INTRODUCTION: To evaluate the significance of hypoalbuminemia in red blood cell transfusion requirement in patients with acute non-variceal upper gastrointestinal bleeding (UGIB).
METHODS: In this retrospective study data from consecutive patients admitted and hospitalized with UGIB during the period from January 2007 to January 2009 were collected. The data of total 353 (265 men, 88 women, mean age of 55.44±19.62 years; range from 15 to 97) patients eligible for the study were analyzed. Existence of chronic hepatic disease, variceal bleeding, chronic renal failure, malignancy and hematological disease were exclusion criteria. Hypoalbuminemia is defined as serum albumin < 3.5 g/dL. The outcome assessments in the hypoalbuminemia and normal albumin groups were compared.
RESULTS: Hypoalbuminemia was seen in 174 (49.29 %) patients. Compared to patients with normal albumin, patients in the hypoalbuminemia group were older (57.69±20.08 vs 53.27±18.96 years, p=0.035; had more red cell transfusion (RBC) requirement (3.55±2.28 vs 1.57±1.65 unit, p<0.0001), longer hospital stay (6.61±3.12 vs 5.83±2.24 days, p=0.007), lower hemoglobin level (8.57±2.49 vs 10.36± 2.43 g/dL, p<0.0001), and had higher blood urea nitrogen (BUN) level (38.53±21.55 vs 30.99±16.83 mg/dL, p<0.0001) and BUN/creatinine ratio (40.47±18.46 vs 34.05±15.33, p=0.001) at admission. RBC transfusion requirement was correlated negatively with serum albumin (r= -0.498, p<0.0001) and hemoglobin levels (r=-0.480, p<0.0001), positively with BUN level (r=0.243, p<0.0001), age (r=0.123, p=0.021), hospital stay (r=0.283, p<0.0001) and white blood cell count (r=0.161, p=0.001).
DISCUSSION AND CONCLUSION: Hypoalbuminemia can be an indicator for the severity of non-variceal UGIB.

INTRODUCTION: To investigate, in detail, the spermiogram results of cases with primary and secondary infertility and to evaluate the obtained results in light of the data from the literature.
METHODS: A total of 942 cases that had spermiograms performed for primary and secondary infertility at our hospital’s andrology laboratory between November 2008 and December 2010 were included in the study. After the semen was liquefied, macroscopic and microscopic evaluations were performed. Microscopic evaluations involved the assessment of sperm concentration and motility and the evaluation of morphology according to the Kruger strict criteria, all of which were performed in accordance with the criteria of the World Health Organization (WHO). The motility of each sperm was scored according to four categories, which were: rapid forward motility (a), slow forward motility (b), non-progressive motility (c), and immotile (d). Comparison of the spermiogram results of cases with primary and secondary infertility was performed retrospectively according to age (years), volume (ml), sperm concentration (ml/106), total motility (A+B+C) (%), motility A (%), motility B (%), motility C (%), motility D (%), the Total Progressive Motile Sperm Count (TPMSC) and normal morphology (% normal) values. The characteristics of primary and secondary infertility in cases diagnosed with varicocele were also compared. All results were compared statistically.
RESULTS: During the comparisons performed on patients with varicocele according to the type of infertility, no statistical differences were identified with regards to the evaluated parameters. Based on the comparisons performed according to the type of infertility, cases with secondary infertility had higher age, sperm concentration (ml/106), total motility (A+B+C) (%), motility A (%), motility B (%), TPMSC, and normal morphology (% normal) values compared to cases with primary infertility, while motility C (%) and motility D (%) values were higher in cases with primary infertility.
DISCUSSION AND CONCLUSION: As expected, varicocele did not alter sperm parameters when infertility was present. Spermiogram results demonstrated various differences depending on the presence of varicocele, infertility type and many other factors.

INTRODUCTION: The aim of this study is to show the effects of mother receiving general and regional anesthesia at newborns. 60 patients whom pregnancy week is 38 and over, ASA I-II, age 18-45 are included. Groups are chosen as Group GA (General Anesthesia,n=20), Grup EA (Epidural Anesthesia, n=20) ve Grup SA (Spinal Anesthesia, n=20). All mothers undergoing general anesthesia received
2-2,5 mg/kg propofol, 0,6 mg/kg rocuronyum for induction followed by N2O2-(O2 %50-%50) and 0,5 MAC sevoflurane. 16cc %0,5 bupivacaine and 100mcg fentanyl was used in mothers receiving epidural, 3cc %0,5 hiperbaric bupivacaine was used in mothers receiving spinal anesthesia and all mothers receiving regionel anesthesia were given oxygen during case. Mother’s hemodynamical parameters, new born’s APGAR*, NACS** (neuroadaptive capacity score), first feeding time, umblical venous blood gas, 2. hour blood glucose, 4. hour AST/ALT after born and heart beats intrauterin and at 1. ve 5. minutes after born are recorded. Also start time of operation and cordon clemping time is recorded. PaO2 parameters in GA, APGAR at 5. minutes, 4.hour ALT, 24.hour NACS in EA was significantly high. We have found that newborn’s APGAR and NACS parameters in EA were favorable.
METHODS:
RESULTS:
DISCUSSION AND CONCLUSION:

INTRODUCTION: To evaluate the presence of methicillin resistance and slime formation of nasal Staphylococcus aureus strains isolated from nurses.
METHODS: 122 nasal swab samples taken from nurses enrolled to this study in 2013. To identify bacterial strains samples were inoculated onto blood agar and MacConkey agar, for slime production, strains were inoculated onto Congo red agar. Methicillin resistance was determined by disc diffusion method according to CLSI 2012 M100-S21 recommendations.
RESULTS: Bacterial growth was detected 116 (95%) of 122 samples. The bacteria were coagulase negative staphylococci (CNS) (91%), S.aureus (2.6%), CNS+S.aureus (2.6%), CNS +alpha hemolytic streptococci (1.7%), KNS+K.pneumoniae (1.7%), respectively. Only one S.aureus strain showed methicillin resistance (17%). Four (%66.6) S.aureus strains were slime producers. Methicillin resistant strain showed no slime production.
DISCUSSION AND CONCLUSION: Although several infection control practices, methicillin resistant, slime producing S.aureus strains can be observed. This is a risk factor for nosocomial infections.

INTRODUCTION: Laparoscopic applications require long learning curve especially the oncological and reconstructive ones. ın this study we evaluated our results of the initial series of laparoscopic surgery and focused on the urooncologic cases.
METHODS: In our clinic between April 2012-August 2013, 45 patients (mean age; 52.3, range 17-80) underwent laparoscopic surgery. All procedures were related with upper urinary system such as pyeloplasty (3), ureterolitotomy (8), simple nephrectomy (14), radical nephrectomy (9), partial nephrectomy (2), nephroureterctomy (3) and remaining 8 were cyst excision. The series was performed by single surgeon via transabdominal method and there were 7 oncological cases out of 22 (31.81%).
RESULTS: Average operative times were 128 (range 60-450) and 166 (range 60-490) minutes for the oncologic and entire cases respectively. Blood transfusions were needed for 7 (only one oncologic case who underwent secondary surgery for bleeding) patients; 2 (%15.5) and 5 (%16) respectively oncological and non-oncologıcal cases. The average hospitalizations were 5.39 (3-23) and 5.9 (3-30) days for the oncological and the entire ones respectively. One of the cyst excisions was complicated with bowel perforation which was repaired laparoscopically at the second postoperative day.
DISCUSSION AND CONCLUSION: We think that upper system urooncologic and reconstructive surgery can be initiated at the early steps of urologic laparoscopic learning curve via surgical team that complete basic training process of laparoscopy.

Thoracolomber junction syndrome (TLJS) consists of all the painfull conditions caused by dysfunction of thoracolomber junction. The classical definition was made by Maigne. The pathology is most frequently seen inbetween the levels of of T11-12 and T12-L1, T10-L2 level can be effected. Distrubution of pain and clinical findings would be felt lombar, groin and thorachanteric region due to the branches of T12-L1 spinal roots. Due to the diversity of clinical manifestations it may be misdiagnosed and mistreated because of confusions experienced in differential diagnosis. The diagnosis is made by clinical evaluations. In this article detailed informataion about diagnosis and treatment of TLJS will be with the review of the current literature.

High jugular bulb is a vascular abnormality of jugular vein. However, it is generally asymptomatic and is detected incidentally. In symptomatic cases, it may cause conductive hearing loss, sensoryneural hearing loss, pulsatil tinnitus and vertigo according to localization of jugular bulb. Jugular bulb dehiscence was found in 6% in temporal bone studies. Temporal bone computerized tomography, particularly the coronal plan, is very important to diagnose this abnormality. Awareness of high and dehiscent jugular bulb is mandatory to prevent excessive bleeding during middle ear surgery. In this case report a young woman with a high jugular bulb is presented.

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and is especially prevalent in Africa and East Asia. Late-stage HCC usually metastasizes to the regional lymph nodes and lungs, but less commonly to the skeleton. Scalp metastases from HCC are very rare but must be considered when treating a patient with known cirrhosis, hepatitis, or HCC. 61 years old male patient presented to the emergency room with complaint of headache. He had known HCC for one year and had an operation for it. There was no known metastasis of tumor, yet. In his physical examination there was no important finding except scalp mass on the right parieatal bone of cranium.When it was questioned, we learned that it was slowly growing for 4 months. In his cranial computed tomography there was an osteolytic, expansile, and hypervascular lesion in right parietal bone and multiple lytic lesions were detected in other cranial bones. Especially in Asia, skull metastases from HCC should be included in the differential diagnosis of skull tumors, even if the patient is asymptomatic of liver cirrhosis. With the increase of survival in HCC patients, clinically significant bone metastases have also increased, affecting the patients’ quality of life. Therefore, early diagnosis and proper management of bone metastasis from HCC is essential to prevent deterioration in the quality of life of HCC patients.