Object. Melatonin is a very effective antioxidant agent. This study was performed to investigate the effects of melatonin in experimental spinal cord injury (SCI). The authors also compared its effects with those of methylprednisolone, which also protects the spinal cord from secondary injury because of its antioxidant effect on membrane lipids. Methods. Adult male albino rats were used for the study, and paraplegia was produced using a previously described weight-drop technique. Melatonin and methylprednisolone were given intraperitoneally by bolus injections of 100 mg/kg and 30 mg/kg, respectively, immediately after induction of trauma. The animals were killed, and 1-cm samples of injured spinal cord were obtained at 1, 24, and 48 hours postinjury. Lipid peroxidation was estimated by thiobarbituric acid test. Electron microscopic studies were performed to determine the effects of melatonin on neurons, axons, and subcellular organelles after experimental SCI. A grading system was used for quantitative evaluation. Following SCI, there was significant increase in lipid peroxidation. In melatonin- and methylprednisolone-treated groups, lipid peroxidation was found to decrease to the baseline (preinjury) levels. There was a significant difference between trauma-alone and treatment groups, but no statistical difference was found between the melatonin- and methylprednisolone-treated groups. Electron microscopic findings showed that SCI produced by the weight-drop technique resulted in profound tissue damage. Conclusions. Both melatonin and methylprednisolone have been shown to protect neuron, axon, myelin, and intracellular organelles including mitochondrion and nucleus. However, this study provides quantitative evidence that this protection of neurons and subcellular organelles of spinal cord after secondary injury is much more obvious in melatonin-treated rats than those treated with methylprednisolone. In view of these data, melatonin has been shown to be very effective in protecting the injured spinal cord from secondary injury.

AMAÇLiteratürde, yaşlılarda akut apandisitin özellikleri bazı ça-lışmalarda tarif edilmiştir, ancak skorlama sistemlerinin uygulanabilirliğini değerlendiren bir çalışma yoktur. Bu çalışmanın amacı 65 yaşından yaşlı hastalarda Alvarado ve Lintula skorlarını karşılaştırmaktır. GEREÇ VE YÖNTEMTanısı patolojik inceleme ile kesinleşmiş 65 yaşından yaş-lı hastalar, büyük acil polikliniğine başvuruları sonucunda spesifik olmayan karın ağrısı tanısı almış aynı yaş grubundaki hastalarla başvuru yılına göre sınıflandırılarak karşı-laştırıldı. Alvarado ve Lintula skorları hasta dosyalarından retrospektif olarak hesaplandı. BULGULARHer iki skorlama metodu da apandisite bağlı karın ağrısı ve spesifik olmayan karın ayrısını ayırt etmede başarılı bulundu. Alvarado skoru, Lintula skoruna göre öngörme özelliği açısından üstündü. Kontrol ve apandisit gruplarında iki parametrenin (tınlayıcı, tiz bağırsak sesleri olması veya bağır-sak seslerinin alınamaması ve bulantı) prevalansı benzerdi. İki skor, bu iki parametre olmadan tekrar hesaplandı. Dü-zenleme sonrası iki skorda daha iyi ve birbirlerine daha çok benzer sonuçlar verdi. SONUÇGeriatrik yaş grubunda hem Alvarado hem de Lintula skorlarının akut apandisitin tanısında yüksek sensitivite ve spesifitesi vardır. Bu skorların performansları "bulantı" ve "tınlayıcı, tiz bağırsak sesleri olması veya bağırsak seslerinin alınamaması" parametreleri çıkartıldığında daha iyi hale gelmektedir.Anahtar Sözcükler: Akut apandisit; Alvarado skoru; yaşlı; Lintula skoru.

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Background: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It is related to various etiological factors. The treatment of IGM is challenging as there is a lack of consensus in the literature and treatment options vary widely. Conservative treatment with antibiotics, glucocorticoids and immunosuppressive drugs, and surgery are used in the management of the disease. In this article we report our experience with IGM patients receiving immunosuppressive treatment. Patients and Methods: The medical records of patients with IGM receiving systemic therapy at the Hacettepe University Hospital between October 2007 and May 2010 were reviewed. 15 cases of histopathologically proven IGM were identified. The data was examined for risk factors and success of treatment. Results: 14 patients were given prednisolone together with azathioprine, and 1 patient who was pregnant at the time of diagnosis received only prednisolone (30 mg/day). 11 (73%) patients had a complete response to systemic therapy. 2 patients had a relapse, of whom 1 required surgical drainage and 1 was treated with a higher dose of glucocorticoids. Conclusion: Systemic therapy is a safe and effective treatment for IGM. The addition of azathioprine to glucocorticoid therapy permits quick tapering of the steroid doses and increases the treatment success.

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