Makale Arama

Objective: The aim of this study is to evaluate the perioperative and postoperative follow-up results of patients operated for a parotid mass.

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Materials and Methods: A total of 66 patients who were operated between 2000 and 2011, were evaluated retrospectively.

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Results: The mean age of the patients was 48,6. On the basis of post-operative histopathologic assessement, 61 of the cases were found to be primary benign, 3 of the cases  primary malignant and 2 of the cases secondary malignant. Pleomorphic adenoma was the most common in primary benign tumors group with 29 cases, Warthin tumors were in the second place with 14 cases. Adenoid cystic carcinoma, adenocarcinoma and expleomorphic adenoma were observed as primary malignant tumors. Both of the seconder malignant tumors were metastasis of squamous cell carcinoma. Sensitivity and specifity of the preoperative fine needle aspiration biopsy in the benign-malignant differentiation were found as 60 % and 96 %, respectively. Superfacial parotidectomy, total parotidectomy and radical parotidectomy were used as surgical procedures. In addition to this procedure, neck dissection was performed in several cases. The most frequent complication was temporary facial nerve paresis.

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Conclusion: Fine needle aspiration biopsy is an effective diagnostic procedure for the benign-malignant differentiation of the parotid tumors. Superfacial parotidectomy is an adequate and efficient surgical procedure for the benign parotid tumors and complication risk is considerably low when applied carefully. For malignant tumors, superfacial, total or radical parotidectomy should be performed and when necessary, neck dissection and postoperative radiotherapy should be added to the treatment.

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In this article, 191 cases were presented who operated in The Thoracic and Cardiovascular Sur-gery Clinic, University of Selcuk between 1987 and 1994. 52.87% of them were male and 47.12% of were female. Most of the patients were 11-20 years of age. 99 of cystes (51.83%) were in right lung, 84 (43.97%) were in left lung and 8(04.17%) of them were in both lungs. Median sternotomy was per-formed in 5 cases, segmentectomy in 6 cases, wedge resection in 7 cases, lohectomy in 9 cases, cystotomy and capitonage in 159 cases, decortication in 10 cases and cystectomy in 4 cases. 13 liver cystes and one spleen cyste were excised via trans-diaphragmatic approach. Empyerna was seen in 4 cases and succesfully treated. Only one case died on respiratory failure. Relapse was not seen in any case.

With the rapid technological advances, ultrasonography (US) has become an important breast imaging procedure in the last decade. In addition to the complementary role to mammography and magnetic resonance imaging, today it has an important place in interventional situations such as guiding needle aspiration, core needle biopsy and presurgery needle localization. American College of Radiology has developed “The Breast Imaging Reporting and Data System” (BIRADS) lexicon to standardize the terminology in the US reports. This lexicon includes the descriptors from several feature categories, the assessment of findings and the recommendation of the action to be taken. Six morphologic features were described for solid breast masses: shape, orientation, margin, lesion boundary, internal echo pattern and posterior acoustic features. Despite the known overlap between benign and malignant features, typical signs of benignity were oval shape, gently lobulation, homogenous hyperechogenity, parallel orientation; typical signs of malignity were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, decreased sound transmission. The purpose of this article was to discuss reliability of these BIRADS US lexicon descriptors in the differentiation of benign from malignant solid masses of the breast.

Objective: To evaluate the chest roentgenogram and CT findings of 63 patients with pulmonary hydatid disease. Methods: Sixty-three (27 female and 36 male, aged between 3 and 76 years) patients with surgically proven pulmonary hydatid cysts were included to the study. Chest roentgenogram and thorax CT were obtained from all the patients. Radiological features (number, localization, diameter, internal architecture) were determined. Results: On CT examination, 107 cysts were determined but on 78 of 107 cysts were detected on chest roentgenogram. Single cysts were seen in 36 patients, while multiple cysts were seen in 27 on CT. Eighteen cysts were larger than 10 cm in diameter. CT scan showed crescent sign (3 patients), water lily sign (9 patients), air-fluid level (11 patients), dry cyst sign (8 patients), and homogenous shadow (46 patients). In addition, atelectasis (n 17), pleural effusion (n 29), and pericystic infiltration (n 38) were also seen on CT. On the other hand, 58 cysts were homogenous and 20 cysts were rüptüred on chest roentgenogram. Conclusion: Although chest roentgenogram is helpful for diagnosis of pulmonary hydatid disease, CT examination must be done to evaluation nature and localization of cysts.

Eosinophilic pulmonary diseases (EPD) are defined as a group of diseases characterized by the in crease of eosinophils in the air way and/or lung tissue. While a part of the sedis orders mainly affects the pulmonary, others show systemic in volvement. Chronical eosinophilic pneumonia (CEP) should be kept in mind in the existence of subacute or chronic respiratory and general symptoms, alveoler and/or bloode osinophilia and peripheral pulmonary in filtrates on chest radiography. A 53-year-old male patient was admitted to our clinic with on going complaints of cough, occasional fever and malaise for six months. When two-sided apical, subapical and the infiltration around hiluses were detected on chest x-ray, the case was hospitalized with the prediagnosis of pulmonary tuberculosis. Eosinophilia in hemogram, bilateral infiltrative lesions with irregular contours and bilateral cystic bronc hiectasis foci were detected on high resolution computed tomography (HRCT). Bronchoscopy revealed purulent secretions and thick mucous in hibations. No specific etiologic cause was defined in the etiology, and the case wase valuated as CEP. Due to unusual bronchoscopic and radiological findings, the case was presented and discussed.

In order to investigate the relation hetween the thyroid radionuclide scanning and the histopathological findings, we reviewed 125 patients operaled on from 1984 to 1988 in Korkuteli State Hospital. Sixty seven point five percent of patients had multinodular and 32.5% uninodular goiter. One hundred sir patients underwent thyroid radionuclide scanning and 85.8% revealed hypoactive, 6.6% hypoactive and normoactive, 3.8% hyperactive nodules and 3.8% other pathologies. Ali of the 125 patients were euthyroid at the time of operation. Mnety seven point six percent of the patients underwent unilateral or bilateral subtotal thyroidectomy. In 100 patients who had histopathologic exarnination had 131 hislopathologic diagnosis. In 81 patients who had hypoactive nodules determined with radionuclide scanning, 68.8% were diagnosed as multinodular goiter, 16.5% follicular edenoma, 7.4% chronic thyroiditis, 5.5% malig,nant thyroid disease and 1.8% colloidal cyst histopathologically. All cases with malignant thyroid disease had hypoactive nodules, five of them were multinodular and one solitary nodule.

Patients with hydatid cysts generally show an asymptomatic progress until they are randomly diagnosed or until they develop a complication.A The 80-year-old patient, who was being followed-up in the ICU of the neurology department because of hypoxic brain, was evaluated for a swelling in the epigastric area which was existent for a while. The patient’s physical examination revealed an exophytic mass lesion of about 5x6 cm on the epigastric area. During the surgery it was seen that the patient had an infected hydatid cyst originating from the left lobe of liver with percutaneous fistulization.The patient was discharged on post-op day 7 without any problems with 20 mg/ kg albendazole treatment. Consequently, it should be noted that hepatic hydatid cysts could give way to very rare complications like skin involvement and percutaneous fistulization even if they are on advanced stages.

The aim of the study is determine the incidence of pathologies detected by abdominal ultrasonography in Konya. Screening has begun in 2011 after the necessary permissions from local ethical committee. Participators’ identity, age, gender, history and family history has been recorded. Abdominal ultrasonography has been performed in supine position. Hepatobiliary, genitourinary systems, spleen, midline structures and anterior abdominal wall has been evaluated. The mean age of 2010 participants was 46 (18-94). There were 1071 (53.3%) female and 939 (46.7%) male. In abdominal ultrasonography; hepatosteatosis in 371 (18.5%), liver hemangioma in 14 (0.7%), hidatic cyst of liver in 11 (0.5%), cholelithiasis in 60 (3%), splenomegaly in 13 (0.6%), simple cyst of spleen in 3 (0.1%), aortic aneurism in 4 (0.2%) participants were detected. In renal evaluation; nephrolithiasis in 34 (1.7%) and simple cyst in 145 (7.2%) participants were detected. In pelvic evaluation; prostatic hypertrophy in 4 (0.4%) males and myoma uteri in 8 (0.7%) females were detected. In Konya population most common pathologies at abdominal ultrasonography were hepatosteatosis, renal cyst, cholelithiasis and nephrolithiasis.

Hepatic hydatid cyst perforation into the biliary tree may involve the small intrahepatic bile dutcs, common hepatic duct or common bile dutc. On sonogram, dilatation of intra and extrahepatic biliary tract was demonstrawd in two cases with jaıındice that is a compiication of hydatid cyst. Ultra-sonography (US) and percutaneus transhepatic cho-langiography (PTC) showed that hydatid cyst foud at porta hepatis causes to compression to the extra-hepatic biliary tract in one case. Ultrasonography (US) and computed tomography (CT) disclosed that cystic mass localized in medial segment of the left liver lobe and porta hepatis caus-es to the same finding as well as in one case. Preop-erative radiologicfindings vere confirmed surgically in 4 cases.

Percutaneous cyst aspiration and iophendylate application were performed tü 19 patients who were evaluated as having a simple cyst when they applied to our clinic between the dates of January 1990 and August 1992. The applications were carried out under ultrasonographic control and local anesthesia. The cytologic and bacteriologic examination of the cyst liquid were performed. The results proved the preoperative simple cyst diagnose. lt was understood that iophendylate had a sclerosant effect on the cyst in the periodic post operation examinations. Also it was understood that this application had an important support on preventing the negative effects of great cystic mass on the paranchima and collector system and also it had an importance on deciding the nature of the cyst and in the reductions of cyst volume.

A series of 460 cases of hydatid cyst of the lung has been studied. Preoperative diagnosis has been made radiologically in 90<,-, of the cases. In 395 cases, cystotomy has been performed with subsequent capitonnage, while, wedge resection has been performed in 27 cases, with lobectomy in 15 cases and segment resection in 23 cases. Following a careful he-rnorrhage control, two drains have been placed in the thorax and the thoracic cavity has been closed. Recurrence occured in two cases (0.43 %), three cases resulted in exitus (0.65 %); no recurrence has been encountered in other cases as revealed by post-operative follow-up cheks within a period of theree years after operation.

Benign cysts of Mullerian type present as pelvic mass in perimenopausal and postmenopausal women mimicking ovarian malignancy. Herein, a case of benign uterine mullerien cyst detected in a woman with postmenopausal uterine bleeding resistant to medical treatment and operated with a preoperative diagnosis of right ovarian simple cyst is presented. Differential diagnosis is also discussed. Sixty two years old postmenopausal woman presented with complaint of abdominal pain and vaginal bleeding. A cystic mass of 4x3 cms thougth to be originated from right ovary was determined on pelvic ultrasound. The patient with postmenopausal uterine bleeding resistant to medical treatment of 6 months given before went to surgery with a preoperative diagnosis of right ovarian simple cyst. After pathologic examination, the cyst was diagnosed as benign uterine mullerien cyst.

There is no consensus in approach to patients suffered from gunshot injuries since they almost die in scene or on the way to the emegency room. Manegement of the patients with gunshot bullet wounds of thorax is different even among thoracic surgeons. Complication of penetrating chest trauma due to gunshot injuries can occur within days, months even within years. A patient was admitted to the thoracic surgery clinic in bad condition. Foreign body was detected in chest X-ray patient. He had been considered stable and non complicated and discharged from hospital after a penetating gunshot injury of thorax two years ago. We report late presentation of empyema as a late complication of bullet after two years of injury.

Moebius syndrome is a rare, non-progressive congenital syndrome presenting with complete or partial facial paralysis. It is usually associated with orofacial malformations, musculoskeletal defects, brainstem dysplasia, and other cranial nerve palsies. Mean incidence is 2-20/million, although there is considerable regional variation. The most common presentation is with bilateral lateral rectus palsies and facial diplegia. Frequently, the 5th, 10th, 11th and 12th cranial nerves are involved and may cause cough, difficulty in chewing and swallowing, and respiratory insufficiency. Complete or partial facial nerve palsy is necessary for a diagnosis of Moebius syndrome. A 4-month-old girl was brought to our clinic with complaints of inability to close her right eye completely and internal deviation in that eye, beginning from birth. She had micrognathia and an inability to completely close the right eye. Both eyes were turned inwards during primary gaze. She had limited lateral gaze, a pes equinovarus deformity in her feet, and flap ears. Cranial magnetic resonance imaging was performed because of the dysmorphic features and revealed micrognathia and volume loss at the tongue. Bilateral facial nerves could not be visualised by a 3D FIESTA scan, suggesting bilateral facial nerve agenesis. This case is presented to highlight Moebius syndrome in the differential diagnosis of cases presenting with congenital facial weakness.

Pericardial cysts and diverticula compose %7 of all mediastinal masses. Pericardial cysts and diverticula are generally present at right cardiophrenic sinus also within left cardiophrenic sinus, superıor mediastinum, aortic arch level and left hilum. Pericardial cysts and diverticula are lesions which resemble themselves in shape, localiaztion and symptoms. Radiography, CT and MRI has demonstrative importance in their diagnosis. We want to present similarities and differences of symptoms, diagnosis and treatment of pericardial cysts and diverticula which are important in differential diagnosis of mediastinal cystic lesions within these 3 cases.

Aim: Epidermoid cyst is an uncommon ectoderm originated benign cyst. Although intracranial epidermoid cyst may commonly occur in the cerebellopontine angle and chiasma opticum, it can be detected in cerebral hemispheres as well as intraventricular area. Syringomyelia, a progressive hydrodynamic disorder of spinal canal usually occurs in cervical region although it can be seen in thoracic and lomber portion of the spinal cord. Case report: We describe a patient with syringomyelia associated with posterior fossa located epidermoid cyst. Siringomyelia has been spontaneously regressed after the removal of the posterior fossa epidermoid cyst. Conclusion: Primary intervention to spinal cord cavitations must be avoided because it can be spontaneously regressed after the removal of the posterior fossa tumor.

Aim: To report an immature teratoma case that was differentiated from mature teratoma. Case report: A 29 year old woman consulted to Gynecology and Obsterics clinic vvith pelvic pain. İn the histoıy of the patient, it was un- derstood that she had left sided ooferectomy due to left ovarial cyst. At that time the ovarial pathologyhad been reported as normal. İn the pelvic examination of the patient a pelvic mass that can not be differentiated from ute- rus was detected. İn the pelvic ultrasonography of the patient, at the right ovarial area a smooth bordered hete- rogenous mass that had calcified areas vvith in the body, and that was measured as to be 11x11 cm and found to have solid and cystic components was detected.İn the laboratory finding AFP: 10,5 (0-7), CEA: 6,4 (0-4,1), CA 125: 32,9 (0-21), CA19.9: 322 (0-18,4), CA 15.3 :24,5 (7,5-53 ), HCG < 1 was found. The patient had been operated, the right ovarial mass extirpation and right ooferectomy had been done. The diagnosis vvith the histopathological examination of the mass was defined as immature teratoma grade-l. Conclusion: İt is needed to get several biop- sies of the pathological spesimen in order not to skip. The immature components of the teratomas and neural com­ ponents should be shown vvith immunohistochemical methods.

Porencephaly is a disorder of Central nervous system characterized by cysts/ cavities in the cerebral hemisphere. It has varied clinical manifestations like seizures, paresis, learning disabilities, mental retardation and rarely psychiatric manifestations. Among psychiatric symptoms, psychosis is the most commonly seen manifestation. There have been only few case reports of porencephaly presenting with psychiatric syndromes. Hereby the author discusses a unique case of porencephaly with seizure disorder, organic personality change and agitated depression.

Hydatid disease which is caused by Echinococcus granulosus, is endemic in the husbandry regions. Primary localization of the disease is liver; however, echinococcosis may infect every organ and tissue of the human body. Aim of this report is to emphasize that primary peritoneal hydatidosis may clinically be presented with an acute mechanical intestinal obstruction in endemic regions.

Purpose: In this study, contrubitions of computed tomography (CT) and magnetic resonance imaging (MRI) were researched in the diagnosis of benign paranasal sinüs (PNS) lesions. Materials and methods: According to the clinical findings, between January 2001 – February 2004, 30 cases have been studied who were thought to have benign lesions belonging to nasal cavity, PNS or neighboring structures. CT and MRI studies are made to the all case. Inner structure characteristics, locations and radiological apperarances coursing pathological diagnosis of lesions in CT and MRI have been assessed. Results: The histopathological diagnoses of lesions were mucocele (8), odontogenic cysts (4), fibrous dysplasia (3), inverted papilloma (2), hemangioma (2), menengioma (2), schwannoma, osteoma, osteochondroma, paget disease, ameloblastom, giant cell tumor, central giant cell granuloma. Whwn assessed according to pathological results, sensitivity of CT and MRI were found to be 86.6% and 83.3% respectively. In 3 cases showing radiological malign feature (1 giant cell tumor, 2 inverted papillomas) the correct diagnosis was made histopathologically. Canclusion: CT is an effective method to show bone expansion and destructions, tumors originated from bone and intratumoral calcifications. MRI offers better the inner structures of cystic lesions, intratumoral hemorhages and differentiation of tumor from inflammation. Therefore, CT and MRI should be used jointly in the evaluation of the PNS lesions.

Simple kidney cysts are common, benign and asymptomatic masses and usually unrequire any treatment. However, this simple cyst can grow over time, may become symptomatic and develop complications they may require treatment. In our study, we aim to present, the 63 -years-old male patient admitted to our clinic with dyspnea, abdominal pain and asymmetric abdominal distension. Abdominal ultrasonography (USG) showed that exophytic renal cyst reached 195x180 mm. We underwent sclerosing agents in the presence of continuous percutaneous catheter drainage and dyspnea decreased at the follow-up. Subsequent USG after six months revealed disparition of the cysts.

268 cases on which laparoscopic cho-lecystectomy was treated in General Surgical De-partment at the University of Selcuk, Faculty of Me-dical Science between 1994 th January-1995 th June were taken into consideration. 236 patients have de-veloped gallbladder stone which moves along with bilecholic, 32 patients have developed acute cho-lecystitis and 4 patients, because of having de-veloped splenic abcess, splenic eccinococcous cyst, simple cyst at left lobes of the liver, simple cyst at right over were taken into operation. Despite the successful application of la-paroscopic cholecystectomy at 252 patients, 16 pa-tient had necessarly been take into laparotomy. Mortality rate is nil. The operation approximately takes 50 minutes and patients are kept at our hos-pital for nearl 2 days and the patient's recoveries takes a week. Serious complications was observed at 6 patients. We come to the conclusion that the reason for the complications peeing high is that this kind of surgical attempts are very recently applied in our clinic.

Salivary gland tumours are rare, and majority occur in the parotid gland. Minör salivary gland tumors are approx- imately 10 times less frequent than the majör salivary gland tumors. However they have a higher incidence of malignancy. The most common site of malignant minör salivary gland tumors is the hard palate. The base of tongue is the second common site. The majority of these tumours are adenoid cystic carcinoma and mucoepider- moid carcinoma. We present here a 53-year-old female with adenoid cystic carcinoma of the base of the tongue as a rare case. The literatüre was revievved and characteristics of this tümör are discussed

Cystic lesions of the parathyroid gland are uncommon. Although majority of patients with cystic parathyroid adenoma present with mild hypercalcemia, some may present with parathyroid crisis which can be a life-threatening clinical condition. In this article, we present a patient who applied to emergency service with symptoms of acute parathyroid crisis, was diagnosed parathyroid adenoma with cystic degeneration and treated. A 46 years old male patient was applied to emergency service with confusion. In blood analyses, calcium level was 16,6 mg/dl and akut kidney failure was determined. In radiological imagination, parathyroid adenoma with cystic degeneration was determined and patient was treated minimal invasive parathyroidectomy.After the operation, parathormon and calcium levels were returned the normal levels. Parathyroid cysts are uncommon, and they are classified as functional or nonfunctional so far as hypercalcemia. Functional cystic parathyroid adenomas are very rare. These patients can approach with symptoms of hyperparathyroidism or parathyroid crisis. Parathyroid adenomas with cystic degeneration and functional parathyroid cysts should be considered about causes of primary hyperparathyroidism and acute parathyroid crisis.

The scolocidal solutions which are used in surgi-cal treatment of hydatid cysts such as forrrzaldehite (%2), hypertonic sodyum chloride (%20), povidone iodine (%1) and silver nitrate (%05) were performed to the biliary tract of 50 dogs each group including 10 dogs and the lesions were evaluated histopatho-logically and radiologically. As to the histopathologir findings of liver le-sions and cholangitis and radiological findings of sclerosing cholangitis, there was no significant dif-ference between scolocidal solutions groups (p>0.05) but the dillerence between scolocidal solutions and control group was significant (p<0.01). We concluded that ali scolocidal agents has toxic ellects to the liver and biliary tract.

Objective: The aim was to review the hormonal status, treatment and histopathological diagnosis of patients admitted to our endocrinology outpatient clinic with the diagnosis of adrenal incidentaloma.

Material and Methods:Between 2015-2018, 217 patients with adrenal incidentaloma who were admitted to the endocrinology outpatient clinic were included in the study. 1 mg overnight dexamethasone suppression test (DST), 24 hour urine free cortisol, 24-hour urine methanephrine and normetanephrine levels were evaluated in all patients.Patients who also have hypertension or hypokalemiawere screened for the plasma aldosterone/renin activity ratio. CT or MRI imaging properties of adrenal incidentalomas were screened.

Results: In the evaluation of cases; 180 (83%) of the masses were evaluated as non-functional and 37 (17%) as functional. Of the 37 patients evaluated as having functional adrenal mass; 10 (4.6%) pheochromocytoma, 5 (2.3%) Cushing's syndrome, 9 (4.1%) subclinical Cushing’s syndrome and 13 (6%) primary hyperaldesteronism were detected. In 180 patients who were evaluated as having non-functional adrenal mass; metastatic disease in 7 (3 non-small cell lung cancer, 1 breast cancer, 1 prostate carcinoma and 2 unknown primary cancer), myelolipoma in 4, ganglioneuroma in 1, hydatid cyst in 1, adrenocortical carcinoma in 2 patients were detected.

Conclusion: According to the results of this study, it is not uncommon for adrenal incidentalomas to be functional. It may be malignant in some cases. For this reason, adrenal incidentaloma is a condition that should be examined both in terms of
functionality and malignancy potential.

Positive end expirium pressure(PEEPi) develops due to dynamic hyperinflation caused by increased airway resistance during the COPD exacerbations. This PEEPi causes muscle weakness and ventilation deficiency. It is thought that noninvasive mechanical ventilation(NIMV) helps the muscle to relax and provide a better feeling in severe COPD patients. In this study we aimed to evaluate whether NIMV has additional benefit to medical therapy in patients with nonasidotic COPD exacerbations. Forty five patients presented with COPD exacerbation were divided into three groups randomly. First group received medical therapy, second group received 2 hours of BiPAP in addition to medical therapy in the first day and third group received BiPAP for two hours in addition to medical therapy every day. The dyspnea scores and StGoerge respiratory questionnaire was applied. All patients underwent MIP, MEP measurement and 6 minutes walking test before discharge. While there was significant decrease in dyspnea scores obtained during discharge compared to admission scores in all three groups, no significant difference was found between discharge and 1st month control scores. Also, while significant improvement was present in StGoerge Questionnaire of first and second groups during hospitalization, no difference was present in the third group. The treatment options caused no significant improvement in the arterial blood gas(ABG) parameters in all three groups. We found that NIMV had no additional effect on hospitalization period, ABG and functional status of the cases admitted with COPD exacerbation, so NIMV had no place in exacerbation treatment of these patients.

Ovarian cysts rarely reach enormous dimensions. The giant ones could be get mixed with mesenteric cysts, lymphangioma, local ascites or peritoneal inclusion cysts. We presented a case in which the preoperative evaluations revealed a lymphangioma eventhough the final hystopathological diagnosis was an endometriotic cyst (a type of benign ovarian cyst). Cystic lesions related to gonadal structures should be kept in mind when you’re dealing with giant cystic structures which are encountered rarely as a result of physical and laboratory examination at acute abdomen. The fertility situation and wish of patient should be considered when the treatment algoritm with an interdisciplinary approach are drawn .

Background: Acute appendicitis is the mostcommon surgical problem in pregnancy after obstetric reasons. Pregnant patients operated with diagnosis of acute appendicitis were reviewed retrospectively in this study. Patients and Methods: 24 pregnant patients operated with diagnosis of acute appendicitis in Ankara Numune Training and Research Hospital between January and December 2003 were included in this study. Results: 19 out of 24 patients (%79.2) were pathologically diagnosed as acute appendicitis. Out of other 5 patients, 2 patients had ovarian cystrupture, 1 had ovarian cyst torsion and 2 had negative laparatomies. Distribution of patients was 2, 16 and 6 patients respectively, for 1st, 2nd and 3rd trimester. 2 patients had pretermlabour and 1 fetus resulted with exitus. Preoperative ultrasonography showed similarity to peroperative findings in 12 of 24 patients. Discussion: Diagnosis of acute appendicitis in pregnancy is quite difficult and physical examination and patient history are still most important diagnostic tools. Perforation risk in pregnant patients higher than normal population.

in this study, 13 cases were examined with hypoactive nodule by Scintigraphy and are cystic sonographically. Of 13 cases, 4 were examined by CT. in conclu.vion, the results were cornpanecl with hystopathologic findings. We discussed contrubition of three imaging modalities in the differantial diagnosis of these lesions.

Bronchogenic cysts (BC) are rare congenital malformations arising during the development of the ventral foregut. Bronchogenic cysts form as a result of abnormal budding of the bronchial tree during embryogenesis (between 4th-6th weeks). Most bronchogenic cysts originate in the mediastinum, while 15% to 20% occur in the lung parenchyma. According to the literature, most intrapulmonary cysts occur in the lower lobes. But bronchogenic cysts are commonly found in the middle and superior mediastinum. The bronchogenic cyst in our patient was subcarinal. It was striking in terms of its giant size and laying on two hemithoraxes.The bronchogenic cysts are usually asymptomatic and often diagnosed incidentally during routine chest roentgenogram for other reasons.They may not be detected until adulthood. Our patient was 56 years old. She had no obvious symptoms . The patient was referred to our clinic because of cough,and her bronchogenic cyst was determined. Basic treatment of bronchogenic cyst consists of surgical excision. However, in cases where resection cannot be performed, the epithelium should be peeled as in our case.

Abdominal actinomycosis is a rare infectious disease caused by an anaerobic bacterium actinomyces israeli. Pelvic actinomycosis is generally associated with the use of intrauterin devices (IUD). This chronic suppurative infection can mimic pelvic malignancy. The diagnosis of the disease is frequently miss preoperatively. The surgeons must be aware of this rare complication in order to avoid an extensive surgical procedure. Case: We present the case of a 31 year old premenoposal woman with an abdominal pain and a history of IUD us efor 6 years. On physical examination the patient had tenderness on right lower abdomen and a palpable cystic mass 8x10 cm in size on pelvic bimanual examination. A preoperative transvaginal USG showed a 9x9 cm cystic mass originated from right ovary. The patient was taken to the emergency operating suite with the diagnosis of torsion of the right cystic ovary by gynaecologist. During the exploratory laparotomy we observed an extensive diffusely infiltrating process involving right adnexa, sigmoid colon sacrum and right pelvic Wall. A loop of jejunum was adherent to this infiltrating process and a mass 5x6 cm in size was palpated in sigmoid colon. These findings were highly suggestive of a colonic carcinoma and the patient was consulted with a general surgeon intraoperatively. Right salpingo -ooferectomy + sigmoid resection + segmental jejunal resection was performed. Pathologic findings showed chronic inflammatory tissue with evidence of actinomycosis. Conclusion: The case described here underlines that surgeons must be aware of this unusual infectious disease in the differential diagnosis of pelvic mass.

A previously well 20 years old girl presented with sudden chest pain. After lett sided pleuresy diagnosed, thoracocentesis was performed. The appearance of fluid was turbiddy and exudative features were confirmed by biochernical tests. Although bacteriologic tests were negative, antibacterial therapy was applied. By Computerized Tomoraphy scan and Magnetic Resonance Imaging cardiac cyst hydatid was identified and twa dimensional echocardiograpy confirmed the diagnosis. We applied medical antihelmintic treatmerıt of Albendazole and 2 months later control examinations indicated partially resolufion of pleural effusion. We consider there is existing a localizational relationship between cardiac cyst hydatid and pleural effusion. Possibfy, the turbiddy appearance of pleural fluid is due ta development of seconder infection.

In this article, the results of 141 hepatic hydatid cyst cases operated in our clinic are presented. Surgical treatment was applied 180 times to 192 liver hydatid cysts detected in 141 patients. Marsupialization 83, partial cystectomy and closure of the remaining part without drainage 70, pericystectomy 11, partial cystectomy and tunneling 10, left lateral seg-mentectomy 5, drainage of the cyst and abdominal cavity was used once. Nine of 141 hepatic hydatid cyst cases were lost, postoperative mortality was 6.4%.

391 cases were examined by US (Ultrasonography) at the department of Radiology of Medical Faculty of Selçuk University, between May 25, 1985 and December 30, 1985. Hydatid csyt to have localized in the liver in twenty three cases, in the liver and abdomen in one case, in the liver and left kidney in one case, liver ci.rrhose characteriezd by splenomegaly, acsites and the increase of connective tissue in twenty cases and solid (tumour) lesion in eight cases were determined in the liver. US findings were compared wi.th operation findigns. The diagnosed csyt. US has become a guide for clinical diagnostic studies and to determine operation indication.

With the understanding that adipose tissue is not only a passive energy store, but also an endocrine organ, interest in bioactive factors secreted from adipose tissue has increased. Adipose tissue, consisting of pre-adipocytes, macrophages, endothelial cells, fibroblasts and leukocytes, as well as adipocytes, has an important role in systemic metabolic regulation. Chemerin, called tazarotene-induced gene 2 (TIG2) or retinoic acid receptor responder 2 (RARRES2), was first discovered in 1997 in psoriatic skin lesions as a retinoic acid-sensitive gene. It was later determined that chemerin regulates adipogenesis and adipocyte metabolism, with data showing that it alters adipocyte differentiation, expression of important genes in glucose and lipid metabolism, and is classified as a new adipokine. The effects of chemerin in circulating and inflammatory fluids are mediated through receptor G protein-bound receptor chemokine-like receptor 1 (CMKLR1). The increase in the number of clinical trials associated with increased levels of local and / or circulating chemerin in various diseases, from obesity, metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), polycystic ovarian syndrome (PCOS) to inflammatory diseases, supports the important roles of chemerin in the pathogenesis of these diseases. Although it is clear that serum chemerin levels increase in these diseases, the mechanisms regulating the expression of the chemerin are not fully understood. More randomized controlled studies are needed to understand the mechanisms of action of chemerin.

Hydatid disease is common in Turkey. The common sites of invol-vement are lungs and liver. Localisation of csyts in face and the neek are exceptionally rare. A. case of hydti.cl csyt which was localised in masseter muscle is reported.

Echinococcus multilocularis is an uncommon and life-threatening zoonosis caused by cestodes that is rarely encountered in children. A 7-year-old girl had for week been suffering from fever, maculopapular rush and right-sided upper abdominal symptoms not related to food intake. Laboratory tests were unremarkeble, except for an accelerated erythrocyte sedimentation rate (16/40 mm) and transaminases (ALT 42 Ü/L, AST 40 Ü/L) and eosinophilia (5%). Upper abdominal sonography revealed multipl cyst, about 2-3 cm in diameter, in the right liver lobe. The antibody titre against echinococcus antigen was 1:320. Preoperative and postoperative treatment consisted of the administration of albendazole (20 mg/kg/Daily twice a day) for two years. Albendazole was administered in 4-week cycles with intervals of 14 days. We report this case because this disease is very rare in childhood and oral albendasole is able to effective in the treatment.

Cystic lesions of the adrenal gland are seen very rare. Cysts are mostly asymptomatic and found incidentally, and the majority of these cystic lesions are endothelial cysts and pseudocysts. Endothelial cysts, lined by endothelial cells are the structures resembling lymphatic channels. Cysts are divided into two groups, named lymphangiomatous and angiomatous cysts. In this study we presented a case of csytic structure, lined by endothelial cells, and reviewed the literatüre.

Purpose: Cross sectional imaging technigues more widely available in the recent years for evaluation of pelvic and tubo-ovarian lesions. We discussed the primary contribution of these methods in the diagnosis of uterine masses in the patients with tubo-ovarian lesions. Materials and Method: IVe present 41 tubo-ovarian lesion with pathologic correlation. Transabdominal sonography, enhanced and nonenhanced CT seans were performed in ali cases. Moreover sagittal and axial T1-weighted as well as T2- vveighted, and fat-saturated unenhanced and gadolinium- enhanced MR images of the pelvic region. kVe compared our radiologic findings with histopathological results. Results: Three of 41 cases had corpus luteum eyst, 10 had eystadenoma, 7 had ovarian carcinoma, 7 had dermoid eyst, 4 had endometrioma, 3 had abcess, 2 had eyst hydatid, and 1 had ovarian fibroma on histopathological examination. Correct diagnosis was established in 33 (80%) out of 41 lesions with US, in 29 (80%) out of 36 lesions with CT scan and in 33 (83%) out of 40 lesions with MRI. Correct diagnosis was established in 33 (83.3%) out of 36 lesions with US, in 29 (77.7%) out of 36 lesions with CT scan and in 33 (86.1%) out of 36 lesions with MRI. Conclusion: Because of ability to detect invasion and in defining the extent of disease, MRI is better than sonography, and CT, and appears to be the modality of choice for evaluated of the pelvic masses. Although US pas potantial advantages and limitations, it should be preferred as the first method of searching for pelvic pathologies.

Cystic hygroma is a hamartomatou.s lesion of lymphatic origins. It is a benign tumor that appear to arise from congenital malformation of the lym-phatic resulting in blockage of lymphatic flow. It has a tendency to infiltrate and surround adjacent tissues and vital organs. Respiratory distress, hem-orrhage and sepsis are major complications of giant cystic hygroma. Total exicion of this benign tumor is sometimes impossible. Alternative treatment to sur-gery is investigated. In this report three cases of the cervical (n=1) and cervicoaxillary (n=2) cystic hy-groma that were treated at the Department of ►e-diatric. Surgery, Faculty of Medicine, Selcuk Uni-versity were presented

in this study, we investigated the relation of fibrocystic disease and carcinoma of the breast. We tok specimens from every quadrani of breasts removed for carcinoma, which have been sent to Department of Pathology from Department of Sur,gery for pathologic examination. We wanted to investigate the fibrocystic disease together with carcinorna. Among 18 specimens we found that fibrocystic disease together with carcinoma was 55,6%, and thought that there might be a relation between fibrocystic disease and carcinoma of the breast, we tizus concluded that fibrocystic disease might be a predispose to a breast carcinoma.

The advantages of laparoscopic surgery are similar for pregnant and nonpregnant women; nevertheless, this procedure was avoided during pregnancy because of concerns that it may be harmful to the fetus. Within the last decade, however, multiple case reports and case series describing the safe performance of laparoscopic procedures in pregnant patients have been published, resulting in a paradigm shift. Appendicitis, gallbladder disease, mesenteric cysts, and adnexal masses/torsion have been successfully managed laparoscopically during pregnancy. More advanced laparoscopic procedures, such as radical nephrectomy, splenectomy, salpingectomy, adrenalectomy, retroperitoneal lymphadenectomy, and ventral hernia repair, have also been reported in gravid patients. This topic will discuss issues specific to laparoscopic surgery during pregnancy. Discussions of laparoscopic surgery in the general population and specific laparoscopic procedures can be found separately.

in this report. a case of an endometriotic cyst of the right ovary in a pregnant women is presented and clinical and pathological findings were compared to those in the literature. The effects about infertility and pregnancy of endometriosis were discussed.

Radiography, ultrasonography (US) and computed tomography (CT) findings of hydatid cysts localized in the thorax were evaluated in 63 cases. Simple, complicated, or ruptured hydatid cysts were better visualized with CT than plain roentgenograms.

Previously, patients who were diagnosed and operated for cyst hydatid, were recalled and 32 of them were screened again ultrasonographycly. Arnong them 10 patients showed recurrence of new hydatid cyst development, Further examinations have shown that these cysts were, homogen cyst, daughter vesicul#e cyst, and abdorninal cyst, respectively. Six of the 10 patenti were reoperated for this diagnosis. Ultrasonographic exarninations and peculiarities were discussed further in this study.

Hydatid cyst was diagnosed in thirty seven cases exatnined by sonography at the Department of Radiology, Medical School of Republic University, Sivas between March, 1986 and November, 1987. Sonographic findins were compared with surgical findings. Ultrasonographic criteria of abdominal cyst hydatides were represented.

Mesenteric cysts are rare intra-abdominal tumors. The goal of this study is to analyze the clinical symptoms and the pathological features of mesenteric cysts and the surgical approaches. The data of 17 patients who had surgeries because of mesenteric cysts between 2005 and 2012 at our clinic were evaluated retrospectively. Eleven (65%) of our patients were female, while six (35%) were male and the median age was 32 (17-70). The most frequently seen clinical presenting complaint of our patients was abdominal pain and abdominal mass. The mesenteric cysts were most frequently located in the small intestine mesentery (70.5%). The cyst sizes varied between 2 and 25 cm. The most frequently performed surgical procedure was enucleation (76%). While surgical site infection was seen in two patients, anastomosis leak was seen in one and this patient had loop ileostomy. The mean period of hospitalization was 8 (2-17) days. No mortality cases were seen in the post-op period. Mesenteric cysts are rare intra-abdominal masses. They can be seen in different localizations within the abdominal cavity. Patients are generally diagnosed by radiological methods. The rate of recurrence is low following total excision and it has a good prognosis. Although laparoscopic resection is a preferred method, physicians should secure total resection in malign cases and the cyst should not be perforated.

This is a group of Progressive renaldisorders that usualy have their onset in childhood. The common characteris- tic is the peresence of a variable number of cysts in the medulla associated with significant cortical tubular atro- phy and interstitial fibrosis. Although the presence of medullary cysts is important, the corticaltubulointerstitial dam- age is the causeof the eventual renal incufficiency. İt has four variants: 1- Sporodic, nonfamilial (% 20); 2- Familial juvenile nephronophytisis (% 50), inherited asa recessive disease; 3- Renal - retinal dysplasia (% 15), recessively inherited and associated with retinitis pigmentosa; and 4-Adult onset medullary cystic disease, dominantly inherited (%15). The case had shown the view of sporadic nonfamilial variant of UMCD and was presented because of the rarity in literatüre it.

The aim of this study was to compare laparoscopy to laparotomy in the management of patients with suspected adnexal torsion. Seventy two patients with initial diagnosis of adnexal torsion that presented to our clinic with acute abdomen or were referred from other centers between January 2007 and December 2009 were included in this retrospective analysis. Data regarding age, gravidity, parity, size of adnexal mass, pre-operative and post-operative hemoglobin values, operation time and duration of hospitalization of patients that had adnexal detorsion, cystectomy, oopherectomy, total abdominal hysterectomy and bilateral salpingo-oopherectomy (TAH-BSO) performed via laparoscopy or laparotomy were recorded. Twenty eight patients were treated laparoscopically while 44 patients had laparotomy. In the laparoscopy group 6 cases had detorsion, 17 had detorsion and cystectomy and 5 cases had salpingo-oopherectomy. In the laparotomy group 3 had detorsion, 17 had detorsion and cystectomy, 7 had salpingo-oopherectomy and 17 patients had TAHBSO. Laparoscopy group consisted of young patients with low parity, operation time was shorter in laparoscopy group and the patients were discharged more rapidly. Average adnexal mass size was bigger in laparotomy group. Adnexal torsion is one of gynecological emergency that require urgent operation the most appropriate surgical approach is laparoscopy especially in patients who want to preserve their fertility.

Papillary cystic neoplasrn of the pancreas is a rare pancreatic condition with low grade malignant behavior. It occurs mainly in young adult females and surgical resection is amenable to cure in early cases. A 26 yaar old woman who had epigastric mass and pain was operated on with the diagnosis of pancreatic tumor and biopsy specimens showed papillary cystic tumor. We report this case for it is a rare condition. great in size and his-tologically documented vascular and capsular invasion with no metastases.

The aim of this prospective study is to evaluate the results of our total laparoscopic hysterectomy (TLH) cases. Forty one patients underwent TLH due to benign or malign disorders were reviewed prospectively between January 2013 and April 2014. Rigid instruments 10 mm telescope, and advanced bipolar energy modalities were used during the procedure. A primary 10-mm trocar was inserted directly through a 1-cm sub umbilical incision. The laparoscope was inserted through this trocar after insufflation of the abdominal cavity with 3–4 L of CO2. The second and third incisions were performed in the avascular right and left lower quadrant of the abdomen and two ancillary 5-mm trocars were inserted through these incisions. Uterine manipulation was performed by using RUMI® II. During the removal of the specimen, if necessary, intracorporeal myomectomy and morcellation were performed before the uterus and ovaries were delivered intact through the vagina. A 0-Vicryl suture was used for close the vaginal cuff. The sutures were passed through the left and right uterosacral and cardinal ligaments in all patients. All procedures were performed by the same surgeon. The mean age of the cases, body mass indexes (BMI), duration of operations, the amounts of blood loss, rates of complications and post operative hospital stay were assessed. The indications of for hysterectomies were, 16 myoma uteri, 6 medical treatment-resistant abnornal uerine bleeding, 5 benign ovarian cyst, 4 adenomyozis, 3 myoma uteri+ovarian cyst, 2 endometrial polyp, 2 endometrioma, 2 endometrial hyperplasia and 1 early stage cervical cancer. The mean age of patients were 47.5 (30-68 years), mean BMI of patients were 30.2 (24-44), mean specimen weight was 215.9 (90-650 gr), mean operation duration was 107.9 (60-210 min), mean blood loss was 81.1 (30-300 ml), mean preoperative hemoglobin (Hb) was 12.5±0.9 gr/ dl, mean postoperative Hb was 11.5±0.8, and the mean hospital stay was 2.5 (2-4 days). There were no intraoperative complications. Late postoperative complication was vaginal vault infection in 2 cases. Total laparoscopic hysterectomy is safe and feasible method for gynecological diseases. Careful selection of patients is critical for obtaining the best results.

Simple renal cysts are asymptomatic incidental findings; however, for a small subset of benign renal cysts, patients may present with pain, hematuria, urinary infection, pyelocaliceal obstruction or hypertension. Laparoscopic cyst ablation is an effective minimally invasive modality for the treatment of benign renal cyst. Our aim was to show the ultrasonic energy safe and effective method during laparoscopic renal cyst excision. In our clinic 14 patients underwent operated laparoscopic renal cyst excision with transperitoneal approach between January 2006 and February 2010. Trocar port for camera was inserted to the peritoneum in order to open the told line, gerato fascia and fat over the cyst. Harmonic™ scissor with the cautery was used to incise the cyst wall. Mean age of the patients was 58,1 years. Mean operation and hospitalization times were 59,2 minutes and 1,57 days, respectively. We did not need the fourth trocar during operation and the operation was finished. There was no complication in this procedure. Mean follow-up time was years. In long-term follow-up period symptomatic recurrence was observed in one patient and someone else be observed radiologic recurrence. We believe that using ultrasonic device is safe and effective method in laparoscopic cyst decortication. However, prospective controlled trials are needed to evaluate the other energy sources.

\r\n Colloid cysts are rare benign tumors of the third ventricle and have a wide range of clinical representations from incidentomas to acute death.  The growth of these cysts is an uncommon event and may cause obstructive hydrocephalus that lead to sudden deterioration in the patient's condition and may cause life-threatening complications. The large colloid cyst of third ventricle caused sudden death of children due to clogging, diagnosed in vivo is a very rare case in literature. We are representing here a case which patient admitted to emergency room for sudden loss of consciousness. Even he had urgent ventriculostomy due to acute hydrocephalus development, brain death has occured because of 3rd ventricle colloid cyst.

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Thirty Wistar rats were anesthesizeci with k.etamine hydroclorure and the abdornen was opened thorough a midline incision 4 cm. tong. Omenturn was tied with 310 black silk suture.rnaterial in 3 clifferent paris and on the right side, 3 x 0,5 crn. patches of the parietal peritoneum and underlying mus.cle were resected. The resuitant defect ciosed with inderrupted 310 black silk suture. We formed 3 groups each including 10 rats. The first group was control with no instillate. second group, 50.000 U of aprotinin and in third group 2 nıL of new poviclone-iodine1PVP solution was injected into the periitoneal cavity. All rats were sacrified at one week and assessment -of adhesion formation was made. Treatrnent with aprotinin and povidone-iodinelPVP SOlidit:»8 resulted in fewer adhesions then controls (p 0.01). There was no significant difference between group 2 and 3 (p> 0.05). in conclusion, this study shows that aprotinin and povidone lodine/PVP solution are both effective in reducing peritoneal adhesions.

Asymptomatic huge overial benign mucinous cystadenoma: A case report. Overial benign mucinous cystadenoma can grove huge sizes. Abdominal cysts are usually asymptomatic unless they have huge sizes. It is a rare condition asymptomatic clinical course of a huge abdominal cyst as like in our case. We aim to examine abdominal cysts by presenting a case of huge overial benign mucinous cystadenoma in this article. Abdominal ultrasound imaging is a useful exemination in diagnosis of abdominal cysts. For differential diagnosis abdominal tomography and magnetic resonance must perform as a advenced imaging method. Surgical treatment is usually open surgery performed by a median incision. Although open surgical tecniques are protecting importance as a convential prosedure laparoscopic surgical methods are increasingly having popularization.

The aim of this study was to evaluatie of adnexal masses cases that were diagnosed and laparoscopically treated during pregnancy in our clinic. This retrospective study included 18 cases that were diagnosed to have adnexal masses during pregnancy or referred from other clinics to our clinic and treated by laparoscopy between January 2005 and December 2009. Patient’s characteristics such as age, gravidity, parity, symptoms, gestational age at the time of diagnosis, sonographic findings, and type of laparoscopic surgery, operation time and hospitalization time were recorded. Eighteen women with adnexal masses during pregnancy who underwent laparoscopic surgery were included in this study. The average age of the patients was 28.5±4.3 (range 20–37) years and the average gestational age was 13.1±3.3 (range 8–20) weeks. The patients presented usually with pelvic pain. Adnexal cyst was mostly seen by ultrasonographic evaluation. Adnexal torsion was detected in 8 patients. Nine patients were in first trimester, other 9 patients were in second trimester. We performed laparoscopic cystectomy in 10 patients, detorsion and cystectomy in 6 patients and salpingoooferectomy in 2 patient’s. Mean adnexal mass size was 7.8±2.3 (range 5–15) cm. Mean operation time was 37.2±7.1 (25–50) minutes and mean hospitalization time was 1.8±0.6 (1–3) days. Abortion was not detected in our cases. According to these findings, laparoscopic surgery is the most appropriate treatment for patients with adnexal masses during pregnancy in the presence of expert surgeons. Laparoscopic surgery if performed by experienced surgeons seems to be safe and better management method for maternal-fetal health.

\r\n Tubal torsion is a very rare case, especially in pregnancy. We present a case of a patient of 24 weeks gestation that was admitted to our clinic with acute abdomen. Radiological and biochemical investigations did not reveal the cause of abdominal pain which resulted in laparatomic exploration. During the operation, the Morgagni cyst, previously explored by ultrasonographic examination, and the right fallopian tube were found twisted among themselves. Cystectomy and detorsion was performed of the Morgagni cyst and the fallopian tube, respectively.  

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Cystic fibrosis (CF) which is occurred by mutations in the gene regulation of transmembrane message shows autosomal recessive inheritance. It is also the most common fatal diseases in white race. The frequency of disease is estimated as 1/2500-1/3500 in white race, 1/1700 in African Americans. But the frequency of CF is not known for our countries. In this study, the frequency of disease was tried to find in children with malnutrition and/or recurrent pulmonary infections who admitted to hospital. This prospective study was conducted between February 2007 and January 2010 and children with malnutrition and/or recurrent pulmonary infections were enrolled the study. The diagnosis CF was made by using positive sweat test and appropriate clinical findings and rule out of other diseases which also caused recurrent pulmonary infections or malnutrition. A total of 491 children were enrolled the study. The mean age of children was 26,1±35.01 months with the range of 2-216 months. Of all children, 335 (68.3%) were male and 156 (31.7%) were female. Positive sweat test was found in 35 (7.1 %) children. The frequency of CF was found to be 5.3 % in children with malnutrition and 8.8 % in children with recurrent pulmonary infections. Finally we emphasized one more times that CF should be keep in mind in children with malnutrition and/or recurrent pulmonary infections due to its early diagnosis and prevention of late complications.

Aim: To evaluate the results of posterior chamber intraocular lenses implanted by scleral fixation technique. Method: 34 eyes of 34 cases which had intraocular lens implantation by scleral fixation method between January 2002 to December 2006 were retrospectively evaluated. The parameters evaluated were the age and sex distribution, primary or secondary IOL implantation, type of implanted intra ocular lens, visual acuity, intra ocular pressure and complications. Results: The mean age of the patients was 52.55± 22.08 years (range 4 to 83 years). The mean follow up time was 6.41±6.49 (3–36) months. The mean postoperative best corrected visual acuities (BCVA) in PMMA IOL group and foldable IOL group were, 0.39±0.35 and 0.57±0.27, respectively (p=0.146). The mean postoperative best corrected visual acuities (BCVA) in primary implantation group and secondary implantation group were, 0.44±0.34 and 0.47±0.32, respectively (p=0.758). The postoperative complication rates in PMMA IOL group and foldable IOL group were 40.9% and 16.6%, respectively. Postoperative IOP increase and cystoid macular edema were the main complications. Implanted twenty-two IOLs were PMMA, and twelve were 3-piece hydrophobic acrylic. Conclusion: Implantation with scleral fixation of IOLs may be preferred in eyes with absence of zonular and capsular support. Although visual outcomes were similar for the two IOL types, scleral fixation of foldable IOLs take less time, have low incidence of complications and earlier visual rehabilitation. Long term studies with larger number of patients may better define the role of scleral sutured posterior chamber intraocular foldable lens implantation.

There were a little microscopic differences in the kidneys of the rats which were fed up oraly with 2,4-7-Triamino-fenil-plerident+Hydrocholorothylazi-de for 20 days and there were remarkable dillerences in those which were fed up with Amilorid HCI dihydrate+Hidrocholorothiazide and it reminded a reversible acquired renal cystic disease.

To investigate the level of 25(OH)D and association between 25(OH)D level and hormonal-biochemical parameters in Polycystic ovary syndrome (PCOS). Thirty three patients diagnosed with PCOS and 42 age- body mass index (BMI) matched control group admitted to Bolge Training and Research Hospital from May to October were included in the study. Serum total testosterone (TT), free testosterone (fT), 25(OH)D, dihydroepiandrostenodione sulphate, LH, FSH, thyroid stimulating hormone (TSH), cortisol, 17αOH-progesterone, fasting glucose, insulin levels were evaluated after 12 hour fasting. HOMA-IR (fasting glucose level x fasting insülin / 405) was calculated. Serum 17αOH progesterone and 25(OH)D levels were significantly lower in PCOS group (p<0.01). Serum LH, LH/ FSH TT, FT, insulin, ACTH, and DHEAS levels were significantly higher in PCOS group (p<0.01). There was statistically significant negative correlation of 25(OH)D levels with PCOS, LH/FSH, TT, fT, DHEAS ve FGS. There was no statistically significant correlation between 25(OH)D levels and age, body mass index and insulin resistance. The results of this study indicated that vitamin D deficiency is highly prevalent among women with PCOS independent of body mass index. We also demonstrated that vitamin D deficiency was correlated with hyperandrogenism in PCOS women. Low serum 25(OH)D levels might exacerbate PCOS symptoms. Large intervention trials are needed to evaluate the effect of vitamin D supplementation on hormonal and clinical parameters in PCOS women.

Lesions in the peripheral lung area chest roentgenograms may be examined by ultrasonography. Solid and cystic lesions may be differentiated with ultrasonography (Us). ln 49 of 57 patients the US diagnosi.s of cases was correct. In 25(%51) of 49 patients lung !umar was diagnosed. In 6(%12) cases pneumonia, in 6(%12) cases hydatid cyst, in '" 5(%6) cases empyerna. in 3 (%6) cases encapsuie fluid collection, in 2(%4) cases absces5', in 1(%2) cases left ventrikül anevriysm and in 1(%2) case pericardial hydatid cyst were diagnosed. Consolidations were imagined in solid structures that include hypoechoic and branching sutructures. Tumors were imagined ta be more echogenic and homogeneus solid maseses. Atelectasis waüs imagined in structures consist of hypoechois bronchial and vascular echoes.

Many scolicidal agents are used in surgical treat-ment of hydatid disease. The efficiency and side ef-fects of these agents are known and in this study we compared scolicidal elliciency of formol and polyvin-yl pyrolidone (PVP) in vivo and in vitro. Ilydatid liquid was obtained from sheep liver and living scolex were observed by eosin test and micro-scopically. 10% formül and PVP mixed with hydatid liquid in 10%, 20% and 50% concentrations. The vi-ability of the scolices were determined by eosin test and microscopically after 3, 5, and 10 minutes. In vivo study, we forrned 5 groups each containing 10 rats. The control group was inoculated with ,1 mi of living hydatid liquid intraperitoneally and hydatid cysts were observed in peritoneal cavity of alt rats after 8 weeks. In the study group formül and PVP were used in dijfererıt concentrations and durations. We concluded that PVP is effective as a scolicidal agent even in low concentrations but formül is not useful.

Chronic otitis media and mastoiditis are the result of infection by an organism of low virulence or of acute infection with incomplete resolution. Mastoid inflammation produces thickening of some trabeculae secondary to reactive new bone formation and at the same time mineralization of other trabeculae. A cholesteatoma is an epidermoid cyst that consists histologicaly of an iner layer of stratified squamous epithelium. The lumen of the cyst is filled with desquamated epithelial debris. As the cyst enlarges and comes into contact with contigious bony structures of the middle ear, mastoid and petrous pyramid, erosion of these structures occurs owing to pressure necrosis and enzymatic lysis of bone. Ossicular erosion is seen %70 ratio. Ossicular erosion is seen later and the long crus of incus is eroded the most frequently. But the bigger lesions may make erosion whole ossicles. Cholesteatomas may make tegmen erosion, mastoid cortex irregularity, fasial nevre contour irregularity and semisircular canal defect according to bigness and period. Tympanosclerosis develops in the result of collecting hyalin and calsific deposits in tympanic membran and the submucosa of middle ear. These are tympanosclerotic plugs. It appears in the result of otitis media or trauma.

In 692 cardiac surgeries performed between 1987-1995 years in Selcuk University Faculty of Medicine GogUs Ka1p Vascular Surgery Clinic, 11 cases (1.59%) were detected in the heart mass in 6 of these cases (0.87%) and 5 of them were 0.72). formed neoplasms, stur. 0.721 of the cyst hy-dynamics are also placed on the left ventricle free on the du-vanna.

Background: Tyrosine rich crystals (TC) are curious structures, rarely encountered at histopathology, more so at cytology. These crystals have been documented exceptionally in various non-neoplastic and neoplastic lesions of salivary gland, lacrimal gland and rarely in larynx. The finding of these crystals in nasolabial cyst has not been reported till date.

Case: A 35-year-old female with a clinical and radiologic diagnosis of nasolabial cyst underwent fine needle aspiration cytology (FNAC). Tyrosine crystals in singles and in groups assuming ‘petaloid’ and ‘daisy head’ forms were noted along with few lymphocytes and histiocytes. Amylase crystals were also noted.

Conclusion:  Regardless of the precise cause, cytologic recognition of TC is important to avoid confusion. Identification of these crystals at FNAC is a matter of avid observation and encourages cytopathologist for meticulous examination of all fluids. The case also highlights that the occurrence of TC is not restricted to SG and the circumstances in which it occurs is diversified.

Intraspinal synovial cysts are uncommon lesions. İn this article a 72 year-old woman who developed a spinal synovial cyst at the left side of L4-5 disk space is reported. Beside her clinical signs and symptoms, magnetic resonance imaging, operative andpathological findings are presented. Treatment options, clinical, radiological and pathological aspects of intraspinal synovial cysts are discussed.

Post-traumatic pseudocysts of lung are rarely seen complications of blunt chest traumas. Usually spontaneous resolution is seen in 2- 4 months after trauma, but a few of them are get into abscess or tension cyst formation after Progressive expansion and in these circumstances surgical resection is indicated. Radiologically they are frequently seen as thin-wall cysts consisting air-liquid levels. Unless they had a drainage bronchus in the beginning they are usually seen as pulmonary hematomas due to hemorrhage. 14/e herein report 15, 17, 47 and 49 year old four cases who were hospitalized for blunt chest traumas in our clinic. Three of them were male and one was female. Ali the pseudocysts localized in the right lung, and in two of the case the cysts resolved in a period of 2.5 and 4 months with medical treatment. But in two cases surgical treatment needed for their Progressive expansions.

Aim: We used Ligasure vessel sealing system in order to lessen the bleeding while cutting the parenchyma or to have a non-bleeding resection at 15 patients with mass at the liver. We aimed to present the data of the 15 patients where we applied hepatectomy and pericystectomy by the help of Ligasure, as a preliminary study. Material and Method: The records of 15 liver patients for whom we applied hepatectomy and pericystectomy by the help of Ligasure at Selcuk University Meram Medical Faculty of General Surgery Department during 2005-2007, were examined retrospectively. 10 of the patients were liver tumors (4 of them were hemangiomas, 2 were an adenoma and 4 were hepatocellular carsinoma), 3 of them were liver cyst hydatid, one of them was gall bladder Ca and the other was hepatolithiazis. Ligasure vessel sealing system (Ligasure Valleylab®) was used for all cases. Hepatectomy and pericystectomy by the help of Ligasure were applied to the patients. During parenchyma transection, sutures were used for great vessels a one patient. Result: The mean age of the patients was 53.7(32-65) and male/female ratio was 15/17. Mean blood loss was 217(30-700)cc and blood transfusion was not needed accept one case. Mean transection time was 48.93(25-85) minutes. There were no significant increases at biochemical parameters at the postoperative period. There was no morbidity at the late postoperative period. Conclusion: Ligasure application seems to be the precursor of a non-bleeding period at liver transection at them treatment of benign and malignant diseases of the liver

A case of hydatid cyst treated in our clinic is presented. The cilinLd er,d laborutory finding, treatınent and prevention is reviewed and discussed.

Mesenterk cysts are uncom.rnon, benign, ımilocular ör multilocular cysts. Although !hese are rarely in population, !hey may present with potential life-threatening complications especially in children. in ankle a case of jejunal obstruction due to mesenteric cyst in a 3 morıthold infani was described.

Thrce cases of spinal hydatid cysts are reported. Ali the patients were admitted with symptoms of compression of the spinal cord. The patients were treated surgicall, recurrens was in only one patiant and no mortality.

In this report, an 8 months infant, who has a heavy dyspnea, cyanosis and mediastinal shift to left side is explained and the cliagnosis and treatment methods are discussed.

In children, fracture may occur in growth plate before the epiphysis of hand distal phalanx become closed. Because of the asymmetry of the insertions of the extensor and the flexor tendons, the clinical manifestation of this injury in young children mimics a mallet finger deformity. When admitted to the emergency service due to the hand squeezing in the door of the car, the 13-year-old male child was diagnosed with Seymour fracture as a result of investigations. Fractures were fixed by a Kirschner wire (K wire) and healed without complications. Because of this case, the diagnosis and treatment of Seymour fracture‘s interesting pattern which resembles other injuries, have been researched with the accompaniment of the literature.

The pericardial hydatid cyst is a very rare entity. In this study, a pure pericardial multiple hydatid cyst case is presented. And the diagnostic methods are discussed.

Hydatid cyst is a parasitic infestation caused by Echinococcus granülosus. In this study we present a pulmonary hydatid cyst case that has radiological and bronchoscopic view like a malign mass. A 17 year-old male patient. He has cough, sputum and hemoptysis complaints. He has 10 kg weight loss in last two mounths. Thorax computed tomography showed a consolide lesion in the the right upper lobe. Fiberoptic bronchoscopy was performed in this case. There was an endobronchial hump lesion covered with necrotic tissue, in the right upper lobe anterior segment. The result of bronchoscopic biopsy was reported as ‘hydatid cyst’. We found a cystic lesion at the left liver lobe in abdominal ultsonography. Patient transferred for operation at thoracic surgery department. Hydatid cyst was rejected by operation. Hydatid cyst is usually located in the lower lobes of the lungs. Although cyst has classic radiologic, bronchoscopic findings, we should think hydatid cyst in different radiological and bronchoscopic findings too.

In this study, 36 patients sufteering from infenility were divided into 5 groups and verin washed inutero insemination applied on each of them and 8 of these resulted in pregnuncv. Sperm washed application was fourıd to have positive results in case of oligo-asthenospermia, impotancy, irnınunological inferti-impaired post coital test and anatomical defects. in our mudy we obtained the best result in cases of infertiliry of unknown etiology. 6 of the patients had given binh to healthy babies, 2 pregnancies are stili being monitored Results were not found to be statis-tically significant . This application is anyway thoughtbe useful for infertile couples at a certain rate.

Aim: Cardiac masses are rare and categorized as non-neoplastic and neoplastic. Different imaging
methods play a vital role in the diagnosis and surgical planning of cardiac masses. Echocardiography
is the primary method of mass detection. Computed tomography (CT) and magnetic resonance imaging
(MRI) are used to detect and monitor cardiac masses. In this study, we aimed to evaluate the role of
radiology in the detection of rare cardiac masses and treatment planning.
Patients and Methods: Admission symptoms of five patients with cardiac masses detected in our
radiology unit between 2018 and 2021, the imaging methods in which the lesions were determined, and
whether the imaging findings were consistent with their patholo gical diagnosis were evaluated.
Results: The masses of patients diagnosed with lymphoma, pleomorphic sarcoma, and hemangioma
were larger than 3 cm. The margins of the malignant masses were ill-defined, and invasion into adjacent
structures was seen. Cardiac hemangioma, pericardial cyst, and myxoma had diagnostic radiological
findings.
Conclusion: It is significant to know the imaging findings according to the pathological diagnosis of
cardiac masses in patient management and treatment planning.

Two patients, 11 and 12 years old treated for choledoc cysts are presented, One of :hem was diagnosed by ultrasonography and the other by uhrasonography and hepatobiliary scanning technics preoperatively. One patiem undenvent choledochocystoduodonostomy and the other Roux-en Y choledochocystojejunostomy. They had no complaints postoperatively.

The hytiatid disaese of bone is very rare then the other organ involvements. The vertebral column is in-volved in about 50 % of the patients. Vertebral hyda-tidosis is characterized by serious complications and it causes many diagnostic and therapeutic problems. One patient with hydatidosis of the vertebral column who was treated succesfidly by ehemoterapy and sur-gery was reported in this article

Epidermoid cyst refers to the implantation of epidermal elements into the dermal and deeper tissues. In head and neck, incidence ranges from 1.6 to 7%. In the tonsillar area it is extremely rare i.e less than 0.01%. They occur in fetal period  as congenital lesion or as an acquired lesion  either due to a trauma or  as post surgery implant. In this case report, we will discuss the epidermoid cyst, in a 46-year-old male who presented with history of pain in the throat with previous history of bilateral tonsillectomy. 

Benign nonparasitic cysts of the spleen are un-comrnon. A total of 650 cases have been described in the literature until 1989. in this paper we pre-sented arz. asymptomatic cas'e of congenital splenic cvst which was treated bir partial splenectomy.

The hydatid cysts that are common geographically over the world; causing serious complications and considered as a high recurrent average disease . In spite of the infective nature of the disease; the primary treatment is a surgical one . And in this point the surgery techniques and the using of the scolicidal agents is important to increase the chances of the successful treatment.

In the literature, there is not enough information about the determination of the most effective scolicidal substances. Therefore clinically there are different opinions in the using of the different agents

In this study, in –vitro we investigated the activity of some frequent used scolicidal substances related to the time . All the agents that used in our study for 20 minutes were successful. But we have seen that the earliest and the most effective response is noticed with praziquantel. These findings that demonstrate the success of praziquantel to kill E. granulosus are proposing to support the medical treatment.

To determine the ideal scolicidal material that will be used in the medical and the surgical E.granulosus treatment, and its side effects more efficiencies-study analysis must be performed

The pre vtant rats were fed with diphenylamine derivatives (. tmilorid dihidrat + hid-roelorothiafid) clurin,,? the last week of gestation ins-pired by phanesetin and its major metabolic bre-akdown products are similar chemically diphenvlamine. The di (frrence., that reminded glomerulocystic kidney were -determined with histopathologie exa-mination in kidneys of offvpriti;,- However this dif-frrenees were not noted in olIcpi-inf;s or rats that led normally. We conclude that fetal kidney is susceptible to the interstitial intiantatory elkcts of phanacetin lie-rivairives and the resultmz tubular obstruction pro-duced the cystic changes.

In this study, the number of mast cells in the uterus at an early _stage after fetrilization was investigated. The number of mast cells increased anti! a certain point when tı depletion is noticed. It is concluded that, this decrease may depend upon a stimuli of maternal origin and blastocyst may cause this effect, and this depletion is associated with implantation.

A patient wirh diffuse cystic angiomatosis of bone which is very rare entity was reported in this article. This disease should be considered in the differential diagnosis of the patients characterized ikvith diffiıse cystic lesions .of their skeleton on radi-ographic examination.

Between January 1994 and December 1995.29 pa-tients were treated with laparoscopic surgery in our department. The aim of this study is to present our ex-perience with the indications and efficacy of la-paroscopic surgery in pediatric surgery. The age of the patients was heteen one and 16 years. The most common procedure that we per-formed was appendectomy (13 patients). The other-common procedures were ovarian cyst drainage (four patients), hemostasis in traumatic int-raabdominal hemorrhage (three patients). sple-nectomy (four patients). Swenson's procedure (three patients), and cholecystectomy (three patients). We had to converse to open surgery for technical reasons in a total of four patients (10%). We observed extra peritoneal insujilation in ma patients, transient tachycardia and arrhythmia in five patients. and tran-sient hyperthermia in another two patients as int-raoperative complications. One patient developed postoperative ileus after appendectomy. The duration of the laparoscopic procedures was longer than that of the open surgery in spknectomy and Swenson's procedure. similar in apendectomy, but shorter in cholecystectomy, ovarian cyst dra-inage, and hemostasis for intraandominal he-morrhage. Hospital stays were shorter in all la-paroscopic procedures comparing with open surgery. Laparoscopic surgerey is a useful method with low incidence of complications which are well to-lerated for the treatment of the surgical pediatric pa-tients.

From 1984 to 1994. 11 patients with urererocele suffering from liank pain, dysuria, pollacuria were admitted to our hospital of these patient 5 had right ureterocele, 3 left ureterocele and 3 also bilateral ureteroceles_ .Transurethral incision for 5 cases were applied, transurethral partial resection for 3 cases, both t•ansvesical resection and ureteroneocystostomv for 3 cases. Treatment and results in the patients with ureterocele have been discussed.

Left to right shunting immediately after and 6 months later the procedure was investigated in 22 patients who had undergone PMBV in Koşuyolu Heart and Research Hospital catheterization la-boratory. Oxymetric method was used for the de-tertion of shunting. Na left to rigt shunting was de-tected before PMBV. lmmediately after PMBV it was detected left to right shunting in eight cases (36.36%). The ratio of mam pulmonary w systemic (QpiQs)flow was Six mounths later cont-rol catheterization was peıformed and it was found that teli' ta right shunting in only 3 cases with a lower QpiQs ratio. It was concluded that PMBV can induce left to right shunting in a subtantial propardon of patients but üs cliııical importance is negligible.