İç Hastalıkları anabilim dalına beş yıllık süre içinde yatan kronik karaciğer parankim yetmezliği olan hastaların değerlendirilmesi

Bu çalışma Selçuk Üniversitesi Tıp Fakültesi İç Hastalıkları Kliniğinde 1989 - 1994 yıllarında kronik karaciğer parankimal yetmezlik tanısı ile izlenen 200 hastanın epikiriz ve dosya bilgilerinden faydalanılarak geriye dönük olarak yapıldı. Hastaların 3/2 si erkek yaş ortalaması ; erkeklerde 50,5±14,6, kadınlarda 55,2±24 idi. Erkekler daha genç yaşta siroz oluyor görünmekte idi. Etiyolojik olarak ilk 3 sıra şöyle idi 1-%41HBV, 2- % 33, HCV, 3- % 19 alkol Bu sıralama oranlardaki farklılığa rağmen Türkiye'deki yapılan çalışmalardaki sıralama ile uyumlu görünüyor. Yurt dışında yapılan çalışmalar da ise; Avrupa ve ABD'de alkol ilk sırada, üçüncü dünya ülkelerinde ise çok yüksek rakamlarla HBV ilk sırada idi. Hastalar semptomlarına göre şöyle sıralanıyordu; 1- Halsizlik-yorgunluk, 2- Karın şişliği, 3- İştahsızlık ve kilo kaybı Fizik muayene bulgularında en sık hepatomegali daha sonra asit ve splenomegali geliyordu. Semptom ve fizik muayene bulgularındaki sıralama Türkiye'deki genel sıralamaya uygundur. Komplikasyon olarak 5 major komplikasyonda en sık özefagus varis kanaması bulundu. İstanbul'da ise en sık hepatik enselofelapati bulunmuştu.51 Sirozlu hastalarda endoskopik olarak varis kanaması ve ultrasonda vena porta çapına bakıldı. Vena porta çapı arttıkça özefagus varisi ve varis kanaması şansı artıyordu. Tersinden bakacak olursak varis ve varis derecesi arttıkça vena porta çapının arttığı bulundu. Bu Türkiye'deki çalışmalarla uyumlu idi. Fransa ve Avusturya'daki çalışmalarda aradaki bu ilişkinin Türkiye'den zayıf olarak tesbiti anılan ülkelerde hastaların hastaneye erken müracaatından kaynaklanıyor olabilir.This study was performed retrospectively by evaluating the 200 pa tients' data who had the diagnosis of chronic paranchymal liver disease from 1989-to 1994 in Internal medicine Depertmant of Selçuk University school of medicine Two - third of the study population was male (mean age 50, 5±14,6 years), and the remainder was female (mean ages 55, 2±24 years) In the etiolojik distribution ; HBV (% 41) was the leoding cause, where as HCV (% 33) was the second and alcohool consumption was the third causal factor. Although there are some differences in the ratios, this distribition was consistent wilh the results of other studies in Turkey. On the other hand, while the leading couse of chronic parenchymal liver disease is alcohool con- siymption in Europa and USA, it is an infectious agent, HBV, in developing countries weakness and fainting, abdominal swelling and loss of appetite and body weight were the most promient symptomps. The commonest abnomality in physical examination was hepatome- paly which was followed by ascitess and splenomegaly. The distribution of symptomps and physical findings were consistent with the distribution in li terature published in Turkey. In aur study, easophagial bleeding dup to varicess was the leading complication of the 5 the major complication while hepatic encephalopathy was reported as the commonestona of chronic liver disedse in Istanbul. The findings of endoscophic and ultrasonic examinations were also consistent with other studies which performed in Turkey that implies the wider v. porta diameter, the more common varices bleading Lack of such a strong correlation about this topic in France and Austuria might be due to more earlier sealing of medical aid of the patiants in these countries.53 Uzmanlık eğitimime bilgi ve deneyimleri ile yol gösteren, S.Ü. Tıp Fakültesi îç Hastalıkları A.B.D. Başkanı Sayın Hocam Prof. Dr. Ahmet YILMAZ, Doç. Dr. Şamil ECİRLİ, Doç. Dr. Mehdi YEKSAN, Doç. Dr. Ahmet KAYA ve emeği geçen diğer tüm hocalara şükranlarımı sunarım. Tezimin hazırlanmasında katkıları nedeniyle, başta Sayın Hocam Yrd. Doç. Dr. Hakkı POLAT olmak üzere emeği geçen herkese teşekkür ederim. Dr. A. Hamdi EKİCİ Haziran 1995 KONY

Investigation of Elemental Distribution in the Sheet Sections After Aluminum Continuous Sheet Casting, Cold Rolling and Heat Treatment Processes

Aluminum is used in millions of different products in many diverse industries from the aerospace industry to the food industry. Owing to its low density, high strength when alloyed, high elasticity, recyclability, high resistance to corrosion, easy workability, high heat and electrical conductivity, light and heat reflectivity and environmental friendliness; aluminum has become a material seen in all aspects of daily life. Twin roll casting products are converted into either flat plates or rolls of metal by cold rolling with the final thickness, surface quality, mechanical and metallurgical properties in mind; and are fine tuned for the desired application. Inherently low strength values of pure aluminum can be increased considerably by alloying with other metals. The most commonly used alloying elements for aluminum are: Cu, Mg, Si, Mn, Fe and Zn. The phase distribution in aluminum sheets is an important metallurgical condition affecting the final mechanical properties of the sheet and plate products. The amount of deformation experienced by the material in the rolling process changes the inner structure of the material. In this study, elemental analysis distributions were investigated depending on the amount of mechanical deformation in forging alloys, heat treatment temperature and duration, and process differences

The Distribution of Hepatitis C Virus (HCV) Genotypes in 59 HCV Infected Patients: A Multicenter Study

Eighty anti-HCV positive serum samples were collected at university centers in Malatya, Erzurum, Samsun and Konya. HCV-RNA sequences were detected in 59 (73.3%) of these samples by reverse transcriptase-polymerase chain reaction (RT-PCR) using primers from the 5’ non-coding region. HCV-RNA positive samples were subsequently genotyped using type-specific primers from the core region of the virus. Type II (I b) infection was detected in 41 samples (69.5%), while a mix type I (I a) and II (I b) infection were found in another 3 samples (5.1%). The remaining 15 samples (25.4%) could have not been typed. These results together with the results of previous studies suggest the predominance of genotype II infection in Turkish patients which is known to have poorer prognosis and lower responce to interferon treatment