Makale Arama

\r\n Aim: The aim of this study is to determine the relationship between pregnancy outcomes and histopathology examination of the intended placenta and umbilical cord specimens.

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\r\n Patients and Methods: 112 placenta materials were scanned as retrospective in an archive of Usak University Education and Research Hospital of Pathology Department. Term placentas measurement were based on Kaufmann’s Pathology thus; 37-40 week, size 18 cm, weight 350-750 gr, thickness 2-2,5 cm. Umbilical cord's vessel number, membrane structure, chorioangioma, infarct, hematoma, hemorrhage were recorded. Infarct, chorioamnionitis, subchorionic fibrin deposit, congestion of chorionic vessel, subchorionic hemorrhage, corangiosis, chorioangioma, calcification, perivillous fibrin deposit, an effect of meconium, fibrinoid necrosis, villitis, ectasia of a chorionic vessel were detected as histopathologic findings. Gender, mode of delivery, maternal disease, birth weight, maternal age, parity, birth length, head circumference, APGAR between 0-9 were recorded.

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\r\n Results: 112 placentas; 4 of 29 (13,7%) placental infarct, 2 of 19 (10,5 %) placental corangiosis, one of 17 (5,8%) subchorionic haemorrhage, 2 of 29 (6,8%) chorioamnionitis, one of 12 (8,3%) umbilical cord congesione cases were detected with abnormal pregnancy outcomes. Statistically significant results were found between subchorionic haemorrhage and placenta size (P = 0, 004), maternal age and umbilical cord dimension (P = 0, 0001), birth weight and placenta and umbilical cord dimensions (p = 0.000). However, no association was found between these parameters and pregnancy outcomes. Relationship between baby weight and placenta and umbilical cord size was determined in diabetic, preterm, ablatio placenta, and stillbirths and pregnancies. No significant association was found between histopathologic findings and pregnancy outcomes.

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\r\n Conclusion: When placenta and umbilical cord specimens are evaluated, the location and size of the lesion should be indicated along with the presence of the lesion in order to explain regular clinical follow-up and adequate anamnesis as well as the effect on the pregnancy outcome.

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We aimed to compare the effects of 20 % mannitol, 3 % or 7 % hypertonic saline on hemodynamic parameters, intracranial pressure and electroencephalography in experimental head trauma. Bilateral craniotomy were carried out in the parietal region and standart head trauma was applied for all rabbits. The rabbits were randomly divided into four groups. In group I rabbits were only observed. In group II: 20 % mannitol, in group III: 3 % hypertonic saline and in group IV: 7 % hypertonic saline was administered intravenously to achieve similar osmolar load. Electroencephalography, mean arterial pressure, heart rate, intracranial pressure were recorded before trauma and 5 and 60 minutes after trauma. Increased intracranial pressure was significantly decreased by mannitol, 3 % and 7 % hypertonic saline solutions at the end of study (p0.05). The mean arterial pressure and heart rates increased after trauma in all groups (p

Successful management of inguinal hernia depends on not only prevention of recurrence but also patient comfort. Although recurrence is lower in procedures using prosthetic meshes, complications related to these meshes negatively affect patient comfort. The procedure described by Desarda, draws attention due to lower recurrence, conformance to physiology and higher patient comfort. In this study we present results of patients treated using desarda procedure. Seventy two patients admitted to our clinic with inguinal hernia between 2010 and 2012 and treated using Desarda procedure were included in this study. Patients with recurrent inguinal hernias, femoral hernias, patients below 18 years of age and patients with systemic disease excluded. Demographic properties, types of hernias, postoperative complications and recurrence of the patients were recorded. Of the patients, 71 were male and 1 was female. Median age was 51 (range 18-85). Median operating time was 34.7±11.5 for single sided cases and 76.1±15.4 minutes for bilateral cases. Mean hospitalization was 1.02 days (range 1-2), mean follow up was 22.0±4.2 months. Early recurrence was observed in 1 (1.3%) patient at 6th month. One (1.3%) patient had scrotal edema, 3 (4.1%) patients had edema of spermatic cord, 2 (2.7%) patients, one of these using anticoagulant, developed hematomas. None of the patients required analgesics beside routinely used non-steroid analgesics and no neuralgia was observed. Desarda procedure is a remarkable technique for treatment of inguinal hernias of suitable patients, which is non-expensive, easy to learn and more physiologic technique providing lower recurrence and higher patient comfort.

We tried to explain the patologic reason of tinnitus in 'his search. Our searchment showed that even alt efforts no pathology was observed in the rnajor wrıouni of our patients. On the other hamd we observed %44 acoustic trauma, taba dy,sfonction, ototoxicity and head traurna in our patients. Alsa pulsatil tinnitus was observed in seven cases.

Diagnostic and therapeutic cardiac catheterization attempts have recently been increasing. Numerous complications may develop after cardiac catheterization, including local complications, such as thrombosis, pseudoaneurysm, arteriovenous fistula, bleeding, infection, and distal embolization at the catheter insertion site, as well as complications associated with the anesthetic agents, such as respiratory depression, tachycardia and bradycardia. A total of 120 patients, who underwent cardiac catheterization between June 2010 and June 2012 were retrospectively evaluated. The patients were aged from 9 days to 15 years (mean 3.5±4.2 years) and 58 (48%) were female and 62 (52%) were male. Of the 120 patients, 102 (85%) underwent a diagnostic cardiac catheterization procedure, whereas in 18 (15%) patients an interventional procedure was performed. Complications were encountered in 7 (5.8%) patients, aged from 9 days to 15 years (3.5±4.2 years). There were femoral hematoma in two patients, femoral bleeding in one patient, femoral thrombosis in two patients, bradycardia in one patient, and a patient developed respiratory arrest during sedation (with midazolam). Femoral venous thrombosis, which was seen in two patients, was treated with low molecular weight heparin in one case and with low molecular weight heparin and pentoxifylline in the other. Two patients who developed femoral hematoma underwent local treatment. One patient developed resistant bradycardia, for which a temporary pacemaker was inserted. A patient with femoral hemorrhage was treated with protamine sulfate. One patient, who developed respiratory arrest due to midazolam, was treated with respiratory support. All patients were discharged in a good condition after the treatment. The complications in patients who underwent cardiac catheterization in our clinic, and the risk factors for these complications were analyzed retrospectively. Patients undergoing cardiac catheterization should be closely monitored in terms of possible local and general complications. The incidence of the complications can be reduced by taking appropriate measures. The morbidity and the mortality can be reduced by early diagnosis and treatment of the complications.

Retrospectively evaluated patient with thoracic trauma who were hospitalized and treated at chest surgery clinic from january 2005-july 2009 A total of 255 patient(220 male-35 female mean age 38.2) with thoracic trauma were evaluated with respect to etiology¬ thoracic pathologies assosiated injuries and treatment methods. Blunt and penetrating thoracic injuries were found in 167 and 88 patients .Respectively the most common cause were traffic accidents (%78) and stab wounds, (%92) for blunt and penetrating thoracic injurıes.The most frequent thoracic pathologies were soft injurıes(%35) followed by pneumothorax(%24), multpl rib fractures ,(%21) hemopneumothorax(%20) and hemothorax(%17).Extrathoracic injurıes were seen in 60(%23.5) patients .The most common being cranial(%45) ,extremity injuries(%38) and abdominal (%18.3). Treatment was conservative 53 patient (%20.78) tube thoracostomy (n- 167 %67.49)diapragmatic repair or bleeding control with thoracotomy (n-35 %13.7). Mortality occured in 3 patients (%1.17) It is important that thoracic trauma patients with increased risk of mortality and morbidity should recieve immidiate and systematic treatment

The liver is the most frequently wounded organ in the abdominal traumas and the rate of mortality is still very high. We aimed to present a case that was treated with non-operative methods which led to hepatitis because of increase in intraparenchymal hematoma in the late period. Seventeen-year-old male patient who had liver laceration after blunt abdominal traumas was treated with embolectomy due to liver hematoma. In late period, liver parenchymal hematoma can be increased and patients can develop hepatitis because of increased hematoma pressure on intraparenchymal biliary tract and this situation can be effectively treated with non-surgical methods.

The Analysis Of 127 Patients With Congenital Dislocation Of The Hip 127 cases with congenital dislocation of the hip were determined at tlıe Department of Orthopedic Surgery of the Medical School of Selçuk University, between March 12, 1983 and November 11, 1984. 23 (18 per cent) were boys, 104 (82 per cent) were girl.s of the patients. The dislo-cation of the hip was on the right hip in 24 cases (18 per cent), on the left hip in 28 cases (23 per cent), and on the bilateral hip in 75 cases (59 per cent). 57 per cent of the cases were firt child of the family. The diag-nosis of congenital dislocation of the hip was made in 0 age period in 62.3 per cent of the cases. it has been determined that swadling clothes has been applicated in 97 per cent of the cases between one to eighteen months. 40 per cent of the cases were treated concervatively 26 per cent of the cases were treated by surgery (iliac osteotomy), in 15 per cent of the cases the treatment was delayed. and no treatment was performed in 19 per cent of the cases.

Caesarean delivery is preferred to vaginal delivery in the breech presentation because it is safer. In this case report, we aimed to present femur fractures associated with cesarean section as a rare complication of breech presentation. A 2670g male infant was delivered at 36 weeks by emergency cesarean section for breech presentation. On the third day after the birth, he was admitted to our hospital with a preliminary diagnosis of cellulitis because of swelling in the right leg. The examination revealed a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae. Caesarean delivery reduces the risk of traumatic injury of the newborn compared to vaginal delivery, but does not eliminate this possible accidental complication.

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

Purpose: to evaluate the ocular and periorbital anthropometric measurments in young adults and adults. Methods: Our study were enrolled two different age groups, first group (young adults) was consisted of 200 medical students aged between 18 to 21(19.73±1.6) years, and second group (adults) consisted of 150 patients aged between 42 to 65 (52.48±9.2) years who were examined in department of opthalmology. Cases with history of trauma and congenital anomaly were excluded from the study. In all cases the intercanthal distance (ICD), the outercanthal distance (OCD), the interpupillary distance (IPD), the palpebral fissure height (PFH) and the palpebral fissure distance (PFD) were measured. Measurments were performed by the same examiner using a single electronic compass instrument. In both groups the measurments between males and females as well as the measurments of the same gender between the both groups were compared. Results: In the evaluation of the measurments, in ICD, OCD and IPD there was statistically significant differencess between the genders (ie male/female) in same group (p<0.05), while there was no statistically significant differencess between the gender in the same group, while there was statistically significant differencess in between the two groups (p<0.05), and in PFH there was statistically significant differencess between the genders in the first group (p<0.05), however there was no such defferencess in the second group (p>0.05). Conclusion: Our results on one hand and the contrary results of other studies on the other hand, arise the need for further studies including different ages and ethnics groups to set standarts for ocular and periorbital anthropometric measurments. These measurments in healthy subjects may be useful guide for early identification of some dysmorphological abnormalities and of planning surgical intervention.

Aim: To highlight the neurovascular complications of hemodialysis and discuss the therapeutic approaches with the relevant literature. Case Report: A 19- year old man on maintenance hemodialysis who admitted to our clinic with intracerebral hematoma is discussed. Conclusion: Neurovascular complications are being recognised as the major causes of mortality and morbidity in hemodialysis patients. Prevention of neurovascular complications of uremia and accelerated hypertension requires the cooperation of both the neurologists and nephrologists.

Trauma is stili an important mortality and morbidity cause among the young population in the world. Therefore, trauma should be seriously considered in view of medical and social factors. İn this study, it was aimed to inves- tigate the types of trauma in respect to reasons, and to provide data to epidemiologic Information of our country. Between January 1999 and December 1999, totally 2850 cases with trauma [(2051 male (72%) and 799 female (28%)] applied to Emergency Department of Selçuk University, Meram Medical Faculty, were analyzed retro- spectively. AH cases were evaluated according to their sex, age, type of trauma, time of trauma, the duration betvveen the onset of trauma and application time to the Emergency Service, and type of transportation. 2332 (82%) of cases were aged betvveen 0 and 40 years. 1593 (55.9%>) of the cases had trauma due to car-crush. Only 885 cases (31.1 %) were transferred to Emergency Service vvithin 1 hour. Most of the trauma occurred on Sundays (n=467, 16.4%), and in June (n=342, 12%>). The most frequent reason of the trauma was found to be fail (50.5%). İt was concluded that, in the organisation of trauma, the vvounded subject should be transferred to the nearest trau­ ma çenter, according to the degree of his/her trauma.

This prospective study was undertaken to cornpare the results of peritoneal lavage and ultrasonography in 30 patients with blunt abdorninal trauma admitted to etnergency room in two years. We performed ultrasonography and peritoneal lavage respectively. The physicians who evaluated peritoneal lavage were unaware of ultrasonographic results. Sixteen patients whose results of ultrasonography and peritoneal lavage were positive were operated on. Of 30 cases, 14 were true positive, one falso positive, 13 true negative and tıvo incleterminate in ultrasonography. There were 14 true positive tesis in ultrasonography and peritoneal lavage, equal to each other (93%). The accuracy raie of true negative patients was 86% in ultrasonography and 100% in peritoneal lavage. We believe that ultrasonography is as useful as peritoneal lavage in patients with blunt abdorninal trautn.a ı-vhen it is perfortned by experienced physicians and with new technical development in the field of ultrasonography.

This prospective study was undertaken to cornpare the results of peritoneal lavage and ultrasonography in 30 patients with blunt abdorninal trauma admitted to etnergency room in two years. We performed ultrasonography and peritoneal lavage respectively. The physicians who evaluated peritoneal lavage were unaware of ultrasonographic results. Sixteen patients whose results of ultrasonography and peritoneal lavage were positive were operated on. Of 30 cases, 14 were true positive, one falso positive, 13 true negative and tıvo incleterminate in ultrasonography. There were 14 true positive tesis in ultrasonography and peritoneal lavage, equal to each other (93%). The accuracy raie of true negative patients was 86% in ultrasonography and 100% in peritoneal lavage. We believe that ultrasonography is as useful as peritoneal lavage in patients with blunt abdorninal trautn.a ı-vhen it is perfortned by experienced physicians and with new technical development in the field of ultrasonography.

This prospective study was undertaken to cornpare the results of peritoneal lavage and ultrasonography in 30 patients with blunt abdorninal trauma admitted to etnergency room in two years. We performed ultrasonography and peritoneal lavage respectively. The physicians who evaluated peritoneal lavage were unaware of ultrasonographic results. Sixteen patients whose results of ultrasonography and peritoneal lavage were positive were operated on. Of 30 cases, 14 were true positive, one falso positive, 13 true negative and tıvo incleterminate in ultrasonography. There were 14 true positive tesis in ultrasonography and peritoneal lavage, equal to each other (93%). The accuracy raie of true negative patients was 86% in ultrasonography and 100% in peritoneal lavage. We believe that ultrasonography is as useful as peritoneal lavage in patients with blunt abdorninal trautn.a ı-vhen it is perfortned by experienced physicians and with new technical development in the field of ultrasonography.

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

Betvveen the period December 1999 and February 2001, 93 women who undervvent excision biopsy of the breast were included into a controlled randomized trial to determine the effect on postoperative morbidity and hospital stay of drainage of the biopsy cavity. Among the 93 patients, drain was used in 45 (group I) and 48 (group II) had no drain. The vvounds were examined seven days after operation vvith ultrasonography. Collections such us haematoma or seroma were present in 41 (%91.1) patients with undrained vvounds compared with 39 (%81) patients wuth drained vvounds. Median collection volüme was 30.67 ml±24.87 (SD) (range 0-140) in the undrained group and 25.00±16.47 mİ (SD) (range 0-80) in the drained group. There vvas one infection (% 2.2) in undrained group and two (% 4.1) in drained group. While there vvas no significant difference betvveen two groups in terms of vvound infection and seroma (p>0.05), the length of hospital stay vvas statistically longer in drainage group (p<0.01). We conclude that breast biopsy cavity drainage with penrose drain, does notprevents vvound collections and infections.

Coronary artery spasm is a special type of ischemic heart disease characterized by spontaneous episodes of chest pain accompanied by transitory ST segment elevations during the episodes. This syndrome may be associated with acute myocardial infarction, ventricular tachycardia or fibrillation, as well as with sudden death. Psychosocial stresses are also associated with an increased risk for acute myocardial infarction. We reported a 23 years old, male patient who applied to the emergency department for ongoing chest pain which had begun just after psychosocial trauma arising from heavy business tempo. He had neither ECG, nor cardiac enzym changes during admission, however acute MI with ST elevation occurred while following up period. There was no stenosis in coronary arteries on angiography. Given the typical symptoms, an ergonovine test was considered unnecessary. Administration of Ca-channel blocker and nitrates ameliorated his symptoms. The patient was prescribed a calcium channel blocker at discharge and has had no further chest pain. Finally, we thought that the cause of acute myocardial infarction for this young patient that occurred after vasospasm might be due to sympathetic hyperactivity and psychosocial stresses resulting from heavy work load conditions.

Mesenteric panniculitis is a situation which effects adipose tissue of the mesentery with inflammation and fibrosis. There may be symptoms like stomachache, nausea, vomiting or asymptomatic. Trauma, abdominal surgery, infection are the main causes and recently its association with the malignancy has been increased. We reported asymptomatic mesenteric panniculitis in a patient with chronic lymphocytic leukemia that hasn’t been experienced before in the literature.

Hereditary angioedemais a genetic autosomal dominant disease caused by C1-esterase inhibitor protein (C1INH) deficiency that sometimes results in death due to obstruction of upperair ways from severe edema. Here in, we present a young male,who secon dition was known before, faces a severe brea thing difficulty because of uvula and diffuse face edema after a minor travma on his head. His condition rapidly and complete lyimproved with in 2 hours after two units of fresh frozen plasmain fusion.

Both auditory and visual evoked cortical po-tentials have been recorded in 52 amateur boxers. It has been clinically found that of these boxers, two had horizontal nistagmus, two had insecurity in do-sed-eye walking, one had psychotic reaction (%9.8). None of the visual evoked potentials has shown pat-hology. In the studies of auditory evoked potentials, it has been found out that the latency of the 5th wave in boxers showed pathological increase. Findings have been discussed in the light of the biome•hanics of chronical traumatic encephalopathy syndrome. It has been concluded that the evoked potential studies do not contruhute to the determination of chronic traumatic encephalopathy syndrome in its early stage.

To inform the doctors and nurses working in intensive care units about the pain in newborns, its effects on neonatal development, and the use of nonpharmacological methods for effective pain management. Newborns are challenged by several painful stimuli because of diagnostic and therapeutic preoperative invasive procedures, surgical trauma, and postoperative invasive procedures in the neonatal intensive care units. These babies face physiologic, psychological, and metabolic consequences because of pain. Pharmacologic and nonpharmacological methods are regarded as complementary in effective pain management. Studies showed that nonpharmacologic methods themselves are not only effective in management of pain resulting from invasive procedures but they also increase the effectiveness of medical therapy when used in combination.

During nine years (1976 - 1985) 80 patients with upper extremity arterial injuries after shotgun, cunt trauma etc. were treated surgically. Earliest admission was two his and latest was 18 his. 66 of patients had uneventful recovery and 14 were palliated with acceptable results. This article emphasises the importance of such injuries and early admission to a vascular surgical unit.

Multiple intracerebral hemorrhage represents 2 % of ali intracranial hemorrhages. Multiple intracerebral hemor- rhages have been known to occur most frequently in patients with coagulation defects, neoplasms, angiopathies or sinüs thrombosis. The finding of recurrent intracerebral hemorrhages is not unusual in patients with systemic arterial hypertension, but simultaneous occurence of multiple hemorrhages is rare in these patients. However, multiple spontaneous intracerebral hemorrhages vvithout an identifiable etiology were also reported in the literatüre. Here, we describe a hypertensive patient who developed multiple intracerebral hematomas. The patient had bilateral thalamic hematoma that extended the lentiform nucleus. There was apathy, loss of emotional concern, upvvard gaze palsy, tetraparesis and hypertensive retinopathy in the neurologic examination. Conditions other than hypertension that might cause intracerebral hemorrhage were excluded by laboratuary investigations.

It is claimed that the use of ultrasound-assisted liposuction in bodyshaping surgery produces less blood loss and more skin contraction than conventional liposuction. In the literature, however, we could not find any studies comparing the efficacy of conventional liposuction with ultrasonic liposuction in the treatment of arm contour deformities. In this study, therefore, it is aimed to compare the efficacy, complications and bleeding rates of conventional liposuction with ultrasonic liposuction in the treatment of arm contour deformities. Twenty patients with the complaints of arm contour deformity during the period of 2012-2016 were included in the study. All of the patients were treated with liposuction. The patients were divided into two groups; ultrasonic liposuction (Group 1; n: 10) and conventional liposuction (Group 2; n: 10). Necrosis was defined as a major complication. Seroma, hematoma, asymmetry and roughness in the skin were defined as minor complications. The location of the thickest part of both arms of patients in both groups were measured at the end of the surgery and at the end of the first postoperative year. A total of 5 ml lipoaspirate samples were taken from each patient intraoperatively. The specimens were stained with hematoxylin-eosin and the numbers of erythrocytes per unit area were determined. According to Triceps Skin Classification, 4 of the patients were Type 2, 3 were Type 3 and 3 were Type 4, in Group 1. In Group 2, 3 of the patients were Type 2, 3 were Type 3 and 4 were Type 4. The average arm circumference of the patients in Group 1 was 36 cm (minimum 32 cm - maximum 40 cm), while in Group 2 the average arm circumference was 35 cm (minimum 31 cm - maximum 39 cm). At the end of the operation, the average arm circumference of the patients in Group 1 was 31 cm (minimum 28 cm - maximum 32 cm) while in Group 2 the average arm circumference of the patients was 32 cm (minimum 28 cm - maximum 33 cm). At the end of the first postoperative year, the average arm circumference was decreased to 30 cm in Group 1 and 31.8 cm in Group 2. Moreover, the number of erythrocytes calculated in cm2 in Group 2 was 50-60 / 1HPF (HPF: high power field) at 40x magnification and this value was calculated as 20 / 1HPF in Group 1. The mean arm thickness before the surgery was similar in both groups. However, the mean postoperative arm thickness of the patients in Group 1 was significantly lower than Group 2 (p <0.05). Moreover, the number of erythrocytes seen in the lipoaspirate unit area was significantly lower in Group 1 than in Group 2 (p<0.05). In this study, we have demonstrated that ultrasonic liposuction could provide more skin contraction in the treatment of arm contour deformities with appropriate patient selection. In this indication, a better appearance can be obtained with less sagging compared with conventional liposuction.

Nd-YAG laser iridotomy was applied to 23 (676 %) patients with narrow angle glaucoma, 6 (17.6 %) patients with secondary angle closure glaucoma (secondary angle closure caused by trauma, uveitis etc.) and 5 (14.7 %) patients with acute glaucoma crisis. Because of avascularity or little vascularity, preferentially upper nasal or upper temporal pe-ripheral iris regions were chosen for the iridotomies. The mean laser energy applied to the patients was 63.7±18.4 mJ. Small irldotomies were enlarged because of corneal edema in three patients with angle closure glaucoma. Ir) 27 (79.4 %) patients, mild to moderate hemorrhage was observed. In 26 (76.5 %) patients, iritis developed within 1-5 days pos-toperatively. After iridotomy, a rise in intraocular pressure in the first 24 hours was observed in 15 patients (44.1 %). During monthly follow-up. there were no changes in visual acuity and visual field analysis.

\r\n Synesthesia is a phenomenon in which stimulation of one sensory system leads to a different experience in a second sensory system. There is more than sixty types of Synesthesia, like grapheme-color, sound-color (chromesthesia), sound-movement, sound-flavor, color- flavor etc. have been identified so far. Synesthesia is seen in 4% in general population. The grapheme-color and sound-color Synesthesia are the most common types. A case is discussed that has auditory-visual and smell-color types Synesthesia started at 6 yo but currently she has had fewer symptoms than before. An active psychiatric pathology is not found in clinical evaluation.  There is neither significant patient history nor family history for psychiatric disorders other than a younger sister who has similar symptoms. She has not experienced any seizures or trauma. Her MRI and EEG were within normal limits. Functional MR imaging showed greater activation in the cerebral hemisphere that indicate lateralization. Since there is a positive familial history, we might consider genetic predispositions.

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The excessive maternal alcohol drinking results in Fetal Alcohol Syndrome which is a pathology caused by the embryotoxic effects of ethanol in prenatal period. The mechanisms of ethanol action at the cellular or molecular levels are scarce. In this study it was aimed to investigate the effects of ethanol on growth and development of mammalian embryos as well as the morphological structure and the role of free radicals on these effects. Wistar rats were obtained from the Selcuk University Experimental Medicine Research Center and their 9.5 days embryos were explanted and cultured for 48 hours in rat serum. Whole rat serum used as a culture medium fort he control group while different concentrations of ethanol (250-500 mg%) were added tor at serum fort he experimental groups. Also, the lowest effective concentration of ethanol for all parameters was added to the culture media in the presence of an antioxidant superoxide dismutase (SOD). Ten embryos were used for each experimental condition. Dose-dependent effects of ethanol on embryonic developmental parameters such as; total morphological score, yolk sac diameter, crown-rump length, somite number, embryo and yolk sac protein contents were compared using morphological and biochemical methods. Each embryo was evaluated for the presence of any malformations. Compared to the control embryos, ethanol significantly decreased all developmental parameters döşe-dependently (p<0.05) with an increase in overall dismorphology. The haematoma in different regions, especially in the neural tube was most frequently observed. When the SOD was added to theculture media in the presence of ethanol, growth and developmental parameters were improved (p<0.05) and there was a decrease in the incidence of malformations (p<0.05). A döşe dependant developmental toxicity of ethanol on rat embryos during organogenesis wasdetermined, these effects might involve free oxygen radicals.

Novvadays, patients suffering from blunt abdominal trauma are examined by abdominal ultrasonography, routinly. Subcapsular bleeding of the spleen in these patients can be overlooked if there isn't free fluid in the abdominal cavity, ultrasonographic examination carried out in suboptimal contitions and after the trauma attention was in- tensified on the Central nervous system injury. İn 3 cases who have been examined by abdominal ult­ rasonography just after the trauma, any pathological finding was not been determined related with their spleen also examined by upper abdominal computed tomography because of their some complaints after the trauma (1 wk-1 yr) and splenic subcapsular hematomas were establised in these patients. İn patients with delayed de- velopment of splenic subcapsular hematoma following abdominal trauma can cause late rupture of the spleen, so we think that the patients suffering from blunt abdominal trauma must be examined by the control radiological methods after the trauma.

Abstract

 

Objective

There is still no consensus on nonoperative management (NOM) for the treatment of patients with liver injury due to multiple trauma. In this study, we aimed to present our experience in patients who underwent NOM in our hospital due to liver injury resulting from blunt trauma.

Material & Methods

In this study, a total of 104 patients who presented to our hospital with liver injury due to multiple trauma were retrospectively evaluated. Patients with successful NOM and those who underwent laparotomy due to failure of NOM were grouped.

Results

All of the 104 patients had solid organ injury due to blunt abdominal trauma, and 58 of these had thorax trauma. NOM was successfully performed in 94 patients with liver injury due to blunt abdominal trauma. The treatment was converted to surgery in 10 patients during conservative follow-up. According to injury grades; 35 patients were graded as Grade 1, 23 patients as Grade 2, 24 patients as Grade 3, and 12 patients as Grade 4. Data of 10 patients with liver trauma and NOM failed were compared with those of the NOM group.

Conclusion

The development of complications increases in patients with high-grade injury or those accompanied by thorax trauma. The rate of complications is high in patients who receive NOM in Grade 4 injury.

In this study, 22 cases with frontal sinüs frac-tures, between 1989 and 1992, were examined and di-agnoses, treatments and complications of frontal sinüs fractures are revised. Most of the fractures were on the anterior table and causes were traffic accidents. CT is most valuable technique in diagnoses. Espe-cially the type and localization of the fracture must be initially identified and then managed to therapy. Although our follouw-up time is short, complica-tion rate is very low.

To analyse the clinical characteristics of globe lacerations known as the main cause of visual loss due to ocular trauma and determine the risk factors. Material and method: This retrospective study included perforating eye injuries followed at the Ophthalmology Department of Selcuk University. The following parameters of cases are recorded from registrations of our clinic: age, sex, affected eye, activity at the time of injury, causative agent, localization of injury, the length of time from injury to the initial examination in our clinic, initial visual acuity, surgical procedure, best corrected visual acuity measured at the last visit. Result: Of the 215 cases with perforating eye injuries 168 (78.1%) were male and 47 (21.9%) were female. The most common activity at the time of injury was home and work activities in 51.6% of cases caused by cutting and perforating matters in the majority. Analysis of injury localization revealed cornea as the most comman affected region in (110 cases 51.2%). The initial visual acuity was equal to or below 0.1 in 157 (77.3%) of cases. This number of cases decreased to 62 (31.5%) when the stabilised final visual acuity was determined. The surgical intervention was corneal or corneoscleral reparation in 149 (69.3%) cases, cataract surgery in addition to reparation in 52 (24.2%) cases, foreign body extraction in 5 (2.3%) cases and evisseration in 9 (4.2%) cases. Conclusion: Despite advances in technology, the high incidence of visual loss after perforating globe injuries pointed out the importance of preventive efforts. Increasing the knowledge of risk groups about eye injuries, taking the necessary preventive measures during risky activities would decrease perforating eye injuries.

Penetrating trauma of the spine can be rarely seen. A 28 year old male patient admitted to our emergency clinic with cutter injury. A two-centimeter skin incision was determined at the patient’s lumbar region. Neurological examination was with in the normal range. A metallic cutter tip was seen at the lumbar tomography and lumbar plain radiograph at the level of L1 corpus and L1-2 disc space. The patient operated at emergency settings. Under general anesthesia the patient was taken into left side lateral decubitus position. Previous skin incision enlarged to the anterolateral direction. Surgical dissection was advanced to the anterolateral direction from posterior aspect. Left L1 and L2 processus transversus was reached. Then the cutter tip was seen at the L1 corpus and L1-2 disc space just lateral from the nevre root. The cutter tip was withdrawn slowly without laminectomy. The main goal of the surgical treatment for neurologically intact patients with penetrating injuries is to remove the foreign object with minimal damage to the patient in the light of radiological studies. The foreign object should be removed from the spine because late neurological deficits can be seen in these patients.

The effects of both anesthesia and surgical intervention on the defense system have gained importance for patients and anesthetists today. Most of the immune changes seen in patients after surgery are caused either by the direct effect of anesthetic agents or as a result of these drugs contributing to surgical trauma and endocrine response. While the effect of surgery varies according to the size of the operation and the individual's stress response; The effect of anesthesia may vary depending on the breakdown level of the stress response, the immune status of the individual, the time of exposure to the anesthetic agent, the chemical structure of the preparation used and the anesthesia method (1,2,3). Although it has been suggested in many studies that surgical stress may be responsible for immunodepression seen in the postoperative period, some in vitro studies have also observed that anesthetic agents have an effect. The main difficulty in in vivo studies is to distinguish the effects specific to the anesthetic agent and the effects of many intraoperative factors (type-duration of surgery, body temperature, blood and plasma infusions, other diseases, basal immunological status, nutrition) (4,5).

It has been described that aldosteron response to trauma depressed by safin solıdion which were giyen before and during operation. These ınethody r f inhibition were applied tn patients undergoing cholecystectomy. iVe investigated inhibition aldosteron in 21 patients with euthyroid goitre which are difficult ta keep irt uniform. Unlike the liger4.2ture, wc constituted a group paiient adınin. istered aldosteron antagonim (Spironofacton). We compared the results of the groups Ivith each other. The results showed that increase of aldosteron could be inhibited by spironolackın and safin adminisration.

İn this descriptive study, determining the demographic features, death causes and death origins of medicolegal deaths which vvere occured betvveen the years of 1991 and 2000 in Konya was aimed. Totally 4281 death cases to vvhom forensic examination and autopsy vvere performed vvere taken for evaluation. İt was observed that death cases vvere more dense in summer months. Male / female ratio was 3.32/ 1 in forensic deaths. The cases vvere cumulated betvveen the ages of 20 and 29. Deaths due to accidents was the main death origin with 75.3 % and it was follovved by homicides (8.0 %) and suicides (5.9 %). İt was stated that the ratio of the deaths due to traffic accidents was 53.5 % of the total deaths and was 71.1 % of the accident originated deaths. The cause of death in 69.5 % of the cases was blunt trauma and it was follovved by pathological deaths with 6.8 % and asphyxic deaths vvith 5.8 %. İt was concluded that causes and origins of the deaths vvere varied by gender and age differences.

We have briefly discussed laboratory findings, treatments and the results of treatment of the patients admitted to our deparment with diaphragınatic injuries during the last 5 years.

We carried out a retrospective and prospective study of 47 patients who had sustained injuries over the last three years from the hand passing through or striking glass. The demographic data, severity of injury, history of psychiatric illness and outcomes of the patients were evaluated. The preoperative examination of these injuries significantly underestimated the amount of damage. A simple and small laceration has the potential to conceal an underlying deep injury. For this reason, if glass is implicated as a causative agent, careful preoperative evaluation and surgical management should be considered.

A 14 - year-old boy was admitted to the in-tensive care unit (ICU) of the Seljuk University Hos-pital because of a traffic accident. He had a chest tube in the middle axiller line of his right thorax on the 8 th. intercostal space. Pulmonary parenchym of the right lung had closed at his chest roentgenogram and ultrasonografi. This patient required an emer-gency operation with his symptoms and laboratory findings. Emergency thoracotomy was performed in the patient which had led to a tear in the right side of diaphragm and intrathoracic migration of the liver, hepatic filexura of the colon and the omentum were seen. Hepatic flexura of the colon had got two perforations. They have to he attentive for diagnosis and treatment after thoracoabdominal blunt trauma. Never forget that some manipulations to diagnosis or treatment may make abdominal viscera destroy in the chest.

Chylothorax is the effusion of the chyle into thoracic cavity as a result of rupture of «ductus thoracicus» or branches there of due to a severer fit a coughing arising from such etiologic factors as tuberculosis, cancer, metastasis of cancer, trauma, parasite, etc. In the case in present article, abdominal and thoracic branches of «ductus thoracicus» have been per-forated due to parasites. This article has been published because the case is seen rarely.

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.

Time management and making a correct diagnosis are very important for survival of patients with altered state of consciousness. In our study, we aimed to determine the value of the infrascanner device, which is a non-invasive and a fast method in detection of intracranial hemorrhage. A total of 38 patients who had been admitted to the emergency department of our hospital with the complaint of altered state of consciousness were included in the study. The patients underwent investigations with regard to hemorrhage immediately after admission using the infrascanner device by trained residents of emergency medicine. 20 (52.6%) of the patients were male. The mean age was 51.8 years and the Glasgow Coma Scale was 10.6 (15-3). While hemorrhage was detected on cerebral CT in 22 (57.9%) patients, it was not detected in 16 (42.1%). In the infrascanner device examination, negative results were detected in 24 (63.2%) patients and positive results were detected in 14 (36.8%) patients. The sensitivity of the infrascanner device was found to be 63.6%, specifity was found as 100%, the positive predictive value was found as 100%, and the negative predictive value was found as 66.7%. The results obtained from the study indicate that the infrascanner device provided beneficial clinical data in addition to symptoms and neurological examination in patients who required further imaging procedures. The high specificity puts forth that patients in whom hemorrhages are detected using the infrascanner device, should definitely be evaluated with further tests.

Hand and wrist have very important functions in daily living activities and their injuries are very frequent. The purpose of hand rehabilitation is ta maximize the residual functional capacity of patients with injured. in this study, we have evaluated the causes and characteristics of traumatic hand injuries rehabilitated in acar

Adult respiratory distress syndrome is an advanced degree of distressing respiratory failure in adults. Various factors play a role in this clinical picture. Although respiratory failure associated with trauma and shock has been reported since the beginning of the twentieth century, the definition of respiratory distress seen in adults is very recent. In 1967, Asbaugh et al. Described this entity with its clinical and physiopathological features.

Künt travmayı izleyen perikard rüptürü çok nadir olarak meydana gelmektedir. Perikard rüptürünün tarihçesi 19. yüzyıla dayanmaktadır. Stokes, 1831 yılında, su çarkının kolu tarafından yaralanan genç bir has-tada perikard yaralanmasını teşhis etmiştir (2). Morel Lavalle, 1864 yılında, düşme sonucu göğüs travmasına maruz kalan 3 hastanın birinde dinleme bulgusu olarak su çal kahin suya çarpması sonucu çıkan sese benzeyen bir ses bulmuştur. Otopside bu 3 vak'ada da perikard yırtığı görülmüştür (2). Crynes ve Hunter, 1939 yılında, «travmatik perikard rüptürü» teşhisini almış 58 vak'anın raporlar= topladılar, fakat bunla-rın hiçbirisi ölümden önce tespit edilernemişti. Perikardial yırtıklar ancak otopsi ile teşhis edilmiş ve vak'aların ölüm nedeni bu .yırtıklardan oluşan kalp herniasyonuna baglanmıştır. Bu yazarlar kendi kurumlarındaki 4107 otopside. 22 pelikard rüptürü vak'ası gördüler. Crynes ve Hunter'in gözlemlerinden bugüne kadar literatür taraması sonucunda 142 vak'a toplanmıştır (2).

To evaluate the etiologic and anatomic aspects of the patients who admitted a university clinic with vision loss from Diyarbakir and surrounding cities. Between May 2011-April 2013, the records of patients who admitted Dicle University Hospital Chairman of the Board Health with low vision and without any systemic disease were reviewed retrospectively. Demographic characteristics of patients, uncorrected and the corrected best visual acuity were recorded. Patients with best corrected visual acuity less than 0.5 were divided into 4 groups according to the classification of World Health Organization’s vision loss. Group 1 (best corrected visual acuity <0.05) were evaluated. Those patients were divided into 2 groups as bilateral and unilateral according to visual loss. The etiologies of vision loss in patients were classified into 5 groups as anterior segment pathology, retinal disease, optic disc disease, simulation, globe/refraction related disorders.167 patients were enrolled.88(52.6%) patients had bilateral and 79(47.4%)had unilateral visual loss. The most common cause of bilateral blindness was retinal diseases. The most common retinal disease was retinitis pigmentosa. The most common cause of unilateral blindness was anterior segment pathologies in which cataract/congenital cataracts were consist of the most common subgroup. The second most common cause was perforating of trauma and refraction disorder. In this study the most frequent etiologic factor was found to be retinal diseases especially hereditary retinal dystrophies in patients. We thought that might be due to particularly from the marriage between closely related individuals. Public awareness about marriage between closely related individuals and prevention of trauma is likely to reduce exposure to these results.

A rare cause of acute abdomen; appendiceal neuroma. Case report

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    Acute abdomen refers to nontraumatic pathologies of abdominal origin which are characterized by sudden-onset abdominal pain. In most cases the cause of pain is a pathological condition requiring urgent surgical intervention. Acute appendicitis is the most common indication for surgical intervention in patients presenting to emergency department with acute abdomen. Obstruction of appendiceal lumen has been widely accepted as the precipitating factor in the pathophysiology of acute appendicitis. It usually develops as a result of food or feces particles entering into and obstructing appendiceal lumen, leading to inflammation and swelling of regional lymph nodes. Luminal obstruction results in overproduction of bacteria, excessive mucus secretion, and increased intraluminal pressure. Some studies in recent years have suggested a neural component in the pathophysiology of this condition. Such cases may present with various diagnoses such as obliterated appendix, fibrous obliteration, appendiceal neuroma, and neurogenic appendicitis. In this paper we present a case operated with the initial diagnosis of appendicitis and histopathologically diagnosed with appendiceal neuroma, a rare cause of acute abdomen.

A retrospeetive study was done of the treatrnent of closed and open fractures of the tibia in 133 patients with 140 fractures. These patients vith shafi fractures of tibia were treated at the Department of Orthopaedics and Trawıatology of the Selçuk Oniversitiy Hospital, between 1983 and 1989 The mean oge al initiation of treatrnent was 32 years. Their ages ranged from 13 to 72 years old. ln all, 96 fractures were closed and 44 were opera. Traffic accidents were the most cause of the injury. In 96 patients, the tibial fracture was the only inju.ry, i,x 37 patients other injuries also were present. 7 patients had bilaterall tibial fractures. The patients were followed al least unlu/ to clinical and radiographical union of the fracture. Iri (his series, the overall succes rates in healing of the fractures with open and closed method_v were highly satisfactory

Aim: The aim of the study was to evaluate the clinical features and consultation process of the patients who
were consulted from the pediatric emergency department to the surgical departments during the pandemic
period, and to compare the findings with the data before the pa ndemic.
Patients and Methods: The research was conducted between 11.03.2020-11.03.2021 in the pediatric
emergency department of our hospital. The enrolled patients at 0-18 years of age were retrospectively
evaluated in terms of gender, age, diagnosis, consultation result, consultation response time. Our study was
compared with the prepandemic data between 01.01.2019 and 31.12 .2019.
Results: Of the patients; 42,4% were female and 57,6% were male. The mean age was 6,9±4,9 years. It
was determined that 27,3% of our patients were consulted to one of the surgical clinics with the diagnosis of
foreign body, 22,2% acute abdomen, 10.6% foreign body aspiration. It was found that 38,5% of the patients
were consulted to the pediatric surgery department, 33,9% to the otolaryngology department and 11,4% to the
thoracic surgery department. The mean consultation response time was 72,2±48,8 minutes. The distribution
of diagnoses, consultation response time, consulted surgical departments, consultation results by age groups,
and distribution of the consultation response times by surgical departments during the pandemic were found
to be statistically significant compared to the pre-pandemic pe riod (p<0,05).
Conclusion: In our study, it was found that the number of patients admitted to the pediatric emergency
department decreased during the pandemic period, the number of hospitalizations increased, the diagnoses
associated with trauma and close physical contact decreased, and the diagnosis of epididymorchitis increased.
In addition consultation response times were observed to be con siderably longer.

To prevent testicular degeneration caused by the effect of temperature, infertility, the formation of groin hernias, testicular torsion, predisposition to travma and negative effect to children psychologically at the children who had undescended testes are important. The testis doesn’t descend into the scrotum if hemiscrotum doesn’t grow sufficiently. If right or left scrotum appears to be normal, testis ascends or is retractil. Testes at the children who had retractil testes remain in scrotum after drawing into scrotum, the size of the testes are normal and the testes are frequently in scrotum since before. Ectopic testis can be localised at the regions of perineal, femoral, pubisopenil regions or contralateral scrotum. Orchiopexy or laparoscopic orchiopexy is performed after observing the children, who had undescended testis for one year. Surgical procedure should be carried out without waiting for the children who had ectopic testes, but not for the children who had retractile testis.

Glioblastoma multiforme (GBM) is the most malign glial tumor. It rarely causes skin metastasis. It is frequently misdiagnosed as a primary subcutaneous tumor. The number of cases related to skin metastasis of GBM reported in the literature is limited. We here presented a GBM case with scalp invasion and applied with cheloidlike formations on the old craniotomy scar. The patient applied to us with cutaneous, firm, infiltrated nodules in skin color in area concomitant with the incision scar on frontal region. Within 2 months, the nodules turned into a giant tumoral mass covering whole frontal region. The result of the biopsy conducted on nodular lesions were reported as undifferentiated tumor (malign tumor metastasis) scalp. The patient died 3 months after scalp invasion.

Background: Facelift surgery is a frequently preferred aesthetic surgery procedure to reduce the signs of aging and achieve a more youthful appearance. The incidence of complications such as hematoma is quite high among patients undergoing facelift surgery. This study aims to compare the efficacy of TXA and hemostatic net technique in terms of preventing hematoma formation in facelift surgery patients.

Patients and Method: The study included 65 patients (56 F, 9 M) who underwent deep plan facelift and face and neck lift between October 2019 and February 2023. Patients were evaluated in four different groups: TXA given, those applied hemostatic net, those applied both, and the control group applied neither. Demographic information, follow-up findings, any hematoma or other complications in the postoperative period were recorded. Differences between the groups were evaluated statistically.

Results: The mean age of the patients was 54 years. The patient group using only TXA consisted of 17 patients, the group hemostatic net applied consisted of 9 patients, the group applied both consisted of 21 patients, and the control group consisted of 18 patients. Hematoma was observed in 6 patients in total. Although a numerical decrease in the incidence of haematoma was observed in patients in whom only haemostatic net was used and in patients in whom only TXA was used, it was not statistically significant (p>0.05). The incidence of haematoma decreased that is statistically significant in patients in whom TXA and haemostatic net were used together (p<0.05).

Conclusion: Tranexamic Acid and hemostatic net both together showed to be effective in reducing the incidence of hematoma. It is thought that these measures may improve surgical outcomes and accelerate the recovery process of patients.

Between 1983-1988 378 patients with thoracic trauma were admitted to the Department of Thoracic and Cardiovascu-lar Surgery, Selçuk University School of Medicine. In 74.3 percent of the cases cause was blunt injury and 25.7 percent due to penetrating trauma. In majority of the patients treatment was Conservative. Only 2.2 percent of the cases had emergency thorocotomy. Overall mortalıty rate was 5.3 percent.

One of the rare infective factors of bacterial origin from the external ear canal is Achromobacter xylosoxidans. Although in this group of bacteria as the agent of infection in human rarely seen, this bacteria often encountered associated with water environments. Those most infections are nosocomial origin. Sources of infection include dialysis fluids, distilled or deionized water, tap water, chlorhexidine solutions and intravenous fluids. The disease usually affects patients due to other underlying disease, impaired immune resistance, using immunosuppressants, premature babies or organs impaired immune resistance due to trauma. Ear drops containing cortisone used for a long time in the presence of resistant external otitis external otitis due to Achromobacter xylosoxidans’a should be considered. Classical antibiotic treatment is ineffective. Trimethoprim-sulfamethoxazole, third-generation cephalosporins and antipseudomonal penicillins (piperacillin, ticarcillin, and carbapenems) ‘s should be used.

Betvveen April 1990 and May 1997, 101 patients with unstable thoracolumbar vertebral fractures were treated operatively. The mean follow-up was 27 (3-66) months. There were 70 men and 31 women. The mean age was 35.9 (18-69) years. Etiology was falling from a height in most of them (56.4%). The delay from the original trauma to the presentation ranged from 2 hours to 7 days. First lumbar vertebra was affected mostly (35.5%). According to the Deniş classification, there were 94 burst fractures, 22 compression fractures, 4 fracture-dislocations and one seat-belt injury. Fiftynine patients had Frankel type E, and 14 had Frankel type A neurologic status. The me- dium angle of local kyphosis was 24° and the percentage of anterior compression was 40.7%. The percentage of average spinal canal involvement was 44.5%. The average time after the trauma till the operation was 4.5 days (6 hrs-20 days). The mean operative time was 135 minutes and 2.8 units of whole blood transfusion was used on the average, intraoperatively. Postoperative bracing was applied to ali of the patients. One CSF fistula, two su- perficial infections and one pressure sore were noted as early complications. Eighteen patients with neurologic deficits had partial, and two patients had full recovery. 394 transpedicular screvvs vvere used and there vvere 31 (7.8%) bent screvvs, 9 (2.2%) screvv breakages and 19 (4.8%) screvv migrations. Transpedicular fixation was found to be an effective method for thoracolumbar vertebral fracture surgery.

Anterior abdominal wall hematoma is a rare pat-hological condition.It may simulate the acute surgi-cal abdomen. Ilematoma was diagnosed by utilizing ultrasonography (USG) and computerized tomogra-phy (ST) in six patients who vere thouht to have acute abdomen orland abdominal mass. Although the diagnosis was made by USG, CT had been used to investigate localization, extension and associated pathological conditions of the hematoma. In !his article,differential diagnosis of andominal wall hematomas from acute surgical abdomen in six patients by using USG and CT are presented.

Initially extracmporeal shock wave lithotripsy (ESWL) was used for mechanical stimulation of asy-stolic heart and was larer to be used routinelv for urinary and gall bladder stone extraction. Soıne re-ported preliminary studies imply that ESWL can be used to treatment pseucloarthrosis, delayed union. epicondilitis, tendinosis calcarea and prostetic re-vision. Between July 1994- October 1995, in de-partment of Orthopedics and Traumatology, Me-dical Faculty, Selçuk University a study was undertaken for 5 patients with tihial pseudoarthrosis. For this purpose Dornier MFL 9000 lithotripter was used. An intensity of 20-22 kV. totalling 3000 pul ses were applied to the end of each fracture. Solid ttili011 was achieved on an average of 4 months (ranging 3-6 months). As a result of Iliis study, the technique ofkrs a potantial altrenative rreatment modality for cases for whom other techniques can be used with difficulty and for pseudoarthrosis which mav develop after opeıı fractures.

Idiopathic retroperitoneal hematoma is a rare condition, affecting apparently histopathological normal retroperitoneal blood vessels. In cases of idiopathic retroperitoneal hematoma no definite cause can be identified. We report on a patient idiopathic retroperitoneal hematoma presenting as acute abdomen.

Between 1983 and 1996 splenic surgerv was peıfonned irr a tatar` of 47 .children in the Research Hospital of Medical Faculty of Selçuk Unive•sity. The age• of the patients were betıveen one and 16 vc'ars. Of the patients 38 under•ent splenectomy. of. which 17 were pelforıned general sur.,!:;eons be-Pre 1991_ Pediatric surgeons have been performin these procedures since rhen. When these two periods are coınpared It is frJldlrfl that. the most U)/i dication.v for ,splenectomy are trannut and he-motological diseases before 1991 aml cıfıer tlıen. respectivelv. Wc' suppusod that. the ı-eason of the (lif-frrence between tvı,o periods is the impo•tance of- the jımetions of the spleen is not elem- in adults as iır (.-hildren and therefrre. .fi)r the menagemenı of the trattmatic children, the methocl used hrgenaral sur-geons i.s different from ılıaı (ıf pedian-k:surgeons_

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

Aim: Diagnosed with multifocal dystonia, the subjects without trauma, exposure to toxic substances, metabolic diseases or the history of chronic drug use were aimed to be discussed in light of literature. Case Report: A 62- year-old man was recruited to our clinic with the complaints of the pain on the right half of the neck, tenderness, contractions on both hands, more definite on the right. In his history, it was determined that the pain on the right half of the neck had been present for two years and the complaint of contraction on the right hand had just started after the right neck pain, and that contraction on the left hand had existed for one year. On his physical examination, a mass which could palpably be felt, in size of 1x1 cm, of neatly framed and tender was observed on the right half of the neck. On the neurologic examination, dystonia existed on both hands, more marked on the right, and tonus had increased on both upper extremities in the nature of rigidity. On the cervical MRI, definite protrusion on C5-6, left paramedian protrusion on C5-6, C6-7 and cord impression on C5-6 were present. Conclusion: What makes our case remarkable is timely correlation between pain on right half of neck and beginning of dystonia on right upper extremity. Chronic pain could lead to movement disorder in the form of dystonia by disinhibitation of the silent spinal cord central pattern generator by causing hyperexitability of spinal interneurons.

is a method used especially in the tre-atment of urinary and biliary tract stones. A recent model is also used in Orthopedics. However there is a disadvantage of se-quiestration of broken pieces of stones at the level of lower calyx and leading to stone street. In this study we applied controlled inversion to stones to be fal-len down which were at a diameter of greater than 4 mm and broken by ESWL, but their pieces were se-questered at the level of lower caliyx or formed stone street. ESWL is applied to 33 patients 21 of them who had sequestered pieces at the level of lower caliyx, were treated by inversion-vibration method for 6 minutes at 45 degrees trendeblundum position, we used US with 15 Watticm2 and vib-ration to 12 patiens who had sequestered pieces for 6 minutes each while they are standing. The results were positive in 10. In addition to 12 patients wiho had primary uretery stones, only US and vibration were applied and 8 of them were fallen down. All these procedures were performed in 2-5 sessions. No significant complication was observed. As results we concluded that controlled inversion threapy is a relliable, effective and economic met-hod.

A twelve years old virgin patient who was menstruating regularly for one year presented with severe pelvic pain associating with her menstruation. She was diagnosed to have right renal agenesis before 4 months. In her physical examination she had annular hymen and normal external genital organs. Vaginal depth was 6 cm. In her pelvic ultrasonography, the endometrial thickness was 8 mm on left side uterus and 8x10 cm hematometra appearance was seen on right side. Laparotomy was planned for the patient. During the operation double uterus and double endometrial cavities were seen with fusion line in the middle. Double cervices were palpated by hand. Hematometra was seen on right side. Bilateral ovaries were normal. Uterus was incised from the middle the separating fibrous tissue was removed, hematoma was evacuated and the two cavities united. The patient was discharged on the 2nd postoperative day without complications. After two weeks she presented with severe vaginal bleeding for which laparotomy was done. The metroplasty line was opened. A bleeding arterial end was noticed on left lateral isthmic wall and it was not related to the incision line. The vessel was sutured and the patient was discharged on the 4th postoperative day without complication.

Traumatic diaphragmatic rupture (TDR) is recognized consequence of high velocity blunt trauma to the abdomen. TDR is uncommon injury but an important marker of severe trauma. The recognition of diaphragmatic rupture is important because of the frequency and severity of associated injuries.The treatment of TDR is surgical repair. In this case report, two patients with TDR were described.

Hepatitis B infection is one of the major health problem and the risk of hepatitis releated disease ma-nifestation is higher around the world. There for he-alth releated personnel is under great risk if any pre-cautionary measures are not taken. In order to determine, a study was undertaken at the department of orthopaedics and traumatology from December 1992 to June 1994, how seriously health worker inc-luding doctors were exposed to-hepatitis B infection. All in patients were checked routinely for a hepatitis B surface antigene (HBsAg) carriage. During these 19 months pariod 685 patients were investigated. Among them 47 (%6.8) patients were HBsAg(+). Ho-wever these patients did not have clinical and la-boratory (biluribins, SGOT, SGPT etc) findings re-lated to hepatitis B. Fifty randomly selected discharged patients who were initially HBsAg(-) were recalled for follow up and checked for HBsAg positivity. Only one patient (%2) was HBsAg (+) si-milarly, this patient did not have clinical and la-boratory findings related to hepatits. This findings suggested that protective measures should be taken and necessary immunisation should be done for the health personnels in the cilinics.

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

Aim: The aim of this study is to evaluate the versatility of the use of FDMA flaps in soft tissue defects in
the fingers.
Patients and methods: Patients who underwent reconstruction due to soft tissue defect in the upper
extremity between May 2018 and May 2021 were scanned over the file. Among these patients, patients
who had a finger defect and were reconstructed with the first dorsal metacarpal artery flap were included
in the study .
Results: 12 patients were included in the study. The etiology of the defect was trauma in all patients.
Tunneling technique was used in 5 patients for flap adaptation. No patient experienced total flap or graft
loss. Age, gender, comorbidity, defect localization, defect size and operation time were examined in terms
of complications. No statistically significant difference was detected. Smokers and non-smokers were
examined, no statistically significant difference was found. The use of tunnel for flap adaptation did not
make a statistically significant dif ference in terms of complications.
Conclusion: First dorsal metacarpal artery flap is a very reliable option for defects in the 1st and 3rd
fingers. If the tunnel technique is used, it should be ensured that the tunnel width is suf ficient.

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.

Pneumomediastinum can develop spontaneously or in the setting of trauma. Spontaneous pneumomediastinum (SPM) is a rare condition and treatment of these patients is generally limited to observation. We discovered SPM in 15-year- old male patient, who had been wrestling, admitted to our emergency service with chest pain and shortness of breath. In this case report we discussed that in a patient without trauma, medical intervention for developing pneumomediastinum, the increased vagal maneuver may lead to SPM.

The effectiveness of ultrasonography which is used for routine determination of postvoiding residual urine volüme was compared vvith transurethral catheterization. İn 58 male patients who had prostate disease and bladder emp- tying difficulty, pre-postvoiding bladder volumes vvere measured ultrasonographically using Simpson’s method (iti 6 x W x D x H). After ultrasonographic examination, residual urine volüme was determined by postvoiding 10F catheterization. Postvoid residual bladder urine volumes measured by ultrasonography and transurethral cat­ heterization vvere between 0-367 mİ (mean 62.2) and 0-500 mİ (mean 70.7) respectively. A high correlation was demostrated betvveen the catheterized volüme and ultrasound estimation. There was no statistically significant dif- ference betvveen them. Ultrasonography is a noninvasive. practical method vvithout a complication risk and an ef- fective method to evaluate bladder and prostate morphology. Catheterization has risk of urinary infection and urethral stricture secondary to the procedure, also this is an invasive method. l/Ve think that bladder ult­ rasonography techniçue, vvhich does not carry the risk of urinary tract infection or trauma must be preferred in ac- curate determination of postvoiding residual urine volüme.

Most pancreatic injuries are minor and can be treated by external drainage. CT represents the best noninvasive diagnostic method for the detection of pancreatic injury, with sensitivity and accuracy of at least 80%. Morbidity and mortality rates for isolated pancreatic trauma are directly related to the presence of damage at the pancreatic duct. This article is based on 4 patients who have applied to our Department of General Surgery in Ümraniye Training and Research Hospital between April 2009 and December 2011. Three of the patients were men, and one of them was woman. The average age of the patients was 22 (17-28). Two of them have undergone surgery and drainage. Two patients have been treated with conservative treatment. Pancreatic fistula was seen in two patients. External drainage and conservative treatment are effective treatments for the low grade pancreatic injuries.

Aim: We aimed to report the long-term results of the patients undergone posterior preperitoneal tension-free mesh hernioplasty operation for inguinal hernia. Patients and Methods: IVe icnluded in this study 624 patients undergone posterior preperitoneal tension-free mesh hernioplasty operation for inguinal hernia betvveen October 1992 and June 2000. The patients were invited for control in the first and third postoperative months and yearly. The patients who did not come to control were asked by telephone and letter if they had any recurrences and problem with their operation. The patients lost their communication with us after the operation were excluded from this study. The patients were examined and evaluated for urinary retention, bleeding, spermatic cord edeme, wound infection, neuralgia and recurrence in the early and late postoperative periods. Results: 584 of the patients were men and 40 were women. The patients were follovved 37.4 months (range: 6-108 months) after the operation. We found 1.8% recurrence, 0.3%> bleeding, 2.7%> infection, 4.2% spermatic cord edeme, 0.6% neuralgia and 0%> urinary retention ratio. Conclusion: We concluded that, posterior preperitoneal tension-free mesh hernioplasty operation is a safe method with low morbidity and recurrence rate in inguinal hernia repair.

n determination the ethiology of subarachnoid haemorrhage some radiological diagnostic methods are used. Su- barachnoid haemorrhage, intracranial haemotoma and intravetricular bleeding can be correctly detected by com- puted tomography (CT), but in demostration of small aneurysm or trombosed aneurysm CT can be insufficient. Angiography which is an invasive examination also effective in the diagnosis of intracranial aneurysms and de­ termination of surgical strategy. 98 patients (45 M, 53 F) who have been admitted the hospital because of their acute neurological findings have intracranial aneurysms which were shown by angiography. Ali of these patients have been examined by CT also before angiography. 96 of 98 patients (97.9%) had subarachnoid haemorrhage and in 98 patients there were 103 aneurysms. Only 24 of 103 (23.3%) aneurysms were shown by CT exa- mination. We think that in patients with intracranial haemorrhage which are shown by CT examination, con- ventional angiography or digital substraction angiography remains the gold standart for detailed aneurysms de- tection and also for surgical planning.

IVe evaluated the medical records of 26 patients vvith kidney injuries resulting from multiple trauma at urological department. The patients vvere classified as minör and majör depending on the pathological sign. 65.4% of the patients had majör renal damage vvere as 34.6% of the patients had minör renal damage. From kidney injuries 76.8% was blunt injuries. 88.8% of majör kidney injuries vvere associated with multiple organ damage. Surgical treatment's vvere used for majör renal traumas wereas only conservative treatment vvere used in management of minör renal injuries. VVhile emergency interferances vvere reçuired only due to early complications of multiple trauma like hemorrage and urinoma, and late complications like htfdronephrosis, hypertension and arteriovenoous fistulas.

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.

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.

İn this study, we investigated the effects of nimodipine on tissue lactate (LA) and malondialdehyde (MDA) levels in rabbit brain one hour after experimental head trauma. The vveight drop method was used to produce head trauma in 25 Nevv-Zeland rabbits. The rabbits were divided into three groups Group 1 was the sham operated group. Group 2 (control group) received head trauma only and in group 3 nimodipine was administered 20 pgr./kg (i. v) immediately after the head trauma via the jugular vein. İn group 2 and 3 samples from the non contused side was named as "a" and contused side as "b". The tissue mean LA and MDA levels vvere 15.33+1.89 micromoles per gram wet vveight (pmol/gvvvv) and 66.21 ± 8.69 nanomoles per gram wet vveight (nmol/gww) in group 1, 18.24±1.84 //mol/gvvvv and 89.64 ± 9.65 nmol/gvvvv in group 2a, 25.50+1.78pmol/gww and 142.43±8.69 nmol/gww in group 2b, 18.67±1.81 pmol/gww and 91.09±11.86 nmol/gvvvv in group 3a, and 25.25±1.95 pmol/gvvvv and 137.60±9.59 nmol/gvvvv in group 3b respectively. The results vvere found similar betvveen the group 2 and 3. These results demonstrated that nimodipine has no effect on tissue LA and MDA levels in the early period of experimental head trauma.

in this study, 41 patients with peripheric traumatic false aneurysm ireaied in otu- clirxic between 1977-_1987 were investigated. 43 opera_tion were perfomed in 41 patienis_LAim_ al periodic follow tip of the patients, normal pulses were felt.

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

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

184 of 1111 patients admitted ta hospital with chest injuries were children during 14 year period. 110 of them had blunt chest injuries, 55 stab wounds and 19 gunshot wounds. in 96.19 percentage of cases conservative treatment was giyen, surgical tre-atment was carried in 3.81 % of them.. Death was not occur in any case.

The essential feature of this disorder is a marked inzpairment in speech fluency characterized by frequent repetitions or prolongations of so. unds or syllables. [Ip until now it has been considered to be a neurotic condition, a learned behavior or structurel disorder. Never the lens, the cause of this disorder has not been established for certain.In (his study to onlighten the etiology of (his condition dıllerences related to sex has been investigated. With (his aim medical records of 45 children diagnosed as stuitering, has been reviewed, differences documented and compared. in statistical calculations t-test has been used. As a rest& of this study it has been found that in females emotional trauma prior to illness, family history of psychiatric disorder and family disharmony vere significantly more abundant compared to males. These results suggest that in stuttering emotional factor may be presipitating or etiological factors in females more so than males.

1064 cases who were treated in the Thoracic Surgery Clinic, Faculty of Medicine, Universty of Selcuk between 1983 and 1994 were presented 762 of them injured due to blunt trauma, 249 were due to sharp weapons and is were gunshad wounds. 50 cases were treated surgically. Results are sum-marized in the article and involving literature was discussed.

Aim: In this study, it was aimed to investigate the kidney function, hypertension development and
proteinuria in individuals with only one kidney .
Patients and Methods: The study included 96 patients who had previously undergone nephrectomy with
the causes of nephrolithiasis and chronic pyelonephritis-induced nonfunctional kidney, RCC (Renal Cell
carcinoma), trauma, and donor nephrectomy among 17800 patients who applied to the Siirt State Hospital
Nephrology and Urology outpatient clinics between January 2016 and December 2019. The data of the
patients were obtained from patient files database retrospectiv ely.
Results: A total of 96 patients, 45 female and 51 male, were included in the study. 23 (24%) of the
patients had donor nephrectomy (DN), and 73 (76%) had nephrectomy (DE) due to nephrolithiasis, chronic
pyelonephritis, trauma, and renal cell cancer (RCC). The patients were divided into two groups as those
who underwent DN and DE due to other etiologies. Between DN and DE group, there was no statistically
significant difference in terms of mean age, distribution of gender, presence of HT before nephrectomy,
DM, presence of hematuria and new onset proteinuria (P> 0.05). Compared to the DN group, the frequency
of new onset in CKD and HT development was significantly higher DE group.
Conclusion: Nephrectomy is a risk factor for the development of CKD, proteinuria and hypertension.
Therefore, preventive measures should be taken in a timely manner to reduce the prevalence of
nephrectomies due to benign diseases.

The purpose of this study was to present, through a retrospective case series, results of the patients who were treated arthroscopically for anterior glenohumeral instability. We evaluated 41 patients. Mean follow-up of the patients were 45 months (range 32-80). There were 4 (10%) female and 37 (90%) male with a mean age of 32 (range 24- 44). There were 27 (65%) right and 14 (35%) left shoulders. Dominant side was injured in 25 patients. All of the patients were suffered from a traumatic shoulder dislocation. Many etiological factors are responsible for these traumatic dislocations like swimming, falling on the side while playing soccer or volleyball or a direct trauma to the shoulder. MRI was performed before the surgery and it was found to be a Bankart lesion for all the patients. Also, all patients were evaluated according to Rowe and Constant scores. Postoperatively, mean Rowe score was 87 (range 15-100) and mean Constant score was 95 (range 88-100). Excellent resuls were obtained in 33 (80.5) patients. There were 8 (19.5) patients of recurrences and 2 of them had arthroscopic revision surgery and Laterjet procedure was performed for the latter 2 patients. Arthroscopic shoulder surgery is a long learning curve, requiring the training process but also has the advantages of less bleeding, easy rehabilitation and wound healing. As a result, this effective method can be performed for recurrent shoulder instability patients with less complication rates.

Traurnatic diaphragmatic rupture is a condition which the diagnosis is difficıdt. in Mis article 4 cases with traumatic diaphragmatic rupture which presented intestinal obstruction, volvulus of the dyspepsia and intraabdominal haemorhagea were evaluated retrospectively. Two cases were diagnosed prooperatively and the athers during operation. Unless probabilitiy is thought the diagnosis could easily be ınissed. Chest X-rays and other routine diagnostic ınethods were our diagnostic criteria in Mese cases. ff ultrasonographic exarnination is available diagnosing of such cases becomes accurate and easy.

Although the dental urch is generally symmetric, some cases of both mathematically and morp-hologieally deviated Pons have been reported. Irı our study,we aimed ta investigate the morphological pattern of dental ardı in adult maks and females. Using plaster casts, we peıformed our examination on 50 peoplc (25 males and 25 females, ranging from 17 to 35 years of ages), who had no anomalies or disorders of maxilla and mandible, and had no previous or CUITC111 dental treatmems. The results revealed that the width of the first intermolars in mandibles was significantly different between sexes (the value of the first intetınolar width in mandibles was largeı in males, p(0.05). There vere no sig-nificant differences in the other nıorphological .fe-atures examined.We. therefore believe that both the quantitative and qualitative analysis of the size and shape of the dental arch is especially important j'or the diagnosis, treatment and determination of the developnıental differences in dentistry.

Although the dental urch is generally symmetric, some cases of both mathematically and morp-hologieally deviated Pons have been reported. Irı our study,we aimed ta investigate the morphological pattern of dental ardı in adult maks and females. Using plaster casts, we peıformed our examination on 50 peoplc (25 males and 25 females, ranging from 17 to 35 years of ages), who had no anomalies or disorders of maxilla and mandible, and had no previous or CUITC111 dental treatmems. The results revealed that the width of the first intermolars in mandibles was significantly different between sexes (the value of the first intetınolar width in mandibles was largeı- in males, p<0..05). There vere no sig-nificant differences in the other nıorphological .fe-atures examined.We. therefore believe that both the quantitative and qualitative analysis of the size and shape of the dental arch is especially important j'or the diagnosis, treatment and determination of the developnıental differences in dentistry.

Introduction: In this study, in order to shed light on the intraparenchymal pressure reduction mechanism of dexmedetomidine, the effect of two different doses of 80 and 320 µg kg-1 on the levels of vasoconstrictor Endothelin-1(ET-1) and vasodilator prostaglandin I2 (PGI2) in blood and cerebrospinal fluid (CSF) in transient global cerebral ischemia model in rabbits was examined. This study was conducted in the Selcuk University Experimental Medicine Research Center between June 2005 and January 2006 and approved by an ethical committee. All rabbits were randomly divided into four groups; six rabbits in each group. In Group 1, a craniotomy was performed and the ischemia was not created. In Group 2, only an ischemia-reperfusion was performed. During reperfusion, 80 µg kg-1 intravenous dexmedetomidine was administered to Group 3, and 320 µg kg -1 intravenous dexmedetomidine was administered to Group 4. After the application of craniotomy and cervical neck dissection of the rabbits in Groups 2, 3 and 4, the bilateral carotid arteries were clamped and an ischemia was performed for one hour. Then, the clamps were removed and reperfusion was performed for one hour. In addition, ıntraparenchymal pressure were recorded after craniotomy and reperfusion. Blood and CSF samples were collected from rabbits after craniotomy in Group 1 and reperfusion in Groups 2,3 and 4 to determine levels of ET-1 and PGI2. Intraparenchymal pressure values after the reperfusion in Group II and IV were significantly higher than Group I( p< 0.05), but any significant increase in Group III (p>0.05). ET-1 levels of both blood and CSF were increased in the group performed ischemia and reperfusion and no treatment (Group II) and the group administered low dose dexmedetomidine (Group III) were similar with the sham group (p>0.05). However, PGI2 levels of CSF were significantly decreased in the group administered low dose dexmedetomidine (p< 0.05). Dexmedetomidine can reduce the intraparenchymal pressure by reducing the level of ET-1 in the transient global cerebral ischemia model.

Intraocular foreign body (IOFB) caused by penetrating eye injuries may lead to various findings by depending on the location, size and nature. However, in rare cases IOFB may remain silent for years without any complaint. In this study, we present the case of IOFB causing recurrent anterior uveitis 13 years after trauma in the patient with cataract. A 31-year-old male patient admitted to Ophthalmology department with the complaint of decreased vision which have been two years and pain, redness, light sensitivity with attacks in left eye. 15 years ago, a history of left eye injury occurred with exploding an object type of ceramic or porcelain was present. On the anterior segment examination, minimal peripheral corneal nefelyon at 2 hours position, peripheral iris defect size of 2x1 mm, grade 2 cell reaction in anterior chamber and posterior subcapsular cataract were present in left eye. In computerized tomography scan was detected the hyperdense foreign body placed in the posterior pole at the size of 3x2mm within the left globe. The possibility of intraocular foreign body should be kept in mind in patients with idiopathic uveitis specially in children and young people.

Between 1982 and 1995, ten patients who had vascular injuries of the subclavian artery were ope-rated. Five of them were combined with venous in-juries and three had hemopneumothorax. Clinically and angiog•aphically improving was obtained in 8 patient and two cases were lost owing to hypo-volemic shock.

Between 1982 and 1995, ten patients who had vascular injuries of the subclavian artery were ope-rated. Five of them were combined with venous in-juries and three had hemopneumothorax. Clinically and angiog•aphically improving was obtained in 8 patient and two cases were lost owing to hypo-volemic shock.

Infravesical obstruction as a result of acute üretral stricture was a common pathology in males and a rare pathology in female. İt developed secondary to infection and trauma. İt gain importance because by preventing urine flovv it produce upper urinary tract damage. İn our clinic a total of 243 patients with a mean age of 58 years have shown to have üretral stricture during last 10 years. We benifit from their physical examination, retrograde uretherografhy, IVP+postvoiding cystogram, ultrasonography and uretherography. İnternal urethrotomy was applied for 150 patients, bladder neck TUR for 36 patients, urethroplasty for 6 patients and rail-road urethroplasty for 3 patients. Four years of follovv up shovved recurrent urethral narrovving in 60% of patient internal urethrotomy, 6 montly dilatation in 75% of patients vvith urehral dilatation, recurrent narrovving in 10% of patients vvith bladder neck TUR and internal urethrotomi in 60% of patients vvith rail-road uretroplasty. Inspite of a new developed techniçues for urethral stricture it keep its recurrent, narrovving especialty which recquires continous follovv up.

Objective: Brain death is defined as the complete and irreversible loss of all brain functions including the brain stem. Three major findings used for the diagnosis of brain death are coma, absence of the brain stem reflexes and apnea. The diagnosis of brain death has become more important with the increasing number of patients waiting for transplantation. The objective of this study was to determine the efficacy of computed tomography angiography in confirming brain death.

Material & Methods: Clinical brain death was reported in total 21 patients hospitalized in critical care unit of our hospital between October 2015 and June 2018. One of these patients was excluded since he underwent magnetic resonance angiography. CTA findings of the remaining patients were retrospectively evaluated. Patients were aged between 25 and 75 years with a mean age of 45 ± 1 years. CTA evaluations were performed using a 64 detector device. 100 mL contrast agent was delivered with a double head automated pump at a rate of 3.5 – 4 cc/sec as 350-375 mg/mL. When the region of interest reached to 90-100 HU cut off value, the images were acquired at 15-20 sec intervals on the axial plan. CTA findings were interpreted using 10- point scale.

Results: Causes of death were reported as intracranial hemorrhage in eight patients, ischemic cerebrovascular events in four patients, hemorrhage after craniotomy in three patients, cardiac arrest in two patients, post-traumatic contusio cerebri in one patient, and metabolic reasons in two patients.

Contrast filling was “0” in the ACA, PCA, MCA distal, and ICA supraclinoid branches of all 20 patients. Suspected contrast filling was found in MCA proximal in eight patients and unilateral ACA proximal in two patients. Each loss of opacification in the intracranial brancges was scored as 1 point. Accordingly, all patients were scored as 10 points.

Conclusion: According to our results, CTA is an effective and sensitive method for the diagnosis of brain death which is obligated by regulations.

 

Atrophic rhinitis is a rarely witnessed inflamatory and chronic infection characterized by the atrophy of nasal mucosa and conchas, nasal crusting with bad smell and the enlargement of the nasal space with paradoxical nasal congestion. Primary and secondary forms of atrophic rhinitis are well-established. While primary atrophic rhinitis occurs in a previously healthy nose, secondary form frequently occurs following extensive sinus surgery, nasal trauma and chronic granulomatos diseases. On the physical examination of the case during anterior rhinoscopy, common crut and purulent, yellowish-dark green discharge were determined in nasal cavity. Klebsiella ozaenae and Staphylococcus aureus in aerobic culture with automated bacteria identification and susceptibiltiy testing system (Phoenix 100) and Actinomyces naeslundii in anerobic culture were yielded. Klebsielle ozaenae was found to be resistant only to ampicillin and was susceptible all the other tested antibiotics, and expanded spectrum beta-lactamase (ESBL) was negative. Staphylocccus aureus was found to be resistant to cefazolin, clindamycin, erythromycin, fucidic acid, meropenem, oxacillin, penicillin G and ampicillin. Actinomyces naeslundii was found to be resistant to metronidazole; susceptible to moxifloxacin and meropenem, with E-test method and beta lactamase test was negative. Presenting atrophic rhinitis in a 10-year-old male patient with clinical, microbiological and pathological features, the subject were discussed in the light of related literature.

In pregnant women, trauma is responsible for nonobstetrik maternal-fetal mortality and morbidity. Approach to trauma in pregnancy is similar to non-pregnant women. Approach to patient with considering physiological changes during pregnancy and timely prevention of possible obstetrical complications is significant keeping in mind that these complications may affect maternal mortality and morbidity.

Among ürogenital system injuries posterior urethral injuries are very few and generally will be seen as a result of traffic accedent, perforatting and cutting injuries and fail from hight. We evaluated a total of 25 cases with posterior uretral injuries resulting from multiple trauma.

We retrospectively investigated the cases of 98 children having 128 talipes equinovarus. Their conservative and surgical treatment were performed at the Department of OnItopaedics and Traumatology, Faculty of Medicine, Selçuk University between 1983 to 1991. Overall average age was 9.4 rnontlıs. The man age of consen;atively and surgically treated groups were 46 days and 34 ınonths, respectively. Conservative treatment was used .for 93 feet of 69 children... Surgical treatment with and without conservative treatment was done on 47 children with 58 feet. The avarege follow-up period was 37 months. The results were evaluted by the criteria of Main et al (1). The sucsess rates of the conservative, conservative plus surgical and surgi-cal treatment were 59 %, 82 % and 91 %, respectively.

Vestibular examination was performed on 47 amateur boxers with a test battery including neurological, electroencephalographic and minimal balance tests. Dysrhythmia was observed on electroencephalography (EEG) in 38.29% of the patients in whom no neurological finding could be obtained at clinical level. This finding was consistent with the literature information. Vestibular tests showed signs of decreased vestibular sensitivity, which was evident in the right labyrinth. These findings were discussed with the literature on biomechanics of chronic traumatic encephalopathy syndrome (fist drunkenness). It was concluded that vestibular tests may be important for the detection of this syndrome at a subclinical level and for early warning.

In recent years, a better understanding of the relationship between the recurrent nerve and the thyroid gland has led to a decrease in the rate of vocal cord paralysis, which is a complication of thyroid surgeries. However, the frequently variable anatomical course of the recurrent nerve requires the routine identification of this nerve during thyroid surgery, so the thyroid surgeon must acquire this skill. In order to contribute to the subject, the anatomy suitable for surgical trauma (..) and recommended indentification methods of the recurrent nerve were reviewed. We focused on clinical boards and their precautions due to recurrent nerve trauma.

The recuıTence rate and testicular complications seen (iter COnventional inguinal hernıa repair are stili being dehated. Reilıforcement of the inguinal prepe-ritoneal space between the peritoneal and musculo-fascial planes may have some advantages over the conventional hernia repair. Between November 1988 and December 1992,84 groin hernias in 56 patients >vere treated with preper-itoneal svnthetic mersilen mesh hernioplasty through a suprapubic transverse incision. During hernioplasty, lower abdoıninal operations (12 trans-vesical prostatectomy, 2 Ripstein operations and 2 oyarian cystectomies) vere pelformed on 10 of the patients. Early recurrence in one patient and hematoma in 8 patients developed

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

Fine needle aspiration biopsy %vas pet:formed in 6 patients with diagnosed retroperitoneal masses by routine •adiologic investigation in our clinic in the last I year. In 4 patients renal cell carcinoma, in 1 patient hematoma, in .1 patient perirenal abscess was di-agnosed with fine needle aspiration biopsies. Renal cell carcinomas MU corrected with histopathologic examination of nephrectomy specimen. The patient ►•ith hematoma was treated conservatively. We conclude that fine needle aspiration biopsy to be a simple, cheap and relatively noninvasive for preoperative tissue diagnosis.

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

Aim: Burns are common, especially in children. Here, we aimed to determine incidence of attention deficit
hyperactivity disorder (ADHD) symptoms in children with burns a nd compare them with healthy children.
Patients and Methods: This prospective study was conducted between August 2019 and April 2021. The
study group consisted of pediatric patients aged between 3-16 years admitted to the pediatric emergency
with burns. Children aged between 3-16 years admitted for non-traumatic reasons also constituted the
controls. Cultural and demographic characteristics of both groups were similar. After initial intervention
and stabilization, the revised Conners’ Parental Rating Scale (CPRS-R) was applied to both groups.
Results: The study group consisted of 143 individuals with a mean age of 6.93±2.96 years, and 69
(48.3%) were girls. The control group consisted of 140 children (mean age: 6.72±2.48 ranging between
3-16 years), and 49.3% were girls. There was no statistically significant difference between both groups
regarding age and gender (p=0.36, 0.84, respectively). The most common cause of burns (69.2%)
was exposure to hot water or oil spill. Most of the victims due to burns (89.5%) were discharged from
emergency after outpatient intervention. All subscale scores calculated through CPRS-R, except for
cognitive problems/inattention subscale scores, were significantly higher in the study group than the
controls. The educational status of the parents in the study group was hi gher than those of the controls.
Conclusion: Our findings indicated that the incidence of ADHD symptoms may be higher in children
admitted to the emergency department due to burn injuries.

Pelvic fractures associated with blunt trauma contributed significantly to morbidity and mortality.We reviewed 271 patients with pelvic fractures which were treated between March 1985 and Sep-tember 1994 in this study. Tint average age of pa-tients was 26.7 (between 3-70) years. The majority of the patients (%41.3) had one or more associated injuries: 43 with blunt abdominal trauma, 27 with - genitourinary tract injuries, 23 with thoracic in-juries, 22 with head trauma, 4 with neurologic in-juries and 3 with vascular injuries. There were Jive open pelvic fractures. Altough the overall mortality was %5.5 the mortality rate in. unstable pelvic "'Fac-tures was %9.6. The major causes of death in our patients were closed head injury, intra-abdontinal and intro-pelvic hemorrhage. The pelvic .fractures with associated injuries are serious trauma and re-quire more prompt and effective treatment methods.

Treatment and Follow up Traumatic arteriovenous fistulas are mostly occur as a result of penetrating injuries and so-metimes iatrojenic causes. Surgical treatment was performed on 8 tra-umatic arteriovenous fistula cases between the dates September 1989 and February 1996. Two patients were female and six patients were male ages ranged between 1.5 to 44. Etiology was gun shut wound in 5, stuhing and penetrating wound in 2 and as a re-sult of puncture to vein in I. Time interval after tra-uma was ranged between I day and 10 years. Ar-teriovenous fistulas were ntnd in the localization of right femoral artery - femoral vein in 3, left popliteal artery - vein in 1, left posterior tibial artery - vein in 1, right carotis artery - internal juguler vein and left brachial artery - basilic vein in I. Arterial end to end anastomosis in 5, primary arterial repair in 1. ar-terial prosthetic graft intopozitions in 1 and otojen yen patch angioplasty in I were used for the closure of the arteriovenous fistulas. Venous primary repair in 5, otogen safenous vein graft interposition in I. ve-nous ligation in 2 were used for the closure of the ar-teriovenous fistulas which venous repair.

Fistula of parotid gland is usually found rarely. The majority of cases occur by the injuries following a surgical intervention and the past history of the infection in the lodge region of parotid. In this article, a patient with an over discharge especialiy when he is eating from the opening of his fistula in the left retroauricular area is presented. The patient was succestWay treated.

A characteristic feature of this disease is the cutaneous response to intracutaneous trauma. This phe-nomenon is termed pathergy. It can be a useful diag-nostic test to demonstrate pathergy in the patienz. Pathergy was studied in 50 patienıs with Behçet's Syndrome.

The 25 Consequitive cases of urogenital trauma treated al Selçuk Medical Hospital between 1986-1990 are reviewed. Of the 25 cases of urogenital traurna 23 was male and 2 female. Of 21 patient with blunt trauma 12 was due to motor vehicle accident, 9 falling down_ Of 25 patient with penetrating 2 was due to stab wounds and 2 gunshot wounds. Of 25 patient with urogenital trauma 11 had posterior urethra rupture, 8 renal trauma, 2 ureter and 4 bladder trauma

Desmoid tumors are rare benign tumors with local aggressive clinical course but without the risk of metastasis. Etiopathogenesis of desmoid tumors is not known clearly. They can develop after trauma. Desmoid tumors are mostly located on abdominal wall and very rarely on suprapubic region. There is not a standard treatment approach for desmoid tumors. Firstly a wide surgical excision should be performed. As local recurrence rates are high patients should be followed up closely after surgery. Here in, a case with giant desmoid tumor located on suprapubic region treated successfully with a reconstructive surgery and followed up without a recurrence was reported.

Computr was in use in our clinic since April 1989. The computer programs were provided by use which used for medical recording. Computer is becoming an important equipment in Orthopeufıc clinics

The clinical presentation and management of 20 popliteal artery injuries following penetrating and blunt trauına were rewiewed during the period 1990 to 1996 of at the Cardiovascular Surgery De-partment of the Medical Faculty of Karadeniz Tech-nical University. Clinical and Doppler evaluation identified arterial injury in 16 (%80 per cent) pa-tients. In four (%20 per cent) patients with arterio-venous fistula or false aneurysms pedal pulses were palpable during initial assesnıent. Autogenous vein grafting was used in 8 patient, PTFE prosthesis was used in 2 patients, a direct end-to- end anastomosis was succesful in 8 patients, trombectomy was done in 1 patient and lateral repair was done in 1 patient. As a routine repair of associated venous injuries, early fasciotomy were used. External, internal fi-xation, skeletal traction was done for compoutıd and comminuted fractures. The significant functional orthopedic disability following blunt arterial trauma at the knee is emphasized

22 cases with traumatic peripheı-al aneurysm were treated at the Clinic of Cardiovasculer Suı-gery of Selçuk Univeı-sity Medical Faculty hetween 1989 - 1995 years. In eleyen of the cases were etiology due to injuı-ies of gun wounds, eight of them were penetrating instruments, rwo cases were after A.V. Fistüla anastomatic operation and one case was after invasiye vasculer procedure. Vein replacement was petformed in six cases and 9. Cases end ta end anastomosis was done and synthetic greft rep-lacement ta four case (PTFE) and in 3 cases were done arterial ligation. Twenty cases were resulted with healing. Postoperative compiications developed in two cases. In one of them was transposed the graft saphenous yemi!, and forearm amputation was applied to other patient..

Epıphvsis is a rıtare common site of injury fnllowing traııma to the skeleton in children. They are particular importance because of the cbmplication of growıh disturbance. It was the aim of this study to analize of 1320 long-bone factures in children for determination of the incidance of epiphyseal fracture.s. Epiphyseal fractures was accounted for 6.2%. The most frequently injuired site were the disıal Mune. rus and distal radius. 26 of 78 epiphyseal fractures were treated with operative method. Complication rate was %11.