Neutropenia can be seen in newborns for many reasons. One of them is maternal hypertension and the physiopathology, clinical importance and treatment is not clear of that. This study was performed over 145 newborns. Neutropenia was seen more in the newborns of hypertensive mothers and it was independent on the birth weight. An infection was seen in 31.5% of the neutropenic newborns.

Chlamydiae, an obligate intracelluler parasite, consists of three species, classified according to their antigenic, biochemical characteristics and the pathogenity to the host and diseases. These microorganisms are responsible for eye, respiratory tract and sexually transmitted diseases. C.trachomatis is the most frequently studied species, because of the high prevalance of infections caused by this pathogen and various clinical syndromes. Since Chlamydial infections frequently follow a nonspesific clinical course, laboratory tests have an important role in diagnosis. Tissue culture, cytologic tests, direct diagnostic methods such as DFA and EIA, moleculer biological techniques such as PCR and hybridization are used for laboratory diagnosis. This study was planned to detect C.trachomatis antigen with two methods in 50 patients who are sexually active and attended to the hospital with vaginal discharge. Endocervical specimens of the patients were examined by EIA and a rapid test for C.trachomatis antigen. Of 50 specimens with rapid test 4(8%) and with EIA 1(2%) was positive. These results showed that both methods can be widely used for centers, where diagnostic tests such as culture, DFA and molecular techniques cannot be performed and rapid tests are particularly suitable for screening studies.

To evaluate the clinical and pathological data and therapy results of the Hodgkin's lymphoma diagnosed cases was aimed in this study. Fifty four patients diagnosed pathologically as Hodgkin's lymphoma according to the Rye classification, between the years 1997-2002 and treated in the first internal medicine clinic at Dr. Lütfi Kýrdar Kartal Training and Research Hospital were analyzed retrospectively. The patients' stages and therapy results were evaluated according to the age, gender, beginning site of the disease, pathological Rye classification, B symptoms and Cotswold's staging. Twenty five cases were women, 29 were men. W/M ratio was 0.86. Ages were between 15-85 years. Beginning site of the disease was as follows: Cervical site in 42 cases (78%), axillary site in 7 cases (12%), inguinal site in 3 cases (6%), mediastinal site in 2 cases (4%). According to the Cotswold's staging; 11 cases were at stage I-II (20%), 16 cases were at stage III (30%), 27 were at stage IV (50%). At least one of the B symptoms was present at 38 cases (70%). Histopathological types according to the Rye classification were as follows: Nodular sclerosing type in 22 cases (41%), mixed type in 20 cases (37%), lymphocyte-rich type in 8 cases (15%), lymphocyte-poor type in 4 cases (7%). Generally the patients had approximately 6 cures of ABVD (Adriamycin 25 mg/m, Bleomycin 10 mg/m, Vinblastine 6 mg/m, DTIC 375 mg/m) protocol at 1st+15 th days. 10 patients had second step EVAP (Etoposide 120 mg/m, Vinblastine 4 mg/m, Cytarabine 30 mg/m, CDDP 40 mg/m) therapy at 1st + 8th + 15 th days. Three patients had a third level therapy. Twenty two cases received radiotherapy. Thirty three cases were in remission, while in 11 cases the disease relapsed. Six patients are currently at 1 step therapy. Four cases died (3 because of the disease itself and 1 because of interfering infection). As the side effects of the therapy 11 patients had febrile neutropenia, 3 had dermal lesions due to radiotherapy, 2 had difficulty in swallowing. Patients diagnosed as Hodgkin's lymphoma were frequently middle-aged men. Nodular sclerosing type was the most frequent type, while mixed type was the second. The least frequent type was the lymphocyte-poor type. Generally the patients had ABVD therapy protocol and therapy results were found to be similar with the literature. We have concluded that, the retrospective data of the Hodgkin's lymphoma cases followed by the first internal medicine clinic of our hospital are well-adjusted with the other Hodgkin's lymphoma case-series.

Acne is a disease with multietiological factor, which affect the young population and the cause of which is currently unknown. One of these etiological factors is hormonal effects. This study investigated whether the hormone levels of a group of female patients with acne showed a significant deviation from the normal. The levels of Follicle Stimulant Hormone (FSH), Luteinizing Hormone (LH), Prolactin (PRL), Total Testosterone (TES), Dehydroepiandrosterone Sulfate (DHEA-S), Progesterone (P), Eustrodiol (E2) and Cortisol (COR) were measured by standard enzyme immunoassay method in the morning fasting blood on the 5th day of menstruation on 60 female patient with acne and 30 control subject in the similar age group. Female patients with acne were examined for the localization and intensity of the lesions, hirsutismus and secondary sex characteristics. They were evaluated for the starting age of the lesions, menstruation activation, cyclus order, galactorrhea, alopecia and family history. The acne intensity was mild in 19(31.67%) patients, moderate in 24(40.0%) and severe in 17(28.33%). While no significant difference was encountered from the control group in terms of hirsutismus, menstruation activation, cyclus order, galactorrhea, alopecia and family history; dysmenorrhea was found to be statistically higher (p=0.011) in the patient group (58.3%) compared to the control group (30.0%). At least one hormone was higher than normal in 45(75.0%) of the patients. The patients group's serum cortisol level (16.02±7.19 µg/dl) was found to be significantly lower (p=0.023) compared to the control group (19.79±6.98 µg/dl), whereas no difference was encountered in the other serum hormone mean values. Also, the serum DHEA-S values were found to be significantly lower in the moderate intensity group (193.61±66.99 µg/dl) compared to the other groups (p=0.043). These data obtained by us show that is no significant difference between the acne group and the control group in terms of the serum levels of the hormones. All these data and signs were discussed and interpreted against the literature.

To determine the recurrence rates in treatment of primary pterygium with simple excision using the bare sclera technique was purposed in this study. 40 eyes of 39 patients (20 male, 20 female) was included in this study. Simple excision using bare sclera was performed in the eyes. Follow up period was 12 months (average 3-22 months). Recurrence was seen in 22 of 40 eyes (55%). Recurrence rates are high in pterygium simple excision using bare sclera technique for treatment of primary pterygium. To decrease the recurrence rates, combined technique should be performed.

In this study, we aimed to compare the efficacy of remifentanil, alfentanil and fentanyl in attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation. Following institutional approval and patient consent, 150 patients, ASA I-II, aged 18-60 years, scheduled for elective surgery, were assigned to three groups in a randomised manner. The patients of group I (n=50) received 1 µg/kg remifentanil, group II (n=50) received 15 µg/kg alfentanil and group III (n=50) received 2 µg/kg fentanyl intravenously. Anaesthesia induction and maintenance were performed respectively with propofol 2 mg/kg, rocuronium 0.6 µg/kg, isoflurane 1% in 50% N2O+50% O2 in all groups. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR) and peripheric oxygen saturation (SpO2) values were recorded before induction, immediately after the injection of the drug, before laryngoscopy, and at 1, 2, 3, 5, 10 min after the intubation. SAP, DAP, MAP, HR and SpO2 values were not significantly different before the induction and immediately after the injection of the drug. In all groups, during the study period SAP, DAP, OAP values decreased with respect to time before induction. Significant decreases were detected in SAP, DAP, OAP before laryngoscopy and at 1 min after intubation in group I compared to group III (p<0.01). None of the patients experienced hypotension (MAP<70% of the preinduction baseline value) during the study period. HR values at 1 min after intubation were found significantly higher in group II and III (p<0.001). There wasn't any difference between the groups with respect to other parametres. As a result of our study, we conclude that remifentanil are more effective and safe for attenuation haemodynamic response to laryngoscopy and endotracheal intubation.

To evaluate the effect of pterygium excision combined with limbal-conjunctival autograft transplantation in preventing recurrence in recurrent pterygium cases was purposed. Pterygium excision were combined with limbal-conjunctival autogfrat transplantation in 16 eyes of 16 patients with recurrent pterygium. Follow-up period was 21(3-39) months averagely. There were no recurrence during follow up period in this study. Graft retraction was recorded in 1 case, in 3 cases epitelial inclusion cycsts and in 2 cases subepitelial fibrosis related irregular astigmatism developed. In cases with recurrent pterygium limbal-conjunctival autograft transplantation is an effective and reliable method in preventing recurrence.

Urethral stricture is still one of the most important problems in urology because of the difficulties in treatment and complications at high rate. Though many procedures have been tried until today, none of them has been demonstrated to be superior to the other. In this study, everted femoral vein was intervened to the defect created at the anterior uretra in 20 adult, male, hybrid dogs. Urethral stent administered intraoperatively was removed at the 7 postoperative day. 3 weeks later retrograde urethrogram was performed and dogs were sacrified and urethral tissues were undergone histopathologic examination. Two cases died in the early postoperative period. The procedure was completed with 18 cases. While there was no complication in 11 of the 18 cases (61,1%), stenosis at different degrees occurred in 7 cases (38.1%). While in 2 of the 7 cases (28,6%) stenosis and fistula formation at the anastomosis level was seen, in other 5 cases (71,4%) only stenosis was detected. Consequently, everted vascular graft may be a treatment modality to be preferred in complicated urethral stenosis.

OBJECTIVE: To compare the recurrence rates of primer pterygium excision and pterygium excision combined with limbal-conjunctival autograft transplantation in eyes with advanced primary pterygium was purposed in this study.
METHODS: 36 patients (18 male,18 female) with advanced primary pterygium were included. 26 eyes of 25 patients were treated with only primary pterygium excision and in 11 eyes of 11 patients pterygium excision were combined with limbal-conjunctival autograft transplantation.
RESULTS: Follow up period was 2-24 months (average 13 months). There was %53 recurrence rate in primary pterygium excision group. The recurrence rate was %9.9 in which autograft transplantation were performed. Subepitelyal fibrosis developed in 3 eyes. Limbal-conjunctival autograft transplantation was carried out after recurrence in 5 patients in primary pterygium excision group.
CONCLUSION: In eyes with advanced primary pterygium, limbal-conjunctival autograft transplantation is an effective method in decreasing recurrence rates.

In this study, growing state of total 583 student is evaluated separately and relation between criterians is examined by using their own weight and height measurement with the advanced indices such as weight for age, height for age, relative weight measurement and ponderal index in a private school in Istanbul on December 2000. Malnutrition is 24.9%, 15.9% and 16.9% respectively according to weight for age, relative weight measurement and ponderal index in sequence. The evaluation result of these three indices is compared with Friedman nonparametric variance analysis and it is found that there is significant difference between them. As a result, in order to evaluate growing state accurately, standards for our country needed to be developed.

The recently better recognized biological effects of cytokines have shown the roles they play in the pathogenesis of acute and chronic complications of dialysis therapy. In this study; we searched the plasma TNF-alfa levels in the various staged chronic renal failure patients who have not yet been started dialysis therapy and who are under ongoing dialysis and in a healthy control group. The study consisted of a total of 45 cases who are being followed in the nephrology department of Dr. Lütfi Kýrdar Training and Research Hospital. The three groups were: Chronic renal failure patients who are not yet under dialysis (15 patients, mean age: 38±14,4 yrs, M/W: 10/5), chronic renal failure patients who are currently having dialysis (15 patients, mean age: 41,2±8 yrs, M/W: 10/5) and healthy control group (15 patients, mean age: 29,6±2,6 yrs, M/W: 6/9). Patient exclusion criteria were: Diabetes mellitus, congestive heart failure, polycystic renal disease, diseases like multiple myeloma, amyloidosis and obstructive nephropathy that can cause chronic renal failure. All the patients' kidneys were bilaterally diminished in size. For the dialysis patients, synthetic polysulphone dialysors were used. Five mililiters of blood were collected from all the cases and preserved at -85°C. TNF-alfa enzyme-linked immunosorbent assay kits (00927, Diaklon, France, 2001) were used with the ELISA testing. As we compared the parameters like urea, creatinine, clearance of creatinine, protein output in 24 hours urine; in the healthy and predialytic group, the predialytic group's results were statistically significantly rised (p<0,001). These parameters of the currently dialysed cases couldn't be evaluated because of their having dialysis 1-3 times per week. As we compared the TNF-alfa results; there was statistically significant difference between the control (p<0,01) and the patient (p<0,001) groups. But the difference between the predialytic and dialytic groups were not statistically significant (p>0,05). In conclusion; we decided that TNF-alfa, a proinflammatuar cytokine, had a role in chronic renal failure depending on chronic glomerulonephritis, but the forthcoming prospective studies will explain the relationship better between TNF-alfa and renal diseases.

Behçet's disease, originally described in 1937 as a symptom triad of recurring iritis, ulceration of the mouth, and ulceration of the genitalia, is now recognized to involve additional organ systems, including the skin, central nervous system, heart, any part of the vasculature, lungs, and joints. The purpose of this case report is to review the anesthetic approach in Behçet's disease.

In this paper, latissimus dorsi musculocutaneous flap reconstruction for the gun shot defect at the left breast is presented. In general, breast reconstruction is performed for the defects occuring after mastectomies but reconstruction for this kind of traumatic breast defects with latissimus dorsi musculocutaneous flap and silicon mammarian implant is rare in literature. In this procedure coverage for the difficult wound with treating osteomyelitis of ribs and restoring an aesthetic form and function is accomplished. This kind of breast reconstruction with latissimus dorsi musculocutaneous flap is reliable, safe choice and can be performed easily with minimal morbidity.

Osteogenesis imperfecta (OI) is an inherited disease of connective tissue. Osteogenesis imperfecta is characterised by an excessive tendency to bone fractures and retarded growth as well as variable involvement of other connective tissues such as teeth, sclerae, auditory bones and ligaments. Difficulties in the administration of general anaesthesia to patients with osteogenesis imperfecta were recognised and managed accordingly. We would like to report a patient who had osteogenesis imperfecta that we administered total intravenous anaesthesia (TIVA) and laryngeal mask airway (LMA) succesfully for an orthopedic operation.

Priapism is an uncommon condition of prolonged erection without sexual desire and stimulation. It is to be classified in two groups in terms of etiopathogenesis; ischemic (veno-oclusive, low-flow) and non-ischemic (arteriyel, high-flow) priapism. While, intracavernous injection therapy for impotence may be the most common cause of ischemic priapism, non-ischemic priapism that is a rare condition is usually secondary to traumatic factors. In this paper, a case of a non-ischemic priapism secondary to perineal trauma is reported.

Wilm's tumour (nephroblastoma) is the most common abdominal tumour of childhood. It presents usually between 6 monts and 5 years and may be associated with hypertension, anemia, hematuria, fluid and electrolyte imbalance and haemodynamic problems. Treatment is surgical resection followed by radiotherapy or chemotherapy. We describe the anaesthetic management of a child with a nephroblastoma.

Primary megaureter is an uncommon disease in adult. When it is complicated by a lithiasis or an infection, it may be symptomatic. We report a case with a primary megaureter presenting as an acute abdomen. Like in our case, unusual presentation of rare congenital ureteral anomaly such as primary megaureter should be considered in the differential diagnosis of acute abdomen to avoid misdiagnosis and unnecessary surgical interventions.

Hydatid disease is zoonotic infection caused by cestodes of genus Echinococcus. Most of the embryos are trapped in the liver where they form cysts; however, some may pass through the liver and form cysts in other organs, particularly the lungs, and less frequently the brain, kidneys, heart and bones. During surgery, the cysts must be handled carefully to prevent spillage of the antigenic fluid and viable protoscolices that can cause anaphylaxis or peritoneal echinococcosis. For this reason, surgery should be extremely cautious and the cyst must be isolated from the surgical field and sterilized with saline solution or other substances. We know that hypertonic saline solution is the least toxic solution. We believe that the course of anaphylactoid reaction which we have seen in our case was the result of rupture of the cyst in the liver, in the other hand occurrence of anaphylactoid reaction may be developed by sterilization of hydatid cysts with povidone-iodine during surgery. This report has been described a case of liver and lung hydatidosis and discusses its clinical manifestations, complications, treatment and anaesthetic implications.

Tramadol is a centrally acting synthetic analgesic with opioid receptor affinity and is believed to exert its analgesic effect by inhibiting the re-uptake of norepinephrine and serotonin. There are limited data on the toxicity in overdose but we know that 800 mg was the lowest dose associated with coma and respiratory depression. It is a safe and affective analgesic in patients of all ages who suffers from chronic pain. The presented 2 patients had tramadol overdose with symptoms such as nausea, vomiting, lethargy, tachycardia and both were treated.