GÝRÝÞ ve AMAÇ: Bu çalýþmada amacýmýz Ýnönü Üniversitesi Karaciðer Nakli Enstitüsünde 2016-2017 yýllarýnda operasyona alýnan sað hepatektomi yapýlmýþ olan vericilerin geriye dönük olarak preoperatif volüm ile intraoperatif volüm hesaplamalarýn kýyaslanmasý, yaþ cinsiyet ve vücut kitle indeksinin hesaplamalara olan etkisini belirlemektir.
YÖNTEM ve GEREÇLER: Karaciðer donör olarak 2016-2017 tarihleri arasýnda operasyona alýnan 225 donörün verileri incelendi. Sol hepatektomi ve sol lateral hepatektomi olanlar çalýþma dýþý býrakýldý. Toplamda sað hepatektomi yapýlan 174 donör çalýþmaya dahil edildi. Görüntülemede BT incelemesi rutin dinamik karaciðer BT protokolüne göre sýrasýyla kontrast öncesi ince kesit tarama ve non-iyonik kontrast madde sonrasý arteryel, portal ve hepatik fazlarda ince kesit tarama þeklinde yapýldý. Canlý vericili karaciðer naklinde preoperatif volüm hesaplamalarý için otomatik volüm hesaplama programý kullanýldý.
BULGULAR: Preoperatif hesaplanan volüm deðerleri 800 ±112 gr, intraoperatif hesaplanan volüm deðeri 750 ±131gr iki volüm hesaplanmasý arasýnda anlamlý fark saptandý (p = 0,003). Hesaplanan karaciðer volümü, operasyonda çýkan karaciðer volümü arasýndaki farklýlýða vücut kitle indeksi ve yaþýn etkili olduðu ancak cinsiyetin etkili olmadýðý izlendi.
TARTIÞMA ve SONUÇ: Hastalarý küçük greft sendromu veya büyük greft sendromundan korumak için canlý vericili karaciðer naklinin mortalite ve morbiditesini belirleyen preoperatif volüm hesabýnýn çok iyi analiz edilmesi gerekmektedir. Özellikle preoperatif volüm ölçümünde %10 yanýlma payýnýn tüm karaciðer nakli cerrahlarýnýn göz önünde bulundurmasý gerekmektedir.

INTRODUCTION: The aim of the present study was to retrospectively evaluate the difference between the preoperative estimated volume and the actual intraoperative graft volume determined in donor right hepatectomies and to evaluate the possible effect of age, gender, and body mass index on the difference.
METHODS: A total of 225 donor hepatectomies performed at the center between 2016 and 2017 were evaluated for the study. Left hepatectomies and left lateral segmentectomies were excluded from the analysis. As a result, 174 donor right hepatectomies were included in the study. Volumetric analysis was performed with dynamic hepatic computed tomography (CT), including non-contrast analysis, followed by non-ionic, contrast-enhanced arterial, portal, and hepatic-phase, thin-slice scanning. Volumetric analysis was performed based on the CT images using automatic volume calculating software.
RESULTS: The mean preoperatively estimated graft volume was 800±112 g and the mean intraoperatively measured actual graft volume was 750±131 g. There was a statistically significant difference (p=0.003). Age and body mass index had a significant impact on the discrepancy between the predicted and actual graft volume, while gender did not.
DISCUSSION AND CONCLUSION: A thorough preoperative evaluation of the donor graft volume should be performed in order to prevent donor morbidity and mortality, as well as small-for-size and large-for-size phenomena in the implanted grafts. Physicians working in the field of transplantation should be aware of the fact that a difference of 10% between the predicted and the actual graft volume is usually encountered.

GÝRÝÞ ve AMAÇ: Meme kanseri dünyada kadýnlarda en yaygýn görülen kanser tipidir ve insidansý postmenopozal dönemde artmaktadýr. Anastrozol menopoz sonrasý östrojenle iliþkili meme kanserlerinin tedavisinde birinci sýrada kullanýlan, non-streoid yapýda (tip II) 3. kuþak aromataz inhibitörüdür. Çok sayýda çalýþmada aromataz inhibitörlerinin etkililik ve güvenlikleri ile tamoksifene üstünlükleri araþtýrýlmýþtýr ancak aromataz inhibitörlerinin genotoksik etkilerini araþtýran bir çalýþmaya rastlanmamýþtýr. Bu çalýþmanýn amacý tedavisinde anastrozol kullanýlan hastalarda modifiye alkali comet tekniði ve bireysel DNA onarým kapasitesinin ölçümü ile olasý DNA hasar risk profilini deðerlendirip hasta güvenliliðine ve saðlýk ekonomisine katký saðlamaktýr.
YÖNTEM ve GEREÇLER: Çalýþmamýza menopoz sonrasý meme kanseri tanýsý konulmuþ; prospektif olarak henüz tedavi almamýþ hastalar (n=12) ve retrospektif olarak en az 6 ay anastrozol(n=6) kullanan hastalar dahil edilmiþtir. Bireylerin periferal kan lenfositlerinde DNA baz hasarý endo III ve Fpg kullanýlarak modifiye alkali comet tekniði ile deðerlendirilmiþtir. Ayrýca bireyler arasý gözlenebilecek DNA hasar duyarlýlýðý farklýlýðýný araþtýrmak amacýyla H2O2 ile challenge yöntemi sonrasý comet tekniði kullanýlarak bireysel DNA onarým kapasitesi ölçülmüþtür.
BULGULAR: Çalýþmamýzda kontrol grubu ile anastrozol kullananan bireyler arasýnda DNA hasarý, pirimin ve pürin baz hasarý ve H2O2 hasar duyarlýlýðý ile %DNA onarým kapasitesi açýsýndan istatistiksel olarak anlamlý farklýlýk bulunmamýþtýr (p>0.05). Çalýþmamýza dahil edilen hastalarda yaþ ile H2O2 hasarýna duyarlýlýðýnýn arttýðý gözlenmiþtir (p<0.05).
TARTIÞMA ve SONUÇ: Çalýþmamýzdan elde ettiðimiz sonuçlara göre anastrozolün oksidatif DNA hasarýnda rolü bulunmamýþtýr. H2O2 ile indüksiyonun comet tekniði ile kullanýlmasýnýn, yaþlanma ve kanser gibi hasar duyarlýlýðýnýn arttýðý durumlarýn araþtýrýlmasýnda kullanýlmasýnýn faydalý olduðu düþünülmektedir.

INTRODUCTION: Breast cancer is the most common cancer in women worldwide and the incidence increases in postmenopausal women. Anastrozole is a non-steroidal (type II), third-generation aromatase inhibitor (AI) that is used in the treatment of postmenopausal estrogen-related breast cancer. Several studies have been conducted to assess the efficacy, safety, and superiority of AIs to tamoxifen; however, a literature search did not reveal a study that investigated the genotoxic potential of AIs. The aim of this study was to investigate the possible DNA damage risk profile and individual DNA repair capacity of patients using anastrozole with the modified alkaline comet assay in order to contribute to public health and health economics.
METHODS: Women diagnosed with breast cancer after menopause comprised the study group. Six patients who had taken anastrozole for at least 6 months were retrospectively enrolled, and 12 patients who had not yet received treatment were prospectively enrolled as a control group. Peripheral blood lymphocytes were used to measure oxidized DNA damage using formamidopyrimidine DNA-glycosylase (FPG) and endonuclease III (endo III) in a modified comet assay. Individual DNA repair capacity was evaluated with the comet assay after a hydrogen peroxide (H202) challenge to examine the difference in DNA damage susceptibility.
RESULTS: Analysis of DNA damage, oxidative base damage, susceptibility to DNA damage, and repair capacity revealed no significant difference between the control group and the patients taking anastrozole (p>0.05). Susceptibility to H2O2 damage was observed to increase with age (p<0.05).
DISCUSSION AND CONCLUSION: According to the results obtained in this study, anastrozole did not contribute to oxidative DNA damage. An H2O2 challenge with the comet assay is useful to evaluate circumstances of increased vulnerability to damage, such as aging and cancer.

GÝRÝÞ ve AMAÇ: Tiroid cerrahisinde en sýk ve kritik komplikasyonlar tekrarlayan laringeal sinir(RLN) felci ve hipokalsemidir. 21. yüzyýlýn ilk yýllarýnda, RLN hasarýný önlemek için intraoperatif nöromonitorizasyon (IONM) yeni bir teknik olarak tanýtýldý. Ancak IONM'nin rolü ve faydalarý halen tartýþmalýdýr. Bu çalýþmada, tiroid cerrahisi esnasýnda IONM kullanýlan (Grup1) ve IONM olmadan geleneksel doðrudan görmenin kullanýldýðý (Grup2) gruplar arasýndaki postoperatif komplikasyon oranlarýnýn karþýlaþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: 2014 - 2016 yýllarý arasýnda Lütfiye Nuri Burat Devlet Hastanesi, Genel Cerrahi Kliniðinde tiroid cerrahisi yapýlan tüm hastalarýn retrospektif olarak incelenmesi yapýldý. Hastalar 2 gruba ayrýlmýþtýr (Grup1 ve 2).
BULGULAR: Çalýþma kapsamýna toplam 191 hasta dahil edildi ve Grup1, 79 hasta; Grup2, 112 hastadan oluþturuldu. Grup1’de 7 hastada (%8.9), Grup 2'de 15 hastada (%13.4) tek taraflý RLN felci görüldü ve gruplar arasýnda anlamlý fark bulunmadý (p=0.368). Grup1'de 5 hastada (%6.3), Grup2'de 18 hastada (%16.1) hipokalsemi vardý ve bu fark istatistiksel olarak anlamlýydý (p=0.045). Diðer komplikasyonlar (hematom, sütür reaksiyonu) açýsýnda gruplar arasýnda anlamlý fark yoktu. Ameliyat süreleri karþýlaþtýrýldýðýnda Grup1’deki ortalama süre (93.08 dakika) grup2’den (116.54 dakika) anlamlý olarak daha kýsa bulundu (p=0.03).
TARTIÞMA ve SONUÇ: IONM'nin RLN felci üzerindeki kanýtlanmýþ etkisi, halen tartýþmalýdýr. Fakat RLN'nin daha kolay tespit edilmesiyle cerrahýn özgüvenindeki artma ve ameliyat süresideki kýsalma, daha düþük hipokalsemi oranlarý için faktörler olabilir.

INTRODUCTION: The most frequent and critical complications of thyroid surgery are recurrent laryngeal nerve palsy and hypocalcemia. In first years of the 21st century, intraoperative neuromonitoring (IONM) was introduced as a new technique to avoid the recurrent laryngeal nerve (RLN) injury. However, the role and the benefits of IONM are still controversial. In this study, we aimed to compare the postoperative complication rates during thyroid surgery with IONM usage (Group 1) and conventional direct visual technique without IONM usage (Group 2).
METHODS: We conducted retrospective review of all patients undergoing thyroid surgery in Lütfiye Nuri Burat State Hospital General Surgery Department between 2014 and 2016 years. Patients have been classified in to two groups: Group 1 and 2.
RESULTS: Overall, 191 patients were included in the study; Group 1 comprised 79 patients and Group 2 comprised 112 patients. Unilateral RLN paralysis was observed in 7 patients in Group 1 (8.9%) and 15 patients in Group 2 (13.4%) without any significant difference between the groups (p=0.368). Hypocalcemia was encountered in 5 patients (6.3%) in Group 1 and 18 patients (16.1%) in Group 2; this difference was statistically significant (p=0.045). Other complications (such as hematoma and suture reaction) were not significantly different. Operation time was found to be significantly shorter in Group 1 (Mean time, 93.08 min) than in Group 2 (116.54 min) (p=0.03).
DISCUSSION AND CONCLUSION: Proven effect of IONM on RLN paralysis is still controversial. However, easy identification of RLN, which gives more confidence to surgeon, and shorter operation time may be factors to lower hypocalcemia rates.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda, koroner arter stent çapý ile yaþ, cinsiyet, diabetes mellitus (DM), böbrek disfonksiyonu, sol ventrikül ejeksiyon fraksiyonu (SVEF), myokardiyal iskeminin klinik sunumu arasýndaki iliþki ciddi stenoz içeren lezyonlara stent implante edilen hasta kohortunda incelenmiþtir.
YÖNTEM ve GEREÇLER: Çalýþmamýz, perkütan koroner giriþim (PKG) yapýlan 2256 (ortalama yaþ 59.3± 10.9 yýl; erkek 62%) hastayý içermektedir. Hastalarýn baþvuru anýndaki klinik durumlarý þu þekilde alt kategorilere ayrýlmýþtýr: ST-yükselmeli myokard infarktüsü, ST-yükselmesiz myokard infarktüsü, kararsýz angina pektoris, kararlý angina pektoris. Stent çaplarý tip ve markadan baðýmsýz olarak iki gruba ayrýlmýþtýr: grup 1, 2.5 mm ve 2.75 mm; grup 2 ise 3 mm ve üzerini içermektedir.
BULGULAR: Primer PKG, erken invaziv strateji, eleftif stentlemeleri içeren iþlem tipi, koroner arter stent çapý için anlamlý bir etken olarak bulunmamýþtýr. Koroner arter stent çapý ile yaþ, cinsiyet, DM ve SVEF arasýnda hem univaryant hem de multivaryant analizde anlamlý bir iliþki saptanmýþtýr.
TARTIÞMA ve SONUÇ: Bu çalýþma cinsiyet, yaþ, DM hikayesi ve orta-ciddi sol ventrikül disfonksiyonunun, koroner arter stent çapý ile baðýmsýz iliþkide olduðunu göstermiþtir.

INTRODUCTION: This study aimed to determine the relationship between the diameter of coronary artery stents and age, gender, diabetes mellitus (DM), left ventricular ejection fraction (LVEF), renal dysfunction, and the clinical presentation of myocardial ischemia in the cohort of patients with implanted stents in coronary arteries with severe stenotic lesions.
METHODS: This study included 2256 patients (mean age, 59.3±10.9 years; men, 62%) who underwent percutaneous coronary intervention (PCI). The clinical status of the patients at presentation was subcategorized as follows: ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina pectoris, and stable angina pectoris. The diameters, without any type or brand differentiation, were divided into two groups as follows: Group I, which included 2.5- and 2.75-mm-diameter stents, and Group II, which included ≥3-mm-diameter stents.
RESULTS: The type of procedure, including primary PCI, early invasive strategy, and elective stenting, was not found to be a significant factor affecting the diameter of coronary artery stents. Univariate and multivariate analyses revealed a relationship between the diameter of coronary artery stents and age, gender, DM, and LVEF.
DISCUSSION AND CONCLUSION: This study demonstrated that the diameter of coronary artery stents was independently associated with gender, age, a history of DM, and moderate-to-severe systolic left ventricular dysfunction.

GÝRÝÞ ve AMAÇ: Bu çalýþma, farklý alanlarda öðrenim gören üniversite öðrencilerinin yaþlý ayrýmcýlýðýna yönelik tutumlarýný belirlemek amacýyla yapýlmýþtýr.

YÖNTEM ve GEREÇLER: Tanýmlayýcý tipte bu çalýþma 2015-2016 öðretim yýlýnda eðitim alan üniversite öðrencileri ile yapýlmýþtýr. Tabakalý örnekleme yöntemi ile örneklem sayýsý 416 olarak belirlenmiþ olup, öðrenciler basit rastgele örneklem ile seçilmiþlerdir. Veriler “Tanýtýcý Bilgiler Formu” ve “Yaþlý Ayrýmcýlýðý Tutum Ölçeði (YATÖ)” kullanýlarak yüz yüze görüþme yöntemiyle toplanmýþtýr. Ýstatistiksel analizler SPSS 20.0 paket programý kull anýlarak analiz edilmiþtir.

BULGULAR: Öðrencilerin genel YATÖ toplam puan ortalamasý 67.7±6.0 olarak bulunmuþtur. Erkek öðrencilerin YATÖ toplam puaný ve yaþlýnýn yaþamýný sýnýrlama puaný kýz öðrencilere göre anlamlý düzeyde yüksek bulunmuþtur (p<0.05).

TARTIÞMA ve SONUÇ: Farklý alanlarda öðrenim gören üniversite öðrencilerinin yaþlý ayrýmcýlýðýna yönelik olumlu tutuma sahip olduklarý belirlenmiþtir. Yaþlý ayrýmcýlýðýný gidermek için harekete geçilmeli ve toplumsal duyarlýlýðý artýrmak için politikalar geliþtirilmelidir.

INTRODUCTION: This study was conducted to determine the attitudes of university students studying in different fields toward discrimination of the elderly.
METHODS: This descriptive study was conducted with students who were still studying in the 2015-2016 period. A sample size of 416 students was determined by the stratified sampling method, and students were selected by simple random sampling. Data were collected using an identifying information form and an Age Discrimination Attitude Scale (ADAS) by face-to-face interview. Statistical analysis was performed using the program SPSS 20.0.
RESULTS: The mean total ADAS score of students was 67.7±6.0. The total ADAS scores and the scores of male students on limiting the life of the elderly was significantly higher than those of female students (p<0.05).
DISCUSSION AND CONCLUSION: It was determined that university students studying in different fields have a positive attitude toward the elderly. Action must be taken to remove discrimination of the elderly, and policies must be developed to increase social sensitivity.

GÝRÝÞ ve AMAÇ: Bu araþtýrmanýn amacý toplumumuzun çalýþan bir grubundaki uyku kalitesi ve anksiyete düzeylerini belirlemek, birbirleriyle ve diðer faktörlerle iliþkilerini saptamaktýr.
YÖNTEM ve GEREÇLER: Kesitsel tipte düzenlenen bu araþtýrma bir üniversiteye ait kampüste çalýþan 185 kiþiden örnekleme dahil edilen 130 kiþi ile yapýlmýþtýr. Veri toplama aracý olarak tanýmlayýcý anket, Pittsburgh Uyku Kalitesi Ýndeksi, Beck Anksiyete Ölçeði kullanýlmýþtýr. Tek deðiþkenli analizlerin yaný sýra iki ölçek arasýndaki korelasyon Spearman korelasyon analizi ile deðerlendirilmiþtir.
BULGULAR: Araþtýrmada katýlýmcýlarýn %38,9’unun kötü uyku kalitesine sahip olduðu görülmüþtür. Cinsiyet, gelir durumu, kronik hastalýk varlýðý, düzenli ilaç kullanýmý, aile ve sosyal çevre ile iliþkilerin durumu faktörlerinin uyku kalitesi ve anksiyete düzeyini etkilediði bulunmuþtur. Uyku kalitesindeki kötüleþmenin anksiyete düzeyindeki yükselmeyle birlikte olduðu hesaplanmýþtýr.
TARTIÞMA ve SONUÇ: Kötü uyku kalitesi ve yüksek anksiyete düzeyleri ülkemizde de tüm dünyada olduðu gibi sýk görülen sorunlardýr. Kiþilerin sosyoekonomik düzeylerinde yapýlacak iyileþtirici müdahaleler ve özellikle kronik hastalýk gibi risk faktörü taþýyan bireylere verilecek psikososyal bakým onlarýn uyku kalitesi ve anksiyete düzeylerinde ve genel olarak psikososyal saðlýk düzeylerinde iyileþme saðlayacaktýr. Uyku kalitesi ve anksiyete düzeyi arasýndaki iliþkinin daha ayrýntýlý bir biçimde ortaya konmasý için farklý gruplarla, daha geniþ örneklemli ve ileriye dönük araþtýrmalara ihtiyaç vardýr.

INTRODUCTION: The aim of this study was to measure the sleep quality and anxiety level of a group of employees, as well as determine the relationship between sleep quality and anxiety and other factors.
METHODS: A total of 130 of 185 employees at a university campus were enrolled in this cross-sectional study. A descriptive questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Anxiety Inventory were the data collection instruments. In addition to univariate analysis, the relationship between the 2 scales was examined with Spearman correlation analysis.
RESULTS: Of the participants, 38.9% had poor sleep quality. Gender, income level, presence of a chronic disease, regular medication use, and relationship with family and the social environment were found to affect both sleep quality and anxiety. A decrease in sleep quality was associated with an increase in the level of anxiety.
DISCUSSION AND CONCLUSION: Poor sleep quality and a high anxiety level are common in this country, as in the rest of the world. Socioeconomic interventions and psychosocial support to improve the status of individuals with risk factors, such as chronic disease, will reduce anxiety and improve sleep quality and overall psychosocial health. Further prospective studies should be conducted with different groups of participants and with larger samples to expand knowledge of the relationship between sleep quality and anxiety.

GÝRÝÞ ve AMAÇ: Bu çalýþmada topikal çinko uygulamasýyla tüberkülin deri testinin (PPD) tanýsal güvenilirliðinin arttýrýlmasýnýn mümkün olup olmadýðýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Altý, on dört yaþ aralýðýnda 100 çocuk olguda 10-12 saatlik açlýk sonrasý plazma çinko düzeylerine bakýlmýþ, her iki ön kola PPD yapýlmýþ, bir kola %40 çinko oksit krem, diðer kola plasebo olarak baz krem sürülmüþtür. 72 saat sonunda endürasyon çaplarý ölçülmüþtür.
BULGULAR: Olgularýn %26’sýnda yerel çinko uygulanan tarafta PPD çaplarýnda anlamlý artýþ saptanmýþtýr. Ancak endürasyon çaplarýyla serum çinko düzeyleri arasýnda iliþki bulunamamýþtýr.
TARTIÞMA ve SONUÇ: Tüberküloz tanýsýnda, topikal çinko uygulamasýyla tüberkülin yanýtýnýn duyarlýlýðýnýn arttýrýlabileceði sonucuna varýlmýþtýr.

INTRODUCTION: We aimed to evaluate the sensitivity of tuberculin skintest (purified protein derivative-PPD) by topical zinc application on test site to improve diagnostic reliability.
METHODS: We performed this study in 100 children aged 6–14 years, and plasma zinc levels were analyzed after 10–12 hours fasting. After PPD,we applied 40% zinc oxide cream on one forearm and placebo on the other forearm. PPD indurations were measured 72 hours later.
RESULTS: In this study, 26% of the children showed increases in PPD induration following local zinc applications. There was no correlation between indurations size and serum zinc levels.
DISCUSSION AND CONCLUSION: We concluded that topical zinc cream application can enhance sensitivity of tuberculin reactivityin the diagnosis of tuberculosis.

GÝRÝÞ ve AMAÇ: Gastrik poliplerin sýklýðý, çalýþma populasyonlarýna göre büyük farklýlýklar gösterir. Gastrik poliplerin (GP) sýklýðý çeþitli çalýþmalarda %0,33-6,7’dir. Gastrik poliplerin çoðunluðunu hiperplastik polip (HP), fundik gland polibi (FGP) ve adenomatoz polip (AP) oluþturur. AP’lerde malign olma potansiyeli yüksek iken sporadik FGP’lerinin malign olma potansiyeli yoktur. Aksine HP’ler ise düþük malign potansiyel taþýrlar. Polip tipinin belirlenmesi ve displazinin saptanmasý için sadece biyopsi almak her zaman yeterli olmayabilir. Bu nedenle bazý poliplerin total eksizyonu gereklidir.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya 2005-2011 yýllarý arasýnda Ankara Numune Eðitim ve araþtýrma Hastanesi Endoskopi Ünitesinde özofagogastroskopide gastrik polip ya da polipe lezyon saptanan ve biyopside polip veya malign histoloji saptanmýþ hastalar dahil edildi

BULGULAR: 56300 üst endoskopik incelemede 192 (%0,34) hastada GP saptandý. Çalýþmaya 51 (%26,6) erkek, 141 (%73,4) kadýn, toplam 192 hasta dahil edildi. Hastalarýn yaþlarýnýn ortalamasý 61,9±13,3 (14-90)’idi. HP, AP ve FGP’lerinin sýklýðý sýrasýyla %88, %2,6 ve %1,6 idi. Poliplerin boyutu 137 (%70) hastada 1 cm ve altýnda idi. Sadece bir polip, 141 (%73,4) hastada saptandý. Poliplerin en yaygýn lokalizasyonu antrum ve korpus idi. Endoskopik snare polipektomi (ESP), 64 hastada yapýldý. ESP sonrasý endoskopik iþlem gerektiren bir kanama saptandý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda GP sýklýðý düþük saptandý (%0.34). HP sýklýðýnýn yüksek olmasý, ülkemizde Helikobakter pilori (HPy) enfeksiyonun sýklýðýnýn yüksek olmasý nedeniyle olduðunu düþünmekteyiz. Fundik Gland poliplerinin sýklýðý, muhtemelen HPy enfeksiyonun sýk görülmesi ve kýsa süreli proton pomps inhibitörü (PPI) kullanýlmasý sebebiyle oldukça düþüktü

INTRODUCTION: The incidence of gastric polyps (GPs) greatly differs according to study populations and was found to be 0.33%–6.7% in various studies. The majority of GPs are composed of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high risk of malignant potential, sporadic FGPs have no malignant potential. Conversely, HPs have a low risk of malignant potential. It is not sufficient to perform a biopsy to identify the polyp type and the presence of dysplasia; thus, some polyps may require multiple biopsies or total excision.
METHODS: This retrospective study included patients with GPs or polypoid lesions found on esophagogastroscopy with polyp or malignant histology on biopsy at Ankara Numune Training and Research Hospital Endoscopy Unit between 2005 and 2011.
RESULTS: In a series of 56.300 upper endoscopies, 192 patients (0.34%) were found to have GPs. Among the patients, 51 (26.6%) were men and 151 (73.4%) were women. The average age of the patients was 61.9±13.3 (14–90) years. The frequency of HPs, APs, and FGPs were 88%, 2.6%, and 1.6%, respectively. The size of the polyps was ≤1 cm in 137 (70%) patients. One polyp was determined in 141 (73.4%) patients. The most common localizations of polyps were the antrum and corpus. Endoscopic snare polypectomy was performed in 64 patients. One bleeding episode was observed, which required endoscopic treatment after ESP.
DISCUSSION AND CONCLUSION: In our study, the GP frequency was low (0.34%), whereas the frequency of HP maybe high due to the high frequency of Helicobacter pylori (HPy) infection in our country. The frequency of FGP is probably low due to the high frequency of HPy infection and the short-term use of proton-pump inhibitors.

GÝRÝÞ ve AMAÇ: Çalýþmanýn amacý, laparoskopik kolesistektomi sýrasýnda safra kesesi perforasyonunun (SKP) risk faktörlerini ve sonuçlarýný ortaya çýkarmaktýr.
YÖNTEM ve GEREÇLER: Kliniðimizde elektif kolesistektomi yapýlan tüm hastalarýn video görüntüleri geriye dönük perfore olan ve olmayanlar olarak iki gruba ayrýldý. Muhtemel risk faktörleri ve erken dönem sonuçlarý sorgulanmýþtýr.
BULGULAR: 664 olgu (524 [% 78.9] kadýn, 49.7 ± 13.4 yaþ) ve SKP 240 olgunun (% 36.1) çoðunlukla da safra kesesi yataðýndan ayrýlýrken meydana geldi (n = 197,% 82.1). SKP; operasyon notlarýnýn 177' inde (% 73.8) kaydedilmemiþti. Çalýþýlan parametreler arasýnda hiçbiri preoperatif olarak yükselmiþ ALT seviyesi (p = 0.005) dýþýnda SKP 'da anlamlý risk faktörü olarak bulunmadý. Ancak bu deðerin SKP öngörmedeki duyarlýlýðý ve özgüllüðü sýrasýyla % 14.2 ve % 7.4 idi. Sonuçlar iki grup arasýnda benzerdi, ancak SKP grup hastalarda operasyon süresi uzadý (35.4 ± 17.5 vs 41.4 ± 18.7 dakika, p = 0.000) ve dren kullanýmýnýn insidansý arttý (% 25'e karþý% 45.8, p = 0.000).
TARTIÞMA ve SONUÇ: Bu çalýþma, SKP 'nun elektif laparoskopik kolesistektomi uygulanan hastalarýn % 36.1 'ini oluþturduðunu, ancak çoðu olguda kaydedilemeyebileceðini ortaya koymaktadýr. Bu çalýþma, SKP olasýlýðýný artýran herhangi bir güvenilir risk faktörünün bulunmasýný reddetmektedir. SKP operasyon süresini ve dren kullanýmý insidansýný artýrýr, ancak diðer sonuçlar SKP olan ve olmayan hastalarda benzerdir.

INTRODUCTION: This study aimed to reveal the risk factors and outcomes of gallbladder perforation (GP) during laparoscopic cholecystectomy.
METHODS: Videotapes of all patients who underwent an elective cholecystectomy at our department were retrospectively analyzed, and the patients were divided into two groups based on the presence of GP. The possible risk factors and early outcomes were analyzed.
RESULTS: In total, 664 patients [524 (78.9%) females, 49.7±13.4 years of age] were observed, and GP occurred in 240 (36.1%) patients, mostly while dissecting the gallbladder from its bed (n=197, 82.1%). GP was not recorded in the operation notes in 177 (73.8%) cases. Among the studied parameters, there was no significant risk factor for GP, except preoperatively elevated alanine transaminase level (p=0.005), but the sensitivity and specificity of this measure in predicting GP were 14.2% and 7.4%, respectively. The two groups had similar outcomes, but the operation time (35.4±17.5 vs 41.4±18.7 min, p=0.000) and incidence of drain use (25% vs 45.8%, p=0.000) increased in the GP group.
DISCUSSION AND CONCLUSION: The present study reveals that GP occurs in 36.1% of patients who undergo laparoscopic elective cholecystectomy, but it may not be recorded in most cases. We did not find any reliable risk factor that increases the possibility of GP. GP causes an increase in the operation time and incidence of drain use; however, the other outcomes were found to be similar in patients with GP and those without.

INTRODUCTION: The aim of this study was to evaluate the effect of trabeculectomy on ocular higher-order aberrations following surgery in a group of patients with open angle glaucoma.
METHODS: In this prospective study, patients with primary open angle glaucoma underwent wavefront aberrometry before trabeculectomy with mitomycin-C. Coma-like, spherical-like, and total ocular higher-order aberrations were measured as root mean square values. The measurements were repeated 1 month and 3 months after the procedure.
RESULTS: A total of 20 eyes from 20 patients were examined. There was a significant decrease in intraocular pressure following surgery at 1 month and 3 months postoperatively. However, there was no statistically significant change in the spherical equivalent of the eyes. One month after surgery, a significant change in coma-like, spherical-like, and total higher-order aberrations of the eyes was observed. However, the repeated measurements performed 3 months after procedure revealed no significant difference compared to the baseline values.
DISCUSSION AND CONCLUSION: Ocular higher-order aberrations increased 1 month following trabeculectomy surgery. However, this effect seems to be transient, as the values returned to the preoperative measurement 3 months after the procedure.

Böbreðin berrak hücreli sarkomu çocukluk çaðýnýn nadir görülen bir tümörüdür. Böbrek tümörlerinin yaklaþýk olarak %2-9’unu oluþturur ve genellikle 5 yaþýndan önce görülür. Çoðunlukla diðer böbrek tümörlerini taklit eder. Yedi yaþýnda kýz hasta kusma ve karýn aðrýsý þikayeti ile getirildi. Ultrasonografide sað böbrekte kitle saptandý ve baþvurusundan saatler sonra sað böbrekte hematom geliþti. Wilms tümörü ön tanýsý ile sað nefroüreterektomi yapýldý ancak histopatolojik inceleme ile berrak hücreli sarkom tanýsý konuldu. Böbreðin berrak hücreli sarkomu, yaþ, klinik ve histopatolojik özellikleri ile Wilms tümörü ile benzer, ancak tedavi metodu ve prognozlarý birbirinden farklýdýr. Bu nedenle ayýrýcý taný çok önemlidir. Bu olgu, berrak hücreli sarkomun nadir görülen bir prezentasyonuna dikkat çekmek için sunulmuþtur. Spontan böbrek hematomu ile gelen böbrek kitlelerinin ayýrýcý tanýsýnda böbreðin berrak hücreli sarkomu akýlda tutulmalýdýr.

Clear cell sarcoma of the kidney (CCSK) is an uncommon renal neoplasm of childhood. It represents between 2% and 9% of all pediatric renal tumors, and generally arises before the age of 5 years. It often mimics other pediatric renal tumors. Presently described is the case of a 7-year-old girl who presented with complaints of vomiting and abdominal pain. Abdominal ultrasonography revealed a right renal mass, and the patient developed a renal hematoma a few hours after admission. The patient underwent a nephroureterectomy with a provisional diagnosis of Wilms tumor; however, histopathological examination of a specimen revealed CCSK. CCSK is similar to Wilms tumor in terms of the typical age of appearance and clinical and histopathological features, but the treatment method and prognosis are different. Therefore, the differential diagnosis is very important. This case was presented to draw attention to a rare presentation of clear cell sarcoma. CCSK should be kept in mind in the differential diagnosis of a renal mass.

Infliximab is a monoclonal antibody that antagonizes the activity of tumor necrosis factor alpha to induce and maintain remission in patients with inflammatory bowel disease. Adverse effects associated with Infliximab infusions include infusion reactions, risk of infections, development of hematological malignancies, and pancytopenia. Autoimmune hemolytic anemia has rarely been reported in ulcerative colitis. Herein we report a case of drug-induced hemolytic anemia after infliximab infusion for treating ulcerative colitis.

22 yaþýnda kadýn hastada tiroid sað lobundaki nodüle dýþ merkezde ince iðne aspirasyon (FNA) yapýlýyor ve Bethesda system Kategori IV; Hurthle hücreli foliküler neoplazi olarak rapor ediliyor. Hastanemize baþvuran olgu opere ediliyor. Sað total tiroidektomisinde totale yakýn infakta gitmiþ bir nodül, ve bu enfarkt alanlarýnýn çevresinde papiller yapýlar tespit edilmiþtir. Bu papiller yapýlarýn reaktif papiller deðiþiklikler mi?, yoksa FNA tanýsý yetersiz rapor edilmiþ bir papiller karsinom mu? olduðunun tanýsýný koyarken yaþadýðýmýz zorluklarý bildirmek, immünohistokimyasal analiz ve moleküler genetik testleri kullanarak nasýl bir çýkýþ yolu bulduðumuzu sunmak, ayrýca olguda tiroidektomi sonrasý tespit edilen senkron beyin sapýnda astrositom mevcut olduðundan olguyu literatür eþliðinde irdemelek istedik.

A 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing. In addition, we examined the case along with a literature review because an accompanying synchronous brain stem astrocytoma was detected in the patient after thyroidectomy.

Gerçek radiyal arter anevrizmalarý, nadir görülen patolojilerdir ve travmaya baðlý oluþan false anevrizmalarýn aksine genelde organik bir etyolojiye sahiptirler. 52 yaþýndaki erkek hasta, sol el enfiye çukuru alanýnda pulsatil bir kitle ile baþvurdu. Anevrizma, rekonstrüktif prosedür ile tamir edildi. Travma sonrasý geliþen ve iyatrojenik birçok radial arter psödoanevrizma olgusu bildirilmiþ olmasýna raðmen; rapor edilen gerçek idiyopatik anevrizma olgu sayýsý azdýr. Bu yazýda, gerçek idiyopatik radial arter anevrizmasý için yapýlmýþ olan rekonstrüktif cerrahi olgusu sunuldu.

True radial artery aneurysms are uncommon pathologies and have an organic cause, unlike trauma-induced false aneurysms. A 52-year-old man presented with a pulsatile mass at the anatomical snuff box area of his left hand. The aneurysm was repaired with reconstructive procedure. Although many posttraumatic and iatrogenic cases of false aneurysm of the radial artery have been reported; there are a few reported cases of a true idiopathic aneurysm. A case of reconstructive surgery for true idiopathic radial artery aneurysm is reported in this paper.

Vücuda uzun bir bölümüyle isabet etmiþ yabancý cisimler son derece ciddi sorunlar oluþturabilmektedirler. Hastanýn transferinden cismin çýkarýlmasýna, ameliyatýndan takibine kadar iyi bir organizasyon ve tam bir takým içinde hareket etmek gerekmektedir. Bu yazýda, karla kaplý sokakta kayarken anüs sað yanýndan girip belinden çýkan 12 metrelik inþaat demirinin itfaiyeciler tarafýndan kesilinceye kadar kar içinde bekleyen çocuðun, hastaneye getirilmesi, acil ekibi tarafýndan ilk deðerlendirilmesi, tetkik edilmesi ve tedavi planý oluþturulmasý süreçlerinin tümünden edindiðimiz deneyimleri paylaþmak amaçlanmýþtýr.

Foreign bodies which strike the body with their long edges can cause severe problems. From the transfer of the patient to the removal of the foreign body, and from surgery to the follow-up, it is required to work as a team in a well-organized manner. Herein, we present our experience including the transfer, initial assessment by the emergency team, examination, and treatment plan of a pediatric case who had a 12-meter long construction iron traversing from the right side of the anus to the loin, while sliding through the snow-covered street and had to wait on the snow, until the fire department arrived and cut the construction iron.

Typical human gut flora has been well characterized in previous studies and has been noted to have significant differences when compared with the typical microbiome of various disease states involving the gastrointestinal tract. Such diseases include Clostridium difficile colitis, inflammatory bowel disease, functional bowel syndromes, and various states of liver disease. A growing number of studies have investigated the use of a fecal microbiota transplant as a potential therapy for these disease states.