Introduction: Patients with neurological diseases may require intensive care support as a result of respiratory failure due to various reasons. Some of them benefit from intensive care supportive treatment while others continue to live as caregivers or need rehabilitation programs. It is important for the rational use of intensive care beds that the routing process to the palliative care, rehabilitation centers or discharge of patients with prolonged treatment in the intensive care unit should be managed well

Materials and Methods: We retrospectively evaluated the data of our patients who were hospitalized with the diagnosis of primary neurological diseases in the intensive care unit and terminated with exitus or referred to home / palliative care between January 2017 and May 2018 with the permission (17073117-050.06 decision no) of XXXXXXXXXXXXXXX scientific studies committee. Patients who transferred to other clinics were excluded from the study. APACHE II/SAPS II scores, hospitalization day, mechanical ventilation time, tracheostomy and percutaneous endoscopic gastrostomy requirement, home ventilator supply and the situation of discharge from intensive care unit of patients were recorded

Results: A total of 942 patient files were reviewed retrospectively and 74 (7.8%) of our patients were neurological patients who were died or discharged to directly home\palliative care. Most of the patients in the study had severe dementia (30 patients, 40.5%) and fewer number of patients had ischemic stroke (21 patients, 28.3%). Sixty of the 74 patients (81.1%) died in the intensive care unit. Only 5 patients were transferred to palliative care (6.8%).

Conclusion: Increasing transfer from intensive care to palliative care is important for the effective use of intensive care beds. Therefore, it is suggested that intensive care patients should be evaluated periodically to be directed to palliative care

Aim: Brucellosis, a zoonotic disease, may affect several body systems and cause various clinical manifestations considering the infection sites. Diagnosis of brucellosis is mainly based on culture and serological methods, specifically Rose Bengal agglutination (RBT) and standard tube agglutination tests (STA). When RBT, which is usually used as a screening method, is positive for Brucella antigens, STA is prefered to detect an agglutination titre by using serial dilutons of serum sample. On the otherhand, false negative results can be obtained by STA due to the presence of blocking antibodies. The refore, these two methods may be in adequate for diagnosis of Brucellosis. The aim of this study is to compare a novel method, Brucella Coombs gel test (BCGT) with other four serological methods, RBT, STA, Brucella immune-capture agglutination test (BCAP), and Brucella ELISA IgG, IgM tests. Patients and Methods: Serum samples taken from 100 patients, admitted from various clinics at Konya Training and Research Hospital were sent to the Medical Microbiology Laboratory with a clinical diagnosis of Brucellosis. Each serum sample was studied with RBT (Seromed Laboratory Products, Turkey), STA (Biomedica, Canada), BCAP (Brucellacapt, Vircell SD Spain), BCGT (ODAK, ISLAB, Turkey), and ELISA Brucella IgG, IgM (Euroimmune, Germany) methods. All procedures were carried out in accordance with the manufacturer’s recommendations. Results: The rates of positive results for each method were as follows: BCGT 88 (88.0%), RBT 74 (74.0%), STA 56 (56.0%), BCAP 84 (84.0%) and Brucella IgG, IgM test 92 (92.0%). Conclusion: Statistical analysis could not be executed due to lack of a gold standard method in the study. Yet, BCGT provided faster results than STA and BCAP methods because it does not require a 24-hourincubation. This novel test, BCGT, also showed an advantagein the diagnosis of Brucellosis because of detecting blocking antibodies. More comprehensive studies are needed to be performed to confirm the results.

In this study, 479 criminal children were sent to Forensic Medicine Divisional Directorateship for their discrimination and mental capacities to be sulted for child correction institutions. Twenty five children were out of the age range of examination of disc-rimination and mental capacity. Remaining 454 sub-jects were largely males (96.5 %). The large per-centage of criminal ages were 15 (39.7 %) and 14 (33.9 %) years of age. The most attempted erime was steeling and burglary (54.4 %). Of those 96.6 % were the age of discrimination and mental capacity and knowing attempted to the crimes. Twenty sub-jects, although they had the ages older than 11 years old, were below the discrimination and mental ca-pacity level. Among them two (10.0 %) were mentally retarded. Ten subjects (50.0 %) were inclined to at-tempt criminal temptations due ta their fawer socio-economic cultural type of living. Of those, six (30.0 %) of thern were lacking behind the psychobiological developments and unaware of the judgement of their criminal acts. The remaining two (10.0 %) subjects were deaf and dumb, and they were considered to have low level of discriminative ability and mental ca-pacity. This study when compared ta similar studles carried out else where in Turkey, it can be concluded that the type of erime attempted and the ratio of disc-riminative and mental capacity were of similar.

Visual fixation locations were founded on the tines by measuring saccades amplitudes which occur durıng reading. Fixations ara san to be on the right Naif of the verbs though :hey occur on the left .h.alf of the other vords. This finding was considered likely to be resulied from the agglutinative property of Turkish Language.

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.

Abstract:

Objective: Our objective in this study was to present our four years of experience in laparoscopic surgery for urinary system accompanied by literature.

Material and Methods: Between January 2014 and October 2018, laparoscopic surgical intervention was made on urinary system for 97 patients in our clinic. 54 patients had right and 42 patients had left laparoscopic surgical intervention and 1 patient had radical prostatectomy. Patients were retrospectively examined for operation duration, average blood loss, intraoperative and postoperative complications, hospitalization duration and drain installation time after separating into two groups as right and left.

Results.

Average age of the patients was 44(16-67). Male/Female rate was 54/43. Apart from radical prostatectomy, 54 patients had right and 42 patients had left kidney laparoscopic surgical intervention. Average operation duration was 145 (40-210) minutes, average drain removal time was 3.1 (1-10) days, hospitalization duration was 3.4 (1-14) days and bleeding amount was 150(20-500) cc in all interventions. Lengthened urinary drainage was observed from the drain in one patient who had pyelolithotomy and one patient who had radical prostatectomy. When all interventions were considered, the average complication ratio was found 5.1%. No differences were observed in the parameters compared among right and left laparoscopic surgery interventions.

 

Conclusion: For a surgeon in the first learning phase of laparoscopy, choosing relatively simpler procedures in the beginning but passing to more complex operations without much delay may quickly shorten the learning phase. Through the selection of suitable patients and adequate equipment, laparoscopic surgery can also be applied safely in peripheral centers.

The contraction responses induced with serotonin (5-M) irz a medium without Ca2 + showed a dese-dependent increase by acicling Ca2+ into the extracellular mediutn. This contraction due to external Ca2+ used has significantly been inhibited by verapamil and diltiazem added into the extracellular medium. Similarly, in an isolated gastro-oesophageal sphincter, in a medium containing no Ca2+ the contraction induced with acetylcholine (ACh) has alsa been increased with Ca2+ used at a cumulative concentration and significantly inhibited by either calcium antagonists. Findings indicate that veraparnil and diltiazem have inhibited the eniry of extracellular Ca2+ intr. the tissues.

\r\n Aim:  In this study, we aimed to evaluate the effect of pupillary dilatation on intraocular pressure values and corneal biomechanical properties using Ocular response analyzer in eyes with primer open angle glaucoma.

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\r\n Patients and Methods:  Goldmann correlated intraocular pressure, corneal corrected intraocular pressure, corneal hysteresis and corneal resistance factor were all respectively evaluated in 28 eyes of 15 patients with primary open angle glaucoma before and 30 minutes after tropicamide 0.5% instillation.

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\r\n Results: Their mean age was 57.7±13.2 years (range 45–65 years). The mean corneal hysteresis, corneal resistance factor, Goldmann correlated intraocular pressure and corneal corrected intraocular pressure measurements of the eyes were 9.5±2.2 mmHg, 10.1±2.1 mmHg, 16.2±2.8 mmHg, 17.2±3.6 mmHg before tropicamide instillation, and 9.7±2.2 mmHg, 10.1±2.0 mmHg, 16.9±3.5 mmHg, 18.2±4.0 mmHg after tropicamide instillation, respectively. There was statistically significant difference between pre- and post-tropicamide instillation for Goldmann correlated intraocular pressure and corneal corrected intraocular pressure (p=0.043, p=0.015, respectively; paired t-test) while no statistically significant difference was found for corneal hysteresis and corneal resistance factor (p=0.057 p=0.702, respectively; paired t-test ).  

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\r\n Conclusion: Pupillary dilatation with 0.5% tropicamide seems to have a decreasing effect on on intraocular pressure while no effect was noted for corneal biomechanical properties in primer open angle glaucoma patients.

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In this study; the lipofuscin pigment of the neuron of the spinal ganglions, formatio reticularis, three parts of the spinal cord and purkingje cells of the cerebellum of the aged white New Zealland rabbits were studied. The pigment were studied following: Alternative Nile Blue Methode +, Hueck rnethode +, PAS and indephenol +, Sudan Black B +, Schmorl methode -„ Long Ziehl Neelson -, Masson-Fontana and Chrom Alum -. The lipofuscin pigment in the Purkinje cells have never been found.

In this study, Cornputerized Tomographic findings that are the most definitive diagnostic criteria for rnultiple sclerosis have been evaluated. Computerized tornographic findings were discussed under the light of literature. In 8 cases of 17 cases (8117) the diagnosed by means of clinical findings and history. As a result, we carne ta the conclusion that CAT findings may change in addition to the periods of the disease and the other neurological disorders. Should be alsa taken into consideration irı the dillerential diagnosis.

Amaç: Sağlıklı bireylerde yaş ve cinsiyetin ganglion hücre kompleksi ve retina sinir lifi kalınlığı üzerine etkisinin RTVue optik kohorens tomografi ile değerlendirilmesi

 

Hastalar ve Yöntem: Yaşları 10-84 arasında değişen 393 sağlıklı katılımcıyı bu kesitsel çalışmada değerlendirdik.  Yaşa bağlı değişikler  lineer regresyon  analizi ve Pearson korelasyon analizi ile incelendi. Retina sinir lifi kalınlığı ve ganglion hücre kompleksi arasındaki ilişki pearson korelasyon testi ile değerlendirildi.

 

Bulgular: Tüm populasyonun ortalama retina sinir lifi kalınlığı 108.94±9.77 µm idi ve  yıllık  0.101 µm  (95% güven aralığında , -0.151, -0.051; lineer regresyon analizi ile, p<0.001) azalmaktaydı. En önemli azalma üst temporal bölümde ve yıllık 0.197 µm  (0.197 µm/yıl, 95% güven aralığı, -0.293, -0.101; lineer regresyon analizi ile, p<0.001) olarak görüldü. Üst kadran hariç retina sinir lifi kalınlığında cinsiyete göre fark bulunamadı. Ortalama ganglion hücre kompleksi kalınlığı 97.45±6.42  µm olarak bulundu ve her yıl  0.043 µm azalmaktaydı (95% güven aralığında, -0.079, -0.007; lineer regresyon analisi ile, p=0.019). Cinsiyetle ganglion hücre kalınlığı arasında bir ilişki bulunmazken retina sinir lifi ile ganglion hücre kompleksi arasında anlamlı korelasyon tespit edilmiştir (p<0.001 ve r=0.630).

Sonuç: Retina sinir lifi kalınlığı ve ganglion hücre kompleksi kalınlığı yaşla birlikte önemli ölçüde azalmaktadır ancak ganglion hücre kalınlığı daha az etkilenmektedir. Ek olarak bu çalışmada ganglion hücre kalınlığı ve retina sinir lifi kalınlığı RTVue veri tabanından yüksek bulunmuştur. Bu fark tanıda gecikmeye neden olabileceğinden dikkate alınmalıdır.

Saddle block is an ideal procedure that can provide sufficient anesthesia by protecting hemodynamic stability especially in elder patients with high cardiac risk. A 52 years old male patient with bladder tumor who was scheduled for transurethral bladder resection (TUR-B) had history of hypertension, diabetes mellitus and congestive heart failure. Echocardiography showed that LVEF was 20%; RVEF was 28% and there were insufficiency (MVI) of third degree, insufficiency (TVI) of second degree, biventricular global hypokinesia and remarkable dilatation on the right and left structures of the heart. The patient was considered as having ASA class IV. He had TUR-B under saddle block. In conclusion, we considered that saddle blockade was a more safe and efficient anesthetic procedure rather than neuroaxial blockade or general anesthesia for the highrisk patient who had bladder tumor.

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

Background

Hypertension (HT) is a controllable and preventable public health problem that is a risk factor for many serious diseases, especially cardiovascular diseases. Hypertension, which can be silent and lethal, can not be diagnosed in many people. HT constitutes a significant part of the daily practice of the primary care physician. Today, the Family Medicine is a medical discipline constitutes the first level of the health system in Turkey.

Aim

In our study, the effectiveness of family medicine practice in the diagnosis of arterial hypertension was investigated.

Material and Method

We retrospectively reviewed the data of the patients aged 18 years and older who had access to their data in our family medicine department between 2017-2018. A total of seven questions, including personal information (age, gender and education level) and disease identification information (how many years were diagnosed with hypertension, baseline symptom, where and how the diagnosis of hypertension was first established) were retrospectively reviewed from the Family Medicine Information System.

Results

A total of 286 patients, 178 female and 108 male were detected. 9% of the participants were illiterate while 94.1% were literate . 59.8% of the illiterate patients were in primary education, 10.5% in high school and 16.8% in graduate education. 7.7% of the participants were diagnosed in the family medicine polyclinic, and the remaining 92.3% were diagnosed in secondary health care facilities and other places except family medicine. According to education level, 7.7% were diagnosed in family medicine and 92.3% were diagnosed in second-level health facilities and elsewhere except family medicine.

Conclusion

In our study; patients with arterial hypertension were diagnosed more frequently in secondary health care institutions regardless of their education level. Although the rate of diagnosis of arterial hypertension was increased from 1.5% to 16.3% in primary care after starting the practice of family medicine in Konya, we believe that the role of family medicine practice on the diagnosis of arterial hypertension should be increased even more.

 

 

Purpose : This study compares the organ doses at risk by using the Eclipse treatment planning system for two common total body irradiation techniques (TBI) at extended source skin distance.

Material and Methods: 3D treatment plans with AP-PA (anteroposterior) technique were created retrospectively for 20 patients treated bilateral TBI. For each patient, the whole body, kidneys, lungs, thyroid and liver were contoured to create (DVH) dose volume histograms and examine 3D dose volume distributions. The mean doses of thyroid, lung, kidney, liver, whole body and treatment volumes and the maximum doses of 2% volumes (D2) were calculated from the dose volume histogram and transferred to the SPSS file. The non-parametric Wilcoxon test was used to compare the dose values for two techniques.

Results: Thyroid gland mean doses were significantly lower in lateral technique (11.98 and 12.64 Gy, p = 0.21). It was observed no statistically dose difference between the two techniques in terms of lung doses. Since, the lungs were protected by lead blocks in both of two techniques. The mean doses of liver and kidney were lower in the lateral TBI technique (p = 0.002 and p = 0.004, respectively). D₂ doses of liver were lower in AP-PA planning technique (p = 0.032). In comparison of the hot points between the two techniques, the lateral position was significantly superior (p <0.0001).

Conclusions: In present study, it was observed that the bilateral position was superior to the AP-PA position in order to prevent the hot spots. In the AP-PA position, it is more difficult to tolerate the body irregularities. Additionally, when comparing the dose distributions of the organs (liver, kidney, thyroid), it was seen that the results were statistically better in the lateral position. The lateral position provides an advantage in terms of more homogenous dose distribution and better quality planning.

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

Coronary ectasia is localized or diffuse dilation of coronary arteries. There are limited data about the percutaneous coronary intervention (PCI) of ectatic coronary arteries with stenosis. Different stent systems such as carotid, bilier and venous graft have been used in these lesions. Post-dilation has been performed by peripheric balloon catheter, if necessary. In this case, we reported a patient with acute inferior myocardial infarction and ectatic right coronary artery who was treated with primary PCI using a renal stent.

Purpose: V/e evaluated clinical features, diagnosis and characteristic findings in a cases of pigmented pa­ ravenous retinochoroidal atrophy. Case: Best corrected visual acuity of a 58 year old vvoman who was diagnosed on routine examination as pigmented paravenous retinochoroidal atrophy was 20/30 in the right eye and 20/50 in the left eye. No other family members are knovvn to have eye disease. Anterior segments and intraocular pres- sures were normal. İn ali qudrants, bilaterally, there was striking paravenous pigmentary retinal pigment epithelial atrophy vvith dense black bone-spicule pigmentation. The optic discs, maculas and retinal vessels outside of the pigmentary regions appeared normal. The fluorescein angiogram revealed areas of hyperfluorescence in- terspreaded vvith pigment clumps. There was no leakage from the retinal vessels. Conclusions: Pigmented pa­ ravenous retinochoroidal atrophy is a rare disorder that is not we understood or classified. The diagnosis of pig­ mented paravenous retinochoroidal atrophy is established on the opthalmoscopic appearence of a striking disturbance of the retinal pigment epithelium in a distinctly perivascular distribution vvith or vvithout bone spicule pigmentation.

In this study, It was made the short intestine by performing the massive resection including ileocecal valve in 20 dogs and then it was carried out new ile-ocecal valve model using jejunal flap. The dogs di-vided two groups. It was made jejunocolostomy in first group and a new ileocecal valve model with jej-unocolostomy in second group. At the end of postoperative second month, it was one more measured üs weights, then intraluminary pressures in proximal and distal paris of anastomosis were measured and specimens were taken for colony counts and colonographic study was performed by barium. While mean weight loss was 24.9% in first group, it was 11.4 % in second group. The dillerenee between the weight loss values of two groups was statistically significant (p<0.01). While the mean dıfference of pressure values was 0.89±0.78 cm. Water in first group, It was 6.00i-0.94 cm. Water in secont group. The difference between the pressure gradients was statistically sig-nıficant (p<0.01). There was tube Ilke apperance and the increased peristaltic waves al the jejunal side, in colonographic radyograms. We believe that the new valve model performed by us may be used during the first operation in short bowel syndrome unable to save the ileocecal valve.

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

Aim: To present a case in which the umbilical cord has the abnormality of including a single umbilical artery. Case report: The patient was 30 years old, has passed 6 pregnancy, 1 parturition, 4 abortions and has none alive children. At the 36 gestational week she was admitted to the clinic of obstetrics and gynecology and the patient was diagnosed as in utero ex fetus. After parturition of the dead fetus, placenta and the infant’s umblical cord was sent to the the clinic of pathology for examination. During the examinations, the absence of the right umbilical artery was determined. İn histopathologic investigation brain tissue congestion and vascular dilatation in places, necrosis areas, intestinal mucosa and liver necrosis and ali organs congestion have seen. Pathologic findings include lesions because of ischemic tissue perfusion insufficiency. Results: The abnormality of a single umbili­ cal artery especially the absence of right umbilical artery is rare. The abnormalities of umbilical cord are diag­ nosed easily during prenatal period by using doppler ultrasonography. The cases in which are diagnosed umbili­ cal cord abnormalities must be examined for chromosome abnormalities and congenital malformations.

Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare congenital heart disease in which left coronary artery leaves from the pulmonary artery. Patients are usually asymptomatic in neonatal period during the pulmonary artery pressure decreases up to a critical level. However, afterwards left ventricular failure and infarction were present. An asymptomatic newborn patient who was referred our clinic due to cardiac murmur was presented. Dilated cardiomyopathy and anomalous left coronary artery from pulmonary artery were diagnosed with echocardiography and during the cardiac catheterization ALCAPA syndrome was confirmed.

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

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

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

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

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

The presence of cardiac disease in pregnancy is still one of the most important reason of maternal mortality. The possibility of acute coronary syndrome increases in pregnancy. Birth with caesarean section provides proper hemodynamic monitoring and management in parturients with cardiac disease. However the ideal anesthetic to be applied to parturient with cardiac disease is controversial. Although regional anesthesia is usually preferred method, general anesthesia may be applied in some special cases. Invasive monitoring reduces mortality and morbidity in cardiac patients undergoing general anesthesia. Opioid use reduces the stress response to surgery and intubation. If the use of opioid is required before birth, remifentanil is the ideal agent because of its rapid onset of action and metabolism. In this case, we aimed to present our general anesthesia experience on a parturient with high cardiac risk where regional anesthesia is contraindicated because of the use of anticoagulation.

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.

Melkersson-Rosenthal syndrome is a disease, characterized by recurrent orofacial edema that predominantly involves the lips, recurrent facial nerve paralysis and fissured tongue. It is usually seen in second decade of life. The most common finding is orofacial edema. Facial paralysis, another finding of syndrome, is typically recurrent, can be unilateral or bilateral and may be partial or complete. The fissured tongue is the least common symptom and considered as congenital. Although Melkersson-Rosenthl Syndrome’s etiology is unknown, genetic tendency and environmental factors suspected to play role. The syndrome is diagnosed clinically. Although various medical and surgical methods implemented, there is no consensus for its treatment protocol. In this case report, we presented a Melkersson-Rosenthal Syndrome case which classic triad seen together and taken a late diagnosis.

Melkersson Rosenthal syndrome (MRS) is a rare disorder of unknown etiology, undefined incidence, and inconsistent classification. (1) MRS unilateral or bilateral peripheral facial paralysis recurrent attacks, orofacial edema, fissure in the language (lingua plicata) is characterized by a table. This syndrome have been in the giant cells in histological as multinuclear, together with increased inflammatory cells and dilated lymphatic channels are observed. (2) This syndrome is rare in childhood 2 of life and 3 decad is seen more often. It is rare to see a classic triad and often monosymptomatic or oligo symptomatic involvement is monitored. It is rare to see a classic triad and often monosemptomatik or oligo symptomatic involvement is monitored. Results with one or two of the biopsy is enough to recognize the existence granulomatous chelitis. (1,2) In this study we aimed to invstigate case with alone facial edema in terms of MRS.

Erector spinae plane block (ESPB), one of the popular regional anesthesia techniques in recent years, has first been used for upper thoracic neuropathic pain. Later, it has been used in many different indications for both acute and chronic pain treatment at different lower thoracic and lumbar levels. Our limited experience demonstrates that bilevel bilateral sacral ESPB is an easy and effective method in the treatment of perianal chronic intermittent pain. However, many issues, such as the application site, the volume of local anesthetics and the sensory blockade, still remain being investigated. Due to the lack of clinical research, our review is currently unable to support the evidence and routine use of sacral ESPB. We consider that anatomical radiological and  clinical studies are needed to elucidate the efficacy and mechanism of action of sacral ESPB

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.

Liver atrophy after portacaval shunt is explained by lack of the liver from hepatotrophic factors. This study is undertaken to evolve the (2hanges in liver atter portac.aval shunt. The animals were calegorized in 3 groups each including 15, 10 and 10 animals respectivefy and we performed dillerent interventions. Anitnaly were sacrified at 15th day. Ilisiopathological exarnination revealed lipid accumulation, hyperchrornatosis and increasing of rnitotic activity in liver lobes which left branch of portal yein were not ligated and diffuse haernorrhagic infarct and necrosis in left kbes of the anirnais which had only ligation of the left branch of porta! yein. We deiermined only rninimal atrophic changes in left

Thyroid ectopy is caused by failure of the descent of thyroid tissue through thyroglossal duct during embryological development. Base of the tongue is the most common ectopic localisation of thyroid gland. It is usually asympthomatic. Adenoma, hyperplasia, inflammation, malignancy similarly can be seen in ectopic thyroid tissue, as may occur in normal thyroid tissue. In this report, we present the case who has no thyroid tissue on normal localisation, searched for ectopic localisation with scintigraphycally; treated for hypothyroidism and followed.

The effects of starvation and refeeding on intestinal mucosa nere studied in ileum of rat intestine. Forty-two adult male rats nere used in this study. Animals nere divided into three groups. First groups of twenty-one rats nere starved for 1, 2, 3, 5, 9, 11 and 14 days. Second group of fifteen rats nere refed after a period of starvation and then decapitated after 1, 2, 3, 5 and 12 days. Third groups of three rats nere used as control animals. Starved rats nere alloned to drink nater ad libitum. Control animals had free access to nater and to chon pellets until the time of killing. Animals nere neighed daily during the fasting period. Animals nere killed under ether anesthesia. Ileal sections nere stained. Ileal villi size nere measured by ocular micrometre. After 3-day fasting, villi heigth nas observed to be gradually decreased nith days of fasting. Body neigth and after 3-day-fasting villi heigth gradually decreased nith days of fasting. Lymphatics nere dilated (5, 9, 11 and 14 day fasting), blood vessels nere fulled up nith erytrocyte at the long term fasting (9, 11 and 14- day fasting). Paneth cells and their granules nere gradually increased nith days of fasting. Ileal villus nere determined to height increased after refeeding. Paneth cells and their dense granules nere persistent.

On a group of patients which were sended la aur laboratories and swpected of having brucellosis who were admitted to our hospital's iR patieni and out paıient Wright aggluiination tesis (WAT), Rose Bengal Tesis (RBT), and SİR, tesis (ST) were performed and evrıluaıed fr r Bruce11a abor While ST and RIIT were negative, WAT was 1140 positive, in a patient's serum. RBT was posi-tive, and WAT was 1140 positive, ha ve heen found, in anoıher serum. ST and RBT were positively correlated with 1180 and higher dilutions of WAT (100 per ccnt).

In this report 2365 cases that were diagnosed at the Department of Pathology of Medical School of Selçuk University between 1988-1992 are examined by age, sex, organ distribution and histopathological types. The ratio of lung carcinoma in men and skin carcinoma in women were the highest.

We have studied on 47 thyroidectomy material that vvere came to Fırat University Medical Faculty Department of Pathology for the determination of proliferative activity. PCNA method vvere applied, normal thyroid(9), adenomatous goiterfl 1), follicular adenoma(7), papillary carcinoma(l6), follicular carcinoma(2) and anaplastic carcinoma(2). Ali cases paraffin sections stained PCNA/cydin monoclonal antibody. Positive painted nuclei vvas evaluated and PCNA indices vvere calculated as percentage. PCNA indices vvere evaluated normal thyroid %0.5, adenomatous goiter %2.1, follicular adenoma %2.6, papillary carcinoma %6.2, follicular carcinoma %15.7 and anaplastic carcinoma %32.2. As a conclution, thyroid carcinomas shovved significantly increased numbers of PCNA positive cells when compared vvith benign thyroid tumors.

In this study we have determined intraleukocytic 3', 5'-cyclic adenosine monophosphate levels of 25 healty subjects aged between 27-56 years and 37 pa-tients with cancer aged between 30-72 years. There was no significant dillerence between values of the two groups. Dur results were discussed with literature findings.

In reading of a text the eyes fixate on the most apprepriate point on the line for word identification. There is a great deal of variability both within and between subjects in respects of saccade lenghts and fixation duration. The variabilites mentioned in the relevant English and French literature are also detected in Turkish language by this study. Additionaly, fixation point is more persistent on the left half of the isolated words than on the ie.?ft half of the contectual ones. This results is disscussed in the light of rhe knowledge about parafoveal perception and contectual effects

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.

Peyronie's disease was named after King XV of France, who lived in 1743. Lui's surgery is more than Francois de la Peyronie. In the disease, scar tissue forms (plaque) in the cysts where the tunica albuginea surrounds the corpus cavernosum due to various reasons, which causes the loss of elasticity in the affected plan crest, and thus, it causes a congestion in that region during erection. The disease, whose incidence has been determined as 1% in the studies, is still. It is mostly seen in middle-aged patients. It is rare in young people and very old age. It is less seen in black and almost never seen in eastern.

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.

Introduction: Our aim is to evaluate the cardiac involvement of Neurofibromatosis type 1  patients in our region and to compare them with other clinical findings. In this study, we wanted to show the frequency and variety of cardiac involvement.

Material and Methods: Patients diagnosed with Neurofibromatosis type 1  in Hatay Mustafa Kemal University Medical Faculty Pediatric Neurology Clinic between 01/09/2019 and 01/09/2020 were included in the study. The patients included in the study were examined by a Pediatric Cardiology Specialist, and echocardiography and electrocardiography were taken. Demographic information, examination findings, brain magnetic resonance images were collected from the files of the patients. Electrocardiography and echocardiography were examined and recorded by the Pediatric Cardiology Specialist.

Results: We accepted 17 patients from our center to the study. Six patients (35.3%) were diagnosed with sporadic Neurofibromatosis type 1, while 11 patients (64.7%) had familial Neurofibromatosis type 1. All of our patients had cafe au late spots on the skin. In addition, 10 (58.8%) patients also had axillary and / or inguinal freckles. We detected optic glioma in 3 of our patients with ocular involvement, and lish nodules in 3 of them with papillary edema. When we looked at central nervous system involvement, we encountered various involvements in brain MRIs of 8 (47%) patients. In our cardiac examination, we found QT length in 1 patient’s electrocardiography. In the echocardiography we performed for the detection of cardiac structural pathologies, we detected nodular appearance compatible with subendocardial neurofibroma in 3 patients, mitral insufficiency in 3 patients, patent foramen ovale in 1 patient, atrial septal defect in 1 patient, and bicuspid aorta in 1 patient.

Discussion: In our study, unlike the literature, subendocardial nodular hyperechogenic appearance was present in 3 patients. Although these findings are quite rare, subendocardial nodular hyperechogenic images in 3 of our 17 patients suggest that this pathology may be more common. In addition, one of our patients had a long QT. As far as we know, this is the first case of Neurofibromatosis type 1 and Long QT syndrome. In conclussion; Cardiac involvement in patients with Neurofibromatosis type 1 could more common than mentioned in the literature.

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

Aim: Atrial fibrillation is a common disorder and is an important cause of thromboembolic events. Recently, direct oral anticoagulant drugs (DOACs) are being used to reduce the frequency of thromboembolic events among these patients. DOACs have several advantages over oral vitamin K antagonists, such as fixed dosage and fewer side effects. However, since the drugs and their affects cannot be monitored directly, difficulties are encountered in assessing drug efficacy and side effects. For this purpose, platelet indices and their relationship with DOACs may be utilized for the prediction of thromboembolic and hemorrhagic events.

Patients and Methods: 301 patients with atrial fibrillation who were using DOACs were included in the study. Platelet indices such as platelet count, platelet distribution volume, plateletcrit, platelet-large cell ratio were evaluated at the first and sixth months. The effect of DOACs on these indices and relationships with bleeding events were investigated.

Results: All groups were similar in regard to baseline platelet indices, except for lower P-LCR value among recipients of rivaroxaban. When post-treatment results were compared, all groups were found to have similar values in all parameters. However, time-bound comparisons revealed that apixaban and dabigatran significantly reduced P-LCR value after 6 months of use.

Conclusion: This study showed that apixaban, rivoraxaban and dabigatran had no effect on platelet count, MPV, PDW, PCT values in whole blood count of patients with non-valvular AF. All characteristics of those with and without hemorrhagic events were also similar of patients with non-valvular AF.

Esophageal achalasia in childhood especially in whom below one year of age is a rare lesion and difficult to diag- nose. An 11 months age female infant has been treated successfully by pneumatic dilatation, after returning of the esophagus to it’s normal calibre there was no complications seen in the barium study that performed later. After a follow up period of 12 months there was no vomiting or feeding problems or recurrence of the achalasia.

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

Introduction and Objective

Brucellosis is a zoonotic infection seen as an endemic in Turkey and is a public health problem at the same time. The objective of this study was to evaluate demographic/epidemiologic, clinic, laboratory features, complications and treatments in brucellosis patients followed-up in our clinic.

Material & Methods

In this study, features of patients followed-up between 01/01/2010 and 31/12/2018 in our clinic were retrospectively evaluated. Descriptive data were expressed as number and percentage. Categorical variables were analyzed with Chi-square test and numerical variables with Student’s t test.

Results

Of the total of 365 brucellosis patients, 159 (43.56%) were female and 206 (56.44%) were male. The mean age of the patients was 45.9±14.51 (18-82) years. The most common time of presentation was summer season with 137 (37.5%) patients. The most common transmission route of the disease was a history of animal husbandry with 252 (69%) patients. Of all cases 168 (46%) were acute, 96 (26.3%) were subacute, and 101 (27.7%) were chronic brucellosis. The most common complaint of the patients was fatigue in 302 (82.7%) patients with being higher in acute brucellosis (p=0.0015). Anemia was found in 53 (33.3%) male and 114 (55.3%) female patients with being significantly higher in female patients (p=0.0283). Leukopenia was found in 7.9%, leukocytosis in 16.2%, thrombocytopenia in 9.6%, neutropenia in 4.1%, neutrophilia in 9% and lymphomonocytosis in 12% of the patients. Wright agglutination test was performed in 26 (7.1%) and brucella immunocapture agglutination test in 361 (98.9%) patients and all results were positive. Of all patients, 172 (47.1%) developed complications with spondylodiscitis being the most commonly found in 58 (15.9%) patients. Sixty-one (31.8%) of patients developed relapse.

Conclusion: Since brucellosis is endemic in our country, it should be considered in presumed diagnosis of patients presenting with complaints such as fatigue, articular pain and fever.

Aim: Gastric diverticula are uncommon and usually asymptomatic. Only one case of pyloric obstruction secondary to a gastric diverticulum was published in the literature. A case treated for pyloric obstruction secondary to a gastric diverticulum and the related literature are reviewed. Case report: The 66-year-old female, treated for peptic ulcus along three month, consulted to our hospital complaining about vomiting after eating something for last 15 days. Having examined upper gastrointestinal system, diverticulum was found on at lesser curvature, located adjacent to and partially including the pylor. Patient was treated with endoscopic balloon dilatation. Conclusion: Even if simple resection was suggested for symptomatic gastric diverticula, pyloric stenosis secondary to a gastric diverticulum can be cured with endoscopic balloon dilatation was reosanable.

It was examined iwo hundreci and seven cases havıng the unders-cended iestis and scrotal patholo-gy by ultrasonography. Ultrasonographic findings were discussed in association with clinical and op-eration findings. It was discussed that, ultrasonography coıdd give US positive chıes in Ille investiga. tion of dillerential diagnosis of clinic and subclinic varicocele and undescended testis.

Very long-chain fatty acid dehydrogenase (VLCAD) deficiency is an autosomal recessive disorder of mitochondrial fatty acid oxidation. Elevated plasma level of acyl-carnitine by Tandem mass spectrometry prompts the diagnosis of VLCAD. We herein report a neonate with a diagnosis of VLCAD whose mother’s pregnancy was complicated with HELLP syndrome. Physical examination revealed poor peripheral perfusion and hypotonia on the 15 days of life. Metabolic acidosis, dilated cardiomyopathy developed during follow-up.

Abstract

Animal bites to the face can cause serious defects. In select cases when the avulsed part has been carefully preserved and brought-in with the patient, replantation may be the best solution.

In other cases, few strategies are present. The classical “watchful waiting” strategy to treat such patients could be described as letting the wound to heal and only then, initiate reconstruction. Wound scarring and patient’s psychological disturbance due to prolonged rehabilitation are its biggest disadvantages. However, a proactive method with reconstruction initiated early during the convalescent phase, can result in faster rehabilitation.

Herein, we present detailed description of a successful early reconstruction of the perioral area in a teenage girl following a dog bite; the reconstruction encompassing the anatomical, functional and aesthetic spectrum. Thus, we believe, proactive strategy has a huge potential in the modern era of reconstructive head and neck surgery.

Aim: Diabetes, which has turned into a pandemic in the twenty-first century, concerns all branches of medicine. This study aims to investigate the prevalence of diabetes unawareness by checking HbA1c in patients hospitalized in clinics other than internal medicine and evaluate the factors associated with them.

Patients and Methods: The study included 630 patients hospitalized outside internal medicine services at or over the age of 18 whose anthropometric measurements could be made. The sociodemographic properties and comorbidities of the patients were recorded. Their anthropometric measurements, fasting blood glucose and HbA1c measurements were made. Those without a known diabetes diagnosis but with an HbA1c value of ≥6.5% were grouped as diabetes unaware. The differences among known diabetes, diabetes unaware and no diabetes  groups  were examined.

Results: The study was conducted between 01.03.2017 and 31.12.2017. The mean age of the patients was 58.04±18.56, while 54.6% (n=344) were male. The number of the patients with known diabetes was 190 (30.2%), 396 (62.9%) did not have diabetes, and unknown diabetes was detected in 44 (7%). Among the 234 patients with diabetes, 18.8% (n:44) had diabetes unawareness. The rate of those under the age of 45 in the diabetes unaware group (11.4%) was higher than that in the known diabetes group (3.7%) (p<0.01). Again, the rate of the male sex was also higher among the same individuals (68% vs 47.9%, p:0.15). The rate of overweight in the diabetes unaware group (56.8%) was higher than those in the known diabetes (37.9%) and no diabetes (39.1%) groups (respectively, p:0.36, p<0.01). There was no significant difference among the three groups in terms of educational levels. The rate of comorbidity presence was higher in the known diabetics (89.5%) than the diabetes unaware group (75%) (p:0.01). All patients with diabetes were evaluated by logistic regression analysis. The male sex, age<45 years, being overweight and absence of a comorbidity were associated with diabetes unawareness.

Conclusion: Undiagnosed diabetes was detected in 7% of the patients. Among all diabetic patients, 18.8% had diabetes unawareness. Conducting diabetes screening with HbA1c in inpatients and paying special attention to those under 45, males, overweight patients and those without comorbidities may help detect unknown diabetes.

This study was retrospectively registered at the Protocol Registration and Results System (Clinicaltrials.gov PRS)  with the registration number NCT04694326.

The disease was first described by Scheuermann as the dorsal kyphosis of juveniles in 1920. Scheuermann's disease is the most common cause of thoracic hyperkyphosis in adolescence. There are two sub-types: thoracic and thoracolumbar / lumbar. Histologically, when the irregularities in the vertebral end plates are examined, collagen fibrils are seen to decrease or vanish. As a result, end-plate continuity deteriorates and Schmorl nodules appear when the disc material protrudes into the corpus. Deformations cause wedging in the vertebral corpus, resulting in narrow angled kyphotic deformity. In the large series, the prevalence is up to 8%, and the genetic transition and mechanical stress come into prominence in the epidemiology of the disease. Pain can be accompanied by deformity in symptomatic state. Classical radiological features include irregular vertebral endplates and kyphosis more than 45 degrees with 5 degrees of wedging in 3 or more vertebrae. In some cases, minimal scoliosis may accompany to kyphosis. Periodic radiologic follow-up is recommended for patients below 50 degrees of kyphosis. Bracing is appropriate in uncompleted skeletal maturation with kyphosis up to 75 degrees. In cases above 75 degrees, it is appropriate to perform surgical treatment when bracing is unsuccessful in adolescence and presence of exceeding pain despite the conventional methods and obvious deformity in adults. 

Iron is a medication that is used more in iron deficiency anemia. The use of iron in high doses can cause a multisystemic effect. The toxicity of iron depends upon the amount of elemental iron ingested. The minimum toxic dose and the lethal doses of iron are not firmly established. However, side effects that may be life-threatening are seen on the heart and liver. This paper presents a 16-year-old patient who used 720 mg; 12mg / kg / dose preparation of iron for suicide purposes. The control blood tests performed while planning the discharge of the patient, who had no complaints but were followed up clinically, continued to be followed up because of the increase in the value of troponin. The patient who has no record of physical examination, electrocardiogram (ECG), echocardiography (ECO) and indication for iron chelation and in whose troponin level a decrease was diagnosed in the monitoring was discharged with recommendations. Due to the rare occurrence of cardiac involvement and being the first case reported in our country, the effects of the drug on toxicity were discussed in the light of the literature.

 

Evaluation of body temperature in a day period in Down syndrome children with congenital heart disease and comparison of results with control group. Fifty-one Down syndrome children with congenital heart diseases who were hospitalized and followed up in pediatric cardiology clinic because of various non-infectious etiologies between September 2010 and August 2011 were included in the study. The two control groups were selected from 26 non-Down children who had and had not congenital heart disease respectively. Sedimentation rate, C-reactive protein and procalsitonine levels, white blood cell and platelet counts were determined in all groups during hospitalization. Humoral and cellular immune systems were evaluated in Down syndrome patients with recurrent and/or nonexplained upper and lower airway infectious. Body temperature was determined in all patients twice a day in morning, noon, evening and night. No statistical differences was detected between the groups according to sedimentation rate, C-reactive protein and procalsitonine levels, white blood cell and platelet counts. Isolated ventricular septal defect is the most common detected congenital heart disease in Down syndrome patients. Body temperature measurements were statistically different in Down syndrome group than two control groups and it was detected that basal body temperature was higher during the day. Body temperature is higher in Down syndrome children with congenital heart disease during the day. This is because of the defect in hypothalamic temperature regulator center rather than the hemodynamic defect. For this reason the limit temperature of fever in Down syndrome patients should be different than healthy children.

\r\n PURPOSE
\r\n             The aim of this study is to analyze if there were any factors that would indicate the diagnosis of dilating vesicoureteric reflux (VUR) (≥ grade 3) in the second voiding cystourethrogam (VCUG) of children with a normal first VCUG.

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\r\n MATERIAL AND METHODS
\r\n             Patients who underwent VCUG between 2012 and 2017 were retrospectively reviewed. Within the cohort, patients who required more than one VCUG were abstracted and those with an abnormal first VCUG (VUR, posterior urethral valve, etc.) were excluded. Factors such as; age, gender, lower urinary tract dysfunction (LUTD), renal scarring, recurrent urinary tract infection, abnormal ultrasonography findings (bladder abnormalities/variable degrees of hydronephrosis), and technical problems (absence of voiding phase) were noted. Mann-Whitney U test was used for continuous variables whereas Chi Square test was used for categorical values.

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\r\n RESULTS
\r\n             A total of 25 patients were found to have undergone more than 1 VCUG (19 girls, 6 boys; mean age 6 ± 3 years). Median time period between the two VCUGs were 12 months (range 1 – 72 months). VUR was detected in 11 patients, while dilating VUR was discovered in 7 patients. Among those, 6 patients were diagnosed with bilateral VUR. Recurrent UTI was found to be the only factor that would indicate dilating VUR in the second VCUG (p=0,049). Interestingly, no VUR was detected in cases that were performed after a first VCUG with inadequate technique. 

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\r\n CONCLUSION

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\r\n             Recurrent UTI was shown to be the sole factor that would indicate the diagnosis of dilating VUR in the second VCUG. In our study, 28% patients with a normal first VCUG were shown to have dilating VUR in the second study. Therefore, in recurrent febrile UTI, second VCUG should be considered in patients with a normal previous imaging.
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Purpose: Extensor digitorum longus (EDL) and extensor hallucis proprius (EHP) muscles were overloaded in Ischaemic and normal muscle in order to determine how muscle hypertrophy occurred under these conditions, and to vvhat extend fibres of different size in the same muscle responded to overload during different time courses. Methods: İn this experiment 87 male rats were used and divided into control (C), ischaemic (I) achieved by unilateral ligation of the common iliac artery, overloaded (O) achieved by unilateral ablation of the synergist tibialis anterior, and overloaded plus ischaemic (O+l) groups. Histological analysis was performed on cryostat sections. Results: İn EDL hypertrophy occurred at the same level during the first 4 vveeks (P<0.05 vs. O), while in the smaller EHP hypertrophy occurred progressively över this time (P<0.01). After 6 vveeks, hypertrophy of the EDL was clearly greater than at earlier time points. İn the EDL muscle the response to hypertrophy was greatest in the smaller muscle fibres (P<0.01). VVhile hypertrophy was not signlficant in the larger fibres, atrophy was significant during ischaemia (P<0.01). VVhen overloaded muscle was made ischaemic there was less hypertrophy compared to non-ischaemic muscle during the first 4 weeks but it reached the same level by 6 vveeks, possibly due to angiogenesis in this time. Conclusions: There was greater hypertrophy in the smaller muscle vvhen a synergist muscle was removed, and there was also greater hypertrophy in the smaller fibres vvithin same muscle. İt is postulated that in order to prevent atrophy and stimulate angiogenesis in the ischaemic muscle, as vvas shovvn in the O+l muscle, careful exercise is reçuired although possible pain during the initial period may limit the response.

Obesity, in its simplest meaning, must be raised in body fat. Keeping the body weight within normal limits can be achieved by establishing the energy balance by having blackberries and calories spent, and it is expressed as "Caloric balance = Kcal obtained with food - Kcal consumed in metabolism (Basal metabolism + work metabolism) + Urine, consumed as feces and Kcal" (one)

In this article, we presented six ovarian Sertoli-Leydig cell turııors with histopatologic and clinical features. This cases classified in 3 grades as: well, intermediate and poorly dillerantiation. There was retiforrn dıfferentiation in only one case. We couldn't encounter heterolog elements in any case.

Flow-mediated vasodilation (FMD) of the brachial artery, which is indicative of endothelial function is correlated with cardiovascular risk factors. The relationship between FMD and collateral formation in patients with coronary artery disease (CAD) has not been investigated up to date. In our study, we investigated this relationship. The study enrolled 91 (12 female, 79 male) patients with a mean age of 59±11. In patients with at least one coronary artery stenosis of %90 or greater were included in the study In the presence of angiographic coronary collateral classification was made according to Rentrop. Patients were divided into 2 groups as patients with poor collaterals vessels (Rentrop grade 0 or l; 42 patients) and good collaterals vessels (Rentrop grade 2 or 3; 49 patients). Using highresolution ultrasound, both the FMD and sublingual nitroglycerininduced vasodilation in the brachial artery were measured in all patients. FMD was not significantly different between the two groups (4.55±0.69 vs 4.52±0.64, p= 0.83). In conclusion, in this study, lack of association between an impairment of FMD in the brachial artery and the presence of poor collaterals was observed. The reason for this, collateral formation is a complex phenomenon consisting of several distinct processes.

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

Between april 1989 to july 1990. 15 male impo-tent patients who applied ta the hospital of Selçuk University were investigated at our eiınıc. Patknts were al ages of betwecn 18 and 65 (mean 37) 19 male between 18 and 62 years old were taken as control group (mean 36). Prolactin, (ola/ testosteron, FS1I and LH levels in the blood of male patients with impotence and control group were ıneasured at our hospital. Only FS11 was high in male impotent patients. In addition su.blingual temperatur and fossa navicularis tempera-ture were determined in both group but there was not an important dillerence. Pharmacocavernosography and poilısion pharmacocavernosography was made in a male patient with impotence, who had venous leaknge.

Aim: Ginkgo biloba is used in traditional Chinese medicine for the treatment of various illnesses, including asthma, cough, and enuresis. Standardized Ginkgo biloba extract, EGb-761 contains flavonoids and terpenoids, which induce vasorelaxation in animal vessels. Little information is present on the effects of EGb–761 on human umbilical circulation. This in vitro study assesses the vascular effects of EGb-761 on the isolated human umbilical artery and the role of nitric oxide (NO) and prostaglandins in these effects.

Materials and methods: Isolated human umbilical artery strips were suspended in organ baths containing Krebs-Henseleit solution, continuously gassed with 95% O2-5% CO2. After a resting period, the isometric vasoactive changes to the applied agents were recorded. The following experimental procedures were conducted in different groups of strips (n=9); 1) Effect of cumulative EGb-761 (50-500 µg/ml) on the basal tonus of the artery strips. 2) The relaxant effect of cumulative EGb-761 on contraction elicited by 10-6 M 5-HT. 3) Effect of L-NAME incubation on the relaxant effect of cumulative EGb-761 on contraction elicited by 5-HT. 4) Effect of indomethacin incubation on the relaxant effect of cumulative EGb-761 on contraction elicited by 5-HT. 5) Combined effect of L-NAME and indomethacin incubation on the relaxant effect of cumulative EGb-761 on contraction elicited by 5-HT. Mixed effect models were used for Statistical analysis of the data. p<0.05 was considered significant.

Results:

The application of cumulative EGb-761 (50-500 µg/ml) did not alter the basal tone of the artery strips (p>0.05). Cumulative EGb-761 (50-500 µg/ml) generated concentration-dependent relaxation in 5-HT induced contraction (p<0.05). L-NAME significantly reduced the relaxation responses at all concentrations of EGb-761 (50-500 µg/ml) on 5-HT induced contractions (p<0.05). L-NAME completely inhibited relaxation responses of low concentrations (50-100 µg/ml) of EGb-76. Indomethacin significantly inhibited these responses at higher concentrations of EGb-761 (200-500 µg/ml) (p<0.05). L-NAME + indomethacin resulted in significant inhibition of relaxation responses with all concentrations of EGb-761 (50-500 µg/ml) (p<0.05). In addition, the co-administration of L-NAME and indomethacin resulted in a stronger inhibition in these relaxation responses at certain concentrations of EGb-761 than L-NAME and indomethacin alone.

Conclusions: EGb-761 does not affect the basal tone of the human umbilical artery. Cumulative application of EGb-761 in human umbilical artery strips precontracted with 5-HT generates significant concentration-dependent relaxation. NO and prostaglandins are involved in the mechanism of vasodilatation with varying potentials depending on the EGb-761 concentration. Prostaglandins also create synergy with NO in these responses.

We aimed to propose a management in a patient with thyroidectomized and high thyroglobulin (Tg) level, but negative radioiodine scan, whose lymph nodes detected with PET/CT. PET/CT was done to a patient, 31 years-old, with thyroidectomized and given radioiodine treatment, but not followed for a long time, for high Tg level and negative radioiodine scan. Metabolically active lymph nodes were detected in the cervical region. So, lymph nodes were excised with minimally invasive surgery. Radioiodine treatment was done because of papillary carcinoma metastasis. PET/CT may contribute to diagnosis in cases of high Tg levels, but negative radioiodine treatment in differentiated thyroid carcinoma.

In this in vitro study, the inhibitory effects of pi-naverium bromide and the calcium antagonists such as veraparnil and diltiazem were investigated on carbachol-induced contractions in isolated guinea-pig stomach fundus. The strips were mounted in organ baths con-taining Krebs-Henseleit solution and contracted with 104 M carbachol. The contractions induced witht carbachol showed a dose-dependent re-laxations by addition of cumulative concentration (10-9-104M) of each antagonist. The results suggest that in isolated guinea-pig stomach frnclus the contractions induced by car-bachol were inhibited by antagonists significantly and the rank order of potencies of these antagonists measured as the IC so was pinaverium=verapamil> diltiazem (P<0.05).

Between the years of 1989-1993, 67 patient with ureteropelvic strictures have been treated in Konya Selcuk University, Urology Department.. We performed 30 dismembered pyeloplasty, 5 Foley Y-V plasty, 2 vertical flap pyeloplasty, 2 spiral flap pyeloplasty, 2 Heineke Mikulich procedure, 2 Davis' intubated ureterostomy and 24 endoscopic transluminal balloon dilatation. Transluminal ballon dilatation was successful approximately 67 percent of the ureteropelvic strictures for a year follow-up. If endourolgic treatment failed one of the open surgical procedures was per formed. As a result of the study, we believe that transluminal ballon dilatation is a good alternative to open procedures in selective cases

Objective: Pap smear test is a commonly used and effective screening method in detection of cervical cancer and its precursor lesions. There is a very limited number of studies on use of Pap smears in diagnosis of the endometrial carcinomas. We have aimed to investigate the incidence rate of atypical endometrial cells in Pap smears of the patients diagnosed with endometrial carcinoma and the correlation between these cells and clinicopathological parameters.

Material and methods: In this study, patients who were diagnosed with endometrial carcinoma and who had smear sampling between January 2015 and September 2017 were examined retrospectively. Histological type, nuclear grade and Pap smear results of endometrial carcinoma cases were evaluated.

Results: Pap smear sampling was concurrently performed in 59 of the 97 patients diagnosed with endometrial carcinoma. The ages of the patients who underwent smear sampling ranged between 42 and 82 years (mean 57.43±9.08 years). The menopausal status evaluation of the women revealed that 12 (20.3%) and 47 (79.7%) patients were premenopausal and postmenopausal, respectively. Endometrioid type carcinoma was encountered in 51 (86.4%) patients as the most commonly found histological type. Serous, clear cell and mucinous carcinomas were determined in 6 (10%), 1 (1.8%) and 1 (1.8%) patients, respectively. The results of Pap smear tests were atypical in 24 (40.7%) patients whereas normal results were obtained in 35 (59.3%) patients. Nuclear grade assessment of the carcinomas showed that grade 1, grade 2 and grade 3 carcinomas were discovered in 24 (40.7%), 25 (42.3%) and 10 (17%) patients, respectively. The rate of the atypical endometrial cells encountered by Pap smears has increased as grade of the tumors increased.

Conclusion: We have concluded that the detection rate of atypical cells by Pap smear in endometrial carcinomas is considerably high. The incidence of atypical cells is higher in nonendometrioid and high-grade carcinomas.

Aim: Bites are an essential cause of injury since the world. Treatment of bites is made according to specific guides and principles. The study's purpose is to examine the demographic characteristics of patients hospitalized due to bite wounds and to be a guide for new studies and treatments by sharing surgical treatment experiences.

Material and Method: Patients who were bitten and required surgical treatment were included in the study. Demographic characteristics, tetanus, and rabies prophylaxis applications, infection agents isolated from the wound site, antibiotherapies applied, and surgical treatments were recorded.

Results: Of the patients, 43 were male and mean age (±SD) of 34.5±23.8years (range, 3-85 years). Bites were in the head and neck region in 13(65%) of patients under 15 years old and in 12(27.3%) of the patients over 15 years old. In extremities, the injury was present in 7(35%) patients under 15 and in 28(63.6%) patients over 15 years old. Of the injuries, 50(78.1%) were caused by dogs, 8(12.5%) by wild animals (7 pigs, one wolf), 4(6.3%) by other pet species (horse, donkey, cow), and 2(3.1%) by humans. The intervention was made to all the patients according to guide of rabies prophylaxis specified by the Ministry of Health, General Directorate of Public Health. Irrigation was applied to the wound site with plenty of pressurized and soapy water. Forty patients received tetanus prophylaxis, 62 patients received rabies prophylaxis, and rabies immunoglobulin was applied to patients considered as suitable. Prophylactic amoxicillin clavulanate treatment was started in 38 of the patients, crystalline penicillin-G in 12, sultamicillin in 6, the combination of sultamicillin and aminoglycoside in 6, and cefazolin treatment in 2. 12(18.8%) patient underwent an urgent operation for repair process without any microbiological examination on the date of arrival. Among the patients to whom repair was applied on the first day, 7 had primary saturation, 3 had a local flap, 1 underwent ear, and 1 underwent nasal replantation, one patient had femoral artery repair, and one patient had peroneal nerve repair. Among 52 patients who underwent late repair, primary suturation was applied to 35, skin graft to 4, local flap to 17, and paramedian forehead flap to 2. No complication was seen in any of the patients who underwent early and late repairs.

Conclusion: Bacterial burden of the wound can be reduced enough to allow urgent repair owing to the irrigation of the wound with plenty of pressurized and soapy water in bites. 

Vertebrobasilar dolichoectasia refers to a markedly dilated and tortuous vertebrobasilar arterial system, occasionally presenting with thomboembolic episodes or symptoms related to local compressive effects, such as cranial nerve palsies. Vertebrobasilar dolichoectasia is an uncommon cause of hiccups. A rare cause of hiccups, vertebrobasilar dolichoectasia is presented with imaging findings.

Actinomyces is a chronic suppurative infection caused by Gram positive anaerobic bacteria which grows hardly in bacterial culture. It is commonly isolated from cervicofacial, respiratory, and gastrointestinal system. Its exact pathogenesis is still unknown. Actinomyces located in the cervicofacial region is frequently accompanied by maxillofacial trauma and dental procedures. Herein, we report a 45-year-old female case of actinomyces in tongue which was treated with antibiotherapy and good oral hygiene.

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.

In 33 patients with peptic ulcer which were included by radiologic and clinic examination and history were evaluated for hematologic values. These patients should not have a history of gastrointestinal hemorrhage and occult blood and parasites in stool. These patients group were compared with 10 normal people who had not peptic ulcer and gastric compliants and no prominent anemia. At the end of the study; the patient group had a ligde dillerence from the normal group in 1lb, red blood cell count, PCV. There was important dillerence between the values of iron and total Iran binding capacity.

Amaç: Çocukluk döneminde Epstein-Barr virüsüne (EBV) nedenli enfeksiyöz mononükleoz olguları yüksek sıklıkta görülmektedir. Akut EBV enfeksiyonu belirti ve bulguları farklı klinik tablolarla kendini gösterebilmektedir. Çalışmamızda çocuklar arasında yaş ve yüksek riskli yaş gruplarına göre akut EBV enfeksiyonlarının klinik sunumunun incelenmesi amaçlandı.

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children.

Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively.

Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups.

Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.

in this manuscript a cervical vagal schwannomo is reported. Von Reckiirzklıausen disease was associated to the schwannoma. The relationship between two entilles is discussed. The imporiance of the vagal schwannoma in the dillerantial diagnosis of the head-neck massed rs impressed and the pertinent literature reviewed.

Aim: It was aimed to discuss a rare case which was diagnosed as Goldenhar syndrome. Case Report: Goldenhar syndrome is a defect of the structure arising from first and second branchial arches. The hereditary pattern is mainly sporadic, except for some autosomal dominant and recessive cases. It may be diagnosed by the detection of the external, middle and inner ear abnormalities, epibulbar dermoids, facial and vertebral anomalies. In the course of time the disability of speech and language have occurred in the patients with Goldenhar syndrome and early detection of these communication disorders is necessary in order to take precautions. Conclusion: A 10-month-old female case who has dysmorphic features consistent with Goldenhar syndrome, such as preauricular tag, hemifacial microsomia and ear abnormalities has been presented in this report.

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.

Tracheal stenosis related to prolonged intubation is a important clinical problem, currently. Its incidence has decreased with recognition of its etiology and modifications in the endotracheal and tracheostomy tubes. A tracheal stenosis related to prolonged intubation was detected by three dimension computed tomography and bronchoscopy in a 46-year-old man. Although the bronchoscopic dilatation, stenosis recurred. Therefore the tracheal sleeve resection was performed. We aimed to emphasize the diagnosis and treatment in the tracheal stenosis related to prolonged intubation.

To present a patient who was diagnosed as Preterm Premature Rupture of Membrane at 17th gestational week, she didn’t accept termination of her pregnancy and followed up for 14 weeks period. The patient was 35 years old and had 17 weeks pregnancy estimated using the date of the patient’s last menstrual period, referred to our clinic with vaginal discharge. The patient hospitalized for fetal and maternal monitoring with diagnosis of Preterm Premature Rupture of Membrane because of continued vaginal discharge at anamnesis, positive result at nitrazine paper and decreasing amniotic fluid on ultrasound. The family was asked for termination of pregnancy but they wanted to continue pregnancy. The patient was followed up for 14 weeks period with giving antibiotics. The patient’s labour started spontaneously on 31 gestational age, increased cervical dilatation at vaginal examination so that the patient was delivered by cesarean section. On first postoperative day the patient complained from swelling at left leg so left extremity venous doppler was performed and acute deep vein thrombosis was detected. Because of shortness of breath with continued fever at the patient, contrast computerized tomography and pulmonary angiographytaken with the preliminary diagnosis of pulmonary thromboembolism. The absolute result was pulmonary thromboembolism. The patient was discharged without any problem on 10th postoperative day for use warfarin sodium (Coumadin®, Zentiva, İstanbul )5 mg / day po. The prevalence of thromboembolic events among women for whom extended bed rest is prescribed as part of the treatment of premature labor or preterm premature rupture of membranes is significantly increased with respect to that among pregnant women who do not receive this therapy

 

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.

 

Melkersson- Rosenthal syndrome (MRS) is a rare disorder of unknovvn etiopathogenesis. This syndrome is characterized by a triad of recurrent orofacial edema, relapsing facial palsy, and scrotal tongue. İn this report a 24 year old man with the typical clinical symptoms and signs of MRS is reported. İn addition, the literatüre on MRS is revievved with respect to incidence, etiology, clinical features, pathology, diagnosis and treatment.

STUDY AIM: In this study, it was aimed to identify the accurate and inaccurate conceptions among the society on COVID-19 disease, which is considered as a public health problem and has a high risk of transmission. 

METHODS: The research was performed online at https://docs.google.com/forms in May 2020. The questionnaire form was composed of 40 queries, which were on sociodemographic characteristics and COVID-19. Following the study, the answers obtained from the questionnaire were analyzed by inserting related data to the software of SPSS. 

RESULTS: Of 580 participants involved in the study, 363 (62.6%) were female. The median age of the participants was 34.0 (18.0-77.0). Of the individuals who completed the questionnaire, 342 (59.0%) were married and 438 (75.5%) were university graduated and / or postgraduated. Of the individuals included in the study, 497 (85.6%) stated that they watched television / news channels to be informed about COVID-19. Most of the questions related to COVID-19 were answered accurately by the participants. The percentage of the premise, which was answered most accurately, was 577 (99.5%), whereas the lowest percentage of the accurately answered premise was 137 (23.6%). It was found that there was a statistically significant difference among the genders in terms of the percentage of accurate responses to the conceptions (p<0.05).

CONCLUSION: It was determined that the vast majority of the participants utilized from at least one news resource on COVID-19. Participants typically have accurate knowledge about COVID-19. Educational programs can be planned to enhance the awareness of the society about the conceptions, which were answered mostly inaccurately.

Aim: Spinal arteriovenous malformation is a rare pathology located in the dura along the spinal canal. Multi-detector computed tomographic (MDCT) angiography is a recently developed imaging technique. We present findings of magnetic resonance (MR) imaging and multi-detector computed tomographic angiography in 16-year-old patient with spinal arteriovenous malformations. Case report: MR images showed signal voids dilated vessels at the surface of the spinal cord at C1-2 level. Also, multi-detector computed tomographic angiography demontrated dilated varix-like vessels. The patient was diagnosed as having a spinal arteriovenous malformation. Result: Multi-detector computed tomographic angiography can be a non-invasive usefulness technique in detect the spinal arteriovenous malformatios.

In this present investigation the relationship between surgical travma and plasma zinc concentration preoperatively and postoperatively was studied in 20 patients. We established that surgical travma produced a sharp decrease in serum zinc concentration. We can not found any corelation between this decrease and urinary zinc extration.

ANTEGRAD URETERAL STENTING; INDICATIONS - METHODS - COMPLICATIONS AND RADIOLOGICAL APPROACH TO  COMPLICATIONS

 

Abstract:

Objectives

The aim of this study is to evaluate the indications, success rate, complications, technical success enhancing method, methods of antegrad ureteral stenting and the radiological management of complications due to retrograde and antegrade ureteral stenting in the treatment of ureteral obstructions and ureteral leaks caused by malignant and benign etiologies.

Materials and Methods

In this retrospective study, fluoroscopy and US-guided antegrade ureteral stenting procedures between January 2016 and December 2018 were examined. The study included 110 antegrade ureteral stenting and percutaneous nephrostomy in a total of 78 patients with 25 female patients (32.05 %), a mean age of 65.87 (20-90) and 53 male patients (67.94%) with a mean age of 68.73 (30-90).  Demographic data, antegrade ureteral stenting indications, procedure results and complications were evaluated for each patient.

Results

Antegrade ureteral stenting is a good alternative for patients with retrograde ureteral stent placement and already with percutaneous nephrostomy catheters. It has a high technical success rate and low complication risk. The use of the equipment used in other radiological procedures in antegrade ureteral stenting increases the technical success. Malposition,  perforation, hemorrhage, urinoma, abscess complications such as retrograde or antegrade ureteral stenting can be managed by radiological methods.

Key Words: Double J Ureteral stent, Ureteral obstruction, Percutaneous, Antegrade, Hydronephrosis,

In this light microscopic study, the effects of age and sex on the thickness of epidermis and the number of melanocytes were determined in human skin samples by using histological methods. Skin samples from a group of various ages including 10 men and 10 women were fixed in 10 % formaldehyde solution.The formalin fixed skin samples were processed using routine histologic procedures and embedded in paraffin. In this study, the most consistent results are in the epidermis of aging individuals is flattenning of the dermo-epidermal junction and decreased number of dermal papilla. However, it was found that numbers of melanocytes in epidermis decreased with age and changed with sex. Consequently, there is a significant statistical difference between epidermis thickness and age ( p< 0,0001 ). However, a high negative correlation was determined between epidermis thickness and age ( r= -0,8047). In conclusion epidermal thickness decrease %80 with age. But there is a no significant statistical difference between epidermis thickness and sex ( p= 0,7622). Also, there is a significant ( p

Propolis is a resin collected by honeybees from various plant sources, has attracted the attention of researchers due to its several biological and pharmacological properties in recent years. The aim of this study was to investigate the antimicrobial activity of ethanolic extract of propolis (EEP) collected in Kayseri and its surroundings against some clinically important microorganisms. In the study, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori, Candida albicans, Candida glabrata strains were used and agar dilution method was performed to investigate of antimicrobial activity according to the CLSI. By using microbroth kinetic system based on continuous monitoring of changes in the optical density of bacte¬rial growth, turbidimetric growth curves of a model bacteria (S.aureus) in the presence of increasing concentrations of EEP were also generated and determined minimum inhibitory concentration (MIC). MIC values of EEP against tested microorganisms were found between 64 and 1024 µg/ml by agar dilution method. The results in microbroth kinetic system were similar to the agar dilution method for S.aureus and in vitro antimicrobial susceptibility was determined in an earlier stage. Kayseri propolis have shown antimicrobial activity against common pathogens, is important to evaluate the availability of treatment.

Oro-facio-digital syndrome, a group of congenital anomalies, is characterized by malformations of the oral cavity (cleft palate and tongue, abnormal dentition, high arched palate, tongue lobulation, hamartomata on the tongue), face (frontal bossing, facial asymmetry, hypertelorism, facial milia), and digits (syndactyly, brachydactyly, clinodactyly, polydactyly. This syndrome has nine different types. Oro-facio-digital syndrome type I (OFDS1) is the most common type, which identified by French dentists Papillon Leage and Psaume Jean, in 1954. OFDS 1 is an X-linked dominant condition that is lethal for males. OFDS 1 is a rare syndrome, occurring in approximately 1/250,000 live births. Approximately 75% of cases are sporadic. There is no specific therapy for OFDS 1 other than surgical correction of the dysmorphic features. Being a rare entity, this paper presents a case of OFDS 1 in a newborn.

İn our study, kVe have aimed to search the findings seen on the tissue specimens taken from the liver, kidney, ovary, testis and pancreas of many rats that have been poisoned by long- term high doses of florid. Twenty rats which belong to VVistar Albino species were being eçually separated into two groups, one is as the experimental group, the other as the control group [10 (5 male + 5 female) + 10 (5 male + 5 female)]. For a 17 weeks time, drinking water consisting of 1 ppm florid to control group and consisting of 150 ppm florid to experimental group has been given. Pieces taken from the tissue specimens of the liver, kidney, spleen, ovary, testis and pancreas were being examined under the light microscope. İn the experimental group, the following findings were being obtained: İn peripheral lobule of the liver, focal sinusoidal dilatations, in the portal area, lymphocyte infiltration; in hepatocytes a liftle hydropic and vacuolar degeneration; in the kidney either in proximal or distal tubule, a liftle hydropic degeneration were being determined. There hasn’t been seen any pathology in the spleen, ovary, testis and pancreas sections taken from the experimental group. As a result, it was determined that high doses of florid causes minimal structural changes primarily in the liver tissue and then in the kidneys, besides it has no considerable effect on the testis, ovary, spleen and pancreas tissue.

in the present in-vitro study, the effeets of Cyclospoı-in A (Cs A), ascorbic acid (vitamin C) and tx-tocopherol (vitamin E) on the acetylcholine (Ach)- induced relayation responses in the rabbit ıhoracic