INTRODUCTION: In this study it was evaluated the demografic features, etiological factors and the management of acute pancreatitis.
METHODS: 110 patients hospitalized due to acute pancreatitis were retrospectively examined. The data of gender, disease severity, treatment options and complications were analysed.
RESULTS: The mean age of patients were 60.3 (43 men and 67 women). The causes of acute pancreatitis were as follows: gallbladder stone was 89, hyperlipidemia was 5 and idiopathic was 16 patients. Severe pancreatitis was developed in 2 patients in the biliary pancreatitis group and ERCP was performed. Cholecystectomy was performed to all biliary pancreatitis group patients after acute pancreatitis subside. The mean hospital stay period was 5.31 (1-18) day.
DISCUSSION AND CONCLUSION: Severe acute pancreatitis is a mortal disease. The most common etiological cause of acute pancreatitis is biliary origin. The first line treatment modality of acute pancreatitis is medical. Cholecystectomy should be planned to the all biliary caused acute pancreatitis patients after the attack subside. ERCP is a useful treatment modality in the case of clinical worsening and suspicion of acute cholangitis. ERCP procedure used 2 patients in our series. We suppose that ERCP procedure should be planned selectively and conservatively.

With this paper, we presented our study series on modified open carpal tunnel decompression operation with mini incision, not crossing the wrist line, performed in three centers between 2000-2004. Regional wrist anesthesia was used in all patients. The operation was carried out via a 2-2.5 cm incision made on the palm in 62 wrists of 52 patients (46 females and 6 males), with a mean age of 41 years (22-54 years), under regional wrist anesthesia and using pneumatic tourniquet. Under direct sight, distal portion of the ligament was sectioned. Proximal portion of the ligament and the antebrachial fascia were released by a blunt dissection once they were separated from the palmar aponeurosis and the subcutaneous adipose tissue. Following the decompression of the carpal tunnel, the layers were closed and compression bandage was applied. Compression bandage was removed on the same day and patients were allowed for daily activities. During postoperative follow-up visits (Mean: 21 months, range: 16-26 months) none of the patients reported recurrence of complaints and all were satisfied with the technique. Carpal tunnel decompression with mini incision and wrist anesthesia is a method that provides safe release of the median nerve, shortens hospitalization period and increases patient comfort.

INTRODUCTION: The aims of this study were to asses the impact of fracture on quality of life in osteoporosis patients, factors related with fractures and compare them with osteoporosis patients without fracture.
METHODS: 115 (106 women, 9 men) osteoporosis patients who came to Ministry of Health Göztepe Education and Research Hospital Physical Medicine and Rehabilitation Department out-patient clinic were included in the study. Patients were divided into three groups as; vertebral fracture group, hip fracture group and no fracture group. Patients answered questions in forms that includes sociodemographic properties, risk factors, QUALEFFO-41 quality of life scale. Bone mineral density was measured by dual x-ray absorbsiometry and vertebral fractures were detected by Genant method.
RESULTS: Age of these 115 patients were changing between 49 and 90 with average of 68.32±8.91. Mean age of patients without fractre was significantly lower than other groups. There was no significant difference between groups about height, weight, body mass index, life style ( nutritional calcium intake, cigarette smoking, coffee and alcohol use, physical activity, sun exposure, wearing style), menopause age, menopause type, menarche age, familiy history of fracture, previous non vertebral and nonhip fractures but menopause duration was higher in patients with fracture. Parity of hip fracture group was lower than other groups. Risk factors related with falls were significantly higher in hip fracture group. Bone mineral density and T-scores of lomber region in vertebral fracture group were significantly lower than no fracture group and femur total BMD and T-scores of vertebra and hip fracture groups were significantly lower than no fracture group. QUALEFFO-41 pain, physical function, social function and total scores were significantly higher in vertebra and hip fracture groups meaning worse quality of life.
DISCUSSION AND CONCLUSION: It was detected that older age, long duration of menopause and lower BMD were related with fractures. Fractures decreases quality of life in osteoporosis patients. We think that detection of factors related with fractures in studies could achieve this personal, social and economic problem.

INTRODUCTION: In ambulatory practice measurement of blood ketone bodies is indicated in all diabetic patients, especially in cases of symptomatic and/or unusual hyperglycemia (capillary blood glucose (CBG) > 250 mg/dl). However, little is known about ketonemia in type 2 diabetes. The aim of the present study was to assess prevalence of asymptomatic ketonemia and ketonuria in patients with hyperglycemic type 2 diabetic.
METHODS: Fasting capillary blood glucose (CBG) and capillary ketone levels (beta-hydroxybutyrate) of 441 patients with Type 2 diabetes (female, 301; male 140; mean age, 55.6±10.2 years), who were consecutively enrolled in the study, were measured, and presence of ketone in urine was determined. Patients were divided into two groups; CBG ≤250 mg/dL and CBG >250 mg/dL. The prevalence of ketonemia and ketonuria and other clinical parameters were compared in two groups. A blood ketone level of >0.5 mmol/L was considered as positive ketonemia.
RESULTS: Prevalence of asymptomatic ketonemia and ketonuria was 1.8 % and 3.4 %, respectively. In group with CBG >250 mg/dL, the prevalence of ketonemia and ketonuria and mean ketone levels were higher than in group with CBG ≤250 mg/dL (5.7 % vs. 0.6 %, p<0.01; 10.4 % vs. 1.2 %, p<0.01 and 0.22±0.24 mmol/L vs. 0.17±0.08 mmol/L, p<0.05, respectively). Ketonemia was positively correlated with triglyceride levels (r=0.102, p=0.033) and waist circumference (r=0.096, p=0.043).
DISCUSSION AND CONCLUSION: Routine monitoring of ketonomia is clinically significant in type 2 diabetic patients with hyperglycemia, even if they are asymptomatic.

Epilepsy is a medical problem effecting life of patient and families as emotional and psychosocial. Accidents relating seizures, increasing of physical diseases, psychological problems such as anxiety, depression in epilepsy patients may cause to decreasing of self-esteem, desperation, aggression, sexual problems, decreasing of educational success, unemployment and decreasing of life quality. Patients with epilepsy may experience intensive stress because their family focus on disease. Therefore, in management of epilepsy diseases should be considered life of patients in terms of psychosocial and emotional.

In this study, metabolic disturbances developed in a 60 years old female patient having bipolar disorder whose treatment has been going on and treatment approaches were outlined. There was a sharp increase in her weight (+5 kg) after adding olanzapine 2.5 months before who has still been taking sodium (Na) valproate treatment. But, she failed to accordance with diet and to loose weight because of carbohydrate craving, night eatings and low activity level. Than she gave up dieting. After 2.5 years from the first consult, she applied to dietitian again to loose weight. This time, her weight was 100 kg (+17.5 kg), and in biochemical tests, glucose, HbA1c and homocystein levels were higher than reference values, but zinc and copper levels were lower. According to endocrinologic evaluation IGT was detected with OGTT and so metformin was added to treatment and quetiapine replaced to antipsychotic olanzapine. Determined body fat percent at second consult (% 52.9) was too higher than expected (% 35.0). It was thought that carnitine deficiency might be the cause. So, L-carnitine (1 mg/day) was added to treatment. Our patient, whose follow up period has been going on loosed % 13.3 of her weight and % 7.7 of her body fat than values determined at the beginning. Blood sugar, HbA1c and HOM levels improved at treatment period and reached to normal levels.

Hereditary angioedema (HAE) is due to deficiency of C1 esterase inhibitor, inherited as an autosomal dominant trait, manisfested by attacks of swelling of the extremities, face, trunk, airway and abdominal viscera. The angioedema of HAE most often involves the upper extremities and oropharyx. The trunk and lower extremities are less often involved. Laryngeal edema is the major source of HAE related mortality. Hormonal fluctiations play a role in HAE and travma precipitates about half of the attacks. Androgen steriods, fresh frozen plasma, C1 inhibitor concentrates are used in treatment.

Widespread use of renal transplantation, and successful kidney transplant practices in young patients and children, has highlighted the demands of pregnancy in transplanted patients who are in the fertile age group. In this paper, a 35 years old pregnant women who had two consecutive second trimester abortion previously, without a living children, carrying donor transplant kidney for six years is presented. At the 37th gestational week of the pregnancy, delivery of a live 2500 g male infant was performed via ceserean section. No congenital anomalies were detected. We aimed to discuss this issue which requires a multidisciplinary approach by emphasizing obstetric management of a transplanted patient.

Tularemia is a rarely encountered zoonotic disease in otololarygologic daily practice. The disease may present with ulceroglandular, oropharyngeal, pneumatic and septic forms. Although there are many contagion ways the common infection sources are rodent bits, contagionous water, meat, and inhalation.
In this paper, we report a tularemia case and surgical outcomes of a patient who represents with neck mass and sore throat and resistant to antibiotheraptic agents with past history of drinking contaginous water.

Hairy polyps are rare congenital oropharyngeal malformations containing ectodermal and mesodermal components. The symptoms are associated with the location and size of the mass. Upper airway obstruction and feeding difficulty are common symptoms. Because of these symptoms they are diagnosed at or shortly after birth. Hairy polyps are usually pedunculated masses but sometimes attached to the broad area of the oronasopharynx. There are different theories about the pathogenesis of hairy polyps. We report a case of neonatal respiratory distress associated with oropharyngeal polypoid mass in a 3-day-old girl. The patient operated under general anesthesia. The examination of the patient after intubation showed a pedunculated mass which was orginated from the upper pole of left palatin tonsil and obstructed oropharynx. The mass was totally removed. After operation no complications developed and the patient discharged after begining orally nutrition. Histopathological diagnosis was made as hairy polyp.