GÝRÝÞ ve AMAÇ: Kritik bacak iskemisi, aterosklerotik periferik arter hastalýðýnýn (PAH) son aþamasýný temsil eder. Kritik bacak iskemisinden etkilenen hastalar, PAH'ýn en karmaþýk alt kümesidir ve tipik olarak hipertansiyon, hiperlipidemi, diyabet ve böbrek yetmezliðinin kronik patolojik sonuçlarýný taþýr.
YÖNTEM ve GEREÇLER: Biz çalýþmamýzda infrapopliteal seviyede darlýðý veya oklüzyonu olan hastalarda perkütan transluminal anjiyoplasti (PTA) nin erken dönem ve 6.aydaki sonuçlarýný deðerlendirdik. Hastalara bir seansta yalnýzca bir bacaða tedavi uygulandý. Hiç bir hastada infrapopliteal stent uygulamasý yapýlmamýþ olup hastalara yalnýzca balon anjioplasti yapýldý
BULGULAR: Çalýþmamýzda 31 hastadaki toplam 48 lezyonu olan 41 damar tedavi edildi. Takipte tedavi edilen damar segmentlerinin primer açýklýk oraný %72.9 olarak bulundu.
TARTIÞMA ve SONUÇ: PTA da, prosedürdeki baþarýsýzlýklar ve patensi kaybý, çözülmesi gereken temel terapötik zorluklardýr. Çaðdaþ, kanýtlanmýþ tedavi standartlarýný geliþtirmek için mevcut infrapopliteal tedavi yöntemlerini sistematik olarak deðerlendiren geniþ ölçekli, çok merkezli, prospektif çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Critical leg ischemia represents the final stage of atherosclerotic peripheral arterial disease (PAD). Patients affected by critical leg ischemia are the most complex subset of PAD and typically have chronic pathological consequences of hypertension, hyperlipidemia, diabetes and renal failure.
METHODS: In this study, we evaluated the early and sixth-month outcomes of percutaneous transluminal angioplasty (PTA) in patients with stenosis or occlusion at the infrapopliteal level. Only one leg was treated in one session. None of the patients received infrapopliteal stents, and only balloon angioplasty was performed.
RESULTS: In our study, 41 vessels with a total of 48 lesions in 31 patients were treated. The primary patency rate of the vascular segments treated at follow-up was 72.9%.
DISCUSSION AND CONCLUSION: In PTA, failure in the procedure and loss of patency are the main therapeutic challenges to be solved. Large-scale, multicenter, prospective studies that systematically evaluate existing infrapopliteal treatment methods are needed to develop contemporary, proven treatment standards.

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GÝRÝÞ ve AMAÇ: Ektopik pankreas dokusu (EP), %95 oranýnda gastrointestinal sistemde görülür, genellikle rastlantýsal olarak saptanýr. Pediyatrik vakalar nadir olarak bildirilmiþtir. Burada 2015-2018 yýllarý arasýnda endoskopik iþlem sýrasýnda saptanan hastalar sunulmuþtur.
YÖNTEM ve GEREÇLER: Ýki farklý merkezde Özofagogastroduodenoskopi yapýlan (2015-1018 yýllarý arasýnda) 475 hasta retrospektif olarak deðerlendirildi.
BULGULAR: Ýþlem sýrasýnda makroskopik olarak ektopik pankreas dokusu ile uyumlu olabilecek lezyon 14 hastada (8 erkek, 6 kýz) saptandý. Hastalarýn yaþ aralýðý 12.3±4.1 idi. Lezyonlarýn 11’ü pre-pilorik antrumda, 1’i distal özofagusa lokalize idi. Histopatolojik deðerlendirme ile özofagustaki biyopsi örneðinde ve antrum biyopsi örneklerinin 6’sýnda ektopik pankreas dokusu gösterildi.
TARTIÞMA ve SONUÇ: EP, patogenezi tam olarak bilinmeyen, embriyonik hayatta ön barsaðýn rotasyonu sýrasýnda ortaya çýkan bir defektten kaynaklandýðý düþünülen konjenital bir lezyondur. Otopsi serilerinde %0.55-13 oranýnda saptandýðý bildirilmiþtir.
EP sýk olarak gastrointestinal sistemde görülmektedir (özofagus, mide, duodenum, jejunum, ileum, omentum, safra kesesi, Meckel divertikülü), ancak; karaciðer, dalak, mesane, akciðer ve mediastinal yerleþim saptanan olgu raporlarý mevcuttur. Mide yerleþimi en sýk prepilorik antrumda ve büyük kurvaturdadýr. EP, tüm yaþ gruplarýnda görülebilmektedir, sýklýkla asemptomatiktir. Bununla birlikte spesifik olmayan dispeptik yakýnmalara, lezyon boyutuyla iliþkili olarak gastrointestinal sistemde obstrüksiyona, daha nadir olarak pankreatite neden olabilir. Lezyon boyutlarý deðiþken olup, genellikle merkezinde bir çentik olan, krater görünümünde submukozal bir nodul þeklindedir. Tanýda altýn standart histopatolojik deðerlendirmedir. Biyopsi örneklerinde pankreas dokusunu göstermek lezyonun submukozal yerleþimi nedeniyle her zaman mümkün olamayabilir. Pediatrik yaþ grubuna az sayýda vaka sunumu þeklinde yayýnlar mevcuttur. Biz, serimizde EP görülme sýklýðýný %1 olarak saptadýk.

INTRODUCTION: Ectopic pancreatic tissue (EP) occurs in the gastrointestinal tract at a rate of 95%, usually detected incidentally. Pediatric cases have been reported rarely. Here, we present the patients who were detected during the endoscopic procedure.
METHODS: Between 2015-2018, 485 patients who underwent esophagogastroduodenoscopy in two different centers were evaluated retrospectively in this study.
RESULTS: During the procedure, the lesion was detected in 14 patients (eight boys and six girls), which could be macroscopically compatible with ectopic pancreatic tissue. The age range of the patients was 12.3±4.1 years. Eleven of the lesions were localized in the pre-pyloric antrum and one of them was located in the distal esophagus. Histopathological examination revealed ectopic pancreatic tissue in the esophagus biopsy specimen and in six of the antrum biopsy specimens.
DISCUSSION AND CONCLUSION: EP is usually asymptomatic, commonly detected in the gastrointestinal tract (esophagus, stomach, duodenum, jejunum, ileum, omentum, gallbladder, Meckel's diverticulum) and can be seen in all age groups. The gold standard for diagnosis is histopathological evaluation. There are few case reports in the pediatric age group. In our series, we found the incidence of EP to be 1%.

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GÝRÝÞ ve AMAÇ: Medial ve lateral posterior tibial eðimlerinin konvansiyonel Manyetik Rezonans Görüntüleme (MRG)’ de ayrý ayrý ölçülmesi ve bu ölçümlerin ön çapraz bað (ÖÇB) yaralanmalarýný öngörebilmedeki yerinin ortaya konulmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya klinik ve radyolojik olarak ÖÇB yaralanmasý tanýsý alan 31 hasta ve 31 kontrol grubu dahil edildi. Her iki grupta da konvansiyonel MRG’de medial ve lateral posterior tibial eðimler, interkondiler çentik geniþliði, çentik geniþlik indeksi (ÇGÝ), distal femur geniþliði, medial ve lateral kondiler geniþlik ve derinlik deðerleri ölçüldü. Ýstatistiksel analizde hasta ve kontrol grubu arasýndaki fark Student t testi ile deðerlendirilmiþtir.
BULGULAR: ÖÇB yaralanmasý olan grupta lateral posterior tibial eðim ile lateral kondiler derinlik deðerleri daha yüksek bulunurken distal femur geniþliði kontrol grubuna göre daha düþük bulundu (p<0.005).
TARTIÞMA ve SONUÇ: Medial ve lateral posterior tibial eðimin ayrý ayrý ölçülmesine MRG olanak saðlamaktadýr. Yüksek lateral posterior tibial eðim ve lateral kondiler derinlik ile düþük distal femur geniþliðinin kombinasyonu ÖÇB yaralanmasý için major bir risk faktörü olabilir.

INTRODUCTION: To measure the medial and lateral posterior tibial slopes separately on conventional Magnetic Resonance Imaging (MRI) and to investigate whether this method can be used in the prediction of anterior cruciate ligament (ACL) rupture.
METHODS: This study included 31 consecutive patients with a definitive diagnosis of isolated ACL rupture and 31 healthy subjects. The medial and lateral posterior tibial slopes, intercondylar notch distance, notch width index (NWI), distal femur width, medial and lateral condylar width and depth were measured by MRI in both groups. The difference between patients with ACL rupture and controls were studied using the Student’s t-test.
RESULTS: The lateral posterior tibial slope and lateral condylar depth measurements were significantly higher, and the distal femur width was lower in the group with ACL rupture when compared to controls (p<0.005).
DISCUSSION AND CONCLUSION: MRI is the modality to measure lateral and medial tibial slopes separately. A combination of increased lateral posterior tibial slope, lateral condylar depth and decreased distal femur width could be a risk factor in ACL rupture.

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GÝRÝÞ ve AMAÇ: Metabolik sendrom kardiyovasküler hastalýk riskini arttýrmaktadýr. Koroner arter hastalýðýnda (KAH) kýrmýzý kan hücresi daðýlýmýnýn (KKHD)önemi bir çok çalýþmada gösterilmiþtir. Bu çalýþmanýn amacý, koroner arter hastalýðý olan metabolik sendromlu hastalarda KKHD’ nin anlamlýlýðýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya anjiografi yapýlan 120 hastanýn 89’u dahil edildi. Tüm grup kritik ve nonkritik KAH olarak 2’ye ayrýldý. Altgruplar, kritik KAH olan metabolik sendromlu hastalar ve kritik KAH olan metabolik sendromu olmayan hastalardan oluþturuldu. Kardiyometabolik risk parametreleri deðerlendirildi ve KKHD tam kan sayýmýndan hesap edildi.
BULGULAR: Metabolik sendrom prevalansý, kritik (%71) ve nonkritik (%59.5) KAH arasýnda anlamlý olarak farklý deðildi. RDW tüm populasyonda anlamlý olarak metabolik sendroma eþlik etmekteydi (p=0.037) ve kritik koroner arter hastalýðý olan metabolik sendromlu hastalarda anlamlý olarak yüksekti (p=0.018).
TARTIÞMA ve SONUÇ: Sonuç olarak, KKHD koroner arter hastalýðý olan metabolik sendromlu hastalara eþlik eden bir inflamasyon belirtecidir. Yüksek düzey KKHDdeðerleri kritik koroner arter hastalýðýna eþlik etmektedir. Uzun dönemde geliþebilecek kardiyak olaylarý tahmin etmek için, KKHD ’nin metabolik sendrom üzerine olan etkisini gösteren gelecek çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Metabolic syndrome (MetS) increases the risk of cardiovascular diseases. The value of red blood cell width (RDW) has been demonstrated in several studies in coronary artery disease. This study aims to investigate the significance of RDW in MetS patients with coronary artery disease (CAD).
METHODS: In this study, 120 of 89 patients undergoing coronary angiography were included. The whole group was divided into two groups according to coronary stenosis as noncritical and critical CAD. The study group was also divided into MetS and non-MetS. The cardiometabolic risk parameters were evaluated and RDW was calculated from complete blood count.
RESULTS: MetS prevalence was not significantly different between critic (71%) and noncritical CAD (59.5%) groups. RDW was significantly associated with MetS in whole study population (p=0.037) and was significantly higher in critic-CAD-MetS group (p=0.018).
DISCUSSION AND CONCLUSION: RDW is an inflammation marker that is associated with MetS patients in CAD. The higher value of RDW is associated with critic-CAD. Future studies are needed to demonstrate the role of RDW on MetS to predict long-term cardiovascular events.

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GÝRÝÞ ve AMAÇ: Akut pankreatit vakalarýnýn çoðu iyi seyirlidir ancak aðýr vakalar risklidir ve erkenden baþlanan yoðun tedaviden fayda görebilirler. Kýrmýzý küre daðýlým geniþliði (KKDG) indeksini akut pankreatit þiddetini öngörmede potansiyel bir belirteç olarak incelemeyi amaçladýk.

YÖNTEM ve GEREÇLER: Toplam 123 akut pankreatitli hasta yüksek riskli (Ranson skoru 3 ve üstü) ve düþük riskli (Ranson skoru 1-2) olarak sýnýflandýrýldý. Hastalar kýrmýzý küre daðýlým geniþliði indeksinin hastalýðýn þiddetine olan iliþkisi ve hastanede uzamýþ kalýþ süresine etki eden faktörler açýsýndan incelendiler.
BULGULAR: Medyan yaþ ve hastanede kalýþ süresi 56 (46-71) yýl ve 4 (3-5) gün idi. Artmýþ KKDG deðerleri düþük riskli hastalar le karþýlaþtýrýldýðýnda yüksek riskli hastalarla anlamlý olarak iliþkili olarak bulundu, 13,40(13,00-1400)'e karþý 13,90(13,40-14,78), P=0.001. Hastanede uzamýþ kalýþ daha yüksek Ranson skorlarý ve artmýþ lipaz deðerleri ile anlamlý oranda ilgili (sýrasýyla p=0.001 ve P=0.006) ancak KKDG ve amilaz düzeyleri ile ilgisiz olarak bulundu, (sýrasýyla P=0.805 ve P=0.058).

TARTIÞMA ve SONUÇ: Artmýþ lipaz deðerleri uzamýþ hastanede kalýþ süreleri ile iliþkili olarak bulunmuþtur. Hasteneye yatýþ anýnda artmýþ olarak bulunan KKDG deðerleri akut pankreatit hastalarý arasýnda yüksek riskli olanlarýn öngörülmesi konusunda yardýmcý olabilir.

INTRODUCTION: Most of the acute pancreatitis cases (AP) are mild; however, severe forms are risky for the patients, and those patients may benefit from early aggressive therapy. In this study, we investigated the predictivity of red cell distribution width (RDW) as a potential biomarker of severity.
METHODS: In this study, a total of 123 patients with AP were classified high risk (Ranson score ≥3 or more, HR) and low-risk patients (Ranson score ≤3, LR). The patients were then investigated about the relationship of RDW to the severity of the disease and factors that affect prolonged hospital stay.
RESULTS: The median age and stay were 56 (IQR 46-71) years and four (IQR 3-5) days. Elevated levels of RDW corresponded to HR patients compared with the LR patients, 13.90 (IQR 13.40-14.78) vs 13.40 (IQR 13.00-14.00), p=0.001, respectively. Prolonged hospital stay was related to higher Ranson scores and elevated lipase levels.
DISCUSSION AND CONCLUSION: High lipase levels at hospitalization may be associated with prolonged hospital stay. Elevated RDW levels may help in prediction of high risk in acute pancreatitis patients at hospital admission.

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GÝRÝÞ ve AMAÇ: Periodontitis (PD) ve romatoid artrit (RA), genetik, çevresel ve inflamatuar faktörler dahil olmak üzere karmaþýk multifaktöriyel patolojik süreçleri paylaþan kronik enflamatuar hastalýklardýr. Bu çalýþmanýn amacý RA'lý hastalarda periodontal durumu ve sosyodemografik ve klinik faktörlerle iliþkisini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþmaya 51 RA hastasý dahil edildi; yaþ ortalamasý 49.75 ± 9.79 ve hastalýk süresi 10.59 ± 6.37 yýl idi. Sosyodemografik veriler ve hastalýðýn detaylý profilini içeren romatolojik deðerlendirme ve seroloji kaydedildi. Gingival indeks, Plak indeksi, Cep sondalama derinliði ve Klinik ataþman seviyesini içeren tam aðýz periodontal muayenesi bir periodontist tarafýndan yapýldý. Periodontal durum, Hastalýk Kontrol Merkezi-Amerikan Periodontoloji Akademisi klinik olgu tanýmlarýna göre sýnýflandýrýldý.
BULGULAR: Kýrk beþ hasta (% 88.2) kadýndý. Hastalarýn% 37.3'ünde DAS28> 3.2 idi. Tüm hastalarda hafif (% 54.9) ila orta (% 45.1) þiddette PD vardý. Yaþlanma, bozulmuþ oral hijyen, sigara içme, sekonder Sjögren sendromu ve yüksek hastalýk aktivitesi, orta derecede PD ile iliþkiliydi.
TARTIÞMA ve SONUÇ: Bu çalýþma sonuçlarý, RA hastalarýnda aðýz saðlýðýna özel bir dikkat gösterilmesi gerektiðini ve bu hastalarý periodontal deðerlendirme ve tedavi için yönlendirmenin ciddi bir ihtiyaç olduðunu belirledi. Periodontal hastalýklarý önleme çabalarýnýn RA'nýn önlenmesine yardýmcý olup olmayacaðýný daha iyi belirlemek için gelecek çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Periodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory diseases that share complex multifactorial pathologic processes, including genetics, environmental and inflammatory factors. This study aims to evaluate the periodontal status and its association with sociodemographic and clinical factors in patients with RA.
METHODS: This study included 51 patients with RA; the mean age was 49.75±9.79 years old and 10.59±6.37 years of disease duration. Sociodemographic data and the rheumatologic assessment included detailed profiling of the disease and serology were noted. A full mouth periodontal examination, including the Gingival index, Plaque index, Pocket probing depth and clinical attachment level, was carried out by a periodontist. The periodontal status was classified according to the Centers for Disease Control-American Academy of Periodontology clinical case definitions.
RESULTS: Forty-five patients (88.2%) were female. 37.3% of patients had DAS28>3.2. All patients had PD, in mild (54.9%) to moderate (45.1%) severity. Aging, impaired oral hygiene, smoking, secondary Sjögren’s syndrome and high disease activity were associated with moderate PD.
DISCUSSION AND CONCLUSION: This study results identified a serious need to pay particular attention to oral health in patients with RA and refer these patients for periodontal evaluation and treatment. Future studies are needed to better investigate whether if efforts to prevent periodontal disease may also help prevent RA.

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GÝRÝÞ ve AMAÇ: Tiroit nodülleri ciddi bir klinik problemdir ve çoðunlukla neoplastik özellik taþýmayýp ameliyat gerektirmez. Ýnce iðne aspirasyon biyopsisi (ÝÝAB) tiroit nodüllerinin deðerlendirilmesi ve gereksiz cerrahinin önlenmesi için en önemli taný aracýdýr. Bu çalýþmada; tiroit nodülü nedeniyle opere edilen hastalarýn ÝÝAB sonuçlarý, postoperatif histopatoloji sonuçlarý ile karþýlaþtýrýldý ve frozen section uygulanan hastalarýn sonuçlarý deðerlendirildi.
YÖNTEM ve GEREÇLER: Çalýþmaya 1999-2003 yýllarý arasýnda Ýstanbul Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi 2. Genel Cerrahi Kliniði’nde soliter tiroit nodülü ve multinodüler guatr nedeni ile opere edilen ve preoperatif ÝÝAB uygulanan 206 hasta dahil edildi. Hasta dosyalarýnýn retrospektif olarak deðerlendirilmesinde; Tiroit Hastalýklarý Formu ve patoloji raporlarýndan yararlanýldý.
BULGULAR: Ýki yüz altý hastanýn 170’i (%82.52) kadýn ve 36’sý (%17.48) erkek olup, yaþ ortalamasý 46,56 idi. ÝÝAB’de benign lezyon olarak deðerlendirilen 179 olgudan 4’ü histopatolojik inceleme sonucunda tiroid kanseri (%2,23) olarak bildirilirken, atipik/þüpheli olarak deðerlendirilen 13 olgudan 9’u (%69,24), malign olarak bildirilen 7 olgunun tamamý histopatolojik inceleme sonrasýnda tiroit kanseri (%100) olarak bildirilmiþtir. ÝÝAB sonuçlarý ile histopatolojik sonuçlar arasýndaki iliþki tüm gruplarda istatistiksel olarak anlamlý bulunmuþtur (p < 0.05).
TARTIÞMA ve SONUÇ: ÝÝAB’nin, tiroit nodüllerinde cerrahi hasta seçiminde ve tiroit karsinomlarýnýn ameliyat öncesi tanýsýnda kullanýlabilecek ucuz ve güvenilir bir taný aracý olduðu ve birçok gereksiz cerrahi giriþimi önleyebileceði sonucuna varýldý. ÝÝAB sitolojisinin atipik/þüpheli olarak bulunduðu hastalarda frozen section’ýn operasyonu yönlendirme bakýmýndan yararlý olabileceði deðerlendirildi.

INTRODUCTION: Thyroid nodules present serious problems, and mostly they do not carry neoplastic characteristics. Thus, they do not need to be surgically treated. Fine-needle aspiration biopsy (FNAB) is the most important diagnostic tool in the assessment of thyroid nodules and the prevention of unnecessary surgery. In this study, FNAB results of the patients operated for thyroid nodules were compared with postoperative histopathology results and the results of the frozen section were evaluated.
METHODS: In this study, 206 patients who underwent preoperative FNAB for solitary thyroid nodules and multinodular goiter in the 2nd General Surgery Department of Istanbul Haydarpaþa Numune Training and Research Hospital between 1999 and 2003 years were included. Thyroid Disease Form and pathology reports were used to evaluate the patient files retrospectively.
RESULTS: The study population (n=206) consisted of 170 (82.52%) female and 36 (17.48%) male patients and the median age of the population was 46,56. When FNAB and histopathological examination results of the nodules were compared, four of 179 cases evaluated as benign lesions in FNAB were reported as thyroid cancer (2.23%) as a result of histopathological examination of the surgical specimen. Nine (69.24 %) of 13 cases as evaluated as atypical/suspicious, and all of the seven cases (100%) reported to be malignant in FNAB were reported as thyroid cancer after histopathological examination. The relationship between FNAB and histopathological results was statistically significant in all groups (p<0.0002).
DISCUSSION AND CONCLUSION: It was concluded that FNAB is a useful method in the evaluation of thyroid nodules, and will prevent many unnecessary operations as a cheap and reliable diagnostic tool that can be used in the selection candidates for surgery and preoperative diagnosis of thyroid carcinomas. It was also evaluated that the frozen section may be useful in guiding the operation of patients in whom FNAB cytology is considered as atypical/suspicious.

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GÝRÝÞ ve AMAÇ: Kardiyovasküler tutulum, akut biliyer pankreatitin, multisistemik tezahürlerinden biridir. Bizler akut biliyer pankreatit hastalarýnda prediktivitesi yüksek bir elektrokardiyografik marker olan Tpeak-Tend aralýk süresinin nasýl etkilendiðini literatürde ilk kez incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Bu retrospektif vaka kontrol çalýþmasýna toplam 68 birey dahil edildi. QTc ve Tpeak-Tend aralýk sürelerini belirlemek için tüm katýlýmcýlarýn elektrokardiyografileri precordial V5 lead de manuel olarak incelendi.
BULGULAR: Çalýþmamýzda hasta grubunun Tpeak-Tend ve QTc aralýk süresi kontroller göre daha uzundu ve bu fark istatistiksel olarak anlamlýydý (p<0,05). Akut biliyer pankreatit için QTc'nin duyarlýlýk ve özgüllüðü ise sýrasýyla %68,4 ve %67 (AUC = 0.660, CI: 0.529-0.791; p= 0.024) Tpeak-Tend 'in ise sýrasýyla %76,3 ve %63,3 (AUC = 0,647, CI: 0.508-0.787; p= 0.038) olarak hesaplandý.
TARTIÞMA ve SONUÇ: Tpeak-Tend süresi, akut bilyer pankreatit hastalarýnda aritmi riski açýsýndan deðerlendirildi. Çalýþmamýz akut pankreatit hastalarýnda QTc süresi ile beraber Tpeak-Tend süresinin nasýl etkilendiðini, akut pankreatitin uzamýþ QTc ve Tpeak-Tend nedenleri arasýnda olabileceðini gösterdi.

INTRODUCTION: Cardiovascular involvement is one of the multisystemic manifestations of acute biliary pancreatitis. In this study, we aimed to examine, to our knowledge, for the first time, how the Tpeak-Tend (TpTe) interval, a highly predictive electrocardiographic marker, is affected in patients with acute biliary pancreatitis.
METHODS: A total of 68 subjects were recruited in this retrospective case-control study. To determine the Corrected QT Intervals (QTc) and TpTe intervals, the electrocardiographs of all subjects were manually examined using the precordial V5 lead.
RESULTS: We found that the TpTe and QTc intervals were longer in the cases compared to the controls, and this difference was statistically significant (p<0.05). With respect to acute biliary pancreatitis, the QTc had 68.4% sensitivity and 67% specificity (AUC=0.660, CI: 0.529-0.791; p=0.024) and the TpTe interval had 76.3% sensitivity and 63.3% specificity (AUC=0.647, CI: 0.508-0.787; p=0.038).
DISCUSSION AND CONCLUSION: The Tpeak-Tend interval was evaluated for the risk of arrhythmia in patients with acute biliary pancreatitis. Our study demonstrated how the Tpeak-Tend and OTc intervals were affected in patients with acute biliary pancreatitis and that acute pancreatitis might be one of the causes of prolonged QTc and Tpeak-Tend intervals.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý acil servise ev içi düþme nedeni ile baþvuran 65 yaþ ve üstü hastalarýn evde düþme nedenleri ve klinik sonuçlarý açýsýndan deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþma Acil Servise 2 aylýk dönemde ev içi düþme ile baþvuran hastalar üzerinde yapýlmýþtýr. Hastalarýn sosyodemografik verileri, ilaç kullanýmý, evin hangi bölümünde düþtüðü, düþmeye neden olan durum, hastaya konan taný, yatýþ/ taburculuk gibi veriler belirlenmiþ ve bu veriler birbiriyle karþýlaþtýrmalý olarak analiz edilmiþtir.
BULGULAR: Bu kriterlerle baþvuran 159 hastadan 73’ü kriterlere uymadýðý için çalýþma dýþýnda kalmýþtýr. Olgularýn 59’u (%68,4) kadýn; ortalama yaþ 76,7’dir. Olgularýn 69’u (%81,2) yumuþak doku travmasý (YDT), 16’sý (%18,9) kýrýk tanýsý almýþtýr. Kýrýk saptanan 16 hasta daha yaþlýdýr (p=0.016). Ayak takýlmasý en sýk düþme nedenidir.
TARTIÞMA ve SONUÇ: Ev içi düþme nedeni ile baþvuran yaþlýlarda düþmeler büyük oranda basit yaralanmalar ile sonuçlansa da daha yaþlý, sigara/alkol alýþkanlýðý olan, düzenli ilaç kullananan hastalarda kýrýk saptanma oraný yüksektir.

INTRODUCTION: To describe the characteristics of the elderly patients admitted to the emergency department (ED) due to domestic falls concerning the causes and outcomes of the accident.
METHODS: This study included all consecutive elderly patients admitted to the ED within two months due to domestic falls. Descriptive analyses regarding demographics, history, and clinical findings were performed.
RESULTS: In this study, 159 elderly patients were admitted with falls in the study period, while 73 patients had exclusion criteria. Mean age was 76.7±7.1 and 68.4% (n=59) were female. 81.2% of the patients were diagnosed with soft tissue injuries. Sixteen patients with fractures were older than patients without fractures (p=0.016). “Trip and fall” was the most common mechanism (n=37, 43.5%).
DISCUSSION AND CONCLUSION: Although a majority of domestic falls in the elderly result in simple injuries, fractures occur in older patients, patients with smoking habits and/or alcohol use, or on routine use of medicines.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada dudak vermilyon sýnýrýndaki piyojenik granülom tedavisinde cerrahi eksizyon sonrasý elektrokoter uygulamasýnýn etkiliðinin deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Þanlýurfa Mehmet Akif Ýnan Eðitim ve Araþtýrma Hastanesi Plastik cerrahi ve Þanlýurfa Balýklýgöl Devlet Hastanesi Dermatoloji polikliniklerine dudak vermilyonu yerleþimli kitlesi mevcut olup cerrahi eksizyon sonrasý patoloji raporlarýnda piyojenik granülom olduðu bildirilen 16 olgu çalýþmaya dâhil edilerek gerçekleþtirilmiþtir. Olgularýn yaþ, cinsiyet, lezyon yerleþimi ve çapý, uygulanan tedavi, nüks varlýðý ve klinik özellikleri deðerlendirildi ve analiz edildi.
BULGULAR: Çalýþmaya 12 kadýn (% 75) ve 4 (% 25) erkek hasta olmak üzere 16 hasta dâhil edilmiþtir. Hastalarýn yaþlarý 14-42 arasýnda deðiþmekteydi. (Ortalama yaþ: 26,25). Olgularýn 9’unda (% 56) kanama en belirgin þikâyet olarak belirlendi. 7 olgu (% 43) ise kozmetik nedenler ile kliniðimize baþvurdu. 16 yaþ altýnda 3 olgu mevcuttu. (% 18) 2 olguda (% 12,5) lezyon üst dudak, 14 (% 87,5) olguda alt dudak vermilyonu yerleþimliydi. Hastalarýn þikâyetleri 2 hafta ve 6 ay arasýnda deðiþmekteydi.Olgularýn ortalama takip süresi 13 aydýr. (6-17 ay) Operasyonlar sonrasý hiçbir olguda komplikasyon ve nüks geliþmemiþtir.
TARTIÞMA ve SONUÇ: Cerrahi eksizyonun avantajlarý, bir seansta lezyonun çýkarýlmasýna izin vermesi ve düþük nüks oranýnlarýdýr. Vermilyon yerleþimli piyojenik granülomlarýn tedavisinde ülserli ve hemorajik lezyonlarýn malignite ve çeþitli hastalýklarla iliþkili olabileceðini düþünerek tam histopatolojik muayene yapýlmasýna izin vermesi nedeniyle cerrahi eksizyonu önermekteyiz.

INTRODUCTION: This study aims to retrospectively analyze the features and treatment of pyogenic granuloma of the vermillion border of the lip.
METHODS: Information regarding 16 cases of pyogenic granuloma of the vermilion border of the lips that underwent biopsy was retrieved from the pathology records of patients seen at the Plastic Surgery Department of Sanliurfa Mehmet Akif Inan Training and Research Hospital and Dermatology Department of Sanlýurfa Balýklýgol State Hospital. Data were reviewed and analyzed for age, gender, lesion site and diameter, treatments, recurrence and clinical features.
RESULTS: Sixteen patients (12 female (75%) and four (25%) male patients) were included in this study. The ages of the patients ranged from 14 to 42 years (mean age: 26.25). In nine of the cases (56%), the bleeding was the most obvious complaint. Seven cases (43%) referred to our clinics for cosmetic reasons. There were three cases under 16 years of age (18%). Fourteen lesions (87.5%) were located on the lower lip, two lesions (12.5%) on the upper lip. The duration of complaints of the patients varies between two weeks and six months (mean: five weeks). The average follow-up period was 13 months (6-17 months). Complications and recurrences did not develop in any case after the operation.
DISCUSSION AND CONCLUSION: The advantages of surgical excision are allowing the removal of the lesion in one session and the low recurrence rate. We recommend surgical excision for the treatment of pyogenic granulomas located on vermilion because it permits complete histopathologic examination considering that ulcerous and hemorrhagic lesions may be associated with malignancy and various diseases.

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GÝRÝÞ ve AMAÇ: Týp fakültesi öðrencilerine verilen rasyonel farmakoterapi eðitimi, hekimlerin hastalarýný rasyonel ilaç kullaným ilkelerine uygun olarak tedavi etmelerini saðlar. Bu tanýmlayýcý analiz, dördüncü sýnýf týp fakültesi öðrencilerinin eðitim programýna iliþkin algýlarýný tespit etmek için geri-bildirim formu ile yapýlmýþtýr.
YÖNTEM ve GEREÇLER: 2018-19 eðitim-öðretim yýlýnda bir haftalýk klinik farmakoloji stajýna toplam 100 dördüncü sýnýf týp öðrencisi katýlmýþtýr. Stajýn tamamlanmasýnýn ardýndan, öðrencilere program hakkýndaki görüþlerini sorgulayan geri-bildirim formu daðýtýldý ve isimsiz doldurmalarý istendi.
BULGULAR: Toplam 100 öðrenci staja katýldý ve forma cevap verenlerin oraný %72 idi. Staj sonu anket sonuçlarýna göre, öðrencilerin % 77.8'inin stajýn týp öðrencileri için faydalý olduðu ve öðrencilerin programýn bileþenlerinden genellikle memnun olduðu görülmüþtür. En yüksek memnuniyet, eðitim ortamýnýn görüþlerini ifade edebilmelerine uygun olmasý (%88,9) ve tartýþmalarýn etkileþimli bir ortamda yapýlabiliyor olmasý idi (%79,2). Çoðu (% 88,9) kiþisel (K-) ilaç seçimi rasyonelini kavradýklarýný belirtti. En düþük memnuniyet, oturum süresi (% 51,4) ve eðitim süresi (% 58,3) ile ilgili olup, tartýþma süresinin daha kýsa olabileceði ve staj süresinin iki haftaya kadar uzayabileceði þeklinde olmuþtur.
TARTIÞMA ve SONUÇ: Sonuç olarak, bu analiz, týp fakültesinin dördüncü yýlýnda klinik farmakoloji programýna katýlan öðrencilerin staj ile ilgili olumlu algýlarý olduðunu göstermektedir. Öðrenciler eðitimin faydalý olduðunu, tartýþmalara aktif olarak katýldýklarýný, K-ilaç seçimini öðrendiklerini ve bunlarýn meslek yaþamlarýna katkýda bulunacaklarýný belirtti.

INTRODUCTION: Rational pharmacotherapy training given to undergraduate medical students enables the doctors to treat their patients in accordance with the principles of rational drug use. The present descriptive analysis was carried out on fourth-year medical students to detect their perceptions on this training program using a questionnaire.
METHODS: During the academic year of 2018-19, a total of 100 fourth-year medical students attended the one-week clinical pharmacology course. Upon completion, of course, an unnamed questionnaire asking their opinion about the program was given to them.
RESULTS: A total of 100 students participated in course, and the percent response to the survey questions was 72%. The post-course questionnaire results revealed that 77.8% of the students found the course was useful for medical students, and the students were generally pleased with the components of the program. The highest satisfaction was with the environment being appropriate for expression of their opinions (88.9%) and discussions conducted in an interactive environment (79.2%). Most of them answered that they had covered the rationale for personal (P-) drug selection (88.9%). The lowest satisfaction was with the duration sessions (51.4%) and duration of education (58.3%) that the discussion sessions may be shorter in duration while the duration, of course, may be extended to two weeks.
DISCUSSION AND CONCLUSION: In conclusion, the present analysis shows the favorable perception of the students who attended the clinical pharmacology program during the fourth year of medical school. The students stated that education is useful, they actively participated in the discussions, learned P-drug selection, and these will contribute to their professional lives.

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GÝRÝÞ ve AMAÇ: Major alt ektremite amputasyonlu hastalarda sosyal fobi, depresyon ve yaþam kalitesini ampute olmayanlara göre karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Geçmiþte diz üstü veya diz altý amputasyonu geçiren hastalar, hastane kayýtlarý incelenerek retrospektif olarak deðerlendirildi. Kontrol grubu, hastanede yakýnlarýný ziyaret eden kiþiler arasýndan rastgele seçildi. Tüm katýlýmcýlara Liebowitz Sosyal Anksiyete Skalasý (LSAS), Hastane Anksiyete ve Depresyon Skalasý (HADS) ve Kýsa-Form 36 (SF-36) uygulandý.
BULGULAR: Hasta sayýsý, amputasyon grubunda 30 (21 erkek, 9 kadýn) ve kontrol grubunda 30 (22 erkek, 8 kadýn) idi. Yaþ ortalamasý, amputasyon grubunda 41.8±14.09 yýl ve kontrol grubunda 43.3±18.68 yýl idi. Amputasyon grubunda kontrol grubuna göre tüm LSAS ve HADS skorlarý daha yüksek ve SF-36 skorlarý daha düþüktü (p<0.05). 5 yýldan daha uzun süre önce ampute edilen hastalar, 5 yýldan daha kýsa süre önceki hastalara göre daha yüksek LSAS sosyal korku ve HAD depresyon skorlarýna sahipti (sýrasýyla; p=0.035, p=0.024). Çalýþan hastalarda iþsiz hastalara göre daha düþük HAD depresyon ve HAD toplam skorlarý vardý (sýrasýyla; p=0.008, p=0,049). Týbbi komplikasyonlar nedeniyle ampute edilen hastalarda, travmatik amputasyonlu hastalara göre anksiyete skorlarý daha yüksekti (sýrasýyla; p=0.005, p=0.016).
TARTIÞMA ve SONUÇ: Sosyal fobi, depresyon ve düþük yaþam kalitesi majör alt ekstremite amputasyonlu hastalarda sýk karþýlaþýlan sorunlardýr. Beþ yýldan sonra, sosyal fobinin artacaðý, depresyonun ise ciddiyeti ile birlikte azalacaðý unutulmamalýdýr. Bu nedenle, amputasyonlu hastalar psikiyatrik danýþmanlýk almalý ve tedavi edilmelidir. Ayrýca, yaþam kalitesini yükseltmek için daimi istihdam olanaklarý saðlamak önemlidir.

INTRODUCTION: In this study, we aimed to compare the social phobia, depression and quality of life in patients with major lower limb amputation to non-amputated.
METHODS: Patients who were underwent above or below the knee amputation in the past were evaluated retrospectively by examining the hospital records. All the participants were administered Liebowitz Social Anxiety Scale (LSAS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 (SF-36).
RESULTS: The number of patients was 30 (21 males, nine females) in the amputated group and 30 (22 males, eight females) in the control group. The mean age was 41.8±14.09 years in the amputated group and 43.3±18.68 years in the control group. All LSAS and HADS scores were higher, and SF-36 scores were lower in the amputation group compared to the control group (p<0.05). The patients who were amputated more than five years ago had higher LSAS social fear scores, and lower HAD depression scores compared to patients less than five years (p=0.035, p=0.024, respectively). The employed patients had lower HAD depression and HAD total scores compared to unemployed patients (p=0.008, p=0,049, respectively). The patients amputated due to medical complications had higher scores in anxiety compared to the patients with traumatic amputation (p=0.005, p=0.016, respectively).
DISCUSSION AND CONCLUSION: Social phobia, depression and poor quality of life are common problems in patients with major lower limb amputation. After five years, it should not be forgotten that social phobia will increase; depression will decrease along with its seriousness. Therefore, amputated patients should be psychiatrically counseled and treated. It is important to provide permanent employment opportunities to improve the quality of life.

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GÝRÝÞ ve AMAÇ: Aort stenozu en sýk ve tehlikeli doðal kapak hastalýðýdýr; 65 yaþ üstündeki insanlarýn %2-4’ ünde görülmektedir[1]. Ancak cerrahi tedavisinin özellikle yaþlý ve yandaþ hastalýðý olanlarda riskleri çok fazladýr[2]. Bu retrospektif çalýþmada hastanemizde yapýlan TAVÝ prosedürlerini inceleyip deðerlendirdik.

YÖNTEM ve GEREÇLER: Materyal ve metod: Etik kurul izni alýndýktan sonra Haziran 2012 ile Aralýk 2014 arasý retrospektif olarak taranarak ilk 100 hastanýn demografik verileri, STS, EuroSCORE, aort kapak gradientleri, anestezi yöntemi ve monitorizasyon ve postoperatif komplikasyonlar kaydedildi. Tüm veriler ortalama ± standart deviasyon olarak verildi.

BULGULAR: Sonuçlar: Sonuçlarý toplanan 100 hastanýn yaþ ortalamasý 78,6 ± 6,7 olarak bulundu. Hastalarýn 65’ i kadýndý. Ortalama pulmoner arter basýncý 46,9 ±14,2 mmHg, ortalama basýnç gradienti (PG) 48,8 ± 10,7 mmHg, TAVÝ iþlemi öncesi en yüksek PG deðeri 75,5 ± 17,1 mmHg; sol ventrikül ejeksiyon fraksiyonu ise %51,2 ± 14,2 olarak ölçüldü. Ortalama STS deðeri 7,8 ± 4,7 ve ortalama EuroSCORE deðeri ise %34,9 ± 14,1 olarak bulundu. Tüm hastalara monitorizasyon için transözofageal ekokardiyografi probu ve geçici bir pacemaker yerleþtirildi. Takýlan kapak hastalarýn % 56’ sýnda geniþleyebilen CoreValve, % 43’ ünde Edwards Sapiens XT Valve idi. Ýþlem tamamlandýktan sonra vasküler yaralanma olmadýðýný kontrol etmek amacýyla son bir femoral anjiyografi yapýldý. Ekstübasyon sonrasý hastalar koroner yoðun bakýma transfer edildi. Postoperatif dönemde hastalarýn %11’ inde minör komplikasyon geliþti.


TARTIÞMA ve SONUÇ: Sonuç: Bu retrospektif araþtýrmamýzýn sonuçlarýna dayanarak iþlem basamaklarý titizlikle takip edildiðinde TAVÝ iþleminin ciddi aort stenozu olan hastalarda düþük komplikasyon oranlarý olan bir giriþim olduðunu söyleyebiliriz. Anestezist giriþimin öncesinde, sýrasýnda ve sonrasýnda ekibin önemli bir üyesi olmalýdýr. Devam etmekte olan prospektif ve retrospektif çalýþmalar bu göreceli yeni tekniðin endikasyonlarý, anestezi tipi, prosedürün nerede yapýlmasý gerektiði gibi tartýþmalara ýþýk tutacaktýr.

INTRODUCTION: Aortic stenosis is the most common and dangerous native valve disease and it affects 2-4% of the patients over 65 years of age. However, the surgical procedure leads the patients to undergo great risks, especially in the elderly population and in patients with concomitant disorders. In this retrospective study, we described and analyzed our experience on TAVI procedures performed in our hospital.
METHODS: After the approval of the Ethics Committee to conduct this study, patients’ files from June 2012 to December 2014 were reviewed retrospectively and first 100 patients’ demographic data, STS, EuroSCORE, aortic valve pressure gradients, the methods of anesthesia and monitoring and postoperative complications were collected. All of the data were expressed as mean±standard deviation.
RESULTS: Among 100 remaining patients, on whom data were collected, mean age was found as 78.6±6.7 years and 65 of the patients were female. The mean pulmonary artery pressure was 46.9±14.2 mmHg and mean pressure gradient (PG) was 48.8±10.7 mmHg, whereas the peak PG was 75.5±17.1 mmHg before the TAVI procedure; left ventricular ejection fraction before the TAVI procedure was calculated as 51.2±14.2%. Analysis of the patient charts revealed a mean value for STS as 7.8±4.7 and a mean value for EuroSCORE as 34.9±14.1%. In all patients, a probe for transesophageal echocardiography was inserted for real-time monitoring, together with a temporary pacemaker. Implanted valves were expandable CoreValve in 56%, and the Edwards Sapiens XT Valve in 43%. Following completion of the procedure, final femoral angiography was performed to verify that there were no vascular injuries. The patients were transferred coronary ICU after extubation. During postoperative period, minor complications were encountered in 11% of the patients.
DISCUSSION AND CONCLUSION: The findings showed that TAVI was a procedure with a low rate of complications in patients with severe aortic stenosis when the steps of the procedure had been followed meticulously, according to the results of our retrospective study. The anesthesiologist should be a key member of the staff prior, during, and following the intervention. The ongoing prospective trials and retrospective research together with the debate on indications, type of the anesthesia, location where the procedure is held will shed light on the evolvement of this relatively novel technique.

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GÝRÝÞ ve AMAÇ: Yüksek miyopinin tedavisi için implante edilen bir fakik iris kýskaçlý göz içi lensinin (fGÝL) uzun dönem sonuçlarýný deðerlendirmek.
YÖNTEM ve GEREÇLER: Artiflex (Ophtec BV, Hollanda) ya da Veriflex (Abbott Medical Optics Inc., Kalifornia) fGÝL’i implante edilen hastalarýn dosyalarý retrospektif olarak deðerlendirildi. Beþ yýl takip süresi bulunan hastalar çalýþma kapsamýna alýndý. Hastalarýn ameliyat öncesindeki ve ameliyat sonrasý beþinci yýldaki manifest refraksiyonlarýnýn sferik eþdeðerleri (SE), düzeltilmemiþ görme keskinlikleri, düzeltilmiþ görme keskinlikleri, santral endotel hücre yoðunluklarý ve komplikasyonlar deðerlendirildi.
BULGULAR: Çalýþmaya 23 hastanýn 23 gözü alýndý. Ameliyat öncesi ortalama SE -10,71D±2,84 D idi ve ameliyat sonrasý beþinci yýlda -1,60D±0,80 D olarak tespit edildi. Ameliyat öncesindeki ve ameliyat sonrasý beþinci yýldaki ortalama düzeltilmemiþ görme keskinlikleri sýrasýyla 1,47±0,22 logMAR ve 0,26±0,16 logMAR idi (p<0,05). Ameliyat öncesindeki ve ameliyat sonrasý beþinci yýldaki ortalama düzeltilmiþ görme keskinlikleri sýrasýyla 0,26±0,15 logMAR and 0,17±0,12 logMAR idi (p<0,05). Ortalama endotel sayýsý ameliyat öncesinde 2526±268 hücre/mm2 iken, beþinci yýlda 2357±295 hücre /mm2 olarak bulundu (p<0,05) Ameliyat sonrasý dönemde, iki hastamýzda steroid kaynaklý geçici göz içi basýncý artýþý saptandý.
TARTIÞMA ve SONUÇ: Ameliyat sonrasý 5. yýlda Artiflex/Veriflex fGÝL implantasyonu etkili ve güvenli bulanmuþtur. Ancak 5 yýllýk takip süresi endotelyal güvenlik profilini ortaya koymak açýsýndan yeterli deðildir

INTRODUCTION: To report long term results after foldable iris-claw phakic intraocular lens (pIOL) implantation for the treatment of high myopia.
METHODS: The medical records of patients who underwent Artiflex (Ophtec BV, Netherlands) or Veriflex (Abbott Medical Optics Inc., USA) pIOL were retrospectively analyzed. Patients with five years of follow-up were included in this study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and central endothelial cell density (ECD) were analyzed preoperatively and in five years after surgery. The complications observed during and after surgery were also recorded.

RESULTS: This study included 23 eyes of the 23 patients. Mean preoperative SE was -10.71D±2.84D and improved to -1.60D±0.80D at the postoperative 5-year visit. Mean preoperative and postoperative UDVA were 1.47±0.22 logMAR and 0.26±0.16 logMAR, respectively (p<0.05). Mean preoperative and postoperative CDVA were 0.26±0.15 logMAR and 0.17±0.12 logMAR, respectively (p<0.05). Mean ECD decreased from 2526±268 cells/mm2 to 2357±295 cells/mm2 in five years postoperatively. (p<0.05) In two eyes, a temporary, steroid-induced increase in intraocular pressure (IOP) was detected.

DISCUSSION AND CONCLUSION: Artiflex/Veriflex pIOL implantation was found safe and effective in five years after surgery. However, a 5-year follow-up is not sufficient to evaluate its long term endothelial safety profile.

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GÝRÝÞ ve AMAÇ: Makrofaj migrasyon inhibitör faktör (MIF) geninin promotor bölgesindeki -173 G/C polimorfizmi yüksek MIF seviyeleri ile iliþkili olup çalýþmamýzda bu polimorfizm ile akut pankreatit (AP) oluþumu ve þiddeti arasýndaki iliþki araþtýrýldý.
YÖNTEM ve GEREÇLER: Çalýþmaya 62 AP hastasý ve 83 saðlýklý gönüllü alýndý. Hastalarýn demografik, klinik, laboratuvar ve radyolojik bulgularý kaydedildi ve kan örneklerinde genetik analiz yapýldý.
BULGULAR: Hastalarýn 35’i kadýn 27’si erkek, ortalama yaþ 51’dir. AP þiddeti 37 hastada hafif, 21 hastada orta þiddette ve 4 hastada þiddetli bulundu. Hasta ve kontrol gruplarýnda genotip ve allelik daðýlým istatistiksel olarak farklýydý (p<0.001; p=0.03). Hafif, orta ve þiddetli AP gruplarý arasýnda anlamlý farklýlýk bulunmamakla birlikte orta þiddette ve þiddetli AP gruplarýnda CC genotipi ve C allel sýklýðý, hafif AP grubunda ise GG genotipi daha yüksek olmaya eðilimli idi. SIRS geliþen dokuz hastanýn sekizinde CC genotipi saptandý ve C allel sýklýðý % 88.9 idi. Lökosit sayýsý CC genotipinde ve C allel grubunda daha yüksek bulundu.
TARTIÞMA ve SONUÇ: Bulgularýmýza göre CC genotipi ve C allel sýklýðý AP oluþumu ile iliþkili olmakla birlikte, AP þiddeti dikkate alýndýðýnda istatistiksel anlamlýlýk kanýtlanamamýþtýr.

INTRODUCTION: Promoter polymorphism -173G/C of macrophage migration inhibitory factor (MIF) is related to higher MIF levels. In this study, we have investigated the effects of this polymorphism with the occurrence and severity of acute pancreatitis (AP).


METHODS: Sixty-two AP patients and 83 healthy volunteers were included in our study. The demographical, clinical, laboratory and radiological findings were recorded, and peripheral blood samples were genetically analyzed.
RESULTS: In this study, 35 female and 27 male patients were included. The mean age was 51. The AP severity was mild at 37 patients, moderate at 21 and severe at four patients. Genotype and allelic distribution at patient and control groups were statistically different (p<0.001; p=0.03). Although no significant difference between mild, moderate and severe AP groups detected, there was a tendency of CC genotype and C allele frequency being higher at moderate and severe AP and GG genotype being higher at mild AP. Eight of nine SIRS developed patients had CC genotype and C allele frequency was 88.9%. The leucocyte count at CC genotype and at C allele increased.

DISCUSSION AND CONCLUSION: According to our results, CC genotype and C allele frequency were related with AP occurrence. However, considering the severity of AP, the statistical significance could not be proven.

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GÝRÝÞ ve AMAÇ: Bu çalýþmamýzda, ülkemizde lokalize prostat kanserli hastalara üroloji uzmanlarý önderliðindeki ekip tarafýndan uygulanan brakiterapi serisinin kýsa dönem sonuçlarý sunulmaktadýr.
YÖNTEM ve GEREÇLER: Kliniðimizde Eylül 2003 - Ocak 2007 tarihleri arasýnda prostat kanseri nedeniyle prostat brakiterapisi yapýlan 41 hasta deðerlendirildi. Tüm hastalarda biyopsi ile kanýtlanmýþ adenokarsinom mevcuttu. Hastalara, genel anestezi altýnda, intraoperatif-interaktif planlama ile periferal yükleme yöntemine göre LDR prostat brakiterapisi uygulandý. Tüm hastalarýn ameliyat öncesi ve takiplerindeki Prostat Spesifik Antijen (PSA) seviyeleri, Uluslararasý Prostat Semptom Skoru (IPSS) ve Uluslararasý Erektil Fonksiyon Ýndeksi (IIEF) deðerleri kaydedildi.
BULGULAR: Hastalarýn operasyon öncesi ortalama PSA, Gleason skoru ve prostat volümleri sýrasýyla 7.7±5 ng/ml (4-22.5), 5.8±0.9 (4-8) ve 36.8±12.6 ml (15-58 ml) idi. Hastalarýn ortalama yaþý 62.3±6.3 (52-76) idi. Ortalama takip süresi 36.5 (7-60) aydý. Brakiterapi sonrasý 3. (1.4±1.3 ng/ml) ve 6. (1.0±0.7 ng/ml) aylardaki PSA deðerleri operasyon öncesi deðerlerden istatistiksel anlamlý olarak daha düþüktü (p<0.05). Operasyon öncesi (12.1±5.3) ve operasyon sonrasý 3. ve 6. aylardaki IPSS deðerleri (sýrasýyla 13.5±6.5, 11.7±7.5, p>0.05) karþýlaþtýrýldýðý zaman anlamlý bir fark olmadýðý görüldü. Operasyon öncesi (14.2±2.6) ve operasyon sonrasý 3.ve 6. aylardaki IIEF deðerleri (sýrasýyla, 11.3±6.5, 10.8±7.5, p>0.05) karþýlaþtýrýldýðý zaman da anlamlý bir fark bulunmadý. Operasyon sonrasý 2 hastada kronik üriner retansiyon geliþti ve bir hastaya kronik üriner retansiyon, bir hastaya da artmýþ alt üriner sistem yakýnmalarý nedeni ile brakiterapiden 6 ay sonra TURP uygulandý. Toplam 41 hastanýn sadece bir tanesinin 1.ay kontrol dozimetrisinde soðuk kaldýðýnýn (yetersiz radyoaktivite) gözlenmesi üzerine hasta EBRT’ye yönlendirildi.
TARTIÞMA ve SONUÇ: Son dönemlerde kullanýmý giderek azalmasýna raðmen Brakiterapi, lokalize prostat kanseri tedavisinde etkili, güncel kýlavuzlarda önerilen bir yöntemdir

INTRODUCTION: In this study, we present the short-term results of our brachytherapy series in patients with localized prostate cancer administered by a team led by urologists.

METHODS: Forty-one patients who underwent prostate brachytherapy between September 2003 and January 2007 were evaluated in this study. All patients had biopsy-proven adenocarcinoma. Low dose rate (LDR) Iodine-125 prostate brachytherapy was performed under general anesthesia according to intraoperative-interactive planning and peripheral loading technique. Preoperative and follow-up Prostate-Specific Antigen (PSA) levels, International Prostate Symptom Scores (IPSS) and International Index of Erectile Function-5 (IIEF-5) scores of all patients were determined.
RESULTS: Preoperative mean PSA, Gleason score and prostate volume of the patients were 7.7±5 ng/ml (4-22.5), 5.8±0.9 (4-8) and 36.8±12.6 ml (15-58 ml), respectively. The mean age of the patients was 62.3±6.3 (52-76) years. The mean follow-up period was 36.5 (7-60) months. Mean PSA value at the third (1.4±1.3 ng/ml) and sixth months (1.0±0.7 ng/ml) was significantly lower than preoperative mean PSA value (p<0.05). There was no significant difference between preoperative mean IPSS score (12.1±5.3) and mean IPSS scores at the third and sixth postoperative months (13.5±6.5 and 11.7±7.5, respectively, p>0.05). There was no significant difference between the mean preoperative IIEF score (14.2±2.6) and mean IIEF scores at the third and sixth postoperative months (11.3±6.5 and 10.8±7.5, respectively, p>0.05). TURP was performed in two patients after brachytherapy because of chronic urinary retention in one patient and because of increased lower urinary tract symptoms in other patient. One patient was referred to radiotherapy due to inadequate radioactivity in the dosimetric control tomography.
DISCUSSION AND CONCLUSION: Brachytherapy is an effective method in the treatment of localized prostate cancer and it is recommended in current guidelines despite the recent decline in its use.

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GÝRÝÞ ve AMAÇ: Lumbar spinal stenosis (LSS) etyolojisi halen tam bilinmemekle birlikte multifaktöryel bir hastalýktýr. Aterosklerozis sebebiyle azalmýþ kan akýmýnýn spinal dejeneratif deðiþiklikleri hýzlandýrdýðý düþünülür, ancak kan lipid profili ile spinal stenosis geliþimi arasýnda bir iliþki olup olmadýðý bilinmemektedir. Biz bu çalýþmada, cerrahi yapýlmýþ olan LSS olgularý ile, dar kanal bulgularý olmayan olgularý karþýlaþtýrarak; hiperlipideminin spinal stenosis etyolojisindeki rolünü deðerlendirmeyi hedefledik
YÖNTEM ve GEREÇLER: Çalýþmamýzda eþit sayýda kadýn ve erkekten oluþan ve 60-70 yaþ aralýðýndaki iki ayrý grubun kan lipid deðerleri (total kolesterol, trigliserid, LDL kolesterol, HDL kolesterol) retrospektif olarak incelenip karþýlaþtýrýldý. Grup 1 (LSS grubu); kliniðimizde opere edilmiþ olan 40 LSS olgusu (20 kadýn/20 erkek), Grup 2 (kontrol grubu); nonspesifik sebeplerle (baþ aðrýsý vs) polikliniðe baþvurmuþ olan hastalardan oluþturuldu.
BULGULAR: Grup 1 ve Grup 2 nin HDL ve LDL düzeyleri açýsýndan istatistiksel olarak anlamlý bir farklýlýk bulunmamaktadýr. Grup 1’ in VLDL düzeyi, Grup 2’ den istatistiksel olarak anlamlý düzeyde yüksektir (p: 0.000; p<0.05). Grup 1’ in trigliserid düzeyi, Grup 2’ den istatistiksel olarak anlamlý düzeyde yüksektir (p: 0.000; p<0.05).
TARTIÞMA ve SONUÇ: VLDL ve trigliserid düzeyleri ile spinal stenosiz geliþimi arasýnda bir iliþki olduðu düþünülmektedir. Ancak HDL ve LDL ile böyle bir iliþki söz konusu deðildir.

INTRODUCTION: The etiology of lumbar spinal stenosis (LSS) is still unknown, but it is a multifactorial disease. Reduced blood flow due to atherosclerosis is thought to accelerate spinal degenerative changes, but it is not known whether there is a relationship between blood lipid profile and the development of spinal stenosis. In this study, we compared the LSS patients who underwent surgery and the patients without narrow canal findings., We aimed to evaluate the role of hyperlipidemia in the etiology of spinal stenosis.
METHODS: In our study, the blood lipid values (total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol) of two different groups between the ages of 60 and 70, consisting of women and men, were analyzed and compared retrospectively. Group 1 (LSS group) with 40 LSS cases (20 females/20 males) operated in our clinic, Group 2 (control group)with the patients from patients who applied to the outpatient clinic for nonspecific reasons (such as headache).
RESULTS: There was no statistically significant difference in Group 1 and Group 2 concerning HDL and LDL levels. The VLDL level of Group 1 was statistically significantly higher than Group 2 (p=0.000; p<0.05). The triglyceride level of Group 1 was statistically significantly higher than Group 2 (p=0.000; p<0.05).
DISCUSSION AND CONCLUSION: It is thought that there is a relationship between VLDL and triglyceride levels and the development of spinal stenosis. However, there is no such relationship with HDL and LDL.

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GÝRÝÞ ve AMAÇ: Kataraktý ve düþük-orta düzeyde astigmatý olan hastalarda astigmatizmayý azaltmak için uygulanan limbal gevþetici insizyon uygulanan manüel metodla VERION sisteminin kýyaslanmasý.
YÖNTEM ve GEREÇLER: VERION sistemi yardýmýyla astigmatik koreksiyon yapýlan 22 hastanýn 38 gözü ile, manuel metod uygulanan 24 hastanýn 40 gözü retrospektif olarak kýyaslandý.
BULGULAR: Ameliyat sonrasý 1. ve 6. ay ortalama düzeltilmemiþ görme keskinliði, düzeltilmiþ görme keskinliði, sferik ve silindirik deðerleri açýsýndan iki grup arasýnda anlamlý bir farklýlýk yoktu (p deðerleri sýrasýyla, 0.054, 0.068, 0.946, 0.957, 0.971, 0.947, 0.254 ve 0.195).Birinci grubun 1. ve 6. ay ortalama silindrik deðerleri, ikinci gruba göre daha düþüktü, ancak aradaki fark istatistiksel olarak anlamlý deðildi (p=0.254 ve p=0.189).
TARTIÞMA ve SONUÇ: Düþük-orta düzeydeki astigmatý düzeltmek için katarakt cerrahisi esnasýnda uygulanan limbal gevþetici insizyonlar tatmin edici sonuçlar vermektedir.Bunun için uygulanan manuel metodla VERION sistemi arasýnda anlamlý bir fark yoktur

INTRODUCTION: To compare the results of Verion system with manual marking in the reduction of astigmatism in eyes with cataract and low to moderate astigmatism by forming limbal relaxing incisions (LRIs).
METHODS: Thirty-eight eyes of 22 patients who had undergone standard phacoemulsification surgery and limbal relaxing incision for astigmatic correction with the help of image-guided system (Verion) were compared retrospectively with 40 eyes of 24 patients, who had undergone standard phacoemulsification surgery and limbal relaxing incision for astigmatic correction with manual marking.
RESULTS: There was no significant difference between two groups concerning the mean 1st and 6th month postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical and cylindrical values (p-values, 0.054, 0.068, 0.946, 0.957, 0.971, 0.947, 0.254 and 0.195, respectively). Even though the mean postoperative 1st-month and 6th-month cylindrical values of the second group were higher than those of the first group, the difference was not significant statistically.
DISCUSSION AND CONCLUSION: LRIs performed during cataract surgery are efficient in reduction of low to moderate astigmatism. LRIs performed with Verion system seem to be not different significantly from LRIs performed with manual marking in the reduction of astigmatism during cataract surgery.

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Plummer-Vinson Sendromu; disfaji, demir eksikliði anemisi ve özofageal web ile giden klinik bir durumdur. Son yýllarda beslenme ile iliþkili bozukluklarýn olmamasý ve demir eksikliði anemisinin erken teþhis ve tevdisinden dolayý sýklýkla görülmemektedir. Plummer-Vinson sendromunun nadir nedenlerinden biri çölyak hastalýðýdýr. Çölyak hastalýðý ile birlikte Plummer-Vinson sendromunun birlikteliði ile seyreden literatürde az sayýda vaka billdirilmiþtir. Bu vakada nadir birliktelik olmasýna raðmen günümüzde de halen görülebildiðini ve akýlda tutulmasý gerektiðini dikkat çekmek amaçlý yazýya aldýk.

Plummer-Vinson syndrome (PVS) is a clinical condition accompanied by dysphagia, iron deficiency anemia and esophageal web. PVS has not been encountered in recent years since the factors related to nutritional have been improved and iron deficiency anemia has been diagnosed and treated early. A rare cause of PVS is Celiac disease. There are very few cases reported in the literature related to Celiac disease and PVS coexistence. We wanted to present this case both to emphasize this togetherness PVS is rarely seen and because PVS may still be seen today.

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Guillain-Barre sendromu(GBS) hýzla geliþen motor zaafiyetle prezente olan, periferik sinir sisteminin immün aracýlý bir hastalýðýdýr. GBS hastalarýnda kranial sinir tutulumlarý nadir olmayýp, sýklýkla fasial ve faringeal kaslarda güçsüzlük þeklindedir. Ekstraokuler kas tutulumlarý ve özellikle oftalmopleji olmaksýzýn pitoz nadiren karþýlaþýlan klinik prezentasyonlar olup teþhiste güçlük yaratabilir. Hastalýðýn baþlangýç bulgularý olarak bilateral pitoz ve hafif jeneralize güçsüzlük tespit edilen genç erkek bir vakayý tartýþma eþliðinde sunduk.

Guillain-Barre syndrome (GBS) is an acute-onset and immune-mediated disorder of the peripheral nervous system characterized by rapidly developing motor weakness. GBS patients often develop cranial nerve involvement, usually in the form of facial or pharyngeal weakness. Ocular involvement, and in particular, isolated ptosis without ophthalmoplegia are rare manifestations and may bring about considerable diagnostic challenges. Herein, we report a young man presenting with bilateral ptosis along with mild generalized weakness as initial manifestations of GBS.

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