GÝRÝÞ ve AMAÇ: Çalýþmada aðýz ve dil kanserleri ile ilgili, internet haber sitelerinde yer alan haber sayýlarý ile ‘aðýz kanseri’ ve ‘dil kanseri’ terimlerinin google arama hacimleri arasýndaki iliþkinin deðerlendirilmesi; ayrýca, haber içeriklerinin belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Türkiye’ de en çok okunan 5 haber sitesi belirlenerek, bu haber sitelerinde yer alan aðýz kanseri ve dil kanseri haberleri ile haberlerin tarihleri kaydedildi. Google Trends uygulamasý kullanýlarak, internet basýnýnda yer alan ilk haber tarihi ile Kasým 2019 tarihleri arasýnda Türkiye’ de aðýz kanseri ve dil kanseri terimleri için arama hacim indeksleri belirlendi. Aylýk - yýllýk ortalama arama hacim indekslerinin, haber sayýlarý ile iliþkileri istatistiksel olarak deðerlendirildi. Ayrýca haber içerikleri de kaydedildi.
BULGULAR: Aðýz kanserleri ile ilgili toplam 92 habere ulaþýldý. Aylýk - yýllýk haber sayýlarý ile ortalama arama hacim indeksleri arasýnda anlamlý iliþki tespit edilmedi. Aðýz kanseri belirtileri en sýk gözlenen haber içeriðiydi. Dil kanserleri ile ilgili toplam 45 haber tanýmlandý ve haberlerin büyük kýsmý dil kanseri vakalarýydý. Yýllýk ortalama arama hacim indeksleri ile yýllýk haber sayýlarý arasýnda pozitif yönde güçlü korelasyon tespit edildi.
TARTIÞMA ve SONUÇ: Dil kanseri arama hacim indeksi ile dil kanseri haber sayýlarý arasýnda iliþki mevcuttur. Medyada orofaringeal kanserler hakkýnda haber sayýlarýnýn artmasýyla, toplumun bu konudaki ilgi ve bilgi düzeyinde artýþ saðlanabilir.

INTRODUCTION: In the study, it was aimed to evaluate the relationship between the number of the news on oral and tongue cancers on the internet news sites and Google search volumes of the terms "mouth cancer" and "tongue cancer"; also, it was aimed to determine the contents of the news.
METHODS: Five most visited news websites in Turkey were identified; the news and the dates of the news about the mouth and tongue cancers were recorded. Using Google Trends application, search volume indexes were determined between the date ‘first news on the news websites were published’ and November 2019, for search terms ‘mouth cancer’ and ‘ tongue cancer’. Relationship between average monthly - annual search volume indexes and number of the news were statistically evaluated. Also, contents of the news were recorded.
RESULTS: A total of 92 news were identified about mouth cancers. No statistically significant correlation was determined between monthly - annual news count and average search volume indexes. Mouth cancer symptoms were the most frequently observed news content. Forty five news about tongue cancers were identified and the vast majority of the news were tongue cancer cases. Strong positive correlation was determined between annual news counts and annual average search volume indexes.
DISCUSSION AND CONCLUSION: There is a relationship between ‘tongue cancer’ search volume indexes and news counts. With the increasing number of news about oropharyngeal cancers in the media, the level of interest and knowledge of the society can be increased.

GÝRÝÞ ve AMAÇ: Kan basýncýný indirekt ve invaziv olmayan yöntemlerle ölçen çok sayýda teknik vardýr. Günümüzde yaygýn olarak kullanýlan ve invaziv olmayan kan basýncý ölçümü olan Korotkoff seslerinin oskültasyonudur. Bu çalýþmada noninvaziv yöntemlerle elde edilen sistolik ve diyastolik kan basýncý deðerlerinin, intraarteryel ve direkt olarak ölçülen sistolik ve diyastolik kan basýncý deðerlerinin karþýlaþtýrýlmasý ve aralarýndaki korelasyonun incelenmesi amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmaya Bülent Ecevit Üniversitesi Týp fakültesi hastanesinde herhangi bir nedenle opere edilen eriþkin toplam 46 hasta alýndý. Hastalarýn yaþ, boy, kilo ve BMI deðerleri belirlendi. Operasyon sýrasýnda radiyal arterden direkt olarak, diðer koldan brakial arterden osilometrik cihazla indirekt olarak kan basýnçlarý ve nabýzlarý eþ zamanlý olarak ölçüldü. Tüm hastalarda belirli aralýklarla toplam 15 ölçüm yapýldý. Her hastanýn direkt ve indirekt olarak bakýlan sistolik ve diyastolik kan basýnçlarý ortalamalarý alýnarak karþýlaþtýrýldý. Arteryel ile direkt ve koldan manþonlu tansiyon aleti ile indirekt kan basýncý ölçüm farklarý baðýmlý gruplarda Wilcoxon sýralý test istatistiði ile deðerlendirildi.
BULGULAR: Çalýþmaya katýlan hastalarýn koldan manþonla ölçülen sistolik kan basýncý ortalamasý 114,6±18,72 mmHg, direkt yöntemle ölçülen ortalama sistolik kan basýncý 116,1±18,08 mmHg iken, manþonla ölçülen diyastolik kan basýncý ortalamasý 69,42±11,31, direkt yöntemle ölçülen diyastolik kan basýncý ortalamasý 63,81±12,26 mmHg idi. Ýnvaziv ve noninvaziv yöntemlerle ölçülen sistolik basýnç ortalamasý arasýnda anlamlý bir fark yokken (p=0,28), diyastolik basýnç ortalamasý arasýnda anlamlý bir farklýlýk vardý(p<0,001).
TARTIÞMA ve SONUÇ: Ýnvaziv olmayan yöntemlerle ölçülen sistolik kan basýnçlarý gerçek sistolik basýnç deðerlerini yansýtýrken, indirekt yollardan ölçülen diyastolik kan basýnçlarý gerçek diyastolik basýnçlarý ile korele deðildir. Diyastolik kan basýncý anormallikleri düþünülen hastalarda doðrudan diyastolik kan basýncýnýn ölçülmesinde fayda vardýr.

INTRODUCTION: There are several indirect and non-invasive techniques measuring blood pressure. The most popular non-invasive technique for routine examinations and monitoring is auscultation of Korotkoff sounds. We compared non-invasive and invasive systolic and diastolic blood pressure measurements in this study.
METHODS: 46 adult patients to be operated on for any reason in Bulent Ecevit University Hospital were included in the study. The study patients’ age, gender, height, weight and body mass index were recorded. Blood pressure was directly measured from radial arter and indirectly measured from brachial artery via a automated oscillometric device. Invasive and non-invasive blood pressure and pulse measurements were performed simultaneously. Median systolic and diastolic blood pressures obtained from all patients by both methods.
RESULTS: Mean non-invasive systolic blood pressure was 114,6±18,72 mmHg, mean invasive systolic blood pressure was 116,1±18,08 mmHg, mean non-invasive diastolic blood pressure was 69,42±11,31 mmHg, mean invasive diastolic blood pressure was 63,81±12,26 mmHg in the study patients. The difference between mean invasive and non-invasive systolic blood pressure wasn’t significant (p=0,28) but the difference between mean invasive and noninvasive diastolic blood pressure was statistically significant (p<0,001).
DISCUSSION AND CONCLUSION: Although there was a significant correlation between invasive and noninvasive systolic pressure, there was no correlation between invasive and non-invasive diastolic pressure. Direct diastolic pressure measurement should be performed in patients with diastolic blood pressure abnormality.

GÝRÝÞ ve AMAÇ: Epidermal büyüme faktörü reseptörü(EGFR) mutasyonu akciðer kanseri kanserinde kullanýlan tirozin kinaz inhibitörlerinin ek sýk yan etkisi cilt toksisitesidir. Çalýþmamýzda hastanemizde EGFR mutasyonu pozitif saptanan ve erlotinib tedavisi alan hastalarda serum 25(OH) vitamin D3 düzeyi ile tedavi sýrasýnda görülen cilt toksisitesi iliþikisinin deðerlendirilmesini amaçladýk.

YÖNTEM ve GEREÇLER: Ankara Atatürk Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Týbbi onkoloji polikliniðine 2014 – 2018 yýllarý arasýnda baþvurmuþ hastalar çalýþmaya dahil edilmiþ ve verileri retrospektif olarak toplanmýþtýr.

BULGULAR: Toplam 78 EGFR mutasyonu saptanan ve erlotinib tedavisi alan hasta çalýþmaya dahil edildi. Taný anýnda ortalama serum 25 (OH) vitamin D3 düzeyi 34,6 (5-88) ng/ml olarak saptandý. Hastalar taný anýndaki serum 25 (OH) vitamin D3 düzeyi ne göre 2 alt gruba ayrýldý. Toplam 42 (%53,8) hastanýn serum 25 (OH) vitamin D3 düzeyi 20 ng/ml in altýnda 36 (%46,2) hastanýn serum 25 (OH) vitamin D3 düzeyi 20 ng/ml in üstünde saptandý. Serum 25 (OH) vitamin D3 düzeyi 20 ng/ml in altýnda olan grupta grade 2 – 3 cilt toksisitesi daha faza olarak saptandý (p: 0.038).

TARTIÞMA ve SONUÇ: Çalýþmamýzda taný anýnda vitamin D3 eksikliði saptanan hastalarda erlotinibe baðlý yüksek gradlý cilt toksisitesi geliþme sýklýðý daha fazla saptanmýþtýr. Hem EGFR inihibisyonu hem vitamin d düzeyindeki azalma epidermiste direk olarak keratinosit proliferasyon –differensiasyon ve hücre yaþam döngüsünün inhibe olmasýna baðlý cilt toksisitesinde artýþa yol açmýþ olabilir.

INTRODUCTION: Skin toxicities are the most common adverse events of the tyrosine kinase inhibitors that are used to EGFR mutant lung cancer. In our study, we aimed that investigated the relationship between skin toxicities and vitamin D levels in the patients with EGFR mutant and treated with erlotinib.
METHODS: EGFR mutant patients that admitted to Medical Oncology department of Atatürk Chest and Chest Surgery Hospital between 2014 – 2018 are included in this study. The patient’s data were collected retrospectively.
RESULTS: Totally, 78 patients that have EGFR mutation and treated with erlotinib are included in this study. The median level of vitamin D at the diagnosis was 34.6 (5-88) ng/ml. The patients were stratified two group according to vitamin D level. The 42 of whom (53.8 %) had vitamin D level < 20 ng/ml and 36 patients (46.2 %) had vitamin D level ≥ 20 ng/ml. Grade 2 -3 skin toxicities were significantly higher in the patients had vitamin D level < 20 ng/ml (p: 0.038).
DISCUSSION AND CONCLUSION: In our study, we found that the higher grade erlotinib related skin toxicities were more frequently in the patients that had low vitamin D level. Both of the erlotinib treatment and low vitamin D level may have contributed to the inhibition of keratinocyte proliferation, differentiation and cell cycles.

GÝRÝÞ ve AMAÇ: Morbid obezite, tüm dünyada önemli bir saðlýk problemi olan multifaktoriyel bir hastalýktýr. Bu çalýþmada obezite cerrahisinin ülkemizde yeni baþladýðý yýllarda yapýlan konvansiyonel Roux En-Y Tipi Gastrik By-Pass (RYGB) uygulanan hastalarýn ilk iki senelik takiplerini sunduk.
YÖNTEM ve GEREÇLER: Çalýþmamýzda 2005-2007 yýllarý arasýnda morbid obezite nedeniyle RGYB uygulanan 15 hastaya ait operasyon öncesi ve sonrasý veriler restrospektif olarak incelendi. Tüm hastalara ameliyat öncesi ve ameliyattan 1 yýl sonraki dönemde SF-36 Quality Life formu (saðlýkla ilgili yaþam kalitesini ölçen form) ile yaþam kalitesi deðerlendirildi.
BULGULAR: Çalýþmada 6’sý (% 40) erkek, 9’u (% 60) kadýn toplam 15 hastaya ait veriler deðerlendirildi. Hastalarýn yaþ ortalamasý, tüm olgularda 38±12,90 (24-63) yýl olup erkeklerde 31,5±8,16 (24-46) yýl kadýnlarda 42,33±14,02 (26-63) yýl olarak saptandý. Hastalarýn eþlik eden hastalýklar açýsýndan ameliyat öncesi deðerlendirilmelerinde; % 47’sinde (n=7) HT, % 20’sinde (n=3) Tip II DM, % 6,67’sinde (n=1) hipermenore, % 6,67’sinde (n=1) alt ekstremitede venöz ülserler, % 13,34’ünde (n=2) menstrüel siklusta düzensizlik, % 6,67’sinde (n=1) UAS, % 6,67’sinde (n=1) kronik obstrüktif akciðer hastalýðý (KOAH), % 20’sinde (n=3) hepatosteatoz mevcut olduðu belirlendi.
RYGB uygulanan hastalarda ortalama kilo kaybý ilk 12 ayda yaklaþýk 48,2 kg ve ilk 24 aylýk periyotta 52,07 kg kaybý tespit edildi.Hastalarýn postoperatif dönemde vücut kitle indeksi(VKÝ) deðerlerinin ilk 12 aylýk periyotta ortalama 32,16’ya ve ilk 24 aylýk periyotta 30,95’ e kadar gerilediði tespit edildi.Kilo kaybýna paralel bir þekilde kronik hastalýklarýn zamanla düzeldiði gözlendi.Post operatif 1.yýlda yaþam kalitesinin(SF-36 Quality Life formu ile deðerlendirilen) belirgin þekilde arttýðý gözlendi(p<0.05)

TARTIÞMA ve SONUÇ: Konvansiyonel RYGB ameliyatý ülkemizde ilk yapýlan morbid obezite cerrahilerindendir. Morbid obezite tedavisinde hastalarýn kilo vermesini ve ayný zamanda obeziteye baðlý geliþen yandaþ hastalýklarýn iyileþmesini saðlayan güvenli bir yöntem olup hastalarýn yaþam kalitesi üzerinde de anlamlý deðiþikliðe neden olmaktadýr.

INTRODUCTION: Morbid obesity is a multifactorial disease that is a major health problem all over the world. In this study, we presented the first two-year follow-up of patients who underwent conventional Roux En-Y Type Gastric Bypass (RYGB) performed in the years when obesity surgery has just begun in our country.
METHODS: In our study, pre-and post-operative data of 15 patients who underwent RGYB due to morbid obesity.
RESULTS: The data of 15 patients, 6 male (40%) and 9 female (60%), were evaluated in the study. The mean age of the patients was 38 ± 12.90 (24-63) years in all cases and 31.5 ± 8.16 (24-46) years in men and 42.33 ± 14.02 (26-63) years in women. In the preoperative evaluation of patients in terms of concomitant diseases, it was determined that 47% of the patients had HT (n = 7), 20% (n = 3) Type II DM, 6.67% (n = 1) hypermenorrhea, 6.67% (n = 1) venous ulcers in the lower extremity, 13.34% (n = 2) menstrual cycle irregularity, 6.67% (n = 1) UAS, 6.67% (n = 1) chronic obstructive pulmonary disease (COPD), 20% (n = 3) Hepatosteatosis.
DISCUSSION AND CONCLUSION: Conventional RYGB surgery is one of the first morbid obesity surgeries performed in our country. It is a safe method in the treatment of morbid obesity, which enables patients to lose weight and at the same time to recover from obesity induced by comorbid diseases, and causes a significant change in the quality of life of patients.

GÝRÝÞ ve AMAÇ: Esansiyel trombositemide (ET), trombositoz, lökositoz ve düþük riskli olmak üzere akut miyeloid lösemi veya miyelofibrozis gözlenebilir. Bu çalýþmanýn amacý; Türkiye’deki ET hastalarýnýn yaþ ve cinsiyet gibi sosyodemografik özellikleri, verilen tedavi, ikincil malignite öyküsü, miyelofibroz/akut lösemi dönüþümü gibi klinik/patolojik özelliklerini yansýtmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþmada, 2000-2013 yýllarý arasýnda ET tanýsýyla izlenen 200 hasta dahil edilmiþtir.
BULGULAR: Hastalarýn 121'i (% 60.5) kadýn ve 79'u (% 39.5) erkekti. Örneklemimizin yaþ ortalamasý (±SS) 54.93 (±14.21) yýldý. Olgularýn tedavi öncesi ölçülen WBC (p<0.001), Hb (p<0.001) ve trombosit (p<0.001) deðerleri, tedavi sonrasý ölçülen WBC, Hb ve trombosit deðerlerinden istatistiksel olarak anlamlý düzeyde yüksekti. Olgulardan 76’sýna (% 38) hidroksiüre, 92’sine (% 46) hidroksiüre+asetilsalisilik asit, 9’na (% 4.5) anagrelid, 1’ine (% 0.5) hidroksiüre+anagrelid, 15’ine (% 7.5) asetilsalisilik asit, 3’üne (% 1.5) interferon, 1’ine (% 0.5) interferon+asetilsalisilik asit, 2’sine (% 1) interferon+hidroksiüre ve 1’ine (% 0.5) hidroksiüre+warfarin sodyum tedavisi baþlandý. Olgulardan 92’sine (% 46) ek tedavi baþlandý, 108’ine (% 54) ek tedavi baþlanmadý. Toplamda, olgularýn % 54'üne asetilsalisilik asit tedavisi verilmiþtir. Tromboferez uygulanan 7 (% 3.5) olgu, uygulanmayan 193 (% 96.5) olgu vardý. Olgulardan 67’sinin (% 33.5) tedavi yetersizliði nedeni ile ve 25’nin (% 12.5) yan etki nedeni ile tedavisi deðiþtirildi. Miyelofibroz/akut lösemi dönüþümü olan 7 (% 3.5) olgu, olmayan 193 (% 96.5) olgu vardý. Olgularýn sadece 4’ünde (% 2) ikincil malignite öyküsü saptandý.
TARTIÞMA ve SONUÇ: Örneklemimizin yaþ, cinsiyet açýsýndan önceki çalýþmalarla benzer olduðunu gösterdi. Olgularýn WBC deðerlerinin tedavi sonrasýnda belirgin biçimde azaldýðý gözlendi. Önceki çalýþmalarda Hb deðerinde tedaviyle saðlanan azalma bizim çalýþmamýzda da benzer düzeyde gerçekleþmiþtir. Ayrýca, tedaviyle ET olgularýnýn trombosit düzeylerinde anlamlý azalma olduðu da saptandý. Yüksek riskli olgularda sitoredüktif tedavi ve düþük riskli grupta öncelikle antiplatelet tedavisi tercih edildi. Hidroksiüre tedavisi ile yanýt alýnamayanlara ve/veya bu tedaviyi tolere edemeyen veya yan etki gözlenenlerde hidroksiüre tedavisi kesildi veya anegrelid tedavisi baþlandý.

INTRODUCTION: Thrombocytosis,leukocytosis,and a small risk of disease progression into acute myeloid leukemia or myelofibrosis may be observed in essential thrombocythemia(ET).Aim of the study was to investigate sociodemographic and clinicopathologic characteristics of ET in Turkish sample.
METHODS: In this study,200 patients who were followed up with the diagnosis of ET between 2000-2013 were included.
RESULTS: 121 (60.5%) of the patients were female,and 79 (39.5%) were male.The average age (±SD) was 54.93 (±14.21) years.The WBC (p<0.001),Hb (p<0.001) and platelet (p<0.001) values measured before the treatment were statistically significantly higher than the WBC,Hb and platelet values measured after the treatment.Hydroxyurea to 76 (38%),hydroxyurea+acetylsalicylic acid to 92 (46%),hydroxyurea+anagrelide to 1 (0.5%),acetylsalicylic acid to 15 (7.5%),3 (1.5%) interferon,1 (0.5%) interferon+acetylsalicylic acid,2 (1%) interferon+hydroxyurea,and 1 (0.5%) hydroxyurea+warfarin sodium treatment was started.Additional treatment was started in 92 (46%) of the cases,and was not started in 108 (54%).In total,54% of cases were treated with acetylsalicylic acid.There were 7 (3.5%) cases who had thrombopheresis,and 193 (96.5%) cases did not.Treatment of 67 of the cases (33.5%) due to insufficient treatment,and 25 of them (12.5%) due to side effects was changed.There were 7 (3.5%) cases with myelofibrosis/acute leukemia transformation,and 193 (96.5%) cases without.Only 4 (2%) of the cases had a history of seconder malignancy.
DISCUSSION AND CONCLUSION: It was similar in terms of age and gender with previous studies.It was observed that the WBC values of the cases decreased significantly after the treatment.In previous studies,the decrease in Hb value achieved with treatment was similar in our study.It was determined that there was a significant decrease in platelet levels of ET cases with treatment.Cytoreductive treatment was preferred in high-risk cases and antiplatelet treatment was preferred in the low-risk group.Hydroxyurea treatment was discontinued or anegrelid treatment was initiated in those who did not respond with hydroxyurea treatment and/or were unable to tolerate this treatment or observed undesirable events.

GÝRÝÞ ve AMAÇ: Hematopoetik Kök Hücre Nakli(HKHN), hematolojik maligniteler, bazý solid tümörler ve immün yetmezlik hastalýklarý için en etkili tedavi yöntemlerinden biridir ancak bazý komplikasyonlara sahiptir. Epileptik nöbetler tekrarlayan anormal nöronal deþarjlarýn neden olduðu geçici santral sinir sistemi iþlev bozukluðu sonucu oluþan bilinç, motor ve duysal belirtiler olup HKHN sonrasý gözlenen komplikasyonlardan biridir ve prognozu oldukça kötü etkilemektedir. Amacýmýz, HKHN sýrasýnda geliþen epileptik nöbetlerin sebeplerini ve risk faktörlerini saptamak böylece nöbet geliþimini engelleyerek halihazýrda komplikasyon oraný yüksek olan HKHN’in prognozunu olumlu yönde etkilemektir.
YÖNTEM ve GEREÇLER: Ekim 2018 ile Ekim 2019 yýllarý arasýnda Erciyes Üniversitesi Kemik Ýliði Nakli Ünitesinde nakil amacýyla yatýrýlýrken nöbet geçiren 12 hasta çalýþmaya dahil edildi. Hastalarýn verileri geriye dönük olarak incelendi. Subakut sklerozan panensefalit tanýsý konulan hastalar çalýþmaya dahil edilmedi.
BULGULAR: 9 hastaya (%75) Otolog HKHN (OKÝT), 3 hastaya (%25) ise Allogeneik HKHN (AKÝT) yapýldý. OKÝT’lerin %8.2’sinde, AKÝT’lerin %5.4’ünde epileptik nöbet gözlendi. Hastalarýn laboratuvar bulgularýnda hiçbirinde hipoglisemi, hiponatremi, böbrek ve karaciðer fonksiyon testi bozukluðu saptanmadý. Sekiz hastada (%66.6) hipofosfatemi, 6 (%50)’sýnda hipopotasemi, 4 (%33.3)’ünde hipomagnezemi ve 2 (%16.6)’sinde hipokalsemi gözlendi. Hastalarýn median toplam ilaç sayýsý 8 ± 2.1 (6-14) ’dir. Nöbet eþiðini düþüren median ilaç sayýsý ise 5.5 ± 1.4 (4-8)’dýr. Epileptik eþiði düþüren ilaçlardan Flukonazol 9 (%75), Meropenem 7 (%58.3), Metronidazol 6 (%60), Ýzoniazid 4 (%33.3) ve Siklosporin 3 (%25) hastada kullanýlmasýyla dikkat çekti. 9 (%75) hastanýn beslenme durumu total parental nutrisyon ile saðlanmaktaydý. 1 (%8.3) hastamýz exitus oldu.
TARTIÞMA ve SONUÇ: Epileptik nöbet geliþim sebebinin, HKHN sonrasý komplike klinik durumda ayný anda var olan ve birbirleriyle etkileþime giren çoklu faktörlerle korele olduðu düþünülmektedir. HKHN sýrasýnda epileptik nöbet geçiren hastalarýmýzda hipofosfatemi, hipopotasemi gibi elektrolit bozukluklarýnýn sýk olduðu ve polifarmasinin özellikle de nöbet eþiðini düþüren ilaç kullanýmýnýn fazla olduðu gözlendi. Bu nedenle bu iki faktörün yakýn takip edilmesi epileptik nöbet geliþimini önlemede en önemli yaklaþým olarak gözlenmektedir.

INTRODUCTION: Hematopoietic Stem Cell Transplant (HSCT) is one of the most effective treatment for hematological malignancies but has some complications. Epileptic seizures are consciousness, motor and sensory symptoms caused by temporary central nervous system dysfunction caused by recurrent abnormal neuronal discharges. Epileptic seizures are one of the complications of HKHN and affect its prognosis poorly. Our aim is to determine the causes and risk factors of epileptic seizures that develop during HSCT, thus preventing the development of seizures and positively affecting the prognosis of HSCT, which has a high complication rate.
METHODS: Twelve patients who had seizures while being hospitalized at Erciyes University Bone Marrow Transplantion Unit were included between October 2018 and October 2019. Patients diagnosed with subacute sclerosing panencephalitis were excluded.
RESULTS: Nine patients (75%) received ASCT and 3 patients (25%) received allo-HSCT. Epileptic seizures were observed in 8.2% of ASCTs and 5.4% of allo-HSCTs. None of the patients had hypoglycemia or hyponatremia. Eight patients (66.6%) had hypophosphatemia, 6 (50%) had hypokalemia, 4 (33.3%) had hypomagnesemia. The median number of drugs is 8 ± 2.1 (6-14). The median number of drugs that lower the seizure threshold is 5.5 ± 1.4 (4-8). Among the drugs that lower the epileptic threshold, fluconazole 75% (n=9), Meropenem 58.3% (n=7), Metronidazole 60% (n=6), Isoniazid 33.3% (n=4) were used most frequently. One (8.3%) of our patients had died.
DISCUSSION AND CONCLUSION: The reason for developing epileptic seizures is thought to be correlated with multiple factors that co-exist and interact with each other in a complicated clinical situation after HSCT. Polypharmacy, especially the use of drugs that lower the seizure threshold and electrolyte imbalances such as hypophosphatemia and hypokalemia were common in our patients with epileptic seizures. Therefore, close monitoring of these two factors is seen as the most important approach in preventing epileptic seizure development after HSCT.

GÝRÝÞ ve AMAÇ: Prostat Kanseri (PK) erkeklerde en sýk görülen kanser türüdür. Hastalarýn tedavi planýnda tümörün patolojik derecesinin önemli yeri bulunmaktadýr. Çalýþmamýzda PK tanýsý nedeniyle Robot Yardýmlý Laparoskopik Radikal Prostatektomi (RYLRP) yapýlan hastalarda prostatektomi spesmenindeki tümör dereceleri, biyopsi derecelerinden yüksek çýkanlarda, bu artýþý öngörmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Kliniðimizde Aðustos 2019–Mayýs 2020 tarihleri arasýnda PK tanýsý almýþ ve RYLRP yapýlan 109 hastanýn bilgileri retrospektif olarak incelendi. Cerrahi iþlemler Da Vinci Xi robot sistemi (Intuitive Surgical, Sunnyvale, CA, USA) ile gerçekleþtirildi. RYLRP sonrasý incelemedeki ISUP derecesi, prostat biyopsi derecesine göre artmýþ olan hastalar grup-1; ayný kalan ya da azalan hastalar ise grup-2 olarak sýnýflandýrýldý. Bu iki gruptaki hastalarýn yaþ, Prostat Sepsifik Antijen (PSA), prostat hacmi, parmakla rektal muayene (PRM) bulgusu, Nötrofil/ Lenfosit oraný (NLO), Trombosit/Lenfosit oraný (TLO) ve AST/ALT (De Ritis) deðerleri karþýlaþtýrýldý.
BULGULAR: Çalýþmaya dahil edilen hastalarýn ortalama yaþý 64,32±6,20 (46-77) yýl, PSA deðeri 9,46±10,84 (0,5-86) ng/mL ve prostat hacmi 49,19±25,72 (18-145) mL idi. RYLRP sonrasý tümör derecesinde artýþ 33 (%36,7) hastada tespit edildi, 48 (%53,3) hastada derece ayný kalýrken 9 (%10) hastada düþüþ mevcuttu. Yaþ, PSA, prostat hacmi, PRM’de patolojik bulgu oraný, NLO ve De Ritis oraný grup 1’de, grup-2’ye göre yüksek bulunsa da bu yükseklik istatistiksel olarak anlamlý deðildi (p>0,05). TLO ise Grup-1’de, Grup-2’ye göre anlamlý olarak yüksekti (p=0,026).
TARTIÞMA ve SONUÇ: Çalýþmamýzda her ne kadar sadece TLO’daki artýþ istatistiksel açýdan anlamlý olarak bulunsa da prostat hacmi hariç diðer tüm parametreler tümör derecesinde artýþ saptanan grupta yüksek bulunmuþtur.

INTRODUCTION: Prostate Cancer(PCa) is the most common cancer disease among men. The pathologic grade of tumor has an important place in patient’s treatment plan. In our study, we aimed to predict the increase in the tumor grade of prostatectomy specimens than biopsy degree in the patients who underwent Robot-Assisted Laparoscopic Radical Prostatectomy(RALRP) due to PCa diagnosis.
METHODS: The data of 109 patients who were diagnosed with PCa and underwent RALRP between August 2019 and May 2020 were analyzed retrospectively in our clinic. Surgical operations were carried out by Da Vinci Xi surgical robot system (Intuitive Surgical, Sunnyvale, CA, USA). The patients whose ISUP rating in post RALRP examination increased compared to the prostate biopsy were classified as group-1; patients remained same or decreased were classified as group-2. The patient’s age, prostate-specific antigen(PSA), prostate volume, rectal examination by palpation (DRE) findings, Neutrophil/ Lymphocyte ratio (NLR), Platelet/ Lymphocyte ratio(PLR) and AST/ALT (De Ritis) values were compared in these two groups.
RESULTS: The average age of patients included in this study was 64.32 ± 6.20 (46-77) years, the PSA value was 9,46±10,84 (0,5-86) ng/mL and prostate volume was 49.19 ± 25.72 ( 18-145) mL. Increase in tumor grade after RYLRP was detected in 33 (%36,7) patients, while the grade remained in 48 (%53,3) patients, 9 (%10) patients had a decrease. Although, age, PSA, pathological result ratio in DRE, NLR and De Ritis ratio were found higher in group-1 than group-2, this highness was not statistically significant (p>0,05). PLR was significantly higher in group 1 than group 2 (p=0,026).
DISCUSSION AND CONCLUSION: In our study, although only the increase in PLR was found to be statistically significant, all other parameters except for prostate volume were found to be high in the group with an increase in tumor grade.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý ultrason eþliðinde yapýlan transrektal prostat biyopsisinde kullanýlan üç farklý antibiyotik profilaksisinin etkinliðini karþýlaþtýrmaktýr
YÖNTEM ve GEREÇLER: Ultrason eþliðinde transrektal prostat biyopsisi yapýlan hastalar çalýþmaya alýndý. Üç farklý antibiyotik profilaksisi uygulandý. Birinci gruptaki hastalar aðýzdan 500 mg siprofloksasin aldý. Ýkinci gruptaki hastalar aðýzdan 500 mg siprofloksasin ile birlikte tek doz 500 mg amikasini kas içi uygulama þeklinde aldýlar. Üçüncü gruptaki hastalar aðýzdan 500 mg siprofloksasin, tek doz 500 mg amikasin ve 500 mg metronidazolü damar içi uygulama yoluyla aldý. Ek olarak 3. gruptaki hastalara biyopsi iþleminden hemen önce povidon – iyot ile rektal temizlik yapýldý. Biyopsi sonrasý enfeksiyon görülme oranlarý, gruplarýn demografik özelliklerine, son 6 ay içinde antibiyotik kullanýmýna, ek hastalýklarýn varlýðýna ve sonda kulanýmýna göre karþýlaþtýrýldý.
BULGULAR: Birinci grupta 62, ikinci grupta 87 ve üçüncü grupta 91 hasta vardý. Biyopsi sonrasý enfeksiyon 1. grupta 5 (%8,1) hastada, ikinci grupta 2 (%2,3) hastada ve 3. grupta 1 (%1,1) hastada görüldü. Enfeksiyon oranlarý açýsýndan gruplar arasýnda istatistiksel olarak anlamlý farklýlýk vardý (p: 0,049). Enfeksiyon için risk faktörleri olabilecek diabet varlýðý, sonda kullanýmý ve son 6 ay içinde antibiyotik kullanýmý açýsýndan gruplar arasý farklýlýk saptanmadý.
TARTIÞMA ve SONUÇ: Transrektal prostat biyopsisiyle iliþkili enfeksiyonlarý önlemede kombine antibiyotik profilaksisi tek ajan antibiyotik profilaksisine göre daha etkilidir.

INTRODUCTION: The aim of this study was to compare the effectiveness of three different prophylaxis methods after transrectal ultrasound-guided prostate biopsy.
METHODS: Patients who underwent a transrectal prostate biopsy were added to the study. Three different prophylactic antibiotic procedures were applied. In the first group, 62 patients received 500 mg ciprofloxacin orally, 87 patients in the second group received 500 mg ciprofloxacin orally plus one dose of 500 mg amikacin intramuscularly, and 91 patients in the third group received 500 mg ciprofloxacin orally plus one dose of 500 mg amikacin plus 500 mg metronidazole intravenously. Additionally, rectal cleansing with povidone-iodine was performed immediately before biopsy for patients in the third group. Demographic data, antibiotic use within the previous 6 months, comorbidite diseases, and presence of a urinary catheter were compared between the groups according to post-biopsy infection rates.
RESULTS: There were 62 patients in the first group, 87 patients in the second group and 91 patients in the third group. Post-biopsy infection was detected in 5 (8.1%) patients in the first group, 2 (2.3%) patients in the second group and 1 (1.1%) patient in the third group. There were statistically significant differences between the groups according to infection rates (p= 0.049). There were no significant differences between the groups according to the presence of diabetes, urethral catheterization and antibiotic use within the previous 6 months, which are risk factors for infection.
DISCUSSION AND CONCLUSION: Combination therapy is a more effective approach to prevent biopsy-related infectious complications than single agent therapy.

GÝRÝÞ ve AMAÇ: Rektum kanseri cerrahisinde laparoskopik yaklaþým standart olmaya baþlamýþtýr. Bu çalýþmada rektum kanseri nedeniyle laparoskopik aþaðý anterior rezeksiyon yapýlan grup ile laparotomi ile aþaðý anterior rezeksiyon(AAR) yapýlan grubun erken dönem hasta özellikleri, postoperatif komplikasyonlar ve patolojik verilerinin karþýlaþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýzda Ocak 2012 ile Aralýk 2015 tarihleri arasýnda rektum kanseri tanýsý ile ayný cerrahi ekip tarafýndan laparoskopik veya açýk AAR uygulanan ardýþýk 201 hastanýn; cinsiyet, yaþ, tümör yerleþimi, erken dönem komplikasyonlarý ve patolojik verileri retrospektif olarak deðerlendirilmiþtir.
BULGULAR: Çalýþmaya 93 (%46,6) laparoskopik, 108(%53,4) açýk cerrahi teknik ile AAR uygulanan toplam 201 hasta dahil edilmiþtir. Her iki grupta da ameliyat sonrasý erken dönemde mortalite görülmemiþtir. Post operatif morbidite (enfeksiyon, ileus-subileus, anastomoz kaçaðý, stoma komplikasyonlarý) laparoskopi grubunda 12 (%12,9) hastada, açýk cerrahi grubunda 21 (%19,4) saptanmýþtýr(p>0,05). Her iki grupta diseke edilen ortalama lenf nodu sayýsý benzer bulunmuþtur (13.04±7.29 ve 13.24±6.58) (p=0,525). Distal cerrahi sýnýr (DCS) karþýlaþtýrýlýdýðýnda laparoskopik cerrahi grubunun daha uzak DCS mesafesi olduðu bulunmuþtur (3.81±1.82 cm ve 3.04±1.81cm, p<0,001). Radyal cerrahi sýnýr (RCS) laparoskopik cerrahi grubunda daha uzak bulunmuþtur(1.89±1.01 cm ve 1.45±0.79 cm, p<0,001). DCS ve RCS pozitifliði laparoskopik ve açýk cerrahi grubunda hiçbir olguda saptanmamýþtýr.
TARTIÞMA ve SONUÇ: Laparoskopik rektum kanseri cerrahisi yüksek hacimli kurumlarda ve deneyimli cerrahlar tarafýndan gerçekleþtirildiðinde erken dönem klinik sonuçlar ve onkolojik veriler açýsýndan açýk rektum cerrahisine göre özellikle DCS ve RCS ‘ýn geniþliði olarak avantaj saðladýðý görülmektedir.

INTRODUCTION: Laparoscopic approach in rectal cancer surgery has been become the standard technic.In present study, it was aimed to compare the patients characteristics, postoperative complications and pathological data of the group that underwent laparoscopic low anterior resection (LAR) and underwent LAR by laparotomy(open) due to rectum cancer.
METHODS: In present study, between January 2012 and December 2015, laparoscopic or open LAR was performed by the same surgical team to 201 consecutive patients who diagnosed as rectal cancer. These patients’ gender, age, tumor location, early period complications and pathological datas were evaluated retrospectively.
RESULTS: A total of 201 patients who underwent LAR with 93 (46.6%) laparoscopic and 108 (53.4%).Open surgical techniques were included in the study.There was no mortality in the early postoperative period in either group. Postoperative morbidity (infection, ileus-subileus, anastomotic leakage, stoma complications) was detected in 12 (12.9%) patients in the laparoscopy group and 21 (19.4%) in the open surgery group (p> 0.05).The mean number of dissected lymph nodes in both groups was similar (13.04 ± 7.29 and 13.24 ± 6.58) (p = 0.525). When the distal resection margin (DRM) was compared, the laparoscopic surgery group was found to have a statistically significant farther DRM distance (3.81 ± 1.82 cm vs 3.04 ± 1.81 cm), (p <0.001).The circumferential resection margin (CRM), was more distant in the laparoscopic surgery group (1.89 ± 1.01 cm and 1.45 ± 0.79 cm, p <0.001). DRM and CRM positivity was not detected in anycase in either group.
DISCUSSION AND CONCLUSION: When laparoscopic rectum cancer surgery is performed in high-volume institutions and by experienced surgeons, it is seen that it provides an advantage in terms of early clinical results and oncological data compared to open rectal surgery, especially in terms of DRM and CRM width.

GÝRÝÞ ve AMAÇ: Ýdiopatik trombositopenik purpura olarak da adlandýrýlan immün trombositopeni (ITP), derin trombositopeni ve hayatý tehdit edici kanamalarla seyredebilen bir klinik tablodur. Birinci basamakta kullanýlan tedavilere yanýtsýz hastalarda son 10 yýldýr kullanýlmaya baþlanan trombopoetin reseptör analoglarý rompilostim ve eltrombopag etkinliði kanýtlanmýþ yeni ajanlardýr. Bu çalýþmadaki amacýmýz steroide dirençli ITP hastalarýnda eltrombopag etkinliðini ve yan etkilerini gerçek yaþam verileriyle deðerlendirmektir.
YÖNTEM ve GEREÇLER: Bu çalýþma Ocak 2012 – Eylül 2020 tarihleri arasýnda ITP tanýsý ile tedavi edilen hastalarýn retrospektif olarak deðerlendirilmesi ile yapýlmýþtýr. 18 yaþ altý ve ITP dýþý endikasyonla eltrombopag kullanan hastalar çalýþma dýþý býrakýlmýþtýr.
BULGULAR: Çalýþmamýza dahil edilen 31 hastanýn ortanca yaþý 60’dý (25-87). Bu hastalarýn 18’i (%58.0) kadýndý. En az bir komorbiditesi olan hasta sayýsý 19’du (%61.2). Hastalarýn tamamý ITP tedavisi için birinci sýrada glukokortikosteroid tedavisi almýþtý. Steorid tedavisine dirençli olan bu hastalarýn 16’sýna (%51.6) ikinci sýra tedavi olarak splenektomi uygulanmýþtý. Eltrombopag öncesinde ortanca trombosit deðeri 11x109/L (1x109/L - 46x109/L) iken 24 (%77.4) hastada tedaviye yanýt görülmüþtü. Yanýt elde edilen hastalarda ortanca 17.günde (3-57.gün) trombosit sayýsý 50x109 üzerine çýkmýþtý. Bu hastalarýn 16’sýnda (%51.6) 50 mg/gün, yedisinde (%22.5) 25 mg/gün, ve bir (%3.2) hastada ise 75 mg/gün eltrombopag tedavisi ile yanýt elde edilmiþti. Ýki (%6.4) hastada grade 1 karaciðer fonksiyon testlerinde yükselme görülmüþtü. Yan etki nedeniyle tedaviye devam edemeyen ya da tedaviye ara veren hastamýz ise yoktu.
TARTIÞMA ve SONUÇ: Eltrombopagin ITP tedavisi için daha önce çoklu basamak tedavi almýþ olan hasta grubunda bile etkin ve güvenli bir seçenek olduðu görülmüþtür.

INTRODUCTION: Immune thrombocytopenia (ITP), which is also used as idiopathic thrombocytopenic purpura, is a clinical condition that can progress with severe thrombocytopenia and life-threatening bleeding. Thrombopoetin receptor analogues such as rompilostim and eltrombopag, which have been used in the last 10 years, are new agents with proven efficacy. Our aim in this study is to evaluate the efficacy and toxicity of eltrombopag in steroid resistant ITP patients with real life data.
METHODS: This study was conducted with a retrospective evaluation of patients treated with a diagnosis of ITP between January 2012 and September 2020. Patients under 18 years of age and using eltrombopag for non-ITP indications were excluded from the study.
RESULTS: The median age of 31 patients included in our study was 60 (25-87). Eighteen (58.0%) of these patients were women. The number of patients with at least one comorbidity was 19 (61.2%). All of the patients had received glucocorticosteroid treatment in the first line for ITP treatment. Splenectomy was applied as a second line treatment to 16 (51.6%) of these patients who were resistant to steroid treatment. Before eltrombopag, the median platelet value was 11x109/L (1x109/L - 46x109/L), while 24 (77.4%) patients responded to the treatment. In patients with a response, the median day 17 (day 3-57) thrombocyte count increased over 50x109/L. Sixteen of these patients (51.6%) had a response of 50 mg/day, seven (22.5%) 25 mg/day, and one (3.2%) patient 75 mg/day eltrombopag treatment. Two (6.4%) patients had an increase in grade 1 liver function tests. There was no patient who could not continue or interrupted the treatment due to side effects.
DISCUSSION AND CONCLUSION: It has been observed that eltrombopag treatment is an effective and safe option even in the group of patients who have previously received multiple-line therapy in ITP treatment.

GÝRÝÞ ve AMAÇ: ince iðne aspirasyon biyopsisi tiroid nodüllerinin patolojik tanýsýnda en sýk kullanýlan yöntem olup, uygulamasý kolay, tanýsal etkinliði yüksek ve düþük maliyetli bir uygulamadýr. Bazen tiroid ince iðne aspirasyon biyopsisi sonucunda yeterli hücre elde edilemeyebilir ve patolojik deðerlendirme için yetersiz kalabilir. Çalýþmamýzda, ince iðne aspirasyon biyopsisi ile patolojik deðerlendirme için “tanýsal olmayan / yetersiz” materyal elde edilen tiroid nodüllerinin ultrasonografik görünümü araþtýrýldý.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya 186 hasta dahil edildi. Ýnce iðne aspirasyon biyopsisi, 22 G iðne ve serbest el tekniði kullanýlarak ultrason rehberliðinde yapýldý. Bethesda sýnýflandýrmasýna göre patolojik deðerlendirmeler yapýldý. TIRADS skoru, boyutu, nodüllerin bileþimi, iç yapý, ekojenite, þekil, sýnýr, ekojenik odaklar, kenar ultrasonografi ile deðerlendirildi.
BULGULAR: 186 nodülden 70'i solid, 2'si tamamen veya neredeyse tamamen kistikti. 17 nodül anekoik, 55 tanesi hipoekoik, 102 tanesi izoekoik, 12 nodül hiperekoik olarak tespit edildi. 174 iyi sýnýrlý, 12 lobüle konturlu nodül vardý. 156'sýnýn ekojenik odaðý yoktu, 15'inde makrokalsifikasyon ve 12'sinde mikrokalsifikasyon vardý. 166 nodülün TI-RADS skoru 2-4 iken, 4 nodülün 5, 12 nodülün 6 ve 4 nodülün 7 idi.
TARTIÞMA ve SONUÇ: Bu çalýþmada patoloji sonuçlarý yetersiz olan tiroid nodüllerinin ultrasonografik özellikleri deðerlendirildi. Yetersiz materyal sonucu olan nodüllerde kistik baskýnlýk veya makrokalsifikasyon gibi özellikler daha sýk görülmekle birlikte, her tür nodülde bu olasýlýðýn olduðu gösterilmiþtir.

INTRODUCTION: FNAB is the most commonly used method in the pathological diagnosis of thyroid nodules, and it is an easy-to-apply, high diagnostic efficiency and low cost application. Sometimes not enough cells can be obtained as a result of thyroid fine needle aspiration biopsy and it may be insufficient for pathological evaluation. In our study, the ultrasonographic appearance of thyroid nodules that were obtained “non-diagnostic/inadequate” material for pathological evaluation with fine needle aspiration biopsy was investigated.
METHODS: 186 patients were included in this retrospective study. Fine needle aspiration biopsy were performed under ultrasound guidance, using a 22 G needle and freehand technique. Pathological evaluations were made in accordance with the Bethesda classification. TIRADS score, size, composition of nodules, internal structure, echogenicity, shape, margin, echogenic foci, rim were evaluated by ultrasonography.
RESULTS: From 186 nodules, 70 were solid, while 2 of them were completely or almost completely cystic. While 17 nodules were anechoic, 55 were hypoechoic, 102 were isoechoic, 12 nodules were detected as hyperechoic. There were 174 well-circumscribed, 12 lobulated contoured nodules. 156 had no echogenic focus, 15 had macrocalcification and 12 had microcalcifications. The TI-RADS score of 166 nodules were 2-4, while 5 of 4 nodules, 6 of 12 nodules, and 7 of 4 nodules.
DISCUSSION AND CONCLUSION: Ultrasonographic features of thyroid nodules with inadequate pathology results were evaluated. In our study, it has been shown that although inadequate material results in features such as cystic dominance or macrocalcification increase, there is a possibility in all types of nodules.

GÝRÝÞ ve AMAÇ: Tiroid hastalýklarý toplumda oldukça sýk görülen hastalýklardýr. Benign yada malign lezyonlar için farklý cerrahi seçenekler mevcuttur. Bu çalýþmanýn amacý daha önce tiroidektomi ameliyatý geçirmiþ olan hastalarýn geriye dönük olarak incelenerek yaþ, cinsiyet, nodül boyutlarý ince iðne biyopsi sonuçlarý,komplikasyon geliþimi, ameliyat sonrasý patoloji sonuçlarý, malignite türlerinin deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Bu çalýþmada Eylül 2018-Haziran 2020 tarihleri arasýnda Saðlýk Bilimleri Üniversitesi Þanlýurfa M.Akif Ýnan Eðitim ve Araþtýrma Hastanesi Kulak Burun Boðaz Hastalýklarý(KBB) Kliniðinde tiroidektomi yapýlan 59 hasta geriye dönük olarak deðerlendirildi.
BULGULAR: Hastalarýn 40’ý kadýn (%67.7), 19’u erkekti (%22.3).Hastalarýn ortalama yaþý 47.6, yaþ aralýðý 32-74 idi. Tiroid USG’de belirlenen nodul boyutu 8x7mm ile 68 x 40 mm ile arasýndaydý(ortalama 30,2 x 21,7 mm).. Biyopsi sonuçlarý; 24 hastada benign, 8 hastada önemi belirsiz atipi, 7 hastada nondiagnostik, 10 hastada papiller hücreli karsinom, 8 hastada malignite þüphesi ve 2 hastada foliküler neoplazi þeklinde idi. Hastalarýn 25’ine bilateral total tiroidektomi, 34’ine ise unilateral total lobektomi operasyonu yapýlmýþtý. Postoperatif patoloji sonuçlarý; 42 (%71.1) hastada benign (nodüler hiperplazi, benign koloidal nodül, lenfositik tiroidit, haþimato tiroiditi), 17 (% 29.9) hastada malign olarak raporlandý. Malignlerin 15’i papiller karsinom ve 2’si foliküler karsinomdu.
TARTIÞMA ve SONUÇ: Bu çalýþmada tiroidektomi uygulanan hastalarýn daðýlýmý ve malign hastalarda histopatolojik tanýlarý literatür ile benzer özelliktedir. Ancak tiroidektomi sonrasý malignite oraný literatürden yüksektir. Bu durum her hastaya ameliyat öncesi mutlaka ince iðne biyopsisi yapýlmasý gerektiðinde biyopsinin tekrarlanmasý, hasta seçiminde hassasiyet gösterilmesi, gereksiz endikasyondan kaçýnýlmasý ile açýklanabilir.

INTRODUCTION: Thyroid diseases are common diseases in the community. There are different surgical options for benign or malignant lesions. The aim of this study is to retrospectively examine patients who have undergone thyroidectomy, and to evaluate age, gender, nodule size, fine needle aspiration biopsy results, complication development, postoperative pathology results, and types of malignancy.
METHODS: In this study, 59 patients who underwent thyroidectomy at the Department of Otorhinolaryngology (ENT) in Sanliurfa M.Akif Inan Training and Research Hospital between September 2018 and June 2020 were evaluated retrospectively.
RESULTS: 40 of the patients were female (67.7%) and 19 were male (22.3%). The mean age of the patients was 47.6 years and the age range was 32-74. The nodule size determined in the thyroid USG was between 8x7mm and 68 x 40mm (average 30.2 x 21.7mm).. Biopsy results; It was benign in 24 patients, atypia in 8 patients, nondiagnostics in 7 patients, papillary cell carcinoma in 10 patients, suspicion of malignancy in 8 patients, and follicular neoplasia in 2 patients. 25 patients underwent bilateral total thyroidectomy and 34 patients underwent unilateral total lobectomy. Postoperative pathology results; In 42 (71.1%) patients, benign (nodular hyperplasia, benign colloidal nodule, lymphocytic thyroiditis, hachyimato thyriditis) were reported as malignant in 17 (29.9%) patients. 15 of the malignancies were papillary carcinoma and 2 were follicular carcinoma.
DISCUSSION AND CONCLUSION: In this study, the distribution of patients undergoing thyroidectomy and histopathological diagnoses in malignant patients are similar to those in the literature. However, the rate of malignancy after thyroidectomy is higher than the literature. This situation can be explained by repeating the biopsy when every patient needs to perform a fine needle biopsy before the surgery, showing sensitivity in patient selection, and avoiding unnecessary indications.

GÝRÝÞ ve AMAÇ: Lösemi, olgunlaþmamýþ myeloid hücrelerden kaynaklanan bir kanserdir. Akut myeloid lösemi (AML), yetiþkinlerde en sýk görülen akut lösemidir. AML onlarca yýldýr bilinmesine raðmen, etiyolojisi büyük ölçüde aydýnlatýlamamýþtýr. Obezite, lösemi dâhil çeþitli kanserler için bir risk faktörüdür. AML ile obezite iliþkisi uzun zamandýr araþtýrýlmaktadýr. Akut promiyelositik lösemi (APL) ile obezite iliþkisine dair güçlü kanýtlar vardýr. Biz bu çalýþmamýzda AML ve APL de obezitenin sýklýðýný ve saðkalým üzerine etkisini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya Ocak 2012 ile Haziran 2020 arasýnda merkezimizde taný konan, takipleri olan ve tedavi öncesi vücut kitle indeksi (VKÝ) bilgisine ulaþýlabilen 119 AML hastasý dahil edildi.
BULGULAR: Tüm hastalarda medyan yaþ 44 (19-87) idi. Vücut kitle indeksi APL hastalarýnda 23 kg/m2 (16,5-48,9 kg/m2) iken non-APL hastalarýnda 24,4 kg/m2 (15,6-37,8 kg/m2) izlendi, iki grup benzerdi (p=0,9). Medyan saðkalým non-APL hastalarýnda 63 ay (%95 CI, 0-141,7) izlendi, medyan saðkalým VKÝ gruplarýndan etkilenmedi (p=0,8). APL grubunda ise ortanca saðkalýma ulaþýlamadý, ortanca saðkalým VKÝ gruplarý arasýnda farklýlýk göstermedi (p=0,8). Obeziteyi (VKÝ≥30kg/m2) predikte eden faktörler olarak demografik veriler yaþ, cinsiyet ve hastalýk tipi (APL-non-APL) olarak univariate regresyon analizi ile deðerlendirildiðinde, yaþ obezite üzerinde etkisi olan tek faktördü (p=0,001).
TARTIÞMA ve SONUÇ: Çalýþmamýzda AML ve APL de obezitenin etkisi izlenememiþ olup sadece yaþ ile obezite iliþkisi izlenmiþtir. Bu bulgularý doðrulamak ve arkasýndaki biyolojik nedenleri anlamak için daha fazla araþtýrmaya ihtiyaç vardýr.

INTRODUCTION: Leukemia is a cancer caused by immature myeloid cells. Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Although AML has been known for decades, its etiology has not been largely elucidated. Obesity is a risk factor for various cancers, including leukemia. The relationship between AML and obesity has been investigated for a long time. There is strong evidence for the relationship between acute promyelocytic leukemia (APL) and obesity. In this study, we aimed to evaluate the frequency of obesity and its effect on survival in AML and APL.
METHODS: The study included 119 AML patients who were diagnosed in our center between January 2012 and June 2020, who had follow-ups and whose body mass index (BMI) information was available before treatment.
RESULTS: The median age was 44 (19-87) in all patients. While body mass index was 23 kg / m2 (16.5-48.9 kg / m2) in APL patients, 24.4 kg / m2 (15.6-37.8 kg / m2) was observed in non-APL patients, the two groups were similar (p = 0.9). Median survival was monitored for 63 months (95% CI, 0-141.7) in non-APL patients, median survival was not affected by BMI groups (p = 0.8). In the APL group, the median survival could not be reached, and the median survival did not differ between the BMI groups (p = 0.8). When demographic data as the predictors of obesity (BMI≥30kg / m2) were evaluated by age, gender and disease type (APL-non-APL), univariate regression analysis was the only factor that had an effect on obesity (p = 0.001).
DISCUSSION AND CONCLUSION: In our study, the effect of obesity was not observed in AML and APL, and only the relationship between age and obesity was observed. More research is needed to confirm these findings and to understand the biological causes behind them.

GÝRÝÞ ve AMAÇ: Kemik, kanserler için en yaygýn metastaz bölgelerindendir. Kanserin kemiðe metastazý nadiren tam iyileþme ile sonuçlanýr. Kemik metastazý; aðrý, kýrýk riski ve hiperkalsemi gibi çeþitli morbiditelerle iliþkilidir. Onkoloji merkezi olarak kemik metastazý nedeniyle opere ettiðimiz hastalarýn demografik özelliklerini sunmayý amaçladýk.
YÖNTEM ve GEREÇLER: Kliniðimizde ocak 2010 ve aralýk 2018 yýllarý arasýnda kemik metastazý nedeniyle opere edilen hastalarýn bilgilerini arþivlerden retrospektif olarak taradýk. Metastazlarýn neresi kaynaklý olduðu, hastalarýn demografik bilgileri, metastaz yerleri ve yapýlan cerrahi iþlem kaydedildi.
BULGULAR: Bu çalýþmaya %56’sý erkek yaþ ortalamasý 56.7±13.6 (11-85) yýl ve %68,1’i 65 yaþ altýnda olan toplam 477 metastatik kemik tümörü tanýsý almýþ hasta dahil edilmiþtir. Hastalarýn 183’ü (%38.4) patolojik kýrýk ile %13.4’ü ise insidental olarak taný almýþtýr. Tümör metastazlarýnýn %70.4’ü alt ekstremiteyi tutmuþtur ve alt ekstremitede ise en fazla femur yerleþimlidir (%50.1). Metastazlarýn kaynaklandýðý ilk üç yer sýrasý ile akciðer (%27.5), meme (%24.1) ve prostattýr (%14.5). Tedavi olarak hastalara en fazla geniþ rezeksiyon ve megaprotez (%50) uygulanmýþtýr.
TARTIÞMA ve SONUÇ: Sonuç olarak kemiðe en sýk metastaz yapan kanserler, ayný zamanda en sýk görülen kanserler olan akciðer, meme ve prostat kenseridir. Metastatik kemik tümörleri preterminal bulgu olmasýna raðmen, bu tümörlere hastanýn yaþam kalitesini artýrmak, aðrýsýný gidermek ve yataða baðýmlýlýktan kurtarmak amacý ile cerrahi tedavi uygulamasýný öneriyoruz.

INTRODUCTION: Bone is one of the most common metastasis sites for cancers. Metastasis of cancer to the bone rarely results in complete recovery. Bone metastasis; It is associated with various morbidities such as pain, fracture risk and hypercalcemia. As an oncology center, we aimed to present the demographic characteristics of the patients we operated for bone metastasis.
METHODS: We retrospectively scanned the archives of patients who were operated for bone metastasis between January 2010 and December 2018 in our clinic. The origin of the metastases, demographic information of the patients, metastasis locations and the surgical procedure performed were recorded.
RESULTS: A total of 477 patients with a diagnosis of metastatic bone tumors, 56% male, mean age 56.7 ± 13.6 (11-85) years and 68.1% under 65 years were included in this study. 183 (38.4%) of the patients were pathologic fractured and 13.4% were diagnosed incidentally. 70.4% of tumor metastases involve the lower extremity, and the lower extremity is mostly located in the femur (50.1%). The first three places where metastases originate are lung (27.5%), breast (24.1%) and prostate (14.5%), respectively. Wide resection and megaprosthesis was applied to the treated patients the most (50%).
DISCUSSION AND CONCLUSION: As a result, the most common cancers that metastasize to the bone are lung, breast and prostate cancer, which are also the most common cancers. Although metastatic bone tumors are preterminal findings, we recommend surgical treatment for these tumors to improve the patient's quality of life, relieve pain and relieve dependency on bed.

GÝRÝÞ ve AMAÇ: Bu çalýþmada eriþkin hastalarda ön çapraz bað (ÖÇB) yaralanmasý sonrasý rekonstrüksiyon cerrahisinde tibialis anterior allogreft ve hamstring tendon otogreft etkinliðinin karþýlaþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Bu çalýþma kesitsel ve retrospektif olarak yürütüldü. ÖÇB yýrtýðý nedeniyle hamstring otogrefti veya tibialis anterior allogrefti yöntemleri ile rekonstrüksiyon yapýlan hastalarýn cerrahi öncesi ve cerrahi sonrasý 6. ay fonksiyonel parametreleri karþýlaþtýrýldý. Femoral fiksasyon ve tibia fiksasyonu için sýrasýyla cross-pin ve biyo bozunur vida-staple kullanýldý. Deðerlendirmede Lysholm diz skorlama ölçeði (LDSÖ) ve Tegner aktivite düzeyi ölçeði (TADÖ) kullanýldý.
BULGULAR: Çalýþmamýza yaþlarý ortalama 32.74±7.82 yýl olan (19 ile 52 arasýnda deðiþen) toplam 121 hasta (100 erkek, 21 kadýn) dahil edildi. Aðrý ve dizde boþalma hissi en sýk görülen semptomlardý. Tüm hastalarýn cerrrahi öncesi (32.7±7.8) ve postoperatif 6.ayda (64.08±7.8) LDSÖ deðerlerini karþýlaþtýrdýðýmýzda anlamlý bir fark saptandý (p<0.001). Tüm hastalarýn cerrrahi öncesi (2.37±1.2) ve sonrasý (5.52±1.4) TADÖ skorlarý karþýlaþtýrdýðýmýzda anlamlý bir fark saptandý (p<0.001). Allogreft ve otogreft yapýlan hastalarýn cerrahi öncesi ve sonrasý LDSÖ ve TADÖ deðerleri karþýlaþtýrýldýðýnda, her iki grupta da cerrahi tedavi öncesine göre anlamlý artýþ saptanýrken, artýþ miktarlarý gruplar arasý karþýlaþtýrýldýðýnda allogreft grubunda artýþ daha belirgindi (LDSÖ 30.27±4.8 vs 24.43±2.8; TADÖ 3.32±1.1 vs 2.84±0.8). Toplam 5 hastada komplikasyon görülmüþ olup komplikasyon görülme oraný %4.1 olarak saptandý ve hepsi baþarýlý bir þekilde tedavi edildi.
TARTIÞMA ve SONUÇ: ÖÇB rekonstrüksiyonunda hem hamstring otogreft uygulamasý hem de allogreft uygulamasý ÖÇB rekonstüksiyon cerrahisi geçiren hastalarda LDSÖ ve TADÖ skorlarýnýn iyileþmesinde etkili bir yöntemdir. Ayrýca, allogreft grubundaki iyileþme otogreft grubundaki iyileþmeye göre daha belirgindir.

INTRODUCTION: The aim of this study was to compare the effectiveness of tibialis anterior allografting and hamstring tendon autografting reconstruction surgery after anterior cruciate ligament (ACL) injury in adult patients.
METHODS: This study was designed as a cross-sectional and retrospective study. Preoperative and postoperative functional parameters of patients who underwent ACL reconstruction surgery with hamstring autograft and tibialis anterior allograft methods due to ACL rupture were compared. Cross-pin and screw-staple were used for femur and tibia fixations, respectively. Lysholm knee scoring scale (LKSS) and Tegner activity level scale (TALS) were used for the outcome measures.
RESULTS: A total of 121 patients (100 males, 21 females) with a mean age of 32.74±7.82 years (ranging from 19 to 52 years) were included. Pain and giving way phenomenon were the most common symptoms. There was a significant difference between the preoperative (32.7 ± 7.8) and postoperative (64.08 ± 7.8) LKSS values of all patients (p <0.001). A significant difference was found between the preoperative (2.37±1.2) and postoperative (5.52±1.4) TALSvaluesof all patients (p<0.001). Compared with preoperative and postoperative LKSS and TALS scores, the increase in the allograft group was more prominent (LKSS: 30.27±4.8 vs. 24.43±2.8, TALS: 3.32±1.1 vs. 2.84±0.8). Complications were observed in 5 patients (4.1%), and all of them were successfully treated.
DISCUSSION AND CONCLUSION: In the light of our study, both hamstring autograft method and allograft method seem to be effective in improving LKSS and TALS inpatients who underwent ACL reconstruction surgery. However, the improvement in the allograft group is more prominent than that of in the autograft group.

Brenner tümörleri genellikle küçük olup asemptomatiktir ve tesadüfi olarak bulunurlar. Büyük tümörler palpabl kitle ya da aðrý gibi pelvik kitlelerin klinik bulgularýný gösterirler. Klinik olarak görüntüleme yöntemlerinde birçok patoloji ile karýþabilir.Örneðin; fibroma-tekoma gibi over tümörleri veya diðer ovaryan tümörlerle, tip 7 myom (saplý subseröz myom), kist hidatik, gastrointestinal sistem (gis) mezenkimal tümörleri, diðer gis neoplazileri vb. Görüntüleme yöntemlerinden biri olan bilgisayarlý tomografilerde (BT) solid komponent ve kalsifikasyon (geniþ ve þekilsiz olabilmekte) içermesi haricinde, genellikle spesifik bulgulara sahip deðildir(10). Görüntüleme yöntemleri, tümör boyutuyla beraber tümörün lokalizasyonunu belirlememizde ve cerrahi yaklaþýmýmýzda bize katkýda bulunurlar. Overin nadir tümörlerinden olan Brenner tümörünün pre-operatif teþhisindeki zorluk karýn içi diðer patolojilerle karýþabilmesine sebep olmaktadýr. Bu yüzden taný için her zaman diagnostik yöntemler (laparoskopi, ultrason eþliðinde biyopsi vs.) ya da açýk cerrahi prosedürler ile histopatolojik deðerlendirme gereklidir. Vakamýzýn tomografi raporunda ayýrýcý tanýda birden fazla patoloji ve yaygýn asit görünümü belirtildiðinden ayýrýcý tanýda diagnostik laparoskopi ön plana alýndý. Vakamýz geniþ kistik alanlar içeriyordu bu sebeple masif asit ve over ca ile karýþtý. Diagnostik laparoskopi ile ayýrýcý tanýya varýlabildi. Genç hastalarda bu tip patolojiler göz önünde bulundurulmalýdýr.

Brenner tumors are usually small, asymptomatic, and found incidentally. Large tumors show clinical signs of pelvic masses such as palpable mass or pain. Clinically, it can be confused with many pathologies in radiological imaging such as fibroma, tecoma or other ovarian tumors, type 7 myoma (stalked subserous myoma), hydatid cyst, gastrointestinal (GI) mesenchymal tumors, and other GI neoplasms. In computed tomography scans (CTs), they usually do not have specific findings except that they contain solid components and calcification (which can be large and amorphous) (10). Imaging methods help us to determine the location of the tumor together with tumor size, and our surgical approach. The difficulty in pre-operative diagnosis of Brenner tumor, which is one of the rare tumors of the ovary, causes it to be confused with other intra-abdominal pathologies. Therefore, it is required to evaluate them histopathologically with diagnostic methods (laparoscopy, ultrasound-guided biopsy, etc.) or open surgical procedures. Since more than one possible pathologies and diffuse ascites appearance were stated in the CT report of our case, diagnostic laparoscopy was preferred for differential diagnosis. The mass in our case contained large cystic areas, so it was confused with massive acid and ovarian cancer. Diagnosis achieved through diagnostic laparoscopy. These pathologies must be considered in young patients.

GÝRÝÞ ve AMAÇ: Bu çalýþmada 1990 yýlýnda yapýlmýþ Hodgkin lenfoma tezinden yola çýkýlarak günümüzde HL taný, görüntüleme ve tedavi sindeki güncel geliþim vaka örneklemleri ile incelenecektir. Son 30 yýldaki tedavi endikasyonu deðiþimleri, radyoterapi tedavi alanlarýndaki küçülmeler ve radyoterapi doz düþümleri tarihsel süreçler dikkate alýnarak karþýlaþmalý olarak deðerlendirilecektir.
YÖNTEM ve GEREÇLER: Yazarýn 1985- 1990 yýlarý arasýnda Ankara Numune Hastanesi Radyoterapi Kliniðinde tedavisi tamamlanan hastalarýn demografik ve klinik, özellikleri özetlenecek ve o tarihteki güncel görüntüleme yöntemleri ve tedavi yaklaþýmlarý, günümüzdeki yaklaþýmlarla kýyaslanacaktýr.
BULGULAR: 1985-1990 yýllarý arasýnda Ankara Numune Hastanesinde Hodgkin lenfoma tanýsý ile tedavi edilen 60 vakanýn verileri incelenmiþtir. Ortanca yaþ 31 olarak bulundu. Evre ve histolojik tip gruplar arasýnda eþit olarak daðýlmýþtý. Baþlangýç tutulum alanlar; servikal-supraklavikular bölge 34 vaka (% 56), inguinofemoral 8 vaka (%13), aksiller 7 vaka (%11), mediastinal 5 vaka (%8,2), abdominal 3 vaka (% 5,3), tonsil 2 vaka (%3), primer beyin 1 vaka olarak görüldü. Diafram altý baþlayan vakalar totalin % 18 lik bölümüydü. Mikssellüler tip en çok görülen gurubu oluþturdu. Bin dokuz yüz seksenli yýllarda Evre IA ve II A Hodgkin lenfoma da standart tedavi þekli Sub Total Lenfod Iþýnlama (Mantle, Inverted Y) idi. Bu dönemde Hodgkin lenfoma görüntülemesinde kullanýlan en geliþmiþ yöntem Bi-Pedal Lenfanjigrafi iken günümüzde FDG PET-CT primer görüntüleme yöntemidir. Bu çalýþmada radyoterapi alan 58 hastanýn 6 ýnde yineleme olmuþtur. Yinelemelerin 4 ü alan dýþý, 2 si alan içi olarak raporlanmýþtý
TARTIÞMA ve SONUÇ: Alandýþý nükslerin fazlalýðý ve geniþ alan radyoterapi uygulamalarýnýn özellikle çocukluk yaþ grubunda oluþturduðu büyüme geliþme gerilikleri, kardiak sorunlar, ikincil kanserlerin artýþý gibi yan etkiler araþtýrmacýlarý yeni tedavi þekilleri aramaya yöneltmiþtir. Günümüzde giderek boyut olarak küçülmüþ ve dozu azaltýlmýþ radyoteapi uygulamalarý iyi kemoterapi uygulamalarý ile eþleþtirilmiþtir. Hem kemoterapideki iyileþmeler hem de radyoterapi tekniðindeki geliþmeler 5 yýllýk yaþamý % 90 seviyelerinin üzerine çýkarýrken morbid yan etkiler tarihsel makalelerde anekdot olarak kalmýþtýr.

INTRODUCTION: In this study, based on the Hodgkin lymphoma thesis made in 1990, current developments in Hodgkin lymphoma diagnosis, imaging and treatment are examined with case samples. Changes in treatment indication in the last 30 years, shrinkage in radiotherapy treatment areas and radiotherapy dose reductions are evaluated comparatively, taking into account historical processes.
METHODS: The demographic and clinical characteristics of the patients whose treatment was completed in the radiotherapy clinic of Ankara Numune Hospital between 1985-1990 will be summarized and the current imaging methods and treatment approaches at that time are compared with current approaches.
RESULTS: The data of 60 cases treated with the diagnosis of Hodgkin lymphoma in Ankara Numune Hospital between 1985-1990 are analyzed. The median age was 31. Histologic types and stages are distributed evenly between the groups. The initial involvement areas are such that; 34 cases start in the cervical-supraclavicular region (56%), eight in inguinofemoral (13%), seven in axillary (11%), five in mediastinal (8.2), three in the abdominal (5.3%), two in the tonsillar (3%), one in primary cerebral. Diseases that initiated under the diaphragm were 18% of the total. Mixcellular type constituted the most common group. In the 1980s, the standard treatment method for Stage IA and II A Hodgkin lymphoma was Sub Total Lymphoid Irradiation (Mantle, Inverted Y). In this period, the most advanced technique used in Hodgkin lymphoma imaging was Bi-Pedal Lymphangygraphy, while FDG PET-CT is the primary imaging method today. In this study, the number of recurrent patients is to be found 6 out of 58 who received radiotherapy. Four of them were outside the field, and two were within.
DISCUSSION AND CONCLUSION: The excessive number of out of field recurrences, side effects such as growth and development retardation, cardiac problems, and increase in secondary cancers caused (especially in the childhood age group) by wide-field radiotherapy applications; led researchers to seek new treatment modalities. Nowadays, applications of radiotherapy with reduced size and decreased dose combined with better chemotherapy practices. While improvements in both chemotherapy and radiotherapy techniques have increased the 5-year life above 90%, morbid side effects have remained anecdotal in historical articles.