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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The aim of this study was to evaluate colonoscopyassisted pneumatic reduction(CAPR) of experimental colocolic intussusception(CCI). Twenty eight rabbits were divided into 2 groups each containing 14 rabbits: Group A and B. The animals were not fed orally 1 day before the experimental study and fed parenterally. After median line skin incision, abdominal wall was opened. Colocolic intussusception was performed. 100 ml/kg liquid electrolyte solution was given to all rabbits in postoperative period. Group A was observed for 2 days and Group B for 3 days. In Group A, the “currant jelly” stools were observed. Mean weights were 3.970±2.137 kg, reduction duration 3.97±2.47 minutes, air pressure 44.0±2.6 mmHg, and the success rate of reduction 100%. Perforation was not observed in this group. In Group B, the “currant jelly” stools were observed in 5 of 14 rabbits. Mean weights were 4.111±2.754 kg, reduction duration 4.01±1.71 minutes, air pressure 55.9±13.3 mmHg, and the success rate of reduction 93%. Perforation was observed in 1 rabbit in this group. The air pressure in group B was significantly higher than group A (p

Antropometric values of socities appears with effect of genetic structions and enviromental factors. We aimed to present antropometric values of the students that come from different cities for medical education. The study performed on 203 students ( 100 male, 103 female) that studied in Universty of Konya Faculty of Meram Medicine between 2011-2012 in the semesters of first and second.The ages of the participants were between 18-22. In the top of weight and height the diferent measurement had been performed on the whole students. Performed data transferred to the SPSS 15.0 programme. Statistical Analyze method of Pearson Correlation, KiKare and Student T used and appraisalled. The average of the male students height was 178 cm, weight: 74,8 kg and waist size 85,4 cm. On the other hand female students height was 163 cm, weight : 56,8 kg and waist size 75 cm. In the performed data, with the ages rising the height increase and seat height increases detected. Results of the study demonstrate that there is no relation sensible between the left/right hand wirsts size and dominant hand using. Between the genders there is an positive, strong and sensible correlation on BMI ( Body, Mass, Index), weight and wirsts size. The performed actual datas will be usefull for the antropometric studies in the future.

In the Human Skin The efficacy of antimicrobial agents applied to-pically to the skin surface in eradicating coagulase-negative staphylococci (ENS) residing in the skin surface. Five antiseptic solutions (10 % povidone iodine, 2 % iodine, 2 % tincture of iodine, 70 % ethanol, and 0.5 % Chlorhexidine) were applied for 15s with a gauze sponge. The antimicrobial ointments (po-vidone-iodine. silver sulfadiazine, mupirocin, so-dium fucidate, and a double-antibiotic ointment con-taining neomycine, and bacitracin) were applied and covered for 6 th with gauze. After treatment. the surface was sampled. All agents were effective in eradicating ENS from the surface. The antiseptic solutions povidone-iodine. chlor-hexidine and tincture of iodine eradicated surface bacteria in every trial (10 of 10 each), and 2 % io-dine and 70 % ethanol eradicated bacteria from the surface in 9 and 7 of 10 trials, respectively. Four of the five antimicrobial ointments were also effective in the sterilization of the skin sur-face: 1 % silver sulfadiazine was the exception.

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

Aim: The Methylene Blue (MB) is commonly used dye for Sacrococcygeal Pilonidal Sinus Disease (SPSD). The aim of this randomized prospective trial was to determine the benefits and effectiveness of (MB) for (SPSD) by comparing the results of Karydakis flap procedure. Patients and Methods: Between January 2016 and April 2017, a total of 100 patients with sacrococcygeal pilonidal sinus disease were randomly assigned to two equal groups which underwent Karydakis flap procedure with or without MB usage. Patients age, gender, BMI, duration of the disease and number of the orifices, excised specimen height, width, area, circumference, depth, volume,postoperative complications and duration of hospital stay were recorded. Results: Characteristics of the patients were similar in both groups. In the MB used group all the parameters except the depth of the excised specimens found as statistically significant (p<0.01). Conclusion: Our results s

Aim: To compare the vascular densities (VDs) of macular microvascular (MMV) and radial peripapillary
capillaries (RPC) according to Erectile dysfunction (ED) in non-ocular Behçet's (NOB) patients, and to
examine the correlation between the patients' International Index of Erectile Function (IIEF)-15 scores in 5
different sexual function domains and the values measured by OCT -A.
Patients and Method: This cross-sectional study was conducted between April 2019 - March 2020. Of the
94 male Behçet's patients, 23 without eye involvement and who met the inclusion criteria were included in
the study. The control group consisted of 25 age-matched healthy individuals. Values measured by optical
coherence tomography angiography (OCT-A) were compared between patients with and without ED and
controls. The correlation between the patients' scores in 5 different sexual function domains of the IIEF-15
questionnaire and those measured by OCT -A was examined.
Results: Compared to controls, VDs were reduced in the whole area of the deep capillary plexus in both
patients with and without ED. VDs of all vessels of the whole area in the RPC network were also decreased
in EDs compared to controls and non-EDs. In addition, retinal nerve fiber layer (RNFL) thicknesses in the
inferior quadrant were found to be decreased in patients with ED compared to controls and those without ED.
In the correlation analysis between NOB patients' scores in 5 domains of IIEF-15 and OCT-A measurements,
there was a positive correlation between the RNFL thickness values and VDs of all vessels in the whole area
of RPC, and the scores in 4 domains of IIEF-15.
Conclusions: After excluding factors that may cause ED, MMV and RPC VDs and RNFL inferior quadrant
thicknesses were found to be decreased in NOB patients with ED. In addition, a correlation was found between
IIEF-15 scores in sexual function domains and RPC VDs and RNFL thicknesses of NOB patients.

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

İn this study; skin prick test, serum total and specific IgE levels vvere compared in patients with asthma and the diagnostic values of these tests vvere investigated. İn addition sensitivity and specifity of total and specific IgE values vvere calculated for different allergen groups. Skin prick tests vvere applied to asthmatic and control cases and serum total IgE levels vvere determined in both groups. İn asthmatic and control groups, serum specific IgE levels vvere determined for allergens vvhich vvere observed positive in prick test. The serum total IgE levels of asthma group (301.7±412.1 lU/ml) vvere significantly higher vvhen compared to the control group (77.1+55.3 lU/ml). Sex and family history of atopy vvere not factors influencing the total IgE levels in asthmatic patients (p>0.05). The sensitivity of serum total IgE was 57%. The sensitivity and specifity of serum specific IgE was 75-100% and 100% (except for mites), respectively. The correlation betvveen high serum total IgE and serum specific IgE positivity was weak (r=0.25). We concluded that high serum total IgE levels are not sensitive in diagnosis of atopy in asthmatic patients. Serum specific IgE levels should not be investigated in atopic patients as routine, because of it has high specifity vvith allergens positive in skin prick tests.

This study was aimed to examine the effects of ovariectomy and ovariectomy follovved by estrogen administration on the pineal gland by light microscopy. For this purpose 15 female Wistar rats vvere used. Animals were divided into three groups. Group I and II vvere designated as sham-ovariectomised (Control) and ovariectomised, respectively. They received sesame oil (0.1 mİ subcutaneously) alone. The rats in Group III vvere ovariectomised and daily injected vvith Estradiol Benzoate (0.5 mg/0.1 mİ sesame oil per day s.c) for 1 months. At the end, ali animals vvere killed by vascular perfusion. The pineal glands of rats vvere removed, then processed for light microscopy. Ovariectomy caused hypertrophy in pinealocytes and an increase of lipid droplets in the structure of pineal gland. İt was observed that Estradiol administration follovving ovariectomy inhibited ovariectomy induced hypertrophy and increase of lipid droplets. Additionally, the connective tissue betvveen parenchymal cells was increased in this group. İn conclusion, increased of celi activity was seen in the pinealocytes after ovariectomy and this increase was suppressed follovving the administration of Estradiol benzoate.

In this study, we aimed to investigate the pre-valence of ST-segment elevation during exercise stress test (EST) in patients who underwent co-ronary angiography because of EST positivity, and to compare the clinical, EST, angiographic and prognostic data of patients with ST-segment ele-vation in EST with and without prior myocardial in-farction (PM1). Eighteen patients with exercise-induced ST-segment elevation were studied (male: 16 (88.8 %), female: 2 (11 %), mean age 54.1±9.9 years). Of these patients 12 had evidence of PM1. The pre-valence of ST elevation was (% 8.5) in 210 patients who underwent coronary angiography because of EST positivity. Thirteen patients (72 %) showed ST elevation in anterior, 2 (11 %) in inferior and 3 (16.6 %) in inferior+anterior leads. Three of PMI (+) patients showed ST elevation remote from pathological-Q wave, when 9 had ST elevation in the PM! localization. On the other hand, angina occured during EST in all patients with PM1 but in only 5 (41.6 %) of PM] (-) group.

In this study, we have planned to determine: The vaccination situation of the two age groups of children in the first and fifth classes of the primary schools of Konya province by looking at the BCG scars; the effects of BCG vaccination to tuberculin tests; the tuberculin reaction that can distinguish the natural infection in one time vaccinated children. We have also investigated the situation of tuberculosis infection in Konya province for contituting data for our region. We have included 2652 students of first and fifth classes of the primary school (1374 and 1188). 414 (16.2%) of the children had no BCG vaccinations. 2029 (%79.2) of the vaccinated 2148 children had only one and 119 (%4.6) children had two vaccinations. Mean tuberculin endurations were respectively 1,186±2,188 mm 4,489±4,643 mm and 10.890±4.037 mm in unvaccinated and in the children who had waccinated twice. Morower, 9(%2.2) of the unvaccinated 414 children, 438 (21.6) of one time vaccinated 2029 children and 85 (%70.5) of two times vaccinated 119 children had 10mm or larger endurtions. The infection rate was %4.2 in the whole group. In the group of unvaccinated children, the risk of yearly infections was 0.22 in the 7 year old children group and 0.31 in the 11 year old children group. As a result, we have determined that vaccinations in the newborn age group are succesfull but revaccinations are not enough. BCG vaccination is increasing the tuberculin reaction and pozitive tuberculin enduration is ≤14 mm.

Breast reconstruction is an essential part of the breast cancer threapy. The transverse rectus abdominis musculocutaneous (TRAM) flap has been widely used for reconstruction of the breast. Partial loss of the flap is still a major problem. The defficiency of flap perfusion may cause partial necrosis of the flap. Periferic vasodilatation may increases flap viability. The aim of this study is evaluation of affect of nebivolol on rat TRAM flap perfusion. Nebivolol is a selective β1 adrenergic receptor antagonist that causes a direct vasodilator effect attributed to the action on vascular nitric oxide (NO). In this study 30 male spraque–dawley rats were used. A pedicled TRAM flap based upon the the right inferior epigastric artery was elevated and reapproximated. Animals were randomly assigned to 5 treatment groups (n:6). Group 1 received no nebivolol. Groups 2 through 5 were administered 100 mg/kg nebivolol orally 24 hours preoperatif; in addition groups 2 to 4 received orally postoperatif for 7 days. Group 3 also received intraoperatively; groups 4 and 5 were given nebivolol orally for 7 days before the 24 hours preoperatif treatment. Seven days after surgery skin paddles were photographed and assessed for viability. In seventh day blood lactate levels were measured. Statically significant differences were found in all experimental groups relative to the controls. Group 4 displayed the greatest improvement in flap viability, significantly better than other nebivolol groups. This study indicates that nebivolol may provide a useful pharmacologic tool for reducing iscemia-reletad necrosis in TRAM flaps.

The vascular access path is important in cancer patients who need long-term intravenous treatment. With this partial application port named, long-term intravenous application could be performed, and changes were made in the structure and application of these catheters with the over the years. Between January 2006-August 2010, 235 cancer patients underwent permanent venous port were retrospectively reviewed in our clinic. Patients’ age were ranged from 28-82 (mean 45±3). 132 patients were female, 103 were male. All attempts to port catheter performed under local anesthesia in the operating room, monitoring. The total number of days that remained attached to the port for 235 patients ranged from 11-1997 days (mean 603 days). The clinical use of intravenous port catheters has increased, and the importance of them every day to increase. Especially, in patients’ vascular access inappropriate, these catheters used safely. Installing the port by experts, be careful in Huber needle use, than more 10 cc of injector volume, and the port has been inserted after the evaluation of imaging methods, detection of skin under the best of use of the sterile period, and the use of heparin made by persons experienced with the washing process also will extend the life of the catheter and will improve patient comfort.

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

 

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

 

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

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

Aim: İn this study the meningeal structure of the lateral wall of the cavernous sinüs and the microanatomy of Dorell's canal, and the anatomical relations of petrolingual and petrospheonidal ligaments with the adjacent structures were studied. By aim of additional security during the surgical approach in this region this study was performed. Materials and Methods: İn the present study, the microanatomy of the cavernous sinüs and the neighbouring structures in 14 adult human cadavers were examined using for this purpose Olympus operation and stereo microscope. Findings: İn our study, the lateral wall of the cavernous sinüs was found in a form of two layers, superficial and deep. The superficial layer is more thicker and flat vvhile, the deep is in a form of thin, irregular, variable and has dural defects on some region of it. İn our study, we investigated the distances betvveen the cranial nerves and their anatomical relations with the cavernosal part of the internal carotid artery. İt was observed that, the postero-inferior part of the deep layer of the lateral wall of the cavernous sinüs has a continuity with ptrolingual ligament and indicates the site of the entrance of the internal carotid artery; this deep layer can be easily separated from the superficial layer. Conclusion: The present study may be helpful to understand clearly the anatomy of the cavernous sinüs and its relevant structures with their morphometric relationships. Therefore, it can provide a useful Information to reduce the complication risk durring operations upon this region.

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

Lipomas are benign mesenchymal tumours derived from mature adipose tissue. It is very rare to see a giant size of lipomas. A 70 year old male patient applied with an ulcerated and painful mass sizing 20x16 cm on his axilla extending to his back. The mass was suspected as a malignant soft tissue tumour because of showing ulceration and being painful and it was totally excised surgically. The histopathological examination revealed as lipoma. The case was presented as being very rare and mixing malignant soft tissue tumour.

We examined 50 melanocytic tumour specimens vvhich obtained by exicion of the cutaneous tumours. We used P53 immunostaining method. Twenty-five of them had been diaghosed as malignant melanoma and remainders diagnosed as cutaneous nevus. The numbers of Ps3(+) cells per 1000 melenocytic celi used the index of P53 exp- ression. A statistically significant difference was found betvveen the malignant melanoma and nevus cells in res- pect to the malignant melanoma and nevus cells in respect to the index of P53 expression (p=1,673x10~18; p<0,05). Additionally, the higher P53 expersison indexes vvere found in the acral lentigenous and nodular me­ lanoma specimens. İt is well known that such malignant melanoma types have higher metastase rates and prog- ress more quickly compared to the other malignant melanoma types. The P53 expression indexes in the me­ lanom as vvhich invased reticular dermiş vvere found to be higher than the mean value obtained for the vvhole melanoma specimens in this study.

Aim: It was aimed to investigate  the relationship of disease clinical stage between the maximum diameter of primer lesion (LEGÇ), maximum of standardized uptake value (SUVmax), mean of standardized uptake value (SUVmean), tumor volüme (TV) and total lesion glycolysis (TLG) values derived from positron emission tomography/computed tomography (PET/CT) images.

Method: The information of 130 lung cancer patients diagnosed histopathologically between 01.01.2012 and 31.12.2014 in Necmettin Erbakan University Nuclear Medicine Department of Meram Medical Faculty scanned for PET-CT for lung cancer diagnosis and staging,  were included in this study. The values of the maximum diameter of primer lesion, SUVmax, SUVmean, TLG and MTV derived from PET-CT scanning and their histopathological subtypes, other clinical and radyological information of patients were noted. The non-small cell lung cancer patients were graded according to tumor diameter, nodal and involvement metastasis (TNM) staging system using clinical information, PET-CT and other radyological test results if any. On the other hand, the small cell carcinoma diagnosed were categorised as limited or extensive stage.

Findings: In this study, the mean age of 118 men and 12 women,  totally 130 patients, was evaluated  63,46 ±9,96 ( range 40-87 age ). The patients were classified as 106 non-small cell lung Cancer (NSCLC) (81.5%) ve 24 small cell lung cancer (SCLC) (18.5%).  The  histopathologically diagnosed NSCLC patients were consists of  62 squamous cell cancers, 39 adeno cancers, and 5  other types (3 carcinoid tumors, 1 large cell cancer and 1 sarcomatoid tumor). 

Results: In our study, it was observed that there was no significant relationship between the maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG values among SCLC and NSCLC patients. Additionally, it was also found that there was no correlation between these parameters and the SCLC stage.  The maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG parameters were related with stage.

Conclusion: Higher SUVmax, SUVmean, TV, and TLG values of the primary tumor were determined to predict the more advanced clinical stage in NSCLC. This relationship between metabolic parameters and the clinical stage suggest that PET / CT may be valuable in terms of providing prognostic information in NSCLC.

Aim: We aimed to determine types and locations of deep-seated soft tissue foreign bodies (FB) and to evaluate the differences between gender and age groups.

Materials and Methods: A total of 310 patients operated due to deep-seated FB penetration between January 2011 and January 2018 were included in the study. Patients were divided into three groups as under 18 years, 18-45 years, and over 45 years. FB were divided into five groups. Locations of the FB were divided into five region in the upper extremities and into six region in the lower extremities. FB type and location were analyzed according to the gender and age groups.

Results: The most common FB was metal piece in men by 48.4%, and needle in women by 77.3% (P<.0001). Needle was the most common FB by 67.4% in men and 94.2% in women who aged under 18 years (P=.12), whereas the most common FB was metal piece by 54.7% in men and needle by 71.4% in women in the aged 18-45 years age group (P=.0007) and metal piece by 61.3% in men and needle by 70.0% in women in the over 45 years age group (P=.0023). The most common location of FB was hand in men by 35.2% and foot in women by 61% (P<.0001). The most common location of FB was foot by 65.1% in men, and foot by 62.9% in women who aged under 18 years (P=.04), whereas the most common location of FB was hand by 38.9% in men aged 18-45 years and foot by 60.3% in women in the same age group (P=<.0001). The most common location of FB was hand by 65.5% in men and foot by 60% in women who aged over 45 years (P<.0001).

Conclusion: Our study is the first in the literature to evaluate the type and location of the deep-seated FB according to the gender and age groups. The most common location and type of FB were found as foot and needle in women of all age groups and in men under 18 years. This result may be related to the reason that needles, which is used for sewing, are often dropped to the floor due to inattention or neglect of persons, and these persons spend more time at home. Whereas, the most common location and type of FB were hand and metal piece in men over 18 years, respectively. This result may be associated with the labor class doing heavy work which is under risk for hand injury and consists of men over 18 years.

35 rats were divided in 3 groups and resection of 80% the small bowel was performed. First group received 1 mglkgid of famotidine and second group 0.5 mglkgld omeprazole in water and third group re-ceived only tap water. Oral feeding with standart rat food initiated on first postoperative day. The weight and stool consistency were examined everyday. On 15th postoperative day alt rats were sacnfied and liv-er, stomach and ileum biopsies and blood samples for biochemical investigation were obtained. The weight and length of villi, depth of Lieberkühn crypts and the number of villi in 0.43 square mm were compared. Despite the ellect of reducing intestinal pH by blockading gastric acide secretion of famotidine and omeprazole, intestinal adaptation was not influenced in this way or direct ellect to the villi. We esta-blished that adaptation occured not by hypertrophy bul hyperplasia and provided by oral intake in early postoperative period.

Necrotizing fasciitis (NF) is an infectious disease with a possible fulminant course that it is characterized by necrosis of the skin, soft tissues, fascia or muscle. Treatment involves extensive debridement and antibiotherapy. Although, debridement may not always be possible due to limitations in the administration of general and/or block anesthesia in some patients based on such reasons as overall health, bleeding diathesis or medications being used by the patient. There is limited information or studies exploring possible options in such patients, although those that are available support the lifesaving advantages of early fasciotomies performed under local anesthesia. A 76-year-old male patient was admitted with generalized edema to the right forearm and arm, erythema, and a lesion with a bulla and purulent discharge. An NF diagnosis was confirmed with a positive finger test and emergency surgery was planned; however, general anesthesia could not be administered due to the impaired overall health status of the patient, who was using aspirin, preventing blockage. Accordingly, the abscess was drained through arm and forearm fasciotomies that were performed under local anesthesia, and samples were obtained for culture.In conclusion, NF can be fatal when left untreated, while successful results can be achieved with early diagnosis, sufficient debridement and treatment with appropriate antibiotics. That said, drainage of the abscess through multiple fasciotomies can improve the laboratory findings and support treatment in NF patients who cannot undergo rapid debridement or can not tolerate general anesthesia. A fasciotomy may be performed as a supportive treatment prior to debridement in such patients.

Abstract

Psoriatic Arthritis (PsA) is a chronic progressive inflammatory disease that affects 10-30% of patients with psoriasis (PsO). The term "PsA sine psoriasis" is used to describe "patients diagnosed with PsA without skin manifestations". In this study, it was aimed to define the demographic and clinical features of “PsA” “sine psoriasis” according to CASPAR criteria.

Patients and Methods

Twenty-nine patients diagnosed with PsA sine psoriasis according to CASPAR criteria between 2016-2022 were included in the study. Patients with rheumatic diseases and any skin involvement were excluded from the study.

Results

All twenty-nine patients included in the study were diagnosed with PsA according to the CASPAR criteria. 16 of the patients were female. The mean (±SD) age of the patients was 45±11 years. The mean (±SD)  PsA duration of the patients was 6.2±3.0 years. A history of psoriasis in the first-degree relatives of patients with PsA was 54.1%; A history of psoriasis in second-degree relatives was found in 45.9%. 39.4% patients had polyarticular, 35.7% had oligoarticular, 24.9% had axial involvement. DIP involvement was present in 19 (65.5%) of all patients. Nail findings were present in 88.9% of the patients. Besides, enthesitis was detected in 17 (58.6%) and dactylitis was in 18 (62%) of patients.

Conclusion

Patients with clinical symptoms and findings suggestive of PsA and a family history of psoriasis can be classified as PsA sine psoriasis. Patients with dactylitis and DIP arthritis, familial psoriasis may represent a subgroup of PsA.

Several studies reported increased CD4/CD8 ratio in patients with mycosis fungoides (MF). A parallel relationship was indicated between tumor progression and elevated matrix metalloproteinase (MMP) levels. The aim of this study was to evaluate levels of CD4, CD8 and MMP-9, which is an indicator of tumoral invasion, in before and after treatment of MF patients. A total of 10 control patients and 32 patients with plaque stage MF pathologically diagnosed as nonspecific chronic dermatosis were included. Biopsies were taken at the Department of Dermatology, Meram Faculty of Medicine, Selçuk University. Phototherapy was performed for 3 months on all patients diagnosed with MF and control biopsies were taken at the end of 3 months. In 20 patients, there were no findings in favor of MF was diagnosed. MF pathological findings were observed in the other 12 patients. For histopathological examination, sections were taken from a sufficient number of control groups and as well as groups of MF patients before and after treatment. CD4, CD8 and MMP-9 immunohistochemical staining was performed at the Department of Pathology, Meram Faculty of Medicine. Intraepithelial MMP-9 and subepithelial CD4/CD8 values were found to be significantly higher in MFA patients having no benefit from the treatment. It was determined that subepithelial MMP-9, intraepithelial and subepithelial CD4/CD8 values were significantly lower after treatment in the MF patients who had benefit for the treatment. Comparing with the controls, CD4/CD8 and MMP 9 levels were significantly higher in MF patients, and these levels were observed to be decreased in patients who respond well to treatment. Findings of this study were concordant with literature.

Trichotillomania characterized by recurrent chronic hair pulling is an impulse control disorder which is associated with comorbid conditions. In most cases trichotillomania results in a total or partial scalp alopecia. The psychiatric comorbidity is usually seen with trichotillomania in adults. The most common psychiatric comorbidities are affective disorders, anxiety disorders, addiction disorders. The effect of trichotillomania can be quite large and serious. It has many negative effects such as either on relationships between people or causing avoid social activities. The treatment of trichotillomania usually involves participation of both psychiatrists and dermatologists. In this article, a case of a young female patient, who has applied only dermatology policlinic for many years with diagnosis of alopesia totalis and not believing being treated in result, is presented. This case has been prepared as a good example of that trichotillomania causes the depresion and the decrease on the quality of life.

Aim: To identify the effects of sex hormones on inflammation and fibrosis on and around gall bladder. Material and method: In this study 48 rabbit (24 male, 24 female) was used. Acute cholecysstitis was achived by cystic canal ligature (SCL) except control groups. Female (DI, DII, DIII, DIV) and male (EI, EII, EIII, EIV) groups had 4 subgroups, each consist of 6 members. Macroscopic findings of acute cholecystitis were evoluated. Adhesive bands around gall bladder and biopsies from gall bladder were protected in deep freezer. Fibrotic bands and gall bladder were analyzed for hidroxyprolin (HP) and collagen. Results: Acute cholecystitis was developed in all subjects macroscopically. On male subjects adhesions around gall bladder were seen more intensively. Result of subjects with ooferectomy were close to male subjects. On castrated male subjects adhesions were similar to female subjects. The adhessons were less at female subjects with ooferectomy with external estrogen use. The lesions were more at castrated male subjects with external testosteron use. These findings were relevant with quantitative values of HP. Collagen were found more in male subjects compored to female subjects. Conclusion: The results is castrated males were similar to those in females and with usage of external testosteron male type results were achieved. And the similarity of results in female subjects with ooferectomy to males achivement of female type results with usage of external estrogens clearly shows us inflammation and fibrosis increasing effect of male sex hormones in acute cholecystitis.

A case of very large condyloma acuminatum lo-cated in inguinal region in a 62 years old male 40 years history was treated by surgical excision and split thickness skin graft. Altough it had very Tong his-tory there was no malign transformation in histo-pathological examination. We presented it because of its unusual size and tong history without malign transformation.

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

The aim of this study was to research the relationship between the difference in carotid intima media thickness and paraoxonase (PON1) in beta-thalassaemia major (BTM) children. We recruited fifty BTM patients (7.2±5.3 years, 34 boys and 16 girls) and 35 controls (7.9± 2.1 years, 23 boys and 12 girls) consecutively. In all subjects, serum PON1 activity and CIMT were measured. Mean CIMT was significantly increased in BTM patients relative to controls (P

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

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

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

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

In this study, we investigated ultrasonographic findings of pleural effusion in 35 patients with ple-urisy as an aid to differential diagnosis. 25 of the patients were male amd 10 female. The mean age was 41 (range 18 tO 66). All the cases except one with transudate had pleural thickening. The mean thickness of pleura was 5 mm (range 3-11 mm) in cases with tuberculous effusion, 11 mm (range 6-19 mm) in cases with malignant effusion and 7mm (range 4-17 mm) in cases with pneumonic effusions. In cases with tuberculous effusion pleural thickening was diffuse and regular in 12 of 13 cases (%92). It was also determined mobile echogenic fibrils on the surface of pleura in 10 (%77) of the tuberculous ef-fusions. This study suggests that ultrasonography may he useful in the differential diagnosis of tu-berculous pleural effitsions.

Congenital factor VII (FVII) deficiency is an uncommon bleeding disorder with an estimated incidence of 1/300.000-1/500.000. Congenital Factor VII deficiency is an otosomal recessively inherited and 0.5% of all congenital coagulation disorders. Factor 7 deficiency is the fourth of all congenital factor deficiencies in the Factor 8, Factor 9, and lack of the Von Willebrand Factor. It affects men and women in the same proportions. Although there is no correlation between FVII level and bleeding risk. An important part of the patients are asymptomatic until advanced age, often by chance, is investigating the bleeding parameters, only PT’s long, APTT is normal due to the received diagnosis. Fresh frozen plasma (FFP), FVII, prothrombin complex concentrates (PCC), plasma-derived factor VII (pdFVII); recombinant activated factor VII (rFVIIa) are used for prophylaxis or treatment of bleeding. In this case, a pregnant woman at term which her first pregnancy was resulting in vaginal childbirth without any problem, but factor 7 deficiency was detected in her second pregnancy and there was also no problem to term is presented to cesarean operation with recombinant activated factor FVII for the preparation and post-operative management.

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

Aim: It was aimed to discuss a rare case which was diagnossed as pilomatrix carcinoma. Case Report:We report the case of a 50-year- old man with a pilomatrix carcinoma in his left forearm. In his history the patient announced taht the lesion had developed one year ago, and its size had expanded rapidly after the first six- month period. Diagnosis of malignant pilomatricoma is essentially histopathological .The tumor was composed of pleomorphic basaloid cells with prominent nucleoli and frequent atypical mitoses accompanied by central areas with keratotic materials, shadow cells, and foci of necrosis. Vascular or perineural infiltration was not observed. The patient remained disease-free at the 22 months follow- up. Conclusion: Pilomatrix carcinoma is a neoplasm of low-grade malignancy that should be distinguished from the conventional pilomatrixoma and its variants. Clinicians and pathologists should be aware of the occurrence of pilomatrix carcinoma because of its potential for distant metastases. We reviewed the literature and comment on the histopathologic differences from other cutaneous tumors.

Alkaline reflux gastritis has been formed in 20 dogs. 10 of them received 200 mgikg1day sucralfate for 60 days and the others formed control group. We performed total gastrectomy to alt dogs after 2 months and gastrit mucosal lesion score, histopatho-logic results, degree of gastritis, mast cell concentra-don, gastrit pll, and thickness of antral and pyloric mucosa were evaluated. Comparisons of the results were made with Student's t-test. We concluded that alkaline reflux gastritis score was decreased in sucralfate group.

Objective: İn developed populations the increasing trend of electromagnetic pollution survives in an insidious and dangerous dimension. Although estimating the negative effects of electromagnetic field on human organism is very difficult, assessment of their effect on arteries was aimed in this experimental study. Material and Methods: An electrical shaver was choosen as a source of electromagnetic field which was estimated as having a 5-10 gauss electromagnetic field. The shaver was directly performcd on skins of left common carotid and bilateral femoral arteries of 7 Street dogs, weighing meanly 20-25 kg, vvithin a mean period of5months. This was performed on one time in every week with a period of 7 minutes. Totally, 18 periods were performed. At the end of the study carotid and femoral arteries were excised for histopathological examination. Results: Tissue examples of 21 study and 14 control specimens were examined under light microscope. İn study group 8 examples had moderate and 7 examples had severe intimal changes, while in control group 3 examples had mild intimal changes. A chi square test between these groups were considered significant (p<0,05). Conclusion: Endothelial injury and subendothe- lial seperations were significantly found in a very short period. These changes may cause stroke due to athero­ genesis on carotid arteries in a longer period.

35 cases with congenital dislocation of the hip were treated conser-vatively. 7 of the cases (20 per cent) were boys and 28 (80 per cent) were girls. The average age of the cases was 7.5 months (range, 2 to 24 months). The left hip was dislocated in 8 (23 per cent), the right in 7 (20 per cent) and both in 20 (57 per cent) patients. 14 cases were treated with von Rosen splint. In the other cases, skin traction was applied first. Then closed reduction and hip spica cast was applied ender general anesthesia in 19 cases, open reduction was applied in two cases. Adductor tenetorny was nessary in 7 patients (ten hips). The patients were followed average 6.5 months and avascular necro-sis was not determined. The conservative treatment was not sufficient in 2 patients.

Aim: Axillary defects mostly occur after burn contracture releases or hidradenitis suppurativa debridements. Reconstruction of this type of defect is a challenge since the ultimate aim is maintaining a pliable coverage with full mobility of the shoulder joint. Scapular flap is one of the reconstructive options in axillary defect coverage. This study is aiming to present reconstruction of axillary defects with scapular island flaps for different indications and to discuss the outcomes of the donor sites so as to suggest it as a workhorse flap in axillary reconstruction.
Patients and Methods: A total of 7 patients treated with 8 scapular island flaps between 2015 and 2019 were included retrospectively. Five patients were operated for hidradenitis suppurativa and 2 patients reconstructed for axillary contracture. All scapular flap pedicles were skeletonized and transferred to the axilla through the triangular space.
Results: Flap dimensions ranged from 84cm2 to 128 cm2 without exceeding 8cm of the width. Donor site scars widened between 3 months to 6 months post-operatively and independent of patient age. Donor site scars ranged from 1.5-2.6 cm after at least 3 months of follow-up. All flaps survived without any complication except one with a tip necrosis that healed with secondary intention.
Conclusion: Scapular island flaps can cover defects of the axilla created by various causes. Horizontal extension of the flap protects it from burn scar involvements of the posterior axillary line and the arm. Although widening of the scars seems to be a disadvantage, thin and pliable skin coverage with ease

Erythema nodosum is a dermatose characterized by variable-sized nodules in the skin. These nodules are painfull, erythematous and generally localised on the anterior asbect of the inferior extremities. In this study, results of etiologic investigations of 50 patients with erythema nodosum was presented.

Aim: Opopanax hispidus (Friv.) Griseb plant belongs to the Apiaceae family. It is traditionally used for the treatment of hemorrhoids, female infertility, and purification of blood. We aimed to examine the histological changes in the murine ovarian tissue following the administration of a methanolic extract of the aerial parts of the Opopanax hispidus (Friv.) Griseb plant.

Materials and methods: Twelve adult female Swiss-Albino mice were randomly allocated into 2 groups. Control group received no administration. In the Opopanax hispidus group the methanolic extract (200 mg/kg/day) was administered via oral gavage for 5 days. At the end of the experiment right ovarian tissue of each subject was excised. Routine histological processing of tissue samples fixed in 10% formalin were then sectioned at a thickness of 5 µm. The sections were stained with hematoxylin and eosin and examined with a light microscope. The modified method of Cavalieri principle was used in the stereological measurement. The total tissue volume ratio was measured with a point counting grid provided by the Shtereom version 1.5 software package. Mann-Whitney U test was used to compare the groups.The significance level was set at 5%. All statistical analyses were performed using SPSS (ver: 20) software package.

Results: A significant difference was observed with respect to the number of antral follicles (p<0.05). A comparison of ovarian volumes between the groups revealed a significant decrease in the Opopanax hispidus group (p<0.05).

Conclusion: We demonstrated that Opopanax hispidus exerted positive effects on the ovarian tissue and increased the number of antral follicles, probably due to its antioxidant effect.

The aim of this study was to evaluate the frequency and clinical characteristics of psoriatic arthritis (PsA) in patients with psoriasis (Ps). One hundred and four patients who are following with psoriasis in Dermatology outpatients were included. The patients were examined for PsA according to Classification criteria for psoriatic arthritis (CASPAR). Psoriatic arthritis was determined in 10 (% 9.6) patients. The first presenting symptom was skin lesion in five patients. The most common type of skin lesion was plaque Ps both Ps and PsA. Peripheric joint involvement was detected in 9 patients. The most common manifestation pattern is oligoarthritis (4 patients), followed by polyarthritis (3 patients), spondyloarthropathy (2 patients) and distal interphalangeal (DIP) arthritis (1 patient). The psoriasis area and severity index (PASI) was observed similarly in patients with PsA (4.92±5.3) and those without PsA (4.87±3.3). Nail involvement was significantly more common in patients with PsA (%100) than those without PsA (%53.2). As a result; the frequency of PsA in patients with Ps was found as % 9.6. Nail involvement was observed in all patients with PsA.

  Brusellosis is a zoonotic disease which is transmitted with nonpasteurized milk and milk products. Mostly effects the gastrointestinal system and less the genitourinary system. Most common genitourinary complication of brucellosis is epididymo-orchitis.

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 Here we present a case which presented with right lower quadrant pain in which physical examination lead us to the preliminary diagnosis of appendicitis after laboratuary results, cilinical findings and deepining the history the patient was diagnosed with unilateral epididimoorchit and here presented with clinical laboratuary findings. Brusellosis which is endemic in our country, should be kept in mind especially when accompanied with acute abdomen eventhoug imaging prosedures do not confirm the diagnosis. 

Dyke-Davidoff-Masson Syndrome (DDMS) is rarely seen and a clinical entity with features of drug-resistant epileptic seizures, cerebral hemiatrophy, contralateral hemiparesia, facial asymmetry, mental retardation or learning disability. A 27 year-old-male patient presented with complaint of seizure. His first attack was occurred when he was three-days-old. His seizures were complex partial seizures. He has used varios of antiepileptics but seizures could not be controlled since he was three-years-old. Neurological examination revealed mild hemiparesis, hyperactive deep tendon reflexes and Babinsky’s sign positivity at the right side. Magnetic resonance imaging (MRI) of the brain revealed left cerebral cortical hemiatrophy. The patient was diagnosed with DDMS considering that learning difficulties in additon to the above clinical features. He has used 1000 mg/day carbamezepine and 200 mg/day topiramate for 10 months and he is seizure free now. Absence, complex partial or secondary generalized seizures may seen in patients with DDMS. Surgical procedures like hemispherectomy may be performed in patients who have frequent and drug-resistant seizures. In our patient, seizures were controlled with oral antiepileptic drugs without any need of surgery. This case is presented because of the rarity of the syndrome and demonstratively of the brain MRI.

This study was designed to determine the effects of interferon alpha - 2b and octreotid treatments on some hormonal parameters in rats. Total 36 Wistar - Albino male rates were used as control (n = 12), interferon alpha -2b (n = 12) and octreotide (n = 12) groups. 250.0001U of interferon alpha - 2b was introduced to interferon group rats at intervals of 48 hrs. To the octreotide group rats, 3 times in a day (8 hrs intervals) for 7 days, 10 mg oct-reotide was injected subcutaneously with a insulin ınjector. The levels of TSH, total T4, total T3, testosteron and growth hormone were determined in blood samples of the rats by RIA. Plasma TSH levels of interferon alpha-2b group was found lower than that of control group (P<0.05). However, no significant difference in T3 and T4 levels were determined among control, ocreotid and interferon treated groups. (P<0.05). It was established that in-terferon alpha - 2b and octreotide treated groups have lower testosteron levels than that of control group (P<0.05). Inteıferon alpha 2b group had lower testosteron levels comparing to octreotide treated group (P<0.05). Nevertheless, there was no significant difference in the growth hormone levels of the groups_ The results of the study showed that the treatments of interferon alpha 2b and octreotide can be affect some hormonal parameters in the rats.

Aim: The purpose of this study was to investigate the value of contrast material-filled virtual cystoscopy in the detection of bladder tumors. Material and method: Thirty-six consecutive patients (28 male and 8 female; range age, 51-82 years; mean age ± SD, 65 ± 7 years) who had painless hematuria and suspected to have bladder neoplasm prospectively evaluated with virtual cystoscopy. After the intravenous injection of contrast medium, the contrast material-filled bladder was examined with single detector helical computed tomography (CT) scan with 2-mm slice thickness. Source CT data were transferred to a workstation for interactive navigation using surface rendering. All patients also underwent conventional cystoscopy. The results of virtual cystoscopy were compared with the findings of conventional cystoscopy. Results: Seventy-one of 78 bladder tumors detected with conventional cystoscopy in 28 patients were also shown on virtual images. Five patients had a normal appearance on both conventional cystoscopy and virtual cystoscopy. On virtual cystoscopy, seven of the 12 lesions 5 mm or smaller in diameter could be identified. We found the following statistical values for the identification of bladder lesions on virtual cystoscopy: sensitivity, 94%; specificity, 90%; positive predictive value, 87%; negative predictive value, 93%; and accuracy 93%. Conclusion: CT virtual cystoscopy is a noninvasive technique which is used successfully for detection of bladder tumors larger than 5 mm.

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.

Diabetic muscle infarct is a rare complication of type 1 insulin dependent diabetic patient, resenting with focal thigh pain, tenderness, swelling and erythema. These pathologic findings were observed in 72 years old male patient, 5 days after he was accepted to our clinic because of diabetic foot ulcer. The mass was thought that on abscess at first but unixue extensor hallucis muscle infarct was observed by surgical exploration.Necrosed muscle was excised and defect area was reconstructed with split thickness skin graft. V/e have presented a case of extensor hallucis longus muscle infarction in a diabetic patient first in the literatüre.

The aim of this study was to evaluate the role of allergy in patients with nasal polyposis. The study included 100 patients with nasal polyposis and 50 healthy individuals. The study was approved by the Ethics Committee of the Selcuk University Meram Medical Faculty and written informed consent was obtained in all cases. Patients were divided into 3 groups. The first group consisted of patients with asthma and aspirin intolerance; second group consisted of patients with only asthma, third group consisted of patients have no disease. Polyp size by Physical examination, computed tomography (CT) and endoscopic scores, skin-prick test results, blood total eosinophil count, serum levels of total immunoglobulin E and symptom scores were analyzed in 100 patients with nasal polyposis. The results were compared between patients with nasal polyposis and healthy individuals. Prick test results were positive on 42% (n;42) of the patients and 22% (n;11) of the control group. While serum total IgE values of 45% (n;45) of NP patients were higher than the accepted value, serum eosinophil values of 27% (n;27) of the patients were higher than the accepted values. As serum total IgE values of 30% (n;15) of control group were higher than the accepted value, serum eosinophil values of 12% (n;6) of them were higher than accepted value. The values of the serum total eosinophil count and positive prick test results were higher in patients with nasal polyposis than in healty individuals.This result shows that allergy is a important factor on etiopathogenesis of nasal polyposis.

We present a case of Jessner's lymphocytic in-filtrate of the skin in a 40-year-old man. The patient had non healing ch•onic inflarnmatory erit-hemapustulous lesions on the face and uppeı- pan of the auı•icles. bilaterally. First histopathologic di-agnosis of the patient was "Discoid lupus ery-thematosus". The lesions appeared on the ,face and made a deformity on the nose. In o•der to achieve exact diagnosis and treatment, all the lesions on the face excised and reconstructed hy a split skin grafit. Auricular lesions that were not treated such a this way, heakd spontaneously. Histopathologic exa-mination of the specimen that was excised from the lesion and healthv skin. revealed that the diagnosis is Jessner's lymphocvti• infiltrate. The reason of spontaneous healing of the auricular lesions exp-lained with no exposure of the auricles to sunshine.

Chronlc myeloid leukemia accounts for 2-5% of cases of childhood leukemia. There are two types: adult type (A-CML) and juvenile type (J-CML). Juvenile type accounts for 18% of cases of the childhood myelodysplastic syndrome. Adult type is seen in the childhood period two fold of juvenile type. Leucocytosis, splenomegaly, lymphadenopathy, bone marrow elements in the periferic smear are the common findings. Skin rash, monocytosis, fetal hemoglobin above 10% and absence of Philadelphia (Ph) chromosome are the typical findings of J-CML and increase in the number of the megakaryocytic and eosinofilic series in the bone marrow, leucocytosis above 100.000/mm 3 and existence of Ph chromosome are the typical findings of A-CML. Since the chronic leukemia cases are rarely seen in the childhood period, we aimed to present two cases having mentioned symptoms, one of which is a 3 years old boy diagnosed as J-CML, the other is 4 years old boy diagnosed as A-CML.

Usually markers for proliferating cells need freshly frozen tissues for evaluation; therefore retrospective study is impossible. Proliferating celi nuclear antigen (PCNA) isapplicable to formalin-fixed, paraffin embedded tissues. İn this study, PCNA expression in cutaneous keratinous neoplasms were determined by immunohistochemical stain- ing using the 19A2 done. Sçuamous celi carcinoma (SCC) a unique expression of PCNA, which frequently involved the nuclei of ali keratinocytes vvithin the lesion was found. PCNA expression in verruca vulgaris (VV) and found a pattern similar to that in SCC. SCC and VV showed significantly increased numbers of PCNA positive cells when compared with other keratinocytic neoplasms.

Aim: To determine the course and the variations of radial nerve and its muscular branches in human fetuses. Material and Method: Radial nerve dissections were made on the 200 arms and forearms of 100 fetuses (50 males and 50 females). Length, thickness and distance measurements were taken by the same person using a 0.01 mm sensitive digital compass. Results: In all arms, primarily, the medial branch of muscular branch was separating from radial nerve. This branch was originating from posterior superior part of radial nerve in 153 arms (76.5%) and anterior superior part of radial nerve in 47 arms (23.5%). On forearms it was observed that the first branches of radial nerve reached to the brachioradialis muscle and extensor carpi radialis longus muscle. It was found that the motor branch which innervates extensor carpi radialis brevis muscle exit from deep branch in 48% of the arms, from radial nerve (separating location of the deep and superficial branches) in 42% of the arms, and from superficial branch in 10% of the arms. Also it was observed, in 26% of the cases, that a muscular branch originated from radial nerve and reached to the inferolateral segment of brachial muscle. It was found that there was no relationship between radial nerve and humerus body’s upper (superiorly 0.18) and lover (inferiorly 0.17) parts. Conclusion: The course, muscular branches, innervation patterns and variations of radial nerve should be well known by the specialists especially dealing with the local surgery of this region. In the fetuses, the knowledge of the spiral course of the radial nerve on the posterior face of humerus is crucial to determine the operation approach point, and this area is less safer than adults in the fetuses, according to our results.

In Patients With Chronic Uraemia it is well known that uraemia is one of the re-asons for polyneuropathy. The subject of this study was to investigate if and how much the uraemia cases autonomic dysfunction. 38 patients with chronic renal failure have been included in the study. Right median nerve motor and sensory conduction. ulnar nerve sensory conduction, peroneal motor conduction and rural nerve sensory conduction have all been recorded from these pa-tients, R-R intervals have also been studied in both during resting and deep inspirium. In addition to that, the sympathetic skin responses evoked by res-piratioit and noise have also been simultaneously from both hands recorded. 56.75% of the patients showed nerve conduction values which indicate polineuropathy. The data re-levant to the R-R inten►ks (during resting %l = 5.58 ± 3.27, during deep inspirium %D = 11.3 ± 5.9, %D-%1= 5.47 ± 5.05. %Dl%1 = 2.19 ± 1.43) have been compared to the values obtained from the control group.1 .The established correlation between R-R intervals and the age of the control group does not exist in the patients with iiremia.2.11 has been found that the %D,%1 and %D-%1 values are sta-tistically different from the values of the control group.The sympathetic skin response could not have been obtained from nine patients(%23_68)_Longer latency values have been observed as compared to the control group. In conclusion it may he surmised that the pa-tients with chronic renal failure show to an im-portant degree an autonomic disfithction (probably due to the autonomic neuropathy) together with polvneuropathy.

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.

House dust mites are found in human housing, particularly in bedding and furniture in many parts of world. İt feeds on epidermal flakes shied from human skin and, some humans become allergic disease. Because of the fact that house dust mites and their dropping are the most important causative of the allergic rhinitis, asthma and atopic dermatitis world wide. Medical and economical importance, taxonomy, biology, description, detection, control of such mites are revievved in the light of recent literatüre.

We hospitalized and ireated 50 patients with burn injuries between 1983 and 1989. Of diem, 35 were children and 15 were adult. Twenty six children were in first decade. Of 50 patients, 34 adrnitted to the hospital early and 16 lately. Skin byopsies were useful in differential diagnosis of second and therd degree burn. There were second degree burn in 22 patients, third degree in 5 and second and third degree in 7. We applied surgical intervention to 27 patients and 5 early tangential excision and pulverised 10 percent of silver nitrate in early cases. Of 50 patients, 3 died and 3 developed psychiatric disorders requiring treatment. in order to prevent hyperirophic burn scar and contracture we used splint and pressure garrnents.

Aim: We aimed to evaluate the relationship between magnetic resonance (MR) enterography and diffusion magnetic resonance imaging (MRI) investigations in inflammatory bowel disease (IBD) patients during active inflammation and remission phases. 

Patients and Methods: We included patients diagnosed with IBD between 01.12.2015-31.08.2016 at our hospital. 47 patients were included; 30 were male (63.8%) and 17 were female (36.2%). Thirty two (68.1%) of them had ulcerative colitis and 15 (31.9%) had Crohn’s disease. Standard institutional sequences for upper and lower abdomen scan included: sagittal and axial T2 TRUFI, axial and coronal fat suppressed T2 TRUFI and coronal and axial T1 VIBE following intravenous (at 60 seconds) contrast medium administration. First group of patients (n=10) had MRI investigations both at active and remission phases, whereas in the second group of patients (n=37) apparent diffusion coefficient (ADC) values, bowel wall thickness and contrast enhancement grades were compared between actively inflamed and non-inflamed bowel segments.

Results: A statistically significant difference was found regarding ADC values and bowel wall thickness measurements in the first group of patients when compared between active and remission phase MRI investigations (p=0.005). Bowel wall contrast enhancement degree did not differ between active and remission phases in the first group (p=0.059). In the second group, there was a statistically significant difference between active and normal bowel segments regarding ADC values, bowel wall thickness and contrast enhancement (p<0.001).

Conclusion: MR enterography and diffusion MRI may be beneficial to determine the degree of inflammation and response to treatment in IBD patients.

Aim: In this study, it was aimed to investigate the frequency of bacteria isolated from blood samples accumulated from different clinics and their sensitivity to antimicrobials during the last year. Material and Method: Blood cultures were examined using Becton Dickinson 9120(USA) automatic blood culture system, and classical methods were used to isolate the bacteria. To identify pathogenic bacteria, sceptor (Becton Dickinson-USA) device and panels were used. Brucella polyvalan antisera of Refik Saydam H›fz›s›hha Institution were used to identify different types of Brucella. Also, Sceptor (Becton Dickinson-USA) panels or Müller-Hinton Agar Disc Diffusion Method were used in the provision of the sensitivity of bacteria to antimicrobials. Result: Of 565 pathogens isolated during one-year’s time, 165 (29%), 116 (21%), 60(11%), 48(8%), 36(6%) and 107 (19%) were determined to be derived from Coagulasis Negative Staphylococcus (CNS), Staphylococcus aureus, Streptococcus spp, Escherichia coli, Brucela spp., Klebsiella spp. and other microorganisms, respectively. It was detected that antimicrobials for which pathogens are the most sensitive are vancomycin, chloramphenicol, ciprofloxacin for gram negative bacteria, such as Staphylococcus and Streptococcus; the most effective antibiotics are imipenem, amikacin, cefoxitin, ciprofloxacin and cefuroxime for gram negative bacteria, such as Escherichia coli and Klebsiella pneumoniae. However, tetracycline, streptomycin and ceftriaxone were detected to be the most effective against Brucella strains isolated from the blood samples. Conclusion: Investigated the blood cultures provided from the in-patients in our hospital, Staphylococcus and Streptococcus were determined to be isolated as the most prevalent ones; then, the second most isolated group was gram negative bacteria.

Diabetic nephropithy is one of the major cause of early mortality among the diabetic patients. In order to reduce the mortality, the prevention of nephropathy and the meticulous control of diabetesz are necessary. Various trials are beige carried out with antihypertensive drugs to control diabetic nephropathy. Although, physiologic or protective role of these drugs is not to be verified in this study. For this, renal changes in streptozotocin induced diabetic rats were intesvigated morphologically at 4 weeks and 8 weeks intervals and the results were compared histologically with those of cilazapril treated strep-tozotocin induced diabetic rats. Cilazapril arrested the nephropathy at early hypey'unction and hyperthropy stage in streptozotocin induced diabetic rats. The ratio, of the left kidney weight to body weight of cilazapril treatment received diabetic rats was either similar to 4 weeks old diabetic rats or higher than that of 8 weeks old diabetic rats which was the farther support of nephropathic arrest by the cilazapril treatment. Histologic studies also revealed that glomerular basement membrane thickness, fatty degenerative of epithel cells of tubuli, tubular necrosis. pyelonephritis, and intenstitial fibrozis were conspicuously regressed by cilazapril treatment

Lagophthalmus is the inability to close the eyelids completely leading to exposed cornea (scleral show) which can result in corneal scar formation and vision loss. The skin of upper eyelid is soft and flexible, so this makes winking easier. To return the upper eyelid its soft and flexible structure, Z-plasty, VY advancement flaps, full-thickness skin grafts, and pedicle flaps are defined as treatment options. The aim of this study was to demostrate the usage of bipedicle flap and midface lift as an alternative treatment option for lagophthalmus that is related to the vertical shortness of upper eyelid developed after blepharoplasty.

Sneddon syndrome(SS) is a rare, progressive vasculopathy with recurrent ischemic attacks. There is no specified treatment recommendation, various treatment methods such as anticoagulants, antiaggregants, and immunosuppressions are recommended. A 44-years-old woman who applied with a temporary numbness on her right side and speech disorder. In her neurological examination, there was central facial asymmetry on the right and mild dysarthria in his speech. In cranial diffusion MR, there was an acute ischemic change in the left lentiform nucleus and at the head of the caudate nucleus. In cranial MR, there were perivascular ischemic gliotic changes and diffuse cerebral cortical atrophy. The patient underwent a skin biopsy to have livedo reticularis-like lesions on both legs. Skin biopsy was compatible with vasculopathy. Due to the ischemic attack, periventricular ischemic changes, and livedoreticularis, the patient was accepted as SS. Since the antiphospholipid antibodies (APL) were negative, that she was followed up with dual antiplatelet therapy. There was no new attack within a year with dual therapy. Dual antiplatelet therapy may be used in SS patients with recurrent ischemic events and negative APL.                                                                                                                                           

Involvement of the eye, skin, genitalia, oral may be the initial pre sentation. There is no marker for the disease. Renal involvement is rare. Focal hecrotizing glomerulonephritis and diffuse proliferative glo-merulonephritis with epithelial cell crescent formation can occur

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

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

Vitamin D is a liposoluble prohormon and a secosteroid which is produced in the skin after exposure to sun-shine. It is turned to calsitriol which has an important role in the calcium and phosphate metabolism by different metabolic pathways. Deficiency of vitamin D is related to some factors such as less sunlight exposure, inadequately intake of vitamin D and absorbtion problems. Studies recently done have shown vitamin D deficiency exists in many people. The effects of vitamin D deficiency on numerous diseases and functional disorders such as chronic musculoskeletal pain, Type 1 and Type 2 Diabetes Mellitus (DM), obesity, multiple sclerosis, rheumatoid arthritis, cardiovascular diseases, osteoporosis, microalbuminuria, renal failure involving colon, prostat and breast cancers either are reported in literature.Vitamin D is one of the main structural elements playing an essential role in several metabolic pathways both directly and indirectly providing numerous functions carring vital importance for organism. In spite of causing a lot of functional disorders and diseases, vitamin D replacement therapy in case of deficiency is safe, economic and simple unless neglected. In this review, we aimed to demonstrate the metabolism, functions and effects of vitamin D, increased risks of chronic diseases likely to be encountered in vitamin D deficiency and the importance of vitamin D replacement therapy.

Atopic dermatitis (AD) is a chronically relapsing skin disease that begins most commonly during early childhood. The prevalence of AD is increasing because of the alteration lifestyle and the disease effects life quality indifferently. In this study, subjects were 30 patients who were admitted to Dermatology Clinic of Selçuk University Meram Medical Faculty with the diagnosis of AD. There were 20 healty subjects as a control group, without any atopy history and have no clinical symptoms. Skin prick tests, composed of 51 materials; house dust mites, tree polens, grass polens, insects and mold were performed both groups. In this test histamin solution was positive and serum salin were negatif controls. Pricks tests were reactive mostly for house dust mites, mold, grass pollens and the other pollens in the AD group. In the healty group, there were reactive results for house dust mite and candida only in one subject. Serum total IgE levels elevated in 17 of 30 patients (56.7%) in AD group , and 2 subjects in the healty group (10%). Statistical analyses showed that, in the AD group, serum total IgE levels are significantly higher than healty controls (p

The morphomethri• analysis of fetal adrenal glands development vvas studied by fifty-two human fetuses.ranging in age fi-om 13 ta 24 weeks of ges-tation. The)' were collected fi-om spontaneous. The adrenal glands weight in•reased fi-om 0_1 gr. ta 1.0 gr during the second trimestr. The lenght (L1). the height (L2) and the thickness (L3) at the adrenal glands were measured and the results were com-pared ıı'ith previous sttıdies in the literature.

In the 1984-1985 academic year, among 4065 students who were randomly selected from primary school children in Diyarbakır city center with a systematic sampling rate of 10%, the rate of rheumatic fever by using a questionnaire was found to be 9.1%. This rate is higher than the rates found in studies conducted in other regions of our country. When the anamnesis of these children were deepened retrospectively, the fact that at the time of diagnosis, most of the children had only extremity pain and no examination was performed, it was thought that some of these pains may have occurred due to reasons other than rheumatic fever. Because of the retrospective diagnosis, the rate of major findings was lower than that reported in the literature. The distribution of patients with rheumatic fever history and valvular lesions by gender did not show a significant difference in accordance with the literature. The distribution of children with valve damage by age has increased gradually in accordance with the literature. Valvule lesion was found in 1.2% in our study. These values ​​are lower than the values ​​reported from Iran, but higher than the values ​​reported in other developing countries and in our country. In the examination of valvule lesions, it was observed that, in accordance with the data in the literature, the most frequent mitral valve involvement was followed by aortic valve involvement. Again, in accordance with the literature, the most common type of valve lesion was mitral insufficiency. Unlike the difference reported in the literature, both mitral and aortic involvement did not differ significantly according to gender. In the retrospective examination of the anamnesis of the cases with valve involvement, no complaints were found by reducing rheumatic fever in 37.2% of the cases. This situation was attributed to the symptoms being mild and forgotten or the occurrence of carditis without other major findings.

Aim: Platelet-rich plasma (PRP) is thought to exerts its effect through the growth factors present in the alpha granules of the platelets, depending on its high platelet concentration. The increasing feeling of pain in recurrent attempts raises the question that PRP may cause hyperalgesia associated with hypersensitization. There is no publication in the literature reporting peripheral sensitization caused by any recurrent injection of PRP. In this study, we aimed to investigate whether hyperalgesia occurs due to hypersensitization in PRP patients with androgenetic alopecia. Patients and Methods: Between 2016 and 2017, 10 male patients aged 25-35 years who had androgenetic alopecia were included in the study. Autologous PRP was injected intradermally as 1 mL per cm2 in the diseased frontal and parietal area of scalp, and then the injection was repeated at the first, second and sixth months. Patients’ responses to painful stimulus were investigated immediately before all injections and at the first year using Von Frey filaments in variable. Hyperalgesia scores of each measurement were determined by averaging results of the two surgeons. Patients who had hair loss were evaluated with dermoscopy. The number of hair follicles per unit area was detected and the patients’ photographs were taken at each control. Results: The mean age of the participants was 29.4 years. When patients were evaluated for hyperalgesia, it was observed that after each PRP application, pain was felt with less amount of g stimulation compared to before PRP injection (p <0.05). The highest period of hyperalgesia was in the first year after PRP (P <0.05). The increase in hair density was calculated as 6.4, 9.4, 21, and 27,6% at 1st, 2nd, 6th, and 12th months after the first treatment. Conclusion: We determined that hyperalgesia may occur in patients because of repeated PRP injections. The development of hyperalgesia in these patients may be due to growth factors in the PRP content. Further experimental and clinical studies are needed to determine the cause of hyperalgesia occurring after repeated PRP injections.

The common skin malignancies are basal cell carcinoma, squamous cell carcinoma and malign melanoma. It is well known that they are more or less related to ultraviolet light. However one may encounter these type lesions on unexposed areas. The cases so far treated and followed -up for at least 5 years showed that apart from ultraviolet light, some other predisposing factors are influential on the onset of the diseases. In this presentation the cases that might prone to these predisposing factors are also discussed.

Extensive surgical excision, free skin graft and regio•al lymphadeno-idectomy for therapeutic or prophylactic reasons were performed in fifteen malign skin melanoma cases. They were kept under postoperative chemotherapy, radiotherapy, immunotherayp afterwards and various aspects of melanomas were examined.

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.

Between January 1983-January 1993, 315 pa-tients with deep vein thrombosis were treated in our clinic. In 49 of them pulmonary embolism were present. 4 paiients with pulmonary embolism died in hospital, 3 of them died due to embolism. Ali pa-tients were symptomatic, diagnosis of them were de-pended on clinical and laboratory findings. It was ac-cented that pulmonary embolism may occur on silent thrombosis and the importance of the relation-ship between deep yein thrombosis and pulmonary embolism. Importance of prophylaxis on high risk patients was reminded

Aim: Many options have been reported in reconstruction of the facial defects such as skin grafting, local flaps and free flaps. The extended V-Y flap, a modified V-Y advancement flap, is very useful in closing defects following excision of large facial lesions. Herein, we presented our 6 years experience for covering of the large facial defects with extended V-Y flaps. Material and Method: This procedure was applied to 27 patients with age ranging from 38 to 79 between 2001 and 2007. All operations were performed under local anaesthesia. The lesions were either squamous cell carcinomas, basal cell carcinomas, malignant melanoma, trichilemmoma, seborrheic keratosis or actinic keratosis and they were localized in the malar area, infraorbital area, lateral nasal aspect, the zygomatic area and the forehead. The size of the defects ranged from 3 x 3 cm to 6 x 5, 5 cm. Results: All of the flaps were achieved suitable closure of defects. The functional and aesthetic results were satisfactory for patients, and no tumor recurrence was observed during the 9 to 17 months follow-up period. Conclusion: Extended V-Y flap can be used reliably for the reconstruction of large facial tissue defects.

Aim:

In this study, we aimed to evaluate the repetitive effects of hyperbaric oxygen treatment on patients’ pulmonary functions and diaphragmatic movement.

Patients and Methods:

The study group consisted of 22 patients diagnosed with various diseases who were administered hyperbaric oxygen treatment between June 2019 and December 2019. Respiratory functions such as dynamic and static lung volumes, diffusion capacity, and maximum inspiratory and expiratory pressures were evaluated before the start and end of the treatment sessions. Besides, the diaphragm thickness and the diaphragm movements during tidal volume and deep inspiration were measured with thoracic ultrasonography.

Results:

Twenty-two patients (16 male;6 female) with a mean age of 53.3±10.0 years were included. At the end of hyperbaric oxygen therapy total lung capacity, vital capacity, and residual volume were significantly increased (p<0.05). The other static lung volumes, maximum inspiratory and expiratory pressures, and diffusing capacity of the lungs for carbon monoxide did not change. The thickness of the diaphragm and diaphragmatic movement during tidal volume and vital capacity were also increased (p<0.05).

Conclusion: In our study, we evaluated the effect of hyperbaric oxygen therapy on diaphragmatic and respiratory functions by using, diffusing capacity, as well as spirometry and diaphragmatic imaging techniques. As a result, hyperbaric oxygen treatment led to a significant change in pulmonary and diaphragmatic functions.

Keywords: Diaphragm, Diffusing capacity, Hyperbaric oxygen, Lung, Toxicity

ABSTRACT

Aim: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Although it can be corrected by simple methods if detected earlier, treatment failure or delay in sternal dehiscence may result in mediastinitis, which is highly lethal.  In this study, we aimed to investigate alternative sternal closure systems, mainly sternal talon (STalon) and titanium sternal plates (SPlate). Patients and Methods: In between April 2015 and January 2018, patients with sternal dehiscence after any kind of open cardiac surgery were included in this study. These patients were retrospectively evaluated according to the their demographic data, risk factors for sternal dehiscence, type of operations, techniques used for fixation of the sternum, mainly focusing on the STalon and titanium SPlate fixation. Results: A total of 45 patients were taken into surgical correction because of sternal dehiscence.  Thirty-four (75.6%) of the patients male, whereas 11 (24.4%) were female. Mean time interval after the first operation to sternal dehiscence was 68.5 days (1-780 days). Mean body-mass-index (BMI) was 31.52 kg/m² (22.03-43.69 kg/m²). Before the sternal fixation, mean CRP value was 68.34, whereas it was 75.55 before discharge. Confounding risk factors were internal mammarian artery (IMA) harvesting for coronary artery disease, diabetes mellitus, bronchial asthma, chronic pulmonary artery disease and advanced age. Mean post-operative intensive care unit (ICU) length-of-stay (LOS) was 5.02 days (1-29 days), whereas hospital LOS was 17.18 days (2-74 days). Early mortality was observed in 3 patients (6.67%). The first choice of operation was simple closure and/or Robicsek closure. Apart from simple and Robicsek closure techniques, sternal talon and/or titanium plates were used in 24 patients (53.3%). DM was found to be related to extanded total hospital LOS, ICU LOS, and postoperative time to discharge. DM also increased the risk of both superficial and deep sternal infection rates (p<0.05).  Conclusion: Ideal sternal closure should stabilize the sternum, be cost-effective and provide shortest hospital LOS with minimal post-operative complications. In patients with intact intercostal spaces, sternal talon may eliminate serious complications, such as cardiac rupture mainly caused by dense adhesions. Sternal plates are mainly effective in fragmented fractures without stable intercostal spaces. All patients should be individualized according to type of lesions and sternal fractures.

Objective: Direct immunofluorescence examination contributes to the correct and differential diagnosis and treatment management of immune-mediated dermatological diseases that can also affect the mucous membranes.

In this study, it was aimed to compare skin/mucosa biopsies performed using direct immunofluorescence and histopathological examination, compliance with the preliminary diagnosis and to evaluate the diagnostic value of immunofluorescence examination.

Patients and Methods: A total of 207 patients’ biopsies sent to the pathology laboratory between January 01, 2019 and December 31, 2019 were evaluated. Groups were formed according to the preliminary diagnosis (intraepithelial/subepithelial separation conditions, lupus erythematosus, lichen planus, vasculitis), and histological (intraepithelial/subepithelial separation, clasia, dermal mucin deposition) and direct immunofluorescence (immunoglobulin G, M, A, and C3 depositions, patterns) findings were recorded. SPSS 23.0 package software with Kappa statistics and the McNemar test were performed. P<0.05 was considered statistically significant.

Results: Direct immunofluorescence results were negative in 115 patients, positive in 91 patients and could not be evaluated in one patient. Histological agreement was found in 19 of 44 (43.2%) patients with bullous pemphigoid, 10 of 18 (55.6%) with pemphigus, 26/51 (50.9%) with lupus erythematosus, 10/15 (66.7%) with lichen planus, 6/6 (100%) with Henoch Shönlein purpuras and 37/62 (59.7%) with other vasculitides. Direct immunofluorescence positivity was found as 19/19 for bullous pemphigoid, 10/10 for pemphigus, 11/26 for lupus erythematosus, 2/10 for lichen planus, 6/6 for Henoch Shönlein purpura, and 28/37 for other vasculitides (κ = 0.021).

Conclusion: Direct immunofluorescence examination significantly supports clinical and histopathological findings in the diagnosis of immune mediated dermatologic diseases and in the differential diagnosis of vesiculobullous diseases.

Aim: The aim of the study was to investigate effectiveness of corneal collagen cross-linking treatment in patients with progressive keratoconus. Patients and Methods: Ten patients (6 female and 4 male) who showed progression in the parameters of Keratoconus were included in the study. Complete ophthalmological examinations including uncorrected and best-corrected visual acuities (UCVA and BCVA), slit-lamp anterior and posterior segment investigation and intraocular pressure was performed in all patients. Corneal topographic measurements were done by Sirius Corneal Topography system. All patients underwent an intervention of corneal collagen cross-linking procedure with riboflavin and UV-A. Results: Sim K max value of all patients in topographic measurement decreased (mean 0,95±0,22 D) after 6 month follow-up. The value of sim K min decreased (mean 0.39 D) in 8 patients, while it showed no change in 2 patients (20%). A decrease of mean of 10,1±1,37μm central corneal thickness was observed. In 6 eyes (60%), BCVA showed improvement when compared to the baseline values, while BCVA in 4 (40%) eyes remained stable during the follow-up period. Conclusion: Corneal collagen cross-linking treatment as a first applications of our clinic using Apollon device seems to be effective in prevention of keratoconus progression according to our experience in our small series. Long-term, prospective, large studies are needed to display the long-term effectiveness of this treatment.

Camptodactyly is a congenital flexion deformity of the proximal interphalangial joint in the anteroposterior plane. Many factors have been claimed for its etiology and, many alternatives have been proposed for treatment. Eleven patients with an average age of 21 were treated between 1993 and 2001 and included in this study. Ali the patients had bilateral camptodactyly in the fifth finger. After releasing the skin contracture by “Z” plasty, dynamic splint was applied for both fingers in extension for approximately 6 months. The mean follow-up time was 20 mounths and there were no recurrences in any patient. Our method of treatment has no surprises tike extensive surgical treat­ ment and has acceptable results in selected cases.

Aim: N-hexane is a commonly used alyphatic hydrocarbon derivative due to being an expensive solvent, and known as having neurotoxic characteristics. A case being exposed to hexane based chemicals for the purpose of the stabilization of electrical pressure circuits on cell phones and developing sensory neuropathy owing to the exposure was aimed to be discussed in the light of the literature. Case Report: A 50 year old man applied to the Neurology policlinic with the complaint of numbness first starting on the feet, then radiating to the legs and hands 3 years ago. On his neurologic examination, no pathologic findings were found except for the finding in the form of glove-sock hypoesthesy. In the history of the patient without any known systemic diseases, it was found out that the patient was a cell phone technician for the last 3 years, and that he was particularly exposed to hexan-based chemicals for the purpose of the stabilization of electrical pressure circuits on cell phones in very inappropriate conditions and for a long time. On the examination of his EMG, widespread peripheric pure sensory neuropathy was determined. Other causes leading to sensory neuropathy were excluded. It was thought that sensory neuropathy may be dependent on the longterm exposure to hexan-based chemicals for the purpose of the stabilization of electrical pressure circuits on cell phones in inappropriate conditions. Conclusion: Dependent on long- term n-hexane exposure, peripheric sensory neuropathy may develop in those dealing with cell phones becoming widely used in recent years, and the maintenance of these cell phones after their mechanic defects.

To determine the contribution of imaging techniques for diagnosis and therapy planning of patients with parotid masses. 16 patients (10 female, 6 male; between 13-75 age; mean age 41.12±16.97 years) were evaluated retrospectively. Age, gender, clinical characteristics of patients, imaging studies which were performed preoperatively, location and characteristics of masses and invasion to the surrounding tissue, histopathologic examination of surgery specimens were evaluated in the current study. Histopathologic examinations of specimens revealed that all cases were benign. Histopathologic findings revealed no malignancy. Histopathologically, lesion was diagnosed as pleomorphic adenoma in 11 patients (%68.75) and Warthin tumor in 5 patients (%31.25). The mass was located in left parotid gland in 8 (%50) patients and in right parotid gland in 8 (%50) patients. Preoperative, ultrasound (US) was performed in 7 patients; computed tomography (CT) was performed in 9 patients; magnetic resonance imaging (MRI) was performed in 5 patients. US should be the initial investigation of choice for patients with parotid masses because of superficial location. US is effective, inexpensive, nonradiation, non-invasive, practical and does not require sedation in diagnosis parotid masses. Deeply located tumors and malign tumors should be evaluated with CT or MRI. CT or MRI alone is sufficient for evaluation.

Aim: We aimed to evaluate surgical procedure carried out to an 8 years old child, clinically diagnosed as Henoch-Schönlein Purpura (HSP), undergoing intussusception repair, because of allergic vasculitis, erythamatose maculopapuler rashes, rectal bleeding, abdominal pain and intussusception, under the light of literature data. Case Report: An eight years old and a male child was consultated because of his biliary vomiting, nausea and diffuse maculopapuler rushes which were localised especially in lower extremites. The symptoms of HSP were observed at histopathologic examination of skin. On examination, the symptoms of acute abdomen, which were characterised with diffuse tenderness and distansion, hipoactive intestinal sounds and abondant biliary drainage from nasogastric tube, were identified. The pneumatic and hydrostatic reductions were not performed because of the risk of perforation due to severe peritonitis and his poor general condition. The patient was operated on after preoperative resuscitation. During the explorative laparatomy, edema and the symptoms of insufficient vascularisation in all intestinum were present. Also, it was observed that approximately 20 cm’s intestinal segment which begins from 10 cm proximal of ileocaecal valve, had been necrotic and ileostomy was carried out after resecting this segment. Meanwhile, it was observed that the whole intestine was edematous and localised blood circulation was distorted in some areas. The patient was operated on to make bridectomy when evisceration and brid ileus occurred on postoperative eleventh day, and the ileostomy was closed at the same session. The patient was delivered with complete recovery 16 days after closing of ileostomy. Conclusion: Although HSP is rarely seen as the cause of acute abdomen, too serious complications of this disease must be kept in mind.

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

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

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

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

The Morphometric Analysis of the Brachial Plexus Formation in Human Fetuses. This study was carried out in 100 fetuses (75; 2nd trimester, 25; 3rd trimester) and totally 200 brachial plexus were evaluated under examination stereomlcroscope. After bilateral fine dissection, to perform morphometric stu- dies; the thickness and/or length of the each part that contribute to the formation of the brachial plexus were me- asured by calipers. Photographs of the brachial plexuses were taken after dissection. Data was statistically analy- sed by Pearson correlation and Student t-tests using SPSS softvvare (for vvindovvs 8.0). İn this study, 93 fetuses vvere decided as normal (the brachial plexus consist of the 5th, 6th, 7th, 8th cervical nerves and 1st thoracic nerve). The mean value of the length of the 8th cervical, 1st thoracic, upper trunk and middle trunk showed sta­ tistically significant difference betvveen female and male. The mean value of the thickness of the posterior di­ vision of lower trunk showed statistically significant difference betvveen right and left side. There was no sig­ nificant difference in other parameters. Pegarding to the correlation values betvveen the age and the measured parameters, the grovvth rate of the each part that contribute to the formation of the brachial plexus was higher in 2nd trimester than in 3rd trimester. The reported results may provide useful information about the fetal de- velopment of peripheral nervous system, and in the diagnostic and therapeutic approach of paediatric surgeons for preventing complications.

The Morphometric Analysis of the Brachial Plexus Formation in Human Fetuses. This study was carried out in 100 fetuses (75; 2nd trimester, 25; 3rd trimester) and totally 200 brachial plexus were evaluated under examination stereomlcroscope. After bilateral fine dissection, to perform morphometric stu- dies; the thickness and/or length of the each part that contribute to the formation of the brachial plexus were me- asured by calipers. Photographs of the brachial plexuses were taken after dissection. Data was statistically analy- sed by Pearson correlation and Student t-tests using SPSS softvvare (for vvindovvs 8.0). İn this study, 93 fetuses vvere decided as normal (the brachial plexus consist of the 5th, 6th, 7th, 8th cervical nerves and 1st thoracic nerve). The mean value of the length of the 8th cervical, 1st thoracic, upper trunk and middle trunk showed sta­ tistically significant difference betvveen female and male. The mean value of the thickness of the posterior di­ vision of lower trunk showed statistically significant difference betvveen right and left side. There was no sig­ nificant difference in other parameters. Pegarding to the correlation values betvveen the age and the measured parameters, the grovvth rate of the each part that contribute to the formation of the brachial plexus was higher in 2nd trimester than in 3rd trimester. The reported results may provide useful information about the fetal de- velopment of peripheral nervous system, and in the diagnostic and therapeutic approach of paediatric surgeons for preventing complications.

The bacterial and fungal colonisation of the hands flora of the 50 medical doctors working at the hospital of faculty of medicine and 50 dentists wor-king at the hopsital of faculty of dentist were in-vestigated.From the hands of the 7 (14%) medical doctors we determined gram negative bacterial co-lonisation but no fungus. We determined gram ne-gative colonisation from only one (2%) of the hands of the dentists who were using glovws while working and also from the hands of the dentists we could`nt derirmine fungal colonisation. We had been de-termined 20.4% gram negative and 8.6% fungal co-lonisation from the hands of the nurses that worked at the same hospital in our previous investigation. We thought that using gloves and washing hands had been decreased gram negative and fungal co-lonisation and this is very important for preventing nosocomial infections.

Oral squamous cell carcinoma (OSCC) is the most frequent malignancy of the oral cavity. Squamous cell carcinoma of floor of the mouth during pregnancy is not reported in the literature. 26-year-old female patient admitted to our clinic with a lesion in the mouth for 2 weeks. The patient was 34 weeks pregnant and non-smoker. ENT examination revealed that the fragile, ulcerated, 2×1 cm width and 6-7 mm depth lesion was on the left side of the floor of mouth. In eight days, the tumour was almost double in size. Median mandibulotomy was applied to facilitate the resection of the tumor via transmandibular way and the tumour was removed en bloc together with the neck dissection specimen. The patients with oral squamous carcinomas during pregnancy should be treated more quickly, patients and families should be informed about the tumor progression.

The process of treating skin lesions by adding chemical burning to dermabrasion is called salabrazion. During this surgical procedure, after the superficial skin and bad formations are removed, epithelization developing from sweat glands, fat and hair follicles covers the open area. Antibiotic impregnated gases are covered to protect this new epithelium and to prevent infection. Instead of this cover, we applied the amnion membrane, which contains physiological and biological properties, in its fresh and dried form, which we achieved very good results in covering the areas where grafts were taken before. We suggested the use of this method because of the very good results we got.

Moisturizers are important for regulating epidermal barrier and it’s water contenent. They are also important for maintenance of healthy skin. Moisturizers acts as occlusives and humectans to increase the skin water capacity. There are many preperats enhancing these functions. Choice of moisturizer is depent on many factors. Aplication of moisturizers can save as important adjunctive therapy for patients with various dermatologic disorders.

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

ABSTRACT

Introduction: Most of the large defects in the hand are required vascularized skin coverage because they exposed tendons and bones. A pedicled groin flap has been offered as a standard flap for this indication. But immobilization of the upper extremity can be a disadvantage. Raising the groin flap is also possible as a free flap. The disadvantage of free flap is a time-consuming microsurgical procedure. We aimed to compare the pedicled and free groin flap reconstructions in patients with large hand defects based on patient-reported outcomes.

Materials and Methods: Sixteen patients who had groin flaps pedicled or free for the large defects of their hands were included in this study between 2013-2020. This study was performed retrospectively clinical survey work. Patients were divided into two groups: the pedicled groin flap group (n=8) and the free groin flap group (n=8). Patients were followed for 2 years. The patients were subjected to DASH and SF-36 tests after a postoperative period. Pre- and postoperative pain were evaluated with the Visual Analogue Scale. On which day they could walk and sit in the toilet without pain and not needed a second person for daily work, the patients were asked.

Results: Half of the patients with pedicled flaps had serious elbow and shoulder pain and required physical therapy. The wound healing was completed significantly earlier in the free groin flap group (p<0.05). The mean hospital stay in the pedicled group was longer than the free flap group (21 days and 13 days, respectively), which was statistically insignificant. The DASH scores were found to be 92 and 72 in the subacute and chronic stages in the pedicled flap group, whereas 52 and 24 were found in the free flap group, respectively (p = 0.012 and 0.002). According to SF-36 scores, physical functions were impaired significantly in the pedicled flap group (p < 0.001). The number of days needed by the second person for daily work was 79 in the pedicled group and 24 in the free flap group (p = 0.041). Sitting in the toilet without pain was started on the 63rd day in the pedicled group and on the 15th day in the free flap group (p = 0.036).

Conclusions: By transferring the groin flap as a free flap, the problems related to shoulder and elbow joints have disappeared, hand rehabilitation could be started earlier, and the time to return to daily work was shortened. So, if the groin flap is preferred, free style should be considered first.

Mycozis Fungoicles in a culaneus lyrnphotna of T cell origin. in the pretnycolic phase, there is eczetnatoid or nonspecific dermatitis. Later in the course of the disaease, this phase progress to plaque, nodules, ulsers or diffuse erytroderma. The diagnosis of the disease can be made clefinitely when three characteristic histologic features are present: a) A bandlike rnononuclear cells infiltrate in the Iffier dermis_ b) Mycosis cells present in the dermis. c) Pautrier's microabscess present in the epidermis. in this report, we presented a case of rnycosis fungoides and discussed its clinicopathologic features according to literature daie.

Orgamıphosphorus insecticides are widely used agents which are quickly absorbed through the skin and mucous membranes. The effects of acute expo-sure to these agenıs can be .severe and imensive the-rapy mav be required. Specific drugs are available to reverse the muscarinic. nicotinic and central effects of !hese poisons. when giyen early they are very ef-fective and early diagnosis and treatment may there-fore be life saving. Iıı Iliis study seven cases of acute poisoning with an organophosphorus insecticide are reported. The sings and semptoms of acute poisoning are described anda rational approach to treatment is discussed.

Split hand-foot malformation is a congenital limb malformation, characterized by a deep median cleft of the hand and/or foot due to the absence of the central rays. Split hand-foot malformation can occur as isolated anomalies or as one component of multisystem syndromes. The majority of the familial cases are inherited in an autosomal dominant manner. Some patients with split handfoot malformation have been found to have mental retardation, ectodermal and craniofacial findings. We presented a split handfoot malformation case with liver and cutaneous hemangioma by the literature. According to our investigations, this is the first case of split hand-foot malformation with existence liver and cutaneous hemangioma.

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.

The etiology and pathogenesis of Dupuytren contractures, which have been studied and deseribed by Cont Chigot, since 1831 is not clear yet. We have discussed the 21 cases which we operated during the last five years. We compared these with the literature. We have operated on 27 hands by regional or total fasciectomy using Z plasty or Skoog's quardran-gular skin incision. We compared our results by Michon-Tubiana's clas-sification table. We have tried to draw attention to this conditions because very few cases have ben reported in Turkish Medical Literature.

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.

It is the sudden occlusion of the pulmonary artery and its branches by an object such as thrombus air, fat, tumor parcast coming through the bloodstream (1). In the USA, about 630 thousand people are exposed to pulmonary embolism every year and about 200 thousand people are exposed to it. While the mortality rate is 8% in those who can be diagnosed and are treated, it approaches 30% in those who cannot be felt (2). Deep thrombosis was found in 33% of the cases (3,4). Pulmonary thromboembolism is a known complication from the beginning of the 19th pain. Previously, the thrombus was thought to be inside the artery, but later it was defined as embolic. In 1858, Wirchow first demonstrated that the so-called pulmonary thrombosis was an embolism, and he described a triad. Accordingly, local travnia at the wall of the vessel stays with the tendency of the blood to clot (5). These factors still maintain their validity in etiology. ETIOLOGY The reasons leading to pulmonary thromboembolism are mainly thrombi and lysis: fat, air, amnion tumor tissue, parasite eggs, foreign bodies such as catheters. Pulmonary artery embolism was found in 1 out of 3 cardiac autopsies on average, with mitral stenosis being in de-cornized cases. The right heart may be the source of thrombi in cases with atrial fibrillation or past myocardial infarction. In addition, factors that facilitate ventricular thrombosis are among the risk factors for pulmonary enriboli. Situations where the risk of pulmonary embolism is increased.

Purpose: The development of orbita and surrounding region were evaluated with the anthropometric measure- ments in human fetuses during the intrauterine period. Materials and method: The study group constituted 140 (70 male, 70 female) fetuses without craniofacial or other anomalies or pathologies and ages ranging between 10 and 40 gestational vveeks. Fetuses nere divided into 4 groups as first, second, third trimesters and full-term. Nine anthropometric values from cranium and orbital region and chantal index were determined. Studied parameters were head circumference, head width, facial width, facial height, outer orbital distance, inner orbital distance, orbital height, orbital width, oro-palpebral distance and chantal index. Results: There were significant correlations between gestational age and ali parameters (p<0.001). There were significant differences between groups in ali anthropometric parameters (p<0.05). Chantal index significantly differed between first trimester and full term or second trimester and full term fetuses (respectively; p<0.05, p<0.01). Outer Chantal measurements showed more increments than inner chantal measurements during fetal period. İn fetal period, orbital width showed more increase than orbital height through full term. Conclusions: İt is determmed that there is no significant difference between sexes in respect to ali parameters (p>0.05). New data a e derived for fetal period to evaluate orbital development. VVe hope that our data will be useful in evaluation of fetal orbital development.

In a diabetic person, foot malformations frequently occur due to neuropathy, infection and vascular disorders. Radiographic destruction of bones was detected in 16 of 70 diabetic patients (10 type 1.60 type II). In 7 of these 16 patients, erythema, ulceration and gangrenous lesions were detected on the skin of the feet. Radiological destruction of the foot bones was demonstrated in 9 of 55 diabetic patients without skin lesions and gangrene. No relationship could be established between the duration of diabetes and the patient's age and foot lesions. Heart failure is the most important factor that accelerates skin lesions. Also, poor foot hygiene provokes the event. Therefore, in order to prevent complications that may occur in the diabetic foot, it is necessary to keep the patient away from foot care and provoking factors.

In this study, thirty cases af laringeal carcinoma which diagnosed in our clinic between November-1994 June-1996 are compared by preoperative CT, laryngoscopy and postoperative speciemen findings. By laryngoscopy one could evaluate the status the mucosal lining and vocale cord motility. Lımitations of the cord vocale motility is attributed to deep invasion of the tumour but, the exact dimensions of the tumour could not be estimated. The conventional radiologic examination methods da not add any useful knowledge to the laryngoscopy. The com-puted tomograpic examination is useful to determine the precise anatomic localization and spread of the tumour which is very useful ta surgeon to choose the surgical treatment method. We concluded that CT is valuable di-agnostic method in evaluating the preepiglottic area, paraglottic area, subglottic area and the inferior areas of the larynx which is obstructed by the large laryngeal masses and the cartilage invasion which could not be evaluated by laryngoscopy and other conventional radiological methods. Also we concluded that there may be wrong de-cisions about the cartilage invasion due to the irreguler calcifications and microinvasions by CT examination. In the evaluation of the small mucosal lesions CT could yield false negative results and these lesions could be more accurately determined by laryngoscopy. CT evaluation of the laryngeal carcinoma patient prior to surgical in-tervantion is an additional diagnostic tool to the laryngoscopy and very useful for the determination of the best conservative surgical method.

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

The choice of anaesthetics for ceasarean sections is important for both the nevvborn and the mother. Emergence phenomena (EP) is observed with clinical doses of ketamine that can be avoided with lower doses. Ketamine- thiopentone or ketamine-midazolam combinations were used for ceasarean section anaesthesia induction. Side effects and newborn APGAR scores were evaluated. After institutional approval and informed consent 42 women (ASA I) were randomly allocated to two groups . Group I (n=21) recieved induction doses of IV ketamine 1mg/ kg+thiopentone 3mg/kg, group II (n=21) recieved ketamine 1 mg/kg+midazolam 0.2mg/kg. Both groups were in- tubated with IV1-1.5mg/kg succinylcholine. The patients were ventilated with 100% 02 until the umblical cord was clamped. Anaesthesia was maintained with 50%02+50%N20, 1-1.5% isoflurane and atracurium. Heart rate, ar- terial pressures were recorded before the operation, induction, skin incision and perioperatively. The APGAR sco­ res were evaluated at the first and 5th minutes. The patients were intervieved 12 hours postoperatively for EP. The data was analysed with Student's t test. The two groups were hemodynamicaly comparable (p>0.05). EP was observed in 2 patients of group I. The APGAR scores were similar in both groups (p>0.05). Both anaesthetic combinations shovved similarity in APGAR scores and anaesthesia. Because of its fewer side effects ke- tamine+midazolam combination is more favourable.

The aim of this study was to evaluate the tuberculin reaction which develops with Th 1 type immune reaction in asthma in which Th2 type immune reaction is dominant. This study included 36 cases with allergic asthma, 64 cases with non allergic asthma and 51 cases without asthma. Tuberculin skin test was applied with Monteux method to all cases and induration diameter developed after 72 hours was recorded as millimeter. Tuberculin positivity was significantly different between cases with asthma and cases without asthma (p0.05). With respect to tuberculin positivity, significant difference was not present between asthma cases that are allergic and non allergic (p>0.05). While the tuberculin skin test results are evaluated presence of allergic diseases should be taken into consideration.

Nonmicrovascular replantation of an avulsed auricula as a composite graft is an unreliable solution. The use of retroauricular pocket to enhance survival of the composite ear graft is a multistage procedure and aesthetic results are poor. In this case report the vascularity of the composite graft is attempted to be increased by transposing fascial flap. Fifty-four year old man had an amputation of his ear due to a human bite. The amputated ear was reattached to its original position as a composite graft. Afterwards a temporoparietal fascia flap has been transposed between the posterior skin and the cartilage of the amputated ear. Amputated ear had been revascularised completely without any distorsion at the cartilages. Acceptable aesthetic result was obtained. An ear amputation can succesfully be replanted as a composite graft by using the described technique in a single stage.

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.

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ABSTRACT

Objective: Endometrial cancer is the most common malignancy of the female genital tract and the fourth leading cancer among women. Our aim is to share the surgical treatment and results of endometrial cancer cases in our gynecological oncology clinic.

Material and Methods: In this study, the records of 164 endometrial cancer patients operated by the same surgical team between 2009-2019 were reviewed retrospectively. The clinical, surgical and histopathological features of the patients are presented here. Four patients who had sarcoma as a result of pathology, 7 patients who underwent complementary surgery and 1 patient with a second primary tumor were not included in the study.

 

Results: The mean age of the patients included in our study was 61.3 and the mean body mass index was 25.8. According to the postoperative pathology results; mean tumor size was 3.4 cm and mean number of collected lymph nodes was 28.8. Lymph node metastasis was observed in 19 patients and all of the metastases were in pelvic lymph nodes. Endometrioid type adenocarcinoma was seen in 81% of the patients. Myometrial invasion > 50% in 81 patients (49.4%). Twenty patients (12.2%) had cervical involvement, 11 patients (6.7%) had adnexal involvement and 28 patients (17.1%) had lymphovascular area invasion. 76 patients (46.3%) were grade 1, 61 patients (37.2%) were grade 2, 19 patients (11.6%) were grade 3. When the patients were staging according to the FIGO system in 2009, 70 (42.7%) stage 1A, 58 (35.4%) stage 1B, 12 (7.3%) stage 2, 3 (1.8%) stage 3A 17 patients (10.4%) were stage 3C1 and 4 patients (2.4%) were stage 4.

Conclusion: Endometrial cancer is the most common gynecological cancer, and it is usually diagnosed at an early stage as a result of early signs. Tumor size, depth of myometrial invasion and histopathologic grade are used to evaluate the risk of the disease, but studies with a higher number of high stage patients will be more useful in determining the risk.

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

Today health related quality of life with its ever increasing importance has become an inherent part of treatment and follow up in all departments of medicine including diagnosis and treatment. In neuro-intensive care unit, the severest patients with the most intensive diagnosis and treatment period are followed up. Neurologic disorders with neurointensive care requirement include so many parameters potentially affecting the quality of life in acute and severe stages besides in chronic term. Apart from the effects of these diseases on life quality, there are many other important parameters related to quality of life. It is possible to list chief parameters as malnutrition in intensive care unit, agitation, pain, disruption of skin integrity, musculoskeletal system involvement, cardiovascular and autonomous involvement, side effect of drugs and multidrug interactions. In this review, the relationship between nutrition and health related quality of life in neurointensive care unit will be reviewed.

Larygoscopy and endotracheal intubation are known to increase blood pressure and heart rate by release of cathecholamines from the sympathetic nervous system. Our study aimed to evaluate, remifentamTs effect on this response. This study was performed on 40 ASA l-ll class patients aged between 19-45 years planned for laparoscopic elective surgery. Patients were randomised in two groups. Ali patients received 0.03 mg kg-1 midazolam IV. After Standard monitorisation (ECG, noninvasive blood pressure, heart rate, SpO2) 1.5 pg kg-1 remifentanil was given to group I and 25 pg kg-1 alfentanil to group II patients as bolus injection. Standard anesthesia induction was made 1 minute after these drugs. (Propofol 2 mg kg-1, succinylcholine 1.5 mg kg-1). Measurements (sistolic blood pressure, diastolic blood pressure, heart rate) were performed: in the beginning (t0), before propofol (tğ, before laryngoscopy (t2), 1and 3 minutes after the endotracheal intubation (t3, t4), 1 minutes after skin inc'ıslon / trochar insertion (t5). Statistical comparisons were made by student t tests. İn each of the two groups t1t t2, t3, t4, t5 values (systolic, diastolic blood pressures, and heart rate) were signrficantly decreased (p<0.05). The response to tracheal intubation (t3, t4) and skin incision (t5) were less in remifentanil group than in alfentanil group (p<0.05). As a result, we think that remifentanil can be preferred to alfentanil because remifentanil can supress the haemodynamic response sufficiently the larygoscopy endotracheal intubation

Skin test and the determination of total lgE level in serum are the methods often used in the diagnosis of allergy. A prospective analysis was performed on 399 clinically atopic patients with bronchial asthma, rhinitis and conjunctivitis between May 1996- July 1998. This study was designed to investigate the allergens and the corelation between the serum total lgE and skin test reactions. Skin test reactions were positive in 207 patients. We found 73.91% positive skin test reactions for mixture of cereals, 59.42% for tree pollen extracts, 47.83% for grass pollen extracts, 27.05 for weed mixture and 23.67% for house dust mites. Skin test reactions were positive in 31%, 74%, 42%, 71%, 60% in brochial asthma, rhinitis, rhinitis+asthma, rhinitis+conjunctivitis, rhinitis+conjunkctivitis+asthma, respectively. 71% of patients with bronchial asthma and 33% of patients with rhinitis had high total lgE levels. We didn't determine positive correlation between the skin test positivity and high serum total lgE levels.

Bathing with the water containing suiphure has succesful effects in pruritic dermal lesions. Being ex-posed to its vapour or ingestion may cause collaps, coma and death. Even in low doses of sulphure may cause irritation in mucosa and adverse effects. The acidic characteristic of this water is the main cause of the irritation in mucosa. High levels of organic substance and ammonium show discontinued nit-rification of the water. The water containing organic substances may cause intestinal infections. The absence of protective area may increase ammonium concentration and total organic substance. High chlorine con-centration confirms that the water is contaminated with the urine of human beings or animals.

The ideal therapy for sacrococcygeal pilonidal disease (SPD) would be a prompt cure that allowed patients to return quickly to normal activity, with minimal morbidity and a low risk of complications. We report the case operated with excision and primer suture for SPD a month ago had infected and decomposed wound. A 23-year-old male patient was admitted to the emergency room with complaints of intergluteal discharge and pain that last for 10 days. Surgery which was excision and primer suture was applied him in other health center for SPD a month ago. There was infected and decomposed wound and a large cavity under sutured skin on intergluteal area. In the second operation, we excised decomposed wound including cavities and skin as modified equilateral quadrangle shape, a right flap was prepared and rotated to left side for primer suture. Patient was discharged on postoperative 3th day and drain was getting out on postoperative 5th day. Patient recovered completely without any complication on postoperative 20th day. Our case is no not only unique but also rare. However, we think that the most appropriate method for treatment of SPD should be known and applied by all surgeons in our country.

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

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

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

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

Multiple sclerosis(MS) lesions can occur in different parts of the central nervous system therefore cause a variety of symptoms and signs.In this case receive a diagnosis of MS without finding anything other than dysesthesia and changed into a very different clinical pictures of musculoskeletal symptomatology of MS would like to draw attention to an insidious course. 22-year-old female patient physical therapy clinic complaining of dysesthesia that since the last 1 month in the right arm.All examination of the outside of the left arm common dysesthesia;cranial nerve,superficial and deep sensory,motor,deep tendon reflex and pathological reflexes examination was normal. There was no resume and family history feature.Neck x-ray was normal.But magnetic resonance imaging (MRI) in the spinal cord to be C2-3 and C3-4 levels hyperintense signal in the T2sequence and also in the brain in the left centrum semiovale hypointense signal in T1,hyperintense signal in T2sections,and after İV of Gad,bialteral centrum semiovale and periventricular white matter was observed enhancing rim millimeter-sized demyelinating plaques. In CSF oligoclonal bands tended positive IgGindex was 0.98. Routine blood tests was normal. After evaluating the case with neurology,clinical,radiological and laboratory data were evaluated by the MS after the exclusion of other etiology. 1000 mg/day dose intravenous methylprednisolone was given for 5 days. When the diagnosis of MS is easy to put the classic symptoms,but atypical in navigation is difficult to diagnose. This is how a variety of signs and symptoms within the scope of physical therapy clinics and how different it may indicate an underlying disease.

\r\n A decrease in retinal nerve fiber layer thickness can be secondary to glaucoma, several neurologic diseases, optic nerve diseases other than glaucoma, retinal diseases, toxic, nutritional or vascular causes such as shock optic neuropathy. Glaucoma, which is among the commonest causes of blindness worldwide, is a progressive optic neuropathy characterized by a decrease in retinal nerve fiber layer thickness secondary to retinal ganglion cell death, cupping of optic nerve head and visual field loss. Although the best known risk factor associated with glaucoma is high intraocular pressure, it is thought that systemic vascular disorders, which are among the risk factors of glaucoma, play role especially in the pathogenesis of normotensive glaucoma where intraocular pressure is low. In our study, we described a patient with decreased retinal nerve fiber layer thickness and thought normotensive glaucoma as the most probable diagnosis, who also had multiple systemic vascular diseases. 

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

Bone wax is a commonly used hemostatic agent derived from beeswax. It is used widely in neurosurgery, orthopaedic surgery, maxillofacial and orthognathic surgery.  Although few case reports have emerged regarding complication due to the bone wax, the use of it continues in various surgical sites.  We report an unusual case of a non-healing ulcer over the iliac crest appearing one year after bone harvest was done for alveolar bone grafting

A fifty two year old woman sustaining bilateral hand injurles after a traffic accident was admitted to our clinic. She had right thumb amputation from the carpometacarpal level, tendon and skin loss in the right hand secönd finger, loss of the 2-3 extensor tendons and the overlying dorsal skin in the left hand. Reconstruction in a single session was planned and palmaris longus tendons from both hands were taken and used as intercalary grafts for extensor tendon losses after which the skin loss was covered with a radial forearm flap. Afterwards, the second injured finger in the right hand was taken and pollicisized using the Buck Gramcko technique. At the last follow-up examination 8 months after the injury, she was able to pick up small objects and grip large and heavy objects using her right hand. The range of motion of the wrist and the fingers of the left hand was completely restored. The importance of treatment design tailored individually for each patient was stressed in this case.

Daptomycin, is currently the first and only member of a new age antibiotics class labeled as cyclic lipopeptides. The spectrum of its effectiveness is limited with gram positive aerobe and anaerobe bacteria. It is effective against; staphylococci including methicillin resistant S.aureus (MRSA), vancomycin intermediately sensitive S.aureus (VISA), vancomycin resistant S.aureus (VRSA), enterococci including E.faecalis and E.faecium, and penicillin resistance streptococci including S.pneumoniae. Daptomycin, first used in the world in 2003, was licensed in our country in 2009. The clinical indications for daptomycin use are the same with other countries; namely, complicated skin and soft tissues infections, and S.aureus bacteremia and S.aureus right sided endocarditis.

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

Between 1982 - 1987 9 patients with localised skin hemangiomas treated surgically is presented and results reviewed with literature.

Free radicals derived fi-om molecular oxygen are receiving particular attention irı medicine. Skin as a sit,• of ()Aygen radical production is a target organ for their &imaging properties. In this review the desen-prim'r of radical oxygen species and their ef-fects on skin is presented, antioxidant defence ince-hanisms and possible novel therapeutic antioxidant agents are mentioned.

Aim: In this study, we aimed to discuss our experience and results of non-operating room anesthesia.

Materials and Methods: Anesthesia records of patients older than 18 years who underwent sedo-analgesia outside the operating room for diagnosis and treatment between May 2017 and December 2017 were retrospectively screened. The records were examined in terms of demographic data, applied procedure, duration of the procedure, sedation grade, medications used, developing minor and major complications, chronic obstructive pulmonary disease story and intensive care need. Relationships between complications with demographic data and categorical variables were analyzed.

Results: Totally 2562 patients underwent sedo-analgesia. 1428 (55.7%) of these cases were female and 1134 (44.3%) of them were male. The average age of patients was 53.08±16.55. 268 (10.5%) of the cases were ASA I, 1683 (65.7%) were ASA II, 598 (23.3%) were ASA III and 13 (0.5%) were ASA IV. 519 (20.3%) patients were minimally sedated, 1541 (60.1%) were moderate sedated and 502 (19.6%) deep sedated. The longest procedure time in endoscopic retrograde cholangiopancreatography was 28.7 ± 16.3 min, and the shortest procedure time in endoscopy was 10.3 ± 3.1 min. The most commonly performed procedure was colonoscopy with 31%. The most commonly used drug combination was midazolam + propofol + fentanyl applied to 1231 patients (48%). 148 (5.76%) patients had minor complication, and 10 (0.37%) patients had major complication. A total of 15 (0.58%) patients underwent intensive care after the procedure. Desaturation was statistically significantly higher in patients with ASA III and above, in procedures take longer than 15 minutes, in patients older than 65 years, and in the presence of chronic obstructive pulmonary disease. The intensive care need after the procedure was also significantly higher in these patient groups.

Conclusion: The incidence of non-operating room anesthesia is increasing steadily. The risks associated with these practices are similar to the anesthesia in the operating room. In order to increase patient safety and reduce complications, it is important to carry out a thorough evaluation before the procedure, to provide proper monitored anesthesia care in appropriate physical conditions, and to establish healthy communication between the teams.

62 isolated KleLsiella strains were cultivated from urine, stool, upper respiratory tract specimens (throat, phlegm), bile, skin lesions and blood specimens. In result of bioche-mical tests, 49(79,3%) of 62 strains were Kl. pneumoniae, 9(14,53%) Kl. ozaenae, 2(3,22%) KI. rhinoscleromatis. Two Klebsiella strains were not determined. In serological determination of 40 Klebsiella species type 2 have been found more than others.

in this experimental study, filırıs which are in gradually thicknesses were placed under the rignt n.Opticus in 10 rabbits, and flash visual evoked po-tential (VEP) records were taken after the replace-ment of each film. Under the light of the literature the changes in la-tens time and amplitude values of the recordings which we have got were discussed due to changes of film thicknesses.

Suprascapular notch located on the superior border of the scapula and just medial to the base of the coracoid process. This notch is covered by superior transverse scapular ligament and is turned into a foramen. Suprascapular nerve passes under this ligament and suprascapular vessels passes together over it. The images of the patients undergone MDCT examination between 2008 and 2009 were used in this study. Total 88 right and left MDCT scapula images obtained from 44 individuals (22 male, 22 female) were used. Suprascapular notch was divided into 5 types from these images. These types; Type 1: with deep and large notch, Type 2: with deep and narrow notch, Type 3: with shallow and large notch, Type 4: with shallow and narrow notch, Type 5: without a notch. In our study, the most common type was with (29,54%) deep, large notch and the least common type was the group (2,27%) without a notch. In addition, the relationship between suprascapular notch and supraglenoid tubercule, superior angle and inferior angle was evaluated.

Introduction: Circulating stem cells (CSCs) are released from bone marrow in to the circulation after myocardial injury to improve tissue repair. Radiofrequency ablation (RFA) of cardiac arrhythmias, particularly for atrial fibrillation, has been shown to trigger the release of CSCs through inflammatory mediators. We aimed to investigate whether CSCs are increased in the circulation following non-extensive ablation procedures such as slow pathway or accessory pathway ablations.

Methods: Twenty-six patients [13 females, 54 (18-74) years old] who underwent slow pathway ablation for atrioventricular nodal reentrant tachycardia (n=18) and accessory pathway ablation for atrioventricular reentrant tachycardia (n=8) were included. Peripheral blood CD34+ cell count and multiple serologic markers [troponin I (Tn-I), C-reactive protein (CRP), interleukin-6 (IL-6), stromal cell derived factor (SDF) 1 alpha] were evaluated before the ablation procedure and 7 and 30 days after the procedure.

Results: The CD34+ cell count was significantly increased on the 7^th day after the procedure when compared to baseline [33 (15-133) vs. 22,5 (5-79) cells per microliter respectively, P<0.001]. The CD34+ cell count was similar to baseline on the 30^th day following the procedure. Levels of Tn-I, CRP, IL-6 and SDF1-α did not change significantly following ablation. The amount of energy applied during RFA (watts) was significantly correlated with the 30^th day CD34+ cell count (r: 0.460; p= 0.018).

Conclusions: Peripheral blood CSCs are increased after slow pathway or accessory pathway ablations which are less extensive ablations compared to atrial fibrillation ablation. The levels return to baseline by the 30^th day following the procedure. The increase in CSCs was positively correlated with the amount of energy delivered during the procedure.

Aim: It is important to identify allergens in reducing disease-related symptoms and improving quality of life in the allergic diseases. Therefore, we aimed to evaluate the frequency of aeroallergens in allergic patients in our region.

Method: 1078 patients (2-18 years) who applied to the pediatric allergy immunology outpatient clinic between September 2017- March 2018 were included to the study. The demographic and clinical characteristics of 642 patients with at least one allergic sensitization in the skin prick test were evaluated retrospectively. Total IgE levels, peripheral eosinophil counts in the blood, aeroallergen sensitivities in skin prick test were evaulated from the patient’s files. The study was approved by the Ethics Committee of the Alanya Alaaddin Keykubat Medical Faculty.

Results: In 642 of the patients (59.5%), a positive response was observed against at least one aeroallergen. Among patients, 34.8% had asthma, 73.7% had allergic rhinitis, 12.6% had atopic dermatitis, and 3% had chronic urticaria. 24.8% of the patients (159) had more than one allergic disease. When the evaulation of the patients with positive skin prick test, 57.3% were male and 42.7% were female. The mean age was 8.49 +/- 4.15 years. The sensitivity of house dust mites was the most common (76.1%). In the second and third frequency, molds (51.8% Alternaria alternata, 41.7% Claudosporum herbarum) and grass and cereal pollen (39.8%) sensitivity were observed. Other determined aeroallergen sensitivity frequencies were; weed pollen mixture (24.6%), trees pollen mixture (21.7%), cockroach (17.8%), cat hair (31.2%), olive tree (20%). The mean serum total IgE level was 215.6 IU/ml and the mean eosinophil count was 410.63/mm³.

Conclusion: Detection of responsible allergens is important to control symptoms and to give the chance the course of the disease with immunotherapy in the selected cases.

 

Purpose: The aim of this study was to detect the effectiveness of mannitol’s antioxidant capacity in the treatment of ischemia-reperfusion injury after acute Peripherie arterial occlusion. Material and Methods: 20 healthy individuals and 32 patients with acute arterial occlusion were taken to study. Of the acute isehemia diagnosed patients, Standard surgery was performed on 17 patients and surgery and mannitol infusion were given to 15 patients. Blood samples were taken from the deep veins and MDA, CPK, GSH-PX levels were measured in the acute isehemia diagnosed period and 120th minutes of the reperfusion. Results: MDA of mannitol treatment group in the isehemie period meaningfully inereased in consideration with the control group. İn consideration of reperfusion period with isehemie group in mannitol treatment MDA signjficantly decreased. İn the reperfusion period of mannitol treatment GSH-PX significantly inereased according to control group. Although the CPK results showed significant inerease in each period of both treatments, the reperfusion period of mannitol treatment showed a significant decrease in CPK considering with it’s isehemie period. Conclusion: İn acute arterial occlusions it was shown that mannitol decreases the activity of free oxygen radicals, inereases the antioxidant capacity, and decreases the tissue injury meaningfully.

İn this study the effects of low-dose morphine hydrochlorur on rat kidney vvere determined at light microscopical level. A total of 30 Sprague Davvley rats from both sexes (15 male and 15 female) vvere used. Five rats from both sexes vvere served as Controls, vvhereas 10 rats from each sex vvere used as experimental group. Control animals vvere injected subcutaneously vvith physiological şaline (5mg/kg), the animals of experimental group vvere given morphine hydrochlorur at a dose of 5 mg/kg in every other day. At the end of the experiment, the animals vvere perfused vvith buffered formaline (pH=7.4) under anaesthesia, and kidneys vvere extirpated, and morphometrical measurements (thickness, height, length) vvere taken. Follovving, kidney samples vvere processed by means of routine histological techniques and the sections vvere taken at 7pm thickness, and stained. Slides vvere then examined using light microscope. The investigations have revealed that the low-dose-morphine hydrochlorur caused to glomerular destruction, epithelial necrosis and desquamation in both proximal and distal tubuli, vascular hyperemia and hemorrhagies. Based on the findings, it was concluded that the results of this study might be specific to the rat kidney vvhich is devoid of detoxification enzymes in tubuler epithelial cells and a study should be performed on an animal having similar metabolism with human.

Aim: Venous thromboembolism (VTE) events covering deep vein thrombosis (DVT) and pulmonary
embolism (PE) constitute the most important morbidity-mortality cause in obesity surgery. The objective
of this study was to assessment of thromboembolism results in patients who underwent bariatric surgery
with standard dose prophylaxis.
Patients and Methods: The patients who were operated for morbid obesity in our clinic between 2015 and
2019 were retrospectively examined. Cases that had laparoscopic sleeve gastrectomy and were applied
standard dose Enoxaparin prophylaxis were included in the study. Demographic data, preoperative
preparation and postoperative antiembolic treatment conditions of the patients were registered.
Results: Eighty-seven patients who had laparoscopic sleeve gastrectomy were included in the study. 66
(%75,8) of the patients were female and 21 (%24,1) were male. The mean age was 38.7 (18-55). Mean
hospitalization duration was 6.6 (3-69) days. Four patients (% 4,5) had postoperative complication. PE
developed in two patients while leak-related mediastinitis and incisional hernia (%1,1) developed in one
case each.
Conclusion: Despite available prophylaxis methods, VTE constitutes an important morbidity and mortality
cause in patients who had bariatric surgery. While high-dose low-molecular weight heparin (LMWH) use
may cause bleeding, the possibility of VTE increases with using low-dose LMWH. This situation appears
as a limitation of LMWHs. New studies are needed for increased dose at early period and standard dose
application after discharge.

Abstract

Aim: We aimed to assess the changes in retinal nerve fiber layer (RNFL) and optic nerve head (ONH) in patients with chronic obstructive pulmonary disease (COPD).

Patients and Methods: Thirty patients having severe COPD and 29 age and sex-matched healthy subjects were enrolled in the study. After a detailed ophthalmic examination, the ONH and RNFL thickness measurements were taken by an optical coherence tomography (OCT) (Stratus OCT-3). Arterial blood gases (pO₂ and PCO₂) were measured and respiratory functional tests were performed for the staging of COPD patients. The OCT parameters were compared difference between the 2 groups using independent t test, while Pearson correlation analysis was performed to assess the correlations between respiratory functional tests, arterial blood gases and RNFL thickness parameters. A p value less than 0.05 was accepted as statistically significant.

Results: There were no significant differences in optic disc area, cup area and rim area between COPD and healthy subjects (p>0.05). Parameters of mean and superior quadrant RNFL thickness were found to be significantly thicker in COPD subjects (114.52±7.7 µm and 141.07 ±18.2 µm, respectively) compared to the control subjects (107.9±5.4 µm and 131.31±13.6 µm, respectively) (p<0.05). No correlation was found between pO₂ and RNFL thickness (r=-0.22, p=0.33). There was a moderate correlation between pCO₂ and superior quadrant RNFL (r= 0.53 and p=0.017), and a high negative correlation between FEV₁/FVC and superior quadrant RNFL (r=-0.76, p=0.003).

Conclusions: The increase in pCO2 and the decrease in FEV1 / FVC indicate increased hypoxia. Peripapillary RNFL loss associated with RGC death can be masked by hypoxia / ischemia-induced retinal and optic disc edema. Increased mean RNFL thickness in COPD patients was thought to be due to retinal edema associated with increased hypoxia.

In the study, in psorialic cutaneous tissues of 15 pallent ıvith psoriasis and in the healthy tissues of 20 control group zinc ion has been determined. Zinc ion in the control group was 1 .04±0.68 pgıg and Zn.2.49±1.02 1.41g at patients group as wet lissuc. Zinc ionfound to be greater (p<0.001) in psoriat-le iissue us compared with the ratio healthy tissue.

Many different aproaches were reported for the reconstruction of columella defects that local flaps through microvascular tissue transfer. There was a columella defects in 22 years old male patient because of the explo- sion of bomb and the reconstruction was not thought by a local flap owing to large scar tissues next to the defect. After the dissectlon of wide adhesion of the septum nasi spongostan tampons were put into new plane. Then 2x1,5 cm diameter skin island flap with angular artery pedicul was prepared on the right nasolabial skin and transferred to the defect in order to the reconstruction of columella. The flap was folded and sutured. İt was made the flap thin by defatting 3 weeks later. The result was acceptable aesthetically. The results and short operative time for this flap were thought us that it is an alternatlve to the microvascular reconstruction and morbidity of the donor area was acceptable.

\r\n Parkinson’s disease (PD) is a progressive neurodegenerative disorder that leads to a selective loss of dopaminergic neurons in the basal ganglia of the brain. The main characteristics of the disease are tremor, bradykinesia and rigidity. There are also several non-motor manifestations of PD, one of which is visual system involvement. There is a decrease in retinal nerve fiber layer thickness in PD. In our study, we described bilateral optic atrophy along with a decrease in macular and retinal nerve fiber layer thickness in a patient with PD. 

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Psychiatric disorders and psychological stress has been implicated as a potential trigger in onset and exacerbation of dermatological diseases. Additionally, skin diseases have often been found to be associated with anxiety, depression and impaired quality of life. Therefore, it may be considered that there are a reciprocal influence between psychiatric status and skin diseases. Although significant majority of the cases begin before adulthood, limited data are available about relationship between skin disease and psychiatric morbidity in childhood and adolescence. In this article, psychodermatologic disorders in these age groups and our current scientific knowledge on these disorders will be discussed.

In this retrospective investigation, 106 children diagnosed as anaphylactoid purpura between 1983-1990 were evaluated. The disease was mostly encountered 5-14 years old. There was no sex predilection. 38% of the patients had predisposan factors and most of them were respiratory tract in-fections. The important symptorns were cutaneous manifestations, abdornirzal pain, limp pain consec-utively. Skin (100%), gastrointestinal system (65%), kidneys and musculoskeletal system (42%) were mainly allected. The leading cutaneous manifestations were purpuras and petechias. 38% of the pa-tients with gastrointestinal manifestations had hemorrhage. One patient was diagnosed as pancreaii-tis. The percent of the recurrences was 15%. The noticable laboratory abnormalities were the increas-ing of erythrocyte sedimentation rate, the elongation of prothrombin time, CRP and ASO positivity. [Jetirn perforation was developed during corticosteroid therapy in a case.

The study was based on a series of 30 normal mide subjects ageing between 20 to 30. Femoroti-bial angle of the knee joint was analyzed using a an-teroposterior roentgenogram of the knee. Femoroti-bial angle was 5(right) - 6(left) degree at the decubit-us pozition, and 3 .6(right) 2.9(left) degree at the standing. At the right lateral subfood wedge, varus of the knee was increased at the right knee (28, %93.3), and valgus of the knee was increased at the left knee (12, %40). Valgus of the right knee was decreased with right lateral subfood wedge. Thickness of the wedge didn't increase valgus of the right knee, but increased valgus of the left knee.

Neurofibromatosis type I (NF1) is a complex disorder caused by mutations of the neurofibromin protein-encoding gene on the chromosome 17. NF1 is an autosomal dominant disorder. The prevalence of NF1 is approximately 1:2500 to 1:3500. Both genders are equally affected. Herein, we report a 27-year-old female patient who had multiple hyperpigmented skin macules, multiple café-au-lait spots, axillary freckling, optic glioma, hundreds of soft cutaneous neurofibromas and lisch’s nodules on the iris of both eyes. According to the clinical features, we suspect from NF1 and-then sequence analysis of NF1 gene was performed. A heterozygous c.980 T> G (p.L327R) mutation was detected in the NF1 gene. This mutation has not been reported previously.

In this in vitro study, the effects of maturation and hypothermia on the contractile responses to phenylephrine (PHE) and clonidine (CLO) and on the inhibition of these responses by prazosin (PRA) or yohimbine (YOH) on young (2-3 months old) and mature (11-12 months old) rab-bit and guinea-pig aortas have been in-vestigated. The cumulative addition of PHE and CLO were dose-dependently contracted these tissues and the dose-dependent relaxations were obtained with the cumulative addition of PRA or YOH on maximum contractions. At 37 °C. as the pa2 values of PHE and CLO were significantly greater in the aortas from mature rabbits and guinea-pigs than from young groups, no age-related changes in the IC50 and 11/2 values of PRA and YOH were detected in both aortas. At 28 °C, the pD2 values of agonists, and the IC50 and t11, values of antagonists were significantly lower than of 37 °C. Furthermore, at 37 °C, as its expected, the values for PRA against PHE were significantly greater than the values obtained with YOH against CLO on aortas from mature rabbits and guinea-pigs. In conclusion, as it's seen in many other tissues, in in vitro conditions on rabbit and guinea-pig aortas. the responses to a-adrenergic receptor agonists were altered with age and temperature although the responses to antagonists were altered with the temperature only.

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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. 

Sclerodenna is a rare mıthisystem disorder characterized bv inflammatory, vascular, and fib-rotic changes of the skin with various organ involements. The associatiOn between scleroderma and malignancy has not been described with certainry so far, bur there are some case reporu that might have us ta think the close causal relationship between the onsets of scleroderma and neoplasms. We have peıformed f lrae needie aspiration biopsy two times from the hypoactive thyroid nodule in a patient with scleroderma. Both of the thyroid smears have been reported as "suspect of malignancy (Class III)". Thus, we thought that our patient might be a model for the relation between the on_sets of sclerodenna and neoplasms and reviewed the literature.

In women, 0.1 % of the all nevus are found in Mu skin of vulva. About 8-11 % of the vulva carcinoma are malignant melanoma.

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

Purpose:

Primary and metastatic digestive system malignant melanomas are extremely rare. In our study, we aimed to compare lymph node metastasis with clinical and pathological parameters in gallbladder, stomach, small intestine and anorectal region malignant melanomas.

Materials and methods:

This retrospective study included 20 cases diagnosed with malignant melanoma in the gastrointestinal tract organs between January 2010 and January 2020 at XXXXXXXXXXXX. In our study, we wanted to evaluate the relationship between regional lymph node metastasis and age, gender, tumor localization, tumor size, extraintestinal melanoma history, melanin pigment, neutrophil-lymphocyte ratio and post-diagnosis life span in primary and metastatic malignant melanoma cases. We also reviewed the origin and literature of the cells from which melanoma originates in the digestive system.

Results:

There was a statistical relationship between tumor diameter and regional lymph node metastasis (p =0.000). As the tumor diameter increased, the lymph node metastasis rate increased. There was a relationship between survival and gender, tumor localization, distant metastasis, primary and metastatic digestive system melanoma (all p <0.05). Most of the men and those who did not metastasize away from the digestive system were alive. All patients with melanoma metastases to the digestive system and all patients with gallbladder and small intestine localization were alive. Our 70 year old patient with gallbladder primary malignant melanoma was the oldest patient we could identify in the literature.

Conclusions:

Regardless of cutaneous or origin, all melanomas originate from melanocytes, cells derived from embryological nerve crest. Malignant melanoma can be primary in every region, more frequently in the anorectal region in the gastrointestinal tract. The most common metastasis is to the small intestine. Accurate diagnosis is vital in places where it is rarely seen, such as the digestive system. Recently, in metastatic melanoma, immuno-oncological agents are used in adjuvant therapy to help prevent metastatic spread of the disease. Thanks to these treatments, it is reported that more than half of patients with melanoma who have the risk of metastasis after surgical resection provide recurrence-free survival. Although it is very rare, it should be kept in mind that there may be primary or metastatic malignant melanoma in the evaluation of digestive system biopsies.

Malign hemagioendotheliorna is a rare bone Nı.- mor. it is most fraquently primary in the skin and visceral organs. Since it is so less often seen in the bones, this is the report of ahemangioendothelioma with multıfocally located on the acromion and the proximal port of the humerus. Also we reviewed the liteı-ature and discussed its diagnosis and the treatment.

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

Aim: We aimed to report our experience of a digital artery perforator flap use in fingertip and pulp defects reconstruction

 Materials and Methods: 8 patients underwent reconstruction with digital artery perforator flap for their finger defects were enrolled in the study. The patients were evaluated in terms of etiology, sex, age, comorbidities and outcomes.  The size of the flaps ranged from 20 x10 mm to 25 x20 mm.

 Results: The average age of the patients was 43,6 (range:19-66) years. 6 of 8 flaps survived completely and healed uneventfully.1 flap was totally lost where as 1 flap had partial skin necrosis.  No patients complained of cold intolerance or residual joint contracture. Mild hooked nail deformity occurred in one of the patients.

 Conclusions:  The DAPF is a reliable and versatile flap for fingertip defect reconstructions in non smoker patients without comorbidities. Single-stage operating procedure, ease of harvest, rapid recovery and preservation of digital arteries are the most important advantages.

140 cases of lower extremity deep vein thrombosis were hospitalised and trealed at our clinic between the years of 1983 and 1989. Bed rest with leg elevation and heparanization were applied to 137 cases (%97.9), 3 cases (%2.1) had surgical treatment (thrombectomy). Treattrıent in 127 patients otu of 137 were satisfactory, and ampulation ampuiation operation over the knees was carried out at 4 cases (%2.85) of phlegmasia cerulea dolens. °iller 5 cases of phlegmasia cerulea dolens responded to medical treatment and related extrernities did not need to be amputaled. After the complation of oral anticoagulation treatment we found a post thrombophlebitis syndrome in 22 patients (9;35.7) at the controls that were carried out every 6 mounth.

The endoscopic approach for brow lifting has many advantages such as better exposure of the operative
field, shorter scars, reduced risk of alopecia and scalp sensory changes. Correct dissection technique,
release of the soft tissue attachments and efficient fixation of the forehead flap play an important role
in the outcome of the procedure. In this paper, we describe a modification of cortical tunnel fixation
technique, which allows delivering thick, weight-bearing suture s easily from the tight cortical tunnel.

The purpose of this review is to systematically review the intervention studies conducted and published to
prevent central catheter-related bloodstream infections. In this study, MEDLINE, CINAHL COCHRANE Library
and PUBMED databases were searched using “Preventing CLABSI infections” (Central Line-associated
Bloodstream Infection = CLABSI) as a keyword. Studies published in international journals between January
1, 2016 and November 10, 2020 were evaluated, and 99 publications were reached as a result of the search.
Seven studies were included in the scope of the review in line with the inclusion / exclusion criteria. As a
result of the investigated studies, the application of evidence-based infection control measures such as
hand hygiene, adherence to maximum barrier precautions during catheter insertion, skin antisepsis with 2%
chlorhexidine, appropriate dressing, avoiding the femoral vein and questioning the need for daily catheters
through appropriate methods It has been found to be effective in preventing associated bloodstream infections.
As a result of this systematic review, it was determined that evidence-based infection control measures
should be continued to be applied in adult intensive care units, especially in adult intensive care units, in order
to reduce the incidence of central catheter-associated bloodstr eam infections.

It was reported that cila:april, a new ACE in-hibitor, decreases arteial blood pressure, ine-reases regional flows by 25 %. in the kidney, 37 gf in the stomach, 57(. in the ileum and 37 % in the skin in spontaneously hyper tansive rats. 11-e evaluated the effects of treatment with ci-la:april (2.5 mg once a day) to kidneys in rats with renovasetilar hvertension that occurred partial renal artery SIC110SiS.

Dermatoses associated with malign diseases may be helpful for the diagnosis. In tlüs case the patient with acquired ichthyosis was diagnosed as Hodgkin's Disease.

Deep neck infection (DNI) used to manifest itself with a lethal compliactions when early diagnosis and treatment was ignored. Although, the advent of antibiotics has reduced considerably the incidence of overall number of deep neck infections. However, insufficient cure of infection of concerned tissue or the USC of inappropriate antibiotic treatment can mask the DNI related symptoms and findings. In this report, we are presenting a case tha was admitted to our clinic with a gastrointestinal hemorrhage and Iater her deep neck infection was diagnosed. The pus was drained out and treated with appropriate antibiotic regiment.

People's fingertips. The skin on the palm and base of the feet is not flat, but has a corrugated structure showing different line shapes. These line formations and studies on lines are called dermatoglyphics (derma = skin and glyp = carved "deriolet").

People's fingertips. The skin on the palm and base of the feet is not flat, but has a corrugated structure showing different line shapes. These line formations and studies on lines are called dermatoglyphics (derma = skin and glyp = carved "deriolet").