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The factors associated with hypocalcaemia were defined to be "gender, preoperative diagnosis, parathyroid gland injury, nodule size and vitamin D deficiency", it is a multifactorial problem and it would not be proper to define a few etiological factors.

Objective: Blue code systems (BCS) are communication systems that ensure the most rapid and effective resuscitation when a patient is in respiratory or cardiac arrest. A hospital employee faced with the situation of a cardiopulmonary arrest (CPA) starts the system by dialing 6666 from any phone in the hospital. We created a five-person team that includes a doctor, nurse, anesthesia technician, stretcher officer and security guard. The purpose of this study is to share our experiences in initiating the use of the BCS in our hospital. Materials and Methods:In our hospital, the records of calls that were made by Callvision BCS were analyzed retrospectively from May 2010 to the end of January 2011.Results: A total of 474 calls were made using the blue code system. Of those calls, 402 (84.5%) were determined to be inappropriate calls. The remaining 72 calls were responded to. Of the 72 patients who were treated, 21 were discharged after they were hospitalized in the service or intensive care unit, 45 cases resulted in exitus, and 5 cases were referred to the Ataturk University faculty of medicine. Conclusion:The BCS has achieved its goal. The discharge rate of 29.5% that we achieved is a successful result.

Objective: In this study, anticancer effects of mirtazapine on rats were investigated in an adenocarcinoma model induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and compared with those of cisplatin. Materials and Methods: For this purpose, 10 mg/kg doses of mirtazapine were administered orally to one group of rats, while 1 mg/kg doses of cisplatin were administered intraperitoneally to another group. At 1 hour after administration, 200 mg/kg doses of MNNG were given orally to both groups. MNNG administration was repeated once every 10 days through 3 months, after which period, gastric tissue was taken and pathologically evaluated. Results: Mirtazapine prevented adenocarcinoma induction by MNNG in rats to a greater extent than cisplatin. Some of the rats receiving cisplatin demonstrated severe dysplasia in gastric samples and others exhibited mild dysplasia. Rats given mirtazapine were not observed to suffer severe dysplasia, only mild dysplasia being observed. Conclusion: For adenocarcinoma induced by MNNG on rats, mirtazapine was determined more effective than cisplatin. In order to make statement about mechanism of anticancer activity of mirtazapine, wider studies are required.

No abstract

Objective: Gastric cancer is the second most common cause of cancer-related deaths. It is mostly seen between the ages of 50-70 years. In our study, we aimed to present our 11 years of experience about surgical treatment of gastric cancer. Method: In our medical faculty hospital between January 2000 and December 2010, a total of 504 patients, who operated with the diagnosis of gastric cancer, were analyzed retrospectively. Morbidity and mortality rate were evaluated according to type of operations and risk factors. Results: 182 of the patients (mean age 62.4 years) were female (36.1%) and 322 (63.9%) were male. The tumor location was antrum in the 202 (40.1%) patients, corpus in the 107 (21.2%) patients, cardia and fundus in the 195 (38.7%) patients. Distal subtotal gastrectomy was done 160 (%31.7) of the patients, total gastrectomy was done 204 (%40.5) of the patients and 140 (%27.8) of the patients were considered to be nonresectable because of reasons such as the liver metastasis, peritoneal dissemination and invasion of adjacent organs. Morbidity was found to be %17.6 (n=89) and early mortality rate was found as %5.5 (n=28), respectively. Conclusion: We found that gastric cancer patients are diagnosed at advanced stage in our region. Especially people who are at risk and have symptoms should be undertaken to screening programs such as endoscopy. In patients with gastric cancer, there is a relationship between advanced age, hypoalbuminemia, and serious co-morbidity with surgical mortality. AnahtarKelimeler: Mide Kanseri, cerrahit tedavi, mortalite.

orectal cancer obstructions are responsible for about 85% of colonic emergencies. The aim of this study was to investigate the results of urgent surgical intervention that applied in acute colonic obstructions related to cancer. Methods: In this study, 86 cases presenting with acute colonic obstruction who were operated with the diagnosis of colonic tumor between January 2010 and December 2010 were assessed retrospectively. Age, gender, symptoms on presentation, presence of concomitant disease, surgical methods applied, complication and mortality rates were recorded.Results: Fifty of the cases were male, 36 were female. The mean age was 63.6 years. Twenty cases had undergone emergency colonoscopic examination at diagnosis and an obstructive lesion had been observed. The surgical operations performed were right hemicolectomy in 18, sigmoid resection in 34, left hemicolectomy in 10, abdomino-perineal resection in 2, subtotal colectomy in 4, transverse colectomy in two. Primary anastomosis was performed in thirty-four cases. Mortality was observed in 12 cases. Conclusions: In selected cases of left colon cancers with obstruction, resection and primary anastomosis is generally possible. Those over 70, presence of co-morbidities, albumin level under 3 g/dl, ASA score 3 and higher, blood loss of more than 500 ml, and preoperative blood transfusion were related to the high postoperative morbidity.Key words: Colorectal cancer, obstruction, surgical treatment, outcome

Gastric cancer is quite rare during pregnancy. Gastrointestinal symptoms consequent to pregnancy such as nausea, vomiting, and abdominal pain make the diagnosis of the disease difficult. At diagnosis, patients present with advanced stage tumors. A 32-years-old female patient gravida 3 parity 1. Her pregnancy was at 27 weeks live mono fetus on obstetric ultrasound. Her story, her present gastrointestinal complaints had been persisting for one year, but were exacerbated in the last three months. On upper gastrointestinal endoscopy, there was a giant ulcer at the cardia level. Early diagnosis is important for gastric cancers. Upper gastrointestinal endoscopy should be considered in order to rule out malignancy in patients with persistent gastrointestinal symptoms due to pregnancy. Key words: Gastric cancer, pregnancy, early diagnosis ÖZETGebelik sırasında mide kanseri oldukça nadir görülmekte-dir. Gebeliğe bağlı bulantı, kusma ve abdominal ağrı gibi gastrointestinal semptomlar hastalığın tanısını güçleştir-mektedir. Tanı sırasında ise hasta ileri evre tümör olarak karşımıza çıkmaktadır. 32 yaşında kadın hastanın gravida 3 paritesi 1 di. Mevcut gebeliğe yönelik yapılan obstetrik ultrasonografide 27 haftalık canlı tek fetüs izlendi. Hikayesinde mevcut gastrointestinal şikayetlerin 1 yıldır devam ettiği ve bu şikayetlerin son 3 aydır arttığı öğre-nildi. Yapılan üst gastrointestinal sistem endoskopisinde kardia'da dev ülser izlendi.Erken tanı mide kanserleri için önemlidir. Gebeliğe bağlı ısrarla devam eden gastrointestinal semptomları olan hastalarda malignensi düşünüle-rek üst endoskopi yapılmalıdır. Anahtar kelimeler: Mide kanseri, gebelik, erken tanı GİRİŞMide kanseri sıklıkla 5. ve 7. dekatlar arasında görü-lür. Düşük sosyoekonomik gruplarda görülen mide kanseri erkeklerde kadınlara göre iki kat daha sıktır [1]. Genç hastalarda ise kadın cinsiyette görülme sıklığı daha fazladır [2]. Mide kanserinin gebelikte görülme sıklığı %0,1'dir [2]. Gebelikte mide kanserinin tanısı oldukça zordur ve vakaların % 97'sinde tanı konulduğunda tümör ileri evrededir [3]. Mide kanserinin erken tanısı önemli olmakla birlikte gebelikte sık görülen epigastrik ağrı, bulantı-kusma, doygunluk hissi gibi gastrointestinal sistem semptomlar nedeniyle tanı koymakta güçlük çekilmek-tedir [2].Biz bu çalışmamızda gebelik esnasında mide kanseri teşhis edilen bir olguyu sunduk. OLGU SUNUMU32 yaşında kadın hasta, 3. gebeliği ve gebeliğin 27. haftasındaydı. Hastanın yaklaşık 1 yıldır devam eden karın ağrısı, bulantı, kusma ve iştahsızlık şi-kayetleri mevcuttu. Karın ağrısı esas başvuru sebebiydi ve yaygın bir ağrı şeklindeydi. Hastanın son 2 aydır vücut ağırlığının %10'undan fazlasını içeren kilo kaybı vardı. Şikayetleri gebelik ile artmış ve son 3 ayda belirginleşmişti. Hikayesinde başka bir bulgu mevcut değildi ve pozitif aile öyküsü de yoktu. Fizik muayenesinde karnında yaygın hassasiyet mevcuttu, musküler defans ve rebound hassasiyet yoktu. Laboratuvar bulgusu olarak orta derecede anemi (hemoglobin: 9,8 g/dl), hipoalbuminemi (albumin 2,3 ...