Aim: The results of single session single entry percutaneous nephrolithotomy applied to horseshoe kidney stone were evaluated. Materials and Methods: Between May 2009 and April 2013 between the ages 25 and 57, 2 male and 1 female, with three horseshoe kidney stones, with an average size of 21.6 mm with a single login trading session underwent percutaneous nephrolithotomy. Results: The mean postoperative clinically insignificant stone free rate is evaluated as millimeter-sized 100% of the residual stone, 66.6% were evaluated for its potential as a mechanism to trigger. The mean operative time was 63 minutes and fluoroscopy time was determined as 6.6 minutes. None of the patients needed blood transfusion. None of the patients displayed post-operative fever, lung, liver or other intra-abdominal organ injury. Conclusion: A single trading single entry session percutaneous nephrolithotomy in patients with horseshoe kidney is a technique that can be applied safely and successfully in the treatment of renal stones.

Aim: To evaluate the efficacy and morbidity in a total of 57 percutaneous nephrolithotomy (PCNL) patients. Material and Methods: Between January 2010 and May 2013 the records of 57 patients in whom PCNL was performed due to kidney stones were retrospectively evaluated. All patients were evaluated with intravenous urography (IVU) and / or abdominopelvic tomography (CT). Patient-related factors such as patient age, sex, party, ipsilateral open surgery, PCNL, extracorporeal shock wave lithotripsy (ESWL), as well as the story of stone size, stone location, degree of hydronephrosis, the location and number of access, operation and fluoroscopy times, intraoperative and postoperative complications, blood transfusion requirement, the success rate was evaluated in terms of length of hospital stay, and secondary treatment requirements. Results: Of the 57 PCNL applications, 29 (51%) were women and 28 (49%)were men, 28% right sided, 54% left sided, 17% bilateral, the average volume of stone 3196.64 mm3, and mean age 54.9 years (21-84), respectively. Pre-operative story revealed open surgery in 4 (7%) patients, ESWL in 10 patients (17%), PCNL in 5 (8%) patients. There was no hydronephrosis in 20 (35.1%) patients before the operation, while 37 (64.9%) patients were found to have hydronephrosis. Balloon dilator was used in all of the 57 patients. 3 patients (5%) had horseshoe kidney, and one patient (1.7%) had malrotion. No perioperative complications occurred in 53 patients (92.9%). Perioperative complications were observed in 4 patients (7.1%). Blood transfusion was required in 3 patients (5%). The mean operation time was 95 minutes and fluoroscopy time was 5.1 min. Conclusion: PCNL method with acceptable complication rates can be applied effectively and safely in the treatment of kidney stones.

Aim: The most important cause of preventable morbidity and mortality is smoking. Seventeen milion persons smoke in Turkey and every year one hundred thousand people die due to smoking releated disease. Materials and Methods: Patients who were started varenicline or bupropion after admission to smoking cessation treatment were retrospectively evaluated in terms of smoking cessation success. Patients ongoing drug therapy for 3 months or patients who could be contacted by phone controls were included in the study. 274 patients were included in the study. 70.4% of patients (n = 193) were male and 29.6% (n = 81) were female. 151 people were included in varenicline group, and 123 people in bupropion group. No significant difference was found between Varenicline and bupropion for smoking cessation in patients. Result: In cases of natural disaster such as an earthquake, drug efficacies are less than the normal population, and disasters in drug activities, active and effective smoking cessation clinics concluded functions should continue.

Aim: To determine the rates of amniocentesis indications and karyotype results of the five-year data in our center and to evaluate the approach to amniocentesis in pregnancies with advanced age. Material and Method: Between 2008 and 2012, 307 cases of amniocentesis were evaluated retrospectively. Indications were classified as advanced maternal age, increased risk on screening test, advanced maternal age with increased risk on screening test, abnormal ultrasound findings, and others. Cytogenetic findings were classified as normal and abnormal. Maternal age was also classified as older than 35 years old and others. The relation of abnormal karyotype with indications and age was analyzed by chi-square test. Results: Increased risk on screening test (37.8%), advanced maternal age (32.6%), advanced maternal age and the positive screening test (20.8%) were the indications. Cell culture was not successful in 4 cases. Abnormal karyotype was detected in the 26(8.5%) of 303 patients. The frequency of anomalies was not different in terms of the maternal age and the indications. However, in the group with advanced maternal age and increased risk screening test, the detection rate of trisomy 21 was higher. Conclusion: In the course of amniocentesis decision in advanced age pregnancies; the use of ultrasound and biochemical diagnostic methods increases the potential for detection of anomaly. Patients should be illuminated enough about it, and all the facilities of medicine should be used when deciding on the indication.

Aim: The aim of this study is to compare the mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR) and platelets/lymphocyte ratio (PLR) in patients with abnormal uterine bleeding (AUB) aged 40 years or more with a diagnosis of endometrial cancer stage 1-2 and benign endometrial pathology. Materials and Methods: The patients with AUB who underwent hysteroscopy, dilatation curettage, or endometrial biopsy between July 2012 and July 2013 were included. All data was achieved by examining inpatient medical records retrospectively. Results: The mean age of patients was 52.81±11.47 years. 37.1% of the patients was at menopause. Endometrioid endometrial adenocarcinoma diagnosed in 10 patients (14.2%), papillary serous carcinoma in 1 patient (1.4%) and endometrial stromal sarcoma in 1 patient (1.4%). Non-invasive benign endometrial histological changes were identified in 58 patients (83%). There was no statistically significant difference between the patients with endometrium cancer and without endometrium cancer in terms of MPV, NLR and PLR values (p=0.148, p= 0.775 and p=0.942, respectively). Conclusions: It has been shown in some studies that MPV, NLR and PLR values increase with advanced stage endometrial malignancies and can be used as prognostic factor. However, in order to clearly identify the alternation of these parameters between patients with early-stage endometrial carcinoma and benign endometrial pathology new and comprehensive studies are needed.

Aim: Esophageal cancer is a malignancy with high incidence and mortality rates. In this retrospective study, we aimed to evaluate esophageal cancer patients’ survival results and the effects of various prognostic factors on the patients treated with chemoradiotherapy. Materials and Methods: In this study, curative chemoradiotherapy outcomes have been reviewed in data from 30 patients diagnosed with esophageal cancer. Results: Overall survival time was from 2.77 to 81.17, median follow-up time was 15.36 months. The median overall survival time was 16.33 months, 2-year and 3-year overall survival rate was 34.0% and 22.7% respectively. Disease-free follow-up period was from 2.53 to 81.17 months, median follow-up was 13.26 months. The median disease-free survival was 14.86 months, 2-year and 3-year have disease-free survival time was 30.5% and 22.9% respectively. Factors affecting survival in patients undergoing definitive chemotherapy 3 or more than 3 were found to be statistically significant. Conclusion: The expected survival rates of esophageal cancer results are still not in level of what we want to have. New chemotherapy agents and targeted therapies, and 4-D conformal RT and IMRT are being effectively applied, and less toxic treatments randomized studies are required to investigate.

Aim: Evaluation of moderate and severe ovarian hyperstimulation syndrome patients. Material and Method: In April 2006- February 2012, moderate and severe ovarian hyperstimulation syndrome patients’ clinic datas were analyzed retrospectively. Result: 49 patients were studied. 18 patients were early, 31 patients were late ovarian hyperstimulation syndrome. 4 clinical pregnancy were seen in early ovarian hyperstimulation group; in the other group 13 clinical pregnancy were seen. Complication rate of the ovarian hyperstimulation syndrome was 2.04%. Discussion: Ovarian hyperstimulation syndrome is an iatrogenic complication. Thus, identification of high risk patients, selection of appropriate strategies and protocols in the first stage will prevent this life- threatening complication.

Tessier face clefts are seen extremely rare and accompanied with lots of congenital anomalies. Especially Tessier cleft type 3 which includes oblique facial cleft, lip and palate rifts pretty complicates airway management of such patients. The anesthetic management requires a multidisciplinary approach. In this paper, anesthetic application and management of a patient with Tessier 3 facial cleft is discussed.

Drug-induced hemolytic anemia (HA) is an uncommon manifestation in childhood. Cephalosporins are the most common cause of drug-induced HA. More than 50% of all reported cases of HA are associated with third-generation cephalosporins. We herein report an eight-year-old boy who developed HA during ceftriaxone treatment. He received intravenous ceftriaxone, which was combined with ornidazole for aphthous stomatitis. On third day after being discharged from the hospital, the patient was brought to the emergency room with complaint of convulsions. cardiac arrest depending on the implementation of ceftriaxone. The patient was taken into intensive care unit after the development of cardiac arrest, and died 3 hours later.

Pilonidal sinus disease is a disorder that is located commonly in the sacrococcygeal region but can be observed rarely in the umblical area. A twenty-four-year old male patient with the diagnosis of umblical pilonidal sinus was treated with sinus excision and reconstruction of the umblicus. In eighteen month follow-up time he encountered no problems and no recurrence.

We report a case of Mycetoma of the forearm and hand in a 52 year-old man caused by Streptomyces spp. Because of the extensive involvement of all compartments that rendered the extremity functionless, an above elbow amputation was done. In the early stages of the disease the treatment with antibiotics is curative. We report this case of extensive actinomycotic mycetoma of the hand for its rarity and we encourage clinicians to maintain a high index of suspicion in cases of chronic granulomatous infection of the upper extremity to prevent the catastrophic complications that may result in limb amputation.

Primary synovial sarcoma of the thorax is a rare disease. Lung parenchyme, as can be seen in the pleura or chest wall involvement may be more of these areas. Primary pulmonary sarcomas make up less than 1% of all thoracic malignancies. A 59 -year-old woman presented with chest pain and shortness of breat. On chest radiograph, right side lower zone mass not clearly limited by the borders of the diaphragm was detected. Computed tomography revealed a 74x55mm well circumscribed mass adjacent to the right middle lobe and oblique fissure, based on the intercostal spaces from the chest wall. Although the imaging findings are not specific, synovial sarcoma, which is rare in primary malignant neoplasms of the thorax, should be taken into consideration in differential diagnosis.

Pes equinovarus is the most common anomaly of the skeleton system. It is a deformity which requires orthopedic treatment starting from birth. The aim of treatment is to correct all components of the deformity so that the patient will have a pain-free, plantigrde foot with good mobility, without calluses, and without the need to wear special or modified shoes. The first treatment option in pes equinovarus is conservative. Early treatment is important. Along with bandage, cast, manipulation with hand and applications which are provided by devices, the continuous passive action treatment which is developed in recent years also takes place among the conservative treatment options. Since it is a long term treatment which requires cooperation with the family, the family should understand the treatment at a good level. Therefore it is important to materialize the nursing, observation, and orthesis treatment in the right way during the plaster treatment at home. In this context, a good training and support should be provided to the family.