Aim: Total thyroidectomy is one of the surgical procedures that may be chosen in benign thyroid diseases. In our study we aimed to evaluate total thyroidectomy surgery in terms of its complications in Van – Muradiye region where endemic thyroid diseases are reported and to discuss by determining incidentally detected thyroid carcinoma rates. Material and Method: Age, sex, surgery indications, transient-permanent hypoparathyroidism, rates of temporary-permanent vocal cord paralysis were recorded from the files of patients who had total thyroidectomy surgery due to benign thyroid diseases between 2003 and 2010 in Van, Muradiye region. The incidence of thyroid carcinoma was determined from the post-operative pathology reports. Result: 208 patients who underwent total thyroidectomy due to their benign thyroid diseases were included in our study. When it was evaluated with regards to early period complications, post-operative hematoma was developed in one (0.48%) patient. Transient hypoparathyroidism and permanent hypoparathyroidism were detected respectively in 24 (11.53%) patients and in 1 (0.48%) patient. When it was evaluated with regard to vocal cord paralysis, while temporary vocal cord paralysis was detected in one (0.48%) patient, permanent vocal cord paralysis was not detected in any patient. Incidental thyroid carcinoma was reported in 23 (11.0%) patients. Discussion: When we consider that incidental thyroid cancer may be observed more frequently in endemic areas and its higher recurrence rates, we suppose that total thyroidectomy should be the method applied in benign thyroid diseases.

Aim: In this study, Lepidium sativum L.'s cytoprotective effects on pulmonary fibrosis was investigated in bleomycin (BLM)-induced rats. Methods: Rats were classified into 4 groups each group containing 8 rats. The first group was defined as the control group. In the second group, BLM was applied intratracheally as a single dose of 7,5 mg/kg. In the third group, in addition to the BLM, the metanol extract of Lepidium sativum L. was orally applied daily in 20 mg/kg dose for 30 days. In the fourth group, in addition to the BLM, the water extract of Lepidium sativum L. was orally applied daily in 20mg/kg dose for 30 days. Results: When control group was compared with the other groups, significant increase of fibrosis grade was determined in BLM-induced group (p<0.01). Comparing of water and methanol extract of Lepidium sativum L. with control group reveals that, grade of fibrosis is significantly higher in both groups than control group (p<0.01). However comparing of water and methanol extract of Lepidium sativum L. with BLM group was showed that, grade of fibrosis is significantly lower in both groups than the BLM group (p<0.01 ). Comparing of water extract of Lepidium sativum L. with methanol extract of Lepidium sativum L. did not show significant difference. Conclusion: The application of Lepidium sativum L. extract in pulmonary fibrosis in BLM- induced rats, can decrease grade of fibrosis. The cytoprotective effect of Lepidium sativum L. can be explained with strong anti-oxidant effect as obstructing the free oxygen radical formation or eliminating from the environment.

Aim: In the present study; by analyzing the data of patients with tubo-ovarian abscess, we aimed to discuss the predisposing factors, clinical and laboratory results, operations that were performed and their outcomes. Material: We retrospectively reviewed the medical records of 38 patients who were surgically managed for tubo-ovarian abscess in two referral hospitals between January 2011 and December 2012. We analyzed the data including; demographic and clinical features at admission, predisposing factors for TOA, laboratory results, surgical methods and complications. Results: Median age of the patients was 32.4 years. During admission, all patients reported abdominal pain, 76.3% had fever, 34.2% had malodorous vaginal discharge. Of the patients; 47.3% were detected to have an intrauterine device, 23.6% had a history of previous pelvic inflammatory disease, 13.1% had diabetes mellitus, 10.5% had a history of surgical abortion within a period of 2 months before their admission, and 7.9% had a history of intra-abdominal operation within 1 month before admission. Leukocytosis was detected in 94.7% of the patients and all had elevated CRP levels within the first hour. The most commonly isolated microorganism was Escherichia coli. Laparoscopy was performed in one patient while remaining of the patients underwent laparotomy. We performed unilateral salpingoopherectomy in 21 patients, bilateral salpingectomy in 3 patients, total abdominal hysterectomy and bilateral salpingoopherectomy in 6 patients, and abscess drainage in 8 patients. Conclusion: Early diagnosis and management of tubo-ovarian abscess is important due to its impact on morbidity and mortality. Organ-preserving surgery may be performed in women who have fertility desires.

Aim: Heme oxygenase 1 is derived from alveolar macrophages and serves in the lung as a protective anti oxydant enzyme, reserves heme three antioxydant and anti-inflammatory final product; bilirubin, carbon monoxide and iron. The aim of our study was to examine Heme oxygenase 1 enzyme latest products in Chronic Obstructive Pulmonary Disease patients according to stages. Methods: The study included a total of 76 cases; 55 patients with Chronic Obstructive Pulmonary Disease and 21 volunteers older than 40 years old with normal lung function tests. Complete blood count, total bilirubin and serum iron levels were determined. Spirometric tests included forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/FVC rate. Patients were classified as mild, moderate, severe and very severe according to Postbronchodilator FEV1 values. Results: The control and study groups displayed no statistically significant differences in terms of bilirubin and iron levels, and iron binding capacity. Bilirubin levels were increased with increasing stage of Chronic Obstructive Pulmonary Disease among themselves, no statistically significant difference was detected. Iron levels were significantly decreased while the stage of Chronic Obstructive Pulmonary Disease increased. Conclusion: Increased Chronic Obstructive Pulmonary Disease stage with decreasing iron levels could point to decreasing Heme oxygenase 1 enzyme levels. Further studies on this subject are necessary.

At the present day, gradually increasing resistance to antimicrobial agents utilised for infections related to gram negative bacilli have become an important healthcare problem in our country, as in the whole world. This situation requires to develop new antimicrobial agents. Objective: Tigecycline is one of the last recent developed antimicrobial agents. It is the first member of glycilcycline group of drugs. Material and methods: In this study, that planned to search sensitivity of tigecycline on 50 Gram negative bacilli, 25 of them Escherichia coli, 25 of them Klebsiella spp, isolated from different clinical specimens in Fırat University Microbiology Laboratory. While antimicrobial susceptibility of these strains were determined with disc diffusion method, tigecycline susceptibility was tested by broth microdilution method. Results: 100% of 25 Escherichia coli, 100% of 25 Klebsiella spp strains tested were detected susceptible to tigecycline. Conclusion: At the end of our study it was found that tigecyclin had better in vitro efficiency on E. Coli and Klebsiella species than beta lactam antibiotics,aminoglycozides, or fluoroquinolones.

Aim: Surgical removal is the gold standart treatment for renal cell carcinoma. In recent years laparoscopic radical nephrectomy has taken the place of open radical nephrectomy. In this study we compared the surgical margin positivity between laparoscopic and open radical nephrectomy performed in our clinic. Methods: We retrospectively analayzed the data from 139 patients who underwent radical nephrectomy between January 2005 and August 2009. Open radical nephrectomy was performed through a subcostal incision. Laparoscopic nephrectomy was performed by use of the transperitoneal approach in all cases. Results: Ninety-four patients underwent open radical nephrectomy and 45 patients underwent laparoscopic radical nephrectomy . There were no statistically significant differences between the two groups in the patients’ demographical data and pathological specimen. The surgical margin positivity was observed in 5 of 94 cases (5.4%) at ORN group and none of the 45 cases in LRN group (p: 0.17). But this result was statistically incoherent. Conclusion: LRN represents a safe surgical option about surgical margin positivity for RCC patients.

hepatic hemangioendothelioma (IHH) is a benign vascular tumor of infancy and early adolescence. Most cases present in the first 6 months. We aimed to introduce our case following the opinion that clinically the formation of such serious complications as liver rupture, heart failure, jaundice, consumptive coagulopathy and liver masses of infancy age should be taken into consideration in the differential diagnosis. Our case, a four day old baby girl, was admitted to Harran University Faculty of Medicine, Child Surgery Clinic with the complaints of abdominal distention and jaundice. On USG, color Doppler USG and CT scanning, a mass was seen in the right lobe posterior of the liver. The mass was totally removed through right lobectomy. On the gross examination of the material, was found a neoplastic tissue of 7,5x5 cm, having no capsule but bleeding and necrotic changes in the center. On microscopic examination, the lesion was composed of small vessel structures lined by plumper endothelial cells and normal appearance bile ducts. Extramedullary hematopoesis and thrombus were seen in some of the vessels. The endothelial cells were stained with Factor VIII, CD31 and CD34 on immunohistochemical examination. The case was regarded as IHH on account of these findings. Most commonly seen in the first six months of life and likely to cause serious complications, this neoplasm needs to be taken into consideration in the differential diagnosis of the liver tumors of the infancy age.

Hypercalcemia secondary to malignancy is common. It can be due to invasion of bone by tumor cells or may develop secondary to humoral hypercalcemia of malignancy. Cholangiocarcinoma is a rare cancer, with an incidence of 1 to 2 cases per 100.000 population. Cholangiocarcinoma can develop anywhere within the biliary tract. Peripheral cholangiocarcinoma is a rare form of the disease. When delta hepatitis is found, it is even more difficult to distinguish these tumors from hepatocellular carcinoma. Humoral hypercalcemia is a rare condition in Cholangiocarcinoma. Herein we report a case of intrahepatic cholangiocarcinoma in a hypercalcemic patient with delta hepatitis. Coexistance of delta hepatitis and cholangiocarcinoma is very rare. The possibility of cholangiocarcinoma should be considered in all patients with delta hepatitis.

Objective: Acute infantile hemorrhagic edema is an acute cutaneous leucocytoclastic vasculitis that can be seen in infancy and characterized by fever, palpable purpura and edema. Although it presents with severe symptoms; clinical course is benign and the disease resolves in a short time. Case report: In this report, two cases are presented that were admitted with cutaneous purpuric rash and edema of the extremities and, subsequently diagnosed as acute infantile hemorrhagic edema. Conclusion: We emphasize that acute infantile hemorrhagic edema should be kept in mind in the differential diagnosis of Henoch-Schonlein purpura, meningococcemia, and purpura fulminans.

Urachal carcinoma is an extremely rare tumor, comprising 0.17-0.34% of all bladder tumors. Most of the histopathological diagnosis is adenocarcinoma in this group of tumor. A 26-year-old man complaining of macrohematuria admitted to our institute. Ultrasonography, computed tomography and cystoscopy demonstrated a tumor at the bladder dome. Transurethral resection was performed. Adenocarcinoma was determined at the hystopathologic examination of the specimen. Patient has been alive and disease free for 10 months when this case was reported. Because of younger age and lack of distant metastases at the time of the diagnosis, the present case is found worth reporting.

The angiographic incidence of the coronary artery aneurysm is reported to be between 1.5% to 4.9%, and it is more frequent in males. The aneurysm of left main coronary artery is a rare entity. We present and discuss a 66-year-old male patient with unstable angina pectoris in whom a huge left main coronary artery aneurysm was observed in the coronary angiography.

Ichthyoses are a heterogeneous group of cornification disorders affecting the skin and characterized by hyperkeratosis. Lamellar ichthyosis (LI) is a form of them. The incidence of LI inherited autosomal recessive is 1 per 300000 live births. The diagnosis is based on clinical data and analyses including skin biopsies and genetic results. Therapy includes moisturizing of the skin, restriction of fluid loss and keratolytics. Oral retinoids have a benificial effect in LI, but do not alter the underlying defect. Herein, a premature newborn with LI is reported because of its rare occurrence and very good response to oral retinoid therapy.

Gray scale ultrasonography, color and power Doppler US are the first examination techniques in the diagnosis of hepatocellular carcinomas. The characterisation of hepatocellular carcinoma usually relies on dynamic contrast enhanced computed tomography or magnetic resonance imaging. Recently dynamic contrast enhanced ultrasonography has extended the role of liver ultrasound in the detection and characterisation of focal liver lesions and hepatocellular carcinomas. In this report, we present a case of hepatocellular carcinoma examined by dynamic contrast enhanced ultrasonography.

Coronary artery aneurysms are rare cases among the coronary artery anomalies. Their angiographical incidence has been reported between 0.3 % and 5.2 %. The most common etiology was the coronary atherosclerosis, and iIn a significant proportion of the cases, inflammatory diseases and connective tissue diseases have been detected. In this paper, a 50-year-old male patient accepted with acute anterior myocardial infarction and with giant coronary artery aneurysm of the left anterior descending coronary artery in coronary angiography is presented.

Even if the aspiration or swallowing of foreign body is a common situation in children, it is often encountered with swallowing or aspiration of needle in adult ages especially in young women in our country. The approaches used in the treatment of the swallowed gastrointestinal foreign bodies are endoscopy, observation and surgery. While a rigid bronchoscopy is usually used in the removal of the aspirated foreign bodies in children, both rigid and fiberoptic bronchoscopy are used in adults. In our region, the aspiration or swallowing of needle in young women especially during the wearing of headscarves is a situation that we have quite frequently encountered in the emergency services. We herein aimed to present a case admitted to our clinic with the aspiration of a needle.

The group, asthma attacks of which acutely start and that requires the emergency intervention is the most frequently encountered group within the problems belonging to the respiratory system in the clinic. Asthma attacks are very often seen in children and young adults and these symptoms can occur at any time of the life. The first step in the treatment of acute asthma attacks is to assess the severity of the attack and to determine the risk of respiratory failure of the patient. Although the risk of respiratory failure is a very rarely encountered situation, it is necessary to act very quickly within the limited time that will not even allow the clinical evaluation according to some authors. Admitted to the emergency department with acute asthma attack after the use of analgesics, disappearing the need for the mechanical ventilation after a rapid and intensive treatment and responding to treatment very quickly, a case was presented in this study.

Mast cells have many functions in addition to their well–known roles in allergy and parasitic infestations and involve in various events such as bacterial infections, inflammation, angiogenesis, tissue repair, and wound healing. Besides, mast cells have important roles in cancer. Potential mast cell effects on tumor growth can be categorized as either direct effects on tumor cells, such as mast cell–mediated cytotoxicity, or indirect effects such as mast cell–directed angiogenesis, tissue remodelling of the neighbouring environment and immune cell recruitment. In this review, the importance of mast cells in cancer, their cytotoxic and phagocytotic effects, and their relationship with angiogenesis will be discussed in the light of the recent literature and our study results.

Percutaneous nephrolithotomy (PCNL) has been widely used in the treatment of kidney stones. PCNL in parallel with developments in technology, the development of tools and equipment used in surgery, increase the safety and efficacy of PCNL procedure. In this review, PCNL surgery tools and equipment used in the literature are analyzed.