GÝRÝÞ ve AMAÇ: Amacýmýz ülkemizde yaþayan insanlarýn diz morfolojisini anlamak ve ülkemizde yaygýn olarak kullanýlan diz artroplasti markalarýna ait protezleri ile olan uyumunu deðerlendirmek.
YÖNTEM ve GEREÇLER: Çalýþmaya farklý nedenlerle dolayý alt ekstremiteye anjiyo bilgisayarlý tomografi çekilmiþ 104’ü (%52) erkek, 96’sý (%48) kadýn 200 hasta dahil edildi. Proksimal tibiadan ve distal femurdan beþer farklý parametre deðerlendirme kriteri olarak kullanýldý. Ölçümler sonrasý her bir protez markasýnýn o hasta için uygun protez boyu belirlendi ve uygun protez boyu ile hasta ölçümleri istatistiksel olarak deðerlendirildi.
BULGULAR: Hastalarýn elde edilen femoral ölçümleri ile çalýþmaya dahil edilen firmalara ait protezlerin femoral komponentleri arasýnda istatistiksel olarak uyum saptanamadý (p>0.05). Tibia ölçümleri ile çalýþmaya dahil edilen firmalara ait protezlerin tibial komponentleri arasýnda istatistiksel olarak uyum saptanamadý (p>0.05).
TARTIÞMA ve SONUÇ: Yapýlan metrik deðerlendirmeler sonucu diz protez markalarý boyutlarý ile ülkemizdeki yaþayan insanlarýn antropometrik deðerleri arasýnda bir uyumun olmadýðý görülmüþtür.

INTRODUCTION: Aim is to investigate the morphology of the knee of the people living in our country and to evaluate the harmony of the knee arthroplasty with their prosthetics, which are widely used in our country.
METHODS: In this study, 200 patients, who had a CT taken for the angio of the lower extremity for various reasons, were included. Among 200 patients, 104 (52%) of them were male and 96 (48%) of them were female. Five different parameters from the proximal tibia and distal femur were used as evaluation criteria. After the measurements, the appropriate denture size for each denture brand was determined and the appropriate denture size and patient measurements were statistically evaluated.
RESULTS: The femoral measurements of the patients and the femoral components of the prosthetics of the companies included in this study were not statistically compatible (p>0.05). Similarly, the tibia measurements and tibial components of the prosthetics of the companies included were not statistically compatible (p>0.05).
DISCUSSION AND CONCLUSION: As a result of the metric evaluations, it was observed that there was no harmony between the size of knee prosthetic brands and the anthropometric values of living people in our country.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý, anomalili bölgedeki sorunu saðlam segmentlere zarar vermeden çözümlemek için segmentasyon defektlerindeki epifiz eksikliðini telafi etmek amacý ile büyüme plaðý transferinin kullanýlabilirliðini ve büyüme üzerine etkisini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþmamýzda 6 adet kuzuda L3-4 vertebra arasý disk ve büyüme plaklarýndan 6.5 mm çapýnda bir greft çýkarýlýp ayný bölgeye reimplante edildi. L2 ve L5 vertebra kontrol grubu olarak alýndý. Ýki ay sonra büyümenin etkilenmesi radyolojik ve histolojik olarak incelendi.
BULGULAR: Sonuç olarak çalýþma ve kontrol gruplarýnýn 2 aylýk büyüme yüzdeleri karþýlaþtýrýldýðýnda, radyolojik açýdan anlamlý bulundu [çalýþma: %5.467, kontrol: %4.17; p=0,025, (p<0.05)]. Histolojik olarak üç vertebrada normale yakýn epifiz yapýsý, üç vertebrada ise yoðun fibrozis görüldü. Hiçbir preparatta epifiz iskemisinin bulgusu olan proliferatif zon kalýnlaþmasý görülmedi. Fibrozis görülen preparatlarýn sadece bir tanesinde fiz hattýnda kemik köprüleþme gözlendi.
TARTIÞMA ve SONUÇ: Konjenital segmentasyon defektlerinde büyüme plaðý transferi, fizyolojiye yakýn vertebral büyüme saðlayan uygulanabilir bir tekniktir.

INTRODUCTION: This study aims to evaluate the possibility of treating the defective segment without damaging the healthy adjacent vertebrae using growth plate transfer in segmentation defects.
METHODS: In this study, a 6.5 mm diameter graft of intervertebral disc and growth plate between L3-4 vertebrae of six lambs were harvested and reimplanted to the same area. L2-L5 vertebrae were taken as a control group. Two months later, the growth of the reimplanted tissue underwent radiological and histological evaluation.
RESULTS: Radiologically, comparison between study and control groups concerning bimonthly growth percentages (study: %5,467, control: %4,17) were found statistically significant [study group: %5,467, control group: %4,17; p=0.025, (p<0.05)]. Histologically, three vertebrae epiphyses were found to be near normal appearance, but in three vertebrae, severe fibrosis was seen. Proliferative zone thickening, which is evidence of epiphyseal ischemia, was not observed in any of the samples. Bone bridging of the physics was seen in only one sample.
DISCUSSION AND CONCLUSION: Growth plate transfer in the treatment of congenital spinal deformity has found to be feasible technique, which provides a physiological vertebral growth.

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GÝRÝÞ ve AMAÇ: Ülkemizde ve tüm dünya genelinde eriþkin saðlýðý düþünüldüðünde, aþýlama gibi koruyucu týp uygulamalarý önemini korumaktadýr. Çalýþmamýz ile eriþkin aþýlamasý konusundaki hekim yaklaþýmlarý ve uygulamalarý konusunda farkýndalýk oluþturmayý amaçladýk.
YÖNTEM ve GEREÇLER: Eriþkin aþýlamasý ile ilgili güncel literatür incelenip 22 adet çoktan seçmeli sorudan oluþan farkýndalýk anketi oluþturuldu. Yerel etik kurul onayý alýndýktan sonra, 200 adet hekime sorular soruldu. Verilen cevaplar sýklýk hesabýna göre yüzdesel olarak deðerlendirildi.
BULGULAR: Hekimlerden alýnan bilgilere göre; hekimlerin eriþkinlikte aþý olma oraný %87, en fazla olunan aþý Hepatit B aþýsýdýr. Hekimlerin hastalarýna aþýlama önerme oraný %90 olup oldukça yüksek saptanmýþtýr. Hekimlerin sadece %20’si mezuniyet sonrasýnda aþý ile ilgili bir eðitim faaliyetinde yer almýþtý ve sadece %30’u günlük pratiðinde eriþkin aþýlamasýna gereken önemi verdiðini ifade etti. %88.5’lik oran ile hekimlerin çoðu kendilerine pratik hatýrlatma sisteminin getirilmesini istiyordu.
TARTIÞMA ve SONUÇ: Teorik bilgiler ve cevaplarýn doðruluk oranlarýna bakýldýðýnda genel olarak hekimlerin teorik bilgilerinin yeterli olduðu tespit edilmiþtir. Ancak riskli gruplarda yapýlmasý gereken aþý uygulamalarý ve seyahat saðlýðý konusunda mevcut bilgilerinin güncellenmesi gerektiði düþünülmüþtür.

INTRODUCTION: When adult health is considered in our country and all over the world, preventive medicine applications, such as vaccination, remain important. With this study, we aimed to raise awareness about physician approaches and practices in adult vaccination.
METHODS: For this study, the current literature on adult vaccination was examined, and an awareness questionnaire consisting of 22 multiple choice questions was prepared. After the approval of the local ethics committee, 200 physicians were asked questions. The responses were evaluated as a percentage according to the frequency calculation.
RESULTS: According to the information obtained from the physicians, the Hepatitis B vaccine was the most common vaccine in adults. The rate of doctors recommending vaccination to their patients was 90%, which found to be quite high. Only 20% of the physicians were involved in vaccination-related training after graduation, and only 30% of them said they attach the necessary importance to adult vaccination in their daily practice. With a rate of 88.5%, most physicians wanted to have a practical reminder system.
DISCUSSION AND CONCLUSION: When the accuracy of the theoretical information and answers were examined, that the findings suggest that the theoretical knowledge of physicians was sufficient. However, we should note that the current knowledge about vaccination applications and travel health should be updated in risky groups.

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GÝRÝÞ ve AMAÇ: Evre C proliferatif vitreoretinopatinin (PVR) eþlik ettiði retina dekolmaný hastalarýnda primer vitrektomi cerrahisinin sonuçlarýný deðerlendirmek.
YÖNTEM ve GEREÇLER: Geriye dönük, tek cerrah olgu serisi. Evre C PVR’si olan ve 23-gauge vitrektomi uygulanmýþ ve cerrahi sonrasý takip süresi en az 12 ay olan retina dekolmaný hastalarý çalýþmaya alýndý. Çalýþmanýn birincil sonlaným noktasý tek cerrahi sonrasý anatomik baþarý (retinanýn tamamen yatýþýk olmasý) oraný idi.
BULGULAR: Toplamda 42 hastanýn 42 gözü çalýþmaya alýndý. Ortalama yaþ 57.6±13.9 (27-88 arasý) yýl ve ortalama takip süresi 17.1±4.8 (12-22 arasý) ay idi. Kýrk iki hastanýn 32’sinde (%76.2) tek cerrahi sonrasý anatomik baþarýya ulaþýldý. Kalan 10 hasta yeniden opere edildi ve final anatomik baþarý oraný %95.2’ye (42 hastanýn 40’ý) yükseldi.
TARTIÞMA ve SONUÇ: Evre C PVR’li retina dekolmaný hastalarýnda vitrektomi etkili bir tedavi yöntemidir.

INTRODUCTION: To assess the outcomes of primary vitrectomy in retinal detachment (RD) patients with grade C proliferative vitreoretinopathy (PVR).
METHODS: In this study, retrospective, single-surgeon case series were examined. The patients who had an RD with grade C PVR and underwent 23-gauge vitrectomy, and had a minimum follow up period of 12 months were included. The primary outcome measure of this study was the anatomical success (achievement of the totally attached retina) rate after a single surgery.
RESULTS: A total number of 42 eyes of 42 patients were included in this study. The mean age was 57.6±13.9 years (range 27-88 years), and the mean follow-up was 17.1±4.8 months (range 12-22 months). The anatomical success rate after a single operation was achieved in 32 of the 42 patients (76.2%). The remaining 10 patients were operated again, and the final success rate increased to 95.2% (40 of the 42 patients).
DISCUSSION AND CONCLUSION: The findings suggest that vitrectomy is effective in the treatment of RD with grade C PVR with satisfactory anatomical success.

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Fibromiyalji sendromu (FMS), kronik yaygýn kas iskelet sistemi aðrýsý, sertlik ve çoklu noktalardaki hassasiyet ile karakterizedir. FMS, diðer týbbi bozukluklarýn varlýðýna göre primer veya sekonder olarak sýnýflandýrýlabilir. Sýklýkla FMS ile iliþkili komorbid bir hastalýk olan irritabl baðýrsak sendromunun, gluten'in inflamasyon, villöz atrofi ve malabsorpsiyon ile sonuçlanan ince baðýrsak mukozasýnda bir otoimmün reaksiyonu tetiklediði çölyak hastalýðý (ÇH) ile iliþkili olduðu bildirilmiþtir. Primer biliyer siroz (PBS), ÇH’de en sýk bildirilen karaciðer hastalýðýdýr. Glutensiz bir diyet, ÇH için tek etkili tedavidir ve hastalýðýn zahmetli sonuçlarýný önler. Burada yüksek karaciðer biyokimya testleri ve demir eksikliði anemisinin nedenlerini araþtýrdýktan sonra ÇH ve PBS tanýsý alan bir fibromiyaljik kadýn hastayý sunuyoruz.

Fibromyalgia syndrome (FMS) is characterized by chronic widespread musculoskeletal pain, stiffness and tenderness at multiple points. FMS can be classified as primary or secondary according to the presence of other medical disorders. Irritable bowel syndrome, a comorbid disorder frequently associated with FMS, has also been reported to be associated with celiac disease (CD) in which gluten triggers an autoimmune reaction in the small intestinal mucosa, which results in inflammation, villous atrophy, and malabsorption. Primary biliary cirrhosis (PBC) is the most common reported liver disease in CD. A gluten-free diet is the only effective treatment for CD and prevents the troublesome consequences of the disease. Herein, we present a fibromyalgic female patient in whom the diagnosis of CD and PBS were established upon investigating the causes of elevated liver biochemistry tests and iron-deficiency anemia.

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Supraorbital nevralji (SON), frontal bölgede supraorbital sinirin yayýldýðý alanda þimþek çakmasý gibi ifade edilen aðrý ve parestezi ile karakterize, nadir görülen bir nevralji tipidir. SON için “International Classification of Headache Disorder-2”de þu kriterler belirlenmiþtir; 1) Alýnda, supraorbital çukurda aðrý; 2) Supraorbital çukur ve supraorbital sinir trasesinde hassasiyet; 3) Semptomlarda supraorbital sinir blokajý ile kesin, ancak geçici rahatlama olmasý. Hipoestezi, parestezi ve allodini gibi duysal disfonksiyonlar ve tipik nevraljik özellikler vardýr. Burada SON tanýsý koyduðumuz ve spontan olarak þikayetleri düzelen bir olguyu sunuyoruz.

Supraorbital neuralgia (SON) is a rare type of neuralgia characterized by persistent pain over the supraorbital region and forehead along with shock like paresthesia in the distribution of the supraorbital nerve. SON is defined by the “International Classification of Headache Disorder-2” by the following three criteria: 1) Pain on the supraorbital notch, forehead; 2) Tenderness in the supraorbital notch and in the area supplied by the supraorbital nerve; 3) Absolute-but transitory-relief of symptoms upon supraorbital nerve blockage. Sensory dysfunctions, such as hypoesthesia, paresthesia and allodynia and typical neuralgic features, may be present. Herein, we present a patient with supraorbital neuralgia who spontaneously resolved.

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Venöz tromboembolizm genellikle ileri yaþlarda görülmekle birlikte genç popülasyonda da görülebilmektedir. Bu olgularda etiyolojide genetik bozukluklar ön planda olduðundan genetik tarama tedavinin bir parçasý olmalýdýr. Otuz dört yaþýnda genç hasta karýn aðrýsý ile acil servise baþvurdu. Klinik ve radyolojik bulgular dalak infarktýný iþaret etmiþti. Sorunsuz bir splenektomiden sonra hasta ciddi karýn aðrýsý nedeniyle tekrar acile baþvurdu ve mezenter iskemi tanýsý ile tekrar opere edildi. Genetik tarama sonucunda hastada PAI SERPINE 1 homozigot 4G/4G, MTHFR homozigot 1298 CC and factor II prothrombin 20210GA heterozigot mutasyonlar saptandý.

Venous thromboembolism is known as a geriatric disorder, but sometimes, it can be seen in young adults. In these cases, the physician must consider genetic disorders for etiological factors, and genetic screening must be a part of the management plan. A previously healthy 34 years old man admitted to the emergency room with abdominal pain. After clinical and imaging evolution, a diagnosis of splenic infarct was made. After an uneventful splenectomy, the patient was re-admitted with severe abdominal pain and re-operated because of mesenteric ischemia. The genetic screening revealed PAI SERPINE 1 homozygous 4G/4G, MTHFR homozygous 1298 CC and factor II prothrombin 20210GA heterozygous mutations.

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