ISSN: 2149-2247 | E-ISSN: 2149-2549
ERCİYES MEDICAL JOURNAL - Erciyes Med J: 36 (3)
Volume: 36  Issue: 3 - 2014
REVIEW
1.Next-Generation DNA Sequencing Technologies
Gülsüm Kayman Kürekçi, Pervin Dinçer
doi: 10.5152/etd.2014.7803  Pages 99 - 103
Recently, the requirement for fast, low-cost, and highly reliable methods has triggered the development of next-generation DNA sequencing technologies. In addition to overcoming the restrictions in Sanger sequencing methods, large-scale genetic data have provided the development of different analysis methods. In this paper, widely used next-generation sequencing platforms, the analyses of the data obtained, and the applications of these technologies are discussed.

ORIGINAL ARTICLE
2.Ophthalmopathy Consciousness Level in Graves Patients: Graves Ophthalmopathy
Elif Kılıç Kan, Emrah Kan, Gülçin Cengiz Ecemiş, Çiğdem Tura Bahadır, Ramis Çolak
doi: 10.5152/etd.2014.7982  Pages 104 - 107
Objective: We aimed to examine the knowledge and consciousness levels of participators about Graves orbitopathy (GO) by conducting an investigation of ophthalmopathy consciousness of Graves patients, providing coordination among all health institutions and ophthalmologists and giving information about the subject to patients.
Materials and Methods: A total of 50 Graves patients applying to the Ondokuz Mayis University Endocrinology outpatient service were included in the study. Specially prepared questionnaire forms were used for the evaluation. The education levels of the patients were evaluated in four groups as illiterates and graduates of primary school, secondary school-high school, and university.
Results: Overall, 38.8% of the graduates of primary school, 71.4% of the graduates of secondary school-high school, and 63.6% of university graduates had GO consciousness. Although 24% of the patients had this consciousness, they were not going to regular eye check-ups; 86% of the patients had this GO information through their physicians. Also, 46% of the patients were smoking, and it was detected that just half of them were warned about smoking.
Conclusion: It was observed that although the patients who were followed up with Graves were seen by all healthcare centers, they were not adequately informed about eye involvement. Thus, these patients should be informed at the first visit, and regular ophthalmologic examinations should be provided for them.

3.The Current Situations and Problems of Family Physicians in the Province of Kayseri and Their Views about the Family Medicine System
Fevziye Çetinkaya, Zeynep Baykan, Melis Naçar, Ahmet Öksüzkaya
doi: 10.5152/etd.2014.7535  Pages 108 - 114
Objective: The purpose of the study is to determine the current situations and views of family physicians in Kayseri province about the family medicine system.
Materials and Methods: This study, carried out in Kayseri province in 2012, administered a questionnaire to 325 family physicians.
Results: The top reasons for preferring to be a family physician are the desire to be in the new system, high income, and the view that it is more prestigious than being a general practitioner. Also, 44.9% of the physicians stated that they were worried about the exit of enrolled people from their list, and 42.8% of them stated they are worried about other physicians’ desire to take their population; 63.8% of them stated that the system caused moral corruption, and 43.3% of them stated that it ruined the team approach. Almost half of the physicians (45.9%) stated that the family medicine system caused anxiety for the future, and 42.3% of them mentioned that it affected their personal rights negatively. The physicians claimed a mostly unnecessary medical report (92.5%), prescribing medicine without seeing the patient, and facing requests of prescribing unnecessary medicaments as problems. One-third of the physicians believed that the system increased drug consumption. The rate of physicians who believed that the system increased workload was 73.0%; 52.7% of the physicians were content with working in the family medicine system. The only factor affecting the contentment of the physicians with working in the system according to the logistic regression analysis was thinking that it was prestigious to work as family physicians.
Conclusion: Half of the physicians were satisfied with working in the system. They thought of the improvement of factors providing patient satisfaction as a positive aspect of the system and an increasing work load, corruption, and the increase in the use of medicaments as negative aspects.

4.Does Septoplasty Affect Middle Ear Pressure and Eustachian Tube Function?
Mehmet İlhan Şahin, Şafak Güleç, Ümit Perişan, İsmail Külahlı
doi: 10.5152/etd.2014.8745  Pages 115 - 118
Objective: To investigate the effects of septoplasty on middle ear pressure and Eustachian tube function.
Materials and Methods: Patients who were suffering from nasal obstruction and underwent septoplasty due to nasal septal deviation and healthy volunteers not suffering from nasal obstruction were involved in the study. Nasal patency was evaluated by rhinomanometry, and middle ear pressure and Eustachian tube function were evaluated by tympanometry. Total nasal resistance (TNR) and tympanometric peak pressure (TPP) values were used for this purpose. If TPP changed more than ±10 daPa with Valsalva and Toynbee maneuvers, the Eustachian tube function of that ear was accepted as good. Rhinomanometry and tympanometry measurements were performed for patients in the preoperative period and in the 1st and 3rd postoperative months. To determine the normative levels of TNR, rhinomanometry was performed in the control group.
Results: Twenty-three patients and 30 volunteers were involved in the study. The preoperative TNR values of the patients were remarkably higher than the control group (p<0.001), but they decreased significantly in the 1st and 3rd postoperative months (p<0.001), and they were similar to those of the control group in the 3rd postoperative month (p>0.05). Middle ear pressures and Eustachian tube function did not differ significantly in the 1st and 3rd postoperative months compared to the preoperative period (p>0.05).
Conclusion: It was found that septoplasty did not affect middle ear pressure and Eustachian tube function.

5.Evaluation of Hearing Loss in Patients with Ankylosing Spondylitis
Mehtap Bozkurt, Mehmet Çağlayan, Demet Uçar, Pelin Oktayoğlu, Serda Em, Ramazan Gün, Ali Gür, Kemal Nas
doi: 10.5152/etd.2014.7024  Pages 119 - 122
Objective: The aim of this study was to evaluate the rate of hearing loss in patients with ankylosing spondylitis (AS) and to analyze whether the rates of hearing loss were different from the control group or not.
Materials and Methods: A total of 50 AS patients and 34 healthy controls were enrolled into the study. Physical examinations and disease activity score measurements were performed in patients with AS.
Results: The mean age was 32.20 years (18-55) in AS patients and 35.58 (20-50) in the control group. The mean disease duration was 5.27 years (0-22) in patients with AS. Hearing loss was detected in seven (14%) of the AS patients and three (8.8%) of the control patients. In terms of hearing loss, a statistically significant difference was not found between the two groups. Sensorineural hearing loss was the most commonly detected type of hearing loss in the two groups. Hearing loss was present in two (28.5%) of the seven AS patients in whom the duration of disease was more than 10 years. There was no statistically significant correlation between the duration of disease and hearing loss.
Conclusion: There was no significant difference between the AS and control groups with respect to hearing loss. The rate of hearing loss increased in line with the duration of disease.

6.Open Heart Surgery in Dialysis-Dependent Chronic Kidney Failure Patients: Clinical Experience
Orhan Bozoğlan, Bülent Meşe, Erdinç Eroğlu, Ekrem Doğan
doi: 10.5152/etd.2013.61  Pages 123 - 126
Objective: We aimed to present patients with dialysis-dependent chronic kidney failure who underwent open heart surgery.
Materials and Methods: Sixteen patients with dialysis-dependent end-stage chronic kidney failure (7 males, 9 females; mean age 62±11; range 30-75) were involved in the study. Coronary artery bypass surgery was performed for 12 patients, 2 patients underwent both coronary artery bypass surgery and aortic valve replacement, 1 underwent both ascending aorta and aortic valve replacement, and right atrial myxoma resection was performed for 1 patient. The preoperative, intraoperative, and postoperative data were analyzed retrospectively.
Results: Fourteen patients underwent coronary artery bypass surgery, and the mean distal bypass was found to be 3.07±0.9. The mean cross-clamp time was 50±27 minutes, and the total cardiovascular bypass duration was 87±40 minutes. None of the patients needed revision. The mean drainage volume was 500±150 milliliters. Atrial fibrillation occurred in 4 patients (25%), and all of them converted to sinus rhythm through medical treatment. One patient died on the second postoperative day because of fatal arrhythmia that occurred after dialysis, and 1 patient died because of low cardiac output during the intensive care follow-up. The mortality rate was 12.5%. The mean intensive care unit hospitalization time was 52±4 hours, and the total hospitalization time was 7±2 days.
Conclusion: Open heart surgery can be performed with acceptable mortality and morbidity rates for patients having dialysis-dependent chronic kidney failure.

CASE REPORT
7.Clavis Panax Induced Anxiety Disorder: A Case Report
Abdullah Akpınar, Ayşe Rümeysa Yaman, Cafer Çağrı Korucu, İnci Meltem Atay
doi: 10.5152/etd.2014.7200  Pages 127 - 129
Herbal mixtures are frequently used by some patients as treatment options due to the belief that they do not have any side effects. This case report presents a male patient who used clavis panax in order to ameliorate his diabetes mellitus. In the third week of his clavis panax use, he was admitted to the hospital with complaints of uncontrollable worries about almost everything, restlessness, difficulty breathing, fatigue, and sleep disorder. Clavis panax-induced anxiety disorder is presented in this case report. Herbal preparations should be carefully evaluated in terms of their side effects, as well as their possible benefits.

8.A Case Report: Hallermann-Streiff Syndrome
İbrahim Hakan Bucak, Gökhan Tümgör, Perihan Yasemen Canöz, Göksel Leblebisatan, Mehmet Turgut
doi: 10.5152/etd.2013.5413  Pages 130 - 2
Hallermann-Streiff is a rare syndrome characterized by multiple congenital anomalies, especially in the head and face. It was first described by Hallermann in 1948 and later by Streiff in 1950. Patients have a bird-like face, skin atrophy, dwarfism, various eye abnormalities, and hypotrichosis. In the case admitted to our hospital with complaints of fever, cough, and failure to thrive, we detected microphthalmia, bilateral leukocoria, cataract, eyebrow hypotrichosis, a prominent nose, and depressed nasal root. The patient was diagnosed with Hallermann-Streiff syndrome. This case was presented because of its rare occurrence in the literature.

9.Protective Surgical Procedures for Carotid Body Tumors: A Case Series
Faruk Toktaş, Gündüz Yümün, Arif Gücü, Tuğrul Göncü, Cüneyt Eriş, Çağdaş Çayır, Kağan As, Şenol Yavuz
doi: 10.5152/etd.2013.65  Pages 133 - 135
Glomus tumors are benign tumors that originate from neural non-chromaffin cells. Its symptoms usually depend on the mass effect. The tumor can be treated with embolization, excision, and radiotherapy. The most important complications of surgery are hemiplegia and nerve injury at the surgical site. In this article, we report four cases of carotid body tumor. Four female patients presented with neck swelling and/or hypertension, and the diagnosis was made with the aid of ultrasonography, angiography, and computed tomography. These cases were classified as type 3 according to Shamblin’s classification, and surgical resection was performed under local anesthesia without the need for graft interposition. These tumors were excised with the carotid artery adventitia. No complication associated with the surgery was observed in any patient.

10.The Retroconversion of Immature Teratoma with Chemotherapy: A Case Report and Review of the Literature
Oktay Bozkurt, Halit Karaca, Eray Eroğlu, Sümeyra Koyuncu, Veli Berk, Mevlüde İnanç Polat, Ayşe Ocak Duran, Ersin Özaslan, Melike Ordu, Gülşah Çubukçu, Metin Özkan
doi: 10.5152/etd.2013.66  Pages 136 - 138
Immature ovarian teratoma is a rarely seen germ cell tumor. Although testicular germ cell tumors and their association with chemotherapeutic retroconversion have been reported at a substantial rate of 2%-8% in the literature, the retroconversion of immature ovarian teratoma to mature teratoma is quite uncommon. It is important to reveal this conversion by biopsy for establishing a subsequent treatment chart of patients. A 45-year-old female patient was operated on due to immature ovarian teratoma. Then, she was re-operated on, because local recurrence occurred during the drug-free follow-up period, and systemic chemotherapy was administered. Liver metastasis was detected after chemotherapy, and the liver biopsy demonstrated a mature teratoma. This case is presented in this paper.

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