Aim: We aimed to present short and long-term outcomes of patients undergoing PEG and our experiences. Method: PEG applied 64 patients were evaluated from January 2009 to February 2012 retrospectively. Patients demographics, primary disease, the causes of the process failure, additional diseases, referring clinics, complications, and mortality rate were evaluated. Results: 34 (53%) patients were male, 30 (47%) were female, and the most common age was >80 (39%). The most common indication was neurological diseases (80%) and reffering clinic was neurology (69%). The cause of the process failure in three patients were insuffient translumination and gastroduedonoscopy failure according to larynx tumour. In follow-up; 20% within the first 6 months, 11% between 6-12 months, 10% between 12-18 months, and 14% later than 18 months were died. Leakage from the edge of the catheter (20%), catheter dislocation (14%), cutanous-subcutaneous infections (8%), bleeding on the skin (3%) were developed as minor complications, but no major complications were developed in patients. Conclusion: PEG can be applied safely and effectively, we think that executing PEG procedures at surgical endoscopy units is an appropiate approach because of minor and major complications which can occur during or after procedure and need surgical treatment or follow-up.

in adults and most of them are benign. This study aimed to evaluate overall patients operated in our clinic due to ovarian masses. Patients and Methods: In this study, between 2008- 2012 medical record of patients ( age ≤ 16 ) whom operated for the ovarian masses, patients’ demographic structures, presenting symptoms, surgery, and pathology were evaluated retrospectively. Results: In this study, 34 patients (11,64 +4,22 years ) were included in this study. Abdominal pain was the most common complaint. Only 4 patients were administered hormonal therapy. Others were diognosed as an ovarian mass during operation or admission. The 73.4% of the cases were underwent preoperative ultrasonography. Ovarian mass was localized in the right ovary (n=19), in the left ovary (n=13), and bilateral (n=2). Fourteen of all patients with were admitted because of torsion, 4 of them with haemorrhage-rupture were underwent surgery and 7 of them with abdominal mass were underwent surgery. Seven of 34 patients were underwent oophorectomy. The remaining patients were managed with ovary sparing. The histopathology assessment in 13 patients with abdominal mass were mature cystic teratoma, the remaining masses in patients were simple, serous, mucinous and follicule cysts. Conclusions: The most of ovarian pathologies in children are benign therefore surgery for ovary should be preferred preserving surgical procedures.

Aim: Percutaneous nephrolithotomy (PCNL) surgery has become the gold standard treatment for many kidney stones. In this study, we evaluated the success and complication rates of PCNL in the first 200 patients. Materials and Methods: Between September 2005 and May 2011, the records of 200 renal stone patients who underwent PCNL were reviewed retrospectively in Urology Clinic of the İzmir Atatürk Training and Researching Hospital. Patient related factors such as age, stone size and localization were noted. Number and localization of access, blood transfusion requirement, success rate, lenght of hospitalization, intraoperative and postoperative complications and additional therapy requirements were reviewed. Patients were evaluated with direct urinary tract X-ray on postoperative first day and with intravenous pyelography at postoperative third month. Results: 123 men (61.5%), 77 women (38.5%), 47.5% right side, 52.5% left side, mean stone burden 7.36 ± 6.31 cm² were determined in patients who underwent PCNL. Before the PCNL procedures 94 patients (47%) had grade 2 or grade 3 hydronephrosis. 91 patients had simple stones and 109 patients had complex stones. 79% (158 renal unit) success rate (CIRF + Stone free) was achieved at postoperative 1st day. After additional therapy was applied 24 patients (12%), this rate was increased 83% at postoperative 3rd month. Complications occured in 29% of patients who underwent PCNL. Required blood transfüsions in 32 patients (16%). None of patients had died during the operation. Hydrothorax occured in 2 cases and drainage was achieved by chest tube. Conclusion: PCNL which needs surgical experience, can be considered as an effective and safe treatment option for renal stones with high success rates, short duration of hospitalization, and acceptable complication rates. It was seen that the urologists could perform PCNL operation with similar results to the literature, if they have adequate surgical equipment.

Aim: In this study, it was aimed to assess the relation between Human Papillomavirus (HPV) and various risk factors by determination of HPV types in precancerous cervical lesions in our hospital. Methods: A Pap smear test was performed on a total of 61 patients who applied to the Obstetrics and Gynecology Clinic with some gynecological complaints. HPV typing was performed in cervical samples collected from the patients by reverse hybridization method using automated Auto-lipa system (Gen ID). The relation between HPV DNA positivity and the age, parity, sexual activity duration, smoking and oral contraceptive use was investigated. Results: Whereas HPV DNA positivity rate of the cases with normal Pap test results was 36%, this was 87.5% in patients diagnosed with high-grade squamous intraepithelial lesion (HSIL), 50% in low-grade-squamous-intraepithelial-lesion (LSIL) and 11.1% in atypical-squamous-cells-of-undetermined-significance (ASCUS). HPV DNA positivity rate of the cases diagnosed with HSIL was found to be statistically significantly high. The most frequently identified types of HPV were 16 and 18. While a positive relation was determined between cigarette smoking and HPV positivity, it was found that an increase in the duration of sexual activity reduced HPV positivity. The average age of HPV DNA positive cases was found to be lower than that of HPV negative cases. No statistically significant evidence of a relation between other factors and HPV was found. Conclusion: It was seen that some HPV types could be responsible for the cervical cytological changes. Generally, the detection rate of HPV was found to be relatively high and this was more pronounced in younger ages. Additionally, HPV DNA rate was found to be higher in smokers.

Aim: It is aimed to investigate frequency and risk factors of acute bacterial prostatitis (ABP) after transrectal prostate biopsy. Method: Three hundred and thirty five patients, who underwent ultrasound-guided transrectal prostate biopsy at Urology Department of Mustafa Kemal University, Medicine School, between February 2010-April 2012, were retrospectively evaluated. Age, history of chronic diseases, prostate volume, number of core in biopsy, indications of biopsy, number of previous biopsies and results of urine and blood culture test in patients with ABP were recorded. Findings: Frequency of ABP was found as 2.4% after biopsy. It was found that there was levofloxacin-resistant Escherichia coli growth in urine and/or blood culture tests in 6 (75%) of the 8 cases in which ABP was developed after biopsy. It was detected that, of these, 3 (50%) produced broad spectrum beta-lactamases. Isolates were found to be susceptible to cephalosporins and aminoglycosides. It was found that number of repeated biopsies was significantly higher in patients with ABP. Conclusion: In many cases, fluoroquinolones are effective antibiotics in the prophylaxis of transrectal biopsy. Repeated biopsies may increase development of ABP. Cephalosporins and aminoglycosides may be more effective in the treatment, as higher rates of resistance to fluoroquinolones may be encountered in patients with ABP.

Brucellosis is a zoonotic infectious disease having still high mortality in Turkey. Despite the fact that the gastrointestinal system involvement is frequent, the manifestation of acute abdomen is rarely seen. Rebound, defense and sensitivity, which make one think of acute abdomen, were present in both cases, who presented with the complaints of abdominal pain and fever. While the aspartate aminotransferase level was high in both cases, one of the cases had hepatosplenomegaly. In the first case, Wright tube agglutination was measured as 1/1280 positive. In the second case, Wright tube agglutination was 1/320 positive, and Brucella Melitensis proliferated in blood cultivation. Specific antibiotherapy (rifampicine and doxycycline) was begun in both cases. Both recovered without any complications. These cases have been presented with the purpose of reminding that in countries like Turkey in which it is endemically seen, brucellosis with multisystemic involvement which is rarely seen especially in children, can cause a false diagnosis and unnecessary treatment due to its mimicking acute abdomen.

Coombs positive autoimmune hemolytic anemia, accompanied to Hodgkin’s lymphoma, was firstly defined in 1967. Hodgkin’s disease along with autoimmune hemolytic anemia is rare. Autoimmune hemolytic anemia may appear before Hodgkin’s disease, during the diagnosis, or years after the diagnosis. Here, two women cases, one of 16-year-old applying with cervical lymphadenopathy and hemolytic crisis and receiving autoimmune hemolytic anemia diagnosis and the other 34-year-old, two years ago treated with diagnosis of nodular sclerosing type of Hodgkin’s lymphoma with thrombocytopenia and hemolytic anemia (Evans syndrome) were presented. The first case was resistant to the immunosuppressive treatment and splenectomy. Because of the hemolytic anemia, portal vein thrombosis developed after the splenectomy. After the diagnosis of Hodgkin’s disease, hemolytic anemia of the patient improved after chemotherapy. The second case responded to the immunosuppressive treatment. The patient was evaluated for lymphoma recurrence and no recurrence was determined. In conclusion; these cases show that during the diagnosis or after the remission of Hodgkin’s lymphoma, autoimmune hemolytic anemia and thrombocytopenia can be seen.

Aim: Fibroepithelial stromal polyps of vulvovaginal region are uncommon tumors and their clinical features may overlap with those of malignant neoplasms. They have a wide range of morphologic appearances so a biopsy is often necessary to make a definitive diagnosis. Case: We present a case of a 38-year-old woman with 9 weeks of pregnancy who developed a 15- cm polypoid lesion localized in the left labium. Total surgical resection of the lesion was performed. Histologically, in a hypercellular focal myxoid stroma, typically there were mesenchymal stellate cells, spindle- shaped cells and multinucleated giant cells. The clinical and immunohistochemical findings of this case suggest a fibroepitelial stromal polyp of the vulva. Her pregnancy progressed normally, and she underwent an uncomplicated vaginal delivery. The patient showed no evidence of recurrence one year after the resection. Conclusion: This vulvar lesion has been evaluated as an example of giant fibroepithelial stromal polyp in association with pregnancy.

Radical Cystectomy and Ileal bladder substitution were planned in a 63 years old patient with invasive bladder carcinoma. During the operation, Meckel diverticula was seen in location of 50 cm proximal to ileocecal valve in small intestine. Meckel diverticula was used for ileo-urethral anastomosis as native bladder neck by Studer method. The usage of Meckel divertucula for anastomosis between urethra and urinary bladder is found not only easy to perform but also could help decrease urinary incontinence.

First identified in 1951, congenital deficiency of factor VII (FVII) is an autosomal recessive hemorrhagic diathesis leading to hemorrhagic disorder related to level of factor. Its half-life has been reported as 2.5 to 3 hours. Today, hemorrhage control is achieved with factor VII in the individuals with deficiency of FVII. Here we present a case with congenital FVII deficiency who was hospitalized with diagnosis of supracondylar femoral fracture. As long-term response was obtained following single dose of rFVIIa in the challenge test performed to the patient, we achieved post-traumatic and perioperative control of hemorrhage at replacement dose of 25 µg/kg/6 hours.

In homocystinuria, clinical involvement may include the skeleton, brain, orbita, and vascular system. We report a 7-year-old male who initially presented with fever, edema on feet and legs, and bruising on the hands, and was followed-up with the diagnosis of homocystinuria. On account of the case we would like to emphasize homocystinuria should be considered in cases of cataract, systemic hypertension and purpura fulminans.

Laryngeal myxoma is an extremely rare benign tumor of mesenchymal cell origin. The tumor is frequently misdiagnosed as a vocal polyp because its appearance resembles vocal polyp on laryngeal examination. Definite diagnosis of laryngeal myxoma is obtained by biopsy. A 61-year-old man presented with a laryngeal myxoma arising from the left vocal cord. Laryngeal myxoma can be confused with laryngeal polyp clinically and must be considered in the differential diagnosis of laryngeal masses.

Although prevalence of headaches declines with advancing age, headache is a common complaint in the aged population. The incidence of primary headaches (such as migraine, tension-type headache, cluster headache etc.) decreases with advancing age, while that of secondary headache increases (such as medication overuse headache, giant cell arthritis, lesional headaches etc). Headache in elderly patient can be a sign of serious, potentially life-threatening disorders. Management of headache requires multidisciplinary team approach. Because the comorbid conditions, especially depression, anxiety and cognitive impairment, potential interactions with the multiple drugs are seen often in elderly patients. Therefore, healthcare professionals should pay careful attention to these conditions and perform a full assessment, including a complete neurologic examination. This article reviews the most primary and secondary headache disorders and management of headaches.

Oral cavity anomalies are the most common congenital anomalies of the head and neck region. These anomalies are developmental disorders in embryogenesis and/or result of intrauterine corruption of fetal growth. These anomalies may be simple lesions, but also can be severe that lead to airway, suction, swallowing and aspiration problems in infants. In addition, these anomalies may cause serious psychological problems with cosmetic defects in the next few years. Therefore, early diagnosis and treatment is essential to avoid the problems encountered in advanced. The embriyological development of the anatomical structures of oral cavity, and pathogenesis, diagnosis and treatment of major encountered congenital anomalies were summarized.

The molecular pathology of the inherited retinal degenerations is one of the important research topics recently. As a result of research performed in this area, a high number of genes were found to be responsible for retinal degenerations, however the molecular pathology of most of these diseases are still unknown. All the genes and the functions of their protein products in the cell should be understood for the elucidation of the molecular basis of inherited retinal degenerations. The disease can be inherited in autosomal dominant, autosomal recessive, X linked and digenic modes. In this review, Retina Pigment Epithelia, retinal degeneration causative genes and Retinitis pigmentosa and Leber congenital amaurosis from diseases in this group are outlined recent advances and from molecular genetic point of view.