüne alýndýðýnda, Türk çocuklarýnýn beslenme durumu ve yetersiz beslenme kýzamýk enfeksiyonunun seyrini olumsuz yönde etkileyebilmektedir ve dikkatli bir þekilde ele alýnmalýdýr.

INTRODUCTION: The aim was to evaluate patient demographic features and morbidity and mortality, and to control and prevent epidemics of measles with the help of our evaluation.
METHODS: This is a retrospective study that included 20 measles patients in the pediatric age group who were diagnosed at the Istanbul Haydarpaþa Numune Training and Research Hospital Clinic of Pediatrics between 2013 and 2014.
RESULTS: Only definitive measles cases were included in the study, as defined by the Permanent Guideline for the Surveillance of Measles, Rubella, and Congenital Rubella Syndrome of the Turkish Ministry of Health. All of the data were obtained from the patients’ medical records, patient files, and Turkish Ministry of Health Measles/Rubella Case Review forms. The majority of our cases accumulated during the summer, which differs from the normal course of measles. Based on a comparison of the number of cases in previous years using the Turkish Ministry of Health data and the data of our clinic, it is obvious that there was a measles epidemic in 2013 in Turkey. In the present study, we found a very high complication rate of 70% (14 patients).
DISCUSSION AND CONCLUSION: The most frequent complication was bronchopneumonia. As a result of the political instability in neighboring countries, new vaccination campaigns must be organized. An online national data network must be assembled to make notification of infectious disease easier and faster. Given the high complication rate, nutritional inadequacy and nutritional status overall in Turkish children may make the course of measles worse and must be evaluated carefully.

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GÝRÝÞ ve AMAÇ: Demir eksikliði anemisi geliþmekte olan ülkelerde önemli bir sorun teþkil etmektedir. Demir eksikliði anemisi tespit edilen çocuklarýn ve ailelerinin demografik özelliklerini, serum çinko düzeyi ile karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi Çocuk Saðlýðý ve Hastalýklarý Polikliniði’nde 01.11.2013-01.12.2013 tarihleri arasýnda 6 ay-12 yaþ arasýndaki demir eksikliði anemisi olan çocuklarýn boy ve aðýrlýk persentillerine bakýlarak, beslenme alýþkanlýðý ve ailenin gelir düzeyi sorgulanarak, serum çinko örneði için kan alýndý. Hastalardan alýnan kan örneklerinden çinko düzeyi saptanarak çinko düzeylerindeki farklýlýklarýn demir eksikliði anemisi ile iliþkisi deðerlendirildi.
BULGULAR: Demir eksikliði anemisi olan hastalardan bakýlan serum çinko düzeyi ile cinsiyet, beslenme, aile gelir düzeyi, aile eðitim durumu arasýnda istatiksel olarak anlamlý fark bulunmadý (p>0,05). Çinko düzeyi ile yaþ ve aðýrlýk arasýnda anlamlý pozitif korelasyon mevcuttu (p<0,05). Çinko düzeyi ile boy ve Fe/Febk % deðeri arasýnda anlamlý korelasyon yoktu (p>0,05).
TARTIÞMA ve SONUÇ: Biz bu çalýþmada demir eksikliði anemisi olan çocuklarda anlamlý bir çinko eksikliði tespit etmedik. Bunu, çalýþmaya alýnan çocuk yaþ grubu yelpazesinin geniþ olmasýna, özellikle büyük çocuklarýn çinko ihtiyacýný kuruyemiþten ve proteinden karþýlayabilmesine baðlýyoruz. Ancak konuyla ilgili daha fazla sayýda hasta içeren çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Iron deficiency anemia is a leading problem among children in developing countries. In this study we aimed to evaluate the correlation between demographic features and serum zinc levels in children with iron deficiency anemia.
METHODS: This study was performed in Haydarpaþa Training and Research Hospital between 01.11.2013 and 01.12.2013, among children with iron deficiency aged 6 months to 12 years. Height and weight percentages, nutrition behaviors and family social and economic features were investigated. Blood samples for zinc deficiency were performed and the correlation between iron and zinc deficiency in the samples was evaluated.
RESULTS: There was no statistically significant difference between serum zinc levels and gender, nutrition, monthly incoming and parental education level among children with iron deficiency (p>0.05). There was positive correlation between serum zinc levels and age and weight (p<0.05). There was no significant correlation between serum zinc levels and height and serum transferrin saturation (p>0.05).
DISCUSSION AND CONCLUSION: In this study we did not demonstrate zinc deficiency in children with iron deficiency. This result is related with different ages of children and specially related with consumption of large amounts of nuts and proteins among the older children. We decide that studies including larger samples are needed.

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GÝRÝÞ ve AMAÇ: Kliniðimizde böbrek tümörü nedeniyle laparoskopik parsiyel nefrektomi yapýlan ilk 103 hastanýn cerrahi, onkolojik ve uzun dönem fonksiyonel sonuçlarýnýn deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Kliniðimizde 2008-2016 tarihleri arasýnda laparoskopik parsiyel nefrektomi yapýlan toplam 103 hasta çalýþmaya dahil edildi. Demografik veriler, perioperatif renal fonksiyonlar, tümörün patolojik ve radyolojik özellikleri retrospektif olarak deðerlendirildi.
BULGULAR: Yaþlarý ortalama 54,72 yýl (19-71) olan 68 erkek, 35 kadýn toplam 103 hastaya transperitoneal laparoskopik parsiyel nefrektomi uygulandý. Ortalama tümör çapý 32,42 mm (12-82 mm) olarak hesaplandý. Tümörlerin 4’ü (%3,88) bilateral, 45’i (%43,68) sað ve 54’ü (%52,42) sol böbrek yerleþimli idi. Yine tümörlerin 32’si (%31,06) üst pol, 41’i (%39,80) alt pol ve 30’u (%29.12) orta zon yerleþimliydi. Hastalarýn 2002 TNM sýnýflamasýna göre; 64’ü (%62,13) T1a, 32’si (%31,06) T1b ve 7’si (%6,79) T2a klinik evre ile prezente oldu. Hastalarýn preoperatif ortalama kreatinin deðerleri 0.78 mg/dl (0.4-1.7), postoperatif ilk gün ortalama kreatinin deðerleri 1,04 mg/dl (0.5-2.48) ve postoperatif 1. ayda ortalama kreatinin deðerleri 0.89 mg/dl (0.4-1.8) olarak hesaplandý. Hastalarýn preoperatif ve postoperatif 1. aydaki kreatinin deðerleri arasýnda istatistiksel anlamlý fark görülmedi (p>0,05).Patolojik inceleme sonucunda lezyonlarýn 6’sý (%5,82) onkositom, 12’si (%11,65) anjiomyolipom ve 85’i (%82,52) renal hücreli karsinom olarak raporlandý. Renal hücreli karsinomlarýn 62’si (60,19) berrak hücreli karsinom, 14’ü (%13,59) papiller karsinom ve 9’u (%8,73) kromofob karsinom olarak saptandý. Fuhrman sýnýflamasýnda; 18’i (%17,47) grade 1, 75’i (%72,81) grade 2 ve 10’u (%9,70) grade 3 olarak rapor edildi. Hastalar ortalama 46 (6-92) ay takip edildi. Takiplerinde cerrahi sýnýr pozitif olanlar dahil hiçbirinde radyolojik olarak lokal nüks ve metastaz saptanmadý. 4 hastada kanser dýþý ölüm görülen çalýþmada, hastalýða özgü saðkalým oraný %100 ve genel sað kalým oraný %96.22 olarak tespit edildi.
TARTIÞMA ve SONUÇ: Açýk ve laparoskopik parsiyel nefrektominin onkolojik sonuçlarýnýn benzer olmasý ve laparoskopinin hastaya saðladýðý avantajlar nedeniyle, her ne kadar öðrenme eðrisi uzun olsa da laparoskopik teknik ile deneyimli ellerde çok baþarýlý sonuçlar elde edilebilmekte ve gün geçtikçe uygulanma oraný artmaktadýr.

INTRODUCTION: We aim to evaluate surgical, oncological and functional outcomes of our first 103 laparoscopic partial nephrectomy experience.
METHODS: A total of 103 patients underwent laparoscopic partial nephrectomy between 2008 – 2016 were identified retrospectively. Demographic data, perioperative renal functions, radiological and pathological features of tumors were recorded.
RESULTS: Mean patient age was 54,72 (range: 19-71) and mean tumor diameter was 32,42 mm (12-82 mm). Preoperative mean creatinine value was 0.78 mg/dl (0.4-1.7), postoperative first day creatinine value was 1,04 mg/dl (0.5-2.48) and creatinine value at postoperative 1. month was 0.89 mg/dl (0.4-1.8). There was no statistical significance between preoperative and postoperative functional parameters.
Pathological study revealed 6 (%5,82) oncocytomas, 12 (%11,65) angiomyolipomas and 85 (%82,52) renal cell carcinomas. Of 85 renal cell carcinomas, 62 (%60,19) clear cell, 14 (%13,59) papillary and 9 (%8,73) chromophobe subtypes reported. Mean follow-up was 46 (range: 6-92) months. There was no local recurrence or metastasis ocurred during follow-up including patients with positive surgical margins. Cancer specific survival was %100 and overall survival was %96.2 with 4 non-cancer related death.
DISCUSSION AND CONCLUSION: Although it has a challenging learning curve, laparoscopic partial nephrectomy has impressive results regarding patient comfort and similar oncological outcomes with radical neprectomy.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda multipl skleroz (MS) hastalarýnda lenfosit alt popülasyonundaki deðiþimin akan hücre ölçer ile belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 25 ataklý yineleyici MS hastasý ayrýca yaþ ve cinsiyet uyumlu 11 saðlýklý kontrol de dahil edildi. CD3+ T hücre, CD4+ yardýmcý T hücre, CD8+ sitotoksik T hücre, CD3+CD4+CD25parlak düzenleyici T (Treg) hücre, CD19+ B hücre, CD16+CD56+ doðal öldürücü (NK) hücre, CD3+CD56+ NKT hücre kantifikasyonu dört renkli akan hücre ölçer ile deðerlendirildi.
BULGULAR: Akan hücre ölçer cihazýnda hücre gruplarý deðerlendirildiðinde, T hücre, düzenleyici T (Treg) hücre, B hücre, doðal öldürücü (NK) hücre, NKT hücre gruplarýnda hasta ve saðlýklý kiþiler arasýnda anlamlý fark olmadýðý gözlendi. T ve B lenfositlerinin hasta ve saðlýklýlarda yüzdeleri oldukça yakýn iken hastalarda NK ve NKT hücre gruplarýnda hastalar lehine gözlenen azalma anlamlý seviyede deðildi. Ayrýca yardýmcý, sitotoksik ve düzenleyici T hücrelerinin de hasta ve saðlýklýlarda benzer seviyelerde olduðu belirlendi.
TARTIÞMA ve SONUÇ: Bu bulgular, MS patogenezinde rol oynayan merkezi sinir sistemi inflamatuar deðiþikliklerinin ve lenfosit aktivasyonun periferik kan örneklerinde belirlenemeyeceðini ortaya koymaktadýr.

INTRODUCTION: In this study, lymphocyte subpopulation alterations of multiple sclerosis (MS) patients were aimed to be identified by flow cytometry.
METHODS: Twenty-five relapsing remitting MS patients and age-gender matched 11 healthy controls were included. CD3+ T cell, CD4+ helper T cell, CD8+ cytotoxic T cell, CD3+CD4+CD25high regulatory T (Treg) cell, CD19+ B cell, CD16+CD56+ natural killer (NK) cell, CD3+CD56+ NKT cell percentages were quantified by four color flow cytometry.
RESULTS: Assessment of cell populations yielded no significant differences among T cell, T reg cell, B cell, NK cell and NKT cell groups of MS patients and healthy controls. While T and B cell percentages were comparable between patients and healthy controls, NK and NKT cells were found to be decreased in MS patients albeit at an insignificant level. Helper, cytotoxic and regulatory T cells were determined to be at similar percentages in patients and healthy individuals.
DISCUSSION AND CONCLUSION: Our results suggest that lymphocyte activation and inflammatory alterations of the central nervous system involved in MS pathogenesis can not be determined in peripheral blood cell samples.

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Týkanma sarýlýðý en sýk koledok taþlarý ve periampuller bölge tümörlerinden kaynaklanýr.Duodenum divertikülleri az rastlanan lezyonlar olup çoðu zaman asemptomatiktir. Duodenal divertiküllerin safra yollarýný týkamasý Lemmel sendromu olarak bilinir.Taný ve tedavisi güçlükler içermektedir. Kliniðimizde ile takip edilen 84 yaþýndaki hasta ERCP ile baþarýlý bir þekilde tedavi edilmiþtir.Bu olgu sunumunda ilgili hasta tartýþýlmýþtýr.

Biliary obstruction is most commonly caused by choledocholithiasis and periampullary tumors.Duodenal diverticula is a rare pathology and usually asymptomatic.Obstruction of bile duct due to duodenal diverticula is known as Lemmel’s syndrome.There are difficulties in both diagnosis and traetment.A 84 years old patient was succesfully treated with ERCP in our clinic.The patiet was discussed in this case report

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Günümüzde ilerleyen tedavi yöntemleriyle kanserli hastalarýn sað kalým süresi uzamýþtýr. Bu nedenle ikincil primer tümör görülme sýklýðýnda artýþ gözlenmektedir. Hastanemize baþvuran 52 yaþýndaki erkek hastada senkron pankreas duktal adenokarsinomu ve tiroid medüller karsinom tespit edilmiþtir. Bu iki tümör birlikteliði daha önce bildirilmediðinden literatürde paylaþmayý amaçladýk.

Due to advancements in modern medicine the survival rate for cancer patients has increased. Occurrence of two or more primary tumors in the same patient has thus also increased. Synchronous ductal pancreas adenocarcinoma and thyroid medullary carcinoma was found in a 52 years old male patient presenting at our hospital. Occurrence at this tumors simultaneously has never been reported. We aim to share our experience.

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Human herpes virüs tip 6 (HHV-6) çocuklarda özellikle yaþamýn ilk iki yýlýnda görülen benign, ateþli bir hastalýk olan exanthem subituma (ES) neden olur. ES ani baþlayan yüksek ateþ ve ateþin düþmesiyle birlikte döküntünün ortaya çýkmasýyla karakterize bir hastalýktýr. ES hastalarýnda en sýk görülen komplikasyonlar febril nöbet ve ensefalit gibi merkezi sinir sistemi (MSS) komplikasyonlarýdýr. Bu yazýda çocuk acil kliniðimize döküntü, emmede azalma ve uykuya meyil þikayetleri ile gelen ve ES sonrasý ensefalit tanýsý konulan bir olgu sunulmuþtur.

Human herpes virüs 6 causes exanthem subitum (ES), which is a benign disease presenting with fever in the first two years of life. ES is characterized by the abrupt onset of high fever and rash which occurs immediately after resolving of fever. The most common complications are central nervous system (CNS) complications such as febrile seizures and encephalitis. In this article, we report a case of encephalitis after ES who admitted with the complaints of eruption, poor feeding and drowsiness to our pediatric emergency clinic.

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Mesane ile sigmoid kolon arasýnda spontan fistül oluþumu oldukça nadirdir. Genelde altta yatan sebep sigmoid kolon divertiküllerinin inflame olmasý ve mesane duvarýna perfore olmasýdýr. Bazen sigmoid kolondaki tümörlerin mesaneye infiltre olmasý ile de geliþebilir. Bunlarýn dýþýnda inflamatuar baðýrsak hastalýklarý, tüberküloz, lenfoma, travma ve geçirilmiþ cerrahi giriþimler altta yatan diðer sebeplerdir. Biz bu sebeplerin hiçbirinin olmadýðý, spontan geliþen ve nedeni belli olmayan bir vezikosigmoid fistül olgusunu sunduk.

Spontaneous fistula formation between the bladder and the sigmoid colon is a very rare entity. In general, the underlying cause is that the sigmoid colon diverticula is inflated and perforated in the bladder wall. Sometimes, it can also develop due to infiltration of the sigmoid tumors to the bladder wall. Apart from these, inflammatory bowel diseases, tuberculosis, lymphoma, trauma and previous surgical interventions are other underlying causes. Herein, we presented a case of a vesicosigmoid fistula that was spontaneously developed without any underlying specific etiology.

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