Objective: The aim of this study was to evaluate the effects of metformin and standardized diet for weight loss on body mass index and the possible mechanisms of its action through leptin in over-weight and obese polycystic ovary syndrome (PCOS) patients and which method is effective to determine the relation between serum leptin level and. BMP
Study Design: Our study included 88 over-weight, and obese PCOS patients who had. no other health problem, with age variation between 20-30 years. The patients were later divided into two groups, patients taking metformin and patients having diet program for weight loss.
Results: In both of the groups the BMI was significantly decreased. The weight loss was more in the group which was treated with metformin and this difference was also statistically significant. In both of the groups the serum leptin levels were decreased parallely to the weight loss, however the in the leptin serum values were observed to be more in the group with metformin treatment and there was also statistical difference between, the groups on this matter.
Conclusions: Metformin affects the serum leptin levels in over-weight and obese PCOS patients with an unknown mechanism. Separately from the adipose tissue decreas, it shows direct suppressive effect on leptin formation.

Introduction: Patients with diabetes have an increased risk of urinary tract infections compared with normal population. Even though UTI’s are asymptomatic and does not affect life quality, it may cause serious complications like pyelonephritis, emphysematous cystitis, renal abcesses and bacteriemia.
Matherial and methods: A total of 261 patients with diabetes who had no complaints of urinary tract visiting diabetes outpatient clinic were included in the study in order to determine to determine the prevalance of asymptomatic bacteriuria (ASB) in diabetic women. The mean age of the patients was 46,5 (18-70). Exculision criteria were pregnancy, pathological findings of urinary tract in sonography and vaginal infections. All patients had urinanalysis and urine cultures. ASB was defined as the presence of at least 10 CFG per mililiter in at least two clean voided midstream urine samples.
Results: Seventy four patients (28,6%) had type I DM and 187 patients (71,4%) at type 2 DM. The mean age was 52 and mean duration of DM was 18 years in the patients having ASB, while the mean age was 47 and mean duration of DM was 13 years in patients without ASB. We found the prevalance of ASB in diabetic women as 29%, the ratio of ASB in type 1 DM 22% and the ratio of ASB in type 2 DM women was 31%. The most isolated microorganism was E.Coli. in the follow-up period 78 patients (30%) had cystitis. Altough given apropriate antibiotherapy 20 patients developed 2 UTI’s and 10 patients 3 or more UTI’s. 2 patients had pyelonephritis and I patient had pyonehrosis.
Conclusions: The prevalance of ASB is higher in diabetic women. This situation clinically may be a serious risk factor that can cause renal function loss in diabetic women.

Objective: 93 cases of cleft palate, operated by department of plastic and reconstructive surgery in. our hospital between 1999-2004, were evaluated.
Study design: In this retrospective analysis of the patient records, patients were evaluated according to age, gender, accompanied malformations, type and duration of operation, and peroperative and postoperative complications.
Results: 37 percent of 93 patients were female while 63 percent were male. Mean age were 25±10 and 23±I2 months for female and male patients, respectively. 2 of the patients (2%) were diagnosed as Pierre-Rohin sequence, 1 patient (1%) as Larsen syndrome. Two of the patients (2%) were presented with atrial septal defect (ASD), one of the patients (1%) had ventricular septal defect (VSD), while 1 patient (1%) had renal and ana1 agenesis. 72 of the patients (77%) were used Veau Wardill Kilner technique, 15 of the patients (16%) were performed Von Langenbeck tecnique and 6 of the patients (7%) were repaired Furlow tecnique. Average of operation time was 188+25 minutes. Three of our patients (3%) could not be entubated and consequently operated. I / of the patients (12%) experienced postoperative respiratory stress and followed up in ICC for a limited time. Blindness devoloped in 2 of the patients (2%).
Conclusion: In spite of the improving technologies and growing experience in anesthesiology and. plastic surgery, cleft palate patients remains as a challenging task due to specific comorbid conditions and postoperative complications.

The aim of our study was to compare non-contrast spiral CT, US and X-ray kidney, ureter and bladder (KUB) in the evaluation of patients with urinary tract calculi. During the study period of February 2002 to December 2002, 51 patients (35 male,!6 female) with suspected renal colic or ureteral colic in the urology department of our hospital underwent non- contrast spiral CT US and X-ray KUB. On CT. II patients had renal calculi, 20 patients had ureteral calculi and 14 patients had other urinary tract pathologies. 9 patients had renal and ureteral calculi in the same time.7 patients were normal. 23 calculus were greater than 3 mm (% 73.9): 6 calculus were 3 mm and smaller (%20.6) on spiral CT. All the 6 calculus which diameter 3 mm and smaller were detected on CT(%]()0), only 3 of this small calculus were detected on US (% 50) and only 2 of them detected on X -ray KUB(% 33).All the 23 calculus which diameter greater than 3 mm were detected on CT (%100), 7 of them were detected on US (% 30.4) and 7 of them detected on X -ray KUB(% 30.4). In our study, the sensitivity of X-ray KUB was %3I and specificity was % 95: the sensitivity of US was % 34, specificity was % ¡00 and the sensitivity of CT was %100 and specificity was %97. When appreciating all the advantages and. disadvantages of non-contrast spiral CT, it should be reserved for cases where US and X-ray KUB do not show the cause of symptoms.

Purpose: The presence of hepatosteatosis in type 2 diabetics is a well-known but poorly investigated subject. In our study, we investigated hepatosteatosis prevalence in type 2 diabetics using ultrasonography.
Material and method: 50 diabetic and 50 non-diabetic patients who applying from various clinics were included in our study. None of the patients had chronic alcohol abuse history.Body mass index (BMI), serum transaminase and lipid levels are also evaluated. All patients were evaluated by Diasonics synergy multisync m500 ultrasonography.
Results: Hepatosteatosis was determined in 30 patients in diabetic group (% 60) and 12 patients in control group (% 24) by using ultrasonography (p < 0.01). There was no significant statistical difference between two groups in regard of body mass index (BMI), serum transaminase and serum lipid levels (p>0.05).
Conclusion: In our study, we concluded that hepatosteatosis is increased in patients with type II diabetes mellitus independent of other hepatosteatosis risk factors, in comparison to control group.

In this study, we studied serum levels of two ylycolithic enzymes, phosphoheksose izomerase and aldolase in histopatholoyically confirmed malign tumor patients, and we compared these levels between patients with and/or without metastasis and lymphadenopathy. The aim of the study is to determine the relationship between these enzymes and tumor metastasis and to assess whether they can be used as a tumor marker in the therapy and follow-up. Histopatholoyically confirmed 100 cancer patients under therapy and foil owe d-up by the Department of Radiation Oncology of Sisli Etfal Education and Research Hospital and a control group of 50 healthy individual are included in the study. In healthy control group, serum PHI enzyme levels were determined as 10-59 UIL (average 31.9 UIL), ALD levels as 1.2-6.8 UIL (average 3.81 UIL). Values obtained in patients with malign cancer were 18- 492 UIL (average 82.14 UIL) for PHI and 1.4-61.3 UIL (average 6.87 UIL) for ALD. If any classification according to tumor type was not done, PLII in 59 % of patients and ALD in 23 % of patients were above the upper limits. When such a classification was done according to tumor type, the rates of increased levels were: Lung 85.1 %, sarcoma 83.3 %, breast 60 %, gastrointestinal tract 40 %, genitourinary system 33.3 % and lymphoma 33.3 %. The rates of increased ALD levels in same tumor types were found as 40 %, 33.3 %, 16%, 13.3 %, 11.1 % and 33 % respectively. A significant difference was obtained between patient group and control group for PH! (P: 0.000) and ALD (P.O.002) levels. Levels of PHI (P.0.000) and ALD (P: 0.001) were markedly higher in patients with metastasis than in control group. When patients with metastasis and without metastasis were compared it was observed that ALD levels (P: 0.042) showed a marked difference compared to PHI levels (P: 0.128>0.05). Any significant difference was not obtained between patients with and without lymphadenopathy, cither for PHI (P: 0.154>0.05) or for ALD (P: 0.176>0.05). In conclusion, we observed that both parameters were elevated in cancer patients, aldolase levels being more significant in determining metastasis. We suggest that these parameters have the advantage of being unexpensive and easily automated.

Mature cystic teratomas are benign tumours composed of ectodermal mesodermal, and endodermal elements. They occupy %IO-25 of all ovarian neoplasms. Mostly they occur in young and reproductive women between the age of 20-40. In symptomathic patients, pelvic pressure, abdominal pain and abdominal mass can be seen. Here we report a case of a mature cystic teratoma originating from right ovary and its typical radiological findings and discussed in the view of the literature.

Bezoars are defined as foreign bodies formed in the stomach and!or small bowel due to an accumulation of swallowed substances. The most common complication associated with gastrointestinal trichobezoar is intestinal obstruction and, less frequently, small bowel perforation. For this reason the diagnosis must be established as early as possible, in order to provide an effective treatment. The Rapunzel Syndrome is a rare form of gastric trichobezoar extending throughout the bowel, therefore we report it here.

A 24 years old male patient who presented with fever, cough, weight loss, pain in the right shoulder and chest as well as swelling with severe pain in the right thigh, has been hospitalized in our clinic. These symptoms were present since one month and with no response to wide spectrum antibiotics administered under non-hospitalized conditions. Cachexia, inadequate oral hygiene and limitations of movements were also observed. Non respiratory sounds could be heard on the right with auscultation and there was extensive dullness. A fluctu¬ating hot abscess of approximately 10X10 cm diameter was detected on the right thigh. 12 600/mm3 of leucocytes, a shift to the left in the formula, normocytic anemia were also noted. In his chest X-ray, diffuse homogenius density at the right and at the thorax CT, locular, encysted pleural effusion was detected. At CT sections obtained from femoral level, two collections of abscess were observed on the right. Pleural and abscess fluid cultures were Stafilococcus aureus positive. Immune deficiency that was also observed clinically was confirmed by lymphocytes subpopulation analysis. Cefasolin at 2 g/day doses has been administered for I month for treatment. As the patient was not belonging to the child, or elderly population and he did not presented with nasocomial infection characteristics, it was considered as a staphylococcic infection case with a course of multilocular abscesses and encysted pleural empyema as a result of a possible sepsis due to staphylococci of the mouth flora.

Kawasaki’s disease, sometimes called mucocutaneous lymph node syndrome, is first described by Kawasaki in 1967. The disease is an acute febrile ilines of infancy and early childhood, charecterized by multiple organ system inflammation and diffuse arteritis. Myocardial ischemia and myocardial infarction are the most serious complications of coronary artery lesions in children with Kawasaki Disease. We wanted to reviewed with literature, a case with Kawasaki disease, had had an acute myocardial ischemia while he was operated.

Hypothalamic hamartoma, also called tuber cinereum hamartoma is a rarely seen lesion located between the infundibular stalk anteriorly and the mamillary bodies posteriorly. These lesions are few milimeters to I -2 centimetres in size and composed of nonneoplastic heterotopic normal neuronal tissue. Clinically two distinc presentations have been noted, accompanied with precocious puberty or seizure. Since the diagnosis depends on the radiologic demonstration of the lesion in the presence of appropriate clinical setting, an appropriate imaging technique should be used, with detailed examination for small sized lesions. Biopsy is not an option mostly even for lesions with a larger size because of central location and this shows the importance of radiologic imaging and differential diagnosis. In this report we discussed the radiologic imaging features of hypothalamic hamartoma detected in 9 months old male patent.