Hastanemiz Acil Polikliniðine Supraventriküler Taþiaritmi ataðý ile müracaat eden 3'ü erkek 15 hastaya 0.25 mg/ kg dozda intravenöz diltiazem uygulandý. Olgularýn baþlangýç ve 5. 10. 15. dakikalarda sistolik ve diyastolik kan basýnçlarý, kalp atým sayýlarý ölçüldü, ritm traseleri kaydedildi. Bu aþamada olumlu yanýt alýnamayan 2 olguda 2. aþama tedavi uygulandý (0.35 mg/kg diltiazem,IV) ve ayni þekilde kan basýncý, kalp hýzý ve ritm trasesi ile takip edildi. Olgulardan 13'ü I. aþama tedaviye olumlu yanýt verdi. Olumlu yanýt oraný %86 idi. Ýkinci aþama tedaviye alýnan 2 olgudan birinde olumlu yanýt alýndý. Diðer olguya kardioversiyon uygulandý. Sonuç olarak diltiazem uygulanan 15 olgudan 14'ü l ve 2 aþama tedaviye olumlu yanýt verdi (%93). IV diltiazem, olgularýn sistolik ve diyastolik kan basýnçlarýnda anlamlý bir deðiþiklik yapmaksýzýn kalp atým sayýlarým anlamlý bir þekilde azaltmýþtýr (p<0.001). Sonuçlar; Supraventriküler taþiaritmi ataklarýnda IV diltiazem'in baþarýlý ve kolay uygulanabilir olduðunu göstermektedir.

A total of 15 patients (three men and twelve women), with sinusal tachycardia, atrial fibrillation and atrial tachycardia, were coming over to our Emergency Clinic, were treated with 0.25 mg per kg diltiazem intravenously. The patients were examined for systolic and diastolic blood pressure and heart rate before treatment and 5,10,15 minutes after treatment periods, and ECG were recorded at the same time. This treatment was called as first step of treatment. 13 patients were responded to first step of treatment (the ratio of positive response was 86 percent). At the second step of treatment, one out of two patients, has failed the positive response and to be needed lo cardioversion. As a result, 14 of 15 patients were treated Diltiazem, were responded to first and second steps of treatment. The ratio of positive response was 93 percent. There were no serious changes in their sistolic and diastolic blood pressures, but their heart rates were markedly decreased by IV diltiazem (p<0.001). The results of this study, suggested that IV diltiazem is an successful and easily administrable agent in the treatment of supraventriculer tachyarythmia.

Bu çalýþmada, transrektal ultrasonografi (TRUS)'nin prostat kanseri (PCa)'nin tedaviye cevabýný izlemedeki yeri araþtýrýlmýþtýr. Çalýþma kapsamýna, histopatolojik olarak PCa olduðu saptanan ve uygun tedaviden sonraki izlemleri 12 ile 36 ay arasýnda deðiþen 25 hasta alýnmýþtýr. TRUS'daki deðiþikliklerin diðer izlem metodlarý ile olan uyumu araþtýrýlmýþ ve rektal tuþe ile % 60, klinik gidiþ Ýle % 80, prostatik asit fosfataz (PAP) ile % 64, prostat spesifik antijen(PSA) ile % 72 oranýnda uyum gösterdiði saptanmýþtýr. Elde edilen verilere göre TRUS'nin PCa izleminde kullanýlabilecek önemli metotlardan biri olduðu sonucuna varýlmýþtýr.

The value of transrectal ultrasonography (TRUS) in monitoring the response of prostate cancer to therapy was investigated in this study. Twenty-five patients with biopsy proven prostatic cancer were enrolled in the study. The follow-up period after appropriate therapy changed between 12 and 36 months. The correlation of TRUS with digital rectal examination, clinical course, prostatic acid phosphatase and prostate specific antigen was 60, 80, 64 and 72 %, respectively. It was concluded that TRUS is one of the methods which can be used in monitoring prostate cancer

Moyamoya hastalýðý,.bilateral internal karotid arterlerde daralma ve intrakranial dolaþýmýn kollateralizasyonu ile karakterize, nadir görülen, kronik progresif bir damar hastalýðýdýr. Klinik olarak hemoraji, Ýnfarkt, Transient Iskemik Atak (TÝA), epilepsi görülmektedir. Çocukluk çaðýndý TÎA ve epilepsi görülürken, eriþkinlerde genellikle hemoraji tablosu ile ortaya çýkmaktadýr. Bu yazýda, TÝA öyküsü ve serebral iskemi bulgularý olan, karotid anjiyogramý Moyamoya hastalýðý Ýle uyumlu, 33 yaþýnda kadýn hasta bildirildi. Bilgisayarlý beyin tomografisi ve magnetik rezonans görüntüleme incelemelerinde bilteral subkortikal "watershed" infarktlar saptandý. Son literatür gözden geçirilerek, Moyamoya hastalýðý taný kriterleri tartýþýldý.

Moyamoya disease is an unusual vascular disorder high lighted by progressive bilateral internal carotid artery occlusion and collateralization of intracranial blood flow. The clinical manifestations of Moyamoya disease are hemorrhage, infarction, Transient Ischemic Attack (TIA) and epilepsy. Hemorrhage tends to occur in the adult group while TÝA and epilepsy are seen in children. We report a 33 year-old woman who had a history of TÝA and present cerebral ischemic deficits. Carotid angiograms demonstrated the evolution of Moyamoya disease, Cerebral computed tomography and magnetic resonance imaging revealed bilateral subcortical "watershed" infarctions. The diagnostic criteria of Moyamoya disaesa is discussed in the light of recent literature.

Tekrarlayan kusma ataklarý olan ve rehidratasyon ile klinik ve laboratuvar bulgularý kýsa sürede düzelen hastaya yapýlan ayrýntýlý incelemeler sonucu sol MKDB hastalýðý saptandý. Literatürde destekler açýklama olmamasýna raðmen, MKDB'nin kusma nöbetleri ile bir iliþkisinin olup olmayacaðý sorusu ortaya çýktý. Sol nefrektomi uygulanan hastada kusma ataklarý sýklýðý ve þiddetinde belirgin bir azalma oldu.

After detailed laboratory tests, left MCDK disease was diagnosed in a patient who had recurrent attacks of vomiting and her clinical and laboratory conditions improved after rehidratation in spite of the absence of any supportive data in literature, we thought whether there was any correlation between MCDK and vomiting at tacks. After left nefrectomy, significant decrease appeared in frequency and intensity of vomiting attacks.

Bu olgu sensoryel afazi, baþ aðrýsý, kusma, þuur kaybý, bir ayaðýnda monopleji þikayetleri ile baþvuran ve þikayetleri gebelik sonrasý oluþan 21 yaþýnda bir kadýn hastadýr. Rutin tetkikler ve MRÝ incelemesi sonucunda superior sagital sinüs trombozu tespit edildi. Yapýlan tedaviye olumlu yanýt alýndý. Þifa ile taburcu edildi.

This case was a 21 years old woman. She had been hospitalized after pregnancy with complaints of headache, vomiting, speech problems and consciousness. She had got Wernicke's dysphasia and lower limb monoplegia. There had been found superior sagital sinus thrombosis by MRI. Anticoagulant therapy had been made. Response to medical therapy was satisfactory. 20 days later the patient was externed with welfare.

Adrenal kistler nadir görülür. Rapor edilen olgular genellikle otopsi bulgusudur. Klinik olarak saptanabilen boyuttakileri çok azdýr. Vaka, retro poperitoneal bölgeden kistik lezyon çýkartýlan 52 yaþýnda bir kadýn hastadýr. Nadir oluþu nedeniyle sunulmuþ ve literatür gözden geçirilmiþtir.

Adrenal cysts are rare lesions. Those reported are rare mostly autopsy findings. A 52 year old woman was operated for a cystic lesion in the retroperitoneal region. The cyst was found to be an adrenal cyst. The case is re ported with the literature findings.