GÝRÝÞ ve AMAÇ: Peptik ülser hastalýðý; mide asit-pepsin salgýsýyla mukoza bariyeri arasýndaki dengenin bozulmasýndan kaynaklanmaktadýr. Dünya üzerinde her yýl yaklaþýk 4 milyon insan peptik ülser hastalýðýndan etkilenmektedir. Peptik ülser hastalýðý insidansý %1,5-3 arasýnda deðiþmektedir ve bu hastalarýn yaklaþýk %10-20’sinde komplikasyonlar görülmektedir. Bu çalýþmada, laparoskopik onarým ve konvansiyonel onarým yöntemlerinin peptik ülser perforasyonu tedavisindeki etkinliði karþýlaþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Ocak 2011-Aralýk 2019 tarihleri arasýnda peptik ülser perforasyonu nedeniyle opere edilen 169 hasta çalýþmaya dahil edildi. Peptik ülser perforasyonu onarýmý için perforasyon alanýna primer onarým ile birlikte omental yama uygulamasý veya yalnýzca omental yama uygulamasý teknikleri uygulandý. Çalýþmada hastalar; yaþ, cinsiyet, “American Society of Anesthesiologists” skorlarý, operasyon süreleri, peroperatif ve postoperatif komplikasyonlar, yatýþ süreleri, perforasyon lokalizasyonlarý ve readmisyon nedenleri açýsýndan deðerlendirildi ve bilgiler retrospektif olarak taranarak önceden hazýrlanmýþ veri tabanýna kaydedildi.
BULGULAR: Ocak 2011-Aralýk 2019 tarihleri arasýnda peptik ülser perforasyonu nedeniyle opere edilen 169 hasta çalýþ-maya dahil edildi. Peptik ülser perforasyonu onarýmý için perforasyon alanýna primer onarým ile birlikte omental yama uygulamasý veya yalnýzca omental yama uygulamasý teknikleri uygulandý. Çalýþmada hastalar; yaþ, cinsiyet, “American Society of Anesthesiologists” skorlarý, operasyon süreleri, peroperatif ve postoperatif komplikasyonlar, yatýþ süreleri, perforasyon lokalizasyonlarý ve readmisyon nedenleri açýsýndan deðerlendirildi ve bilgiler retrospektif olarak taranarak önceden hazýrlanmýþ veri tabanýna kaydedildi.
TARTIÞMA ve SONUÇ: Bu çalýþmada, peptik ülser perforasyonunda laparoskopik onarým ile konvansiyonel onarým arasýnda etkinlik ve güvenlik açýsýndan istatistiksel olarak anlamlý fark saptanmasa da laparoskopik onarýmýn birçok yönden konvansiyonel onarýma göre avantajlý olduðu saptandý. Seçilecek cerrahi yönteme, cerrahýn deneyimi doðrultusunda karar verilmesi gerektiðini düþünüyoruz.

INTRODUCTION: Peptic ulcer disease (PUD); it is caused by the disturbance of the balance between gastric acid-pepsin secretion and the mucous barrier. Approximately 4 million people around the world are affected by PUD every year. The incidence of PUD varies between 1.5 and 3% and complications are seen in approximately 10–20% of these patients. In this study, the efficiency of laparoscopic repair and conventional repair methods in Peptic ulcer perforation (PUP) treatment was compared.
METHODS: A total of 169 patients who were operated for PUP between January 2011 and December 2019 were included in the study. Omental patch application with primary repair or only omental patch application techniques were applied to the perforation area for PUP repair. Patients in the study; age, gender, the American Society of Anesthesiologists (ASA) scores, operation times, peroperative and post-operative complications, hospitalization times, perforation locations, and reasons for readmission were evaluated and the information was retrospectively scanned and recorded in a previously prepared database.
RESULTS: Post-operative complications were observed in 19.3% of the patients who underwent conventional repair, in 10.5% of the patients who underwent laparoscopic repair, and in 12.5% of the patients who converted to conventional repair from laparoscopic repair, and there was no statistically significant difference between them (p>0.05). Mortality developed in 11.3% of cases with conventional repair, in 10.8% of cases with laparoscopic repair, and in 12.5% of cases that converted to conventional repair from laparoscopic repair, and there is no statistically significant difference between them (p>0.05).
DISCUSSION AND CONCLUSION: In this study, although there was no statistically significant difference in efficacy and safety between laparoscopic repair and conventional repair in PUP, we found that laparoscopic repair was advantageous over conventional repair in many aspects. We think that the surgical method to be chosen should be decided in line with the surgeon’s experience.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, perkütan nefrolitotomi uygulanan hastalarda akses için kullanýlan tek basamaklý dilatasyon ve sýralý dilatasyon tekniklerinin sonuçlarýnýn karþýlaþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmada, Temmuz 2017 ile Aralýk 2020 tarihleri arasýnda perkütan nefrolitotomi uygulanan 159 hastanýn verileri retrospektif olarak deðerlendirildi. Dilatasyon yöntemleri; demografik özellikler, ameliyat süresi, floroskopi süresi, hemoglobin düþüþü, kreatinin artýþý, komplikasyon oraný, hastanede kalýþ süresi ve ameliyat baþarý oraný açýsýndan karþýlaþtýrýldý.
BULGULAR: Yetmiþ dokuz hastaya tek basamaklý dilatasyon, 80 hastaya sýralý dilatasyon uygulandý. Ortalama ope-rasyon süresi tek basamaklý dilatasyon grubunda istatistiksel olarak anlamlý düþük saptandý (sýrasýyla 51,14±22,33 ve 60,19±18,91 dakika) (p<0,01). Floroskopi süresinin ise tek basamaklý dilatasyon grubunda sýralý dilatasyon grubuna göre daha düþük olduðu görülse de istatistiksel olarak anlamlý fark saptanmadý (sýrasýyla 119,70±51,03 ve 136,54±44,24 saniye) (p>0,01). Baþarý ve komplikasyon oraný açýsýndan tek basamaklý dilatasyon ve sýralý dilatasyon gruplarý arasýnda fark bulunmadý (%91-%85,0 ve %11,3-%15) (p>0,01).
TARTIÞMA ve SONUÇ: Tek basamaklý dilatasyon tekniði, perkütan nefrolitotomi operasyonu düþünülen hastalarda güvenle kullanýlabilen; komplikasyon oranlarýný artýrmadan doðrudan giriþ, operasyon ve floroskopi sürelerinin azalmasýna katký saðlayan baþarýlý bir giriþ yöntemidir.

INTRODUCTION: In this study, the authors aimed to compare the results of one-shot dilation (OD) and sequential dilation (SD) techniques which are used to access in patients who had undergone percutaneous nephrolithotomy (PCNL).
METHODS: The authors retrospectively evaluated the data of 159 patients who had undergone PCNL between July 2017 and December 2020 in our clinic. The dilation methods were compared concerning demographic characteristics, operation time, fluoroscopy time, hemoglobin decrease, creatinine increase, complication rate, length of hospital stay, and operation success rate.
RESULTS: While OD was applied to 79 patients, SD was applied to 80 patients. The mean length of operation time and fluoroscopy time were shorter in the OD group than SD group (51.14±22.33 vs. 60.19±18.91 min, 119.70±51.03 vs. 136.54±44.24 s, p<0.001 p=0.028, respectively). The mean operation time was found to be statistically significantly lower in the OD group (51.14±22.33 and 60.19±18.91 min, respectively) (p<0.01). Although the duration of fluoroscopy was lower in the OD group than in the SD group, no statistically significant difference was found (119.70±51.03 and 136.54±44.24 s, respectively) (p>0.01). No differences were found between OD and SD groups in terms of success and complication rate (91% vs. 85.0% and 11.3% vs. 15%) p≥0.05 (p>0.01).
DISCUSSION AND CONCLUSION: The OD technique is a successful access method that can be utilized safely in patients considered for PCNL operation, contributing directly to the reduction of entry, operation, and fluoroscopy times without increasing complication rates.

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GÝRÝÞ ve AMAÇ: Ýnflamatuvar baðýrsak hastalýðý, otoimmünitenin mukozal bariyeri kapsadýðý, kronik bir inflamasyona yol açtýðý ve gastrointestinal sistemin farklý bölgelerini ve katmanlarýný etkilediði düþünülen kronik bir hastalýk-týr. Baþlýca inflamatuvar baðýrsak hastalýðý tipleri, genellikle diðerlerinden ayýrt edilemeyen ülseratif kolit, Crohn hastalýðý ve belirsiz koliti içerir. Düþük kemik mineral yoðunluðunun prevalansý, saðlýklý bireylere göre inflamatuvar baðýrsak hastalýðý olan hastalarda daha yüksektir. Bu çalýþmada, ülseratif kolit, Crohn hastalýðý olan hastalarda ve saðlýklý bireylerde kemik mineral yoðunluðunun deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Bu prospektif çalýþmaya toplam 71 inflamatuvar baðýrsak hastalýðý olan hasta (21 Crohn hastalýðý, 50 ülseratif kolit) ve 30 yaþ ve cinsiyet uyumlu saðlýklý birey dahil edildi. Lomber omurga ve femur boynunun kemik mineral yoðunluðunu ölçmek için dual enerjili X-ýþýný absorpsiyometrisi yapýldý.
BULGULAR: Çalýþma ve kontrol gruplarý arasýnda yaþ, cinsiyet ve beden kitle indeksi açýsýndan anlamlý fark yoktu (p<0,05). Kemik mineral yoðunluðu deðerleri 21 Crohn hastasýnýn 16'sýnda (%76,2) anlamlý olarak daha düþüktü. Ülseratif kolitli toplam 27 hastanýn (%54) patolojik T-skorlarý vardý, bu da sýnýrda anlamlýlýða iþaret ediyordu (p=0,058). > 5 g/gün kortikosteroidle tedavi edilen inflamatuvar baðýrsak hastalýðý olan hastalar ile ≤ 5 g/gün veya daha önce tedavi görmemiþ hastalarla tedavi edilen inflamatuvar baðýrsak hastalýðý olan hastalar arasýnda beden kitle indeksindeki azalma anlamlý deðildi (p>0,05).
TARTIÞMA ve SONUÇ: Çalýþmanýn sonuçlarý inflamatuvar baðýrsak hastalýðý olan hastalarda, özellikle Crohn hastalarýnda kemik mineral yoðunluðunun anlamlý olarak daha düþük olduðunu göstermektedir.

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic disease, in which autoimmunity has been thought to involve the mucosal barrier, leading to a chronic inflammation and affecting different regions and layers of the gastrointestinal tract. The main types of IBD include ulcerative colitis (UC), Crohn’s disease (CD), and indeterminate colitis which often cannot be distinguished from the other ones. The prevalence of reduced bone mineral density (BMD) is higher in patients with IBD than healthy individuals. In this study, we aimed to evaluate the BMD in patients with UC, CD, and in healthy individuals.
METHODS: A total of 71 IBD patients (21 CD, 50 UC) and 30 age- and sex-matched healthy individuals were included in this prospective study. Dual-energy X-ray absorptiometry was performed to measure BMD of the vertebra and femoral neck.
RESULTS: There was no significant difference in the age, sex, and body mass index between the study and control groups (p<0.05). The BMD values were significantly lower in 16 of 21 CD patients (76.2%). A total of 27 patients (54%) with UC had pathological T-scores, indicating borderline significance (p=0.058). The reduction in BMD was not significant between the IBD patients treated with >5 g/day corticosteroids and those treated with ≤5 g/day or treatment-naive patients (p>0.05).
DISCUSSION AND CONCLUSION: Our study results suggest that BMD is significantly lower in IBD patients, particularly in CD patients.

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GÝRÝÞ ve AMAÇ: Kandaki ürik asit seviyesi bazý hastalýklarda vücudun oksidatif stres durumunu gösterebilmektedir. Bu çalýþmada, oksidan-antioksidan yolaklardaki rolüyle ilgi çeken ürik asitin þizoafektif bozukluktaki serum seviyelerinin araþtýrýlmasý ve saðlýklý kontrollerle kýyaslanmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya þizoafektif bozukluk tanýsý almýþ remisyonda olan 67 hasta ve 51 saðlýklý kontrol dahil edildi. Tüm katýlýmcýlara sosyodemografik veri formu ve pozitif ve negatif sendrom ölçeði, Young mani derecelendirme ölçeði ve Beck depresyon ölçeði uygulandý. Ardýndan tüm katýlýmcýlardan rutin kan biyokimya parametrelerinin yanýnda serum ürik asit düzeylerinin çalýþýlmasý amacýyla venöz kan örneði alýndý.
BULGULAR: Hastalarýn serum ürik asit seviyeleri, pozitif ve negatif sendrom ölçeði alt boyutlar ve toplam puanlarý, Young mani derecelendirme ölçeði ve Beck depresyon ölçeði puanlarý kontrol grubundan anlamlý þekilde yüksek bulundu. Serum ürik asit seviyeleri ile pozitif ve negatif sendrom ölçeði, Young mani derecelendirme ölçeði ve Beck depresyon ölçeði arasýnda pozitif yönde anlamlý bir korelasyon görüldü.
TARTIÞMA ve SONUÇ: Þizoafektif bozukluk hastalarýnýn serum ürik asit seviyeleri saðlýklý kontrollerden daha yüksek saptandý. Bu yükseklik duygudurum epizodu veya psikotik dönemlerden baðýmsýz bir bulgu olarak karþýmýza çýkmaktadýr. Þizoafektif bozukluk hastalarýnýn remisyon dönemlerinde saðlýklý kontrollerden daha yüksek serum ürik asite sahip olmalarý bize bu durumun hastalýðýn kendisine özgü olabileceðini düþündürmektedir. Sonuçlarýmýz þizoafektif bozukluk patofizyolojisine ait bizlere ipucu verebilir.

INTRODUCTION: The level of uric acid (UA) in the blood can indicate the oxidative stress state of the body in some dis-eases. In this study, it was aimed to investigate serum levels of UA in schizoaffective disorder (SD), which attracts attention with its role in oxidant-antioxidant pathways and to compare it with healthy controls.
METHODS: The study included 67 patients with SD in remission and 51 healthy controls. Sociodemographic data form and positive and negative syndrome scale (PANSS), young mania rating scale (YMRS), and beck depression inventory (BDI) scale were administered to all participants. Then, venous blood samples were taken from all the participants to study the serum UA levels as well as the routine blood biochemistry parameters.
RESULTS: Serum UA levels, PANSS sub-dimensions and total scores, and YMRS and BDI scores of the patients were significantly higher than the control group. There was a significant positive correlation between serum UA levels and PANSS, YMRS, and BDI.
DISCUSSION AND CONCLUSION: Serum UA levels of SB patients were found to be higher than healthy controls. This elevation appears as a finding independent of mood episodes or psychotic episodes. The fact that SB patients have higher serum UA during remission periods than healthy controls makes us think that this situation may be specific to the disease itself. Our results can give us a clue about the pathophysiology of SB.

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GÝRÝÞ ve AMAÇ: Çalýþmada, günübirlik çocuk cerrahisi olgularýnda çocuklarýn yaþýnýn uyanma ve derlenme üzerine etkilerinin araþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Retrospektif olarak günübirlik çocuk cerrahisi yapýlan hastalarýn dosyalarý taranarak, indüksiyon ve idame ajaný olarak sevofluran kullanýlan ve hava yolu idamesinde larengeal maske yerleþtirilen “American Society of Anesthesiologist I (ASA I)” hastalarýn dosyalarý incelendi. Anestezi sýrasýnda nöromusküler bloker kullanýlan hastalar çalýþmaya dahil edilmedi. Hastalar yaþlarýna göre 36 ay ve altý, 36 ay üstü olarak iki gruba ayrýldý. Hastalarýn hemodinamik verileri, cerrahi bitiminde larengeal maske çýkarýlma zamanlarý ve ekstübasyon zamanlarý ile derlenme ünitesinde Aono’s Four Point Scale ile hastalarýn ajitasyonu ve Steward Recovery Score ile derlenme kalitesi incelendi.
BULGULAR: Larengeal maske çýkarýlma zamanlarý ve göz açma zamanlarý açýsýndan yaþa göre fark bulunmadý. Derlenmede Aono’s Four Point Scale ve Steward Recovery Scale yaþý 36 ay ve altý olan çocuklarda daha yüksek bulundu.
TARTIÞMA ve SONUÇ: Çalýþmada incelenen tüm yaþ gruplarýnda uyanma deðerlendirildiðinde larengeal maske çýkarýlma zamanlarý ve ekstübasyon zamanlarý benzerken, küçük yaþ hastalarda derlenme daha hýzlý oldu ve uyanma ajitasyonu daha fazla görüldü.

INTRODUCTION: In this study, we aimed to investigate the effects of children’s age on awakening and recovery in ambulatory pediatric surgery cases.
METHODS: The data of patients who underwent ambulatory surgical procedures were reviewed retrospectively, and the files of ASA I patients who used sevoflurane as an induction and maintenance agent and were placed in a laryngeal mask for airway maintenance were reviewed. Patients who used neuromuscular blockers during anesthesia were not included in the study. The patients were divided into two groups according to their age, as Group K (age of 36 months and below) (n=34) and Group B (age of over 36 months) (n=28). Hemodynamic data of the patients, laryngeal mask removal times at the end of surgery, and extubation times were evaluated. The Aono’s 4-Point Scale, which evaluates the agitation of the patients in the recovery unit, and the Steward Recovery Score, which evaluates the recovery quality, were examined.
RESULTS: There was no difference according to age in terms of laryngeal mask removal times and eye opening times. Aono’s 4-Point Scale and Steward Recovery Scale were found to be higher in children aged 36 months and below in recovery unit.
DISCUSSION AND CONCLUSION: While the laryngeal mask removal times and extubation times were similar in all age groups we examined in our study, recovery was faster in younger patients and emergence agitation was observed more frequently.

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GÝRÝÞ ve AMAÇ: D vitamininin bilinen metabolik etkilerinin yanýnda aðrý modülasyonundaki rolü tartýþma konusudur. Çalýþmada, D vitamini düzeyi düþük olan kadýn hastalarda nöropatik aðrýnýn demografik veriler ve kanýn bazý biyokimyasal deðerleri ile olasý iliþkisinin araþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Fiziksel Týp ve Rehabilitasyon Polikliniðine Ocak 2017-Ocak 2018 tarihleri arasýnda müracaat eden hastalarýn verileri retrospektif olarak deðerlendirildi. Dahil etme kriterlerini karþýlayan D vitamini düzeyi düþük olan 79 kadýn hasta çalýþmaya alýndý. Nöropatik aðrý varlýðýný deðerlendirmek amacýyla painDETECT aðrý anketi kullanýldý. Bu ankete göre hastalar nöropatik aðrý yok, þüpheli ve nöropatik aðrý var olmak üzere üç gruba ayrýlarak incelendi.
BULGULAR: D vitamini düzeyi düþük olan kadýn hastalarýn 15’inde (%19) painDETECT anketi ile nöropatik aðrý komponenti saptandý. Nöropatik aðrý gruplarý arasýnda yaþ, öðrenim düzeyleri, doðum sayýsý ve beden kitle indeksi açýsýndan istatistiksel olarak anlamlý bir fark bulunmadý. Ayný þekilde nöropatik aðrý gruplarý arasýnda D vitamini, alkalen fosfataz, paratiroid hormon ve kalsiyumun plazma deðerleri açýsýndan da istatistiksel olarak anlamlý bir fark bulunmadý.
TARTIÞMA ve SONUÇ: Bu retrospektif çalýþmada, farklý derecelerde nöropatik aðrý ve düþük D vitamini düzeyleri olan hastalarda benzer biyokimyasal veriler gözlemlendi. D vitamini düzeyi düþük olan nöropatik aðrýlý hastalarda D vitamini takviyesinin tedavide fark yaratýp yaratmayacaðýnýn prospektif olarak araþtýrýlabileceðini düþünüyoruz.

INTRODUCTION: Besides the known metabolic effects of vitamin D, its role in modulation of pain is controversial. In our study, we aimed to investigate the possible relationship between demographic data and some biochemical values of blood who has in female patients with low vitamin D levels and neuropathic pain.
METHODS: The data of the patients who applied to the Physical Medicine and Rehabilitation Polyclinic between January 2017 and January 2018 were evaluated retrospectively. Seventy-nine female patients with low vitamin D levels who met the inclusion criteria were included in the study. The painDETECT pain questionnaire was used to evaluate the presence of neuropathic pain. According to this questionnaire, the patients were divided into three groups as no neuropathic pain, suspicious, and present.
RESULTS: Neuropathic pain component was detected by the painDETECT questionnaire in 15 (19%) of the female patients with low vitamin D levels. There was no statistically significant difference between neuropathic pain groups and age, education levels, number of births, body mass index as well as plasma values of vitamin D, alkaline phosphatase, parathyroid hormone, and calcium in female patients with low vitamin D levels.
DISCUSSION AND CONCLUSION: In this retrospective study, we observed similar biochemical data in patients with different degrees of neuropathic pain and low vitamin D levels. We think that it can be prospectively investigated whether vitamin D supplementation will make a difference in treatment the patients with low vitamin D levels and neuropathic pain.

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GÝRÝÞ ve AMAÇ: Akut taþlý kolesistit tedavisinde perkütan kolesistostominin teknik ve klinik etkinliði, iþlem sonrasý morbidite ve komplikasyonlarý etkileyen faktörler, hastalýðýn nüksü ve nihai kolesistektomi gibi uzun dönem sonuçlarý etkileyen prediktif faktörler komorbid hastalýklarý olan yaþlý bir kohortta deðerlendirildi.
YÖNTEM ve GEREÇLER: Çalýþma grubu 50 yaþ ve üstü 80 perkütan kolesistostomi hastasýndan oluþturuldu. Akut Kolesistit Ýçin Tokyo Kýlavuzu 2018’e (TG18), Charlson Komorbidite Ýndeksi (CCI) ve Amerikan Anestezistler Derneði (ASA) Fiziksel Durum Sýnýflandýrma Sistemine göre derecelendirildi/sýnýflandýrýldý.
BULGULAR: Teknik baþarý oraný %100 idi. Klinik etkinlik %65 ve kýsmi klinik etkinlik %93,33 idi. Komorbid durumlara baðlý 30 günlük mortalite %11,25 ve ortalama ölüm süresi 14,78±5,91 gün idi. Ölen ve hayatta kalan hastalarda, ortalama ASA skorlarý (p=0,003) ve ortalama TG18 dereceleri (p=0,032) önemli ölçüde farklýydý. Majör komplikasyon sadece %2,5 hastada, minör komplikasyon ise %3,75 hastada görüldü. Perkütan kolesistostomiden taburcu olmaya kadar geçen medyan süre beþ gündü. On iki aylýk bir takip sýrasýnda hastalarýn %18,75’i eksitus oldu. Kalan hastalarýn %86,15’i sadece geçici perkütan kolesistostomi ile tedavi edildi. Bir yýllýk interval kolesistektomi oraný %13,85 idi. Kolesistektomiye kadar geçen medyan süre 72,50 gündü ve 7 ile 340 gün arasýnda deðiþiyordu. TG18/CCI ile kolesistektomi ihtiyacý arasýnda bir iliþki yoktu.
TARTIÞMA ve SONUÇ: Akut taþlý kolesistitli yaþlý ve komorbid hastalarda perkütan kolesistostomi erken dönemde önemli bir klinik iyileþme saðlamaktadýr ve hayat kurtarýcýdýr.

INTRODUCTION: The technical and the clinical efficacy of percutaneous cholecystostomy (PC) in the management of acute calculous cholecystitis, factors affecting postprocedural morbidity and complications, and predictive factors that affect long-term results including recurrence of disease and eventual cholecystectomy were evaluated in a cohort of elderly with comorbid diseases.
METHODS: The study group consisted of 80 PC patients, aged 50 or older. They were graded/classified according to Tokyo Guidelines 2018 for Acute Cholecystitis (TG18), Charlson Comorbidity Index (CCI), and the American Society of Anesthesiologists Physical Status Classification System.
RESULTS: The technical success rate was 100%. The clinical efficacy was 65%, and the partial clinical efficacy was 93.33%. The 30-day mortality due to comorbid conditions was 11.25% and the mean time to death was 14.78±5.91 days. Patients who died and who survived were significantly different regarding mean ASA scores (p=0.003) and mean TG18 grades (p=0.032). Major complication was seen in only 2.5% and minor complication was seen in 3.75% patients. The median time from PC to discharge was 5 days. During a 12-month course, 18.75% of patients died. Of the remaining patients, 86.15% were able to be managed only with a temporary PC. The 1-year interval cholecystectomy rate was 13.85%. The median time to cholecystectomy was 72.50 days with a range between 7 and 340 days. There was no relationship between TG18/CCI and the subsequent need for cholecystectomy.
DISCUSSION AND CONCLUSION: PC provides a significant clinical improvement in the early course and is life-saving in elderly and comorbid patients with acute calculous cholecystitis.

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GÝRÝÞ ve AMAÇ: Magnezyumun vasküler sistem üzerinde önemli etkileri olduðu ve magnezyum eksikliðinin vazokonstrüksiyonu tetiklediði ve vasküler endotel hasarýný kolaylaþtýrdýðý bilinmektedir. Ýskemik inmede magnezyum düzeyleri, etiyolojik alt tipler ve lezyon boyutu arasýndaki iliþkiyi araþtýran birçok çalýþmada çeliþkili sonuçlar bulunmuþtur. Bu çalýþmada, serum magnezyum düzeyleri ile inme etiyolojisi arasýndaki iliþkinin, lezyon boyutunun ve lokalizasyonunun incelenmesi amaçlandý.
YÖNTEM ve GEREÇLER: Akut iskemik inmenin ilk 24 saati içinde baþvuran 18 yaþ üstü 545 hasta ve 189 saðlýklý kontrol çalýþmaya dahil edildi. Hastalar, TOAST sýnýflandýrmasýna göre ve ayrýca ön ve arka sirkülasyon infarktlarý açýsýndan gruplandýrýldý. Ýnfarkt hacmi, büyük (≥5 cm3) ve küçük (<5 cm3) infarkt olarak manyetik rezonans görüntüleme taramasý ile belirlendi. Serum magnezyum seviyeleri ile etiyoloji, lezyon boyutu ve lokalizasyon arasýndaki iliþki incelendi.
BULGULAR: Serum magnezyum düzeyi hasta grubunda 1,90±0,23 mg/dL, kontrol grubunda 1,93±0,18 mg/dL idi ve istatistiksel olarak anlamlý bir fark bulunmadý (p=0,11). Ortalama magnezyum düzeyi aterotrombotik grupta 1,90±0,2 mg/dL; kardiyoembolik grupta 1,87±0,2 mg/dL; laküner grupta 1,88±0,18 mg/dL; belirlenemeyen grupta 1,92±0,2 mg/dL; diðer inme grubunda 1,91±0,2 mg/dL olarak bulundu. Etiyoloji (p=0,25) ve lokalizasyon (p=0,109) açýsýndan magnezyum düzeyleri arasýnda istatistiksel olarak anlamlý fark yoktu. Ortalama magnezyum seviyesi büyük ve küçük infarkt gruplarýnda sýrasýyla 1,87±0,24 mg/dL ve 1,91±0,2 mg/dL idi. Ortalama magnezyum seviyeleri ile infarkt boyutu arasýnda ters bir iliþki bulundu (p=0,044, r=-0,087).
TARTIÞMA ve SONUÇ: Çalýþmanýn sonuçlarý, magnezyumun infarkt patofizyolojisinde rol oynayabileceðini ve nispeten yüksek magnezyum seviyelerinin lezyon boyutunu sýnýrlayabileceðini düþündürmektedir.

INTRODUCTION: Magnesium is known to have important effects on vascular system and deficiency of magnesium triggers vasoconstriction and facilitates vascular endothelial damage. There were conflicting results in several studies searched for relationship between magnesium levels, etiologic subtypes, and lesion size in ischemic stroke. We aimed to examine relationship between serum magnesium levels and etiology of stroke as well as lesion size and localization.
METHODS: A total of 545 patients over the age of 18 years who presented within the first 24 h of acute ischemic stroke and 189 healthy controls were included in the study. Patients were grouped according to TOAST classification and also as anterior and posterior circulation infarcts. Infarct volume was estimated using MRI scan as large (≥5 cm3) and small (<5 cm3) infarct. The relationship between serum magnesium levels and etiology, lesion size, and localization was examined.
RESULTS: Serum magnesium level was 1.90±0.23 mg/dL in the patient group and 1.93±0.18 mg/dL in the control group, and no statistically significant difference was found (p=0.11). The mean magnesium level was 1.90±0.2 mg/dL in the atherothrombotic; 1.87±0.2 mg/dL in the cardioembolic; 1.88±0.18 mg/dL in the lacunar; 1.92±0.2 mg/dL in the undetermined; and 1.91±0.2 mg/dL in the other stroke group. There was no statistically significant difference between the magnesium levels according to etiology (p=0.25) and localization (p=0.109).The mean magnesium level was 1.87±0.24 mg/dL and 1.91±0.2 mg/dL in the large and small infarct groups, respectively. An inverse rela-tionship between mean magnesium levels and the infarct size was found (p=0.044, r=−0.087).
DISCUSSION AND CONCLUSION: Our results suggest that Mg may play a role in the pathophysiology of infarction and relatively high Mg levels may limit the lesion size.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, granülomatöz mastit olan olgularda meme dokusundaki hacim deðiþikliklerinin ve deformasyonun manyetik rezonans bulgularýný deðerlendirmek ve diðer taraf normal meme ile karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþma, histopatolojik olarak kanýtlanmýþ 15 granülomatöz mastit hastasýný içermektedir. Üç planda meme boyutlarý ve meme hacmi hesaplandý. Parankimal ödem, meme baþýnda çekilme ve memede deformasyon bulgularý not edildi.
BULGULAR: Ölçümler, sadece sagital boyut (hasta ve normal memeler için sýrasýyla, 124,4±26 mm ve 116±22,9 mm) ve hacimde [hasta ve normal memeler için sýrasýyla, 329,3 cc (IQR: 245-572 cc) ve 281,6 cc (IQR: 217,3-310,3 cc)] anlamlý artýþ olduðunu gösterdi. Koronal boyut hasta tarafta daha küçük olmakla birlikte, anlamlý farklýlýk göstermedi. Parankimal ödem 10 (%66,6) hastada, deformasyon 4 (%26,6) hastada, meme baþýnda çekilme 5 (%33,3) hastada saptandý.
TARTIÞMA ve SONUÇ: Granülomatöz mastit, etkilenen tarafta meme hacmini artýrmakta olup bu artýþ sagital ve aksiyel çap artýþlarýyla iliþkilidir. Bunun aksine hastalýk, koronal çapta küçülmeye neden olmaktadýr. Deformasyon ve meme baþýnda çekilme hastalýðýn seyri sýrasýnda belli oranlarda geliþebilmektedir.

INTRODUCTION: The objective of this study was to evaluate the volume changes and the findings of deformation in the breasts with granulomatous mastitis and to compare the findings with the contralateral normal breasts.
METHODS: This retrospective study included histopathologically proven 15 granülomatous mastitis (GM) patients. Breast diameters in three planes and the volume were measured on Magnetic resonance imaging (MRI). Parenchymal edema, nipple retraction, and deformation of the breast were noted.
RESULTS: The measurements were only showed significant increase in sagittal diameter (124.4±26 mm and 116±22.9 mm, for diseased and normal breasts, respectively) and volume (329.3 cc [IQR: 245–572 and 281.6 cc [IQR: 217.3–310.3] for diseased and normal sides, respectively) in the breasts with GM when compared with normal side (p<0.05). Coronal diameter was lesser in the diseased side without significant difference. Ten patients showed parenchymal edema (66.6%), four patients had deformation (26.6%), and five patients had nipple retraction (33.3%) on MRI.
DISCUSSION AND CONCLUSION: GM enlarges the breast volume in the affected side which is related with the increase in the axial and sagittal diameters. On the contrary, the disease causes a reduction in the coronal diameter. Deformation and nipple retraction may occur to some extent, in the course of the disease.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, eldeki falangeal benign yumuþak doku tümörlü hastalarý ve cerrahi sonrasý kýsa dönem komplikasyonlarýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: Ocak 2019-Ekim 2021 tarihleri arasýnda falanks yumuþak doku tümörlü 59 hasta (31’i kadýn, 28’i erkek; ortalama yaþ 48,96±13,33 yýl, daðýlým 20-75 yýl) demografik veriler, histopatolojik taný, memnuniyet düzeyi, nüks ve komplikasyonlar açýsýndan deðerlendirildi.
BULGULAR: En sýk görülen falanks yumuþak doku tümörü tenosinovyal dev hücreli tümörlerdi (n=15, %38,4). Diðer sýk görülen histolojiler ise ganglion kistleri (%12,8), epidermal inklüzyon kisti (%10,25) ve fibrolipom (%7,6) idi. Yumuþak doku tümörleri en sýk ikinci ve üçüncü falankslarda (her ikisi de %26,2) bulunurken, bunu dördüncü (%13,8), birinci (%12,3) ve beþinci (%9,2) falankslar takip etti. El falanksýnda tümörler %40 proksimal, %29,2 distal ve %30,8 falanksýn farklý bölgelerindeydi. Ortalama VAS skoru eksizyonel cerrahi öncesi 5,9±3,1 idi; son kontrolde 3,47±1,3 idi (p<0,01). Yedi hastada ameliyat sonrasý nüks görüldü (%11,8). Cerrahi alan enfeksiyonu diðer komplikasyondu ve 3 (%5) hastada tespit edildi.
TARTIÞMA ve SONUÇ: Deneyimlerimiz, en sýk gözlenen yumuþak doku falanks tümörlerinin tenosinovyal dev hücreli tümörler olduðunu gösterdi. Falanksýn yumuþak doku tümörlerinin eksizyonel cerrahi tedavisi, iyi memnuniyet oranlarý ve düþük nüks ve komplikasyon oranlarý elde etmek için dikkat gerektiren bir cerrahidir.

INTRODUCTION: Our aim in this study is to evaluate patients with phalangeal benign soft-tissue tumors of the hand and to evaluate their short-term complications after surgery.
METHODS: Between January 2019 and October 2021, 59 patients (31 female, 28 male; mean age 48.96±13.33, range 20–75 years) with phalangeal soft-tissue tumors were evaluated according to demographic data, histopathological diagnosis, satisfaction level, recurrence, and complications.
RESULTS: The most common phalangeal soft-tissue tumor was tenosynovial giant cell tumors (n=15, 38.4%). Other frequent histologies included ganglion cysts (12.8%), epidermal inclusion cyst (10.25%), and fibrolipoma (7.6%). Soft-tissue tumors were most commonly found on second and third phalanx (both 26.2%), followed by fourth (13.8%), first (12.3%), and fifth (9.2%) The location of soft-tissue tumors was found in the phalanx of hands that were 40% proximal, 29.2% distal, and 30.8% in different parts of the phalanx. The mean visual analog scale score was 5.9±3.1 before excisional surgery; it was 3.47±1.3 at the last follow-up (p<0.01). Seven patients had recurrence after the surgery (11.8%). Surgical site infection was the other complication and seen in three patients (5%).
DISCUSSION AND CONCLUSION: Our experience has shown that the most frequently observed soft-tissue phalanx tumors are tenosynovial giant cell tumors. Excisional surgical treatment of soft-tissue tumors of the phalanx is a surgery that requires attention to get good satisfaction rates and low recurrence and complication rates.

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Polianjitis ile birlikte olan eozinofilik granülomatöz, önceki adýyla Churg-Strauss sendromu, nadir rastlanýlan; astým, eozinofili ve sistemik vaskülit ile seyreden bir hastalýktýr. Eozinofilik granülomatöz polianjit iskemik inmenin nadir nedenleri arasýnda gösterilebilir. Nörosifiliz ise geniþ klinik belirtileri nedeniyle birçok hastalýðý taklit edebilen ve sýklýkla tanýsý atlanýlan bir hastalýk olup, bu hastalarýn bir kýsmý günümüzde acil servislere akut inme ile gelmekte ve ancak bu þekilde taný almaktadýr. Buradaki olgu iskemik inmenin iki nadir nedeni bir arada olduðu için sunuldu.

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare disease with asthma, eosinophilia, and systemic vasculitis. EGPA may be among the rare causes of ischemic stroke. Neurosyphilis, on the other hand, is a disease that can mimic many diseases due to its wide clinical symptoms, and the diagnosis is often delayed or missed. Some of these patients present to the emergency services with acute stroke and are only diagnosed after suffering a cerebrovascular complication. We present this case, because two rare causes of ischemic stroke are together.

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Tekrarlayan polikondrit kýkýrdak dokularda tekrarlayan ve progresif inflamasyonla karakterize nadir otoimmün bir hastalýktýr. Auriküler kýkýrdak, en yaygýn klinik bulgusu ve en sýk baþlangýç tutulum yeridir. Nazal kondrit hastalarýn %15’inde vardýr. Nazal kartilajýn yýkýlmasý ile semer burun deformitesi geliþebilir. Burada, 38 yaþýnda nazal kondrit ile baþlayan semer burun deformitesi geliþen ve rinoplasti sonrasýnda tekrarlayan polikondrit tanýsý alan bir hasta sunuldu.

Relapsing polychondritis (RP) is an uncommon autoimmune disease characterized by repeated and progressive inflammation in cartilage tissue. The auricular cartilage is the location of the most common clinical findings and the most common site of initial involvement. Nasal chondritis is a manifestation present in 15% of patients. Progressive destruction of nasal cartilage leads to the characteristic flattening of the nasal bridge, resulting in saddle nose deformity. The case is, here, presented of a 38-year-old patient who developed nasal chondritis which resulted in saddle nose deformity, and was diagnosed with RP following rhinoplasty.

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