Search

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P lt;0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients( p= 0.002).Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF.

Introduction: The non-invasive prenataldiagnosis of the fetus RhD genotype in RhD incompatibility has a crucial rolein the prevention of increased anti-D immunoglobulin therapy for haemolyticdiseases in pregnant women carrying RhD negative fetus. It was aimed to detectfetal RhD genotyping by using maternal circulating cell-free DNA in the currentstudy.Methods: Maternal blood samples werecollected in different trimester of pregnancies (12-40 weeks) in 12 D-negativemothers. Cell-free fetal DNA was extracted from 2 ml of maternal plasma by anconventional DNA isolation technique (Qiagen, Hilden, Germany) and real-timePCR was performed for genotyping target RhD exons 7 and 10 and GLO genes.Postnatal serological evaluations were performed and the results wereconfirmed.Results: 6 cases (50 %)were determined D positive and 6 cases (50 %) were determined D negative. Allresults were also confirmed after birth serologically.Conclusions: In conclusion,the current results showed us the non-invasive target RhD genotyping from cellfree fetal DNA from maternal plasma samples have a diagnostic accuracy in RhDincompatibility pregnancies.

Introduction: Thepresent study aimed to evaluate macular and choroidal thicknesses in childrenwith MEFV gene mutations.Methods: Thirty-five childrenwith MEFV gene mutations and 40 healthy controls were included in the study.MEFV gene profiles for the current cohort were genotyped by Pyrosequencing anddirect Sanger sequencing techniques. The thicknesses of the macular and choroidof each subject’s right eye were measured using spectral-domain optic coherencetomography.Results: Meanarteriolar and venular diameters were 95.75±11.98 µm and 127.61±10.44 µm inchildren with the MEFV gene mutations and 110.19±11.10 µm and 138.54±10.04 µmin control group respectively. Children with the MEFV gene mutations were foundto have a significantly less mean arteriolar diameter (p lt;0.001), meanvenular diameter (p lt;0.001), less macular thickness (p=0.016), and lesschoroidal thickness (p=0.014) compared to healthy controls.Conclusion: Children with theMEFV gene mutations had narrowing of the retinalarterioles, retinal venules, and macular and choroidal thinning. Future studiesshould aim to investigate endothelial dysfunction in children with FamilialMediterranean Fever by non-invasive and effective methods.

Objectives: The purpose of this research is to understand the etiology of sudden hearing loss due to genetic factors in Turkish people. Determination of these genetic factors and better understanding of molecular pathogenesis may guide more realistic planning and treatment recommendations., Patients and Methods: Forty patients (Group 1; 19 males, 21 females; mean age 37.9+/-15.6 years; range 9 to 76 years) who presented with sudden hearing loss to the Ear, Nose and Throat Clinic of Medical Faculty Hospital of Cumhuriyet University between January 2008 and June 2009, and were diagnosed with sudden hearing loss through history, physical examination and review of audiometric findings, and 20 healthy volunteers (Group 2; 14 males, 6 females; mean age 31.7+/-4.4 years; range 24 to 43 years) for the control group were included in this study. All Patients were evaluated by the genetic clinic for the GJB2, GJB3, GJB6 and WFS1 gene using multiplex ligation-dependent probe amplification (MLPA) method mutation analysis., Results: No difference was found in the peripheral blood sample analyses of the two groups at WFS1 exon 8 and connexin 26, 30 and 31 gene zones using the MLPA method with respect to heterozygous mutation (p=0.291, p>0.05). In four patients in group 1 heterozygous mutation was detected at the target gene zone. Heterozygous mutation was in the WFS1 exon 8 zone in two patients; and in the WFS1 exon 1 zone in other two patients., Conclusion: Sudden hearing loss studies in the future should include connexin 26, connexin 30 and other gene mutations that may affect the function of the gap-junction located in the region of the cochlea stria vascularis (stV), basal membrane (BM), spiral limbus (Li) and spiral ligament (SL). These studies should be performed on larger series, and should include family members of patients with sudden hearing loss.

Intestinal parasites still maintain as a major public health problem in our country. In this study, we aimed to investigate the distribution of intestinal parasites in 1st and 2nd grade students of Mustafa Cengiz Primary School, aged between 7-9 and to contribute to the parasitological data of our province. For this purpose, stool examinations of a total of 195 students, including 82 boys and 113 girls, were performed. The results of the microscopic analysis of stool samples revealed one or more parasites in a total of 117 (60%) samples including 45 male students (54.8%) and 72 female students (63.7%). The diagnosed parasites and their ratios in children were; Giardia intestinalis 36.4%, Entamoeba coli 17.9%, Blastocystis hominis 14.4%, Hymenolepis nana 10.8%, Chilomastix mesnili 3.6%, Ascaris lumbricoides 2.6%, Entamoeba hartmanni 1.5%, Trichuris trichiura 1%, Iodamoeba butschlii 0.5%, Retortamonas intestinalis 0.5% ve Endolimax nana 0.5%, respectively. From 117 positive samples for parasites, only one parasite was found in 71 (60.7%), and more than one parasites were found in 46 (39.3%). As a result, parasitic infectious diseases still maintain its importance in our region. We conclude that incidence of parasitic infectious diseases will be reduced with education about personal hygiene and improvement of physical conditions.

Helicobacter pylori proteins CagA (cytotoxin-associated gene A) and VacA (vacuolating cytotoxin A) are among the virulence factors of this species. CagA gene carrying H. pylori strains are particularly associated with gastric adenocarsinoma. This study was conducted to evaluate Western Blot (WB) method to determine specific H. pylori antibodies in a group of patients with gastric cancer and in a control group with no malignancy. A total of 99 patients with gastric cancer (94 adenocarcinoma, 2 adenosquamous cell carcinoma, 3 non-Hodgkin lymphoma) and 150 control cases with epigastric complaints such as nausea, vomiting, diarrhea, gastroesophageal reflux and abdominal pain, were included to the study. H. pylori IgG-ELISA was positive in all study (mean age: 56.7 +/- 1.2 years, 62 male) and control (mean age: 24.2 +/- 1.3 years, 64 male) patients. Specific antibodies against CagA, VacA, OMP (outer membrane protein)-67, urease-A, urease-B, HSP (heat shock protein) and flagellin antigens determined by a commercial WB-based kit (RIDA Blot Helicobacter, R-Biopharm GmbH, Germany). Interestingly, no anti-VacA positivity was detected in none of the patient and control groups. The positivity rates for H. pylori CagA, OMP-67, urease A, urease-B, flagellin and HSP specific antibodies were as 78%, 54%, 37%, 60%, 53% and 82% in the gastric cancer group and 85%, 71%, 55%, 43%, 61% and 75% in the control group, respectively. There was no statistically significant difference (p > 0.05) between gastric carcinoma and control groups in terms of CagA, HSP and flagellin antibodies (p > 0.05). On the other hand, a statistically significant difference was found between the 2 groups in terms of urease-A, urease-B and OMP-67 (p < 0.01). These results suggested that this test should be assessed again by the manufacturer for its detection power directed towards specific H. pylori antibodies, especially for Vac-A. Further molecular and clinical studies are necessary to determine the factors that affect H. pylori virulence and disease prognosis.

Background: We examined the role of programmed cell death (PCD) in the etiology of contralateral testis injury as well as the protective effect of carnitine., Methods: Thirty-six Wistar Albino rats were used in the study. Rats were divided into six groups as control, sham, torsion-detorsion with 6- and 24-hour intervals, and torsion-detorsion-carnitine administration with 6- and 24-hour intervals. The left testes of all rats were torsioned 720 degrees. Intraperitoneal carnitine was administered to groups as 100 mg/kg one hour before detorsion. Orchiectomy was applied to the contralateral testis a week after detorsion. Testes were examined with respect to diameters of seminiferous tubules (DST), ratios of malonyl dialdehyde and Johnsen biopsy scores (JBS), and PCD ratios. Results were evaluated by ANOVA test., Results: Programmed cell death ratios were significantly higher in the torsion-detorsion with 6- and 24-hour intervals groups compared to the sham group. Those increases were more prominent in the torsion-detorsion with 24-hour interval group. DST and JBS of the control group were significantly higher than in the experimental groups (p < 0.05). The protective effect of carnitine was significant in the 24-hour torsion group, while no significant difference were detected in the 6-hour torsion-detorsion-carnitine group., Conclusion: Increased injury and PCD in the contralateral testis was observed with prolonged exposure time in this model. It was possible to decrease the injury with carnitine.

High-risk human papillomaviruses (HPV) are associated with the development of cervical cancer and its precursor lesions. In addition to cytological screening, nucleic acid testing is the mainstay of diagnosis and follow-up. The molecular tests used for the detection of HPV-DNA in cervical specimens, usually rely on consensus polymerase chain reaction assays that target L1 region of the viral genome. Diagnostic assays that monitor mRNAs from HPV oncogenic proteins, E6 and E7, have also been recently developed. This study was aimed to detect E6/E7 mRNAs from high-risk HPV types 16, 18, 31, 33 and 45 qualitatively by a commercial Nucleic Acid Sequence Based Amplification (NASBA) assay (NucliSENS EasyQ HPV; bioMérieux, France) from cervical specimens. Cervical smear samples were collected from 57 women who had suspected lesions in gynecologic examination and transported by a commercial liquid-based cytology system (ThinPrep Pap Smear Method, Cytyc, USA). Nucleic acid purification was performed by an automated commercial station (NucliSENS easyMAG, bioMérieux, France) as directed by the manufacturer. Presence of viral E6/E7 mRNAs were detected in 38.6% (22/57) of the samples. HPV type 33 mRNA was observed as the most common (11/22, 50%), followed by type 16 (9/22, 41%), 31 (5/22, 22.7%), 45 (4/22, 18.2%) and 18 (1/22, 4.5%). Single and multiple infections with 2 HPV types were identified in 63.6% (14/22) and of 36.4% (8/22) of the positive samples, respectively. The most common co-infection pattern was observed as HPV type 16 and 33 that comprised 13.6% (3/22) of the positive samples. This study was conducted as a preliminary evaluation of commercial NASBA E6/E7 mRNA testing in routine molecular microbiology applications. More studies are required to fully assess the performance of the system for diagnostic laboratories in Turkey.

Full night polysomnography (PSG) remains the gold standard diagnostic test for the evaluation of sleep and the detection of sleep disorders. The computer-assisted scoring methods have been developed to accelerate the scoring. It is said that there was a concordance up to 80% between these scoring softwares and manual scoring. According to our experiences, it is not matched with this belief. In this study, we intend to examine whether the results of automatic analysis match with manual (visual) evaluation. The PSG records of 30 cases with a diagnosis of obstructive sleep apnea syndrome (OSAS) are chosen randomly. We compare the results of automatic analysis with the results of two scorers who have a concordance of 80-95% and at least 1000 PSG scoring experiences. We evaluated 21.060 epochs of 18 men with 48.83 + or - 13.51 ages, and 12 women with 44.56 + or - 14.28 ages. In automatic analysis; total sleep time (p= 0.003) and sleep efficiency (p= 0.004) were low. AHI (p= 0.802) and ODI (p= 0.193) values were high. The epochs scored differently were 8819 epochs (41.88%). The stage I (88.43%) scored mostly different, was allocated to be awake (572 epochs). Stage II and stage IV were scored as stage III in 2276 and 983 epochs respectively. REM epochs were allocated to stage II (574 epochs). The differences in recording times and sleep architecture of PSG tests which examed by automatic analysis will affect all other parameters. Thus, we believe that it will make mistakes in the diagnosis and treatment of sleep disorders.

Brucellosis remains a world-wide public health problem especially in developing brucellosis remains a world-wide public health problem especially in developing countries. Although involvement of the respiratory system in brucellosis is an acknowledged but rare event, its clinical manifestations and focal complications are often troublesome in making a diagnosis. Herein, we report a pneumonia case which proved due to Brucella melitensis in a 57-year-old man who presented with chronic cough, sputum, hemoptysis and fever.

This study aimed to evaluate the relations between the levels of CRP, leukocyte count and ESR on admission and the severity of pneumonia according to the criteria of Turkish Thoracic Society (TTS) and British Thoracic Society (BTS) CAP guidelines. This study included the adult patients with CAP admitted to our clinic between the years 2003-2005. The history, physical findings, hemogram, ESR, the levels of CRP and the results of other laboratory investigations were obtained from the medical records. The patients were grouped according to BTS and TTS guidelines. The mean age was 47.2 years; 70 patients (75.3%) were male and 23 patients (24.7%) were female. The severity of pneumonia according to BTS criteria was correlated with the levels of CRP and leukocyte count (p= 0.037, p= 0.01, respectively). The severity of pneumonia according to TTS criteria was correlated with the levels of CRP, leukocyte count and ESR (p= 0.000, p= 0.014, p= 0.015, respectively). Among TTS pneumonia groups, there were statistically significant differences between groups 1 and 3; groups 1 and 4; groups 2 and 3 (p= 0.006, p= 0.041, p= 0.05, respectively) for mean CRP levels. The mean levels of CRP (103.2 +/- 76.4 mg/L), leukocyte count (19.8 +/- 9.5 x 10(3)/microL) and ESR (57.2 +/- 26.8 mm/hour) were statistically significantly higher in inpatients than the mean levels of CRP (53.2 +/- 52.8 mg/dL), leukocyte count (14.6 +/- 5.4 x 10(3)/microL) and ESR (43.1 +/- 25.9 mm/hour) in outpatients (p= 0.000, p= 0.001, p= 0.012, respectively) according to TTS. It is considered that CRP, a powerful marker of inflammation, is related with severity of pneumonia and a high level of CRP may be useful to make a decision about hospitalisation.

Schizophrenia and obsesive compulsive disorder (OCD) are among the oldest described psychiatric disorders. Although they appear to be two distinct psychiatric disorders, early literature about the existence of obsessive-compulsive symptoms in schizophrenia dates back to the 1920's. The findings that atypical antipsychotics exacerbate obsessive-compulsive symptoms among schizophrenic patients and the emergence of a possible biological relation between the two diseases increased interest in this subject. Until the 1990's information about the aetiology of obsessive-compulsive symptoms which are observed in about 60% of schizophrenic patients, was insufficient. Recently there has been progress in explaining the structural and functional abnormalities in both OCD and schizophrenia. Knowledge of the cortico-subcortical circuits might explain the co-incidence of symptomatology in the two disorders. It is shown that there is prefrontal cortex dysfunction in both disorders but the bases of dysfunctions are distinct from each other. These dyfunctions derive from two different neuro-anatomical systems partially connected with each other and with different neuro-anatomical connections. It is suggested that dorsolateral prefrontal cortex (DLPC) dysfunction occurs in schizophrenia and ventro-medial prefrontal cortex dysfunction (VMPC) in OCD. In this review, the incidence of obsessive-compulsive symptoms in schizophrenia, their effect on the disorder, the features of the schizo-obsessive patient group and the mechanism of how atypical antipsychotics exacerbate obsessive compulsive symptoms are discussed. Thus, we aimed to highlight the neurobiologic heterogeneity and phenomenology of schizophrenic disorder.

Objectives: We evaluated the efficacy of hyperbaric oxygen (HBO) treatment in patients with sudden hearing loss unresponsive to medical treatment., Patients and Methods: Fifty-one patients (37 males, 14 females; mean age 37 years; range 9 to 63 years) with sudden hearing loss were treated with HBO following unsuccessful medical treatment. Time elapsed from the occurrence of sudden hearing loss ranged between 15 to 45 days. Treatment included two sessions daily for the first three days, followed by a single daily session, to make 20 sessions of 90 minutes. Treatment was discontinued because of early recovery in two patients. Audiometric examinations were made at the end of every five sessions. The patients were classified according to age, gender, and audiogram curves., Results: The mean hearing thresholds were 75.3 dB and 65.6 dB before and after treatment, respectively. Recovery was rated as complete in two patients (3.9%), moderate in two patients (3.9%), mild in 19 patients (37.25%), and as no recovery in 28 patients (54.9%). No significant differences were found between the patient groups in terms of improvement and hearing gain (p>0.05)., Conclusion: We propose that HBO be resorted to when other means of medical treatment prove unsuccessful in patients with sudden hearing loss.

Objectives: We evaluated the results of orbital decompression in patients with Graves' disease., Patients and Methods: Orbital decompression was performed by endoscopic transnasal medial wall approach and transantral inferior wall approach in 18 eyes of 12 patients (8 males, 4 females; mean age 41 years; range 24 to 65 years). The degree of exophthalmos was evaluated with the use of the Hertel exophthalmometer preoperatively, and postoperatively in the 24th hour, first and third months., Results: At the end of the third month, exophthalmos decreased by a mean of 4.4 mm (range 3 to 7 mm). Visual acuity and field defects improved considerably in all patients. Complications occurred in three cases (25%) including diplopia, displacement of one eye inferiorly, and maxillary sinusitis caused by the encroachment of the adipose tissue upon the ostium, respectively., Conclusion: With the increasing ease of surgical procedures and enhanced experience on the part of surgeons, successful treatment of exophthalmos has become possible with decreased complication rates.

Penetrating injuries to abdomen and especially deep gluteal injuries causes vascular and non vascular injuries which necessitates emergency surgery. Surgical management of the penetrating injuries is very difficult, especially exploration of the gluteal region is very difficult. Management of the injury of iliac artery branches is extremely difficult. Two cases with penetrating injury to the gluteal region in 1998 and 2000 one was operated on urgently and the other was operated on electively. Coil embolization was tried to be performed for elective case but intervention was unsuccessful. In both cases internal iliac artery was ligated and aneurysm was repaired. There were no complications in postoperative period. In postoperative angiographic controls, aneurysm in the internal iliac artery was regressed and there were no vascular complications at this region such as hematoma. Penetrating injuries at gluteal region causes injury to the internal iliac artery branches which seriously necessitates emergency management, internal iliac artery ligation and repair.