The relationship between biochemical parameters, interleukin-6 and ovarian morphology in polycystic ovary syndrome
Sühha Mehmet Bostancı, Merih Bayram, Faika Ceylan Sevinç, Hatice Paşaoğlu, Şehri Elbeğ
J Clin Exp Invest 2012;3(3):307-312.
https://doi.org/10.5799/ahinjs.01.2012.03.0169
Research Article
[Abstract]
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ABSTRACT
Objectives: The aim of this study is to investigate relationships between biochemical parameters and interleukin-6 according to the ovarian morphology in polycystic ovary syndrome (PCOS).
Materials and methods: A total of 85 patients with PCOS were divided into three groups according to the ultrasonographic examination of the ovaries; group 1 (with no polycystic image at any of the ovaries, n=22), group 2 (with polycystic image at only one ovary, n=41), and group 3 (with polycystic image at both of the ovaries, n=22). Serum interleukin 6 (IL-6), hormone levels, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured.
Results: The mean serum IL-6 levels for groups 1, 2 and 3 were 14.65 ± 6.18 pg/mL, 16.22 ± 6.55 pg/mL, and 14:53 ± 7.32 pg/mL, respectively. There was no statically difference between three groups for serum IL-6 levels (p>0.05). For metabolic profile, the mean of HOMA-IR was 3.09±1.56 for group 2 and this was significantly lower than other groups (p<0.05).
Conclusions: There were no differences in hormonal and inflammatory markers according to the ovarian morphology in PCOS patients based on data derived from our study.
Keywords: PCOS, interleukin-6, ovarian morphology
Knowledge and attitudes of patients about the role of anesthesiologists in a military hospital
İsmail Aydın Erden, Recep Tütüncü
J Clin Exp Invest 2012;3(3):313-317.
https://doi.org/10.5799/ahinjs.01.2012.03.0170
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Objectives: We designed a study to assess the Turkish patients’ understanding and knowledge on the anesthesiologist’s role and to evaluate the influence of the patient’s prior education, preoperative anxiety and experience with anesthesia on such understanding.
Materials and Methods: Two hundred adult patients undergoing general anesthesia for surgery, from September to December 2008 at Etimesgut Military Hospital were enrolled in the study. A self-administered structured questionnaire distributed to patients waiting for preoperative evaluation.
Results: Only 40% of respondents knew that the anesthesiologist was a doctor. There was a relationship between the level of education and the knowledge of the patient regarding whether the functions and responsibilities of an anesthesiologist in the hospital.
Conclusions: The responses have shown poor knowledge of the public regarding the role of anesthesiologists. It indicates a need for exposure of the specialty to patients that can increase patient’s knowledge that may help to decrease preoperative anxiety.
Keywords: Anesthesiologist, patient, knowledge
Awareness of human papilloma virus, cervical cancer and HPV vaccine in healthcare workers and students of medical and nursing schools
Nilgün Güdücü, Gökçenur Gönenç, Herman İşçi, Alin Başgül Yiğiter, İlkkan Dünder
J Clin Exp Invest 2012;3(3):318-325.
https://doi.org/10.5799/ahinjs.01.2012.03.0171
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Objectives: Establishment of the knowledge and the need to make conscious in medicine students, nursing students and nurses due to the effective role of updating conscious of the health workers, we aimed to assess the knowledge of nurses and students of İstanbul Bilim University and affiliated hospitals about HPV and cervical cancer.
Materials and methods: Because healthcare personnel illuminate and influences the public, the survey was conducted to medicine students of the first three years, nursing students and nurses. The reason of choosing the first three years of medicine students is with the begining of the gynecology courses at the 4th year of education in medical faculty, learning takes the place of awareness. Totally 743 participants were asked to survey but 603 subjects responded (81.2%) then the surveys that was not asked for the identity information were taken into consideration
Results: Nurses and students of nursing had better knowledge about smear test when compared to students of medicine (first 3 years) and other healthcare personnel. Only 52% accepted to get a daughter vaccinated. The main reasons for vaccine rejection were the concerns about vaccine safety (41%), cost of the vaccine (10%) and sexual promiscuity (5%) after vaccination. Religious aspects were not considered as an obstacle.
Conclusions: The awareness of HPV, cervical cancer and HPV vaccination should be increased.
Keywords: HPV, HPV vaccine, cervical cancer, knowledge
Long term neurodevelopmental outcome of preterm infants with periventricularintraventricular hemorrhage
Erhan Bayram, Meral Torun Bayram, Yasemin Topcu, Semra Hiz, Ertan Kayserili
J Clin Exp Invest 2012;3(3):326-330.
https://doi.org/10.5799/ahinjs.01.2012.03.0172
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[Abstract]
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Objectives: To determine the neurodevelopmental morbidity of preterm infants with periventricular- intraventricular hemorrhage, at the age of 4.
Materials and methods: The patients at the age of 4 were evaluated through neurologic examination and motor assessment by a pediatric neurologist and Denver II Developmental Screening Test by a psychologist. The results were compared with Denver II Developmental Screening Test results which had been made at 3-6 and 6-12 months.
Results: Patients with grade ІІІ-ІV Periventricular-Intraventricular Hemorrhage had significantly lower Denver II Developmental Screening Test results at the age of 4, compared with grade І-ІІ Periventricular-Intraventricular Hemorrhage group. Similarly, ≤ 32 weeks patients had significantly lower Denver II Developmental Screening Test at the age of 4 when compared with > 32 weeks patients.
Conclusions: Children who were born ≤ 32 gestational weeks and/or patients with grade ІІІ-ІV periventricular-intraventricular Hemorrhage have an increased risk of neurologic impairment. All premature infants should be evaluated by Denver II Developmental Screening Test in early childhood period of life.
Keywords: Prematurity, periventricular hemorrhage, intraventricular hemorrhage
Serum S-100B levels in children with Subacute Sclerosing Panencephalitis
İbrahim Hocanlı, Mustafa Çalık, Alpay Çakmak, Hakim Çelik, Addürrahim Koçyiğit, Akın İşcan
J Clin Exp Invest 2012;3(3):331-334.
https://doi.org/10.5799/ahinjs.01.2012.03.0173
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Objectives: S-100B a protein prevalent in the central nervous system is a peripheral biomarker for blood-brain barrier disruption and neuronal damage. The objective of the study was to investigate the S-100B levels in patients with subacute sclerosing panencephalitis.
Materials and methods: A group of 40 patients with SSPE and 40 healthy controls were recruited. Serum S-100B protein concentrations were measured using a commercially available electrochemiluminescence immunoassay (ECLIA) kit, as supplied and according to the manufacturer's standards.
Results: Median S-100B levels were 0.095 ± 0.017 μg/L in patients with SSPE and 0.097±0.019 μg/L in the control group. This difference was not statistically significant (p>0.05). The patient group was further subdivided into two subgroups according to the presence or absence of brain atrophy. The S-100B levels were 0.096 ± 0.018 μg/L in the subgroup with atrophy and 0.094±0.014 μg/L in the subgroup without atrophy. This difference was also not statistically significant (p>0.05).
Conclusions: Our results suggest that serum S-100B is not a reliable marker for neuronal damage in SSPE.
Keywords: Subacute sclerosing panencephalitis, S-100B level, serum biomarker
Retrospective analysis of 286 Brucellosis cases in the southeast of Turkey
Recep Tekin, Zehra Çağla Karakoç, Özlem Demirpençe, Fatma Bozkurt, Özcan Deveci, Duygu Mert
J Clin Exp Invest 2012;3(3):335-339.
https://doi.org/10.5799/ahinjs.01.2012.03.0174
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Objectives: The aim of this study was to evaluate the clinical, laboratory findings and therapeutic features of the patients inhabiting in Diyarbakır, Mardin and Batman province, in Southeastern Anatolia of Turkey.
Materials and methods: In this study, 286 patients with brucellosis, followed in departments of infectious diseases and clinical microbiology between June 2007 and July 2009, were evaluated retrospectively.
Results: One hundred fifty six (55%) of the patients were female and 130 (45%) were male. Mean age was 32.8 + 15.3 (range15-78) years. The patients were categorized as acute (75%), subacute (23%) and chronic (2%) brucellosis. Major transmission route was the consumption of unpasteurized fresh cheese. The transport of animals in the region is not controlled. Malaise, fever, myalgia arthralgia and sweating were the most frequently observed symptoms. The most common signs were fever 90.8%, arthritis 54.1%, splenomegaly 18.3% and hepatomegaly 11%. The most frequent laboratory finding was a high C-reactive protein level (60%). Diagnosis was made based on the clinical features and positive Rose-Bengal test combination with an initial Brucella antibody titer greater than or equal to 1/160. The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination.
Conclusions: Brucellosis is still an important public health problem in Turkey. The disease has an important morbidity and mortality. Brucellosis should be kept in mind in endemic regions of our country with the symptoms of fever, leukopenia and osteoarticular symptoms.
Keywords: Brucellosis, Southeastern Anatolia, Turkey
Stapled hemorrhoidopexy: clinical results for 65 cases
Ahmet Pergel, Ahmet Fikret Yücel, İbrahim Aydın, Dursun Ali Şahin
J Clin Exp Invest 2012;3(3):340-344.
https://doi.org/10.5799/ahinjs.01.2012.03.0175
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Objectives: To present results of our patients underwent stapled hemorrhoidopexy due to hemorrhoidal disease and discuss in accompaniment with the literature.
Material and methods: The patients, who diagnosed by 3rd-4th degree hemorrhoidal disease and underwent hemorrhoidopexy with Longo method between January, 2009 and April, 2011, were included. All data were prospectively collected and retrospectively examined. The patients were evaluated in terms of demographic properties, complaints on admission, and postoperative complications.
Results: Forty-three (66%) of 65 patients were male, 22 (34%) were female. The mean age was 38±11.9 (range:23-76) years. The most frequent complaints were bleeding, swelling, itching, pain, constipation respectively. Third degree hemorrhoid was present in fifty-eight (89%) patients, 4th degree hemorrhoid was in 7 (11%) patients. The mean operation duration was 37.6±8.1(range:24-55) minutes, the mean hospitalization duration was 27±7.8 (range:20-76) hours. One or more complication developed in total 17 (26%) patients. As complication, bleeding was determined in 13 (20%) patients, pain was in 6 (9%), urinary retention was in 2 (3%), tenesmus was in 3 (5%), external hemorrhoidal thrombosis was in 1 (2%), and recurrence was in 4 (6%).
Conclusions: The patients can return their daily activities early with stapled hemorrhoidopexy because of less pain and quick recovery period. We consider that appropriate patient selection and proper application of the technique are important in the success of this method. Particularly in 3rd degree hemorrhoidal disease, Longo’s technique can be suggested as an alternative to classical methods.
Keywords: Hemorrhoidal disease, stapled hemorrhoidopexy, Longo’s procedure
Serum S100B levels in patients with obstructive sleep apnea syndrome
Gülfer Öztürk, Zeynep Giniş, Berna Arlı, Şule Bilen, Gönül Erden, Ersin Kasım Ulusoy, Cevdet Züngün
J Clin Exp Invest 2012;3(3):345-349.
https://doi.org/10.5799/ahinjs.01.2012.03.0176
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Objectives: Obstructive sleep apnea syndrome (OSAS) which is characterized by recurrent pharyngeal narrowing and breathing disturbances, can affect central neural system (CNS). S100B, which exerts neurotrophic and gliotrophic features, is a calcium binding protein. The aim of this study was to evaluate serum levels of S100B in patients with OSAS.
Materials and methods: Clinical and laboratory assessment were performed in 26 patients (5 women and 21 men) with OSAS and 28 (8 women and 20 men) age-, body mass index (BMI)- and sex- matched healthy subjects served as controls . The patients included in the study had whole-night polysomnography (PSG) performed in the sleep laboratory. Measurements of S100B were done using the commercially available ELISA kit.
Results: Patients and controls were well matched with regard to demographic characteristics. Serum S100B concentrations were 149.4±84.5 ng/L and 139.2±70.7 ng/L for patients with OSAS and control subject, respectively. There was no statistically significant difference in serum S100B concentrations between OSAS and control groups (p>0.05).
Conclusions: Serum S100B protein level in serum did not significantly higher in patients with OSAS compared to the healthy subjects. However, further investigations are required, particularly in the area of biochemical markers of mild cerebral damage in patients with OSAS.
Keywords: Obstructive sleep apnea syndrome, serum S100B, brain, polysomnography
In vitro effects of ellagic acid in C6 rat glioma cell cultures in terms of cytotoxicity and proliferation
Cenap Ekinci, Aysun Ekinci, Bülent Ahıshalı, Ayhan Bilir
J Clin Exp Invest 2012;3(3):350-356.
https://doi.org/10.5799/ahinjs.01.2012.03.0177
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Objectives: Ellagic acid is a plant-derived polyphenolic compound. The aim of this study is to investigate in vitro effects of ellagic acid on the proliferation and viability of rat C6 glioma cell lineage depending on dose and time and also is to evaluate ultrastructural changes in C6 glioma spheroids.
Materials and methods: Effects of ellagic acid on rat C6 glioma cell line were investigated by using two-dimensional models of tumor cell culture depending on dose and time. The effects of Ellagic acid was evaluated as cell proliferation, cell viability, and synthesis phase of cell cycle, and cell structure at 24th, 48th, 72nd hours. Cell structure was evaluated at 24th and 72nd hours in three dimensional cell culture spheroid models.
Results: Reducing effect of ellagic acid on cell proliferation and cell viability was seen in two dimensional cultures (p<0.05). Increment or decrement were not seen in synthesis phase in two dimensional cultures (p>0. 05). Electron micrographs in which three dimensional cell culture spheroid models was investigated, structural changes was found to be different from the control group.
Conclusions: In the evaluation of effects of ellagic acid on rat C6 glioma cells using two-dimensional culture models, it was observed that ellagic acid caused reduced cell viability, deterioration in cell structure and prevented cell proliferation.
Keywords: Ellagic acid, C6 glioma cells, cell culture, brain tumor, glioma
Çocuklarda akut glomerülonefrit: Üçüncü basamak sağlık merkezinde yedi yıllık deneyim [Acute glomerulonephritis in children: A seven-year experience in a tertiary health center]
Ali Güneş, Aydın Ece, Servet Yel, İlyas Yolbaş, Ünal Uluca, İlhan Tan, Velat Şen
J Clin Exp Invest 2012;3(3):357-362.
https://doi.org/10.5799/ahinjs.01.2012.03.0178
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Objectives: The aim of this study was to examine clinical and laboratory characteristics of children with AGN in a tertiary university hospital.
Materials and methods: Hospital records of children, which hospitalized with AGN diagnosis in Pediatric Nephrology Unit, between 2004 and 2011, were retrospectively reviewed. Patients were divided into three subgroups as age <5 years, 5-10 years and >10 years. Characteristics at hospital admission including, blood pressure, diuresis state, serum urea, creatinine and electrolyte levels, complement factors C3 and C4, complete blood count and urine analysis results were recorded. Data about primary infection, treatments, disease course and outcome were recorded and analyzed.
Results: Totally 220 children (157 male, 71.2%; 63 female, 28.8%) were included. Probable etiological infections were tonsillopharyngitis in 133 (60.5%), pyoderma in 12 (5.5%), other infections in 27 (12.2%) children. In 48 (21.8) children with AGN, no primary infection were detected. Edema was found in 81.4% of patients, hypertension in 73.6%, and pulmonary stasis in 22.6%. Low C3 levels were found in 89.1%, azotemia in 45.9%, hematuria in 95.4%, nephritic proteinuria in 80.5%, and leukocyturia in 37.6% of patients. Diuresis was enabled within one week in 82%. Additional vasodilators were given to 45 (20.5%) patients, and hemodialysis was performed to three. Except for frequency of low C3 (p=0.018) and anemia (p=0.006), no significant differences were found in clinical and laboratory findings between age groups (p>0.05).
Conclusions: No difference was found in clinical and laboratory features of AGN based on age groups, excluding low C3 and anemia frequency.
Keywords: Acute glomerulonephritis, childhood, clinical findings, laboratory findings, age groups
Bir üniversite hastanesinde tanı konulan sarkoidoz hastalarının klinik özellikleri [Clinical characteristics of sarcoidosis patients diagnosed in a university hospital]
Özlem Abakay, Abdurrahman Abakay, Abdullah Çetin Tanrıkulu, Fatih Meteroğlu, Cengizhan Sezgi, Hadice Selimoğlu Şen, Ayşe Aydın Dallı, Mehmet Kabak
J Clin Exp Invest 2012;3(3):363-367.
https://doi.org/10.5799/ahinjs.01.2012.03.0179
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Objectives: The clinical characteristics and treatment results of patients diagnosed with sarcoidosis was investigated in Dicle University Medical Faculty Hospital.
Materials and methods: A total of 39 patients were included diagnosed with sarcoidosis between 01 January 2008 and31 December 2011.Demographic data, laboratory findings, spirometric test data, diagnostic methods and treatment regimens for the study were recorded form. According to pulmonary function test results of patients, 61.5% were normal pattern, 30.8% were restrictive pattern and 7.7% were obstructive pattern.
Results: Of the 39 patients 15.4% male, 84.6% were female. The mean age was 39.5±13.1 years for males, females 44.8±14.0 years. All patients of was 17.9% stage 1, 66.7% stage 2, 10.3% stage 3 and 5.1% stage 4. 61.5% were symptomatic, 38.5% were asymptomatic. Methods of diagnosis of the patients examined, 25.6% of patients bronchoscopic biopsy procedures, 74.4% of patients surgical biopsy procedures. Of the 56.4% patients had received corticosteroid treatment, 5.1% patients had received corticosteroid + methotrexate treatment, 38.5% were followed up without the pharmacological treatment. Pharmacological treatment in the group complete at the time of the study 20.5% concluded the treatment of the person. Patients who treatment ending 8.4 months had used pharmacological treatment.
Conclusions: Interstitial lung diseases which are prevalent among patients with sarcoidosis diagnosed by examining the clinical features, differential diagnosis and treatment may be possible detection of potential problems.
Keywords: Sarcoidosis diagnosis, treatment
Larenks kanserli hastalarda servikal metastazların boyundaki seviyelere göre dağılım sıklığı [The frequency of distribution of cervical metastases according to the neck level in patients with larynx cancer]
Engin Şengül, Tekin Bağlam, Cengiz Çevik, Cemile Arıkan Şengül, Ferit Kara, Zeynel Abidin Karataş, Muzaffer Kanlıkama
J Clin Exp Invest 2012;3(3):368-371.
https://doi.org/10.5799/ahinjs.01.2012.03.0180
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Objectives: In this study we aimed to assess the frequency of distribution for cervical metastases, according to the neck level in patients with larynx cancer who underwent neck dissection. In addition, we also evaluated the safety of selective neck dissection compared to comprehensive neck dissection especially in preoperative N0 patients.
Materials and methods: In our experience, to determine the frequency of metastases in each level, the specimen is sent for pathological examination by dividing each level separately after neck dissection. In our study; we retrospectively analysed the medical records of 145 laryngeal cancer patients who were treated with surgery (total or partial laryngectomy) as primary treatment and combined with neck dissection between 2005 and 2010 in our Otolaryngology Department. The patients with the diagnosis of laryngeal cancer who underwent surgery without neck dissection were excluded from the analysis.
Results: Level I or level V involvement was not observed in preoperative N0 cases. In cases that had contralateral involvement, there was ipsilateral involvement too and all of these cases were preoperative N+ cases. The classification based on the distribution of levels of 145 cases’ cervical metastases revealed that among ipsilateral involvements, 1 (0.6%) was detected at level IA, 32 (22%) at level IIA, 3 (2%) at level IIB, 19 (13%) at level III, 2 (1.3%) at level IV and 1 (1.3%) at level V. When contralateral involvement considered, 13 (8.9%) were detected at level IIA and 1 (0.6%) at level III.
Conclusions: The neck specimen findings of 145 laryngeal cancer patients treated with surgery as either total or partial laryngectomy and combined with neck dissection revealed that the most common metastases were observed at the level IIA and level III; however metastases at level I, level IIB, level IV and level V were least common. Those findings indicated that selective neck dissection was a safe surgical approach (levels II-IV) in T1 T2 N0 cases.
Keywords: Larynx cancer, cervical lymph node metastases, level
Adenozin difosfat ile uyarılan trombositlerde Kaspaz-3 gen anlatımı [Caspase-3 gene expression in adenosine diphosphate stimulated platelets]
Özge Çevik, Zelal Adıgüzel, Azize Şener
J Clin Exp Invest 2012;3(3):372-377.
https://doi.org/10.5799/ahinjs.01.2012.03.0181
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Objectives: Platelets are known blood cells differentiated from megakaryocytes in bone marrow and they play a key role in coagulation mechanism. They live several days in blood circulation and they aggregate in respond to stimulants such as thrombin, collagen, ADP (adenosine diphosphate) and epinephrine. Although platelets are known anucleated cells, it has been reported in vivo and in vitro that they undergo to apoptosis. In this study apoptotic effects of ADP on the platelets was investigated.
Materials and methods: P-selectin binding with flowcytometry, calcium levels with fluorometer, cytochrome-c levels with ELISA, caspase-3 gene expression with qRT-PCR, caspase-3 releasing with western blotting were determined in platelets.
Results: Platelets were incubated for 1 hour at 37°C with 10µM ADP. P-selectin binding, calcium and cytochrome-c levels, caspase-3 releasing and gene expression are significantly increased compared to control in ADP stimulated platelets.
Conclusions: Platelets can induce caspase-3 gene expression when stimulated with ADP which is a key enzyme plays an important role in apoptotic pathway.
Keywords: Platelets, caspase-3, qRT-PCR, P-selectin, ADP
İzole humerus tüberkulum majus kırıklarında tedavi sonuçları [Treatment results in isolated humerus majus fractures]
Hakan Serhat Yanık, Mehmet Kerem Canbora, Atilla Polat, Hasan Bombacı, Şevki Erdem, Abdullah Demirtaş
J Clin Exp Invest 2012;3(3):378-382.
https://doi.org/10.5799/ahinjs.01.2012.03.0182
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Introduction: The aim of this study is to evaluate the results of patients with the isolated greater tubercul fractures (GTF) of humerus who conservatively or surgically treated.
Materials and methods: 23 patients were admitted (11 women, 12 men) with GTF (54% dominant side of 24 shoulder) between 2008 and 2011. All of patient were evaluated with MRI as preoperatively soft tissue injury. There was supraspinatus muscle tear together with GTF in 3 case and their shoulder were arthroscopically assisted rotator cuff repair. Osteosynthesis was performed in 3 case with screw and fixation in 2 case with suture. GTF of 16 shoulder were conservatively treated. Shoulder function after treatment were evaluated according to Constant score (CS), Quick-DASH score (QDS) and VAS score.
Results: Three patients with screw fixation had CS 68,6 points, QDS 12,8 points, VAS score 1,66. Two patients with suture fixation had 67,5 CS points, 5,1 QDS pointsp, and 2 VAS score. Three patients with rotator cuff tear repair had 82,6 CS points, 16,6 QDS points, and 2,33 VAS score. In patients with conservatively treated mean CS was 63,9 points, QDS 26,1 points, VAS 2,96 points.
Conclusions: In this study, conservative and surgical treatment results were satisfactory. In terms of pain the results were excellent. In conclusion, GTFs are rare but trouble-free with a good observation and sufficient rehabilitation.
Keywords: Humerus, fracture, greater, tubercul
Bir bölge hastanesi acil servisine kuduz şüphesiyle başvuran olguların değerlendirilmesi [The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies]
Nurettin Tunç, Gökhan Temiz, Evin Aras, Aytaç Bilgiç, Sevda Onat
J Clin Exp Invest 2012;3(3):383-386.
https://doi.org/10.5799/ahinjs.01.2012.03.0183
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Objectives: Rabies is one of the highest mortality rates infectious disease. The aim was the evaluation of the patients who admitted to The Batman Regional State Hospital Emergency Service with suspect of rabies in the dates between June 2011 and November 2011.
Materials and methods: Totally, 166 cases who admitted to our center was recorded according to the following data: place of residence (rural/urban), contact type and wound information, time after the contact, whether vaccine or immunoglobulin is applied or not and also the species, breed and being owned of suspected animal.
Results: Our study population consisted of a total of 166 cases including 38 women (23%), 128 men (77%) with the mean age of 22.01 ± 17.90 years. Of all subjects, 105 (63%) lived in urban and 61 (37%) lived in rural areas. Eighty-five percent of suspicious animals (51%) had an owner, while 81 animals were unattended.
Conclusions: Our results showed that all admitted patients were vaccinated and the ones contacted with pets or had a surface wound were vaccinated with 3 doses. Moreover, since the 49% of our cases were contacted with animals which cannot be follow-up, our study obviously reveals that in our country deficiencies in the control of waifs still is a public health problem and increases the cost of vaccination.
Keywords: Rabies, suspected bite, rabies prophylaxis
Multipl skleroz hastalarında otonom sinir sistemi ile ilişkili sempatik cilt yanıtlarının değerlendirilmesi ve yorgunluk skorları [Sympathetic skin responses associated with the autonomic nervous system and fatigue scores in patients with MS]
Şeyda Bayil Yetik, Emine Rabia Koç, Ali Kemal Erdemoğlu
J Clin Exp Invest 2012;3(3):387-391.
https://doi.org/10.5799/ahinjs.01.2012.03.0184
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Objectives: In this study, we aimed to investigate the effect of autonomic dysfunction on quality of life and symptoms of fatigue patients with MS.
Materials and methods: The study included 30 patients with MS and 35 healthy subjects as control group. Disability was assessed using the Expanded Disability Status Scale (EDSS); autonomic functions were assessed by SSR; fatigue symptoms were assessed by Fatigue Descriptive Scale (FDS); effect of autonomic dysfunction on quality of life and fatigue symptoms was assessed by SF-36 scale.
Results: There was no significant difference between the left hand SSR latency, mean amplitude and area between patient and control groups. Mean FDS value was significantly higher in MS group. SSR amplitude and area were significantly smaller in patients which received prophylactic treatment. There was no relation between the FDS scores and SSR values in patients receiving prophylaxis. In the patient group, a positive correlation was detected between EDSS and FDS score; and significantly negative correlation between pyramidal, cerebellar and spasticity; a significant positive correlation was found between amplitude and the size of area of the SSR and brain stem functions. There was no significant relationship between FDS with SSR area, latency and amplitude.
Conclusions: SSR measurements are not sensitive in order to evaluate autonomic dysfunction in patients with multiple sclerosis. Symptoms of fatigue has a negatively effect on the activity of the patient's daily life. SSR test is not sufficient to show the relationship between fatigue and autonomic dysfunction.
Keywords: Multiple Sclerosis, autonomic nervous system, sympathetic skin response, fatigue.
Adrenal bez kalınlığının multi-dedektörlü bilgisayarlı tomografi ile değerlendirilmesi [Evaluation of the thickness of the adrenal glands with multi-detector computed tomography]
Cihad Hamidi, Cemil Göya, Salih Hattapoğlu, Mehmet Guli Çetinçakmak, Memik Teke, Abdurrahim Dusak, Suzan Kuday
J Clin Exp Invest 2012;3(3):392-394.
https://doi.org/10.5799/ahinjs.01.2012.03.0185
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ABSTRACT
Objectives: The aim of this study was to investigate adrenal gland size, and whether there is a thickness difference between two sides of adrenal glands by multi- detector computed tomography, by which anatomic details can be evaluate better.
Materials and methods: Totally, 100 patients, who do not have adrenal gland pathology and outer adrenal gland body, are analyzed retrospectively by computed tomography with 16 and 64 detectors in regards of bilateral adrenal gland thickness.
Results: After measurements, it was found that the difference between both adrenal gland medial and lateral limb thickness was statistically significant (p< 0.001, p=0.035). But no significant difference was found between both adrenal gland bodies (p=0.611).
Conclusions: It was observed that left adrenal gland was thicker than the right in regards of variety. Further studies are necessary to conduct comprehensive investigations in regards of standardization of adrenal gland thicknesses.
Keywords: Adrenal gland, multi-detector computed tomography, thickness
Successful use of ketamin combined with remifentanil in two patients with epidermolysis bullosa
İlker Öngüç Aycan, Aysun Ankay Yılbaş, Sennur Uzun, Özgür Canbay, Turgay Öcal, Saadet Özgen
J Clin Exp Invest 2012;3(3):395-397.
https://doi.org/10.5799/ahinjs.01.2012.03.0186
Case Report
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Epidermolysis Bullosa (EB) is characterized by the presence of extremely fragile skin and painful blister formations in the skin. We present the anesthetic management of 15-years-old, twin sisters with EB during the syndactyly operation. Premedication was done with 0.5 mg/kg nasal midazolam. Anesthesia induction was performed with sevoflurane without touching the facial masks to the skin. After intravenous 2 mgkg-1 ketamine and 50 μg fentanyl, anesthesia was maintained by intravenous 1 mg/kg/hr ketamine and 0.1 μg/kg/min remifentanil. We injected 2 mg intravenous morfin for postoperative pain control. Ketamine with remifentanil seems to be effective, simple, and safe for airway management and practical way to provide general anesthesia and analgesia of EB.
Keywords: Epidermolysis bullosa, ketamin, remifentanil, anesthesia
Sugammadex use in difficult intubation due to ankylosing spondylitis and severe restrictive respiratory disease
Yakup Tomak, Habib Bostan, Başar Erdivanlı, Ahmet Şen
J Clin Exp Invest 2012;3(3):398-400.
https://doi.org/10.5799/ahinjs.01.2012.03.0187
Case Report
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ABSTRACT
We describe anesthesia management of a 50-year-old man scheduled for thoracic spinal reconstruction, presenting with severe restrictive respiratory disease and difficult airway due to ankylosing spondilitis. The patient was unable to extend his head, had difficulty in breathing and sleeping in supine position due to thoracal deformities. The patient was intubated using intubating laryngeal mask airway to overcome the difficulties of limited mouth opening and head extension. He was extubated following administration of sugammadex to obtain optimal conditions in terms of respiratory muscle function and to prevent hypersecretion and bronchospasm.
Keywords: Restrictive lung disease, airway management, laryngeal masks, sugammadex, ankylosing spondylitis
An unusual cause of epistaxis, anemia and upper respiratory tract obstruction, Leeches: Report of three cases
Engin Şengül, Salih Bakır, Cemile Arıkan Şengül, Ömer Erdur
J Clin Exp Invest 2012;3(3):401-403.
https://doi.org/10.5799/ahinjs.01.2012.03.0188
Case Report
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ABSTRACT
The leech is an endoparasite for man and may cause lethal complications. In this article, we report two cases of 4 and 6-year-old who presented epistaxis due to leech infestasyon in nasopharynx and other case of 65-year-old adult with alzheimer who presented obstruction of upper respiratory tracks and anemia due to leech infestation in larynx. Especially in rural areas, it should always be borne in mind that leech might cause high mortality and morbidity due to serious complications such as anemia and obstruction of upper respiratory tracts and should be considered in evaluating the differential diagnosis of upper airway obstruction.
Keywords: Leech, epistaxis, anemia, obstruction of upper respiratory tract.
Intramuscular cavernous hemangiomas arising from masseter muscles
Hanifi Bayaroğulları, Yaşar Çokkeser, Ercan Akbay, Ece Karaoğlu, Emre Karaoğlu, Cengiz Çevik
J Clin Exp Invest 2012;3(3):404-408.
https://doi.org/10.5799/ahinjs.01.2012.03.0189
Case Report
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ABSTRACT
Intramuscular hemangiomas are rarely seen benign tumors, constituting %1 of all hemangiomas. They mostly occur in the trunk and extremities. They are uncommon in the head and neck region and arising most frequently from masseter and trapezius muscle. The patients usually complain about progressive and painless swelling in facial-parotid region. Due to its location, 90% of all intramuscular hemangiomas are misdiagnosed and often clinically mistaken as a parotid swelling. Radiologic images play important role for diagnosis of these hemangiomas.
Keywords: Intramuscular hemangioma, head and neck muscles, imaging modality
Primary intracerebral lymphoma: Case report
Olcay Eser, Önder Şahin, Serhat Korkmaz, Gazi Mehmet Boyacı
J Clin Exp Invest 2012;3(3):409-411.
https://doi.org/10.5799/ahinjs.01.2012.03.0190
Case Report
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ABSTRACT
We describe a case of primary central nervous lymphoma (PCNSL) that may be confused with magnetic resonance imaging (MRI) findings of high grade glioma. Primary central nervous lymphoma is a rare tumour and it account for 0.3-3% of intracranial tumours. A 61 year’s old woman was admitted to our clinic with a severe headache, vomiting, left hemiparesia and transient loss of consciousness. Primary central nervous lymphoma may show various biological and radiological characteristics. We herein emphasized being confused with MRI findings of PCNSL and high grade glioma.
Keywords: Primary central nervous lymphoma, high grade glioma, B-cell, diagnosis
Epidermolysis bullosa dystrophica inversa: A case report
Enver Turan, Mehmet Salih Gürel, Aslı Turgut Erdemir, Burcu Işık, Nurdan Yurt
J Clin Exp Invest 2012;3(3):412-414.
https://doi.org/10.5799/ahinjs.01.2012.03.0191
Case Report
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ABSTRACT
Epidermolysis bullosa (EB) is a heterogeneous group of genetically determined, mechanobullous disorders characterized by blister formation in response to mechanical trauma. Three major subgroups, simplex, junctional, and dystrophic EB, contain more than 20 genetically and clinically distinct subtypes. Epidermolysis bullosa dystrophica inversa (DEB-I), which is a rarely seen form of epidermolysis bullosa, shows autosomal recessive inheritance and it is characterized by bulla formation and erosions on flexural areas, frequently affecting the oral and esophageal mucosa. Blistering rash occurs in the newborn period, which in early childhood heals with atrophic scars. DEB-I is rarely seen in adults period, with only a few case reports in the literature. In the present case, we described a patient diagnosed with epidermolysis bullosa dystrophica inversa due to presence of typical clinical features and histopathological and immunofluorescence findings.
Keywords: Blistering disorders, mechanobullous, epidermolysis bullosa
A case of mixed type laryngocele presented with deep neck infection and review of the literature
Salih Bakır, Aylin Gül, Vefa Kınış, Musa Özbay, Hakan Özkan
J Clin Exp Invest 2012;3(3):415-419.
https://doi.org/10.5799/ahinjs.01.2012.03.0192
Case Report
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ABSTRACT
Laryngocele is an abnormal dilatation of the laryngeal ventricular saccule that may extend into the subcutaneous tissues of the neck through the thyrohyoid membrane or confined to the endolarynx. The etiology is still unclear. Many laryngoceles are asymptomatic. An asymptomatic laryngocele appears and produces symptoms only as it enlarges or when it becomes infected. In this report, we present a 40-year-old female patient, which had an asymptomatic neck swelling for 20 years, referred for deep neck infection, dysphonia and dyspnea.
Keywords: Larynx, laryngocele, laryngopyocele, neck mass
Agressive angiomyxoma: Case report
Fatma Eskicioğlu, Tülay Gükmen
J Clin Exp Invest 2012;3(3):420-422.
https://doi.org/10.5799/ahinjs.01.2012.03.0193
Case Report
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ABSTRACT
Aggressive angiomyxoma is a rare benign mesenchymal neoplasm. It is often diagnosed in genital, pelvic and perineal region of women in reproductive ages. Aggressive angiomyxoma is associated with a high risk of local recurrence. Aggressive angiomyxoma is mixed with Bartholin’s gland cyst, lipoma and vaginal cysts in diagnosis. Generally, stromal invasion is detected in these benign neoplasms. Therefore, wide local excision should be performed to treat. GnRH agonists could be administered in patient with aggressive angiomyxoma, either primary or recurrent. We reported a case with vulvar aggressive angiomyxoma presented with vulvar mass and treated with wide local excision.
Keywords: Angiomyxoma, myxoma, vulvar mass
The treatment of giant abdominal aorta aneurysm with endovascular stent-graft
Şeref Ulucan, Ahmet Keser, Ahmet Kuzgun, Fatih Aygün, Duran Efe
J Clin Exp Invest 2012;3(3):423-425.
https://doi.org/10.5799/ahinjs.01.2012.03.0194
Case Report
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ABSTRACT
The usage of endovascular stent-graft in the treatment of abdominal aorta aneurysm has been increasing in the abdominal surgery. This paper presents the case of a patient with right iliac artery aneurysm who was treated with the application of endovascular stent-graft.
Keywords: Abdominal Aorta Aneurysm, EVAR, Stent-graft
Meme kanserli bir hastada 18-Floro-de-oksi-Glukoz pozitron emisyon tomografisinde multiple kemik metastazları: Olgu sunumu ve literatürün gözden geçirilmesi [Multiple bone metastases detected on 2-[18F]-fluoro-2-deoxy-d-glucose PET]
Zeki Dostbil, Buğra Kaya, Oktay Sarı, Erhan Varoğlu, Murat İsmailoğlu
J Clin Exp Invest 2012;3(3):426-429.
https://doi.org/10.5799/ahinjs.01.2012.03.0195
Case Report
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ABSTRACT
Bone scintigraphy has been widely used to assess skeletal metastasis in patients with breast cancer. 18F-FDG-PET/CT is another imaging modality that has gained previously wide use to determine metastasis based on increased glucose metabolism in malignant cells. Generally, these two modalities give similar results in evaluation of bone metastasis of breast cancer. In this breast cancer case, 99mTc-MDP bone scintigraphy showed normal findings in regards to skeletal metastasis while 18F-FDG-PET/CT, contrast-enhanced CT and MRI revealed multiple metastatic focuses.
Keywords: 18F-fluorodeoxyglucose, bone metastasis, bone scintigraphy, positron emission tomography
Malign melanomlu bir hastada yapılan pozitron emisyon tomografide rastlantısal olarak tespit edilen tiroid papiller karsinom [Incidentally detected thyroid papillary carcinoma on PET in a patient with malignant melanoma]
Zeki Dostbil, Buğra Kaya, Oktay Sarı, Erhan Varoğlu, Murat İsmailoğlu
J Clin Exp Invest 2012;3(3):430-432.
https://doi.org/10.5799/ahinjs.01.2012.03.0196
Case Report
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ABSTRACT
Focal or diffusely increased 18F-fluorodeoxyglucose (18FDG) uptake in thyroid gland are occasionally seen during 18FDG positron emission tomography (PET) scanning. Increased 18FDG uptake in thyroid nodules may be associated with benign or malignant tumours. In our case who was diagnosed as malignant melanoma, focally increased 18FDG uptake in a thyroid nodule was noticed. Thus, fine needle aspiration biopsy of the thyroid nodule was performed. On suspicious findings for the thyroid papillary cancer were reported, total thyroidectomy was performed. Histopathological evaluation revealed the thyroid papillary carcinoma. So, therapy for the incidental thyroid papillary carcinoma was commenced in this case who was under the follow-up for the malignant melanoma.
Keywords: Thyroid, papillary carcinoma, FDG-PET, thyroid incidentaloma
Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]
Harun Aydoğan, Şaban Yalçın, Ahmet Küçük, Hasan Hüsnü Yüce, Aysun Camuzcuoğlu, Mehmet Ali Eren
J Clin Exp Invest 2012;3(3):433-434.
https://doi.org/10.5799/ahinjs.01.2012.03.0197
Case Report
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ABSTRACT
Clinical thyrotoxicosis is one of the rare complications of molar pregnancy. The cause of the symptoms associated with hyperthyroidism in mol hydatiform is the thyrotrophic effects of high levels of β-hCG. The hCG molecule consists of α and β subunits; the α subunit is identical to TSH and the β subunit has a similar structure to TSH. In this case report it was aimed to discuss the anesthetic management of a dilatation and curettage case in a patient with mol hydatiform and thyroid crisis.
Keywords: Hydatidiform mole, hyperthyroidism, anesthesia
Burun tıkanıklığının nadir bir nedeni: Sfenokoanal polip [A rare cause of nasal obstruction: Sphenochoanal polyp]
Musa Özbay, Ediz Yorgancılar, Vefa Kınış, Salih Bakır, İsmail Topçu
J Clin Exp Invest 2012;3(3):435-437.
https://doi.org/10.5799/ahinjs.01.2012.03.0198
Case Report
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ABSTRACT
Choanal polyps mostly arise from the antrum of maxillary sinus. Sphenochoanal polyp arising from the sphenoid sinus is extremely rare. It presents with similar symptoms of antrochoanal polyps. Radiological examination is important in differentiation of these two types of choanal polyps. Inadequate surgery that leaves some part of the polyp has a high risk of recurrence. We present a case of sphenochoanal polyp treated successfully with endoscopic sinus surgery. The patient is symptom free for 1 year.
Keywords: Polyp, sphenoid sinus, endoscopic sinus surgery
Çocuk suprakondiler humerus kırığında çoklu sinir zedelenmesi [Multiple neural injuries in a pediatric supracondylar humerus fracture]
Mehmet Erdil, Yunus İmren, Hasan Hüseyin Ceylan, Kerem Bilsel, İbrahim Tuncay
J Clin Exp Invest 2012;3(3):438-442.
https://doi.org/10.5799/ahinjs.01.2012.03.0199
Case Report
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ABSTRACT
Supracondylar humerus fracture, child elbow trauma, nevre injury, iatrogenic
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