Bu çalýþmada, allerji polikliniðinde izlenen solunum yolu alerjisi olan 50 hasta deðerlendirildi. Olgulara Allergo Pharma firmasýna ait allerjen ekstreleri ile prick testi, serumda EIA metodu ile Biochem-Ýtalia-ALLERgen kitleri ile spesifik ÝgE ölçümleri ve dýþkýda parazitolojik inceleme yapýldý. Deri testlerinde en yüksek duyarlýlýklar ev tozu akarlarýna (% 70-72) ve hamam böceði antijenine karþý (% 44) bulundu. Total ÝgE hastalarýn % 80’inde yüksekti. Spesifik ‹gE deðerleri D. Pteronyssinus için % 52, D. Farinea için % 48, küf mantarlarý için % 2, polenler için % 2 hastada yüksek bulundu. Ev tozu akarlarý için deri testi pozitiþiði ile spesifik ÝgE deðerleri arasýnda anlamlý korelasyon bulunduðu halde diðer antijenler için anlamlý iliþki bulunmadý. Hastalarýn % 2’sinde dýþkýda parazit tespit edildi.

Sonuç olarak solunum yolu allerjilerinin tanýsýnda prick testinin en deðerli metod olduðu, spesifik ‹gE ölçümünün özel koþullarda yapýlmasýný ve bu hastalarda parazit enfestasyonlarýna az sýklýkla rastlandýðýný söyleyebiliriz.

In this study 50 respiratory allergic patients were evaluated. Prick test were performed by using allergen extracts of Allergo Pharma, spesific IgE values in serum were measured
with Biochem-Italia ALLERgen kits and stool specimens were examined for parasite. The highest sensitivities were for house dust mites (% 70-72) and cockroach antigens (% 44).
Total IgE values were high in 80 % of patients.

Spisific IgE were high fo D. Pteronyssinus. D. Farinea, molds and polens, % 52, % 48, % 2, % 2 respectively. Significant corelation was found for prick tests and specific IgE values
for mites; whereas there was not any corelation for other antigens. Only one (% 2) stool specimen were positive for parasite. In summary, we conclude that prick test is the most
valuable test for allergy diagnosis, spesific IgE may be asked under special conditions and parasites are found in a small of these patients.

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Çalýþmamýz, rokuronyumun farklý indüksiyon ajanlarýyla intubasyon kalitesi ve intubasyona hemodinamik yanýt üzerindeki etkilerini araþtýrmayý amaçlamaktadýr.

Hastanemiz Etik Kurul onayýndan sonra ASA I-II 80 hasta eþit 4 grup halinde çalýþmaya dahil edildi. Anestezi indüksiyonu Grup P’de 5 mg kg-1 tiyopental sodyum, Grup E’de 0.3 mg kg-1 etomidat, Grup PR’de 2 mg kg-1 propofol ve Grup NLA’da 0.005 mg kg-1 fentanil ve 0.1 mg kg-1 dehidrobenzperidol ile gerçekleþtirildi. Ýlk üç grupta indüksiyon ajanýna 0.001 mg kg-1 fentanil ilave edildi. Olgularýn tümünde endotrakeal intubasyon 0.6 mg kg-1 rokuronyumla 60 sn içinde gerçekleþtirildi. Ýntubasyon skoru, kalp atým hýzý, arter kan basýncý (sistolik: SAB, diyastolik: DAB); indüksiyondan hemen önce (T0), intubasyondan 1 ve 5 dk sonra (T1,T2) kaydedildi.

Gruplar arasýnda iyi-mükemmel intubasyon skor yüzdeleri benzerdi. Hemodinamik veriler açýsýndan kan basýncý deðiþimleri grup içi ve gruplar arasýnda anlamlý bulunmadý. Kalp atým hýzý PR grubunda intubasyondan 5 dk sonra NLA grubuna göre anlamlý oranda (p<0.05) yüksekti. Bu bulgu klinik açýdan önemsiz bulundu.

Sonuç olarak, uygulanan indüksiyon ajanlarýnýn rokuronyumun intubasyon kalitesi ve intubasyona hemodinamik yanýt üzerinde anlamlý etkisinin bulunmadýðý kanýsýna varýldý.

After Hospital Ethical Commitee’s approval, 80 ASA I-II patients were included into this study in equal 4 groups (n: 20). Anaesthesia induction was performed with 5 mg kg-1
thiopental sodium in Group P, 0.3 mg kg-1 etomidate in Group E, 2 mg kg-1 propofol in Group PR and 0.005 mg kg-1 fentanyl+0.1 mg kg-1 dehydrobenzperydol in Group
NLA.0.001 fentanyl was added to the induction agent in the first three these groups. In all patients tracheal intubation was done with 0.6 mg kg-1 rocuronium within 60 seconds. The
intubation score, heart rate, arterial blood pressures (systolic: SBP, diastolic: DBP) were recorded before the induction (t0); 1 and 5 min after endotracheal intubation (T1-T2).
Good-excellent intubation score percentages were similar between the groups. By the mean of haemodynamic data, blood pressure changes (SBP, DBP) didn’t found to be significant within and between the groups. Heart rate was significantly higher in group NLA 5 min after intubation (p<0.05). This finding was not clinically important.

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Çalýþmamýzda klinik ve sitogenetik olarak Down sendromu tanýsý konan olgulardaki konjenital kalp anomalisi sýklýðýný araþtýrdýk.

Çalýþmamýzý 01.01.2000-31.12.2000 tarihleri arasý SSK Bakýrköy Doðumevi Kadýn ve Çocuk Hastalýklarý Eðitim Hastanesi polikliniklerine baþvuran, servislere yatarak tedavi gören, Kadýn Hastalýklarý ve doðum Kliniði’nde doðumu gerçekleþtirilen klinik ve sitogenetik olarak Down sendromu tanýsý konan 48 olguluk bir grup üzerinde gerçekleþtirdik. Hastalarýn tümüne ekokardiyografi yapýldý.

Çalýþmaya alýnan 48 olgunun 21’inde konjenital kalp anomalisi saptandý. Bu 21 olgunun 10’u erkek, 11’i kýz idi.

Sonuçlarýmýzdaki konjenital kalp hastalýðý sýklýðý göz önüne alýndýðýnda, Down sendromlu olgulara rutin olarak ekokardiyografi yapýlmasý gerekliliði ortaya çýkmaktadýr.

In our study, we considered cases in which Down syndrome was diagnosed clinically and cytogenetically. We investigated the frequency of congenital heart anomalies in these cases.

We made our study on a group of 48 cases Down syndrome was diagnosed clinically and cytogenetically. These cases were chosen from those that applied to SSK Bakýrköy
Maternity Hospital between 01.01.2000 and 31.12.2000, that were hospitalized in various department and that were born in delivery department.

In 21 out of 48 cases which were studied, congenital heart anomalies was detected. Of these 21 cases 10 were males, and 11 were females. When the frequency of congenital heart anomalies is taken into consideration, we can conclude that there is a need to make echocardiography to these having Down syndrome on a routine basis.

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Diz eklem hastalýðýnýn son döneminde tedavi açýsýndan çok önemli bir yaklaþým olan total diz artroplastisinde (TDA) postoperatif rehabilitasyon ile ilgili pek çok çalýþma yapýlmasýna raðmen preoperatif egzersizin etkinliðine yönelik araþtýrmalar sýnýrlý kalmýþ ve TDA’da preoperatif egzersizin rolü belirlenememiþtir. Bu konuyu araþtýrmak üzere diz osteoartriti tanýsý alan ve ortopedi kliniðince TDA planlanan 30 hasta iki gruba ayrýldý. Birinci gruba ayrýlan 15 hastaya önce preoperatif sonra postoperatif rehabilitasyon programý uygulandý. Ýkinci gruba ayrýlan 15 hastaya sadece postoperatif refabilitasyon programý uygulandý. Olgularýn demografik özellikleri, vücut kitle indeksleri, vizüel analog skala ile aðrý durumlarý sorgulandý. Kas güçleri manuel olarak ölçüldü. Preoperatif 6. hafta ve 1. haftada ve postoperatif 3, 6 ve 12. haftalarda deðerlendirildiler. Bu deðerlendirme için Knee Society Deðerlendirme Formu esas alýndý. Knee Society ile aðrý, eklem hareket açýklýðý (EHA), instabilite, deformite, fonksiyonel kapasite deðerlendirildi.Her iki grubun da postoperatif olarak aðrýlarýnda belirgin azalma olmuþ, fonksiyonel skorlarý yükselmiþ, fakat eklem hareket açýklýðý, yürüme mesafesi ve merdiven kullanýmýnda anlamlý deðiþme olmamýþtýr. Gruplar arasýnda da bir fark tesbit edilmemiþtir. Hastalar preoperatif egzersizden fayda gördüklerini ifade etmelerine raðmen bu verileri destekleyen kanýt yoktur.

A very important approach in the treatment of knee joint disorders is total knee arthroplasty (TKA). Although there are many studies on postoperative rehabilitation with TKA, studies on the effectiveness of exercise has not been determined. 30 for TKA in our orthopedics clinic were separated into two groups for further evaluation. Patients in the first group received both preoperative and postoperative rehabilitation programmes. The second patient group received only a postoperative rehabilitation programme. The demographic characteristics, body mass indexes and pain evaluations with visual analog scale of all cases were recorded. Muscle strength were measured manual. The cases were evaluated in the 6. and 1. postoperative weeks and in the 3., 6. and 12. postoperative weeks. For this evaluation the Knee Society Clinic Evaluation Form was used. Pain, range of motion (ROM), instability, deformity and functional capacity were
evaluated with Knee Society Clinic Evaluation Form.In both groups, there was a significant decrease in pain complaints and increase in functional scores in the postoperative period. There were no significant changes in ROM, walking distance
and stair climbing between the two groups. Both groups appeared to be similar. Although the patients express that they have been benefited from preoperative exercise there
were no evidences to support this idea.

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Kronik böbrek yetersizlikli hastalarda kardiyovasküler mortalite ve morbititenin önemli nedenlerinden biri, bu hastalardaki lipid metabolizmasý bozukluðudur. Üremik dislipidemi
yüksek veya normal total kolesterol, düþük HDL kolesterol ve yüksek trigliserid düzeyleri ile karakterizedir. Renal replasman tedavisi alan hastalarda da serum lipid profilindeki bozukluðun devam ettiði bilinmektedir. Bu çalýþmanýn amacý, hemodiyaliz ve periton diyalizinin serum lipid profili üzerine etkisini araþtýrmaktýr.

Hemodiyaliz ve SAPD programýnda olan hastalar çalýþmaya dahil edildi.Sonuçlar SAPD grubunda hemodiyaliz grubuna göre serum total kolesterol, LDL kolesterol ve trigliserid düzeylerinin daha yüksek olduðunu gösterdi, fakat aradaki fark istatistiksel olarak anlamlý deðildi.

Sonuç olarak, renal replasman tedavisinin tipi lipid profilini etkileyebilir ve bu sorunun cevabýný verebilmek için daha geniþ randomize çalýþmalara gereksinim vardýr.

One of the important reasons of cardiovascular mortality and morbidity in patients with chronic renal failure is the disturbed lipid metabolism. Uremic lipidemia is charecterized by
high or normal total cholesterol, low HDL cholesterol and high trygliseride levels. It is known that disturbances in serum lipid profile persist despite renal replacement therapy. The aim of this study is to assess the differences between the effect of hemodialysis and peritoneal dialysis on serum lipid profile.

Patients, who were in the hemodialysis or CAPD program, were enrolled in the study. The results showed that serum total cholesterol, LDL cholesterol and trygliseride levels are
found higher in CAPD group than hemodialysis group, but the differences were not statistically significant.

In conclusion the type of renal replacement therapy could effect the serum lipid profile and it seems that larger randomised controlled trials are needed to reply this question.

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Tubularize insizyonel plate üretroplasti (TIPU) tekniðinin nüks hipospadias tamirindeki sonuçlarýmýzý retrospektif olarak deðerlendirdik. Çalýþmaya, kliniðimizde Nisan 1994 ve Aralýk 2001 tarihleri arasýnda baþarýsýz hipospadias tamiri nedeni ile baþvuran ortalama yaþý 6.7 (17 ay-15 yaþ arasý) olan 32 hasta dahil edildi. Tüm hastalara en azýndan bir kez hipospadias tamiri uygulanmýþtý. Preoperatif mea yerleþimi 24’ü distal, 4’ü midpenil ve 4’ü proksimal penil idi. Tüm hastalarda uygulanan cerrahi yöntem orijinal olarak tanýmlananla ayný idi ve üretral stent (8-12 F silastik) kullanýldý. Hafif kordi olan olgularda dorsal plikasyon uygulandý. TIPU tekniði ile 30 hastada fonksiyonel neoüretra ve kozmetik görünümü normal meatus oluþturuldu. Beþ hastada (% 15.6) komplikasyon oluþtu, bunlar; 4 hastada üretral fistül (% 12.5), 3 hastada ilaveten meatal stenoz (% 9.3), 1 hastada glans ve neoüretrada ayrýlma ve balanitis kserotika obliterans (% 3.1) idi. TIPU, nüks hipospadias olgularýnda baþarý ile uygulanabilir. Daha önceki cerrahi giriþimdeki üretral plate insizyonu, üretral plate canlý ve esnek görünümde ise kontrendikasyon oluþturmamaktadýr.

We retrospectively assessed the results of tubularized incised urethroplasty (TIPU) in a series of reoperative hypospadias repair in children. The study comprised of review (from April 1994 until December 2001) of 32 patients (mean age 6.7 years, range 17 months to 15 years) who had at least one previous hypospadias repair. The location of meatus at reoperation was distal penile in 24 patients, mid-penile in 4, and proximal penile in 4. The TIPU repair was undertaken as previously described for primary surgery. All patients were stented (8-12 F silastic). The dorsal plication was used to correct mild chordee. TIPU resulted in a functional neourethra and a cosmetically normal meatus in 30 of the 32 patients. Five patients (15.6 %) had complications. A urethrocutaneous fistula
occurred in 4 patients (12.5 %), of whom 3 (9.3 %) had meatal stenosis. One patient (3.1 %) had glans dehiscence and balanitis xerotica obliterans. TIPU can successfully used
for hypospadias reoperation. Previous incision of the urethral plate was not a contraindication in these selected cases in which the urethral plate appeared supple.

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Ýnflamasyon ve ASCUS smear sonucu olan olgularda kolposkopi ve kolposkopik biyopsi sonuçlarýnda displazi oranýný araþtýrmak amacýyla bu çalýþma planlandý.

Bethesda sistemine göre smear neticesi selim (inflamasyon) olan 56 ve ASCUS tespit edilen 13 hastaya kolposkopi ve kolposkopi eþliðinde biyopsi ve endoservikal küretaj uygulandý. Bu hastalardan elde edilen materyaller histopatolojik olarak deðerlendirilerek displazi oranlarý saptandý.

Selim karakterdeki smear neticeleri olan olgularýn yapýlan biyopsilerinde en fazla kronik servisit (% 59) gözlendi. Bu kiþilerin % 10.7’sinde CIN I ve % 1.7’sinde CIN II-III histopatolojik taný sonucu geldi. ASCUS smear sonucu olan olgularýn yapýlan biyopsilerinde en fazla (% 30.7) metaplazi sonucu geldi. % 15.4 oranýnda CIN I ve yine % 15.4 oranýnda CIN II-III histopatolojik taný sonucu gözlendi.

Selim karakterdeki smear neticeleri olan olgularýn yapýlan biyopsilerinde orta ve yüksek dereceli displazik epitel gösteren olgular % 1.7 olduðu için, rutin smear kontrolleri yapmak ve smear alýnýþ tekniðini ve zamanýný doðru uygulayarak yanlýþ negatif sonuçlarý azaltmak, gerek harcanan zaman gerekse maliyet açýsýndan en doðru yaklaþým olacaktýr. ASCUS smear sonucu ile baþvuran kiþilerdeki orta ve yüksek dereceli displazik epitel sýklýðý saptamak için daha fazla olgu ile yapýlacak çalýþmalara ihtiyaç vardýr.

The purpose of this study is to investigate the displasia rates of colposcopy and colposcopy directed biopsy results in the cases with inflammation and ASCUS smear results.

The patients that their smear has been detected benign (inflammation) and ASCUS according to Bethesda system had undergone colposcopy and colposcopy-directed biopsy and endocervical curettage. Of the cases that have been included in our study, 56 had inflammation and 13 have ASCUS smear results.

In the biopsies that have been obtained from the cases with smear results in benign character, it has been observed chronic cervicitis at most (59 %). 10.7 % and 1.7 % of those persons had CIN I and CIN II-III histopathological diagnosis results, respectively. In the biopsies that have been obtained from the cases with ASCUS smear results, it has been detected metaplasia at most (30.7 %) CIN I and CIN II-III histopathological diagnosis results have been observed in 15.4 % and still 15.4 % ratios, respectively.

Because the cases with benign smears showing moderate and high grade displastic epithelium is 1.7 %, obtaining routine smear controls and decreasing the false negative results by applying smear obtaining technique and its time correctly will be the most accurate approach for both spending time and cost. To detect the incidence of moderate to high dysplastic epitelium in the patients who has admitted with ASCUS smear
results,it is necessary to make studies with more cases.

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Ayakta küçük parmaklar olarak adlandýrýlan 2., 3. ve 4. parmaklarda geliþen deformitelerde kliniðimizde uyguladýðýmýz cerrahi tedavi sonuçlarýný deðerlendirdik.

1999-2002 yýllarý arasýnda ayak küçük parmak deformitelerine yönelik cerrahi tedavi uygulanan 56 hastanýn 68 ayaðý çalýþmaya dahil edildi. Hastalarýn 48’i kadýn, 8’i erkek idi. Deformitelerin 42’si (% 61) sol, 22’si (% 39) sað tarafta idi. Toplam 106 parmaða cerrahi giriþim uygulandý. Bunlar;78 çekiç parmak, 22 tokmak parmak ve 6 pençe parmak deformitesi idi. Parmaklarýn tümüne lokal anestezi altýnda patolojinin anatomik yerine uygun olarak parsiyel falanks rezeksiyonu ve bir adet Kirschner teli ile fiksasyon uygulandý; 3 hafta sonra Kirschner teli çýkarýldý. Ortalama takip süresi 19 ay (5-32 ay) idi. Hiçbir hastada infeksiyon ve cilt nekrozu görülmedi. Hastalar ayakkabý giyme sorunlarý, kozmetik yakýnma ve aðrý varlýðýna göre deðerlendirildi. 46 (% 82) hasta sonuçtan memnun idi.

Küçük parmak deformitelerinde deformite yerinin doðru bir þekilde tespiti ve deðerlendirilmesi hasta memnuniyetinin en önemli gerekliliðidir.

Surgical Treatment of Lesser Toe Deformities of the Foot To evaluate the results of surgical treatment of foot lesser toe deformities.

Fifty-six patients (sixty-eight feet and one hundred six toes) with lesser toe deformities were treated between 1999-2002. Fourty-eight (% 85) of the patients were female and forty-two of deformities were in the left foot. There were 78 (% 74) hammer toe, 22 (% 21) mallet toe and 6 (% 5) claw toe deformities. Under local anaesthesia partial phalangeal resection and fixation with one Kirschner wire were applied for all deformities. Kirschner wire was removed after three weeks. Avarage length of follow-up was nineteen months (5-32 months). None of the patients had wound infection or necrosis. The results were excellent in 46 (% 82) patients.

The correct detection of the level of deformities is most important point for patient satisfaction.

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Bu çalýþmada diabetes mellituslu olgularda serum immünglobulin düzeyleri ile mikrovasküler komplikasyonlar, glukoz regülasyonu diabet süresi ve tedavi rejimleri arasýndaki iliþki araþtýrýldý. 84 tip II diabet (yaþ ortalamasý: 53.4±11.7) ve 38 nondiabetik (yaþ ortalamasý: 49.2±14.8) çalýþmaya alýndý. Olgularýn klinik ve biyokimyasal de¤erleri kaydedildi. Serum immünglobulin düzeyleri ölçüldü.

Diabet süresi 10 yýldan fazla olanlarda, IgA düzeyi, kontrol grubu ve diabet süresi 10 yýldan az olanlara göre yüksek bulundu (p<0.05). IgG, IgM ve IgE düzeyleri arasýnda diabet süresi ile iliþki bulunmadý. Kötü kontrollü diabetiklerde (HbA1c >% 10), IgA düzeyleri di¤er olgulara göre anlamlý derecede yüksekti (p<0.05). Glukoz regülasyonu ile IgM, IgG ve IgE düzeyleri arasýnda iliþki bulunmadý. Nefropati, nöropati,ve retinopati ile komplike olan diabetiklerde, IgA düzeyi anlamlý oranda yüksekti (p<0.05). Retinopatisi ve nöropatisi olanlarda IgG düzeyi düþük saptandý. Ýnsulin kullanan hastalarda IgA düzeyi kontrol grubuna göre yüksek bulundu. Sonuç olarak bu çalýþma, diabetiklerdeki yüksek IgA düzeyi ile diabetik mikrovasküler komplikasyonlarýn, diabet süresinin ve glukoz regülasyonunun arasýnda bir iliþki oduðunu düþündürmektedir.

To investigate the relationship between immunoglobulin levels and microvasculer complications in diabetic patients, 82 type 2 diabetic patients were involved in our study and 38 non-diabetic patients were involved as a control group. They were classified according to diabet period, insulin or oral antidiabetic treatment duration, HbA1c, immunoglobulin levels, microalbuminurea, neuropathy and rethinopathy presence.

IgA level in patients with diabet period more than 10 years were higher than the patients in control group and the patients with diabet period less than 10 years (p<0.05). No relationship was found between IgG, IgA, IgE levels and diabet period. IgA level of inproper treated diabetics were significantly higher (p<0.05) than the others IgG level in patients with rethinopathy and neuropathy was low.

According to our study, it seems that in diabetic patients there is a relationship between high IgA and diabetic microvascular complications, diabets period and glucose regulation.

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Bu çalýþmada, egzema prevalansýný ve etkileyen risk faktörlerini araþtýrmayý amaçladýk. Çalýþma, 6-18 yaþ arasýndaki okul çaðý çocuklarý rasgele seçilerek yapýldý. Soru listesi, International Study of Asthma and Allergies In Childhood (ISAAC) soru listesi temel alýnarak oluþturuldu.

Adana’da 3164 (% 51.9 kýz, % 48.1 erkek), Payas’ta 1353 (% 50.5 kýz, % 49.5 erkek) öðrenci çalýþmaya dahil edildi. Egzema prevalansý; Adana’da % 8.3, Payasta ise % 9.3 olarak saptandý. Bu iki yerleþim birimindeki fark istatistiksel olarak anlamlý deðildi (p=0.27). Ailesel atopi, allerjik rinit ve astýmýn öðrencide bulunmasý, Adana ve Payas’taki çocuklarda egzema için risk oluþturmaktaydý (P<0.00001). Bununla birlikte, son 12 ayda ve daha önce sinüzit, rinit tanýsý alanlar ve bronþit enfeksiyonu geçirenler ve evde nem olmasý egzema için her iki yerleþim birimindeki çocuklarda risk faktörü olduðu görüldü. Adana’daki öðrencilerde 15-18 yaþ gurubuna göre, 6-10 yaþ grubundaki çocuklar ve evde bir paket ve üzerinde sigara içilmesi egzema için riskli iken, Payas’taki öðrenciler için herhangi bir risk saptanmadý. Her iki yerleþim birimi için; ýsýnma þekli, cinsiyet, evde hayvan beslenmesi, evde sigara içilmesi ve babanýn sigara içmesinin bir risk oluþturmadýðý saptandý (P>0.05). Payas’taki çocuklar için ise annenin sigara içmesi, çocuklarýn tüylü oyuncaðýnýn olmasý egzema için risk oluþtururken (p<0.05), Adana’daki çocuklarda risk saptanmadý (p>0.05).

The aim of this study was to determine the prevalence of eczema and factors affecting eczema among schoolchildren in Adana and Payas, Hatay. The prevalence survey was conducted in schoolchildren aged 6-18 years old. The questionnaire was based on the ISAAC questionnaires and was distributed among primary and secondary schoolchildren.
If the children were younger than 12 years of age their parent completed the questionnaire.

This study was done among 3164 students in Adana (51.9 % boys, 48.1 % girls) and among 1353 students in Payas (% 49.5 boys, 50.5 % girls). The prevalence of eczema was found 8.3 % in Adana and 9.3 % in Payas. The family histories of atopy, dampness at home, allergic rhinitis, bronchitis, rhinitis, history of frequent sinusitis, rhinitis and sinusitis in the last year were found to be significantly higher in both cities. On the other hand, the heating systems, sexuality, father smoking habits, the smoking habits at home, presence of domestic animals at home weren’t important for eczema in both the cities. In addition toys made out of feather’s, smoking habits among mother’s were found to be significantly higher for eczema in Payas, but it wasn’t same for Adana. In comparison to children aged 15-18 years among eczema children, the age group 6-10 and one or more packet of cigarette smoking at home was higher risk in Adana but there weren’t
the same risks among student in Payas.

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Bu çalýþmada, katarakt cerrahisinden sonra oluþan arka kapsül kesafetinin tedavisinde kullanýlan YAG-lazer kapsülotomi iþleminin, göz içi basýncý üzerine etkisi ve % 0.5’lik apraklonidin uygulamasýnýn etkinliðinin deðerlendirmesi amaçlanmýþtýr.

Ocak ile Mayýs 2000 tarihleri arasýnda SSK Göztepe Eðitim Hastanesinde takip edilen 62 hastanýn 62 gözü çalýþma kapsamýnda deðerlendirilmiþtir. YAG-lazer kapsülotomi sonrasý apraklonidin verilen 36 hasta birinci grubu, ilaç verilmeyen 26 hasta ikinci grubu oluþturmuþtur. Hastalarýn, iþlem öncesi ve iþlem sonrasý 1. saatte, 24. saatte ve 72. saatte göz içi basýnçlarý Goldman applanasyon tonometresi ile ölçülmüþtür.

% 0.5’lik apraklonidin verilen 1. gruptaki hastalarýn ortalama göz içi basýnçlarý, iþlem öncesi 16.9 mmHg, iþlem sonrasý 1. saatte 14.4 mmHg, 24. saatte 15.4 mmHg, 72. saatte 14.5 mmHg bulunmuþtur. ‹laç verilmeyen 2. gruptaki hastalarýn ortalama göz içi basýnçlarý, iþlem öncesi 12.8 mmHg, iþlem sonrasý 1. saatte 16.4 mmHg, 24. saatte 16.6 mmHg, 72. Saatte 18.2 mmHg olarak ölçülmüþtür.

Sonuç olarak, % 0.5’lik apraklonidin’in YAG-lazer kapsülotomi sonrasýnda artan göz içi basýncýnýn düþürülmesinde etkili olduðu görülmüþtür.

Our purpose is to search the effect of YAG-laser posterior capsulotomy and 0.5 % apraclonodine to the change in intraocular pressure.

Between January and May 2000, 62 eyes of 62 patients were included in this study. 36 eyes were treated by apraclonidine, 26 eyes were not treated after YAG-laser capsulotomy. Intraocular pressures were measured before and after capsulotomy on the first, 24th and 72th hours by Goldmann applanation tonometry.

36 eyes were given 0.5 % apraclonidine head a mean intraocular pressure of 16.9 mmHg before the capsulotomy, 14.4 mmHg on the 1st, 15.4 mmHg on the 24th and 14.5 mmHg on the 72th hours respectively. 26 eyes that were not given apraclonidine had a mean intraocular pressure of 12.8 mmHg before the capsulotomy, 16.4 mmHg on the first, 16.6 mmHg on the 24th and 18.2 mmHg on the 72th hours respectively.

As a result 0.5 % apraclonidine is effective in decreasing intraocular pressure that an increase after YAG-laser capsulotomy.

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Chylothorax is accumulation of lymphatic fluid in pleural cavity, which is enriched with fat secreted by intestinal cells. Chylothorax is an uncommon disease in children and is usually a postoperative complication mainly occuring after thoracic or cardiac interventions. The volume and the speed of chyle loss determine the clinical symptoms and severity. The diagnosis is confirmed by finding lymphatic fluid in pleural effusion. Most of the patients respond to medical treatment with use of total parenteral nutrition enriched with medium chain triglyceride (MCT) oil and pleural drainage. Extended period of effusion may require surgical intervention. In this article our aim is to present a case with chylothorax which is
rarely seen in children that is developed after a minor trauma and recovered with conservative treatment.

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Hemochromatosis is a disease due to excessive storage of iron in the body that would lead to functional disorders in many organs (liver, pancreas, myocardium, hypophysis etc.). This
disease can both be seen as a secondary to excessive ironintake or repeated transfusions, and it can also have primary form inherited autosomal recessive. The primary form of this
disease, which has an incidence of % 0.3 in community, is presented with the following case.

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Small bowel neoplasms are exceedingly rare despite the fact that the small bowel constitutes approximately 80 % of the total length of the GI tract and makes up more than 90 % of the mucosal surface area. Only 5 % of all GI neoplasms and only 1 to 2 % of all malignant tumors of the GI tract occur in the small bowel (1,2). There are four major types of malignant small bowel tumors-adenocarcinoma, gastrointestinal stromal
tumors (leiomiosarcomas), carcinoid tumors, and lymphomas. About 30 % to 50 % of all small bowel cancers are adenocarcinoma. Anatomically these tumors occur in decreasing frequency as one progresses distally through the small intestine, with the periampullary duodenum being the most comman site. In this article we report a rare entity case of primary duodeum adenocarcinoma.

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Kaposi sarcoma (KS) is a multicentric neoplasia deriving from both vascular and lymphatic endotelial cells. There are four subtypes presenting with different clinical courses; classic (sporadic), endemic (African type), immunosupressionrelated (iatrogenic) and AIDS-related. The incidence of KS is extremely high among people treated with immunosuppressive therapy especially in the ones with organ transplants. Its incidence is higher in patients treated with cyclosporin A rather than azathioprine and methylprednisolone. This high incidence is probably related to the strong immunosuppressive action of cyclosporine. It is said that cell mediated immunity may play a role in the pathogenesis of immunosuppression related KS and immunosuppressive drugs not only interfere with the immun defences of human body but also have mutagenic potantial. ‹mmunosuppression related KS usually presents with cutaneous lesions and visceral involvement is not expected. The lesions usuallly resolve with the cessation or tappering of immunosuppressive therapy. Herein we report two cases of KS developing in patients who were receiving immunosuppressive therapy; in patient 1 for the prevention of rejection after renal transplantation and in patient 2 for the
therapy of pyoderma gangrenosum. The increased incidence of KS in patients receiving immunosuppressive therapy should be considered while evaluating the lesions developing in these patients.

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Bartter syndrome are characterized by normal blood pressure, hypokalemia, metabolic alkalosis, prostaglandinuria, hyperreninemia and hyperaldosteronism and defined as a
family of inherited recessive autosomal tubulopathies. Pseudo-Bartter’s syndrome may produce a hypokalemic metabolic alkalosis without primary renal disease. The underlying
illnesses are primary hyperaldosteronism, Cushing syndrome, hypertrophic pyloric stenosis, cystic fibrosis and some drogs. In this article a 3 mounts old boy who diagnosed cystic fibrosis presenting as a pseudo-Bartter’s syndrome was evaluated.

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Carcinosarcomas of the lung are rare biphasic tumors. This paper presents two cases of carcinosarcoma of the lung. Computed tomography of the thorax demonstrated atelectasis and a mass lesion obliterating the middle lobe bronchus and proximal part of the lower lobe bronchus in the first case. Bronchoscopic examination revealed a necrotic mass lesion obliterating the middle lobe bronchus. Computed tomography of the thorax showed left hilar mass and atelectasis of left upper lobe in the second case. Fiberoptic bronchoscopy demonstrated a mass lesion in the proximity of left upper lobe. The pathological diagnosis of bronchoscopic biopsy materials was reported as squamous cell carcinoma in both cases. Right inferior bilobectomy was performed in the first case. The
tumor was composed of adenocarcinoma component and a malignant mesenchimal element. Left lobectomy superior was performed in the second case. Tumor was composed of squamous cell carcinoma, osteosarcoma and fibrosarcoma components
in this case.

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Sertoli-Leydig cell tumors belong to the group of sex-cord stromal tumors of the ovary. They account for less than 0.5 % of all ovarian neoplasms. Because they produce androgens, they cause virilization. In this report 53 years old patient admitted for virilization signs, was diagnosed as Sertoli-Leydig cell tumor, is discussed with the literature.

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Brucella species are small, nonmotile, gram-negative coccobacilli. The species that infect humans are Brucella abortus, Brucella melitensis, Brucella suis, and, rarely, Brucella canis Brucellosis is a zoonotic disease. Humans are accidental hosts, contracting the disease by direct contact with infected animals secretions or by ingesting unpasteurized milk or milk products. We reviewed that the patient had a case of acute human brucellosis caused by B melitensis infection.

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Familial mediterranian fever (FMF) is a genetic disease characterized by recurrent febrile attacks and inflammation of serous membranes. Artralgia and artritis can be seen in 75 %
of patints. Here we report a case diagnosed as FMF by clinical progress and family history and supported by genetic diagnosis.

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