OBJECTIVE: To compare the mammographic, demographic and clinicopathological characteristics of patients whose mammographies were classified as category 4 subgroups of the Breast Imaging – Reporting and Data System (BI-RADS).
METHODS: In total, 103 patients with mammography (Senographe senix 600t; General Electric, Moulineaux, France) results classified as BI-RADS 4. Demographic data (age, menopause, family history) were recorded. All data were compared among BI-RADS 4 subgroups.
RESULTS: In all, 68.9% (71/103), 7.8% (8/103) and 23.3% (24/103) patients were in groups 4A, 4B and 4C, respectively. The incidence of malignancy was higher in groups 4B and 4C than in group 4A (p < 0.05), but similar in groups 4B and 4C (p > 0.05). Mean age was lower in group 4B than in groups 4A and 4C (p < 0.05). A positive family history was more common in group 4A than in group 4B (p = 0.025). The frequency of menopausal patients was greater in groups 4A and 4C than in group 4B (p = 0.021 and p = 0.003, respectively).
CONCLUSION: The rate of malignancy was higher in groups 4B and 4C than in group 4A. A positive family history was more common in group 4A than in group 4C. Group 4A and 4C patients tended to older and were more likely to be menopausal than those group 4B patients.

OBJECTIVE: Aim of this study is to examine depression and anxiety related arrhytmia risk in fibromyalgia syndrome (FMS).
METHODS: 59 patients with the diagnosis of FMS and 20 control participants were included into the study. Fibromyalgia impact questionnaire, visual pain scale were applied to determine the severity of the disease. Beck anxiety (BAS) and depression scales (BDS) were applied to all participants. Electrocardiogram was performed to participantss, P wave dispersion(Pd) used for determining the atrial arrhythmia risk, and QT wave dispersion (QTd) and corrected QT(QTdd) used for determining the ventricular arrhythmia risk.
RESULTS: BAS and BDS results were significantly higher in patients group compared to controls (p ˂ 0001). In patients group, Pd was significantly longer (p = 0.034). There were not significant differences in the other datas.
CONCLUSION: In this study, the risk of arrhythmia in FMS was evaluated and increased Pd in patients with FMS compared to control group was detected. This shows that risk of atrial fibrilation (AF) in patients with FMS have increased. With the knowledge of fibromyalgia is consisted of relatively young patients and risk of AF is increased with age, it is important to follow-up these patients in later ages for AF risk.

OBJECTIVE: In this study, we aimed to compare vitamin D levels of children with recurrent tonsillopharingitis and healthy controls. Also, we investigated the relationship between sociodemographic characteristics and serum vitamin D.
METHODS: The study included children with recurrent tonsillopharingitis and healthy controls from the outpatient clinics of Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital from January to October 2012, prospectively. Children were aged between 2-12 years. Serum 25 (OH) vitamin D levels were studied by Tandem MS. Risk factors associated with vitamin D levels have been questioned. Ethical aproval was obtained from Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital ethical comitee and informed consent was obtained from the legal guardians of the study subjects.
RESULTS: A total of 147 children; 74 (50.3%) patients and 73 (49.7%) controls were included. Age, gender and demographic characteristics did not differ significantly between the two groups. Vitamin D levels in patients with recurrent tonsillopharingitis and controls were 19,7±8,7 ng/ml and 23,6± 9,2 ng/ml, respectively (p<0,01). Although duration of Vitamin D usage was shorter in children with recurrent tonsillopharingitis, this difference was not statistically significant (p>0,05).
CONCLUSION: Vitamin D levels in children with recurrent tonsillophargitis were significantly lower compared to the control group. We believe that serum vitamin D levels should be checked in children with recurrent tonsillopharingitis and deficiencies should be treated.

OBJECTIVE: Cigarette smoking carries higher risks for most of the chronic diseases. It also has chronic and acute effects over the hematologic system. This study explores the effects of cigarette smoking on some blood values of the healthy young male smokers.
METHODS: In this study, cigarette smoking and usage of substance, additional diseases, birth areas and education levels of 171 healthy male subjects between the ages of 20 and 30 years were investigated. Anthropometric measures of the occurrences were made. The values of Thyroid Function Tests, Vitamin B12, Folic Acid, Ferritin, Ferrous/Iron, Total Iron Binding Capacity, Leucocytes, Platelet, Hemoglobin, Hematocrit, Mean Corpuscular Volume (MCV), Mean Platelet Volume (MPV), HBs AG, Anti-HBs and Anti-HIV were evaluated. The subject groups of smokers and non-smokers were compared. The group of smokers was also sorted into subgroups of “2 years smokers”, “5 years smokers” and “10 years smokers” according to their smoking durations. The effects of smoking durations over the blood values were also investigated.
RESULTS: The MCV values of the subject group of smokers were higher than the values of the subject group of non-smokers, which was statistically meaningful (p < 0.05). As a result of the subgroup analyses of smokers, the white blood cells (WBC) of the subjects with 5 years or more smoking duration were higher than the subjects with less than 5 years smoking duration, which was statistically meaningful (p < 0.05).
CONCLUSION: This study supports the idea that cigarette smoking and especially longer durations of smoking have adverse effects over the hematologic parameters.

OBJECTIVE: In this study, we aimed to eveluate the efficacy of pegylated interferon alpha 2a and adefovir dipivoxil treatment in chronic hepatitis B patients.
METHODS: This study was performed on patients treated for chronic hepatitis B in the infectious disease clinic of Eskiþehir Osmangazi University between the dates 01.09.2005 and 31.03.2008. A total of 30 patients aged between 18 and 65 years compose the study group. One of patient groups received (10 HBeAg negative, 4 HBeAg positive) PEG-IFN alpha 2a at the dose of 180 μg/once a week, whereas the other group (11 HBeAg negative, 5 HBeAg positive) received 10 mg/day ADV treatment. Treatment response evelauted at week 48.
RESULTS: There were 4.8 log10 copy/ml and 4.2 log10 copy/ml reductions were defined in serum HBV DNA in HBeAg negative patients in ADV and PEG-IFN alpha 2a groups, at week 48, respectively. Biochemical response rates were 60% and 90. 9% in PEG-IFN alpha 2a and ADV groups, respectively. Among HBeAg positive patients, reductions in serum HBV DNA levels were 3. 2 log10 copy/ml and 4 log10 copy/ml in ADV and PEG-IFN alpha 2a groups, at week 48, respectively. Biochemical response rates were 50% and 40% in PEG-IFN alpha 2a and ADV groups, respectively. No significant difference was determined in biochemical and virological responses in HBeAg positive and negative patients between PEG-IFN alpha 2a and ADV groups, at week 48. When both treatment groups were evaluated for side effects, it was observed that side effects were significantly common in PEG-IFN alpha 2a group.
CONCLUSION: When we compared PEG-IFN alpha 2a and ADV treatment in both HBeAg positive and negative patients, biochemical and virological response at 48 weeks were similar.

OBJECTIVE: Lateral epicondylitis; is a common disease characterized by pain localized over lateral epicondyle, origin of common extensors, and dorsal aspect of forearm. It is easy to diagnose but treatment involves some inherent drawbacks. Conservative management includes Non-steroidal anti inflammatory drugs, ultrasound therapy, steroid injection, functional bracing, laser therapy and shock wave therapy, however none of these modalities have been shown to be significantly effective. Our study investigates the efficacy of extracorporeal shock wave therapy (ESWT) therapy in the treatment of lateral epicondylitis.
METHODS: 12 patients with lateral epicondylitis were included in the study. 3 sessions of ESWT was utilized (1 session per week). Maximum grasping and pain scores were assessed before and after treatment at 1 month. Specific tests for lateral epicondylitis were utilized and Turkish version of the Patient Rated Tennis Elbow Evaluation (PRTEE-T) survey was administered and analysed.
RESULTS: Visual analogue scale (VAS) scores were significantly lower (p<0,05) and grip strength was significantly increased (p <0,05) after ESWT treatment at first month. Overall PRTEE-T survey scores were decreased significantly at first month (p <0,001) after treatment. Global assessment of both patient and physician were significantly lower after treatment (p<0,05).
CONCLUSION: To conclude, ESWT utilization in conservative treatment of lateral epicondyilitis was found to be effective on reducing pain, functional activities and quality of life.

OBJECTIVE: Axillary plexus anesthesia is one of the widely used technique for upper extremity surgery. In this study, we evaluated retrospectively the single injection axillary plexus block technique that we used in our rutine anesthesia practise, between August 2010–March 2011.
METHODS: The single injection axillary block tecnique which performed by neurostimulation was rewieved in ASA I-III, 40 patients' records (17 female and 23 male) undergoing elective distal part of arm, forearm and hand surgeries retrospectively. The axillary block was performed with 22 G, 50 mm insolated needle by nerve stimulator. The needle was inserted immediately superior to axillary artery, lateral border of the pectoralis major muscle and as proximal as the axilla. The local anesthetic mixture (1% lidocaine 20ml + 0.25% bupivacaine 15ml) was injected to the place (point) that the median and ulnar nerves distal motor response were located at the same time by the stimulation current of 0.5 mA. In our study, demographic datas, the motor and sensory block time, the success rate and the complications were evaluated.
RESULTS: The mean time to perform the block was 1.21 ± 0.39 minutes in our 40 patients. The onset time of the motor block was 14.20 ± 4.96 minutes and the sensory block was 17.19 ± 2.71 minutes. The success rate was % 97,5. No complication was found during 24 hours postoperatively. The sensory and motor functions returned properly in all patients.
CONCLUSION: In our study we found that the single injection axillary block tecnique was easy to perform, the success rate was high and the complications rate was low. Therefore we concluded that axillary block should be supported in appropriate cases.

Hematometrocolpos is blood accumulation in the vagina and uterine cavity due to intra-uterine hemorrhage. A 20- year old female presented at our clinic with massive menorrhagia at menarche after progestin usage.Hematometrocolposwas determined bytransabdominal ultrasonography. She was pale because of heavy bleeding for 5 days and hemoglobin level was measured at 5.1 g/dl. Initial treatment was blood transfusion and medical drug therapy. After resolution of the hematometrocolpos was shown by transabdominal ultrasound 2 days later, the patient, who was stable, was discharged without complication. Obstruction of the female genital outflow tract is rare. Hematocolpos has been reported in elderly women following vaginal occlusion due to radiotherapy, vaginal fibroma and labial synechiae causing infection or inflammatory conditions.The case is presented here of the successful management of hematometrocolpos due to massive dysfunctional uterine bleeding in a young virgin patient.

Trombosis is seen in children with acute lymphoblastic leukemia during or after L-asparaginase treatment. Posterior reversible encephalopathy syndrome is a complex syndrome characterized with sudden hypertension, headache, nausea, vomiting, unconsciousness, vision defect and seizures. The cases related to this syndrome are reported after eclampsia, organ transplantation, immunsuppressive treatments, autoimmune diseases and chemotherapy., vasogenic edema occuring in the brain parencyhma constitues the basic pathophysiology. We present a case who developed seizures during treatment for B-cell acute lymphoblastic leukemia and diagnosed as posterior reversible encephalopathy.

Lupus vulgaris is a secondary form of cutaneous tuberculosis which persists for years without treatment. The head and neck are the most commonly affected sites. Next in frequency are the arms and legs, whereas the involvement of the trunk and the scalp is rare. Here we describe 73-year-old man with a 5- year history of slowly growing, atrophic, some eroded and ulcerated, red-brown plaques on his forehead, nose, cheeks, ear lobes, trunk and extremites. Disseminated lesions improved after anti- tuberculosis therapy.

While being one of the most parental complained deformities, flatfoot does not have a universally accepted description. The reasons of flexible flatfoot are still on debate, but they must be differentiated from rigid flatfoot which occurs secondary to other pathologies. These children are commonly brought up to a physician without any complaint. It should be kept in mind that the etiology may variate from general soft tissue laxities to intrinsic foot pathologies. Every flexible flatfoot does not require radiological examination nor any treatment if there is no complaint. Otherwise further investigation and conservative or surgical treatment may necessitate.