PSA yüksekliði nedeniyle prostat biyopsisi yapýlmýþ hastalarýn biyopsi öncesi tespit edilen tam kan deðerlerinin biyopsi sonucunu ön görüp görmediðini araþtýrmayý amaçladýk. Üç üniversite hastanesinde psa yüksekliði nedeniyle prostat biyopsisi yapýlan toplam 281 hastanýn verileri retrospektif olarak tarandý. Hastalarýn yaþlarý, prostat biyopsisi öncesi tam kan (lökosit, lenfosit, nötrofil, monosit, trombosit), total psa, serbest psa deðerleri, prostat hacmi ve prostat biyopsi sonuçlarý kaydedildi. Prostat biyopsisi sonucuna göre gruplar; I: Prostat kanseri, II: Benign prostat hiperplazisi, III: Kronik prostatit þeklinde oluþturuldu. Biyopsi öncesi tam kan deðerlerinin ve bu deðerlerin birbirlerine olan oranlarýnýn gruplar açýsýndan istatistiksel olarak anlamlý bir öngörü deðerlerinin olup olmadýðý araþtýrýldý. Gruplar arasýnda trombosit sayýsý, trombosit/ lenfosit ve nötrofil/monosit oranlarý açýsýndan istatistiksel olarak anlamlý bir fark saptandý. Grup III' deki hastalarýn hem trombosit hem de trombosit/lenfosit deðerleri Grup I ve Grup II' deki hastalarýn deðerlerinden anlamlý olarak yüksek bulundu. Yine Grup III’ deki hastalarýn nötrofil/monosit deðerleri Grup II' deki hastalarýn deðerlerinden anlamlý olarak yüksek bulundu. PSA yüksekliði nedeniyle prostat biyopsisi planlanan hastalarýn iþlem öncesi trombosit sayýsý, trombosit/lenfosit ve nötrofil/monosit oranlarýna bakýlarak prostat biyopsi sonucunun kronik prostatit sonucunu ön görülebileceði bu çalýþma ile gösterildi. Bununla birlikte geniþ serili prospektif vaka kontrol çalýþmalarý tam kan deðerlerinin prostat biyopsi sonuçlarýný öngörmedeki deðerinin ortaya konmasýna yardýmcý olacaktýr.

We aimed to evaluate, if complete blood counts (CBC) before prostate biopsy could predict the result of the prostate biopsy performed due to the increased PSA levels in this study. We retrospectively evaluated the data of the 281 patients whom undergone a prostate biopsy because of the increased levels of PSA in three university hospital. Patient's age, pre-biopsy CBC, total PSA, free PSA, prostate volume and pathological results were recorded. Patients were grouped according to the pathological results such as; I: prostate cancer, II: Benign prostate hiperplasia, III: chronic prostatitis. We evaluated the predictive effect of CBC and ratios of this counts among the three groups statistically. There were a statistically significant difference among the three groups regarding platelet count, neutrophil/monocyte (NMR) and platelet/lymphocyte ratio (PLR). The patelet count and PLR are significantly higher in group III rather than group I and II. Also the NMR was significantly higher in group III than group II. We have shown that pre-biopsy platelet count, NMR and PLR could predict the chronic prostatitis result of patient whom undergone a prostate biopsy because of the increased levels of PSA. Furthermore, prospective case-controlled, large studies would be helpful to explore the predictive value of CBC on the prostate biopsy results.

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Amaç: Çalýþmamýzda, ST yükselmeli myokard enfarktüsü tanýsýyla primer perkütan koroner giriþim uygulanan hastalarda, inkomplet revaskülarizasyonun kantitatif bir ölçümü olarak kabul edilebilecek rezidüel SYNTAX skoru ile hastane içi dönemdeki sonlaným noktalarý arasýndaki iliþkiyi saptamak amaçlanmýþtýr.
Gereç ve Yöntem: Çalýþmaya, uygunluk kriterlerini karþýlayan 105 hasta alýndý, rSS=0 olan grup komplet revaskülarizasyon, rSS≥1 olan grup ise inkomplet revaskülarizasyon olarak tanýmlandý. Hastalarýn klinik, demografik verileri, laboratuvar deðerleri, anjiografik, prosedürel karakteristikleri, lezyon özellikleri, farklý skorlama sistemleri ve hastane içi sonlaným noktalarý gruplar arasýnda karþýlaþtýrýldý.
Bulgular: Olgularýn 35’ inde (%33,3) rSS=0, 70’ inde (%67.7) rSS ≥1 bulundu. Olgularýn 86’ sý (%81.9) erkek, 19’u (%18.1) kadýndý. Gruplar arasýnda demografik verilerden yaþ, boy, hipertansiyon öyküsü, sigara içiciliði açýsýndan istatistiksel anlamlý fark bulundu (p<0.05). Laboratuvar deðerleri açýsýndan anlamlý fark bulunmadý (p>0.05). Anjiografik karakteristiklerden stent uzunluðu ve çapý açýsýndan gruplar arasýnda anlamlý fark saptandý (p<0.05). Lezyon özellikleri açýsýndan anlamlý fark saptanmadý (p>0.05). Hastane içi sonlaným noktalarýndan yalnýzca rekürren iskemi rSS≥1 olan inkomplet revaskülarizasyon grubunda istatistiksel anlamlý yüksek saptandý (p<0.05).
Sonuç: Ýnkomplet revaskülarizasyonun dolaylý bir belirteci olarak hesapladýðýmýz rezidüel Syntax skoru STEMI hastalarýnda hastane içi sonlaným noktalarýný öngördürmekte yeterli olamamaktadýr. Bu konuda uzun ve kýsa dönem mortaliteyi göstermek açýsýndan daha geniþ kapsamlý randomize kontrollü çalýþmalara ihtiyaç vardýr.

Objective: In our study, we aimed to show the relation between residuel Syntax score which can be considered as a quantitative measurement of residual ischemia and inhospital outcomes who diagnosed ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Material and Methods: 105 patients meeting the eligibility criteria were included to the study. Complete revascularization was defined as rSS=0 and incomplete revascularization was defined as rSS≥1. Clinical, demographic data, laboratory values, angiographic, procedural characteristics, lesion characteristics, different scoring systems and in-hospital endpoints were compared between groups.
Results: 35 patients (33.3%) in rSS = 0 and 70 patients (67.7%) were found in rSS ≥ 1 group. 86 patients (81.9%) were male and 19 (18.1%) were female. Demographic data between the groups in age, height, history of hypertension, cigarette smoking was statistically significant (p <0.05). All laboratory values have no significant difference (p> 0.05). Angiographic characteristics between the groups consistent with the stent length and diameters were significantly different (p <0.05). There was no significant difference in lesion characteristics (p> 0.05). Only recurrent ischemia from in-hospital outcomes was significantly higher in the RSS ≥ 1 group which was defined as incomplete revascularization (p <0.05).
Conclusion: Residual Syntax score which was calculated as an indirect marker of incomplete revascularization is not enough for prediction of in-hospital endpoints patients with STEMI. In this regard randomized controlled and more extensive studies are needed to demonstrate long-and short-term mortality.

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Dirençli glokom olgularýnda Ahmed glokom valf(AGV) implantasyonunun göz içi basýncý, görme keskinliði ve kornea üzerindeki uzun dönem etkilerini deðerlendirmektir. 2003-2014 yýllarý arasýnda dirençli glokom tanýsýyla Ahmed valf implantasyonu yapýlan olgular geriye dönük incelendi. Görme keskinliði en az ýþýk hissi düzeyinde olan ve 12 ay takip süresi olan hastalar seçildi. Ameliyat öncesi ve son muayenedeki en iyi düzeltilmiþ görme keskinliði(EÝDGK), göz içi basýncý(GÝB), medikasyon sayýsý ve merkezi kornea kalýnlýðý (MKK) kaydedildi. Komplikasyonlar ve uygulanan ilave cerrahiler not edildi. Ýlave glokom cerrahilerine ihtiyaç duyulmadan GÝB’nýn ilaçlý/ilaçsýz 5-22 mmHg olmasý ve görme keskinliðinin korunmasý ve kornea saydamlýðýnýn devamlýlýðý tam cerrahi baþarý sayýldý. Neovasküler(n=13), afakik(n=13), penetran keratoplastiye ikincil(n=7), konjenital(n=4), travmatik (n=5) ve primer dirençli glokom (n=6) olmak üzere 47 dirençli glokom olgusunun 48 gözü deðerlendirildi. Yaþ ortalamasý 50.40±22.80 yýl, takip süresi 32.33±20.78(12-84) ay, operasyon öncesi ve son takipteki EÝDGK sýrasýyla 1.50±0.61 ve 1.60 ±0.57 LogMAR, GÝB deðerleri sýrasýyla 39.22±9.47 ve 17.02±4.29 mmHg, medikasyon sayýsý sýrasýyla 3.47±0.92 ve 1.52±1.09, MKK sýrasýyla 590.00±88.86 ve 655.25±170.88 mikron saptandý.(p<0.05) Ýlave uygulanan cerrahiler; suprakoroidal hemoraji drenajý(n=1), tüp ucu temizliði (n=5), anteriyor vitrektomi (n=5), tüp repozisyonu(n=3), tüp ucu kýsaltýlmasý(n=6), grefon/korneal yetmezlik nedeniyle PK(n=3), ilave siklodestriktif iþlem(n=5) þeklindeydi. Tam cerrahi, toplam ve baþarýsýzlýk oranlarý sýrasýyla %46 (n=22), %89.4(n=43), %10.6(n=5) olarak saptandý. AGV ile dirençli glokom olgularýnda tatmin edici göz içi basýncý düþüþü saðlanmaktadýr. Ancak zamanla görünür bir tüp-endotel temasý olmasa bile endotel yetmezliðine baðlý kornea ödemi ve görme kaybý oluþmaktadýr.

To evaluate the efficacy of the long term results of Ahmed glaucoma valve(AGV) implantation at refractory glaucoma cases on intraocular pressure, visual acuity and cornea. The cases AGV implanted with refractory glaucoma were evaluated retrospectively between the years 2003 to 2014. The cases were selected at least light perception visual acuity and followed longer than 12 months. Preoperative and postoperative corrected distance visual acuity levels(CDVA), intraocular pressure(IOP), number of medication and central corneal thickness(CCT) were recorded. Complications and additional surgeries were noted. The perfect achievement were considered as the combination of; no additional surgery necessity, achieved mean IOP level between 5-22 mmHg, stability of visual acuity and corneal transparency. Forty eight eyes of 47 refractory glaucoma cases with neovascular(n=13), aphacic(n=13), secondary to penetrating keratoplasty(PK)(n=7), congenital(n=4), traumatic(n=5) and primer refractory glaucoma(n=6). Mean age was 50.40±22.80 years, mean follow up was 32.33±20.78(12-84) months, preoperative and postoperative CDVA were respectively 1.50±0.61 and 1.60±0.57 LogMAR, IOP values were 39.22±9.47 and 17.02±4.29 mmHg, number of medication were 3.47±0.92 and 1.52±1.09, CCT were 590.00±88.86 and 655.25 ±170.88µm.(p<0.05) Additional surgeries were suprachoroidal hemorhage drainage(n=1), AGV tip cleaning(n=5), anterior vitrectomy(n=5), AGV reposition(n=3), AGV tip shorthening(n=6), corneal greft insufficieny related PK(n=3), additional cyclodestructive procedures(n=5). Perfect surgical, total surgical success and unsucceful surgical rates were detected as %46(n=22), %89.4(n=43) and %10.6(n=5) respectively. AGV was a considerable succesfull surgical option for decreasing the IOP in refractory glaucoma cases. However even there is not a significant AGV endothelial touch, endothelial insufficiency related corneal edema and eventual visual loss was seen.

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Amaç: Çalýþmamýzda spinal anestezi ile yapýlan elektif sezeryan ameliyatýna alýnacak hastalarda vücut kitle indeksi, vücut yüzey alaný, abdominal çevre ve bel/kalça oranlarý gibi ölçülen ya da hesaplanan antropometrik deðerlerin spinal anestezinin sensoryal blok karakteristiðine ve hemodinamiye olan etkilerini saptamayý amaçladýk. Materyal ve metod: Elektif sezaryen operasyonu geçirecek, 18-35 yaþ arasý, “Amerikan Anestezistler Derneði” (ASA) fizyolojik skoru I-II grubu olan 50 olgu çalýþma kapsamýna alýndý. Operasyon öncesi hastalarýn aðýrlýklarý tartýlýp, boylarý ölçülerek vücut yüzey alaný ve vücut kitle indeksleri hesaplandý. Bunun yanýnda abdominal, bel ve kalça çevrelerinin uygun anatomik noktalardan ölçümü yapýldý ve kaydedildi. Oturur pozisyonda L3-L4 aralýðýndan 25G Quincke iðne ile subaraknoid aralýða girildikten sonra 10mg hiperbarik bupivakain HCL ile spinal anestezi uygulandý. Duyusal bloðun T4 seviyesine ulaþma zamaný, maksimum duyusal blok seviyesi her olguda kaydedildi. Spinal anestezi süresince hipotansiyon ve bradikardi geliþen olgular kaydedildi. Bulgular: Antropometrik ölçümlere dayalý yaptýðýmýz çalýþmada; hastalarýn %54’ünde hipotansiyon görülürken kýsa boy, geniþ abdominal çevre, yüksek vücut kitle indeksi, düþük vücut yüzey alaný ve yüksek bel/kalça oranlarý olan hastalarda hipotansiyon görülme sýklýðýnýn arttýðý görüldü. Hastalarýn %18’inde bradikardi geliþirken kýsa boy, yüksek vücut kitle indeksi, düþük vücut yüzey alaný ve yüksek bel/kalça oranlarý olan hastalarda bradikardi görülme sýklýðýnýn arttýðýný saptadýk. Ayrýca çalýþmada boy, kilo ve vücut yüzey alaný deðerleriyle sensöryel bloðun T4 dermatomuna ulaþma süresi arasýnda pozitif korelasyon saptanýrken, vücut kitle indeksi ile maksimum sensöryal bloðun oluþtuðu dermatom sahasý arasýnda pozitif korelasyon olduðunu saptandý. Ayrýca vücut kitle indeksi ve bel/kalça oraný ile efedrin ihtiyacý arasýnda da pozitif korelasyon saptandý. Sonuç: Spinal aneztezi uygulamasý planlanan hastalarda yapýlacak basit ve zaman almayan antropometrik ölçümlerin vereceði deðerlerler doðrultusunda geliþebilecek olasý bradikardi ve hipotansiyon durumlarýna karþý daha hazýrlýklý olunabilir, spinal anestezi duysal blok karakteristiði hakkýnda tahmin yürütülebilir.

Objective: We aimed to determine the effects of anthropometric values; body mass index, body surface area, abdominal circumference, and waist/hip ratio on sensorial block characteristics of spinal anesthesia and hemodynamics in patients to undergo cesarean sections performed under spinal anesthesia. Material and Method: 50 cases aged between 18-35, who would undergo elective cesarean section were included in the study. Weight, length, body surface area, and body mass index, abdominal, waist, and hip circumferences of the patients were measured. Spinal anesthesia was applied with 10mg hyperbaric bupivacaine HCL. The time of sensorial block to reach the T4 level and the maximum sensorial block level were recorded in each case. Cases developing hypotension and bradycardia during the spinal anesthesia were recorded. Results: In our study conducted based on anthropometric measurements; hypotension was observed in 54% of patients and it was determined that the prevalence of hypotension increased in patients with a shorter height, larger abdominal circumference, higher body mass index, lower body surface area and a higher waist/hip ratio. It was found that the prevalence of bradycardia increased in patients with a shorter height, higher body mass index, lower body surface area and a higher waist/hip ratio. This study also determined a positive correlation between the values of height, weight and body surface area and the time of sensorial block to reach the T4 dermatome; and a positive correlation between the body mass index and the dermatome area of the maximum sensorial block. Conclusion: It is suggested to be prepared more against bradycardia and hypotension that may develop in accordance with the values to be given by simple and non-time consuming anthropometric measurements in patients who are planned to receive a spinal anesthesia, and to estimate the sensorial block characteristics of the spinal anesthesia.

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Bu çalýþmada amacýmýz yenidoðan diyabetik anne bebeklerinde kranial ultrasonografi ile serebellar vermis yüksekliði ve transvers serebellar çap parametrelerinin incelenmesidir. Kýrk gestasyonel diyabetli anne bebeði (21 tane gebelik haftasýna uygun, 19 tane gebelik haftasýna göre büyük doðmuþ bebek) ile 40 saðlýklý bebek, gebelik haftalarýna göre eþleþtirilerek doðumlarýnýn ilk 24 saati içinde kranial ultrasonografi ile deðerlendirildi.. Serebellar vermis yüksekliði ve transvers serebellar çap sýrasýyla, ön fontanel midsagital kesit ve mastoid fontanel koronal kesit kullanýlarak ölçüldü. Diyabetik anne bebekleri ve kontrol grubu kýyaslandýðýnda, serebellar vermis yüksekliði ve transvers serebellar çap ölçümleri açýsýndan iki grup arasýnda anlamlý fark saptanmadý. Gestasyonel diyabet, yenidoðan bebeklerde serebellum boyutlarýný etkilemeyebilir. Daha geniþ serilerle yapýlacak çalýþmalarda, diyabetik anne bebeklerinin uzun vadede nörolojik geliþimleri deðerlendirilirken serebellum boyut ve morfolojisinin de deðerlendirilmesi faydalý olabilir.

In this study, our aim was to investigate cerebellar vermis height and transverse cerebellar diameter with cranial ultrasonography in infants of gestational diabetic mothers. Forty infants of diabetic mothers (21 appropriate-for-gestational age and 19 large-for-gestational age infants) and 40 gestational-age matched healthy controls were evaluated with cranial ultrasonography within 24 hours of birth. Cerebellar vermis height and transverse cerebellar diameter were measured midsagitally from anterior fontanelle and coronally from mastoid fontanelle, respectively. In terms of cerebellar vermis height and transverse cerebellar diameter, no statistically significant difference was found between infants of diabetic mothers and healthy controls. Gestational diabetes mellitus could not affect cerebellar size in neonates. In studies with larger series, evaluation of cerebellar size and morphology in infants of diabetic mothers during follow up of their neurodevelopment at long-term could also be useful.

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Çalýþmanýn amacý, gürültülü ortamda çalýþan fabrika iþçilerinin, nörootolojik semptomlar ve yaþam kalitesi açýsýndan deðerlendirilmesidir. Çalýþmaya gürültülü ortamda (85 dbA ve üzerinde) çalýþan 105 erkek iþçi alýndý. Ýþçiler gürültüye maruziyet süresine göre 3 gruba ayrýldý (1. Grup: 0-5 yýl, 2. Grup: 6-14 yýl, 3. Grup: 15 yýl ve üzeri). Sessiz ortamda çalýþan gönüllü 60 birey kontrol grubuna dahil edildi. Tüm bireylerden Baþ Dönmesi Engellilik Anketi (BDEA), Dünya Saðlýk Örgütü Yaþam Kalitesi Ölçeðini (WHOQOL BREF-TR) doldurmalarý ve nörootolojik semptomlara yönelik sorularý cevaplamalarý istendi. Kontrol grubu ile karþýlaþtýrýldýðýnda fabrika iþçilerinde BDEA’nýn; emosyonel, fiziksel, fonksiyonel ve toplam skorlarýnda, WHOQL BREF-TR’nin sosyal ve bedensel skorlarýnda ve nörootolojik semptomlardan sersemlik, dengesizlik, bulantý veya kusma, baþ aðrýsý, konsantrasyon bozukluðu, iþitme kaybý, çýnlama, kulakta dolgunluk, yüksek sesten rahatsýzlýk ve kalabalýk ortamlardan rahatsýzlýkta istatistiksel olarak anlamlý farklýlýk saptandý (p<0.05). Sonuç olarak gürültüye maruz kalan iþçilerde; nörootolojik semptomlarýn yaþam kalitesini etkileyebileceði düþünüldü.

The purpose of this study was to evaluate of the health quality and neurotologic symptoms in the factory workers who work in noisy environments. 105 male workers who had been working in noisy environments (equal to or above 85 dB) were taken to this study. Workers were divided into 3 groups according to the time of exposure to noise (Group 1: 0-5 years, Group 2: 6-14 years, Group 3: 15 years and over). Sixty volunteer males whose working in silent environment were added to control group. It was asked to all subjects to fill results of Dizziness Handicap Inventory (DHI), World Health Organization Quality of Life Questionnairre (WHOQL-BREF-TR) and to answer all the questions about neurotologic symptoms. In comparison to control group, factory workers showed statistically significant difference by means of DHI emotional, physical, functional and total scores, WHOQL BREF-TR social relationship and physical health scores. (p<0.05). As statistically significant differences were obtained between two groups from neurotologic symptoms of lightheadedness, dizziness, nausea or vomiting, headache, lack of concentration, hearing loss, tinnitus, ear fullness, discomfort of the loudness and discomfort of the crowded environment. As a result, it has been considered to affect the quality of life of neurotologic symptoms in the factory workers who work in noisy environments.

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Bu çalýþmadaki amacýmýz plazma seviyeleri çoðunlukla genetik regülasyon altýnda olan Lipoprotein(a)[Lp(a)]’ nýn, Türk dislipidemik hastalarda koroner arter hastalýðý için bir risk faktörü olarak kabul edilip edilemeyeceðini Framingham risk skorlama sistemine göre deðerlendirmekti. Framingham risk skorlama sistemine göre düþük ve yüksek riskli 173 vaka çalýþmaya alýnmýþ ve Lp(a)’nýn diðer majör risk faktörleriyle iliþkisine bakýlmýþtýr. Çalýþma sonucunda Lp(a) düzeyi ile Framingham risk grubu arasýnda istatistiksel olarak anlamlý bir iliþki saptayamadýk. Lipoprotein(a) düzeyi ile trigliseridler arasýnda istatistiksel olarak anlamlý pozitif bir iliþki saptanmasýna raðmen, cinsiyet, yaþ, HT, DM varlýðý, sigara kullanýmý, total kolesterol, HDL kolesterol ve LDL ile Lp(a) yüksekliði arasýnda anlamlý bir iliþki bulunamamýþtýr.

The aim of our study was to investigate the value of genetically controlled lipoprotein(a) as a risk factor for coronary artery disease in Turkish dyslipidemic patients according to Framingham risk scoring system. Totally 173 high and low-risk dyslipidemic patients according to Framingham risk scoring system were enrolled and Lp(a)’s associations with major risk factors were studied. At the end of the study, there was not a statistically significant correlation between the Lp(a) level and Framingham risk group. Although there was a statistically significant positive correlation between TG levels and high levels of Lp(a), there were not such a relationship between Lp(a)’s high levels and other parameters such as age, sex, HT, DM, smoking status, total cholesterol, HDL cholesterol and LDL cholesterol.

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Polikistik over sendromu, kadýnlarda en sýk görülen metabolic bozukluktur. Oluþum mekanizmasý halen net olarak aydýnlanmamýþ olan PKOS ile alakalý pekçok hayvan çalýþmalarý mevcuttur.
PKOS modeli oluþturmak ve hastalýk mekanizmasýný anlamak amacýyla, sýrasýyla dehidroepiandrosteron sülfat uygulamasý, östradiol valerate enjeksiyonu, fetal androgen verilmesi ve letrozol uygulamasý denenmiþtir. Çalýþmamýzda, bu modelleri derlemeye çalýþtýk.

Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder in reproductive aged women. PCOS has a multi-system presentation. The mechanisms involved in polycystic ovary formation and related metabolic dysfunction have not been fully understood, although many animal and human studies have been conducted.
Different techniques were experimented on animals to induce PCOS. Chronologically, the experimental methods used in PCOS induction included dehydroepiandrosterone application, estradiol valerate injection, fetal androgen administration and letrozole use. All of these models were described in this review article.

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Son yýllarda obezitenin osteoporoza karþý koruyucu olduðu yönündeki hakim görüþe karþýt bulgularýn ön plana çýktýðý görülmektedir. Obezite, kalça gibi bazý lokalizasyonlardaki kýrýklar için koruyucu, humerus ve ayak bileði gibi lokalizasyonlar için ise risk faktörü olarak gösterilmektedir. Obezitenin kemik metabolizmasý ile iliþkisi çok yönlü ve karmaþýktýr. Obez kiþilerde kýrýk komplikasyonlarýnýn daha sýk görülmesi ve iyileþme sonrasý elde edilen fonksiyonel düzelmenin yetersiz olabilmesi gibi nedenlerle; obezite kýrýk iliþkisinin aydýnlatýlmasý ve kýrýklarýn öngörülebilmesi çok önemlidir. Bu derlemede obezitenin kemik metabolizmasý ile iliþkisi, kýrýk oluþumu ile ilgili faktörler üzerine etkileri, obez kiþilerde kýrýk riskinin deðerlendirilmesi ve kýrýk lokalizasyonu ile obezite iliþkisi konularý gözden geçirilecektir.

Despite the common belief that obesity confers some protection against osteoporosis, several findings that contrast with this argument have been brought forward in recent years. While obesity is considered to be protective against fractures in some localizations such as hip, it is also regarded as a risk factor for fractures at other sites including humerus and wrist. Interactions between obesity and bone metabolism are multifaceted and complex. Since fracture-related complications are more common and functional improvement following recovery is poor in obese individuals, it is very important to establish the link between obesity and fracture and to predict subsequent fractures. In this article, the relationship between obesity and bone metabolism, the impact of obesity on risk factors related to the development of fractures, assessment of fracture risk in obese persons and the association of fracture site with obesity will be reviewed.

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Amyotrofik lateral skleroz (ALS) nedeni belli olmayan üst ve alt motor nöronlarýn dejenerasyonuyla sonuçlanan progresif bir hastalýktýr. Üst motor nöron bulgularý arasýnda spastisite ve hiperrefleksi yer alýrken alt motor nöron bulgularý arasýnda güçsüzlük, atrofi ve fasikülasyonlar yer almaktadýr. Bu tablodan dolayý multiple skleroz, demyelinizan hastalýklar, servikal myelopati, çeþitli radikülopatiler ve polinöropatilerle karýþtýrýlabilir. Bizim hastamýz da öncelikle spinal stenoz ve de polinöropati olarak deðerlendirildikten sonra yapýlan detaylý inceleme sonucunda ALS tanýsý aldý.

Amyotrophic lateral sclerosis (ALS) is a progressive disease of unknown etiology, characterized with degeneration of upper and lower motor neurons. Hyperreflexia and spasticity appears as upper motor neuron signs and weakness, atrophy and fasciculations as lower motor neuron signs. Because of that symptomatology is easily mixed with MS and other disorders with demyelinization, cervical myelopathy, radiculopathies and polyneuropathies. Our patient was diagnosed first as spinal stenosis and polyneuropathy, but detailed investigation proved ALS diagnosis.

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Prostat yada akciðer tümörlerinde olduðu gibi mastoid kemikte de skuamöz hücreli karsinom, lenfoma, plazmositoma ve metastatik tümörler görülebilir. Plazmositomalar mastoid kemiðin plazma hücreli tümörlerinin nadir bir türüdür. Bu olgu sunumunda mastoidit semptomlarýyla kliniðimize baþvuran ve mastoidektomi operasyonu sonrasý mastoid kemiðin localize plazma hücreli lambda monoclonal neoplazisi tanýsýný alan 34 yaþýnda hasta sunuldu. Soliter plazmositoma gibi maligniteler cerrahi materyallerin patolojik deðerlendirmeleri yapýlýrken koalesent mastoidit ayýrýcý tanýsýnda akýlda bulundurulmalýdýr. Aksi takdirde, tedavi kaçýnýlmaz olarak yetersiz kalacaktýr.

Squamous cell carcinoma, lymphoma, plasmacytoma and metastatic tumors such as, prostate or lung tumor can occur in the mastoid bone. Plasmacytomas are rare plasma cell tumors of the mastoid bone. In this case presentation, a 34-year-old patient who applied to our hospital with mastoiditis symptoms, underwent mastoidectomy and was diagnosed with localized plasma cell lambda monoclonal neoplasia of mastoid bone was presented. Malignancies such as solitary plasmacytoma should be kept in mind and pathological evaluation of surgery materials should be done in differential diagnosis of coalescent mastoiditis. Otherwise, treatment will be inevitably inadequate.

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Bel aðrýlarý en sýk rastlanan kas iskelet sistemi hastalýklarý arasýndadýr. Bel aðrýsý nedenlerinden biri olan lomber disk hernisi (LDH) fiziksel sorunlarýn yaný sýra psikososyal sorunlara da yol açar. LDH’li hastalarda; akut ve progresyon gösteren nörolojik defisiti olmadýðý sürece temel tedavi konservatif tedavidir. Konservatif tedavilere ek olarak tamamlayýcý týp uygulamalarýda tedaviye destek olarak uygulanabilir. Tamamlayýcý týp yöntemlerinden biri de akupunktur tedavisidir. Bu yazýda aðrý ve nörolojik defisiti olup cerrahiyi kabul etmeyen bir vakada akupunktur tedavisi sonrasý klinik ve radyolojik bulgularý gerileyen bir olgu sunulacaktýr.

Low back pain is among the most common musculoskeletal system diseases. One of the reasons of low back pain is lumbar disc herniation (LDH) and it causes physical problems as well as psychosocial problems. Unless there are no neurological deficits in acute and progressive condition, the basic treatment for LDH patients is conservative. In addition to conservative treatment, complementary medicine can be applied as support. One of the complementary medicine methods is acupuncture therapy. Regretion of clinical and radiological findings after the acupuncture treatment of a patient who had pain and neurological deficits but did not accept surgery will be presented in this article.

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