INTRODUCTION: Research for the clinical effectiveness of Finasterid- Doxazosin combination on patients with syptomatic BPH who are unsuitable to performance statue surgical treatment due to internal disease or included in ASA 4 risk group with regard to anestzy.
MATERÝAL METHOD: Total of 63 patients with semptomatic BPH who have IPSS over 7, below MFR: 10 mi! sec. and or below AFR: 8 mi! sec. participated in this research. They have been cured with Doxazosin 4 mg lxl, finasterid 5 mg lxl. Thirty of them have come f or thecontrols regularly in our following protocol. The medication had been started and 3days later urethral catheter has been removed. it had planned to follow with cystostomi tube if post miksiyonel rezidü (PMR) became over 150 mi. Controls has been done at the end of 3rd month, 6th month and 12th month. Clinical inspection, IPSS, uroflowmetri, PSA, ultrasonography has been performed in controls.
RESULTS: This research has been conducted on the total of 63 patients whose average age 73 and average prostate volume 51.8 11 patients had urethal catheter, just 1 patient couldn‘t urinate so this patient was followed via cystostomy. PMR were below 150 mi. in the rest 10 patients on the 3rd day. On the thirty patients, 30.3 % increase in MFR, 29.5 % reduction in AFR, 48.7 % reduction in IPSS obstructive symptoms, 40.5 % decrease in irritative symptoms and 39.1 % reduction in PMR, in 3rd month. in 6th month, 69 %reduction in PSA and MFR 23.0 %, AFR 20.57 % increased, Obstructive IPSS symptoms 41.02 % irritative 27.38 %decrease in prostate volume has been determined. After 1 year control, PSA 59 % decreased, MFR 6.7 % increased, AFR 20.57 % increased, obstructive IPSS symptoms 63.72
%, irritative 44.48 % and prostate volume 29.83 % decrease has been determined.
CONCLUSION: These results seems to similar with our prospective study which planned to investigate the effect of doxazocin treatment. it needs that finasterid should be discussed in that combination. But, we believe that the final conclusion on that issue may be provided with follow-up of comprehensive patient group.

OBJECTIVE: in our study, we aimed to compare the effects of propofol-fentanyl and midazolam-fentanyl combinations on haemodynamic parameters and recovery.
STUDY DESIGN: 40 patients undergoing gynaecological operation in ASA I-II, aged between 18-55 years randomized into two groups. Anaesthesia was induced with propofol 2-2.5 mg/kg in Group P, midazolam 0.3 mg/kg in Group M and fentanyl 3 microg/kg, atracurium 0.5 mglkg in both groups. Anaesthesia was maintained with propofol infusion in a rate of6-12 mg/kg/h in Group P and midazolam infusion in a rate of 0./ mg/kg/h in Group M. Peroperative haemodynamic parameters and postoperative recovery characteristics were evaluated.
RESULTS: A decrease in haemodynamic parameters was observed in both groups after induction, intubation, incision and peroperatively. Diastolic blood pressure values were more stable in Group M. Extubation time, time to responce to verbal stimulus,full orientation time and time to reach the total awareness according to Steward Scoring System were significantly shorter in Group P in recovery period.
CONCLUSION: Haemodynamic stability of propofol-fentanyl and midazolam-fentanyl combinations are found to be similar, while effects of propofol were superior than midazolam on recovery.

OBJECTIVE: in this study we evaluated distant metastases of patients who were treated of lung cancer. 2
STUDY DESIGN: in years of 1989-1997, 2284 lung cancer patients have been follow up in our clinic we evaluated 562 lung cancer patients in our clinic who have been followed more than six months.
RESULTS: in all histological subtypes the most common metastatic site is brain. 450 patients are non small cell lung cancer, 112 patients are small cell lung cancer. 114 patients have metastatic disease when they came first.
CONCLUSION: Due to often recurrence of distant metastases, it is adviseble to ·apply more effective treatment methods.

OBJECTIVE: in this study our aim is to evaluate the cases with orbital and periorbital trauma which were treated in our clinic.
STUDY DESIGN: Forty two case with orbital and periorbital trauma which had been treated to Sisli Etfal Hospital Plastic and Reconstructive Surgery Department between the years 1995 to 1998 were examined retrospectively.
RESULTS: Twenty-one of them had been accepted directly to our clinic. Twenty-one one of them were treated by together with other clinics especially neurosurgery because of another system problems. in 18 case without another system problems, early surgical procedures were applied in the first 48 hours; Eight of cases who could not been applied early surgical procedures because of rhinorrhea, increase of intracranial pressure and other system traumas were applied combined procedures: dura repair,frontal craniotomy withfascia lata in order to support anterior cranial base. Basic principles applied in the treatment of cases can be summarized as early surgical procedures (in proportion in which other system problems permit), rigidfixation with mini, midi, micro p/ate, primary grafting for supporting columns. While rigidfýxation materials were used in approximately 90% cases, autologous bone grafts and medpor implant were used in 14% and 7% cases respectively. in 4 cases who were avoided to use early bone grafts and were treated in /ate period secondary surgical procedures were necessary.
CONCLUSIONS: Periorbital trauma, early surgical procedures can prevent to need secondary procedures.

OBJECTIVE: In our study, the effects of anaesthesia with propofol or sevoflurane on haemodynamic parameters and recovery quality was compared in laryngeal mask airway (LMA) applicated patients undergoing short urological procedures.
STUDY DESIGN: After the approval by the Medical Ethics Committee, 38 patients in ASA /-// were randomized into 2 groups. Anaesthesia was induced with fentanyl (1.5 meg.kg ~!) and propofol (3 mg.kg }) in Group I, 02 + N20 (30 % + 70 %) and sevoflurane (6 %) in Group II and LMA was applicated to all patients. Maintanence of anaesthesia was established with propofol infusion (3 mg.kg ‘7. h ~‘) in Group I and with sevoflurane (%2) in Group II. Haemodynamic parameters at 2 min interval, awakening and recovery characteristics were compared. Student’st test and Anova were used for the statistical analyses and p<0.05 was considered as significant.
RESULTS: Haemodynamic parameters were stable in both groups. But the diastolic blood pressure values were significantly lower in Group I than Group II at 4. at 8. minutes. Time to head lift up and to tell own name were significantly shorter in Group I. Recovery quality was "very good" 68 % of patients in Group I and 63 % of patients in Group II.
CONCLUSION: During the anaesthesia with sevoflurane or propofol in LMA applicated patients undergoing short urological procedures, haemodynamic stability was maintaned and recovery quality was evaluated as very good.

OBJECTIVE: In this study, we aimed to compare the effects of propofol and etomidate TIVA on hemoynamic parameters and recovery time.
STUDY DESIGN: Thirty patients of ASA I, II were divided into two groups. In Group I, 2 mgr/kg fentanyIIV was used before induction and anesthesia was induced with 2- 2.5 mg/kg propofol and 0.1 mg/kg vecuronium. During maintenance of anesthesia propofol was infused at a rate of 10 mg/kg/h during first 10 minutes, 8 mg/kg/h during second 10 minutes and 6mglkglh thereafter. In addition 2 mgr/kg/h fentanyl was infused in %3002% 70 air mixture. Vecuronium was used when needed. Group II received the same anesthesia with etomidate 0.3 mg/kg at induction and 20 *gr/kg/min at maintenance. Before and after induction, after intubation, just before surgical intervention, preoperatively (at every 5 minutes) and after extubation systolic, diastolic, mean arterial blood pressure and heart rate of all patients were noted. In the postoperative period the patients were observed for the recovery and wake up scores.
RESULTS: There were significant decrease and increase in hemodynamic parameters in Group I when compared with other groups (p<0.05). Time to recovery was longer in Group 11 than the other groups. (p<0.05).
CONCLUSION: Finally, TIVA with etomidate is more stable hemodynamically than propofol, but recovery time is shorter in propofol TIVA.

OBJECTIVE: Evaluation of treatment and follow up patients with nonsmall cell lung cancer at our clinic between the years of 1989-1997.
STUDY DESIGN: A total of450 patients who were treated and followed up our clinic for more than 6 months of period of time were retrospectively scruntinized. Patients were classified according to general conditions, stages and treatment methods applied and we used ki-square statistical method in our calculations.
RESULTS: Oldest patient was 77, the youngest was 18. Avarage age was 55, the median age was found, to be 57 years. 49 % of patients were in the age group of 51-65; 437 patients were male, 13 were female. The most common (72.9 %- 328 patients) hystologic type was: Epidermoid cancer. Weight loss found to be small 71.3 % had 10 % weight loss. 30 patients, in stage 1 and 2, were treated with surgery, 38 patients were inoperable 56 patients received no chemotheraphy, the patients receiving chemotheraphy, as follows: ICE protocol (Iphosphamide, Cisplatinum, Etoposide) and cisplatinum + etoposide. 224 patients conventionel 50- 70 Gy dosage external radiotherapy, 56 patients received palliative radiotherapy. From all patients, 84 patients were observed with progression, 56 patients had métastasés. Average métastasés apperency duration calculated to be 4.6 months.
CONCLUSION: Lung cancer is the deadliest and most common type of cancer. The applied method of treatment: Local radiotherapy and systemic chemotherapy can be used as a cure or palliation.

OBJECTIVE: We compared Ketamin infusion and Isoflurane inhalation usage in anaesthesia maintenance with respect to postoperative recovery criteria in pediatric patients.
STUDY DESIGN: According to approval of the Ethical Committee, 30 children (<12ys) of ASA I-II were rabdomly assigned in two groups. Patients were premedicated with intranasal 0.2-0.3 mg/kg Midazolam 30 minutes before operation. While Ketamin infusion 50-80 ug/kg with 0.15 mg/kg intravenously Midazolam addition every 30 minutes were given to first group, Isoflurane inhalation 0.5-1 % with 1 mg/kg IV Meperidine addition were given until 5 minutes before the end of the operation to the second group. Postoperative recovery of the patients was scored according to the Ramsay Sedation Scoring. Unpaired t test, Tukey Kramer Multipl Comparisons Test were used for the statistical analysis.
RESULTS: There were no significant difference between the two groups for the age, weight, operation and anaesthesia duration (p>0.05). In both groups, recovery criterias were significantly high in postoperative 20^ minutes compared to the postoperative 1stminutes. But no significant difference was found with respect to recovery time and quality.
CONCLUSION: We concluded that, either Ketamin infusion or Isoflurane inhalation on equally effective regiments with the aspect of postoperative recovery criteria in pediatric anaesthesia.

OBJECTIVE: To evaluate treatment results on conservative surgical approach in upper urinary tract urothelial tumours and clinical experience.
STUDY DESIGN: 9 of 17 cases who were evaluated retrospectively were applied conservative surgery (52.9%) or endoscopic approach. 4 of these underwent to partial ureterectomy and end to end anastomosis, 5 cases to endoscopic approach (fulgurusation, electroresection). 8 patients (47%) were performed simple nephroureterectomy or nephroureterectomy with removed out cuff from bladder.
RESULTS: One patient of 9 who applied conservative surgery or endoscopic approach was seen tumour recurrence (11.1%). The median follow-up and survival was 20 months in these patients. 2 of 8 patients who performed nephroureterectomy (25%) died because of the local invasion and other organ métastasés. The median follow-up was 16 months, the median survival was 10 months in these patients.
CONCLUSION: We had better results with conservative surgical approaches than nephroureterectomy procedure in cases low stage-grade upper urinary tract urothelial tumours.

This paper presents, the leptospirosis cases studied at the Sisli Etfal Hospital Infection Clinic for three years. Clinic and serological results of all three patients were compared.