Objective: Among the people living in the different geographical regions, there are discrepancies in the frequency of the “malignant tumor”. Several factors such as the environmental conditions, industrialization degree of the country, socio-economical level of the population, nutritional habits and heredity are the effective factors for this discrepancy. In this paper, we tried to introduce the distribution frequency of the malignant tumors according to sex and organs, by collecting data of phenomenon diagnosed as “malignant tumor” during the period of two years inside the population living around “Van” province. Material and methods: We have determined that 1887 cases (847 of them are female and 1040 are male) have been diagnosed as “malignant tumor” during the period from 2006 to 2007. Results: When we viewed the sum of the cases, we observed that male people constituted a majority in number compared to female. In two years, we determined that esophagus cancer (firstly), stomach cancer (secondly), and lung cancer (thirdly) had been seen mostly among the males. Inside female phenomenon, this disease frequency was observed as esophagus cancer, breast cancer and stomach cancer. Conclusion: It’s so clear that second cause of the mortal illnesses is cancer. Similarly, certain cancer descriptions arise mostly in certain regions. The determination of the regional risk factors could serve as a basis for the new methods to guard against the cancer. Therefore, comprehensive and planned researches are vital to determine appropriately the data of the regional cancer.

Aim: Arteriovenous (AV) fistulas with long patency and low complication rates are required for hemodialysis of chronic renal insufficiency patients. In this study AV fistula localizations and their effects to the complications, requiring surgical revision in long and short terms were analyzed. Materials and Methods: From 2003 to 2009, 1043 patients underwent AV fistula operation in our Hospital and 333 patients of this series with various complications were included into this study. Patients with AV fistula operation performed to the proximal segment was classified as Group I and operation performed to the distal segment was classified as Group II. The effects of fistula localization on the complication rates and features were evaluated. Results: Group I consisted of 169 patients. Surgical revision was performed for thrombosis (n:20), bleeding (n:10) and hematoma (n:3). Group II consisted of 874 patients. In group II short term complications were hematoma (n:7), thrombosis (n:105) and bleeding (n:50). Long term complications were aneurysm (n:7), stenosis-thrombosis (n:4), overflow (n:9), peripheric arterial ischemia (n:11) infection related bleeding (n:6) in Group I and aneurysm (n:38), stenosis-thrombosis (n:53), overflow (n:3), pheripheric arterial ischemia (n:3), infection related bleeding (n:4) in Group II. The patients with these complications underwent re-operation. Conclusion: Creating strategies for increasing AV fistula patency would increase the time for hemodialysis with vascular access. Short term complications frequently occured at the distal fistulas however long term complications occured at the proximal fistulas. Although short term ccomplications would be frequent at distal fistulas, the low rate of long term complications make it first choice for AV fistula creating operations.

Objective: Type 2 diabetes mellitus is a pandemic chronic disease with a heavy burden of complications. Undiagnosed diabetes is not a benign event. In this study, we aimed to investigate the presence of microvascular complications at diagnosis as retinopathy, nephropathy and neuropathy in newly diagnosed 50 type 2 diabetes mellitus patients. Material and methods: Diabetic retinopathy was detected with a biomicroscope examination of fundus by opthalmologist. The neuropathy was scanned with electromyography (EMG) by an experienced neurologist. Diabetic nephropathy was searched by measuring urinary microalbumin and glomerular filtration rate (GFR). Pearson’s correlation analysis and unpaired t-test were used for statistical analysis Results: Microalbumin, urid ranging between 30-300mg/day, was detected in 10 (20%) patients and 23 (46%) patients had abnormal EMG signs. Diabetic retinopathy was detected in only 1 (2%) patient. Of the total patients with neuropathy, sensorial type neuropathy was detected in 3 (6%) patients, motor type neuropathy in 1 (2%) patient, mixed type neuropathy in 6 (12%) patients and carpal tunnel syndrome in 13 (26%) patients. Conclusion: One of the microvascular complications was detected in 58% of newly diagnosed type 2 diabetes mellitus patients. It seems necessary for the newly diagnozed type 2 diabetics to be screened for microvascular complications especially for neuropathy and nepropathy to make timely interventions to prevent further progression.

Aim: To discuss brucellar epididymo-orchitis cases in our clinic in terms of clinical and laboratory findings, treatment, and prognosis. Materials and methods: Our diagnostic criteria for the patients having epididymo-orchitis clinical findings are Standard Tube Agglutination (STA) or STA with Coombs test ≥1/160 titer or increase of STA titers four times and more in their serum samples in two weeks. Results: Ten of our cases (66%) had herb cheese eating history and five of them (33%) were dealing with animal husbandry. The most frequently observed symptom in our cases was testicular pain, and the most frequent clinical and laboratory finding was scrotal swelling and the alteration of the C-reactive protein (CRP). The diagnosis was made with STA test in 14 cases (93%), STA with Coombs test in one case (7%). Epididymo-orchitis was diagnosed on the right side in nine cases, on the left in five cases and bilateral in one case on physical examination. The patients were treated with rifampicin+doxycycline. Orchiectomy was done in one case who applied late to our clinic. Conclusion: Brucellar epididymo-orchitis should be thought first in patients applied with orchitis in brucellosis endemic regions, and should not be ignored in nonendemic regions also. It was shown that with early and appropriate medical treatment cases could be cured without surgery.

Purpose: Brucellosis, caused by Brucella spp, is a zoonotic disease that can effect many parts of the body, especially the musculoskeletal system. In this retrospective study, we evaluated the brucella epididymoorchitis cases. Patients and methods: Records of 152 patients who were accepted to our hospital with a diagnosis of epididymitis or epididymoorrchitis were examined. The patients with clinical symptoms (fever, weakness, articular pain, etc), brucella agglutination test ≥ 1/160 and/or positive blood culture for Brucella spp were accepted as brucella epididymoorchitis. Results: Brucella epididymoorchitis were detected in 8.6% (n=13) of the patients with epididymoorchitis. Scrotal pain and swelling were the most common findings in all of the cases. Brucella melitensis was obtained in blood culture of four patients. All of the patients were treated with doxycycline (200 mg/day) and rifampicin (600mg/day) as combined antibiotherapy for 6-8 weeeks. No relaps was seen in any of the patients during follow up. Conclusion: In brucellosis-endemic areas, clinicians encountering epididymoorchitis should consider the likelihood of brucellosis. A detailed history, a meticulous physical examination and rapid laboratory evaluation are helpful for diagnosis. Conservative combined antibiotherapy is adequate for management of brucella epididymoorchitis.

Aim: In this study 42 infants with diarrhea who were diagnosed with malnutrition, pneumonia and rickets, underwent routine clinical and laboratory examinations, and immune standards were researched retrospectively. Materials and Methods: Blood, urine and stool analized with bacteriologic and serologic examinations performed for clarified etiological structure of diarrhea. Results of nonspesific lysosime, fagocyte activity, fagocyte index and also level of Ig A,M,G examinations were evaluated for the status of humoral immunity in patients. Results: Laboratory data from stool culture examples showed grow up of multiple bacterial types which demonstrated development of generalized disbacteriosis resulting from inappropriate antibacterial treatment. Immunological investigations confirmed the deficiency of special and nonspecial immune factors. Conclusion: In the treatment of infants with diarrhea and unsatisfactory premorbid status, special feeding, numerous different supporting drugs including probiotic and prebiotic preparations, and excluding inappropriate antibacterial prescription are mandatory.

During antegrade intramedullary nailing operations in femoral fractures, acute complications could develop as follows; femoral neck fracture, trochanter major fracture, extra complications related with present fracture such as fat embolism syndrome and peripheral nerve injuries. Here we present a patient who developed iatrogenic patella fracture on the ipsilateral patella during antegrade intramedullar nailing operation because of right femoral shaft fracture. The patient complained of right knee pain after the surgical procedure and we examined the X- ray and CT scans and established fracture on the right patella. In the accessible literature we found no data about patella fracture during antegrade nailing of the femur. Therefore we aimed to present and discuss this case with a review the literature.

Intracranial lipomas are uncommon benign mesenchymal tumors, found usually near or at the midline. Although usually asymptomatic, they can sometimes present with epileptic seizures, as well as neurological or psychiatric symptoms. We describe the incidental finding of a lipoma of the corpus callosum at autopsy in a 28 year-old woman with a history of seizures and psychiatric disorder. The most frequent reasons for admission of patients with intracranial lipomas were: headache, epileptic seizures or psychiatric symptoms. CT and MR examination usually lead to the diagnosis.

Acute pericardial tamponade is a potentially life-threatening condition that requires immediate treatment. A 27-year-old woman on warfarin treatment due to deep venous thrombosis applied to emergency room of our hospital with sudden onset of chest and abdomen pain. On chest computed tomography (CT), diffuse hemorrhagic pericardial fluid was observed causing cardiac tamponade. The pericardial fluid was drained with pericardiosynthesis under transthoracic echocardiography. The patient died in intensive care unit two days later. We present a case of fatal cardiac tamponade resulting from warfarin use for deep venous thrombosis, with CT findings.

Secondary malignancies due to chemotheraphy agents used in the treatment of aplastic anemia has been reported at a rate of 1-4%. These secondary malignancies are often related to lymphomas and head and neck squamous cell carcinomas. Such cases mostly develop as a late complication of these treatment modalities. Herein we report a case of aplastic anemia with esophageal cancer which was developed during immunsupressive theraphy. The present case was a 75-year-old female diagnosed with aplastic anemia. Chemotherapy comprising methylprednisolone and cyclosporine was initiated at the time of diagnosis. At the ninth month of therapy; the patient was readmitted with difficulty in swallowing and esophageal squamous cell cancer was diagnosed. This case demonstrates that; esophageal squamous cell cancers may develop in patients with aplastic anemia even at the early course of the immunsupressive treatment.

Cadmium is a potential candidate for a neurotoxin in motor neuron disease. In this study, we present three cases manifesting motor neuron findings associated with cadmium intoxication. Patients with a history of working in such industrial sectors as lead plaque coverage refered to our clinic with various complaints after the beginning period of their employment. The complaints of these patients were weakness in limbs, nausea, weight loss and involuntary tissue pulsations. In electromyographic examination of all patients axonal degeneration findings together with spontaneous denervations attracted our attention. The fact that these three cases worked in the same place and the higher level of plasma cadmium especially in the first case after investigation, metal intoxication brought to our mind that neurologic findings were associated with cadmium toxicity.

When progression comes out after the treatment including transtuzumab in HER2 positive breast cancer, still keeping transtuzumab for the second-line treatment may be thought. However, when the posibility of transtuzumab resistance is considered and results of the prospective studies are assessed, the availability of lapatinib should be kept in mind.