GÝRÝÞ ve AMAÇ: Aksesuar dalak (AS) genelikle batýn ulatrasonografisi sýrasýnda saptanýp, yeteri kadar inceleme yapýlmamaktadýr. Bu çalýþmanýn amacý aksesuar dalaðýn sýklýðýný, görüntüleme özelliklerini saptamaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma 18 aylýk bir dönemde çeþitli klinik bulgularla Ultrasonografi bölümüne baþvuran 190 hasta üzerinde yapýldý. Hastalar yaþ,cinsiyet, aksesuar dalak sayýsý, lokalizasyon, þekil, boyut ve olasý eþlik ettiði splenomegali durumu B-mode ultrasonografide deðerlendirildi.
BULGULAR: Aksesuar dalaklarýn çoðunluðu 10-15 mm arasýnda bir boyuta sahip, yuvarlak þekilli, hilusa daha sýk yerleþim göstermiþ ve kadýnlarda erkeklere göre daha sýk ve ortalama yaþ 32.9 (SD 19.2) olarak tespit edildi. Ýstatiksel olarak splenomegali ve aksesuar dalak boyutu arasýnda anlamlý manalýlýk saptanmadý. Positif anlamlý korelasyona raðmen sadece yaþ ve boyut arasýnda (p<0.05, r=O.305) ve bundan baþka cinsiyet, splenomagali, boyut ve þekil açýsýndan da anlamlý manalýlýk saptanmadý (p<0.05).
TARTIÞMA ve SONUÇ: Bu çalýþmamýzda akesuar dalaðýn ultrasonografik bulgularý incelendi. Bizim düþüncemize göre, bu çalýþmamýz, aksesuar dalaðýn anlamlý ultrasonografik bulgularýný saptadý ve bulgular dalak patolojilerinin teþhisinde güncel bilgi olarak gözönünde bulundurulabilir.

INTRODUCTION: Accessory spleens (AS) usually appear on routine abdominal ultrasonography (US) and frequently not investigated. The aim of this study is to research the prevalence, imaging features and related conditions of AS.
METHODS: This study is based on 190 patients that applied to US department with various clinical symptoms in 18 months period. Patient ages, gender; although AS counts, location, shape, dimension and probable accompanied splenomegaly researched on B-mode US.
RESULTS: Majority of AS had a dimension between 10-15 mm. Usually they are round shaped and localized at splenic hilus. They mostly visualized in female with the mean age 32.9 (SD: 19.2). There was no statistically difference between splenomegaly and dimension of AS. Positive significant correlation was found between not only age and dimension (p<0.05, r=0.305), but also gender and splenomegaly (p<0.05), dimension and shape (p<0.05).
DISCUSSION AND CONCLUSION: Sonographic features of AS are investigated. This report reveals sonographic findings of AS, that may be used on differential diagnosis of splenic pathologies

Abstract | Full Text PDF

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, anti TNF alfa tedavisi alan ve almayan Romatoid Artrit(RA) hastalarýný kemik mineral yoðunluklarý yönünden karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya Saðlýk Bakanlýðý Ýstanbul Göztepe Eðitim ve Araþtýrma Hastanesi Romatoloji ve Fizik Tedavi ve Rehabilitasyon polikliniklerine baþvuran, ACR kriterlerine göre RA tanýsý almýþ olan 32 (30 kadýn, 2 erkek) hasta alýndý. Hastalar retrospektif olarak deðerlendirildi. Metotreksat (MTX) ve/veya düþük doz kortikosteroid (KS) (5-10 mgr/gün) tedavisi alan hastalar (Grup 1, n=20) ile MTX ve/veya düþük doz KS (5-10 mgr/gün) tedavisiyle birlikte anti-TNF alfa tedavisi (adalimumab, inflinksimab, etanercept) alan (Grup 2, n: 12) hastalar karþýlaþtýrýldý. Hastalar, demografik özellikleri, aldýklarý tedaviler, hastalýk süreleri, menopoz durumlarý, hastalýk aktiviteleri (disease activity score-DAS 28) ve lomber AP ve femur boynu DXA ölçümleri yönünden incelendi.
BULGULAR: Çalýþmaya alýnan hastalarýn yaþ ortalamasý 53.31±8.2 (yýl), VKÝ ortalamalarý 29.72±5.17 (kg/m2), hastalýk süresi ortalamalarý 12.7±8.7 (yýl) idi. Hastalarýn 12’si (% 37,5) anti-TNF alfa tedavisi almaktaydý. Anti-TNF alfa kullanýmýyla DEXA ölçüm sonuçlarý arasýnda istatistiksel olarak anlamlý iliþki tespit edilmedi (p>0,05).
TARTIÞMA ve SONUÇ: Bu çalýþmada anti-TNF alfa kullanýmýyla DXA ölçümleri arasýnda istatistiksel anlamlý iliþki bulunmadý. RA’da anti TNF alfa tedavisinin kemik mineral yoðunluðu üzerine etkisinin deðerlendirilmesi için prospektif, iyi dizayn edilmiþ, hasta sayýsýnýn fazla olduðu kontrollü çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Aim of this study is to evaluate the bone mineral density of rheumatoid artritis patients (RA) on anti TNF a therapy and without anti TNF a therapy.
METHODS: 32 patient (30 female, 2 male), who were attended to pysical medicine and rehabilitation outpatient clinic and rheumatology outpatient clinic in Göztepe Education and Research Hospital and diagnosed as RA according to ACR criteria, were included in the research. Study was designed as a retrospective research. Patients were evaluated according to demographic data, received therapy, duration of RA, menopause status, disease activity score-DAS 28, lumbar AP and femur neck DXA measurements.
RESULTS: Mean age of patients was 53.31±8.2 years. Mean VKI of patients was 29.72±5.17 (kg/m2), RA duration was 12.7±8.7 years. A total of 12 (37.5 %) patients used anti TNF a therapy. Statistically meaningful correlation between BMD and anti TNF a therapy was not established (p>0,05).
DISCUSSION AND CONCLUSION: Statistically meaningful correlation between BMD and anti TNF a therapy was not established.

Abstract | Full Text PDF

GÝRÝÞ ve AMAÇ: Çalýþmamýzda, % 0.5 izobarik levobupivakain, % 0.5 izobarik bupivakain, % 0.5 hiperbarik bupivakaini hemodinamik parametreler, spinal anestezi kalitesi ve komplikasyonlar açýsýndan karþýlaþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmaya ASA I-II 120 olgu dahil edildi. Sistolik arter basýncý (SAB), diyastolik arter basýncý (DAB), ortalama arter basýncý (OAB), kalp atým hýzý (KAH) ve periferik oksijen satürasyonu (SpO2); spinal anestezi öncesinde ve sonrasýnda 5 dk.’lýk, 10 dk.’lýk ve 15 dk.’lýk aralýklarla ölçüldü. Olgular üç gruba ayrýlarak intratekal aralýða Grup L’de 15 mg % 0.5 izobarik levobupivakain; Grup I’de 15 mg % 0.5 izobarik bupivakain ve Grup H’de 15 mg % 0.5 hiperbarik bupivakain verildi. Duyusal blok baþlama, gerileme ve T12’ye gerileme süreleri, maksimum duyusal blok seviyesi, motor blok baþlama, gerileme ve sonlanma süreleri kaydedildi. Olgularýn aðrý þiddetleri vizüel analog skala (VAS) ile deðerlendirildi. Ýlk analjezik gereksinim süresi, peroperatif ve postoperatif komplikasyonlar, hasta-cerrah memnuniyeti ve olgularýn tekrar ayný yöntemi tercih etme oranlarý deðerlendirildi.
BULGULAR: Gruplar arasýnda demografik veriler ve SAB, DAB, OAB, KAH, SpO2 deðerlerinde farklýlýk yoktu, grup içi karþýlaþtýrmalarda ise baþlangýç deðerlerine göre belli ölçüm zamanlarýnda anlamlý farklýlýk vardý. Duysal blok baþlama ve gerileme, motor blok sonlanma süreleri ve maksimum duysal blok seviyeleri açýsýndan gruplar arasýnda fark yoktu. Duysal bloðun T12’ye gerileme ve motor blok gerileme süresi H grubunda I grubuna göre, motor blok baþlama süresi; H grubunda I ve L gruplarýna göre kýsa idi. Gruplarýn VAS deðerleri arasýnda fark yoktu. I grubunun postoperatif ilk analjezik gereksinim süresi anlamlý uzun bulundu. Gruplarda perop ve postop komplikasyon geliþimi, hasta-cerrah memnuniyeti ve ayný yöntemi tercih etme oranlarý arasýnda ise anlamlý fark saptanmadý.
TARTIÞMA ve SONUÇ: Sonuç olarak hiperbarik bupivakain ile daha kýsa süreli olmakla birlikte, 3 lokal anestezik ajan ile konforlu ve güvenli spinal anestezi oluþturuldu.

INTRODUCTION: In our study we aimed to compare the effects of 0.5 % isobaric levobupivacaine, 0.5 % isobaric bupivacaine and 0.5 % hyperbaric bupivacaine on hemodynamic parameters, quality of spinal anaesthesia and complications.
METHODS: ASA I-II 120 cases were included in the study. The systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR) and peripheral oxygen saturation (SpO2) were measured before the spinal anaesthesia and 5 min, 10 min and 15 min intervals after the spinal anaesthesia. The cases were divided into three groups; 15 mg 0.5 % isobaric levobupivacaine in Group L; 15 mg 0.5 % isobaric bupivacaine in Group I and 15 mg 0.5 % hyperbaric bupivacaine in Group H was administered into intrathecal space. The sensorial block onset and regression times, regression time to T12, maximum sensorial block level, motor block starting, regression and ending times were recorded. The cases pain scores were evaluated with the visual analog scale (VAS). Perioperative side effects, patient and surgeon satisfactions and the patients preferance for the same method again were evaluated. In the postoperative period, the first analgesic requirement time and the development of complications were recorded for 5 days.
RESULTS: There were no differences between the groups in terms of the demographical data and in the values SAP, DAP, MAP, HR, SpO2, although some differences were observed in baseline values within groups. There were no differences between the groups in values of the sensorial block onset and regression, the motor block ending times and maximum sensorial block level. The group H was found shorter than the group I for the sensorial block regression to T12 and motor block regression times, than the groups I and L for the motor block starting time. There were no difference in VAS scores between the groups. The first postoperative analgesic requirement time of group I was siginficant longer. No differences were observed between groups in perop and postop complications, patient and surgeon satisfactions, prefering the same method again.
DISCUSSION AND CONCLUSION: As a result, three local anesthetic agents provide a comfortable and safer anesthesia although more shorter effect with the hyperbaric bupivacaine.

Abstract | Full Text PDF

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý cerrahi menopoz sonrasý oluþan hormonal deðiþiklerin nazal fizyolojiye olan etkilerini araþtýrmaktý. Deðerlendirme anterior rinoskopi (AnR), anterior rinomanometri (ARM) ve Nazal Obstrüksiyon Deðerlendirme (NOSE) skalasý kullanýlarak yapýldý ve sonuçlar istatiksel olarak analiz edildi. Bu sonuçlarýn Östrojen (E2) ve Folikül Stimülan Hormon (FSH) deðerleriyle olan korelasyonu saptandý.
YÖNTEM ve GEREÇLER: Bu çalýþmaya 39-49 yaþlarý arasýnda, çeþitli nedenlerle ooferektomi yapýlmasý planlanan, menopoza girmemiþ, sigara içmeyen, ilaç kullaným öyküsü(antihistaminik, oral kontraseptif, sistemik veya topikal dekonjestan ve steroid) bulunmayan, akut bir üst solunum yolu enfeksiyonu bulgusu ve kronik nazal hastalýk öyküsü olmayan 22 saðlýklý kadýn hasta dahil edildi. Tüm hastalar ooferektomi operasyonu öncesi menstural siklusun ovulasyon fazýnda (14-16. gün) ve postop 3. ayda olmak üzere toplam 2 kez muayene edildi. Her hastanýn preoperatif (Preop) ve postoperatif (Postop) anterior rinomanometri, anterior rinoskopi, NOSE skalasý, östrojen ve FSH sonuçlarý kaydedildi.
BULGULAR: Preop ve postop anterior rinomanometri farklarý ile anterior rinoskopi ve NOSE skalasý toplam puan farklarý arasýnda istatistiksel olarak anlamlý fark bulundu. Hastalarýn ooferektomi sonrasý burun týkanýklýðý þikayeti azaldý.
TARTIÞMA ve SONUÇ: Ovarian hormonlar nazal mukozada fizyolojik deðiþiklikler yapar, ARM ve AnR nazal fizyolojide meydana gelen deðiþikliklerin tespitinde yararlýdýr.

INTRODUCTION: The aim of this study was to examine the effects of hormonal changes of post surgical menopause on nasal physiology. Evaluation was made by the help of anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and NOSE scale and data was statistically analyzed. The correlation of these results is determined with estrogen and FSH values.
METHODS: 22 women of age between 39-49, planned for oopherectomy surgery for different reasons, non-menopausal, non-smoker, with no history of drug use (antihistaminic, Combine Oral Contraception Pill (COCP), systemic or topical decongestant and steroids), with no upper airway infections signs and chronic nasal disease were included in this study.
All patients were examined twice, first before oopherectomy surgery at ovarian phase of menstrual cycle (day 14-16) and second after surgery in the third month. For all patients pre and post operation anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and NOSE scale results were recorded.
RESULTS: Statistically significant differences were found between pre operation and post operation anterior rhinomanometry differences and anterior rhinoscopy and NOSE scale total score differences. Nasal congestion is decreased in oopherectomized women.
DISCUSSION AND CONCLUSION: Ovarian hormones cause physiological changes in nasal mucosa; ARM and AnR are useful tools in determining nasal physiological changes.

Abstract | Full Text PDF

Hiperhidroz vücudun normal fizyolojik ihtiyacýndan daha fazla ter salgýlanmasý ile karakterize bir hastalýktýr ve primer veya sekonder olarak 2 gruba ayrýlabilir. Sekonder hiperhidroz altta yatan sistemik bir hastalýðýn göstergesi iken, primer hiperhidrozun nedeni belli deðildir ve çoðunlukla avuç içi, ayak tabaný ve aksiler bölgeyi etkiler. Günümüzde primer hiperhidroz tedavisi baþlýca lokal antiperspiranlar ve iyontoforez tedavisini içermektedir.
Ýyontoforez, elektrik akýmý kullanýlmasý yoluyla deri içine çeþitli iyonlarýn giriþidir ve hiperhidroz tedavisindeki etkinliði ve güvenilirliði uzun yýllardýr bilinmektedir. Bu nedenle lokal tedavilere cevap alýnamayan durumlarda invaziv giriþimden önce iyontoforez iyi bir tedavi seçeneði olarak kullanýlabilir. Ancak hastalarýn semptomsuz kalabilmeleri için idame tedavisi gereklidir. Musluk suyu ile uygulanabildiði gibi antikolinerjik ajanlar ve botulinum toksini de ilave edilebilir. Farklý uygulama önerileri olsa da, genellikle haftada 3-5 seans uygulanýr. Bu makalede, hiperhidroz tedavisinde uygulanan iyontoforezin klasik ve güncel uygulama yöntemlerini gözden geçirerek literatür bilgileri ýþýðýnda derlemeyi amaçladýk.

Hyperhidrosis is a disease characterized by the secretion of sweat in excess to the normal physiologic needs of the body and can be classified in 2 groups as a primary or secondary hyperhidrosis. While secondary hyperhidrosis is an indicative of an underlying systemic disease, the cause of primary hyperhidrosis is unknown and most commonly affects palms, soles and axillae.
Current primary hyperhidrosis therapy mainly includes local antiperspirants and iontophoresis. Iontophoresis is the entry of various ions into the skin by using electric flow and its effectiveness and reliability in the treatment of hyperhidrosis have been known for years. Therefore in the cases that no reply taken to treatments, iontophoresis can be used as a good treatment choice before the invasive initiative is planned. However, to keep the patients symptom free, maintanence treatments are required. Although it can be applied with tap water, anticholinergic agents and botulinum toxin can be added. Even if there may be different application advices, 3 or 5 sessions per week is especially advised. In this artcile, we aimed to review the classic and current therapeutic strategies for iontophoresis to treat hyperhidrosis in the light of data in literature.

Abstract | Full Text PDF

Besin reaksiyonlarý; besin veya besin katký maddelerinin oral yolla alýnmasýndan sonra vücutta meydana gelen beklenmedik etkilerdir. Ýmmünolojik mekanizmalarla oluþan reaksiyonlar "besin alerjisi", diðer yollarla oluþan reaksiyonlar "alerjik olmayan besin aþýrý duyarlýlýðý" olarak adlandýrýlýr. Besin alerjisi yalnýzca duyarlý kiþilerde IgE veya IgE’ye baðlý olmayan immunolojik mekanizmalarla oluþur. Besin alerjisinin görülme sýklýðý çocuklarda % 2-8’dir. Özellikle 0-1 yaþ besin alerjisinin en sýk görüldüðü dönemdir. Tanýda altýn standart eliminasyon diyeti ve besin yükleme testidir.
Bu makalede; süt çocuðu döneminde rektal kanama öyküsü ile gelen sigmoidoskopi yapýlarak besin alerjisi tanýsý alan 2 olgu sunulmuþtur.

Food allergy; foods or food additives after taking orally unexpected effects that occur in the body are. Caused by immunological mechanisms are defined as food allergy reactions. formed by other means are referred to as non-allergic food hypersensitivity reactions. Food allergies are occurred that immunological mechanisms with none connected with IgE or IgE. The incidence of food allergies in children is 2-8 %. The most common period of were seen of food allergies are especially 0-1 years. Gold standard for diagnosis is the elimination diet and nutrient loading test. In this article; two cases of food allergy is presented that infants with a history of rectal bleeding and diagnosed with sigmoidoscopy.

Abstract | Full Text PDF

Yenidoðan alloimmun trombositopenisi, fetal trombosit antijenlerine karþý maternal alloimmünizasyon ile karakterizedir. Annenin trombosit sayýsý sýklýkla normaldir. Fetusta veya yenidoðanda ölümle veya nörolojik hasarla sonuçlanabilen intrakraniyal kanama geliþebilir. Tedavide ciddi trombositopeni veya hayatý tehdit eden kanama varlýðýnda antijen negatif trombosit süspansiyonu veya random trombosit süspansiyonu kullanýlabilir.Yüksek doz intravenöz immunglobulin tedavisi günümüzde baþlýca tedavi seçeneðidir. Makat geliþ nedeniyle sezaryan ile zamanýnda doðan olgunun, postnatal 69. saatinde sarýlýðý nedeniyle yapýlan tetkiklerinde, trombosit sayýsý 19.000/mm³ bulundu. Periferik yaymada tekli iri trombositler tespit edildi. Annenin trombosit sayýsý normaldi. Trombosit antikorlarý negatif sonuçlandý. Kraniyal ve batýn USG’lerinde kanama veya hematom saptanmadý. Tedavi olarak 1 gr/kg/gün ÝVÝG verildi. Taburculuktan on gün sonra trombositlerinin tekrar 28000/mm³’e düþmesi üzerine 2. doz 1 gr/kg ÝVÝG tedavisi verildi. Ýzleminde trombositopenisi tekrarlamadý. Yenidoðanda tespit edilen trombositopeni, öncelikli nedenler ile birlikte alloimmun trombositopeniyi de akla getirmelidir.

Neonatal alloimmune thrombocytopenia is charecterised by aganist fetal platelet antigens result of maternal alloimmunization. Maternal platelet count is often normal. Intracranial hemorrhage may develop alloimmune thrombocytopenia. Morever randomly platelets can be used treatment presence of serious or life-threatening bleeding or thrombocytopenia. in patients have antigen negative platelets. It can result permanent neurological damage in fetus or newborn death.Nowadays, intravenous immunoglobulin treatment is the essential treatment of alloimmune thrombocytopenia. The our case delivery was caesarian section due to brech presentation. Because of the investigation due to postnatal hyperbilirubinemia at the laboratory evaluation performed in 69. hours and platelet count was revealed 19.000/mm³, peripheral blood smear revealed single large platelets. The mother's platelet count was normal. Platelet antibodies has resulted negative. Cranial and abdominal ultrasonography was not detected bleeding or hematoma in cranium and abdomen. IVIG were given a single dose 1 g/kg/day at treatment. 10 days after discharge, this case platelets count was 28000/mm³. The platelets due to again to fall into the case second IVIG therapy 1 g/kg was given. Thrombositopenia was not repeated in follow-up. Thrombocytopenia were found in newborns, along with the main reason to do thrombocytopenia, it should bring about alloimmune thrombocytopenia in the differential diagnosis.

Abstract | Full Text PDF

Spontan rektus kýlýf hematomu akut karýn aðrýlarý ve intraabdomial tümör ayýrýcý tanýsýnda yer almasý gereken nadir durumlardandýr. Kliniði ve patogenezi iyi tanýmlanmýþ olup tedavisi de çoðunlukla konservatiftir. Bizim olgumuzda da akut karýn aðrýsý ile gelen hastamýzda taný sonrasý konservatif tedavi ile tedavi saðlanmýþtýr.

Spontaneous rectus sheath hematoma is a rare condition which should be considered in the differential diagnosis of acute abdominal conditios and intraabdominal tumors. Its clinical setting and pathogenesis is well-defined, and treatment is especially conservative. In our case the patient admitted to the emergency unit because of the acute abdominal pain which was resolved in days by conservative therapy.

Abstract | Full Text PDF

Nörofibromatoziste farklý akciðer tutulumlarý mevcuttur. Bu çalýþmada toraks bilgisayarlý tomografisinde (BT) plevral kitle görünümü veren nörofibromatozisli bir olgu sunulmuþtur. 44 yaþýnda erkek hastanýn çocukluðundan beri vücudunun birçok yerinde ciltte nodülleri mevcuttu. Hastaya batýn BT ve toraks BT çekilmiþ. Toraks BT’de, sol ac alt lob süperior segmentte plevraya uzaným gösteren 43*22 mm boyutunda nodüler lezyon tespit edilmiþ. Rutin tetkikler, tümör markýrlarý, fiberoptik bronkoskopi, solunum fonksiyon testleri, karbon monoksit difüzyon kapasitesi normal sýnýrlardaydý. Cilt lezyonlarýndan bir adet biopsi alýndý. Cilt biopsi sonucu nörofibrom olarak geldi. Üç aylýk takip sonucunda, Toraks BT’deki lezyonda hiçbir deðiþiklik saptanmadýðýndan lezyonun nörofibromatozisin akciðer tutulumu olduðu düþünüldü. Nörofibromatozis tanýsý konan olgularda farklý plöropulmoner lezyonlar saptanabilir. Bizim olgumuzda olduðu gibi nörofibromatozis tanýlý olgularda plevral kitle görünümü saptandýðýnda primer hastalýða baðlý nörofibrom da düþünülmelidir.

There is various pulmoner attacks of neurofibromatosis. We presented a neurofibromatosis case with pleural lesion in this study. Fourty four years old male patient. There is a lot of dermal nodules in different sides of his body since childhood. Thorax and abdominal Computed Tomography (CT) has taken. There was a noduler lesion in left lung lower lobe superior segment. It was 43*22 mm size and spurred to pleura. Routine examinations, tumoral markers, fiberoptics bronchoscopy, respiratory function tests and carbon monoxide diffusion capacity test were assessed in normal limits. One biopsy material has taken from dermal lesion. Dermal biopsy result was neurofibrom. After three mounths there was not any difference in lesion at control Thorax CT. The pleural lesion considered as thoracic neurofibroma. There is different pleuropulmoner lesions in neurofibromatosis patients. When we detect pleural mass in neurofibromatosis cases, we must think neurofibrom originated from primer disease in seperator diagnose.

Abstract | Full Text PDF

Akut transvers miyelit duyu kaybý, sfinkter kusuru ve ekstremitelerde ilerleyici güçsüzlük ile karakterize bir hastalýktýr. Ateþ, miyalji, sýrt aðrýsý, bacak aðrýsý, parestezi ve güçsüzlük yakýnmalarý en sýk görülen baþvuru nedenleridir. Biz bu makalede karýn aðrýsý ile baþvuran ve akut transvers miyelit semptomlarý geliþen 13 yaþýndaki bir kýz çocuðunu sunuyoruz. Plazmaferez, intravenöz immünglobulin ve pulse steroid tedavisinin uygulanmasýnýn ardýndan semptomlarý azaldý. Bu olgu bilindiði kadarýyla akut batýn tablosu ile baþvuran ve akut transvers miyelit saptanan ilk olgudur.

Acute transverse myelitis is characterized by paresthesia, sphincter dysfunction, and progressive weakness in the all extremities. Fever, miyalgia, back pain, lower limb pain, paraparesia, and weakness were the most common clinical presentations. We report 13-year-old girl with transverse myelitis who presented with acute abdominal pain. Sphincter dysfunction and weakness improved more slowly than plasmapheresis, intravenous immunglobuline, and methylprednisone pulse therapy were performed. This is the first report, to our knowledge, first presented of acute abdominal pain of a pediatric patient with transverse myelitis.

Abstract | Full Text PDF

Baþ boyun mukozal malign melanomalarý (MMM) kötü prognozla seyreden ve nadir karþýlaþýlan onkolojik hastalýklardýr. MMM baþ boyun bölgesinde nazal septumu, paranazal sinüsleri, lateral nazal duvarý ve oral kaviteyi tutabilir. MMM’larýn ana tedavisi cerrahi olmakla birlikte tedavide kemoterapi ve radyoterapi cerrahiyle veya birbirleriyle kombine edilebilir. Fakat ileri yaþlardaki hastalar için herhangi bir tedavi vermeden sadece takip de bir seçenek olabilir. Biz burada cerrahi de dahil tüm tedavileri reddederek takip seçeneðini kullanan geriatrik yaþtaki 3 vaka sunumunu takip sonuçlarýmýzla ele alacaðýz.

Head and neck mucosal malign melanomas (MMM) are very rare oncologic diseases with poor prognostic outcomes. MMM involves nasal septum, paranasal sinuses, lateral nasal wall, oral cavity in the head and neck region. While the main therapotic option stands to be surgery in the treatment protocol chemotherapy and radiotherapy can be combined with or without surgery. But in the older ages follow up may be a consideration without any treatment. Here we report 3 MMM of the head and neck cases in the geriatric ages who all denied any treatment regimes including surgery and chose follow up option.

Abstract | Full Text PDF