INTRODUCTION: Lung cancer is one of the most common and deadly cancer types in the world. It is known that the duration and amount of smoking plays an effective role in the development of lung cancer. Lung cancer most often occurs in middle-aged and elderly adults and is less often among people under the age of 40 years. In our study we tried to explain clinicopathologic features of patients who has lung cancer under the age of 40 years.
METHODS: Between 2000 and 2015 patients who had lung cancer applied to Department of Medical Oncology of Trakya University Medical School were reviewed retrospectively and the patients who are under the age of 40 years were included to this study.
RESULTS: 15 patients who had eligibility criteria were evaluated.11 of 15 patients were male. 10 patients had smoking history. Over all survival was 7 months for the patients who had smoking history and 43 months for others.
DISCUSSION AND CONCLUSION: Our study has shown that smoking history can be a poor prognostic factor for patients diagnosed with lung cancer under the age of 40 years

INTRODUCTION: The aim of the study was to demonstrate the histopathological and ultrasonographic changes of endometrial tissue due to the tamoxifen use and to evaluate the affect of hypertension, obesity and diabetes mellitus on endometrial alteration.
METHODS: One hundred and twenty eight patients who were administered tamoxifen at Training and Research Hospital between 2007-2012 were included to the study. Patients were checked annually with transvaginal ultrasonography underwent endometrial sampling in case of endometrial thickness > 5 mm and/or uterine bleeding.
RESULTS: The mean time of tamoxifen treatment and the mean endometrial thickness were 4,43 years and 17,83 mm respectively at patients with endometrial cancer. Whenever compared with those cases without malignancy, the mean time of tamoxifen treatment and the mean endometrial thickness is 2,72 years and 9,3 mm respectively.
The specificity and the sensitivity of transvaginal ultrasonography at detecting endometrial pathologies are 76.5% and 88,3% respectively when cut-off value of endometrial thickness was accepted as 8,5 mm. When the cut-off value was accepted 9,5 mm, the sensitivity decreased to 83,3% and specificity increased to 82,4%.
DISCUSSION AND CONCLUSION: tamoxifen precipitates the development of endometrium cancer markedly in the patients with hypertension and diabetes mellitus. The increased duration of tamoxifen use is directly proportional with increasing risk of endometrial cancer. In patients with these risk factors, the sonographic follow-up criteria of endometrial thickness cut-off value should be accepted as 8,5 mm to obtain better result with higher sensitivity and specificity.

INTRODUCTION: Sperm cryopreservation is the process of sperm cryopreservation after spermatozoa procurement before IVF (In vitro fertilisation) or ICSI (Intra Cytoplasmic Injection) procedure. Sperm cyropreservation not only increased the success rate of assisted reproductive treatment methods in the order of but also contributed to future fertility preservation after chemotherapy-radiotherapy, or tescticular surgery etc. Aim of the study is to evaluate effect of cryopreservation methods on pregnancy rates.

METHODS: Data of 5 centres which have performs mean 30 ICSI procedure monthly were included in the study. Freezing method, medium, time, and spermatozoa vitality rates were collected in a data base. For statistiall analysis chi-square test was used.

RESULTS: Annual cryopreserved sperm using ratio were between 4.7-5%. Quick method were used in A,C and D centres. Slow method were used in B and E centres. Pregnancy rates for fresh and cryopreserved used sperm were not statistically significantly different for except for A and E centres (p=001 and p=0.04, respectively).

DISCUSSION AND CONCLUSION: In the present study we could not demonstrate a difference between different freezing methods on pregnancy rates. A possible explanation for this may be difference between included centres, heterogenity of patient population and lack of data on freezed spermatozoa quality.

INTRODUCTION: Cerebral arteriovenous malformation (AVM) is a common vascular disease in neurosurgery, and the indication for alternative treatments remains controversial. Cerebral AVM’s have different alternative treatments as conservative, endovascular, radiosurgery and microsurgical excision. Microsurgical excision is safer and may be best choice for appropriate patients.
The grading scale of Spetzler Martin has been the most widely used scale to predict the operability and surgical risks of AVMs because of its ease, simplicity and practicality. Careful selection of patients and planning of surgery are crucial for the good outcomes.
Developed AVM grading scales like help to predict the safety of treatment, but it doesn’t eliminate the need for careful preoperative planning. Despite having validated predictive value, SM grading system may be somewhat too simplistic for many occasions, and additional scales have been proposed. The objective of this abstract is to briefly discuss these aspects about AVM’s SM Grade III for a decision of surgery. Contrary to common belief, we have good outcomes in SM Grade III patients with the microsurgery.
METHODS: We studied 9 cases of SM Grade III AVM’s received surgical resection at our institution between 2010 and 2016. Spetzler-Martin grading system was used to classify the patients who underwent surgical treatment. Neurological outcome was assassed preoperative and postoperative with the Modified Rankin Scale.
RESULTS: Decision for the surgery and the role of neurosurgeon should be given by a neurovascular team. But it is not limited with the team, also the patient has a main role for the decision of treatment options.
DISCUSSION AND CONCLUSION: With careful patient selection, even high grade lesions, particularly those that have ruptured, may be good candidates for microsurgical treatment.

INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is the adviced technique for kidney stones sized 2 cm and above. We aimed to research success and safety of PCNL in the critical elderly patients who required postoperative intensive care and we investigated the needs of their intensive care unit.
METHODS: We included 116 ASA III patients undergoing PCNL in our university hospital urology department, between June 2013 and November 2016 and who were planned to be followed at intensive care unit (ICU) after surgery. PNL operations were performed under the general anesthesia. After cystoscopy patients were taken prone position then we entered into the kidney. We dilated the entrance with Amplatzer dilatators set until the 30F. The stones were taken out by the help of forceps We evaluated post-operative success of the surgery and the outcome of patients.
RESULTS: The mean age of totaly 116 patients (49 female, 67 male) was 65.1 ± 5.6 years. Mean stone size was determined as 2.4±0.9 cm2 with computerized tomography. Mean surgery time was 67.4±19.2 minutes. The most common causes of pre-operatively predicted ICU requirement were uncontrolled hypertension and/or heart failure (49 patients, 42.2%). The rate of patients who were fully stone-free after the surgery was 70.7% (82 patients). Sixteen patients (13.6%) required additional blood transfusion during post-operative period. Following the surgery, 65 patients (56%) were decided to be taken to the ICU by the anesthetist. No major complications including adjacent organ injury, sepsis or death occured.
DISCUSSION AND CONCLUSION: PNL is a successful and safe technique of surgery for the treatment of kidney stones over 2 cm size, even in critical patients with co-morbidities requiring postoperative ICU follow-up. All patients should be re-evaluated by the urologist and anesthetist just after the surgery regarding the need for postoperative ICU follow-up. It have to be considered that unnecessary ICU follow up will increase the costs.

INTRODUCTION: In this study, to evaluate the technical, hormonal, and gland factors in patients in whom different thyroidectomy techniques have been applied and it is aimed to find out the reasons which cause hypocalcemia.
METHODS: In a study which was conducted prospectively, 145 patients had been included that those patients had undergone surgery because of their benign or malignant thyroidal illnesses. According to the surgical method applied, the patients were categorized into three groups and their demographic information, the characteristics observed during their illness and operation, the postoperative findings, and serum parathormon (PTH) levels were analyzed from a statistical perspective.
RESULTS: Study cohort was consist of 118 female and 27 male patients. The average age of the patients were 45.03±13.5 years. A complication developed in the 34 of the 145 patients (23%). Temporary hypocalcemia was observed to be the most common complication which was seen in 22 (15%) patients. No meaningful difference among groups form the perspective of complication development rate had been found (p˃0,05); however, in group 3 (bilateral total thyroidectomy) the complication rates were higher. Patients in whom hypocalcemia developed, the early and late PTH values were significantly low (p ˂0,001). In multivariate analysis, the fact that the preoperative thyrotoxicosis, nerve dissection and preoperative PTH is near the upper limit, are effctive factors from statistical point of view (p<0.05).
DISCUSSION AND CONCLUSION: The factors which are effective in the development of hypocalcemia after thyroidectomy are: bilateral total thyroidectomy, the application of inoperatve nerve dissection, preoperative toxic goitre diagnosis, and that the preoperative PTH is near the upper limit. The levels of hypocalcemia can be reduced with the help of convenient preoperative preparation and correct surgical technique.

INTRODUCTION: Uroflow-EMG is a non-invasive test used in voiding dysfunction. We identified uroflow-EMG patterns in children who were diagnosed with voiding dysfunction in our study.


METHODS: We studied 90 patients who admitted in our hospital to the pediatric nephrology clinic between January 2016 and December 2016 and diagnosed of voiding dysfunction. All patients underwent a detailed voiding history and clinical assessment, urine and urine culture, lumbosacral radiography, urinary system ultrasonography and residual urine specimen with Uroflow- EMG was performed.
RESULTS: The mean age of the patients was 13.26 ± 2.81 years, 30 of them are male and 60 of them are female. When evaluated with Uroflov EMG, 42 (46.7%) staccato, 22 (24.4%) plateau and 16 (17.8%) intermittent voiding patterns were detected. Positive EMG activity was determined in 4 patients with normal voiding pattern in 10 patients.


DISCUSSION AND CONCLUSION: Voiding dysfunction is a common problem in children. The uroflow- EMG is a non-invasive and reliable test used in the diagnosis and treatment of the patient with voiding dysfunction.

INTRODUCTION: To evaluate the demographic data and treatment methods of patients with external auditory canal and the proporties of foreign bodies.
METHODS: In total, 233 patients (91 females 142 males; average age 13.04±15.48; range 3 months –72 years) who were diagnosed with foreign bodies in external auditory canal. All patients files were evaluated in terms of age, gender, the type, shape and color of foreign bodies, side of presentation, treatment protocols and complications.
RESULTS: Foreign bodies were detected in left ear in 104 patients (%44.6), in right ear in 118 patients (%50.6) and in bilateral in 11 patients (%4.8). The most common foreign bodies in external auditory canal are beads in 90 patients (%38.6), cotton buds in 39 patients (%16.7) and plastic toy parts in 36 patients (%15). Majority (%91.8) of foreign bodies has a color while %8.2 of foreign bodies are colorless (transparent). Fifteen (%6.4) of all patients required general anaesthesia for foreign body extraction in operating condition.
DISCUSSION AND CONCLUSION: Foreign bodies in external auditory canal are common among emergency problem in the field of otorhinolaryngology. Aural foreign bodies should be extracted by an experienced otorhinolaryngologist using suitable techniques and tools to prevent complications. Removal attemps by untrained health professionals and lack of experience in foreign body management induce to complications.

INTRODUCTION: Improving the pain management in vaginal birth is considered a cornerstone in reducing the cesarean delivery on maternal request. Epidural anesthesia is a commonly used technique with regard to its low complication rates, increase adaptation to birth process and not depressing the maternal central nervous system. In this study, it is aimed to compare the clinical findings of epidural analgesia in nulliparous women and to evaluate the effects on newborns.
METHODS: Nulliparous women who have administered epidural analgesia were followed and retrospectively compared to whom had no analgesia between May-December 2014. Augmentation has been performed when required. Obstetric data, birth weight and newborn APGAR scores were recorded. Statistical analyzes were performed with using descriptive statistics, Student-t test, Pearson Ch-square test, Yates (Continuity Correction) Chi-square test and Fisher’s exact tests.
RESULTS: 70 pregnancies were included to the study. Number of patients who were performed augmentation, duration of labor augmentation and the duration of first and second stage of labor were found statistically significantly higher in the epidural analgesia group. Statistical analyzes demonstrated similarity between groups with regard to vaginal/perineal lacerations, cesarean section rates, operative birth rates, side effects and the newborn APGAR scores.
DISCUSSION AND CONCLUSION: Maternal and fetal adverse effects of pregnants’ anxiety, panic and fear status should not be ignored. Routine administration of labor augmentation to pregnant women who are on epidural analgesia may be beneficial for reducing the duration of active labor. Epidural analgesia is considered safe for the newborns. It should be used more frequently for pain management with regard to enhancing the vaginal birth.

INTRODUCTION: Insufficient oral care causes dental problems which require dental treatment especially in childhood. The number of dental procedures performed in operating rooms increases every year. Sufficient data on the estimates of mortality and morbidity associated with anesthesia for dental surgeries is not available. In this study, we evaluate methods of anesthesia used in dental surgeries in pediatric patients performed in the operating room of our hospital.
METHODS: In this study we retrospectively evaluated patients in 103 dental surgeries performed in the operating room of our hospitals in January-February 2016. The patients were divided into two groups: general anesthesia group and sedation group. The factors influencing the decision about the anesthetic methods and the advantages/disadvantages of these two anesthetic methods were compared.
RESULTS: In our study 59 patients received general anesthesia and 44 patients had sedation. Demographics of the patients were similar among the two groups. Additionally no perioperative complications were seen in patients included in the study. Surgery types and mallampati scores were similar among groups, duration of surgery was statistically significantly more in the anesthesia group than the sedation group.
DISCUSSION AND CONCLUSION: We conclude that there is no superiority between general anesthesia and sedation when used in dental surgeries performed in operating rooms. Furthermore, we believe that estimated duration of surgery has an effect on the selection of the anesthetic method therefore sedation should be preferred for short dental procedures whereas general anesthesia should be preferred for dental procedures that are estimated to take longer.

INTRODUCTION: This study was conducted between June 1, 2012 and June 1, 2013 with the aim of evaluating patients who came to the of B Public Hospital's emergency room due to bites by animals suspected to have rabies.
METHODS: All 197 cases that came to the emergency room due to bite and contact with rabies-suspected animals were included in the study. The researcher obtained permission to analyze the Emergency Service Patient Evaluation Forms for these cases retrospectively, and the cases were evaluated considering their age, sex, residence, type of contact, area of contact, shape of wound, duration before coming to the health center after the contact and the administration of vaccination or immunoglobulin. In addition, the researcher determined the suspected animals, their types, and whether they had owners.
RESULTS: In the study sample, 67% of 197 cases were males. Their average age was 30.10± 22.11 years. Of them, 64.5% lived in the country. In 54.8% of the cases, owned animals were involved. An evaluation of the distribution of the cases showed that 55.8% were upper extremity injuries, while 22.3% were lower extremity injuries. The rest were distributed as 6.6% (head and neck) and 15.3% (body and gluteal area). Of all the cases, 77.7% came to the emergency center on the first day after contact, 21.3% waited 2 to 5 days before coming to the center, and 1% waited for more than five days. Of the bite victims who lived in the country, 63.1% had deep wounds, and 31.3% of the bite victims who lived in the city had deep wounds (p<0.001).
DISCUSSION AND CONCLUSION: All the bite victims who came to the emergency service were vaccinated. There was a high rate of contact with owned and monitorable animals at the hospital, which shows that animal control and vaccination are very important in Turkey.

Foreign body ingestion is a common condition. The majority of accidentally ingested foreign bodies is excreted from the gastrointestinal tract without any complications. But sometimes foreign bodies may lead to life-threatening complications such as obstruction and perforation. In this study, a patient with pyloric obstruction due to an apricot seed is presented. A 42- year-old male patient was admitted to cardiology with complaints of vomiting, chest pain and dyspneapatient was referred to our clinic after review for myocardial infarction. In his history, we learned that, he accidentaly swallowed an apricot seed 3 days ago. Pyloric obstruction due to an apricot seed which diameter within 3 cm was observed at endoscopic examination. Apricot seed was removed endoscopically. In This study, we aimed to examine management of ingested foreign bodies accompanied by current guidelines, define similar symptoms of myocardial infarction caused by pyloric obstruciton and the importance of history.

Lipomas are benign, encapsulated, mesenchymal neoplasms and they are derived from mature fat cells. They are often observed on back, shoulders and abdomen. Usually settles subcutaneous and don’t infiltration to surrounding tissues, are well sircumsicribed mass. Least part of the lipomas located in head and neck. Ethyology of the lipomas are unclear besides that the lipomas which located of head and neck can interfere the outher patologies of these region. In this article we aimed to present a sternocleidomastoid muscle lipoma interfered nodular goiter.

Splenic artery aneurysms are the most common in visceral artery aneurysms. It can be seen in all age groups, although more frequent in the 5th and 6th decades. It is usually asymptomatic and is detected incidentally. Rarely ýt can be a cause of portal hypertension and esophageal variceal hemorrhage may be its first finding. It is more common in women. It is is associated with portal hypertension pregnancy, atherosclerosis, DM, alpha 1 antitrypsin deficiency, connective tissue diseases and hereditary vascular diseases. Our aim is to demonstrate that splenic artery aneurysm may cause complications such as life-threatening rupture, esophageal variceal hemorrhage in relation to portal hypertension during pregnancy.

Endobronchial lipoma is an extremely rare benign tumor that originates from the fat cells located in the peribronchial and the submucosal tissue of main bronchi. They may be asymptomatic if present symptoms depend on the location of the tumor, the severity of bronchial obstruction. Radiological diagnosis is based on demonstrating fat density of the lesion. Bronchoscopic biopsies are frequently nondiagnostic due to the tumor’s thick fibrous capsule or may be confusing due to atypical cells are found secondary to chronic inflammation. Thus CT is extremely important in the diagnosis of endobronchial lipomas. A pedunculated homogeneous mass with fat density is encountered on computed tomography (CT) in a 75 year old man with rheumatoid arthritis. Herein we report MDCT and virtual bronchoscopy findings of endobronchial lipoma (EBL).

Rudimenter horn is one of the developmental anomalies of the uterus and pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. Pregnancy in the rudimentary horn increases the risk of rupture, abortus, ectopic pregnancy, preterm delivery, intrauterine growth retardation, developing complications such as malpresentation. In this case we aimed to present 18 weeks gestational rudimentary horn ruptured uterus and intraabdominal replacement of fetus with MRI.