RESEARCH ARTICLE | |
1. | The Evaluatıon Of The Postoperatıve Radıotherapy Results In Endometrıum Carcınoma Makbule Doğan Eren, Şule Karabulut Gül, Mihriban Koçak, Ahmet Fatih Oruç, Erkan Göcen, Alpaslan Mayadağlı Pages 59 - 63 OBJECTIVE: Radiotherapy is an effective treatment modality that has been used in the treatment of endometrial carcinoma for years. It is frequently used in postoperative setting to improve local and regional control. Treatment would be finished with only intracavitary application in medium risk groups and intracavitary insertion after external radiotherapy in high risk groups. But primary therapy has been radiotherapy in patients who can not be treated with surgery. In this study, 79 cases with the diagnosis of endometrial cancer who received postoperative radiotherapy in our clinic between years 1998 and 2003 were evaluated and general charactheristics of patients, prognostic factors, treatment outcome and side effects were presented in the light of literature. METHODS: RESULTS: CONCLUSION: |
2. | The Analysıs Of The Patıents Who Treated Conservatıvely Wıth Solıd Organ Injury After Blunt Abdomınal Trauma Kadir Koray Baş, Mehmet Altıntaş, Ayhan Çevik, Nejdet Bildik, Gülay Dalkılıç, Hüseyin Ekinci, Mustafa Gülmen Pages 64 - 71 OBJECTIVE: The aim of this study was to review the changes on diagnosis, follow-up and treatment modalities for solid organ injury after blunt trauma and to evaluate the nonoperative treatment which we have been performed with an increasing success rate up to date. This was a retrospective study, the medical records of 208 patients with solid organ injury after blunt abdominal trauma from January 2000 through October 2005 at Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of 2. General Surgery were reviewed. One hundred and forty (68%) of these patients underwent surgery and 68 (23%) of the patients were followed up without operation, no other empty organ injury or hemodynamic instability was found in the patients who were treated conservatively. No exitus were seen in the nonoperative therapeutic group. Eight patients died in the operative group with the accompanying injuries. When we evaluate the cases year to year we end with the result that solid organ injury after blunt trauma were diagnosed and treated with following current methods successfully. METHODS: RESULTS: CONCLUSION: |
3. | The Comparıson Of Dexametasone Alcohol And Desonıde Dısodıum Phosphate In The Treatment After Phacoemulsıfıcatıon Erol Çoşkun, Ekrem Kurnaz, Burak Özdemir, Kazım Erol, Nihal Aşık, Musa Çapkın, Fikret Ünal, Yusuf Özertürk Pages 72 - 76 OBJECTIVE: To compare the efficiency and complications of dexamethasone alcohol and desonide disodium phosphate used in patients who had phacoemulsification and intraocular lens implantation surgery without any complication. Sixty eyes of 35 patients who had phacoemulsification and posterior chamber intraocular lens implantation surgery without any complication between June 2005 and September 2005 in Dr. Lütfi Kırdar Kartal Training and Research Hospital were included in this study. The patients were divided into two groups randomly. The first group of patients had received tobramycine 0.3% drop and desonide disodium phosphate 0.25% eye drops, one drop six times daily beginning four hours after the surgery. The second group had received tobramycine 0.3% drop and dexamethasone alcohol 0.1% eye drops, one drop six times daily beginning four hours after the surgery. Patients were controlled on postoperative first day, after one week and after one month. The mean anterior chamber cell count in the first group at day one, after 1 week and one month were 2.77±0.56, 1.2±0.42 and 0, respectively. The mean anterior chamber cell count in the second group at day one, after one week and one month were 2.35±0.6, 1.2±0.42 and 0, respectively. In group I, the mean aqueous flare score in the anterior chamber was 1.64±0.13 on the postoperative first day; 1.13±0.10 after one week. In group II, the mean aqueous flare score in the anterior chamber was 1.57±0.16 of the postoperative first day, 0.81±0.09 after one week. Preoperatively the mean intraocular pressure in group I was 18.56±3.38 mmHg on the first day, 14.50±2.12 mmHg after one week and 13.43±2.23 mmHg after one month. In group II, the mean pressures measured were as followings: 18.73±2.63 mmHg on the postoperative first day, 14.83±2.11 mmHg after one week and 13.27±1.70 mmHg after one month. Desonide disodium phosphate is effective in the treatment of anterior chamber inflammation after phacoemulsification surgery. But when compared with dexamethasone alcohol it is less effective and less comfortable. The patients who receive desonide disodium phosphate treatment after phacoemulsification and intraocular lens implantation surgery must be followed up frequently. METHODS: RESULTS: CONCLUSION: |
4. | The Results Of Adult Femur Fractures Whıch Treated Wıth Antegrade Lockıng Naıl Mını Open Reductıon Technıque Gökhan Bülent Sever, Serhat Gafur Karaca, Muhsin Dursun, Volkan Gürkan, Sinan Karaca Pages 77 - 81 OBJECTIVE: The aim of the study is to compare the treatment results of femur shaft fractured patients who treated by antegrade locked intramedullary nailing with the patients treated by mini open technique and closed technique in literature radiologically and functionally. We have treated 16 patients (14 males, 2 females; mean age 36; range 16-60 years) who had 16 femur shaft fractures by using locked intramedullary nailing. Six fractures were right leg and 10 were left leg. We followed up the patients for mean 24 months (7-60). We evaluated the union time of fractures, radiological and functional results according to Klemm Borner criteria and compared them with results of femur shaft fractured patients who had been operated by closed technique locked intramedullary nailing. The fractures healed in mean 24 weeks (18-27). None of the patients had any complication like neurovascular damage, infection and malunion. Functionally, 2 patients (13%) have good and 14 patients (87%) excellent results according to Klemm Börner criteria. We noticed that there is no discrimination for union time in femur fractures which treated by intramedullary nailing with mini open or closed technique. The mini open technique doesn’t increase complication rate and morbidity. The advantages of mini open locked intramedullary nailing are protecting surgeon, patient and assistants from radiation with decreasing scope using time, decreasing operating time significantly. The disadvantage of mini open technique is that it can be used only in Winguist Hansen type 1 and 2 fractures. Because of these advantages mini open locked intramedullary nailing could be preferred in treatment of femur shaft fractures as an alternative of closed technique. METHODS: RESULTS: CONCLUSION: |
5. | Our Resectıon Outcome In Lung Cancer: Evaluatıon Of 45 Consequentıal Patıents Recep Demirhan, Alpaslan Mayadağlı, İrfan Sancaklı, Nagehan Özdemir, Mahmut Gümüş, Cem Parlak, Nesrin Kıral, Feriha Temizel, Bülent Arman Pages 82 - 88 OBJECTIVE: Surgical treatment is an important therapeutic option in lung cancer, providing a long-term survival and curability. Three hundred and ninety six patients had been diagnosed as lung cancer in the pulmonary and thoracic surgery clinics of our hospital from 2004 to 2007. However, surgical treatment could be performed to only 45 of these patients (11.3%). Two patients were female and 43 were male. Mean age was 61 (38-74) in the study. Preoperative diagnosis was established with fiberoptic bronchoscopy in 28 patients (62.3%), with rigid bronchoscopy in 4 patients (8.8%), with transthoracic needle aspiration biopsy in 7 patients (15.5%) and open lung biopsy in 6 patients (13.5%). Preoperative histopathological evaluation diagnosed 38 patients as non-small cell lung cancer (NSCLC) and one patient as small cell lung cancer, whereas diagnosis of NSCLC was made by open lung biopsy in 6 patients. For staging purposes, mediastinoscopy was performed to 41 patients (91%) and additional anterior mediastinotomy was carried out in 5 patients (11.1%). Mediastinal involvement (N2 +) was noted in two patients with mediastinoscopy. Lobectomy was the most frequent resection procedure performed (in 62.3%). Epidermoid carcinoma was reported to be the most frequent postoperative histopatological diagnosis. In our series, postoperative complication was noticed in 5 patients (11.1%) while postoperative mortality was observed in 3 patients (6.6%). Postoperative follow-up period was 18 months in our series. Patients with stage I and stage II lung cancer, who had been operated, were observed to experience no problem in this period. In conclusion, surgical resection is the most effective treatment option recommended for the treatment in non-small cell lung cancer. METHODS: RESULTS: CONCLUSION: |
CASE REPORT | |
6. | Prımary Squamous Cell Carcınoma Of The Breast: A Case Report Aylin Ege Gül, Coşkun Yıldız, Gülay Dalkılıç, Sevinç Hallaç Keser, Yunus Gül, Nimet Karadayı Pages 89 - 92 Primary squamous cell carcinoma (SCC) of the breast is a very rare entity. The case we present was diagnosed as SCC after histopathogical analysis. Since metastatic SCCs of the breast mostly origin from lung, cervix, urinary bladder, esophagus and skin, after the diagnosis, those sites were examined. No other tumor focus was detected and therefore, the case was considered being a primary breast carcinoma. In order to put stress on the need to exclude the probability of metastasis in such kind of rare entities, the recent literature is reviewed and presented. |
7. | Complıcated Lıver Hydatıd Cyst Wıth Abscess Formatıon Fazlı Cem Gezen, Selahattin Vural, Barış Tüzün, Nimet Süslü, Feyyaz Onuray, Gülay Dalkılıç, Tolgay Akın, Orhan Şad Pages 93 - 96 The liver hydatid cyst still remains as a challenging disease in the current practice. The most common complication is related to biliary system. Bilioenteric anastomoses or external biliary drainage may be necessary for the treatment of biliary complications. Hydatid cyst of the liver is space occupying lesion that can form atrophy and hypertrophy complex. Iatrogenic lacerations can develop during operation due to the atrophy hypertrophy complex and dense adhesions of the hydatid cyst disease of liver. In this paper a patient with infected hydatid disease is presented. The exploration of the common bile duct was not performed, since the patient has dense adhesions to the hepatoduodenal ligament related to the hydatid cyst and atrophy and hypertrophy complex. A postoperative biliary fistula was observed which was diagnosed with ERCP and treated with endoscopic syphincterotomy. The fistula was healed on the seventeenth day. |
8. | “Shıgella Sonneı” Causıng Chronıc Dıarrhea In A Patıent Wıth Hıv/Aıds Kadriye Kart Yaşar, Şemsinur Karabela, Gönül Şengöz, Özcan Nazlıcan Pages 97 - 100 Diarrhea occurs in more than half of the patients with HIV/AIDS during the course of the disease especially in the last period of the disease and it's an important cause of morbidity and mortality. “Shigella sonnei” was isolated as an agent from the stool of a HIV/AIDS patient with chronic diarrhea and, the disease and life quality of the patient improved following the quinolone treatment. By means of this case, we wanted to emphasize that the acute bacterial diarrhea agents could also cause chronic diarrhea in HIV/AIDS patients. |
9. | Mıvacurıum Induced Prolonged Neuromuscular Block Hakan Erkal, Yaman Özyurt, Gülten Arslan, Hüslü Süslü, Zuhal Arıkan Pages 101 - 103 Mivacurium is a short-acting nondepolarizing neuromuscular blocking agent hydrolyzed by plasma cholinesterase. We present a case of unexpected prolonged neuromuscular blockade in a woman with previously undiagnosed plasma cholinesterase deficiency. A 28-year-old female patient without personal or family history suggestive of anaesthetic problems was admitted to our hospital for bronchoscopy. Anesthesia induction was performed with propofol (2 mg.kg-1) and maintained with propofol infusion (2 mg.kg.h-1) and 100% oxygen. Single dose of mivacurium (0.2 mg.kg-1) was used as neuromuscular blocker. The operation lasted for 15 minutes. But, she did not recover as quickly as expected from the anaesthetic effect of the agent. She had prolonged neuromuscular blockade. The patient was kept ventilated mechanically and sedated in the intensive care unit because she could not attain adequate muscle power 40 minutes after termination of anaesthesia. The muscular paralysis persisted for 4 hours after the single bolus dose of mivacurium. Later, it was shown that the patient had a pseudocholinesterase deficiency, and this was determined to be a congenital condition. Pseudocholinesterase deficiency is an uncommon occurrence but should always be highly suspected in cases of prolonged paralysis following the administration of a short-acting muscle relaxant. In such patients; the use of a nerve stimulator is recommended whenever muscle relaxants are used, and muscle relaxants should be used only when facilities for prolonged ventilation are available. |
10. | Idıopathıc Granulomatous Mastıtıs: Case Report Gülay Dalkılıç, Aylin Ege Gül, Hakan Acar, Engin Baştürk, Cem Gezen, Selahattin Vural Pages 104 - 106 Idiopathic granulomatous mastitis (IGM) is a rare benign disorder of the breast with an unknown etiology which can be confused with inflammatory carcinoma. Clinically it mimics inflammatory breast carcinoma since it presents with a painful mass or abscess with a fistulae. In the type forming abscess, a specific microorganism can not be detected. Since imaging techniques are not useful for diagnosis, histopathological analysis is mandatory for precise diagnosis. Fine needle aspiration biopsy carries low sensitivity, so insicional biopsy is needed. Histopathologically, confined to lobules, epitelioid histiocytes, Langhans type giant cells, macrophages and small foci of abscesses are found. This case which has been presented with a reddened breast, mass and pain was diagnosed as IGM after histopathological analysis. For treatment, surgical resection as well as steroid therapy and low-dose methotrexate is recommended. In our case, excision was performed and steroid therapy was administered and no recurrence was seen at 13 month follow-up. |
REVIEW | |
11. | Kanserli Hastalarda Palyatif Bakım ve İlkeleri Tamer Kuzucuoğlu, Feriha Temizel, Tuğba Güler, Müjge Yücekaya, Gülten Arslan, Zuhal Arıkan Pages 107 - 110 Abstract | |
12. | Hasta Hakları ve Sorumlulukları Recep Demirhan, Reşat Dabak, Songül Mangan Pages 111 - 116 Abstract | |