OBJECTIVE: In this study cardiovascular and arterial blood gas changes during laparoscopic cholescystectomy were investigated.
STUDY DESIGN: This study was based on 24 ·patients­ who underwent lapuroscopic cholecysrectomy (LC). Thiopentone, atracurium, isoflurone, N2O + O2] were used for general anesthesia. In all patients radial arter was catheterisated. Heart rate (HR), mean arterial blood pressure (MABP) and arterial blood gazes were measured in preoperative period, after indication just after jýeritýmeal insufflation of CO2 60 minutes after insufflation and at extubation. Arterial blood gazes analyses covered arterial pH PaO2, PaCO2, HCO3 and BE.
RESULTS: After insufflation, in all measurements HR, MABP PaCO2 were increased (p<0.05). and pH decreased significantly (p<0.001). HCO3 value 60 minures after insufflation was decrased, BE value was increased in negative way (p<0.05).
CONCLUSION: We conclude that the complications of LC can he avoided by a careful monitoring of cardiovascular system and arterial blood gazes.

OBJECTIVE: The aim of this study was to determine the levels of endothelin-1 (ET-1) which is indicator for disfunction of endoethelin at the normotensive patients who have essential hypertension and atherosclerosis and to compare with the levels of ET-1 in healty people.

STUDY DESIGN: The levels of plasma ET-1 is determined at the 45 patients who have a essential hypertansion and 15 patients who have normotensive atherosclerotic coronary heart disease and 15 healthy people with the met­hod of radio immunassay (RİA).

RESULTS: It is determined that when the intensity of hypertension and damage of the organ are increased at the patients who have essential hypertension, the fevels of ET-1 increased significantly too. There was a positive correlation between the levels of ET-1 and age,duration of hyper­tension, body mass index, sistolic and diastolic blood pressure, smoke, the levels of plasma glucose, total cholestem/ and negative correlation with the levels of HDL choleste­rol. The levels of plasma ET-1 was high significantly at the normotensive patients who have atherosclerotic coronary heart disease.

CONCLUSION: ET-1 wlýich is an indicator of disfunction of endothel plays an important role in the etiopatogenes of both disease and the development of complications.

OBJECTIVE: lg A nephropathy is the most common primary glomerulorýephritis, no consensus has emerged to permit a unified disease, spesific approach to treatment. In this study we evaluated the efficacy of immunosuppressive therapy in lg A nephropathy.
STUDY DESIGN: Our study was carried out in 14 patients with biopsy-proven lg A nepropatlýy (9 males and 5 females, aged between 15-62 years, mean aýe 30.5±14.1 years). Their presenting symptoms were macroscopic/microscopic hematuria aýýd proteinuria ranging between 0.5-2 gr/day. Twelve patients with normal renal function (Cer 74-120 ml/min) underwent combined therapy using prednisolone (40 mg/day) and azathioprine (100 mg/day) for four months. Two patients who displayed renal failure (Ccr<60 ml!mirý) were treated with prednisolone (40 mg/day) and cyclophosphamide (100 mg/day).
RESULTS: By four months of therapy hematuria disappeared in all patients except one. Seven of the nine patients with proteirýuria underwent total remission of proteinuria within four months. Two patients had no significant decrease in proteirýuria. Two patients with renal failure showed significant improvement in renal functiorn.
CONCLUSION: These data may suggest that immunosupressive therapy reveals encouraging results in the management of Ig A nephropatlýy.

OBJECTIVE: This study is planned to confirm the relation between Apgar scores and umbilical cord blood gases and to assignee the physiological hypoxia of' newborn infants.
STUDY DESIGN: The Apgar scores and umbilical cord blood gases of 18 healthy term newborn infants, who were born at the Obstetric and Gynecology Department at Istanbul Şişli Etfal Hospital were selected.
RESULTS: Those infants who had Apgar scores over 7 at 1 and 5 minutes, had the average umbilical cord blood pH value 7.26 (7./9-7.39), the average P02 value 23.36 ( 17.4- 31.2) mmHg, the average PC02 value 45.49 (31.8-61.2) mmHg and the average hase excess value of-6.00 (-1.00-- 14.9).
CONCLUSION: These results, which are the same as the scentific knowledge, proves us that the umbilical cord blood gases is an effective and current method, to describe the newborn physiological hypoxia

OBJECTIVE: This study is made to investigate the relationship between the impaired glucose tolerance (IGT) and atherosclerosis, to see the metabolic changes of glucose after myocardial infarction and to take into consideration the relationship between the IGT and other parameters of metabolic syndrom in patients with post myocardial infarction.
STUDY DESIGN: 2 groups of patients are selected from Şişli Etfal Hospital, II. Medicine Clinic and Coronary Intensive.Care Unit with simple sampling method. For the with acute myocardial infarction in the first group oral glucose tolerance test (OGTT) was made between the 14-21 days and for the other 24 patients­ with acute myocardial in farction in the second group. OGTT was made 16-18 month later. As for the control, group 24 healthy sample was selected and OGTT was made. Mean while for the 7 patients in the first group with the IGT.·OGTT was repeated 3 months later.
RESULTS: In the first group 13 patients out of 20 (65%)had IGT, in the second group 13 patients out of 24 (54%) had IGT. in the control group I patient out of I6 had IGT. Between the control group and the other two groups, there has been a great difference statistically (p<0.001, p<0.001). On the other hand no difference between the study groups has been seen(p>0.5 ). Gathering the results of study groups a positive correlation has been detected between the IGT and other parameters of metabolic syndrom like android obesity, hypertension, blood levels of total cholestaol, trigliserid, LDL and VLDL cholesterol. As well as that a negative correlation has been detected between the IGT and blood levels of HDL cholesterol.
CONCLUSION: According to these results we can say that patients with the atherosclerotic coronary heart disease have more frequent IGT with respect to normal people and IGT is a risk factor for atherosclerosis. Also we detected no change in glucose metabolism 2 weeks after myocardial infarction and we claim that IGT is among the parameters of metabolic syndrom and there is need to investigate IGT with the other risk factors in patients with the atherosclerotic coronary heart disease.

ln 53 children patients aged between 1-10 years and ASA I-II, we compared the effects of peroral applicated Midazolam, Triclofos sodium Alfentanyl versus placebo, as premedicant agents.
For evaluation sedation scale, atitudes while separeted from parents, reactions to induction methods (IV or mask applications), Systolik and Diastolik Arterial Pressure (SAP and DAP), heart rate, sP02 and vomiting episodes were examined.
According to the placebo, sedation scales were significant evident in the 3 groups and children who applicated Midazolam or Alfentanyl were calm while separated from parents.
We can propose Midazolam causing less side effects and more sedation as orally premedicant agent in children.

OBJECTIVE: Although ACE inhibitors have heen used to reduce proteinuria in patients with nephrotic syndrome in recent years, their effect in renal amyloidosis has not yet been investigated. Nephrotic: syndrome due to renal amyloidosis is very frequent (32%) in our statistics. Therefore we intended to study the effect of ACE inhbitors on proteinuria in patients with nephrotic syndrome due to renal amyloidosis.
STUDY DESIGN: Nine patients (aged between 18-49 years, 5 males and 4 females) were included to our study. All the patients were normotensive and had normal renal function except one. The patients were commenced on captopril (25-100 mg/day) and were followed up for 1- 19 months (mean follow-up period was 7 months).
RESULTS: At the end of the follow-up period peroteinuria decreased from 7.96±4.42 g/day to 6.16±4./2 g/day. The decrease in proteinuria was not statistically significant (p>0.05). No signifýcant changes in serum urea, creatinine, sodium aýýd potassium levels were observed. One patient was withdrawn from the study because of severe hypotension. In two patients orthostatic hypotension developed during the treatment.
CONCLUSJON: This study may suggest that ACE inhibitors had no sigrýifýcarýt ejfý: ct oýý rerýal amyloidosis witlý lýeavy prrýteiýýýýria. Orthostatic hypoteýýsimý appeared to he a major problem in the treatment with ACE inhibitors.

OBJECTIVE: We assess the effect of urinary volum in fetal bladder to amniotik fluid volume.
MATERIAL AND METHOD: Our study group consisted of 118 patients who applied to our polclinic. Amniotic fluid volume in four quadrants and tize greatest diameter of fetal urinary bladder were measured ultrasonographically. The second measurement was performed 1hour after the first. Statistical assesment of the results was performed using student-t test.
CONCLUSION: The cases where statistically meaningful decrease in fetal urinary volume present, the increase in amniotic fluid volume was also meaningful.

OBJECTIVE: In this study we have investigated the role of magnetic resonance imaging (MRI) in determining the etiology in 63 patients with partial epilepsy.
MATERIALS AND METJIODS: The MRI findings of 63 patients with partial epilepsy followed by Epilepsy Outpatient Department of Şişli Etfal Hospital Neurology Clinic were investigated retrospectively. The type of seizure was detemýined by the informatiorý taken from the patients and their relatives who had seen the seizure. The electroecephalogram was recorded twice yearly in each patient. All patients were screened in T1, T2 and proton density.
RESULTS: Thirty-two patients were female and 31 were male. The seizure type was simpily partial in 6 patients, complex partial in 14 patients and secondarily generalised in 43. EEG was pathologic in 47 patients and normal in 16. Thirty-six of 63 patients had abnormal MRI. Ten patients had atrophy, followed by 5 multiple, small lesion in white matter, 4 space occupying leisons. 4 developmental abnormalities, 3 hypoxic encephalopaty, 2 mesial temporal sclerosis, 2 venturicular asymmetry, 2 calcified lesion. 1 hydrocephaly, 1 vascular lesion, 1 multipl hamartomatous lesions in white matter in accordance with neurofibromatosis. One patient with hyperintense symmetrical lesions in occipital lobe could not he classified.
CONCLUSION: We claim that MRI is a very important tool revealing the etiology in patients with partial seziures MRI allows us to determine the migration ubnormalities and demyelinating lesions which could not be shown in CT.