GÝRÝÞ ve AMAÇ: Çalýþmamýzda tinnutusu olan hastalarda nötrofil lenfosit oraný (NLO) incelendi, ayrýca daha önceki tinnitus hastalarýný içeren çalýþmalarda bakýlmayan platelet lenfosit oraný (PLO), ortalama platelet hacmi (MPV), MPV/PLT oranýna bakýldý.
YÖNTEM ve GEREÇLER: Prospektif çalýþma, Aðustos 2015- Kasým 2015 tarihleri arasýnda Kahramanmaraþ Sütçü Ýmam üniversitesi KBB bölümüne baþvuran 65 tinnitus þikayeti olan hasta ve 65 kontrol grubundan oluþmaktadýr. Tam kan sayýmý parametreleri hemoglobin, eritrosit, lökosit, nötrofil, lenfosit, platelet sayýmý ve PLO ve NLO deðerleri hesaplandý. Hastalardan tinnitus handikap indeksi doldurulmasý istendi. Hastalar tinitus handikap indeksine göre 5 gruba ayrýldý.
BULGULAR: : Tinnituslu hastalarýn ortalama yaþlarý 47.95±11.82 idi. %55,6’ sý (35) kadýn, % 44,4’ si (28) erkek idi. Kontrol hastalarýnýn ortalama yaþlarý 47.5±11.83 idi. % 53.1’ i (34) kadýn, % 46.9’ u (30) erkek idi. Hasta grup nötrofil lenfosit oraný ile kontrol grup nötrofil lenfosit oraný arasýnda anlamlý bir farklýlýk saptanmamýþtýr. Ayný þekilde platelet lenfosit oraný ve MPV/ platelet oraný arasýnda anlamlý farklýlýk tesbit edilmemiþtir. (Sýrasý ile p deðerleri 0.213, 0.216, 0.262).
TARTIÞMA ve SONUÇ: Tinnitus sýk görülen etyolojisi multifaktöriyel olan bir semptomdur. Tinnitusu olan hastalarda literatürde yapýlan çalýþmalarda NLO anlamlý bulunmasýna raðmen bizim çalýþmamýzda bu oran anlamlý bulunamamýþtýr. Hasta grubunun sayýsýnýn yüksek tutulmasý bu oranýn anlamlý çýkmasý için bir etken olabilir.

INTRODUCTION: In our study neutrophil lymphocyte ratio (NLR) and also lymphocyte platelet ratio (LPR), mean platelet volume (MPV), MPV/PLT examined in patients those suffer from tinnitus.
METHODS: Prospective study. 65 patients those suffer from tinnitus and admitted to Kahramanmaras Sutcu Imam University ENT Department between August 2015- November 2015 is the first group and the second group is control group. Blood count parameters; haemoglobin, erytrocyte, leucocyte, neutrophil, lymphocyte, platelet count and, PLR, NLR examined. Patients were asked to fill out the tinnitus handicap index. Patients divided into five groups according to the tinnitus handicap index.
RESULTS: The mean age of the patient with tinnitus was 47.95±11.82. %55.6(35) was female, %44.4(28) was male. There was no significant difference between group1 and control group according to NLR. Likewise there was no significant difference between two groups according to PLR and MPV/PLT ratio. (p values 0.213, 0.216, 0.262)
DISCUSSION AND CONCLUSION: Tinnitus is a common symptom with multifactorial etiology. In previous researchs conducted in patients with tinnitus NLR found significant, but in our study the NLR was not statistically significant between two groups. Keeping the high number of patients is essential for the significant rise in the ratio.

GÝRÝÞ ve AMAÇ: Amplatz ve balon dilatatör kullanýmýnýn Modifiye Clavien derecelendirmesine göre komplikasyon oranlarýna etkisini karþýlaþtýrmak.
YÖNTEM ve GEREÇLER: Kasým 2008 – Aralýk 2015 tarihleri arasýnda böbrek taþý nedeniyle PNL yapýlan 206 hastaya ait kayýtlar retrospektif olarak gözden geçirildi. Tüm hastalar operasyon öncesi ayrýntýlý bir anamnez formu ile deðerlendirildi. Genel dahili muayenesi yapýldý ve sistemik hastalýk açýsýndan sorgulandý. Hastalar operasyon öncesinde hemogram, seroloji, kan biyokimyasý ve idrar kültürü ile deðerlendirildi. 119 hastaya balon, 97 hastaya amplatz dilatasyon uygulandý. Komplikasyonlar Modifiye Clavien sistemine göre karþýlaþtýrýldý.
BULGULAR: Basit böbrek taþý olup balon dilatasyon uygulanan 66 hastanýn 44’ünde, amplatz dilatasyon uygulanan 46 hastanýn 31’inde; kompleks taþý olup balon dilatasyon uygulanan 53 hastanýn 34’ünde, amplatz dilatasyon uygulanan 41 hastanýn 24’ünde hiçbir komplikasyon geliþmedi. Ýki grup arasýnda tüm alt derecelendirmeler dahil edildiðinde komplikasyonsuzluk oraný bakýmýndan anlamlý fark saptanmadý (p > 0,05). Alt gruplar incelendiðinde kompleks taþlarda yalnýzca derece 3b komplikasyonlar balon dilatatör kullanýlan grupta amplatz dilatatör kullanýlanlara göre anlamlý olarak daha az izlendi (p = 0,03).
TARTIÞMA ve SONUÇ: Modifiye Clavien derecelendirmesine göre tüm alt gruplar dahil edildiðinde amplatz ve balon dilatasyon yöntemlerinin komplikasyon oranlarý açýsýndan birbirlerine üstünlükleri izlenmemiþtir.

INTRODUCTION: Comparing balloon and amplatz dilatation complication rates according to Modified Clavien classification in percutaneous nephrolithotomy (PCNL).
METHODS: Records of 206 standard PCNLs performed between Nov 2008 and Dec 2015, were evaluated retrospectively. All patients were evaluated with a detailed medical history form preoperatively. General examination was held and interrogated in terms of systemic disease. Patients’s preoperative blood count, serology, blood biochemistry and urine cultures were evaluated. 119 patients underwent balloon, 97 patients underwent amplatz dilation. Complications were compared according to the Modified Clavien classification.
RESULTS: No complication was seen in 44 of 66 patients who underwent balon dilatation and 31 of 46 patients who underwent amplatz dilatation for simple kidney stones. Also no complication was seen in 34 of 53 patients who underwent balon dilatation and 24 of 41 patients who underwent amplatz dilatation for complex kindey stones. When all subgroups were included there was not any significant statistical difference seen between the two groups in terms of complication rates ( p > 0.05). Only in complex stone formers, degree of 3b complications were seen less in balloon dilatation group (p = 0.03 ).
DISCUSSION AND CONCLUSION: No superiority was observed in terms of complications between amplatz and balloon dilation methods when all subgroups were included according to Modified Clavien classification except degree 3b in the complex stone formers.

GÝRÝÞ ve AMAÇ: Laparoskopik kolesistektomi ameliyatlarýnda; trokar giriþ yerlerine ait insizyon hattýna preinsizyonel ve operasyon sonunda uygulanan levobupivakain infiltrasyonunun postoperatif dönemde hasta konforu, aðrý kontrolü ve analjezik ajan gereksinimlerine olan etkilerini karþýlaþtýrdýk.
YÖNTEM ve GEREÇLER: Laparoskopik kolesistektomi uygulanan ASA I-III, 19-65 yaþ arasýnda 80 hasta randomize olarak iki gruba ayrýldý. Laparoskopik kolesistektomi operasyonunda kullanýlan trokar giriþ yerlerine preinsizyonel levobupivakain infiltrasyonu uygulananlar Grup 1, insizyon hattý kapatýldýktan sonra levobupivakain infiltrasyonu uygulananlar ise Grup 2 olarak tanýmlandý.Hastalarda aðrý takibi postoperatif 0. dakika, 1., 4., 8., 12. ve 24. saatlarde VAS deðerleri ile yapýldý. VAS skoru ≥ 4 olan hastalara 0,5 mg kg-1 tramadol iv uygulandý. Her hastanýn ilk analjezik ihtiyacý zamaný ve 24 saatlik toplam tüketilen analjezik miktarý kaydedildi. Ek analjezik ihtiyacý 0-4., 4-12. ve 12-24. saatler arasýnda kaydedildi.
BULGULAR: Gruplar arasýnda ilk analjezik zamaný ve analjezik tüketimi açýsýndan istatistiksel olarak anlamlý farklýlýk gözlenmiþtir (p=0,024, p=0,044). Grup 1’de hastalarýn ilk analjezi gereksinimleri daha uzun süre sonunda gerçekleþmiþ olup toplamdaki opioid tüketimi daha azdýr. Ayrýca Grup 1’deki hastalarýn hasta memnuniyetinin Grup 2’deki hastalara göre daha yüksek olduðu görülmüþtür (p=0,041).
TARTIÞMA ve SONUÇ: Laparaskopik kolesistektomi ameliyatlarýnda 10 mL %0,25 levobupivakainin trokar giriþ yerlerine ait insizyon hattýna preinsizyonel infiltrasyonunun postoperatif analjezide etkin ve güvenli olduðunu, opioid gereksinimini azaltýp hasta memnuniyetini arttýrdýðýný gözlemledik.

INTRODUCTION: We compared the effects of preincisional versus endoperative levobupivacaine infiltration around trochar ports on pain control, analgesic requirements and patient satisfaction after laparoscopic cholecystetomy.
METHODS: Eigthy ASA I-III Laparoscopic cholescytectomy patients aged 19-65 were randomly assigned into two groups; levobupivacaine infiltration surrounding trochar ports was performed preincisionally in Group 1 and after closure of incision in Group 2. VAS scores were asked at 0., 1., 4., 8., 12 and 24. hours for postoperative pain evaluation. Intravenous 0.5 mg/kg tramadol was administered to the patients with VAS score ≥ 4. First analgesic requirement time and 24 hours total analgesic consumption were recorded for each patient. Additional analgesic requirements were noted at 0-4., 4-12. ve 12-24. hours.
RESULTS: Regarding first analgesic requirement time and total analgesic consumption, there was statistically significant difference between groups (p=0.024, p=0.044). First analgesic requirement was later and total opioid consumption was lower in Group 1. Patient satisfaction was also increased in Group 1(p=0,041).
DISCUSSION AND CONCLUSION: Preincisional infiltraton of 10 ml 0,25 levobupivacaine around trochar ports is an effective and safe method to obtain better results in sense of pain control, analgesic consumption and patient satisfaction after laparoscopic cholesistectomy surgery.

GÝRÝÞ ve AMAÇ: Malnutrisyon,insan metabolizmasýnda sistemik inflamasyon ile baþlayýp immun yetmezliðe dek uzanan klinik bir süreçtir.Biz bu çalýþmada gastrointestinal kanser tanýlý hastalarda anket yolu ile taný anýndaki nutrisyon durumunu deðerlendirmeyi planladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya 52 gönüllü hasta dahil edildi.Hastalar sadece gastrointestinal kanser tanýsý konmuþ hastalar olup,baþka bir sistem kanseri olanlar, tümör ameliyatý geçirenler, neoadjuvan tedavi alanlar çalýþma dýþý býrakýldý.Tüm hastalara MNA-SF formu uygulanýp vücut kitle indekslerine bakýldý.
BULGULAR: Hastalýklarýn evrelerine bakýlacak olursa taný anýnda malnütre ve malnütrisyon riski altýnda bulunan hastalýk oranlarý evre 1 de %50,evre 2 ‘de %77,8, evre 3’de %72 ve evre 4’de %100 olarak saptanmýþ olup istatistiksel olarak anlamlýlýk gözlenmemiþtir.Yine BMI ile malnütrisyon oranlarýný karþýlaþtýracak olursak, taný konduðu anda malnütre ve malnutrisyon riski altýnda olan hastalar; zayýf hastalarda %100, normal hastalarda %75, fazla kilolularda %76,2, obez hastalarda ise % 50 olarak saptanmýþ olup istatistiksel olarak anlamlýlýk gözlenmemiþtir.(p: 0,222)
TARTIÞMA ve SONUÇ: Gastrointestinal sistem kanserleri toplumda çok sýk görülen kanserlerdir.Taný konulunca en kýsa sürede nutrisyon durumu taranýp uygun besenme desteði baþlanmalýd

INTRODUCTION: Malnutrition is a clinical process that begins with a deficiency in immune system of human metabolism and dispreads through systematic inflammation.. We have planned a nutritional condition scanning with a simple scanning questionnaire for the patients who are diagnosed with gastrointestinal cancer.
METHODS: 52 voluntary patients were included in the research. Patients are the patients who had just received the diagnosis of gastrointestinal system cancer. Patients who had received neoadjuvant treatment, who had had a tumor operation and who has another type of cancer were excluded from the study. MNA-SF forms were applied to the patients, and their body mass indexes (BMI), were recorded.
RESULTS: When phases of the patients were taken into consideration, rates of illnesses with the risk of malnutrition at the time of diagnosis were 50% for first phase, 77,8% for second phase, 72% for third phase and 100% for fourth phase, and there is not any statistical significance. When we take a look at the comparison between BMI and malnutrition rates, patients who are under the risk of malnutrition; it is designated as 100% for weak patients, 75% for normal patients, 76,2% for over-weight patients and 50% for obese patients, and there is not any statistical significance (p: 0,222).
DISCUSSION AND CONCLUSION: Gastrointestinal system cancers are the cancers that are observed very frequently among the society. As soon as diagnosis was received by the patient, their nutritional conditions shall be evaluated with nutritional scanning and most appropriate nutritional support shall be provided for those patients.

GÝRÝÞ ve AMAÇ: Akut biliyer pankreatit(ABP) ataðý sonrasý tekrarlayan biliopankreatik olaylarý önlemek amacýyla definitif tedavi kolesistektomidir. Özellikle ABP vakalarýnýn %80 ini oluþturan hafif biliyer pankreatitte kolesistektominin zamanlamasý konusunda farklý yaklaþýmlar mevcuttur. Bu çalýþmamýzda, hafif biliyer pankreatit ataðý sonrasý erken(ilk yatýþta) ve interval (4 - 12 hafta sonra) dönemde laparoskopik kolesistektomi yapýlan hastalarýn sonuçlarýný karþýlaþtýrmayý amaçladýk
YÖNTEM ve GEREÇLER: Çalýþmamýzda, kliniðimizde Ocak 2010 – Aralýk 2014 tarihleri arasýnda kliniðimizde ABP tanýsý ile laparoskopik kolesistektomi uygulanan hastalar retrospektif olarak deðerlendirildi. Grup 1(n: 23), erken( ilk yatýþta) kolesistektomi yapýlan hastalar, grup 2(n: 54) geç( 4 – 12 hafta sonra) kolesistektomi uygulanan hastalardan oluþturuldu. Gruplar; demografik veriler, operasyon süresi, komplikasyon, mortalite ve tekrarlayan biliopankreatik olaylar açýsýndan karþýlaþtýrýldý.
BULGULAR: Çalýþmamýza hafif akut biliyer pankreatit tanýsý ile kolesistektomi uygulanan 77 hasta dahil edildi. Tedavi kýlavuzlarýna uygun olarak erken kolesistektomi hastalarýn sadece %29,8(23/77) uygulandý. Erken dönem (Grup 1) ve interval dönemde(Grup 2) kolesistektomi uygulanan gruplar arasýnda operasyon süresi, konversiyon ve komplikasyonlar açýsýndan istatistiksel anlamlý farklýlýk saptanmadý(sýrasýyla p: 0,210, p: 0,540, p: 0,307). Grup 2 de hastalarýn %14,8 inde ( 8/54) tekrarlayan biliopankreatik olaylar görüldü. Grup 1 de hastanede kalýþ süresi istatiksel anlamlý olmak üzere daha kýsa idi(p: 0,001).
TARTIÞMA ve SONUÇ: Hafif ABP ataðý sonrasý erken dönemde laparoskopik kolesistektomi yapýlmasý güvenli ve tekrarlayan biliopankreatik olaylarý önlemede etkin bir yaklaþýmdýr. Ancak ABP tedavisinde erken kolesistektomi klinik pratikte sýnýrlý sayýda hastaya uygulanmaktadýr. Bu yaklaþýmýn nedenleri ve bu sorunun giderilmesine yönelik öneriler sunan çalýþmalara ihtiyaç vardýr.

INTRODUCTION: After an attack of acute biliary pancreatitis (ABP) in order to avoid repetitive biliopancreatic events, the definitive treatment is cholecystectomy. In particular, different approaches to the timing of cholecystectomy in ABP which was constituted 80% of mild forms of pancreatitis. In this study, we aimed to compare the outcomes of patients after mild biliary pancreatitis attacks who underwent early (in the first admission) and late (after 4 - 12 weeks) laparoscopic cholecystectomy.
METHODS: In this study, patients who underwent laparoscopic cholecystectomy in our clinic between January 2010 and December 2014 with the diagnosis of ABP were retrospectively evaluated. Patients divided into two group; in group 1 (n = 23) early (in the first admission) cholecystectomy and in group 2 (n = 54) late (after 4 - 12 weeks) cholecystectomy was performed. Groups were respectively compared in terms of demographic data, operation time, complications, mortality and recurrence of biliopancreatic events.
RESULTS: In this study, patients who underwent laparoscopic cholecystectomy in our clinic between January 2010 and December 2014 with the diagnosis of ABP were retrospectively evaluated. Patients divided into two group; in group 1 (n = 23) early (in the first admission) cholecystectomy and in group 2 (n = 54) late (after 4 - 12 weeks) cholecystectomy was performed. Groups were respectively compared in terms of demographic data, operation time, complications, mortality and recurrence of biliopancreatic events.
DISCUSSION AND CONCLUSION: In mild ABP attack early period laparoscopic cholecystectomy is a safe and effective treatment choice for preventing recurrent biliopancreatic events. However, early cholecystectomy in the treatment of ABP is applied to a limited number of patients in clinical practice. New studies are need for the reasons of this approach and suggestions to fix this problem.

GÝRÝÞ ve AMAÇ: Endoskopi iþlemleri son yýllarda sedasyon altýnda yapýlmaktadýr. Biz bu çalýþmada endoskopik retrograt kolanjio pankreatografi uygulanacak hastalardaki monitorize anestezi bakýmýnda deksmedetomidin-propofol ve remifentanil-propofol protokollerini karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Grup deksmetedomidin-propofol’e 1 μg/kg deksmedetomidin 10 dk'da yükleme dozu uygulandýktan sonra 0.5 μg/kg/st deksmedetomidin infüzyonuna devam edildi. Grup remifentanil-propofol’e 0,2 μg/kg remifentanil 5 dk’da yükleme dozu uygulandýktan sonra 0,1 μg/kg/dk remifentanil infüzyonuna devam edildi. Her iki gruba eþ zamanlý olarak 3 mg/kg/st dozunda propofol infüzyonu baþlandý.
BULGULAR: Grup deksmetedomidin-propofol’de kalp atým sayýsý, sistolik arter basýncý, diastolik arter basýncý Grup remifentanil-propofol’den anlamlý derecede düþük saptandý (p<0,05). Buna karþýn Grup deksmetedomidin-propofol’de apne ve derlenme süreleri anlamlý derecede yüksek bulunmuþtur (p<0,05).
TARTIÞMA ve SONUÇ: Monitorize anestezi bakýmýnda remifentanil-propofol ve deksmedetomidin-propofol kombinasyonlarý uygulanabilir protokollerdir. Fakat monitorize anestezi bakýmýnda hangi ilaç kombinasyonu kullanýlýrsa kullanýlsýn genel anestezi hazýrlýðýnýn tam olmasýnýn hayati öneme sahip olduðu kanaatindeyiz.

INTRODUCTION: In recent years endoscopic procedures are being under sedation. In this study we aimed to compare deksmedetomidine –propofol vs. remifentanyl-propofol sedation at monitored anesthesia care on patients who underwent endoscopic retrograde cholangio pancreatography procedure.
METHODS: In the deksmedetomidine –propofol group deksmedetomidine loading dose of 1 mg/kg was administered in ten minutes. Following the loading dose, deksmedetomidine infusion rate of 0,5 mg/kg/hr was continued. In the remifentanyl-propofol group, remifentanyl loading dose of 0,2 μg/kg was administered in five minutes and infusion of 0,1 mcg/kg/dk was continued. In both groups patients were given 3 mg/kg/hr of propofol infusion
RESULTS: We found a significantly lower heart rate, systolic arterial pressure, diastolic arterial pressure in group deksmedetomidine –propofol. But controversly, apne and recovery times were found significantly higher in group deksmedetomidine –propofol than group remifentanyl-propofol.
DISCUSSION AND CONCLUSION: At monitored anesthesia care, both deksmedetomidine –propofol and remifentanyl-propofol sedation protocols are applicable. But in any case all equipments must always be ready to be able to give general anesthesia for the patient in order to control safety.

GÝRÝÞ ve AMAÇ: Bu çalýþmadaki amacýmýz ilk altý ay içerisinde geriye dönük elde ettiðimiz giriþimsel nöroloji verilerinin analizini yapmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 2015 yýlý Temmuz ayý ile 2016 yýlý Þubat ayý arasýnda inme merkezine ardý sýra baþvurmuþ hastalar alýndý. Baþvuru þikâyetleri, demografik verileri, nöro-görüntüleme özellikleri, anjiyo bulgularý ve klinik özellikleri kayda alýndý.
BULGULAR: 74 hastaya anjio yapýldý. Beþ hastaya karotis stentleme (bir hastaya ayný seansta hem ektrakraniyal hem intrakraniyal stentleme) yapýldý. Anevrizma vakalarýndan ikisine anevrizma koilleme, dördüne akým yönlendirici stentleme yapýldý. 10 hastaya IV trombolitik, iki hastaya IV trombolitik artý mekanik trombektomi uygulandý.
TARTIÞMA ve SONUÇ: Bu çalýþmada inme merkezimizin ilk altý aylýk dönemde aktif olarak hizmete geçtiði görülmektedir.

INTRODUCTION: The aim of this study is to analyze the data we obtain retrospective interventional neurology in the first six months.
METHODS: We admitted patients between February 2015 and July 2016. Symptoms, demographic data, neuro-imaging features, angiography findings and clinical characteristics were recorded.
RESULTS: Angiography was performed to the 74 patients. Carotid stenting was performed to five patients (a patient had both extra-cranial and intra-cranial stenting in the same session). Two patients had aneurysm coiling and four patients had flow-diverter stenting for their aneurysms. We gave IV thrombolysis to 10 patients and two patients underwent mechanical thrombectomy plus IV thrombolysis.
DISCUSSION AND CONCLUSION: In this study it observed that the first six months of the stroke center is now in active service.

Rizozomal kondrodisplazi punktata (RKDP) lipid biyosentezi için gerekli olan peroksizomal genlerdeki mutasyonlar sonucu geliþen bir hastalýktýr. Etkilenen hastalarda proksimal olarak kýsa ekstremiteler, epifizyal punktat kalsifikasyon, bilateral katarakt, büyüme ve geliþme geriliði karakteristiktir. Hastalarýn büyük çoðunluðu RKDP tip 1, %5 civarý ise tip 2 veya 3 tür. Bu makalede RKDP tip 3 tanýlý, rehabilitasyonu ihmal edilmiþ 9 yaþýndaki erkek çocuðu sunduk. Makalemizde, yapýlan küçük bir rehabilitatif giriþimin kiþinin fonksiyonelliðine çok fazla katkýda bulunduðunu göstererek rehabilitasyonun önemini vurgulamak istedik.

Rhizomelic chondrodysplasia punctata (RCDP) is a disorder resulting from mutations in peroxisomal genes essential for lipid biosynthesis. Affected patients have characteristic features like proximally shortened limbs, epiphyseal punctuate calcification, bilateral cataracts, growth and developmental delays. The majority of patients have RCDP type 1, around 5% have RCDP type 2 or 3. In this paper we report a case of 9 years old male child diagnosed as RCDP type 3 whose rehabilitation was ignored. We would like to emphasize the importance of rehabilitation which even a slight intervention of rehabilitation can contribute a lot to his functionality.

Periferik arteryel dolaþým bozukluklarý günümüzde önemli bir morbidite ve mortalite nedenidir. Ekstra-anatomik baypas operasyonlarý ekstremite kurtarýlmasý için yüksek riskli hasta gruplarýnda tercih edilebilen alternatif yöntemlerdir. Bu olgu sunumunda, ileri evre Kronik obstruktif akciðer hastalýðý ve istirahat dispnesi, geçirilmiþ torakal aort operasyonu ve geçirilmiþ lomber disk hernisi operasyonunun eþlik ettiði kronik aortoiliyak týkayýcý arter hastalýklý, lokal ve tümesan anestezi eþliðinde ekstra-anatomik baypas grefti operasyonu uyguladýðýmýz 54 yaþýndaki erkek hastayý sunmayý amaçladýk.

Peripheral arterial circulatory disorders is an important cause of morbidity and mortality today. Extra-anatomic bypass operations in patients which have high risk for limb salvage are alternative methods that may be preferred. In this case, we aimed to present a 54 year-old male patient who underwent extraanatomic bypass graft surgery for chronic aortoiliac occlusive arterial disease under local and tumescent anesthesia because of to accompany with advanced stage chronic obstructive pulmonary disease and resting dyspnea, previous thoracic aortic surgery and migrated lumbar disc hernia operations.

Tekrarlayan polikondrit, kýkýrdak ve bað dokunun destrüksiyonu ve inflamasyonu ile seyreden nadir kronik otoimmün bir hastalýktýr. Hastalýðýn klinik özellikleri aurikuler, nasal ve trakeal kartilajýn kondritini;odyovestibüler disfonksiyonu; oküler inflamasyonu; vasküliti; myokarditi ve non-eroziv artriti içermektedir. Bu makalede otolarengoloji kliniðimize her iki kulakta aðrý, ödem, eritem þikayetleri ile baþvuran 54 yaþýnda bayan hasta sunuldu

Relapsing polychondritis is a rare chronic autoimmune systemic disease that presents with destruction and inflammation of cartilaginous and connective tissues. Clinical features of the disease include chondritis of the auricular, nasal, and tracheal cartilages; audiovestibular dysfunction; ocular inflammation; vasculitis; myocarditis and nonerosive arthritis. In this paper a 54-year-old woman who presented to our otolaryngology clinic with complaints of pain, eritema, edema on both auricules are reported.

Serebral venöz sinüs trombozu (CVST) arteryal sisteme göre daha nadir görülen bir inme tipidir. 35 yaþýnda kadýn hasta CVST tanýsý aldý. Standart antikoagülasyon tedavisinden fayda görmedi. Kliniði kötüleþme gösteren hastaya endovasküler müdahale uygulandý. Yeterli antikoagülasyona raðmen özellikle yaygýn, þiddetli trombozu olup hýzlý klinik kötüleþme gösteren hastalarda endovasküler müdahalenin can kurtarýcý olabileceðini göstermek amacýyla sunulmuþtur.

Cerebral venous sinus thrombosis (CVST) is a less common stroke type compared with arterial system. 35-year-old female patient was diagnosed CVST. She did not benefit from standard anticoagulation therapy. When clinical signs of patients worsened she underwent endovascular intervention. We aimed to show patients who show rapid clinical deterioration despite adequate anticoagulation, endovascular intervention can be life-saving.

Subaraknoid kanama kanýn subaraknoid mesafeye daðýldýðý patolojik bir durumdur ve orta-ileri yaþ grubunda önemli bir morbidite ve mortalite nedenidir. Subaraknoid kanamalý bir hastanýn tedavisinde primer hedef anevrizma kesesinin tamamýnýn, rezidü býrakmadan güvenli bir þekilde oklüde edilmesidir. Ancak yalnýzca anevrizma kesesini oklüde etmek yeterli olmayýp subaraknoid kanamaya baðlý meydana gelen komplikasyonlarda dikkatlice tedavi edilmelidir. Anevrizma tedavisinde hastalarýn monitörize edilerek yakýn bir þekilde takip edilmesi ve bu komplikasyonlarýn geliþmesi halinde erken taný konularak müdahale edilmesi postop morbidite ve mortalite oranlarýný büyük oranda azaltacak ve baþarý oranýný arttýracaktýr.

Subarachnoid hemorrhage is a pathologic condition that exists when the blood spread through the subarachnoid space and it is an important cause of morbidity and mortality in middle-age group. Primary goal in the treatment of patients with subarachnoid hemorrhage is to occlude the aneurysm sac entirely and safely without leaving a residue. However, it is not adequate the occlusion of aneurysm sac but also the complications that occurs due subarachnoid hemorrhage should be treated carefully. Morbidity and mortality rates will decrease greatly, if close miniaturization and early intervention is done for the patients of aneurysms to prevent postoperative complications.