In this study, we assessed the urinary microalbumin, ß2MG and ß-NAG levels to predict the renal damage in patients with insulin-dependent diabetes mellitus (IDDM). The study population included 15 type i diabetics and 10 healthy controls, aged 5-17 years (mean 11.6 y.) and 7-13 years (mean 10.1 y.) respectively. The averaged duration of the disease was 4.87±2.8 (2-11) years. Microalbumin, ß2MG and ß-NAG levels in the morning urine samples were studied and the results were corrected dividing by urine creatinin. The mean urinary albumin, ß2 MG and ß-NAG levels of patients and controls were13.32±18.12 mg/grCr, 10.71±11.17 mg/grCr; 24.41±15.01 µgr/grCr, 18.21±9.18 µgr/grCr; 9.46±4.89 U/grCr, 7.07±3.48 U/grCr, res-pectively. No statistical significance was found in all urinary protein levels between patients and controls (p>0.05). in conclusion, we suggest that no important glomerular and tubular dysfunction developes in earlieer period of IDDM; however, it seems reasonable to make a comparison, increasing the number of patients, in groups that have different characteristics to assess the sensitivity of the procedures.

Key words: insulin-dependent diabetes mellitus, renal tubular proteinuria, microalbu-minuria.

In recent years, investigation of the rate of Cavum septi pellucidi and cavum vergae has gained importance, which are considered an abnormality in brain development and are postulated to be an ethiologic factor of psychotic disorders. New imaging modalities such as sonography, computed tomography and magnetic resonance imaging have been added to the cadaver and autopsy studies for the evaluation of the brain. in our study, the cranial computed tomography scans of 3400 adult subjects with no psychotic disorders have been reviewed retrospectively to detect the frequency of these midline cystic cavities. The rate of cavum septi pellucidi was found 4.2 % and that of cavum vergae 1.9 %. The rate of simultaneous presence of cavum septi pellucidi and cavum vergae was 0.8 %.

Key words: Cavum septi pellucidi, cavum vergae.

in this study we investigated the efficacy of selegiline added to levadopa treatment in 20 patients with stage i-iii Parkinson's disease (PD). The group consisted of 11 males and 9 females. Their mean age was 63.2 ± 1.7 years, their mean duration of PD was 4.9 ± 1.0 years and their mean duration of levadopa treatment was 3.1 ± 0.5 years. in the first part of the study for investigating the efficacy of selegiline, we evaluated the patients with Webster Scale at the baseline and after one month of adding selegiline. The difference was significant (p<0.05). in the second part of the study we were able to reduce the daily dose of levadopa by 32.02 % for 16 patients and at the end of one month of this reduction we again evaluated patients with Webster Scale, the dose difference of which was also significant (P<0,05). Our observations suggest that selegiline as an adjunct to levadopa is effective for relieving the symptoms and for reducing the daily leva-dopa doge in PD.

Key Words: Parkinson's Disease, Selegiline, Levadopa.

This study was carried out in 22 temporal bones of the 11 adult skulls by the Departments of Ear-Nose-Throat Diseases and Anatomy of the University of Akdeniz between 1994 and 1995. in this study, critical points in mastoid surgery; criteria in search of antrum; the relations of facial canal, dural plate, semicircular canals, sigmoid sinus and mastoid apex points with antrum were investigated. The findings were discussed with the review of literature.

Key words: Mastoid surgery, anatomical variation.

Can Özkaynak, Gökhan Arslan, Saim Yilmaz, Timur Sindel, Ersin Lüleci

Anterior cruciate ligament injuries involve a lot of people, especially the athletes. Among the reasons, intercondylar notch dimensions and configuration have been the focus of interest more and more. Eighteen cases who had the preliminary diagnosis of anterior cruciate ligament rupture were examined by computed tomography. The normal group had 18 cases. We studied both groups with 9 parameters using computed tomographic measurements. Student t test was used for statistical evaluation. Final diagnosis was established by arthroscopy or operational findings. in the injured patients, intercondylar notch angle, femoral condylar width, notch area/condylar area at the anterior outlet, lateral femoral condylar width/total condylar width were statistically different from those of normal group. So, intercondylar notch narrowness was accepted as a predisposing factor in anterior cruciate ligament injuires. At present, especially the intercondylar notch angle has become the most reliable diagnostic parameter on which all of the researchers agreed. Besides this, computed tomograaphy is a simple and reliable method for the evaluation of intercondylar notch.

Key words: intercondylar nocth, computed tomography.

in this study in a group of epileptic patients interictal EEG findings were compared with regional cerebral blood flow which was evaluated quantitatively by Tc-99m HMPAO brain perfusion scintigraphy. 14 epileptic patients (7 women and 7 men; age:11-44) whose seizures were under control with antiepileptic drugs, were included in this study. 8 of the 14 patients had both hypoperfused and hyperfused areas in several regions, 5 patients had only hypoperfused areas in one or more regions and 1 patient had hyperfused area in only one region. in EEGs performed just after or before with SPECT we haven't seen any epileptic discharge. in conclusion, our study suggest that in the interictal period of epilepsy Tc 99m-HMPAO study may show various perfusion abnormalities even though the patients have normal EEG's.

Key Words: Epilepsy, EEG, SPECT.

We studied cognitive functions by using Mini Mental State Examination (MMSE), EEG and P300 potential in 15 healthy elderly and 12 patients which have age related cognitive decline. The mean MMSE score was 21,6±3,6/30 in patients and normal range in controls. EEG findings were not different between the patients and controls. The mean P300 latency was 365,3±33,2 msn at Fz electrode position in the controls. in the patients the P300 latency was found prolonged according to the controls and 405,1±58,9 msn at Fz electrode position. The patients used a dopaminergic agonist piri-bedil at a dose of 50mg/day for three months. Their MMSE, EEG and P300 potentials were evaluated after the treatment again. Their MMSE scores increased (22,5±4,3), but the EEG findings and P300 potentials were not statistically different after the treatment.

Key Words: Cerebral ageing, age-related cognitive decline, piribedil, EEG, event-related potentials, P300, Mini-Mental State Examination, cognition.

in this study, 57 patients who underwent urgent surgical intervention due to liver trauma between 1980 - 1994 were analysed. in 40 patients (%70,18) the liver injury was due to the penetrating trauma whereas in 17 patients (%29,82) was due to the blunt trauma. On classification according to the Moore's criteria, 23 patients were in Class1, 20 patients were in Class2, 7 patients were in Class3, 3 patients were in Class4, 4 patients were in Class5. in 38 patients hepatorraphy, in 7 patients electrocautery, in 7 patients hemostatic agents were used. Only in 7 patients major surgery was performed. The most frequent complications were intraabdominal abscesses and wound infection. Our mortality rate was %8,77. it was concluded that, satisfactory results can be obtained with simple surgical prcedures.

Key Words: Blunt liver trauma, penetrating liver trauma, hepatorraphy.

There are some uncomman findings, as prolonged refractory period of sensory nerve fibers and decremental responses during repetitive stimulation in multiple sclerosis (MS). These findings indicate that peripheral nervous system may also be affected in MS. But conduction velocity of the fastest conducting fiberes are usually in normal limits. So, in this study, we measured conduction velocty of slower conducting fibers of n. medianus A-µ fibers group by using Hopf's technique to show the possible involvement of peripheral nervous system in MS. 12 MS patients (10 definite and 2 possible MS) and 20 healthy controls in the same age group with patients were evaluated. We found maximum and minimum conduction velocities were decreased in MS group in comparison with controls. While minimum conduction velocity was 21.56 m/s and maximum conduction velocity was 35.23 m/s in patients, these were respectively 28.20 m/s and 41.50 m/s in controls. The decrease of minimum conduction velocity was more significant. These findings showed that peripheral nervous system has also been affected in MS.

Key words: Multiple sclerosis, peripheral neuropathy, minimum conduction velocity.

Studies with piracetam (UCB-6215, Nootropil, Noorotrop) had shown that this drug prevents retrograde amnesia due to hypoxia and simi-lar causes, accentuates mind and makes it easy to learn, by accelerating aerobic and anaerobic glycolysis and rising ATP concentration. Depending on these data we established that piracetam significantly decreases of recovery in the postoperative period; after carrying a study on 100 patients in ASAi-ii group and over 50 years.

Key words: Piracetam, postopereative time of recovery.

in this study, the performances of two autoanalysers; Coulter Dacos (CD) and Technicon Axon (TA), in the central Biochemistry Laboratory of Akdeniz University Hospital were compared. This comparison was performed with 12 different samples which were sent from an external quality assessment centre for a period of six months between March 1994 and August 1994 by intervals of 15 days. 16 biochemistry parameters were included in this comparison. "Murex Diagnostics (Wellcome) Clinical Chemistry Quality Assessment Programme" was used as reference. The results obtained from two autoanalyzers were compared not only with the reference values but also within themselves. The results of 10 parameters from TA autoanalyser and the results of 6 parameters from CD autoanalyser were closer to the reference values. According to the referance values the average coefficient of variation (CV) of all parameters for TA autoanalyser was 2.54 %, while for CD autoanalyser was 3.23 %. The average CV of all parameters for the two autoanalysers taken together was 2.75 %. No statistically significant difference was detected between the results of all parameters obtained from two autoanalysers and also with the reference values.

Key words: Quality assessment, autoanalyser, biochemical parameters.

Y.Mustafa Karagöz, Mehmet Atilgan in this study, the records of 1408 children send for discrimination and mental capasity examination with the claim of committing crime between 1987 - 1993 in Antalya were investigated and evaluated from points of: sex, age, type of crime, collective crimes and mental capasity ratio. 96,6 % of cases were male. 29,5 % of the children were 15 years old, 29,2 % of them were 14 years old. The most common crime type was teft with 66,5 %. Children who committed crime collectively were consisting 28,4 % of the all cases. An according to the results of examinatons: 98,8 % of children had discriminitive ability and normal mental capasity.

Key words: Discrimination and mental capasity. Juvenil delinquency.

Neurological involvement is a serious complication of Behçet's disease effecting the prognosis worse. Different results were announced about neurological involvement up to now. in our study, randomly selected 31 patients suffering from Behçet's disease were examined for the frequency and characteristics of involvement of central nervous system (CNS) clinically and radiologically. Cerebral CT was used for radiological evaluation and the results were compared with the control group. While the involvement of CNS was clinically found out in 2 cases (6.4 %) in the patient group, it was explored in 14 patients (45.16 %) by CT. There were only 5 (16.12 %) pathological findings in the control group. Finally, although CNS involvement in Behçet's disease is relatively rare, it is necessary to follow-up Behçet's disease by CT especially for the risky progress.

Key words: Behçet's disease, neurological involvement, BBT.

in this study, patients who where admitted to the Emergency Department (ED) of Akdeniz University Hospital in period of five years (1989-1994), requiring emergent surgical interventions due to injuries of their hands, wrists and forearms, have been evaluated on regional basis in terms of age, sex, occupation, dominant hand, injured hand, place, cause and type of injury, referral time to ED, the nature of emergency treatment to find out the injury, referral time to ED, the nature of emergency treatment to find out the injury type, occupations and ages at risk, periods when referrals are higher, and number of cases requiring microsurgical interventions. There was an increase in the number of patients of the ED also the number of cases requiring microsurgical interventions are increased every year and they were brought mostly between 16.00-24.00 hours. Therefore, we recommend the number of staff working between 16.00-24.00 hours in ED and operating theater should not be reduced and a team of orthopdic surgeons experienced in microsurgery should be ready to perform the operation for the treatment of the injuries in a short time.

Key Words: Trauma, emergency department, hand injury, microsurgery

This is a case-control study which is designed on a cross-sectional study aimed to determine the prevalence of hypertension among a group of armed forces personnel and to evaluate some risk factors of hypertension. All ranked personnel in two Military troops in Ankara in September 1995 were taken into study. Hypertension was diagnosed in 20.4 % (119) of participants of the study group. it was found that age and BMi were obviously risk factors for hypertenison.

Key words: Hypertension, risk factors, case-control study.

in developing countries, rapid urbanisation creates huge squatter areas near the city centers. These areas determine the health problems of the whole town not only because of their population but also their very poor health indicators. Prevalence of malnutrition can be a good indicator for child health status in squatter areas. in this study, we evaluated 1147 0-59 month children living in Ahatl› squatter area of Antalya for three indices, weight for age, weight for height and height for age. The prevalence of stunting was % 15.2, wasting % 1.1 and underweight % 3.7. Differences in the prevalence of malnutrition in various age groups, sex and social groups were discussed and recom-mendation made for interventions in such areas.

Key words: Malnutrition, anthropometry, 0-59 month-old children, squatter areas.

Neuro-ophthalmologic findings correlated with the localization of thalamic hemorrhage are investigated in 20 patients (mean age 66.3±9 yrs, F/M: 12/8). Twenty thalamic hemorrhages were classified into four types depending on topographic localization. Posterolateral type hemorrhages were the most frequent type. Ocular abnormalities were upward gaze palsy, convergence impairment, ipsilateral oculosympathic findings, horizontal gaze deviation toward the side of the lesion, ipsilateral skew deviation, pupils reacted incompletely to light.

Key words: Thalamic hemorrhages.

The development of DNA sequencing technique has markedly faciliated the determination and analysis of the primary structure of genetic information carrier, DNA. The sequencing of DNA has undergone rapid improvement since the invention of chemical cleavage and the controlled interruption of enzymatic replication (dideoxy sequencing) methods. Direct sequencing of specific regions of genomic DNA has become feasible with the advances in methodology in PCR technology which permits asymetrical amplification of genomic DNA. in this study, implemantation of the dideoxy sequencing protocols and the modifications which appear to be important prerequisites have been examined in example of human ß-globin gene as a model system. The adequate results have been also discussed for the adaptations which will be applied in our department.

Key words: PCR, direct sequencing, point mutations, ß-globin.

The human genome contains approximately 50.000 copies of an interspered repeat with the sequences (dT.dG/dA.dC)n, where n=~10-70. These "Microsatellite" variable number of tandem repeats (VNTRs) may be scored by PCR, using unique flanking primers to amplify the repeat-containing regions and resolving the products on DNA sequencing gels. in this work, two VNTR sequences (ig-JH and PYNZ 22) were used and amplified by PCR to confirm either maternal contamination with fetal trophoblast cells for prenatal diagnosis in the first trimester of pregnancy. The importance of PCR analysis using by VNTR sequences at forensic medicine and linkage analysis were also discussed.

Key words: VNTR, PCR, prenatal diagnosis.

in order to assess the significance of fine needle aspiration cytology (FNAC) in the diagnosis of metastatic lesions all FNAC cases were reviewed in the Pathology Department of Akdeniz University Medical Faculty during the period from 1st 1.1993 to 31st 1.1996. There were 23 metastatic lesions. 12 cases had a previous malignant tumor while the others did not have such a history. The importance of FNAC in diagnosing metastatic tumors were discussed.

Key Words : FNAC, Metastatic lesions.

in this study, sixteen pituitary adenoma cases diagnosed during a period between 1981-1995 in Pathology Department of Akdeniz University Medical Faculty were assessed with characteristics of radiologic, clinic and histopathologic.

Key Words : Pituitary, adenomas.

The pattern of decrease in Hb F synthesis during infancy was investigated in Antalya which is located in the south part of Turkey and where thallasemic syndromes and hemoglobinopathies are common. The study was performed in 145 infants with different ages ranging from birth to 12 months. The fetal hemoglobin level was measured by alkali denaturation method. Hb F was found 61.2±2.4 % in the fist 24 hours of life. Hb F synthesis declined rapidly down to 8.3±0.6 % in the fourth month. The decline was slower thereafter being 7.4±1.5 % in the 6th, 6.3±0.5 % in the 7th, 5.0±0.6 % in the 9th and 3.4±0.7 % in the 12 th month of age. Hb F levels of our infants between 6-12 months of age was higher than the results of other investigators. This difference was thougth to be related to ethnic factors.

Key words: Fetal hemoglobin, infancy

Abid Demircan, H. Ümit Özçaglar, Hasan Ekim We have performed 4 total oesophagectomy and pharyngogastrostomy in our University, whowere diagnosed in S.S.K. Antalya Hospital as 1990 - 1994, and reviewed the literature about this subject. in our opinion it is convenient to perform a thoracotomie, from the point of view that there may be a mediastinal lymphatic spread in these cases.

Key words: Upper third carcinomas of oesophagus, Pharyngo gastrostomie.

The accidental ingestion of kerosene is an important cause of poisioning among children in the developing and underdeveloping countries in where kerosene is still used for cooking, heating and lighting. Accidental kerosene poisioning is largely confined to the age group of 1-5 years and the majority comes from the low socioconomic class. in most of the cases, poisoning was mostly caused by drinking mistakely of kerosene containers. Therefore, pneumonia of kerosene poisoning case, 3 years old, which had been required mechanical ventilation for 11 days, and discharged on 17 th day of hospitalization, was reported.

Key words: Kerosene ingestion, aspiration pneumonia, hydrocarbons.

Cardiac surgery is evolved into an important adjunct for the management of endocarditis caused by organisms resistant to antimicrobial therapy as well as for drainage of intracardiac abscesses and repair of the damage done by endocarditis. Hypovolemia, congestive heart failure, administration of nefrotoxic drugs, acute allergic interstitial nephritis secondary to antibiotics and glomerulonephritis cause renal failure in bacterial endocarditis. Renal failure is one of the most important causes of mortality in bacterial endocarditis. in this acticle we present cases who underwent valve replacement for treatment of bacterial endocarditis with renal failure and review literature.

Key words: infective endocarditis, renal insufficiency, cardiac surgery.

Renal abscess is rare in childhood. The site of infection in the renal cortex presumably is related to the fact that the major proportion of the renal blood flow. it is usually located unilaterally, affecting the right kidney more often than the left. Abscesses of the renal medulla occasionally develop during the course of acute pyelonephiritis, in which case E.coli is the usual organism. Staphylococcus is still the predominant causative agent in renal abscess, especially in otherwise healthy patients with bacteraemia. The case presented here is a 14.5 years old boy who was referred with abdominal and flank pain. Bilaterally located renal abscesses were diagnosed with microbiological and radiological methods. Renal abscesses were treated with intravenous antibiotics and drained by transperitoneal exploration.

Keywords: Renal abscess, healthy children, case.

There may be defects varying from a small concussion to a rupture in heart after blunt chest traumas. The manner of effects of blunt traumas that produce cardiac injuires the mechanisms of heart ruptures and autopsy findings are well known. it is easier to explain the mechanism due to the elastic chest wall especially in children. But the incidence of childhood rupture is rare. The findings related to children are also limited in the literature. Death is occured within 24 hours in most of the cases that heart injury is produced after blunt trauma. Delayed heart rupture is a clini-cal manifestation that is rarely seen after blunt trauma, rupture is arised following a short or long asymptomatic period. As the event stays still, clinical diagnosis is difficult until rupture arises. it is important because after rupture arises, the manifestations dramati-cally become heavier, and it ends up with death in a short time. Delayed ruptures are valuable in Forensic Medicine especially in the cases with long asymptomatic period, in order to make connection between to direct trauma and rupture at autopsies (performed due to sudden death) and the forensic procedure.

Key words: Delayed heart rüptüre, blunt trauma, childhood traumas.

We report a case of traumatic diaphragmatic hernia (TDH) with thoracic splenosis in a 35 year old male. He was involved in a motor vehicle accident 14 years prior to hospital admission. He was sought because of a month history of nausea, pain in the left upper quadrand of the abdomen, and dyspnea. Diagnosis of the TDH was established with PA chest radiograph and CT Scanning of the chest. We performed left thoracotomy. At thoracotomy herniated abdominal viscera and a reddish brown solid mass in 1.5 cm diameter were found in the thoracic cavity. Histological examination of the mass revealed to be splenic tissue. Consequ-ently, diagnosis of the TDH with thoracic splenosis was confirmed. Postoperative recovery wes uneventful and discharged with healing. He is currently asymptomatic for 10 months following surgery.

Key words: Traumatic diaphragmatic hernia, thoracic splenosis.

Early occlusions of the saphenous vein grafts are the result of faulty technique or poor arterial run-off. On the other hand, late graft occlusion is due to progression of atherosclerosis. The progression of venous coronary by pass graft disease can be separated into three phases (Acute thrombotic occlusion, intimal hyperplasia and atherosclerosis). Acute thrombotic occlusion occurs within the first month after operation and is mediated mainly by platelets. intimal hyperplasia (smooth muscle cell proliferation) becomes a main cause of occlusion between 1 and 12 months after operation. Atherosclerosis becomes evident after 3 years and related atherosclerotic clinical changes occur between the fifth and tenth postoperative year.

Keywords: Coronary bypass graft, intimal hyperplasia, atherosclerosis.

The event-related potentials (ERPs) comprised of a group of components have been studied extensively since they were first described in the mid-1960s. The interest has been centered mostly on P3 component of ERPs occurring at latencies of 250 to 600ms. This potential is generated in response to infrequently attented task relevant stimuli in the auditory, visual or somatic modalities. it has been shown to be associated with various cognitive processes. The P3 component is used to evaluate the cognitive functions. Prolongation of latency or decrease of the amplitude have been employed as an objective measurement for assessing the degree of cognitive disorders. in the recent years, growing attention has been focused on age-related differences of ERPs with respect to clinical application of P3 component for the assessment of cognitive disorders. The P3 progressively increases in latency as well as diminishes in amplitude in aging.

Key words: P3, cognitive potential, age, disease.

Atrial fibrillation is one of the most common arrhythmia encountered in clinical practice. This arrhythmia is most frequently seen in the course of rheumatic valvular heart disease, coronary heart disease and hypertension. its prevelance increases with age. it may cause hemodynamic compromise with the loss of atrial kick and it may cause serious complications with increased risk of thromboembolic complications and stroke. Treatment of atrial fibrillation has two objectives. One is to relieve patient's symptoms and the other is to prevent stroke and thromboembolic complications.

Key words: Atrial fibrillation, antiarrhythmic therapy, cardioversion.

Formal teaching of medical ethics in the medi-cal schools curriculum has gain special a impontart in nowadays. Ethics educatio›n has been achieved both continuity and take a new content and a form. in this issue, for to make a sound discussion and an evaluation, the goal and content of teaching medical ethics with teaching methods and definition of educator should have been determined. At the medical schools in our country, it's useful to deal with whole aspect of teaching medical ethics for to develop the ethics education.

Key words: Medical ethics, medical educations, medical ethics educations, medical ethics training program.

SODIUM-POTASSIUM ATPASE(ATP PHOSPHOHYDROLASE AC.3.6.1.3)

The sodium-potassium ATPase, an integral membrane protein, is an enzyme system that hydrolyzes ATP while transporting sodium and potassium ions present in most of the cells. Many investigations have been done in the last few years and the mechanism, the molecular structure and the DNA clones of the subunits have been enlightened. Here, we review some of the studies about this enzyme system from a biochemical point of view.

Key words: Sodium-potassium, ATPaz.