Aim: In this study, the aim was to investigate whether fluoroquinolone antibiotics have any effects on central nervous system (CNS) and if so how possible interactions may develop when these drugs are administered together with some of the pharmacological agents with known effects on CNS (teophylline and etomidate). Method: A hundred and sixty mice were used in the study. The neuropharmacological tests performed were based on thirty-one criteria and the results were evaluated accordingly. Results: Ciprofloxacin significantly augmented the effects of teophylline (p<0.05) on auricular, corneal and ipsilateral flexor reflexes, vigilance, visual perception, restlessness, irritability, distress, environmental reactivity, spontaneous activity, reaction to touch, reaction to pain, flight-reaction, leg tonus and grip strength. In addition, reaction to pain was found to be significantly lower in ciprofloxacin group compared to control animals. Ofloxacin, on the other hand, increased some of the effects of teophylline including those on leg tonus, grip strength, auricular, corneal and ipsilateral flexor reflexes (p<0.05) while causing a decrease in the reaction to pain compared to controls (p<0.05). As far as the reaction to touch is concerned, animals that received pefloxacin exhibited a subtler response than control animals (p<0.05). Pefloxacin, however, significantly augmented the effects of teophylline on reactions to touch and pain, leg tonus, grip strength and ipsilateral flexor reflex (p<0.05). Finally, while norfloxacin increased the effects of teophylline on irritability, reaction to touch, flight reaction, grip strength and ipsilateral flexor reflex, it decreased this drug’s effects on restlessness, environmental reactivity and leg tonus. Conclusion: Although no significant findings have been obtained regarding the interactions between these drugs and etomidate, fluoroquinolones were found to interact with teophylline at varying degrees according to the types of these antibiotics.

Aim: Upper gastrointestinal cancers are important causes of morbidity and mortality all over the world and in Turkey. In this study we evaluated the prevalence, anatomic, histopathologic characteristics of upper gastrointestinal Ca in Eastern Turkey and in Van. Method: We investigated retrospectively 4763 persons from December 1994 to January 2000 in our endoscopy unit. Five hundred eight (10.6%) patients with gastrointestinal Ca were diagnosed with endoscopic, radiological and histopathological methods . Results:Of the 4763 patients, 207(4.3%) were esophageal cancer, 301(6.3%) were gastric Ca. The highest prevalences of both cancer groups were between the ages of 50 and 70 . Gastric Ca was 1.5 fold frequent than esophageal Ca. Esophageal epidermoid Ca was more frequent in women, whereas gastric and esophageal adenocancers were more frequent in men. In lake Van and its vicinity, endoscopic examinations revealed a significantly high prevalence of upper gastrointestinal cancer, when compared with the reports of western cities of Turkey. Conclusion: We have concluded that there is an urgent need to conduct studies in a large scale in order to determine the epidemiological factors and incidence of upper GİS for they have a widespread occurence in our region.

Aim: In this study, we investigated the results and efficacy of the ultrasound-guided cutting needle biopsies in children with renal parenchymal diseases. Method: This study included 37 children (23 boy, 14 girl) aged between 3-15 years old (mean 10.7?1.2) with renal parenchymal diseases. After sedation, local disenfection and local anesthesia, ultrasound-guided cutting needle biopsy was performed in the lower pole parenchyma of the right kidney. Renal and perirenal area was examined with color Doppler ultrasonography for the postbiopsy complications. Obtained tissue sample was evaluated histopathologically. An average of 2 punctures were performed. All patients were diagnosed histopathologically except one whose biopsy material was insufficient because of insufficient material. Results: Microscopic hematuria was seen in all patients and macroscopic hematuria in 8 patients (21.62 %). There was no serious complication in any patients. Conclusion: We suggest that cutting needle biopsy in the renal parenchymal diseases should be done under ultrasound guidance, because it is safe, inexpensive, highly diagnostic and rarely may be associated with a serious complication.

Aim: In this study, it was assessed the knowledge and attitude of mothers on nutritional requirements and feeding practise of infants at urban area in Van. Method: Two hundred mothers who had babies aged between 12-24 months, were interviewed. Results: All families’ economic levels were very low, 51% of the mothers have never been gone to school. 70% of the infants were under the 25 percentages. 66% of the mothers had given breast milk to their babies during in first six month of their life. The main two reasons for terminating breast feeding were new pregnancy and insufficiency of breast milk. The most common supplementary food were cow’s milk, rice flour and fruit juice. The most common fault of the baby nutrition was early given supplementary foods (43%), early terminating breast feeding (47%), giving too many cereals, for example biscuits and bread (68%) and too many cows milk (64%). Conclusion: It was concluded that serious and radical development exhaustions is required in economic and sociacultural areas in the region for healthier and more well grown children

:Heparinization is used to prevent postphlebitic syndrome and pulmonary emboli in the patients with popliteal and iliofemoral deep venous thrombosis. But, heparinization is controversial in the patients with infrapopliteal deep venous thrombosis. The purpose of our study was to compare the outcomes of the treatments of infrapopliteal deep venous thrombosis in patients who did and did not receive heparin. Method: From 1995 through 1999, 54 limbs of 50 patients were identified, by means of duplex scanning and/or venography, as having isolated infrapopliteal deep venous thrombosis. Of these patients, 30 (60%) were women and 20 (40%) were men; the median age was 52.?5,6 years ( range, 24 to 72 years). 25 patients (group A) received anticoagulant therapy and the remaining 25 patients (group B) did not. They had follow-up from 1 to 5 years (means, 2.5 years). Results:Comparisons were made between group A and group B with respect to proximal thrombus extension, pulmonary emboli, thrombolysis, recanalization and reflux. Proximal thrombus extension occurred in 2 of group B patients (8%) within 10 days of diagnosis. All patients had symptoms except 2 of group A patients. These 2 patients who were previously diagnosed to have pulmonary emboli had no symptoms of deep vein thrombosis in their extremities. Asymptomatic infrapopliteal deep vein thrombosis was diagnosed as a result of search for a source of pulmonary emboli. The most common sites for infrapopliteal deep vein thrombosis were peroneal vein and posterior tibial vein, respectively. Complete thrombolysis of infrapopliteal thrombi was found in % 96 of the cases by 3 months. Valvular reflux was developed in 4 of 50 cases (8%). At the end of the follow-up period, only 1 patient had hyperpigmentation, swelling and varicose veins. No ulcers occurred. There were no differences between group A and group B with respect to postphlebitic sequelae and reflux. 2 patients of group B had proximal thrombus extension within 10 days. These 2 patients had previous deep vein thrombosis attacks. Conclusion:We conclude that if a treatment without anticoagulation is preferred, duplex scanning and close follow-up should be carried out for at least 10 days of the initial diagnosis.

Pheochromocytoma, although rare, is associated with high degree of morbidity and mortality if not recognized. 10% of tumors are malign, and diagnosis should be confirmed with the measurement of vanilylmandelic acid and total metanephrine in urine. Computerized tomography, magnetic resonance imaging and labelled-metaiodobenzylguanidine-MIBG scanning could be used for tumor localization. Surgical resection should be recommended for primary tumor and metastasis if it is possible. In metastatic disease, radiotherapy and/or chemotehrapy may partly be usefull. In this article, we present benign and malignant pheochromocytoma cases who had distinctive clinical features and discuss the information in the light of literature.

In this case, we have discussed peripheric facial paralysis developing twice in a patient; first as a complication of chronic otitis media with cholesteatoma in the right ear and chronic otitis media without cholesteatoma in the opposite ear alternately.

The injury of recurrent laryngeal nerve is a serious complication in thyroid surgery. The anatomy of the recurrent laryngeal nerve is variable. Non-recurrent nerve is a very rare variation of the inferior laryngeal nerve. Because of the anatomical variations of the nerve, preservation of the nerve is optimal strategy during the operation. In this case report, we presented a non-recurrent laryngeal nerve abnormality, in a case who underwent thyroidectomy for benign thyroid disease, and the non-reccurrent laryngeal nerve was identified during the nerve exploration.

Impaired cellular immunity is a predisposing factor for tuberculosis in end stage renal disease (ESRD) patients. Incidence of tuberculosis was significantly higher in these patients. Three patients with tuberculosis were diagnosed in our clinic; two of them were presented with fever, productive cough, and pneumonic infiltrations on PA chest rontgenogram, the third case was presented with fever and ascites. Diagnosis was confirmed with a positive culture of bronchial lavage fluid in one case, the other two were diagnosed based on clinical and radiological grounds. In conclusion for patients with ESRD, in the presence of unexplained fever, pulmonary lesions or ascites, detailed diagnostic investigations should be done and after other differential diagnoses ruled out, antituberculous therapy should be started and clinical response should be considered as an indicator of tb.