2001; 32 (3): 129-200.
CONTENTS


ABSTRACTS

The results of the survey shows that launching Quit and Win Campaigns is a worthwhile strategy to curb smoking epidemic

Polat SA, Sezer E

Cerrahpasa J Med 2001; 32: 133-141.

BACKGROUND AND DESIGN: This is a follow up study aimed to evaluate the effects of the Smoking Cessation Campaign in Elazř­ 1996. A random sample of 1000 participants were drawn randomly from a list of 1299 participants. Number of the individuals in the final list was 978. Most of the questions in the questionnaire were the ones requested by the international Quit and Win campaign coordination center. The study was conducted during may 1997 just one year after the cessation campaign had been launched. Of the individuals in the sample 759 responded. RESULTS: The participation rates were 2,84% and 0,34% among the smokers in the provincial center and the rest of the Elazř­ respectively. The overall participation rate was 1.37%. Of the respondents 83.0% were male, 70.0% were between the ages of 25-44. Most of the respondents had at least a high school degree. And 63.6% of the responders were able to give up smoking during campaign period. Among the main reasons reported by the ones who failed to give up smoking were tobacco withdrawal symptoms, and stress. One year abstinence rate among respondents was 33.9%. (If 176 individuals who did not respond are supposed to have failed to give up, this figure will decrease to 27.0%) Among the respondents 23,7% reported that they had smoked sometimes during the 12 months after quit day but they did not smoke at the time of survey; 7.4% reported that although they had continuously smoked in the last year they did not smoke at the time of the survey; 35.0% reported that they had smoked in the last year and they also continued to smoke at the time of the survey. CONCLUSION: The results of the survey shows that launching Quit and Win Campaigns is a worthwhile strategy to curb smoking epidemic.(Return)


Peripheral nerve system damage in chronic toluene and n-hexane intoxication: electrophysiologic investigation

Uzun N, Karaali Savrun F, Křzřltan ME

Cerrahpasa J Med 2001; 32: 142-150.

BACKGROUND AND DESIGN: We present electrophysiological features of neuropathy due to chronic exposure to different organic hydrocarbon derivatives (toluene/methyl benzene and n-hexane) that are known to be neurotoxic. Twenty-five subjects who abuse toluene by sniffing and 29 subjects who have been exposed to n-hexane by way of inhalation and skin contact have been included in the study. None of the subjects who abused toluene for an average of 3 years had any complaint. Ten subjects with exposure to n-hexane were asymptomatic, however 19 patients had symptoms of varying severity. The mean exposure time to n-hexane was 32.3 months, and 28 months in the groups of subjects with and without symptoms respectively. Electroneuromyographic examination was performed in these patients. RESULTS: Mild sensorymotor polyneuropathy was detected in 12% of subjects in the toluene group, and 60% of subjects in the asymptomatic n-hexane group. Neurological examination disclosed predominant central nervous system involvement in subjects with exposure to toluene. Motor and less severe sensory polyneuropathy of moderate to severe degree was noted in all of the patients in the symptomatic n-hexane group. Involvement of myelin component was more prominent in the adult patients with longer period of exposure to n-hexane. CONCLUSION: We propose that n-hexane leads to predominantly peripheral nervous system damage, whereas toluene leads to central nervous system involvement.(Return)


The retrospective evaluation on the palliative effect of external radiation therapy in patients with total atelectasis of lung cancer

Erdogan Kocak M, Oner Dincbas F, Koca S

Cerrahpasa J Med 2001; 32: 151-155.

BACKGROUND AND DESIGN: We evaluated the effect of radiation therapy in 27 patients with total atelectasis with lung cancer, between January 1980 and December 1996. The mean age of the patients was 56 years (31-87) of whom 26 were males. The patients were treated by primary radiation therapy, with doses ranging from 3000 to 6600 cGy. Initial symptoms included dyspnea in 24 (%88.8), cough in 22 (%81.4), hemoptysis in 5 (%18.5) and pain in 11 (%40.7) patients. The response of atelectasis to radiation therapy was established on the basis of follow-up chest roentgenograms. Follow-up was 1 to 24 months (median 6 months). RESULTS: Tweenty-seven patients with obstructive atelectasis were treated with external radiation therapy. Subjective response was achieved in %65 (17) of cases, objective response was %74 (20) of the cases. Dyspnea improved in %58.3, cough in %54.3, hemoptysis in %80, pain in %54.5 of the patients. Twelve of 20 patients (%60), who had receive objective responses were treated with doses ranging from 5000-6600. CONCLUSION: Radiotherapy is a feasible treatment modality of total atelectasis developed by means of lung cancer. (Return)


Gastrointestinal complications in renal transplant patients

Ilkova F, Gursu RU, Gunturk A, Dobrucali A, Bal K, Tuncer MM, Oktay E

Cerrahpasa J Med 2001; 32: 156-162.

BACKGROUND AND DESIGN: Gastrointestinal complications are very important in morbidity and mortality of renal transplant receivers in developed countries. In our study we retrospectively examined 140 patients (103 male and 37 female) who had renal transplantation from 1985 to 1999 in Cerrahpa■a Medical Faculty, Internal Medicine Department, Transplantation section. RESULTS: There were 15 patients who smoked cigarette continuously (10.71%). None of the patients had a story of alcohol using and 4 of them (2.85%) used analgesic drugs regularly. Story of gastrointestinal disturbances were found in 23 patients (16.42 %) before transplantation. Stomachache (14 patients) was the most seen disturbances in these patients (60.86%). During the preparation period for the transplantation; gastrointestinal endoscopy was made to 71 patients (50.71%), 22 of them (30.98%) was found to be normal. Pathologies found in 49 (69.01%) patients were; gastroduodenitis (12, 24.48%), duodenal ulcer (9, 18.36%), gastritis (8, 16.32%) antral gastritis (6, 12.24 %) duodenitis (5, 10.20%), gastrooesaphageal reflux and peptic ulcer (4 each, 8.16%). In 38 of 56 (67.85%) patients who had no complaints before transplantation, pathologies were found by endoscopic examination. Prophylactic medical treatment were given to 72 patients (51.42%) before transplantation. The most used drugs were H2 receptor antagonists. CONCLUSION: In our study we found that there is no relationship between gastrointestinal complaints and smoking, alcohol drinking and analgesic using in chronic renal patients who were preparing for transplantation. To find gastrointestinal pathologies; endoscopic examination must be performed to every patient whether they have complaints or not and the pathology must be cured before the transplantation in order to prevent post transplant complications. (Return)


Reconstruction of lower eyelid tumors with Tripier flap

Aydin Y, Guzel Z, Tas T, Kuyubasi S, Yildirim I

Cerrahpasa J Med 2001; 32: 163-168.

BACKGROUND: The aim of the study was to evaluate the late results of lower eyelid defects, which were reconstructed by myocutaneus flaps prepared from upper eyelid and septal chondromucosal graft. DESIGN: 13 patients with lower eyelid defects due to neoplasm resection were reconstructed by myocutaneus flap prepared from upper eyelid and septal chondromucosal graft between 1989 and 1999. RESULTS: Five patients that lost 50% of lower eyelid were reconstructed by unipedicular myocutaneous flaps, while remaining 8 patients with defect of more than 50% of lower eyelid were reconstructed with bidepicular myocutaneous flaps. Patients were followed between 1 to 10 years. No complications were seen during early and late follow up periods. CONCLUSION: Tripier flap is an alternative method to other procedures for lower eyelid reconstructions. It has lower complication rate and functionally and cosmetically better results. Especially it must be the first choice of surgeon for horizontally oriented lower eyelid full thickness defects. (Return)


Experience obtained in an electromyography laboratory after the August 17, 1999 earthquake

Uzun N, Savrun Karaali F, Yazici S, Caksibaeva C, E Kiziltan M

Cerrahpasa J Med 2001; 32: 169-174.

BACKGROUND: In this study, we present the clinical and electromyographic (EMG) findings in patients who were referred to our EMG laboratory after August 17, 1999 earthquake. DESIGN: A total of 80 patients (42 female and 38 male) with a mean of 31,4 were evaluated. 47% of these patients were examined in the first month following the earthquake. 73% of patients were younger than 40 years. EMG examination was performed more than once in 31 patients. RESULTS AND CONCLUSION: Peripheral nerve injury was detected in 83% of the patients, and lower extremity involvement was noted in 47% . Of these patients with peripheral nerve injury, 77.6% were severely affected according to the data obtained with EMG abnormalities. Distal parts of nerve extremities were more frequently injured. Moderate to severe handicap and disability scores between 10-100% were assigned in 90% of the patients. (Return)


Severe hypokalemia and respiratory arrest due to renal tubular acidosis in a patient with primary Sj÷gren's syndrome

Bavunoglu Tufekci I, Tunckale A, Yirmibescik S, Ayata E, Karter Y, Ozturk E, Dogusoy G

Cerrahpasa J Med 2001; 32: 175-179.

BACKGROUND: Sj÷gren's syndrome (SS) is an autoimmune exocrinopathy that involves both glandular and extraglandular systems. This disease may cause hypokalemic quadriparalysis due to distal renal tubuler acidosis (RTA). OBSERVATION: We report here a 19-year-old girl who presented with life-threatening hypokalemic paralysis requiring admission to an intensive care unit. Biochemical investigations showed severe hypokalemia with hyperchloremic metabolic acidosis, a spot urine pH of 6.8, and a positive urinary anion gap, establishing the diagnosis of renal tubular acidosis. A positive Schirmer's test and characteristic findings in a minor salivary gland biopsy revealed Sjogren's syndrome as the underlying cause. She recovered following potassium and alkali replacement. Hypokalemic quadriparalysis due to distal renal tubuler acidosis (RTA) has not previously been reported in Turkish literature. (Return)


Anaesthesia management in the primary bullouse emphysema

Salihoglu Z, Karaca S, Kose Y, Demiroluk S, Demiraran Y

Cerrahpasa J Med 2001; 32: 180-183.

BACKGROUND: Paraseptal emphysema is a kind of lung emphysema. In this emphysema, alveoles swells and connects with each other and eventually generates bullae in the lung. This state is named primary bullouse disease. The patients who have primary bullouse emphysema, anesthetic management must be chosen carefully, because mechanical ventilation can cause explotion of the bullae and this may result in pneumothorax. OBSERVATION: In this case report we presented a patient with primary bullouse emphysema, context primary bullouse disease and its characteristics. (Return)


Epidemiology of deep mycoses; considerations on antifungal prophylaxis and antifungal susceptibility tests

Kantarcioglu AS, Yucel A

Cerrahpasa J Med 2001; 32: 184-199.

BACKGROUND: Invasive mycoses are deep seated fungal infections involving mucosa and penetrate host tissues. This term actually covers "subcutaneous" and "systemic mycoses". The virulence factors of the fungus and host immune status play role in the pathogenesis of invasive mycoses. Fungus that possess high virulence causes diseases in immunocompetent individuals. Invazive fungal infections due to low virulence opportunistic fungi are associated with increased morbidity and mortality in immunocompromised patients. Some of these pathogens show resistance to currently available antifungal agents. Understanding the risk factors associated with deep fungal infection may facilitate identification of high risk patients and guide appropriate initiation of antifungal therapy. This paper briefly reviews current knowledge of the changing epidemiology for invasive mycoses, controversial considerations about antifungal prophylaxis, and current status of antifungal susceptibility tests. (Return)