Aims: Patients infected with both hepatitis B virus (HBV) and hepatitis B virus (HDV) tend to progress more severe liver injury than those infected with HBV alone. In Eastern Anatolia, HDV infection is one of the the major causes of chronic liver disease. This study was conducted to determine the epidemiology and clinical aspects of delta hepatitis in Van region of Eastern Turkey. Methods: This study was conducted in the years 2008 and 2009. Serological markers of HBV infection (HBsAg, HbeAg, Anti-HBS) were determined by ELISA test in patients with chronic hepatitis B. Serum HBV- DNA and HDV-RNA were determined by polymerase chain reaction (PCR) method in chronic hepatitis B patients. Thereafter, liver biopsy samples from 24 patients with delta hepatitis were studied. Results: Chronic HDV infection was more frequent in males (p<0.001). Mean age of delta hepatitis patients was 34,3±9 (16-54) years. Delta hepatitis cases had solely greater portal and parenchymal inflammatory changes. Conclusions: HDV is a novel satellite virus and may increase the degree of hepatic damage in patients with Hepatitis B. Rural clustering of male cases is a striking finding in endemic areas.

Objective: Our purpose was to determine the levels of trace elements, parathyroid hormone (PTH), total T3 (TT3), total T4 (TT4) and total iron-binding capacity (TIBC) in patients with chronic renal failure (CRF) and to investigate the influence of hemodialysis (HD) on these trace elements, hormones and TIBC. Material and Methods: The study groups included HD patients (n:15) and control group (CG) of healthy subjects (n:15). Zn, Cu, Fe and Cd, levels were measured by inductively coupled plasma emission spectrometry (ICP-AES). TT3, TT4, PTH and TIBC were measured using routine methods. Results: The values of before dialysis (BD) Cd, TIBC and PTH were higher than CG levels (respectively P<0.01, P<0.01, P<0.01). TT3 and TT4 levels were lower than that of CG levels (P<0.01, P<0.01, respectively). After dialysis (AD) Cu, Fe, Cd levels were higher (P<0.05, P<0.05, P<0.01) than CG levels, Zn and TT3 levels were lower (P<0.05, P<0.01) than CG levels respectively. AD TT4 levels were higher (P<0.01) than BD and plasma PTH levels were lower (P<0.05) than that of BD. Conclusion: It has been concluded that the determination of the levels of biochemical parameters in CRF patients may contribute in monitoring the disease.

Purpose: Cytokinins play an important role in angiogenesis. The aim of this study is to investigate serum Interleukin-6 levels in colon cancer patients and to describe the importance of this parameter. Methods: In our study, we investigated serum Interleukin-6 levels by enzyme immunassay in 89 colon cancer patients with liver metastasis and in 90 colon cancer patients without liver metastasis. Results: We found higher levels of serum Interleukin-6 in patients with liver metastasis. Conclusion: In conclusion, we suggested that the serum Interleukin-6 levels may be an important marker in colon cancer patients.

: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral infection which may be of fatal outcome, and is seen to occur from the year 2002 on in our country. In this study, we aimed to evaluate our cases diagnosed with CCHF. Materials and Methods: The cases admitted to our clinic between the years 2007-2009 and diagnosed with CCHF were retrospectively evaluated. Precise diagnosis of the cases were established by using ELISA and/or PCR tests. Finding: Nine of the twelve patients with diagnosis of CCHF were followed up in our outpatients clinic and three of them were hospitalized. Ten of the cases were male and two were female with the mean age of 21.4±10.2 years. History of tick bite was present in all cases and the mean incubation time was 4.6±1.8 days. Fatigue and weakness were present in all of the cases, where high fever and generalized body pain were present in two third, headache and nausea in one third of the cases. All of the patients healed with full recovery. Conclusions: While mortality rate of the disease is reported higher, it is 5% in our country according to the data of Ministry of Health. The basic reason of this discrepancy in mortality rates is thought to be due to efficient early supportive treatment or geographic variability of the virus. Because our opinion is parallel to this finding, more studies related to virulence of the virus from various centers have to be performed.

A 36 year old woman presented with fever and right upper quadrant pain. Physicial examination revealed positive murphy sign. Also leucocytosis and eosinophilia were detected. Abdominal computerized tomography (ct) of the liver showed geographic tracts. A duodenoscopy was performed and examination of duodenal aspirate revealed fasciola hepatica ova. Triclabendazole was given for two days. And three months after treatment, physical, laboratory and radiological examinations were all normal. Fasciola hepatica is still a very rare cause of acute cholangitis and hepatitis. Because fasciola hepatica has a special tropism for the liver; abdominal pain, hepatomegaly, and constitutional symptoms are among the most common manifestations of fascioliasis. Eosinophilia is the most frequent laboratory abnormality. The ct scan has become a useful technique in the diagnostic work-up. A definitive diagnosis may be established by the detection of parasite ova in the feces or duodenal aspirate, but most cases may be diagnosed by serologic methods. Triclabendazole and bithionol are the most effective drugs against fasciola hepatica.

Cheilothorax is the collection of lymphatic fluid in pleural space due to disintegration of lymphatic duct’s integrity. Development of lymphatic leakage in the postoperative period is encountered 1-4% after esophagus surgery. It is contraversial that the treatment of this complication would be whether conservative or surgical method chosen. All surgical interventions not always elicit definite cure and bring forth other complications. In the management of cheilothorax therapy somatotostatin; an agent used increasingly in recent years seen as an alternative method to surgery.

Kostmann syndrome; is a rare disease charactarized by pausing of myelopoesis at the promyelocyte and myelocyte stage. Absolute neutrophile count is usually under 200/mm3. Beginning from the first years of life; pneumonia, otitis media, gingivitis, perianal and urinary infections may be seen. Many years ago, this syndrome was fatal and mean survival time was 13 years. But since granulocyte colonystimulating factor has been used in the treatment of this syndrome; survival and life quality increased prominently. Our patient had absolute neutrophile count 200/mm3 and recurrent pulmonary infections in his history. He was diagnosed as Kostmann Syndrome. We reported this case to emphasize that the Kostmann Syndrome as a rare disease in children with recurrent infections and neutropenia especially before the first year of life.

Respiratory distress syndrome (RDS) is a major cause of morbidity and mortality in preterm neonates. Pulmonary surfactant deficiency is the primary cause of RDS. It affects 40-50% of the neonates born before 32 weeks of gestation and results in high morbidity and mortality. Surfactant-replacement therapy is a life-saving treatment for preterm infants with RDS. There are two forms that include synthetic surfactants and animal derived surfactant extracts. Two disorders, meconium aspiration syndrome and bronchopulmonary dysplasia (BPD), might also be amenable to surfactant-replacement therapy. After the licensing of exogenous surfactant to treat RDS in the early 1990s, and more widespread use of prenatal corticosteroids in the mid-1990s, severe BPD became an unusual event. This paper discusses the structure of surfactant, its pharmacological characteristics, pharmaceutics in our country, the use of surfactant-replacement therapy in RDS, with a review of the literature.