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Amaç: Bu çalýþmada amacýmýz kilolu ve ohez polikistik over sendromlu hastalarda metformin ve standart zayýflatýcý diyet tedavisi ile vücut leptin seviyeleri ve BM! (Body Mass Index)‘inde meydana yelen deðiþikliklerin önemli olup olmadýðýný ve hangi yöntemde leptin deðiþiminin daha etkin olduðu¬nu, leptin düzeyleri ile BMI arasý iliþkinin derecesini sapta¬maktý.
Gereç ve Yöntem: Çalýþmamýzda yaþlarý 20-30 arasý deðiþen kilolu ve ohez PKOS (Polikistik Over Sendromu) dýþýnda saðlýk sorunu olmayan 88 hasta alýndý. Hastalar metformin ve standart zayýflatýcý diyet alan iki gruba ayrýldý.
Bulgular: BMI‘i her iki grupta da belirgin olarak azaldý. Kilo kaybý metformin alan grupta daha fazlaydý ve bu yükseklik istatistiksel olarak anlamlýydý. Serum leptin konsantrasyonlarý her iki grupta da kilo kaybý He paralel olarak azaldý, ancak metformin grubunda azalma dalýa fazla idi ve iki grup arasýndaki fark istatistiksel olarak anlamlý bulundu.
Sonuç: Metformin; kilolu ve ohez PKOS‘lu kiþilerde serum leptin seviyeleri üzerinde bilinmeyen bir mekanizma ile etkili olmakta, cýdipoz doku azalmasýndan ayrý olarak direkt leptin oluþumu üzerinde supresif bir etki göstermektedir.

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.

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Giriþ: Diyabetik kadýn hastalarda üriner sistem enfeksiyon riski normal populasyona yöre daha yüksektir. Asemptomatik seyretmesi nedeni ile yaþam kalitesini etkilemese de pyelonefrit, renal abse, amfizömatöz sistit, perinefritik apse ve hakteriyemi gibi ciddi komplikasyonlara neden olabilmektedir.
Gereç ve yöntem: Diyabetik kadýn hastalarda asemptomatik bakteriiiri (ASB) prevalansýný saptamak amacýyla hastanemiz diyabet polikliniðine baþvuran, iiriner sistem þikateti bulun¬mayan 261 hasta çalýþmaya alýndý. Hastalarýn ortalama yaþlan 46,5 (18-70) idi. Vajinal akýntýsý olanlar, 111trasonagrafide üriner sistem patolojisi saptananlar ve gebe olanlar çalýþma dýþý býrakýldý. Hastalarýn hepsine tam idrar tahlili ve idrar kültürü yapýldý. Üriner sistem semptomlarý olmayan diyabetik kadýn hastalarýn orta akýný idrar örneðinden en az iki kez alýnan idrar kültüründe 105 koloni üremesi asemptomatik bakteriüri olarak tanýmlandý.
Bulgular: Çalýþmaya alman 261 hastanýn 74’ii (28,6) tipi DM, /87’si tip 2 DM idi. ASB saptanan grubun yaþ ortalamasý 52 ve diyabetli yaþam süresi ortalama 18 yýl olarak tespit edilirken ASB saptanmayan grubun yaþ ortalamasý 47 ve diyabetli yaþam süresi ise 13 yýl okýrak bulunmuþtur. Çalýþmamýzda hastalarda asemptomatik bakteriiiri prevalansýný %29 olarak bulduk. Tip 1 DM olan ASB‘li kadýnlarda hu oran %22, Tip 2 DM olan ASB’li kadýnlarda %31 idi. Býý hastalarda en sýk izole edilen üropatojen E.Coli idi. Hastalarýn takibinde 78 hasta (%30) sistizm þikayetleri ile polikliniðimize baþvurdu. Bunlarýn tümüne uygun antibiyoterapi yapýlmasýna raðmen 20 hastada 2 kez, 10 hastada ise üç veya daha fazla semptomatik üriner sistem enfeksiyonu, iki hastada pyelonefrit, bir hastada pyoýýefroz saptandý.
Sonuç: Diyabetli kadýn hastalarda asemptomatik bakteriüri normal topluma göre daha sýk görülmektedir Klinik olarak bu durum, diyabetik kadýnlarda renal fonksiyon kaybýna kadar götüren ciddi bir risk faktörü olarak karþýmýza çýkabilmektedir.

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.

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Amaç: 1999-2004 tarihleri arasýnda Plastik Cerrahi Kliniði tarafýndan yarýk damak nedeni ile opere olan 93 olgunun deðerlendirilmesi amaçlandý.
Gereç ve yöntem: Anestezi ve Plastik Cerrahi Klinikleri kayýtlarýndan retrospektif olarak, olgularýn operasyon yaþlarý, cinsiyetleri, eþlik eden anomalileri, ameliyat tipi, ameliyat süresi, ameliyat sýrasýnda ve sonrasýnda geliþen komplikasyon¬lar araþtýrýldý.
Bulgular: Öpere edilen 93 olgunun % 37’si kýz, % 63‘ ii erkekti. Kýzlarýn yaþ ortalamasý 25±10 ay, erkeklerin, yaþ ortalamasý 23±I2 ay olarak tespit edildi. 2 olguda (%2) Pierre Rohin sendromu, 1 olguda (%l) Larsen Sendromu mevcuttu. Yarýk damak anomalisine 2 olguda (%!) atrial septal defekt (ASD). I olguda (%!) ventral septal defekt (VSD), I olguda (%l) ise anal ve renal agenezi eþlik etmekte idi. 72 olguya (%77) Veau Ward.ill Kinler, 15 olguya Voýý Langenbeck (%I6) ve 6 olguya (%7) Furlow yöntemleri ile damak ameliyatý uygulandýðý tespit edildi. Operasyon süresi ortalama I88±25 dakika idi. 3 olgu (%3) endotrakeal entübe edilemedikleri için baþka bir merkeze sevk edildi. II olguda (%I2) erken postoperatif solunum sýkýntýsý geliþtiði için postoperatif yoðun bakýný ünitesinde takip edildi. 2 hastada (%2) erken postoperatif dönemde körlük geliþtiði tespit edildi.
Sonuç: Yarýk damak operasyonlarý teknoloji, ve ameliyat tek¬niklerindeki geliþmelere raðmen hastalarýn beraberinde eþlik eden hastalýklarý ve geliþebilecek komplikasyonlar açýsýndan anestezi hekimlerinin en dikkatli olmasý gereken, vaka grup tanrýdandýr.

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.

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Amaç: Bu çalýþýna, üriner sistem taþlarýnýn deðerlendirilmesinde, kontrastsýz ahdominopelvik spiral BT ile Direkt Üriner Sistem Grafisi (DÜSG) ve Ultrasonografi‘rýin (US) taný deðerini karþýlaþtýrmak amacýyla planlandý.
Gereç ve Yöntem: Þýýbat 2002-Aralýk 2002 tarihleri arasýnda polikliniðimize baþvuran ve ürolojik muayenesinde üriner sistem taþ hastalýðý düþünülen 35’i erkek Kýþý kadýn, toplam 51 hasta çalýþmaya alýndý. Hastalar DÜSG, US ve spiral BT ile deðerlendirildi.
Bulgular: Çalýþmaya alman 51 hastanýn yapýlan kontrastsýz spiral BT incelemesinde II olguda böbrek taþý, 20 olguda üreler taþý, ¡4 olguda diðer üriner sistem patolojileri saptandý. 9 olguda böbrek ve üret er taþý birlikte bulundu. 7 olguda normal sonuç izlendi. Çalýþmamýzda saptadýðýmýz taþlarýn 23 tanesi (%73,9) 3 mm’den büyük: 6 tanesi (%20,6) 3 mm ve altýndaydý. 3 mm ve altýndaki taþlarýn (ýsýda BT‘ de saptaýýabilirken (%I00), US’da üç tanesi (%50), DÜSG’de iki tanesi (%33) izlendi. 3 mm‘ den büyük taþlarýn 23 tanesi BT‘ de (%]()()), 7 ta¬nesi (% 30,4) US‘de, 7 tanesi (% 30,4) DÜSG‘de saptandý.
Sonuç: Çalýþmamýzda DUSG‘nin sensitivitesi %3/, spesifitesi %95; US’ýýin sensitivitesi %34, spesi.fitesi %!()() ve BT’nin seýýsitivitesi %/()(), spesifitesinide %97 olarak bulduk. Avan¬tajlarý ve dezavantajlarý göz öniine alýndýðýnda, kontrastsýz spiral BT‘nin. US ve DÜSG ile taný koýýulamayan vakalarda kullanýlmasýnýn ýýygým olduðu görülmektedir.

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.

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Amaç: Tip 2 diyabette hepatosteatoz varlýðý, bilinen fakat, yeterince incelenmemiþ bir konudur. Çalýþmamýzda, transabdominal ultrasonografi kullanarak tip 2 diyabetli olgularda he¬patosteatoz varlýðýný araþtýrdýk.
Gereç ve Yöntem: Çalýþmamýza, çeþitli kliniklerden baþvuran, 50 diyabetik ve 50 non-diyabetik hasta dahil edildi. Çalýþmaya dahil edilen hastalarýn hiçbirinde kronik alkol kulla¬nýmý öyküsü yoktu. Çalýþmada, hastalarýn beden-kitle indeksi (BK1), transanýinaz düzeyleri ve kan lipid profilleri göz önüne alýndý. Tüm incelemeler Diasoýtics synergy multisync m500 ultrasonografi cihazý ile yapýldý.
Bulgular: Diabetik grupta 30 hastada (% 60), kontrol grubunda ise 12 hastada (% 24) USG ile hepatosteatoz belirlendi (p< (),()/). Her iki grup karþýlaþtýrýldýðýnda transanýinaz düzeyleri, lipid profilleri ve BKI açýsýndan anlamlý istatiksel fark bulunmadý (p>0.05).
Sonuç: Çalýþmamýzda, tip 2 DM Tu hastalarda, hepatoste- atoza neden olan diðer etkenlerden baðýmsýz olarak, kontrol grubu ile kýyaslandýðýnda hepatosteatoz oranýnýn arttýðýný saptadýk.

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.

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Biz bu çalýþmada, glikolitik yolda yer alan fosfoheksoz izomeraz (PHI) ve aldolaz \n (ALD) serýým düzeylerini histopatolojik olarak malign tümör varlýðý saptanan hastalarda anýþtýrýp, uzak metastazý vt‘/veya lenfadenopatisi olan ve olmayan hastalarýn serumlarýnda sözkonusýý enzimlerin düzeylerini karþýlaþtýrdýk. Çalýþmanýn amacý her iki enzimin tümör metastaz iliþkisini ortaya koymak ve höylece kanser hastalýðýnýn tedavisinde ve takibinde tümör markýrlarý olarak kullanýlýp kullanýlamayacaklarýný araþtýrmaktýr. Çalýþmaya Ýstanbul, Þiþli Etfal Hastanesi Radyasyon Onkolojisi Kliniði’nde takip ve tedavileri sürdürülmekte olan histopatolojik olarak tanýlarý konulmuþ kanserli 100 hasta ve 50 saðlýklý kiþiden oluþan kontrol grubu dahil edilmiþtir. Kontrol yruhundaki saðlýklý kiþilerin serumlarýnda ekle edilen PHI düzeyleri 10-59 IHL (ortalama 31.9 UIL), ALD düzeyleri 1.2-6.005) yöre daha anlamlý olduklarý sonucuna varýldý. Lenfadenopatisi olan ve olma¬yan hastalar arasýnda, ne PLII (P: ().!54>0.05) ne de ALD (P: 0.I76>0.05) bakýmýndan anlamlý bir baðlantý ekle edilebildi. Sonuç olarak, her iki parametrenin kanserli hastalarda yülselmiþ okluðunu, Aldolaz deðerlerinin metastazý tespit etmede daha atýlmalý olduðunu izledik. Lier iki parametrenin de otomasyona kolay uygulanmasý ve ucuz oluþunuda avantaj olarak deðerlendirdik.

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.

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Ovaryan matür kistik teratomlar, ektodermal. mezoclermal ve endodermal elemanlar içeren bcnign tümörlerdir. Tüm över tümörlerinin %10-25‘ini oluþtururlar. Genellikle reprodüktif dönemde, 20-40 yaþ arasýndaki bayanlarda görülürler: Abdominal dolgunluk, aðrý, kitle olarak kendini gösterebilirler. Çalýþmamýzda, sað överden kaynaklanan matür kistik teratomun tipik ýýltrasonografi. BT ve MR görüntüleri sunulmuþ ve mevcut literatür bilgileri ýþýðýnda tartýþýlmýþtýr.

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.

Bezoarlar yutulan maddelerin mide ve I veya ince har sakta birikmeleri ile oluþan yabancý cisimleri tanýmlamada kullanýlýr. Gastrointestinal trikobezoarlarm en sýk komplikasyonu intestinal obstrüksiyonlardýr. Nadir olarak ince barsak perforasyonlarý da görülebilir. Bu nedenle hasta komplikasyonlar geliþmeden erken teþhis edilerek tedavi edilmelidir. Biz de mideden karsaða uzaným gösteren nadir gastrik trikobezoar formu olan Rapunzel scrýdromunu tartýþmayý amaçladýk.

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.

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Ateþ, öksürük, zayýflama, sað omuz ve göðüs aðrýsý, sað uylukta.þiddetli aðrýlý þiþlik þikayetleri ile kliniðimize interne edilen 24 yaþýndaki erkek hastanýn anamnezinden, semptomlarýn bir ay süreli olduðu ve ayaktan uygulanmýþ olan geniþ spektrumlu antibiyotiklere cevap vermediði öðrenildi. Kaþeksi (boy 163 cm., kilo 43 kg) aðýz hijyeni bozukluðu, hareket kýsýtlýlýðý gözlendi. Saðda oskültasyonla solunum sesleri duyulmuyordu ve yaygýn matite mevcuttu. Sað uylukta yaklaþýk 10x10 cm. çapýnda fluktuasyon veren sýcak abse saptandý. Lökosit 126001mm3 idi. Formülde sola kayma, normokrom normositik anemi saptandý. PA akciðer graf isinde saðda total, yer yer homojen opak dansite artýþlarý ile bilgisayarlý tomografide loküle ankiste plevral efiizyon saptandý. Femoral düzeyden alýnan BT kesitlerinde saðda collum femoralis düzeyinde 3.5x5.5x12 cm. çapýnda ve ileopsoas kasýnda 3 cm.’lik iki adet abse koleksiyonu gözlendi. Plevral sývý ve abse kültürlerinde Staphylococcus auýeýýs üredi. Klinik olarak gözlenen imnün yetersizliði ayrýca kanda lenfosit subpopulasyon incelemesi ile kanýtlandý. Tedavide bir ay süre ile sefazolin sodyum 2g/gün dozunda uygulandý. Subplevral kapalý tüp tora kostomi ile‘toplam 4000 mi. sývý 25 günde aspire edildi. Hastanýn çocuk veya ileri yaþ grubunda olmamasý, nozokomiyal infeksiyon niteliði göstermemesi nedenleriyle genç eriþkinde %I0 gibi düþük bir sýklýkla aðýz florasýndan stafilokoklara baðlý olasý bir sepsis sonucu multilokule aliseler ve ankiste plevral ampiyemle seyreden stafilokok in.feksi.yonu tablosu. olarak deðerlendirildi.

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.

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Mukokutanöz lenf nodu sendromu olarakda bilinen Kawasaki hastalýðý ilk kez 1967 yýlýnda Kawasaki tarafýndan tanýmlanmýþtýr. Hastalýk multipl organ sistem enflamasyonu ve diffüz arteritle karakterize infant ve erken çocukluk çaðýnýn akut ateþli bir hastalýðýdýr. Myokard iskemisi ve enfarktý Kawasaki hastalýðý olan bir çocuktaki koroner arter lezyonlarýnýn en ciddi komplikasyonlarýdýr. Biz,operasyon esnasýnda akut myokard iskemisi geliþen Kawasaki hastalýðýna sahip bir vakayý literatür eþliðinde gözden geçirmek istedik.

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.

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Tuber cinereum hamartomu olarak da adlandýrýlan hipotalamik hamartomlar nadir görülen, infundibüler stalk ile mamiller cisimcik arasýnda kalan hipotalamik bölgede lokalize, milimetrik boyutlardan birkaç santimetreye kadar boyutlarda olabilen, neoplastik olmayan heterotopik normal nöronal dokudan oluþan kitlelerdir. Klinik olarak prekok puherte veya epilepsi ile ortaya çýkan iki farklý tipi mevcuttur. Uygun klinik bulgularýn varlýðýnda taný radyolojik olarak milimetrik boyutlarda olsa hile lezyonun radyolojik olarak görüntülenmesine baðlýdýr. Büyük boyutlu lezyonlarda bile lokalizasyon nedeniyle biopsinin zor olmasý ayýrýcý tam açýsýndan radyolojik görüntülemenin önemini ortaya koymaktadýr. Bu olgumuzda 9 aylýk erkek çocukta saptadýðýmýz biiyük boyutlu hipotalamik hamartom olgusu eþliðinde hipotalamik hamartomun görüntüleme bulgularýný tartýþtýk.

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.

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