GÝRÝÞ ve AMAÇ: Bu çalýþmada kliniðimizde toplam 107 hastaya yapýlan perkütan nefrolitotomi (PNL) giriþiminin deðerlendirilmesi yer almaktadýr.
YÖNTEM ve GEREÇLER: Eylül 2001-Haziran 2004 tarihleri arasýnda ortalama yaþ 38(5-76) olan 70 erkek, 27 kadýn ve 10 çocuk hastada toplam 107 hastaya PNL uygulandý. 1 hastada 1 hafta, 2 hastada 1 ay ara ile bilateral PNL uygulandý.
BULGULAR: Renal ünitelerin 55'i alt pol, 18' i multipol, 25' i renal pelvis, 15'i üst pol, 32' si orta kaliks grubu taþlarýydý. Renal ünitelerin ortalama taþ yükü 898mm² idi (100- 3000mm²). Ortalama cerrahi süresi 97 (47-390) dakika olarak belirlendi. Ortalama hastanede kalýþ süresi 5 (2-15) gündü. Tüm lokalizasyonlar için taþsýzlýk oraný %80.6 (117/145), 4 mm altý rezidü taþlar klinik olarak önemsiz kabul edildiðinde taþsýzlýk oraný %93.1 (135/145) olarak bulundu. Postoperatif 4 hastaya transfüzyon uygulandý. 24 saati geçen ürin drenajý 25 hastada oldu. Hastalarýn 3'ünde interkostal giriþ ile uygulanan PNL sonrasýnda hidrohemotoraks geliþti. 2 hastadan plevral mayi drene edildi, 1 hasta konservatif izlendi. 1 hastaya nefrostomi konulurken geliþen kanama nedeniyle açýk nefrolitotomi yapýldý. 2 hastada postoperatif dönemde septisemi geliþti.
TARTIÞMA ve SONUÇ: PNL taþsýzlýk oraný yüksek, morbiditesi düþük güvenilir bir metoddur. Taþ yükü fazla olan ve kompleks böbrek taþlarýnda komplikasyon oraný artabilmektedir.

INTRODUCTION: In this study, the evaluation of percutaneous nephrolithotomy (PNL) intervention performed in 107 patients in our clinic is included.
METHODS: Between September 2001 and June 2004, PNL was applied to a total of 107 patients, 70 male, 27 female and 10 pediatric patients with a mean age of 38(5-76). Bilateral PNL was performed with an interval of 1 week in 1 patient and 1 month in 2 patients.
RESULTS: Of the renal units, 55 were lower pole, 18 were multipole, 25 were renal pelvis, 15 were upper pole, 32 were middle calyx group stones. The mean stone load of the renal units was 898mm² (100- 3000mm²). The mean surgery time was 97 (47-390) minutes. The mean hospital stay was 5 (2-15) days. The stone-free rate was 80.6% (117/145) for all localizations, and the stone-free rate was 93.1% (135/145) when residual stones less than 4 mm were considered clinically insignificant. Transfusion was applied to 4 patients postoperatively. Urinary drainage exceeding 24 hours occurred in 25 patients. Hydrohemothorax developed in 3 of the patients after PNL with intercostal access. Pleural fluid was drained from 2 patients, 1 patient was followed conservatively. Open nephrolithotomy was performed in 1 patient due to bleeding during nephrostomy. Septicemia developed in 2 patients in the postoperative period.
DISCUSSION AND CONCLUSION: PNL is a reliable method with a high stone-free rate and low morbidity. Complication rate may increase in patients with high stone burden and complex kidney stones.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, yoðun bakým ünitesinde yatan dekompanse kronik kalp yetmezliði (KKY) olan hastalarda Nutrisyonel Risk Tarama (NRS-2002) skoru ile N Terminal-Pro B tipi Natriüretik Peptit (NT-pro BNP) düzeyi arasýnda bir iliþki olup olmadýðýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþmaya dekompanse KKY tanýsý konulan ve beslenme durumu NRS-2002 skoru ile deðerlendirilen ardýþýk 125 hasta dahil edildi. Hastalar iki gruba ayrýldý: NRS-2002 skoru <3 ve NRS-2002 skoru ≥3. NRS-2002 skoru ≥3 olan hastalar malnütrisyonlu olarak tanýmlandý.
BULGULAR: 125 dekompanse KKY hastasýnýn 93'ü (%74,4) NRS-2002 skoru ≥3 grubunda ve 32'si (%25,6) NRS-2002 skoru <3 grubundaydý. Hastalarýn %74,4'ünde malnütrisyon bulundu. NRS-2002 skoru ≥3 grubunda ortalama NT-pro BNP seviyesi 9327 (4927-15793) pg/mL ve NRS-2002 skoru <3 olan grupta ortalama NT-pro BNP seviyesi 3953 (2310-8939) pg/mL idi. Ýki grup karþýlaþtýrýldýðýnda, ortalama NT-pro BNP düzeyi, NRS-2002 skoru≥3 grubunda daha yüksekti ve bu bulgu istatistiksel olarak anlamlýydý (p=0,005). Bir yýllýk takip döneminde NRS-2002 skoru<3 grubunda 7 (%21,9) hasta ve NRS-2002 skoru≥3 grubunda 28 (%30,1) hasta; toplam 35 (%28) hasta öldü.
TARTIÞMA ve SONUÇ: KKY, mortalite ve morbiditenin önde gelen nedenlerinden biridir. NT-pro BNP düzeyi, dekompanse KKY'li hastalarda NRS-2002 skoru≥3 grubunda NRS-2002 skoru<3 grubuna göre daha yüksek bulundu ( p= 0,005).

INTRODUCTION: The aim of this study was to investigate whether there was a relationship between Nutritional Risk Screening (NRS-2002) score and N Terminal-Pro B type Natriuretic Peptide (NT-pro BNP) level in intensive care unit (ICU) patients with decompensated chronic heart failure (CHF).
METHODS: Consecutive 125 patients who were diagnosed with decompensated CHF and whose nutritional status were evaluated using NRS-2002 score were included in this study. The patients were divided into two groups: NRS-2002 score <3 and NRS-2002 score ≥3. The patients with NRS-2002 score ≥3 were defined as malnutrition. After evaluation, the patients were followed up for one-year.
RESULTS: Of the 125 decompensated CHF patients, 93 (74.4 %) were in the NRS-2002 score ≥3 group and 32 (25.6%) were in the NRS-2002 score <3 group. Malnutrition rate was found 74.4% of the patients. The median NT-pro BNP level was 9327 (4927-15793) pg/mL in the NRS-2002 score ≥3 group and the median NT-pro BNP level was 3953 (2310-8939) pg/mL in NRS-2002 score <3 group. When the two groups were compared, median NT-pro BNP level was higher in NRS-2002 score≥3 group and this finding was statistically significant (p=0.005). During the one-year follow up period, 7 (21.9%) patients in NRS-2002 score<3 group and 28 (30.1 %) patients in NRS-2002 score≥3 group; total 35 (28%) patients died.
DISCUSSION AND CONCLUSION: CHF is one of the leading causes of mortality and morbidity. NT-pro BNP level was higher in NRS-2002 score≥3 group than NRS-2002 score<3 group in patients with decompensated CHF (p= 0.005).

GÝRÝÞ ve AMAÇ: Jinekolojik kanseri olan hastalarýn depresyon, anksiyete ve yaþam kalitelerinin deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu kesitsel çalýþma Nisan-Temmuz 2021 tarihleri arasýnda jinekolojik onkoloji polikliniðine baþvuran hastalarda yapýlmýþtýr. Avrupa Kanser Araþtýrma ve Tedavi Organizasyonu Yaþam Kalitesi Ölçeðin (EORTC QLQ-C30) ve Hastane Anksiyete ve Depresyon Ölçeðinin (HADS) kullanýlarak kullanýlmýþtýr.
BULGULAR: 372 hastanýn 40'ý rahim aðzý kanseri, 32'si yumurtalýk kanseri, 53'ü endometriyal kanser ve 247'si servikal intraepitelyal neoplazi idi. Duygusal iþlev (72.06±25.93) en çok etkilenen alan olurken, sosyal iþlev (86.33 ± 22.84) en az etkilenen alan olmuþtur. Týbbi bir saðlýk sorunu bildiren, örgün eðitim almamýþ, iþsiz hastalar, ve aylýk aile geliri yoksulluk sýnýrýnýn altýnda olan hastalarýn yaþam kalitesi önemli ölçüde daha düþüktü. Endometriyal kanseri olan hastalar daha iyi bir QoL ile iliþkilendirilirken, over kanseri olan hastalarý daha kötü QoL'ye sahipti. Radyasyon ve kemoterapi alan hastalarda fiziksel ve sosyal iþlevsellik önemli ölçüde zayýftý (p<0,05).
TARTIÞMA ve SONUÇ: Araþtýrma sonucuna göre, bazý sosyo-demografik ve klinik özelliklerde QoL ile duygusal stres arasýnda anlamlý bir iliþki saptanmýþtýr ve QoL'yi iyileþtirmeye yönelik müdahalelerde dikkate alýnmalýdýr.

INTRODUCTION: To evaluate the depression, anxiety, and quality of life in gynecologic oncology patients.
METHODS: This cross-sectional study was conducted on patients attending gynecologic oncology outpatient clinic from April to July 2021. A total of 372 patients were interviewed using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS).
RESULTS: Of 372 patients, 40 were cervical cancer, 32 were ovarian cancer, 53 were endometrial cancer, and 247 were cervical intraepithelial neoplasia. Emotional function (72.06±25.93) was the most affected domain, whereas social function (86.33 ± 22.84) was least affected. Patients who reported a medical health problem, received no formal education, unemployed, and having a montly family income below poverty line had significantly lower QoL. Endometrial cancer was associated with a better QoL, while ovarian cancer patients had worse QoL. Receiving radiation and chemotherapy had significantly poor physical and social functioning (p<0,05).
DISCUSSION AND CONCLUSION: There was a significant association between QoL and emotional distress on some socio-demographic and clinical characteristics and should be taken into consideration in interventions to improve QoL.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý proteinürisi olan ve olmayan fetal büyüme kýsýtlýklý (FBK) gebeliklerin maternal ve perinatal sonuçlarýnýn kýyaslanmasýdýr. Yapýlacak bu kýyaslama neticesinde olumsuz etkilenen maternal ve fetal sorunlara karþý önlemlerin alýnmasý gerektiðine katkýda bulunmak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmada, fetal büyüme kýsýtlýlýðý tanýsý almýþ 50 gebe deðerlendirildi. Proteinürili ve proteinürisiz FBK gruplarýnda; tahmini doðum aðýrlýðý, karýn çevresi, dopler bulgularý, oligohidramniyoz, nöroproteksiyon oranlarý, doðum haftasý, APGAR skoru, yenidoðan yoðun bakým ünitesi ihtiyacý, annenin kan tahlil sonuçlarý, preeklampsi geliþimi, sezaryenle doðum oraný gibi maternal ve fetal parametreler kýyaslandý.
BULGULAR: Doðum haftasý proteinürisi olan gebelerde daha erken bulundu (p=0.02). Ortalama tahmini fetal aðýrlýk ve bebeklerin ortalama doðum aðýrlýðý proteinüri olan grupta daha düþük olarak bulundu (p=0.03). Fetal nöroproteksiyon ihtiyacý proteinüri olan grupta 12 (%39), proteinüri olmayan grupta 2 (%10 ) hastada geliþti (p=0.03). Proteinüri olan grupta 15 (%48) hastada uterin arterde direnç artýþý varken, proteinüri olmayan grupta 2 (%10) hastada vardý (p=0.03). Proteinüri olan grupta 18 (%58) hastada preeklampsi geliþirken, proteinüri olmayan grupta 1 (%5) hastada geliþti (p<0,001).
TARTIÞMA ve SONUÇ: Fetal büyüme kýsýtlýlýðý olan gebelerde proteinüri varlýðý araþtýrýlmalýdýr. Proteinürisi olan hastalar preeklampsi ve olumsuz perinatal sonuçlar bakýmýndan daha riskli görülmektedir.

INTRODUCTION: The aim of this study is to compare the maternal and perinatal outcomes of pregnancies with and without proteinuria with fetal growth restriction (FGR). As a result of this comparison, it is aimed to contribute to the need to take measures against adversely affected maternal and fetal problems.
METHODS: In this retrospective study, 50 pregnant women who were diagnosed with FGR were evaluated. In FGR groups with and without proteinuria; maternal and fetal parameters such as estimated fetal weight, abdominal circumference, doppler findings, oligohydramnios, neuroprotection rates, delivery time, APGAR score, need for neonatal intensive care unit, maternal hematological paremeters, development of preeclampsia, and cesarean delivery rate were compared.
RESULTS: The week of delivery was found earlier in pregnant women with proteinuria (p=0.02). Mean estimated fetal weight and mean birth weight were found to be lower in the group with proteinuria (p=0.03). Fetal neuroprotection was essential in 12 (39%) patients in the group with proteinuria and in 2 (10%) patients in the group without proteinuria (p=0.03). While there was an increase in uterine artery resistance in 15 (48%) patients in the proteinuria group, it was present in 2 (10%) patients in the non-proteinuria group (p=0.03). While preeclampsia developed in 18 (58%) patients in the proteinuria group, it developed in 1 (5%) patient in the non-proteinuria group (p<0.001).
DISCUSSION AND CONCLUSION: The presence of proteinuria should be investigated in patients with fetal growth restriction. Patients with proteinuria seem to be at higher risk in terms of preeclampsia and adverse perinatal outcomes.

GÝRÝÞ ve AMAÇ: Migren (M) ve gerilim tipi baþ aðrýlarý (TTH), tüm popülasyonda görülen en yaygýn baþ aðrýlarýdýr. Bu baþ aðrýlarý hormonal deðiþikliklerden etkilenebilir ve her yaþta baþlayabilir, ancak bu baþ aðrýlarýnýn sýklýðý ve davranýþý hamilelik sýrasýnda deðiþmektedir.
YÖNTEM ve GEREÇLER: Bu çalýþmada gebelikte M ve TTH'nin seyri deðerlendirilmiþtir. Gebelik öncesinde M ve TTH olan 32 gebeye, gebelikleri boyunca 3 ayda bir MIDAS ölçeði ve baþ aðrýsý anketi kullanýlarak, gebelik öncesi dönemleri retrospektif ve gebelik süreçleri de prospektif olarak incelenmiþtir.
BULGULAR: Aurasýz migren (MWOA) grubunda gebelik arttýkça baþ aðrýsý günlerindeki (HD) azalma istatistiksel olarak anlamlý bulundu. (p: 0,0001). Auralý migren (MWA) grubunda gebelik ve gebelik öncesi dönemler arasýnda aðrý sýklýðý açýsýndan istatistiksel fark bulunmazken (p: 0,516), gebelik haftasý arttýkça baþ aðrýsý atak sayýsýnda azalma gözlendi. Gebelik öncesi ve gebelik dönemleri karþýlaþtýrýldýðýnda TTH grubunda istatistiksel olarak fark olmamasýna raðmen (p: 0,15) 1. ve 3. trimesterde özellikle 1. trimesterde aðrý sýklýðýnda artýþ gözlendi.
TARTIÞMA ve SONUÇ: MWOA grubundaki baþaðrýlý günler gebelik sýrasýnda önemli ölçüde azaldý ve bu azalma istatistiksel ve klinik olarak anlamlýydý. MWA ve TTH gruplarýnda gebelik öncesi ve gebelik dönemleri arasýnda baþ aðrýsý günleri açýsýndan istatistiksel fark yoktu.

INTRODUCTION: Migraine (M) and tension-type headaches (TTH) are the most common headaches among the whole population. These headaches can be influenced by hormonal changes and can start at any age, but frequency and the behavior of these headaches may change during pregnancy.
METHODS: In this study, the course of M and TTH during pregnancy is evaluated. 32 pregnant woman who have M and TTH before pregnancy are questionnaired prospectively by using the MIDAS scale and headache questionnaire in each 3 trimesters during pregnancy prospectively and retrospectively for pre-pregnant period.
RESULTS: In the migraine without aura (MWOA) group, the decrease in headache days (HD) was found to be statistically significant as pregnancy increased. (p: 0.0001). Although there was no statistical difference in terms of pain frequency between pregnancy and pre-pregnancy periods for the migraine with aura (MWA) group (p: 0.516), a decrease was observed in the number of headache attacks as the gestational week increased. When the pre-pregnancy and pregnancy periods were compared, although there was no statistical difference in the TTH group (p: 0.15), an increase in pain frequency was observed in the 1st and 3rd trimesters, especially in the 1st trimester.
DISCUSSION AND CONCLUSION: HDs in the MWOA group decreased significantly during pregnancy and this decrease was statistically and clinically significant. There was no statistical difference in terms of headache days between pre-pregnancy and pregnancy periods in the MWA and TTH groups.

GÝRÝÞ ve AMAÇ: Covid 19 ilk olarak Aralýk 2019’da Çin’in Wuhan kentinde tanýmlanmýþ ve hýzla yayýlarak pandemi haline gelmiþtir. Bu çalýþmada Covid19 pozitif tanýsý alýp serviste yatarak tedavi olmuþ gebelerle Covid 19 pozitif olup yoðunbakým ihtiyacý olan gebelerin laboratuvar parametrelerindeki farklýlýklarýn saptanmasý, her iki grubun perinatal sonuçlarýnýn karþýlaþtýrmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma Mart 2020 ve Haziran 2021 tarihleri arasýnda kadýn doðum kliniðinde yatýrýlan 134 Covid 19 pozitif gebenin datalarýnýn retrospektif olarak taranmasýyla gerçekleþtirilmiþtir. Bu iki grup hastanýn Covid pozitif tanýsý alýp yatýþ kararý verildiðinde bakýlan laboratuvar parametreleri ve perinatal sonuçlarý karþýlaþtýrýlmýþtýr.
BULGULAR: Bu iki gruba bakýldýðýnda; yoðunbakýma yatýrýlan hastalarýn lenfosit (Ly) (p<0,001), üre (p<0,001) ve D-dimer (p=0,01) deðerleri anlamlý düzeyde düþük, glukoz (p<0,001), alanin aminotransferaz (ALT) (p<0,001), aspartat aminotransferaz (AST) (p<0,001), total protein (p<0,001), albümin (p=0,001), C reaktif protein (CRP) (p<0,001), ferritin (p<0,001) ve prokalsitonin (p<0,001) düzeylerinin anlamlý derecede yüksek olduðu görülmüþtür. Yine iki grubun perinatal sonuçlarý karþýlaþtýrýldýðýnda yoðunbakýma yatan hastalarda gravide deðeri (p=0,028), ek hastalýk görülme oraný (p=0,006) anlamlý derecede yüksek iken, medyan gebelik haftasýnýn anlamlý derecede düþük olduðu görülmüþtür (p<0,001).
TARTIÞMA ve SONUÇ: Yoðunbakým ihtiyacý olan Covid pozitif gebelerin laboratuvar parametrelerinde hastaneye ilk yatýþta bile farklýlýklar görülebilir. Ayrýca perinatal sonuçlar açýsýndan bakýldýðýnda yoðunbakým ihtiyacý olan gebelerde mortalite ve morbidite daha yüksek olabilir.

INTRODUCTION: Covid 19 was first seen and identified in Wuhan, China in December 2019, and within a few months it quickly spread all over the world and became a pandemic.In this study, we aimed to determine the differences in laboratory parameters of pregnant women who were hospitalized in the ward and those who needed intensive care, and to compare the perinatal results between the two groups
METHODS: This study was carried out by retrospectively scanning the data of 134 Covid positive pregnant women hospitalized in the gynecology clinic March 2020 and June 2021.When these two groups of patients were diagnosed as Covid positive and decided to be admitted to the ward, laboratory parameters and perinatal results were compared.
RESULTS: Looking at these two groups, lymphocyte (Ly), urea (p<0.001), D-dimer (p=0.01), glucose (p<0.001), alanine aminotransferase (ALT) (p<0.001), aspartate aminotransferase (AST) (p<0.001), total protein (p< 0.001), albumin (p=0.001), C reactive protein (CRP) (p<0.001), ferritin (p<0.001) and procalcitonin (p<0.001) levels were significantly higher. Again, when the perinatal results of the two groups were compared, the gravide value (p=0.028), the incidence rate of additional diseases (pOctober0.006) were significantly higher in patients admitted to intensive care, while the median week of pregnancy was significantly lower (p<0.001).
DISCUSSION AND CONCLUSION: There may be differences in the laboratory parameters of Covid positive pregnant women who need intensive care, even at first hospitalization. Also, in terms of perinatal outcomes, morbidity and mortality may be higher in pregnant women who need intensive care.

GÝRÝÞ ve AMAÇ: Prostat kanseri riski dolaþýmdaki yüksek insülin seviyesi ve insülin rezistansý ile artýþ gösterir.. Diyabet hastalarýnda düþük insülin seviyelerinden dolayý riskin azaldýðýna dair bazý çalýþmalar vardýr. Bu çalýþmada diyabetik 50 yaþ ve üstü erkeklerde serum Prostat Spesifik Antijen (PSA) düzeylerinin incelenmesi hedeflenmiþtir.
YÖNTEM ve GEREÇLER: Çalýþma; Mart 2008 ve Kasým 2008 tarihleri arasýnda Düzce Üniversitesi Dahiliye polikliniðine baþvuran 50 yaþ ve üstü 137 ( 67 vaka, 70 kontrol ) erkek hastada yapýldý. Vaka grubu ve kontrol grubu yaþlara göre üçe ayrýldý. PSA deðerleri bu yaþ gruplarý arasýnda karþýlaþtýrýldý. Ayrýca diyabetin taný süresine göre hastalar üç gruba ayrýlýp serum PSA deðerleri karþýlaþtýrldý.
BULGULAR: Diyabetik 50-59 yaþ grubunda ortalama serum PSA deðeri 0.76 ± 0.35 ng/mL olup ayný yaþ grubundaki non-diyabetiklerin ortalama PSA deðerinden (1.08 ± 0.75 ng/mL) daha düþük bulundu. 60-69 yaþ gruplarýnda benzer þekilde diyabetik hastalarýn serum PSA deðerleri non-diyabetiklere göre anlamlý derecede düþük bulundu. >70 yaþ gruplarý arasýnda ve diabetin sürelerine göre olan gruplar arasýnda PSA deðerleri arasýnda anlamlý fark bulunmadý.
TARTIÞMA ve SONUÇ: Diyabetik 50-59 yaþ ve 60-69 yaþ gruplarýnda serum PSA deðerlerini diyabetik olmayanlara göre anlamlý þekilde düþük bulduk. Diyabetin süresi ile PSA arasýnda istatistiksel anlamda fark bulamadýk. Sonuç olarak diyabetiklerde prostat kanseri riskinin diyabet olmayanlara göre daha düþük olduðunu düþünüyoruz.

INTRODUCTION: Risk of the prostate cancer is associated with high insulin levels in circulation and insulin resistancy. There are some studies that suggested lower risk in diabetics due to decreased insulin levels. In this study we aimed assesment of serum Prostate Specific Antigen (PSA) levels in diabetic men age of 50 and over.
METHODS: 137 patients age over 50 years ( 67 case, 70 control) admitted to Duzce University School of Medicine outpatients clinic from March 2008 to Novenber 2008 have been included in this study. Case and control groups were divided three groups as their age. PSA values were compared between in these age groups. Moreover, case group were divided three groups as their diagnosed diabet time and these group’s PSA values were compared.
RESULTS: Serum mean PSA values of diabetic patients age of 50-59 years was 0.76 ± 0.35 ng/mL and it was found lower than same age group of non-diabetic patient’s serum PSA values (1.08 ± 0.75 ng/mL). Similary in age groups of 60-69 years, diabetic patient’s PSA values were found significiently lower than non-diabetic patient’s PSA values. Between over age of 70 years groups and between diagnosed time of diabet groups, serum PSA values were not found significiently different.
DISCUSSION AND CONCLUSION: We found serum PSA levels sigificiently lower in diabetic groups than non-diabetic groups age of 50-59 years and 60-69 years. We couldn’t find istatically difference between PSA and diagnosed time of diabet. Consequently, prostate cancer risk may be lower in diabetic patients than non-diabetics.

GÝRÝÞ ve AMAÇ: Bu çalýþmada; Multipl skleroz (MS)’lu gebelerde kullanýlan ilaçlarýn gebelik öncesi kullanýmý ve kesilmesi ile relaps oluþumu;gebelikde, yenidoðan döneminde ve annedeki etkisi belirlenmeye çalýþýlmýþtýr.
YÖNTEM ve GEREÇLER: Bu çalýþma bir eðitim ve araþtýrma hastanesi nöroloji ve kadýn doðum kliniklerinde yapýlan hasta verilerinden elde edilen retrospektif bir çalýþmadýr. Hasta grubu olarak 2012- 2021 yýllarý arasýnda nöroloji ve kadýn doðum kliniklerine baþvuru yapan doðum yapmýþ 31 MS hastasý, kontrol grubu olarak doðum yapmýþ saðlýklý 39 gebe alýnmýþtýr. Sosyodemografik veriler, gebelik öncesi ve sonrasý ÝMT (Ýmmün Modülatör Tedavi) kullanýmý, relaps, progresyon, obstetrik veriler, ek hastalýklar, hemogram parametreleri deðerlendirilmiþtir. MS’i olan doðum yapmýþ gebeler perinatal ve postnatal olarak ve normal gebelerle karþýlaþtýrýlmýþtýr.
BULGULAR: Çalýþmada MS’li hastalarda tek gebelik oraný; saðlýklý gebelerde üç ve üzeri gebelik oranýnýn anlamlý olarak daha yüksek olduðu belirlenmiþtir. MS’li gebelerin WBC deðerlerinin daha düþük olduðu izlenmiþtir. MS’li gebelerde doðumda genel anestezi oraný saðlýklý gebelere göre yüksektir. Saðlýklý gebelerde erken doðum, düþük doðum aðýrlýðý ve yoðun bakýmda kalýþ gözlenmezken; MS’li gebelerde erken doðum, düþük doðum aðýrlýðý ve yeni doðanda yoðun bakýmda kalýþ süresinin anlamlý olarak yüksek olduðu tespit edilmiþtir.
TARTIÞMA ve SONUÇ: MS’i olan gebelerde; kullanýlan ilacýn kesilmesine baðlý olarak geliþtiði düþünülen; gebelik ve gebelik sonrasý dönemde geçirilen atak sayýlarýnýn istatistiksel olarak farklýlýk göstermediði sonucuna varýlmýþtýr. Atak sayýlarý sýklýk olarak interferon 1a ve fingolimod kullanan hastalarda; diðer MS ilaçlarýný kullanan gebelere göre daha belirgin olsa da istatistiksel olarak farklýlýk yaratmamaktadýr.

INTRODUCTION: It was tried to determine the effect of the drug used before pregnancy and in relapse formation in pregnant women with multiple sclerosis (MS), on pregnancy, neonatal period and mother, its use before pregnancy and its discontinuation.
METHODS: This is a retrospective study obtained from patient data obtained from Derince Training and Research Hospital Neurology and Obstetrics clinics. As the patient group, 31 MS patients who applied to toneurology and gynecology clinics between 2012-2021 and 39 healthy pregnant women who gave birth as the control group were included. Sociodemographic data, use of immunomodulatory therapy (IMT) before and after pregnancy, recurrence, progression, obstetric data, comorbidities, hemogram parameters were evaluated. Pregnant women with MS who gave birth were compared with normal pregnant women perinatally and postnatally.
RESULTS: In the study, it was determined that the rate of single pregnancy was higher in MS patients; The rate of three or more pregnancies is higher in healthy pregnancies. It was observed that leukocyte (WBC) values of pregnant women with MS were lower. The rate of application of general anesthesia at birth in pregnant women with MS is higher than in healthy pregnant women. While preterm birth, low birth weight and staying in intensive care are not observed in healthy pregnant women; Premature birth, low birth weight and duration of stay in neonatal intensive care unit were found to be significantly higher in pregnant women with MS.
DISCUSSION AND CONCLUSION: It was concluded that there was no statistical difference in the number of attacks during pregnancy and postpartum in MS patients, and this might be due to discontinuation of the drug used. Although the number of attacks in patients using interferon beta 1a and fingolimod drugs is higher than in pregnant women using other MS drugs, it does not make a statistical difference.

GÝRÝÞ ve AMAÇ: Alkol kullaným bozukluðunda tedavi sürecindeki en büyük sorun baðýmlýlýðýn nüks etmesidir. Objektif bir biyobelirteç ile hastalarýn prognozu öngörülebilirse bireyselleþtirilmiþ tedavi ve takip seçenekleri tedavi baþarýsýný artýrmada faydalý olacaktýr. Bu çalýþmanýn amacý; alkol kullaným bozukluðu tanýsý almýþ hastalarýn NLO (nötrofil / lenfosit oraný) ve PLO (platelet / lenfosit oraný) deðerlerini saðlýklý kontrol grubu ile karþýlaþtýrmak, erken prognostik belirteçler olarak alkol yoksunluk þiddeti, NLO ve PLO’yu deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþmamýza AMATEM (Alkol ve Madde Baðýmlýlýðý Tedavi ve Eðitim Merkezi) yataklý servisinde yatan 39 alkol kullaným bozukluðu hastasý ve 39 saðlýklý birey dahil edilmiþtir. Hastalar 3 aylýk takip sonuçlarýna göre relaps grubu ve remisyon grubu olarak 2’ye ayrýlmýþtýr. Hasta ve saðlýklý gruplarýn NLO ve PLO deðerleri, relaps ve remisyon gruplarýn NLO, PLO ve alkol yoksunluk þiddeti deðerleri birbirleriyle karþýlaþtýrýlmýþtýr.
BULGULAR: Alkol kullaným bozukluðu olan hastalar saðlýklý kontrollere göre anlamlý olarak daha yüksek ortalama NLO deðerlerine sahipti (p: 0.001). Relaps grubunda NLO (p: 0.04) ve yoksunluk þiddeti (p: 0.017) remisyon grubuna göre anlamlý olarak daha yüksekti.
TARTIÞMA ve SONUÇ: Alkol ve madde kullaným bozukluðunda inflamatuvar belirteçlerin arttýðýný gösteren çalýþmalar mevcuttur. Bu çalýþma alkol kullaným bozukluðunda bir inflamatuvar belirteç olarak NLO düzeyinin arttýðýný göstermektedir. Ayrýca alkol yoksunluk þiddeti ve yüksek NLO düzeylerinin relaps ile iliþkili bir gösterge olabileceðini düþündürmektedir.

INTRODUCTION: The biggest problem in the treatment process of alcohol use disorder is the relapse of addiction. If the prognosis of patients can be predicted with an objective biomarker, individualized treatment and follow-up options will be beneficial in increasing the success of treatment. The aim of this study; to compare the NLR (neutrophil / lymphocyte ratio) and PLR (platelet / lymphocyte ratio) values of patients diagnosed with alcohol use disorder with the healthy control group, to evaluate alcohol withdrawal severity, NLR and PLR as early prognostic markers.
METHODS: Our study included 39 patients with alcohol use disorder and 39 healthy individuals hospitalized in the inpatient service of AMATEM (Alcohol and Substance Addiction Treatment and Education Center). The patients were divided into 2 groups as relapse group and remission group according to their 3-month follow-up results. NLR and PLR values of patient and healthy groups, NLR, PLR and alcohol withdrawal severity values of relapse and remission groups were compared with each other.
RESULTS: Patients with alcohol use disorder had significantly higher mean NLR values than healthy controls (p: 0.001). NLR (p: 0.04) and withdrawal severity (p: 0.017) were significantly higher in the relapse group than in the remission group.
DISCUSSION AND CONCLUSION: There are studies showing that inflammatory markers increase in alcohol and substance use disorder. This study shows that NLR level is increased as an inflammatory marker in alcohol use disorder. It also suggests that the severity of alcohol withdrawal and high NLR levels may be an indicator associated with relapse.

GÝRÝÞ ve AMAÇ: COVID-19 vakalarýnda koku ve/veya tat kaybý gibi minör ve nonspesifik bir semptomun olmasý, taný için tek baþýna bir bulgu olabilir. Bu nedenle COVID-19 ile koku ve/veya tat kaybý arasýndaki iliþkinin bilinmesi kritik bir öneme sahiptir. Özellikle major semptomlarý olmayan hastalarda akut koku ve/veya tat kaybýnýn görülmesi, erken taný ve izolasyonla birlikte viral yayýlýmýn önlenmesi açýsýndan yararlý olacaktýr.
YÖNTEM ve GEREÇLER: Çalýþmamýzda Amerikan Otolaringoloji-Baþ Boyun Cerrahisi Akademisi tarafýndan klinisyenler için geliþtirilmiþ ve validasyonu saðlanmýþ olan koku kaybý ölçümleme aracý esas alýnarak kohort bir araþtýrma yapýldý.

BULGULAR: Bu çalýþmada COVID-19 pozitif olan ve tat ve/veya koku kaybý görülen hastalarýn %40,4’ünde koku ve/veya tat kaybý þikayeti taný konulmadan önce baþladýðý görüldü. Koku ve/veya tat kaybý prevalansýnýn, cinsiyet ve yaþ gruplarýna göre anlamlý farklýlýk göstermediði saptandý.
TARTIÞMA ve SONUÇ: Bu çalýþmada COVID-19 pozitif hastalarda koku ve tat kaybý semptomlarý literatürle uyumlu olarak anlamlý derecede yüksek oranda görülmüþtür. Ayrýca Kulak Burun Boðaz kliniði açýsýndan önümüzdeki dönemde de potansiyel COVID-19’ a baðlý koku ve/veya tat kaybý vakalarý görülmeye devam edecektir. Bu nedenle polikliniðe baþvuran tüm hastalarda mutlaka koku ve/veya tat kaybýnýn sorgulanmasý, yüksek risk taþýyan endoskopik muayene ve diðer iþlemlerde dikkat edilmesi açýsýndan çok önemlidir.

INTRODUCTION: The presence of a minor and nonspecific symptoms, such as loss of smell and/or taste in patients, may be a stand-alone symptom for the diagnosis of COVID-19 infection. Therefore, it is critical to know the relationship between COVID-19 and loss of smell and/or taste. Especially in patients without major symptoms, acute loss of smell and/or taste will be beneficial not only for early diagnosis and isolation but also for preventing viral spread.
METHODS: In our research, a cohort study was conducted based on the olfactory loss measurement tool developed and validated for clinicians by the American Academy of Otolaryngology–Head and Neck Surgery.
RESULTS: In 40.4% of cases, the complaint of loss of smell and/or taste was determined to present itself before the diagnosis of COVID-19. It was found that the prevalence of loss of smell and/or taste did not differ significantly depending on gender and age groups.
DISCUSSION AND CONCLUSION: In this study, symptoms of loss of smell and taste in COVID-19 positive patients were observed at a significantly higher rate in line with the literature. Additionally, in terms of Otorhinolaryngology clinic, it can be expected that potential cases of loss of smell and/or taste due to COVID-19 will continue to be seen in the future. For this reason, it is particularly important to question the loss of smell and/or taste in all patients who apply to the outpatient clinic, and to pay attention during endoscopic examination and other procedures that carry a high risk in possible cases.

Ökaryotik hücrelerde biyokimyasal süreçler organel adý verilen hücresel kompartmanlarda gerçekleþmektedir. Hücre içinde membranla çevrili organellerin yaný sýra membranla çevrelenmeyen yapýlar da bulunmakta ve bu yapýlar membransýz cisimcikler olarak adlandýrýlmaktadýr. Sývý-sývý faz ayýrýmý mekanizmasýyla oluþan bu cisimcikler, çekirdekte veya sitoplazmada oluþarak biyokimyasal süreçlerin hýzlý ve verimli olarak gerçekleþmesini saðlamaktadýr. Membransýz cisimciklerde farklý hastalýk gruplarýnda deðiþikliklerin saptanmasý nedeniyle, cisimciklerin yapý ve oluþumlarýnýn anlaþýlabilmesine yönelik araþtýrmalar son yýllarda hýz kazanmýþtýr. Bu derlemede fizyolojik ve patolojik süreçlerde oluþan membransýz cisimciklerin oluþum mekanizmalarý, yapýlarý ve görevleri özetlenmiþtir.

Biochemical processes occur in cellular compartments, called organelles, in eukaryotic cells. In addition to membrane-enclosed organelles, non-membrane bound structures, namely membraneless bodies, are also found in cells. These bodies are formed in nucleus or cytoplasm by liquid-liquid phase separation mechanism and ensure that biochemical processes take place rapidly and efficiently. Since, alterations have been detected in membraneless bodies in different disease groups, investigations about the structure and formation of bodies have been accelerated in recent years. In this review, the mechanism of formation and structures of membraneless bodies were summarized in physiological and pathological states.

GÝRÝÞ ve AMAÇ: Koroner revaskülarizasyon, aterosklerotik iskemik kalp hastalýðýnýn tedavisinde hayati bir role sahiptir. Koroner arter baypas greftleme (CABG) esas olarak kardiyopulmoner bypass (CPB) kullanýlarak yapýlýrken, 1990'larýn ortalarýndan beri kardiyopulmoner baypas (Of-pCABG) kullanýlmadan yapýlmaya baþlandý. Of-pCABG tekniði ile yüksek riskli ve yaþlý hasta gruplarýnda, postoperatif inotrop ve intraaortik balon pompasý kullanýmýnda azalma, kan kaybý ve kan transfüzyonunda azalma, böbrek yetmezliði, solunum sistemi problemleri ve atriyal fibrilasyonun rsiskini azalmasý ile mortalite ve morbidite oranlarýnýn da azalma görülür. Ayný zamanda postoperatif hastanede kalýþ süresini ve hastane maliyetlerini önemli ölçüde azalttýðý da gösterilmiþtir.
YÖNTEM ve GEREÇLER: 2018-2020 arasýnda of-pCABG tekniði ile izole koroner arter baypas yapýlan 260 hastanýn verileri retrospektif olarak incelenmiþtir. Cerrahi sýrasýnda kullandýðýmýz kardiyak stabilizasyon yöntemleri ve koroner arterlerin kontrol tekniklerini paylaþmak istedik. Erken dönem sonuçlarýmýzý bildirdik.
BULGULAR: Hastane içi mortalite oranýmýz %3.0 (8 hasta) iken, serebrovasküler hastalýk %2.3 (6 hasta) olarak görülmüþtür. Postoperatif hemodiyaliz ihtiyacý %2.6 (7 hasta) idi. Yoðun bakým ünitesindeki ortalama kalmak 2.3 (± 0.9) gün olarak hesaplanýrken, hastanede kalýþ süresi 9.7 (± 7.07) gündü.
TARTIÞMA ve SONUÇ: Konservatif CABG tekniðinden daha az invaziv olan of-pCABG tekniðinin, (çoklu koroner arter hastalýðýnda, düþük EF'li hastalarda akciðer hastalýðý, kronik böbrek hastalýðý gibi komorbid hastalarda) tatmin edici sonuçlarla uygulanabileceðini düþünüyoruz.

INTRODUCTION: Coronary revascularization has a vital role in treating atherosclerotic ischemic heart disease. While coronary artery bypass grafting (CABG) is mainly performed using cardiopulmonary bypass (CPB) with cardioplegic arrest, CABG has been started to be performed without using cardiopulmonary bypass (of-pCABG) since the mid-1990s. In high-risk patient and elderly patient groups, it has been reported that with of-pCABG, a decrease in the need for postoperative inotropes and the use of intra-aortic balloon pumps, a decrease in blood loss and blood transfusion, complications such as kidney failure, respiratory system problems, and atrial fibrillation, as well as mortality and morbidity are reduced. Additionally, off-pump CABG has also been shown to reduce the postoperative length of stay and hospital costs significantly.
METHODS: Data of 260 patients with isolated coronary artery bypass with the technique of Of-PCABG between 2018 and 2020 were retrospectively examined. We wanted to share the cardiac stabilization and coronary artery control techniques we used during surgery. We have reported our early results.
RESULTS: While our in -hospital mortality rate was 3.0 %(8 patients), cerebrovascular disease was seen as 2.3 %(6 patients). The need for postoperative hemodialysis was 2.6 %(7 patients). The average stay in the intensive care unit was calculated as 2.3(±0.9) days, while the remaining time in the hospital was 9.7(±7.07) days.
DISCUSSION AND CONCLUSION: We think that the of-pCABG technique, which is less invasive than the conservative CABG technique, can be applied with satisfactory results in multi-vessel diseases, patients with low EF, and comorbid patients (such as lung disease, chronic kidney disease, or failure).

GÝRÝÞ ve AMAÇ: Warfarin en sýk kullanýlan antikoagülan ilaçlardan biridir. En ciddi advers etkisi kanama olarak bilinmektedir. Warfarinin spontan intraserebral kanama hacmi ve mortaliteyle iliþkisini incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Spontan intraserebral kanama tanýsý olan 184 hasta retrospektif olarak taranarak çalýþmaya dahil edildi. Hastalar antikoagülan kullanmayan, warfarin kullanan, aspirin kullanan, hem warfarin hem aspirin kullanan olarak dört gruba ayrýldý. Hastalarýn morbiditeleri, demografik özellikleri, uluslararasý normalleþtirilmiþ deðer (INR), serebral hemoraji hacimleri, hemoraji lokasyonlarý, ventriküle açýlýmlarý ve mortaliteleri retrospektif olarak deðerlendirildi.
BULGULAR: Hastalarýn artan yaþý, diyabet ve dislipidemi hastalýklarý kanama hacmi ile anlamlý derecede iliþkilidir.(p<0,05) Ýntrraserebral kanamalar en fazla talamik ve lober bölgede olmuþtur. Warfarin kullanan grup hem ilaç kullanmayan hem de aspirin kullanan gruba göre daha fazla kanama hacmine sahiptir.(p<0,05)
TARTIÞMA ve SONUÇ: Warfarin kullanýmý toplumumuzda spontan intraserebral kanamalý hastalarda daha geniþ hacimli hemoraji ve daha yüksek oranlý mortalite ile iliþkilidir. Warfarin dozunun ayarlanmasýndaki zorluklar, ilaç ile gýda etkileþimlerine açýklýðý ve genetik farklýlýklardan kaynaklanmaktadýr. Bu sebeple warfarin kullaným öyküsü olan intraserebral kanamalý hastalara daha radikal yaklaþým tarzlarý geliþtirilmelidir.

INTRODUCTION: Warfarin is one of the most commonly used anticoagulant drugs. The most serious adverse effect is known as bleeding. We aimed to examine the relationship of warfarin with spontaneous intracerebral hemorrhage volume and mortality.
METHODS: 184 patients with a diagnosis of spontaneous intracerebral hemorrhage were retrospectively screened and included in the study. The patients were divided into four groups as those who do not use anticoagulants, use warfarin, use aspirin, and use both warfarin and aspirin. The morbidity, demographic characteristics, cerebral hemorrhage volumes, hemorrhage locations and mortality of the patients were evaluated.
RESULTS: Increasing age of the patients, diabetes and dyslipidemia diseases were significantly associated with bleeding volume. (p<0.05) Intracerebral hemorrhages were most common in the thalamic and lobar regions. The group using warfarin had a higher bleeding volume than the group using both drugs and aspirin.(p<0.05)
DISCUSSION AND CONCLUSION: Warfarin use is associated with larger volume hemorrhage and higher mortality in patients with spontaneous intracerebral hemorrhage in our population. Difficulties in adjusting the dose of warfarin are due to its vulnerability to drug-food interactions and genetic differences. For this reason, more radical approaches should be developed for patients with intracerebral hemorrhage who have a history of warfarin use.

GÝRÝÞ ve AMAÇ: Kliniðimizde semptomatik iliyak arter darlýðý veya týkanmasý olan ve stent implantasyonu ile revaskülarizasyonu saðlanan hastalarýn, stent açýklýk oranlarýný araþtýrmak. Restenoz saptanan hastalarda, stenozun olasý risklerini deðerlendirmek için hastalarýn demografik, anatomik ve yapýlan prosedürlerin özelliklerini deðerlendirmekti.
YÖNTEM ve GEREÇLER: Çalýþmaya Kocaeli Üniversitesi Hastanesi' nde iliyak arter darlýðý nedeniyle kritik bacak iskemisi veya medikal tedaviye yanýtsýz kladikasyo þikayeti nedeniyle iliyak artere stent implantasyonu yapýlmýþ olan hastalar alýnmýþtýr. Hedef damarda geçirilmiþ endovasküler giriþim, cerrahi revaskülarizasyon öyküsü, akut trombüs ve hedef damarda anevrizma gösterilen hastalar çalýþma dýþý býrakýlmýþtýr. Dýþlanma kriterlerine sahip olan hastalar çalýþma dýþý býrakýldýktan sonra geriye kalan toplam 58 hasta çalýþmaya dahil edilmiþtir. Çalýþmada stent açýklýðýnýn kaybý; doppler ultrasonografide akým hýzýnýn >2,4 kat artmasý, kontrastlý anjiyografide oklüzyonun gösterilmesi veya lümen içinde %50’ den fazla daralma olarak tanýmlanmýþtýr. Ýliyak stent takýlan hastalarýn demografik özellikleri, lezyon özellikleri, iþlem prosedürleri ve takiplerinde geliþen restenoz miktarý ve restenoza etki eden faktörler retrospektif olarak araþtýrýlmýþtýr.
BULGULAR: Hastalarýn klinik ve iþlem özelliklerine göre stent açýklýk oranlarý karþýlaþtýrýldýðýnda; ana iliyak artere stent implantasyonu yapýlan hastalarýn 26’ sýnda (%89,6), ana iliyak ve dýþ iliyaký kapsayan lezyonlarýn 8’ inde (%66,6), dýþ iliyak arter lezyonu olan hastalarýn ise 15’ inde (%100) takiplerinde restenoz saptanmamýþtýr (p=0,034). Çoklu stent takýlanlarýn 6’ sýnda (%54,5), tekli stent takýlanlarýn ise 43’ ünde (%95,5) restenoz saptanmamýþtýr (p=0,002). Diðer parametrelerde restenoz açýsýndan istatistiksel olarak anlamlý fark izlenmemiþtir.
TARTIÞMA ve SONUÇ: Ýliyak arter darlýklarýnda, her TASC grubu lezyonlarda, total týkalý lezyon olsun veya olmasýn revaskülarizasyon stratejisi olarak endovasküler giriþimlerin güvenli bir þekilde, yüksek baþarý oranlarý ile kullanýlabileceði gösterilmiþtir.

INTRODUCTION: We aimed to investigate the stent patency rates of patients with symptomatic iliac artery stenosis or occlusion and revascularized with stent implantation in our clinic and to define the demographic, anatomical and procedural characteristics of the patients to assess the possible risks of stenosis in patients with restenosis.
METHODS: We included 58 patients who underwent stent implantation to iliac artery due to claudication that decreased the quality of life at Kocaeli University Cardiology Clinic. Loss of stent patency was defined as 2,4-fold increase in flow velocity in Doppler ultrasonography, demonstration of occlusion in contrast-enhanced angiography or >50% stenosis of vessel lumen. Demographic characteristics, lesion characteristics, procedural procedures and the amount of restenosis developed in follow-up and factors affecting restenosis were investigated retrospectively.
RESULTS: When the stent patency rates were compared according to the clinical and procedural characteristics of the patients; restenosis was not detected in 26 (89,6%) patients with common iliac artery stent implantation, in 8 (66,6%) patients with lesions involving main iliac and external iliac artery and in 15 (100%) patients with external iliac artery stenting (p=0,034). In addition, restenosis was not observed in 6 (54,5%) of the patients with multiple stenting and 43 (95,5%) of those who had single stent (p=0,002). There was no statistically significant difference in restenosis in terms of other parameters.
DISCUSSION AND CONCLUSION: It has been shown that endovascular procedures can be safely used with high success rates as a strategy of revascularization in iliac artery stenosis, with or without a totally occluded lesion in each TASC group lesion.

GÝRÝÞ ve AMAÇ: Performans durumu, evre, yaþ, cinsiyet, kilo kaybý gibi klinik ve hastalýk iliþkili faktörler;halen kullanýlan sað kalým ile iliþkili faktörlerdir. Son yýllarda sað kalým üzerinde etkili yeni faktörlerin potansiyel etkileri araþtýrýlmaktadýr. Bunlardan birisi olan Tiroid Trankripsiyon Faktör-1( TTF-1), tiroid ve akciðer dokusundan salýnan bir nükleer proteindir, embriyogenezis süresince bu organlarýn geliþimi ve morfogenezisinde fizyolojik bir rol oynar.TTF-1’in tümör süpresör gen fonksiyonu olduðu düþünülmektedir.
AMAÇ: TTF-1’in saðkalým üzerine etkisini araþtýrmak
YÖNTEM ve GEREÇLER: 368 primer akciðer adenokarsinom tanýlý hasta dosyasý retrospektif olarak incelenmiþtir. Hastalarýn yaþ, cinsiyet, sigara öyküsü, TNM evresi, opere olanlarýn patolojik evresi, EGFR-ALK mutasyon varlýðý, KOAH varlýðý ve patolojik taný gibi verileri kaydedilmiþtir. Hastalarýn taný tarihi ve ölüm tarihi kaydedilmiþtir. 39 hasta opere edilmiþtir. Alýnan biyopsi örneklerinden immünhistokimyasal boyama yöntemi ile TTF-1 incelemesi yapýlmýþtýr. Hastalar TTF-1 pozitif ve negatif olmak üzere 2 gruba ayrýlarak incelenmiþtir.
BULGULAR: Bizim çalýþmamýzda akciðer adenokarsinom tanýlý hastalarda her bir evreyi ayrý ayrý TTF pozitif ve negatifliðine göre incelediðimizde sað kalým açýsýndan anlamlý fark saptanmadý fakat evreden baðýmsýz olarak deðerlendirildiðinde TTF-1 pozitifliðinin daha iyi sað kalýmla iliþkili olduðu literatürle uyumlu olarak gösterildi.
TARTIÞMA ve SONUÇ: Günümüzde akciðer adenokarsinomunda grade sistemi ve moleküler tiplendirmede ortaya çýkan geliþmeler ile hem tedavi hem de prognoz açýsýndan saðkalýmý olumlu etkileyen sonuçlar elde edilmekte ve bu açýdan çalýþmamýzýn bir torasik onkoloji ünitesinin belirli bir dönemi için verilerini demonstre etmesi anlamýnda literatüre katkýda bulunacaðýný düþünmekteyiz. Gelecek çalýþmalar, kötü prognozun moleküler mekanizmasý ve yeni tedavilerin tespitini araþtýrmak için desteklenmelidir.

INTRODUCTION: Thyroid Transcription Factor-1 (TTF-1), which is a nuclear protein that is released from thyroid and lung tissue, and which plays a physiologic role in the development and morphogenesis of these organs during embryogenesis. TTF-1 is considered to have a tumor-suppressor gene function.The present study investigates the effects of TTF-1 on survival.
METHODS: Primary lung adenocarcinoma were reviewed retrospectively, and data regarding the patients’ age, gender, smoking history, TNM stage, pathological stage in operated patients, presence of EGFR-ALK mutations, and pathologic diagnosis were recorded. Dates of diagnosis and dates of death were also retrieved from the medical records. Patients were categorized into two groups as TTF-1 positive or negative.
RESULTS: Our analyses revealed no significant difference in the disease stage in patients diagnosed with lung adenocarcinoma related to TTF positivity and negativity, although in line with the previous literature, TTF-1 positivity was found to be associated with better survival rates when analyzed irrespective of disease stage.
DISCUSSION AND CONCLUSION: Currently, advances in grading systems and molecular typing in cases of lung adenocarcinoma have had positive outcomes on survival, both regarding treatment strategies and disease prognosis, and we believe the present study may contribute to literature through its contribution of the data collected at a thoracic oncology unit over a specified period. Future studies should be supported that enlighten the molecular mechanisms underlying poor prognosis and novel treatment options in patients with lung adenocarcinoma.

GÝRÝÞ ve AMAÇ: Bu çalýþmada kliniðimize baþvuran paratiroid hastalarýnýn sosyo-epidemiyolojik verileri, preoperatif ve postoperatif laboratuvar deðerleri, görüntüleme özellikleri ile kliniðimizin paratiroid hastalýklarýný tedavi ederken uyguladýðý yaklaþýmlarýn ve sonuçlarýnýn retrospektif olarak incelenmesi amaçlandý.
YÖNTEM ve GEREÇLER: Bu çalýþmaya 2013-2018 yýllarý arasýnda paratiroid hastalýklarý nedeniyle Dicle Üniversitesi Týp Fakültesi Genel Cerrahi Ana Bilim Dalý’nda tedavi edilen 200 hasta dahil edildi. Bu hastalara ait klinik ve laboratuvar verileri hasta dosyalarýndan retrospektif olarak deðerlendirildi. Çalýþmaya paratiroid hastalýðý tanýsý almýþ ve tedavi seçeneði olarak cerrahi planlanan olgular dahil edildi.
BULGULAR: Çalýþmadaki 200 hastadan 33’ünün (%16.5) erkek, 167’sinin (%83.5) kadýn olduðu gözlendi. Ortalama yaþ 51.76 (18-93) idi. Ek tiroid hastalýðý bulunmayan 128 (%64) hastaya unilateral cerrahi yaklaþým ve lokal eksplorasyon ile sadece paratiroid adenom eksizyonu uygulandý. Ek tiroid hastalýðý olan 45 (%22.5) hastanýn 41’ine bilateral total tiroidektomi, 4’üne sol tamamlayýcý tiroidektomi uygulandý. Hastalarýn 182 (%91)’sinde patolojik taný paratiroid adenomu olarak raporlandý. Patolojik taný ile preoperatif USG bulgularý arasýnda 129 (%75.6) hastada, sintigrafi ile ise 110 (% 73.3) hastada uyum saptandý. Preoperatif yüksek olan serum PTH deðerine oranla, intraoperatif, postoperatif 1. gün ve 1. ay çalýþýlan PTH deðerinde anlamlý düþme olduðu görüldü (p<0.001). Preoperatif yüksek olan serum kalsiyum deðerindeki postoperatif 1. gün ve 1. ay sonundaki düþmenin istatistiksel olarak anlamlý olduðu tespit edildi (p<0.001). Ameliyat sonrasý dönemde bakýlan serum fosfor deðerlerindeki artýþýn istatistiksel olarak anlamlý olduðu gözlendi (p<0.05). Postoperatif dönemde 9 (% 4.5) hastada komplikasyon görüldü.
TARTIÞMA ve SONUÇ: Çalýþmamýzda paratiroid bozukluklarý tedavisinde, cerrahinin uygun preoperatif deðerlendirme ile deneyimli ellerde, dikkatli eksplorasyon yaparak, çok düþük komplikasyon oraný ile gerçekleþmesinin mümkün olacaðý gösterildi. Kýlavuzlara uygun olarak bu hastalýklarda öncelikle tercih edilmesi gereken tedavi yöntemi de cerrahi yaklaþým olmalýdýr.

INTRODUCTION: This study aimed to retrospectively evaluate the socio-epidemiological data, preoperative and postoperative laboratory values, and imaging characteristics of patients with parathyroid disorders, as well as our clinic’s approaches to treat parathyroid diseases and their outcomes.
METHODS: This study included 200 patients who were treated for parathyroid diseases at Dicle University Faculty of Medicine, Department of General Surgery between 2013 and 2018. The clinical and laboratory data of these patients were retrospectively obtained from their medical records. The study included patients who were diagnosed with parathyroid disease and intended for surgical treatment.
RESULTS: Out of 200 patients enrolled by the study, 33 (16.5%) were male and 167 (83.5%) were female. The mean patient age was 51.76 (18-93) years. Parathyroid adenoma excision with unilateral surgical approach plus local exploration alone was performed for 128 (64%) patients without accompanying thyroid disease, bilateral total thyroidectomy for 41 of 45 (22.5%) patients with accompanying thyroid disease, and left completion thyroidectomy for the remainder 4 patients with accompanying thyroid disease. The pathological diagnosis was reported as parathyroid adenoma in 182 (91%) patients. The pathological diagnosis was in agreement with preoperative USG in 129 (75.6%) patients and scintigraphy in 110 (73.3%) patients. There occurred a significant decrease in the PTH levels measured intraoperatively, on the first postoperative day, and at the first postoperative month compared with the preoperatively elevated serum PTH level (p<0.001). The decrease in preoperatively elevated serum calcium level on the first postoperative day and at the first postoperative month were statistically significant (p<0.001). The increase in serum phosphorus level at the postoperative period was statistically significant (p<0.05). Postoperative complications occurred in 9 (4.5%) patients.
DISCUSSION AND CONCLUSION: Our study showed that it is possible to perform surgery for parathyroid diseases with a very low complication rate, provided that an appropriate preoperative evaluation is performed and a careful exploration is carried out by experienced hands. In accordance with the current guidelines, surgical approach should become the preferred treatment method for the treatment of these disorders.

GÝRÝÞ ve AMAÇ: Yenidoðan yoðun bakým ünitelerinde (YYBÜ) sýklýkla kullanýlan osilometrik yöntem ile elde edilen kan basýncý deðerlerinin intraarteryel ölçüm deðerleriyle korele olup olmadýðý tartýþma konusudur. Biz bu çalýþmada intraarteryel ve osilometrik yöntemlerle ölçülmüþ sistolik (SKB), diyastolik (DKB) ve ortalama (OKB) kan basýncý deðerlerinin karþýlaþtýrýlmasýný; karþýlaþtýrma sonucunda anlamlý fark bulunmasý durumunda hangi parametrelerin bu farklýlýða neden olduðunun belirlenmesini hedefledik.
YÖNTEM ve GEREÇLER: Prospektif olan bu çalýþmaya, izleminde umbilikal arter kateterizesyonuna gerek duyulan 20 prematüre bebek (gebelik haftasý 25-37 hafta olan) dahil edildi. Beþ gün boyunca eþ zamanlý intraarteryel ve osilometrik yöntemlerle ölçülmüþ 400’er sistolik, diyastolik ve ortalama kan basýncý deðerleri, eþ zamanlý aldýðý ilaç tedavisi (inotrop, sedatif), solunum desteði, beslenme durumu, gebelik haftasý, doðum aðýrlýðý, kol çevresi, anne yaþý, surfaktan alýp almadýðý, eritrosit desteði,fototerapi alýp almadýðý, sepsis varlýðý, antenatal risk faktörleri kaydedildi.
BULGULAR: Osilometrik SKB, intraarteryel SKB’ye göre 2.61±6,84 mmHg anlamlý daha yüksek (p<0,001); osilometrik DKB intraarteryel DKB’ye göre -2,41±7,94 mmHg anlamlý daha düþük ve osilometrik OKB intraarteryel OKB deðerlerinden -3,02±6,84 mmHg anlamlý daha düþük (p<0,001) olarak saptanmýþtýr.
Osilometrik ve intraarteryel yöntem arasýndaki farklýlýðý etkileyen baðýmsýz deðiþkenler; SKB için sedatif kullanýmý (p=0,02 R²=0,33), DKB için inotrop alýmý (p=0,001), gebelik haftasý (p=0,005), vücut aðýrlýðý (p=0,001) ve surfaktan alýmý (p=0,014) olarak belirlenmiþtir. OKB’yi etkileyen baðýmsýz deðiþken bulunmamýþtýr.
TARTIÞMA ve SONUÇ: Osilometrik yöntem ile intraarteryel yöntem arasýnda anlamlý istatistiksel farklýlýk bulunmuþtur. Genel durumu kötü, hasta yenidoðanlarda umbilikal kateterizasyon aracýlýklý kan basýncý ölçümü tercih edilmelidir.

INTRODUCTION: It is a matter of debate whether the blood pressure values obtained by the oscillometric method, which is often used in neonatal intensive care units (NICU), correlate with intraarterial values. We aimed to compare systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure values measured by intraarterial and oscillometric methods;to determine which parameters cause difference if there is a significant difference.
METHODS: This prospective study included 20 premature newborns who were required umbilical artery catheterization during follow-up. 400 systolic, diastolic and mean blood pressure values that are simultaneously measured by intraarterial and oscillometric method for five days and also simultaneous received medication (inotrope, sedative), respiratory support, nutritional status, gestational age, birth weight, arm circumference, surfactant, erythrocyte support, phototherapy intake, sepsis, the presence of antenatal risk factors, vital signs, sleep-wake status were recorded.
RESULTS: Oscillometric SBP was significantly higher than intraarterial SBP by 2.61±6.84 mmHg (p<0.001), oscillometric DBP was significantly lower by -2.41±7.94 mmHg compared to intraarterial DBP, and oscillometric MBP was significantly lower by -3.02±6.84 mmHg than intraarterial MBP values (p<0.001).Independent variables affecting the difference between oscillometric and intraarterial methods were sedative use for SBP (p=0.02 R2=0.33), inotrope intake, gestational week (p=0.005), body weight (p=0.001) and surfactant intake (p=0.014) for DBP (p=0.001).There were no independent variables affecting MBP.
DISCUSSION AND CONCLUSION: A statistically significant difference was found between the oscillometric and the intraarterial method. Blood pressure measurement via umbilical catheterization should be preferred in sick newborns with poor general condition.

GÝRÝÞ ve AMAÇ: Bu çalýþmada, nötrofil-lenfosit oraný (NLO), platelet-lenfosit oraný (PLO), C-reaktif protein (CRP)/lenfosit oraný (CLO) ve CRP/albümin oraný (CAO) gibi inflamasyon belirteçleri ve tümör belirteçlerinin (karbonhidrat antijeni 19-9 [CA19-9] ve TNM evresi) opere olmuþ pankreas kanseri hastalarýnda saðkalýmý öngörmede kullanýlabilirliðinin araþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya, opere olmuþ 54 pankreas kanseri hastasý dahil edildi. Hastalarýn demografik özellikleri, taný anýndaki TNM evresi ve taný öncesi 1 ay içindeki inflamasyon belirteçleri (NLO, PLO, CLO ve CAO) ve CA 19-9 deðerleri ve saðkalým sonucu kaydedildi. Klinikopatolojik parametreler ve inflamasyon belirteçleri genel saðkalým süresi ve mortalite riski ile iliþkileri açýsýndan tek-deðiþkenli ve çok-deðiþkenli Cox-regresyon analizleri ile deðerlendirildi.
BULGULAR: Toplam popülasyonda genel saðkalým süresi 13 ay (%95 GA 0.80-25,1 ay) olarak bulundu. Ileri yaþ (HR 2,21, %95 GA 1,10-4,42, p=0,019) ve ileri T evresi (HR 2,33, %95GA 1,07-5,06, p=0,033) tek-deðiþkenli analizde mortalite riskinde artýþla iliþkisi gösterilen tek parametreler iken, çok-deðiþkenli analizde bu iki parametrenin saðkalým üzerindeki anlamlý öngördürücü etkisi doðrulanamadý (sýrasýyla, p=0,071 ve p=0,083). CA 19-9, NLO, PLO, CLO ve CAO dahil olmak üzere tümör veya inflamasyon belirteçlerinin hiçbirisinin saðkalým süresi veya mortalite riski üzerine anlamlý etkisi saptanmadý
TARTIÞMA ve SONUÇ: Sonuç olarak, bulgularýmýz opere olmuþ pankreatik adenokarsinoma hastalarýnda, preoperatif olarak ölçülen inflamasyon belirteçlerinin (örn. NLO, PLO, CLO ve CAO) veya CA 19-9 düzeylerinin saðkalým üzerine anlamlý bir etkisi olmadýðý yönündedir.

INTRODUCTION: This study aimed to investigate the utility of inflammation-based markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP)/lymphocyte ratio (CLR), CRP/albumin ratio (CAR) and tumor markers (carbohydrate antigen 19-9 [CA19-9] and TNM stage) in predicting survival outcomes among patients with operated pancreatic cancer.
METHODS: A total of 54 patients with operated pancreatic adenocarcinoma were included in this retrospective study. Data on patient demographics, TNM stage at diagnosis, the inflammation-based markers (NLR, PLR, CLR and CAR) and CA 19-9 values within 1 month prior to diagnosis and the final survival outcome were recorded. Clinicopathological parameters and inflammation-based markers were evaluated with respect to overall survival (OS) time and mortality risk using univariate and multivariate Cox-regression analyses.
RESULTS: OS time was 13 months (95% CI 0.80 to 25.1 months) in the overall study population. Older age (HR 2.21, 95% CI 1.10 to 4.42, p=0.019) and advanced T stage (HR 2.33, 95% CI 1.07 to 5.06, p=0.033) were the only factors associated with increased risk of mortality in the univariate analysis, whereas multivariate analysis did not confirm their predictive role on survival (p=0.071 and p=0.083, respectively). None of tumor or inflammation-based markers including CA 19-9, NLR, PLR, CLR and CAR had significant impact on survival time or mortality risk.
DISCUSSION AND CONCLUSION: In conclusion, our findings in patients with operated pancreatic adenocarcinoma revealed that none of the preoperatively determined inflammation-based marker ratios (i.e., NLR, PLR, CLR and CAR) or CA 19-9 had significant impact on survival outcome

Konjenital müsküler tortikollis, sternokleidomastoid (SKM) kasýn kontraksiyonu ve fibrotik bantlar ile karakterize, klinik görünüm olarak baþýn etkilenen tarafa, çenenin karþý tarafa doðru yönelimi þeklinde ortaya çýkan bir hastalýktýr.
Bu makalede, 25 yaþýnda erkek hasta, boynun sað kýsmýnda ele gelen gerginlik, baþýný ve boynunu düzeltememe, baþ ve boynun sað tarafa, çenenin sol tarafa doðru eðriliði þikayeti ile baþvurdu. Yapýlan fizik muayenede sað SKM boyunca uzanan sert, aðrýsýz, gergin bir bant þeklinde lezyon palpe edildi.
Hastaya konjenital müsküler tortikollis tanýsý konulup, sað SKM kasýnýn sternum ve klavikulaya yapýþan distal bölgesinde saptanan fibrotik bantlar elektrokoterle eksize edilerek unipolar serbestleþtirme yapýldý. Postoperatif boyun egzersizleri önerilen hastanýn 1. yýl takibinde baþ ve boyundaki fonksiyonel ve kozmetik problemin düzeldiði gözlendi.

Congenital muscular torticollis (CMT) is a disorder characterized by the contraction of the sternocleidomastoid muscle (SCM), which develops fibrous stripes, with clinical presentation of the head tilted towards the affected side and the face and jaw to the opposite side.
This is a case study of a 25-year-old male patient presenting with complaints of tension in the right side of their neck extending to the hand and an inability to move and correct the positioning of the head and neck or turn the head and neck towards the right side and the jaw towards the left side. Physical examination detected a palpable lesion extending along the right SCM in the form of a hard, painless and tense stripe.
The patient was diagnosed with CMT. Accordingly, the fibrous stripes detected in the distal right SCM adjacent to the sternum and the clavicle were excised by electrocautery, achieving unipolar release of the stripes. The patient was recommended neck exercises during the postoperative period, and after one year of follow-up, the patient had recovered from the functional and cosmetic problems in the head and neck.

GÝRÝÞ ve AMAÇ: Egzersize dayalý kardiyak rehabilitasyonun (CR), koroner arter hastalýðý (KAH) olan hastalarda kardiyovasküler (KV) morbi-mortaliteyi azaltabileceði gösterilmiþtir. Artan arteriyel sertliðin KAH'lý hastalarda morbi-mortalitenin baðýmsýz bir belirleyicisi olduðu gösterilmiþtir. Bu çalýþmada, stabil KAH'lý hastalarda, kardiyo-ayak bileði vasküler indeksi (CAVI) ile CR'nin arter sertliði üzerindeki etkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Doktorlarý tarafýndan Faz III KR programýna sevk edilen ayaktan 202 ardýþýk stabil KAH olan hasta ve KR programýný kabul etmeyen 96 stabil KAH olan hasta çalýþmaya dahil edildi. CAVI, VaSera VS-1000 (Fukuda Denshi Co. Ltd, Tokyo) tarafýndan hesaplandý. <0,05 p deðeri istatistiksel olarak anlamlý kabul edildi.
BULGULAR: Çalýþma popülasyonu (298 hasta), önce-sonra (Delta) CAVI deðerleri arasýndaki farka göre 3 eþit persentile göre gruplandýrýldý. Grup 1: 1-33 persentil arasýnda [Delta CAVI ≥ (-0,5)]; Grup 2: yüzde 34-66 arasýnda [Delta CAVI <(-0,5) - ≥ (-1,3)]; Grup 3: 67-100 persentil arasýnda [Delta CAVI < (-1.3)]. Çok deðiþkenli analizde, CAVI-pre (p: <0,001) ve CR'nin (p: <0,001) Delta CAVI'nin baðýmsýz belirleyicileri olduðu gösterildi.
TARTIÞMA ve SONUÇ: Bu çalýþma, egzersize dayalý CR'nin KAH'lý hastalarda arteriyel sertliði iyileþtirdiðini gösterdi.

INTRODUCTION: It was shown that exercise-based cardiac rehabilitation (CR) might reduce cardiovascular (CV) morbi-mortality in patients with coronary artery disease (CAD). Increased arterial stiffness has been shown to be an independent predictor of morbi-mortality in patients with CAD. In this study, we aimed to investigate the effect of CR on arterial stiffness by cardio-ankle vascular index (CAVI), in patients with stable CAD.
METHODS: We enrolled 202 consecutive stable CAD out-patients who were referred for Phase III CR program by their physicians and 96 stable CAD out-patients who did not have accept CR program. CAVI was calculated by VaSera VS-1000 (Fukuda Denshi Co. Ltd, Tokyo). A p-value of <0.05 was considered statistically significant.
RESULTS: Study population (298 patients) was divided into 3 equal percentile groups according to the difference of post-pre (Delta) CAVI values. Group 1: between 1-33 percentile [Delta CAVI ≥ (-0.5)]; Group 2: between 34-66 percentile [Delta CAVI <(-0.5) - ≥ (-1.3)]; Group 3: between 67-100 percentile [Delta CAVI < (-1.3)]. In multivariate analysis, it was shown that CAVI-pre (p: <0.001) and CR (p: <0.001) were independent predictors of Delta CAVI.
DISCUSSION AND CONCLUSION: This study showed that exercise-based CR improves arterial stiffness in patients with CAD.

GÝRÝÞ ve AMAÇ: Covid-19 pandemisinden sonra dünyada tüm saðlýk sisteminin yeniden düzenlenmesi gerekti. Bu olaðandýþý durumda, hýzlý çözümlere ihtiyaç vardý. Bu çalýþmada, 6 ileri yaþlý hastanýn lateral mandibular defektinin konservatif tedavisini araþtýrdýk ve bunlarýn temporomandibular eklem (TME) bozukluðunun fonksiyonel sonuçlarýný gözlemledik.
YÖNTEM ve GEREÇLER: Aðustos 2020’den Mayýs 2021’e kadar dört erkek ve iki kadýn hastaya 4 cm’den daha uzun lateral segmental mandibulektomi uygulandý. Defektler sadece rekonstrüksiyon plaðý ile onarýldý. Ameliyattan en az 6 ay sonra tüm hastalarýn TME fonksiyonu fizik muayene ile deðerlendirildi.
BULGULAR: Hastalarýn ortalama yaþý 70’di. Kemik defekleri 41 ile 70 mm arasýndaydý. Wilkes sýnýflamasýna göre, hastalar ipsilateral tarafta evre 1 ile 3 TME bozukluðuna sahipti. Tüm hastalarda kontralateral TME bozukluðu evre 1’di. Ayrýca defekt boyutu ile TME fonksiyonu arasýnda herhangi bir iliþki bulamadýk. (p>0,05)Tüm hastalar estetik sonuçlardan memnun kaldý.
TARTIÞMA ve SONUÇ: Lateral mandibula defektlerinin rekonstrüksiyon plaðý ile rekonstrüksiyonu erken postoperatif dönemde ciddi problemlere neden olmaz. Büyük lateral mandibular defektlerin konservatif tedavisinde “bekle ve gör” stratejisi yaþlý hastalarda pandemi gibi koþullarda tercih edilebilir.

INTRODUCTION: After Covid-19 pandemic, all the healthcare system components in the World must have been reorganized. In this extreme situation, there was a need for quick solutions. In this study, we researched the reconstruction with reconstruction plate of the lateral mandibular defect of six elderly patients and observed the functional outcomes of temporomandibular joint (TMJ) disorder of them.
METHODS: From August 2020 to May 2021, four male and two female patients underwent lateral segmental mandibulectomy with over 4 cm lenght. The defects were reconstructed with only reconstruction plate. At least 6 months postoperatively, TMJ function of all patients were evaluated using physical examination.
RESULTS: Mean age was 70 years. Bone defects were ranging 41 to 70 mm. According to Wilkes classification of TMJ internal derangement, the patients have been staged from 1 to 3 TMJ disorder on the ipsilateral side. On the contralateral side, all patients had only stage 1 TMJ disorder. We also did not find any correlation between the defect size and TMJ function. (p>0,05) All patients were satisfied with the aesthetic results.
DISCUSSION AND CONCLUSION: Reconstrruction of the lateral mandibular defects with reconstruction plates do not cause serious problems at early postoperative period. “Wait and see” strategy of conservative management of the large lateral mandibular defects is preferable in a pandemic condition for elderly patients.