Eksitatör aminoasitler (EAA) santral sinir sisteminde sinapslarda iletimin yayýlmasýný saðlayan, birçok nörolojik hastalýðýn fizyopatolojisinde rol alan nörotransmitterlerdir. Kainik asit (KA), bir glutamat analoðu olup güçlü nöroeksitan ve nörotoksindir. KA’in eksitasyonuna karþý en duyarlý alanýn hipokampusun CA3 ve CA1 bölgeleri olduðu sanýlmaktadýr. Sýçanlarda KA’in neden olduðu beyin hasarýna karþý bir NMDA antagonisti olan MK-801’in nöroprotektif etkisi bildirilmiþtir.

KA’in intrahipokampal olarak verildiði çalýþmamýzda, 1. gruba KA+serum fizyolojik, 2. gruba KA+MK-801 verildi. 3. gruba cerrahi iþlem yapýldýktan sonra hiçbir ilaç uygulanmadý.
Sýçanlar, ilaç verilmesinden 24 saat sonra dekapite edilip, beyinleri patolojik çalýþma ile incelendi.

Çalýþmamýzda, bir eksitatör aminoasit antagonisti olan MK-801’in KA’in verilmesinden sonra oluþan nöron kaybýný ve glial hücre proliferasyonunu azalttýðý gözlendi.

Synaptic transmission in the central nervous system is supplied by chemical agents knows as neurotransmitters. Kainic acid is a strong neuroexcittory agent in brain which increase
releases excitatory acids such as glutamate and aspartate. MK-801 in neuroprototective agent which reduces the effect of MK-801 on brain damage induced with kainic acid.

In this study 25 rats were divided into three groups. Kainic acid was given in the hipocampus. The first groups was given kainic acid+saline, the second group was given kainic acid+MK-801 (as intraperitoneal) and the third group were given any pharmacologic agent.

In the study, we concluded the MK-801 is moderately effective on brain damage induced by kainic acid in rats.

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Akciðer tümörü ile akciðer tüberkülozunun (tbc) birlikte görülmesi nadirdir. Biz de bu amaçla, merkezimizde izlediðimiz, yeni geliþen akciðer tüberkülozu ile yeni geliþmekte
olan akciðer tümörünün, birlikte bulunduðu 19 olguyu prospektif olarak inceledik.

Olgularýmýzýn yaþ ortalamasý 51.8 (23-71) olup, 18’i erkek, 1’i kadýndý. Tümör tanýsý 9 olguda transtorakal ince iðne aspirasyon biyopsisi (TTÝÝAB) ile, 9 olguda bronkoskopi ile ve bir olguda da lenf bezi biyopsisi ile kon-du. Tüm olgularda asidorezistan basil (ARB) kültüründe üreme oldu ve direnç çalýþmasý yapýldý.

Olgular her iki hastalýk için de tedaviye alýndý. Yapýlan kontrollerinde,mevcut bulunan tüberkülozun, tümör seyrini etkilemediði kanýsýna varýldý.

Pulmonary tumors and pulmonary tbc are rarely encountered simultaneously. In our center we examined prosectively 19 cases representing with both pathology.

Mean age was 51.8 (23-71) and 18 were males, 1 fema-le. In 9 cases diagnosis was made by TTIIAB, in 9 ca-ses by bronchoscopy and 1 case lymph node biopsy was done. In all cases, ARB grew on cultures and resistance studies were performed.

All cases were treated for both pathologies. In their controls, it was determined that tbc did not affect the tu-moral process (growth).

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Rubella çocukluk çaðýnýn döküntülü bir hastalýðý olup gebelikte geçirildiðinde ölü doðum, düþük ve konjenital malformasyon nedeni olabilmektedir. Çalýþmamýzda doðurganlýk çaðýndak 356 kadýnda Rubella seroprevalansý araþtýrýldý. Rubella IgG tespiti için ELISA yöntemi kullanýldý. Deneklerde % 95.5 seropozitiþik tespit edildi.

Rubella is an eruptional disease of infancy and intrauterine Rubella infection may be fallowed by spontaneous abortion of the infected fetus, a stillbirth, and live birth of an infant with
malformations. In our study; seroprevalans of Rubella was investigated on 356 women of childbearing age. ELISA test was used for detecting Rubella IgG. 95.5 % seropositivity was
detected.

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Preeklampsideki endotel hasarý ve trombosit agregasyonunda artýþ sonucunda koagülasyon ve fibrinolizis mekanizmalarýnda aktivasyon gerçekleþmektedir. Pýhtý oluþumun ve ortadan kaldýrýlmaya çalýþýlmasý çeþitli proteaz inhibitörlerinde azalmaya neden olmaktadýr. Bu nedenle, preeklampsinin þiddetinin saptanmasý ve prognozunun belirlenmesi amacýyla proteaz inhibitörlerinden biri olan serum alfa 2 makroglobulin düzeylerini araþtýrdýk.

25 preeklamptik ve 15 saðlýklý gebede alfa 2 makroglobulin seviyeleri ölçüldü. Ortalama alfa 2 makroglobulin seviyesi preeklamptik gebelerde 2.19 g/l±0.63, kontrol grubunda 3.223 g/l±0.647 olarak saptandý (p<0.05).

Alfa 2 makroglobulinin preeklampside prognozu belirlemede diðer yöntemlerle beraber kullanýlabileceði sonucuna varýldý.

Coagulation and fibrinolysis mechanisms are activated by the endothelial damage and an increase in the trombocyte aggregation in preeclampsia. Clot formation and fibrinolysis cause a decrease in various protease inhibitors. We investigated the role of a protease inhibitor alfa 2 macroglobulin serum levels in the determination of the severity and prognosis of the preeclampsia.

The levels of alfa 2 macroglobulin in 25 preeclamptic and 15 healthy pregnant women were measured.

The avarage level of alfa 2 macroglobulin was 2.12 gr/l±0.63 in preeclamptic women, 3223 gr/l±0.647 in the healthy control group.

It was concluded that the level of alfa 2 macroglobulin can be used with other methods for determination of prognosis in preeclampsia.

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Bu çalýþmada, losartan ve kaptoprilin hem serum eritropoietin ve prolaktin düzeylerine etkilerine hem de arteriyel kan basýncý üzerine etkilerini araþtýrdýk.

In this study, we compare and identify the effects of losartan and captopril on serum erytropoietin and prolactin levels as well as on arterial blood pressure.

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Bu çalýþmamýzda polikliniðimizde otitis ekstern tanýsý alan hastalarda topikal ve sistemik siprofloksasin tedavisinin etkinliði karþýlaþtýrýlmýþtýr.

Yapýlan bakteriyolojik inceleme sonucunda (+) kültür sonucu alýnan 40 hasta, yirmiþerli iki gruba ayrýldý. Birinci gruba topikal sprofloksasin, ikinci gruba ise oral siprofloksasin uygulandý. Her iki gruba da topikal steroid, oral antihistaminik ve oral antiinflamatuvar ortak olarak kullanýldý.

Tüm hastalar tedavi öncesi kaþýntý, kanalda ödem, eritem, aðrý, koku ve tragus hassasiyetleri yönünden deðerlendirildi. Her iki grup, tedavinin 3. ve 6. günlerinde bu bulgulardaki deðiþiklikler yönünden tekrar deðerlendirilmiþtir.

Sonuç olarak, çalýþmaya aldýðýmýz hastalarda oral ve topikal siprofloksasin uygulamasý arasýnda anlamlý bir fark bulunmadý.

In this study, we compare the effectiveness of topical and oral use of ciprofloxacin among the patients seen in our outpatient clinic and diagnosed as otitis externa.

Forty patients, after bacteriologic studies shown to be culture positive, divided into two groups. Each group composed of 20 patients. First group was given topical ciprofloxacin and second group was given oral cipro-floxacin. Topical steroids, oral antihistaminics, non-ste-roid antiinflamatuars were administered to the both groups. All patients questioned for
pruritis, external ear canal edema, pain, tragal tenderness. Both groups eva-luated for the changes in their symptoms between days 3 and 6.

At the end of our study, we couldn’t find any statistical difference between the use of topical and oral cipro-floxacin among the patients in this study.

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Yaþlý hastalarýn trokanterik kýrýklarýnýn tedavisinda asýl amaç, hastayý olabildiðince erken ayaða kaldýrarak, tam yük vererek basabilmesini saðlamak, oluþabilecek bir dizi komplikasyonu önleyerek, kýrýk öncesinde sahip olduðu günlük aktivasyona dönebilmesini saðlamaktýr. Bu çalýþmamýzda, kliniðimizdeki Ender çivi uygulamasý yapýlan ve ortalama
yaþlarý 72.3 olan 30 erkek, 44 kadýn hastayý redüksiyon yeterliliði, kalça fonksiyonlarý ve hastanýn memnuniyeti açýsýndan deðerlendirdik. Bu uygulamanýn, modifiye Evans Tip I ve Tip II intertrokanterik femur kýrýklarýnda uygulanabilecek güvenilir bir tedavi yöntemi olduðu kanýsýna vardýk.

The main goal in the treatment of the intertrochanteric femur fractures in the elderly patients is to give full weightbearing and mobilizing the patient as soon as possible preventing a sequence of complications and getting him to his daily activities before the fracture. This study includes the results of our Ender pin fixation method used in the intertrochanteric fractures of 30 male and 44 female patients with a mean age of 72.3. We evaluated our results according to the adequacy of reduction, hip functions and the satisfaction of the patients. We came to the conclusion that Ender nailing is a safe and easily appliable method that can be used in the intertrochanteric femur fractures that are Modified Evans Type I and II.

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Hiperbilirübinemi, yenidoðan prematüre ve term bebeklerin çoðunluðunda ortaya çýkan bir bulgudur. Ancak, bu çocuklardan çok azýnda serum bilirübin düzeyleri deðiþim transfüzyon gerektirecek ölçüde yükselir. 1999 yýlý içinde, hastanemiz yenidoðan yoðun bakým ünitesine hiperbilirü-binemi tanýsý ile yatýrýlan 583 olgu, retrospektif olarak deðerlendirildi. Bunlarda
85’ine (% 14.5) deðiþim transfüzyon uygulandý. Hastalara deðiþim transfüzyon sonrasýnda proflaktik antibiyotik verilmedi. 85 olgudan yalnýzca 1’inde sepsis geliþtiði gözlendi (% 1.4). Sonuç olarak, sterilite kurallarýna uyulduðunda, deðiþim transfüzyonu sonrasý proflaktik antibiyotik baþlamanýn gerekli olmadýðý söylenebilir.

Hyperbilirubinemia is a common finding in the majority of newborn premature and full term infants. But very few of these infants had high bilirubin levels that need exchange transfusion. We evaluated 583 newborn babys, who were dmitted to our newborn intensive care unit in 1999 with hyperbilirubinemia, retrospectively. 85 (% 14.5) of these infants, had gone under exchange transfusion and one baby had sepsis after the prosedure (% 1.4). In conclusion, if exchange transfusion is performed under steril conditions, there is no need for proflactic antibiotics.

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Incisura scapulae, omuz bölgesindeki önemli yapýlarýn geçmesine izin vermesi sebebiyle Scapulae’nýn önemli bir bölümüdür. Ýncisura scapulae tipleri literatürde çeþitli gruplara
ayrýlmaktadýr. Ýncisura scapulae’daki yapýsal farklýlýklar suprascapular sinir sendromuna kuvvetli etkendir. Bu amaçla; Akdeniz Üniversitesi Týp Fakültesi Anatomi Anabilim Dalýnda bulunan 100 Scapulae kemiði incelendi. Çalýþmamýzda Ýncisura Scapulae’lar morfolojik þekline ve derinliðine göre gruplandýrýldý ve Ýncisura scapulae tiplerindeki farklýlýklar
saptandý.

Sonuç olarak, çalýþmamýzda morfolojik þekline göre Ýncisura scapulae tiplerini 8 gruba ayýrdýk. Derinliðine göre Ýncisura scapulae tiplerini ise 3 grupta inceledik. Ýncisura scapulae’nýn morfolojik yapýsýndaki farklýlýklar göz önünde bulundurularak, Ýncisura scapulae’nýn morfolojik yapýsýnýn rolü ve öneminin benimsenmesi, bu konuda yapýlacak
çalýþmalar için yol gösterici olabilir.

The suprascapular notch is an important part of the Scapulae because it allows passage of vital structures in the shoulder region. The types of Suprascapular notch in literature are classified in various groups. The structural differences in Suprascapular notch have severe effects on suprascapular nerve syndrome. For this reason; 100 Scapulae bones were examined in Akdeniz University, Faculty of Me-dicine, Department of Anatomy. In our study, the suprascapular notch were grouped according to their morphologic shape and depth. Additionally differences in Suprascapular notch types were determined. As a result of our study, we have classified suprascapular notch into 8 groups according to their morphologic shapes. We examined the suprascapular notch types according to their depths in 3 groups. By taking the morphological structure differences into consideration
and realising the importance and the role of the morphologic structure of suprascapular notch, our study may provide guidance for studies in this field.

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As a common and increasing health problem alcoholic liver disease has been reviewed by means of pathogenesis. Still many unclear questions are present especially by means of
“individual” differences among patients. As a result of intercommunity relations drinking style is getting homogenous and the different countries show an increase in cirrhotic endpoints.

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Hyperimmunglobulin E Syndrome is a rare disorder of the immune system. Typical symptoms are fever, recurrent urticarial rashes, lymphadenitis, and bacterial infections of the skin. Patients have very high levels of serum immunglobulin E.

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Infectious mononucleosis is the primary Epstein Barr Virus (EBV) infection seen in the healty host. Infectious mononucleosis is an acute infectious disease occurring predominantly in
older children and young adults. Disease may begin with an atypical clinical picture such as: skin manifestatations or hepatitis. Rarely, a chronic active infection may improve with
EBV.

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Tricuspid atresia is characterized by absence of the tricuspid orifice, an interatrial communication, hypoplasia of the right ventricle, and the presence of communication between the systemic and pulmonary circulations, usually a ventricular septal defect. What is immedialety apparent is that lood can not flow across the tricuspid valve from the right atrium in to right ventricle. This path depends on the presence of other defects, like pulmonary stenos and transposition of the great arteries. In this article a case of adult tricuspid atresia is presented.

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The essential features of autoimmune hemolytic anemia are shortened red blood cell survival in vivo and evidence of host antibodies reactive with autologous RBC, most frequently demonstrated by a positive direct anti-globulin reaction (Coomb’s test). This anti-globulin is form mostly IgG. In this article a case of immunohemolytic anemia is presented.

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Tumours arising from the surface epithelium are the most common tumours of ovaries. They are classified in five major groups including serous, mucinous, endometriod, clear cell and Brenner tumours. These tumours may cause mixed or intermediate lesions. In 30 % of benign Brenner tumours a second surface epithelial tumour is detected in the ipsilateral or contralateral ovary.

43 years old female patient is operated because of a left adnexial mass and she is diagnosed to have Brenner tumourmucinous cystadenoma histopathologically. The case is presented as this type of mixed ovarian tumour is not so common with an incidence of 30 % and the case has typical microscopic and macroscopic features.

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Pheochromocytoma is a catecholamine-producing tumor of cells of neural-crest origin. It commonly develops in the adrenal medulla but may arise within sympathetic ganglia outside the adrenal glands in about 10 % of patients. The most common clinical features
of a pheochromocytoma are hypertension, headaches, palpitations, and sweats. The importance of this disease in the perioperative period is that, patients with these tumors are at high risk for hypertensive crisis or catecholamine-induced arrhythmias during anesthesia, surgery, or arteriography. 25 to 50 per cent of hospital deaths of patients with pheochromocytoma occur during induction of anesthesia or during operative procedures. Once the diagnosis is made, the tumor must be localized and prepared for surgery. Preoperative use of alpha adrenergic blocking drugs is recommended because they are likely to re-duce the incidence of hypertensive crisis. The standart preparation generally used is phenoxybenzamine but, prazosin and doxazosin are also being used by some clinicians. 37 years-old female patient was scheduled to undergo surgery for
removal of an adrenal mass which infact was an unrecognized pheochromocytoma. Following standart monitorizing and anesthesia induction operative procedure began. The blood pressure increased to 270/150 mmHg and pulse was 120/min immediately
after surgical manipulations. The operation was terminated and planned to postpone for diagnose and preope-rative preparation with an alpha blocking agent. Doxazosin was started by an internist and the patient was monitorized for blood pressure, ECG, for three
weeks. The second surgical attempt was also unsuccessful because of a hypertensive crisis during induction of anesthesia just before laryngoscopy and endotracheal intubation. We conclude that, alpha-adrenergic blockade with doxazosin was not sufficient for preoperative preparation of pheochromocytoma leading to uncontrolled hypertensive reaction immediately after induction in our patient.

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A 35 years-old female patient with the complaints of confusion, widespread eruptions and ichterus was admitted to our clinic. Diagnosis of rickettsia meningoencep-halitis was made
clinically with eruption, Tache Noire and cerebrospinal fluid findings and it was confirmed with laboratory findings. 4 grams/day chloramphenicol was administered intravenously
for 12 days. Considering the multiorgan effect (known in literature) because of that could relaps following the treatment with chloramphenicol, doxcyclin (200 mg/day) was given
orally to the patient for one week after chloromphenicol treatment. After a long convalescence period of 4 months patient was recovered.

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An obese patient of 57 year old woman has been brought to our outpatient polyclinics of internal medicine department because of adynamia, dyspneae, causalgia of the tongue. Anemia, mild tachycardia, significant vertigo and splenomegaly were present. Pancytopenia was remarkable through the laboratory values. Sternal aspiration was revealing megaloblastic changes. Recognizing the inattentive diet of the patient so as to lose weight which gives rise to the cyanocobalamin deficiency, management by substitution of the vitamin B12 is started for the diagnosis of pernicious anemia.

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Small bowel stromal tumors are rare gastrointestinal tumors. Diagnosis of them with complications are more rare. In our study we planned to present the importance of differential diagnosis in emergency surgery and this rare tumor type with regard to a patient 90 years old, operated with an acute abdomen.

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The incidence of malignancies arising after transplantation is 50-to 100-fold that seen in the general populations. Multiple myeloma, however, is rare despite the frequent finding of
monoclonal gammopathies after transplantation. We report a 44-year-old patient in whom the diagnosis of non-secretuar multiple myeloma was made 4 years after renal transplantation and reviewed the literature.

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A short-acting nondepolarising neuromuscular blocking agent mivacurium mainly hydrolysed by pseudocholin-esterasc like succinylcholine. The muscle relaxation period may be prolonged in patients with atypical form of pseudocholinesterase or in patients having pseudocholin-esterase deficiency. In this paper we mentioned a patient with prolonged apnoea after mivacurium.

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