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Öğe Investigation of the Parameters That May Predict Hemodialysis Frequency(Trakya Üniversitesi, 2020) Kıral, Gökhan; Certel, Alperen Taha; Özyiğit, Irmak İrem; Söyleyici, Begüm; Aygün, Güray; Gökalp, CenkAims: This study investigates the relationship between the clinical parameters at the beginning of hemodialysis therapy and the changing in the frequency of weekly hemodialysis sessions in ongoing treatment. Methods: The study population was composed of all of the patients that were started chronic hemodialysis treatment between January 2015 and January 2020. The patients were classified as twice-weekly (2/7) and thrice-weekly (3/7) groups according to the hemodialysis schedule at the start of treat- ment. The 3/7 group is additionally subdivided according to the dialysis schedule switches to the thrice-weekly program. Basal demographics and biochemical parameters were obtained from medical records at the start of hemodialysis. Results: The total number of subjects in the study was 433 (141 in the twice-weekly program, 292 in the thrice-weekly program). Forty-six (32.6%) patients in twice-weekly hemodialysis program were shifted to a thrice-weekly program during the follow-up. The female/ male ratio in the 2/7 program is different from the 3/7 program. Serum creatinine and C-reactive protein levels were higher in patients on the 3/7 program. Serum calcium and albumin levels were higher in patients on a 2/7 program. The statistically sig- nificant increments were found in calcium, hemoglobin, hematocrit, urea, creatinine, and potassium levels between the before and after switch results of the 3/7 group which switched from 2/7. Conclusion: Urea, creatinine, and potassium levels can guide the decision to compose a hemodialysis schedule. However, patients' future weekly treatment schedules cannot be predicted by biochemical parameters obtained at the start of hemodialysis.Öğe Risk Factors and Management of Hepatitis B Virus Reactivation in Patients With Hematological Disorders(Trakya Üniversitesi, 2018) Akay, Fatih Erkan; Tan, Berfin; Güldağ, Mahmut Alper; Çifcibaşı, Hilal Sena; Elmacı, Kubilay; Ümit, Elif GülsümAims: The aim of this study is to evaluate hepatitis B virus serological status and to categorize the risks of our treatmentmodalities in patients with both benign and malignant hematological disorders.Methods: This was a retrospective study of 552 patients who were admitted to the Trakya University Hospital Hematologyunit between 01.01.2017 and 31.12.2017. All data regarding the diagnosis, treatment and HBV serologicalstatus were collected from patient files. Data were analyzed with IBM SPSS V.20 using descriptive statistical analysis.Results: Hepatitis B surface antigen was positive in 45 (8.2%) patients, antibody to the hepatitis B surface antigenwas positive in 279 (50.5%) patients and antibody to the hepatitis B core antigen was positive in 247 (44.7%) patients.According to these results, 32 patients were found to be vaccinated for hepatitis B virus. Reactivation was observed in4 (0.7%) patients who have been hepatitis B surface antigen positive and have received adequate duration of antiviralprophylaxis with tenofovir. These 4 patients have received monoclonal antibody for immunosuppressive treatment.Conclusion: To conclude, although the rate of hepatitis B surface antigen reactivation is quite low, as many patientsas possible should be vaccinated to reduce the costs of antiviral treatments and monitorization. If there is notime to vaccinate, patients should be categorized according to guidelines by their hepatitis B surface antigen serologicalstatus and by the planned immunosuppressive treatments.Öğe A Rare Case of Recurrent Signet Ring Cell Carcinoma Presenting With Thrombocytopenia(Trakya Üniversitesi, 2021) Sayın, Sezin; Kasapoğlu, Elçin; Gökyer, AliAims: Signet ring cell carcinoma is a rare type of gastric cancer most commonly seen in the stomach. There is a 60% systemic recurrence rate of gastric cancer after curative resection, and it most commonly recurs in the liver, peritoneum, and lungs. Bone metastasis is extremely rare in gastric cancer. We aim to present a rare case of signet ring cell carcinoma with thrombocytopenia as a primary symptom of bone marrow metastasis years after the patient’s primary diagnosis with gastric adenocarcinoma. Case Report: A 52-year-old male patient was admitted to the Medical Oncology Division of Trakya University Hospital with dyspeptic complaints six years ago, whereupon gastroscopy revealed an ulcerated lesion in the antral region of the stomach, and the pathological biopsy revealed adeno- carcinoma. The patient underwent subtotal gastrectomy and lymph node dissection, combined with adjuvant chemoradiotherapy. In the follow-up, a complete blood count revealed thrombocytopenia, and poorly differentiated adenocarcinoma metastasis with a signet ring cell component was demonstrated through imaging studies and pathological examination. Treatment with cisplatin and 5-fluorouracil was initiated after the diagnosis of human epidermal growth factor receptor-2 negative, stage 4 gastric adenocarcinoma. The patient showed clinical and laboratory response to the treatment and will continue with the current regimen. Conclusion: In this case, the primary tumor was in the stomach, and he had signs of thrombocytopenia only. When the prognosis of the patient was evaluated, it was thought that there was tumor residue at a cellular or clonal level in the stomach after gastrectomy, or an asymptomatic metastasis present and unnoticed in the bone marrow during the surgical treatment. In conclusion, this case shows that physicians should be alert to the changes in blood parameters in terms of recurrence with bone marrow involvement even if there is no visible recurrence in the patient.Öğe Retrospective Analysis of Follicular Lymphoma Patients in Trakya University School of Medicine: a Single Center Experience(Trakya Üniversitesi, 2021) Akay, Fatih Erkan; Koçyiğit, Beliz; Şişman, Fevzi Oktay; Ayrık, Mert Yücel; Savaşır, İpek; Cengiz, Elif; Demirci, UfukAims: To establish a dataset including demographic features, disease characteristics, and survival rate of follicular lymphoma patients in Trakya Universi- ty School of Medicine and contribute to the database of follicular lymphoma in Turkey. Methods: In this retrospective cross-sectional study, we analyzed data constituting of follicular lymphoma patients over 18 years of age followed during the years of 2015-2020 in Trakya University Division of Hematology. Results: Out of 43 patients, 22 (51.2%) were female and 21 (48.8%) were male. The mean age was 56.56 (standard deviation 13.24) years. There were 5 (11.6%) pa- tients with B symptoms, presence of bone marrow involvement was seen in 17 (39.5%) patients, lastly, there were 18 (41.9%) patients with splenomegaly. Twen- ty-one (48.8%) patients received rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, making it the most common treatment protocol administered in our study. Conclusion: Follicular lymphoma patients usually end up getting diagnosed at an advanced stage of the disease, presenting with incidentally noticed painless lymphadenopathy. Additionally, based on evidence in the literature, a clear gap in the successful diagnosis of follic- ular lymphoma patients can be observed between developed and developing countries. To overcome this hurdle, enhanced cooperation with hematopathology may lead to an increased awareness enabling physicians to make a more accurate diagnosis. Nonetheless, further studies are still needed to fully apprehend the epidemiology of follicular lymphoma patients in Turkey.Öğe The Evaluation and Interpretation of the Most Common Intervertebral Discs in Cervical Hernias: a Retrospective Study(Trakya Üniversitesi, 2016) İşkan, Nur Gülce; Kurt, Cansu; Akşar, Aslıhan; Tekataş, AslanAims: In this study it is aimed to determine the most common intervertebral discs in cervical hernias and to discuss the possible causes of prevalence.Methods:The data of 110 patients who were diagnosed with cervical disc hernia in Trakya University Health Center for Medical Research Neurology Clinics EMG lab in between 2012 and 2015 was analyzed retrospectively by looking at the age, gender and herniated intervertebral disc. Chi- Square test was used to determine the frequency of the cervical disc hernia in intervertebral discs in both genders. Independent Samples T Test was used to determine the correlation between prevalence of herniated intervertebral discs, age and gender. Arithmetic mean ± standard deviation, number and percentages, median (minimum-maximum) were used as descriptive analysis.Results: Out of 110 patients, there were 60 males (52.3%) and 50 females (48.7%) with the mean age of 50.43 ±12.67, the youngest patient was 26 and the oldest was 82. The most involved disc was found to be C5-C6 (15 males with a percentage of 25% and 23 females with a percentage of 46%). Conclusion:The most common intervertebral disc in cervical hernia was detected as C5-C6. It may be because of the maximal extension and flexion, functional overloading and micro traumas which affect C5-C6 segmentÖğe A Rare Case For Awareness: Metaplastic Carcinoma of Breast(Trakya Üniversitesi, 2017) Gül, Seray; Şahin, Müge; Sunar, Ahmet Orhan; Albayrak, DoğanAims: Metaplastic breast carcinoma is an infrequent kind of breast carcinoma, more aggressive and has poorer prognosis than other breast carcinomas. With this case report, we aim to reveal pathologic and clinical features of the metaplastic breast carcinoma and its similarities to ductal invasive carcinoma. However its differentation is possible and should not be skipped in diagnosis. Case Report: A BIRADS category of 4c mass that measured 38x31 mm in the ultrasonography was detected in a 71-year-old female patient who applied with a complaint of a palpable mass under the right areola. The result of biopsy was interpreted morphologically as spindle cell proliferation containing necrosis. Thereafter, the mass was excised with simple mastectomy. The results of the immunohistochemical examination of the tumor with the diameter of 6 cm revealed progesterone receptor, estrogen receptor and HER2 to be negative, p63 staining to be positive. The mass was histopathologically diagnosed as metaplastic carcinoma with well differentiated squamous cell and malignant mesenchymal component (osteosarcomatous area). Conclusion: Metaplastic breast carcinoma which resembles invasive ductal carcinoma with general characteristics is differentiated from invasive ductal carcinoma with larger tumor size, less lymph node involvement, less hormone receptor positivity. In order to prevent the delay of diagnosis, invasive ductal carcinoma should be considered in the definitive diagnosis in the elderly patients. Treatment should be started immediately and followed closely because of the high risk of local recurrence.Öğe Enteric Nervous System: a Review(Trakya Üniversitesi, 2015) Kurt, Cansu; Göy, Defne Flora; Özden, Gülşah; Barutçu, Öykü; Bozer, CüneytEnteric nervous system directs and regulates the breakdown, absorption and elimination of food in our digestive system. However, alongside its digestive functions, enteric nervous system has also gained importance because of the discovery of its bidirectional link with intestinal flora, which has recently started to be considered as a separate organ in addiction to its digestive functions. Enteric nervous system contains approximately 100 million nerve cells, operates both independently and in coordination with the central nervous system, interacts with many neurotransmitters and is related to many conditions and structures such as the intestinal flora, mood, immune system and the efficiency of food utilization. It has a clinical importance on account of the diseases it is associated with. Recent studies focus on the connections between the intestinal flora, enteric nervous system and mechanisms of disease development. In order to understand these studies and pathological mechanisms it is essential to know the structure, connections and functioning of enteric nervous system. Considering these, we addressed the enteric nervous system and its communications with other structures of the digestive systemÖğe Gastrointestinal Tract Multiple Lymphomatous Polyposis Presented As Mantle Cell Lymphoma(Trakya Üniversitesi, 2019) Akay, Fatih Erkan; Can, Nuray; Cezik, Mert; Kırkızlar, Hakkı Onur; Soyluoğlu, Fatma Selin; Öz Puyan, FulyaAims: Mantle cell lymphoma is a mature B cell non-Hodgkin lymphoma which may be presented with the involvement of the gastrointestinal tract as multiple lymphomatous polyposis. The aim of this case report is to increase the awareness of including lymphomatoid polyposis as an entity in the differential diagnosis of multiple polyposis of the gastrointestinal tract. Case Report: A 69-year-old male patient was admitted to the Trakya University Emergency Department with acute abdominal pain. His cli-nical findings were anorexia that started 3-4 months ago together with constipation and nausea causing him to lose 10-15 kg in 7-8 months, with denial of other parameters of B-symptoms (fevers and night sweats). Endoscopic biopsies that were taken from bulbus and duodenum were investigated and he was diagnosed with mantle cell lymphoma. The patient went through an ileoce-cal resection due to his intussusception that caused abdominal pain in the first place. Conclusion: Although being an infrequent disease, gastrointestinal lymphomatoid polyposis should be an entity comprised in differential diagnosis for multiple polyposis of the gastrointestinal tract. On the other hand, there is still not a therapeutic protocol with a definitive cure for gastrointestinal tract mantle cell lymphoma. Elderly patients in high risk group such as our patient should be given treatment by taking their conditions into consideration. Keywords: Mantle cell lymphoma, polyp, non-Hodgkin lymphomaÖğe Effectiveness of Pet/Ct in Evaluation of the Lymphoma(Trakya Üniversitesi, 2019) Atnallar, Göktuğ; Özdemir, Büşra; Ümit, Elif Gülsüm; Durmuş Altun, GülayAims: Prognosis and survival of Hodgkin lymphoma have been improved dramatically by the development of treatments as well as the sensitivity of evaluation tools. In this case report, we aimed to emphasize the importance of positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography in the initial staging of Hodgkin’s lymp-homa, evaluating the response to treatment, and to demonstrate residual tissue or recurrence. Case Report: A 25-year-old male patient presented to Trakya University Hospital with swelling in the right groin and was diagnosed with Hodgkin’s lymphoma. Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography scan was used for initial staging and assessment of response to treatment. Conclusion: Positron emission tomography is a feasible imaging modality for the evaluation of lymphomas. It is sensitive to detect minimal recurrence as well as alterations of lesions’ metabolic activity. Keywords: Positron emission tomography, lymphoma, hodgkin diseaseÖğe Systemic Cannabidiol Does Not Reduce Compound 48/80-Induced Itching Behavior in Mice(Trakya Üniversitesi, 2019) Demirel, Hatice; Baksın, Elif; Özgür, Ece Önay; Topuz, Ruhan Deniz; Ulugöl, AhmetAims: Cannabinoids are chemical compounds including natural cannabinoids found in the Cannabis plant, their synthetic counterparts, and endocannabinoids. Cannabidiol, a phytocannabinoid derived from the Cannabis plant, exerts anticonvulsant, anxiolytic, anti-inflammatory, neuroprotective, analgesic effects. Although there are many similarities between the pathophysiological mechanisms of pain and itch, researches that investigate the effect of cannabinoids on itching are insufficient. Here, we aimed to examine the antipruritic effect of cannabidiol and the contribution of spinal cannabinoid receptors. Methods: Male Balb/c mice, weighing 20-30 g, were used. Itching behavior was produced by intradermal injection of compound 48/80 (100 ?g/50 ?l); cannabidiol (1, 3, 10 mg/kg, ip) was administered 30 minutes before compound 48/80 injections. Then, scratching of the injected site by the hind paws was videotaped for 30 minutes. Locomotor performances were assessed using a rotarod apparatus. Results: Cannabidiol had no effect on compound 48/80-induced itching behavior at any dose given; moreover, cannabidiol did not produce any impairment on motor function. AM-251, a cannabinoid receptor type 1 antagonist, and AM-630, a cannabinoid receptor type 2 antagonist were administered intrathecally to observe the contribution of spinal cannabinoid receptors to the antipruritic action of cannabidiol. We observed that cannabidol did not possess any effect on itching behaviour. Conclusion: Our results indicate that systemic administration of cannabidiol does not attenuate compound 48/80 induced itching behavior in miceÖğe Use of Electrocardiographic Markers to Predict Ventricular Arrhythmias in Acute Myocarditis Patients(Trakya Üniversitesi, 2017) Yumurtacı, Öznur; Kurt, Cansu; Uçar, Fatih Mehmet; Öztürk, CihanAims: Acute myocarditis is an inflammatory disease of the myocardium and is characterized by a large heterogeneity of clinical presentation. Myocarditis is becoming to be recognized as a contributor to unexplained mortality, and is thought to be a major cause of sudden cardiac death in the first two decades of life. Myocardial inflammation, ion channel dysfunction, electrophysiological and structural remodelling may play important roles in life-threatening arrhythmias. We aimed to investigate the ventricular arrhythmia predictors in myocarditis patients by using electrocardiographic markers. Methods: A total of 56 patients (mean age 22.5 ± 3.7 years; 89% males) with acute myocarditis were enrolled in the study. Tpeak-Tend intervals, Tpeak-Tend/QT and Tpeak-Tend/corrected QT (QTc), cardio-electrophysiological balance (QT/QRS) and heart rate-corrected QT(QTc)/QRS ratios were calculated from 12-lead electrocardiogram. Results: Heart rate, QT and QTc values were similar between groups. QRS complexes were lower in arrhythmia positive group than arrhythmia negative group (p=0.004). Tpeak-Tend intervals, Tpeak-Tend/QT, Tpeak-Tend/ QTc, cardio-electrophysiological balance and heart rate-corrected QT(QTc)/QRS values were significantly higher in arrhythmia positive group ( lt; 0.001, lt; 0.001, p=0.03, p=0.04 and lt; 0.001, respectively). Conclusion: In this study, we observed that higher Tpeak-Tend, Tpeak-Tend/QT, Tpeak-Tend/QTc , cardio-electrophysiological balance (ICEB) and heart rate-corrected QT(QTc)/QRS ratio are associated with ventricular arrhythmic episodes in acute myocarditis patients. These electrocardiographic markers may be beneficial to identify high risk patients for arrhytmias complicating myocarditis.Öğe F-18-Fdg Pet/Ct Findings in Differentiated Papillary Carcinoma of Thyroid and Determination of Metabolic Activity(Trakya Üniversitesi, 2017) Tezel, Mehmet Oğulcan; Mercan, Oğuz; Yumurtacı, Öznur; Kurt, Cansu; Altun, Gülay DurmuşAims: In well differentiated thyroid cancers, FDG PET has a relatively low sensitivity. F-18 FDG PET/CT is an imaging method which is used before the treatment and in high risk patient groups with suspected recurrent disease. In this study we aim to determine the character of metabolic activity in differentiated thyroid cancer and in case of metastasis and to evaluate the findings of F-18-FDG PET/CT images in high risk patient group of differentiated thyroid cancer. Methods: The data of 79 patients who underwent imaging for staging or restaging and followed at Trakya Univerısity Faculty of Medicine from 2010 to 2015, were included in this study. Patient reports were analyzed retrospectively. Age, gender, size of thyroid lesion, presence of lymphadenopathy, other organ metastases (lung, liver, brain, bone) were included in the study. Results: The findings of 79 patients (29 male, 50 female) with papillary differentiated thyroid cancer were included in the analyses. The mean age of participants was 51±15 years. 14 patients (18%) were evaluated as normally. Recurırent disease was detected in the thyroid gland of 10 patients (13%) (SUVmax: 6.2±5.1; 2.3-19.3). In 54 patients (68%) lymph node metastasis was detected (SUVmax; 5.8±5.1; 2.1-24.2). 12 patients had liver metastasis (SUVmax: 5.7±3.9; 2.0-11.7), 12 patients had bone metastasis (SUVmax: 6.1±2.9; 2.2-13.9), 8 patients had lung metastasis (SUVmax: 4.3±4.5; 1.0-4.9) and one patient had brain metastasis (SUVmax: 10.2). Conclusion: Papillary differentiated thyroid cancer is associated with a tumor showing low glucose affinity, but it is understood that the tumor changes its behavior and gets metabolically active in the patients within the high risk group and in those with systemic metastasisÖğe Evaluating Orthorexia Tendency Among Trakya University Medical School Students(Trakya Üniversitesi, 2015) Özkan, Aslı Nur; Ülkücü, Attila; Kanter, Tuğba; Tapan, Mehmet Emin; Turgutlugil, Begüm; Çaylan, AyşeAims: In this study, it is aimed to bring up Orthorexia nervosa tendency among Trakya University Medical Schoolstudents and determine the effect of smoking, alcohol use, drug use, chronic diseases, previous regimes, doing sports, possibility of individuals of cooking for themselves in their daily life and socio-demographic variables.Methods: This is a cross-sectional survey study that was applied to the 1278 students who are enrolled in TrakyaUniversity Medical School in 2014-2015 academic year. A questionnaire is prepared by the researcher including questions to determine orthorexia nervosa tendency, socio-demographic factors and Orto-11 scale. 705 students filled the questionnaire and only 676 could be used in the study. The mean age of the students was 20.92 years (min. 17 years max. 40 years). 62.1 % was female (420) and 37.9% was male (256). Results have been evaluated by using SPSS programme. In this evaluation, Kruskal Wallis and chi-square test were used.Results: Among the factors which were searched, it is seen that smoking, alcohol use and drug use decreased Orthorexia nervosa tendency while it is increased with possibility of cooking, male sex and doing sports. No significant difference were observed between other factors and Orthorexia nervosa.Conclusion: Even though there are not adequate studies in literature and it is not described in DSM-V, Orthorexianervosa might affect individual’s quality of life later in their lifetime. It is important to carry on more comprehensive studies on this topicÖğe Retrospective Analysis of Chronic Myeloid Leukemia Patients in Trakya University School of Medicine(Trakya Üniversitesi, 2019) Akay, Fatih Erkan; Koçyiğit, Beliz; Tan, Berfin; Atlı, Emine İkbal; Baş, Volkan; Kırkızlar, Hakkı OnurAims: This study aims to establish the data; including demographic features, molecular response status, disease characteristics, and survival rate of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors in Trakya University School of Medicine. Methods: In this study, the data of 102 patients over 18 years old who were diagnosed with chronic myeloid leukemia in Trakya University School of Medicine between January 2003-October 2019 were analyzed retrospectively. Data was analyzed using SPSS 23.0.0.0. Results: The total number of patients in the study was 102. There were 95 (93.1%) patients on chronic phase and 6 (5.9%) patients on accelerated phase. Eighty-three (81.4%) of the patients had at least a major molecular response and 17 (16.7%) patients could not achieve at least a major molecular response. Conclusion: As our study showed, first line treatment with imatinib may not be enough for some of the patients to recover and therefore different TKIs such as dasatinib, nilotinib, bo-sutinib, and ponatinib are being used in the treatment of CML. Inadequate response, drug side effects and incompliances are the causes of switching the drug choice. Further studies are needed to thoroughly reveal the epidemiology and treatment regimens.Keywords: Chronic myeloid leukemia, tyrosine kinase, neoplasmsÖğe Impact of T Wave Amplitude in Lead Avr on Predicting Appropriate Therapies in Hypertrophic Cardiomyopathy Patients With An Implantable Cardioverter Defibrillator(Trakya Üniversitesi, 2018) Söyleyici, Begüm; Hünkar, Pelinsu Elif; Girit, Çağrı; Kurt, Cansu; Uçar, Fatih MehmetAims: Although implantable cardioverter defibrillator reduces mortality in hypertrophic cardiomyopathy patients,inappropriate implantable cardioverter defibrillator shocks are related to increased mortality. The aim of this studyis to investigate whether a new electrocardiographic marker of T wave amplitude in lead aVR can be used to predictappropriate therapy of implantable cardioverter defibrillator (shock or anti-tachycardia pacing) in hypertrophic cardiomyopathypatients.Methods: Thirty-six hypertrophic cardiomyopathy patients, who were admitted to the outpatient clinic for pacemakercontrol, with implantable cardioverter defibrillator were retrospectively examined (mean age: 51 ± 10.2 years,72.2% male). The primary endpoint was appropriate implantable cardioverter defibrillator therapy. All hematological,biochemical and electrocardiogram parameters were measured before implantable cardioverter defibrillator wasimplanted.Results: Over a median follow-up period of 33 months, 9 (25%) patients experienced appropriate implantablecardioverter defibrillator therapy. Heart rate and QRS interval were similar between groups. QT and QTc valueswere higher in patients that received appropriate shocks. Patients who have T wave inversion were higher in therapypositive group. T wave amplitude in lead aVR values were significantly associated with appropriate therapy.Conclusion: Using simple ECG parameters, we may predict arrhythmic episodes before ICD implantation and animprovement of the medical antiarrhythmic therapy might be protective for HCM patients with ICD.Öğe Clinicopathological Features of Myeloid Sarcoma Patients From a Single Center Experience(Trakya Üniversitesi, 2020) Akay, Fatih Erkan; Kırkızlar, Hakkı Onur; Mercan, Elif; Öz Puyan, FulyaAims: This retrospective study aims to emphasize clinicopathological data and diagnosis of an uncommon myeloid neoplasm;myeloid sarcoma. Methods: Data of all patients from 2000-2019 were retrieved from the archives of Trakya University Schoolof Medicine Hematology and Pathology Departments. Patients’ charts were examined retrospectively by collecting data including age, gender, anatomic site, history of hematological malignancy, blood count, pathological characteristics and treatmentsadministered. Results: There were 8 patients; 6 male and 2 female. The median age was 42.5 years (range: 29-69 years). Themost prevalently involved sites were skin, lymph node and bone/soft tissue. There were six patients as myeloid sarcoma withpreexisting or concurrent acute myeloid leukemia, one patient as de novo and one patient as acute myeloid leukemia with myelodysplasia related changes. One of the concurrent acute myeloid leukemia patients was Down syndrome related acute myeloidleukemia with myeloid sarcoma. Immunohistochemically, out of 8 patients, 4 were of myelomonocytic, 2 were of the myelocyticand 2 were of the monocytic differentiation. Conclusion: Myeloid sarcoma is a tumor mass made up of immature myeloid blastsappearing at an anatomical site other than bone marrow. Taking into account of having a challenging diagnosis, unusual cellularinfiltration at any site on a patient especially with a history of acute myeloid leukemia should have myeloid sarcoma in theirdifferential diagnosis. Keywords: Myeloid sarcoma, acute myeloid leukemia, myeloid neoplasiaÖğe Helicobacter pylori ınfection and benign gastroduodenal diseases, data from the Trakya Region(2010) Ümit, Hasan Celalettin; Ünsal, Gülbin; Tezel, Ahmet; Soylu, Ali RızaAmaç: Helikobakter pilori (H. pilori) gastrik ve duodenal ülser, non-ülser dispepsi, atrofik gastrit, mide kanseri ve MALT lenfoması etiyolojisinde rol oynamaktadır. Çalışmamızda Trakya bölgesinde beniğn gastroduodenal hastalıklarda H. pilori infeksiyonu prevelansı araştırılmıştır. Gereç ve Yöntemler: Trakya Üniversitesi Tıp Fakültesi Endoskopi Ünitesine başvuran ve beniğn gastroduodenal hastalıklar saptanan 4714 hastada retrospektif olarak H. pilori infeksiyonu prevelansı araştırıldı. Bulgular: Hastaların %52.8'inde H. pilori pozitif saptandı. H. pilori bulber ülser hastalarında %65, gastrik ülserli hastalarda %60.2, gastritli hastalarda ise %48.4 oranında pozitif bulundu (p<0.001). Trakya bölgesi kökenli hastaların %52'sinde, Anadoludan göç eden hastaların %56.3'ünde, Avrupadan göç eden hastaların %48.7'sinde H. pilori pozitif bulundu (p=0.02). Helikobakter pilori kadınlarda %53.2, erkeklerde %52.2 oranında pozitifti (p=0.52). Üreaz pozitifliği 30-60 arasındaki hastalarda 30 yaşından küçükler ve 60 yaşından büyüklere göre daha fazlaydı. Sonuç: Trakya bölgesinde H. pilori infeksiyonu hem ülkemizin diğer bölgeleri ile hemde komşu avrupa ülkeleri ile benzer epidemiyolojik özellikler göstermektedir.Öğe Is fondaparinux an effective alternative anticoagulant in patients with heparin-ınduced thrombocytopenia type II? A case report and review of the literature(2009) Tekgündüz, Emre; Akpınar, Seval; Öztürk, Erman; Pamuk, Emel Gülsüm; Turgut, Burhan; Demir, MuzafferHeparine bağlı trombositopeni (HIT) nadir olmasına karşın heparin tedavisinin en çok korkulan komplikasyonlarından biridir. Heparine bağlı trombositopeni heparin ile temas sonrası oluşan, antikor aracılı edinsel ve geçici bir trombotik bozukluktur. Fraksiyone olmayan heparin hemodiyaliz sırasında kullanılan standart antikoagülandır ve heparin ile sürekli temas eden hemodiyaliz hastalarında HIT riski artmıştır. Burada kronik zeminde akut böbrek yetersizliği olan ve hemodiyaliz sonrasında HIT gelişen 75 yaşında bir erkek hastayı bildiriyoruz. Hastada derin ven trombozu saptandı ve fondaparinuks ile başarıyla tedavi edildi. Bu yazımızda ayrıca HIT hastalarında gelişen trombozun profilaksi ve tedavisinde fondaparinuksun endikasyon dışı kullanımını derledik. Fondaparinuks heparin ile reaksiyon veren antikorların çoğunluğunca tanınmayacak kadar küçük olduğundan lepirudin ve danaparoid gibi lisanslı ilaçların bulunmadığı durumlarda, semptomatik HIT hastaları için mantıklı bir alternatif antikoagülan olabilir.Öğe Tip 2 diabetes mellituslu hastalarda tiroid hastalığı(2009) Taşkıran, Bengür; Güldiken, Sibel; Peynirci, Hande; Altun, Uğur Betül; Tuğrul, ArmağanAmaç: Tiroid hastalıkları ve tip 2 diabetes mellitus (DM) toplumda sık görülen iki hastalıktır. Bu çalışmada, tip 2 diyabetik olgularda tiroid hastalıklarının sıklığını inceledik. Hastalar ve Yöntemler: Trakya Üniversitesi Endokrinoloji Bilim Dalında takip edilen tip 2 DM hastalarından tiroid fonksiyon testleri, anti-tiroglobulin antikoru, anti-tiroid peroksidaz antikoru ve tiroid ultrasonografi ve/veya sintigrafi sonuçları bulunan 306'sı retrospektif olarak incelendi. Bulgular: Yirmi dokuz (%9.5) olguda Hashimoto tiroiditi, beşinde (%1.7) multinodüler guatr, üçünde (Graves hastalığı (%1) ve bir olguda (%0.3) toksik soliter adenom olmak üzere toplam 38 (%12.4) olguda tiroid hastalığı belirlendi. Sonuç: Yapılan inceleme sonucunda tip 2 DM olgularında tiroid hastalıklarına genel popülasyondakine benzer sıklıkla rastlandığını tespit ettik. Tip 2 DM'li hastaların, kardiyovasküler hastalık eğilimi yaratan başta hipotiroidi olmak üzere tiroid hastalıkları açısından genel popülasyon için geçerli olan öneriler dışında ayrıca taranmasına gerek olmadığı sonucuna vardık.Öğe The relationship between proinflammatory cytokine levels and fibrinolytic system in obese patients(2008) Gerenli, Murat; Tuğrul, Armağan; Demir, Muzaffer; Arıkan, Ender; Güldiken, Sibel; Azcan, ŞennurAmaç: Obez kişilerde proinflamatuar sitokinlerden TNF-? ve IL-6, fibrinolitik sistem parametrelerinden t-PA ve PAI-1 ve insülin direnci arasındaki ilişki araştırıldı. Hastalar ve Yöntemler: Çalışmaya obez (VKİ ?30 kg/m2) olarak değerlendirilen 54 kişi (41 kadın, 13 erkek; ort. yaş 33.5) ve obezite sorunu olmayan (VKİ <25 kg/m2) 30 kişi (19 kadın, 11 erkek; ort. yaş 22.3) alındı. Fibrinojen düzeyleri koagülometrik olarak ve TNF-?, IL-6, t-PA, PAI-1 düzeyleri ELISA yöntemiyle ölçüldü. Bulgular: Kontrol grubuyla karşılaştırıldığında, obez kişilerde fibrinojen (p<0.01), PAI-1 (p<0.001), TNF-? (p<0.01) ve IL-6 düzeyleri (p<0.001) anlamlı derecede yüksek, t-PA düzeyi (p<0.001) ve t-PA/PAI-1 oranı (p<0.001) anlamlı derecede düşük bulundu. Obezlerde TNF-? ile t-PA (p=0.007) ve t-PA/PAI-1 oranı (p=0.016) arasında ters ilişki saptandı. İnsülin direnci olan ve olmayan obez kişilerde parametreler arasında fark yoktu. Sonuç: Obezitede adipoz dokudan salgılanan özellikle TNF-? gibi inflamatuar sitokinlerin artması fibrinolizde azalmaya yol açar. Obez kişilerde görülen bu değişiklikler, insülin direncinden bağımsız olarak ateroskleroza neden olabilir.
