INTRODUCTION: The aim of this study was to retrospectively review files of patients who had tumor resection and reconstructive surgery performed by thoracic and plastic surgeons due to chest wall tumor, and to create reconstruction algorithm.
METHODS: Records of 45 patients who underwent surgery for chest wall tumor between 2006–2014 were included in this study. Data including age, sex, tumor localization, defect size, quantity of resected costa and bone, and method of skeletal and soft tissue reconstruction were gathered retrospectively from patient files.
RESULTS: The largest defect was 325 cm2 and smallest was 36 cm2. Titanium mesh was used in 54% of patients, while prolene mesh was used in 32%. Pectoralis kite flap (n=14), latissumus dorsi muscle-skin muscle flap (n=12), latissumus dorsi muscle flap and pectoral kite flap (n=5), vertical rectus abdominus skin muscle flap(n=6), omentum flap (n=3), transvers rectus abdominus skin muscle flap (n=3), free anterolateral thigh flap (n=2), and local rotation flap (n=1) were used for soft tissue reconstruction.
DISCUSSION AND CONCLUSION: Algorithm for soft and skeletal tissue reconstruction was created in accordance with obtained data.

INTRODUCTION: The present study examined the progression of fetal pyelectasis detected in patients during antenatal period and its relationship to postnatal urinary tract pathology.
METHODS: Medical records of 10 patients in whom isolated fetal pyelectasis (defined as anteroposterior [AP] diameter of renal pelvis of 5 mm or greater in the second trimester and 7 mm or greater in the third trimester) was detected in prenatal sonographic examination at perinatology clinic between January 2013 and August 2014 were retrospectively reviewed. Fetuses with additional congenital anomalies or aneuploidy were excluded.
RESULTS: Nine fetuses were male and 1 was female. Fetal renal pelvis AP diameter was <10 mm in 5 (50%), 10–15 mm in 3 (30%), and >15 mm in 2 patients (20%). Six patients (60%) had unilateral and 4 (40%) had bilateral pyelectasis. Progression of pyelectasis in those 4 patients was followed during pregnancy. After birth, ultrasonographic (US) findings of ureteropelvic junction stenosis (UPJ) (n=1), urethrocele (n=1), vesicoureteral reflux (VUR) (n=1), and posterior urethral valves (PUV) and VUR (n=1).
DISCUSSION AND CONCLUSION: Serial US examinations are important in followup of patient with fetal pyelectasis. Progressive and bilateral pyelectasis may be predictive of postnatal uropathy.

INTRODUCTION: The aim of this study was to evaluate the effect of topical brimonidine on intraocular pressure (IOP) after Neodymium: yttrium aluminum garnet laser posterior capsulotomy.
METHODS: Forty patients (40 eyes) who underwent posterior capsulotomy were included in the study. Patients were divided into Groups A and B. Topical brimonidine was applied 1 hour prior to and right after laser procedure in Group A. Group B was assessed as control group. Intraocular pressures of the patients were measured using aplanation tonometry (Goldmann) before, 1 hour, 1 day and 1 week after laser procedures.
RESULTS: Mean IOP at baseline was 14.7±3 mmHg in Group A and 14.6±3.9 mmHg in Group B. In Group A, IOP decreased to 12.7±3.3 mmHg after 1 hour, 13.7±2.3 mmHg after 1 day, and 14.2±2.3 mmHg after 1 week. The values were measured respectively as 15.1±2.9 mmHg, 14.9±2.1 mmHg, and 14.5±2 mmHg in Group B. IOP had decreased significantly at 1 hour and at 1 day after laser treatment when compared with baseline in Group A; no significant difference was found after 1 week. No statistically significant difference was found during follow-up period compared to baseline in Group B.
DISCUSSION AND CONCLUSION: Use of brimonidine was demonstrated to prevent rise in IOP. In addition, there was no significant IOP increase as result of fewer shots and low energy laser treatment.

INTRODUCTION: Pressure ulcers are a health problem that can be seen in hospitalized patients in intensive care units (ICU). Malnutrition, advanced age, impaired circulation, immobilization, reduced sensory perception, infection, incontinence, moisture, neurological deficit, sedation, and friction may play a role in development of pressure ulcers. Pressure ulcers should be prevented and must be treated aggressively when they occur. This study analyzed occurrence of pressure ulcers in ICU patients.
METHODS: Records of patients treated in hospital ICU between January 2012 and May 2013 were analyzed retrospectively. Demographic and clinical characteristics of patients, risk of developing pressure ulcers, duration and degree of pressure ulcers, parts of body affected, and treatment results were evaluated.
RESULTS: A total of 461 patients were included in the study. While 3 patients (0.7%) had existing pressure ulcers on ICU admission, 14 patients (3%) developed new pressure ulcers, and 444 patients (96.3%) did not develop pressure ulcers. Pressure ulcers most often occurred 25 to 50 days after admission.
DISCUSSION AND CONCLUSION: Patients admitted to ICU should be evaluated for pressure ulcers, necessary measures should be taken for patients at risk of developing pressure ulcers to avoid their development, and any pressure ulcers should be treated effectively.

INTRODUCTION: The present study is an analysis of appropriateness of antibiotics use for patients in whom infectious agent was detected. Data from patients in orthopedics and traumatology department of 2 hospitals in the same district were evaluated according to rational antibiotic drug use guidelines and culture antibiogram results.
METHODS: Data of patients diagnosed with infection between January 1, 2014 and December 31, 2015 in orthopedics and traumatology department of 2 different hospitals were analyzed. Patients diagnosed with malignancy or who were discharged from other departments were excluded. A standard form was used to collect demographic data, culture antibiogram results, details of infectious agent, source of culture material, posology of antibiotic used, duration and appropriateness of use, and length of hospital stay. Costs were estimated based on number of units used and price per unit according to 2014 Ministry of Health price list. Mean price of antibiotics used per patient was calculated and descriptive analyses were also completed.
RESULTS: It was determined that appropriate antibiotics for detected infectious agent were not always selected. Though there were effective, less expensive antibiotics that could have been used according to antibiogram results, more expensive antibiotics were often chosen, resulting in greater total cost.
DISCUSSION AND CONCLUSION: Multidisciplinary approach in patient care and use of evidence-based guidelines should be increased. Teams should be formed and led by infectious disease and pharmacology specialists. New strategies should be developed immediately in health economics and new pharmacoeconomic models should be initiated in orthopedics and traumatology departments.

INTRODUCTION: Atrial septal defect (ASD) is the second most frequently seen type of congenital heart disease. The aim of the present study was to predict clinical prognosis of ASD based on age at diagnosis, patient complaints, findings of physical examination, electrocardiogram and telecardiogram results, and echocardiographic measurement of diameter of defect in 388 patients with ASD.
METHODS: Patients at pediatric cardiology outpatient clinic of Ondokuz Mayýs University Faculty of Medicine Department of Children’s Health and Diseases between January 2003 and June 2008 who were 0–18 years of age, had echocardiographic examinations performed at least twice, and were followed-up for at least 6 months were included in the study.
RESULTS: The study population included 182 (46.9%) male and 206 (53.1%) female patients (female/male ratio: 1.13) with median age at diagnosis of 3 months (range: 1 month-17 years). In 189 patients (53.4%), ASD closed spontaneously. A total of 24 patients (6.8%) underwent surgery. In 43 patients (12.1%), defect was repaired using transcatheter procedure. At time of study, 98 patients (27.7%) were still under follow-up care. Early diagnosis and diameter of defect correlated with spontaneous closure (p<0.001).
DISCUSSION AND CONCLUSION: Age at diagnosis and size of defect are the most important criteria for clinical prognosis and spontaneous closure of defect in cases of ostium secundum ASD.

INTRODUCTION: The aim of the present study was to evaluate the follow-up results in patients who initially had cervical smear results showing low-grade squamous intraepithelial lesions (LSIL) in order to determine their histologic outcomes and develop a management guideline.
METHODS: A total of 240 non-pregnant women with LSIL in their cervical smears were evaluated with colposcopy, and colposcopically directed biopsies and endocervical sampling were done as indicated. Patients had follow-up smears every 3 to 4 months.
RESULTS: Of the 240 patients with LSIL, 108 patients (62.8%) were classified as having cervical intraepithelial neoplasia 1 (CIN 1), 28 (16.3%) cases had CIN 2, 12 patients (6.8%) had CIN 3, and 4 patients (2.3%) were diagnosed with invasive cervical carcinoma. At 12-month follow-up, persistence was observed in 38 (22%) cases, and progression to high-grade dysplasia was seen in 16 (9%) cases. Regression to normal smear was observed in 118 cases (68%).
DISCUSSION AND CONCLUSION: Since cervical minor abnormalities can change to low-grade lesions, high-grade lesions, or even cervical carcinoma, colposcopy was found to be an appropriate method for a correct diagnosis. Colposcopy in combination with smear was the ideal approach during follow-up.

INTRODUCTION: In this study, we evaluated the clinical efficacy and safety of ertapenem treatment for urinary tract infections (UTIs) in children.
METHODS: In this retrospective study, we analyzed the records of 22 patients, aged 5 months to 153 months, who received ertapenem therapy for UTI caused by extended spectrum beta-lactamase (ESBL)-producing microorganisms between August 2015 and June 2016.
RESULTS: Sixteen (72.7%) female and 6 (27.2%) male children with a mean age of 53.0±43.6 months (range: 5 to 153 months) were enrolled in the study. Escherichia coli (n=21), and Klebsiella pneumoniae (n=1) were identified in the urine cultures of these 22 patients. Treatment duration was 10 days for all patients. No adverse drug-related effects were seen.
DISCUSSION AND CONCLUSION: Ertapenem can be used safely to treat UTI in children caused by ESBL-producing microorganisms.

INTRODUCTION: Described in this study is surgery to treat retrocaval ureter, a rare congenital anomaly, and relevant literature findings.
METHODS: Data on patients who underwent surgery in the clinic between January 2003 and January 2015 were reviewed retrospectively. Three patients who were operated on for retrocaval ureter were included in the study. Age, sex, laterality, symptoms, and degree of hydronephrosis were analyzed. Open ureteroureterostomy with double J stent insertion was performed on all 3 patients. Double J stents were removed after 3 weeks and patients were evaluated at postoperative 3 months.
RESULTS: Mean age of patients was 17.66 years (range: 13–24 years). Two patients were male, 1 was female. All cases had right-sided retrocaval ureter. Proximal ureteral dilatation and reverse J images were seen on in travenous pyelograms (IVPs) of all patients before surgery. On postoperative thirdmonth evaluation, ureteral drainage was normal, proximal ureteral dilatation had regressed and patients were asymptomatic.
DISCUSSION AND CONCLUSION: Open surgery for retrocaval ureter is effective and preferred treatment modality with high success rate.

Hemangiopericytoma (HPC) can originate in capillary pericytes of any part of the body. It is a rare vascular tumor, mostly seen in retroperitoneal space, hips, and thighs. Based on clinical and radiological findings, it is difficult to distinguish supratentorial intracranial HPC from meningiomas, Intracranial HPC accounts for 0.4% of all primary central nervous system (CNS) tumors. The World Health Organization (WHO) classified it as grade 2 tumor, and mesenchymal tumors are characterized as having variable malignant potential. Meningeal HPC is an extremely rare tumor, usually found in supratentorial location. Meningioma should be considered in differential diagnosis. Definitive diagnosis is made with histopathological analysis after surgery. In the present report, clinical and pathological features of a 37-year-old male patient who presented with meningeal HPC are described. This case is presented because of the scarcity of such instances in the literature.

Fascioliasis is a zoonotic disease that is very rarely seen in human beings. Histopathological examination of surgical specimen of a 43-year-old male patient who underwent surgery for cholelithiasis revealed the presence of Fasciola hepatica. Fascioliasis has liver (acute) and biliary (chronic) phases. Peripheral eosinophilia is dominant during liver phase; signs of cholelithiasis are dominant in biliary phase.

Cervical ectopic pregnancy is a very rare form of ectopic pregnancy. Cervical ectopic pregnancy can be a cause of severe bleeding and it is associated with high morbidity and mortality. In recent years, many conservative methods of treatment seeking to preserve fertility have been reported. Presently described is case of pregnant woman at gestational age of 7 weeks and 4 days who was admitted to clinic with vaginal bleeding. Fetal cardiac activity was negative. Patient was successfully treated with high ligation suture and McDonald cerclage. There is no consensus yet on best treatment of cervical ectopic pregnancy, but conservative methods can avoid major surgical procedure such as hysterectomy and its consequences.

Today, in spite of improved diagnostic tools and appropriate antibiotic usage, life-threatening complications of sinusitis such as orbital abscess and subdural empyema can still be observed. These complications may cause serious, disabling sequelae. Presently described is case of 12-year-old girl with frontoethmoidal sinusitis as well as orbital abscess and subdural empyema. Prompt diagnosis and treatment resulted in uncomplicated outcome. For patients with subdural empyema, early diagnosis is possible with cranial magnetic resonance imaging (MRI) and surgery is not necessarily required for clinical improvement. Otolaryngologists should pay attention to additional symptoms such as confusion or loss of consciousness in patients with orbital abscess in order to diagnose a secondary complication such as subdural empyema promptly.

Hydatid cyst disease (HCD) is a parasitic infection caused by Echinococcus granulosus larvae. Habitat of the disease is most frequently liver, followed by lungs; intracardiac occurrence is rare. When it occurs, cardiac involvement is more common in left ventricle, where blood supply is intense. Disease is extremely rare in right atrium. While following case at clinic with diagnosis of bilateral pulmonary hydatid cyst, right atrium involvement was incidentally found. Since hydatid cyst disease with intracardiac localization is rarely seen, present report was prepared in order to draw attention to importance of thorough diagnosis and treatment of these patients.

Urethral foreign body is a rare condition, and while there are many possible reasons, it is generally caused by self-insertion of a foreign object into one’s own urethra and requires emergency intervention. Sexual or erotic stimulation, trauma, medical interventions, and psychiatric problems may play a role in etiology. Radiological findings are important in order to obtain information about the foreign body and make accurate diagnosis, and treatment of this condition may require various instruments due to adjacent organ injury. Presently described is effort to determine possible causes of bladder gas, considered evidence of severe urological problem, and its association with urethral foreign body with a lumen. Treatment approaches to urethral foreign body as reported in the literature are also discussed.

Burns that occur in the first 2 decades of life are usually caused by preventable accidents. Scald burns are the most common in the first decade. Flame burns have high morbidity and mortality rates in infants. This case report is presented to demonstrate appropriate anesthesia management and the multidisciplinary approach required in an intensive care unit (ICU). A 35 -day-old infant was admitted to ICU with second and third degree flash burns on the face, neck, and body covering 18% total body surface area according to Lund and Browder chart. Patient also had facial and oral edema, which resulted in difficult airway (grade IV). Burns were secondary to an accident at home involving matches lit by her brother.

Percutaneous nephrolithotomy (PCNL) is an effective and minimally invasive method used for the treatment of kidney stones in selected patients. Some complications can occur with this method as in any surgical procedure. We report the laparoscopic diagnosis and treatment of a rare case of gallbladder perforation which occurred during percutaneous nephrolithotomy. Although it is a rare complication, biliary tract injury should be considered in patients with peritonitis after PCNL. Laparoscopic surgery can provide both diagnosis and minimally invasive treatment for cases in whom exact location of injury could not be determined with radiographic examinations.

A self-sufficient 77-year-old patient with no systemic disease other than type 2 diabetes mellitus and hypertension sought treatment at a private medical center because she gave inconsistent and nonsensical responses to relatives and developed confusion. Cranial magnetic resonance imaging showed acute cytotoxic edema. Patient was transferred to emergency unit with high fever and right lower extremity jerking. Examination of cerebrospinal fluid (CSF) revealed positive polymerase chain reaction for herpes simplex virus type 1, and based on diagnosis of viral encephalitis, acyclovir therapy was initiated. On the fourth day of follow-up in the neurology clinic, the patient was orotracheally intubated and admitted to intensive care unit (ICU) because of respiratory distress and loss of consciousness. Thoracic computed tomography revealed atelectasis and air bronchogram in the right lung, which indicated pneumonia. On the seventh day in the ICU, the patient was able to opened her eyes spontaneously and follow commands. Weaning from mechanical ventilation was initiated and the patient was discharged home with cure on the sixteenth day of admission. Detection of virus in CSF analysis, prompt administration of antiviral therapy and ICU support ensured rapid recovery without any residual sequelae in this case of herpes simplex encephalitis.