INTROduCTION In humans, alveolar echinococcosis (AE) of the liver is caused by canine tapeworm called Echinococcus multilocularis. The disease is most prevalent in the northern hemisphere and in the eastern part of Turkey. ObjECTIvEs The aim of the study was to review the natural history of AE and its clinical and radiological features. PATIENTs ANd mEThOds The retrospective study involved 23 patients (10 men, 13 women), aged 34-75 years with AE who had been referred to our liver disease clinic in the past 4 years. Only patients with pathologically proven AE were included in the study. The sociodemographic, clinical, and radiological features of AE were also evaluated. REsuLTs The main laboratory characteristics of AE included mild eosinophilic leukocytosis with hypergammaglobulinemia, elevated C-reactive protein levels, near-normal liver transaminases, and increased levels of cholestatic enzymes and immunoglobulin E. Eight patients (35%) had hepatitis B e antigen-negative hepatitis B infection. Budd-Chiari syndrome was identified in 3 of 23 patients (13%). Eighty-three percent of the patients had a seropositive test result for AE, and approximately one-third of the patients had distant metastasis. Surgical treatment was administered in 4 patients. Four patients died due to complications during follow-up. CONCLusIONs Patients with AE have numerous complications and advanced disease at the time of diagnosis. The clinical picture of AE comprises a number of hepatic and extrahepatic disturbances related both to destructive and mass effects of the tapeworm.

Amaç: Glikojen akantozis, etiyolojisi bilinmeyen nedenlerden dolay› özofagusun skuamoz epitelinin benign kal›nlaflmas› olarak bilinmektedir. Etyolojisi bilinmemesine ra¤men gastroözofageal reflü ve hiatal herni ile iliflkili olabilece¤i rapor edilmifltir. Bu çal›fl-

This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40)K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpınar (326.0) and Ozalp (377.1) counties (p<0.001). As to the results of the gross alpha and gross beta radioactivity measurements in the drinking water, these two counties also had high beta radionuclide levels: Gurpınar (140 mBq/dm³) and Ozalp (206 mBq/dm³). Even if within the normal range, a relation between the higher rate of the incidence of stomach and esophagus cancers with that of the higher rate of beta radionuclide activity was clear. On Spearman correlation analysis, the relation between higher beta radionuclide levels and cancer incidence was found to be statistically significant (p<0.01). According to the results of the analysis, Van residents receive an average 1.86 mSv/y annual dose from outdoor gamma radiation, ingestion of radionuclides in the drinking water, and indoor 222 Rn activity. Moreover, gross alpha and beta activities were found to be extremely high in all of the lakes around the city of Van, Turkey. Further investigations with long-term detailed environmental radiation measurements are needed regarding the relationship between cancer cases and environmental radioactivity in the city of Van.

We aimed to evaluate the clinical and demographic data of adult patients diagnosed with acute disseminated intravascular coagulation (DIC) who had been referred to the hematology unit by other clinics, as well as to evaluate the effect of clinical and laboratory parameters on patient survival. Materials and Methods: The records of 87 adult patients admitted to the Department of Hematology of Yuzuncu Yil University Faculty of Medicine between January 2013 and May 2017 and diagnosed with acute DIC were retrospectively examined. Of the patients participating in the study, 64 (73.6%) were female and 23 (26.4%) were male. Regarding the distribution of etiology in patients with acute DIC, the most common etiology, at 49.3%, was obstectic pathologies. Acute DIC was more frequent in women and younger adults (p = 0.001). Patients with trauma had the highest mortality rate (p = 0.001). Patients diagnosed with acute DIC who died as a result were older, and mortality was higher in males (p < 0.001 for both). Comparing ISTH scores, patients with acute DIC had significantly higher mortality (p = 0.028). In this study, a majority of the patients diagnosed with acute DIC were young and female. De spite their high incidence of acute DIC however, the mortality rate for young female patients was low. The mortality rate was higher in elderly and male patients, although intensive treatment was administered following diagnosis of acute DIC. We believe th at early diagnosis and appropriate treatment are of critical importance for patients thought to have acute DIC, regardless of underlying condition.

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ÖzetAmaç: Onkolojik hastalıkların erken tanı ve tedavisinde yeni gelişmeler hayatta kalma oranlarının artmasına neden olsa da, artmış sağ kalım oranlarına bağlı olarak gelişen uzun takipler sırasında ikinci primer maligniteler ortaya çıkabilmektedir. İkincil primer tümörlerin gelişimi için birçok faktör vardır. En önemlisi, yaşlı hastaların uzun vadede kanserojenlere maruz kalma olasılıkları daha yüksektir. Çoklu primer tümörler, genellikle iki malignite tanısı arasındaki zaman çizelgesine bağlı olarak metakron veya senkron olarak görülür. Senkron hastalıklar sıklıkla benzer karsinojenlere maruz kalma sonucu oluşsa da, metakron olanlar daha çok primer tümörün tedavisine bağlı advers etkilerle ilişkili olabilir. Bu tek merkezli çalışma, Ocak 2007 ile Aralık 2016 arasında multipl primer tümörlü hastaların klinikopatolojik özelliklerini araştırmayı amaçladı ve bunlardan 20'si senkron, 36'sı metakron olarak toplam 56 hasta dahil edildi. En yaygın kanser çiftlerinin erkeklerde kolon-akciğer ve prostat-mesane, kadınlarda meme-kolon ve meme-tiroid olduğu tespit edilmiştir.

ÖzAmaç: Çalışmamızda sağ kolon ile sol kolon yerleşimli tümörler arasındaki farkın iki bölge arasındaki inflamatuvar süreçle ilişkili olup olmadığını basit bir yöntem olan nötrofil lenfosit oranına bakarak karşılaştırmayı amaçladık.Gereç ve Yöntem: Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji bölümüne Temmuz 2011-Haziran 2015 tarihleri arasında başvuran evre 1-3 kolorektal kanser tanısı almış 142 hastanın dosyalarını retrospektif olarak inceledik. Tümör lokalizasyonu ile nötrofil lenfosit oranı (NLO) ve hastalıksız sağ kalım arasında ilişki olup olmadığını araştırdık.Bulgular: Hastalar splenik fleksura baz alınarak sağ ve sol kolon şeklinde ikiye ayrıldı. Sağ kolon olarak tanımladığımız 35 (%24), sol kolon olarak tanımladığımız 107 (%76) hasta vardı. Hastaların 85'i (%60) erkek, 57'si (%40) kadındı. Tanı anındaki NLO karşılaştırıldı. Sağ ve sol kolonun NLO ortalama değerleri sırasıyla 4,43 ve 5,05 olarak hesaplandı. Sağ ve sol kolon arasında NLO açısından istatiksel olarak anlamlı farklılık saptanmadı (p=0.234). Hastalıksız sağ kalım oranları sağ kolon tümörlerinde sol kolona göre istatiksel anlamlılığa ulaşmasa da daha düşük olarak hesaplandı (20. ayda 0,88/0,84; 40. ve 60. ayda sırasıyla 0,80/0,77 ve 0,80/0,77; p =0,064). Sonuçlar:Yaptığımız çalışmada metastatik olmayan kolorektal kanserli hastalarda tanı anında bakılan NLO ile hastalığın lokalizasyonu arasında ilişki bulamadık. Hastalıksız sağ kalım oranlarını sağ kolon tümörlerinde sol kolona göre istatiksel anlamlılığa ulaşmasa da daha düşük olarak hesapladık.Anahtar Kelimeler: Sağ-sol kolon, kolorektal kanser, NLO 64 Abstract Aim: We aimed to compare the neutrophil lymphocyte ratio(NLR), which is a simple method, to determine whether the difference between the right colon and the left colon tumors in our study is related to the inflammatory process between the two regions. Material and Method:We retrospectively reviewed the files of 142 patients who were diagnosed with stage 1-3 colorectal cancer between July 2011 and June 2015 at Medical Oncology Department, Dışkapı Yıldırım Beyazıt Education and Research Hospital. We examined whether tumor localization correlates with neutrophil lymphocyte ratio (NLR) and disease-free survival. Results:The patients were divided into right and left colon based on splenic flexure. There were 35 patients (24%) defined as right colon and 107 (76%) patients defined as left colon. 85 (60%) of the patients were male and 57 (40%) were female. The ratio of neutrophil and lymphocytes at diagnosis was compared. The mean NLR values of the left and right colon were calculated as 4.43 and 5.05, respectively. No statistically significant difference was found between the right and left colon (p = 0.234). The disease-free survival rates were lower in the right colon tumors than in the left colon, but not statistically significant (0,88 / 0,84 40th and 60th at 20th month) 0.80 / 0.77 and0,80/0,77; p = 0.064) Conclusion:In our study, we could not find any relation between the NLR and the localization of the disease ...

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