Erkan Melih Şahin

Inflammatory Myofibroblastic Tumor of the Gallblader

BACKGROUND Inflammatory myofibroblastic tumors are rare benign tumors that can mimic malignancy. Their precise aetiology is unknown. They are seen more frequently in childhood and the most common involvement is seen in the lungs. Primary inflammatory myofibroblastic tumors of the gallbladder are rather infrequent. The present knowledge is based on case reports. CASE REPORT A 66 year-old male patient presented to the hospital with complaints of abdominal pain, nausea and vomiting. Upon physical examination, a clinical picture of abdominal tenderness on the right upper quadrant of the abdomen was identified. Laboratory examinations revealed leukocytosis and hypochromic microcytic anaemia with an increased erythrocyte sedimentation rates and C-reactive protein levels. A mass almost completely filling the gallbladder was detected by imaging studies. The patient was operated on with a malignant preoperative diagnosis and underwent a liver resection of segments 4 and 5, which included a cholecystectomy. The histopathological examination of the surgical specimen revealed an inflammatory myofibroblastic tumor including many histiocytes stained positively with CD 68. CONCLUSION Inflammatory myofibroblastic tumors can be localised in the gallbladder mimicking gallbladder cancer.

Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children.

BACKGROUND There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. AIMS To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. STUDY DESIGN Prospective clinical trial. METHODS PATIENTS SCHEDULED FOR ADENOIDECTOMY OR TONSILLECTOMY WERE CLASSIFIED INTO THREE GROUPS BASED ON INDICATIONS: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. RESULTS Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. CONCLUSION In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.

Çocuklarda kulak burun boğaz muayene sonuçları ve etkileyen faktörler: Okul tabanlı-kesitsel çalışma

Giris: Calismada okul cagi populasyonunda kulak burun ve bogaz muayenesi yaparak sik gorulen patolojileri ve bu durumlarla iliskili faktorleri saptamak amaclanmaktadir. Yontem: Kesitsel desendeki calisma Eylul-Aralik.2013 tarihleri arasinda Canakkale il merkezindeki ilk ve ortaokullarda yapildi. Ogrencilerin ve ailelerinin hastalik oykulerini ve aliskanliklarini sorgulayan anket uygulandi. Kulak, burun ve bogaz muayeneleri yapilarak, ogrencilerin muayene formlarina not edildi. Bulgular: Calismaya toplam 1938 ogrenci alindi. Ogrencilerin 1369 (%70,6)’u ilkokul, 569 (%29,4)’u ortaokulda egitim gormekteydi. Ogrencilerin yas ortalamasi 8,6 ± 2,3 idi. Calismada sirasiyla tonsiller hipertrofi %25,2, kepce kulak %14,8, otitis media %3,3, anterior nazal deviasyon %10,4 siklikta gozlendi. Kepce kulak erkek ogrencilerde daha fazlaydi (p0,05). Sonuc: Okul cocuklarinda sirasiyla tonsiller hipertrofi, anterior nazal deviasyon ve otitis media en sik saptanmistir. Ogrencilerin ve ailelerinin tibbi oyku ozellikleri ile ailelerin tibbi oyku ve aliskanliklari, kulak, burun ve bogaz patolojisinin varligi icin risk faktoru degildi.

Developing of health perception and psychosocial skills in disadventaged students: a school based interventional study from Çanakkale

AIM: The aim of this study was to develop health perception and psychosocial skills in disadvantaged students in a primary school. METHOD: This interventional study was conducted in a primary school between May 2012 and June 2012 in Kepez, Canakkale within the context of “Consultancy Application in Primary Schools”as the first step of “From Local to Cambridge and NASA: Development of Canakkale Values and Promotional Awareness in Disadvantaged Students” (TR22.11.SK01.0111) project. Fifteen students with different disadvantages at the 5th,6th,7th,and 8th grades in the second semester were included in the study. Training studies were performed to develop psychosocial skills and health perception of students. These studies were performed at the school library twice a week for three weeks. In this study, socio-demographic, health perception evaluation and psychosocial skill evaluation forms were used as material. Study data were analyzed using by SPSS, 15.00 version. RESULTS: Most students (66.6%) were female. Statistically significant difference was defined in psychosocial skill developments of students between the median values measured three weeks apart (p

Farklı bir klinik tabloyla başvuran, sigmoid ve inen kolon yerleşimli mezenterik kist: Olgu Sunumu

The colon mesentery is the origin of approximately 20% of childhood mesenteric cysts. Although these cysts are mostly asymptomatic, they may cause various clinical pictures according to the dimension, localization, and content of the cyst and whether it is complicated. Children may therefore present with symptoms of abdominal pain, nausea, vomiting, constipation, diarrhea, weight loss, abdominal mass, distention, and may also suffer from various findings related to the cyst such as torsion, infection, hemorrhage and rupture. We present a mesenteric cyst case originating from the descending and sigmoid colon mesentery that presented with symptoms of fever, abdominal pain and diarrhea considered to be due to the infection of the cyst in the descending colon

Unclassified Diffuse Ductal Cholangiocarcinoma; Report of a Case

Cholangiocarcinoma (CCA) is the second most common malignant tumor of the liver. It is simply classified as intrahepatic and extrahepatic CCA (including perihilar and distal extra hepatic CCA) according to the anatomic localization. Various classification systems were described for staging cholangiocarcinoma. We represent an interesting case of cholangiocarcinoma which is in the shadow area of classification by involving intrahepatic, hilar, and distal extra hepatic bile ducts. To our knowledge, this is the first case in the literature with diffuse bile duct involvement.

Kardeşlerinin saçını yolan farklı bir trikotillomani olgusu / The child who pulls his little brothers’ hair: a different trichotillomania case

Trikotillomani, cocukluk cagi alopesi nedenlerinden biridir. Sunmus oldugumuz olgu, 8 yasinda olup, yaklasik 4 yildir suren sac yolma, tirnak yeme, burun karistirma, tirnak yolma ve sac derisini koparma yakinmalari ile getirilmistir. Sac bolgesinin ozellikle frontal ve verteks kisminin etkilendigi gozlenmistir. Olgunun saclarini infantil donemde yolmaya basladigi ve kronik, duzelmeyen bir gidisinin oldugu ogrenilmistir. Son 2 yildir, kendisinden kucuk iki kardesinin sacini yolmaya basladigi ve siklikla birlikte oyun oynarken veya kardesleri uyurken saclarini yoldugu belirtilmistir. Her iki erkek kardesinin sacli derisinde alopesi gozlenmistir. Evde siklikla kavga, siddet ve olumsuz davranislarin oldugu ogrenilmistir. Literaturde kardeslerinin sacini yolan vaka sayisi oldukca seyrektir. Cocukluk caginda yasanan travma, fiziksel ve duygusal ihmalin ve olumsuz etkilenmis olan anne-cocuk iliskisinin bu vakada ortaya cikan trikotillomani icin onemli etmenler oldugu dusunulmustur. Cocukluk cagi trikotillomani olgularinda kardesler uzerinde herhangi bir belirtinin olup olmadiginin arastirilmasi onemlidir.