GÝRÝÞ ve AMAÇ: Ektopik gebelik tespit edilen olgularýn baþvuru þikayetleri, risk faktörleri ve tedavi yönetimleri açýsýndan retrospektif analizini yapmak.
YÖNTEM ve GEREÇLER: Haydarpaþa Eðitim ve Araþtýrma Hastanesi Kadýn Hastalýklarý ve Doðum Kliniðinde ektopik gebelik tanýsý alýp tedavi edilen toplam 59 hasta retrospektif analiz edildi.Tüm olgular ektopik gebelik etiyolojisinde rol oynayan risk faktörleri açýsýndan ve kliniðe baþvuru þika- yetleri açýsýndan deðerlendirildi. Cerrahi ve medikal tedavi alan hastalar, tedavi baþarýlarý, ultrasonografik bulgularý ve kan deðerleri açýsýndan karþýlaþtýrýldý.
Bulgular: Çalýþmada hastalarýn yaþ ortalamasý 32±6.0 idi. Hastalarýn baþvuru þikayetleri vajinal kanama(%32.2), pelvik aðrý (%28.8), vajinal kanama ve pelvik aðrý bir arada (%27,1), sadece adet rotarý (%5,1) ve acil servise hipovolemik þok tablosu ile getirilen (%5.1) dir. Olgularýn %40,7 ‘sinde özgeçmiþlerinde özellik saptanmazken, %13,6’sý pelvik inflamatuar hastalýk,%1,7 ’si geçirilmiþ tubal cerrahi, %11,9 ‘u ektopik gebelik öyküsü, %15,3 ‘ü rahim içi araç (RÝA) kullanýmý, %1,7 ‘si levanorgestrelli RÝA kullanýmý,%1,7’si uterin anomali, %13,6’sý ise geçirilmiþ sezaryen operasyonu öyküsüne sahipti. Hastalarýn %54,3’üne Metotreksat tedavisi verildi, %3,4 hasta spontan
takip edildi, %40,7 ‘sine cerrahi uygulandý. Tek doz Metotreksat tedavisi verilen gruptan 6 hastaya ikinci doz Metotreksat teda- visi verildi, 2 hastada tedaviye cevap alýnamayýp cerrahi yapýldý. Toplamda Metotreksat tedavisi %93.7 hastada etkili bulundu.
BULGULAR:
TARTIÞMA ve SONUÇ: Çalýþma grubumuzda geçirilmiþ pelvik inflamatuar hastalýk ve RIA kullanýmý en sýk karþýlaþýlan risk faktörleri olarak bu- lunmuþtur. Tedavi yöntemleri içerisinde de, iyi seçilmiþ vakalarda Metotreksat tedavisi konservatif tedavi imkaný saðlayan, olduk- ça baþarýlý bir yöntem olarak bulunmuþtur.

INTRODUCTION: To analyse the ectopic pregnancy cases retrospectively considering their initial complaits, risc factors and treatment methods.
METHODS: The data of 59 patients who were seen at the Haydarpaþa Numune Education and Research Hospital Obstetrics and Gynecology Clinic were analysed retrospectively. All cases were analysed considering their etiological risc factors and complaints. The patients that received surgical or medical treatment were compared in terms of their ultrasonographic findings, labaratory results and treatment success.
RESULTS: The mean age of the patients was 32±6.0. The initial complaints of the patients were vaginal bleeding (32.2%), pelvic pain (28.8%), vaginal bleeding and pelvic pain(27,1%), delayed menstruation only (5,1%), and admittance to emergency room with hypovolemic shock findings (5.1%). 40,7 % of the cases had non-specific histories, 13.6 % had pelvic inflammatory disease,1.7% had prior tubal surgery, 1.9% had history of ectopic pregnancy,15.3% had intra uterine device (IUD), 1.7% had levanorgestrel IUD, 1.7% had uterine anomaly, 13.6% had prior cesarean section. 54.3% were treated with Methotrexate, 3.4% were followed without treatment, 40.7% had surgical treatment. Among patients treated with Methotrexate 6 patients required a second dose, and two patients required surgery. Methotrexate was effective for 93.7% of those given the treatment..
DISCUSSION AND CONCLUSION: History of pelvic inflammatory disease and IUD use were commonly encountered risk factors in our study group. Among the treatment modalities, Methotraxate was a quite effective method for conservative treatment of selected cases.

GÝRÝÞ ve AMAÇ: Serebral palsi (SP) çocuk nöroloji pratiðinde yer alan önemli hastalýklarýnda biridir. Retrospektif olarak yapýlan bu çalýþmamýza hastalarýnýn demografik ve klinik özelliklerinin deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Son on iki ay içerisinde en az bir kez takip ve kontrol muayenesi yapýlan 134 SP hastasý dahil edildi. Ortalama yaþlarý 6.73 ± 3.45 yýl saptanan hastalarýn %38.1’i kýzdý. Hastalarýn %15.7’si prematür olarak doðmuþtu. Serebral palsi tipinin 123 hastada spastik ve olgularýn 18’inde tek taraflý serebral palsi olduðu belirlendi.
BULGULAR: SP hastalarýn büyük çoðunda kaba motor iþlev ölçeði seviye 5 olarak deðerlendirildi. Hastalarýn %54.5’ü epileptik nöbet geçirmekteydi ve %32.8’inde aðýr zeka geriliði mevcuttu.
TARTIÞMA ve SONUÇ: Sonuç olarak serebral palsinin sosyodemografik ve klinik özelliklerinin belirlenmesi hastalýðýn patofizyolojisinin anlaþýlmasý ve multidisipliner bir yaklaþýmla tedavi edilmesi bakýmýndan önemlidir.

INTRODUCTION: Cerebral palsy (CP) is one of the important diseases in child neurology practice. The aim of this retrospective study was to evaluate the demographic and clinical proper-ties of patients.
METHODS: One hundred and thirty-four patients who came to the control visit were taken into study. The mean age of patients was 6.73 ± 3.45 and 38.1% of cases were girl. The 15.7 % of patients were premature. The CP type was spastic in 123 patients and eighteen of them were unilateral. The gross motor activity scale was level 5 in most of patients.
RESULTS: The frequencies of epilepsy and mental retardation were 54.5% and 32.8% respectively.
DISCUSSION AND CONCLUSION: In conclusion, the determination of demographic and clinical features of CP is important for the development of multidisciplinary treatment modalities.

GÝRÝÞ ve AMAÇ: Kawasaki sendromu; çogunlukla 5 yaþtan küçük çocuklarý tutan, etyolojisi bilinmeyen, küçükorta çaplý damarlarý etkileyen çocukluk çaðý vaskülitidir. Tedavi edilmediðinde % 25 oranýna kadar koroner damarlarý da etkileyen ve giderek daha iyi tanýnan bir hastalýktýr. Bu çalýþmada; çocuk kardiyoloji polikliniðimizde takip edilmekte olan Kawasaki olgularýmýzý retrospektif olarak deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Kawasaki tanýsý almýþ ve çocuk kardiyoloji polikliniðinde dosya açýlýp takip edilen olgularýn dosyalarýndan olgulara ve hastalýða ait bilgiler retrospektif olarak olarak incelendi.
BULGULAR: Çalýþmaya alýnan 69 olgunun 45 (% 65) erkek, 24 (% 35) kýz idi. Olgularýn hastalýða yakalanma yaþ ortalamasý 40;4 ay ±2,3 (2- 144ay) idi. Kawasaki taný kriterlerinde kullanýlan belirtilerin tamamýna sahip olgu sayýsý 25 (% 36) idi. Bu kriterlerden ateþ, tüm olgularda görülen tek semptomdu. Hastalýk sýrasýnda 30 (%46) olguda ekokardiyografi bulgusu vardý. Bunlarýn 22’sinde (% 30) koroner tutulumu vardý. Koro- ner tutulumu gösteren olgularýn 7 tanesinde sol koroner arter, 4 tanesinde sað koroner arter, 11 tanesinde her iki koroner arterde tutulum görüldü. Bu olgularýn 7’sinde (% 10) takipte koroner tutulum devam etti. Olgularýn 45(%69) ’ýnda IVIG tedavisi 10 günden önce verilmiþti. Olgularýn laboratuvar bulgularý tartýþýldý.
TARTIÞMA ve SONUÇ: Taný için kesin diyagnostik laboratuvar bulgularýnýn olmamasý, tanýda gecikme ve inkomplet olgularýn olmasý ve koroner tutulumunun olmasý bu hastalýðýn önemini artýrmaktadýr.

INTRODUCTION: Kawasaki syndrome; is childhood vasculitis with unknown etiology affecting small – medium sized vessels, mostly small children under 5 years.The Syndrome affects coronary arteries up to 25 % of untreated cases, andI t is increasingly well known. In this study; We aimed to investigate Kawasaki Syndrome cases who followup at the pediatric cardiology clinics.
METHODS: The datas of findings Kawasaki Syndrome and cases with this syndrome obtained from their files at the our pediatric cardiology policlinic.
RESULTS: In this study There were 45 (65%) male and 24 (35%) female totally 69 patients. The age of disease of patients was 40; 4 months ± 2.3 (2-144ay) at mean. The number of cases have all the symptoms of Kawasaki diagnostic criteria in 25 (36%). The number of cases have all the symptoms of Kawasaki diagnostic criteria used in 25 (36%), respectively. The only criterion was fever that in all cases. 30 ( 46 %) patients had echocardiographic findings during illness. 22 (30%) of these had coronary involvement. There were left coronary artery involvement in 7 cases, coronary artery in 4 cases, in both coronary artery involvement in 11 cases.The coronary artery involvement had improvement in 7(10%) patients at the follow-up.The IVIG treatment was given before 10 days in 45(%69) of cases. Laboratory findings of the cases were discussed also.
DISCUSSION AND CONCLUSION: The lack of definitive diagnostic laboratory findings for diagnosis, being incomplete cases and causing delay in diagnosis and having involvement coronary artery increases the importance of this disease.

GÝRÝÞ ve AMAÇ: Bu çalýþmada Ýstanbul Avcýlar ve Küçükçekmece ilçelerinde yer alan Küçükçekmece Gölü havzasýnda
“arkeolojik kazýlarda, mezarlarýn açýlmasý ve çýkarýlan insan buluntularýnýn adli antropolojik sonuçlarýnýn, kimliklendirme ve ölüm nedenlerinin belirlenmesi hedeflenmiþtir.
YÖNTEM ve GEREÇLER: Çýkarýlan 15 farklý bireye ait iskeletlerin 5’inin eriþkin erkek, 4’ünün eriþkin kadýn, 4’ünün çocuk, 2’sinin fetus olduðu deðerlendirilmiþtir. 15 iskeletin boy ölçümleri %93 oranla, yaþ aralýðý tespitleri ise %100 oranla yapýlabilmiþtir.
BULGULAR: Çalýþmada elde edilen kategorik veriler kikare testi ile nonparametrik veriler Mann Whitney U testi ile deðerlendirilmiþ olup veriler ortalama ve standart sapma olarak verilmiþtir.
TARTIÞMA ve SONUÇ: Birey sayýsýnýn net belirlenmesi, cinsiyet, boy ve yaþ tayininde yüksek tespit oranlarýna ulaþýlmasýnda mezarlarýn kazý öncesi tahmini olarak yerlerinin tespit edilmesi, iskeletlerin bir mezarlýk içinde gömülmeleri, mezar boylarýnýn ölçülebilmesi, mezarlarýn araþtýrmacý gözetiminde açýlmasý, mezar baþýnda ölçümlerin yapýlmasý ve insitu olarak iskeletlerin pozisyonlarýnýn gözlenebilmesi katký saðlamýþtýr.

INTRODUCTION: The aim of this research was to identify and determine the cause of death for the archeo- logical excavations, grave openings and the anthrolpologic results of the human remains found in the districts of Avcýlar and Kucukcekmece situated in the Kucukcekmece basin in Ýstanbul province.
METHODS: Of the excavated 15 different skeletons, we analysed that five of them belonged to adult male, four were adult female, four were children and two of them were fetus skeletons. We were able to carry out 93% of the height measurements of the 15 skeletons and 100% of their age range.
RESULTS: The categoric data of the reseach were analysed using chi-square test, non parametric data with Mann-Whitney U test and the data is given as mean and standard deviation.
DISCUSSION AND CONCLUSION: The determinations of the exact location of the graves before excavation, the burial of all the skeletons in single grave, the ability to measure the grave sizes, the opening of the graves under the supervition of experts, the measurements being done at the grave site and the insitu observation of the skeleton positions contributed much to the determination of the exact number of bodies,the high accuracy rate of height and age determination.

GÝRÝÞ ve AMAÇ: Prostat kanserine yönelik olarak tedavi planýnýn oluþturulmasýnda en önemli parametrenin Gleason skoru olduðunu bilmekteyiz. Çalýþmamýzýn amacý Gleason skoruna etki eden parametreleri gözden geçirmektir.
YÖNTEM ve GEREÇLER: Çalýþmamýza, Fatih Sultan Mehmet Eðitim Araþtýrma Hastanesi Üroloji Kliniðinde 2008 ve 2016 yýllarý arasýnda transrektal ultrason (TRUS) eþliðinde ince iðne prostat biyopsisi ile prostat kanseri tanýsý alýp, radikal ret- ropubik prostatektomi (RRP) yapýlan toplam 114 erkek hasta dahil edildi. Hastalarýn yaþ, biyopsi öncesi prostat spesifik antijen (PSA) düzeyleri, biyopsi öncesi vücut kitle indeksi (VKÝ), biyopsi iþlemine baþlamadan TRUS ile ölçülen prostat volümleri ile TRUS eþliðinde yapýlmýþ olan prostat biyopsileri sonucu elde edilmiþ patoloji sonuçlarý ve cerrahi iþlem sonrasý patoloji sonuçlarý retrospektif olarak incelendi. Karþýlýklý uyumun deðerlendirilmesinde kappa katsayýsý kullanýldý.
BULGULAR: Tüm olgularda biyopsi ve cerrahi spesmenleri arasýnda orta düzeyli (%38.3) uyum görülmektedir (Kappa uyum katsayýsý: 0.383; p: 0.001; p<0.01). Toplamda olgularýn %66.7’sinde (76/114) sonuçlar uyumlu bulunmuþtur. PSA, prostat volümü, yaþ ve VKÝ ayrý ayrý deðerlendirildiðinde de bu uyumun buna paralel olarak %60 ile %70 arasýnda deðiþtiði gözlenmiþtir.
TARTIÞMA ve SONUÇ: Literatürde bu uyuma yönelik çok sayýda çalýþma ve buna paralel olarak çok geniþ aralýkta oranlar mevcuttur. Bizim çalýþmamýzda da literatürle uyumlu sonuçlar mevcuttur. Ancak Gleason skoruna etki eden parametreler ayrý ayrý deðerlendirildiðinde benzer uyum oranlarý gözlense de tek deðiþkenli analizler ile nomogramlara eklenebilecek yeni parametrelerin bulunabileceðini düþünmekteyiz.

INTRODUCTION: We know that Gleason score is the most important parameter in the decision-making process for the construction of a treatment plan for prostate cancer. The objectiv e of our study is to review the parameters effecting Gleason score.
METHODS: A total of 114 male patients who had undergone radical retropubic prostatectomy (RRP) in the Urology Clinics of Fatih Sultan Mehmet Training and Research Hospital between the years 2008, and 2016 with the diagnosis of prostate cancer based on the histopathology results of transrectal ultrasound-guided (TRUS) fine-needle transrectal biopsy specimens were included in the study. Age, pre-biopsy prostate specific antigen (PSA) levels, body mass indices (BMIs), and prostate volumes of the patients measured with the help of TRUS, histopathology results of prostate biopsy, and RRP specimens were retrospectively analyzed. For the evaluation of mutual agreement kappa coefficient was used.
RESULTS: In all cases, a moderate level (38.3 %) of agreement was seen between biopsy, and surgical specimens (kappa coefficient of agreement: 0.383; p: 0.001; p<0.01). Overall, in 66.7 % (76/114) of the cases the results were in agreement. When PSA, prostate volume, age, and BMI were evaluated separately, this rate of agreement changed between 60, and 70 %, in parallel with these results.
DISCUSSION AND CONCLUSION: In the literature, sample number of studies on the agreement between these parameters with agreement rates varying within a wide spectrum. In our study we also obtained results consistent with those cited in the literature. Although when parameters effective on Gleason score were evaluated separately similar rates of agreement have been observed, we think that new parameters, which can be included in univariate analyses, and nomograms will be identified in the near future.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda, inflamasyon tabanlý ve minimal invaziv prognostik bir gösterge olan Glasgow prognostik skoru (GPS)’ nun, prostat iðne biyopsisi öncesi prostat kanserini öngörebilme deðerini saptamayý ve bu sayede prostat iðne biyopsisinin olasý komplikasyonlarýný azaltýp kansere spesifikliðini arttýrabilmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Prostat spesifik antijen (PSA) düzeyi 4-10 mg/dl arasýnda olan, rektal tuþede malignite þüphesi olmayan, prostat iðne biyopsisi yapýlan toplamda 160 hasta içerisinden patoloji sonucu prostat adenokarsinomu gelen 30 hasta ve geri kalanlar içerisinden patoloji sonucu kronik prostatit olarak raporlanan hastalardan rastgele seçilen 30 hasta çalýþmaya dahil edildi. Hastalarýn iþlem öncesi serum PSA, Creaktif protein (CRP), albümin düzeyi, prostat hacmi, vücut kitle indeksi (VKÝ), uluslararasý prostat semptom skorlarý (IPSS) ve diðer komorbiditelerin varlýðý (diyabet, hipertansiyon, koroner arter hastalýðý) belirlenip raporlandý.
BULGULAR: Çalýþmaya dahil edilen 60 hastanýn yaþlarý 56 ile 75 yýl arasýnda deðiþmekte olup, ortalamasý 66.05±5.48 yýldýr. Gruplara göre olgularýn yaþ ortalamalarý, serum PSA ve CRP düzeyleri arasýnda istatistiksel olarak anlamlý bir farklýlýk bulunmadý (p>0.05). Kronik prostatit (KP) grubunun serum albümin düzeyi ortalamasý, prostat kanseri (PK) grubundan istatistiksel olarak anlamlý düzeyde yüksekti (p: 0.005; p<0.01).Bunun yanýnda PK grubunun GPS ortalamasý, KP grubundan istatistiksel olarak anlamlý düzeyde yüksek saptandý (p: 0.008; p<0.01).
TARTIÞMA ve SONUÇ: Bu öncü çalýþmada serum total PSA düzeyi 4-10 mg/dl arasýnda olan ve rektal tuþede malignite þüphesi olmayan hastalarda, prostat iðne biyopsisi yapma kararý verilirken GPS yüksekliðinin kanser tanýsýný öngörebilme yeteneði olabileceðini gördük. Bu çalýþmanýn sonuçlarýný dikkate alarak günümüzde geçerliliði kanýtlanmýþ bu prognostik parametrenin diyagnostik kullanýmýna iliþkin çalýþmalarýn önü açýlabilir. Bu sayede kimi komplikasyonlarý ve yanlýþ taný olasýlýklarý olabilen prostat iðne biyopsisinin gerçekten kanser olan hastalara uygulanma oranýnýn artabileceðini düþünmekteyiz.

INTRODUCTION: We aimed to determine predictive value of an inflammation-based, minimally invasive prognostic marker of Glasgow prognostic score (GPS) in the diagnosis of prostate cancer (PCa) before performing prostate needle biopsy so as to decrease possible complications of prostate needle biopsy and increase its prostate cancer-specificity.
METHODS: Among a total of 160 patients whose prostate specific antigen (PSA) levels were between 4-10 mg/dl without any suspicion of malignancy on digital rectal examination (DRE) who also underwent prostate needle biopsy. 30 patients whose histopathology results were reported as prostatic adenocarcinoma and 30 randomly selected patients with histologically evidenced chronic prostatitis were included in the study. Before the procedure, serum PSA, C-reactive protein (CRP) and albumin levels, prostate volume, international pros- tate symptom score (IPSS) and presence of other comorbidities were reported.
RESULTS: Sixty patients aged 56-75 years (mean: 66.05±5.48 years) were included in the study. Mean ages of the cases, serum PSA and CRP levels were not statistically significantly different between groups (p>0.05). Mean albumin level of the chronic prostatitis (CP) group was statistically sig- nificantly higher relative to the PCa group (p: 0.005; p<0.01). In addition, mean GPS was statistically significantly lower in the CP group (p: 0.008; p<0.01).
DISCUSSION AND CONCLUSION: In this pilot study, we have seen that while deciding to perform prostate needle biopsy in patients with total PSA levels between 4-10 mg/dl without any evidence of suspect malignancy on DRE, higher GPSs may predict diagnosis of prostate cancer. In consideration of the results of this study, diagnostic use of this validated prognostic parameter may pave the way for the conduction of further relevant studies.

GÝRÝÞ ve AMAÇ: Bu çalýþmada kararsýz angina pektoris hastalarýnda enflamasyonun rolünün ortaya koyulmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 23 kadýn ve 49 erkek hasta olmak üzere toplam 72 hasta alýnmýþtýr. Hastalar kararlý-angina pektoris (n=29) ve kararsýz-angina pektorisi (n=43) olmak üzere iki gruba ayrýldý. Her bir grupta duyarlýlýðý yüksek C-reaktif protein (hs-CRP), fibrinojen, interlökin-6 (ÝL-6) düzeyleri ölçülerek her iki grup arasýndaki farklar araþtýrýldý.
BULGULAR: Hastalarýn yaþ ortalamasý 57.3±8.1, vücut kitle indeksi ortalamasý 27.5±3.1 idi. Kararsýz angina pectoris’li hastalarýn hs-CRP, fib- rinojen ve ÝL-6 seviyeleri (sýrasý ile; 16.68±10.8 mg/dL, 451.2±119.8 mg/dl, 21.2±13.3 pg/mL) kararlý-angina pektoris’li hastalarda ise (sý- rasý ile 6.61±4.4 mg/dL, 383.7±109.6 mg/dl, 7.5±2.8 pg/mL) göre daha yüksekti (tamamý için p<0.05). Ayrýca fibrinojen ve hs-CRP arasýnda (r=), fibrinojen ve ÝL-6 arasýnda (r=), ÝL-6 ve hs-CRP arasýnda (r=) anlamlý bir korelasyonlar bulundu (p<0.05).
TARTIÞMA ve SONUÇ: Bu çalýþma sonucunda kararsýz-angina pektorisin geliþiminde inflamasyonun önemli rolünü gösteren önemli bulgular elde edilmiþtir.

INTRODUCTION: The role of acut inflammatoryu reaction in unstable angina pectoris was investigated in this study.
METHODS: A total of 72 patients including 23 women and 49 men patients have been included in the study. The patients were divided into two groups, as patients with stable angina pectoris (n=29) and patients with unstable angý- na pectoris (n=43). High-sensitivity C-reactive protein (hs-CRP), fibrinogen and interleukin-6 (IL-6) levels were investigated and compared between two groups.
RESULTS: The mean age of patients was 57.3±8.1. Mean body mass index was 27.5±3.1. hs-CRP, Fibrinogen, and IL-6 levels of patients with unstable-angina pectoris (16.68±10.8 mg/dL, 451.2±119.8 mg/dl, 21.2±13.3 pg/mL, respectively) were significantly (p<0.05) higher than patients with stable angina pectoris (6.61±4.4 mg/dL, 383.7±109.6 mg/dl, 7.5±2.8 pg/mL). There were significant correlations between fibrinogen and hs-CRP (r=), between fibrinogen-IL-6 (r=) and between IL-6 ve hs-C- RP arasýnda (r=) (p<0.05 for all).
DISCUSSION AND CONCLUSION: In this study, significant findings that show the role of inflammation in unstable angina pectoris were found.

GÝRÝÞ ve AMAÇ: Üriner sistem taþ hastalýðý, hematüri, tekrarlayan idrar yolu enfeksiyonu gibi hasta- lýklarýn patogenezinde rol alan minerallerin idrar atýlýmlarýnýn, ülkelere, yaþa, cinsiyete ve diyet alýþkanlýklarýna göre deðiþtiði bildirilmiþtir. Türk çocuklarý için ilgili mineral atýlýmlarýný bildirir bir referans tespit çalýþmasýna rastlanmamýþtýr.
YÖNTEM ve GEREÇLER: Bu çalýþmada, Türkiye’de ilk olarak, Samsun ilinde yaþayan 2-16 yaþ grubu saðlýklý çocuklarda 24 saatlik ve sabah ilk idrar örneklerinde kalsiyum, magnezyum, fosfat, ürik asit, kreatinin atýlýmla-rýnýn standart referans deðerlerinin belirlenmesi amaçlanmýþtýr.
BULGULAR: 2-16 yaþýnda 203 saðlýklý çocuk (88 kýz, 115 erkek) çalýþmaya alýnmýþtýr. Söz konusu minerallerin diyetle alýmlarý ve sa- bah ilk idrar ve 24 saatlik idrar örneklerindeki atýlýmlarý arasýndaki iliþki araþtýrýlmýþtýr. Bulgular: Ýdrarda kalsiyum atýlýmý 50p ve 95 p deðerleri sýrasýyla 2.60 ve 6.73 mg/kg/gün; magnezyum için 1.16 ve 2.43 mg/kg/gün; fos- fat için 19.21, ve 37.11 mg/kg/gün; ürik asit için10.21 ve 19.71 mg/kg/gün; kreatinin için 20.61 ve 29.58 mg/kg/gün idi. Çalýþmaya katý- lan çocuklarýn %3.4’ünde asemptomatik hiper- kalsiüri, %4.4’ünde hiperürikozüri tanýmlanmýþ- týr.
TARTIÞMA ve SONUÇ: Minerallerin diyetle alýmlarý ile idrar atýlýmlarý
arasýnda anlamlý iliþki gösterilememiþtir. Mine- rallerin sabah ilk idrarýndaki atýlýmlarý ile günlük idrarda atýlýmlarý arasýnda anlamlý iliþki göste- rilememiþ; sabah ilk idrarýnýn 24 saatlik idrarýn yerini tutamayacaðý belirlenmiþtir.

INTRODUCTION: Previous studies indicate that nor- mal values for urinary excretions of the consti- tuents that are responsible in the pathogenesis of diseases like urinary stone disease,hematu- ria, reccurent urinary tract infection may vary according to age, sex, diet traditions in different regions. Reference values of the related cons- tituents were not available for Turkish children.
METHODS: The aim of this study was, for the first time in Turkey, to determine the standart reference values for excretions of calcýum, magnesium, phosphate, uric acid and creatinine in the first morning and 24-h urine samples in 2-16 years old healthy children in Samsun region.
RESULTS: A total of 203 children (88 girls, 115 boys), aged 2-16 years partici- pated in the study. The relationships between the dietary intake and the urinary excretion of the minerals in the first morning and 24-h urine samples were investigated.The 50p and 95p values for urinary excretions of calcium were 2.6 and 6.73 mg/ kg/day; for magnesium 1.16 and 2.43 mg/kg/ day, for uric acid 10.21 and 19.71 mg/kg/day, for phospate 19.21 and 37.11 mg/kg/day,for creatinine 20.61 and 29.58 mg/kg/day respe- ctively. Asemptomatic hypercalciuria and hy- peruricosuria were diagnosed in 3.4% and 4.4 %of children who were enrolled in the study respectively.
DISCUSSION AND CONCLUSION: There was no significant correla- tion between the dietary intake and the urinary excretions of the constituents. There was also no significant correlation between the urinary excretions of the constituents in the first mor- ning and 24-h urine samples, therefore we su- ggest that the first morning urine samples can not replace the 24-h urine sample measure- ments.

Ýdiyopatik hiperkalsiüri (ÝH), serum kalsiyum deðerinin normal, idrarla atýlan kalsiyum miktarýnýn fazla olmasý ile karakterize, çoðu hastada semptomsuz seyretmesi nedeniyle tanýda atlanýlan, ancak ilerleyen dönemlerinde tekrarlayan üriner sistem patolojilerine sebep olan bir hastalýktýr. Tekrarlayan karýn aðýsý olan çocuklarda akýlda tutulmasý gereken bir hastalýk olmasý nedeniyle sunduk.

Idiopathic hypercalciuria is a disease characterized by normal serum calcium levels and high levels of calcium excreted in urine, that is overlooked in most patients due to being asymptomatic but which recurs in its later stages and leads to urinary system pathologies. We presented it because it is a disease that should be kept in mind in the case of children with recurrent abdominal pain.

Nekrotizan fasiit, subkutan dokunun ve fasyanýn enfeksiyonu olup, hýzlý ilerleyen ve geniþ açýk yaralarla sonuçlanabilen bir hastalýktýr. “Et yiyen bakteriler” olarak bilinen mikroorganizmalarýn yol açtýðý nadir ve aðýr bir enfeksiyon tablosudur. Hayatý tehdit eden ve yüksek mortalite ile seyreden bir durumdur. Nekrotizan fasiitin diabet hastalýðý ve kronik alkol baðýmlýlýðý olan kiþilerde daha sýk geliþtiði gözlenmiþtir. Acil cerrahi debridman, bu hýzlý ilerleyen hastalýðýn yönetiminde esas tedavi modalitesidir. Cerrahi debridmandan sonra genellikle geniþ bir açýk yara kalýr ve bu yarayý kapatmak için ikincil bir cerrahi giriþim gerekir. Yara yataðýnýn genellikle kirli ve unstabil olmasýndan dolayý iyileþme uzun sürer ve ikincil müdahale gecikir. Negatif basýnçlý yara terapisi, doku perfüzyonunu artýrýcý ve yara ödemini azaltýcý etkisinden dolayý kronik yaralarý kontrol etmek için kullanýlmaktadýr. Biz bu olgu sunumu ile uygun anbiyotik ve cerrahi debridman, negatif basýnçlý yara terapisi ve geç dönemde cerrahi rekonstrüksiyon ile tedavi edilen bir karýn duvarý nekrotizan fasiit vakasýný sunmayý amaçladýk.

Necrotizing fasciitis is the infection of subcutaneous tissue and fascia. It’s a rapidly progressive disease that can result with wide-open wound caused by microorganisms known as “flesh-eating bacteria”. The most common causes are group A beta-hemolytic streptococcus. Emergency surgical debridement combined with early diagnosis is the main treatment modality in the management of rapidly progressive disease. But often a large open wound remains after surgical debridement for infection management and secondary surgical procedures such as skin grafts, local flaps or free flaps would be needed to close the wound. The delay in closing the open wound may result in delayed infection, deterioration of the patient’s general condition and generalized sepsis. Prolonged recovery is expected due to the dirty and unstable wound bed after skin grafting. Negative pressure wound therapy (NPWT) is getting used to control chronic wounds due to the effect of reducing the wound edema and increasing the tissue perfusion. We ai- med to present an abdominal wall necrotizing fasciitis case (a 60 year -old immobile, schizophrenic woman) which has been tre- ated in few weeks by 3 steps [1-antibiotics and surgical debridement, 2- negative pressure wound therapy, 3-Late surgical reconstruction (skin graft)].

Kist hidatik ülkemizde sýk görülen bir hastalýktýr.En sýk karaciðer ve akciðer dokusuna yerleþen ekinokoklar çoðunluk kronik bir enfeksiyona sebep olur. Son yýllarda özellikle cerrahi tedavide laparoskopik iþlemler ön plana geçmiþtir.Yine travma sonrasý batýn içine yayýlým nadir görülen ancak ciddi bir durumdur.Bu olgu sunumunda travma sonrasý batýn içi yayýlým gerçekleþmiþ kist hidatik olgusu ve laparoskopik tedavisi sunulmuþtur.

Cyst hydatid is the frequent morbidity in our country. Echinococus commonly localized in liver and lung and it causes chronical infection. In last years laparascopic operations are gained popularity in surgical practice.Intraabdominal rupture after trauma is a rare but serious event. In this case report a patient with cyst hydatid, intraabdominl rupture after trauma and treated with laparoscopic surgery was reported.

Kromozom Ring 13 sendromu; bir çift 13. Kromozomunun sadece birinin kýsa kolunda meydana gelen bir grup gen kaybý sonrasý, uzun ve kýsa kollarýnýn birleþerek halka þeklini almasý ile bazý geliþimsel ve morfolojik deðiþimlerin görüldüðü bir hastalýktýr. Bu hastalýk klinik olarak 1968 yýlýnda gösterilmiþ olsadailk defa genetik analizlerinin yapýlmasýndan sonra tanýmlanabilmiþtir1. (Resim 1)
Geliþim sürecinde gecikme, beslenme bozukluklarý, özellikle ayakta olmak üzere iskelet anomalileri, yüksek damak, anüs anomalileri, küçük alçak çene, böbrek anomalileri, kalp bozukluklarý, normal olmayan beyin yapýsý ve anormal göz yapýsý gibi belirtiler bu hastalýða eþlik etmektedir2.
Bizim olgumuz; aralarýnda akrabalýk baðý bulunmayan 28 yaþýndaki anne ile 30 yaþýnda ki bir babanýn ilk çocuklarýdýr. 30 haftalýk olarak C/S ile erken doðumla meydana gelen bebekte doðduðu zaman prematürite+ RDS’sinin yanýnda imperfore anüs, ambigusgenitalia ve prenatal dönemde saptanan kardiak ve serebralanomalilermevcuttu. Ýlk yapýlan gözlemlerde kromozom 13 sendromunun mevcut olduðu düþünülmüþtür. Bu çalýþmanýn amacý; sunulacak olan olgumuzla hastalýðý literatür ýþýðýnda tekrar gözden geçirmektir.

Ring chromosome 13 syndrome is a disease where some developmental and morphological changing have been seen, because of a group of missing geneononlyone of the 13 chrosome pair at short arm, small and long arms have fused together to form a ring. Although this syndrome were showe dupclinically in 1968, the first describing of it has been defined after analysis of genetic.
Development delay, feding difficulties, unusual bone structure most commonly footanomaly, highpalate, anus anomalies, small lowjaw, kidney anomalies, heart defects, abnormal brain structure and abnormal eye structure accompany this disease.
Ourfact is a firstbaby of a mother at theage of 28 and a father 30 who do not haveanyline of descent. When the baby was born at just 30 weeks by C/S,(sezeryan) along side being prematüre + RDS it had also imperforate anus, ambigus genitalia, cardiac and cerebral anomalies which were determined at prenatal period. During the first monitoring, it was thought that there was chromosome 13 syndrome. The purpose of this essay is to reconsider this disease in thelight of literature with our fact will be presented.