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Central neurocytomas are WHO grade II neuroepithelial intraventricular tumors with fairly characteristic imaging features that can cause obstructive hydrocephalus and manifest as increased intracranial pressure. Here we present the case of a 32-year-old man with no known chronic disease presenting with headache and papilledema of 2 months duration. Brain magnetic resonance imaging revealed a mass lesion growing from the septum pellucidum level into both lateral ventricles, measuring approximately 67x60 mm in size, containing cystic areas consistent with neurocytoma.

Pandemi Sırasında İnme Merkezi Kurmak: İlk Yıl DeneyimleriÖzet Amaç: Pandemi döneminde ülkemizde yeni açılan bir hastanenin Nöroloji Yoğun Bakım Ünitesi’ne, acil servise başvurarak yatırılan intravenöz trombolitik tedavi ve/veya mekanik trombektomi uygulanan iskemik inmeli hastaların verilerinin incelenmesi amaçlandı.Yöntemler: Ocak 2020-Aralık 2020 tarihleri arasında XXXXXX İnme Merkezi’nde akut iskemik inme tanısı ile yatırılan ve intravenöz trombolitik tedavi ve/veya mekanik trombektomi uygulanan ardışık 85 hastanın dosyaları retrospektif olarak incelendi.Bulgular: Hastaların ilk semptomdan kapıya kadar geçen süre (p, Establishing a Stroke Center During the COVID-19 Pandemic: First-year ExperiencesAbstractObjective: This study examines the data of patients of ischemic stroke who underwent intravenous thrombolytic therapy and/or mechanical thrombectomy after applying to the emergency department of a newly opened hospital in our country during the COVID-19 pandemic. Methods: The files of 85 consecutive patients who were hospitalized in the Stroke Centre of XXXXXX with a diagnosis of acute ischemic stroke between January and December 2020 who underwent intravenous thrombolytic therapy and/or mechanical thrombectomy were retrospectively reviewed. Results: Symptom-to-door times (p

OBJECTIVE Migraine, a highly prevelant headache disorder, is regarded as a polygenic multifactorial disease. Serotonin (5-HT) and their respective receptors have been implicated in the patogenesis. METHODS We investigated the 5-HT1A, 5-HT1B, 5-HT2A, and 5-HT2C receptor gene polymorphisms and their association with migraine in Turkish patients. The rs6295, rs1300060, rs1228814, rs6311, rs6313, rs6314, rs6318, rs3813929 (-759C/T) and rs518147 polymorphisms were analyzed in 135 patients with migraine and 139 healthy subjects, using a BioMark 96.96 dynamic array system. RESULTS We found no difference in the frequency of the analyzed eight out of nine polymorpisms between migraine and control groups. However, a significant association was found between the rs3813929 polymorphism in the promoter region of 5-HTR2C gene and migraine. Also, the allele of rs3813929 was more common in the migraine group. CONCLUSION This result suggests that the 5-HTR2C rs3813929 polymorphism can be a genetic risk factor for migraine in a Turkish population.

Glutamate excitotoxicity and oxidative stress are held responsible for the pathogenesis of Alzheimer's disease (AD). Prolidase is known to have a crucial part in the recycling of proline for collagen synthesis. Elevated proline levels have been shown to increase glutamate concentration. To our knowledge, prolidase activity in AD has not yet been studied. In this study, we aimed to reveal the relationship of AD with oxidative stress and collagen turnover by comparing AD patients and healthy control group with regard to total antioxidant status (TAS), total oxidant status (TOS), and prolidase levels. Fifty patients (mean age, 72.5 ± 8.9 years) diagnosed with AD and a control group comprised of 39 healthy individuals (mean age, 69.1 ± 7.1 years) were compared relative to serum TAS, TOS, and prolidase levels. The relationship of cognitive performance with prolidase, TAS, and TOS was evaluated by Mini mental state examination (MMSE). Alzheimer's disease group demonstrated statistically significantly higher prolidase and TOS levels as compared to the control group (p = 0.01, p = 0.018, respectively). Total antioxidant status level was significantly lower in the dementia group than in the control group (p = 0.032). MMSE manifested a negative correlation with prolidase and TOS levels (p = 0.001, r = -0.33; p = 0.002, r = -0.32, respectively), while displaying a positive correlation with TAS levels (p = 0.002, r = 0.32). In conclusion, elevated prolidase and TOS levels along with reduced TAS concentrations suggest that oxidative stress and collagen breakdown are involved in the cognitive impairment in AD.

Objectives: We aimed to evaluate antioxidant paraoxonase-1 (PON-1) activity together with malondialdehyde (MDA) (an oxidative stress parameter) levels in patients with epilepsy. Materials and methods: Forty-five epilepsy patients were included in the study and compared with healthy controls (n = 45). The levels of serum MDA and PON-1 activities were measured by the Ohkawa method and the Eckerson method, respectively. Results: Serum MDA level was significantly higher (P = 0.015), whereas PON-1 activity was sigificantly lower (P = 0.011) in the patient group than the controls. Conclusions: Increased reactive oxygen species levels in epilepsy may result in a oxidative stress, which in turn could result in decreased antioxidant PON-1 activity and increased MDA levels., Amaç: Amacımız epilepsili hastalarda serumda antioksidan olarak paraoksonaz-1 (PON-1) aktivitesi ve malondialdehit (MDA) (oksidatif stres parametresi) düzeylerini değerlendirmektir.Gereç ve yöntem: Çalışmaya kırk beş epilepsi hastası alındı ve kontrol sağlıklı 45 kişi ile karşılaştırıldı. Serum MDA düzeyleri ve PON-1 aktiviteleri sırasıyla Ohkawa ve Eckerson metodları ile ölçüldü.Bulgular: Serum MDA seviyeleri hasta grubunda (3,97±0,71 nmol/mL) kontol grubuna (3,52±0,95 nmol/mL) göre anlamlı yüksek (p = 0,015) iken, PON-1 aktiviteleri hasta grubunda kontrol grubuna göre anlamlı düşük bulundu (45,17±29,70 U/L ve 66,50±46,15 U/L, p= 0,011).Sonuç: Epilepside reaktif oksijen türlerinin seviyelerinin artması oksidatif stresin bir sonucu olabilir. Bu sebeple antioksidan olarak PON-1 aktivitesi azalırken, MDA düzeyleri artabilir

Objectives: Intracerebral hemorrhage (ICH) is one of the most mortal subtypes of stroke. Due to the angiogenic, neurotropic, and vessel-dilating properties of basic fibroblast growth factor (bFGF) in the brain, role of bFGF has been investigated in a number of neurological disorders. So far, there is only study about serum bFGF levels in patients with ICH. The first aim of the present research is to investigate whether increased serum bFGF in patients with ICH. Also, second aim was to study the association between serum levels of bFGF and clinical status in patients with ICH.Materials and methods: We measured the serum levels of bFGF in 30 patients with ICH during acute period. Age and sex matched healthy subjects (n=30) were included in controls. Serum bFGF levels were measured using an enzyme-linked immunosorbent assay method.Results: The patients with intracerebral hemorrhage had higher serum levels of bFGF when compared with the healthy controls (12.89±3.23 ng/ml, 5.28±1.75 ng/ml; p=0.001). No statistically significant difference was determined between bFGF levels of the patients who died as compared to the patients who lived (13.49±4.13 ng/ml; 12.43±3.43 ng/ml, p>0.05). No statistically significant difference was found between bFGF levels of the patients with intraventricular hemorrhage as compared to the patients without intraventricular hemorrhage (13.54±3.92 ng/ml; 12.24±2.29 ng/ml, p>0.05). There was no correlation between serum bFGF, hematoma volume, Gloskow coma scale, and National Institutes of Health stroke scale (p>0.05).Conclusion: The increased bFGF level may be one of the mechanisms that lead to angiogenesis and neuroprotection after ICH in human. . J Clin Exp Invest 2011; 2 (3): 282-286.

Neurotoxicity due to isoniazide (INH) and streptomycin has been reported. Experimental studies reported that sildenafil can reduce toxic effects of some drugs. The aim of this study was to investigate the possible toxic effects of long-term streptomycin and INH use and probable protective effects of sildenafil on the rat brain and cerebellum.Materials and methods: In this study, 78 rats were divided into eight groups as follows; control group (n=10), INH group (n=10), streptomycin group (n=10), INH + streptomycin group (n=10), sildenafil group (n=10), INH+sildenafil group (n=10), streptomycin+sildenafil group (n=8) and INH+streptomycin + sildenafil group (n=10). At the end of 30 days of the treatment, the brain and cerebellar tissues of the rats were examined histopathologically. On the all tissues, inflammation, edema, congestion, degeneration and necrosis were investigated under a light microscope by the same pathologist blinded to the experimental groups.Results: Degeneration was significantly more prominent in the streptomycin group compared with the control group (respectively, p=0.002, p

Aim: The aim of this study was to investigate the relationships between the disability (EDSS) scores, magnetic resonance imaging (MRI) lesion burden, the visual evoked potential (VEP) latencies and the cytokine levels in patients with multiple sclerosis (MS) that previously not studied. Method: Study group consisted of 40 MS patients with either relapsing-remitting (RR) (n=29) or secondary progressive course (n=11) and control group comprised 35 matched healthy subjects. Student’s t test, Mann-Whitney U, Chi-squared and correlation analyses were used for statistical analyses. Result: In patient group EDSS scores varied from 1.5 to 8.5, all had abnormal MRI T2 plaque burden and 65.0% had abnormal VEP latencies. Serum levels of tumor necrosis factor-alpha (TNF-а) and interleukin-2 receptor (IL-2R) were significantly higher in patients compared to controls (P 0.05). The total EDSS scores significantly correlated with the T2 plaque counts (r=0.637, P 0.05). Conclusion: Our data indicate that despite clinical stability, immunological activity is not interrrupted in MS and the production of different cytokines were not uniformly affected by the immunomodulator medication. New therapeutic strategies correcting cytokine balance may be useful in MS.

Aim: Migraine and tension type headache (TTH) are two most common headaches. In this study, we aimed to investigate whether the hopelessness, anxiety and social self-esteem scores are different in two headache groups.Materials and Methods: This study was conducted with 72 migraine patients, 28 TTH patients and 50 healthy controls. Participants filled the General Information Form, Hopeless-ness Scale (HS), Spielberger Trait Anxiety Inventory (STAI-II) and Social Comparison Scale (SCS). Results: There were no differences between the groups with respect to gender, age, education years, marital status and economical status. Hopelessness scores of the TTH group was higher than the migraine and control group (p=0.001). There were no statistical differences between the migraine and TTH groups with respect to STAI-II scores but TTH group scores higher in study groups (p=0.003). Control group SCS scores were higher than both patient groups with no significant differences (p=0.072).Conclusion: These findings indicate that the patients with TTH have more hopelessness than the migraine group and more anxious than the healthy control group.

Amaç: Bu çalışmamızın amacı, otopsi kayıtlarından yararlanarak bölgemizdeki travmaya bağlı çocukluk dönemi ölümlerinin epidemiyolojik ve bazı klinik özelliklerinin değerlendirilmesidir. Gereç ve Yöntem: 0-17 yaşları arasındaki 122 olgunun savcılık dosya belgeleri, otopsi raporları, olay yeri inceleme ve ölü muayene tutanakları incelenmiştir. Bulgular: Toplam 122 olgunun 75’i (%61.5) erkek ve yaş ortalamaları 9.1±5.4 idi. En yüksek mortalite oranının 36 olgu (%29.5) ile 5-9 yaş arasında olduğu belirlendi. En önemli ölüm sebebinin kaza (%84.4) olduğu ve kazalar içinde de en sık 73 vaka (% 59.8) ile motorlu taşıt kazalarının görüldüğü tespit edildi. Motorlu taşıt kazalarının en sık 25 olgu (%34.2) ile 5-9 yaş arasındaki çocuklarda görüldüğü saptandı. Motorlu taşıt kazalarının 38’inin (%58.0) araç dışı kaza olduğu tespit edildi. En sık yaralanan vücut bölgesinin, 85 olgu (%69.7) ile baş-boyun bölgesi olduğu belirlendi. Toplam 26 olguda (%21.3) otopsi yapıldığı saptandı. Sonuç: Çocukluk çağı travmalarında, motorlu taşıt kazalarının ve yüksekten düşmelerin ön planda olduğu ve çoğunlukla taşıt kazalarının yayaya çarpma şeklinde meydana geldiği görülmektedir. En fazla baş-boyun bölgesinin etkilendiği, ölümlerin çoğunlukla olay yerinde olduğu ve ölüm sebebinin tayininde adli dış muayenenin yeterli olduğu anlaşılmaktadır.Anahtar Kelimeler: Çocukluk Dönemi, Yaralanma, Ölüm, Otopsi

Cerebrovasculer disease are the most frequent disease of the brain. Cerebellar infarct remains % 1.5-4.2 of these diseases. Etiological factors, lesion localization, symptoms and findings and relationship with prognosis of our patients with cerebellar infarct were investigated in our study. For this purpose, 32 patients were evaluated who were admitted to the Dicle University Medical School Department of Neurology in 1995-2001 hospitalized with the diagnosis of clinically and radiological confirmed cerebellar infarction.All of patients in the study group, 21 (%65.6) were male and 11 (%34.3) female. Age of overall patients ranged between 40 and 75 years with a mean of 57.8±10.2 years. Atherothrombotic infarct was the most frequent reason at the etiologic clinical classification. The most frequently found localization was the posterior inferior cerebellar artery infarct (%50). The leading two risk factors were hypertension (%78.1) and cigarette smoking (%50). The most common sign and symptoms were vertigo (%93.7), vomiting (%75), headache (%68.7) and cerebellar dysfunction findings (%50). The mean duration of hospitalization was 16.3±7.6 days. Overall mortality rate was found to be % 6.2. Finally, the most remarkable risk factors at cerebellar infarct patients are hypertension and atherosclerosis at etiology. We are considering that, controlling of these factors will reduce the appearance frequency of cerebellar infarcts.

Objective Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff’s brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin’s Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation. RESUMO Objetivo Diplegia facial (DF) é uma manifestação neurológica rara proveniente de diferentes causas. Este artigo visa avaliar sistematicamente a etiologia, avaliação diagnóstica e tratamento de DF. Método O estudo foi retrospectivo e incluiu 17 pacientes com diagnóstico de FD. Resultados Os pacientes foram diagnosticados como casos de síndrome de Guillain-Barré (SGB) (11), encefalite de tronco de Bickerstaff (1), neurosarcoidose (1), linfoma não-Hodgkin’s (1), meningite tuberculosa (1) reativação de herpes simplex (1) e causa idiopática (1). Além disto, duas pacientes haviam desenvolvido DF durante a gestação. Conclusão Diplegia facial é uma manifestação com diversas causas que requer investigação cuidadosa.

Objective: This study aimed to assess some demographical and clinical aspects and laboratory findings of patients presenting with the complaint of renal colic to the emergency department. Material and Methods: The study included a total of 150 adult patients presenting to the emergency department of our University hospital with the complaint of renal colic between January 2009 and January 2010. The data were derived from the patient files of our hospital. Demographical data, time of admission, clinical findings together with laboratory and radiologic findings of patients were assessed. Mean values were calculated as mean value ± standard deviation. Results: Of the patients 91 (68,4 %) were male and the mean age was 38,9±16,5 years. Most of the patients were admitted in October (n= 22, 16,6 %). The most common complaint of the patients was flank pain. The erythrocytes was revealed in 72,2 % of the patients by the urinalysis. Calculus formation was determined in 71 (53,4 %) of the patients. The urinary system ultrasonography (USG) was applied to 39,1 % of the patients and localized renal calculus was detected in 52,0 % of those patients. It was identified that the most common region of localization was the ureter and detected in 29 of the patients (40,9 %). Conclusion: Ultrasonography is considerably a valuable method in identifying renal complications that might lead to dysfunctions in these patients. However, the absence of hematuria does not necessarily rule out the renal colic. We think that emergency physicians should rule out the urinary obstruction in such kind of patients, Amaç: Bu çalışmada acil servise renal kolik ile başvuran hastaların bazı demografik ve klinik özelliklerinin ve laboratuvar bulgularının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmamız Ocak 2009-Ocak 2010 tarihleri arasında Üniversite hastanesi acil servisine renal kolik nedeniyle başvuran, erişkin, 150 hastayı kapsamaktadır. Veriler, hastanemizin hasta dosyalarından elde edilmiştir. Hastaların demografik özellikleri, başvuru zamanı, klinik bulguları, laboratuvar ve radyolojik verileri değerlendirildi. Ortalama değerler, ortalama ± standart sapma olarak verildi. Bulgular: Hastaların 91’i (% 68,4) erkekti ve yaş ortalamaları 38,9±16,5 yıl idi. En fazla hasta başvurusu ekim ayında oldu (n= 22, % 16,6). Hastaların en sık şikayeti yan ağrısı idi. Yapılan idrar analizinde hastaların % 72,2’ sinde eritrosit tespit edildi. Hastaların 71’inde (% 53,4) taşın lokalizasyonu belirlendi. Üriner sistem ultrasonografi (USG)’si uygulanan hastalarda (n=52, % 39,1) taşın görülme oranı % 52,0 idi. Tespit edilen en sık taş yerleşim yerinin 29 hasta (% 40,9) ile üreter olduğu belirlendi. Sonuç: USG, bu hastalarda böbreğin işlev kaybına sebep olabilecek komplikasyonları saptamak için oldukça değerli bir yöntemdir. Renal kolikli hastalarda mutlak hematüri olmayabilir. Acil hekimlerinin bu tür hastalarda üriner obstrüksiyonu dışlamaları gerektiğini düşünmekteyiz

The role of epicardial fat thickness (EFT) in ischemic stroke (IS) has not been previously investigated. The aim of the present study was to evaluate EFT and neutrophil/lymphocyte ratio (NLR) among patients with IS and to examine the relationship between these inflammatory markers and the incidence of IS.The cross-sectional design includes 38 patients with IS and 47 age- and sex-matched healthy controls. Echocardiographic measurement of EFT was conducted according to previously published methods. An automated hematology analyzer was used to generate total and differential leukocyte counts from patient blood samples.Mean EFT was 4.86 ± .68 mm in the control group and 5.95 ± 1.14 mm in the IS group. EFT was significantly greater in the IS patients in relation to the control group (P.001). Mean NLR was significantly greater among IS patients in relation to the control group (2.5 ± .6 vs. 1.8 ± .4, P.001). No significant confounding factors were identified in the data set. Spearman's correlation analysis revealed a mild, but highly significant correlation between EFT and NLR (r = .293, P = .006).This study demonstrates for the first time the association between EFT and cerebral IS. Echocardiographic EFT was significantly correlated with NLR. NLR and echocardiographic EFT represent inexpensive and readily available clinical markers that maybe useful in estimating risk of IS.

Amaç: Bu çalışmada acil servise renal kolik ile başvuran hastaların bazı demografik ve klinik özelliklerinin ve laboratuvar bulgularının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmamız Ocak 2009-Ocak 2010 tarihleri arasında Üniversite hastanesi acil servisine renal kolik nedeniyle başvuran, erişkin, 150 hastayı kapsamaktadır. Veriler, hastanemizin hasta dosyalarından elde edilmiştir. Hastaların demografik özellikleri, başvuru zamanı, klinik bulguları, laboratuvar ve radyolojik verileri değerlendirildi. Ortalama değerler, ortalama ± standart sapma olarak verildi. Bulgular: Hastaların 91’i (% 68,4) erkekti ve yaş ortalamaları 38,9±16,5 yıl idi. En fazla hasta başvurusu ekim ayında oldu (n= 22, % 16,6). Hastaların en sık şikayeti yan ağrısı idi. Yapılan idrar analizinde hastaların % 72,2’ sinde eritrosit tespit edildi. Hastaların 71’inde (% 53,4) taşın lokalizasyonu belirlendi. Üriner sistem ultrasonografi (USG)’si uygulanan hastalarda (n=52, % 39,1) taşın görülme oranı % 52,0 idi. Tespit edilen en sık taş yerleşim yerinin 29 hasta (% 40,9) ile üreter olduğu belirlendi. Sonuç: USG, bu hastalarda böbreğin işlev kaybına sebep olabilecek komplikasyonları saptamak için oldukça değerli bir yöntemdir. Renal kolikli hastalarda mutlak hematüri olmayabilir. Acil hekimlerinin bu tür hastalarda üriner obstrüksiyonu dışlamaları gerektiğini düşünmekteyiz. Objective: This study aimed to assess some demographical and clinical aspects and laboratory findings of patients presenting with the complaint of renal colic to the emergency department. Material and Methods: The study included a total of 150 adult patients presenting to the emergency department of our University hospital with the complaint of renal colic between January 2009 and January 2010. The data were derived from the patient files of our hospital. Demographical data, time of admission, clinical findings together with laboratory and radiologic findings of patients were assessed. Mean values were calculated as mean value ± standard deviation. Results: Of the patients 91 (68,4 %) were male and the mean age was 38,9±16,5 years. Most of the patients were admitted in October (n= 22, 16,6 %). The most common complaint of the patients was flank pain. The erythrocytes was revealed in 72,2 % of the patients by the urinalysis. Calculus formation was determined in 71 (53,4 %) of the patients. The urinary system ultrasonography (USG) was applied to 39,1 % of the patients and localized renal calculus was detected in 52,0 % of those patients. It was identified that the most common region of localization was the ureter and detected in 29 of the patients (40,9 %). Conclusion: Ultrasonography is considerably a valuable method in identifying renal complications that might lead to dysfunctions in these patients. However, the absence of hematuria does not necessarily rule out the renal colic. We think that emergency physicians should rule out the urinary obstruction in such kind of patients.

There are limited studies evaluating the fibrinogen levels in patients with migraine. It remains unknown whether the levels of the haematological marker of thromboembolism, D-dimer, and the levels of galectin-3, which plays an important role in inflammation as a proinflammatory mediator, change during the attacks in patients with migraine. The present study aims to compare galectin-3, fibrinogen and D-dimer levels in patients with migraine during the attacks and interictal periods, and to compare galectin-3, fibrinogen and D-dimer levels between patients with migraine and healthy controls to investigate the role of these parameters in the pathogenesis of migraine. Fifty-nine patients with migraine and 30 age-gender matched healthy control subjects were enrolled in the study. Blood galectin-3, fibrinogen and D-dimer levels were measured in patients with migraine. Patients with migraine had higher levels of galectin-3, fibrinogen and D-dimer compared to the healthy controls (p 0.05). No statistically significant difference was found between galectin-3 and fibrinogen levels during the attacks and interictal period in the migraine group (p 0.05). Migraine patients had higher D-dimer levels during the attacks compared to the patients in the interictal period in the migraine group (p = 0.05). In conclusion, we found increased levels of fibrinogen, D-dimer and galectin-3 in patients with migraine compared to the healthy control group. Furthermore, we showed increased galectin-3 levels in patients with migraine, and higher D-dimer levels during migraine attacks compared to the interictal periods for the first time. These findings may be associated with the hypercoagulability and neurogenic inflammation during migraine headaches.

Giriş: Ülkemiz ve dünyada, yaşlı insan nüfusunun, giderek arttığı belirtilmektedir. Çalışmamızın amacı, yaşlılarda önemli bir sağlık sorunu olan, akut zehirlenme olgularının özelliklerinin araştırılmasıdır. Gereç ve Yöntem: Ocak 2005-Aralık 2011 tarihleri arasında bir üniversite acil kliniğine akut zehirlenme nedeniyle başvuran 65 yaş ve üzeri hastaların tıbbi dosyaları incelendi. Zehirlenmenin kaynağı ve nedenleri, hastaların demografik özellikleri geriye dönük olarak değerlendirildi. Bulgular: Acil kliniğine akut zehirlenme nedeniyle başvuran toplam 3106 hastanın, 126'sı (%4.06) geriatrik yaş grubunda idi. Yaş ortalaması 73.36 6.38 olarak saptandı. Hastaların 67'si (% 53.2) erkek, 59'u (%46.8) kadındı. En sık görülen akut zehirlenme nedenleri şu şekildeydi: 68 (%54) olgu ilaç zehirlenmesi, 34 (%27) karbon monoksit zehirlenmesi ve 16 (%12.7) tarım ilacı zehirlenmesi. Zehirlenmelerin 105'i (%83.3) kaza kaynaklı, 16'sı (%12.7) özkıyım kaynaklıydı. Kaza kaynaklı zehirlenmelerin 57'sinin (%45.2) reçeteli ilaç kullanımına bağlı olarak meydana geldiği saptandı. Tarım ilacı kullanarak özkıyım riskinin, diğer nedenlere oranla anlamlı olarak yüksek olduğu izlendi (OR4.09, p0.03). Sonuç: Bu çalışma sonuçları ışığında, reçeteli ilaçların uygun olmayan şekilde kullanımının geriatrik hastalarda en sık zehirlenme nedeni olduğunu tespit ettik. Geriatrik hastalarda ilaca bağlı zehirlenmelerin önlenmesine yönelik, halk sağlığı programlarının geliştirilmesine gereksinim olduğu görüşündeyiz. Karbon monoksit ve tarım ilacı zehirlenmelerinin önlenmesine yönelik, yaşam alanları içinde gerekli güvenlik tedbirlerinin alınmasının gerekli olduğu düşüncesindeyiz. Introduction: The elderly population is rapidly growing in Turkey and in the world. The aim of our study is to investigate the features of acute poisonings which is a major health problem among the elderly. Materials and Method: Medical files of patients aged 65 years and over admitted to the emergency department of a university hospital for acute poisonings between January 2005 and December 2011 were reviewed. The demographic characteristics of patients, causes and origins of poisonings were evaluated retrospectively. Results: Among 3106 patients who presented with acute poisoning, 126 (4.06%) were geriatric cases. The mean age of the patients was 73.36 ± 6.38. Sixty seven (53.2%) were male and 59 (46.8%) female. The most common causes of acute poisonings were as follows; 68 (54%) drug intoxication, 34 (27%) carbon monoxide and 16 (12.7%) pesticide poisoning. The origins of poisonings were as follows; 105 (83.3%) accidental, 16 (12.7%) suicidal. Fifty seven (45.2%) accidental poisonings occurred due to use of prescription drugs. The risk of suicidal death by using pesticides was significantly higher than the other causes (OR 4.09, p 0.03). Conclusion: Based on the results of the present study, it is concluded that inappropriate prescription drug use is the most common cause of poisonings in geriatric patients. We believe that public health programs for preventing drug poisonings among geriatric patients are necessary. For prevention of carbon monoxide and pesticide poisonings, security measures must be established in the living areas.

Isospora belli özellikle immun sistemi baskılanmış hastalarda ciddi ishallere neden olabilen koksidiyan bir protozoondur. Tanı gaitada ookistlerin, lugol ile direkt inceleme ya da özel boyalarla gösterilmesi ile konur. Bu olgu birçok kronik hastalığı olan yaşlı hastalarda görülen ishallerde isosporiyazise dikkat çekmek amacıyla sunulmuştur. Özgeçmişinde hipertansiyon, Alzheimer hastalığı, iki yıl önce geçirilmiş serebrovasküler atak ve sağ hemiplejisi olan, 81 yaşında debil erkek hasta son on gündür halsizlik, iştahsızlık, üşüme, titreme, karın ağrısı, idrarda yanma, öksürük, balgam çıkarma ve ishal şikayetleri ile hastaneye başvurmuştur. Gaita örneğinden formol etil asetat çoklaştırma yöntemi ile hazırlanan lugollü preparatın incelenmesi ile I. belli ookistleri tespit edilmiştir. Örnek modifiye asit-fast ve trikrom boyama yöntemleri ile de incelenmiş ve her iki yöntem ile de I. belli ookistleri gösterilmiştir. Tedavi için trimethoprim-sülfametoksazol 160/800 mg dozunda günde 2 kez 10 gün süre ile başlanarak, enfeksiyon hastalıkları polikliniğine sevk edilmiştir. Bu olguda olduğu gibi yaşlı, birçok kronik hastalığa, beslenme ve bakım yetersizliğine bağlı olarak immun sistemi baskılanmış olabilen hastalarda I. belli kaynaklı enfeksiyonlar meydana gelebilir. Sonuç olarak; inatçı diyaresi olan bireylerin, immun durumu da göz önüne alınarak muayene ve tetkiklerinin yapılması, gaita incelemelerinin sık aralıklarla, çoklaştırma yöntemleri kullanılarak ve özel boyama yöntemleri ile yapılması gereklidir. Isospora belli is a coccidian protozoon that can cause serious diarrhea especially in immunocompromised patients. The laboratory diagnosis depends primarily on the identification of oocysts in stool specimens by direct microscopic examination with iodine or special stains. This case is presented in order to draw attention to isosporiasis among the diarrheas that can be seen in elderly patients with several chronic diseases. A 81 year-old debilitated male, who had a history of hypertension, Alzheimer‘s disease, previous cerebrovascular accident and right hemiplegia, was admitted to our hospital complaining of malaise, anorexia, chills, abdominal pain, dysuria, cough, sputum and diarrhea of ten days duration. I. belli oocysts were detected by microscopic examination of the sample with iodine after concentration by formalin-ethyl acetate sedimentation. Then, modified acid-fast and trichrome stains were performed and I. belli oocysts were detected with both methods. Similar to this case, infections caused by I. belli can occur in elderly immunocompromised patients with several chronic diseases and inadequate nutrition and care. Consequently, in individuals with persistent diarrhea, examinations and tests should be carried out by taking their immune status into consideration and stool examinations should be done at frequent intervals using the concentrations methods and special stains.

Objectives: Increased levels of free radicals and oxidant molecules and decreased levels of antioxidant molecules have been defined in patients with multiple sclerosis (MS). Ischemia-modified albumin (IMA) levels have been advocated as a biomarker for evaluating the oxidative stress status. The aim of this study was to investigate the relationship between oxidative stress and MS. Materials and methods: We compared serum ischemia modified albumin levels and prolidase activity of 42 patients with MS (30 female, 12 male) and 30 age-matched healthy controls (21 female, 9 male). Results: Ischemia modified albumin levels of MS patients (73,07±26,53 ng/mL) were significantly higher than those of controls (60,18±18,01 ng/mL) (p=0.024). However, there were no significant differences in prolidase levels between patients and healthy controls (p=0.856). Conclusions: Increased ischemia modified albumin levels, supports the role of oxidative stress in patients with multiple sclerosis., Amaç: Multipl skleroz (MS) hastalarında oksidan moleküller olan serbest radikallerin arttığı ve antioksidan moleküllerin düzeylerinin azaldığı bilinmektedir. İskemik modifiye albüminin oksidatif stresi gösterebilecek biyolojik bir belirteç olduğu savunulmaktadır. Bu çalışmanın amacı MS ve oksidatif stres ilişkisini göstermektir. Gereç ve yöntem: Kırk iki MS hastası (30 kadın, 12 erkek) ve 30 sağlıklı kontrol (21 kadın, 9 erkek) bireyde iskemik modifiye albümin düzeyleri ve prolidaz aktivitesi ölçüldü. Bulgular: İskemik modifiye albümin düzeyleri MS hastalarında (73,07±26,53 ng/mL) kontrol grubuna (60,18±18,01 ng/mL) göre anlamlı düzeyde yüksek bulundu (p=0.024). Hasta ve kontrol grupları arasında prolidaz seviyeleri açısından ise anlamlı fark saptanmadı (p =0.856). Sonuç: İskemik modifiye albümin düzeylerinin artışı multipl skleroz hastalarında oksidatif stresin rolünü destekler.

The vascular calcification regulators and inflammatory markers including fetuin-A, osteopontin (OPN), and matrix Gla protein (MGP) may play an important role in the development of intracerebral hemorrhages (ICHs). So far, the relationship between these parameters and ICH has not been studied. Therefore, this study was designed to elucidate whether fetuin-A, MGP, and OPN are involved in the pathophysiology of ICH. The ICH group consisted of 27 consecutive patients with spontaneous ICH evaluated in the neurology intensive care unit within the first 24 hours from the onset of the stroke. The serum OPN levels were significantly increased in patients with ICH compared to the controls. On the other hand, the serum MGP and fetuin-A levels were significantly decreased in the patients with ICH in comparison to the controls. In the patients with ICH, the serum MGP levels of the nonsurvivors were statistically significantly lower than the MGP levels of the survivors. In conclusion, the change in serum fetuin-A, MGP, and OPN levels after ICH indicates that these parameters play a role in the pathophysiological processes leading to an ICH. Measurement of the serum MGP levels may also be of value to estimate mortality.

Metil alkol toksik bir sıvı olup, endüstride antifriz, boya, cila gibi birçok ürünün yapısında bulunur. Toksik doz 20-250 ml olup beyin ve beyin sapı ödemi, putaminal nekroz gibi zehirlenme belirti ve bulguları en erken 12-24 saat sonra ortaya çıkar. Bu yazıda, manyetik rezonans görüntüleme yöntemiyle metil alkol intoksikasyonuna bağlı nadir görülen bazal gangliyonlarda kanama saptanan bir olgu sunulmaktadır., Methyl alcohol is a toxic liquid that is a present in industrial paint, polish and many other products. Its toxic dose is between 20-250 ml and intoxication sings andsymptoms as brain and brainstem edema and necrosis in putamen are observed early in 12-24 hours. In this article, we present a case report of a patient with a infrequint finding of hemorrhage in the basal gangliae in magnetic resonance imaging (MRI) due to methyl alcohol intoxication.

The total oxidative status (TOS)/total anti-oxidative status (TAS) ratio can provide information on an individual’s absolute oxidative stress index (OSI). We investigated the alterations in the oxidant–antioxidant balance by measuring the oxidant parameters OSI, TOS, and malondialdehyde (MDA) together with the antioxidant parameters such as TAS, and superoxide dismutase (SOD) in patients with relapsing remitting multiple sclerosis (MS). To our knowledge, this is the first study to evaluate OSI in patients with relapsing remitting MS. 35 ambulatory patients with relapsing–remitting MS (35.8 ± 8.7 years) and 32 age- and activity-matched healthy control subjects (35.1 ± 3.7 years) that participated in the study. Serum TAS and TOS levels were determined using new automated methods. MS patients had higher concentrations of MDA (151.5 ± 51.1 vs. 111.3 ± 27.4 nmol/g protein, respectively; p < 0.001), TOS (148.1 ± 162.5 vs. 48.3 ± 46.4 mmol H2O2 Equiv./g protein, respectively; p = 0.002), OSI (21124 ± 32543 vs. 5294 ± 5562, respectively; p = 0.008), and SOD (4.5 ± 0.7 vs. 3.4 ± 0.6 U/L, respectively; p < 0.001) compared with healthy controls. On the other hand, MS patients had lower concentrations of NO (12.3 ± 6.9 vs. 17.4 ± 2.5 μmol/g protein, respectively; p < 0.001) and TAS (0.82 ± 0.27 vs. 0.26 ± 0.15, respectively; p = 0.011) compared with healthy controls. In conclusion, these findings indicate that the oxidative stress plays an important role in the pathogenesis of MS.

Routine electrophysiological studies usually give normal results in patients with early stage carpal tunnel syndrome (CTS). Diagnostic significance of the F-wave inversion (the median of F-wave minimal latencies (FWML) exceeds a normal ipsilateral ulnar FWML by 1 ms) has not been previously reported in early stage CTS. In this study, our primary aim was to investigate the diagnostic value of F-wave inversion in early stage CTS. Additionally, we aimed to demonstrate any possible relationship between F-wave inversion and symptom scores of the Boston questionnaire and functional capacity in early stage CTS. The study included 60 early stage CTS patients who presented with a median sensory nerve conduction velocity of ≥50 m/s. The symptom severity and functional status of the patients were assessed by using the Boston questionnaire. The control group consisted of 45 healthy volunteers. We compared early stage CTS patients and healthy control subjects in terms of the results obtained from median-ulnar FWML. Existence of F-wave inversion was found in 32 (53.3%) of the early stage CTS patients and in 3 (8.7%) of the healthy controls ( p = 0.001). It was also found to be positively correlated with the Boston questionnaire scores ( p = 0.001, r = 0.41) and functional capacity scores ( p = 0.001, r = 0.41). The sensitivity and specificity of F-wave inversion for the diagnosis of early stage CTS were calculated as 53.3% and 93.3%, respectively. The addition of F-wave inversion measurement to the set of the routine nerve conduction studies can increase the reliability of the electrophysiological studies in patients with early stage CTS.

Amaç: Bu çalışmada, parasetamol zehirlenmesi ile acil servisimize başvuran hastalarda intravenöz (İV) N- Asetil Sistein (NAC) uygulanması ile ilgili tecrübelerimizi paylaşmayı amaçladık. Gereç ve Yöntemler: Bu çalışma Ocak 2007 ve Aralık 2009 tarihleri arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Hastanesi Acil Servisine Parasetamol zehirlenmesi ile başvuran yetişkin hastaların hastane kayıtlarının geriye dönük incelenmesi ile yapılmıştır. Çalışmaya sadece toksik dozda Parasetamol alıp İV NAC tedavisi başlanan toplam 53 hasta dahil edilmiştir. Toksik doz kriteri olarak, akut alımlarda 140mg/kg’ın üzeri ve 24 saat içinde 7.5 gr ve üzeri alımlar kabul edilmiştir. Elde edilen veriler, SPSS 15.0 (Statistical Package for Social Science) bilgisayar programına kaydedildi ve analiz edildi. Veriler ortalamastandart sapma olarak verilmiştir. Bulgular: Hastaların 27’si (%50.9) kadın ve yaş ortalaması 25.07.1 iken 26’sı (%49.1) erkek ve yaş ortalaması 29.510.4 idi. Kadın ve erkek hastaların yaş ortalamaları arasında istatistiksel olarak anlamlı bir fark yoktu (p0.05). Hastaların %56.6’sında bulantı ve/veya kusma şikayeti olduğu belirlendi. Alınan parasetamol miktarının ortalama 11.94.5 gr olduğu saptandı. Hastaların %64.2’sinde parasetamol ile birlikte ek ilaç alımı olduğu belirlendi. Ortalama tedaviye başlama süresi 5.84.9 saat idi. İV NAC verilmesine bağlı komplikasyon (ürtikeryal reaksiyon) bir (%1.9) hastada tespit edildi. Bu komplikasyonun da antihistaminik tedavisine yanıt verdiği belirlendi. Sonuç: Parasetamol zehirlenmesinde kullanılan İV NAC tedavisinin, genel olarak çoğu minör olmak üzere az sayıda yan etkisi görülmektedir. Parasetamol zehirlenmesinde İV NAC tedavisi güvenli olarak görülmekle beraber bunu desteklemek için daha geniş prospektif çalışmalar yapılmalıdır. (JAEM 2011; 10: 145-7) Objective: In this study, we aimed to present our clinical experiences of intravenous (IV) N-Acetyl cystein administration in patients admitted to our emergency department with paracetamol intoxication. Material and Methods: This study was conducted between January 2007 and December 2009, in the Ondokuz Mayis University Medical Faculty Hospital, Emergency Service, and the hospital records of adult patients admitted with paracetamol poisoning were examined retrospectively. Fifty three patients who were exposed to toxic dose and administered IV NAC therapy were included in the study. In acute intoxication 140mg/kg and 7.5 gr and above in 24 hours were considered as toxic dose. Obtained data using SPSS 15.0 (Statistical Package for Social Science) program was recorded and analyzed. Data are given as mean±standard deviation. Results: Of the patients, 27 were female (50.9%) average age 25.0±7.1 years, and 26 were male (49.1%) average age 29.5±10.4 years. There was no difference in the average age of the sexes (p>0.05). Nausea and/or vomitting was determined in 56.6% of the patients. Average dose ingested was 11.9±4.5. In 64.2% of the patients, we determined a co-ingestion of other drugs. Average time of therapy initiation was 5.8±4.9 hours. Complication due to IV NAC therapy (urticarial reaction) was observed in one patient (1.9%). This complication improved with antihistaminic therapy. Conclusion: A few complications -most of them were minor-due to IV NAC therapy used in paracetamol intoxication were observed. Even if IV NAC therapy seems to be safe in paracetamol intoxication, wide prospective studies are needed for confirmation. (JAEM 2011; 10: 145-7)

Giriş: Spontan pnömomediastinum, herhangi bir tetikleyici sebep veya travma olmaksızın mediasten içinde hava bulunması olarak tarif edilir. Oldukça nadir görülen klinik bir durumdur. Olgu Sunumu: Acil servisimize, yakınları tarafından psikolojik problemleri olduğu söylenerek getirilen boğazda tıkanıklık hissi, nefes alamama ve göğüs ağrısı şikayetleri olan ve spontan pnömomediastinum tanısı konulan bir olgu sunulmuştur. Sonuç: Konversif reaksiyonlarda, sistemik muayene oldukça önemlidir ve göğüs ağrısı ve nefes darlığının ayırıcı tanısında spontan pnömomediastinum mutlaka düşünülmesi gerekir., Introduction: Spontaneous pneumomediastinum, without any triggers cause or trauma is described as finding air in the mediastinum and this is a rare clinical situation.Case report: Our emergency room, said to be close by psychological problems brought the feeling of congestion in the throat, inability to breathe and chest pain complaints, which present a case with the diagnosis of spontaneous pnömomediastinum.Conclusion: systemic examination is very important in conversif reactions. In the differential diagnosis of chest pain and dyspnea, spontaneous pneumomediastinum should always be considered

Amaç: Bu çalışmada; Afyonkarahisar ilindeki ateşli silah yaralanmasına bağlı ölümler analiz edilerek, ateşli silah yaralanmasına bağlı ölümlerin sosyo- demografık ve klinik özelliklerinin değerlendirilmesi ve yapılan benzer çalışmalar ile karşılaştırılarak tartışılması amaçlandı. Gereç ve Yöntem: Afyonkarahisar il merkezinde, 1997¬2004 yılları arasındaki sekiz yıllık dönemde ölümü adli soruşturmaya konu olan 923 olgudan, ölümün ateşli silah yaralanması sonucu meydana geldiği belirlenen 90 olgu¬nun keşif, ölü muayene tutanakları ile otopsi raporları incelenmiştir. Bulgular: Toplam 923 adli ölüm olgusunun 90’ı (%9.7) ateşli silah yaralanmasına bağlı ölüm olgusu idi. 90 olgu¬nun 79’u (%87.8) erkek ve olguların yaş ortalaması 33.45± (en küçük: 9- en büyük: 69) idi. Olguların en sık 26 olgu (%28.9) ile 21-30 yaş grubunda görüldüğü belir¬lendi. 56 olgunun (%62.2) cinayet orijinli olduğu ve bun¬ların 51 ’inin (%91.1) erkek olduğu belirlendi. 32 olgu (%35.5) intihar orjiıtli olup, bunların 26’sı (% 81.2) erkek idi. En sık kullanılan silah tipinin 48 olgu (%53.3) ile yivli silah (tabanca) olduğu belirlendi. Olguların dış muayene¬sinde tespit edilen öldürücü ateşli silah yaralarının, en sık baş-boyun (%51.1) bölgesinde olduğu saptandı. Olguların 70’inde (%77.8) ölümün olay yerinde meydana geldiği be¬lirlendi. Toplam 78 olguda (%86.7) otopsi yapıldığı tespit edildi. Sonuç: Ateşli silah yaralanmalarının halen başta gelen ölüm nedenleri arasında olduğu, yaralanmaların daha çok cinayet orjinli olduğu ve en fazla genç erkek nüfusun etkilendiği görülmüştür. Objective: The aim of this study was to identify demographic and clinical features of firearm injury which resulted with death in Afyonkarahisar city center. Materials and Method: In this study; scene investigation, death examination records and autopsy reports of 90 firearm fatalities from 923 forensic death cases that occurred from 1997 to 2004 in Afyonkarahisar city center were evaluated retrospectively. Results: 90 people (9.7%) were firearm fatalities. Seventy nine of the victims (87.8%) were males and the mean age was 33.45± (min: 9- max: 69). The most prominent age range was between 21 to 30 years in 26 cases (28.7%). Homicides accounted for 56 cases (62.2%) of all gunshot fatalities and 51 of the victims (91.1%) were males. Suicides accounted for 32 cases (35.5%) and 26 of the victims (81.2%) were males. 48 handguns accounted for 53.3% of the weapons used. The most common sites for the firearm wounds were head and neck (51.1%). 70 of the victims (77.8%) were dead in scene. Medico-legal autopsies were performed in 78 cases (86.7%) of firearm fatalities. Conclusion: This study shows that firearm fatalities are important manner of death at present and affect most frequently young male population and the most frequent manner of death was homicide.

Arm wrestling contests have become a common pub and even professional sport. Although armwrestling injuries are not common, several have been reported in the medical literature. In this case, spiral fracture of the humerus with large free fragments which had occurred during arm wrestling and occurring mechanism of injury was attracted attention. It is concluded that arm wrestling should not be considered a completely harmless sport and it appears appropriate to warn public and arm wrestler against arm wrestling. Bilek güreşi müsabakaları halk arasında ve hatta profesyonel sporcular arasında yaygın bir şekilde yapılmaktadır. Bilek güreşi yaralanmaları çok sık olmamasına rağmen, tıbbi literatürde bir kaç yayın rapor edilmiştir. Bu vakada bilek gü- reşi sırasında meydana gelen, serbest kemik parçası olan humerusun spiral cisim kırığına ve travmanın oluş mekanizmasına dikkat çekildi. Bilek güreşinin tamamiyle zarasız bir spor olarak düşünülmemesi gerektiği ve bilek güreşine karşı bu sporla uğraşan profesyonel sporcuların ve halkın uyarılmasının uygun olduğu sonucuna varıldı.

ÖZET Koroziv özofagus yanıkları, önemli bir sağlık sorunu olarak çözüm beklemektedir. Akut dönemin atlatılmasından sonra hasta ve hekimi ilgilendiren en önemli sorun striktür gelişmesidir. Koroziv özofagus yanıklarının tedavisinde esas hedef striktür oluşmasının engellenmesidir. Son zamanlardaki çalışmalar striktür oluşumunu engellemede yara iyileştirilmesini kontrol eden ajanlara yöneldi. Biz de çalışmamızda koroziv özofagus yanıklarında L-arginin'in iyileştirici etkisini araştırdık. Çalışmamızda toplam 60 adet rat kullanıldı ve her biri onar rattan altı gruba ayrıldı. İlk üç grupta deney 48. saatte sonlandınldı. Son üç grupta ise 28. günde sonlandınldı. Grup I ve IV deki ratlarda yanık oluşturulmadı ve tedavi edilmedi. Grup II ve V'deki ratlarda % 10 NaOH ile yanık oluşturuldu fakat 51tedavi yapılmadı. Grup III ve VTdaki ratlarda % 10 NaOH ile yanık oluşturuldu ye ilki yanık oluşturulduktan yarım saat sonra olmak üzere 250 mg/kg/gün L- arginin günde tek doz verildi. Grup IIFde tedavi iki kez yapıldı. Grup VFda ise tedavi bir hafta yapıldı. İlk üç grupta 48. saatte (ikinci günün sonunda) son üç grupta ise 28. günde özofagus distal 1.5 cm'lik kısım alınarak histopatolojik olarak incelendi. Histopatolojik incelemede ödem, enfiamasyon, SMKA, MMH ve TMKB'ne bakıldı. İlk üç grup kendi arasında, son üç grup ise kendi arasında karşılaştırıldı. L-arjinin ile tedavi edilen grupta ikinci günün sonunda ödemin belirgin olarak tedavi edildiği mikroskobik olarak tespit edildi. L-arjinin ile tedavi edilen grupta ikinci günün sonunda enflamasyonun mikroskobik olarak azaldığı görüldü. L-arjinin ile tedavi edilen grupta 28. günün sonunda ortaya çıkan MMH'ın mikroskobik olarak azaldığı tespit edildi.. L-arjinin ile tedavi edilen grupta 28. günün sonunda ortaya çıkan SMKA'nın belirgin olarak azaldığı mikroskobik olarak tespit edildi. L-arjinin ile tedavi edilen grupta 28. günün sonunda ortaya çıkan TMKB'nin azaldığı mikroskobik olarak tespit edildi. Sonuç olarak, L-arginin'in yara iyileşmesini hızlandırıcı etkisi, NO sentaz inhibitörlerinin GİS mukoza bütünlüğü ve kan akımı üzerine olan zararlı etkilerini azaltıcı veya geriye döndürücü ve mikrosirkülasyonunu artırıcı etkisi ile koroziv özofagus yanıklarında iyileştirici etkisi olduğu kanısına varıldı. 52 SUMMARY Corosive burns of the esophagus are still among serious health problems requiring new and effective treatment modalities. The most important problem following the acute phase is development of stricture. The main objective in treatment of corosive burn of the esophagus is prevention of stricture formation. Recent studies on prevention of stricture formation has been interested in agents which control wound-healing process. We investigated wound-healing effects of L-arginine in corozive burns of the esophagus induced with 10 % sodium hydroxide in rats. A total of 60 rats were divided into 6 groups, each containing 10 rats. The experiment lasted for 48 hours in the first 3 groups and 28 days in the second 3 groups. No corosive burn was induced in groups 1 and 4. Esophagial corosive burn was induced with 10 % NaOH in groups 2 and 5 but no treatment was applied. Esophagial corosive burn was induced with 10 % NaOH in groups III 53and VI and 250 mg/kg of L-arginine was administered orally in single dose each day. The first dose was given 30 minutes after the induction of the burn. Group 3 received the treatment twice. The treatment lasted for 1 week in group 4. A 1.5- cm piece of the distal esophagus was excised at the 48th hour in the first 3 groups til and on the 28 day in the second 3 groups and examined histopathologically. Histopathologic examination was performed according to presence of the following changes: edema, inflammation, increase in submucosal collagen, damage to the muscularis mucosa, and collagen deposition in the tunica muscularis. Each of the first 3 groups was compared with one another. The same comparisons were made among the second 3 groups. Microscobic examination of the samples from the group given L-arginine revealed that edema was significantly resolved at the end of the 2nd day. Resolution of inflammation was observed microscobically at the end of the 2nd day. The 28th day microscobic examinations of the samples from the group treated with L-arginine showed a significant decrease in increase in submucosal collagen, decrease in damage to the muscularis mucoza, and decrease in collagen deposition in the tunica muscularis. In conclusion,, the findings of this experiment suggests that orally administered L-arginine may contribute to healing of corosive esophagial burn injuries through its effects on maintenance of gastrointestinal mucosal integrity and enhancement of microcirculation. 54 62