Vitiligolu hastalarda sýklýkla eþlik eden baþka otoimmün hastalýklar bildirilmiþ ve vitiligonun bir hastalýk olabileceði öne sürülmüþtür. Bu çalýþmada vitiligo patogenezinde otoimmünite teorisinin rolünü deðerlendirmek amacýyla hastalarda organ özgül otoantikorlar ile eþlik eden otoimmün hastalýklar araþtýrýldý.
Klinik olarak vitiligo tanýsý konan 45 hastada antimitokondriyal otoantikor (AMA), antitroglobulin otoantikor (ATG), tiroid mikrozomal otoantikor (TPO), gastrik pariyetal hücre otoantikoru (GPC), adacýk hücre otoantikoru (ICA), düz kas otoantikoru
(SMA), karaciðer-böbrek mikrozomal otoantikor (LKM) ve antinükleer otoantikor (ANA) düzeyleri ve eþlik eden diðer otoimün hastalýklar araþtýrýldý. Kontrol grubu 35 saðlýklý bireyden oluþturuldu ve sonuçlar vitiligo hasta grubunun bulgularý ile karþýlaþtýrýldý.
Hasta grubunda 13 (% 28.8), kontrol grubunda ise 7 (% 20) olguda bir veya birden fazla otoantikor pozitif bulundu. Ýki grup arasýnda otoantikor pozitifliði açýsýndan anlamlý bir farklýlýk gözlenmedi (p>0.05). Hastalýk süresi uzun olgularda GPC seropozitifliði anlamlý derecede yüksek bulundu.
Bulgular otoimmün etyopatogenezi desteklememekle birlikte, uzun süren vitiligolu hastalarda otoantikorlarýn saptanmasý subklinik veya klinik otoimmün hastalýklarýn geliþme olasýlýðýný göstermesi açýsýndan önemlidir.

Many studies suggest that vitiligo might be an autoimmune disease and has been frequently described in association with other autoimmune diseases. The purpose of this study was to determine the presence and frequency of organ-specific autoantibodies
and other auto›mmune diseases in vitiligo patients.
45 vitiligo patients were involved to study and Anti-mithocondrial antibody (AMA), antithyroglobulin antibody (ATG), thyroid microsomal antibody (TPO), gastric parietal cell antibody (GPC), islet cell antibody(ICA), smooth muscle antibody, liver-kidney antibody and antinuclear antibody were determinated in their sera. Concomitant autoimmune disease were investigated. 35 normal patients were used as control and the findings were compared with vitiligo patient's.
One or more positive autoantibodies were established in 13 (% 28.8) patients and 7 (% 20) healty people. There was no significantly difference between two groups. However a correlation was found between the duration of illnes and GPC seropositivity.
Our findings does not support an autoimmune etiology in vitiligo but we suggest that presence aoutoantibodies in patients who have the disease for a long time may show probability of a clinical or subclinical autoimmune disease.

Abstract | Full Text PDF

Niðde Devlet Hastanesine baþvuran 26 kalp-damar hastasý çalýþma grubu ve bunlarla eþleþtirilmiþ 53 kiþi kontrol grubu olarak araþtýrmanýn kapsamýna alýndý. Antropometrik ölçümleri ile vücut kütle göstergeleri (VKG=kg/m2) bulundu, bazý yiyecek tüketim sýklýðý alýndý ve serum kalsiyum ve magnezyum düzeyleri tayin edildi. VKG'ye göre, gruplardaki bireylerin hafif þiþman kategorisinde toplandýðý, bu oranýn çalýþma grubunda daha yüksek olduðu saptandý. Ayný þekilde alkol, sigara ve kahve alýþkanlýklarýnýn da çalýþma grubundaki bireylerde daha sýk olduðu dikkati çekti. Yiyecek tüketim sýklýðýnda hastalýktan koruyucu olduðu savunulanlarýn özellikle kurubaklagil, süt ve süt ürünlerinin çalýþma grubunda kontrol grubuna göre istatistiksel olarak önemli derecede seyrek tüketildiði bulundu. Üstelik bu bulgu þeker gibi rafine ve boþ kalori veren yiyeceklerde de kendini gösterdi. Gruplarýn serum kalsiyum düzeylerinde belirgin bir farklýlýk yokken, magnezyum düzeyinin çalýþma grubunda önemli derecede arttýðý, alkol alanlarda ise düþtüðü saptandý. Bu farklýlýk hastalýðýn halen aktif olduðunu ve alkol alanlarda gereksinmenin arttýðýný gösterebileceðini düþündürmektedir.

Twenty six cardiovascular patients who applied Ni¤de State hospital and fifty three volunteer's people have been included into the research as working group and control group respectively. Their anthropometrics measurements were taken and questionnaire about the food consumption frequency. Theirs serum calcium and magnesium levels in serum has been also determined. According to BMI categories majority of the work group' subjects were in obese group. Similar to this finding alcohol, coffee intake and smoke habits were more common in the work group. When food consumption frequency between
the groups was investigated, it was found that the healthy group consumed legumes and dairy products more commonly to that of the work group. The difference between the groups was statistically important. Moreover it was the same for refine foods like table sugar that has only empty calorie and the others. While the group's calcium levels were not different from each others, the magnesium levels were found to be statistically higher for the work group than that of the control group. However magnesium levels of the subjects who alcohol consumption were found to be decreased according to the total
group value. The high value of magnesium in the work group could be a kind of proof that the disease is still active. The decreased value of mineral in alcohol consumption subjects
could be an indicator for increased requirement.

Abstract | Full Text PDF

Diyafragmatik atenüasyon artefaktý (DAA), miyokard perfüzyon-SPECT (MP-SPECT) görüntülemesinde, erkeklerde sol ventrikülün inferiyor duvarýna iliþkili olarak en sýk karþýlaþýlan atenüasyon artefaktýdýr. DAA’nýn giderilmesi için bazý standart yöntemler uygulanmaktadýr. Ancak, bu yöntemlerin bazý kýsýtlýlýklarý mevcuttur. Pron pozisyonunda görüntüleme en yaygýn uygulamalardan biri olmakla birlikte, bazý hastalar bu pozisyonda yatma zorluðu çekmektedirler Bizim çalýþmamýzda kalbin toraks içindeki pozisyonunu ve özellikle solunum sýrasýnda diyafragma ile iliþkisini yansýttýðý düþünülen inspiryumda
kalbin ortalama elektriksel eksen deðiþikliðinin DAA oluþumu üzerindeki etkisi incelendi. Çalýþmaya toplam 67 erkek hasta alýndý. Tüm hastalarýn bel/kalça oranlarý ve beden
kitle indeksleri saptandý, normal solunum ve derin inspiryum sýrasýndaki EKG'leri çekildi ve ortalama elektriksel eksenleri hesaplandý. Rutin MP-SPECT görüntülemesi, pron pozisyon
görüntülmesi ve gated SPECT çalýþmasý yapýldý. Hastalar DAA olanlar ve olmayanlar olarak iki gruba ayrýlarak deðerlendirildi. DAA olanlarda eksen deðiþikliði 13.8±16.2 derece
ve DAA olmayanlarda eksen deðiþikliði 45.8±31.2 derece saptandý ve iki grup arasýnda istatistiksel olarak anlamlý fark bulundu (p<0.05). ROC (Receiver Operating Curves) analizi ile elde edilen veriler, 17 derecelik bir eksen deðiþikliðinin DAA tanýsý yönünden kritik deðer olabileceðini düþündürdü. Sonuç olarak derin inspiryumda kalbin ortalama elektriksel eksen deðiþikliðinin 17 derece ve daha az olmasýnýn DAA'ný belirlemede etkili olabileceði düþündürdü.

Diaphragmatic attenuation artifact (DAA) is the most frequent artifact related to the inferior wall of left ventricle during the myocardial perfusion (MP)-SPECT imaging of male patients. Several standard methods are used to avoid DAA, however all have certain limitations. Imaging in prone position is among the most common methods, although some individuals experience difficulty in lying at this position. We examined the effectiveness of change in the mean electrical axis of heart, on the identification of DAA. It is a parameter believed to reflect the position of the heart within thorax and its relation with the diaphragm, particularly during respiration. A total of 67 patients were included in the study. Waist/hip ratio, body mass index were recorded for all patients. ECG's during normal respiration and deep inspiration were obtained and mean electrical axis was calculated. Routine MP-SPECT imaging, imaging at prone position and gated SPECT study were performed. Patients were evaluated after allocation to either DAA (+) or DAA (-) groups. Mean changes in axis were 13.8±16.2 and 45.8±31.2 degrees for DAA (+) and DAA (-) groups, respectively, with a statistically significant difference (p>0.05). Results of ROC analysis found that 17 degrees or less axis change might be indicative of DAA diagnosis. In conclusion, a 17 degrees or less change in the mean electrical axis of the
heart during deep inspiration might indicate the presence of DAA.

Abstract | Full Text PDF

Cavitas nasi'nin kemik giriþini meydana getiren apertura piriformis ile bu giriþin üst sýnýrlarýný oluþturan os nasale'ler ve bu yapýlara tutunan burun kýkýrdaklarý burun iskeletini meydana getirirler. Burun sýrtýný ve solunum yollarýnýn ilk giriþ kýsmýný oluþturan bu yapýlarýn morfometrisi solunum fonksiyonu açýsýndan önem taþýr.
Bu çalýþmada yaþ ve cinsiyeti belirsiz 38 adet cranium kullanýlarak, apertura piriformis ve os nasale'ler incelenmiþtir. Ýncelenen 38 adet cranium'da, os nasale'lerin iç kenar uzunluðu 21.02±3.5 mm, dýþ kenar uzunluðu 24.00±3.53 mm, üst kýsým geniþliði 8±1.94 mm, bilateral 12.25±2.55 mm ve alt kýsým geniþliði 10.29±1.67 mm, bilateral 14.26±1.86 mm olarak tesbit edildi. Apertura piriformis'in yüksekliði 35.95±3.14 mm ve geniþliði en geniþ kýsmý olan alt kýsmýnda 23.99±2.62 mm, üst kýsmýnda ise 15.37±1.97 mm olarak ölçüldü. Os nasale'lerin þekil tipleri incelendiðinde ise Tip 1 % 57.9 ve Tip 4 % 15.8 ile en sýk rastlanýlan tipler olarak saptandý. Elde edilen bulgular literatürdeki diðer çalýþmalarla karþýlaþtýrýldý.

The piriform aperture which is the bony entry of the nasal cavity, the nasal bones and cartilages make the nose structure. The morphometry of these structures making the dorsal part of the nose and the entry paint of the respiratory tract are functionally important for the respiratory system. In this study, the piriform aperture and nasal bones are investigated in 38 craniums. The inner border of the nasal bones were measured 21.02±3.5 mm in length, outer border 24.00±3.53 mm, upper border 8±1.94 mm, bilateral 12.25±2.55 mm, width of the lower border 10.29±1.67 mm, bilateral 14.26±1.86 mm. The piriform aperture height was 35.95±3.14 mm and width at the widest point in the lower margin 23.99±2.62 mm, and width at the upper margin 15.37±1.97 mm. The most common types of the nasal bones were Type 1 (%57.9) and Type 4 (%15.8). The findings of this study were discussed with former studies.

Abstract | Full Text PDF

Son yýllarda dünyada tüberküloz (TB) konusunda önemli geliþmeler olmuþtur. TB sýklýðý üzerinde etkili faktörler araþtýrýlmýþtýr. Bu çalýþmada 1999-2003 yýllarý arasýnda ülkemizde TB sýklýðýna etki eden faktörlerin saptanmasý amacýyla iki ilde TB kontrol çalýþmalarý incelendi. Diyarbakýr'da dört, Kars'ta iki adet verem savaþ dispanseri (VSD) mevcuttur. Bu þehirlerde bulunan dispanserlerinin aylýk hasta taný ve tedavi bildiriminde kullandýklarý formlar retrospektif olarak incelendi.
Bu dönemde Diyarbakýr'da toplam 2387 yeni TB hastasý saptanmýþtýr. Hastalarýn 1844'ü (% 77.2) akciðer TB ve 543'ü (% 22.8) akciðer dýþý TB idi. Akciðer TB hastalarýnýn 691'i (% 37.5) yayma pozitifti. Ayný dönemde Kars'ta 375 yeni TB hastasý saptanmýþtýr. Hastalarýn 276'sý (% 73.6) akciðer TB ve 99'u (% 26.4) akciðer dýþý TB idi. Akciðer TB hastalarýnýn 50'si (% 18.1) yayma pozitifti. Ortalama TB sýklýðý Diyarbakýr'da 37.55/100.000, Kars'ta 19.59/100.000 idi (p<0.05). Akciðer TB sýklýðý Diyarbakýr'da 29.04/100.000, Kars'ta ise 14.53/100.000 idi (p<0.05). Diyarbakýr'ýn deniz seviyesinden yüksekliði 660 metreyken, Kars'ýn ise 1768 metre olarak bulunmuþtur. Devlet planlama teþkilatýnýn yaptýrdýðý araþtýrmaya, þehirleþme oraný ve okur yazarlýk oraný verilerinde iki il arasýnda anlamlý fark saptandý (p<0.05). ‹ki il arasýnda saptanan anlamlý sýklýk farkýnýn ciddi rakým farkýna (2.3 kat) baðlý olduðu düþünüldü. Ayrýca, bazý sosyoekonomik parametrelerin de TB prevalansý üzerine etkili olabileceði düþünülmektedir. Fakat, TB prevalansýna etkili faktörlerin etkilerinin daha iyi anlaþýlabilmesi için daha kapsamlý çalýþmalara ihtiyaç vardýr.

In the last year, there have been very important improvements about tuberculosis (TB) all over the world. In this study, it was researched TB control studies at two cities in Turkey between 1999 and 2003 in order to determined the factors affecting to TB prevalence. The forms using those dispensaries in two cities to informing about diagnosis and treatment of TB have been investigated retrospectively. In This period, 2387 new TB patients were determined in Diyarbak›r, 1844 (77.2 %) of them were pulmonary TB and 543 (22.8 %) extrapulmonary TB. 691 (37.5 %) with pulmonary TB were smear positive. In same period, 375 new TB patients were determined in Kars, 276 (73.6 %) of them were pulmonary TB and 99 (26.4 %) extrapulmonary TB. 50 (18.1 %) patients with pulmonary
TB were smear positive. The average incidence of TB was 37.55/100000 in Diyarbakýr and 19.59/100000 in Kars (p<0.05). The average incidence of pulmonary TB was 29.04/100000 in Diyarbakýr and 14.53/100000 in Kars (p<0.05). The altitude at Diyarbakýr is 660 meters and 1768 meters in Kars. According to research from the State Planning
Organization of Turkey, there has been an important difference regarding the rates of urbanization and rates of literacy between two city (p<0.05). It was thought that the significant difference regarding incidence of TB between two cities was due to the difference of altitude of those city (2.3 times). Moreover, it was thought that some socioeconomic parameters could be affective on TB prevalence. However, some extensive
study should be carrying out to clearly understand the factors affecting TB prevalence.

Abstract | Full Text PDF

Bu çalýþmada; Gaziantep ilindeki Verem Savaþ Dispanserleri'ne (VSD) 2004 yýlýnda baþvuran hastalarýn incelenmesi, geçmiþ yýllardaki olgu sayýlarýna göre tüberküloz (tbc) hastalýðýnýn sýklýðýnda yýllar içinde bir deðiþim olup olmadýðýný belirlemek amaçlanmýþtýr.
Bu retrospektif tanýmlayýcý araþtýrmada, Gaziantep'de bulunan 1 ve 2 nolu VSD'lere gidilerek, tüm kayýtlar incelenmiþ ve veriler hazýrlanan anket formlarýna iþlendi. Yýllara göre hasta sayýlarý her 2 VSD’nin kayýtlarýndan çýkarýldý ve veriler bilgisayarda SPSS paket programýnda deðerlendirildi.
Her 2 VSD'de 2004 yýlýnda kaydý bulunan toplam hasta sayýsý 269 olarak belirlendi. Hastalarýn 166'sý erkek (% 61.7), 103'ü kadýn (% 38.3) ve yaþ ortalamasý 33.51±17.53 idi. Hastalarýn % 48.3'ünün hiçbir sosyal güvencesi bulunmamaktaydý. Hastalarýn sadece % 50.6'sýna aile taramasý yapýlmýþtý. Tedavi durumu incelendiðinde; % 13.8'i tedaviye devam etmiyor, % 24.9'u ise halen tedaviye devam ediyordu. Daha sonra ulaþýlan 81 hastanýn % 60.2'sinde BCG skarý mevcuttu. Bu kiþilerin % 17.1'inin ek bir hastalýðý vardý ve en sýk birlikte görülen hastalýk diabetes mellitus idi. 1994 ve 2004 yýlý arasýndaki sürede hasta sayýlarý incelendiðinde; tüberküloz olgularýnýn yýllar içinde giderek azaldýðý belirlendi.
Türkiye geneline benzer bir þekilde tüberküloz olgularýnýn azalmasýna raðmen; personel, taný koyma, tedavi ve takip sorunlarýnýn devam ettiði gözlenmiþtir. Halen balgam yaymasý yapýlmayan hastalarýn olduðu, nüks olgular için sistemli bir yaklaþýmýn olmadýðý, yakýn çevre taramasýnýn hiç yapýlmadýðý, aile taramasýnýn ise eksik yapýldýðý belirlenmiþtir. Hastalýk bildirimlerinin düzenli yapýlmasý, VSD’lerde çalýþan baþta hekimler olmak üzere tüm personelin eðitime alýnmasý, kurumlararasý iþbirliðinin güçlendirilerek yardýmlaþmanýn saðlanmasý ve Doðrudan Gözetimli Tedavi Stratejisinin en kýsa sürede tüm ülkeye yayýlmasý yararlý olacaktýr.

In this study it was aimed to determine the number of patients applied to Dispensaries of Tuberculosis in the year 2004 in Gaziantep City and to investigate whether if there were any changes in number of those patients in terms of the frequency.
In this retrospective definitive study all the data stored in the Dispensaries nr. 1 and 2 in Gaziantep City were examined and were registered beforehand prepared survey forms. The number of patients in terms of years was determined and the data obtained were assessed using SPSS program.
The number of total patients has record in either of Dispensaries of Tuberculosis nr. 1 and 2 was determined as 269. 61.7 percent of the patients were male (166 persons) and 38,3 percent of those were female (103 persons). The average age determined was 33.51±17.53. 48.3 percent of the patients had no social security. Only 50,6 percent of the patients had their family examined. 24.9 percent had ongoing therapy and 13,8 percent had no ongoing therapy.
Despite the decrease in the number of Tuberculosis patients throughout in Turkey, it was seen that problems regarding personnel, diagnosis, therapy and control still continued. Making the patient announcements systematic, educating the personnel, especially the doctors, working in Dispensaries of Tuberculosis, strengthening the collaboration between the institutions and, widening the direct observing therapy strategy throughout the country as soon as possible would be helpful.

Abstract | Full Text PDF

Bu çalýþmada abdominal histerektomi olgularýnda postoperatif analjezi amacýyla uygulanan rektal parasetamol ve rektal parasetamole intramüsküler tramadol ilavesinin etkinliklerinin
karþýlaþtýrýlmasý amaçlandý.
Abdominal histerektomi planlanan, ASA I-II risk grubu, 18-70 yaþ arasý 90 kadýn hasta çalýþmaya dahil edildi. Standart anestezi yöntemi uygulanan olgular 30'ar kiþiden oluþan 3
gruba ayrýldý. Ekstübasyonu takiben Grup I'deki hastalara rektal parasetamol 1000 mg, Grup II'deki olgulara intramüsküler tramadol 100 mg ve Grup III'deki olgulara her iki ilacýn kombinasyonu verildi. Baþlangýç, ekstübasyon sonrasý, postoperatif 30. dk, 1., 2., 4., 6., 8., 12., 24. saatlerdeki vital bulgularý ve aðrý þiddetini deðerlendirmek amacýyla VRS (verbal rating Score) deðerleri, yan etkiler ve ilk analjezik gereksinim zamanlarý kaydedildi. Postoperatif 24 saatlik takibin sonunda analjezi yöntemiyle ilgili hasta memnuniyeti (zayýf-orta-iyiçok iyi) sorgulandý.
Gruplar arasýnda hemodinamik veriler, ilk analjezik gereksinim zamaný, yan etkiler ve hasta memnuniyeti açýsýndan farklýlýk saptanmadý. Postoperatif takip zamanlarýnda Grup I'in VRS deðerleri, Grup II ve Grup III'e göre anlamlý yüksekti (p< 0.05), Grup II ve Grup III arasýnda ise fark yoktu (p>0.05).
Postoperatif analjezi amacýyla rektal yolla uygulanan parasetamolün tek baþýna etkinliðinin yeterli olmadýðý, tek baþýna kullanýlan tramadol ile tramadol-parasetamol kombinasyonunun etkinliði arasýnda da farklýlýk olmadýðý sonucuna varýldý.

In this study, the effectiveness of rectal paracetamol alone and rectal paracetamol combined with tramadol for pain management in abdominal hysterectomy cases is compared. 90 female patients between 18-70 years, in ASA I-II status, scheduled for
abdominal hysterectomy were included in the study. Patients were allocated in one of three groups (n=30 in each group) and a standardized anesthesia method was adminestered to all. Following the extubation, patients were given rectal paracetamol
1000 mg in Group I, tramadol 100 mg in Group II and the combination of the two drugs in Group III. Vital signs were recorded at the beginning of the anesthesia, immediately
after the extubation and in 30th minutes, 1., 2., 4., 6., 8., 12., 24th hours postoperatively. In the postoperative period, verbal rating score (VRS) values to evaluate the severity of pain and also adverse affects were recorded in above mentioned time intervals. The time of first analgesic requirement and patient satisfaction about analgesic method (poor, fair, good, very good) was questioned 24 hours after the operation. There was no difference between the groups regarding the hemodynamic data, the time of first analgesic requirement, adverse affects and patient satisfaction. In the postoperative follow-up periods, VRS values of GroupI were significantly higher comparing to other two groups (p<0.05) and there was no significant difference between the groups II and III concerning VRS values (p>0.05).
It is concluded that the effectiveness of rectal paracetamol alone in management of postoperative pain is not sufficient and also the effectiveness of tramadol alone or in combination with paracetamol did not differ.

Abstract | Full Text PDF

Klinik hastalýklarýn ortaya çýkýþýnda katkýlarý olan ve alerjen maruziyetine cevap olarak IgE antikorlarý geliþtirmeye artmýþ genetik yatkýnlýk olarak tanýmlanan atopi, allerjenlerle uygulanan cilt testi cevabý ile deðerlendirilebilir. Atopi, astým ve rinit gibi alerjik hastalýklar için önemli bir risk faktörüdür. Bu çalýþmada astým ve rinitli hastalarda besin alerjisini ortaya
koymak amaçlanmýþtýr. Yetmiþ çocuða (3-12 yaþ) Türk diyetinde sýk kullanýlan 18 çeþit besin alerjisi cilt testi yapýlarak deðerlendirildi. Kontrol grubunda cilt testinde besin alerjisine karþý pozitif reaksiyon saptanmamasýna karþýn, rinitli hastalarýn % 12’si ve astýmlýlarýn % 20’sinde cilt testinde besin alerjisine karþý pozitif reaksiyon saptandý. Sadece 1 hastada besinle iliþkili wheezing görüldü.

Atopy is defined as the genetic propensity to develop IgE antibodies in response to exposure to allergens, which may contribute to the development of the clinical disorders and assessed by skin prick test (SPT) responses to common allergens. It is generally agreed that atopy is an important risk factor for allergic diseases such as asthma, and rhinitis. The aim of this study is to determine the food allergy in children with asthma and rhinitis. Seventy children (3 to 12 years) were skin prick tested to evaluate the food allergy 18 kind of foods common in the Turkish diet. Although there are no SPT reactivity in control group, twelve percent of the children with rhinitis and 20 % of the children with asthma had positive SPT reactivity results to food allergen. Only one patient had food-related wheezing.

Abstract | Full Text PDF

The infiltration of breast carcinoma cells into the epidermis of the nipple along mammary ducts without any direct invasion is called Paget's disease of the breast. The infiltration can either be microscopic or gross in the form of scaling, erythema, erosion or ulceration. Here we report a 70-year-old woman without a palpable mass diagnosed as Paget's disease of the
breast.

Abstract | Full Text PDF

Fasciola hepatica, a zoonotic liver fluke, can also cause disease in humans. Common symptoms are epigastric pain, upper abdominal pain and malaise. Fever and arthralgia are common in acute fascioliasis. Eosinophilia is the predominant laboratory finding, especially in patients with the acute form of the disease. Diagnosis is not easy, as physicians rarely encounter this disease. A 25 years old man was admitted to the clinic with severe right upper abdominal pain. There was a two-month history of mild jaundince, trembling and fever. Abnormal laboratory findings were as follows: alanin aminotranspherase: 77U/L, aspartat aminotranspherase: 55U/L, alkalen phosphatase: 648 U/L (N: 11-49) gamma glutamyl transpeptidase: 142 U/L (N: 11-49). Abdomen ultrasonography and magnetic resonance imaging (MRI) revealed multiple, 1,5 cm sized lesions of which biggest was 1.5 cm, compatible with metastasis. Other systems were normal. Since 40 % eosinophilias were present in peripheral blood, fecal examination
was performed but no parasite and parasite eggs were detected. Liver biopsy that was performed for metastatic liver cancer suspicion revealed fasciola hepatica. Fasciola
hepatica antibody result was 1: 80 positive. The patient was administered triclabendazol 10 mg/kg for fasciola hepatica diagnosis. After 3 months, the symptoms were improved and laboratory and imaging results returned completely back to normal. Patients with eosinophilia and abdominal pain should be evaluated for F. hepatica infestation by parasitological, radiological and serological tests.

Abstract | Full Text PDF

Situs ambiguous is a rare anomaly that is characterised by abnormal arrangement of abdominal organs with congenital heart diseases. Patients rarely survive beyond first decade of life as this anomaly generally coexists with cyanotic heart diseases. The correct recogniation and characterisation of cases is important for planning surgical, radiologic and endoscoping interventions. In this case we present an incidentally diagnosed case with midline located liver, multiple spleens and stomach in the right upper quadrant, interruptured inferior vena cava with azygos continuation. The heart was left sided and there was no sign of congenital cardiac anomaly. Hereby we present this case as it was found incidentally at adult age and there was no accompanying congenital heart anomaly.

Abstract | Full Text PDF

In this report, we presented a case with esophageal candidiasis. A 35-year-old woman was admitted our hospital because of dysphagia and substernal burning pain on swallowing. Endoscopy revealed discrete white mucosal patches on the mucosa of the esophagus and hiatal hernia. Diagnosis was confirmed by the demonstration of Candida pseudohyphae and
yeasts in smears of brushings. Fluconazole (200 mg/day) was given by the oral route to the patient who are afebrile and not suspected of having disseminated candidiasis. In conclusion,
esophageal candidiasis should always be kept in mind fort the cause of dysphagia and odinophagia in the patients with gastroesophageal reflux esophagitis.

Abstract | Full Text PDF

A seventy one year old /man patient was admitted to our hospital with cough, sputum hemoptysis and weight lose that were present for two months. Physical examination revealed bilateral rales. On his chest X-ray caviter lesion with pericavitier infiltration was seen in middle zone. Thorax CT showed the infrahiler mass including irreguler bordered, thick walled cavitier lesion. Bronchoscopic endobronchial biopsy revealed squamous cell cancer and caseifie granulomatous bronchit in the entrance of right lower lobe. Anti-Tbc chemotherapy had been started with four drugs (HREZ) because the sputum ARB results were positive. The patient died because of respiratory failure in fifteenth day of therapy. One month prior to admission of the patient to our hospital, bronchoscopic endobronchial
biopsy that was done in an another center revealed squamous cell cancer and also granulomatous process but despite thus any other diagnostic evaluation (such as sputum ARB) had not been performed. We aimed to notify that sputum ARB evaluation should be done in all patients with pulmonary cavitier lesions for differential diagnosis especially in countries that tuberculous is a common infection like our country.

Abstract | Full Text PDF

Familial hypercholesterolemia is a hereditary disease characterized with the increase of LDL- cholesterol level in plasma as a result of mutational defect of LDL receptor gene. The disease presents in two forms as homozygous and heterozygous. The form which is homozygous has an incidance of 0.2 % in the population. Because the patients have high cholesterol, especially LDL- cholesterol levels which are the major factor that contribute to atherosclerosis, early diagnosis and treatment is very important. We therefore presented two families who have this rarely seen metabolic disorder of lipid metabolism which leads to coronary atherosclerosis, myocardial infarction and death at early ages.

Abstract | Full Text PDF