INTRODUCTION: The impairment of arm functions can be observed after trimodality therapy for superior sulcus tumors due to several reasons, such as the tumor invasion of the brachial plexus and subclavian arteries, fibrosis secondary to radiotherapy, neuropathy secondary to chemotherapy, and morbidity caused by surgical resection. This study aimed to evaluate patients’ arm functions and functional exercise capacities after Pancoast tumor surgery.
METHODS: The study included patients that underwent surgery for superior sulcus tumors in our clinic after neoadjuvant therapy between April 2017 and April 2022. The patients were evaluated in terms of age, gender, pathology, neoadjuvant treatment, resection, reconstruction material used, mean hospital stay, drain withdrawal time, amount of drainage, morbidity, mortality, arm functions, and functional exercise capacities.
RESULTS: Between the specified dates, 18 patients underwent surgery for Pancoast tumors in our clinic. All the patients were male. The mean age was calculated as 62.7±8.0 years. The operation was performed on the right side in 12 patients and the left in six. The most frequently performed procedure was upper lobectomy, while bilobectomy was performed in one patient. Prolonged air leak was the most common morbidity (n=5, 27.7%), but no surgical mortality was observed. Non-surgical upper extremity ranges of motion were complete, and joint limitations were found in the extremity on the surgical side at a rate varying between 28 and 78%, depending on shoulder motion. The patients’ mean postoperative six-minute walk test distance was recorded as 536.6±85.7 meters.
DISCUSSION AND CONCLUSION: Preserving the arm and shoulder functions of these patients has gained more importance since it increases the quality of life of these patients. Unfortunately, this study showed that the patients’ arm functions were restricted, and functional exercise capacities decreased after Pancoast tumor surgery. Therefore, we recommend that intensive physiotherapy programs be planned for these patients starting from the pre-operative period.

INTRODUCTION: This study aims to examine the association between the Rockall, AIMS-65, and Glasgow Blatchford (GBS) scores to the presence of active bleeding during the endoscopy in patients who are admitted to the emergency department (ED) and suspected of upper gastrointestinal (GI) bleeding.
METHODS: The data of 337 patients who visited to the ED due to upper GI bleeding during the period determined for the study were included in the study and analyzed retrospectively. In this context, age, gender, comorbid disease, GIS bleeding scores results (GBS, Rockall and AIMS65, and endoscopy) of the patients were evaluated.
RESULTS: Active bleeding has detected in 21.3% of the patients. The GBS and Rockall scores of the patients with active bleeding have found to be high (p<0.05), and there was not an association found between the AIM65 score and the presence of active bleeding (p>0.05). The cutoff value for GBS has determined as 11.5. While the sensitivity at this value was 68.1%, the specificity was 63%. For the Rockall score, the cutoff value has found to be 3.5. While the sensitivity at this value was 50%, the specificity was 79.6%. The cutoff value for the AIMS65 score has found to be 1.5. While the sensitivity at this value was 36.1%, the specificity was 74%.
DISCUSSION AND CONCLUSION: The finding that most has been indicated the presence of active bleeding is GBS, followed by the Rockall score. AIMS65 score has been found insufficient for indicating active bleeding. New prospective studies are needed to confirm the usability of these scores in determining the presence of active bleeding.

INTRODUCTION: Unicondylar knee arthroplasty (UKA) is a surgical procedure primarily used for the resurfacing of the medial compartment and many studies have previously analyzed the changes taking place on the surrounding osseous tissues after the procedure. The purpose of this study is to investigate the effects of bone strain in the medial tibial metaphysis after a cementless unicondylar replacement.
METHODS: Patients treated with a cementless UKA between March 2015 and March 2019 was selected for this study. Inclusion criteria were a minimum of 1 and a maximum of 2 years follow-up and presence of standard radiographs of the operated knee at yearly intervals. A total of 109 patients were included in the study. Two lines at a distance of 5 and 7 cm from the lateral tibial eminence were horizontally drawn and the medial cortical thickness and the total cortical distance were measured. A cortex-to-metaphysis (CTM) ratio was established. The increase of density in the metaphysis was analyzed though the “reactive triangle” phenomenon. We initially hypothesized that some degree of increase in sclerosis would be detected in the medial tibial metaphysis and that the increase would be greater in patients
with an implant underhanging, since more cancellous bone would come under strain.
RESULTS: The CTM ratio showed a decreasing pattern during the 1st post-operative year for all measured levels. An increase in density at the metaphyseal area just below the keel was observed in 58% of patients during the 1st post-operative year and in 80% during the 2nd year. The increase in the density was correlated with the absence of coronal overhanging. Patients with coronal overhanging of the tibial implant showed an increase in CTM ratio.
DISCUSSION AND CONCLUSION: Increased strain after a unicondylar procedure leads to cortical and cancellous bone changes in the proximal tibial metaphysis. These changes depend on the presence or absence of coronal overhanging.

INTRODUCTION: Although orbital infections are one of the rare reasons for admission to Pediatric Outpatient Clinics, the differential diagnosis should be made and treatment should be started quickly due to the serious complications such as intracranial infection, vision loss, and cavernous sinus thrombosis. Our study aimed to evaluate the demographic, clinical, laboratory, and imaging findings and treatment methods of pediatric patients hospitalized and treated with preseptal and orbital cellulitis diagnosis at our center.
METHODS: This retrospective study was conducted on pediatric patients hospitalized with a preseptal and orbital cellulitis diagnosis at Kartal Dr. Lütfi Kırdar City Hospital, Pediatric Outpatient Clinics and Ophthalmology Department between January 2016 and January 2021. The clinical and laboratory findings of the patients were compared.
RESULTS: Forty patients (23 boys and 17 girls) who met the criteria over 5 years were included in the study. The mean age of the patients at the time of diagnosis was 145 (6.5–181.5) months. Thirty-five patients (87.5%) had preseptal cellulitis and five patients (12.5%) had orbital cellulitis. Paranasal sinusitis was the underlying cause in 17 (42.5%) of all cases. Twenty-eight patients (70%) were treated with ampicillin-sulbactam and seven patients (17.5%) with ceftriaxone. Cranial computerized tomography (CCT) was performed in 26 (65%) of 40 patients hospitalized for orbital infection, for both diagnosis and follow-up prognosis. Mean length of hospital stay (days) was statistically significantly lower in the preseptal cellulitis group than in the orbital cellulitis group (p=0.007).
DISCUSSION AND CONCLUSION: In our study, sinusitis was found to be the most common predisposing factor for eyeball infections. Due to the serious complications that can develop, the differential diagnosis of preseptal and orbital cellulitis should be made quickly and treatment should be initiated immediately.

INTRODUCTION: In this study, the results of 26 patients who underwent pulmonary endarterectomy in our center between November 2015 and December 2019 are presented by evaluating together with anesthesia management in pulmonary thromboendarterectomy performed only in certain centers in our country.
METHODS: All the patients routinely monitored using advanced monitoring methods (5-lead ECG, pulse oximetry, radial artery catheterization, ETCO2, central venous catheter, rSO2 to monitor cerebral oxygenation, femoral artery catheterization, and [cardiac output (CO), cardiac index (CI), Pulmonary vascular resistance (PVR), SVR] thermodilution catheter for hemodynamic evaluation). Routinely, all patients were evaluated with perioperative transesophageal echocardiography. All operations were performed under cardiopulmonary bypass with deep hypothermic circulatory arrest. Pulmonary artery pressure (PAP), mPAP, CI, CO, PVR, and SVR values were measured before and after the operation. The length of stay in the intensive care unit, the duration of mechanical ventilator, the length of stay in the hospital, the extracorporeal life support needs, and mortality rates were recorded.
RESULTS: Post-operative CI, CO, oxygen saturation in room air, and 6-min walking distance increased significantly. On the other hand, significant reductions in PAP and PVR were detected. Mean duration of stay on mechanical ventilator was 2 (1–4) days and average hospital stay was 14 (10–18) days. Five patients (19.2%) needed extracorporeal life support. Within the 1st year, 5 mortalities (19.23%) were recorded.
DISCUSSION AND CONCLUSION: Pulmonary thromboendarterectomy is a very complicated procedure in terms of both surgery and anesthesia management. Therefore, the success of the operation can be achieved with a good perioperative anesthesia management as well as surgical success.

INTRODUCTION: The aim of this study is to determine whether the addition of decade and gender to quick Sequential Organ Failure Assessment (qSOFA) is superior to qSOFA alone in predicting the mortality of sepsis patients presented to our emergency department.
METHODS: We included 300 sepsis patients in our study. The gender with higher mortality received 1 more point. We added the qSOFA score and decade to this value and compared qSOFA and the new scoring system to predict mortality. Furthermore, we determined a cutoff value for age to systolic blood pressure to predict mortality.
RESULTS: Forty-six percentages of our patients were female, and 54% were male. Patients in their 80s (34%) and 90s (26%) comprised the majority of the study group. Mortality rates were higher in males when compared with females. Mortality rate was positively related with age and systolic blood pressure. The cutoff value for age and systolic blood pressure was 0.71 (AUC: 0.799, CI: 0.750–0.848, p=0.00). Patients were at higher risk for mortality if their ratio of age to systolic blood pressure was higher than 0.71 (OR: 2.58). We added a decade and one more point to the qSOFA for the male gender and compared this value with the qSOFA score. The new scoring system (qSOFA+decade+male gender +>0.71) (CI: −2.49–−1.67) was superior to qSOFA alone to predict (CI: −1.20–−0.80) mortality.
DISCUSSION AND CONCLUSION: Age to systolic blood pressure ratio alone can also predict mortality better than qSOFA. The qSOFAm scoring system may be useful in determining the mortality of sepsis patients.

INTRODUCTION: Main purpose of the study is to investigate the effects of childhood traumas on bipolar disorder (BD) patients with social phobia (SP) comorbidity.
METHODS: Individuals were divided into three groups, with SP (n=96), without SP (n=27), and without BD divided as the control group (n=32). In this prospective study, the sociodemographic questionnaire, structured clinical interview for DSM-IV axis I disorders (SCID-I), childhood trauma questionnaire, and Liebowitz social anxiety scale were applied to the patients
RESULTS: There were 52 (53.1%) men and 46 (46.9) women with the mean age 41.10±10.90 years during the study. Thirty-six patients (36.7%) were in the SP group, 30 patients (30.6%) were in the without SP group, and 32 (32.7) were in the control group. There is a statistically significant difference between bipolar patients with SP, without SP, and the control group in terms of childhood trauma questionnaire (CTQ) scores (p<0.05). It is found that this significant difference originated from the bipolar patients’ group with SP also, while there is a statistically significant between female patients in terms of CTQ (p<0.05), but there is no statistically significant between male patients in terms of CTQ (p>0.05).
DISCUSSION AND CONCLUSION: It was found that SP comorbidity in BD was highly correlated with childhood traumas in our study.

INTRODUCTION: In this study, we aimed to measure the adequacy of facet joint block injections for pain relief during the 2-year follow-up and evaluate the follow-up results of patients who were candidates for facet joint block injection.
METHODS: This study included 243 patients who administered facet joint block injections in our clinic between 2018 and 2020. Their medical records created over 2 years were examined. We evaluated the demographic features of patients, the need for an additional facet joint block injection, the need for additional surgery, the reason for the additional surgery or the blockage procedure, and the interval between the first interventional procedure and surgery, as well as additional interventional procedures and the need for additional treatment from the physical therapy, algology, or orthopedics departments.
RESULTS: Of the patients included in the study, 93 were male and 150 were female (mean age: 54.55 years, range: 16–90 years). Of them, 62.5% experienced pain palliation after the first facet block injection intervention; 5.7% improved after the first procedure, but the procedure had to be repeated between mean 8.4 months; and 11.4% underwent decompression and instrumentation surgery between 1 and 24 months. Those who did not benefit from the procedure continued to receive treatment in the physical therapy department (14.7%), algology department (0.8%), and the orthopedics department (5.7%) after the procedure.
DISCUSSION AND CONCLUSION: Facet joint block injection is a treatment method with high a success rates because it is less invasive compared to surgical methods for pain associated with the facet joint and eliminates the need for long-term treatment with other branches.

INTRODUCTION: Uric acid (UA) is a molecule whose effect on cerebrovascular diseases, hypertension, and diabetes has been investigated. Conflicting results have been obtained in studies examining the relationship between ischemic stroke and UA. The previous studies have found that both high and low UA levels are associated with poor prognosis in stroke patients. Therefore, we investigated the effects of UA levels on mortality, stroke severity, and clinical outcome in ischemic stroke.
METHODS: The patient demographics, chronic diseases, serum UA (SUA) levels, National Institutes of Health Stroke Scale scores, and modified Rankin scale (mRS) scores were recorded. The patients were divided into three groups based on SUA levels below 3.59 mg/dL, between 3.59 mg/dL and 8.5 mg/dL, and above 8.5 mg/dL. Pearson’s Chi-square test was used to compare the data.
RESULTS: A total of 820 patients were included in the study and 42.4% of them were women. The mean age was 68.53 years. SUA levels were lower in women. Moderate and moderate-to-severe strokes, a high mortality rate, poor neurological outcomes, and the need for intensive care and mechanical ventilation were most common in the patients with SUA levels above 8.5 mg/dL followed by the group with SUA levels below 3.59 mg/dL. The lowest mortality, best neurological outcomes, most cases of moderate stroke, and least need for intensive care and mechanical ventilation were in the group with SUA level between 3.59 mg/dL and 8.5 mg/dL.
DISCUSSION AND CONCLUSION: UA has both oxidant and antioxidant properties and its effect is level dependent. The best prognosis was seen in the group with SUA levels of 3.59–8.5 mg/dL. Therefore, maintaining the UA levels within this range when following ischemic stroke patients might reduce mortality and morbidity.

INTRODUCTION: It is aimed to evaluate the expression of estrogen receptor (ER), progesterone receptor (PR), CerbB2 status, and molecular subtypes in mammary Paget disease and concomitant ductal carcinoma and to discuss their concordance and their relation with other prognostic parameters.
METHODS: This retrospective study evaluated the clinical and morphological data of the mammary Paget disease and underlying ductal carcinoma; immunohistochemical estrogen/PR and CerbB2 status; molecular subgroups and survival; and statistically compared all parameters.
RESULTS: The study included 42 cases of mammary Paget’s disease (PD) and concomitant ductal carcinoma. In breast specimens, 15 cases (36%) had in situ, 4 (9.5%) invasive, and 23 (54%) in situ + invasive ductal carcinoma. Axillary nodal involvement was seen in 13 cases (31%) and all had invasive components. Respectively, ER and PR expressions were detected in 16 (38%) and 8 (19%) of the ductal carcinomas and in 10 (23.8%) and 6 (14.2%) of the cases with PD. CerbB2 expression was 93% (39 cases) in ductal carcinoma and 100% in PD with a 93% concordance. The most frequent molecular subtype was HER2-enriched subtype for both mammary ductal carcinoma (62%, 26 cases) and PD (76%, 32 cases) and the concordance was 82% (p=0.03). The survival was 46.00±32.64 months in the exitus group (n=8), all of which had invasive ductal components (p=0.03).
DISCUSSION AND CONCLUSION: ER and PR positivity were lower while CerbB2 was higher in Paget disease compared to concomitant ductal carcinoma. The most prominent molecular subtype was HER2-enriched subtype in both neoplasias. While hormonal and CerbB2 status of the tumors did not show any correlation with prognostic factors, existence of an invasive ductal component was the factor that correlated with survival.

INTRODUCTION: This study aimed to investigate the effectiveness of low-dose metformin on the HbA1c and plasma lipid levels in pre-diabetic individuals.
METHODS: Between 2018 and 2020, 357 patients with HbA1c levels of 5.7–6.4% were included in the study. The level of HbA1c and lipid response was evaluated in cases followed up for a minimum of 9 months with 1000 mg/day metformin.
RESULTS: A complete response was observed in 39% of the group with HbA1c levels of 6–6.4%, whereas that in the group with HbA1c levels of 5.7–5.9% was 77%. While the response obtained before the age of 40 was 70%, the response was obtained in 36% of the cases over the age of 40. A decrease in non-HDL cholesterol components was observed in 23% of the pre-diabetes cases using low-dose metformin.
DISCUSSION AND CONCLUSION: Low-dose metformin causes a decrease in A1c, as well as in non-HDL lipid components at varying rates. Although the basis of macrovascular complications of diabetes mellitus is laid during the pre-diabetes, the threshold levels required for the administration of statin and fenofibrate are different in patients with DM and pre-diabetes. Pre-diabetes cases can be treated like cases with isolated lipid increases. In these cases, a response to varying levels of non-HDL lipid components can be obtained in some of the patients, along with an HbA1c response with low-dose metformin. Especially in the pre-diabetic dyslipidemia group, the importance of metformin was observed in the group in which we could not arrange statin and fibrate treatment.

INTRODUCTION: The aim of this study was to evaluate the relationship of hyperemesis gravidarum (HG) with placental thickness, pregnancy-associated plasma protein-A (PAPP-A), and free beta-human chorionic gonadotropin (beta-HCG) levels.
METHODS: A total of 263 pregnant women (93 with HG and 172 controls) who applied to the gynecology and obstetrics outpatient clinic for a combined test between 11 and 14 weeks of gestation were included in this study. Crown-rump length (CRL, measured in millimeter) values were measured using ultrasonography, and PAPP-A and free beta-HCG values (MoM) were recorded from laboratory reports.
RESULTS: The placental thickness (p<0.001) and free beta-HCG (p=0.029) values of pregnant women with HG were higher than controls. In the HG group, the placental thickness was positively and weakly correlated with gestational week (p<0.001) and CRL (p<0.001). We also found that higher CRL values and the presence of HG were related to increased placental thickness (R2=0.159, p<0.001) by performing linear regression analysis.
DISCUSSION AND CONCLUSION: Being diagnosed with HG and having increased CRL is related to increased placental thickness. In relation to this result, increased placental thickness and free beta-HCG also seem to cause a higher risk for HG.

INTRODUCTION: Colon is the region where most of the polyps are being observed in the gastrointestinal system. Colorectal cancers are an important cause of mortality and morbidity in our country and all over the world. Since these polyps originating from the submucosa and mucosal epithelium may be precancerous lesions, follow-up and treatment are also important. In our study, we evaluated the type, size, and number of colon polyps detected in our province and examined their histopathological precancerous status.
METHODS: In our study, 698 colon polyp cases detected during 3654 colonoscopy examinations performed in the two large hospitals of our city in between 2013 and 2019, and underwent polypectomy or biopsy with the help of snare or forceps, were evaluated. The demographic characteristics of the patients, location of the polyps, number of polyps, sizes of the largest excised polyps, and pathological diagnoses have been evaluated.
RESULTS: In our study, a total of 698 patients diagnosed with colon polyps were included in the study. A total of 1606 polyps were detected in 698 patients. The mean number of polyps per procedure was 2.3. In our study, the distribution of polyps according to their sizes was 527 (75.5%) diminutive polyps, 70 (10%) small polyps, and 101 (14.4%) large polyps. Polyps were observed most frequently from distal to proximal as 278 (39.8%) in the rectum and 175 (25.1%) in the sigmoid colon. The least polyp localization was seen in the cecum as 22 (3.2%). In the histopathological examination of polyps, tubular adenoma 47% and hyperplastic polyp were found most frequently. While no dysplasia was observed in 386 (55%) patients, 239 (34%) patients had low-grade dysplasia, 6 (0.9%) patients had moderate dysplasia, and 67 (9.6%) patients had high-grade dysplasia.
DISCUSSION AND CONCLUSION: The fact that colon cancers are among the most common cancers of the gastrointestinal system increases the importance of colonoscopy evaluation since colon polyps are found frequently in the colon, the incidence increases by age, and they can be seen as precancerous lesions. Timely endoscopic evaluations and removal of detected polyps gain importance in terms of reducing the risk of cancer development.

INTRODUCTION: This study was evaluation of the relationship between serum lipase elevation and computed tomography (CT) findings in patients with acute pancreatitis (AP).
METHODS: Patients who received AP diagnosis in the emergency department were divided into two groups according to their serum lipase values that were three (group 1) and 10 times (group 2) higher than the normal upper limit, respectively. Demographic characteristics (age and gender), nature of abdominal pain (typical and atypical), duration of presentation, and CT findings were compared between groups in terms of present and absent.
RESULTS: About 53.3% of 122 cases were female. The mean value of patient age in the study was 62.17±6.74 (min 35–max 75) years. About 63.1% of the patients were in Group 2. Themean ED admission interval of the patients was 14.42±10.11 (min 4–max 72) h. The nature of abdominal pain was atypical in 63.9% of the patients. CT findings were present in 56.6% of the patients. Pancreatic necrosis was detected in 3.7% of the patients. Dissimilarities between the two groups were identified in respect of the presence or absence of CT findings (p<0.05). The present rate of CT findings was greater in Group 2. Furthermore, the rates of typical/atypical nature of abdominal pain between patients whose CT findings were present and absent had significant distinction (p<0.001). The rate of atypical nature of abdominal pain was higher in patients with present CT findings (p<0.001).
DISCUSSION AND CONCLUSION: As the serum lipase value increases in patients with AP, the probability of CT findings being present increases.

INTRODUCTION: The search for treatment success in gallbladder carcinomas, which is one of the tumors with the most aggressive course, poor prognosis, and tendency to show resistance to treatment, continues today. Treatments targeting pathways related to genetic changes detected in most solid tumors offer new hope in the treatment of these tumors. Some of these treatment modalities target apoptosis-related pathways, and mammalian target of rapamycin (mTOR), p38, Bcl-2, and caspase-3 are important components of this pathway.
METHODS: In the study, mTOR, caspase-3, p38, Bcl-2, LL-37, MDR1, multidrug resistance protein (MRP)1, MRP6, and MRP7 immunohistochemical staining were applied to paraffin blocks of 27 gallbladder cancer and 62 cases with gallbladder dysplasia. The immunohistochemically stained sections were evaluated and scored.
RESULTS: mTOR, p38, and caspase-3 expressions were found to be significantly increased in dysplasia and tumor groups, and in dysplastic and malignant cells. While there was no significant difference in the expression of MRP1 and MRP7, MRP6 was significantly overexpressed.
DISCUSSION AND CONCLUSION: In this study, increased expression of mTOR, p38, and caspase-3 in the dysplastic and malignant cells of the gallbladder may show that it has a role in the carcinogenesis process in the gallbladder. The study also shows that MRP6 may also play a role in the development of drug resistance in gallbladder carcinoma.

INTRODUCTION: This study aimed to evaluate the neurologic findings of patients who had hypocalcemic seizures due to vitamin D deficiency during a 1 year period.
METHODS: Thirty-two patients aged between 6 days and 24 months who were followed up for hypocalcemic seizures between July 2017 and July 2018 were included in the study. Gross motor, fine motor, language, and social developmental levels were evaluated using the Denver developmental test at the time of diagnosis and the 6th month.
RESULTS: Seventy-two percentages of the patients were male (n=23) and 28% (n=9) were female. Corrected serum calcium level averaged 6.03±1.06 mg/dL, and phosphorus was 5.2±1.72 mg/dL, alkaline phosphatase was 575.2±405.8 U/L, parathormone was 231.4±123.8 ng/mL, and 25 OH-vitamin D levels were found as 9.6±8.5 ng/mL. When the vitamin D levels of the mothers were examined, the average was 7.16±2.62 ng/mL. The 6-month difference in both gross and fine motor development was found to be statistically significant (p<0.001 and p<0.001, respectively). The 6-month difference in the evaluation of social development and language development was not statistically significant (p=0.083 and p=0.180, respectively). The 6-month difference in fine and gross motor development over the patients was considered to be statistically significant (p<0.001).
DISCUSSION AND CONCLUSION: Psychomotor retardation is also observed in infants with vitamin D deficiency, because vitamin D is a neurohormone that has an important role in calcium metabolism, which plays a role in neurotransmitter production, release, reuptake, and in stages of brain cell proliferation, differentiation, and development.

INTRODUCTION: The aim of this study is to identify appendiceal tumors (AT) detected in appendectomy specimens in our center and to analyze the incidence and clinicopathological features of these tumors.
METHODS: A total of 6110 appendectomies performed in our hospital between January 2015 and December 2021 were evaluated retrospectively. Demographic characteristics and histopathological examinations of these cases were analyzed. Demographic characteristics such as age, gender, surgical procedures and histopathological results of cases with AT were analyzed.
RESULTS: A total of 44 (0.72%) AT were detected in the histopathological examination of 6110 appendectomy specimens. These are basically divided into two. The first is appendiceal neuroendocrine tumors (ANET) with 33(75%) cases and the second is appendiceal non carcinoid tumors (ANCT), that is, epithelial tumors, with 11 (25%) cases. ANCTs, that is, epithelial tumors, were detected in the following four features: Low-grade appendiceal mucinous neoplasm in six cases (54.5%), adenocarcinoma with mucinous component in two cases (18.2%), adenocarcinoma with metastasis to the appendix (operated with acute appendicitis clinic) in two cases (18.2%), and adenocarcinoma with ANET component in one case (9.1%). Only appendectomy was performed in 26 (78.8%) cases in ANETs, while secondary right hemicolectomy (RH) was performed in 7 (21.2%) cases. In ANCTs, only appendectomy was performed in 6 (54.5%) cases, wide local excision with perioperative appendectomy in 2 (18.2%), and secondary RH in 3 (27.3%) cases. Secondary RH was performed in 10 (22.7%) cases out of 44 AT patients. Two patients who metastasized to the appendix and one patient with appendiceal carcinoma, that is, 3 (0.05%) patients in total, died.
DISCUSSION AND CONCLUSION: The possibility of malignancy in appendectomy materials is rare and is usually detected incidentally in pathological examinations after appendectomy. Therefore, it is recommended that all appendectomy specimens be routinely sent for histopathological examination. Carcinomas have a worse prognosis than ANETs. Complementary RH is recommended for advanced ANET and appendiceal epithelioid tumors.

INTRODUCTION: Histologic subtypes of non-small cell lung cancer (NSCLC) may be associated with the outcome of the disease. Adenosquamous carcinoma, a rare but aggressive tumor, has been related to poor survival rates. This study aimed to evaluate the survival rates of the patients with histologic subtypes of NSCLC after surgical treatment.
METHODS: A single-center retrospective study for patients with NSCLC who underwent surgical treatment was performed between 2000 and 2009. The histologic types were grouped as adenocarcinoma (Group A), squamous cell (Group S), and adenosquamous carcinoma (Group AS). Patient demographic and clinical characteristics and survival data were collected. The primary outcome was the rate of patients who survived the post-operative 5 years.
RESULTS: A total of 1887 patients (Group A: 834 (44.2%), Group S: 996 (52.8%), and Group AS: 57 patients (3.0%) were included in the study. Lobectomy was the most frequent resection performed in 74%, 71%, and 63% of the cases in Groups A, S, and AS. In-hospital mortality rates in the groups were similar (p=0.555). Five-year survival rates were 41%, 47%, and 36% in Groups A, S, and AS. The rate of 5-year survival in Group AS was significantly lower than in Group A (p=0.04) and Group S (p=0.001). Group S had a significantly higher rate of 5-year survival than Group A (p=0.001).
DISCUSSION AND CONCLUSION: Adenosquamous histology was the worst type of NSCLC regarding survival outcomes. Patients with squamous histology fare better than those with adenosquamous and adenocarcinoma histologic subtypes.

Elizabethkingia meningoseptica is a Gram-negative bacteria which can cause rare but severe infections in humans. Here, we report a case of sepsis due to E. meningoseptica in an immunocompetent pediatric patient. While a 32-month-old girl with a diagnosis of cerebral palsy was being followed in the pediatric intensive care unit, fever and general condition disorder developed. Laboratory results showed white blood cell count: 18600/mm³, hemoglobin level: 9.0 g/dl, platelet count: 186000/mm3, and C-reactive protein level: 17.5 mg/L (0–5 mg/L). Clinical sepsis was suspected and empirical treatment of vancomycin (60 mg/kg/24 h: Q6 h) and cefepime (150 mg/kg/24 h: Q8 h) was started. However, blood culture resulted as E. meningoseptica which was susceptible to trimethoprim/sulfamethoxazole and ciprofloxacin. The patient was successfully treated with trimethoprim/sulfamethoxazole plus ciprofloxacin for 14 days.

Nasopharyngeal papillary adenocarcinoma (NPAC) is a rare tumor that is usually detected in the nasopharynx. Its etiology has not been clearly elucidated. It is thought to be of surface epithelial origin. Histologically similar to thyriod papillary carcinoma (TPC), the tumor shows a unique expression pattern immunohistochemically and can be differentiated from TPC. Correct diagnosis of this tumor, in which local recurrence and metastasis are not reported with complete surgical treatment, is important for the patient to not receive more than necessary treatment and to maintain the comfort of life. In this article, the clinical, pathological, immunohistochemical and molecular findings of two NPAC cases were shared and attention was drawn to the prognostic feature of the tumor. Although it is a rare tumor, it is important to share two cases seen in our center and to keep in mind the existence of this tumor.