Amaç: Larengofarengeal reflii (LFR) semptomlarý ile baþvuran ve LFR okluðu kanýtlanmýþ hastalarda kulak hýýrun boðaz ile ilgili þikayetlerin sýklýðýný ve bu þikayetlerin þiddetinin araþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntem: Þiþli Etfal Eðitim ve Araþtýrma Hastanesi I.Kulak Burun Boðaz Kliniðine olasý LFR semptomlarý ile baþvurmuþ ve LFR olduðu kanýtlanmýþ 36 hasta çalýþmaya dahil edildi. Hastalara þikayetlerinin varlýðýnýn, þiddetinin ve sýklýðýnýn sorgulandýðý 20 soruluk anket formu dolduruldu. Daha sonra elde edilen cevaplar deðerlendirilerek reflüye baðlý þikayetlerin sýklýðý ve bu þikayetlerin varlýðýndaki þiddet ortalamasý deðerlendirildi.
Bulgular: Çalýþmaya katýlan hastalarýn sonuçlarý deðerlendirildiðinde en sýk görülen þikayetlerin ses kýsýklýðý (%86) ve boðaz temizleme hissi (%80) olduðu belirlenmiþtir. Bunun yaný sýra þikayet varlýðýnda þiddet ortalamasýnýn (0-4) boðazda sertlik hissi (3,57) ve tat almada azalmada (3) en yüksek olduðu saptanmýþtýr.
Sonuç: Çalýþmamýzda da tespit ettiðimiz gibi, LFR mide þikayetleri olmaksýzýn kendini farklý semptomlarla gösterebilmektedir. Bu nedenle LFR’/i hastalarýn tipik reflü þikayetlerinin yanýþýný farklý larengofarengeal sistem þikayetleriyle de baþvurabilecekleri akýlda tutulmalý ve LFR tanýsýnda dikkatli bir sorgulama ve deðerlendirme yapýlmalýdýr.

Objective: The aim of this study was to investigate the severity and frequency of complaints related to the ear, nose and throat in patients proven to have LPR or patients presenting with symtomps related to LPR.
Study Design: Patients who applied to the ear, nose and throat clinic of Þiþli Etfal Hospital with symptomps of LPR and 36 patients proven to have LPR were included in the study. A questionnare of 20 questions regardy the presence, severity and frequency of symptomps were asked to be completed by patients later answers were processed to ases the frequency or patients symptoms due to reflux and the mean severity valve when these symptoms were present.
Results: According to our study the most frequent symptomps patients in our study complained about were “hoarseness” (%86) and the urge to continously clear the throat (%80) when mean severity of symtomps was assessed; on a scale of 0-4. The most severe complaints were a lump in the throat (3.57) and loss of taste sensation (3.00).
Conclusion: As depicted in our study smptomps of LPR may be completely independent of complaints regerding the stomach. This indicates that patients with LPR may present with a wide range of symptoms implying that when such symptoms are present LPR should come to mind and a concise examination should be performed for the diagnosis of LPR.

Giriþ: Sporcularda veya düzenli olarak spor yapan kiþilerde, yapýlan spora baðlý olarak farklý dermatolojik problemler ortaya çýkabilmektedir. Spor aktiviteleri sýrasýnda kiþi ýsý, radyasyon, allerjenler gibi çeþitli çevresel /aktörlere maruz kalabilmektedir ve bunlar da bazý deri hastalýklarýnýn oluþumun¬da anahtar rolünü üstlenmektedir.
Amaç: Bu çalýþmada, farklý spor aktivitelerini düzenli olarak yapan bireylerdeki dermatolojik problemlerin sýklýðýný araþtýrmak amaçlanmýþtýr.
Gereç ve Yöntem: Ekim 2003‘leýý Mayýs 201)4’e kadar çalýþýna sürdürüldü. Düzenli olarak spor yapan profesyonel 502 sporcu çalýþmaya alýndý. Sporcularýn önce anket formu dolduruldu ve dermatolojik muayeneleri yapýldý. Saptanan dermatolojik bulgular anket formuna kaydedildi.
Bulgular: Çalýþmaya, 214’ii bayan 2.SS’i erkek olmak üzere 502 sporcu alýndý. Çalýþmamýzda özellikle kallus gibi bazý dermatozlann yapýlarý sportif aktiviteye baðlý olarak oluþan riskinin arttýðý ve akne vulgaris gibi bazý dermatozlann görülme sýklýðýnýn da toplumsal sýklýða uygun olduðu saptandý. Ayrýca çalýþmamýzda, dermatolojik problemlerin sýklýðýnýn sportif aktivitelerin süresi ile arttýðý görüldü.

Sonuç: Spor ile iliþkili dermatozlann erken tanýsý, sporcunun çabuk ve uygun bir þekilde tedavisine olanak tanýr. Bunun için düzenli spor hayatý olan kiþilere, periyodik olarak saðlýk kontrolleri yapýlmalýdýr. Oluþabilecek dermatolojik hastalýklarýn önlenmesi için sporcularýn bu konuda eðitilmesi, hem yaþam kalitelerini yükseltecek hem de spor hayatlarýnda daha etkili bir performans sergilemelerini saðlayacaktýr.

Objective: Different dermatological problems can be seen in the people who arc regularly playing sports. The objective of this study was to investigate the frequency of dermatological problems in professional sportsmen.
Study Design: This study was carried out during the period between October 2003 and May 2004. Five hundred and two professional sportsmen who have completed questionnaire were examined and positive findings were reported.
Results: A total of 502 subjects (214 female and 2
Conclusions: Early diagnoses for the sports-related dermatoses allow quick and appropriate treatment of sportsmen. For this reason, health check-up programmes have to be used for these individuals periodically. For the prevention of these dermatoses, educating the sportmen about the dermatological problems will rise the quality of the sportsmen’s lives and help them to perform better performance in their professional lives.

Amaç: 18 yaþ üstü erkeklerde genital dermatoz sýklýðý ve daðýlýmýný tespit etmekti.
Materyal ve Metod: Dermatoloji polikliniðine muayene için yelen 514 erkek hastanýn genital bölge muayeneleri yapýldý. Mevcut dermatozlar primer ve sekonder genital dermatoz olarak sýnýflandýrýldý.
Bulgular: Toplam 171 hastada (%33.26) ISO genital dermatoz saptandý. Bunlarýn %72,77 si primer, % 27,22‘si sekonder genital dermatoz idi. ¡71 hastanýn 93’ii genital þikayet nedeniyle, 78’i genital dýþý þikayet nedeniyle baþvurdu. Genital þikayet ile baþvuran 93 hastada 100 genital dermatoz saptandý. Bunlarýn %57’si primer %43’ii sekonder idi. Genital dermatoz þikayeti ile baþvurmayan hastalarda sýrasýyla en sýk beni gn lezyon, sekonder genital dermatoz, enfeksiyon görülürken, genital dermatoz þikayeti ile baþvuranlarda en sýk sekonder genital dermatoz, enfeksiyon ve ekzema grubu hastalýk görüldü. Lezyonlarýn yerleþim yerine bakýldýðýnda 171 hastanýn %53,21’inde penil tutulum varken, %22,8’inde skrotal tutulum, %23,97’inde ise penil ve skrotal tutulum vardý.
Sonuç: Genital bölgeyi tutan dermatozlar oldukça sýk görülür. Bunlar içinde benign lezyonlar en büyük grubu oluþturur.

Objective: To determine the incidence and the distribution of dermatoses of male genitalia in men above 18 years old. Study design: The genital regions of 514 men attending dermatology outpatient clinic were examined. The dermatoses were classified as primary and secondary.
Results: 180 dermatoses of the genitalia were found in 171 patients (33.26%). 72,77% of these was primary, 27,22 % was secondary. 93 of 171 patients presented because of the complaint of dermatoses of the genitalia, 78 of those presented because of the other dermatological complaint. 100 dermatoses of the genitalia were found in 93 patients. 57% of these was primary, 43% was secondary. While benign lesions, secondary dermatoses, infections were the most seen in patients with complaint of dermatoses of the genitalia, secondary dermatoses, infections and eczema were the most seen in patients with complaint ofthe other dermatological problems. 53,21% of the patients were involved the penis, 22,8% of them were involved the scrotum, 23,97% of them were involved both the penis and the scrotum.
Conclusions: The dermatoses of male genitalia are rather seen. Most of them constitues benign lesions.

Amaç: Hastane çalýþanlarýnda muskuloskeletal aðrý (MSA) yakýnmalarý, rapor alma, doktor baþvurusu, iþ memnuniyetinin saptanmasý
Gereç ve Yöntem: Hastanemiz çalýþanlarýna anket yoluyla ulaþýlarak MS A yakýnmalarý, rapor alma süresi, doktor baþvurusu sorgulandý. Ýþ memnuniyeti için "Ýþ Stres Anketi" (ÝSA) kullanýldý.
Bulgular: Anket 214 kiþiye (100 doktor, 42 hemþire, 32 yardýmcý personel, 22 teknisyen, IS sekreter/memur) ulaþtýrýldý. Çalýþanlarýn %68’i kadýn (n-147), %32‘si erkekti (n=67). Yaþ ortalamasý 31,6±7,2 (20-51), çalýþma süresi S,3±7,7 yýldý. Çalýþanlarýn %67,3‘ü iþinden memnundu, %18’i memnun deðildi, % 14’ ünün fikri/cevabý yoktu. Aðrýlý çalýþan 173 (%SI), aðrýsýz 41 (%I9) kiþiydi. Aðrýlý bölgeler sýrasýyla; sýrt (%26,4), bel (%24,1), boyun (%2J,6), omuz (%I4,S), el-elbileði (%8,8), dirsek (%4,3) idi. Aðrýlý çalýþanlarýn %42,2’si (n=73) doktora baþvurmuþtu, toplam baþvuru sayýsý ise 91 idi. Alýnan tanýlar: %I4 lornber disk hernisi, %ll servikal disk hernisi., %l1,3 fibromyalji, %11,3 nýyalji, %9,7 tendinit, %6,5 karpal tiinel sendromu, %6,5 mekanik bel aðrýsý idi. 91 doktor baþvurusunun 2 E inde (%23) rapor alýnmýþtý ve rapor süresi 3,5±IS,9 gündü. ISA’ya göre %85’i iþlerinin yüksek beceri istediðini, %69‘ýý iþlerinde baðýmsýz karar verebildiðini, %51’i psikolojik, %69‘u fiziksel zorlanmalara maruz kaldýðýný, %50‘si sosyal destek alabildiðini belirtti.
Sonuç: Hastanemizde yaþ ortalamasý 32 olan 214 kiþi ile yapýlan anket çalýþmasýnda %8! MSA yakýnmasý saptandý. En aðrýlý bölgeler sýrt, bel, boyun ve omuzdu. Aðrýlý çalýþanlarýn %42‘si doktor baþvurusu yapmýþtý ve en çok FTR kliniðine baþvurulmuþtu. Doktor baþvurularýnýn %21’inde rapor alýnmýþtý ve þiire ortalama 3,5 gündü. Yaklaþýk %50 çalýþan psikolojik ve fiziksel zorlanma hissetmesine karþýn %67’si iþinden memnundu.

Objective: To investigate the frequency of musculoskeletal pain (MSA), sick reports, medical visits, and job satisfaction among hospital workers.
Material and Method: MSA complaints, duration of sick leaves, and the number of referrals to a physician among healthcare personnel of our hospital were interrogated using questionnaires. For job satisfaction “Work Stress Questionnaires" (WSQ) were used.
Results: The forms of questionnaires were distributed to 214 individuals (100 physicians, 42 nurses, 32 auxiliary personnel, 22 technicians, 18 secretaries/officials). Sixty eight percent (n=147) of them were female, while 32% (n=67) were male personnel. Mean age was 31,6±7,2 years (20-51 years), and mean duration of the study was 8,3±7,7 years. Eighteen percent of the healthcare workers were not satisfied with their work, while 67,3% of them expressed their satisfaction. Hundred and seventy three (42,2%) personnel worked while experiencing pain, however 41 (19%) of the workers were painless. Painful regions in order of decreasing frequency were back (26.4%), low back (24,1%), neck (21,6%), hand-wrist (8,8%), and elbow (4,3%). Seventy three personnel (42,2%) referred to a physician, and totally 91 visits to physicians were realized. The established diagnoses were lumbar disk hernia, cervical disk hernia, fibromyalgia, myalgia, tendinitis, carpal tunnel syndrome, and mechanical low back pain. In 21 (23%) of 91 physician referrals, sick reports were taken with mean duration of sick leave being 3,5 ±18,9 days. According to WSQ, some workers (84%) stated that their tasks required higher levels of skill, 69,2% of them mentioned that they decided by themselves about the job, while exposure, to psychological (51%) and physical (69%) stresses were also reported. Half of the personnel (50%) specified that they had received social support.
Conclusion: In a survey performed in our hospital on 214 healthcare personnel with mean age of 32 years, 81% of the workers complained of MSA. The most painful regions were back, low back, neck, and shoulders. Forty two percent of the personnel suffered from pain referred to a physician. Twenty percent of physician referrals resulted in sick leaves with a mean duration of 3,5 days. Nearly 50 percent of workers felt psychological strains. 69 percent of workers felt physical strains, while 67% of them were satisfied with their work.

Amaç: Noduler guatr tanýsý ile öpere ettiðimiz hastalardaki papiller mikrokarsinom insidansým ve tedavi seçimlerini deðerlendirmeyi amaçladýk.
Gereç ve Yöntem: Kliniðimizde 2002-2004 tarihleri arasýnda klinik olarak noduler guatr tanýsý ile araþtýrýlýp, operasyon uygulanan 215 hastanýn verileri retrospektif olarak deðerlen¬dirildi.
Bulgular: 215 olguda toplam 15 tiroit papiller mikrokanseri saptanmýþ olup, insidans % 6.98’di. Tümörlü hastalarýn yaþ ortalamasý 46.5 olup, 13’ü (% 86.7) kadýndý. Tümör çapý ortalama 0.41 (0.1-1) cm’di. % 13.3 kapsüler invazyon ve ekstratiroidal yayýlým, % 6.6 multisentrite, %6.6 servikal lenf bezi metastazý saptandý. 1 lobektomi, 6 total tiroidektomi, 1 totale yakýn tiroidektomi uygulandý. 7 olguda ise total lobektomi+ subtotal lobektomi uygulandý. Bunlardan 3‘imde risk faktörü olduðu için tamamlayýcý tiroidektomi uygulandý. Ortalama 22,6 aylýk takipte nüks ve mortalite saptanmadý.
Sonuçlar: Tiroit papiller mikrokarsinomlannm iyi seyirlerinden dolayý, insidental saptanan subtotal tiroidektomili olgularda risk faktörleri yok ise ek tedaviye gerek olmadan olgularýn takip edilebileceði kanýsýndayýz. Subtotal tiroidektomili olgularda iýýsidental saptanan ve tümör ile ilgili risk faktörü olan olgularda onkolojik ve güvenli takip açýsýndan tiroidektominin totale tamamlanmasý gerektiði kanýsýndayýz.

Objective: To evaluate the papillay microcarcinoma incidence and the treatment options in the patients that we operated for nodular goiter.

Study design: The datas for 215 patients who has been examined with the diagnosis of nodular goiter and has been operated in our clinic in the period of 2002-2004 were rewiewed retrospectively
Results: In the 215 patients a total of 15 papillary thyroid micro- carcinoma was detected and the incidence was %6.98. The mean age of the patients who has a tumor was 46.5 and 13 of them were women (%86.7). The mean diameter of the tumors was 0.41cm (0.1 -lcm). Extrathyroidal and capsular invasion was observed in the %13.3 of the patients. %6.6 of the tumors were multifocal and in %6.6 of them cervical lenf node metastase was found. The surgical procedures that were administered to these patients were I lobectomy, 6 total thyroidectomy,I near total thyroidectomy and in 7 cases total lobectomy plus subtotal lobectomy was made. In 3 of these patients completion thyroidectomy was necessary because of risk factors. In the mean fallow up of 22,6 months recurrence or mortality was not encountered.
br> Conclusions: Since the papillary thyroid microcarcinomas have a good prognose in the incidental cases which were found in subtotal thyroidectomy patients we recommend fallow up without additional treatment.In the cases who has risk factors related to the tumor our opinion is to perform a total thyroidectomy in order to achieve a safe oncological fallow up.

Ülkemizde akraba evliliklerinin oranýnýn yüksek olmasý kalýtýmsal hastalýklarýn sýk görülmesine neden olmaktadýr. Bu hastalýklardan biri olan homosistinüri de karþýmýza çeþiti þekillerde gelebilmektedir. Yazýmýzda aðýr bir anemi ile baþvuran ve homosistinüri tanýsý, koyduðumuz bir olguyu sunarak sýk karþýlaþtýðýmýz bir þikayet olarak aneminin ayýrýcý tanýsýnda homosistinüriye dikkat çekmeyi amaçladýk.

Cases with inborn errors of metabolism have been encountered frequently in our country because of high rate of consanguinity in marriages. an example, homocyctinuria may manifest in various clinical forms. In this report, we emphasize on homocyctinuria as a cause of anemia which is a frequently encountered finding, presenting a case that was presented with, severe anemia and then diagnosed as homocyctinuria.

Sürrenal gland, primer akciðer kanseri metastazlarýnýn sýklýkla görüldüðü organlardan biridir. Sürrenal metastazlarýnýn çoðu tek taraflý olmakla birlikte tüm akciðer kanserli hastalarýn % 10’ unda bilateral sümrcnal metastazý görülebilir ve bunlarýn % 2-3’iine küçük hücreli dýþý akciðer kanseri taný¬sýyla ayný anda taný konulabilir. Sekonder tümörler sürrenal glandýn yapýsýný ve fonksiyonunu bozabilir ve hasta için hayatý tehdit edici bir durum olan sürrenal hemorajiye yol açabilir. 54 yaþýnda sýrt aðrýsý ve öksürük þikayetleri ile baþvuran erkek hastanýn yapýlan ilk tetkikleri sonucu belirgin anemi, sol akciðer hiler bölgede spiküle konturlu kitlesel lezyon ve her iki sürrenal glandda büyiik ve heterojen yapýda muhtemelen hemorajik ve nekrotik alanlar içeren kitleler saptandý. Yapýlan hiopsi sonucu akciðerdeki kitlenin primer adenokarsinoma olduðu anlaþýldý.Hasta kemoterapiye baþlandýktan bir hafta sonra sürrenal yetmezliðe baðlý olarak kaybedildi. Intratümöral hemoraji sürrenal metastazlarýn nadir fakat hayatý tehdit eden bir komplikasyonu olup taný konulmasýnýn hemen akabinde tedaviye baþlanýlmasýný gerektirir. Sürrenalektominin mümkün olmadýðý durumlarda metastatik hastalýk durumunda olduðu gibi kombine kemoterapi uygulanýlmalýdýr. Uygun kemoterapötik tedavi rejiminin seçilebilmesi için doðru tanýnýn elde edilmiþ olmasý önemlidir.

The adrenal gland is one of the common sites of metastasis from primary lung cancer. Adrenal metastases are usually unilateral, however bilateral adrenal metastases are seen in 10% of all lung cancer patients; of these 2-3% occurs at the initial presentation of non-small cell lung cancer. Secondary tumors can disrupt the structure and function of the adrenal. This can lead to adrenal hemorrhage, which constitutes a life threatening hazard for the patient. A 54 year-old male presented with back pain and cough. His initial work-up revealed significant anemia, a speculated mass in the hiler region of the left lung and large masses of heterogeneous texture which presumably composed of hemorrhagic and necrotic elements in both adrenal glands. A biopsy confirmed the malign nature of the mass in the lung to be an adenocarcinoma of the lungs. The patient died suddenly one week after the administration of chemotherapy, due to adrenal failure. Intratumoral hemorrhage is a rare but life threatening complication of adrenal metastases and should be treated as soon as it has been diagnosed. If adrenalectomy is not feasible, combination chemotherapy should be applied as in metastatic disease. In order to choose the appropriate chemotherapeutic regimen it is important to accurately establish the diagnosis.

Amaç: Preoperatif primer över karsinomu tanýsý almýþ, postoperatif patolojik incelemede tanýnýn verifiye edilmesine raðmen cerrahi ekplorasyonýýmuza dayanarak patolojik ileri tetkik talebimizin neticesinde meme karsinomu metastazý saptadýðýmýz olgunun irdelenmesini amaçladýk.
Olgu: Kýrkbir yaþýnda virgo lýasta karýnda þiþlik þikayeti ile interne edildi. Yapýlan incelemeler sonucunda hilateral, tüm batýný dolduran, sol id komponcntli kistik kitle saptandý. Primer över karsinomu ön tanýsý ile hasta öpere edildi. Eksplorasyonumuzda vakanýn primer deðil metastatik över karsinomu olabileceðini düþündük. Patoloji kliniðinden ileri tetkik talep ettik. Bunun sonucunda vakanýn meme karsinomunun övere metastazý olduðunu tespit ettik.
Sonuç: Metastatik över karsinomu primer forma göre daha nadir görülmesine ve patolojik ön tanýnýn primer över karsinomu olmasýna raðmen patolojik ileri tetkik ýsrarýmýz sonucunda vakarýný metastatik över karsinomu tanýsýný almasýnda cerrahi eksplorasyonýýn ve klinik deneyimin ne denli önemli olduðunu bir kez daha vurgulamýþ olduk.

Background: Our aim in this case was a patient who was preoperatively diagnosed as primary ovarian carcinoma although the diagnosis of the patient was verified postoperatively, depending on our surgical exploration, our demand for further pathological research showed that it was indeed metastatic breast carcinoma.
Case: Patient, virgin and 41 years of age was interned with the complaint of abdominal distention. After the observations, bilateral cystic mass with solid components, localised in the whole abdominal cavity was found. Patient was operated with the diagnosis of primary ovarian carcinoma: During the exploration we thought that the case wasn’t primary, but could be considered as metastatic. We ordered superior research from the pathology department. As a result of all examinations, it was found out that the case was the metastasis of breast carcinoma to the ovary.
Conclusion: Although the metastatic ovarian carcinoma is rarely seen than the primary ovarian carcinoma, our request for further pathological research, has yielded once more the importance of surgical exploration and clinical experience while diagnosing the case as metastatic ovarian carcinoma.