Bomonti Birası ve Bira Fabrikası

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2013.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Sinan Çetin.Çetin, Sinan. HIST 200-13ÇETİN HIST 200-13/8 2012-1

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

Long extensive transverse myelitis associated with aquaporin-4 antibody and breast cancer: Favorable response to cancer treatment

CONTEXT: Long extensive transverse myelitis (LETM) seldom develops in patients with breast cancer who are aquaporin-4 antibody (Aqp-4 Ab)-positive. Whether this association is coincidental is not well understood. FINDINGS: A 62-year-old woman presented with treatment-resistant LETM and Aqp-4 Ab. Two months later, a stage 3 invasive ductal carcinoma was detected in her right breast. Following tumor resection and chemotherapy, her neurologic symptoms and magnetic resonance imaging findings significantly improved and serum Aqp-4 Ab disappeared. The breast tumor samples of this patient and neurologically normal patients showed inflammatory infiltrates and Aqp-4 expressing cells. CONCLUSION/CLINICAL RELEVANCE: The temporal association between tumor treatment, amelioration of clinical findings, and seroreversion suggest that coexistence of cancer and LETM is not coincidental. Cancer screening should be considered at least in treatment-resistant LETM cases