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.

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 capitelluım 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.

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.

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.

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 Bagcılar district of İstanbul.
METHODS: Women consulted to Clinics of Obstetrics, and Gynecology, Bağcılar 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=1499İ 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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.