Chronic Lymphocytic Leukemia (CLL) is a disease characterized by increased number of mature B lymphocytes in blood stream, bone marrow, lymph node and spleen with different clinical course. In CLL patients, Rai and Binet classification systems are established for determination of the necessity of treatment and prediction of survival. However, the prognostic value of these classifications is limited in early staged patients. The aim of this study was to investigate the effects of surface antigens (ZAP70, CD38, CD16 and CD56) in staging and prognosis of newly diagnosed and untreated patients with CLL. ZAP70 expression was positive in 5 of 35 investigated patients. The majority of patients with low expression levels of ZAP70 was early stage of disease and progression-free survival of these patients was longer than others. CD38 expression was positive in 3 of 35 investigated patients. The majority of patients with low expression levels of CD38 was early stage of disease and progression-free survival of these patients was longer than others. In only one patient, both ZAP70 and CD38 expressions were positive. There was no significant correlation in patients between the expression of ZAP70 and CD38 CD56, CD16 was expressed at low levels in all patients. The majority of patients in this study, expressions of surface antigens such as ZAP70, CD38, CD16 were found as low. Our results are highly significant when 74 % of them are considered to be a early-stage and/or follow-up without treatment. However, Long-term clinical observational studies with control groups should be made for understanding the effects of surface antigens in staging and prognosis of CLL.

Aim: Gastric cancer is one of the leading causes of cancer-related deaths. Tumor budding has been
shown to be a prognostic factor in many cancers. In this study, we aimed to evaluate the prognostic
significance of tumor budding in intestinal-type gastric adenoc arcinoma.
Patients and Methods: A total of 152 cases diagnosed as intestinal type gastric adenocarcinoma in
the Pathology Clinic between 2015 and 2021 were included in the study. Tumor budding was grouped
as low, medium and high. Hematoxylin and eosin-stained slides were re-evaluated in terms of tumor
differentiation, lymphovascular invasion (LVI), perineural invasion (PNI), lymph node involvement, depth
of invasion (pT) and tumor budding.
Results: Tumor budding was low in 30.9% (n=47) of the subjects included in the study, moderate in 37.5%
(n=57) and high in 31.4% (n=48). Statistically, as tumor budding increased, tumor size increased (p<0,05),
follow-up times were shortened, survival time (p<0,05), and tumor differentiation (p<0,05) decreased. A
statistically significant correlation was observed between tumor budding and LVI (p<0,05), PNI (p<0,05),
pT(p<0,05), lymph node involvement(p<0,05), and mortality of the cases (p<0,05). No statistically
significant correlation was observed between tumor budding and gender, age, tumor localization and
operation type (p>0.05).
Conclusions: Tumor budding is associated with poor prognostic factors. As it may be important to guide
the treatment modality and follow-up, tumor budding status may be mentioned in routine pathology reports.

Aim: Gallbladder cancer is an uncommon, but aggressive tumor. Its prognosis is poor and the most cases are incidentally detected in histopathological examinations of cholecystectomies due to benign diseases. With the era of laparoscopic cholecystectomy, the number of cases detected in early stage is increasing. In this study, we aimed to evaluate the rate of cancer encountered and the distribution of non-cancer diagnoses in cholecystectomy materials sent to our department, together with the literature findings.

Materials and Methods: The results of the cholecystectomy materials sent to the pathology laboratory and examined routinely in 2016-2017 were retrospectively evaluated by forming diagnostic groups. Clinical preliminary diagnoses, demographic informations (age, sex), and pathology reports of the patients were reviewed.

Results: We included a total of 1000 cholecystectomy materials into the study. Two of the 7 patients who presented with malignancy were incidentally diagnosed and underwent laparoscopic cholecystectomy with the preliminary diagnosis of cholelithiasis, with the primary focus was gallbladder in one patient, and the other was compatible with colonic adenocarcinoma infiltration. Preoperative and / or perioperative malignancy was detected in the remaining 5 patients. A large proportion (> 90%) of the other cases had chronic or chronic active cholecystitis and low rate of acute cholecystitis included gastric heterotopia found in 2 (0.2%), tubular adenoma in 1 (0.1%), tubulovillous adenoma in 1 (0.1%), adenomyoma / adenomyomatosis in 4 (0.4%), polyp in 6 (0,6%) and dysplasia (Biliary intraepithelial neoplasia, BilIN) in 5 (0.5%) patients.

Objective: The aim of our study is evaluate the association between serum vitB12 levels at time of diagnosis and clinical and laboratory signs in multiple myeloma patients.

Material and Methods: Patients were divided into two groups; those had low and normal levels of vitB12. Groups were analized by using independent simple T, Mann Whitney U and chi-square tests considering by distrubition characteristics of data.

Results: Two hundred-and-twelve patients' records were examined retrospectively. Forty-one (32%) patients had low vitB12 levels. In patients with low vit B12 levels, bone marrow plasma cell ratios were also significantly lower than those found normal vit B12 levels (median %30 vs %50, respectively) (p: 0,024). There was no statistically significant difference between the two groups in terms of age, lytic bone lesion numbers, and serum levels of total protein, lactate dehydrogenase, ß2-microglobulin, calcium, creatinin, albumin. However, 11 patients (%26,8) in low vitB12 group had anemia, while 44 (%50,5) patients in normal vitB12 group had. So, anemia was more often in vitamin B12 normal group patients (p: 0,019). No difference was found in terms of myeloma ISS and R-ISS stages in two patient groups.

Conclusions: Bone marrow median plasma cell ratio was also low in the group with low vit B12 levels. Our data could not show its clinical reflection. Further studies with larger groups are required to evaluate the response to treatment, survival and recurrence rate.

Cerebral Venous Thrombosis occurs less frequently in comparison to the arterial diseases of the brain. The diagnosis can only be made through imaging techniques and its mortality and morbidity is relatively high. Cerebral Venous Thrombosis can occur due to primary or secondary hipercoagulopathies. İt is known to have a varied clinical spectrum. We evaluated the patients with CVT etiological, topographical, presentational, clinical features and prognosis of the patients whom have been followed by our inpatient clinic years between 2009 and 2013 retrospectively. We examined the demographical features, signs and symptoms, ethiological factors, neuroradiological findings and treatments of 33 patients with CVT. Thirty three patients with CVT (24 female, 9 male) were identified. The average age was 33.4 (range:24-58). The most common symptoms were headache (81.8%) and nausea (48.4%). Focal neurological deficits were observed in 36.3% of patients and impaired consciousness was observed in 6.06% of cases. In cerebral venography examinations single sinus involvement was recorded in 16 patients and multiple sinus involvement was reported in 17 cases. Genetic and acquired coagulopathies, vasculitis and hormonal changes were the most common detected etiologic causes. All patients were treated with anticoagulants. Mortality was observed two patient. The patients with CVT have quite different etiological causes and the risk of mortality and severe disability could be reduced by early diagnosis and treatment.

VSD is the most common cardiac malformation among congenital cardiac diseases and ocur in 3-6 in 1000 live births. The pattern of this defect may vary from a minor hole in the muscular septum, with a tendency to spontaneous closure, to complicated lesions requiring heart surgery. The aim of this study was to evaluate retrospectively long-term follow-up results and prognosis of pediatric patients with isolated VSD. The study was conducted in Selçuk University Medicine Faculty Pediatric Cardiology Department between July 2010 and February 2013. The echocardiography results of the patients with isolated VSD have been examined retrospectively. Among the included patients, % 71.52 of cases were perimembranous (n=103), % 40.6 of cases were muscular (n=80) and % 9.72 of cases were multipl VSD (n=14). Spontaneous closure rate was % 52.4 (n=54). % 22.3 of the cases required surgical closure because of heart failure. % 43.4 of the cases that requıred surgical closure were perimembranous VSD defects. VSD is the most common malformation of congenital cardiac diseases and can lead to heart failure by left to right shunt. And also the incidence of endocarditis in these patients has increased so the follow-up of the patients is significant.

Diabetic nephropathy is one of the important microvascular complications of diabetes mellitus. Diabetic nephropathy develops as major complication of both type 1 and type 2 diabetes mellitus. At the same time, it is currently the leading cause of end-stage renal disease. Two of the main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Contribute to the development of diabetic nephropathy other risk factors such as hyperglycemia, hypertension, obesity, hereditary diseases, smoking, and advanced age. The progression from normal albuminuria to microalbuminuria is accepted as the initial step in diabetic nephropathy, and then distinctive proteinuria, decreased glomerular filtration rate, and end-stage renal failure develops.

Hellp Syndrome (Hemolysis-Elevated Liver enzymes-Low Platelets)is characterized by hemolysis, elevated liver enzymes and low platelet count, and related with an increased with an increased foetal and maternal mortality. We aimed in this study to evaluate the morbidity and mortality of 15 Hellp syndrome patients who have been admitted to our intensive care unit, between 2005 and 2009 years retrospectively. Patients ICU admission indications, demographic, clinical and obstetric data was noted down; hemoglobin, serum albumin level, prothrombine time ve active partial thromboplastin time, fibrinogen level, thrombocyte number, total bilirubine ve creatinine levels, AST, ALT, lactate dehidroginase (LDH) levels were analysed. Intensive care unit(ICU)admission of Hellp sydrome patients were convulsion, loss of consciousness, airway control, invasive hemodinamic monitorisation, ARDS, intracerebral hemorrhage and respiration insufficiency During 4 day intensive care unit following of our patients, thrombocyte numbers began to increase from third day of admission. But this increament was statistically significant between admission day to ICU and fourth day. Again similarly AST, ALT, LDH, ürea ve creatinine levels began to decreased at third day and decreament was statistically significant as from fourth day(P

The goal of this study was to determine ischemic modified albumin (IMA) levels and the carotid intima-media thickness (CIMT) in Primary Sjögren Syndrome(pSS) patients. We also aimed to search the relationship between inflammatory parameters and atherosclerosis with ischemic modified albumin levels. Twenty pSS patients and 20 healthy control subjects were enrolled in this study. Clinical evaluations were done by using clinical parameters [Visual analog scale (VAS), dryness of mouth and eyes] and laboratory parameters [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)]. All patients were females. The mean age of all subjects was 46.6±9.1. The mean age for pSS patients was 47.1±7.7 years, and 46.1±10 years for healthy subjects. The duration of disease in pSS patients was 5.8±4.4 years. There were no statistically significant differences between IMA levels of patients and healthy subjects (506.4±52.8 AbsU and 482.7±34.7 AbsU respectively; p=0.101). There were also no statistically significant corelation for clinical parameters. The CIMT were statistically significantly higher for patients when compared to healthy subjects (0.70±0.13 mm and 0.61±0.09 mm respectively; p= 0.016). When we analyzed the relationship between CIMT and clinical parameters, we determined statistically significant positive corelation between CIMT and age (r=0.700, p<0.001), and ESR (r=0.312, p=0.05). As a result, our study revealed normal IMA levels and higher CIMT levels, and no corelation between both of them. The higher levels of CIMT levels may be a precursor of cardiovascular disease in PSS patients without cardiovascular risk factors. Further clinical studies are now required to evaluate IMA levels in pSS

Present study was performed to determine the methods for early diagnosis of necrotizing fasciitis (NF), to indicate the importance of the early surgery and its repetition when necessary, and to predict the prognosis using laboratory tests. Study was performed with 34 patients who were diagnosed NF between 2005 and 2010. Prognosis were retrospectively inspected in terms of the age, gender, etiology, predisposing factors, laboratory findings, the application period, the number of surgical debridement, infection location and culture result of the patients. The most important etiological factors were found to be surgical intervention and local soft tissue infection. Among the predisposing factors of obesity and diabetes were found to be the most common. All patients had laboratory risk indicator for necrotizing fasciitis (LRINEC) score of 7 or above. The mean LRINEC score was found to be 9.1. Abdominal, groin and perineum were the common infection locations. Only 11 patients admitted to the hospital, diagnosed and received treatment for NF within the first 48 hours after the first symptoms. The wound cultures were positive in 26 patients. Most commonly grown microorganisms were E. coli and K. pneumoniae. Four patients who died during treatment were advanced age (mean 74.7), admitted late (5-10 days), had high LRINEC scores (mean, 12) and chronic diseases (diabetes, obesity, chronic lymphocytic leukemia). The patients who have high LRINEC score, over the age of 65 and admitted in 5 days or more after the first symptoms, were observed to have poor prognosis. Whenever a patient is suspected to have NF, physical examination, laboratory tests and invasive diagnostic procedures should be performed immediately in order to have an early diagnosis.

Aim: In this retrospective study, our patients with nephrotic syndrome (NS) were evaluated according to age, sex, etiology, response to steroid, prognosis, and compared with national data and the literature. Material and method: 141 children with nephrotic syndrome (NS) who admitted to the Department of Pediatric Nephrology of Selcuk University between January 2000 and December 2006 were assessed. Patients were classified into two groups according to etiology as primary and secondary NS. Results: 59% of the patients were male and 41% of them were female. Male/female ratio was 1.44, and median age was 9 (0.3-18.5) years. It is observed that 81.5% of the cases had primary and 18.5% had secondary NS. 67 of the patients with primary NS were male and 48 of them were female. Median age was 8 (0.3-18) years. 16 of the patients with secondary NS were male and 10 of them were female. Median age was 14 (7.5-18.5) years. Of patients with primary NS, 76.5% had steroid-responsive, and 22.6% steroide resistant. %64.8 of the patients with steroid responsive NS developed one and more relapses. Percentage of rare and frequent relapses were 3.4% and 61.3%, respectively. Our results showed that mesangioproliferative glomerulonephritis (MesPGN) was the most common histopathologic diagnosis, 15 (45%) of the 31 biopsied patients with primary NS were found to have MesPGN. Henoch Schonlein purpura nephritis was diagnosed in 14 (53.8%) patients and it was the most common cause of secondary NS. As a result, NS frequency and response to rate of steroid therapy are similar to present literature finding. However, frequent relaps ratio was lower than the others studies. Conclusion: We think that further research including more patients population and multiple center and control studies to investigate NS events to reveal causes of concerning with regional, national or race differences at the childhood period is warranted.

Idiopathic thrombocytopenic purpura (İTP) is the most common seen acquired bleeding disorder of childhood. İt has a benign course. Nevertheless, it has a great importance because of an organ bleeding risk and possibility of an existance of underlying serious disease and chronicity. İn our study we investigated retrospectively 86 patients diagnosed as İTP. Peak ages of the cases vvere 5 and 13 years. Except the intracranial bleeding, almost every type of bleeding vvere seen. We prefered corticosteroids for the first choice of treatment. 73 patients received high dose methylprednisolone for the treatment. 41 ofthem (47.6%) recovered totally. Immediate increase in the thrombocyte count after the corticosteroid therapy was observed in 79% of the patients. Chronicity rate was as high as 41.8% and the ages of this group vvere similar to that of the peek incidence ages. None of the patients died. Four patients, resistant to medical treatment went to splenectomy. Hovvever, the increase of thrombocyte count was permanent in only one case. One of the patients diagnosed as İTP was accepted as systemic lupus erythematosus three months later and one as Hodgkin lymphoma three years later. Patients with İTP should be monitered closely because of the bleeding risk and should be detected seriously because of an underlying disease risk and should be alert against the malignity or autoimmune disease at the chronic stage or after the remission phase.

The diagnosis of a congenital diaphragmatic hernia (CDH) is often made on a prenatal ultrasound examination at routine obstetric care. After birth, the spectrum of respiratory symptoms in an infant with a CDH is determined by the degree of pulmonary hypoplasia. The most affected infants develop respiratory distress within the first 24 hours of life. However, some of the infants with this defect present later, depending to the severity of the defect. Defects are more common on the left side, and it has been reported that patients with right-sided defects have a worse prognosis than those with leftsided defects. Here, we reported a case of a newborn infant with respiratory distress developed on the second weeks of life, and which diagnosed with right-sided diaphragmatic hernia containing part of the right lobe of the liver, bowel and the kidney.

Pulmonary embolism(PE) is a serious disease which is one of the most important reason of cardiovascular mortality. In spite of the fact that electrocardography(ECG) has a limited effect on the diagnosis and determination of the prognosis of PE, it is an essential method for clinically differentiating PE from other diseases that might be confused with PE, such as myocardial infarction(MI) .The aim of this case report presentation is to discuss whether this stuation might be a marker on determination of the prognosis.and the fact that PE could mimic the ECG findings of ST elevation myocardial infarction even though it is rare. Fifty six years old patient with acute renal failure and disorder of liver dysfunction, who had been treating in intensive care unit of internal medicine department, complained about chest pain and shortness of breath occuring on second day of his admission to the hospital. The patient was taken from cardiology department with anteroseptal MI prediagnosis after evaulation of the ECG demonstrating about 4 mm ST elevation in V1-V4 precordial derivations. Coronary angiography was performed to the patient being thought to whom primary percutaneous coronary intervention might be neccessary and there was not any lesion determined in epicardial coronary arteries. The parameters obtained from transthoracic echocardiographic evaulation of the patient was corcordant with the diagnosis of PE. It was understood from the imaging reports performed previously that trombus in vena cava inferior had been detected. The patient had cardiac arrest and died while he was being prepared for the pulmonary embolectomy operation after diagnosing of PE. The aspect which made our case report more attractive is that there were only various case reports published about PE in literature, which indicateST elevationmimicing anterior myocardial infartion. It is thought that this situation might be observed in PE and might guide for determination of the prognosis as well when this case report is evaulated together with the other ones.

Penetrating cardiac injuries are one of the most important urgent traumas which can cause life-threatening hemorrhage and cardiac tamponade. A significant number of cases die before reaching the hospital. Rapid response to those who reached the hospital determines the prognosis. Most of cases die because of inefficiencies in transport, delays in transport to operation room and late intervention. We aim to present, early operated penetrating cardiac injury case by a general surgeon without thoracic/cardiovascular surgeon and thorax surgery set in a distinct hospital.

İn this study, we aimed to investigate; diagnostic usefulness and sensitivity-specisifity values of some of the tumor markers (such as:CEA, CA 19-9, CA 125, and AFP) in totally 112 patients (75 male, 37 female) with gastric cancer. Gastric cancer group; the 57 patients (38 male, 17 female) mean age 55.36±1.37 years, benign disease group; the 30 patients (20 male, 10 female) mean age 53.53+1.97 years, control group; the 25 healtly (17 male, 8 female) mean age 57.11 ±2.87 years. No statistical significant difference was found betvveen the groups for age and sex (p>0.05). Preoperative tumor marker values; CEA, CA 125 and CA 19-% levels in gastric cancer group were found to be highly significiant among benign disease and control groups (p<0.05). Postoperative tumor marker values; CA 125 and CA 19-9 levels in gastric cancer group were found to be highly significant control group (p<0.05), but only CA 125 level were found to be highly significant benign disease group (p<0.05). Preoperative tumor marker value; No statistical significant difference was found between benign disease group and control group from ali of the tumor marker levels (p>0.05). Postoperative tumor marker values; CA 19-9 levels in benign disease group were found to be highly significant control group (p<0.01). The sensitivity and specificity of AFP were 3.5-100%, sensitivity and specificity of CEA were 63-100%, sensitivity and specificity of CA 125 were 35-96%, sensitivity and specificity of CA 19-9 were 47-100% in gastric cancer, respectively. İn conclusion, tumor markers, especially CA 125 and CA 19-9 can be used in clinical applications (e.g. diagnosis, preoperative evaluation and follow up ete.) of gastric cancers.

Premature rupture of membranes (PROM) is frequently encountered problems in obstetric practice and PROM is effecting perinatal outcomes. Premature rupture of membranes is associated with 20% to 30% of all preterm births. The prognosis is related primarily to gestational age at presentation and delivery. Appropriate treatment must be applied after patients were evaluated carefully, especially about gestational age and presence of infection. Preterm premature rupture of membranes (PPROM) is a major cause of perinatal morbidity and mortality and the most difficult problem for obstetricians. This reason, diagnosis, treatment and management of PPROM is very important. Diagnosis, treatment and management of PPROM is often discussed, but stil no consensus. In this review, we aimed to discuss how to approach with the support of current literature to problems we faced on PROM management.

Aim: The aim of this study was to evaluate the demographic characteristics, emergency care needs and prognosis of patients aged 65 years and older who presented to our Emergency Medicine Clinic with abdominal pain for a period of one year.

Patients and Methods: In this single-center, retrospective, observational study included patients aged 65 years and older who presented to the emergency department with abdominal pain between June 15, 2015 and June 14, 2016. The related variables were recorded from the patients' electronic and written files. The general patient population and the differences of variables in the 65-74 age group, 75-84 age group and ≥85 age group were investigated.

Results: A total of 1330 patients were included in the study. The mean age of the patients was 75.2 ± 7.2 years and 582 (43.8%) were male. While 58.8% of the patients were discharged from the emergency department, the most common hospitalization wards were General Surgery (14.1%) and Gastroenterology (11.4%). The ICU admission rate increased with age (p<0.001; 3.3% - 5.8% - 11.6%). The mean length of stay in hospital was 5.9 ± 7.1 days and the in-hospital mortality rate was 3.4%. While 50.1% of the patients in the 65-74 age group were discharged from the emergency department without consultation, this rate decreased to 36.6% in the ≥85 age group and the difference was statistically significant (p<0.001). Abdominal ultrasound was performed in 34.1%, abdominal tomography in 20.0% and both of them in 7.5% of the patients.

Conclusion: The patients aged 85 years and older with abdominal pain are more likely to be characterized by more examination needs, more consultation needs, more hospitalization rates and higher mortality rates. Taking these differences into consideration during the management of the elderly patients with abdominal pain in emergency department will help to reduce morbidity and mortality rates while improving patient care quality.

İn this study, we investigated the relationships betvveen tumour proliferating determinants (PCNA, Ki-67, and index of AgNOR) in infiltrating ductal carcinoma of breast both oestrogen receptor protein and P53. Twenty-five cases vvhose were operated and diagnosed as infiltrating ductal carcinoma were included in the study. The tu­ mour containing slides were stained immunohistochemically with PCNA, Ki-67, estrogen receptor protein and P53. One thousand cells were counted and the indexes for each staining were established as the number of po- sitive cells was divided to 1000. Additionally, the NOR corpuscles which were established by silver impregnation technique in 100 tumour cells were counted and the AgNOR index was determined by dividing this count to 100. AH indexes were compared to each other by statistical means. VVe found that oestrogen receptor positiviness was negatively linked to the expression of P53 and the indexes of PCNA, Ki-67, and AgNOR. İn conclusion, we de- monstrated that ali of above mentioned indexes had close relationships to each other, so they may have prog- nostic values.

Aim: The role of ischemia-modified albumin (IMA) was investigated in the early diagnosis of arterial and venous mesenteric ischemia. We aimed to determine novel procedures for the early diagnosis of Acute Mesenteric Ischemia (AMI), by evaluating serum IMA levels during the first 30 minutes, first, and third hours, in groups that have developed arterial and venous ischemia. Materials and Methods: In the experimental part of the study, three groups, each consisting of eight rats; 1st group: control; the 2nd group: ligation of superior mesenteric artery (SMA); and the 3rd group: ligation of superior mesenteric vein (SMV). Samples of venous blood were withdrawn in the first 30 minutes, first, and third hours in all three groups, and serum IMA levels were evaluated. Results: IMA levels in the first 30 minutes, first, and third hours were significantly higher in the 2nd group where SMA was ligated, and in the 3rd group where SMV was ligated, compared with the control group. Statistically significant results were obtained regarding the high IMA levels in the first half hour following ligation of SMA and SMV, which might be indicative of the period prior to ischemia. Conclusion: IMA may be considered as a new marker in the early diagnosis of AMI

Extracapsular spread of lymph node metaitases ir believed to be an indicator of poor prognosis. in general it has been thought that extracapsular spread was limited to the 'fixed" nodes. The patients whose lesions had extracapsular spread had statistically reduced numbers of survival. Other factors eg, tumor dillerantiation and the number of malignant nodes ellects on prognosis. The effect of extracapsular spread on staging, the reporting of retrospective reviews and therapy are discussed.

\r\n Gastric cancer is among the common cancers and chemotherapy is among the treatment plan. Chemotherapy affects many systems, it is important for the individual and her environment to adapt to this process. In order to improve this adaptation, the nursing care process given to the patient with gastric cancer who was receiving the first chemotherapy treatment according to the Roy Adaptation Model was described. According to the data obtained by the permission of the patient,  impaired physical mobility, anxiety, deficient knowledge about chemotherapy treatment process, defensive coping, readiness for enhanced family coping, nursing diagnoses were made and appropriate nursing interventions were applied. The model is thought to be available to patients receiving chemotherapy treatment.

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Congenital lobar emphysema (CLE) is a rare anomaly of lung development that presents in the neonatal period. A 13-day-old girl baby was admitted to our unit because of primary pulmonary hypoplasia. She had presented with severe dyspnea and cyanosis, where chest radiograph and chest computed tomography showed CLE and pulmonary hypoplasia. Pulmonary hypoplasia may worsen prognosis of patient. There fore, we performed a pulmonary magnetic resonance angiography in our patient. Pulmonary vasculature was normal on magnetic resonance angiography. After ward, our patient was operated. In here we would like to highlight that the use of advanced imaging techniques can identify additional pathologies which may affect prognosis after surgery.

One of the complications of gastric peptic ulcer is, malignant transformaiion. in this study, we have investigated the relation between peptic ulcer and gastric carcinorna that develops in chronic :gastric ulcer. Fifteen surgically resected stornachs, with ulcer were studied. Seven of those ulcers were peptic ulcer, five were carcinorna, but there were lesions like uncer-carcinoma. Those lesions had malignant cells in the sinan area at the base or margin of the ulcer. The ulcer-carcinotnas showed that carcinorna !might develop in the chronic gastric ulcer.

Lipomas are benign mesenchymal neoplasm commonly occurring throughout the whole body and comprise mature fat tissue. However, intestinal mesentery originated lipomas are rarely seen. A 42-yearold female patient presented with right sided abdominal distension. Exploratory laparotomy was performed and fat tissue was excised. Lipomas might or might not present with any symptoms. Complete surgical excision is the only treatment with a very good prognosis.

This study was designed to compare AgNOR and MI methods which are known as proliferation indexes in transitional celi carcinoma of urinary bladder (TCC) and to study correlation and regression between grade and AgNOR and MI methods. At the same time we aimed to identify any threshold valve which could help determine grade and prognosis. In this study, 102 cases of TCC were involved which were diagnosed between 2000 and 2003 in the Pathology Department of Meram Medical Faculty, Selcuk University. As control group, thirthy cystitis cases whose epithelia were normal in the surface apperance were chosen. Microscopic features of the cases were retrospectively re-evaluated in the light of latest literatüre. To grade TCC cases we chose the system proposed by Ash. Cases were re-evaluated independently of their previous diagnoses Staining and counting systems proposed for AgNOR by Crocker were used when counting AgNOR spots, spots stained black with silver in the nucleolus (AgNOR I) and those both in nucleus and nucleolus (AgNOR II) were counted, for each case in 100 cells without noticing size and distribution. When performing MI method proposed by Simpson, we calculated possible cell and mitosis counts in ten different microscopic areas. The number obtained by a ratio of total mitosis count to possile cell count was accepted as MI and denominator was expressed as 1000. We have found that AgNOR and MI values increased associating grade of the tumor. We could demonstrate a correlation between MI and grade though there was not such a correlation.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient– physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness. The purpose of the present review is to give knowledge regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning. Improving communication represents an important opportunity for the improvement of the quality of palliative and endof-life care received by these patients.

The cases of twenty patients, treated for turnors and cysts of mediastinurn between 1984-1990, have been investigated. it has been established that a more favourable prognosis could be obtained through early diagnosis and treatrnent of the patients with malignant turnors.

Congenital pyloric atresia (CPA) is an extremely rare condition. It may be isolated or accompanied by other abnormalities. In isolated cases, prognosis is good but congenital pyloric atresia can be fatal depending on another anomali. The etiology is still unknown. Since familial cases were reported in literature, it is suggested that this disease might be inherited. In here, we reported a delayed diagnosed congenital pyloric atresia case that presented with hypernatremic dehydration.

Two cases of morphea which developed after hepatitis B vaccination at the sides of injection were presented. One of these two patients was a 25 years old female. She referred to our clinic with complaints of brownish spots and hardening on external side of her right arm. In her history she said that she was given hepatitis-B vaccination a year ago, on the thickened parts of her arm, twice with 4 weeks internal. Itching, discoloration and hardening started on these regions 3-4 months later, especially inceasing with exposure to sun. The other case was male and 23 years old. He referred to our clinic with complaints of discoloration, regional hardening, hair fall on the upper part of his right arm. He said that he was given two hepatitis B vaccination 8 months ago with 4 weeks interval. Two months after the innoculation he had the mentioned complaints over the innoculated regions of his arm. Incisional biopsy was taken from both of two cases. Histophathologic examinaton results were found accord with morphea. According to clinic prognosis, plaque and slowly progressive type morphea was found in the female patient and lineer and rapidly progressive type morphea was found in the male patient. Systemic involvement was not determined in both of the two patients. The local and/or systemic treatments were begun to both of the patients.

Wilm’s tumor, the most common childhood renal cancer, is a heterogeneous renal tumor in which diffuse anaplastic or negative histology represents poor prognosis. In Wilm’s tumor pathogenesis, a large number of factors remain uncertain. For this reason, the disease continues to be the focus of further research. MicroRNAs are small, protein-encoding RNA molecules that regulate gene expression at post-transcriptional stage. The role of microRNAs in cancer onset and progression has been demonstrated in most solid cancers. MicroRNAs also have a diagnostic potential, and microRNA-targeted treatment is a candidate for an important role in cancer treatment. In Wilm’s tumor, dysregulation of certain key oncogenic or tumor suppressor microRNAs, such as miR-17 ~ 92 cluster, miR-185, miR-204, and miR-483 has been documented. In this study, we will summarize the current evidence about the role of dysregulated microRNAs in the development of the Wilm’s tumor. The possible effects of MicroRNAs on the clinical diagnosis and prognosis of the Wilm’s tumor will also be discussed. Thus, an overview of the future place of microRNAs in the implementation of new treatment options will be presented.

This study was undertaken ta determine the safety af prognostic inflammatory and nutritional index (PINI) as an indicator of metabolic response to surgical stress, and whether there is a relationship between PINI and post-operative morbidity in children. Thirty-two patients who were performed appendectomy were enrolled in the study. Of the pafients 17 had acute appendicitis (Group 1) and 15 had gangrenous or perforated appendicitis (Group 2). Serum albumin (AL), prealbumin (PA), c-reactive protein (CRP) ve alpha-1 acid glicoprotein (AGP) values were measured pre-operatively (-1), on postoperative day 1 (+1), and postoperative day 3 (+3) in all patients. Mean PIN1-1, PINI+1, and PIN1+3 values were calculated by using these parameters. In grup 1, mean PINI-1, PINI+1, and PIN1+3 values were fonud 5.6±3.9, 15.6±7.8, and 5.8±3.6, respectively (p< 0.0001). In group 2, the same values were 25.2±16.4, 47.2±-28.1, and 43.9±24.2, respectively. The difference between PIN1-1 and PINI+1 was found statistically significant (p<0.0001) while there was no significant difference between PIN1+1 and PIN1+3 (p>0.02) in group 2. Mean PINI values were fonud higher in group 2 compared with group 1, and the difference between two groups was statistically significant (p<0.001). These results suggest that PINI is a cafe and valuable index for determination of metabolic response to sur-gical stress in children, and postoperative follow-up of surgical patients.

Pressure ulcers, a major problem worldwide, cause morbidity and lead to mortality. We aimed to conduct a prospective study which includes incidence of pressure ulcer and risk factors for pressure ulcers in intensive care unit of neurology. Forty-six patients were evaluated according to National Pressure Ulcer Advisory Panel during the ICU period strictly. Age, hospitalization period, mean arterial pressure, pressure ulcer degree, hemoglobin and albumin levels, and comorbidities were evaluated. The incidence of pressure ulcer in neurologic intensive care unit was 15%, and hypoalbuminemia, low muscular strength, and prolonged stay in intensive care unit are significantly high in pressure ulcer group than the control group. Primer prevention of pressure ulcers is one of the major issues in intensive care unit, especially to prevent protein malnutrition.

Fort he assesment of the suitable therapy and prognosis; some histopathological features especially determining axillary lymph nodes correctly becomes so much important. Between the years 1998 and 2001 at Selcuk University Meram Medical Faculty pathology Laboratory 777 axillary Iymph nodes materials obtained from 47 modified mastectomy examined retrospectively for determining the micrometastasis that couldn’t be found before. After serial sections in 2 of 19 cases micrometastasis were found. These 19 patient were said not to have metastasis before. The incidence of finding micrometastasis decreased as the serial section counts increased. As a result; serial section method is more effective than routine examinations for determining the micrometastasis and in the examinations using 20µ section interval and taking 6 sections is a recommendable method.

Aim: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract. GISTs are thought to originate from the precursors of interstitial Cajal cells which regulate gastrointestinal peristaltism. GISTs include a group of heterogeneous tumors with different morphology and biologic behavior so their epidemiology, clinico-pathological features and prognosis is distinct in different countries. The aim of this study is to analyze the histopathological, immunohistochemical characteristics and risk groups of 100 patients with GIST in the last 10 years in our depertment. Patients and Methods: Between 2006-2016, 100 patients with GIST diagnosed in our Pathology laboratory were examined retrospectively. Risk groups were determined according to diameter and mitotic rates of the cases. Histopathologic and immunohistochemical features excluding diameter and mitosis were analyzed and the relationship between risk groups was analyzed. A Chi-care- Fischer was used for descriptive statistical analysis. Results: In our cases, there is no relationship between age, gender and risk groups. Colorectal, extra gastrointestinal system (peritoneum, mesentery and retroperitoneum), small intestine and stomach GISTs are in high risk group respectively. Small intestine, colorectal and extra gastrointestinal system tumors are larger diameter than stomach tumors. There is no relationship between immunohistochemical CD-34, S-100, SMA, desmin and risk groups. Tumors expressing over 10% of Ki-67 are in high-risk group. Stomach and extra gastrointestinal tumors represent more CD-34 expression. Tumors with necrosis, haemorrhage and high cellularity are at higher risk group. There is no relationship between risk groups and ulceration, growth pattern and atypia. Conclusions: GISTs are rare tumors of the gastrointestinal tract and may occur in different regions, in different variations. Detailed histopathologic and immunohistochemical examination of the GİSTs

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.

Objective: Most of the renal neoplasms are the epithelial and malign ones. The renal cell carcinoma (RCC), which is the most frequently seen malign renal tumor, consists of 2-4% of all the malign tumors seen among adult individuals and 80-90% of all the malign renal tumors. RCCs peak at sixties and seventies and its prevalence among males is two folds of its prevalence among females. RCCs have bad prognosis. The recurrence is seen in 40% of the cases, and the metastasis despite the early diagnosis was detected in 50% of cases. In present study, it was aimed to distribution of renal tumors in our hospital, discuss the prognostic factors such as the, pathological stage, nuclear grade and tumor diameter accompanied by literature information.

Patients and Method: By retrospectively scanning the records of Pathology Department of Medical Faculty, Fırat University, for the period between 1988 and 2009, 140 renal tumor cases were determined and the previous diagnoses, histological degrees, pathological stages of these cases were evaluated and the final diagnoses were taken as base in the present study. In pathologically staging (pT) of RCCs, TNM classification was used, whereas Fuhrman nuclear grading (FNG) was used in nuclear grading procedure. The patients were divided into different groups based on their genders and ages. The statistical analyses were performed in SPSS-12.0 software by using Chi-Square and Correlation tests.

Results: When compared to the literature in terms of the mean age, the present study involves relatively young population (mean age 57), and the majority was male (male/ female:1.1). The distributions of renal tumours, malign and benign subtypes, and RCC subtypes show similarities with the general literature. When examining the RCCs statistically, no significant relationship was found between diagnosis and age, and between nuclear grade and tumor diameter (p>0.05). In the present study, the RCCs with largest diameter were papillary type (9,78cm) ones, whereas the RCCs with lowest diameter values were classic type. A statistically significant relationship was observed between the benign, borderline and malign tumor diagnoses and diameters (p= 0.023). It was determined that approximately one-four of RCC cases were in highly pathological stage (21,6%, pT3a-3b). A direct proportional and statistically significant relationship was found between nuclear grade and diameter (p=0,002).

Conclusion: RCCs have poor prognosis and their frequency is increasing. Pathological stage, nuclear grade and diameter are the leading factors affecting the prognosis. As in our study, in retrospective studies involving old ages and not enough sampling, tumor diameter may be used as an alternative prognostic factor for pathological staging in tumors with a stage above pT2.

Concha bullosa is a common anatomical variant of intranasal anatomy. Eighty-six patients who had paranasal sinüs infection were evaluated with CT for lateral nasal wall variations. İt was found that 22 % of the patients had concha bullosa at least on one side. İt was seen that paranasal sinüs infections developed vvithout concha bul­ losa and on the other hand, 15 patient that operated endoscopic surgery was shovvn that this prosedüre is useful for the treatment of sinusitis in cases with concha bullosa.

\r\n Objective: Early diagnosis of cutaneous squamous cell carcinomas (CSCC) is the most important factor affecting prognosis and most patients have a good prognosis. Some patients defined as high-risk group have high rates of regional recurrence and distant metastasis, and follow an aggressive course. In addition, recently numerous studies have being performed for determining the importance of sentinel lymph node sampling, and sentinel lymph node (SLN) positivity has been associated with a poor prognosis. In this study, we aimed to determine prognostic importance of SLN outcomes in patients with high-risk patients diagnosed with CSCC.

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\r\n Patients & Methods: A total of 29 patients who underwent excisional operation in various body regions with the diagnosis of CSCC between 2009 and 2017, with available complete clinical and pathologic data were included in the study. At least 9-month clinical follow-up results, high risk factors and sentinel lymph node biopsy outcomes of the patients were recorded and analyzed. Patients with at least one of the American Joint Committee on Cancer (AJCC) criteria were considered as high-risk group.

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\r\n Results: Twenty-five of the 29 CSCC patients were in the high-risk group. SLN positivity rate was 12% (n: 3/25) in the high-risk CSCC patients, all patients in the low-risk group had negative SLNs. All patients with SLN positive underwent local complementary lymphadenectomy, and all of these patients were re-operated due to recurrence. The rate of recurrence was found as 100% (n= 3/3) in high-risk CSCC patients with positive SLN, and 18% (n= 4/22) in high-risk CSCC patients with negative SLN. High recurrence rates (41.6%) and SLN positivity were observed in patients with hand-foot localizations.

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\r\n Conclusion: High rates of local recurrence may be seen during progression of the disease in SLN positive patients. Hand-foot localization of CSCCs can be considered as a high risk factor regardless of a tumor diameter should be above 0.6 cm.

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Objective: Mucormycosis is an infrequent opportunistic fungal infection which may cause an aggressive and invasive soft tissue necrosis. It is usually developed in patients with immune system deficiency, and rarely seen in immunocompetant patients.  We report prognosis and treatment of the immunocompetant patients that developed facial cutaneous mucormycosis after short term corticosteroid therapy.

Material and Method: The patients who were admitted to Manisa Celal Bayar University Hospital after multitrauma and given short term corticosteroids due to cranial and spinal injuries and became immuncompromised and diagnosed as facial cutaneous mucormycosis between 2016 and 2018 were included in the study. Prognosis, medical and surgical treatment outcomes of therapy is reported.

Results: One patient with malar and maxillary involvement was treated with medical therapy and serial debridements and infection was cured. Reconstruction with free flaps were done, acceptable functional and aesthetic results were achieved. Two patients had adequate therapy and reconstructed with local flaps.   One patient was not operated due to recurrent fungal osteomyelitis and intracranial inflammatory findings, and regression in MRI was seen.

Conclusion: Mucormycosis should be kept in mind in contaminated wound infections in patients who have been treated with corticosteroids even for a short time after multitrauma. Rapid, repetitive and aggressive debridemants should be performed and reconstruction should be planned after cure of the fungi.

At times, pleural fluid is milky or turbid. When the milkiness or turbidity persists after cetrifugation it is almost always due to high lipid content of the pleural. High levels of lipid accumulate in the pleural fluid in two situations: Chylous and chyliform pleural effusions. It is important to differentiate these two conditions because the prognosis and management are completely different. The most common causes of the nontraumatic chylothorax are malignancies. We report a 60 year old female patient diagnosis of non-Hodgkin’s Iymphoma with huge mediastinal Iymphadenopathies and bilateral chylothorax. We treated her with chemoterapy.

Backround: Myocardial infarction with coronary artery disease (MICAD) is the leading cause of myocardial injury. Myocardial injury non-related to atherosclerotic plaque disruption (non-MICAD) is a rare and heterogeneous diagnosis. Although MICAD is well studied, non-MICAD was not thoroughly identified in young patient population. We aimed to investigate the frequency, main etiologies, and five-year mortality of patients with non-MICAD younger than 40 years.

Methods: We retrospectively enrolled 292 patients with acute myocardial injury younger than 40 years between January 2010 and December 2014. Clinical, demographic, laboratory, angiographic features, and five-year all-cause mortality were compared between patients with non-MICAD (n=78) and MICAD (n=214).

Results: Median age of patients was 36. Non-MICAD group was younger than MICAD group [32 (28-37) vs 37 (34-39)]. The frequency of female patients with non-MICAD was higher than those with MICAD (24.4% vs 10.3%). Most of the patients with MICAD presented with STEMI (77.1%), while most of the patients with non-MICAD presented with non-STEMI (89.7%). Most common etiologies of non-MICAD in were myocarditis (32%) and vasospasm (9%). Age, female sex, no smoking and, absence of dyslipidemia were independent predictors for non-MICAD. Five-year all-cause mortality in non-MICAD group was significantly lower than MICAD group (2.6% vs 10.3%) (log-rank test p=0.04).

Conclusion: Non-MICAD represents a heterogeneous group of patients who had varying etiologies at different ages. Despite the lower mortality rate of non-MICAD group, different diagnostic and treatment strategies are required for management of patients with non-MICAD.

We aimed to investigate the markers and possible risk factors of urinary infection in predialysıs patients with CRF and patients undergoing dialysis by comparing groups younger or older than 65 years of age. We evaluated 82 patients with chronic renal failure who have been followed by nephrology and infectous disease policlinic due to urinary infection during January 2012 and December 2012 in medical faculty of Kahramanmaras Sutcu Imam University. The patient in the predialysis period was accepted as group I, the patients ongoing dialysis and continuous ambulatory peritoneal dialysis (CAPD was accepted as group II. 58 (70,7%) of these patients were in dialysis program. 34 (29,3%) were in predialysis patients. The average age of the patients in predialysis group was 63, 62±15,482 and the average age of the patients in dialysis group were 50, 08±21,086. (45,1%) of these patients were ≥65 years old and compared with serum levels of the kolesterol, trigliserid ve albumin, levels in ≥65 years old cases were statistically significant than ≤65 years old cases. Escherichia coli was microorganism that the most commonly isolated in urinary cultures in both groups. (43.9%) of patients were diabetic. There was no statistical difference between the levels of serum CRP, ESR and leucocytosis between the groups (p>0.05). Fever, pyuria and nitrite positivity between the predialysis and dialysis groups was statistically no significant. Comorbidity in the group above 65 years of age may increase the tendency of infection.

Breast cancer is the most frequently diagnosed cancer in women and second cancer leading death among cancer deaths in women (after lung cancer). Simultaneous bilateral breast cancer is seen 1-2% and metachronous 5-8%. Bilateral breast cancer has worse prognosis than unilateral breast cancer. Locoregional recurrences after mastectomy is often occure in bone, muscle, skin or subcutaneous tissue of the chest wall, and that was seen approximately until 2 years. In skin metastases; asymmetric nodules, eritematose rash, itching, bleeding, ulceration, symptoms and signs such as necrotic exuda can be seen. Breast cancer treatment should be made by a multidisciplinary team. Radiotherapy in these patients are curative or palliative. In this case, we aimed to show the effectiveness of the electron beam in modern radiotherapy.

Single ventricle is a rare congenital heart disease. The number of patients who reach to adult age without surgical operation due to poor prognosis are rare. There are publications that report cases reached to 5 to 6 decades in the literature. What makes the present case interesting is that it is the single ventricule that reaches the oldest age without operation reported in our country.

Abstract

Aim: Since clinical and prognostic heterogeneity is observed in diffuse large B-cell lymphoma (‎DLBCL) patients, it is vital to determine its prognostic and predictive factors. The frequency of these factors varies geographically and ethnically. We aimed to reevaluate and discuss the prognostic and predictive ‎factors of DLBCL patients who have been treated with R-CHOP in our ‎center based on the WHO 2017 revised 4^th edition.‎ We also investigated the incidence of EBV in DLBCL-NOS.

Patients and Methods: Patients with DLBCL-NOS diagnosed previously in our hospital between 2007-2017 and treated with ‎R-CHOP were included in the study. We evaluated the expressions of CD10, CD5, CD30, BCL-2, BCL-6, MUM-1, MYC, LMP-1, EBNA-2, Ki-67, and p53, by immunohistochemistry, and EBV encoded RNA by in situ hybridization in 104 cases of DLBCL-NOS. The Revised International Prognostic Index (R-IPI) score and the overall survival time ‎was ‎calculated.

Results: The study included 56 men (53.8%) and 48 women (46.2%). The median age was 64.5 years. In 59.6% of the patients, the disease had a nodal beginning, whereas in 40.4% of the patients it had an ‎extranodal presentation. High ‎stage (III-IV) was present in 26.5% of the GCB subtype and 43.6% of non-GCB subtype (p=0.049). A high ‎R-IPI score was observed in 40% of GCB subtype and 54.5% of non-GCB subtype (p=0.028). Survival was significantly lower in the non-GCB subtype (log-rank test p=0.003).‎ The EBV frequency was about 3% as it is reported in Western populations. The frequency of DEL status was 8.7%, indicating that it was associated with inferior survival (p=0.045). De novo CD5⁺ DLBCL ratio as 13% and it was also associated with inferior survival (p=0.013).  We also found CD30⁺ DLBCL ratio as 11.5%, but we could not establish a significant relationship with prognosis.

Conclusion: DLBCL-NOS requires detailed subtyping and elaboration of prognostic factors. ‎The frequency of DEL status and De novo CD5⁺ DLBCL indicated that it was associated with inferior survival. However, we could not establish ‎a meaningful relationship of CD30⁺ DLBCL with prognosis.‎ Three EBV positive cases were identified and two of them were classified as ‘EBV positive large B cell lymphoma’ according to the WHO 2017 revised 4^th edition.

Keywords: Diffuse Large-Cell Lymphoma; Prognostic Factors; Survival

The effects of Chitin molecules, used prevention of abdominal adhesions, on organ functions were investigated. 40 patients, underwent surgery for gastric cancer and colorectal cancer and resectable initiatives were included in this study. After surgery, two Chitin Suprofilm ® in size of 15X10 cm were placed under the incision line. AST, Creatinin, BUN levels were measured in patients at preoperative, postoperative 1st and 5th days. There was no statistically significant difference in means of Creatinin, AST, and BUN levels between groups in three measurement. Having used Suprofilm® (Chitin) with adequate hydration, liver and kidney dysfunction was not developed. We think that Suprofilm® (Chitin) can be used safely as antiadhesive.

Spinal anesthesia is a widely used method in many surgeries. However, some neurological complications are reported including cranial nerve paresis. The cerebrospinal fluid (CSF) leakage was defined may lead to VI th cranial nerve damage and diplopia. After distinction from other cranial pathologies, the patient must be informed about the prognosis of diplopia and should be offered take plenty of fluids.

Aim: Pulse wave velocity (PWV) and augmentation index (AI) are indicators of arterial stiffness and non invasive methods of detecting the severity of vascular injury. This study included large sample size and evaluated PWV and AI in chronic hemodialysis (HD) patients to detect the related risk factors. Method: 881 patients on chronic HD program (44% females) were included in this study. PWV and AI of the patients measured by single operator using pulse wave analysis device (Sphygmocor). Pulse wave was measured from carotid-radial distance. Aortic AI was obtained from aortic pulse wave forms derived from radial artery .for all patients, left ventricular geometry was evaluated by echocardiography and volume status was evaluated by bioimpedence device. Results: The average PWV in patient group was 10.0± 2.5 m/s, average AI was 27±11%. AI -HR75, the heart rate corrected form at 75 beat/minute of AI was found to be 29±11%. PWV and AI were found above limit value in 29% and 67% of the patients respectively. A positive relation was found between PWV and AI. when patients with high and normal AI were compared, albumin values were lower while average blood pressure values, cardiothoracic ratio(CTR) were higher and ejection time longer in patients with high AI. AI had a negative relation with height and weight. AI 75 was also negatively related to height and weight. In patients with high AI75 Araştırma Yazısı 151 more patients had left ventricular hypertrofy (LVH). Male patients percentage and average blood pressure was higher in patients with high PWV. In the analysis of PWV of the subgroup (n:408 patients), evident interdialytic weight increase was present in the group with PWV of ≥ 11.5 m/ sc compared to the group of < 8.5 m/sc. Conclusion: measures that can be used to evaluate vascular stiffness like PWV and AI are related to average arterial blood pressure, cardiothoracic ratio, hypoalbuminemia, interdialytic weight increase. We think that the relation between these parameters and cardiovascular morbidity and mortality will become clear in the follow up of our hemodialysis patients.

Aim: In the present study, the aim is to determine whether centromere protein H (CENPH) gene expression levels change in prostate carcinoma (PCa).
Materials and Methods: Prostate tissue sample of 40 patients with primary prostate cancer was used in the study. Hence, transcriptional analysis of the CENPH gene was conducted in the total paraffin embedded prostate tissues extracted from patients diagnosed with prostate cancer. The expression analyses were obtained from the comparison of the expressions within the tumoral and non-tumoral areas in the prostate tissue of the same patient.
Results: Separate RNA isolation was performed. Subsequent qRT-PCR analyzes were repeated three times and quality controls of the Ct values were performed on the obtained data. The Ct values of the expression of the housekeeping gene GAPDH and the target gene CENPH gene were compared in tissue (tumor and normal) and technical repeat groups. There was no statistically significant difference in CENPH gene expression between tumor and normal tissue specimens in prostate cancer. Moreover, on investigating the causes of death, in none of the patients PCa related death was determined. 
Conclusion: In our study, we could not find any relationship with prostate cancer tumorogenesis in CENPH gene expression anomalies. However, some cancers (non-small cell lung cancer, colon cancer, etc) with high CENPH gene expression are associated with tumor aggressiveness, poor prognosis and drugresistance. More studies are needed on CENPH gene expression and its effect on prostate cancer.

The most serious complication of Paget's disease is the sarcomataus degeneration. Two cases of bone sarcoma in Paget's disease were diagnosed and treated at the University Hospital, departrnent of orthopaedy and Traumatology between 1983 and 1988. Histologically, lesions were osteogenic sarcoma and it is radiographically found ta be osteolitic. Pain, pathologic fracture and tender swelling were constant features. Femur and humerus were the affected bones. Overall prognosis for !hese patients were poor.

in this study, clincal and computarized tomographic features which affeci the prognosis has been inve.stigated in intraserebral hemorrhages.

Free bilirubin level in the hyperbilirubinemia of the newborn. In the newborn with hyperbilirubinemia, the most important factor that causes the kernicterus is the free bilirubin level.In the investigation that is performed about 45 newborn cases with hyperbilirubinemia,it has been observed that the free bilirubin levels are interested in the serum albumin levels. Exchange transfusion effects free bilirubin levels and after exchange transfusion, the free bilirubin in the serum disappears.

Febrile seizures are seizures that occur in febrile children between the ages of 6and 60 months who do not have an intracranial infection, or history of afebrile seizures. In this study, the children’s demographic and clinical characteristics who had hospitalized for febrile seizures in Antalya Education and Research Hospital (AEAH) were reviewed. 56 children’s demographic and clinical characteristics who had hospitalized for febrile seizures between September 2011- January 2012 in AEAH were analysed retrospectively. Analyses were performed using SPSS 16.0 version. 23 patients (41.1%) were male, 33 (58.9%) were female , mean age was 26.8 months, mean duration of hospitalized days were 3.5 days. Fever source was upper respiratory tract infection in 44 (78.6%) patients, lower respiratory tract infection in 6 (10.7%), acute otitis media in 2 (3.6%), urinary tract infection in 1 (1.8%), acute gastroenteritis in 1 (1.8%), hand–foot-mouth disease in 1 (1.8%), roseola infantum in 1 (1.8%) patient. Lumbar punction was done in 2 (3.6%) patients, one of them had aseptic menengitis and other had normally cerebrospinal fluid findings. 34 (60.7%) patients had first attack, 12 (21.4%) had second, 5 (8.9%) had third and 5 (8.9%) had more than three attacks. 4 (7.1%) patient’s seizures who had first febrile attack occured more than once in a 24 hour period. 4 (7.1%) patients had complex febrile seizures, 1 (1.8%) patient had febrile status epilepticus. These results suggest that most febrile seizures are simple, good prognosis and mostly causes of fever is upper respiratory tract infection.

In this study, we looked the distribution and prognostic significance of ventricular arrhythmias (VA) in patients with essential hypertension. Fifty patients with essential hypertension were included. After physical and laboratory exa-mination, interventricular septum (IVS) and left ventricular posterior wall (LVPW) thickness were measured in M-mode echo to detect left ventricular hypertrophy (LVH). Patients were classified into 2 main group according to presence or absence of LVH. Halter monitoring was performed and VAs seen in Halter were defined according to Lawn clas-sification_ All of the patients were followed clinically at least 6 months by 2 monthly intervals. All types of VAs were more common in LVH group, but only Lawn IVA group VA was sig-nificantly higher occurence. There were no malign VA and sudden death while Lawn IA group VAs were more common in the two group of patients.

Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease. It can be seen isolated or with other congenital heart diseases. Here, we presented a neonate with cyanosis and dyspnea because of APVS. A-female-newborn was referred to pediatric cardiology due to cyanosis, respiratory distress and prenatally diagnosed right ventricular dilatation. Rudimentary pulmonary valves and severe pulmonary and tricuspid regurgitations were determined postnatally with echocardiography and magnetic resonance imaging. Additionally, main pulmonary artery and its branches were seen dilated. Unfortunately she died on third day of her life, although supportive and medical treatments were administered intensively. Most of APVS cases are a variant of Tetralogy of Fallot. But clinical findings, prognosis and hemodynamic conditions can be different. Infants requiring mechanical ventilation shold be undergone operation as soon as possible. Our case could not be operated because of unstable vital functions. Absent pulmonary valve syndrome should be considered as a differential diagnosis in neonates with cyanosis and respiratory distress. If prenatal diagnosis is present, we suggest that parturition should happen in a medical center includes pediatric cardiology and cardiovascular surgery and also neonatal intensive care unit.

The phenomenon of bilateral involvement of the testicles was observed nine times in a series of 789 patients with testicular germ cell tumors which were treated in Ankara Oncology Hospital from 1984 to 1994, Four patients evidenced a synchronous bi-lateral tumor (two seminomas, two non-seminomas) and in five others (4 bilateral seminomas, 1 se-minoma and nonseminoma), a second tumor oc-cured after an interval ranging between eight months and eight years eleven months. Three of nine patients had a history of undescended testes. The incidence, histologic findings, therapy and prognosis of bilateral testis tumors are discussed on the basis of a review of the literature. This study emphasizes the small but definite risk for a development of the second testicular tumor and suggests not only the significance of long-term fol-low-up period but also the importance of ult-rasorzography in the early diagnosis of a cont-rlateral tumor.

Aim: The purpose of this study is to compare the effects of different anti-adhesion Materials in Preventing Postsurgical peritoneal adhesion. Material and Method: 60 rats from Wistar Albino spiece that weights 250-300 g and about 10-11 ages are used in the study. They were separated into 5 groups. The rats were operated after Kethamine HCL anesthesia. In all rats, a midline laparatomy was done, in a 4 cm length. To the right side of the abdominal wall, 2 cm along 10 parellel incision were applied. To the left side of it, a peritoneum layer was incised as 2x2 cm2. The abdominal wall was sutured with 3/0 silk by continue method. Group I: Control group, Group II: 3X3 cm2 in size Chitin layers (Suprofilm®) were placed on the incision areas. Group III: 3X3 cm2 in size Na-Hyaluronat / Carboxymethylcellulose layers (Seprafilm®) were placed on the incision areas. Group IV: To the abdominal cavity, 25 % diluted 2 cc Na-Hyaluronat gel was poured, Group V: 15mg/kg metilprednizolon was injected as I.M. On the 11th day of Research, under Ketamine anesthesia, abdominal wall opened and the adhesions were scored according to Granat Score. From all groups of rats, blood samples were taken. On the samples, Hb, AST, BUN and Albumin levels were studied. Results: The Adhesion frequency In Group I, was defined on the right abdominal wall as 82%, on the left as 91%, In Group II, on the right as 8.3%, on the left as 25%, In Group III, on the right as 17%, on the left as 33%, In Group IV, on the right as 50%, on the left as 58%, In Group V, on the right as 50%, on the left as 42%. The adhesion grade in groups was defined as; Group I: 2.63±1.22, Group II: 0.58±0.66, Group III: 1.08±1.08, Group IV: 1.41±1.44, Group V: 1.41±1.50. The adhesion phase in all study groups was found meaningfully low compared to the control group as p<0.05. Besides, the adhesion grade of Suprofilm® group was found meaningfully low compared to the other groups as p<0.05. A meaningful difference was not observed among Serologic and hematological parameters in all groups as P>0.05. Conclusion: Chitin meaningfully decreases the postoperative peritoneal adhesion frequency and adhesion grade on Rats. Referencing this result, it has been understood that Chitin is much more effective than local and systemic anti-adhesive methods.

Aim: Convalescent plasma (CP) therapy has been used for treatment, although it has not been Corona
Virus 2019 Disease (COVID-19) specific antiviral agent so far. However, the effectiveness of CP treatment
on prognosis and mortality is still a matter of debate. In this study, we aimed to share our experiences
about the ef fectiveness of CP treatment in COVID-19.
Materials and Methods: The study was conducted in 126 patients diagnosed with COVID-19 who received
CP treatment in addition to standard treatment between May 2020 and February 2021. 126 patients were
divided into two groups as those who underwent SP within the first five days (Group A) and after five days
(Group B). The patients in these two groups were evaluated in terms of laboratory parameters, clinical
and mortality.
Results: A total of 126 patients were identified (86 patients in Group A and 40 patients in Group B). 119
(94.4%) patients were discharged with recovery, 7 (5.5%) patients died. The mean days of hospitalization
were found to be 11.4±0.7 in Group A and 18.4±1.7 in Group B (p<0.001). Treatment-related lymphocyte,
PLT, fibrinogen and CRP main effect of change was significant (p<0.001). However, the results were
marginally significant when the two groups were compared in terms of D-dimer. When the simple effect is
evaluated; Group A as not significant, while group B was significant. Starting CP treatment 5 days before
or 5 days later did not change the laboratory parameters. However, D-dimer was marginally significant
(p=0.058).
Conclusion: In our study, it was shown that early initiation of CP treatment reduced the hospitalization,
but had no ef fect on mortality and laboratory parameters.

Aim : İn this study vve aimed at determining the prognostic factors and some risk factors in perforating eye in­ juries which have important role in preventable blindness. Method: VVe retrospectively evaluated data from a total of 157 patients, admitted to Fırat University Medical School, Department of Ophthalmology with perforated eye injuries, betvveen 1994-1999. One or two surgical interventions were performed in ali cases. They were eva­ luated with respect to patients’ age, sex and occupation; etiology of trauma, affected tissue, accompanying pat- hological findings, performed surgical intervention, delay betvveen the injury and surgery, Vision level before and after surgery and complication. Result: Of the total 157patients included in this study, 77.7% was male; 22.3 % female; and mean age of patients was 25.25 (4-85) years old. Perforated eye injuries vvere frequently seen (40.1%) in young patients (0-12 years old). This ratio was found to be 19.1% in vvorkers and 15.3 % in farmers. Among the most frequently injured tissues, cornea vvas the first (62.4%) and knives and Sharp tools were res- ponsible from most of the perforations (22.9%). Of the cases 76% vvas received surgical intervention in the first 24 hours' period. Before operation, visual level frequently found to be betvveen perception and projection (15.9). Most frequent complication among the follovv up period vvas ubnormal shaped pupil (29%) and corneal leukoma (25.9%). Conclusion: İt is knovvn that in perforated eye injury treatments, prevention of injuries is more important th an cure. Therefore prevention al public health Services ar e essential. Our results suggest that, urg en t admission to the hospital and possible early surgical intervention is important determinants of visual prognosis after per­ forated eye injuries.

Bilirubin-binding capacity in the hyperbilirubinemia of the newborn. The hyperbilirubinemia of the newborn is still keeping its importance on. A number of factors effect the occurence of kernicterus due to hyperbilirubinemia. Serum indirect bilirubin levels, bilirubin-binding capacity, serum albumin levels, gestational age, birth weight, postnatal survival days, and whether they have infections and asphyxia or not can be considered as the influenced factors.

In this article, our aim was to evaluate clinical features of acute septic arthritis in relations to its prognosis. One hundred andfifiy-nine patients whose ages ranged fr-om 10 days to 72 years were reviewed two Orthopaedic Clinics in Konya and Kayseri. A compararive analysis was made by dividing the pa-tients into three age groups. First group contained 20 infants vounger [han one year of age. One hundred and six children between 1 and 16 years of age are included in the second group. Patients older than 17 years of age, 33 of them, made up the third group. The hip joim was involved in 70 patients represented largely the first and the second group. The knee was involved in 59 patients. Majority of the third group patients had knee involvement. Microorganisms iso-lated from the cultures of these joints were predorni-nantly Staphylococcus aureus which was followed by gram-negative bactarias.

Primary angiosarcoma of breast is a rarely seen tumor type. İt considered that tumor is developing from the pe- rilobular capillary netvvork. İt metastased with hemotagen pathvvay in early State ıt shows a poor prognosis. Fourty years old woman. Left breast mass and axillary lymphadenopathy presenced in physical examination. Biopsy was reported primer angiosarcoma of the breast. After the modified radical mastectomy, adjuvant chemotheraphy and radiotheraphy was performed. Patient was tost inpostoperative 12th month with lung and bone metastasis.

Aim: Hypoxemia is a vital criterion used to determine prognosis in coronavirus disease (COVID-19)
cases. This study thus examined the effectiveness of capillary refill time (CRT) in defining hypoxiadependent
disease severity in COVID-19 patients.
Patients and Methods: This prospective study was conducted with COVID-19 patients and an agematched
healthy group. The optimum test ambiance was provided, and a stable smartphone platform
was used to record the measurements (in ms) to standardize our method. The captured videos were then
evaluated using a video processing program.
Results: In total, 39 patients with COVID-19 and 40 control groups participated in this study. The patients
were further divided into the moderate (n = 25) or severe group (n = 14) according to disease severity.
The mean oxygen saturation of both moderate/severe groups was above 94%. Per disease severity, the
CRT measurements were higher in the severe group than in the moderate group (p = 0.009). In patients
without lymphopenia (n = 18), CRT values were found to be increased in the severe group (p = 0.008).
The use of CRT in patients with Covid-19 was practicable (AUC: 0.91; 95% CI 0.848-0.978; P = 0.001).
Conclusions: Our results show that CRT prolongation can occur in patients with COVID-19. In patients
without lymphopenia and with normal O2 levels, detecting CRT prolongation may be a criterion for early
admission to ICU.

Abstract

INTRODUCTION

Acute mesenteric ischemia (AMI) is an acute abdominal disease which is age-related with possible bad prognosis; and while its morbidity and mortality rate is 10% in early diagnosis and treatment it may progress with 100% mortality when diagnosis and treatment are delayed.The aim of this study was to unearth the efficiency of neutrophil-to-lymphocyte ratio (NLR) which has recently been started to be utilized in the prediction of AMI prognosis and used as a prognostic factor in many diseases.

MATERIALS and METHODS:

The data of a total of 111 patients, who had undergone surgical procedures and diagnosed with mesenteric ischemia intraoperatively at Necmettin Erbakan University Meram Medical School’s General Surgery Clinic between 2005 and 2013 and whose diagnoses had later on been confirmed pathologically, were retrospectively evaluated within the scope of the study.

The demographic data of all patients (age, sex) were recorded. The hemogram results of the patients, analyzed with peripheral blood, were reviewed for preoperative evaluation. The surgical procedure performed, the part and length of the resected bowel based on pathology results, the duration of hospitalization, survey, presence of comorbidity, white blood cell count, creatinine values, and NLR of the patients were determined. The data were statistically analyzed.

RESULTS:

The patients who did not survive had a mean NLR of 24.77 ±10.38, while the same ratio was found to be 17.6±10.65 for survivors. The NLO value was found to be high in cases with mortality.

 

CONCLUSION:

AMI still proves to have high mortality in spite of the developments in imaging techniques and laboratory analyses. There is no specific laboratory analysis for early diagnosis. High preoperative NLR in patients suspected to have AMI may indicate bad prognosis.

Bleedin in newborn infants is an important problem, among these, caused by disseminated intravascular coagulopathy has the most serious prognosis. In this report we discussed disseminated intravascular coagulopathy which is one of the most serious problem in newborn period in pediatrics.

Hyperthyroid and hiypothyroid patients serum were analyzed for fructosamine, total protein and al-bumin. These values were compared with those of healthy subjects. Serums were obtained from 35 nor-mal healthy and 42 hyperthyroid, 12 hypothyroid pa-tients. Hyperthyroidic people serum levels were: fructosamine 1.99 ± 0.27 mmoIlL, total protein 7.70 ± 0.98 gldl, albumin 4.65 ± 0.63 gidi. The ser-um levels of patients with hypothyroidic were: fruc-tosamine 2.19 ± 0.44 ınnzoliL, total protein 7.64 ± 0.98 gldl, albumin 4.70 ± 0.69 gidi; normal healthy people serum levels were: fructosamine 2.20 ± 0.47 mmol/L, total protein 7.88 ± 0.84 gidi, albumin 4.79 ± 0.73 gidi. Fructosamine values of hyperthyr-oid patients were lower than those of healthy sub-jects (p<0.025). Total protein and albunıin levels of the patients were normal. A positive correlation was found bctween fructosamine and total protein (r 0305, t = 2.03) and fructosamine and albumin (r = 0.365, t = 2.482). This findings were compared with tlwse of literature.

Neonatal hemochromatosis is a rare disease clinically defined as severe neonatal liver disease in association with extrahepatic siderozis. The etiology of neonatal hemochromatosis is not understood exactly. However, according to a theory neonatal hemochromatosis is accepted to be an alloimmune disorder causing liver injury in fetus. After an effected one in the pregnancy the recurrence rate of neonatal hemochromatosis is ~80%. Hepatocellular failure which occurs in the first days of life with coagulopathy, hypoglycemia, hypoalbuminemia, hypofibrinogenemia, thrombocytopenia, anemia, and direct and indirect hyperbilirubinemia characterizes neonatal hemochromatosis. In order to diagnose neonatal hemochromatosis there are some certain criteria that sould be taken into account such as a positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderozis demonstrated with histology or with magnetic resonance. Since an affective medical treatment has not been found yet, liver transplantation is almost always required. The prognosis of neonatal hemochromatosis is generally poor. This review will discuss neonatal hemochromatosis that leads to liver failure in the fetus or newborn.

The human parvovirus B19 has been identified as the causative agent in several diseases, including erythema infectiosum, aplastic crisis,hydrops fetalis and a polyarthralgia that occurs in adults. The major pathophysiologk effect of infection seems to be cessation seems to be cessation of erythropoiesis a result of cytolitic infection of red cell precursors. Except for the potential of neonatal death due to fetal hydrops, the prognosis of patients with par-vovirus infection is generally good. The diagnosis of B19 infection may be established on clinical ob-servations but often requires cofirmation with serum antibody testing. Treatment strategies may include supportive care, analgesic medications, transfusions with red blood cells or administration of intravenous inuniunglobulinidepending on the clinical cir-cumstances.

Amaç: Bu çalışmada, kritik bakım hastalarında yoğun bakım ünitesi (YBÜ) yatışında ölçülen kan üre
azotu (BUN)/albümin oranının hastane içi mortaliteyi tahmin etme açısından prognostik değerinin
değerlendirilmesi amaçlandı.
Hastalar ve Yöntem: Bu retrospektif gözlemsel çalışma, bir üniversite hastanesinin acil servisinde (AS)
gerçekleştirildi. Altı ay (1 Temmuz 2019 - 31 Aralık 2019) boyunca acil AS-YBÜ’ye yatırılan hastalar
çalışmaya dahil edildi. BUN/albümin oranının hesaplanmasında YBÜ’ye kabul öncesi ölçülmüş olan BUN
ve albümin değerleri esas alındı. Çalışmanın birincil sonucu ha stane içi mortaliteydi.
Bulgular: Çalışmaya toplam 572 hasta dahil edildi. Dahil edilen hastaların ortanca yaşı 66 (54–77) yıldı
ve bunların 362'si (%63,3) erkekti. Genel hastane içi mortalite oranı 29.0% (166 hasta) idi. Vefat edenlerin
ortanca BUN seviyesi hayatta kalanlardan daha yüksekti (38,2 (21,4-59,7) ve 21,9 (14,9-36,9) mg/dL,
p<0,001). Vefat edenlerin ortanca albümin seviyesi hayatta kalanlardan daha düşüktü (2,9 (2,3-3,5) ve 3,7
(3,2-4,0) g/dL, p<0,001). Vefat edenlerin ortanca BUN/albümin oranı hayatta kalanlardan daha yüksekti
(13.33 (6.69–22.99) ve 6.21 (3.83–11.21), p<0.001). Eğri altında kalan alanların sıralaması albümin
(0,742), BUN/albümin oranı (0,720) ve BUN (0,678) idi. Hastane içi mortaliteyi tahmin etme açısından
hesaplanan kesim değerleri, albümin için 3,2 g/dL, BUN/albümin oranı için 10 ve BUN için 32 mg/dL idi.
Sonuç: Sonuç olarak, YBÜ’ye yatış sırasında saptanan hipoalbüminemi, kritik hastalarda hastane içi
mortalite ile ilişkilidir. Yüksek BUN ve BUN/albümin oranı da bu hastalarda hastane içi mortalitenin
öngörücüleridir; ancak BUN ve BUN/albümin oranı hipoalbüminemid en daha üstün değildir .

Aim: The aim of this study was to investigate the prognostic significance of extracapsular invasion and its
relationship with clinicopathological data in gastric cancer .
Patients and Methods: A total of 190 patients with primary gastric carcinoma underwent total and
subtotal gastrectomy between 2013 and 2020 were included in the study. 133 (70%) were men, and 57
(30%) were women. Tumour invasion beyond the lymph node capsule was diagnosed as extracapsular
involvement. and evaulated in addition to histological type, lymph node positivity, lymphovascular and
perineural invasion, depth of invasion, and numbers of lymph no de metastasis.
Results: 136 patients (71.4%) had lymph node metastasis. Of these, 87 patients (64%) had extracapsular
invasion. Of the cases with extracapsular invasion, 36 (65.5%) were differentiated and 51 (63%) were
undifferentiated and perineural - lymphovascular invasion was seen in 68 (68%) and 80 (68.4%) cases,
respectively. A statistically significant association was observed with extracapsular invasion in terms of
perineural invasion (p=0.01), lymphovascular invasion (p=0.008) and depth of invasion (p=0.001) and
number of metastatic node (p=0.001). Extracapsular invasion was not associated with sex, histological
type, and resection type. In the multivariate analyse, the risk of extracapsular invasion is 5,501 higher
in those with cardia localization. Those with perineural invasion have an 11,44 higher risk of having
extracapsular invasion.
Conclusion: Cases with extracapsular invasion are associated with poor prognostic parameters. It
should be included in the future staging system of gastric cancers and pathology reports should include
information about extracapsular invasion.

Aim: In this study, it was aimed to evaluate the diagnosis and survival relationships of serum biomarkers
in patients with HCC and HRS, as well as to determine their sui tability for routine use in practice.
Patients and Methods: This is an observational, retrospective cohort study; between years 2005 and
2020. Only cases diagnosed with cirrhosis were included as the control group and these patients did not
have a diagnosis of HCC or HRS. In addition to the control group, 3 different groups were defined; HCC
group, HRS group and HCC&HRS group. Those with malignant disease (non-HCC) were not included in
the control group. Using neutrophil, lymphocyte and platelet counts obtained from hemogram results,
neutrophil-lymphocyte ratio (NLR), neutrophil-platelet ratio (NPR), systemic immune inflammatory index
(SII) score and CRP to albumin ratio (CAR) were calculated for all patient groups.
Results: A total of 110 patients were included in the study; While 26 (23.6%) of the patients were female,
84 (76.4%) were male. There were 29 (26.4%) patients in the cirrhosis group, 27 (24.5%) in the HCC
group, 18 (16.4%) in the HRS group, and 36 (32.7%) in the HCC&HRS group. Regardless of the groups,
63 (57.3%) of the patients in the whole population were diagnosed with HCC, while 54 (49.1%) were
diagnosed with HRS; 36 (32.7%) patients with HRS were Type 1 and 18 (16.4%) were Type 2 patients. In
terms of survival, 68 (61.8%) of all patients died during the follow-up period (exitus); 27 patients (24.5%
of all patients) died within the first year. In comparisons of the HRS detection capabilities of serum
biomarkers with ROC analyses, the only biomarker whose AUC value was not detected above 0.7 is SII;
AUC for >624 threshold: 0.674 (0.578–0.760). Comparisons of serum biomarkers' ability to predict overall
survival independent of diagnostic groups with ROC analyzes found AUC>0.7 for all biomarkers; The
highest sensitivity (70.59%) and specificity (80.95%) values we re determined for NLR and CAR.
Conclusion: Serum biomarkers NLR, NPR, SII and CAR are sufficient to predict overall survival in the
presence of HCC, HRS in cirrhotic patients. NLR, NPR and CAR have sufficient sensitivity and specificity
to detect hepatorenal syndrome.

Purpose: It was aimed to present the clinical and functional results of the patients who underwent tumor resection and endoprosthetic reconstruction due to malignant tumor around the elbow.

Methods: 14 patients who underwent tumor resection and endoprosthetic reconstruction due to malignant tumor in the elbow circumference between 2011-2018 in our clinic were included in the study. While 4 of the patients were primary tumors (1 fibromixoid sarcoma, 1 leimyosarcoma, 1 multiple myeloma and 1 ewing sarcoma), 10 were distant organ metastases (4 breast cancer, 3 lung cancer, 1 stomach cancer, 1 renal cell cancer and 1 thyroid cancer). Musculoskeletal Tumour Society (MSTS) score and Mayo elbow performance score (MEPS) and survival were evaluated.

Results: The minimum follow-up period of the patients was 7 months, and the maximum follow-up period was 55 months. The mean MEPS score of the patients was 67.5 ± 12.0 (range, 45-90), and the mean of the MSTS score was 19.4 ± 2.3 (range, 16-24). Recurrence occurred at follow-up in 3 patients and exitus at follow-up in 7 patients. In this study, the median survival time of the patients was 44 months. The 1-year survival rate was 70.1% while the 3-year survival rate was 54.5%.

Conclusion: Pain and functional results are satisfactory in patients who undergo tumor resection and endoprosthetic reconstruction due to malignant tumor around the elbow. In the future, studies with larger patient series are needed.

Although an effective anti-microbial therapy is applied, the infective endocardit, an infection o endocardium, stili keep its mortality and morbidity. Since it progresses with a general infecsion table. the detay of its diagnos plays an inıportant role in the terapy of it. C ardiac failıa-e tachicardia, valves vegetation and embolic phenemens were effective in the prognosis. Observing vegetation at aorta valve on echocardiography was significiant for diagnose and alt the cases had ı'egatation. lklicroorganism wasn't able ro be cultivated in hemoculture. Only in one case, Brucella bakteria was cultivated from vegetation. There cases who were diagnosed injective endocardit and had aorta valve vegetation were examined and compared ith the literature.

In. this article, a case with interventricular sep-tum rupture which is one of the most serious coup-lications of acute myocardial infarction was int-roduced. The clinical situation of the patient with acute inferior myocard inlarction f1 /5 evaluated with the Doppler echocardiograph. Owing to this case differential diagnosis. diagnostics methods. prognosis and the best treatment of intervetricular septum rupture with acute myocardial infarction was discussed.

Exercise induced proteinuria was studied on 44 healthy players of the Amateur Foothall Tc-urnament Leaque. Their ages ranged from 16 to 25 years. Urine samples were collerted from the players before and after the ganıes, 44 samples were obtained from healty players and analyzedjor urine proteins electrophoreticly. Compared to va-lues obtained from the control pregam• values, the urine protein content increased sigmfirantly con-taining mainly alhumin, fl-globulin, and y globulins. Bul the values for a-globuliğıs did not change significantly. Urine proteins seperated biz nitrocellulose films were also qualitated from the proportions of the densitometric values (!f the peaks on the graphes. The values found in Iliis study and the values cited elsewhere indicated that exercise induced proteinuria is nonselective pro-teinuria and is due to increased permeability of glomerulus and, to impared reabsorption of normal amounts of protein from the glomerular filtrate or ta tubular excretion. Therefore, proteinuria ap-pearing after physical activity can be classified as glomerulo-tubular type.

Acute pancıeatitis is the inflanırnation of this retcoperitoneal organ with various etiological factors varying in severity from slight edema tn peripancreatic necrosis that may deteriorate ta death. In this actiele, we eı'aluated the recolyis of 28 pa-tients with acute pancreatitis ı-etrospectively who adrnitted ta University of Selçuk. General Surgery Department, hetween .lanuaty 1992 and Novembeı-1995. Etiological factoı-s weı-e gallstone in 15, al-cohol in 2. lipe•lipidemia in one and pancreas head cancer in one. There was no identifiable cause in 9 patients. Six patients died of disease_ Three patients underwent lapaı-atomy. FollovıLtıp of the casus sho-wed good correlation with the lmrie prognosticcriterias tiCcriterias criteılas