Bebek isteyen ve gebe olduðunu öðrenen aile için bu bebeðin abortus veya embriyonik ölümle sonuçlanma olasýlýðýný bilmek önemlidir. Ayný þekilde, hekim de ister normal yoldan, ister yardýmcý üreme teknikleri ile elde edilmiþ olsun saptanan gebeliðin bazý ultrsonografik özelliklerine bakarak yüksek veya normal riske sahip gebelikleri önceden tahmin etmek ve rutin kontrolleri buna göre planlamak ihtiyacýndadýr. Böylece aileyi ve kendini gereksiz anksiyete ya da iyimserlikten koruyabilir.

Son adet tarihine göre gebeliðinin 6-12. haftalarýnda olan, kasýk aðrýsý, kramp ve vaginal kanama gibi semptomlarý olmayan, gebeliðin devamýný isteyen, 59 olgu bilgilendirilmiþ onamlarý alýndýktan sonra çalýþmaya dahil edildi. Endovaginal transduser (5 MHz transducer TOSH‹BA 220A SSA) kullanýlarak önce gebelik kesesinin intrauterin olup olmadýðý embriyonik kutup ve embriyonik kalp aktivitesi araþtýrýldý. FKA (+) olgularda gebelik kesesinin sagital planda; anteroposterior ve longitidunal çaplarý, koronal planda; transvers çaplarýnýn ortalamasý, ortalama gebelik kesesi ölçümü olarak kaydedildi. Embriyonun en iyi görüntülenebildiði planda baþpopo uzunluðu ölçüldü. Yine yolk kesesinin sagital ve koronal planlardaki üç ölçümünün ortalamasý, ortalama yolk kesesi çapý olarak alýndý, genel morfolojisi, duvar kalýnlýðý deðerlendirilip bu özellikler kaydedildi.

Tüm olgular 12. ve 20. gebelik haftalarýnda kontrole çaðrýldý, gebeliðin devam edip etmediði öðrenildi.

Yolk sac þekline göre gebeliðin sonlanma durumlarý arasýnda anlamlý fark vardý (p<0.001). Gebeliði olumlu sonuçlananlarýn % 95.5 (42 olgu) normal, düzgün, yuvarlak yolk kesesi þekli mevcuttu. Olumsuz sonuçlananlarýn ise % 78.6 (11 olgu) yolk sac þekli anormaldi.

It is important for a family who desires to have baby and who learns that already has one being carried, to learn the risk of facing miscarriage or embryonic demise. In the same point of view, also the obstetrician feels the need to predict high risk or low risk pregnancies via the ultrasonographic features of detected pregnancy and to plan the routine check-ups accordingly. Hence, the clinician can protect the family and him/her
shelf, from unnecessary anxiety or optimism.

Fifty nine patients are included into the study who are within the 6th and 12th weeks of gestation according to the last menstrual period and those who are free of vaginal bleeding, inguinal pain and cramp-like symptoms and willing to complete the pregnancy to the term after a written approval of the patients has taken. At first visit it has been verified that the location of the gestational sac is intrauterine and presence
of fetal pole, and presence of embryonic fetal heart activity are ascertained with the use of endovaginal transducer (5 MHz transducer Toshiba 220 A SSA). At the Fetal Heart
Activity (FHA) (+) cases, the average of anterior-posterior and longitudinal diameters of the gestational sac in the sagittal plane and transvers diameter of the gestational sac in the coronal plane are registered as the mean gestational sac measurements. Crown-rump length is measured in the most convinient plane. The average of three measurements of yolk sac at the sagittal and coronal planes are taken as mean yolk
sac diameter and general morphology and wall thickness of yolk sac is also evaluated and registered.

All cases are recalled for for control and the maintenance of pregnancy is confirmed at the 12th and 20th weeks of gestation.
There was significant difference between the terminations of pregnancies in terms of yolk sac morphologies (p<0.001). Yolk sac was normal, regular and, rounded shaped in the 95.4 % of cases (42 cases) at whom a successful pregnancy outcome has been reached. But yolk sac was abnormal in the 78.6 % of unsuccessful pregnancies (11 cases).

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Akut miyokard infarktüsü sonrasý, % 40’ýn üstünde sol ventrikül ejeksiyon fraksiyonuna sahip, muhtemel çok damar hastalarýný erken tanýyabilmek amacýyla, infarktüsün 7-10. günleri arasý 30 hastada izometrik egzersiz öncesi ve sonrasý sol ventrikül sistolik zaman intervalleri olan preejeksiyon periyodu/sol ventrikül ejeksiyon zamaný oraný (PEP/LVET) ölçüldü. Daha sonra tüm hastalara koroner anjiyografi uygulanarak koroner anatomi belirlendi. Tüm hastalar dikkate alýndýðýnda izometrik egzersiz öncesi ve sonrasý (PEP/LVET) oranýnda anlamlý deðiþiklik saptanmazken, birden fazla proksimal koroner arterde % 50 diameterden fazla darlýðý olan hastalarda izometrik egzersiz sonrasý (PEP/LVET) oranýnýn anlamlý olarak uzadýðý saptandý.

In our study, (PEP/LVET) preejection period/left ventricle ejection interval times were measured in order to detect early multiple coronary vessel injuries with left ventricle ejection
fractions over % 40 after acute myocardial infarction. All patients were performed coronary angiography to asses coronary anatomy. As a result, in patients with more than % 50 multiple proximal coroner artery stenosis, PEP/LVET ratios were significantly prolonged after isometric exercise.

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Santral retinal ven týkanýklýðý olan hastalarda etkilenen gözlerde akým hemodinamiðinde oluþan deðiþiklikleri incelemek amaçlandý. Çalýþmamýzda santral retinal ven týkanýklýðý olan 20 hastanýn 20 gözü renkli doppler ultrasonografi cihazý kullanýlarak, santral retinal arterde pik sistolik hýz (PSV), end diyastolik hýz (EDV), pulsatilite indeksi (PI), rezistivite indeksi (RI), oftalmik arterde PSV, EDV ve santral retinal vende maksimum hýz (Vmax) deðerleri çalýþýldý.Elde edilen deðerler kontrol grubu deðerleri ve ayný hasta grubunun kontralateral göz deðerleri ile paired student-t testi kullanýlarak karþýlaþtýrýldý.

Hastalarýn 9’u (% 45) kadýn, 11’i (% 55) erkek ve yaþ ortalamasý 59.5±1.0 idi. Santral retinal arterde; PSV ve EDV deðerleri kontralateral göz grubu ve kontrol grubuna göre anlamlý derecede düþük bulundu (p<0.05), PI ve RI deðerleri yine kotralateral göz grubu ve kontrol grubuna göre anlamlý derecede yüksek bulundu (p<0.05). Oftalmik arterde; PSV ve EDV deðerlerinde kontralateral göz grubu ve kontrol grubuna göre anlamlý derecede farklýlýk saptanmadý (p>0.05). Santral retinal venden alýnan Vmax deðerleri kontralateral göz grubu ve kontrol grubuna göre anlamlý derecede düþük bulundu (p<0.05). Çalýþýlan bütün deðerler için, kontralateral göz grubu ve kontrol grubu deðerleri arasýnda istatistiksel olarak anlamlý farklýlýk yoktu.

Renkli doppler ultrasonografinin santral retinal ven týkanýklýðý olan hastalarda vasküler akým hemodinamiðinde oluþacak deðiþiklikleri deðerlendirebilecek yetide olduðu kanýsýna varýlmýþtýr.

In this study, our purpose is to examine the changes in ocular vascular flow hemodynamics. 20 eyes of 20 patients who had central retinal venous occlusion were evaluated by coloured doppler ultrasonography. Peak systolic velocities (PSV), end
diastolic velocities (EDV), pulsation index (PI), resitivity index (RI) in retinal artery, PSV and EDV in ophthalmic artery, maximum velocity (Vmax) in central retinal vein, results of patients with central retinal venous occlusion were compared to the results of control group and to the contralateral eyes of the same patients. Statical analyses were made by
paired student t test.

9 patients were female, 11 male and mean age of patients was 59.5±1.0. In central retinal artery; PSV and EDV result of pa-tients were statistically lower than control group and contra-lateral eyes of the same patients (p<0.05), PI and RI of pati-ents were also stastically higher than control group and contralateral eyes of the same patients (p<0.05). In ophthalmic artery, there were no statistically significant difference
for PSV and EDV results between study and control groups and also contralateral eyes of the study group (p>0.05). Vmax of central retinal vein were stastically lower
than Vmax of control group and contralateral eyes of the study group (p<0.05). For all these results there were no statistically significant difference between contralateral eyes of the study group and control group.

By coloured doppler ultrasonography, it is possible to evaluate vascular flow and hemodynamical changes in central retinal venous occlusion.

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Transfüzyon tedavisi beraberinde önemli komplikasyonlara yol açan demir birikimi ile, plazma ve lökosit askorbik asit düzeyleri arasýndaki iliþkiyi ve talasemi tedavisinde askorbik asitin yerini araþtýrdýk. 25 takipli hasta (13 kýz, 12 erkek) ve 21 saðlýklý çocuk (10 kýz, 11 erkek) çalýþmaya alýndý. Plazma ve lökosit askorbik asit düzeyleri dinitrofenil hidrazin metodu; serum ferritin düzeyleri EL‹SA metodu ile ölçüldü. Lökosit askorbik asit düzeyleri normal olan 14 hastanýn ferritin deðerlerinin ortalamasý 1211.94±179.92 ng/ml iken, lökosit askorbik asit düzeyi normalin altýnda olan 11 hastanýn ferritin deðerlerinin ortalamasý 1338.22±229.65 ng/ml idi (p>0.05). Plazma ve lökosit askorbik asit düzeylerinin azalmasýyla birlikte serum ferritin düzeylerinde yükselme gözlendi, ancak bu istatistiksel olarak anlamlý deðildi.

We investigated the relationship between iron loading, which causes important complications during transfusion therapy, and plasma and leucocyte ascorbic acid levels. 25 followed patients (13 female, 12 male) and 21 healthy children (10 female, 11 male) were studied. Plasma and leucocyte ascorbic acid levels were measured using the method of dinitrophenyl hydrazine and; serum ferritin levels were measured using the
ELISA method. While for 14 patients, whose leucocyte ascorbic acid levels were within normal range, had serum ferritin mean levels of 1211.94±179.92 ng/ml; for 11 patients, whose leucocyte ascorbic acid levels were lower than the normal range, had serum ferritin mean levels of 1338.22±229.65 ng/ml (p>0.05). Decreasing the plasma and leucocyte ascorbic acid levels, serum ferritin levels were found to increase, but it was not important statistically.

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Bu çalýþmada Fiziksel Týp ve Rehabilitasyon polikliniðine aðrýlý omuz yakýnýmý ile baþvuran ve çeþitli konservatif tedavi yöntemleri ile tedavi edilen 72 hasta retrospektif olarak deðerlendirildi.

Hastalara goniometrik ölçüm, manuel kas gücü deðerlendirmesi, rotator manþon ve bisipital tendon deðerlendirme testleri yapýldý. Omuz radyografileri ve ultrason tetkikleri görüldü. Hastalarýn tedavi öncesi ve tedavi sonrasý aðrýlarý vizüel analog skala (VAS) ile, fonksiyonel durumlarý Constant skorlamasý ile deðerlendirildi. Konservatif tedavi olarak hastalara istirahat, buz uygulamasý, medikal tedavi, fizik tedavi, egzersiz, subakromial injeksiyon ve mobilizasyon teknikleri uygulandý. Ýstatiksel deðerlendirmeler SPSS V.10 paket program kullanýlarak yapýldý. Tedavi öncesi ve sonrasý deðerler eþleþtirilmiþ t testi ile karþýlaþtýrýldý.

62 kontrole gelen hastanýn % 53.2’si kadýn, % 46.8’i erkekti. % 93.5 hastada dominant el sað iken sað omuzun etkilenme oraný % 40.3 idi. % 1.6 hastanýn bilateral omuz tutulumu mevcuttu. % 95 hastada rotator manþon testleri pozitifdi. Has-talarýn tedavi öncesi ve sonrasý deðerleri karþýlaþtýrýldýðýnda; VAS, goniometrik ölçüm ve fonksiyonel durumlarýnda (Constnat Skoru) istatistiksel anlamlý düzeyde iyileþme saptandý (p<0.001).

Omuz aðrýsý ile gelen hastalara uygulanan konservatif tedaviler ile etkin sonuçlar alýnmýþtýr. Tedavilerin etkinliklerinin birbirleri ile kýyaslanmasý için ise randomize, kontrollü çalýþmalara ihtiyaç vardýr.

72 patients that were submitted to the phsysical therapy and rehabilitation polyclinic with painful shoulder complaints were retrospectively studied in this study.

Goniometric measurements, manual muscle strength tests, rotator cuff and biceps tendon evaluation tests were performed on all patients. The shoulder radiograms and ultrasound
inspections were evaluated. The pain status of patients before and after treatment were evaluated with visual analog scales (VAS) and the functional states with Constant scores.
The conservative therapy consisted of rest, ice application, medical treatment physical therapy, exercise, subacromial injection and mobilization techniques. Statistical evaluations were performed with the SPSS v10 software. The pre and post treatment values were compared with the paired t test.
62 patients returned for a control examination (29 male and 33 female patients). % 93.5 of the patients were right-hand dominant and the rate of affected right shoulders were %
40.3-% 1.6 of the patients were affected bilaterally. Rotator cuff tests were positive in % 95 of the patients. When the values before and after treatment were compared, there were statistically significant improvements in VAS values, goniometric measurements and functional states (Constant scores) (p<0.001).
Significant results were obtained with the use of conservative therapy on patients with shoulder pain. Randomised and controlled studies are necesssary to compare the effectiveness of different treatment options.

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Diyabetli hastalarda serum glikoproteinleri ve buna paralel olarak sialik asit seviyelerinde deðiþiklik olmasý beklenir. Bu süreç ile diyabet süresi arasýnda iliþki vardýr. En az 5 yýl önce diyabet tanýsý almýþ olan 38 hasta çalýþmaya alýndý. Serum sialik asit düzeyleri enzimatik kolorimetrik metodla, idrarda mikroalbumin (MA) düzeyleri immünopresipitasyon metoduyla ölçüldü. Kontrol grubunda (n=18) sialik asit düzeyleri 61.8±5.7 mg/dl bulundu. MA negatif (13.1±3.8 mg/gün) olan hastalarýn bir grubunda (n=18) sialik asit düzeyleri 68.9±9 mg/dl bulundu. MA pozitif (127.6±98.3 mg/gün) olan diðer hasta grubunda (n=20), sialik asit düzeyleri 82.6±10.8 mg/dl bulundu. Diyabetik hastalarda metabolik kontrolü ve komplikasyonlarý izlemek için kan glukozu ve HbA1c dýþýnda bir parametre olarak sialik asit düzeylerini ölçebiliriz.

It’s expected in diabetic patients that changes in the levels of the serum glycoproteins and as a consequence changes in the sialic acid levels occur. There is a relation between this process and the duration of the time being diabetic. 38 patients, who had been termed as diabetes mellitus for at least 5 years, were studied. Serum sialic acid levels measured by using enzymatic colorimetric method, urine microalbumin levels were measured by using immunoprecipitation method. Group of control (n=18) had sialic acid levels of 61.8±5.7 mg/dl. One group of patients (n=18), who were MA negative (13.1±3.8 mg/day), had sialic acid levels of 68.9±9 mg/dl. The other group of patients (n=20), who were MA positive (127.6±98.3 mg/day), had sialic acid levels of 82.6±10.8 mg/dl. To observe the metabolic control and complications in diabetic patients we can measure the levels of sialic acid as a parameter other than blood glucose and HbA1c.

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N. cutaneus antebrachii lateralis (NCAL)’in anatomik seyrini tanýmlamak amacýyla Ege Üniversitesi Týp Fakültesi Anatomi Anabilim Dalý’nda formalinle fikse edilmiþ 50 adet kadavra örneðinde çalýþýldý. NCAL’in fascia brachii’yi delip yüzeyelleþtiði nokta, interepikondiler çizginin vertikal hat üzerinde ortalama 3±0.51 cm yukarýsýnda, transvers hat üzerinde ise lateral epikondilin ortalama 4.5±0.62 cm medialinde bulundu. Sinirin yüzeyelleþtiði bu seviyede, medialinde yer alan m. bi-ceps brachii’nin tendonunun 21 örnekte oldukça belirgin ol-duðu izlendi. 29 örnekte ise bu seviyede m. biceps’in daha muskuler olduðu, tendonunun daha alt seviyede belirginleþtiði görüldü. 50 kadavra örneðinin 37 adedinde NCAL’in terminal dallarý RS dallarý üzerinde uzanýyordu (overlap). 37 örneðin 10 adedinde RS ile NCAL ön dalý arasýnda direkt baðlantý vardý (complet overlap). 37 örneðin 27 adedinde bu iki sinir arasýnda direkt bir baðlantý yoktu, fakat NCAL ön ve arka dalý RS’in üzerinde örtüþerek birinci metakarpal kemiðin proksimaline kadar uzanýyordu (parsiyal overlap). 13 örnekte ise NCAL baðýmsýz olarak ön kol distaline kadar seyrediyordu. NCAL ön dalýnýn RS’in sadece tenar bölge, baþ parmaðýn radial kenarý ve birinci interosseoz aralýkta uzanan deri dalýyla baðlantý yaptýðý izlendi. Bu örneklerde NCAL’in klasik duyu alanýna ek olarak baþparmak duyusuna da katýldýðý düþünülmektedir.

This study was performed on 50 formalin fixed cadavers at Ege University Anatomy Department to demonstrate the course of lateral antebrachial cutaneus nerve (NCAL). The
point that NCAL pierced the fascia was on the vertical line 3±0.51 cm superior to interepicondylar line and 4.5±0.62 cm medial to lateral epicondyl on transvers line. The tendono of biceps brachii muscle was well-developed than expected in 21 samples at this level. The tendon of biceps muscle was inferior to this level in 29 samples. The terminal branches of NCAL were overlapped on the branches of superficial rami of the radial nerve (RS) in 37 samples of 50. There was a complete overlap between NCAL and RS in 10 samples of 37. There were no anastomoses between these two nerves in 27 of 37 but anterior and posterior rami of NCAL were overlapped on RS going towards proximal to the first metacarp (partial overlap). NCAL was alone in 13 samples and went to the distal
forearm. Anterior ramus of NCAL was connected with RS only lying to thenar area, radial side of the thumb and first interosseos area. It was thouht that NCAL was also attending
to the thumb sensitive innervation.

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Günümüzde TIPU proksimal hipospadias olgularýnda da tercih edilen bir yöntemdir. Bu çalýþmada 26 proksimal hipospadias olgusundaki TIPU sonuçlarý retrospektif olarak incelenmiþtir. Hasta seçiminde en önemli kriter üretral plate’in canlý ve saðlam olmasýydý. Hastalarýn 7’si re-do olgu idi. Tüm olgularda subkutan doku ile ikinci kat kapama uygulandý. Sadece 4 olguda komplikasyon ortaya çýktý ve bu olgulara sekonder giriþim uygulandý. Bir olgu dýþýnda tüm olgularda mükemmel kozmetik sonuç elde edildi.

TIPU proksimal hipospadias olgularýnda da mükemmel kozmetik sonuçlarla, güvenle uygulanabilecek bir yöntemdir.

Nowadays, tubularised incised plate urethroplasty (TIPU) is a preferred method even in the proximal hypospadias cases. We report our experience with this procedure in 26 patients retrospectively. The most important criteria in the selection of the patient for this procedure is the viable and supple appearence of the urethral plate. Seven of 26 patients were re-do cases. In all cases the urethroplasty was covered with an additional layer of subcutaneous tissue. In four cases complications were documented. In complicated cases, secondary
surgical management was performed. Cosmetic results were excellent except one patient TIPU procedure seems to be a reliable technique with excellent cosmetic results for the
treatment of proximal hypospadias as well.

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Bazý gastrointestinal hastalýklarla iliþkisi olan Helicobacter pylori, insanlarda sýk görülen bir patojendir. H pylori infeksiyonunun tanýsý için tartýþýlan yeni non-invaziv tekniklerin araþtýrýlmasý kapsamýnda, gaitadaki H pylori antijeni tespitinde kullanýlan bir EIA’yý (HpSA) deðerlendirdik.

Bu prospektif çalýþmada gastroskopi yapýlan 46 hastadan (23 kadýn, 23 erkek; yaþ aralýðý 18-70, ortalama 42) alýnan gaita örnekleri HpSA ile, endoskopik biyopsi örnekleri hýzlý üreaz testi ve histolojik olarak incelendi. Histoloji ve üreaz test pozitif olanlar Helicobacter pylori pozitif, negatif olanlar ise H pylori negatif olarak tanýmlandý. Belirlenen kriterlere göre H pylori infeksiyonu bulunan 33 hastanýn 30’u HpSA ile pozitif bulundu (duyarlýlýk % 90.9). Ýnfeksiyon saptanmayan 13 hastanýn 11’i HpSA ile negatif bulundu (özgüllük % 84.62).

Helicobacter pylori is a common human patogen implicated in certain gastrointestinal diseases. In the search for new non-invasive techniques to diagnose H. Pylori infection, we evaluated an EIA for H. Pylori antigen in stool (HpSA).

In this prospective study, stool specimens from 46 patients (23 women, 23 men; age range 18-70 years, mean 42) undergoing gastroscopy were tested with HpSA, endoscopic biopsies were tested rapid urease test and histological. Patients were defined as positive for Helicobacter pylori if histology and urease test were positive, as negative if histology and urease test were negative. Of 33 patients with H pylori infection by the predefined criteria, 30 were positive by HpSA (sensitivity 90.9 %). Of 13 patients without infection, 11 were negative by HpSA (specifity 84.62 %).

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Selim ve habis adneksiyal kitlelerin ayýrýmýnda ultrasonografi ve renkli doppler ultrasonografinin tanýsal deðerinin belirlenmesi.

1.4.200-15.3.2001 tarihleri arasýnda SSK Göztepe Eðitim Hastanesi Kadýn Hastalýklarý ve Doðum Kliniðine pelvik kitle ön tanýsý ile yatan ve operasyon endikasyonu verilen 61 hastaya selim-habis ayýrýmý için ultrasonografi, ve renkli doppler ultrasonografi yapýldý. Bu testlerin kullanýmý ile her bir testin duyarlýlýk, özgüllük, pozitif öngörü deðeri (PPD) ve negatif öngörü deðeri (NPD) oranlarý belirlendi.

Sasone ultrasonografik skorlama sistemine göre eþik deðer 9 ve renkli doppler incelemede PI (pulsatýlite in-deks) için eþik deðer <1 ve RI (rezistans indeks) için eþik de-ðer <0.4 alýndýðýnda elde edilen bulgular; ultrasonografi skoru için duyarlýlýk % 69.23, özgüllük % 91.67, PPD % 69.23 ve NPD % 91.67; PI için duyarlýlýk % 92.3, özgüllük % 69.7, PPD % 48 ve NPD % 96.7 ve RI için duyarlýlýk % 46.2, özgüllük % 88.4, PPD % 54.5 ve NPD % 84.4 idi.

Yüksek duyarlýlýk, özgüllük ve PPD saptanan ultraso-nografik deðerlendirme jinekolojik pratikte kullanýlmalýdýr. Doppler deðerlerinde mutlak bir sonuç oluþturulamasa da US verileri ve klinik bulgular ile birlikte deðerlendirilmesi görüþündeyiz.

To determine the dignostic value of ultrasonography and color doppler ultrasonography in discriminating benign and malign adnexinl masses.

To discriminate the benign and ma-lign masses; ultrasonography and color doppler ultrasonography were perhormed to 61 patients who were hospitalized in SSK Göztepe Maternity hospital in between 1.4.2000-15.3.2001 and who had taken the operation ind›cation. With the use of these tests we determined the sensitivity, spesificity, positive predictive value (PPV) and negative predictive value (NPV) of each tests.

With the threshold values, in Sassone ultrasonographic scoring system 9 for PI in colour Doppler examination <1 and for PI in color Doppler examination <0.4, the obtained
results were as following: In ultrasonographic scoring the sensitivity, the specifity, PPV and NPV were 69.23 %, 91.67 %, 69.23 % and 91.67 %, for PI sensitivity, the specifity, PPV and NPV were 92.3 %, 69.7%, 48 %, 96.7 % and for RI 46.2 %, 88.4 % 54.5 %, 84.4 % respectively.

Ultrasonographic evaluation with its assessed high sensitivity and PPD should be used in gynaeccoloical practice. We consider that, although an absolute value can not be elicited in Doppler values, it should be evaluated with ultrasonographic data and clinical findings.

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Mixed connective tissue disease is an autoimmune multisystemic disease which is presented rarely in the childhood period. It is characterised by overlapping clinical features similar
to those of SLE, Scleroderma and Polymyositis/Dermatomyositis and very high titers of circulating antinuclear antibody to a nuclear ribonucleoprotein (RNP) antigen. Hence it can
be sometimes misdiagnosed as JRA, SLE or Scleroderma. This case is reported both becouse of this property and rare presentation in the childhood period.

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Transient electrocardiographic changes in patients with acute cholecystitis, pancreatitis, pneumonia and septic shock have been reported in the past 70 years. These changes usually are in the form of T-wave inversion, ST-segment depression, and rarely ST segment elevation in the absence of coronary heart disease. A vagally mediated cardio-biliary reflex is the presumed cause of these changes. Three cases was diagnosed as acute cohlecystitis, acute pancreatitis and septic shock presented with literature as a review. The signs and symtomps of gallbladder and heart disease may overlap, making diagnosis diffucult. In patients with known coronary heart disease and acute cholecystitis, the surgeon shouldn’t be discouraged from cholecystektomi merely because of questionable electrocardiogram. Undue delay in treatment while awaiting the
result of the cardiac screen may result in both cardiac and septic complications. Dopamine and dobutamine infusion induced coronary vasoconstriction should be use carefully in patients with septic shock.

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In pediatric urology, cryptorchidism is frequent condition and nearly 20 % of the undescended testes are non-polpable and are localized within in the distal end of the inguinal ring or intraabdominally. Laparoscopy has been a very useful diagnostic tool in these patients who have always been challenging to manage.

In this study, we retrospctively evaluated our initial experiences of diagnostic laparoscopy in the dignosis of non-palpable testes.

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Robert’s syndrome is a rare autosomal recessive disorder characterized primarily by symmetric reduction anomalies of all lims, prenatal and postnatal growth retardation and craniofacial abnormalities. A diagnosis of Robert’s syndrome clinical and genetical features was made. This disease is presented because it is seen rarely.

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Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. The majority of MD cases are asymptomatic although they can, occasionally, cause complications such as bleeding, intestinal obstruction and inflammatory process. The diagnosis is difficult and it usually made at surgery. The treatment in symptomatic MD is surgical resection while there are arguments about the
treatment of asymptomatic MD. The study concerns 9 cases of MD. 7 patients were males and 2 patients were females. The ages of the patients range from 21 to 59. The most common complication was diverticulitis in 7 patients. The diverticulectomy was made in all patients. There was not operative mortality and morbidity. We believe that diverticular complications are important; on account of this low postoperative mortality and morbidity, in the absence of containdications, we recommend surgical resection in the cases of asymptomatic MD also.

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Laurence Moon Bardet Biedl is a congenital syndrome which is rarely seen and accompanied by multipl anomalies including skeleton and viscera.

This case report describes the presentation of a child with Bardet-Biedl syndrome. Bardet-Biedl syndrome is an autosomal recessive condition that includes retinal dystrophy, dystrophic extremities (commonly polydactyly), obesity, hypogenitalism, and renal disease. Cognitive deficit has also been considered part of the syndrome. The most common feature of Bardet-Biedl syndrome is retinal dystrophy. The renal disease often goes undetected until specific radiological testing is done after diagnosis of Bardet-Biedl syndrome. This is significant in that early death often occurs in this condition because
of the renal disease. A twelve year old male patient with Laurence Moon Bardet Biedl syndrome was reported and literature was reviewed.

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The most common intracranial complication of sinusitis is orbital cellulitis. Another extracranial complication of sinusitis is frontal supperiostal abscess from frontal sinusitis. Intracranial complication such as epidural abscess, subdural empyema, meningitis, cerebral abscess, and dural-vein thrombophlebitis may result from sinusitis, particulary from frontal or sphenoid infections. Here we report a patient who was with complications from frontal and ethmoid sinuzitis which was with periorbital sellulitis, subdural amphyem and frontal
sinus perforation.

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Atypical bronchial carcinoids are rare tumors. They have distinct clinicopathological features than typical carcinoids. Atypical carcinoids behave more aggressively compared to typical carcinoids. Two cases of atypical bronchial carcinoid are presented.

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Spondylothoracic dysplasia is a syndrome that is due to a defect during the segmentation process of the axial system presenting with multiple vertebral and costal malformation.
Majority of affected individuals die in the infancy with cardiopulmonary insufficiency. The chief features of this syndrome are; short trunk with short neck and “crab-like” rib cage, spina bifida, multiple vertebral and rib defects. Our case is presented to the clinic with respiratory distress. In his x-ray of thoracic cage, multiple costavertebral defects are detected. In his spinal MRI images, cervical and lomber lordosis, dorsal kyphosis, scoliosis, generalized butter-fly and hemivertebra anomalies are identified. This case is diagnosed
with his clinical and imaging findings as spondylothoracic dysplasia and reported due to its rarity in the neonatal period.

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