Cesarean scar pregnancy: A case report

Pregnancy implantation to the cesarean scar could be the life threatening, although it is a rare event, its ratio increased along with the increasing rate of cesarean delivery. Early diagnosis and treatment may be lifesaving with preserving fertility in these patients. In transvaginal ultrasonography; presence of an empty uterine and cervical cavity, lack of continuity of myometrial setting at the anterior isthmic region and pregnancy implantation to this region should suggest the diagnosis. In this article, we aimed to present a patient with scar ectopic pregnancy with the review of the literature

The Misdemeanor of Intoxication

Intoxication refers to the temporary deterioration in the perception and reasoning of a person as a result of using substances such as alcohol and drugs. The drunk person cannot control his/her movements in this state. Although the legislator does not foresee administrative sanctions for the act of intoxication alone, it is a misdemeanor that the drunkenness has reached a state that will affect the society. In this study, it is aimed to examine intoxication misdemeanor, which is regulated in article 35 of the Law on Misdemeanors, in the context of Turkish criminal and misdemeanor law. For this purpose, first the concept of intoxication is defined, then misdemeanor of intoxication is analyzed.Sarhoşluk; alkol, uyuşturucu gibi maddelerin kullanımı neticesinde kişinin algı ve muhakemesinde meydana gelen geçici bozulmayı ifade eder. Sarhoş olan kişi, bu durumdayken hareketlerini kontrol edemez. Kanun koyucu tek başına sarhoşluk fiili için idari yaptırım öngörmemekle birlikte, sarhoşluğun toplumu etkileyecek bir hale gelmesi durumunu kabahat olarak düzenlemiştir. Bu çalışmada Kabahatler Kanunu’nun 35. maddesinde yer alan sarhoşluk kabahatinin Türk ceza hukuku ve Türk kabahatler hukuku bağlamında incelenmesi amaçlanmaktadır. Bu amaçla, ilk olarak sarhoşluk kavramı açıklanmış, ardından sarhoşluk kabahati unsurlarına ayrılarak incelenmiştir

Çocuklarda üst gastrointestinal sistem endoskopilerinde duodenal patolojiler

Aim of this study, to determine the significance and rate of duodenal pathology during Eosophagogastroduodenoscopy (EGDs) in childhood and relation to pathological diagnosis. We evaluated 227 diagnostic EGDs with duodenal biopsies performed in consecutive infants (mean age; 6 month to 20 years; average age, 10.6 years) during the 24-month period from August 2000 to August 2002 retrospectively. Indications of EGDs included chronic abdominal pain (n=116; 52%), suspected gluten sensitive enteropathy (GSE) (n=37; 16%), upper GIS bleeding (n=34; 15%), evaluated for portal hypertension (n=24; 11%) and vomiting (n=14; 6%). Duodenal pathology was found in 39 of 227 patients (17%). Pathologic examination revealed villous atrophy (18 patients; 46%), bulbitis (15 patients; 38%), duodenitis (n=11; 28%), lymphocytes infiltration (n=7; 18%), and duodenal ulcer (n=2; 5%). Of 20 patients diagnosed GSE (54%), followed by Helicobacter pylori infections 13 patients (35%), duodenal ulcer 2 patients and giardiasis 1 patient respectively. Endoskopic duodenal pathology was very rare condition among the patients with portal hypertension (n=3; 0.8%). In cases with GSE mucosal flatting was found to be the most significantly sign (n=10; 50%), followed by granularity (n=5; 20%), mucosal fissured (n=3; 15%) and normal appearance (n=3; 15%) respectively. Duodenal mucosal pathologies were detected 14 of 124 patients by normal EGDs during study period. In this study we found that negative predictive value of 87%, positive predictive value %65 for gastric pathology. The negative predictive value of a normal appearing duodenal mucosa was found 90% arid pozitif prediktif value %68.Bu çalışmanın amacı çocuklarda üst gastrointestinal sistem endoskopilerinde duodenal patolojilerin oranı ve önemi ve patolojik tanıyla ilişkisini saptamaktır. Ağustos 2000-Ağustos 2002 tarihleri arasında 24 aylık sürede tanısal amaçlı yapılan ve rutin duodenal biyopsi alınan 227 üst gastrointestinal sistem endoskopisi değerlendirildi (6 ay-20 yaş arası, ortalama 10.6 yaş). Endoskopi kronik karın ağrısı, (n=116; %52), gluten sensitive enteropati (GSE) şüphesi (n=37; 16), üst GIS kanaması (n=34; %15), portal hipertansiyon için değerlendirme ( n=24; %11) ve kusma (n=14; %6) nedeni ile yapıldı. Histolojik olarak duodenal patoloji 39 hastada saptandı (%17). Patolojik incelemede villöz atrofi (n=18; %46), bulbit (n=15; %38), duodenit (n=11; %28), lenfosit infiltrasyonu (n=7; %18) ve duodenal ülser (n=2; %5) saptandı. 20 hastaya (%54) GSE, 13 hastaya (%35) Helicobacter pylori enfeksiyonu, 2 hastaya duodenal ülser ve bir hastaya giardiyazis tanısı konuldu. Portal hipertansiyonlu hastalar arasında endoskopik olarak duodenal patoloji çok nadir bulundu (n=3; %0.8). GSE'Iİ hastalarda mukoza kıvrımlarının düzleşmesi en önemli bulgu olarak tespit edildi (n=10; %50), Bunu sırasıyla granülarite (n=5; %20), mukozal fissürler (n=3; %15) ve normal görünüm (n=3; %15) izliyordu. Üst GIS endoskopisinde duodenumu normal olarak görülen 124 olgunun 14'ünde duodenal mukozal patoloji tespit edildi. Mide patolojilerinde endoskopinin pozitif tahmin değeri %65, negative tahmin değeri %87, normal görünümlü duodenal mukoza için pozitif tahmin değeri %68, negative tahmin değeri %90 olarak bulundu

Erken süt çocukluğu döneminde Crohn hastalığı: Olgu sunumu

Crohn disease is rare in infancy and early childhood. It is reported that patients with Crohn disease are usually diagnosed during school age and adolescence periods. Chronic diarrhea, failure to thrive, rectal bleeding, abdominal pain, fever, oral and perianal lesions and high levels of acute phase reactants suggest Crohn disease. Inflamatuar bowel diseases should be considered in cases with intractable amoebiasis. Inflammatory bowel diseases should be taken into account for differential diagnosis in cases with amoebiasis resistant to therapy.Crohn hastalığı süt çocukluğu döneminde sık görülmez. Çocukluk yaş grubunda olgular genelde okul çağı ve adolesan yaşlarda görülür. Kronik ishal, gelişme geriliği, rektal kanama, karın ağrısı, ateş, oral ve perianal lezyonların varlığı, yüksek akut faz reaktanlari Crohn hastalığını düşündüren bulgulardır. Öte yandan, amip tedavisine karşın iyileşmeyen amebiyazis olgularında, bu durumun inflamatuvar barsak hastalığına bağlı olabileceği akılda tutulmalı, tedaviye dirençli amip enfeksiyonlarında ayırıcı tanıda inflamatuvar barsak hastalıkları düşünülmeli ve araştırılmalıdır

Determination of intracellular Th1/Th2 type cytokines in lymphocytes of chronic hepatitis B patients treated with interferon-alpha

WOS: 000287286100011PubMed ID: 21331994Background/aims: Host-related immune factors in childhood chronic hepatitis B and change in the initial profile with interferon (IFN)-alpha treatment need to be clarified. Methods: Sixteen patients were included in the study, and 10 million units of IFN-alpha treatment 3 times per week for 6 months was initiated. Pre- and post-treatment percentages of interleukin (IL)-2 and IFN-gamma in CD4+ T cells were assessed to determine intracellular T helper cell 1 (Thl) type cytokine expression. Similarly, percentages of intracellular IL-2 and IFN-gamma were detected to verify cytotoxic T cell 1 (Tc1) type cytokine expression in CD8+ T cells. Percentages of Th2 and Tc2 type cytokine expression (IL-4 and IL-13) were determined in CD4+ and CD8+ T cells, respectively. Resuts: Six (50%) of these were evaluated as having no response and the other half with partial complete response. All patients had higher percentages of Th2 cells with respect to healthy controls pre-treatment. Tc percentages, both Tc1 and Tc2, were significantly different between these groups, being higher in the patient group. When values of the nonresponder group were compared with healthy controls, IL-4 expression was higher and the percentages of Th1 type cells were significantly low. IL-13 expression in Th2 and Tc2 cells decreased after 6 months of treatment in the unresponsive group. The decrease we observed in Th1 percentages with treatment, in the responsive group, may be due to Thl deposition shifting from the periphery to liver tissue, as reported before. Intracellular cytokine profiles of treatment responders and normal controls were not different. Results: This is the first study in children comparing baseline and post-treatment intracellular cytokine profiles with values in healthy controls