Torakoskopik torakal sempatektomi (TTS) üst ekstremite ve baþ bölgesinin sempatik sistem ile iliþkili hastalýklarýnýn tedavisinde kullanýlan bir yöntemdir. Günümüzde en sýk kullaným alaný primer hiperhidrozistir. Bunun yanýnda daha az efektif olmasýna raðmen Raynaud’s sendromu, Buerger hastalýðý, refraktör anjina ve uzamýþ QT sendromundada uygulanmaktadýr. Bölümümüzde 2012 Mart ile 2013 Mart aylarý arasýnda 15 olguya 29 torakal sempatektomi uygulanmýþtýr. Olgular retrospektif olarak incelendi ve uygulanan cerrahi metot, yatýþ süresi, komplikasyonlar ve cerrahi baþarý açýsýndan deðerlendirildi.

Thoracoscopic thoracal sympathectomy (TTS) is a surgical procedure that have been used in the treatment of upper extremity and head diseases which is associated with sympathetic system. Nowadays it is mostly used in the treatment of primary hyperhidrosis. Nonetheless, though it is less effective, it is also used in Raynaud’s syndrome, Buerger disease, refractor angina and long QT syndrome In our department, between March 2012, and March 2013, 29 TTS operations were performed on 15 patients. The patients were analyzed retrospectively and evaluated with respect to surgical procedure, complications, length of hospital stay and surgical success.

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GÝRÝÞ ve AMAÇ: Kapalý tip 1 kapitellum kýrýklarýnda akut rack vida ile açýk redüksiyon internal fiksasyon ile tedavi sonuçlarýmýzý deðerlendirmek istedik.
YÖNTEM ve GEREÇLER: Çalýþmaya kapalý kapitellum kýrýðý nedeni ile cerrahi uyguladýðýmýz 13 hasta alýndý. Sekizi erkek, 5’i kadýndý. Hastalarýmýzýn yaþlarý (12-25) ortalama 18,5’ti. Hastalarýmýzýn tamamý tip 1 kýrýk. Hastalarýmýzdan birinde kapitellum kýrýðý ile beraber ipsilateral subtrokanterik femur þaft kýrýðý diðerinde ipsilateral kollum femoris kýrýðý mevcuttu. Bir hastamýz bilateral kapitellum kýrýðý idi. Bilateral kapitellum kýrýðý olan hastamýzýn sað dirsekte lateral kondil kýrýðýda mevcuttu. Hastalarýmýzýn hepsine kapitellum kýrýðýna yönelik acut track vida kullanýldý. Radyolojik deðerlendirmelere Mayo Clinic Performance Index fort he Elbow (MCPIE) de eklendi. Hastalar ortalama 26 ay (6 ay-48 ay) takip edildi.
BULGULAR: MCPIE sonuçlarýmýz % 99.1 kusursuz, % 0.1 iyi olarak bulundu. Hastalarýmýzýn yalnýzca birinde rezidül agrý sýkýntýsý oldu. Hastalarýmýzýn hiçbirinde artrit, avasküler nekroz, infeksiyon, heterofik ossifikasyon, eklem hareket açýklýðý kaybý olmadý.
TARTIÞMA ve SONUÇ: Kapitellum kýrýklarýnda dirsek biyomekaniðini saðlamak için anatomik redüksiyon saðlamak zorunluluðu vardýr.

INTRODUCTION: We wanted to evaluate the clinical results about the closed type 1 capitellum fractures with open reduction and internal fixation of acute rack screws.
METHODS: Our study population consisted of 13 patients (8 men, and 5 women) with a median age of 18.5 years (range, 12-25 years) on whom we performed surgery with the indication of closed capitelluým fracture. All of our patients with type 1 capitellum fracture. In one of our patients capitellum fracture was associated with ipsilateral subtrochanteric femoral shaft fracture, and in the other patient with ipsilateral collum femoris fracture. One of our patients had bilateral capitellum fractures. The patient with bilateral fractures also had capitellum fracture of the lateral condyle of his right elbow. Acute track screws were used in all patients for capitellum fractures. Mayo Clinic Performance Index for the Elbow (MCPIE) was also added to the radiological examinations. Patients were also followed for an average of 26 months (6 months -48 months).
RESULTS: ccording to MCPIE criteria, our results were excellent, and good in 99. 1, and 0.1 % of the patients respectively. Only one patient had resudial pain. None of our patients had arthritis, avascular necrosis, infection, heterotopic ossification, and loss of range of motion.
DISCUSSION AND CONCLUSION: In capitellum fractures, anatomical reduction should be ensured so as to provide elbow biomechanics.

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GÝRÝÞ ve AMAÇ: Kronik atrofik gastrit (KAG) ve intestinal metaplazi (ÝM) geliþme riskinde tümör nekrozis faktör-α (TNF-α), makrofaj migrasyon inhibitör faktör (MIF) gen polimorfizmleri ve Helikobakteri pilori (H. pilori)’nin etkisini tespit etmek amaçlandý.
YÖNTEM ve GEREÇLER: TNF-α-308G/A ve MIF-173G/C tek nükleotid polimorfizmi Türkiyenin doðusunda bir bölgede 84 hastada (43 KAG ve 41 IM) ve 40 saðlýklý kontrolde polimeraz zincir reaksiyon-restriksiyon fragman uzunluk polimorfizim (PZR-RRUP) analizi kullanýlarak genotiplendirildi.
BULGULAR: H. pilori infeksiyonu negatif ve TNF-α-308G/A genotipli olgularda ya da H. pilori infeksiyonu negatif ve TNF-α-308 AA taþýyýcý olgularda KAG riskinde bir artýþ bulundu. H. pilori infeksiyonu negatif ve TNF-α-308G/A genotipli olgularda yada H. pilori infeksiyonu negatif ve TNF-α-308AA taþýyýcý olgularda IM riskinde bir artýþ bulundu. H. pilori infeksiyonu pozitif ve TNF-α-308G/A genotipli olgularda KAG riskinde bir artýþ bulundu. H. pilori infeksiyonu negatif ve MIF-173GC genotipli olgularda ya da H. pilori infeksiyonu negatif ve MIF-173CC taþýyýcý olgularda KAG riskinde bir artýþ bulundu. H. pilori infeksiyonu negatif ve MIF-173GC genotipli olgularda IM riskinde bir artýþ bulundu. H. pilori infeksiyonu pozitif ve MIF-173GC genotipli olgularda IM riskinde bir artýþ bulundu.
TARTIÞMA ve SONUÇ: Böylece, TNF-α-308G/A ve MIF-173G/C genotipleri erken evre gastrik kanserde biyomarkýr olarak kullanýlabilir.

INTRODUCTION: We aimed to determine the effects of tumour-necrosis factor-α (TNF-α) and macrophage migration inhibitory factor (MIF) gene polymorphisms, Helicobacter pylori (H. pylori) infection, on the risk of developing chronic atrophic gastritis (CAG) and intestinal metaplasia (IM).
METHODS: The TNF-α-308G/A and MIF-173G/C single nucleotide polymorphisms (SNPs) were genotyped using polymerase-chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, in 84 patients (43 CAG and 41 IM) and 40 healthy controls in a region of Eastern Anatolia.
RESULTS: An increased risk of CAG was found in subjects with TNF-α-308 GA genotype, negative for H. pylori infection or TNF-α-308 AA genotype carriers and negative for H. pylori infection. An elevated risk of IM was found in subjects with TNF-α-308 GA genotype and negative for H. pylori infection or TNF-α-308 AA genotype and negative for H. pylori infection. An increased risk of CAG was found in subjects with TNF-α-308GA genotype, and positive for H. pylori infection. An increased risk of CAG was found in subjects with MIF-173GC genotype and negative for H. pylori infection or MIF-173CC genotype carriers and negative for H. pylori infection. An elevated risk of IM was found in subjects with MIF-173GC genotype and negative for H. pylori infection. An elevated risk of IM was found in subjects with MIF-173GC genotype and positive for H. pylori infection.
DISCUSSION AND CONCLUSION: Therefore, the TNF-α-308G/A and MIF-173G/C genotyping may be used as biomarkers at the early stage of the gastric cancer.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada; hastanemiz mikrobiyoloji laboratuvarýna gelen çeþitli klinik örneklerden izole edilen 140 Pseudomo-nas aeruginosa izolatýnýn antibiyotik duyarlýlýklarý araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Ýdentifikasyon ve antibiyogram çalýþmalarýnda Vitek 2 (bioMérieux, Fransa) otomatize sistemi kullanýlmýþ, duyarlýlýk sonuçlarý CLSI kriterleri esas alýnarak belirlenmiþtir.
BULGULAR: Suþlarýn 45’i (% 32) trakeal aspirat, 36’sý (% 26) idrar, 38’i (% 27) yara, 9’u (% 7) kan, 7’si (% 5) balgam, 3’ü (% 2) plevra ve 2’si (% 1) katater örneðinden izole edilmiþtir. Çalýþma kapsamýnda deðerlendirilen suþlarýn siprofloksasin, seftazidim, piperasilin, meropenem ve amikasine direnç oranlarýnýn sýrasýyla % 39, % 44, % 45, % 37 ve % 13 olduðu gözlenmiþtir.
TARTIÞMA ve SONUÇ: Çalýþmamýz ile P. aeruginosa suþlarý için ilk bölgesel veriler sunulmakta olup, bu verilerin P. aeruginosa infeksiyonlarýnda yerel yaklaþýmlarýn belirlenmesinde ve antibiyotik kullaným politikalarýnýn oluþturulmasýnda yardýmcý olacaðý düþünülmektedir

INTRODUCTION: In this study; antimicrobial susceptibilities of 140 Pseudomonas aeruginosa strains isolated from various clinical samples were investigated in our hospital.
METHODS: Vitek 2 (bioMérieux, France) automatised system was used for the identification and antibiotic susceptibility tests, and susceptibility results were determined according to the guidelines of CLSI.
RESULTS: Forty five (32 %) of the strains were isolated from tracheal aspirate, thirty six (26 %) from urine, thirty eight (27 %) from wound, nine (7 %) from blood, seven (5 %) from sputum, three (2 %) from pleura, two (1 %) from catheter samples. Resistance rates of the strains for ciprofloxacin, ceftazidime, piperacillin, meropenem and amikacin were found as 39, 44, 45, 37, and 13 % respectively.
DISCUSSION AND CONCLUSION: Our study represents the first regional data for P. aeruginosa strains that would help to determine local approaches to P. aeruginosa infections and to develop policy for antibiotherapy.

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GÝRÝÞ ve AMAÇ: Son yýllarda hem geliþmekte olan hem de geliþmiþ ülkelerde sezaryen oranlarýnda ciddi artýþlar gözlenmektedir. Bunun nedenleri arasýnda eski sezaryenlerin artmýþ olmasý, elektronik fetal monitörizasyonun yaygýn kullanýlmasý, isteðe baðlý sezaryenlerin daha sýk yapýlýyor olmasý sayýlabilir. Biz de bu çalýþmamýzla Baðcýlar bölgesindeki doðumlar içinde sezaryen endikasyonlarýný ortaya koymayý amaçladýk.
YÖNTEM ve GEREÇLER: Baðcýlar EAH Kadýn Hastalýklarý ve Doðum Kliniðinde 1 Ocak 2011 - 31 Aralýk 2011 tarihleri arasýnda doðum için baþvuran olgular deðerlendirmeye alýndý. Sezaryen yapýlan olgularda; eski sezaryen, fetal distres, uzamýþ eylem, iri bebek, prezentasyon anomalisi, gestasyonel hipertansif durumlar, plasenta anomalisi, kordon sarkmasý ve diðer endikasyonlar (aktif genital herpes vb.) incelendi.
BULGULAR: Bu periyotta toplam 3996 doðum gerçekleþtirilirken, bunlarýn 2497’si (% 62,5) normal doðum ile 1499’u (% 37,5) sezaryen ile gerçekleþtirilmiþtir. Sezaryenler endikasyonlarýna göre incelendiðinde aðýrlýklý grubun 955 olgu ile (% 63.7) eskiden sezaryenli olduðu saptanmýþtýr. Fetal distres 152 olgu (% 10.1), uzamýþ eylem 126 olgu (% 8.4), iri bebek 103 olgu (% 6.8), prezentasyon anomalisi 85 olgu (% 5.6), hipertansif durumlar 30 olgu (% 2), plasenta anomalisi 11 olgu (% 0.7), kordon sarkmasý 1 olgu (% 0.06) ve diðer nedenlerden kaynaklanan 35 olgu (% 2.3) olduðu gözlenmiþtir.
TARTIÞMA ve SONUÇ: Sezaryen reprodüktif kadýnlar arasýnda en sýk uygulanan cerrahi giriþimdir ve infeksiyon, kanama, tromboembolik olaylar, transfüzyon gereksinimi, hastanede uzun kalýþ süresi, iyileþmenin daha geç olmasý gibi riskler hâlen devam etmektedir. Maternal ve perinatal sonuçlar açýsýndan sezaryen yalnýzca medikal endikasyon varsa uygulanmalýdýr. Kliniðimizde toplam doðumlara göre sezeryan oraný % 38’lere ulaþmýþken, primer sezeryan oranýmýz % 13.6 düzeyindedir. Dünya Saðlýk Örgütü (DSÖ) tarafýndan önerilen primer sezaryen oraný % 5-15 arasýnda olup, kliniðimiz bu oranlarý tutturmuþtur.

INTRODUCTION: Recently in both developing and developed countries considerable increase in cesarean section rates have been observed. Among the reasons for this trend, increase in the incidence of prior C/Ss, widespread use of electronic fetal monitorization, and cesarean sections done by patient requests. In this study we have aimed to present cesarean indications in Bagcýlar district of Ýstanbul.
METHODS: Women consulted to Clinics of Obstetrics, and Gynecology, Baðcýlar Training and Research Hospital for childbirth between January 1, 2011-December 31, 2011 were included in the study. In women who had previously delivered by cesarean section, prior and/or current presence of fetal distress, prolonged labor, fetal macrosomia, presentation anomalies, gestational hypertension, placental abnormalities, cord prolapse and other indications (active genital herpes; etc) were interrogated.
RESULTS: During this period 3996 deliveries [vaginal deliveries, n=2497;62.5 %, and cesarean sections, n=1499Ý 37.5 %) were realized.. The indications for C/S included mainly prior cesarean sections (n=955; 36.7 %), followed by fetal distress (n=152; 10.1 %), prolonged labor (n=126; 8.4 %), fetal macrosomia (n=103; 6.8 %), presentation anomalies (n=85; 5.6 %), hypertensive disorders (n=30; 2 %), placental anomalies (n=11; 0.7 %), cord prolapse (n=1; 0.06 %), and other causes (n=35;2.3 %).
DISCUSSION AND CONCLUSION: The most frequently performed surgical procedure in reproductive women is cesarean section. The risks for the procedure are infection, bleeding, thromboembolic events, requirements for transfusion, and longer hospital stay. Cesarean section should be performed, only if there are medical indications. In our clinic cesarean section rate is 38 % for all indications, but the primary cesarean rate is 13,6 % which is in the normal range (5 -15 %) recommended by WHO.

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Radius distal kýrýklarýnýn kapalý redüksiyon eksternal fiksasyon yöntemi ile tedavi sonuçlarýnýn klinik ve radyolojik olarak deðerlendirilmesini amaçladýðýmýz bu çalýþmada Þubat 2008- Ekim 2011 tarihleri arasýnda tedavi edilen 17 radius distal kýrýðý deðerlendirildi. AO sýnýflamasýna göre 6 kýrýk tip C, 11 kýrýk ise tip B idi. Tüm kýrýklar kapalý redüksiyon eksternal fiksatör ile tedavi edildi ve ortalama 25 ay (12-46 ay) takip edildi. Fonksiyonel deðerlendirmede Gartland ve Werley skorlamasýnýn Sarmiento modifikasyonu, radyolojik deðerlendirmelerde ise Modifiye Sarmiento skorlamasý kullanýldý. Güncel yaþam aktivite deðerlendirilmesinde DASH skorlama sistemi kullanýldý.
Radyolojik ölçümlerin sonucuna göre yapýlan anatomik deðerlendirmede 11 kýrýk (% 64) kusursuz, 4 kýrýk (% 24) iyi, 2 kýrýk (% 12) orta-kötü olarak tespit edildi. Radyolojik deðerlendirmede orta-kötü sonuçlarý olan 2 olgunun biri C1 diðeri de C2 tipi kýrýklar idi. Gartland ve Wesley skorlamasý Sarmiento modifikasyonuna göre 9 olgu çok iyi, 5 olgu iyi, 2 olgu orta, 1 olgu kötü olarak deðerlendirildi. Güncel yaþam aktivite deðerlendirmelerinde DASH skorlama sistemine göre ortalama deðer 8.57 idi. Toplam 4 (% 23) olguda Refleks Sempatik Distrofi ve 8 (% 47) olguda yüzeyel çivi dibi infeksiyonu geliþti.
Radius distal uç kýrýklarýnýn tedavisinde eksternal fiksatör yöntemi, klinik ve radyolojik sonuçlarý açýsýndan uygun olgularda iyi bir tedavi seçeneðidir.

Evaluation of clinical and radiological results of distal radius fractures treated with closed reduction and external fixation was aimed in this study. Seventeen cases of distal radius fractures managed between February 2008 and October 2011 were evaluated. According to AO classification, six of these fractures were type C and eleven of them were type B fractures. All of the cases were treated with closed reduction and external fixation. The average length of follow up was 25 (12-46) months. Sarmiento modification of Gartland and Werley scoring system was used for functional evaluation, and DASH scoring system for the evaluation of daily life activities.
In anatomical evaluation based on the results of radiological measurements, 11 cases (64 %) had perfect, 4 (24 %) had good, 2 (12 %) had moderate- poor results. These two bad results were obtained in the treatment of AO-C1 and C2 fractures. According to Sarmiento modification of Gartland and Werley scoring system, 9 cases had perfect, 5 had good, 2 had moderate and one had bad results. According to DASH scoring system, the mean score was 8.57 points. Four patients (23 %) suffered from reflex sympathetic dystrophy, and eight (47 %) cases had superficial pin tract infection.
External fixator is a good treatment option in terms of clinical and radiological results in selected cases with distal radius fractures

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Total diz artroplastisi uygulanan hastalarýn total kalça artroplastisi uygulanan hastalarla karþýlaþtýrýldýðýnda postoperatif dönemde daha fazla analjezik ihtiyacý olduðu düþünülmektedir.
Çalýþmamýzýn amacý genel kanýnýn aksine ayný analjezi protokolünün total kalça artroplastisi ve total diz artroplastisinde kullanýlabileceðini göstermektir.
Randomize, prospektif ve kontrollü olarak planlanan çalýþmaya total diz artroplastisi uygulanan 20 hasta, total kalça artroplastisi uygulanan 20 hasta dâhil edildi. Her iki gruba postoperatif dönemde 4x5 mg morfin sülfat intramusküler olarak uygulandý. Aðrý vizüel anolog skala ile deðerlendirildi. Ýlk gece uyku kalitesi ve morfin sülfatýn yan etkileri sorgulandý. Her iki grup arasýnda 6. ve 24. saatte yapýlan deðerlendir-melerde aðrý skoru, ilk gece kalitesi, morfin sülfatýn yan etkileri açýsýndan istatiksel fark saptanmadý.
Sonuç olarak, ayný analjezi protokolü total diz artroplastisi ve total kalça artroplastisi uygulanan hatalarda kullanýlabilir.

It is said that patients undergoing total knee arthroplasty need more analgesics postoperatively than those undergoing total hip arthroplasty. In this study, we hypothesized that the same intramuscular morphine protocol may be used in both total hip and knee arthroplasties. This was a randomized, prospective, controlled trial. Twenty patients who were hospitalized for total hip arthroplasty and 20 patients for total knee arthroplasty consisted the study groups. Using visual analog scale for pain, the patients responded to questions regarding their first night’s sleep and the side effects of morphine sulfate. On the first postoperative day, 20 mg/day (4x5 mg) intramuscular morphine sulfate were administered. The patients were questioned at the 6th and 24th postoperative hours. There were no statistical differences between the total hip arthroplasty and total knee arthroplasty groups in terms of pain, first night’s sleep or the side effects of morphine sulfate at the 6th or 24th postoperative hours. After administration of the same intramuscular morphine sulfate protocol, early postoperative pain and the side effects of morphine sulfate were comparable between the total hip and knee arthroplasty groups, so the same intramuscular morphine protocol may be used in total hip and knee arthroplasties.

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Feokromasitoma nöral krestin kromaffin hücrelerinden köken alan katekolamin üreten, salgýlayan ve depolayan ender görülen bir tümördür. Hastalar baþ aðrýsý, terleme, çarpýntý, nöbet ataðý þeklinde baþvururabilir. Hastalar bazen tamamen asemptomatik olup, hastalýk rastlantýsal olarak tespit edilir. Uzak metastaz olmasý, ataklarýn tekrarlamasý ve çevre dokulara invazyon olmasý hastalýðýn malign olduðunu düþündürür. Feokromasitomada oluþan hipertansiyon uygun tedavi ile ortadan kaldýrýlabilmektedir. Taný konulmadýðý ya da yanlýþ tedavi edildiðinde öldürücü olabilmektedir.

Pheochromocytoma is a rarely seen neoplasm, and orginating from neural crest chromoffin cells which are responsible from producing, storing and secretion of catecholamines. Patients may refers to hospitals(or emergency services) with headache, sweating, palpitations and seizure attacks. Sometime the patients may be asemtomatic and the diagnose is esteblished incidentally. It is thought that if there are having distant metastasis, recurrent attacks and invasion to peripheral tissues, the disease is malign. The hypertension induced from pheochromocytoma can be treated effectively by some drugs. It may leads to mortality, if the patient’s diagnosis is not made timely or given treatment is inaccurate.

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Manyetik rezonans görüntüleme (MRG) kalça aðrýsý olan hastalarda kemik iliði ödemi paternini kesin bir þekilde göstermektedir. MRG ayný zamanda altta yatan lezyonlarýn doðasýný göstermekte oldukça deðerlidir. Femur baþýnýn geçici kemik iliði ödemi sendromu ve avasküler nekrozu (AVN), MRG’de kemik iliði ödemi paterni ile seyreden, klinik olarak ayýrýcý tanýlarý güç olan, tedavi yöntemleri ve prognozlarý belirgin farklýlýk gösteren iki hastalýk grubudur. Bu derlemenin amacý femur baþý kemik iliði ödemi paterninin MRG bulgularýnýn tanýmlanmasý, geçici kemik iliði ödemi sendromu ve avasküler nekroz için tanýsal yaklaþýmda MRG’nin teknik detaylarý, avantajlarý ve sýnýrlýlýklarýnýn tartýþýlmasý ve tanýda MRG’nin rolünün gözden geçirilmesidir.

Magnetic resonance imaging (MRI) can precisely demonstrate bone marrow edema of the femoral head in patients with hip pain. MRI is also valuable for the demonstration of the nature of underlying lesions. Transient bone marrow edema and avascular necrosis (AVN) which pose difficulties in differential diagnosis with distictly different treatment modalities, and prognoses demonstrate bone marrow edema patterns on MRI. The purpose of this review article is to describe MRI features of the bone marrow edema pattern in transient bone marrow edema and avascular necrosis of the femoral head, and to discuss the technical aspects, advantages and limitations of MRI in the diagnosis of these diseases and to review the diagnostic role of MRI.

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Günümüzde kadýn yaþam süresi uzamaktadýr ve kadýnlarýmýz daha aktif yaþam sürdürmektedir. Artan yaþlanmaya baðlý doku zaafý ve yaþlanmaya sekonder sayýsý artan histerektomi sonrasý vaginal cuff prolapsusu görülme sýklýðý da artmaktadýr ve bu nedenle yapýlan düzeltici operasyon gereksinimi artmaktadýr.
Biz kliniðimize baþvuran 60 yaþýndaki alt genital organlarýnýn ele gelmesi ve idrar kaçýrma yakýnmasý olan hastamýzý vaginal cuff prolapsusu tanýsýyla takip edip abdominal sakrokolpopeksi tekniðini ve Moschowitz sütürünü uyguladýk. Operasyonda rektus fasciasýndan elde edilen otolog greft aracýlýðýyla vaginal cuff sakruma asýldý, cul de sac oblitere edildi. Postop ilk iki aydaki takiplerde komplikasyon izlenmedi.

Nowadays, life expectancies of women have increased, and elderly women enjoy more active lives. Aging and inadequate support of the vaginal vault after hysterectomy are two important factors that have led to an increased frequency of vaginal vault prolapsus and the need for reconstructive pelvic surgery to correct this long-term complication of abdominal and vaginal hysterectomies.
Our case was 60 years old, who had urinary incontinence, and a palpable lower genital organs. We have followed up our patient with diagnosis of vaginal cuff prolapsus, and performed abdominal sacral colpopexy with an autologous fascial graft using Moschowitz suturing technique. An autologous fascial graft harvested from the aponeurosis of the anterior abdominal wall was used to fixate vaginal cuff on the sacrum, and obliterate cul-de-sac. No complication was fobserved after the first 2 months of the operation.

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Mukozal malign melanom (MMM) baþ boyun bölgesinde ender görülen bir tümördür. MMM’ler deri malign melanomlarýna (MM) göre çok daha agresiftirler. Diðer taraftan baþ boyun bölgesinin kompleks bir anatomiye sahip olmasý tümörün cerrahi olarak tam eksizyonunu güçleþtirir. Bu yüzden erken taný ve erken tedavi ayrý bir önem kazanýr. Oral kavite MMM’leri tüm oral malignitelerin % 0.5’ini oluþtururlar. Mandibular gingivanýn MMM’si de oldukça enderdir. Deri MM’lerinin deðiþik formlarý açýk bir þekilde tanýmlanmýþ olmasýna karþýn, MMM’lerle ilgili geniþ seriler bulunmamasý nedeniyle bu konudaki bilgi birikimi sýnýrlýdýr.
Bu makalede, mandibular gingivada yerleþen MMM nedeniyle daha önce opere olmuþ ve lokorejyonel nüks ile kliniðimize refere edilen 29 yaþýndaki bir kadýn hasta sunulmuþ ve MMM’lerin klinik, histopatolojik özellikleri ile tedavi modaliteleri tartýþýlarak literatürle birlikte gözden geçirilmiþtir.

Mucosal malignant melanoma (MMM) is an uncommon tumour of the head and neck region. MMMs are much more agressive than cutaneous malignant melanomas (MM). Complete surgical excision of the tumour is difficult due to complex anatomy of the head and neck region. Therefore early diagnosis and early treatment deserve a special significance. Oral cavity MMMs account for 0.5 % of the oral malignancies. MMM of the mandibular gingiva is also very rare. Although various types of cutaneous MMs have been clearly described, data on MMMs is quite limited due to the lack of large series.
In this article, we report a 29 year-old female patient who was previously operated for MMM of the mandibular gingiva. She was referred to our institution with locoregional recurrent disease. We discuss clinical and histopathological features of MMMs and therapeutic modalities in line with the literature.

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Ligamentum flavum kistleri nörolojik semptom ve bulgularýn ender bir nedeni olup, genellikle 45 yaþ üstü insanlarda görülmektedir. Altmýþ yaþýnda bayan hastada L5-S1 seviyesinde sað tarafta yerleþen bir ligamentum flavum kist olgusunu rapor ettik. Kist cerrahi yöntemle çýkartýldý ve sonuç kusursuzdu. Ameliyat sonrasý hastanýn semptomlarý geriledi. Lomber magnetik rezonans görüntülemede; L5-S1 intervertebral yerleþimli kistik kitle ve L4-5 seviyesinde disk hernisiyle birlikte dar kanal görüntülendi. Sað L4-5 ve L5-S1 hemilaminektomi yapýldý ve kistik kitle sekestre diskle birlikte çýkartýldý. Çýkartýlan materyalin histolojik incelemesi ligamentum flavum kistiyle uyumluydu. Cerrahi sonrasý hastanýn kladikasyo ve radikülopati yakýnmalarý tamamen düzeldi.

Ligamentum flavum cysts are rare causes of neurological signs and symptoms and usually seen in persons over 45 years of age. We report the case of a right-sided ligamentum flavum cyst occurring at L5–S1 level in a 60 year-old woman, which was surgically removed with excellent postoperative results, and complete resolution of symptoms. Lumbar magnetic resonance imaging demonstrated an extradural cystic mass at the L5-S1 intervertebral space and disc hernia with canal stenosis at the L4-5 intervertebral space. Right hemilaminectomy and flavectomy at the L4-5 and L5-S1 space were performed, and cystic mass with sequestered disc was excised. Histological examination of the resected material showed findings consistent with the ligamentum flavum cyst. After surgery, claudication and radiculopaty completely disappeared and the patient made a good recovery.

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Fraser sendromu kriptoftalmus, kutanöz sindaktili, larinks ve genitouriner bölge malformasyonlarý, kraniyofasiyal dismorfizm, orofasiyal yarýk, mental gerilik ve kas-iskelet sistemi anomalileri ile karakterizedir. Fraser sendromu nadir, otozomal resesif bir durumdur. Bu belgede, Fraser sendromlu iki günlük bir yeni doðaný rapor ettik.

Fraser syndrome is characterized by cryptophthalmos, cutaneous syndactyly, malformations of the larynx and genitourinary tract, craniofacial dysmorphism, orofacial clefting, mental retardation, and musculoskeletal anomalies. Fraser syndrome is a rare, autosomal recessive condition. Herein, we report a case of a two day old infant with Fraser syndrome.

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Hipopituitarizm ön hipofiz bezinde üretilen bir veya birden fazla hormonun ya da tüm hormonlarýn yetersizliði sonucu geliþen klinik sendromlara verilen isimdir. Hipopituitarizm intrinsik veya primer hipofiz hastalýðý, intrinsik hipotalamik veya sekonder hipofiz hastalýðý ve ekstrinsik ekstrasellar veya parasellar hastalýða baðlý oluþabilir. Hipofizer yetmezlikde TSH düzeyi düþük gözlenir. Fakat hastamýzda TSH düzeyi yüksek bulundu. Yapýlan ek tetkikler sonucunda beraberinde hashimoto tiroiditi saptadýk. Hipofizde hemorajik sekeli olan, yalnýz TSH yüksekliði (hashimoto tiroiditi saptanan) nedeniyle parsiyel hipopitüitarizm tanýsý alan olguyu ender görülmesi nedeniyle sunuyoruz.

Hypopituitarism is the clinical syndrome which results from failure of the anterior pituitary gland to produce one, more than one or all of its hormones. Hypopituitarism can result from intrinsic or primary pituitary disease, intrinsic hypothalamic or secondary pituitary disease, and extrinsic extrasellar or parasellar disease. Low levels of TSH are observed in pituitary deficiencies, but TSH levels were higher in our patient. We diagnosed concomitant Hashimoto thyroiditis as a result of further evaluation. We present this case which is very rarely cited in the literature.

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Doðumda yenidoðan bebeklerin oral kavitesinde görülen diþler “natal diþ”, doðumdan sonraki ilk bir ay içinde görülen diþler ise “neonatal diþ” olarak adlandýrýlmaktadýr. Bu diþlerin sýklýðý 2000 ile 3500 canlý doðumda birdir. Natal ve neonatal diþler, emme sýrasýnda anneyi rahatsýz etmesi ve/veya bebekte aspirasyon ve yutma riski oluþturmasý durumlarýnda çýkartýlmalýdýr. Bu makalede mandibular santral kesici natal diþleri olan bir yenidoðan sunuldu.

Teeth which are present in the oral cavity of newborn infant at the time of the birth are called “natal teeth” and those which erupt in first month of the postnatal life are called “neonatal teeth”. The incidence of these teeth is 1 in 2000 to 1 in 3500 live births. Natal and neonatal teeth may be uncomfortable for a nursing mother and/or present a risk of aspiration and swallowing of the tooth by the infant. Under these circumstances, natal and neonatal teeth need to be extracted. In this article, a case of natal teeth with mandibular central incisors has been presented.

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Yarýk el ve ayak deformiteleri bulunan olgularda el ve ayak fonksiyonlarý genellikle iyidir. Ailesinde yarýk el ve ayak bulunan durumlarda sýklýkla otozomal resesif geçiþ mevcuttur. Ancak, olgularýmýz otozomal dominant geçiþe sahipti. Biz burada doðuþtan yarýk el ve ayak deformitesi olan bir aileyi sunduk.

Hand and foot functions of the cases with cleft hand and foot deformities are usually good. Autosomal recessive inheritance is frequently seen in a patient with a family history of cleft hand and foot. However, our cases had autosomal dominant inheritance trait. Herein we have presented the family that had congenital cleft hand and foot deformity.

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