Aim: In a former study, we have showed that CAPE has preventive effect on cisplatin-induced nephrotoxicity. In this study we re-analyzed the renal tissues of the rats used formerly and investigated whether cisplatin has any effects on hexokinase (HK), glucose-6-phosphate dehydrogenase (G6PD), lactate dehydrogenase (LDH) and malate dehydrogenase (MDH) enzyme activities in renal tisssues, and the possible preventive role of CAPE on this effect. Methods: The study was performed with 22 rats in 3 main groups: group I (n=6): 0.9% saline solution was applied to the rats intraperitoneally (i.p.); group II (n=9): 7 mg/kg single dose cisplatin was administered i.p.; and group III (n=7): 10µmol/kg from 10µmol/ml CAPE solution was administered daily 1x1 begining 2 days before cisplatin administration. At the 7th day of treatment, the rats were killed by decapitation under anesthesia, autopsied and their kidney tissues were removed. Spectrophotometric methods were used to determine the activities of above-mentioned enzymes in the kidney tissue. Results: The results of the experiment demonstrated that HK and G6PD activities were increased significantly in the cisplatin group compared with the control group (p<0.05). The most increase of HK was seen in the CAPE group. CAPE prevented the increases of G6PD activities nonsignificantly (p>0.05). LDH activity was increased significantly in the CAPE group compared with cisplatin group or the control group (p<0.05). Cisplatin did not affect solely the LDH activity (p>0.05). There was no significant difference in the LDH activity between cisplatin and control groups, and nor in the MDH activities among cisplatin, CAPE, and control groups (p>0.05). Conclusion: From these results, it can be concluded that the activities of enzymes playing role in carbohydrate metabolism like HK and G6PD may increase in the course of cisplatin-induced nephrotoxicity process.

Aim: Heart valve pathologies are rare in chronic renal failure (CRF) patients besides coronary atherosclerosis. Valve disfunctions are primarily due to ischemia, valvular calcification, A-V fistula and increased incidence of endocarditis secondary to dialysis. Methods: In both of our clinics, we performed 178 heart valve replacements between April 2001 and April 2003. 7 (3.9%) of them were CRF patients and 3 (1.6%) were in continuous hemodialysis programme. Remained 4 patients had CRF too, but they didn’t need hemodialysis because their glomerular filtration rate was over 30%. We evaluated the preoperative and postoperative follow-ups, medical therapies and control results of these 7 CRF patients, with heart valve replacements. Results: We performed aortic valve replacement in 3, mitral valve replacement in 2 and coronary bypass plus mitral valve replacement in 2 patients. In the latter 2 cases, valve pathology was valve failure with ischemic nature. 4 patients were in class III and 3 were in class IV according to NYHA functional capacity classification. There wasn’t any mortality or important postoperative complications. During follow-up, symptoms and functional capacity were improved. We used mechanical valves in all patients. Conclusion: Cardiac surgical procedure in CRF patients has an acceptable morbidity and mortality and improves symptoms and quality of life. Also the procedure increases the renal transplantation chance and survival prolongs significantly. We suggest that mechanical valves must be preferred to bioprothesis when calcium metabolism disorders are taken into account.

Aim: it is presenting the adhesive small bowel obstruction following abdominal surgery. Method: 2173 patients who had been operated on abdominal surgery in our clinic were investigated retrospectively, between november 1994-april 2000. Results: Etiologic reason in 76 (46.06%) of 2173 patients who had been operated on abdominal surgery was adhesions secondary to previous abdominal operations. Adhesiolysis were performed for 66 of them and additional abdominal surgeries with adhesiolysis were performed for 10 of them. 13.86% of rectosigmoid operations, 12.19% of colon operations, 13.94% of other intestinal operations, 2.25% of other abdominal operations and 1.5% of appendicectomies, had second operation for small bowel obstruction due to adhesions. Conclusion:The most common cause of small bowel obstructions was adhesions due to previous abdominal operations. Besides, the most common cause of postoperative adhesions was colorectal operations.

Aim: The aim of this study is to detect the distribution of urinary tract infection agents in childhood age groups and their antibiotic susceptibilities. Method: A total of 22.298 urine samples which were collected from pediatrics department and their outpatient services, were evaluated between January 1997 and April 2001. These specimens were cultured in 5% Sheep blood agar (Difco) and Eosine Methylene Blue Agar(Difco) and identification and antibiotic susceptibilities of isolated pathogen bacteria were performed by Sceptor panels (Becton Dickinson-USA). Result: From a total of 22.298 urinary specimens, in 5311 patients (22.8%) positive cultures were detected. Identified microorganisms were E. coli (41,82%), Klebsiella pneumoniae (13.18%), Staphylococcus epidermidis (13.07%), Proteus mirabilis (9,77%), Enterobacter cloacae (3,65%), Klebsiella oxytoca (3,65%), Staphylococcus aureus ( 2.29%), Enterobacter aerogenes (%1.71), Proteus vulgaris (%1), and other gram positive and gram negative microorganisms (%9.86) respectively. The results of antimicrobial tests performed on isolated bacteria, revealed susceptibility of E. coli; to ciprofloxacin 94%, gentamicin, norfloxacin and amikacin 93%, cefotaxime 89%, ceftriaxone 88%, of K. pneumonia; to ciprofloxacin %95, norfloxacin %94, amikacin %82, of P. vulgaris; to norfloxacin %100, ciprofloxacin %95, gentamicin 91%, amikacin 90%, of P. mirabilis; to ciprofloxacin 95%, norfloxacin 93%, cefotaxime 84%, amikacin 83%, of E. cloacae; to norfloxacin 97%, ciprofloxacin 96%, amikacin 90%, of E. aerogenes; to ciprofloxacin 97%, norfloxacin 96%, of S. epidermidis; to nitrofurantoin 93%, amikacin 88%, cefuroxime 85%, ticarcillin 83%, of S. aureus; to amikacin and cefuroxime 100% were found to be the most effective antibiotics against these microorganisms. Conclusion: The study is thought to be a guide for empiric treatment of urinary tract infections of children seen our region and in our cuntry.

In this study, ABO and Rh group of 18.308 subjects were examined in Blood Bank of Van State Hospital between 1997-2002 years. The distribution of A, B, O and AB groups were 45.05 %, 16.14 %, 30.65 % and 8.16 % respectively. Rh positivity was found to be 90.37 %.

Behçet’s syndrome is an episodic disorder of unknown aetiology or pathogenesis, characterized by recurrent oral and genital ulceration and panuveitis. This disease affects all organs of the body concurrently or consecutively and sometimes has a serious prognosis, depending on the system involved. Neurologic disease occurs in less than one-third of patients with Behcet's syndrome and is observed more frequently in men. Abnormalities include aseptic meningitis or encephalitis, cranial nerve palsies, and focal deficits such as paralysis or ataxia. In the present report, we describe a case of Neuro-Behçet which have acute meningial manifestations, and cerebrospinal fluid findings such as pleositosis and elevated protein level. Menengitis form of Neuro-Behçet may also lead to difficulty in differentiating from acute meningitidis.

Ruptured abdominal aortic aneurysm (r-AAA) is still keeping an important clinical situation which needs urgent diagnosis and surgical treatment with a high mortality and morbidity rates despite the novel technological development. Rarely, as in our case, it could be remain silent without any hemodynamic deterioration. This is a case presentation of successful surgical repair of 71-year-old man with a retroperitoneal ruptured 10 x 12 cm diameter infrarenal aortic aneurysm which was diagnosed twenty days ago.