Kilis, Turkey
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Sahpolat M.,Kilis State Hospital | Ari M.,Mustafa Kemal University
Bratislava Medical Journal | Year: 2017

OBJECTIVES: This study aimed to investigate the possible relationship between plasma concentrations of nesfatin 1 and first attack psychosis. METHODS: Totally, 32 patients with the first episode psychosis and 33 randomly selected weight- and body mass index-matched healthy volunteers admitted to Mustafa Kemal University, Faculty of Medicine, Training and Research Hospital, Psychiatry outpatient clinic were included. Healthy control subjects were matched in terms of weight and body mass index (BMI). The Positive and Negative Syndrome Scale (PANNS) was applied to the patient group. The enzyme-linked immunosorbent assay (ELISA) method was used to measure plasma nesfatin 1 levels. RESULTS: The mean nesfatin 1 level was lower in the patients with the first attack psychosis (0.60 ± 1.00 ng/mL) than in the control group (0.75 ± 1.07 ng/mL).However it did not reach statistical significance (t = -0.567, p = 0.573). There was no statistically significant correlation between plasma nesfatin 1 levels and total PANNS scores in the patient group (r = -0.262, p = 0.148). CONCLUSION: Our study was the first to investigate the nesfatin 1 levels in patients with the first episode psychosis. Based on our study results, nesfatin 1 might be related to some central nervous system pathologies, including the severity of a psychiatric disorder; however, further large-scale studies are required to establish a conclusion.


Carman K.B.,Gaziantep Childrens Hospital | Tutkun E.,Ankara Occupational Diseases Hospital | Yilmaz H.,Ankara Occupational Diseases Hospital | Dilber C.,Kahramanmaras Sutcu Imam University | And 5 more authors.
European Journal of Pediatrics | Year: 2013

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 μg/L (min, 2.40 μg/L; max, 4,687 μg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical. © 2013 Springer-Verlag Berlin Heidelberg.


Penetrating head and neck trauma with construction nails are uncommon life-threatening injuries and an important problem in developing countries. Assessment of the neurovascular and systemic physical status is a first requirement, and the decision concerning which surgical approach to perform for the removal of the nail is of critical importance. A 10-year-old girl was presented one hour after a fall injury with complaint of a swelling and foreign body lodgment on the left forehead. Neurological and systemic physical examinations were normal except for weak direct pupillary light reflex on the left side and the patient's state of uneasiness. Radiological investigations showed that the head of the nail had entered from the left infraorbital region and become lodged through the orbital roof, below the frontal bone. Surgical extraction of the nail in the operating room was performed successfully using left pterional craniotomy and lateral orbitotomy technique, and there was no complication after surgery. Here, we report a case with a rare craniocerebral penetrating wound and type, with the head of the nail lodged in the anterior fossa through the orbital roof, which may be defined as 'reverse penetration of the nail'.


Ercan S.,University of Gaziantep | Dogan A.,University of Gaziantep | Altunbas G.,Kilis State Hospital | Davutoglu V.,University of Gaziantep
Thoracic and Cardiovascular Surgeon | Year: 2014

Pulmonary artery aneurysm (PAA) is defined as pulmonary artery diameter of greater than 4 cm. PAA is not frequently encountered in clinical practice. There is a rare report in giant low-pressure PAA in terms of long-term follow-up. Herein, we sought to report a case of idiopathic PAA that was followed for 12 years in view of its learning points and to review the current literature for PAA. Herein we observed learning points according to long-term follow-up of PAA case as follows. PAA progressed dramatically after reaching a diameter greater than 6 cm and resulted in 7.87 cm in 2 years according to our case observation. Pericardial effusion may develop after a dramatic increase of PAA diameter. The reason for pericardial effusion is not always dissection or rupture; the presence of pericardial effusion possibly stemmed from the impairment of lymphatic drainage because of pressure effect on lymphatic circulation. Progressive increase of dilatation may lead to cough, as in our case. © 2013 Georg Thieme Verlag KGStuttgart.


Zengin S.,University of Gaziantep | Al B.,University of Gaziantep | Genc S.,University of Gaziantep | Yildirim C.,University of Gaziantep | And 3 more authors.
American Journal of Emergency Medicine | Year: 2013

Objective: Ultrasonography has been suggested as a useful noninvasive tool for the detection and follow-up for hypovolemia. Two possible sonographic markers as a surrogate for hypovolemia are the diameters of the inferior vena cava (dIVC) and the right ventricle (dRV). The goal of this study was to evaluate IVC and RV diameters and diameter changes in patients treated for hypovolemia and compare these findings with healthy volunteers. Methods: Fifty healthy volunteers and 50 consecutive hypovolemic patients were enrolled in the study. The dIVC, both during inspiration (IVCi) and expiration (IVCe), was measured in hypovolemic patients both before and after fluid resuscitation, and they were also measured in healthy volunteers during the time they participated in the study. The dIVC, in hypovolemic patients both before and after fluid resuscitation, was measured ultrasonographically by M-mode in the subxiphoid area. The dRV was measured ultrasonographically by B-mode in the third and fourth intercostals spaces. Results: The average diameters of the IVCe, IVCi, and dRV in hypovolemic patients upon arrival were significantly lower compared with healthy volunteers (P =.001). After fluid resuscitation, there was a significant increase in the mean diameters of the IVCe, IVCi, and RV in hypovolemic patients (P =.001). Conclusions: The results indicate that the dIVC and dRV are consistently low in hypovolemic subjects when compared with euvolemic subjects. Bedside serial measurements of dIVC and dRV could be a useful noninvasive tool for the detection and follow-up of patients with hypovolemia and evaluation of the response to the treatment. © 2013 Elsevier Inc.


Akdemir U.O.,Gazi University | Tokcaer A.B.,Gazi University | Karakus A.,Kilis State Hospital | Kapucu L.O.,Gazi University
Clinical Nuclear Medicine | Year: 2014

AIM: The aims in this study were to evaluate the role of brain 18F-FDG PET imaging in differential diagnosis of parkinsonism and to correlate brain metabolism findings with patients' clinical findings. METHODS: Brain 18F-FDG PET images were evaluated both visually and quantitatively using the NeuroQ software in 21 parkinsonism patients in whom final clinical diagnoses were established. RESULTS: Final clinical diagnoses were idiopathic Parkinson disease in 7, multisystem atrophy (MSA) in 7, progressive supranuclear palsy (PSP) in 4, corticobasal degeneration in 2, and Lewy body disease in 1 patient. Asymmetrical cortical hypometabolism was observed in most of the patients in frontal and parietotemporal regions. Fifteen of 21 patients had basal ganglia involvement, which was bilateral in patients with MSA and more frequently unilateral in patients with idiopathic Parkinson disease and PSP. Four patients with PSP and 1 patient with corticobasal degeneration had thalamic hypometabolism. Cerebellar hypometabolism was observed in 4 patients with MSA. The Unified Parkinson Disease Rating Scale motor and bradykinesia scores were higher in patients with basal ganglia involvement. CONCLUSIONS: Brain 18F-FDG PET findings in subcortical nuclei and cerebellum were found to be useful in differential diagnosis of patients with parkinsonism. The extent of cerebral cortical and basal ganglia hypometabolism showed correlation with the presentation and severity of clinical findings. © 2013 by Lippincott Williams and Wilkins.


Erbas O.,Gaziosmanpaşa University | Solmaz V.,Gaziosmanpaşa University | Aksoy D.,Gaziosmanpaşa University | Yavasoglu A.,Ege University | And 2 more authors.
Life Sciences | Year: 2014

Aim The aim of this study was to examine the effects of cholecalciferol on systemic inflammation and memory in the setting of fatty liver disease in rats. Materials and methods To induce the development of fatty liver disease, the rats were fed a 35% fructose solution over 8 weeks. Group I (n = 6) was designated as the control group and fed with standard rat chow. Group II (n = 6) was provided with, standard rat chow, and 0.3 μg/kg/day of oral cholecalciferol over a duration of 2 weeks. In addition to standard rat chow, group III (n = 6) and group IV (n = 6) were given 4 mL of the 35% fructose solution per day via oral gavage for 8 weeks. However, group IV was also given 0.3 μg/kg/day of oral cholecalciferol over 2 weeks. After the treatment period, passive avoidance tasks were performed by all groups. The liver and brain were harvested for subsequent biochemical and histopathologic analyses. Key findings The development of fatty liver extends the memory latency period of passively avoiding tasks after 1 trial. Moreover, there were increases in brain TNF-α and plasma MDA levels according to two-way analysis of variance. Cholecalciferol supplementation decreased the latency period of passively avoiding tasks in rats with hepatosteatosis, and also significantly reduced brain TNF-α and plasma MDA levels. Significance Fatty liver may contribute to the development of systemic inflammation, which affects cognition and causes deficits in memory; however, the anti-inflammatory and antioxidant properties of vitamin D may improve the cognitive function of rats with hepatosteatosis. © 2014 Elsevier Inc.


Aim: To examine changes in the basal metabolic rate and body composition of patients with chronic inactive and active hepatitis B (HBV) infection as measured using single frequency bioelectrical impedance analysis (BIA) and to investigate the convenience of this method for follow-up with these patients. Materials and methods: Twenty patients with chronic inactive HBV infection, 22 with chronic active HBV infection, and 43 healthy subjects were enrolled in the study. Using single frequency BIA and basal metabolic rate (BMR), the resistance and body composition of all participants were measured. Results: A total of 85 subjects (31 female and 54 male) with a mean age of 35.1 ± 11.4 years were enrolled. There was no signifi cant diff erence between the groups in terms of mean age, height, or body weight (P > 0.05). Th e mean body mass index (BMI) of the participants was 26.55 kg/m 2. While the BMR was found to be lower, resistance was higher in patients in the inactive group (P < 0.05 for both). Th e body fat index was higher in the inactive group than in the active group, but the diff erence was not statistically signifi cant (P > 0.05). A strong negative correlation was found between BMR and resistance, and the body fat index (rho = -0.804, P < 0.01; rho = -0.337, P < 0.01, respectively). Th ere was a positive correlation between BMR and BMI (rho = 0.408, P < 0.05). Th ere was no signifi cant diff erence between the groups BMI, phase angle, and other body components (P > 0.05). Conclusion: Th is study suggests that single frequency BIA is less useful in the follow-up with the aforementioned group of patients. © TÜBİTAK.


Iflazoglu N.,Kilis State Hospital | Ureyen O.,Izmir Bozyaka Educational and Research Hospital | Oner O.Z.,Antalya Educational and Research Hospital | Tusat M.,Kilis State Hospital | Akcal M.A.,Kilis State Hospital
International Journal of Clinical and Experimental Medicine | Year: 2015

Due to the high kinetic energy, of bullets and explosive gun particles, their paths through the abdomen (permanent cavity effect), and the blast effect (temporary cavity effect), firearm injuries (FAI) can produce damage not only in the organ they enter, but in the surrounding tissues as well. Since they change route after entering the body they may cause organ damage in locations other than those at the path of entry. For example, as a result of the crushing onto bone tissues, bullet particles or broken bone fragments may cause further damage outside of the path of travel, For these reasons it is very difficult to predict the possible complications from the size of the actual injury in patients with penetrating abdominal firearm injuries. The factors affecting the mortality and morbidity from firearm injuries have been evaluated in various studies. Insufficient blood transfusion, long duration of time until presenting to a hospital and the presence of colon injuries are common factors that cause the high complication rates and mortality. A total of 120 cases injured in the civil war at Turkey’s southern neighbouring countries were admitted to our hospital and evaluated in terms of: development of complications and factors affecting mortality; age, gender, time of presentation to the hospital, number of injured organs, the type of injuring weapon, the entrance site of the bullet, the presence of accompanying chest trauma, the amount of administered blood, the penetrating abdominal trauma index (PATI) and the injury severity score (ISS) scores were determined and evaluated retrospectively. The most significant factors for the development of complications and mortality include: accompanying clinical shock, high number of injured organs, numerous blood transfusions administered and accompanying thoracic trauma. It has also been observed that the PATI and ISS scoring systems can be used in predicting the complication and mortality rates in firearm injuries. Consequently, reducing the mortality and complication rates from firearm injuries is still a serious problem. Despite all of these efforts, there is still a need to determine the optimum treatment strategy to achieve this end goal. © 2015, E-Century Publishing Corporation. All rights reserved.


Aim: In this work, failed back surgery syndrome(FBSS) which observed in Lomber disc herniation(DH) postoperatively is analysed; and especially epidural fibrosis and recurrent cases are retrospectively analysed through calculating the success scores. Method: Our work had been carried out between January/2000 - December/2006. In our clinic, 1268 cases in total were examined that were operated by reason of lomber disc herniation in our clinic. Among the cases that were included to the study, the 70 were evaluated as FBSS and the radiological evidences, surgical and clinical findings were analysed retrospectively. Result: Of all the patients 36 were women (51%), the 34 were male (48.6 %). Their ages changed between 22-74 and the age average was found as 49.9. Of all the reoperated cases; the 45 (64%) were reoperated by reason of recurrent DH, 9 (12.8%) epidural fibrosis and recurrent DH, 8 (11.4%) paraspinal abse, 3 (4.2%) lomber stenosis, 3 (4.2%) foraminal stenosis, 1 (1.4%) postoperative discitis, 1(1.4%) Cerebro spinal fluid (CSF) fistule. While the success rate of the cases with epidural fibriosis was found as 37.2 %; 75.9% success rate was recorded for the patients with recurrent DH. Statistical comparison was found as meaningful. (p< 0.05) Conclusion: The most frequent reoperation cause for the patients who were operated by reason of lomber DH is the recurrent herniations which occur at the same level; the same side or the opposite side. The cases with epidural fibriosis must be well-assessed radiologically and clinically and the most effective treatment plan should be aimed and formed.

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