Trakya Üniversitesi Tıp Fakültesi Dergisi
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Öğe Verrucous carcinoma of urinary bladder (vol 23, pg 145, 2006)(Aves Yayincilik, Ibrahim Kara, 2007) Usta, Ufuk; Mizrak, Bulent; Guerses, Iclal[Abstract Not Available]Öğe Hepatic Hydatid Cyst Cases Reply(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan[Abstract Not Available]Öğe Trace Elements in a Rat Model of Cadmium Toxicity: the Effects of Taurine, Melatonin and N-Acetylcysteine(Aves Yayincilik, Ibrahim Kara, 2010) Gulyasar, Tevfik; Aydogdu, Nurettin; Cakina, Suat; Sipahi, Tammam; Kaymak, Kadir; Sener, SeralpObjectives: This study was undertaken to investigate copper, zinc, iron, and selenium in a rat model of cadmium toxicity and effects of antioxidant substances such as taurine, melatonin and N-acetylcysteine. Materials and Methods: Ninety male Sprague Dawley rats were divided into nine groups. Group 1 received tap water comprising the controls; the remaining eight groups received 200 mu g/ml cadmium chloride (CdCl2) for three months. Group 2 had CdCl2. Groups 3, 4, and 5 were administered taurine, melatonin and N-acetylcystein for three months together with CdCl2. Groups 6, 7, 8, and 9 had CdCl2 for three months and then only water as the second control or antioxidants for seven days. Cadmium, copper, zinc, iron, and selenium levels of heart and brain were measured by atomic absorption spectrophotometer. Results: Cadmium accumulated in significant amounts in brain and heart tissues when compared with controls. CdCl2 levels in Group 1 and Group 2 were 2.56+/-0.77 and 27.2+/-5.82 in the heart, 46.16+/-14.81 and 300.34+/-58.19 in the brain, respectively (p<0.001). We found that melatonin was more effective in brain tissue (p<0.05) whereas N-acetylcysteine was more effective in heart tissue (p<0.001) against cadmium accumulation. Conclusion: We suggest that taurine, melatonin and N-acetylcysteine have some protective effects in brain and heart tissues against cadmium accumulation. Furthermore, trace element levels were restorated in different degrees after taurine, melatonin and N-acetylcysteine administration.Öğe Iatrogenic Cushing Syndrome Due to Topical Steroid Administration in an Infant(Aves Yayincilik, Ibrahim Kara, 2010) Tutunculer, Filiz; Tekin, Mustafa; Balci, Demet; Sahaloglu, OzlemTopical therapy with glucocorticoids is used commonly in chronic dermatoses. Although side effects are less common compared to systemic use, infants who are exposed to topical corticosteroids have greater risk for Cushing syndrome or adrenocortical insuffiency caused by suppression of hypothalamic-pituitary-adrenal axis because glucocorticoids are highly absorbed through the diaper area. However, the development of Cushing syndrome in an infant from topical steroid therapy is unusual. We present an infant with diaper dermatitis who developed iatrogenic Cushing syndrome due to prolonged clobetosel propionate use.Öğe Three Cases of Tinea Incognito(Aves Yayincilik, Ibrahim Kara, 2009) Arican, Ozer; Gursel, YildizTinea incognito is a dermatophytic infection which modifies typical clinical presentation due to improper use of topical or systemic corticosteroids. In this report, we present three cases who had been treated with topical corticosteroid as a result of incorrect diagnosis. The first case, a 30-year-old male patient complained of localized, erythematous, scaling papules and plaques on his genitocrural crease and umbilical region for four months. The second case, a 40-year-old male patient had generalized, erythematous plaques with papules and pustules, and macular hyperpigmentation for one month. The third case, a 23-year-old male patient had erythematous macules with papules on his malar areas for three months. In all presented cases, direct microscopic examination was positive and, in the first and second cases, the fungal cultures were positive for Trichophyton rubrum. The lesions also showed complete resolution with antimycotic treatment. In this report, we have reviewed the recent medical literature about tinea incognito.Öğe Frequency Of Thyroid Diseases in Type 2 Diabetic Patients(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Taskiran, Benguer; Guldiken, Sibel; Peynirci, Hande; Altun, Betuel Ugur; Tugrul, ArmaganObjectives: Thyroid diseases and type 2 diabetes mellitus are two abundant diseases in general population. In this study, we evaluated the frequency of thyroid diseases in type 2 diabetic patients. Patients and Methods: The study included 306 type 2 diabetic patients, who were followed up in Trakya University Department of Endocrinology and Metabolism Disorders. All patients had thyroid function tests, antithyroglobulin antibody values, antithyroid peroxidase values, and thyroid imaging (scintigraphy and/or ultrasonography). Results: A total of 38 (12.4%) patients had thyroid diseases with the following distribution: 29 (9.5%) Hashimoto thyroiditis, five (1.7%) multinodular goitre, three (%1) Graves' disease, and one toxic solitary adenoma (0.3%). Conclusion: We found that thyroid diseases in type 2 diabetics were seen as frequent as in general population. We suggest that there is no need to screen type 2 diabetics for thyroid diseases, hypothyroid in particular, that increase the risk for cardiovascular diseases, in addition to the recommended screening of the general population in guidelines.Öğe A new technique in cholesteatoma surgery: CHAT(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Uzun, Cem; Yagiz, Recep; Karasalioglu, AhmetObjectives: Patients with extended cholesteatoma who underwent Combined Heermann And Tos (CHAT) technique, which we developed depending on our studies on Heermann's cartilage palisade tympanoplasty and Tos' modified combined approach tympanoplasty, were analyzed. Patients and Methods: The study included 37 ears of 35 patients, in whom CHAT technique was performed. Posterior-superior bony annulus was widely drilled, transmeatal atticotomy and cortical mastoidectomy with preservation of posterior ear canal wall were performed in each patient. After ossiculoplasty, perforation of the eardrum, opening at bony annulus and scutum were reconstructed with the palisade technique. At the final evaluation, otoscopic and audiologic findings were evaluated and compared (Paired Sample t-test). Results: Median age was 33 (6-57), mean follow-up period was 30 months (range: 6-60; standard deviation: 19). There was no complication in any patient before or after the surgery. There was two (5%) recurrent cholesteatomas (eradication: 95%), one of which was local. The mean hearing and air-bone gap preoperatively versus in last evaluation were 45 (standard deviation: 14) vs 35 dB (standard deviation: 16) (p<0.0001) and 29 (standard deviation: 11) vs 21 dB (standard deviation: 11), respectively (p<0.001). Conclusion: We conclude that CHAT technique is quite successful in the eradication of extensive cholesteatoma with satisfactory results in hearing, although it is a one-stage, canal wall up closed technique.Öğe Quality of Life After Stroke(Aves Yayincilik, Ibrahim Kara, 2010) Birtane, Murat; Tastekin, NurettinSeveral studies have shown that many stroke survivors experience a decline in their Quality of life (QOL) in terms of impaired physical, functional, psychological, and social health. Quality of life is most often assessed by means of either structured interviews or written questionnaires. Many questionnaires have been developed recently for the evaluation of COL in stroke and many studies have been done on this subject. In this study QOL changes in stroke patients, the evaluation of QOL, the QOL measuring instruments and the results of clinical studies on the subject were discussed.Öğe Mean platelet volume and peripheral blood count response in acute ischemic stroke(Aves Yayincilik, Ibrahim Kara, 2008) Guldiken, Baburhan; Ozkan, Hulya; Kabayel, LeventObjectives: Mean platelet volume (MPV) is a marker of the platelet activity and is reported to increase in vascular diseases. The aim of the study is to investigate the relationship between MPV and the subtypes of acute ischemic stroke. Patients and Methods: The patient group consisted of 102 acute ischemic stroke patients who were divided into the large vessel (n=43) and the small vessel (n=59) disease subgroups. Their MPV values were compared with those of 48 age/sex-matched healthy individuals. The relationship of MPV with the subtypes and severity of stroke, and other hematological parameters (platelet count, platecrit, hemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, leukocyte, neutrophil, lymphocyte, monocyte) was further investigated. Results: No difference was found in terms of MPV values between the patient subgroups and control group, and no relation was found between MPV and stroke severity and other hematological parameters (p>0.05). A significant increase in the leukocyte and neutrophil count was seen in patients of the large vessel disease group when compared with the small vessel disease and control group (p<0.005). Neutrophil count is found to be a risk factor for the stroke severity (beta=0.362, p=0.01, OR=1.437, Cl %95 0.02-0.08). Conclusion: No significant change in MPV was seen in acute ischemic stroke. High leukocyte and neutrophil levels are markers for the large vessel disease subtype and severity of ischernic stroke.Öğe Smoking status of medical students(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Sahin, Erkan Melih; Oezer, Cahit; Cakmak, Huriye; Tunc, Zafer; Tastan, Kenan; Can, Fatma Nur EnecObjectives: The aim of this study is to determine the status of smoking habits and quitting behaviors of the students of Trakya University Medical Faculty. Patients and Methods: Smoking habits, nicotine addiction, quitting motivation and behaviors were investigated in the 5th and 6th year students of Trakya University Medical Faculty in 2003-2004 academic year by a self reported questionnaire. Out of 336 students 200 (59.5%) (90 males, 110 females, mean age 24.11 +/- 1.87 years; range 21 to 34 years) were included in the study. Results: There were 129 (64.5%) never smokers, 18 (9%) ex-smokers and 53 (26.5%) current smokers. Smoking rate was increasing with age. Nicotine addiction test scores corresponded to the least addiction. The most frequently declared reason to quit smoking were worries related to health. The most frequently declared reasons to restart smoking were stress and smoking friends. Counseling to quit smoking, nicotine replacement and drug use were very limited. Conclusion: Counseling to quit smoking was insufficient even in this advantageous group of medical students. Action planning targeting physician candidates is immediately required to enhance national movement against smoking.Öğe The importance of serum total and lipid-bound sialic acid as markers in patients with small cell and non-small cell lung carcinoma(Aves Yayincilik, Ibrahim Kara, 2007) Gokmen, Selma Suer; Kazezoglu, Cemal; Tabakoglu, Erhan; Altiay, Guendeniz; Gungoer, Ozgul; Ture, MevlutObjectives: Serum total sialic acid (TSA) and lipid-bound sialic acid (LSA) levels were investigated in patients with small and non-small cell lung carcinoma and their role in discriminating small from non-small cell lung carcinoma and lung carcinoma from healthy individuals was evaluated. Patients and Methods: The study included 159 male patients with non-small cell lung carcinoma (n=102) and small cell lung carcinoma (n=57) who never received chemotherapy and/or radiotherapy and 35 healthy volunteers as controls. Serum TSA and LSA levels were determined by the methods of Warren and Katopodis, respectively. Results: Serum TSA and LSA levels in both patient groups were significantly elevated when compared with controls (p < 0.001), but the patient groups did not differ significantly in this respect. Receiver operating characteristic (ROC) analysis showed that TSA was more specific and LSA was more sensitive in distinguishing patients with non-small cell carcinoma from healthy individuals. On the other hand, LSA was found to be more sensitive in distinguishing patients with small cell carcinoma from healthy controls. Conclusion: Serum total and lipid-bound sialic acid may play an important role as biochemical markers in distinguishing patients with small and non-small cell lung carcinoma from healthy subjects.Öğe Comparison of the Efficacy of SAPS II and MPM II Scoring Systems in Intensive Care Unit Mortality(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Eroglu, Fuesun; Aslan, Uelkue; Yavuz, Luetfi; Ceylan, Berit; Eroglu, Erol; Heybeli, NurettinObjectives: We aimed to investigate the predicting performances of Simplified Acute Physiology Score (SAPS) II and Mortality Probability Model (MPM) II(0) and MPM II(24) on determining the mortality rates of intensive care unit (ICU) patients. Patients and Methods: Consecutive 100 patients admitted to the ICU were investigated retrospectively, and 92 of them were included in the study. Initial SAPS and MPM analysis and calculations for mortality prediction percentages were performed with auxiliary software package. Transfer data, total ICU and hospital stay and duration of mechanical ventilation were calculated. Results: Most of the patients (53%) were transferred to the ICU from the emergency department. Twenty two patients were transferred to another department and 15 patients were discharged. The number of patients died were 50, the mortality rate was determined as 54%. The ICU stay and duration of mechanical ventilation of patients who died were found as statistically significant (p=0.007, p=<0.0001, respectively). Conclusion: Although SAPS II, MPM II(0), and MPM II(24) analysis are related to mortality, they have no effect on predicting the mortality independent from logistic regression analysis. The predicted mortality rates were found related with those determined by logistic regression analysis. Duration of mechanical ventilation and ICU stay and mechanical ventilation duration above 24 hours affect the predicted mortality, independently.Öğe Pulmonary embolysm after cesarean section(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Sahin, Sevtap Hekimoglu; Memis, Dilek; Seker, Sermin; Saritabak, Oezlem; Yandim, TarikPregnancy is a physiologic state with an increased risk for thromboembolic complications. Tachypnea and respiratory distress was evident in a 36-year-old female patient in the postoperative third hour after an elective cesarean section in the 38. week of pregnancy. Thoracic tomography revealed pulmonary embolism, the patient was admitted to the intensive care unit and tranecsamic acid infusion was started. Paradoxical septal motion and a 4x1 cm hpyerechogenic mobile mass on the right atrium attached to the inferior wall was apparent in the echocardiographic assessment. Thrombolytic infusion therapy was started due to the worsening of the patient's respiratory distress and hemodynamic state but was withdrawn due to the active bleeding from the vagina and the operation site. Bleeding was controlled by erythrocyte and thrombocyte suspensions, freshly drawn blood, and fresh frozen plasma. Echocardiographic control revealed lysis of the thrombus in the right atrium and the patient was moved to the obstetrics ward on the 4. day.Öğe The clinical value of avidity test in the management of serologic rubella infection: a case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Sayin, N. Cenk; Ahmet, Nefise; Varol, Fuesun G.28-year-old pregnant woman presented with positive rubella IgM and IgG antibodies at initial admission and at the 11th, 13th, 30th and 36th weeks of gestation. Rubella avidity test revealed high titers and the patient was followed-up to ensure birth of a healthy infant. Rubella infection may be asymptomatic and re-infection may demonstrate a subclinical course. It is easy to make the diagnosis of rubella by following the antibody titers during pregnancy. The critical point in such patients is to differentiate the condition of disease at admission and decide accordingly. Avidity test may be a useful method for the management of such patients.Öğe Comparison between Karydakis flap repair and primary closure for surgical treatment of sacrococcygeal pilonidal sinus(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Polat, Nihat; Albayrak, Dogan; Ibis, Abdil Cem; Altan, AydinObjectives: In this prospective study, we compared primary closure and Karydakis flap repair which has recently proved a popular technique for surgical treatment of pilonidal sinus. Patients and Methods: The study included 48 patients (46 males, 2 females) who were operated on for pilonidal sinus. The patients were randomized to two groups. After sinus excision, 33 patients (group 1) underwent primary closure, and 15 patients (group 2) underwent Karydakis flap surgery. The mean follow-up was 6.8 months (range 4 to 11 months) in group 1, and 6.2 months (range 3 to 10 months) in group 2. Results: Serous liquid collection and discharge were seen at the site of the lesion in four patients (12.1%) in group 1, and in two patients (13.3%) in group 2. Subcutaneous hematoma was detected in one patient (6.7%) in group 2. During the follow-up period, none of the patients developed wound infection. Recurrences were seen in one patient (3%) in group 1, and in one patient (6.7%) in group 2. Conclusion: Excision and primary closure can be the preferred method for the treatment of pilonidal sinus in selected patients due to its advantages such as ease and simplicity, shorter recovery time, and limited scar formation.Öğe Physician Responsibilty and Medical Malpractice After the Legal Regulations(Aves Yayincilik, Ibrahim Kara, 2010) Altun, Gurcan; Yorulmaz, Abdullah CoskunOur penal codes were reviewed again in 2005. Some changes were made in routine forensic services and legal responsibilities of physicians. After the legal regulations, physicians began to worry about serious troubles they can live because of their medical malpractice. This situation is not unique only to our country. In many countries of the world, there have been similar practices in force for a long time. Especially because of the compensation due to malpractice insurance, physicians are in difficult situations. If physicians comply with principles and rules of medical ethics, the laws will protect them.Öğe 13-Year Experience with Penetrating Trauma Patients(Aves Yayincilik, Ibrahim Kara, 2009) Karamustafaoglu, Yekta Altemur; Yavasman, Ilkay; Kuzucuoglu, Mustafa; Mammedov, Ruestem; Yener, YorukObjectives: Thoracic injuries occur in approximately 25-30% of all trauma cases. Among these, 70% is blunt trauma and 30% is penetrating trauma. We presented our clinical experience with penetrating thoracic trauma patients in the last 13 years. Patients and Methods: We retrospectively assessed 200 cases of penetrating thoracic trauma (184 males (%92), 16 females (%8); mean age 27.4 years; range 11 to 80 years) urgently hospitalized at our clinic between 1995-2008. Results: In 153 (76.5%) cases sharp penetrating trauma and in 47 (23.5%) patients gunshot wounds were seen. Intrapleural pathology was found in 174 (87%) cases and extrathoracic organ injury was found in nine cases. Surgical treatment included chest tube thoracostomy in 173 (86.5%) cases and other conservative treatment methods were applied in 27 (13.5%) cases. Thoracotomy was required in 39 (19.5%) of the cases. The morbidity rate was 7.5% and mortality rate was 0.5%. Conclusion: In penetrating thoracic trauma cases, except emergency thoracotomy patients, conservative treatment methods are applied in most of the patients. Trauma with intrathoracic organ injury increases the mortality and morbidity, and requires fast and well-organized multidisciplinary approach.Öğe Evaluation of Surgical and Histopathologic Results of Patients Operated for Parotid Gland Tumor(Aves Yayincilik, Ibrahim Kara, 2009) Tas, Abdullah; Giran, Safiye; Yagiz, Recep; Yalcin, Oemer; Koten, Muhsin; Adali, Mustafa Kemal; Karasalihoglu, AhmetObjectives: To investigate the patients with parotid tumors retrospectively and to evaluate the surgical procedure, histopathologic results, incidence, follow-up time and complications. Patients and Methods: The study included 56 patients (38 males, 18 females; mean age 52.7 years; range 7 to 86 years) who presented with a mass below or in front of the ear between January 2000 and May 2008. The data regarding patient age, sex, surgical procedure, postoperative histopathologic results and follow-up time were recorded. Results: One of the male patients underwent operation twice because of the bilateral parotid mass. According to the postoperative histopathologic results, 37 of the cases were benign (64.9%), and 20 of them were malign (35.1%). Pleomorphic adenoma (13 patients) and Whartin tumor (13 patients) incidence were similar. Partial superficial parotidectomy, superficial parotidectomy, and total parotidectomy were performed. In addition, some of the patients underwent neck dissection. The most frequent complication was transient facial nerve paresis. Conclusion: For the management of benign parotid gland tumors, superficial or partial superficial parotidectomy is a sufficient surgery. For malign tumors, superficial or total parotidectomy; in cases with neck masses, neck dissection; and in cases involving the facial nerve, facial nerve resection and reconstruction should be performed. According to the type of tumor, postoperative radiation therapy and chemotherapy should be performed as well.Öğe Intracranial Complications of Chronic Suppurative Otitis Media(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Yagiz, Recep; Adali, Mustafa Kemal; Tas, Abdullah; Uzun, Cem; Koten, Muhsin; Karasalihoglu, AhmetObjectives: To evaluate the clinical signs and symptoms, diagnosis-treatments, distributions and outcomes of patients with intracranial complications due to chronic suppurative otitis media (CSOM). Patients and Methods: Data of 42 patients (27 males, 15 gemales; mean age 31.3 years; range 9 to 74 years) diagnosed as intracranial complication due to CSOM were reviewed retrospectively. Patients were investigated on the basis of age, sex, symptoms, findings of otoscopic examination, complications, radiological evaluations, methods of management and findings at the operation. Results: Complications occurred predominantly in patients between 31 and 40 years of age (33.3%). Severe headache, nausea-vomiting, otalgia, purulent otorrhea and fever were the most common signs and symptoms. Meningitis was the most common (115 patients, 35.7%), brain abscess (14 patients, 33.3%) and lateral sinus thrombosis (10 patients, 23.8%) were second and third common complications. The overall mortality rate was 2.4% (in one patient who was comatose on admission), whereas it was 7.1% for patients with brain abscess. Conclusion: Intracranial complications of CSOM are still a serious problem due to life-threatening condition. If a patient with active CSOM has severe headache, nausea-vomiting, otalgia and fever, otogenic intracranial complication should be considered, and detailed evaluation should be performed for early diagnosis since the level of consciousness on admission is an important prognostic factor.Öğe Do dietary calcium intake and hormone replacement therapy affect bone mineral density in women?(Aves Yayincilik, Ibrahim Kara, 2008) Ozdemir, Ferda; Kabayel, Derya Demirbag; Ture, MevlutObjectives: In this study, the relationship between postmenopausal bone mineral density (BMD), and hormone replacement therapy (HRT) and the level of dietary calcium intake in women was investigated. Patients and Methods: Two hundred postmenopausal women (mean age 58.89 +/- 8.51 years; range 42 to 83 years) were evaluated retrospectively. Menopausal age and duration, HRT status, and daily dietary calcium intake of all patients were recorded. Evaluation of BMD was made with Dual Energy X-Ray Absorptiometry (DEXA) from lumbar spine and femur and the T scores were obtained. Results: There was a significant negative correlation between the patients' age and duration of menopause, and BMD. The BMD values of the patients not receiving HRT were significantly lower than those of the patients receiving HRT In women with dietary calcium intake above 1000 mg/day, spine and femur BMD values were significantly higher than in those with an intake below 600 mg/ day and between 600-1000 mg/day. Conclusion: We think that dietary calcium intake and HRT status can be an indicator for BMD in postmenopausal women.
