INTRODUCTION: The position, shape and size of the female breast could be variable among people and races. The aim of this study is to calculate the breast volume and to investigate the relationship between the breast size and body components in adult, healthy, unmarried women.
METHODS: Total of 93 healthy volunteers (18-24 age) were included this study. To calculate the breast volume of the right and left breast, we made measurements which include breast projection (BP), breast medial radii (BMR), breast lateral radii (BLR), nipple inframammarial sulcus distance (NIR). Breast volume was calculated by the following formula BV=1/3*3.14*BP2*(BMR+BLR+NIR-BP). Additionally, body weight, Body Mass Index (BMI), Skeletal Muscle Mass (SMM), Body Fat Mass (BFM), Percent Body Fat (PBF) were measured using body composition analyzer (InBody 720); The volumes of right and left breasts were compared with Mann Whitney U test. Body composition parameters and their relation to breast volume were investigated with Spearman Corelation Analyzes.
RESULTS: According to the result of Man Whitney U test, there were no significant differences found between the volumes of the right and left breast (P>0,05). There was a moderate positive correlation between the breast volume and body weight, BMI and SMM (r = 0.29-0.4). There was a low correlation between the breast volume and BFM and PBF in the positive direction (r = 0.2-0.28).
DISCUSSION AND CONCLUSION: Our results; might give an idea about ideal breast dimensions. it was also shown that breast volume is particularly related to body weight and body mass index.

INTRODUCTION: In this study, it was aimed to determine the frequency of Enterobius vermicularis (E.vermicularis) by cellophane-tape method in students in a primary schools in Hatay.
METHODS: The research Zülüflühan Hikmet Çankaya Primary School was established on students. Students were asked to paste the cellophane-band into the anal area before taking the toilet and before bathing, and then paste it on the lame. The next day, lames were collected and examined in light microscope at 10X-40X. SPSS Windows 21.0 (Statistical Package for Social Sciences) package program was used for statistical evaluation and values of p<0.05 were accepted as significant.

RESULTS: In the study involving 167 students, 70 girls and 97 boys aged 6-14 years; in 45 (26.8%) of the samples, E.vermicularis was seen. Among the infected students, the number of female students was found to be 16 (22.9%) and the number of male students was found to be 29 (29.9%). This difference was statistically considerable (p<0.05). E.vermicularis was found in 26 (23.4%) of the 111 students surveyed in the 6-10 age group and 19 (33.9%) of 56 students surveyed in the 11-14 age group. Although E.vermicularis incidence age range 11-14 children higher than the 6-10 age group, there wasn’t statistically considerable.
DISCUSSION AND CONCLUSION: Because of the high E.vermicularis rate that we have observed in our study, it was deduced that the schools in our region should be investigated at certain intervals to determine infection, to provide treatments, and to inform students, teachers and parents about the methods of protection against this effect.

INTRODUCTION: Chest pain is a common complaint in children.However, cardiac chest pain is rarely seen.The aim of our study was to determine the diagnostic reasons in children who applied to the pediatric cardiology clinic for chestpain.
METHODS: 210 cases were enrolled in the pediatric cardiology outpatient clinic between March 2017 and October 2017 with a chest pain complaint.The patients were aged between 3-18 and 111 of them were female and 99 of them were male.Family history,pathologic findings in the examinations,drug use history,electrocardiography and echocardiography results were recorded from the patients' files. The data is evaluated statistically,the etiologic causes and the frequency of the diagnoses and the distributions according to sex and age were examined from the files of the patients.SPSS 22.0 program was used in the analysis.
RESULTS: It was found that chestpain occurred most frequently at rest(66.1%) and at the left side sternum(70.7%).Musculoskeletal(43.8%),idiopathic(28.1%) and psychogenic(14.7%) causes were the most common reasons of chest pain.In one patient cardiac(0.5%) chestpain was detected.Psychogenic chest pain was seen more frequently in girls(54.8%).It is found that most frequent psychogenic causes were depression(68%),anxiety disorder(25.6%) and panic attack.
DISCUSSION AND CONCLUSION: Only a small proportion of childhood chest pain is cardiac-dependent.Idiopathic,musculoskeletal and psychogenic causes should be kept in mind as the cause of chest pain.The finalization of the diagnosis is crucial to relieve the anxiety of the patient and his family and to give correct treatment.Referral to the cardiology unit may not always be an appropriate option as it increases the concerns of the family and may result in expensive long-term evaluations.

INTRODUCTION: In this study, we performed our experience of retroperitoneal and transperitoneal laparoscopic ureterolithotomy in the treatment of proximal ureteral stones and evaluated these two methods comparatively.
METHODS: The data of 41 patients who underwent laparoscopy for upper or middle ureteral stones were analyzed. The stone size of the patients who underwent laparoscopic ureterolithotomy was more than 15 mm, unilateral, impacted and upper of the sacroiliac junction. Gender, age, side and size of ureteral stones, operation time, blood loss, duration of hospital stay and complications were evaluated in all patients.
RESULTS: The mean duration of operation was 119,5±2,12 in the laparoscopic retroperitoneal group and 105,5±4,94 in the transperitoneal laparoscopic ureterolithotomy group. Compared with the operation techniques, operation time is statistically shorter in transperitoneal group than retroperitoneal group(p <0.05). When we compared the periods of return to daily activities after operation, laparoscopic retroperitoneal group was found to be significantly shorter. Stoneless rates were similar in both groups.
DISCUSSION AND CONCLUSION: In less experienced centres, the transperitoneal method is more advantageous than the retroperitoneal method because of its wider operative area, regular anatomy, and ease of suturing. In the retroperitoneal approach, short hospital stay, early drainage, and ureteral catheter withdrawal are avantages. The experience of the surgeon in selecting the laparoscopic method is important.

INTRODUCTION: Cystic echinococcosis (CE) is an important parasitic disease which is common in the world and our country. In this study, It was aimed to retrospectively evaluate the Indirect Hemaglutination (IHA) test results of patients with suspected cystic echinococcosis sent to the Erzurum Regional Training and Research Hospital Microbiology Laboratory.
METHODS: Between January 2008 and December 2016, the results of 3771 patients who had been sent to our laboratory were evaluated retrospectively.
RESULTS: Serum samples obtained from patients were studied by (IHA) method. Results of 1/160 titer and above were evaluated as positive. 530 (%14,05) of the 3771 patients who were included in the study were found to have positive İHA of the 530 patients evaluated as positive, 310 (%58,49) were female and 220 (41,51%) were male. Positive case numbers were observed to be highest in 25-49 age groups, at least in 0-14 age groups,
DISCUSSION AND CONCLUSION: As a conclusion, we can say that women have higher CE positivity and that the incidence of the disease is higher in middle age group irrespective of sex.

INTRODUCTION: The aim of our study was to investigate the frequency of HLA class I and class II alleles in Eastern Anatolia.

METHODS: The study included 1050 unrelated bone marrow donors from the archives. HLA class I and II polymorphisms were identified using polymerase chain reactions (PCR) using sequence-specific primers (SSP) and sequence-specific oligonucleotides (SSO). Ethical approval was obtained.
RESULTS: The most common alleles were HLA-A*02 (21.1%), HLA-A*24 (18.4%), and HLA-A*03 (12.3%) in the HLA-A locus; HLA-B*35 (20%), HLA-B*51 (18.3%), and HLA-B*44 (6.3%) in the HLA-B locus; and HLA-DRB1*11 (22.3%), HLA-DRB1*04 (16.2%), and HLA-DRB1*15 (12.4%) in the HLA-DR locus.
DISCUSSION AND CONCLUSION: : Our results are consistent with the HLA antigens identified in previous studies. We believe that our study will contribute to the determination of HLA diversity in our region.. Consolidating the data obtained in this study and other national data will facilitate the selection of bone marrow donors

INTRODUCTION: miR-1 miR-133a and miR-133b release into the circulation during the early stages of acute coronary syndrome (ACS). However, their discriminative expression pattern in ST-elevation myocardial infarction (STEMI) and Non-ST-elevation myocardial infarction (NSTEMI) remains unknown. The aim of the present study was to characterize and compare the circulating miR-1, miR-133a and miR-133b expression levels in peripheral blood samples of ACS patients to determine their discriminative expression pattern of STEMI or NSTEMI.
METHODS: Peripheral blood samples were taken from 54 patients with ACS (27 STEMI, 27 NSTEMI) and 20 healthy volunteers. The expression levels of miR-1, miR-133a and miR-133b were measured by qRT-PCR. The association of miRNA expressions and characteristics of STEMI and NSTEMI patients were evaluated using a web-based program “RT2 Profiler PCR Array Data Analysis”.
RESULTS: The expression levels of miR-1, miR-133a and miR-133b were higher in ACS than the control group (P< 0.05). However, the expression pattern of miRNAs differs between STEMI and NSTEMI patients, time-dependently. While miRNA expressions were in positive correlation with CK-MB in STEMI, they were in negative correlation in NSTEMI patients.
DISCUSSION AND CONCLUSION: Our findings suggest that the dynamic expression of miR-1, miR-133a and miR-133b could predict the severity and progression of coronary heart disease in ACS patients. Advanced functional studies and larger cohort validations are required.

INTRODUCTION: In this study we aimed to evaluate the efficacy of artificial urinary sphincter (AUS) surgery in the treatment of incontinence especially due to sphincter incompetence after prostate surgery,retrospectively according to surgical outcomes and patient satisfaction.
METHODS: In our clinic the data of patients who underwent AUS surgery between 2009 and 2018 were evaluated retrospectively. In order to evaluate the incontinence status of the patients before and after the operation, the success rate of AUS surgery and patients satisfaction after AUS surgery, the ICIQ-SF (International Consultation on Incontinence Questionnaire Short Form), which is a questionnaire for urinary incontinence evaluation before and after the operation, was filled.
RESULTS: The mean age of the patients was 67.92 ± 24.08 years and the mean follow-up period was 66.38 ± 11.17 months. Daily amount of pad usage and ICIQ-SF score were 4.23 ± 1.49 and 16.84 ± 4.64 in the preoperative period and 1.33 ± 1.01 and 2.91 ± 0.64 in the postoperative period respectively. When these results were compared, there was a statistically significant difference in terms of both the consumption of pads and the ICIQ-SF score (p <0.05).
DISCUSSION AND CONCLUSION: AUS is a safe and effective treatment option for patients who do not benefit from other treatment options with moderate or severe urinary incontinence.

INTRODUCTION: Mobile phones are the most used devices in current daily life but with no sufficient data regarding their prospective side effects. Also any association between mobile phone usage and formation of neural tube defects is controversial. In this paper, any effect of mobile phone radiation on neural development in chick embryos was studied.
METHODS: This study was performed in the neuro-embryology laboratory, Ankara University, Faculty of Medicine, Department of Neurosurgery. The specimens consisted of 6 groups; 20 fertile, pathogen-free, super Nick race chick eggs in each group. These groups arranged as control, standby, call-forwarding, one-minute-call, four-minute-call and seven-minute-call groups. The embryos were evaluated using light microscope after the second day of incubation post radiation-exposure regarding growth failure (GF) and neural tube defect (NTD).
RESULTS: Control group revealed 19 normal, 1 GF; standby group 17 normal, 3 GF; 15 normal and 5 GF specimens were detected in one and four-minute-call groups. Besides, 7-minute-call group revealed 14 normal, 1 NTD and 5 GF.
DISCUSSION AND CONCLUSION: Negative effect of mobile phones on neural development is statically insignificant. Even so, the results in all the standby, one-minute-call, four-minute-call and seven-minute-call groups make it difficult to pass judgment on mobile phone usage in pregnants. It is necessary to perform further studies to clarify any potential damages regarding mobile phone usage.

INTRODUCTION: The aim of this study was to determine the effect of spa therapy on pain, sleep and quality of life of patients with diabetic neuropathic pain.
METHODS: Thirty-five patients with diabetic neuropathic pain were included in the study. Neuropathic pain severity was assessed by Visuel Analog Scale (VAS), sleep quality by Pittsburgh Sleep Quality Index (PUKI), and quality of life by Nottingham Health Profile (NHP). All evaluations were done twice before and after treatment. 15 sessions of spa treatment were applied.
RESULTS: After treatment; the change in severity of pain that was assessed by VAS was statistically significant, although the change was not clinically significant (p=0,033). There was a statistically significant increase in sleep quality assessed by PUKI in patients after treatment (p˂0,001). Statistically significant improvements were observed in the emotional reactions, sleep, social isolation and physical activity subscales of NHP which was used for the assessment of the quality of life (p respectively ˂0,001, 0,002, 0,002, 0,039).
DISCUSSION AND CONCLUSION: In conclusion, spa treatment may not improve the severity of pain in patients with diabetic neuropathic pain, but may improve the sleep quality and quality of life of patients. The treatment of patients with diabetic neuropathic pain, especially where the problem of sleep is prominent, can be supported by the spa treatment.

INTRODUCTION: The upper respiratory tract is the airways over the larynx. Infections can be viral or bacterial, acute or chronic. The literature was systematically reviewed and the studies investigating the prevalence of bacterial agents causing to Upper Respiratory Tract Infection (URTI) were examined by meta-analysis method.
MATERIAL AND METHODS: This study was designed and conducted in accordance with PRISMA guidelines. Using various search database, studies published from 1989 to 2017 were identified and a total of 19 studies were included. IBM SPSS 24 program was used for statistical analysis.
RESULTS: It was determined that S. pyogenes as the highest prevalence rate 1989-1994 and 1995-2000 and, that S. pneumoniae between 2001-2006 and, that H. influenzae as 57.5% with the highest prevalence rate between 2007-2017 period.
CONCLUSION: Since the methods used for bacterial identification differ in each study, there are significant differences in the frequency of URTI agents. Future studies should provide data not only outpatients but also hospitalised patients. This kind data will assist in designing reliable guidelines for empirical treatment in URTI.

INTRODUCTION: Deficiencies of Vitamin D (VitD) has been associated with coronary heart disease, hypertension and left ventricular hypertropy. However its effects on cardiac conduction system and atrial fibrillation (AF) predisposition has not been studied yet. In this study we aim to evaluate the effects of VitD on invasive electrophysiologic parameters and AF inducibility.
METHODS: This retrospective cross-sectional study included 135 patients. Study population was divided into three group as VitD sufficient, VitD insufficient and VitD deficient according to baseline vitD levels. Patients’ invasive electrophysiologic parameters and induced AF episodes were recorded.
RESULTS: Corrected sinus node recovery time, baseline cycle length, atrial-His interval, His-ventricular interval and Wenckebach cycle length were lengthened in vitD deficient group but they didn’t reach statistical significance. The rate of AF inducibility was twice as likely in VitD deficient group than sufficient group, however, it also didn’t reach statistical significance.
DISCUSSION AND CONCLUSION: Baseline VitD levels were not associated with cardiac electrophysiologic parameters and AF inducibility. To demonstrate the role of VitD in cardiac conduction system and AF inducibility thoroughly, further studies such as addressing VitD replacement are warranted.

INTRODUCTION: In this study, it was aimed to investigate that factors triggering seizures and status of seizure recurrence after discharge from a one-week period in patients admitted to the emergency department with complaining of epileptic seizures.
METHODS: The study was prospectively conducted between January 2013 and July 2013 in an emergency department of tertiary care training and research hospital.90 patients were included in the study. All patients’ data were recorded to a standardized study form at the time of admission to the emergency department. Patients were questioned about the frequency of seizures and medication usage by telephone after one week of being discharged. Statistical analysis was conducted via SPSS for Windows 18.0 (SPSS Inc., Chicago, USA) program. Statistically, p<0.05 was considered significant.
RESULTS: When patients were evaluated in terms of factors that increase the frequency of seizures there was no significant difference in age, gender, alcohol intake in the last 24 hours before seizure, antiepileptic drug group that was used or skipping doses of the antiepileptic drug. There was a statistically significant reduction in seizure freguency in patients taking antiepileptic drugs regularly (p <0.05). Whereas there were statistically significant increase in seizure frequency in patients who had a sleepless night last 24 hours before the seizure (p=0.026), were experiencing a stressful situation (p=0.48) and patients who were single (p=0.001).
DISCUSSION AND CONCLUSION: Among the factors that affect the seizure frequency in patients admitted to the emergency department with complaining of epileptic seizure regular antiepileptic drug use, marital status, and deprivation of sleep or the presence of a stressful situation in last 24 hours were statistically significant.

INTRODUCTION: To evaluate the follow-up imaging findings of the postoperative rectal carcinoma (RK) patients.
METHODS: A total of 96 consecutive patients with RK were evaluated. Fifty-five of these patients who underwent surgery and had follow-up imaging examinations were evaluated for postoperative changes, complications and follow-up findings.
RESULTS: The mean age of 55 patients (34E, 21K) was 58,7 (31-81). The mean follow-up time was 31,1 months (6-72 months). Granulation tissue-fibrotic changes were seen in 41 patients (74.5%). Granulation tissue-fibrotic changes were not changed in 27 patients (65.8%) and decreased in 11 patients (26.8%). There were an increase in postoperative changes in 3 patients (7.3%) which were found tumor recurrence in 2 patients (4.8%) and granulation tissue-fibrotic changes in 1 patient (6%). There were no significant pelvic lesions and postoperative fibrotic changes in 9 patients (16.4%). Fistulas (n: 4, 7,3%), cystic collections (n: 4, 7,3%), Hartman pouch leak, anastomosis leak, ileus, bone invasion and inguinal lymph node metastasis (n: 2, 3.6%, per each) were found in follow-up.
DISCUSSION AND CONCLUSION: Most of the pelvic postoperative granulation tissue-fibrotic changes didn’t show dimensional difference or decrease in size on follow-up. However, multimodality follow-up imaging methods are useful in diagnosis of tumor recurrence and postoperarive complications.

INTRODUCTION: The aim of this study was to investigate the effect of caffeic acid phenethyl ester (CAPE) on Nuclear Factor Kappa Beta (Nf-κβ) and inducible nitric oxide synthase (iNOS) activity against hepatic injury with chest trauma model in rats.
METHODS: In the study, 40 adult Wistar albino male rats were divided into 4 groups respectively; control, chest trauma, chest trauma+CAPE and CAPE groups. CAPE administration was performed intraperitoneally at a dose of 10 μmol / kg / day for 7 days. At the end of the experiment, histopathologic changes were determined by hematoxylin-eosin (H&E) stain in liver tissue. In addition, hepatic Nf-κβ and iNOS activities were examined by indirect immunohistochemical method.
RESULTS: Degeneration of hepatocyte cords and sinusoidal dilatation findings were found in the chest trauma group. Histopathological findings of chest trauma + CAPE group were found to be milder than chest trauma group. In addition, a statistically significant reduction in hepatic Nf-κβ and iNOS immunoreactivity was seen in the chest trauma + CAPE group compared to the chest trauma group (p<0.05).
DISCUSSION AND CONCLUSION: CAPE has been shown to exert protective effects by suppressing Nf-κβ and iNOS activity in chest trauma induced hepatic damage in rats.

INTRODUCTION: The prevalence of SCI is higher in the ICUthan in other units of the hospital because of frequent central venous catheters, urinary catheters, mechanical ventilation and long-term hospitalizations. In addition, the use of broad spectrum antibiotics frequently causes colonization and infections with resistant microorganisms in patients in these units. This study was undertaken to describe the impact of various risk factors and the antibiotic resistance of breeding microorganisms in the SBIE epidemiology acquired in the ICU
METHODS: A retrospective study was carried out on prospectively collected data of 62 patients who applied internally at tertiary ICU between January 2014 and December 2017. The SBIH was diagnosed according to the Centers for Disease and Control definitions. All patients' data were obtained from hospital information management system and infection control committee patient follow-up forms.
RESULTS: 36 (58.1%) of the cases were male and 26 (41.9%) were female. The causative agent of infection is primarily A. baumannii, K. pneumoniae and E. coli. The most common infection was found as urinary tract infection with 34%.
Ventilator-associated pneumonia and bloodstream infection were more frequent in patients who were mechanically ventilated, and this was statistically significant
In our study, all A. baumannii strains were carbapenem resistant. TMethicillin resistance was present in all of the coagulase (-) staphylococci.

DISCUSSION AND CONCLUSION: It is also evident that a larger scale of work with a larger number of patients are needed, although each hospital considers that such studies are important in terms of knowing the infection frequency, factors and resistance profile in their unit.

INTRODUCTION: As in all countries, the rate of geriatric group in the population is increasing rapidly in parallel with the improvement of life style.. Geriatric patients frequently refer to ED with cardiopulmonary complaints. The aim of study was to investigate the diagnosis distributions of geriatric patients with chest pain- respiratory distress.


METHODS: This retrospective study was performed with 1343 patients over 65 years of age who were admitted to ED with respiratory distress- chest pain evaluated with computed tomography - cardiac enzyme levels.
RESULTS: A total of 1343 patients with respiratory distress and chest pain from the geriatric age group were included in the study. 531 patients who were admitted due to trauma and more than one admission to hospital with the same complaints were excluded from the study. Respiratory distress and chest pain were observed in 343 of 812 patients (42.24%) cause of pulmonary, 247 (30.41%) patients cardiac, and 222 (27.33%) had due to other causes. In patients with pulmonary-related respiratory distress and chest pain, the most common cause was pneumonia (39.06%);and in 51.41% of patients with cardiac causes, acute myocardial infarction was detected.
DISCUSSION AND CONCLUSION: We believe that to known the etiology of respiratory distress and chest pain will provide better patient evaluation. Considering that the number of geriatric patients who applied for emergency services increases day by day, the fact that emergency workers have more knowledge about geriatrics is an important factor that will increase the success rate of emergency department treatment.

INTRODUCTION: Lichen planus is an inflammatory dermatosis of mucocutaneous surfaces with various clinical manifestations. In this study, we wanted to investigate NLR, PLR rates and MPV values in lichen planus disease
METHODS: Thirty-five patients over the age of 18 and 30 healthy controls were followed up with lichen diagnosis of my work. Leukocyte, erythrocyte, platelet, hemoglobin, platelet volume values were determined in hemogram tests. The NLR ratio was obtained by dividing the number of neutrophils by the number of lymphocytes and the TLR ratio by dividing the platelet count by the lymphocyte count.
RESULTS: The mean age of the participating was 43.0±14.1, leukocyte level was 6.7 (5.6-8.3) hemoglobin level was 14.5±1.6, and the value of MPV was 8.6 (7.9-9.0). The platelet value was 262.1±52.2, the neutrophil value was 3.5 (2.9-4.9), and the lymphocyte value was 2.3 (2.1-2.8). Neutrophil lymphocyte ratio 1.5 (1,0-1,9), platelet lymphocyte ratio 110.4±29.7. Hemoglobin levels were significantly higher in males than females
DISCUSSION AND CONCLUSION: This study showed that TLO, NLO and OTH values did not change in lichen patients. In spite of many expensive markers showing systemic inflammation, PLR, NLR and MPV are simple and cheap markers.

INTRODUCTION: In this study, the effects of adrenaline bleeding control on myringosclerosis (MS) development after myringotomy in experimental model were investigated.
METHODS: Sixteen Wistar-Albino healthy male rats were used in the experiment. The right and left ear of each rat were accepted as the control group and the ears were divided into 4 groups. Group 1: 8 rats, examined 48 hours after Miringotomy, with adrenaline applied to the left ear. Group 2: 8 rats, examined 120 hours after miringotomy, with adrenaline applied to the left ear. Group 3: 8 rats, examined 48 hours after miringotomy, with saline applied to the right ear. Group 4: 8 rats, examined 120 hours after miringotomy, with saline applied to the right ear.At the end of the experiment, ears of rats were examined otomicroscopically and histopathologically.
RESULTS: There was no statistically significant difference between the groups in terms of vascular dilatation, congestion, inflammatory cell, leukocyte count, mast cell degranulation, connective tissue increase and sclerosis.
DISCUSSION AND CONCLUSION: In this study, we have investigated the view that hemorrhage from the margins of myringotomy and the development of inflammatory cell migration to the myringotomy site and the development of inflammation may contribute to the development of myringosclerosis. It is important that the local administration of adrenaline, by virtue of its vasoconstrictor effect, may reduce the amount of bleeding and thereby prevent the development of myringosclerosis. However, there is a need for wider working groups to determine its statistical significance.

INTRODUCTION: The anesthesia procedures outside the operating room have recently emerged as a popular technique widespread around the world for the diagnosis and management of pediatric patients. In this retrospective study, we aimed to evaluate the our anesthesia experiences outside the operating room in pediatric patients.
METHODS: The study included a total of 218 pediatric patients aged under 18 years who underwent sedoanalgesia outside the operating room in our clinic over the last two years. Age, gender, ASA score, comorbidities, surgical procedure, duration of anesthesia, anesthetic agents, and complications were recorded for each patient. Quantitative variables were expressed as mean ± standard deviation (SD) and median (minimum-maximum) and categorical variables were expressed as frequencies and percentages.
RESULTS: The patients included 108 girls and 110 boys with a mean age 9.17±5.13 years. Mean duration of anesthesia was 30.74±28.46 min. Of all the patients, 170 had an ASA score of I and 48 had a score of II. Comorbidities were detected in 46 patients. Most common surgical technique was endoscopy (n=102) and the most common anesthetic agent was the propofol + midazolam combination (n=152). Complications occurred in only 12 patients, with the most common complications including bradycardia (50.0%) followed by desaturation (41.7%).
DISCUSSION AND CONCLUSION: In our hospital, the anesthesia procedures outside the operating room in pediatric patients are most commonly performed by the Gastroenterology department. We consider that the propofol + midazolam combination, which is frequently administered in our clinic, is a safe option for the anesthesia procedures performed outside the operating room in appropriate pediatric patients.

INTRODUCTION: Pertuzumab is a new recombinant humanized monoclonal antibody, has been developed to inhibit the formation of HER2: HER3 heterodimerization. The clinical benefit of pertuzumab therapy in HER2 positive metastatic Breast Cancer (mBC) patients in the first-line setting has been shown in previous phase III studies. Herein we aimed to analyze the efficacy and toxicity profile of pertuzumab in patients with HER2 positive mBC.
METHODS: This was a retrospective study of 28 patients with mBC followed from two different centers in Turkey. All patients were treated with pertuzumab in the first line setting, with combination of trastuzumab and docetaxel. Treatment outcomes along with drug efficacy and safety were retrospectively analyzed.
RESULTS: At a median follow-up time of 10.1 (2.4-25.2) months, among the 28 patients, 1 (3.6%) died and 2 (7.1%) developed disease progression. The median age of study population was 47 (18-74) years. Excluding 1 patient, all had (96.4%) de-novo metastatic disease at presentation. The median number of treatment cycles was 7 (4 - 12) for docetaxel, 18 (4 - 35) for pertuzumab + trastuzumab, and 10 (1 - 29) for the maintenance therapy (pertuzumab + trastuzumab). The most common side effects were; fatigue (75%) and arthralgia/myalgia (64.3%). Grade 3 or 4 toxicity were observed to be very infrequent.
DISCUSSION AND CONCLUSION: Even with a small sample size, our results confirm that, pertuzumab, trastuzumab and docetaxel combination therapy in the first line setting in HER2 positive mBC patients is the standardof care, with acceptable toxicity profile and promising survival results.

Acrodermatitis enteropathica is a rare autosomal recessive inherited disease resulting in zinc deficiency. As a result of disrupted intestinal absorption of zinc, zinc deficiency occurs. Periorificial dermatitis, diarrhea, alopecia and growth retardation occur due to zinc deficiency. Skin lesions are generally eczematous, psoriasiform, bullous and pustular lesions in the periorificial and acral regions. Clinicial symptoms are observed four or six weeks after weaning from breastmilk or from birth in infants who are not breastfed. Clinical symptoms rapidly resolve with systemic zinc supplementation. Due to clinical similarities and rare occurrance, it may be confused with many different dermatoses and occasionally can be missed. Delays in diagnosis of this disease lead to morbidity and even mortality. Here we aimed to present the rare occurrence of a six-month old acrodermatitis enteropathica case due to its teaching properties.

Cerebrotendinous xanthomatosis is a rare autosomal recessive disorder. It occurs as a mutation in the CYP27A1 gene with nine exons in the Long arm of chromosome 2. The patient was diagnosed with epilepsy in our clinic for seven years and was diagnosed with cerebrotendinous xanthomatosis with a weakness in the lower extremities that appeared a few years ago. We think that especially it is worth mentioning that it is a rare disease in childhood and it is diagnosed early.