Showing papers in "Balkan Medical Journal in 2012"

Treatment Effects of Onion (Allium cepa) and Ginger (Zingiber officinale) on Sexual Behavior of Rat after Inducing an Antiepileptic Drug (lamotrigine).

Abstract: Objective: The aim of the present study was to evaluate the beneficial degree of sexual behavior in male rats after inducement of onion and ginger in lamotrigine receiving groups. Material and Methods: Wistar rats (n=70) (male=35, female=35) were allocated so that males were divided into seven groups: control (n=5) and test groups (n=35). Control group used normal Saline (3 cc for each rat). Lamotrigine group were given Lamotrigine (10 mg/kg). Onion group used onion fresh juice (3 cc for each rat/daily). Ginger group was fed on ginger powder (100 mg/kg/daily). Onion a Lamotrigine group used both onion juice (3 cc fresh onion juice for each rat/day) and Lamotrigine (10 mg/kg). Ginger a Lamotrigine group used both ginger powder (100 mg/kg/day) and Lamotrigine (10 mg/kg/day). Onion, ginger a Lamortigine group jointly used ginger powder (100 mg/kg/day) and onion juice (3 cc juice for each rat) and Lamotrigine (10 mg/kg/day). All groups were given treatments orally. For sexual behaviors, Estradiolbenzoate (50 microgram) and 6 hours before test (500 microgram) progesterone was injected to the female rats subcutaneously. Then rats were viewed for erection, ejaculation and cup. Results: There was maximum Serum total testosterone level in the onion group, there was maximum malondialdehyde (MDA) in the Lamotrigine group and there was maximum total antioxidant capacity in both the onion group and ginger group (pl0.05). Conclusion: Results revealed that administration of (100 mg/kg/day) of ginger powder, and freshly prepared onion juice (3 cc for each rat), significantly lowered the adverse effects of lamotrigine, and can have beneficial effects on sexual behavior in male rat. Turkish Baslik: Treatment Effects of Onion (Allium cepa) and Ginger (Zingiber officinale) on Sexual Behavior of Rat after Inducing an Antiepileptic Drug (lamotrigine) Anahtar Kelimeler: Allium cepa, antiepileptik, lamotrijin, cinsel davranis, Zingiber officinale Amac: Bu calismanin amaci Lamotrijin alan gruplarda sogan ve zencefil baslandiktan sonra erkek ratlarin cinsel davranis duzeyi uzerine faydali etkilerini degerlendirmekti. Materyal ve Metotlar: Wistar ratlar (n=70) (erkek=35, disi=35), erkekler yedi gruba ayrilacak sekilde gruplandirildi: kontrol (n=5) ve test gruplari (n=35). Kontrol grubunda normal salin (her bir rat icin 3 cc) kullanildi. Lamotrijin grubuna Lamotrijin (10 mg/kg) verildi. Sogan grubuna taze sogan suyu (her rat icin gunluk 3 cc) verildi. Zencefil grubu zencefil tozu (100 mg/kg/gun) ile beslendi. Sogan+Lamotrijin grubu hem sogan suyu (her bir rat icin gunluk 3 cc taze sogan suyu) hem de Lamotrijin (10 mg/kg) kullandi. Zencefil+Lamotrijin grubu hem zencefil tozu (100 mg/kg/gun) hem de Lamotrijin (10 mg/kg/gun) kullandi. Sogan+zencefil+Lamortigine grubu zencefil tozu (100 mg/kg/gun), sogan suyu (her rat icin 3 cc) ve Lamotrijini (10 mg/kg/gun) birlikte kullandi. Tum gruplara tedaviler oral olarak verildi. Cinsel davranis icin disi ratlara subkutan olarak Ostradiolbenzoat (50 mikrogram) ve testten 6 saat once (500 mikrogram) progesteron enjekte edildi. Daha sonra ratlarda ereksiyon, ejakulasyon ve ciftlesme davranisi incelendi. Bulgular: Maksimum serum total testosteron seviyesi sogan grubunda, maksimum malondialdehid (MDA) seviyesi Lamotrijin grubunda ve maksimum total antioksidan kapasite hem sogan hem de zencefil grubunda mevcuttu (pl0.05). Sonuc: Bulgular zencefil tozu (100 mg/kg/gun) ve taze hazirlanmis sogan suyu (her rat icin 3 cc) verilmesinin Lamotrijinin advers etkilerini anlamli sekilde azalttigini ve erkek ratlarin cinsel davranisi uzerine faydali etkileri olabilecegini gosterdi.

Molecular Characterization of Human and Animal Isolates of Echinococcus granulosus in the Thrace Region, Turkey

Abstract: Objective: Echinococcus granulosus is the causative agent of cystic echinococcosis in humans and many domestic animals, and remains an important global health problem. The aim of this study was to genotype E. granulosus isolates obtained from humans and animals in the Thrace Region of Turkey. Material and Methods: A total of 58 isolates were obtained from patients who underwent surgery at several hospitals and from animals at a slaughterhouse in the province of Edirne. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of ribosomal internal transcribed spacer 1 fragments, and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) of the partial mitochondrial NADH dehydrogenase subunit 1 (ND1) gene, was used to characterize human and animal E. granulosus isolates. To investigate the genetic characteristics of isolates, deoxyribonucleic acid (DNA) sequencing of the mitochondrial cytochrome c oxidase subunit 1 (CO1) and ND1 genes was performed. Results: Fifty-eight E. granulosus isolates, including 42 from human, 13 from cattle and 3 from sheep were, analyzed. The results indicated two distinct genotypes: the G1 (sheep strain) and G7 (pig strain) genotypes. The sheep strain was shown to be the most common genotype of E. granulosus affecting humans, sheep and cattle. Among the concatenated partial CO1 and ND1 sequence data, eight haplotypes of Echinococcus species were identified in the present study. Conclusion: This is the first report indicating that the E. granulosus pig strain is present in humans in this region. We suggest that new strategies be designed for E. granulosus control programs in Turkey. Turkish Anahtar Kelimeler: Echinococcus granulosus, genotip, PCR-RFLP, PCR-SSCP, CO1, ND1, Edirne, Trakya bolgesi, Turkiye Amac: Echinococcus granulosus insanlarda ve bircok evcil hayvanda kistik ekinokokkozisin etkenidir ve dunya capinda onemli bir halk sagligi sorunudur. Bu calismanin amaci Turkiye'nin Trakya bolgesinde insanlardan ve hayvanlardan elde edilen E. granulosus izolatlarinin genotipini belirlemektir. Gerec ve Yontemler: Edirne ilinde cesitli hastanelerde opere edilen insanlardan ve kesimhanedeki hayvanlardan toplam 58 izolat elde edildi. E. granulosus'un insan ve hayvan izolatlarini karakterize etmek icin; ribozomal birinci internal transcribed spacer fragmaninin analizi icin PCR-RFLP (polimeraz zincir reaksiyonu - restriksiyon fragman uzunlugu polimorfizmi) yontemi ve parsiyel mitokondriyal NADH dehidrogenaz subunit 1 geninin analizi icin PCR-SSCP (polimeraz zincir reaksiyonu - tek sarmal konformasyon polimorfizmi) yontemi kullanildi. Izolatlarin genetik ozelliklerinin ileri incelemeleri icin mitokondriyal sitokrom oksidaz c subunit 1 (CO1) ve NADH dehidrogenaz subunit 1 (ND1) gen bolgelerinin DNA (deoksiribonukleik asit) dizi analizi yapildi. Bulgular: Kirk iki insan, 13 sigir ve 3 koyun kokenli olan 58 E. granulosus izolati analiz edildi. Sonuclar G1 (evcil koyun susu) ve G7 (domuz susu) olmak uzere iki farkli genotip bulundugunu gosterdi. Insan, koyun ve sigirlari etkileyen E. granulosus'un en yaygin genotipinin koyun susu oldugu gosterildi. Parsiyel mitokondriyal CO1 ve ND1 verileri birlikte degerlendirildiginde mevcut calismadaki E. granulosus izolatlarinda 8 haplotip tanimlandi. Sonuc: Bu calisma; Trakya bolgesindeki insanlarda E. granulosus'un domuz susunun varligini gosteren ilk rapordur. Turkiye'de E. granulosus'un kontrol programlari icin yeni stratejiler olusturulmasini onermekteyiz.

Clinical and predictive significance of hyponatremia after aneurysmal subarachnoid hemorrhage.

Abstract: Objective: Hyponatremia after SAH was the object of several studies with conflicting results. The aim of this study was to determine a predictive correlation of hyponatremia with delayed cerebral ischemia (DCI) and poor clinical outcome. Material and Methods: We have used a retrospective hospital chart review of 82 patients with SAH treated from August 2008 to August 2010. Patients were divided into hyponatremia and normonatremia groups. Hyponatremia was defined as serum sodium level l135 mmol/l. Information compared and analyzed included demographics, preoperative neurological status, aneurysm characteristics, postoperative intensive care, duration of stay, DCI and clinical outcome at hospital discharge. Pl0.05 was considered significant. Results: Thirty-two patients with SAH (39%) developed hyponatremia. In that group we had a significantly higher WFNS score at admission (p=0.03) and longer duration of stay in intensive care (p=0.001). DCI with transit or definitive deficit included 20 patients (62%) in the hyponatremia group, and 19 patients (38%) in the normonatremia group (p=0.03). Binary enter logistic regression revealed a significant correlation of hyponatremia with DCI (p=0.03) and poor clinical outcome (p=0.001). Conclusion: This result revealed a possible use of hyponatremia as an additional predictor of developing DCI and poor clinical outcome. Turkish Anahtar Kelimeler: Hiponatremi, serebral iskemi, subaraknoid hemoraji, Glasgow outcome skalasi Amac: SAH sonrasi hiponatremi cesitli calismalara konu olmus ve celiskili bulgular elde edilmistir. Bu calismanin amaci hiponatreminin, gecikmis serebral iskemi (GSI) ve kotu klinik sonuclar ile prediktif korelasyonunu belirlemekti. Materyal ve Metotlar: Agustos 2008'den Agustos 2010'a kadar SAH nedeniyle tedavi edilen 82 hastanin hastane cizelgesini retrospektif olarak inceledik. Hastalar hiponatremi ve normonatremi gruplarina ayrildi. Serum sodyum seviyesinin l135 mmol/l olmasi hiponatremi olarak tanimlandi. Karsilastirilan ve analiz edilen bilgilere; demografik ozellikler, preoperatif norolojik durum, anevrizma ozellikleri, postoperative yogun bakim, yatis suresi, GSI ve hastaneden taburculuktaki klinik sonuclar dahildi. Pl0.05 degerleri anlamli kabul edildi. Bulgular: SAH olan 32 hasta (39%) hiponatremi gelistirdi. Bu grupta basvuru sirasinda WFNS skoru anlamli sekilde daha yuksekti (p=0.03) ve yogun bakimda kalis suresi daha uzundu (p=0.001). Gecici veya kalici defisit ile GSI hiponatremi grubunda 20 hastayi (62%) ve normonatremi grubunda 19 hastayi (38%) kapsadi (p=0.03). Ikili (binary) lojistik regresyon hiponatreminin GSI (p=0.03) ve kotu klinik sonuc ile anlamli korelasyon icinde oldugunu gosterdi (p=0.001). Sonuc: Bu bulgu hiponatreminin GSI gelisimi ve kotu klinik sonuc icin ilave bir prediktor olarak kullanilma ihtimali oldugunu ortaya cikardi.

The Protective Effect of Curcumin on Ionizing Radiation-induced Cataractogenesis in Rats.

Abstract: Objective: The aim of the study was to determine the protective effect of curcumin against ionizing radiation-induced cataract in the lens of rats. Material and Methods: Rats were divided into six groups. Group 1: Control, Group 2: Dimethyl sulfoxide (DMSO), Group 3: DMSO+curcumin, Group 4: Irradiation, Group 5: Irradiation+DMSO, Group 6: Irradiation+DMSO+curcumin. A 15 Gy total dose was given to 4, 5, 6 groups for radiation damage. Curcumin (100 mg/kg) was dissolved in DMSO and given by intragastric intubation for 28 days. At the end of the experiment, lenses were graded and enucleated. The lenticular activity of the antioxidant enzymes, total antioxidant and glutathione peroxidase (GSH-Px), and the malondialdehyde (MDA) were measured. Results: 100% Cataract was seen in the irradiation group. Cataract rate fell to 40% and was limited at grade 1 and 2 in the curcumin group. In the irradiation group, antioxidant enzyme levels were decreased, MDA levels were increased. There was an increase in antioxidant enzyme levels and a significant decrease in MDA in the group which was given curcumin. Conclusion: Curcumin has antioxidant and radioprotective properties and is likely to be a valuable agent for protection against ionizing radiation. Hence, it may be used as an antioxidant and radioprotector against radiation-induced cataractogenesis. Turkish Baslik: Sicanlarda Iyonizan Radyasyonla Olusturulan Katarakt Uzerine Curcuminin Koruyucu Etkisi Anahtar Kelimeler: Katarakt, curcumin, iyonizan radyasyon, lipid peroksidasyonu, oksidatif stres, radioprotektif Amac: Calismamizin amaci, sican lenslerinde iyonizan radyasyonla olusturulan katarakt modelinde curcuminin koruyucu etkisini incelemektir. Gerec ve Yontemler: Sicanlar alti gruba ayrildi. Grup 1: Kontrol, Grup 2: Dimetil sulfoksid (DMSO), Grup 3: DMSO+curcumin, Grup 4: Radyasyon, Grup 5: Radyasyon+DMSO, Grup 6: Radyasyon+DMSO+curcumin. Grup 4, 5 ve 6'ya hasar olusturmak icin iyonizan radyasyon toplam 15 Gy dozunda verildi. Curcumin (100 mg/kg), DMSO icinde cozulerek 28 gun suresince intragastrik yoldan verildi. Calismanin sonunda, lensler siniflandirildi ve cikarildi. Lens dokusunda antioksidan durumu degerlendirmek uzere total antioksidan, glutatyon peroksidaz (GSH-Px) enzimleri ve oksidan durumu degerlendirmek uzere malondialdehit (MDA) duzeylerine bakildi. Bulgular: Radyasyon alan grupta %100 katarakt goruldu. Curcumin verilen grupta bu oran %40'a dustu ve grade 1 ve 2 ile sinirliydi. Radyasyon alan grupta, kontrol grubuna gore antioxidan enzim seviyesi dustu, MDA enzim seviyesi yukseldi. Curcumin verilen grupta radyasyon grubuna gore ise anlamli sekilde antioxidan enzim seviyesi yukseldi, MDA enzim seviyesi dustu. Sonuc: Curcumin antioksidan ve radioprotektif ozelliklere sahiptir ve iyonizan radyasyona karsi koruyucu olarak degerli bir ajan olmasi nedeni ile antioksidan ve radioprotektor olarak radyasyon nedenli katarakt olusumunda kullanilmasi onerilebilir.

Advanced analysis of finger-tapping performance: a preliminary study.

Abstract: Background: The finger-tapping test is a commonly employed quantitative assessment tool used to measure motor performance in the upper extremities. This task is a complex motion that is affected by external stimuli, mood and health status. The complexity of this task is difficult to explain with a single average intertap-interval value (time difference between successive tappings) which only provides general information and neglects the temporal effects of the aforementioned factors. Aims: This study evaluated the time course of average intertap-interval values and the patterns of variation in both the right and left hands of right-handed subjects using a computer-based finger-tapping system. Study Design: Cross sectional study. Methods: Thirty eight male individuals aged between 20 and 28 years (Meanaplusmn;SD = 22.24aplusmn;1.65) participated in the study. Participants were asked to perform single-finger-tapping test for 10 seconds of test period. Only the results of right-handed (RH) 35 participants were considered in this study. The test records the time of tapping and saves data as the time difference between successive tappings for further analysis. The average number of tappings and the temporal fluctuation patterns of the intertap-intervals were calculated and compared. The variations in the intertap-interval were evaluated with the best curve fit method. Results: An average tapping speed or tapping rate can reliably be defined for a single-finger tapping test by analysing the graphically presented data of the number of tappings within the test period. However, a different presentation of the same data, namely the intertap-interval values, shows temporal variation as the number of tapping increases. Curve fitting applications indicate that the variation has a biphasic nature. Conclusion: The measures obtained in this study reflect the complex nature of the finger-tapping task and are suggested to provide reliable information regarding hand performance. Moreover, the equation reflects both the variations in and the general patterns associated with the task. Turkish Baslik: Parmak Vuru Performansinin Ileri Analizi: On Calisma Anahtar Kelimeler: Parmak vuru testi, el, performans, analiz Arka Plan: Parmak vuru testi ust ekstremite motor performansini olcmek icin yaygin olarak kullanilan nicel bir degerlendirme aracidir. Bu testte yapilan hareket dis uyaranlar, duygu durum ve saglik durumundan etkilenen karmasik bir harekettir. Karmasik olmasi nedeniyle sadece genel bir bilgi veren ve yukarida bahsedilen sebeplerin neden oldugu anlik etkileri ihmal eden tek bir ortalama vurular arasi zaman degeri (ardi sira vurular arasindaki zaman farki) ile testin yorumlanmasi zordur. Amac: Bu calisma sag elini kullanan bireylerin sag ve sol ellerinden bilgisayar tabanli bir parmak vuru testi sistemi ile elde edilen vurular arasi zaman degerlerinin zamansal seyri ve degisim desenini degerlendirmektedir. Calisma Tasarimi: Kesitsel calisma Yontemler: Calismaya yaslari 20-28 arasinda olan (ort aplusmn; SS= 22.24 aplusmn; 1.65) 38 erkek birey katildi. Katilimcilara 10 sn sureli tek parmak vuru testi uygulandi. Calismada sag elini kullanan otuz bes bireyin sonuclari degerlendirildi. Test sistemi vuru zamanini kayit etmektedir ve veriyi ileri analiz icin ardisik vurular arasindaki zaman farki olarak saklamaktadir. Ortalama vuru sayisi ve vurular arasi anlik dalgalanma deseni hesaplanarak karsilastirildi. Vurular arasi zaman degerlerindeki degisim en uygun egri uydurma yontemi ile degerlendirildi. Bulgular: Test suresindeki vuru sayisinin grafik olarak sunuldugu verilerin analiz edilmesiyle tek parmak vuru testi icin guvenilir bir ortalama vuru hizi tanimlanabilir. Ancak ayni verilerin vurular arasi zaman degerleri olarak farkli sekilde sunulmasi vuru sayisi artisiyla meydana gelen anlik degisimleri gostermektedir. Egri uydurma uygulamalari bu degisimlerin bifazik ozellikte oldugunu vurgulamaktadir. Sonuc: Bu calismada elde edilen olcumler parmak vuru hareketinin karmasik yapisini yansitmaktadir. Soz konusu degerlendirmenin el performansiyla ilgili daha guvenilir bilgi sagladigi dusunulmektedir. Ayrica denklem, hem hareketteki degisimleri hem de hareketle ilgili genel yapilanmayi yansitmaktadir.

Aquaporin-1 and Aquaporin-3 Expressions in the Intervertebral Disc of Rats with Aging

Abstract: Objective: The intervertebral disc (IVD) undergoes biochemical and morphologic degenerative changes during the process of aging. Aquaporins (AQPs) are a family of water channel proteins that facilitate water and small solute movement in tissues and may have a potential role in the aging degeneration of IVDs. One of the important problems in understanding disc degeneration is to find cellular molecules which contribute to the pathogenesis of IVDs. XThe aim of this study was to demonstrate the expression of aquaporin 1 and 3 in nucleus pulposus (NP), annulus fibrosus (AF) cells of rat lumbar intervertebral discs from both young and aged animals using immunohistochemistry. Material and Methods: Twenty Wistar-albino rats were included in the study. The rats were separated into two groups: 2-month-old rats (n=10) as the young group, 18-month-old rats (n=10) as the old group. The intervertebral disc tissues obtained from the lumbar spine (L1nL4, 4 discs) were used for immunohistochemical staining of AQP-1 and 3. Results: This study demonstrated that AQP-1 and AQP-3 immunoreactivity significantly decreased in NP and AF of aged rats compared to the young rats. Conclusion: We suggest that AQP-1 and 3 may contribute to the age related degeneration of the intervertebral disc. Turkish Baslik: Sicanlarda yaslanmayla intervertebral diskte aquaporin-1 ve aquaporin-3 ekspresyonu Amac: Intervertebral disk (IVD) yaslanma sureciyle biyokimyasal ve morfolojik degisikliklere ugrar. Aquaporinler (AQP) dokuda suyun ve erimis kucuk molekullerin hareketini kolaylastiran bir su kanali proteini ailesidir ve IVD'in yaslanmayla dejerasyonunda potansiyel bir role sahip olabilir. Disk dejenerasyonunu anlamakta en onemli sorunlardan biri IVD patogenezine katkida bulunan hucresel molekulleri bulmaktir. Bu calismanin amaci genc ve yasli sican IVD'lerinde nukleus pulposus (NP) ve annulus fibrosus (AF) hucrelerinde AQP 1 ve 3 ekspresyonlarini immunohistokimya kullanarak gostermekti. Yontemler ve Gerec: Calismada 20 Wistar-albino sicani kullanildi. Sicanlar iki gruba ayrildi: 2 aylik sicanlar (n=10) genc grubu, 18 aylik sicanlar (n=10) yasli grubu olusturdu. AQP -1 ve 3'un immunohistokimyasal boyamasi icin lomber omurgadan (L1-L4, 4 disk) IVD dokulari elde edildi. Bulgular: Calismada genclere kiyasla yasli sicanlarin NP ve AF'larinda AQP-1 ve AQP-3 immunoreaktivitesi belirgin seklide azalmis bulundu. SONUC: AQP-1 ve 3'un IVD'in yasla gelisen dejenerasyonuna katkida bulunabilecegini dusunmekteyiz.

Effects of Luteolin on Liver, Kidney and Brain in Pentylentetrazol-Induced Seizures: Involvement of Metalloproteinases and NOS Activities

Abstract: Objective: Flavonoids are an important group of recognized antioxidants in plants. Luteolin (LUT) is a natural flavonoid in the plant kingdom. This study was aimed to investigate the effects of the LUT in the liver, kidney and brain of pentylentetrazol (PTZ)-induced seizure and the relationship between nitric oxide synthases (iNOS, eNOS) and matrix metalloproteinases (MMP2, MMP9). Materials and Methods: LUT (10 mg/kg) was given intraperitoneally during two weeks prior to seizure induction. A single dose PTZ 80 mg/kg i.p. was administered and seizures were observed and evaluated with regard to latency, frequency and stage for one hour. Results: Seizure frequen cy after PTZ administration was significantly decreased in LUT pretreated rats (pl0.05). An increase of immunhistochemical reactions of iNOS and MMP2, but a decrease of eNOS activity, were observed in rat hippocampus and peripheral tissues during the PTZ induced seizures. LUT pretreatment reversed the iNOS and MMP2 activity to the control levels and significantly increased the eNOS activity (pl0.001). Conclusion: LUT seems to have an effective role in reducing the seizure frequency and a protective role on peripheral organ injury in animal models of seizure. The protective effect of LUT in seizures and the seizure induced peripheral tissue damage warrant further investigations.

Polymorphisms of cytochrome p450 genes in three ethnic groups from Russia.

Abstract: Objective: To determine the prevalence of the most common allelic variants of CYP1A1, CYP1A2, CYP1B1, CYP2C9, CYP2E1, CYP2F1, CYP2J2 and CYP2S1 in a representative sample of the three ethnic groups (Russians, Tatars and Bashkirs) from Republic of Bashkortostan (Russia), and compare the results with existing data published for other populations. Material and Methods: CYPs genotypes were determined in 742 DNA samples of healthy unrelated individuals representative of three ethnic groups. The CYPs gene polymorphisms were examined using the PCR-RLFP method. Results: Analysis of the CYP1A1 (rs1048943, rs4646903), CYP1A2 (rs762551), CYP2E1 (rs2031920) allele, genotype and haplotype frequencies revealed significant differences among healthy residents of the Republic of Bashkortostan of different ethnicities. Distribution of allele and genotype frequencies of CYP1A2 (rs35694136), CYP1B1 (rs1056836), CYP2C9 (rs1799853, rs1057910), CYP2F1 (rs11399890), CYP2J2 (rs890293), CYP2S1 (rs34971233, rs338583) genes were similar in Russians, Tatars, and Bashkirs. Analysis of the CYPs genes allele frequency distribution patterns among the ethnic groups from the Republic of Bashkortostan in comparison with the different populations worldwide was conducted. Conclusion: The peculiarities of the allele frequency distribution of CYPs genes in the ethnic groups of the Republic of Bashkortostan should be taken into consideration in association and pharmacogenetic studies. The results of the present investigation will be of great help in elucidating the genetic background of drug response, susceptibility to cancer and complex diseases, as well as in determining the toxic potentials of environmental pollutants in our region. Turkish Baslik: Rusya'da Uc Etnik Grupta Sitokrom P450 Gen Polimorfizmleri Anahtar Kelimeler: Farmakogenetik, genetik polimorfizm, Rusya'dan uc etnik grupta CYP varyantlarin etnik-iliskili farklari Amac: Baskurdistan Cumhuriyeti'nde (Rusya) uc etnik grubu (Rus, Tatar, Baskir) temsil eden bir orneklemde en yaygin gorulen allelik varyantlar olan CYP1A1, CYP1A2, CYP1B1, CYP2C9, CYP2E1, CYP2F1, CYP2J2 and CYP2S1'in prevalansini belirlemek ve bulgulari diger populasyonlar icin var olan yayinlanmis veriler ile karsilastirmak. Materyal ve Metotlar: Uc etnik grubu temsil eden birbiri ile iliskisiz saglikli kisilerden alinan 742 DNA orneginde CYP genotipleri belirlendi. PCR-RLFP yontemi kullanilarak CYP gen polimorfizmleri incelendi. Bulgular: CYP1A1 (rs1048943, rs4646903), CYP1A2 (rs762551), CYP2E1 (rs2031920) allel, genotip ve haplotip frekanslarinin analizi farkli etnik kokenlere sahip Baskurdistan Cumhuriyeti saglikli vatandaslari arasinda anlamli farkliliklar oldugunu ortaya cikardi. CYP1A2 (rs35694136), CYP1B1 (rs1056836), CYP2C9 (rs1799853, rs1057910), CYP2F1 (rs11399890), CYP2J2 (rs890293), CYP2S1 (rs34971233, rs338583) genlerinin allel ve genotip frekans dagilimi Rus, Tatar ve Baskirler arasinda benzerdi. Dunyadaki farkli populasyonlara kiyasla Baskurdistan Cumhuriyeti'ndeki etnik gruplar arasinda CYP genleri allel frekans dagilim paternlerinin analizi yapildi. Sonuc: Iliskilendirme ve farmakogenetik calismalarinda Baskurdistan Cumhuriyeti'ndeki etnik gruplarda CYP genlerinin kendine ozgu allel frekans dagilimi dikkate alinmalidir. Bu arastirmanin sonuclari ilac yanitinin, kansere ve kompleks hastaliklara yatkinligin genetik zeminini ortaya cikarmada ve ayrica bolgemizde cevresel kirleticilerin toksik potansiyellerini belirlemede cok yararli olacaktir.

Evaluation of Cardiovascular Risk Factors in Women with Uterine Leimyoma: Is There a Link with Atherosclerosis?

Abstract: Objective: Both uterine leimyoma (UL) and cardiovascular disease are public health problems affecting women at different age ranges. Smoking, obesity, and hypertension have been shown to be associated with UL in different random studies. However cardiovascular risk factors have not been evaluated systematically in patients with UL. Accordingly, we aimed to evaluate the cardiovascular risk factors and their relation with the presence of UL. Material and Methods: One hundred and eighty nine patients with the pathological diagnosis of UL and one hundred and eighty nine age matched control subjects without UL were retrospectively included in the study from our data base of the pathology and gynecology departments. Controls were patients with intact uteri who had visited the same physicians for a routine checkup that included a pelvic examination and uterine sonogram and without mention of physical findings consistent with UL. The following clinical and demographic parameters were recorded; age, sex, hypertension, diabetes mellitus, and hypercholesterolemia. Current cigarette smoking was defined as active smoking within the past 12 months. Results: Comparison of cardiovascular risk factors between with and without UL revealed that the presence of hypertension (80 (42.3%) vs 53 (28%) p=0.004) diabetes mellitus (33 (17.4%) vs. 16 (8.4%) p=0.009), smoking (31 (16.4%) vs. 11 (5.8%) p=0.001), were significantly higher in patients with UL than in control subjects. The mean-age and presence of hyperlipidemia were comparable between the two groups. Logistic regression analysis revealed an independent and positive association of UL with the presence of hypertension (odds ratio 2.02 CI: 1.25-3.27 p=0.004), diabetes mellitus (odds ratio 2.43 CI: 1.23-4.79 p=0.010), and smoking status (odds ratio 3.46 CI: 1.65-7.22 p=0.001). Conclusion: We have shown that major cardiovascular risk factors namely, hypertension, diabetes mellitus and smoking are significantly and independently associated with UL. Our findings highlight the possible association of UL with atherosclerosis. Turkish Anahtar Kelimeler: Ateroskleroz, kardiyovaskuler risk faktorleri, hipertansiyon, diabetes mellitus, sigara icme, uterus leyomiyomu Amac: Uterus leiomyomu (UL) ve kardiyovaskuler hastaliklar kadinlari degisik yaslarda etkileyen halk sagligi problemleridir. Farkli calismalarda sigara, obezite ve hipertansiyonun UL ile iliskisi gosterilmistir. Buna karsin, UL olanlarda kardiyovaskuler risk faktorleri sistematik olarak degerlendirilmemistir. Bu dogrultuda, kardiyovaskuler risk faktorleri ve bunlarin UL varligi ile iliskisini arastirmayi hedefledik. Hastalar ve Metodlar: Patoloji ve jinekoloji bolumlerinin veri tabaninda kayitli UL tanisi almis 189 hasta ve yas bakimindan eslestirilmis UL bulunmayan 189 kontrol vakasi retrospektif olarak incelendi. Kontrol hastalari rutin check-up amaciyla ayni hekimlere basvuran, pelvik muayene ve ultrasonografisiye gore uterusu normal olup, UL fizik bulgusu saptanmayan kisilerden olustu. Yas, cinsiyet, hipertansiyon, diabetes mellitus ve hiperkolesterolemi icin klinik ve demografik parametreler kaydedildi. Aktif sigara kullanimi son 12 ayda aktif sigara icmek olarak tanimlandi. Bulgular: UL olan ve olmayan hastalarda kardiyovaskuler risk faktorleri kiyaslandiginda, hipertansiyon varligi [80 (42.3%) vs 53 (28%) p=0.004], diabetes mellitus [33 (17.4%) vs 16 (8.4%) p=0.009], sigara kullanimi [31 (16.4%) vs 11 (5.8%) p=0.001] UL olanlarda kontrollere gore anlamli fazla bulundu. Ortalama yas ve hiperlipidemi varligi iki grup arasinda benzer saptandi. Lojistik regresyon analizinde UL ile hipertansiyon varligi (odds orani 2.02 GA: 1.25-3.27, p=0.004), diabetes mellitus (odds orani: 2.43, GA: 1.23-4.79, p=0.01) ve sigara kullanimi (odds orani: 3.46, GA: 1.65-7.22, p=0.001) arasinda bagimsiz ve pozitif iliski gosterildi. Sonuc: Major kardiovaskuler risk faktorlerinden hipertansiyon, diabetes mellitus ve sigara kullaniminin UL ile belirgin ve bagimsiz olarak iliskili oldugunu saptadik. Sonuclarimiz UL ile ateroskleroz olasi iliskisine isik tutabilir.

Residual fragments after percutaneous nephrolithotomy.

Abstract: Clinically insignificant residual fragments (CIRFs) are described as asymptomatic, noninfectious and nonobstructive stone fragments (l4tmm) remaining in the urinary system after the last session of any intervention (ESWL, URS or PCNL) for urinary stones. Their insignificance is questionable since CIRFs could eventually become significant, as their presence may result in recurrent stone growth and they may cause pain and infection due to urinary obstruction. They may become the source of persistent infections and a significant portion of the patients will have a stone-related event, requiring auxilliary interventions. CT seems to be the ultimate choice of assessment. Although there is no concensus about the timing, recent data suggests that it may be performed one month after the procedure. However, imaging can be done in the immediate postoperative period, if there are no tubes blurring the assessment. There is some evidence indicating that selective medical therapy may have an impact on decreasing stone formation rates. Retrograde intrarenal surgery, with its minimally invasive nature, seems to be the best way to deal with residual fragments.

Microporous Polysaccharide Hemospheres and Seroma Formation After Mastectomy and Axillary Dissection in Rats

Abstract: Objective: Seroma is the most common complication after breast surgery. Several methods have been proposed to prevent seroma, but none of these provided a significant effect. A prolonged wound healing process is the most important cause of seroma. Microporous polysaccharide hemospheres (MPH) are used to achieve hemostasis. They may also accelerate wound healing. In this study, the effects of MPH on seroma formation were investigated. Material and Methods: Female Wistar rats weighing between 200 g and 250 g were used. There were eight rats in each of the control and study groups. Right breast mastectomy and axillary dissection were performed in all rats. While no application was performed after the operation in the control group, MPH was locally applied to the surgical site in the study group. Ten days after the operation, seroma fluid was aspirated and the total volume was recorded. The aspirates were analyzed and tissue samples were obtained from the surgical site. Results: Seroma was significantly lower in the study group (p=0.001). The mean albumin and lactate dehydrogenase levels were significantly lower in the study group (p=0.003). Pathological examination revealed that increase in fibrous tissue was significantly greater in the control group (p=0.032). Conclusion: MPH may reduce seroma after mastectomy. Turkish Baslik: Ratlarda Mastektomi ve Aksiller Diseksiyon Sonrasi Mikro Gozenekli Polisakkarit Kurecikler Kullaniminin Seroma Olusumu Uzerine Etkisi Anahtar Kelimeler: Seroma, mastectomy, microporous polysaccharide hemospheres, wound healing Amac: Seroma meme cerrahisi sonrasi en sik gorulen komplikasyondur. Seroma olusumunu onlemek icin bazi yontemler dusunulmustur fakat bu yontemlerin hicbirinin belirgin bir etkisi oldugu gosterilememistir. Uzamis yara iyilesme sureci seroma olusumunun en onemli sebebidir. Hemostazi saglamak icin mikroporlu polisakkarid hemosferler (MPH) kullanilir. Bunlar ayrica yara iyilesmesini hizlandirabilir. Bu calismada seroma olusumunda MPH nin etkileri arastirilmistir. Hastalar ve Yontem: Agirligi 200g ile 250 g arasinda degisen disi Wistar sicanlari kullanildi. Tum calisma ve kontrol gruplarinda 8 sican vardi. Tum sicanlarda sag meme mastektomisi ve aksiller disseksiyon yapildi. Kontrol grubunda ameliyat sonrasi hicbir uygulama yapilmazken calisma grubunda cerrahi sonrasi lokal olarak MPH uygulandi. Ameliyattan 10 gun sonra seroma sivisi aspire edildi toplam sivi miktari kaydedildi. Aspiratlar analiz edildi ve cerrahi sahadan doku ornekleri alindi. Sonuclar: Calisma grubunda seroma belirgin olarak az idi (p=0.001). Calisma grubunda ortalama albumin ve LDH seviyeleri belirgin olarak dusuk idi (p=0.003). Patolojik degerlendirme gosterdi ki kontrol grubunda fibroz dokuda belirgin artis vardi (p=0.32). Cikarim: MPH mastektomi sonrasi seroma gelisimini azaltabilir.

Association of tobacco products use and diabetes mellitus-results of a national survey among adults in saudi arabia.

Abstract: Objective: To compare the tobacco products use patterns of known diabetics and non diabetics. Material and Methods: A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample. Data was collected using a questionnaire which included sociodemographics; tobacco products use habits, history of diabetes, biochemical and anthropometric measurements. Results: Of the total of 4654 subjects who participated in the study, 1016 (21.8%) were ever smoked tobacco products users and 65 (1.4%) were ever smokeless tobacco products users. Known Diabetes prevalence was 15.3% (712 known diabetics). There were no significant differences in diabetic status and smokeless tobacco products use for both ever and current use. For smoked products diabetics are fewer in current smokers and more in ex smokers. Diabetics started smoking significantly older, smoked for longer duration and higher intensity than non diabetics. Conclusion: Diabetes appears to be associated with smoked but not smokeless tobacco products use. Turkish Baslik: Tutun Urunleri Kullaniminin Diabetes Mellitus ile Iliskisi n Suudi Arabistan'da Yetiskinler Arasinda Yapilan Ulusal Tarama Sonuclari Anahtar Kelimeler: Tutun kullanimi, diabetes, yetiskinler, Suudi Arabistan Amac: Bilinen diyabetik ve diyabetik olmayanlarin tutun urunleri kullanim paternlerini karsilastirmak. Materyal ve Metotlar: Yetiskinler arasinda cok-asamali, katmanli, rastgele kume orneklemi ile ASAMAli yaklasimi kullanarak toplum tabanli kesitsel calisma. Veriler sosyodemografik ozellikleri; tutun urunleri kullanma aliskanliklarini, diyabet oykusunu, biyokimyasal ve antropometrik olcumleri iceren bir anket kullanilarak toplandi. Bulgular: Calismaya katilan toplam 4654 kisiden 1016'si (%21.8) herhangi bir zamanda dumanli tutun urunleri kullanicisi ve 65'i (1.4%) herhangi bir zamanda dumansiz tutun urunleri kullanicisiydi. Bilinen Diyabet prevalansi %15.3 idi (712 bilinen diyabetik). Hem herhangi bir zamanda hem de halihazirda kullanim icin diyabetik durum ve dumansiz tutun urunleri kullanimi acisindan anlamli farklilik yoktu. Dumanli urunler acisindan diyabetikler halihazirda iciciler arasinda daha az olup eski iciciler arasinda daha fazladir. Diyabetikler diyabetik olmayanlara kiyasla sigara icmeye anlamli sekilde daha ileri yasta basladi, daha uzun sure boyunca ve daha yogun sekilde icti. Sonuc: Diyabet dumansiz tutun urunleri ile degil ama dumanli urunler ile iliskili gorunmektedir.

Adipoparacrinology: an Emerging Field in Biomedical Research

Abstract: White adipose tissue (WAT) is a dynamic multicellular assembly composed of adipocytes and stromovascular cells, including fibroblasts, endothelial and immune cells, nerve fibers, and stem cells. In humans, WAT is a responsive and secretory (endocrine and paracrine) tissue partitioned into two large depots (subcutaneous and visceral) and many small depots associated with the heart, blood vessels, major lymph nodes, prostate gland, ovaries and mammary glands. This short review conceptualizes evidence for the paracrine activity of adipose tissue in founding a new research field, designated adipoparacrinology. Here we focus on (i) epicardial and periadventitial adipose tissue in atherogenesis, (ii) mammary gland-associated adipose tissue in breast cancer, and (iii) periprostatic adipose tissue in prostate cancer. Other examples include: (i) mesenteric adipose tissue in Crohn's disease, (ii) lymph node-associated (perinodal) adipose tissue in Crohn's disease and HIV-associated adipose redistribution syndrome, (iii) infrapatellar fat pad (Hoffa's fat pad) in knee osteoarthritis, (iv) orbital adipose tissue in thyroid-associated (Graves') ophthalmopathy, and (v) parasellar region-associated adipose tissue in brain disorders. The therapy aspect of adipoparacrinology is also discussed. Turkish Baslik: Adipoparakrinoloji: Biyomedikal Arastirmalarda Gelismekte Olan Bir Alan Anahtar Kelimeler: Adipokinler, ateroskleroz, meme kanseri, epikardiyal adipoz doku, NGF, periadventisyal adipoz doku, periprostatik adipoz doku, prostat kanseri Beyaz adipoz doku (BAD) adipositler ve fibroblastlardan, endotelyal ve immun hucreler, sinir lifleri ve kok hucrelerini iceren stromavaskuler hucrelerden olusan dinamik multiselluler bir topluluktur. Insanlarda BAD, iki buyuk depoya (subkutan ve visseral) ve kalp, kan damarlari, major lenf nodlari, prostat bezi, overler ve meme bezleri ile iliskili bircok kucuk depoya bolunmus yanit veren ve sekretuar (endokrin ve parakrin) bir dokudur. Bu kisa derleme adipoparakrinoloji adinda yeni bir arastirma alani kurmada adipoz dokunun parakrin aktivitesi hakkindaki kanitlari kavramsallastirmaktadir. Burada sunlara odaklanmaktayiz (i) aterogenezde epikardiyal ve periadventisyal adipoz doku, (ii) meme kanserinde meme bezi ile iliskili adipoz doku ve (iii) prostat kanserinde periprostatik adipoz doku. Diger ornekler sunlari icermektedir: (i) Crohn hastaliginda mezenterik adipoz doku, (ii) Crohn hastaliginda lenf nodu ile iliskili (perinodal) adipoz doku ve HIV ile iliskili adipoz yeniden dagilim sendromu, (iii) diz osteoartritinde infrapatellar yag yastikcigi (Hoffa yag yastikcigi), (iv) tiroit ile iliskili (Graves) oftalmopatide orbital adipoz doku ve (v) beyin bozukluklarinda parasellar bolge ile ilsikili adipoz doku. Adipoparakrinolojinin tedavi yonu de ayrica tartisilmaktadir.

Protective Effect of Quercetin Against Renal Toxicity Induced by Cadmium in Rats

Abstract: Objective: The aim of the present study was to examine the protective effect of quercetine (QE) against cadmium (Cd)-induced renal toxicity. Material and Methods: A total of 24 male Wistar albino rats were divided into three groups: control, Cd-treated and Cd-treated with QE; each group containing 8 animals. The Cd-treated group was injected subcutaneously with CdCl2 dissolved in saline in the dose of 2 ml/kg/day for 30 days, resulting in a dosage of 1 mg/kg Cd. The rats in the QE treated groups were given QE (15 mg/kg body weight) once a day intraperitoneally starting 2 days prior to Cd injection during the study period. Results: The renal histology in Cd-treated rats showed mesangial expansion, thickening of capsular basement membranes, glomerular basement membranes and tubular basement membranes, characterized by an increase in periodic acid Schiff (PAS)-positive areas as compared with control animals. With the QE treatment, despite the presence of only a few swollen glomeruli, we noticed a marked protection of renal structure when compared with the Cd-treated rats. Furthermore, QE pretreatment resulted in increased proliferating cell nuclear antigen (PCNA) immunoreactivity and decreased the activity of Terminal Transferase dUTP Nick End Labeling (TUNEL). Conclusion: These findings suggest that QE may attenuate Cd-induced renal toxicity. Turkish Baslik: Sicanlarda Kadmiyumla Olusturulan Bobrek Toksisitesine Karsi Quercetinin Koruyucu Etkisi Anahtar Kelimeler: Bobrek toksitesi, immunohistokimya, kadmiyum, quercetin, TUNEL Amac: Calismamizda kadmiyumla (Cd) olusturulan bobrek toksisitesine karsi quercetinin (QE) koruyucu etkinligini gostermeyi amacladik. Hastalar ve Yontemler: Calismada 24 adet Wistar albino cinsi eriskin erkek sican kullanildi. Sicanlar her grupta 8 adet olmak uzere; kontrol, Cd ve Cd+QE olmak uzere 3 gruba ayrildi. Cd grubuna her gun 1 mg/kg Cd, 2 ml/kg serum fizyolojik icerisinde cozunduruldukten sonra CdCl2 seklinde 30 gun boyunca subkutan enjeksiyon olarak uygulandi. Cd ile birlikte QE tedavisi verilen gruba, Cd enjeksiyonundan 2 gun once baslanarak 15 mg/kg QE, deney suresi boyunca intraperitoneal olarak uygulandi. Bulgular: Bobrek dokularinin histolojik olarak degerlendirilmesi sonucu, kontrol grubuyla karsilastirildiginda Cd verilen sicanlarda mezengial hucrelerde artis, kapsuler, glomeruler ve tubuler basal membranlarda kalinlasma ile birlikte periyodik asit Schiff (PAS)-pozitif alanlarin artisi gozlendi. Cd ile birlikte QE tedavisi verilen grupta sadece birkac glomeruldeki genisleme disinda, Cd'ye bagli bobrek yapisinda olusan degisikliklere karsi QE'nin belirgin koruyucu bir etkisinin oldugu saptandi. Bulgularimiz, Cd ile birlikte QE tedavisi verilen grupta bobrek kortikal dokularinda TdT-(terminal deoksinukleotidil transferaz)- aracili deoksiuridin trifosfat isaretleme (TUNEL) aktivitesinde anlamli bir azalma ile birlikte prolifere olmus hucre nukleer antijeninin (PCNA) ekspresyonunda da artis oldugunu gostermistir. Sonuc: Bu sonuclar QE'nin Cd ile olusturulan bobrek toksisitesini azaltabilecegini gostermistir.

Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

Abstract: Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy. Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8p2.9 cmH20; P-LMA, 27.0p4.7 cmH20; p=0.42) and did not change during the induction of and throughout pneumoperitoneum. The first attempt success rates were 93% with both S-LMA and P-LMA. Mean airway device insertion time was significantly shorter with S-LMA than with P-LMA (12.5p4.1 seconds versus 15.6p6.0 seconds; p=0.02). The first attempt success rates for the drainage tube insertion were similar (P-LMA, 93%; S-LMA 100%); however, drainage tubes were inserted more quickly with S-LMA than with P-LMA (9.0p3.2 seconds versus 14.7p6.6 seconds; p=0.001). In the PACU, vomiting was observed in five patients (three females and two males) in the S-LMA group and in one female patient in the P-LMA group (p=0.10). Conclusion: Both airway devices can be used safely in laparoscopic cholecystectomies with suitable patients and experienced users. However, further studies are required not only for comparing both airway devices in terms of postoperative nausea and vomiting but also for yielding definitive results. Turkish Anahtar Kelimeler: Laparaoskopik kolesistektomi, supraglottik havayolu gerecleri, laringeal maske havayolu, proseal, supreme Amac: Bu calismada laparoskopik kolesistektomide Supreme Laringeal Maske Havayolu (S- LMA) ve Proseal Laringeal Maske Havayolunun (P-LMA) guvenilirligi ve etkinligi karsilastirilmistir. Meteryal metod: 60 yetiskin hasta rastgele secildi. Anestezi induksiyonunu takiben, tecrubeli LMA kullanicilari tarafindan hava yolu gerecleri yerlestirildi. Bulgular: Orofarengeal kacak basinclari iki grupta da benzerdi (S-LMA, 27.8p2.9 cmH20; P-LMA, 27.0p4.7 cmH20; p=0.42) ve pnomoperitonum baslangicinda ve pnomoperitonum suresince degismedi. Ilk denemede yerlestirme basarisi S-LMA ve P-LMA ile %93 idi. Ortalama hava yolu gereci yerlestirme suresi, S- LMA ile P-LMA dan anlamli olarak daha kisaydi. (12.5p4.1 saniye, 15.6p6.0 saniye; p=0.02). Drenaj tupunu ilk denemede yerlestirme basarisi benzer olmasina ragmen ( P-LMA %93; S- LMA %100), S-LMA da drenaj tupu P-LMA dan daha kisa surede yerlestirildi (9.0p3.2 saniye, 14.7p6.6 saniye; p=0.001). Anestezi sonrasi bakim unitesinde, S- LMA grubunda 5 hastada (3 kadin, 2 erkek), P-LMA grubunda ise 1 kadin hastada kusma gozlendi (p=0.10). Sonuc: Her iki havayolu gereci de uygun hasta ve deneyimli uygulayicilarla laparoskopik kolesistektomide guvenli bir sekilde kullanilabilir. Ancak her iki havayolu gerecini hem postoperatif bulanti ve kusma yonunden karsilastiran hem de kesin sonuclar veren calismalar gerekmektedir.

The Effects of Tramadol and Levobupivacaine Infiltration on Postoperative Analgesia in Functional Endoscopic Sinus Surgery and Septorhinoplasty

Abstract: Objective: The aim of this prospective, randomized, double-blind study was to investigate the postoperative analgesic effects of levobupivacaine or tramadol infiltration administered prior to surgery in septorhinoplasty (SRP) or endoscopic sinus surgery (ESS). Material and Methods: Sixty ASA class I-III adult patients electively undergoing SRP or ESC were included the study. Induction of anesthesia was performed with propofol 2-2.5 mg/kg, rocuronium bromide 0.6 mg/kg and fentanyl 1 mg/kg i.v. Sevoflurane 2% with an N2O/O2 mixture (FiO2: 35%) was used for maintenance. Tramadol 0.5 mg/kg (Group T: n=20), levobupivacaine 0.25% (Group L: n=20) and lidocaine 1% (Group C: n=20) in a 1/200,000 adrenaline solution was infiltrated into the surgical area 10 min before the operation (5 mL for ESS and 10 mL for SRP). All patients received fentanyl (bolus dose: 15 mg and lockout interval: 10 min) with a patient-controlled analgesia device during the postoperative period. Pain was assessed using an 11-point visual analogue scale (VAS) every 4 h for the first 24 h. Analgesic requirements, opioid consumption and side effects in the postoperative period were recorded. Results: There was a statistically significant decrease in postoperative fentanyl demand and consumption in patients receiving tramadol. Fentanyl doses in the 24 h period were 345.2p168.8 mg, 221.1p120.6 mg and 184.1p130.3 mg (p=0.002) for the Groups C, L and T, respectively. There were statistically significant differences in fentanyl requirements between the tramadol and control groups at the 16, 20 and 24 h time points (p=0.012, p=0.004 and p=0.002, respectively). The side effect profiles were similar. Conclusions: Our study indicates that the preemptive tramadol infiltration technique is an efficient, practical and safe alternative to levobupivacaine in ESS or SRP operations. Turkish Baslik: Endoskopik Sinus Cerrahisi ve Septorinoplastide Tramadol ve Levobupivakain Infiltrasyonunun Postoperatif Analjezi uzerine Etkileri Anahtar Kelimeler: Infiltrasyon, levobupivakain, tramadol, postoperatif analjezi, hasta kontrollu analjezi Amac: Prospektif, randomize ve cilf kor calismada septorinoplasti (SRP) ve endoskopik sinus cerrahisi (ESC) ameliyatlarindan sonra levobupivakain ve tramadol infiltrasyonunun postoperatif analjezik etkilerinin arastirilmasi amaclandi. Gerec ve Yontemler: Calismaya elektif olarak ESC ve SRP operasyonlari gerirecek ASA I-III sinifi altmis eriskin hasta alindi. Anestezi induksiyonu intravenoz propofol 2-2.5 mg/kg-1, rokuronyum bromid 0.6 mg/kg-1, and fentanil 1 mg/kg-1 ile gerceklestirildi. Idame %2 sevofluran ile N2O/O2 karisimi (FiO2: 35%) ile saglandi. Operasyondan 10 dakika once cerrahi sahaya tramadol 0.5 mg/kg-1(Group T: n= 20), levobupivakain %0.25(Group L: n= 20), ve lidokainin %1(Group C: n= 20) adrenaline solusyonu 1/200000 infiltre edildi (ESC icin 5 mL ve SRP icin10 mL). Postoperatif donemde hastalarin tumune hasta kontrollu analjezi cihazi ile fentanil uygulandi (bolus doz: 15 mg ve kilit araligi:10 dak). Agri postoperative ilk 24 saatte 11 dereceli vizuel analog skala (VAS) ile 4 saat ara ile degerlendirildi. Postoperatif donemde analjezik gereksinim, opioid tuketimi ve yan etkiler belirlenerek kaydedildi. Bulgular: Tramadol verilen grubun fentanil gereksinim ve tuketimi istatistiksel acidan farkli bulundu. 24 saatlik fentanyl dozlari Grup C, L ve T icin sirasi ile 345.2 p 168.8,6 mg, 221.1 p 120.6 mg; and 184.1 p 130,3 mg (p= 0.002) olarak belirlendi. Tramadol ve kontrol grubunun fentanil gereksinimlerinde 16, 20 ve 24. saat peryotlarda (p= 0.012, p= 0.004. ve p= 0.002) farklilik saptandi. Yan etki profili benzerdi. Sonuc: Bulgularimiz ESC ve SRP operasyonlarindan once preemptif tramadol infiltrasyonunun levobupivakainin etkili, pratik ve guvenli bir alternatifi oldugunu dusundurmektedir.

Non-Operative Treatment in Children and Adolescents with Atlantoaxial Rotatory Subluxation

Abstract: Objective: Atlantoaxial rotatory subluxation (AARS) is an uncommon lesion seen mainly in children and adolescents. A retrospective analysis of 12 patients with AARS treated non-operatively is presented in this study. Material and Methods: Twelve patients with AARS who were treated non-operatively were evaluated retrospectively in terms of recent trauma and respiratory tract infection history, accompanying injuries, radiological findings, duration of symptoms, amount and duration of traction and clinical results of the treatment. Results: Traumatic AARS was present in 8 patients. No evidence of trauma was found in 4 patients. Type I subluxations in 10 and type II subluxations in 2 patients were found according to the Fielding and Hawkins classification. All patients were treated using bed-side mentooccipital tractions. The mean duration of bed-side mentooccipital traction was 3,75 days and the mean amount of load was 1.8 kg. All patients were kept in Philadelphia collars for additional 3 weeks after the clinical recovery. No limitations and pain in head movements were present in any patient at the sixth month follow-up examinations. Conclusion: Paediatric patients with neck pain and torticollis should be investigated concerning trauma and recent respiratory tract infection history in order to avoid any delay in diagnosis of a possible AARS. Turkish Anahtar Kelimeler: Atlanto-Axial Eklem, Tortikolis, Boyun Agrisi Amac: Atlantoaksiyel rotator subluksasyon (AARS) cocuk ve adolesanlarda bas-boyun hareketlerinde kisitlilik ve tortikollisle kendini gosteren, genellikle tanida gucluk yasanan ve beraberinde potansiyel riskler barindiran bir durumdur. Bu calismada cerrahi disi yontemlerle tedavi edilen 12 AARS olgusunun retrospektif analizi sunulmaktadir. Hastalar ve yontem: AARS nedeni ile cerrahi disi yontemlerle tedavi edilen, ortalama yasi 11,5 olan 12 hasta travma ve ust solunum yolu enfeksiyonu oykusu, ek yaralanmalar, radyolojik bulgular, semptomlarin suresi, mentooksipital traksiyonun miktari ve suresi ile tedavinin klinik sonuclari acisindan degerlendirildi. Bulgular: Olgularin 8'inde travmatik AARS saptanirken, 4 olguda subluksasyonlarin ardinda travmatik bir neden bulunamadi. Olgularin 10'unda Fielding ve Hawkins'e gore tip I, 2'sinde ise tip II subluksasyonlar saptandi. Tum olgular yatak basi mentooksipital traksiyonla tedavi edildi. Traksiyonda kullanilan ortalama agirlik 1,8 kg iken, ortalama traksiyon suresi 3,75 kg olarak hesaplandi. Olgular traksiyonla elde edilen klinik duzelmenin ardindan 3 hafta Philadelphia boyunlukla takip edildi. Altinci ay kontrollerde hicbir olguda bas-boyun hareketlerinde kisitlilik ve agri saptanmadi. Sonuclar: Atlantoaksiyel eklem, bas rotasyonunun cogundan sorumlu olan karmasik bir yapidir. Cocuk ve adolesanlarda boyun agrisi ve torticollis ayirici tanisinda atlantoaksiyel eklem patolojileri ve AARS mutlaka dusunulmeli ve ekarte edilmelidir. Tanida gecikme yasanan olgularin tedavisinde cerrahi disi yontemlerle basari sansi dusuktur.

The experiences of violence and occupational health risks of sex workers working in brothels in ankara.

Abstract: Objective: The aim of this study was to reveal and discuss occupational health risks, violence against sex workers working in brothels and their working conditions in Ankara. Materials and Methods: The study included 138 sex workers. Data were collected at face to face interviews with a questionnaire composed of 40 questions about socio-demographic features, familial characteristics, reasons for becoming a sex worker, experiences of violence and occupational health risks. Results: Twenty-two point five percent of the women were aged 21-30 years and 39.9% were aged 31-40 years. The mean time of education was 5.9p3.5 (0-14) years. Forty-eight point five percent of the women were exposed to physical abuse and 13% of the women had been exposed to sexual abuse in their childhood. Fifty-five point eight percent of the women reported that their clients always used condoms, but 97.1% of the women noted that their clients insisted on not using a condom. Fourteen point five percent and 70.3% of the women were exposed to physical and verbal violence respectively from their clients. Ten point one percent of the women suffered sexual assault while working. Conclusion: Sex workers, like other people, should have human rights, all types of violence that they face should be eliminated and the social conditions they are exposed to should be improved. Sexually transmitted diseases, the most important health risk of sex workers, should be considered as occupational diseases in the new regulations. Turkish Baslik: Ankara Ili Genelevlerinde Calisan Seks Iscilerinin Siddet Deneyimleri ve Saglikla Ilgili Mesleksel Riskleri Amac: Fuhus sektorunde calisan genelev kadinlarinin mesleksel risklerini, ugradiklari siddeti ve Ankara'daki calisma kosullarini ortaya koyarak sorunu literatur esliginde tartismaktir. Hastalar ve Yontemler: Bu arastirma 138 genelev kadiniyla birebir gorusme yoluyla gerceklestirilmis olup, 40 sorudan olusan gorusme formuyla genelev kadinlarinin sosyodemografik ozellikleri, aile ozellikleri, cesitli yonleriyle fuhus sektorunde bulunma durumlari, yasadiklari siddet deneyimleri ve mesleksel riskleri ele alinmistir. Bulgular: Calismaya katilan genelev kadinlarinin % 22.5'inin 21-30, % 39.9'unun % 31-40 yas araliginda olduklari gorulmustur. Egitim yili ortalamasi 5.9 p 3.5 (0-14)'dir. Kadinlarin % 48.5'i cocukluklarinda fiziksel istismara ugradiklarini belirtirlerken, % 13'u cinsel istismara ugradigini bildirmistir. Son bir yildir cinsel iliski sirasinda ne siklikta musterilerinin kondom kullandiklari soruldugunda, kadinlarin sadece % 55.8'i her zaman yanitini verirken, kadinlarin % 97.1'i musterilerin kondom kullanmamak icin israrci olduklarini belirtmistir. Kadinlarin % 14.5'i musterileri tarafindan fiziksel siddete maruz kaldigini belirtmis olup, %70.3'u sozlu siddete maruz kaldigini bildirmistir. Kadinlarin % 10.1'i bu sektorde calisirken cinsel saldiriya ugradigini belirtmistir. Sonuc: Seks iscileri en az oteki insanlar kadar insan haklarina sahip olmali, onlara yonelen her turlu siddet ortadan kaldirilmali ve yasadiklari sosyal ortamin kosullari duzeltilmelidir. Seks iscileri icin en onemli saglik risklerinden olan cinsel yolla bulasan hastaliklarin meslek hastaligi olarak ele alinmasi yonunde yeni duzenlenmeler getirilmelidir.

Evaluation of antinociceptive and neurotoxic effects of intrathecal dexmedetomidine in rats.

Abstract: Objective: Dexmedetomidine has been reported to produce analgesia after intrathecal administration. In the present study the a2-adrenoceptor agonist dexmedetomidine was evaluated for its potential spinal neurotoxic effects. Material and Methods: Three days after intrathecal cannulation, rats were administered either dexmedetomidine (3 mg/30 mL, i.t.) or saline (30 mL, i.t.). Antinociceptive, sedative and motor effects of intrathecal administrations of dexmedetomidine or saline were evaluated during 90 min. The tail-flick and hot plate tests were used to assess the thermal nociceptive threshold. Seven days after drug administration, animals were sacrified and spinal cords were evaluated for histopathological changes by light microscopy. Results: Dexmedetomidine administered intrathecally produced antinociception. Antinociception was accompanied by immediate sedation and loss of placing-stepping reflexes that lasted over 40 min in all dexmedetomidine administered rats. In all rats, microscopic examination revealed mild gliosis and minimal infiltration of inflamatory r cells in posterior white matter. Mild (total score 4-6) histopathologic lesions were seen in four animals in dexmedetomidine adminisered rats, but there was no statistically significant difference when compared with the saline administered rats. Conclusion: We observed that intrathecal injections of dexmedetomidine at the dose of 3 mg/30 mL produce antinociception but did not cause any histopathological sign of injury in the spinal cord. Turkish Baslik: Ratlarda Intratekal Deksmedetomidin Antinosiseptiv ve Norotoksik Etkilerinin Degerlendirilmesi Amac: Intratekal deksmedetomidin uygulamasi ile analjezi elde edildigi gosterilmistir. Bu calismada bir a2-reseptor agonisti olan deksmedetomidinin olasi spinal norotoksik etkilerinin degerlendirilmesi amaclanmistir. Materyal ve Metod: Ratlara intretekal kanulasyondan 3 gun sonra ya deksmedetomidin (3 mg/30 mL, i.t.) veya salin (30 mL, i.t.) uygulandi. Intratekal deksmedetomidinin veya salinin antinosiseptif, sedatif ve motor etkileri uygulamadan 90 dk sonra degerlendirildi. Termal nosiseptif esigi degerlendirmek icin kuyruk-cekme (tail-flick) ve sicak-zemin (hot-plate) testleri kullanildi. Ilac uygulamalarindan yedi gun sonra, ratlar sakrifiye edildiler ve spinal kord spesmenleri isik mikroskopisi ile histopatolojik degisiklikler acisindan degerlendirildiler. Bulgular: Intratekal deksmedetomidin uygulamasi antinosiseptif etkiye sahiptir. Tum deksmedetomidin uygulanan ratlarda 40 dk suren adimlama (placing-stepping) refleksi kaybina sedasyon eslik etmekteydi. Tum ratlarda, mikroskopik inceleme sonucunda, beyaz madde posterior bolumunde hafif gliozis ve az sayida iltihabi hucre infiltrasyonu gozlendi. Deksmedetomidin uygulanan dort ratta hafif (total skor 4-6) histopatolojik lezyonlar izlendi, ancak salin uygulanan ratlarla karsilastirildiginda istatistiksel anlamlilik tespit edilmedi. Sonuc: Intratekal 3 mg/30 mL dozda deksmedetomidin uygulamasi ile antinosiseptif etki elde ettik, ancak medulla spinaliste injuriye ait herhangi bir histopatolojik bulguya rastlamadik.

The effects of apelin on mesenteric ischemia and reperfusion damage in an experimental rat model.

Abstract: Objective: Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280p20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 mg/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared tothe I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use. Turkish Baslik: Deneysel Sican Modeli Mezenterik Iskemi ve Reperfuzyon Hasarinda Apelinin Etkileri Anahtar Kelimeler: Apelin, mezenterik iskemi, reperfuzyon hasari Amac: Barsak iskemi-reperfuzyon (I/R) hasari yuksek morbidite ve mortalite oranlari ile seyreder. Etkili koruyucu veya tedavi edici ajanlar bulmak icin surekli arastirmalar yapilmaktadir. Barsak I/R hasarinin sican modelinde apelin 13 (AP)'un etkilerini arastirmayi amacladik. Calisma Plani: 6-8 haftalik ve 280p20 g agirliginda 24 adet erkek Sprague Dawley sican esit olarak uc gruba ayrildi (Kontrol, I/R ve I/R+AP). Kontrol grubuna klemp uygulanmadan superiyor mezenterik arter (SMA) ayrildi. I/R ve I/R+AP gruplarinda atravmatik mikrovazkuler bulldog klemp SMA nin aortadan cikis noktasina yerlestirildi. 60 dk iskemiden sonra, klempler alinarak 3 saat reperfuzyon uygulandi. 3 saat Reperfuzyondan sonra, biyokimyasal incelemeler (malondialdehit (MDA) ve glutatyon (GSH) duzeyleri) ve histopatolojikal incelemeler icin doku ornekleri alindi. Bulgular: Kontrol grubu ile karsilastirildiginda MDA duzeyleri I/R grubunda anlamli duzeyde yuksekti. MDA duzeyleri I/R grubu ile karsilastirildiginda I/R+AP grubunda dusuk olmasina ragmen, farklilik anlamli degildi. I/R ile I/R+AP gruplari arasinda GSH duzeyleri arasinda anlamli farklilik yoktu. I/R+AP grubu histopatolojik medyan degerlendirmeleri I/R grubu ile karsilastirildiginda anlamli duzeyde dusuktu (p=0.001). Sonuc: Apelinin oksidatif hasari uzerinde olumlu etkisi oldugu goruldu, bu istatistiksel olarak anlamli degildi. Bu yuzden insanlardan kullanilmadan once, apelinin barsak iskemisinin baslangic tedavisi ile ilgili bulgular uzerindeki rolu icin daha buyuk olcekli hayvan calismalarina ihtiyac vardir.

Quercetin, a Powerful Antioxidant Bioflavonoid, Prevents Oxidative Damage in Different Tissues of Long-Term Diabetic Rats

Abstract: Objective: The role of oxidant damage on the development of end-organ injuries caused by diabetic rat is well known. The aim of this study is to examine the effect of quercetin, which is a strong antioxidant bioflavonoid, on oxidant damage and antioxidant capacity in various organs in the case of medium-term or long-term diabetic rat. Material and Methods: Forty-eight male Wistar rats were divided into five groups, namely, control group, diabetic group of 8-weeks, diabetic group of 16-weeks, quercetin treated diabetic group of 8-weeks, and quercetin treated diabetic group of 16-weeks. At the end of the experiment, malondialdehyde levels, superoxide dismutase, catalase, and glutathione peroxidase activities were measured in the lung, aorta, heart, spleen, liver, and kidney tissues. Results: MDA levels were elevated in all tissues except in the lung in non-treated diabetic groups. Quercetin treatment increased the antioxidant enzyme capacities and considerably reduced oxidant damage. Conclusion: We suggest that quercetin has a protective effect on the aorta, heart, brain, liver, and kidneys from oxidant damage in the case of mediumterm or long-term diabetic rat. It can be argued that quercetin is effective by increasing the antioxidant defence capacity in this process. Turkish Baslik: Guclu Bir Antioksidan Bioflavonoid Olan Quercetin Uzun Sureli Diabetik Sicanlarin Cesitli Dokularindaki Oksidan Hasari Onler Anahtar Kelimeler: Quercetin, diabetes mellitus, oksidan hasar, antioksidan enzimler Amac: Diabetes mellitusun (DM) neden oldugu son organ hasarlarinin gelisiminde oksidan hasarin oynadigi rol iyi bilinmektedir. Bu calismanin amaci orta ve uzun sureli DM ta cesitli dokulardaki oksidan hasara ve antioksidan kapasiteye guclu bir antioksidan bioflavonoid olan quercetinin etkisini arastirmaktir. Hastalar ve Yontemler: Kirksekiz erkek Wistar sican kontrol grubu, diabetik 8 haftalik grup, diabetik 16 haftalik grup, quercetin verilen diabetik 8 haftalik grup ve quercetin verilen diabetik 8 haftalik grup olarak bes gruba ayrildi.Calisma sonunda akciger, aort, kalp, dalak, karaciger ve bobrekteki malondialdehit (MDA)duzeyleri, superoksit dismutaz, katalaz ve glutatyon peroksidaz aktiviteleri saptandi. Bulgular: Quercetin verilmeyen diabetik sicanlardaki MDA duzeyleri akciger disindaki tum dokularda yukseldi. Quercetin antioksidan enzim kapasitelerini artirdi ve oksidan hasar olusumunu onemli miktarda onledi. Sonuc: Calismamizin sonuclarina gore, quercetinin orta ve uzun sureli DM ta aorta, kalp, beyin, karaciger ve bobrekleri oksidan hasardan koruyucu etkisi vardir. Quercetinin bu surecte antioksidan savunma kapasitesini artirarak etkili oldugu soylenebilir. q

Limited Urethral Mobilization Technique in Distal Hypospadias Repair with Satisfactory Results

Abstract: Objective: To assess the outcomes of the Limited Urethral Mobilization (LUM) technique in distal hypospadias repair. Material and Methods: Forty-seven patients, who were operated on with the LUM technique iduring a 6 years period, were grouped according to their ages. Age distribution in Group 1 (n=37) and Group 2 (n=10) were 6-36 and 37-72 months. Meatal localization was glanular in 31, coronal in 7 and sub-coronal in 9 patients. Nine patients were secondary cases. The urethra proximal to the meatus was mobilized for a distance sufficient to allow it to reach the glans tip without tension. Then, the urethra was placed in the glanular bed and glanular reconstruction was performed. Operation duration, distance between the urethral meatus and the glans tip; and urethral mobilization length were measured and post-operative complications were noted. Results: Operation durations were similar in both groups. Three-fold urethral mobilization was sufficient for construction of tension-free urethra-glanular anastomosis. No fistula or retraction of the urethral meatus and chordee were observed. One patient required meatotomy. Conclusion: Distal hypospadias repair with the LUM technique is simple and effective. As no new urethral tube is constructed there is no risk of fistula. A slit-like urethral meatus with good functional results was obtained with the use of theLUM technique. Turkish Baslik: Distal Hipospadias Onariminda 'Sinirli Uretral Mobilizasyon Teknigi' ile Tatminkar Sonuclar Anahtar Kelimeler: Hipospadias, sinirli uretral mobilizasyon Amac: Distal hipospadias onariminda Sinirli Uretral Mobilizasyon (SUM) tekniginin kullaniminin degerlendirilmesi. Hastalar ve Yontemler: Alti yillik donemde SUM teknigi ile onarimi yapilan 47 distal hipospadias olgusu yas dagilimlarina gore 2 gruba ayrildi. Grup 1 (n=37) 6n36 ay ve Grup 2 (n=10) 37n72 ay araligindaki hastalari kapsiyordu. Meatus lokalizasyonu 31 hastada glanuler, 7 hastada koronal ve 9 hastada sub-koronal idi. Alti hastada kordi ve iki hastada ventral cilt kisaligina bagli glans egriligi mevcuttu. Dokuz hasta daha once hipospadias operasyonu gecirmisti. Operasyonda, meatusun proksimalindeki uretra glans tepesine rahatca gelebilecek seviyeye kadar serbestlestirilerek glans icinde hazirlanan yataga yerlestirildi. Uretra glans kanatlarina sabitlendikten sonra glans onarimi yapilarak operasyon sonlandirildi. Operasyon suresi, uretral meatus ile glans tepesi arasindaki uzaklik ve uretral mobilizasyon uzunlugu olculdu. Operasyon sonrasi komplikasyonlar kaydedildi. Bulgular: Gruplarin operasyon sureleri benzerdi. Her 2 grupta da gerilimsiz bir anastomoz yapilabilmesi icin uretral mobilizasyon uzunlugunun, meatus ile glans tepesi arasindaki uzakligin 3 kati olmasi gerektigi saptandi. Bir hastada meatotomi gerektiren meatus darligi gelisti. Fistul ve meatus retraksiyonu saptanmadi. Sonuc: SUM teknigi distal hipospadias olgularinda yuz guldurucu bir yontemdir. Yeni bir uretral tup olusturulmadigi icin fistul riski yoktur. SUM teknigi ile hastalarimizda glans tepesinde yerlesimli normal idrar akimina izin veren lyarik seklinde meatus' olusturulabilmistir.

Glutamine Supplemented Parenteral Nutrition to Prevent Ventilator-Associated Pneumonia in the Intensive Care Unit

Abstract: Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP. Turkish Baslik: Yogun Bakim Unitesinde Ventilator Iliskili Pnomoniyi Onlemede Glutamin Destekli Total Parenteral Beslenme Anahtar Kelimeler: Beslenme Destegi, Glutamin, Ventilator-iliskili Pnomoni Amac: Ventilator iliskili pnomoni (VAP), mortalite ve morbiditeyi artiran, hastanede kalis suresini uzatan ve hastane giderlerini artiran bir nazokomial pnomoni formudur. Glutamin intestinal mukozal yapiyi korur, immun fonksiyonlari artirir ve total parenteral beslenme (TPN) uygulanan hastalarda zararli degisiklikleri azaltir. Biz yogun bakim unitesinde (YBU) mekanik ventilator destegi alan hastalarda VAP gelisiminin glutamin destekli TPN ile onlenebilecegi hipotezini kurduk. Materyal ve Metodlar: Calismamizda etik kurul onayi ve bilgilendirilmis onam alindiktan sonra YBU'nde mekanik ventilator destegi alan 60 hasta takip edildi. Hastalar 3 gruba ayrildi. Ilk grup enteral beslenme (n=20) alirken, ikinci gruba TPN (n=20), ucuncu gruba ise glutamin destekli TPN (n=20) baslandi. C-reaktif protein (CRP), sedimentasyon hizi, vucut isisi, purulan sekresyon gelisip gelismedigi, sekresyon miktarinda artis olup olmadigi, sekresyonlarin karakterinde degisiklik ve derin trakeal aspirasyon ihtiyacinda artis olup olmadigi gunluk muayeneler ve radyografi ile takip edildi. Bulgular: Gruplar arasinda VAP gelisim acisindan istatistiksel olarak anlamli fark bulunmadi (p=0.622). Sonuc: Glutamin destekli TPN alan grupta daha az oranda VAP gelismesine ragmen, gruplar arasindaki fark istatistiksel olarak anlamli degildi. Glutamin destekli TPN, VAP gelisimini onlemede glutaminsiz TPN ve enteral beslenmeden ustun degildir.

Abnormal sexual behavior during sleep in temporal lobe epilepsy: a case report.

Abstract: Herein, we describe a case who presented with abnormal sexual behaviour during sleep. Video-electroencephalography monitoring during sleep revealed an abnormality suggesting an epileptic basis. The patient was successfully treated with carbamazepin. The psychiatric symptoms that were thought to be related to abnormal sexual behaviours were controlled with antipsychotic treatment. Our findings strongly emphasize the fact that efforts should be spent to increase awareness of seizure activity at night, which can be misinterpreted as benign parasomnias. Such a misinterpretation may have serious consequences, such as insufficient seizure control, progressive personality changes, and cognitive impairment.

Prevalence of obesity in elementary schools in mardin, South-eastern of Turkey: a preliminary study.

Abstract: Objective: This research determines the frequency of obesity among primary school-aged children and evaluates the relationship between obesity and family and environmental factors. Material and Methods: Three thousand four hundred sixty students, aged 6-15 years in three primary schools in Mardin city center were taken into the study. Information about eating habits and family-environmental factors were obtained by questionnaire. For each student we calculated the body mass index (BMI) and the g97 percentile was defined as obese, and between 85-97th percentile as overweight. These values were calculated with the SPSS statistical program. Chi-square and t-tests were used for analysis. pl0.05 was considered statistically significant. Results: 48.2% of the students were female. In the assessment of body mass index (BMI) the overweight rate for children was 15.78%, the obese rate was 10.57%. The prevalence of obesity according to gender was 9.05% for girls and 11.97% for boys (pl0.01). The mean BMI of the girls in the age group 13-15 is higher than in males of the same age. Those in the higher socio-economic group had a higher prevalence of obesity (pl0.01). Paternal obesity affected child obesity (pl0.01). Children who eat irregular meals (p=0.05), watch more than 2 hours per day TV (p=0.03), were breastfed for less than 6 months (pl0.05) and the mothers' obesity (pl0.05) were found to have a significantly higher prevalence of obesity. Conclusion: Obesity is increasing throughout the world as a health problem. Being obese in childhood and having obese parent(s) are two of the risk factors of being obese in adulthood. Persistence of obesity into adulthood is the most serious aspect of the problem. The therapeutic success rate in obesity is unfortunately not high. Therefore, a preventive strategy involving early identification of those at risk by incorporating body mass assessments to routine childhood growth assessment appears to be the most prudent strategy. Turkish Baslik: Mardin Ili Ilkogretim Ogrencileri Arasindaki Obezite Prevelansi Amac: Bu arastirmada, Mardin ilindeki ilkogretim cagi cocuklari arasinda obezite sikligi, obezite ile aile ve cevre faktorleri arasindaki iliski degerlendirildi. Materyal ve Metot: Calismada Mardin il merkezindeki, uc ilkogretim okulunda 6-15 yas grubundaki, 3460 cocugun boy ve agirlik olcumleri yapildi. Beslenme aliskanliklari ve aile-cevre faktorlerine ait bilgiler anket yolu ile elde edildi. Her ogrenci icin vucut kitle indeksi (BMI) hesaplandi. Dunya Saglik Orgutu (WHO) tarafindan cocuk ve adolesanlarda fazla kilolu olma ve obezitenin siniflandirilmasinda kullanilmasi onerilen ve 2007 yilinda yayinlanan 5-19 yas grubu cocuklar ve adolesanlar icin buyume referans degerleri baz alinarak hesaplandi. Soz konusu referans degerlerine gore vucut kitle indeksi (BMI)degeri 97. persentil uzerinde olan cocuklar obez; BMI degeri 85-97. persentil arasinda olanlarda fazla kilolu olarak tanimlandi. Veriler bilgisayarda SPSS istatistik programi ile degerlendirildi. Analizler icin ki-kare ve t-testleri kullanildi. Pl0.05 istatistiksel olarak anlamli kabul edildi. Bulgular: Ogrencilerin % 48.2'si kiz idi. Fazla agirligi (overweight) olan cocuk %15.78, obez olan cocuk orani %10.57 idi. Cinsiyete gore obezite sikligi kiz cocuklar icin %9.05 ve erkek cocuklar icin %11.97 idi. Erkeklerde obezite sikligi anlamli derecede daha yuksekti (pl0.01). 13 -15 yas grubundaki kizlarin BMI ortalamalari, ayni yas grubundaki erkeklere gore anlamli derecede yuksekti. Sosyoekonomik duzeyi yuksek olanlarda (pl0.01), duzensiz ogun yiyenlerde (p=0.05) , gunde 2 saatten fazla TV seyredenlerde (p=0.03), 6 aydan az anne sutu alanlarda (pl0,05), annesi (pl0.05) veya babasi (pl0.01) obez olanlarda obezite sikligi anlamli derecede daha yuksek bulundu. Sonuc: Obezite bir saglik sorunu olarak dunya capinda artmaktadir. Cocukluk caginda obez olmak ve obez ebeveyn/(ebeveynlere) sahip olmak, eriskinlikte obez olmanin risk faktorlerinden ikisidir. Yetiskinlikte, obezitenin kaliciligi, sorunun en ciddi yonudur. Obezitede tedavi basari orani, ne yazik ki yuksek degildir. Bu nedenle, rutin cocukluk cagi buyume degerlendirilmesi icin, vucut kitle indeksinin eklenerek, risk altinda olanlarin erken tespiti ile ilgili bir onleyici strateji en akilci yol olarak gorunmektedir.

The rate of seasonal influenza vaccination in diabetic children, the effect of recommendation and the factors influencing the acceptance of recommendation: an interventional study.

Abstract: Objective: To investigate the vaccination rate of influenza in diabetic children and the effect of recommendation and other factors on vaccination rate. Material and Methods: On July 2011, 144 diabetic children and their families were informed about and were recommended to receive the influenza vaccine every year, in September. On December 2011, parents were questioned about the vaccination. Results: Influenza vaccination rate of the previous season (28.3%) increased to 50.0% (pl0.05). Receiving the vaccine in 2010 was the only contributing factor to the recommendation success. The reasons given by the non-receivers were; forgetting (50.0%), fear of adverse-effects (26.4%), not believing in usefulness (15.2%), rejection by the child (4.2%) and effects of media (4.2%). 88.9% of those who forgot declared that they would receive if they were reminded at the beginning of the season. Conclusion: The rate of influenza vaccination was low. The majority of those who didn't recieve the vaccination declared that they would if they were reminded at the beginning of the season and the fact that “receiving the vaccine in 2010” was the only factor influencing the recommendation success indicate that recommending isn't enough but that reminding and giving detailed information about the vaccine will increase vaccination rates independent of other factors. Turkish Amac: Diyabetik cocuklarda grip asisi yaptirma orani ile asilanma orani uzerine tavsiyelerin ve diger faktorlerin etkisini arastirmak Hastalar ve Metod: Temmuz 2011ade 144 diyabetik cocuk ve ailesi her yil eylul ayinda grip asisi yaptirmalari konusunda bilgilendirildi ve bu yonde tavsiyelerde bulunuldu. Aralik 2011ade ailelerle asiyi yaptirip yaptirmadiklari konusunda tekrar gorusuldu. Sonuclar: Grip asisi yaptirma oranlari bir onceki doneme gore artmistir (% 28,3 ten % 50 ye pl0.05). Tavsiyelerin basarisi uzerine katkisi olan tek faktor 2010 yilinda asi yaptirmakti. Yaptirmama sebepleri sirasiyla unutma (50.0%), yan etkilerinden korkma (26.4%), faydasinin olmadigini dusunme (15.2%), cocugun istememesi (4.2%) ve medyanin etkisi (4.2%) idi. Asiyi yaptirmayi unutanlarin % 88.9au eger mevsimin basinda hatirlatilsaydi asiyi yaptirirdik dediler. Karar: Grip asisi yaptirma oranlari dusuktur. Asiyi yaptirmayanlarin buyuk bir bolumu eger mevsimin basinda hatirlatilsaydi asiyi yaptirirdik demesi ve tavsiyelerin basarisi uzerine katkisi olan tek faktorun “2010 yilinda asi yaptirmak” olmasi sadece tavsiye etmenin yeterli olmayacagini ; hatirlatma yapmanin ve asi hakkinda detayli bilgi vermenin asi yaptirma oranlarini diger faktorlerden bagimsiz bir sekilde arttiracagini dusunuyoruz.

Ex vivo produced oral mucosa equivalent by using the direct explant cell culture technique.

Abstract: Objective: The aim of this study is the histological and immunohistochemical evaluation of ex vivo produced oral mucosal equivalents using keratinocytes cultured by direct explant technique. Material and Methods: Oral mucosa tissue samples were obtained from the keratinized gingival tissues of 14 healthy human subjects. Human oral mucosa keratinocytes from an oral mucosa biopsy specimen were dissociated by the explant technique. Once a sufficient population of keratinocytes was reached, they were seeded onto the type IV collagen coated “AlloDerm” and taken for histological and immunohistochemical examinations at 11 days postseeding of the keratinocytes on the cadaveric human dermal matrix. Results: Histopathologically and immunohistochemically, 12 out of 14 successful ex vivo produced oral mucosa equivalents (EVPOME) that consisted of a stratified epidermis on a dermal matrix have been developed with keratinocytes cultured by the explant technique. Conclusion: The technical handling involved in the direct explant method at the beginning of the process has fewer steps than the enzymatic method and use of the direct explant technique protocol for culturing of human oral mucosa keratinocyte may be more adequate for EVPOME production. Turkish Anahtar Kelimeler: Agiz mukozasi, keratinosit, epidermis, dermal matriks Amac: Bu calismanin amaci, direkt eksplant teknik kullanilarak, vucut disinda agiz mukozasi keratinositlerinden uretilen agiz mukozasi esdegerlerinin, histolojik ve immunohistokimyasal olarak incelenmesidir. Gerec ve yontem: Agiz mukozasi ornekleri, 14 saglikli insanin keratinize diseti dokularindan elde edilmistir. Insan agiz mukozasi keratinositleri, agiz mukozasi orneklerinden, eksplant teknik ile ayristirilmistir. Yeterli cogunluga ulastiktan sonra keratinositler, tip IV kollajen kapli “Alloderm” uzerine ekilmis ve kadavra kaynakli insan dermal matriksi uzerine ekimlerinden 11 gun sonra histolojik ve immunokimyasal incelemeye tabi tutulmustur. Bulgular: Histopatolojik ve immunohistokimyasal olarak, 14 ornekten 12sinde, dermal matriks uzerinde, eksplant teknik ile olusan keratinositlerden elde edilen cok katli yassi epitelden olusan vucut disinda uretilmis agiz mukozasi esdegeri basarili bir sekilde olusturulmustur. Sonuc: Enzimatik teknige gore direct eksplant yontem, surecin basinda daha az sayida basamak gerektirmekte ve vucut disinda uretilmis agiz mukozasi esdegeri uretimi icin agiz mukozasi keratinositlerinin elde edilmesinde daha uygun bir yontem olarak one cikmaktadir.

The efficacy of botulinum toxin in patients with cervicogenic headache: a placebo-controlled clinical trial.

Abstract: Objective: Botulinum toxin type-A (BoNTA) has been considered a treatment option for CH. The aim of this study was to assess the effectiveness of BoNTA treatment in patients with medically resistant CH. Materials and Methods: Forty patients with CH were included in the study. Patients in the BoNTA group (n=20) were administered 10 U of BoNTA bilaterally to the frontal muscles, 20 U to the temporal muscles, 15 U to the semispinalis capitis, 15 U to the splenius capitis, and 15 U to the trapezius muscles (total: 150 U). Patients in the placebo group (n=20) received 0.2 mL of saline administrated to the same sites. All participations were evaluated 6 and 12 weeks after treatment; side effects, the number of painful days, severity (by visual analogue scale, VAS) and frequency of pain were evaluated. Results: In the BoNTA group, the severity and frequency of pain 6 and 12 weeks post treatment were significantly lower than pre-treatment levels (pl0.05). At 12 weeks post treatment, the severity and frequency of pain in the BoNTA group were lower than in the placebo group (pl0.05). Conclusion: The findings suggest that BoNTA was an effective treatment for CH.

Comparison of the calcaneal pitch angle and modified projection area per length squared method for medial longitudinal arch evaluation of the foot.

Abstract: Objective: To compare the calcaneal pitch angle (CPA) values measured on direct lateral radiographs of feet, and the modified projection area per length squared (PAL), which was calculated as a new method for the evaluation of the medial longitudinal arch (MLA) of the foot. Material and Methods: Direct lateral radiographs of patients who had weightbearing feet radiographies for any reason except trauma were retrospectively obtained from the archives. Direct lateral radiographs of the feet were printed and a transparent sheet was placed on it. A straight line was drawn between the most plantar process of the calcaneus and the head of the first metatarsal bone for the calculation of the PAL of the MLA. Two semilunar arcs were drawn upon this straight line. PAL1 and PAL2 were estimated using a point-counting technique. The CPA, lateral talo-calcaneal angles (LTCA), and talo-first metatarsal angles (TFMA) were measured. The correlations between PAL1, PAL2 of right and left feet and CPA, LTCA, and TFMA were explored. Results: Fifty patients (27 females, 23 males) with a mean age of 40.12 (4-78) years were evaluated. Significant correlations were detected between PAL1, PAL2 and CPA, and TFMA for both right and left feet (pl0.05). Conclusion: A significant correlation was detected between the modified PAL method as a new technique and the standard CPA method for MLA evaluation. The PAL method is suggested as a simple and practical method for MLA evaluation. Turkish Baslik: Ayagin Mediyal Longitudinal Arkinin Degerlendirilmesinde Kalkaneal Pitch Acisi Ile Modifiye Projeksiyon Alani Metodunun Karsilastirilmasi Anahtar Kelimeler: Mediyal longitudinal ark, kalkaneal pitch acisi, projeksiyon alani Amac: Ayagin mediyal longitudinal arkinin (MLA) degerlendirilmesinde ayak direkt lateral grafisinde olculen kalkaneal pitch acisi (KPA) degerleri ile alternatif metod olarak modifiye projeksiyon alani (PA) metodunun karsilastirilmasi. Materyal, Metod: Travma disinda herhangi bir nedenle basarak ayak grafisi cekilmis hastalarin lateral direkt ayak grafileri arsivden tarandi. Ayak direkt lateral radyografileri basildi ve uzerine transparan kagit yerlestirildi. MLA'nin PA degerini hesaplamak icin kalkaneusun en plantar cikintisi ile birinci metatarsal kemigin basi arasina duz cizgi cizildi. Bu duz cizgi uzerinde iki semilunar ark cizildi. PA1 ve PA2 nokta sayma teknigi ile belirlendi. KPA, lateral talo kalkaneal aci (LTKA) ve talo-birinci metatarsal aci (TBMA) olculdu. Sag ve sol ayak icin PA1, PA2 ile KPA, LTKA ve TBMA arasindaki korelasyonlar arastirildi. Bulgular: Yas ortalamasi 40.12 (4-78) yil olan, elli hasta (27 kadin, 23 erkek) degerlendirildi. Hem sag ve hem de sol ayak icin PA1, PA2 ve KPA ve TBMA arasinda anlamli korelasyon oldugu saptandi (pl0,05). Sonuc: MLA'in degerlendirilmesinde standart bir metod olan KPA ile yeni bir teknik olan modifiye PA arasinda anlamli iliski oldugu saptandi. PA metodu, MLA degerlendirilmesinde basit ve pratik bir yontem olarak onerilebilir.

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Abstract: Objective: We aimed to determine the safety and feasibility of general anaesthesia (GA) compared with local anaesthesia + Monitored Anaesthesia Care (LA+MAC) for One-Day Thyroid Surgery (ODTS); to assess patient and operator satisfaction with either of the anesthetic approaches. Material and Methods: We reviewed prospectively 130 patients who underwent ODTS from 2008 to 2011. 64 patients were operated on under GA and 62 - under LA+MAC. All variables of patient demographic characteristics, duration and type of operation, postoperative complications, difficulty in airway management and postoperative opiate consumption were recorded and analyzed. Results: There is no difference in respect to length of stay, discharge time and major/minor complications rate between two groups, but in the LA+MAC group, pain appears earlier and is more severe (56min; VAS 6, 5) than in GA patients (223 min; VAS 1, 5; palt;0.001). Patient satisfaction was similar but the operator preference was greater for GA. Conclusion: In experienced hands LA with MAC for Thyroidectomy is a safe and wise choice, but GA is even more so! Turkish Baslik: Gunubirlik Tiroid Cerrahisinde Genel veya Lokal Anestezi andash; Fark Eder mi? Anahtar Kelimeler: Gunubirlik tiroid cerrahisi, genel anestezi, lokal anestezi, MAB, komplikasyonlar Amac: Gunubirlik Tiroid Cerrahisinde (GTC) lokal anestezi + Monitorize Anestezi Bakimina (LA+MAB) kiyasla genel anestezinin (GA) guvenliligi ve uygulanabilirligini belirlemeyi ve anestetik yaklasimlarin herbirine karsi hasta ve operator memnuniyetini degerlendirmeyi hedefledik. Materyal ve Metotlar: 2008'den 2011'e kadar GTC uygulanan 130 hastayi prospektif olarak inceledik. 64 hasta GA altinda ve 62 hasta LA+MAB altinda opere edildi. Hastalarin demografik ozellikleri ile ilgili tum degiskenler, operasyon tipi ve suresi , postoperatif komplikasyonlar, havayolu yonetimindeki zorluk ve postoperatif opiat tuketimi kayit ve analiz edildi. Bulgular: Iki grup arasinda hastanede yatis suresi, taburculuk suresi ve major/minor komplikasyon orani acisindan fark yoktur ancak LA+MAB grubunda (56 dk; VAS 6, 5), GA grubuna gore (223 dk; VAS 1, 5) agri daha erken ortaya cikmaktadir ve daha siddetlidir (palt;0.001). Hasta memnuniyeti benzerdi ancak operator tercihi GA icin daha fazlaydi. Sonuc: Deneyimli ellerde Tiroidektomi icin MAB ile LA guvenli ve akillica bir secenektir ancak GA ondan daha iyidir!