Objective: To show change in residual urine volume, Pdetristol Qmax and maximum bladder capacity in prostate symptom scores within early period six months after operation in proportion to pre-operation in three group patients that were non-homogeneous in terms of prostate volumes. Material and Methods: Seventy-five patients with LUSS were included in study, whose bladder outflow fully obstruction had been shown with pressure flow study. Fifty patients as healthy control were included. Of the 50, TVP was applied to 15, TUEP for 15, and TURP for 20. Measurements of symptom scoring, Qmax, PdetQmax, maximum bladder capacity and residual urine volume of all patients were performed pre-operation and post-operation. Paired T-test and Kruskal-Wallis test were used in statistical analysis. P value less than 0.05 was accepted as significant. Results: The mean age for TVP, TUEP and TURP groups were 68.6, 61.3 and 66.6 years, respectively. Postoperative mean prostate volumes for TVP, TUEP and TURP groups were calculated as 79.1 g, 39.75 g and 54.8 g, respectively. Three groups were evaluated in terms of symptom scores, reduction in residual urine volume, Pdetrisol Qmax, and maximum bladder capacity before and after operation. Significant changes were detected for these parameters of patients in the TVP and TURP. On the other hand, no significant change was monitored only in terms of maximum bladder capacity was monitored in patients in the TUEP group. However, significant change was monitored in symptom scores, reduction in residual urine volume, Pdetrisol Qmax. Conclusion: While almost similar significant result was monitored in terms of prostate symptom scores, reduction in residual urine volume Pdetrisol Qmax, and maximum bladder capacity in patient groups applied TVP and TURP despite of different prostate volume, positive result was also monitored in other parameters, except maximum bladder capacity in TUEP group, in selected patients.

Objective: The data of 69 patients with laryngeal cancer who underwent surgery in our clinic between 1994-2011 years were retrospectively evaluated Material and Methods: Retrospective analysis. Results: Eighty-five percent of the patients were male and outstanding complaint was hoarseness and 81.2% of the patients were active smoking. In the prediction of tumor stage, the accuracy of preoperative clinical examination and neck computed tomography was found to be 85%. The correlation between the histological differentiation of the tumor and cervical metastasis was statistically significant (P <0.05). Conclusion: Passive cigarette smoking may be important in the development of laryngeal cancer. Treatment of the neck should be considered in the poorly differentiated cancers. In addition, Neck CT, being a quick and reliable diagnostic method, can be used for accurately detecting the spread of laryngeal cancer lesion and cartilage invasion.

Objective: C reactive protein’s (CRP) measurement is frequently delayed due to transportation of blood and technical problems of laboratory devices. In this study we investigated the changes in CRP levels of sera stored in refrigerated conditions. Method: The CRP levels of sera were detected with Behring nephelometry system without any delay. The serum of 50 patients with CRP levels between 12.6 mg/L and 203 mg/L were kept uncovered at +4 oC. The CRP measurements were repeated at two different times, after 3 and 7 days from the first measurement. Obtained CRP levels were evaluated statistically. Result: The CRP mean level from the first measurements was 55.83 mg/L, where three days later the mean level increased to 76.35 mg/L and seven days later, the mean level decreased to 60.99 mg/L. The difference between first and three days measurements was found statistically significant however there was no significant difference between the first and seven days. Conclusion: If samples can not be analyzed for CRP immediately due to a technical glitch, the right approach would be to work in collaboration with clinicians and request a new sample if possible. Furthermore, this study is important as it shows a need for more comprehensive studies on time-dependent change of CRP levels in the next days and under different conditions and causes for that change.

Objective: To avoid the unnecessary antegrade pyelography after percutaneous nephrolithotomy (PCNL). Material-Method: Between July 2010-August 2011, 85 patients who were performed PCNL were evaluated. In patients; percutaneous way was created by applying the dilation of 30F over a guide wire with Amplatz dilators. The process of crushing stone was carried out by using 26F rigid nephroscope (Wolf, Germany) and pneumatic lithotripter (Vibrolith-Elmed, Turkey). Open-ended 5fr or 6 fr ureteral catheter was placed into the ureter. Urinary tract radiography (DUSG) was taken in the 1st post-operative day and the ureteral catheters were removed. Nephrostomy was clamped and the follow-up of residue was done. Nephrostomy was taken if the residue were <50cc after 2-4 hours. Ureteral Double J (DJ) stent was applied to the patients who had urine from their nephrostomy tract after the removal of the nephrostomy catheter. Results: 68 of the patients were male and 17 of them were female. The mean age was 40.1 ± 12.15 (13-70) years. 74% of the stones (n: 64) was in the group of simple renal stone, but 26% of them (n = 21) was in the complex stone group. The mean stone burden was calculated as 320 mm ². We observed that 70% of our cases were entirely purified from the stone, there were clinically the pieces of insignificant stone at 23% of them, and it was resulted in failure at 7% of them. The average removal duration of the nephrostomy tube was 2.7 (1-5) days, but the average duration of hospital stay was 3.2 (2-6) days. There was no need to take the antegrade pyelography for none of the patients. Wetting from the tract went on in 7 patients for more than 24 hours after the withdrawal of the nephrostomy tube. It lasted for 2 days in 3 patients, 4 days in 2 patients, 8 days in 1 patient and 12 days in 1 patient. Double-J (DJ) catheter was placed to all of these patients. DJ stent was performed due to the detection of the stone fragments considered to be obstructive in DUSG taken in the available state of the ureteral catheter in the 1st day of post-surgery in 2 patients. Conclusions: We can avoid from unnecessary antegrade pyelographies by doing the residual follow-up after the percutaneous nephrolithotomy. Thus, we have prevented the intake of unnecessary radiation and the use of the contrast material.

Lipid embolism occurs with the free lipid molecules which are derived from soft tissue and bone marrow during serious direct, surgical or soft tissue trauma. A morbid obese and diabetic patient having lumbar disc hernia was operated. L5-S1 discectomy + Posterior L5 osteotomy + Bilateral L4 laminectomy + stabilization operation was performed. During stabilization with titanium plate, the patient had cardiac arrest. Although resuscitation was done, the patient died. Autopsy was done to learn the cause of death. At the autopsy, the only positive sign was the diffuse lipid embolism of the lung. In conclusion, care should be taken to avoid lipid embolism during the spinal operations of diabetic and obese patients. If the patient dies, an autopsy must be done to determine the cause of death.

Female hydrocele or hydrocele of canal of Nuck is uncommon. A literature search revealed that little has been published on this condition. Complete obliteration failure of the processus vajinalis results cyst of the canal of Nuck in females. We reported 2 cases of hydrocele of canal of Nuck. One is 4 year-old girl who has been admitted with left groin mass, the other is 3.5 year-old girl who has right groin mass. Both patients were operated with a pre-diagnosis of sliding hernia, and the histhopathological diagnosis was reported as hydrocele of canal of Nuck.

Schwannomas are tumors originating from nerve sheath cells. They are rarely seen in the oral cavity. Their etiology is not precisely known. Twenty seven-year-old female patient was presented to our clinic with a mass in her tongue existing for 15 years. From her history we learned that the mass was small and painless at first, and in the last 1-2 months it grew and started to cause pain. Her oral examination revealed an about 1x1 cm gray colored hard mass, raising from surface on the right side of the tongue. Histopathologic examination of the totally excised mass was reported as schwannoma. The patient having no problem postoperatively was called for follow up. We presented this case because schwannomas are rare and should be thought in the differential diagnosis of oral cavity masses.

Syncope is defined as a transient, self-limiting loss of consciousness, with loss of postural tone and spontaneous recovery. Syncope has numerous potential causes ranging from benign to life threatening conditions. Vasovagal syncope accounts for 10-40% of all syncope patients. Vazovagal syncope is a benign emergent condition that is usually self-limited and has spontaneous recovery without any medication. Herein we present a patient with vasovagal syncope that needed medical treatment with atropine in our emergency service.

Tarsal tunnel syndrome (TTS) is a compressive neuropathy caused by either intrinsic or extrinsic pressure on the posterior tibial nerve or one of its branches. Probable conditions that could lead to the development of TTS can be classified as trauma, space-occupying lesions, metabolic diseases, and biomechanic and idiopathic causes. We report two patients with TTS caused by long time applied elastic bandage after prostetic surgery of the knee, an apparently rare complication.

Duplications which can be found in cystic or tubular structure are among the rare congenital malformations of gastrointestinal system. They can be found in anywhere in gastrointestinal system from mouth to anus. A five years and two months old girl was brought to our hospital with abdominal pain and nausea. In her history, it was learnt that the complaints were begun six months before and different treatments had been given to her for abdominal pain at different centers but the recovery had not been achieved. On admission, general status was well, conscious was open and vital findings were stable. Urine specimen, full blood count, biochemical parameters, liver and kidney function tests were found to be normal. Abdomen ultrasonography revealed a cystic lesion of 30x17 mm which was covered with the gastrointestinal system mucosa neighbourhood of the duodenum first section. Additionally, on computerized tomography examination, a 3x2 cm sized cystic lesion appearance was seen on the neighbourhood of anterior segment of duodenum first section. Duodenum duplication cyst is a rare cause of abdominal pain in children, for this reason we presented this case to be remembered.

Migraine is a primary headache disorder that affects 10% of the population including mostly young and middle-aged individuals and reduces quality of life and labor force. Although many treatment options are put forward, treatment of many patients still is not satisfactory. Better understanding of the disease pathogenesis will cause more effective treatment in the future. These new treatment approaches not only trigger new hopes for patients but also reduce serious socio-economic effects that are induced by this disease.

In this review, it is argued that some topics are common epigenetic mechanisms, epigenetic mechanism in tumor genesis, epigenetic-cancer therapy and cancer oriented biomarkers. Epigenetic which analyzes differences in gene expression, consists of DNA methylation, histone modification, and chromatin modeling. In living organisms, biological function continues steadily with interaction of genetic and epigenetic mechanisms. Genetic aberrations, epigenetic protein alterations or spoiling balance between two systems degenerate working system. This aspect causes diseases such as cancer, neurological and autoimmune diseases. Finally, considering all these, creating pharmacological compounds to target oriented and developing epigenetic biomarkers has become increasingly important.