GÝRÝÞ ve AMAÇ: Down sendromu kromozom 21’de trizomi nedeniyle meydan gelen insanlardaki en yaygýn otozomal anöploidi sendromudur. Görülme sýklýðý toplumlara göre 319 canlý doðumda bir ile 1000 canlý doðumda bir arasýnda deðiþmektedir. Down sendromu’nda kalpte özellikle endokardiyal yastýkçýklarýn anormal geliþimi nedeniyle kalp ve büyük damarlarýn konjenital anomalileri saðlýklý topluma göre daha sýk görülmektedir. Bu çalýþmada Yüzüncü Yýl Üniversitesi Týp Fakültesi Çocuk Kardiyoloji polikliniðine müracaat eden Down sendromu tanýsý almýþ hastalarda doðumsal kalp hastalýðý sýklýðýný saptamak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu prospektif araþtýrma Aðustos 2010-Eylül 2012 tarihleri arasýnda ileri tetkik için Çocuk Kardiyoloji polikliniðine gönderilen Down sendromu tanýsý karyotip analizi ile konmuþ 198 olguda yapýlmýþtýr. Tüm hastalar ekokardiyografi ile deðerlendirilmiþtir.
BULGULAR: Hastalarýn yaþ aralýðý 1 ay ile 13 yaþ arasýndadýr. Down sendromu tanýsý alan hastalarda doðumsal kalp hastalýðý oraný %54 saptanmýþtýr. Doðumsal kalp hastalýðý olarak %49.9 görülme oranýyla en sýk atriyoventriküler septal defekt görülmüþtür. Atriyoventriküler septal defekti sýrasýyla atriyal septal defekt (%14.1), ventriküler septal defekt (%11.3) ve patent duktus arteriyosus (%8.5) izlemiþtir.
TARTIÞMA ve SONUÇ: Van ve çevresindeki Down sendromlu hastalarda doðumsal kalp hastalýðý sýklýðý ve atriyoventriküler septal defekt oraný literatürle uyumlu bulunmuþtur.

INTRODUCTION: Down syndrome is the most common autosomal aneuploidy syndrome in human beings caused by the trisomy in chromosome 21. The congenital cardiac and major vascular abnormalities, caused especially by the unusual growth of endocardial cushions, is seen more commonly compared to the healthy societies in Down syndrome. In this study, the target is to define the rate of congenital cardiac disease in patients who were diagnosed with Down syndrome who applied to the Pediatric Cardiology Polyclinic of Medical Faculty of Yüzüncü Yýl University.
METHODS: This prospective research is performed in 198 cases whose Down syndrome diagnoses were made with the karyotype analyse and who were transferred to the Pediatric Cardiology Polyclinic for further examination in the dates between August 2010 - September 2012. All the patients are evaluated by echocardiography.
RESULTS: The rate of patient's age is between 1 month to 13 years. The rate of congenital cardiac disease in the patients with Down syndrome diagnoses is identified to be 54%. The atrioventricular septal defect is the most common congenital cardiac disease with the incidence rate of 49.9%. The atrioventricular septal defect is followed by; atrial septal defect (14.1%), ventricular septal defect (11.3%) and patent ductus arteriosus (8.5%).
DISCUSSION AND CONCLUSION: The rate of congenital cardiac disease in patients with Down syndrome in and around Van and the rate of atrioventricular septal defect is found consistent with the literature.

GÝRÝÞ ve AMAÇ: Kocaeli Verem Savaþ Dispanseri’nde 2005-2011 yýllarý arasýnda takip edilen akciðer dýþý tüberküloz tanýlý olgularýný demografik özellikleri, tutulum yeri, kullanýlan taný yöntemleri ve tedavi sonuçlarý açýsýndan deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Retrospektif kohort çalýþmamýzda 2005-2011 yýllarý arasýnda Kocaeli Verem Savaþ Dispanseri’nde takip edilen akciðer dýþý tüberküloz tanýlý hastalarýn dosyalarý incelendi. Baþka bölgeye nakil olan, dosyalarýna ulaþýlamayan hastalar çalýþmaya alýnmadý.
BULGULAR: Hastalarýn 172’si kadýn (%52), 159 ‘si erkek (%48) idi. Hastalarýn yaþ ortalamasý 39,2 (±17,6) yýl olup %10,3’ü 20 yaþ altý, %48,3’i 20-40 yaþ aralýðýnda, %23’sý 40-60 aralýðýnda ve % 17,8’i 60 yaþ üzeri idi. Akciðer dýþý tutulum yeri deðerlendirildiðinde en sýk yerleþimin 119 hastada (%36) lenf nodu olduðu saptandý. 112 hastada (%33,9) plevra tüberkülozu, 31 hastada kemik-eklem tüberkülozu (%9,4), 17 hastada genital tüberküloz (%5,1), 15 hastada gastrointestinal sistem (GÝS)-periton tüberkülozu (%4,5), 9 hastada deri tüberkülozu (%2,7), 8 hastada üriner sistem tüberküloz (%2,4), 6 olguda merkezi sinir sistemi tüberkülozu (%1,8), 6 olguda perikard tüberkülozu (%1,8), 5 olguda milier tüberküloz (%1,5), 2 olguda meme tüberkülozu (%0,6) ve 1 olguda (% 0,3) larinks tüberkülozu izlendi. Plevral tüberkülozun daha çok erkeklerde ve erken yaþta, lenf tüberkülozunun ise kadýnlarda daha sýk izlendiði görüldü. Taný, 228 hastada (%68,9) histopatolojik, 17 hastada (%5,1) mikrobiyolojik olarak ve 4 hastada (%1,2) hem mikrobiyoloik hem de histopatolojik yöntemle, 82 hastada (%24,8) bu yöntemler dýþýnda klinik, radyolojik ve diðer ek tetkikler ile konulduðu görüldü. Hastalarýn tedavi sonuçlarý deðerlendirildiðinde 311 hastada (%94) tedavi tamamlama veya kür, 12 hastada (%3,6) tedavi terki, 8 hastada (%2,4) ölüm izlendi.
TARTIÞMA ve SONUÇ: Lenf nodu ve plevral tüberküloz bölgemizde en sýk akciðer dýþý tüberküloz þekilleridir. Bölgemizde verem savaþý etkin biçimde sürdürülmekte, taný koymanýn zor olduðu akciðer dýþý tüberküloz tanýlarý artan sýklýkla objektif taný yöntemleri ile konulmaktadýr.

INTRODUCTION: We aimed to evaluate the demographics, localisation, diagnostic methods and treatment outcome of patients with extrapulmonary tuberculosis treated between 2005 and 2011 in Kocaeli Tuberculosis Dispansary, Turkey.
METHODS: We retrospectively reviewed medical charts of patients. We excluded patients who transferred to the other dispanseria or those medical records couldn’t be obtained.
RESULTS: A total of 331 extrapulmonary tuberculosis patients (52% female, 48% male ) with a mean age of 39,2 (±17,6) years were registered for treatment. Sites of extrapulmonary tuberculosis were lymph node in 119 (36%) patients, pleural in 112 (33,9%), bone and joint in 31 (9.4%), genital in 17 (5,1%), gastrointestinal in 15 (4.5%), skin in 9 (2.7%), urinary in 8 (2,4%), miliary in 6 (1.8%), central neural system in 6 (1.8%), pericardial in 6 (1,8%) breast in 2 (%0,6) and larynx in 1 (0,3%) patients. Pleural tuberculosis were common in male and young age, lymph node tuberculosis were common in female. Histopathological methods in 228 (68,9%), microbiological methods in 17 patients, both microbiological and histopathological methods in 4 patients (1,2%) and clinical, radiological and other methods were used in 82 (24,8%) patients for diagnosis. 311 patients (94%) had a successful treatment outcome. Of patients with unsuccessful outcome, 12 (3.6%) had defaulted, 8 (2.4%) had died.
DISCUSSION AND CONCLUSION: Altough tuberculosis can disseminate all tissues, lymph node and pleura are the most common sites of extrapulmonary tuberculosis. Fight with tuberculosis is continued in tuberculosis and objective diagnostic methods were common methods in diagnosis of extrapulmonary tuberculosis.

GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý allerjik solunum yolu þikayetleriyle baþvuran hastalarda uygulanan deri prick test sonuçlarýndaki pozitif reaksiyon sýklýðýnýn ve daðýlýmýnýn deðerlendirerek yöremizde sýk rastlanýlan allerjenlerin ve mevsimsel daðýlýmýnýn tespit edilmesidir
YÖNTEM ve GEREÇLER: Nisan 2012-Mayýs 2014 tarihleri arasýnda Sakarya bölgesinde allerjik þikayetler nedeniyle deri prick testi yapýlan, yaþ ortalamasý 35.7±14 olan 1336 yetiþkin çalýþmaya alýndý.
BULGULAR: 1336 hastanýn 1014’ünde (%76) en az bir allerjene karþý duyarlýlýk bulundu. En yüksek duyarlýlýk ev tozu akarýna (n=576, %43.1) ardýndan aðaç polenlerine (n= 522, %39.1) karþý tesbit edildi. En fazla test sayýsý ve en sýk pozitiflik Haziran ve Temmuz aylarýnda bulundu.
TARTIÞMA ve SONUÇ: Atopi Sakarya’da oldukça sýk görülmektedir ve coðrafi-mevsimsel özellikleri bölgemizdeki allerjen daðýlýmý ile uyumludur. Çalýþmamýzýn; bölge özelliklerini saptayarak, hastalarýmýzýn taný ve tedavisine katký saðlayacaðý kanaatindeyiz.

INTRODUCTION: The aim of this study; was to determine the spectrum and frequency of positive reactions to skin prick tests in patients with respiratory tract allergic symptoms, and was to identify common allergens in our region.
METHODS: In the study, we retrospectively evaluated skin prick test results of 1336 adults (mean age 35.7±14 years) with allergic diseases history who the skin prick tests performed between April 2012 to May 2014 in the East Marmara Region, Turkey
RESULTS: In 1014 of 1336 patients(76%) we obtained positivity to at least one of the allergens tested. The highest positive sensitivity of allergens in the skin prick tests were house dust mite (n=576, 43.1%)and tree pollens (n= 522, %39.1) have been found. The maximum number of tests and positivity was detected most frequently in June and July.
DISCUSSION AND CONCLUSION: Atopy in Sakarya is frequently seen. Geographic and seasonal features of the region are consistent with the distribution of allergens. We suggest these results will give some help to diagnose and manage of allergic diseases in patients of this region.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda suisid giriþimi sonrasýnda acil servise baþvuran hastalarýn ilk müdahale sonrasýnda hospitalizasyon durumu ve acil þartlarda psikiyatri konsültasyonun 1 yýllýk takip sonrasýnda tekrarlayan suisid giriþimi üzerine etkilerinin tespiti amaçlanmýþtýr
YÖNTEM ve GEREÇLER: Retrospektif gözlemsel çalýþma 3.basamak Eðitim ve Araþtýrma Hastanesi Acil Týp Kliniðine 1 Ocak-31 Aralýk 2010 tarihleri arasýnda suisid giriþimi sonrasýnda baþvuran hastalar etik kurul onayý alýnarak dahil edilmiþtir. Hastalarýn demografik verileri, psikiyatri konsültasyon durumu ve tedavi son durumu hastane arþiv kayýtlarýndan ulaþýlarak kayýt edildi. Hastalar baþvuru sonrasýnda 1 yýllýk gözlem sonrasýnda 1 Ocak 2011-31 Aralýk 2011 tarihleri arasýnda hastane tarafýndan alýnan iletiþim numaralarýndan aranýlarak taburculuk sonrasýnda 1 yýllýk süreçte tekrarlayan suisid giriþimi ya da düþüncesinin olup olmadýðý, psikiyatri poliklinik kontrolüne gitme durumlarý kayýt altýna alýndý.
BULGULAR: 1 yýllýk dönemde suisid giriþimi sonrasýn baþvuran 278 hasta (%0.28) çalýþmaya dahil edildi. 133 hastadan (%57,8) psikiyatri konsültasyonu istendi. Psikiyatri konsültasyonu istenmeyen hastalarda konsültasyon istenen hastalara oranla tekrarlayan suisid giriþimi üzerinde 5,21 kat daha fazla risk artýþý tespit edildi. Psikiyatrik hastalýk özgeçmiþi olan hastalarda olmayan hastalara oranla istatistiksel olarak anlamlý olarak artan suisidal griþim gözlendi. (p=0,014) Müdahale sonrasýnda yoðun bakýma yatýrýlan ya da tedavi bitmeden kendi isteði ile taburcu olan hastalarda diðer hastalara oranla artmýþ oranda suisidal giriþim düþüncesi mevcuttu. (p=0,007) Kendi isteði ile taburcu olan hastalarda hastaneye takip amaçlý yatýrýlan hastalara oranla 3,96 kat daha fazla artmýþ suisidal giriþim riski ayrýca tedavi sonrasýnda taburcu edilen hastalarda hastaneye yatýrýlan hastalara oranla 0,96 daha fazla tekrarlayan suisidal giriþim riski tespit edildi. Yoðun bakýma yatýrýlan hastalarda servise yatýþ verilen hastalara oranla 4,64 kat daha fazla tekralayan suisid griþim riski gözlendi.
TARTIÞMA ve SONUÇ: Çalýþma sonuçlarýna göre suisid giriþimi sonrasýnda acil servise baþvuran hastalardan rutin olarak psikiyatri konsültasyonu istenmesinin uygun olduðunu, hastalarýn özellikle acil servislerde kendi isteði ile taburcu olmalarýný engelleyici önlemlerin alýnmasý gerektiði ve taburculuk sonrasýnda psikiyatri poliklinik kontrolüne gitme durumlarýnýn takibinin yapýlmasýnýn saðlayacak program geliþtirilmesinin uygun olacaðýný düþünmekteyiz

INTRODUCTION: The aim of this study is to investigate effects of hospitalization status after the treatment and requesting emergency psychiatric consultation on recurrent suicide attempts of the patients who admitted to emergency department, during one year of follow up period
METHODS: This retrospective observational study is conducted in the emergency department of a Tertiary Research and Training hospital, on patients admitted due to suicide attempt, between January 1st and December 31-2010 after the ethics committee approval. Archival data were retrospectively screened for the study group and the file numbers of the patients were reached to communicate directly with them
RESULTS: : 278 patients, 0.28% of total admissions, were admitted to the study. 133 patients (57.8%) were consulted psychiatrically. In the patients with the need for a psychiatry consultation, lack of psychiatric consultation was found to be associated with the 5,21 times increased risk for repeated suicide attempts after admission. The rate of suicide reattempts in patients with a history of psychiatric disorder was significantly higher (p=0.014). The patients who were discharged from the intensive care unit and the emergency room with their own request have a higher rate of suisidal thinking than the other patients (p=0,007). The risk of suisidal reattempts was 3,96 times higher in patients discharged upon their own requests than the hospitalized patients, also the risk of suisidal reattempts was 0,96 times higher in patients discharged upon healing than the hospitalized patients.
Patients hospitalized in the intensive care unit had the risk of suisidal reattempts 4,64 times more than the patients hospitalized in other departments

DISCUSSION AND CONCLUSION: Psychiatric consultation before discharging from the emergency departments routinely, and more effective psychiatric follow up of the patients after discharge may decrease recurrent suicide attempts. Preventive algorithm must be defined in order to not allow the patients with own request discharge

GÝRÝÞ ve AMAÇ: Bu çalýþma, kardiyak cerrahi sonrasý geliþen derin sternal yara enfeksiyonlarýnda konvansiyonel tedavi yöntemleriyle vakum yardýmlý kapama tedavi yönteminin uygulandýðý hastalarýn ölüm, reenfeksiyon ve hastanede kalýþ sürelerini karþýlaþtýrmak için tasarlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya Kasým 2006-Haziran 2014 tarihleri arasýnda ayný merkezde açýk kalp cerrahisi sonrasý derin sternal yara enfeksiyon tanýsýyla tedavi uygulanan 72 hasta dâhil edildi. Hasta verileri retrospektif olarak incelendi. Konvansiyonel yara bakýmý ve pansuman yöntemleriyle tedavi uygulanan hastalar Grup 1(n=38), vakum yardýmlý kapama yöntemiyle tedavi uygulanan hastalar ise Grup 2(n=34) olarak sýnýflandýrýldý.
BULGULAR: Hastalarýn 25’i kadýn olup yaþ ortalamasý 65,3±7,8 yýldý. Tedavinin 7.gününde bakýlan ortalama C-reaktif protein(p=0.02), ortalama lökosit sayýsý(p=0.01) ve ortalama eritrosit sedimantasyon hýzý(p=0.005) deðerleri açýsýndan gruplar arasýnda anlamlý fark mevcuttu. Tedavinin 10.günü alýnan mediastinal veya sternal yara akýntý kültüründe Grup 1’de 26 hastada(68,4%), Grup 2’de ise 5 hastada(14,7%) mikroorganizma üremesi mevcuttu(p=0.0001). Doksan günlük mortalite Grup 1’de geliþmezken Grup 2’de ise 6 hasta(%15,8)’da geliþti(p=0.03). Sað kalan hastalarýn hastanede kalýþ süreleri Grup 1’de ortalama 23,3±5,5 gün iken Grup 2’de ise 17,3±3,4 gündü(p=0.0001).
TARTIÞMA ve SONUÇ: Açýk kalp cerrahisi sonrasý geliþen derin sternal yara enfeksiyonlarýn tedavisinde vakum yardýmlý kapama yöntemi konvansiyonel tedavi yöntemlerine göre yara iyileþmesini hýzlandýran, hastanede kalýþ süresini kýsaltan ve yara yerindeki mikroorganizmalarýn daha erken eradikasyonunu saðlayan güvenli ve etkili bir yöntemdir.

INTRODUCTION: In this study, we aimed to compare the conventional treatment methods with vacuum assisted closure treatment technique for mortality, re-infection and duration of hospitalization in patients who had deep sternal wound infection after cardiac surgery.
METHODS: Seventy two patients who had deep sternal infection after open heart surgery between November 2006-June 2014 were enrolled in the study. The data were collected retrospectively. The patients who were treated with conventional wound care were enrolled in group 1(n=38), the patients who were treated with vacuum assisted closure were enrolled in group 2 (n=34).
RESULTS: Twenty five of the patients were female and the mean age of the patients were 65,3±7,8 years. The mean values of C-reactive protein(p=0.02), leukocyte counts(p=0.01) and erythrocyte sedimentation rate (p=0.005) were significantly different between the groups. The incubation of sternal and mediastinal swap at 10 days were positive in 26 patients in group 1(68,4%), and positive in 5 patients in group 2(14,7%)(p=0.0001). The 90-days mortality; no mortality was observed in group 1, and 6 of patients(%15,8) died in group 2 (p=0.03). The duration of hospitalization in survived patients were 23,3±5,5 days in group 1 and were 17,3±3,4 days in group 2 (p=0.0001).
DISCUSSION AND CONCLUSION: The patients who were treated with vacuum assisted closure when compared to conventional wound care, for deep sternal wound infection after cardiac surgery, were associated with shortened hospital stay, accelerate in wound healing and eradication of microorganisms.

GÝRÝÞ ve AMAÇ: Periferik arter hastalýðýnda giriþimsel tedavi yöntemlerinin popülerliði giderek artmaktadýr. Bir çok vasküler alanda perkütan giriþimler tedavide ilk sýradadýr. Çalýþmadaki amaç periferik arter hastalýðýnda giriþimsel tedavi yöntemlerinin merkezimizdeki sonuçlarýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: Temmuz 2011-Ekim 2015 arasýndaki tanýsal ve giriþimsel iþlemler retrospektif olarak tarandý. Giriþimsel iþlem verileri ve hastane içi istenmeyen olaylar hastane kayýtlarýndan incelendi.
BULGULAR: Toplam 11224 adet anjiyografik iþlem tarandý. Bunlardan 1144 tanesi periferik arter hastalýðýna yönelik tanýsal iþlemlerdi. Toplam 167 adet giriþimsel iþlem (ortalama yaþ 62±10, %82'si erkek) tespit edildi. En sýk alt ekstremite (n=101), ardýndan kranial (n=43), üst ekstremite (n=19) ve viseral (n=4) arterlere yönelik iþlemler izlendi. Genel iþlem baþarýsý %95'ti. Intravasküler stentler %81 (n=135) hastada kullanýldý. Hastane içi major istenmeyen olaylardan ölüm 1 (%0.6), serebrovasküler olay 2 %1.2), transfüzyon gerektiren kanama 1 (%0.6), diyaliz ihtiyacý 1 (%0.6) hastada izlendi. Ýþlem sonrasý amputasyon veya miyokard enfarktüsü izlenmedi. Hastalarýn %89'u ertesi gün taburcu edildi. Karotis arter hastalýðýnýn giriþimsel tedavisinde serebrovasküler olay oraný %4.7 (n=2) idi. Ýliak, femoral/popliteal ve subklavian/brakial arter giriþimlerinde iþlem baþarýsý sýrasýyla %97, 92 ve 90 iken karotis/vertebral ve renal arter giriþimlerinde baþarý oraný %100'dü.
TARTIÞMA ve SONUÇ: Periferik arter hasatlýðýnýn giriþimsel tedavisi merkezimizde yüksek iþlem baþarýsý ve kabul edilebilir istenmeyen olay insidansý ile yapýlabilmektedir.

INTRODUCTION: Interventional procedures for peripheral arterial disease have increasing popularity. Percutaneous interventions have become the first line therapy in many vascular territories. Aim of the present study is to evaluate the procedural results of percutaneous interventions for peripheral arterial disease in our single center.
METHODS: Angiographic procedures performed between July 2011 and October 2015 were retrospectively evaluated. Interventional procedural data and in-hospital adverse events were acquired from hospital records.
RESULTS: A total of 11224 angiographic procedures were screened. Of these, 1144 procedures were performed for the diagnosis of peripheral arterial disease. A total of 167 interventional procedures (mean age 62±10, 82% male) were detected. The most common procedure was lower extremity intervention (n=101), which was followed by cranial (n=43), upper extremity (n=19) and visceral (n=4) interventions. Overall procedural success rate was 95%. Intravascular stents were used in 82% (n=135) of patients. Among in-hospital adverse events, death was observed in 1 (0.6%), cerebrovascular events in 2 (1.2%), bleeding requiring transfusion in 1 (0.6%), dialysis requirement in 1 (0.6%) patient(s). Post-procedural amputation or myocardial infarction was not observed. Majority of patients (89%) were discharged from hospital the next day. Cerebrovascular event rate in carotid artery intervention was 4.7% (n=2). Iliac, femoral/popliteal and subclavian/brachial artery interventions had a procedural success rate of 97, 92 and 90%, respectively. Procedural success was 100% in carotid/vertebral and renal artery interventions.
DISCUSSION AND CONCLUSION: Percutaneous interventions for the management of peripheral arterial disease can be performed with high procedural success and acceptable adverse event rates in our center.

GÝRÝÞ ve AMAÇ: Trabekülektomi ve fakotrabekülektomi cerrahisinin merkezi maküler kalýnlýk (MMK) üzerine etkilerinin karþýlaþtýrýlmasý
YÖNTEM ve GEREÇLER: Primer açýk açýlý glokom (PAAG ) tanýlý trabekülektomi cerrahisi planlanan fakik 22 hastanýn 22 gözü, PAAG tanýlý ve eþ zamanlý kataraktý olan fakotrabekülektomi planlanan 20 hastanýn 20 gözü ve kontrol grubu olarak da sadece kataraktý olan ve fakoemülsifikasyon cerrahisi planlanan 25 hastanýn 25 gözü çalýþma kapsamýna alýndý. MMK ölçümleri cerrahi öncesi, cerrahi sonrasý 1. hafta, 1. ay ve 3. ayda optik koherens tomografi (OKT) kullanýlarak yapýldý.
BULGULAR: Postoperatif 1. hafta fakoemülsifikasyon ve fakotrabekülektomi cerrahisi geçiren grupta MMK deðerlerinde artýþ olduðu gözlemlenirken trabekülektomi cerrahisi geçiren grupta gözlemlenmedi. Fakotrabekülektomi ile trabekülektomi geçiren gruplar arasýndaki fark istatistiksel olarak anlamlý bulundu (p=0.03). 1. ayda her üç grupta da MMK deðerinde artýþ görülürken, trabekülektomi ile fakotrabekülektomi uygulanan gruplar arasýnda ortalama MMK deðiþimi açýsýndan yine istatistiksel anlamlý fark saptandý (p=0.01). 3. ayda ise ortalama MMK deðerinin her üç grupta da preoperatif düzeylere yaklaþtýðý ve gruplar arasýndaki farkýn istatistiksel olarak anlamlý olmadýðý görüldü.
TARTIÞMA ve SONUÇ: Fakotrabekülektomi grubunda postoperatif 1. hafta ve 1. ayda ortalama MMK deðerlerindeki artýþ trabekülektomi grubuyla kýyaslandýðýnda istatistiksel anlamlý fark tespit edilmesi fakotrabekülektomi cerrahisi esnasýnda manipülasyonun fazla olmasýna ve cerrahi süresinin uzun olmasýna baðlý olabileceði düþünüldü.

INTRODUCTION: The comparison of the effects of trabeculectomy and phaco-trabeculectomy on central macular thickness (CMT)
METHODS: 22 eyes of 22 patients with primary open angle glaucoma (POAG) which had undergone trabeculectomy surgery, 20 eyes of 20 patients who had been diagnosed POAG with concurrent cataract which had undergone phacotrabeculectomy surgery and 25 eyes of 25 patients with only cataract serving as controls were included. CMT measurements was performed before surgery, at postoperative 1 week, 1 month and 3 months after surgery by using optic coherens tomography (OCT).
RESULTS: Increase in CMT of phacoemulsification and phacotrabeculectomy groups was observed at postoperative 1 week while that of was not observed in trabeculectomy surgery. The difference between trabeculectomy and phacotrabeculectomy group was statistically significant (p=0.03). Postoperative CMT were increased in all groups in the first month, however mean CMT change was statistically significant between trabeculectomy and phacotrabeculectomy group (p=0.01). By 3. month the mean CMT levels were close to the preoperative value in all three groups and the difference between the groups was not statistically significant.
DISCUSSION AND CONCLUSION: When increase in CMT in phacotrabeculectomy group at postoperative first week and first month compared to that of trabeculectomy group, finding out statistically difference may be related to is more manipulation during surgery and longer duration.

Günlük gastroenteroloji rutininde pek çok kez kolon ve ince barsak ülserli hastalarla karþýlaþmaktayýz. Bu hastalardaki ülserlerin ayýrýcý tanýsý her zaman çok kolay olmayabilmektedir. Biz de polikliniðimize baþvuran bir vaka sayesinde bu konuyu irdelemek istedik.

Ýleal ulcers are detected commonly in our clinical practice. Howewer they are always not be result of inflammatory bowel disease. Ýt is important to differentiate them other etiologies from inflammatory bowel disease. We herein report a case of ileal ulcer.

68 yaþýndaki, avukat erkek hasta 3 ay önce sol omuzda geliþen aðrý ve güçsüzlük þikayetiyle polikliniðimize baþvurdu.Hastanýn ilk muayenesinde omuz abduksiyon kas gücü 0/5 idi. Diðer kas güçleri ve nörolojik muayenesi normaldi. Anemnezinde herhangi bir travma ve tekrarlayýcý spor aktivitesi tariflemiyordu. EMG si sol axiller sinirin aðýr aksonal hasarý, sol elde hafif-orta derecede karpal tünel sendromu olarak rapor edildi.
Akut geliþen þiddetli omuz aðrýsý ve güçsüzlüðü geliþen hastalarda izole axiller sinir lezyonu akla gelmelidir. Ayýrýcý tanýda travma tariflemeyen hastalarda nevraljik amyotrofi, vaskülit ve lokalize nörit düþünülmelidir

68-year-old patient who is lawyer admitted to our clinic because of occuring weakness and pain on the left shoulder 3 months ago. His abductor muscle strength of left shoulder was 0/5 in the first examination. The strenght of other muscles and neurological examinations were normal. He did not describe any trauma and repetitive sport activities in the anamnesis. EMG was reported as severe axonal damage of the left axillary nerve and mild to moderate carpal tunnel syndrome.
Isolated axillary nerve palsy should be kept in mind in patients with acute severe shoulder pain and weakness Neuralgic amyotrophy,vasculitis, localized neuritis should be considered in the differential diagnosis in patients who dont describe any trauma.

Frontal sinüs mukoselleri, yavaþ büyüyen ve frontal sinuüste lokal agresif davranan lezyonlardýr. Büyük frontal mukoseller, sinüs duvarýnda destrüksiyon yaparak çevre anatomik yapýlara yayýlýrlar. Mukosel tedavisi cerrahidir. Cerrahi yönetiminde farklý yaklaþýmlar bulunmaktadýr. Bu makalede kliniðimizde tedavi edilen üç dev frontal mukosel olgusu taný, tedavi ve takip aþamalarý güncel literatür bilgileri ýþýðýnda sunuldu.

Frontal sinus mucoceles are slow-growing and locally aggressive lesion of the frontal sinuses. A gradually enlarging lesion results in destruction of the wall of the sinus and extends to the encircling anatomic structures. Treatment of mucocele is surgical. There are different surgical approaches in frontal mucocele. Hereby we reported the diagnosis, treatment and follow-up of three cases of giant frontal mucocele and reviewed the relevant literature.

Konjunktival kanlanma ve yaþarmalý kýsa süreli tek yanlý nevraljiform baþ aðrýsý (SUNCT) sendromu, etiyolojisi kesin olarak bilinmeyen, nadir görülen trigeminal otonomik sefaljilerdendir. Genellikle tek taraflý oftalmik sinir alanýnda hafif-orta şiddetli paroksismal gruplar halinde gelen ağrý ve buna eşlik eden otonomik bulgularýn varlýğý ile ayýrt edilir. Bu sendromda genellikle aðrý süresi 5 ile 240 saniye arasýnda deðiþmektedir. Etyolojisi kesin olarak belirlenebilmiş değildir, ancak buna yönelik çalýşmalar sürdürülmektedir. Çok nadir görülen SUNCT sendromunun tedavisinde deðiþik ajanlar kullanýlmaktadýr. Bu yazýda literatürde bildirilen yaþ aralýðýnýn altýnda ve üstünde olan, karbamazepin (400 mg/gün) ve lamotrijin (150 mg/gün) ile tedavi edilen iki olgu sunulmuþtur.

Short lasting Unilateral Neuralgiform headache with Conjunctival injection and Tearing (SUNCT) syndrome, the etiology of which is not known for sure, is a rare trigeminal autonomic cephalgia. In its distinction paroxysmal groups of pain with low-moderate intensity which is generally unilateral and confined to the ophthalmic nerve region accompanied with autonomic symptoms is important. The usual duration ranges from 5 to 240 seconds. The etiology has not been exactly defined yet, but there are several studies going on over this subject. Various agents are used in the treatment of SUNCT syndrome which is a very rare condition. this paper presents two cases below and over the age range reported in the literature who were treated with carbamazepin (400 mg/day) and lamotrigine (150 mg/day).

Testiküler neoplaziyi taklit eden çift taraflý spermatoseli olan bir olguyu, tanýsýný skrotal ultrason ve cerrahi olarak teyit ederek sunduk. 58 yaþýnda bir erkek sað skrotal þiþlik þikayeti ile kliniðimize baþvurdu.Fizik muayene sonrasý sadece sað tarafta deðil, ayrýca sol tarafta skrotal þiþlik tespit edildi. Yapýlan skrotal ultrasonografide saðda monoloküler, solda multiloküler kistik yapýda kitleler tespit edildi. Yapýlan cerrahi tedavi ile her ikisi de epididimis yanýnda yer alan spermatoseller perforasyon olmadan eksize edildi.Hasta iyi bir þekilde iyileþip, post operatif ikinci gün taburcu edildi. Bir ay sonraki takibinde bir sorun izlenmedi.

We describe a case of bilateral spermatocele mimicking testicular neoplasia, diagnosed at scrotal ultrasound with surgical correlation. A 58 years of man was admitted to our clinic suffering from right scrotal swelling. After physical examination, not only right sided but also left sided scrotal swelling was detected. Scrotal ultrasound revealed cystic fluid masses which are monoloculer on right side and multiloculer on left side. Surgical exploration was arranged and total excision of spermatoceles which are both located near the body of epididymis, was performed without perforation. The patient recovered well and discharged on the second day. No complication was observed in the follow up after one month.