Mekonyum aspirasyonu, tipik olarak fetal hipoksik iskemik stresin intestinal peristaltizme yol açarak, amniyotik sývýnýn mekonyum ile kontaminasyonu ve gasping sonucu akciðerin derin dokularýna kadar nüfuz etmesi ile ortaya çýkar. Tüm doðumlarýn %10-15’inde amniyotik sývý mekonyum ile kontamine iken bu bebeklerin %5-10’unda mekonyum aspirasyonu ve solunum yetersizliði geliþir. Bu derlemede, MAS klinik bulgularý, tanýsal ve tedavisel yaklaþýmý ile ilgili güncel bilgiler sunulmaktadýr.

Aspiration of meconium typically occurs after fetal hypoxic/ischemic stress leading to intestinal peristalsis, meconium contamination of the amniotic fluid, and gasping respirations that draw the noxious meconium-stained fluid deep into the lung. Meconium contamination of amniotic fluid occurs in 10–15% of all pregnancies, and 5–10% of these infants develop meconium aspiration syndrome and respiratory failure. This review presents the update data on clinical, diagnostic and treatment approach for MAS.

Hastanemizde ilk kez açýk kalp cerrahisi Mart 2015’te yapýlmýþtýr ve halen baþarý ile devam ettirilmektedir. Açýk Kalp Cerrahisi, anestezisti tüm aþamalarýnda becerikli ve dikkatli olmaya zorlayan, majör bir cerrahidir. Bu derlemede eriþkin hastalarda kalp damar cerrahisinde anestezinin özelliklerinin özetlenmesi amaçlandý.

In our hospital the first open heart surgery was done in March 2015 and is still beeing processed successfully since. Open heart surgery is a major surgical procedure challenging the anesthesiologist to be skilled and carefully during every stage. In this review we aimed to summarize properties of anesthesia for cardiovascular surgery in adults.

Amaç: Tiroidektomi sonrasý geçici hipokalsemi en sýk görülen komplikasyondur ve oluþtuðunda kolay tedavi edilir. Geçici hipokalsemi ile iliþkili esas problem hastanede kalýþ süresini uzatmasýdýr. Bu çalýþmanýn amacý tiroid cerrahisi uygulanan hasta grubunda postoperatif geçici hipokalsemi için risk faktörlerini belirlemekti.
Gereç ve Yöntem: Ocak 2012 - Aralýk 2013 tarihleri arasýnda total tiroidektomi uygulanan 177 hastanýn verileri retrospektif olarak deðerlendirildi. Hipokalsemi total serum kalsiyum düzeyinin 8 mg/dl altýnda olmasý olarak tanýmlandý. Geçici hipokalsemi total tiroidektomiyi takiben 6 ayda hipokalseminin iyileþmesi olarak tanýmlandý. Geçici hipokalsemi için risk faktörleri olarak cinsiyet, preoperatif D vitamini eksikliði, reküren hastalýk için cerrahi giriþim, hipertiroidi varlýðý, görülen ve korunan paratiroid bez sayýsý, paratiroid bez ekimi yapýlmasý, patolojik spesmende çýkarýlan paratiroid bezi varlýðý deðerlendirildi. Ýstatistik deðerlendirmede ‘Nominal Lojistik Regresyon’ analizi, ‘Ki-kare’ testi ve ‘Fisher’in Kesinlik’ testi kullanýldý.
Bulgular: Çalýþmadaki 177 hastanýn (150K, 27E) 37’sinde (%20.9) geçici hipokalsemi geliþti. Nominal regresyon analizinde sadece patolojik spesmende çýkarýlan paratiroid bezi varlýðý (p=0.025) geçici hipokalsemi için baðýmsýz deðiþken faktör olarak belirlendi.
Sonuç: Patolojik spesmende paratiroid bezi varlýðý yüksek oranda geçici hipokalsemiden sorumludur. Tiroidektomi esnasýnda cerrahi spesmenin intraoperatif dikkatli incelenmesi uygunsuz paratiroidektomi insidansýný azaltabilir.

Objective: Temporary hypocalcemia is the most common complication after thyroidectomy and is easily treated when it occurs. The main problem of the temporary hypocalcemia is the prolongation of hospital stay. The purpose of this study was to identify the risk factors of postoperative temporary hypocalcemia in a group of patients whom underwent thyroid surgery.
Material and Method: The retrospective data of the 177 patients of whom underwent total thyroidectomy between January 2012 and December 2013 were evaluated. Hypocalcemia is defined as total plasma calcium level below 8 mg/dl. Temporary hypocalcemia is defined as recovery of hypocalcemia in 6 months following total thyroidectomy. Gender, preoperative vitamin D deficiency, surgery for recurrent disease, presence of hyperthyroidism, extent of surgery, number of parathyroid glands identified and protected, parathyroid autotransplantation, presence of parathyroid glands in surgical specimen were analyzed as the risk the factors for temporary hypocalcemia. ‘’Nomial logistic regression analysis’’, ‘’Chi-Squared test’’ and ‘’Fisher’s exact test’’ were used for statistics.
Results: Temporary hypocalcemia occurred in 37 of 177 (150F, 27M) (20.9%) patients. In nominal regression analysis, only the presence of parathyroid glands in the surgical specimen was determined as independent variable factor of transient hypocalcemia (p=0.025).
Conclusion: The presence of parathyroid glands in the surgical specimen is responsible for the high rate of temporary hypocalcemia. Careful examination of the surgical specimen intraoperatively can minimalize the incidence of inadvertent parathyroidectomy during thyroidectomy.

Amaç: Hastanemiz yenidoðan kliniðinde invaziv araç ile iliþkili hastane enfeksiyonu oranlarýmýzý belirlemek ve konu ile ilgili düzenleyici eylemler planlamak.
Gereç ve Yöntem: Çalýþma retrospektif olarak yürütüldü. Hastanemiz Yenidoðan Yoðun Bakým Kliniðinde, Ocak 2013- Aralýk 2013 tarihleri arasýnda yatan, 48 saatten uzun süre izlenen tüm bebekler çalýþmaya alýndý. Çalýþmaya alýnan hastalar doðum aðýrlýðýna göre > 2500 gram ve ≤ 2500 gram olarak deðerlendirildi. Hastalara uygulanan invaziv giriþim sayýlarý ve saptanan enfeksiyon oranlarý kaydedildi. Veriler SPSS 15 programý kullanýlarak deðerlendirildi.
Bulgular: Belirlenen tarihler arasýnda, 700 hasta çalýþmaya alýndý. Toplam 19 invaziv araç nedenli enfeksiyon tespit edildi. Toplam invaziv araç iliþkili enfeksiyon insidans dansitesi %2.35 iken kateter nedenli kan dolaþýmý enfeksiyon hýzý %1.4 saptandý. Ventilatör iliþkili pnömoni geliþim hýzý ise %1.29 olarak saptandý.
Sonuç: Kliniðimizde saptanan invaziv araç ile iliþkili hastane enfeksiyon insidans dansitelerinin kabul edilebilir sýnýrlar içerisinde olduðu belirlendi. Ventilatör ile iliþkili pnömoni insidans dansitesinin düþük olduðu belirlendi.

Objective: The aim of the study is to determine invasive device- related nosocomial infection rates and corrective action plan on the subject of neonatal intensive care unit in our hospital.
Material and Method: Our study is retrospective and include all neonates who were hospitalized between January-December 2013 and kept under observation more than 48 hours in the Neonatal Intensive Care Unit. Patients included in the study evaluated according to birth weight as over 2500 grams and under 2500 grams. Number of invasive procedures applied and rates of infections were
recorded. Data were analysed by using SPSS 15 software.
Results: Between the dates specified, 700 patients were enrolled in the study. A total of 19 invasive device related infection detected. Total infection incidence dansity were found 2.35% and catheter related blood stream infection was 1.4% and ventilator-associated infection was 1.29%.
Conclusion: Invasive device associated infection incidence dansity in our clinic was determined to be in acceptable limits. The ventilator-associated pneumonia incidence dansity was found lower.

Amaç: Kliniðimizde laparaskopik sinir koruyucu radikal histerektomi (LSKRH) yapýlan erken evre servikal kanserli hastalarýn taný, tedavi ve takipleri ile ilgili deneyimlerimizi litaratür eþliðinde sunmaktýr.
Gereç ve Yöntem: Çalýþmamýzda retrospektif olarak LSKRH yapýlan erken evre (evre IA1-IB1) serviks kanserli 14 hasta incelendi.
Bulgular: Hastalarýn yaþ ortalamasý 44 (min 26, maks 53), vucut kitle indeksi (BMI) ortalamasý 30 (min 23, maks 47), gravida ortalamasý 4.7 (min 0, maks 12), parite ortalamasý 8 (min 0, maks 8) olarak bulundu. LSKRH ile birlikte pelvik lenf nod diseksiyon yapýlma süremiz ortalama 288 dakikadýr. Ortalama pelvik 15 tane lenf nodu ve ortalama 2.2 cm vajen boyu çýkarýlmýþtýr. Hastalarýn birinci gün barsak fonksiyonlarý geri dönmüþtür. Mesane sondasý ortalama 2.5 (min1, maks 5) gün ve batýn dreni ortalama 3.3 (min 2, maks 7) gün sonra çýkarýlmýþtýr. Tüm hastalarda tam cerrahi rezeksiyon yapýldý. Hasta takip süresi ortalama 15 aydýr. Bu süre içinde hiç nüks geliþmemiþtir ve hasta ölümü olmamýþtýr.
Sonuç: LNSRH, erken evre servikal kanserli hastalarýn tedavisinde diðer cerrahi yöntemler kadar etkili ve mesane fonksiyonlarýnýn daha az bozulduðu için hasta yaþam kalitesi açýsýndan üstün bir yöntemdir.

Objective: To evaluate the safety, feasibility and efficacy of laparascopic approach in management of patients undergoing nevre-sparing radical hysterectomy for early stage cervical cancer
Material and Method: 14 patients who had early stage (1A1-1B1) and undergone laparascopic nerve sparing radical hysterectomy were analysed retrospectively.
Results: Mean age of patients was 44 (min 26 max 53), mean BMI was 30 (min 23 max 47), mean gravida was 4.7 (min0 max 12), mean parity was 8 (min 0 max 8). Mean duration of surgery- both laparascopic nevre-sparing radical hysterectomy and pelvic lymph node dissection- was 228 minutes. Fifteen lymph nodes and 2.2 centimeters of vaginal tissue were extracted in average. Intestinal functions
had returned in one day after surgery. Bladder catheter and abdominal drain were removed after 2.5 days (min 1 max 5) and 3.3 days (min 2 max 7) respectively. Complete surgical resection was achieved in all patients. Mean follow up duration was 15 months. No recurrence or patient death were present during this time period.
Conclusion: In treatment of early stage cervical cancer, laparascopic nevre-sparing radical hysterectomy is as effective as other surgical techniques, and a superior approach for patient’s quality of life considering less altered bladder function.

Amaç: Alt solunum yolu enfeksiyonlarý (ASYE) çocuklarda yüksek morbidite oranýna sahip olup özellikle
erken çocukluk döneminde yüksek mortalite ile seyreder. ASYE tanýsý alan çocuk hastalarda viral
etkenlerin immunofluoresan ve immunokromatografik yöntemler ile araþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntem: Çalýþmamýzda, klinik olarak ASYE tanýsý almýþ 260 çocuk hastanýn (1 ay-5 yaþ)
nazofarengeal sürüntü örnekleri immunofluoresan ve immunokromatografik yöntemler ile araþtýrýlmýþtýr.
Bulgular: Örneklerden 122’sinde (%46.9) viral antijen pozitifliði saptanmýþtýr. ASYE’nin en sýk etkeni
olarak %35.3’lük pozitiflik oraný ile respiratuar sinsityal virus (RSV) tespit edilmiþtir. Hastalarýn
%4.2’sinde influenza A virusu, %1.9’unda ise influenza B virusu saptanmýþtýr.
Sonuç: Pediatrik popülasyonda ASYE’lerde etken olabilecek viruslarýn hýzlý tanýsý, uygun spesifik
antiviral tedavinin zamanýnda baþlanabilmesi, gereksiz antibiyotik kullanýmýnýn engellenebilmesi ve
bu viruslarýn neden olabilecekleri hastane enfeksiyonlarýnýn önlenebilmesi açýsýndan önem kazanmaktadýr.

Objective: Lower respiratory tract infections (LRTI) have high morbidity rates in children. They are
also related with high mortality especially in early infancy. We aimed to investigate of viral agents of
children, clinically diagnosed as LRTI, by immunofluorescent and immunochromatographic methods
Material and Method: In our study, nasopharyngeal swabs of 260 patients (1 month-5 years)
clinically diagnosed as LRTI, were investigated by immunofluorescent and immunochromatographic
techniques.
Results: In 122 (46.9%) of samples the virus was identified. RSV was the most common etiologic viral
agent in LRTI by a rate of 35.3% followed by influenza A virus 4.2%, influenza B virus 1.9%.
Conclusion: In pediatric population, rapid diagnosis of LRTIs will help us to protect children and to
choose appropriate treatment, avoidance of unnecessary antibiotic use and prevention of nosocomial
infections caused by these agents.

Amaç: Çalýþmamýzda kardiyopulmoner resüsitasyon (KPR) sonrasý terapötik hipotermi (TH) uygulanan ve uygulanmayan hastalarda geliþen enfeksiyon sýklýðýnýn, en sýk izole edilen mikroorganizmalarýn belirlenmesi, TH’nin mortalite ve morbiditeye etkisinin saptanmasý amaçlandý.
Gereç ve Yöntem: Çalýþmamýzda baþarýlý KPR uygulanmýþ 44 hastanýn dosyasý retrospektif olarak incelendi. Hastalar TH uygulanan (n=20) ve uygulanmayan (n=24) olmak üzere iki gruba ayrýldý. Hastalarýn 1, 3, 5, 7 ve 9. günlerdeki lökosit sayýsý, C-reaktif protein (CRP) deðerleri kaydedildi. Hastalarýn demografik verileri, yoðun bakým ünitesinde (YBÜ) yatýþ süreleri, kültür pozitifliðinin ilk gerçekleþtiði gün, hangi kültür veya kültürlerde üreme olduðu, kültürlerde üreyen mikroorganizmalar, hastalarýn YBÜ’den taburculuk halleri kaydedildi.
Bulgular: Gruplar karþýlaþtýrýldýðýnda hastalarýn demografik verileri ve Glaskow koma skoru (GKS) ortalamalarý açýsýndan anlamlý fark bulunmamýþtýr. Gruplar arasýnda yoðun bakým takiplerinin ilk 10 gününde gerçekleþen kültür pozitifliði, kan, derin trakeal aspirat (DTA) ve idrar kültüründe üreme oranlarý açýsýndan anlamlý fark bulunmamýþtýr. Gruplar arasýnda mortalite oranlarý açýsýndan anlamlý fark bulunmamasýna raðmen, TH uygulanan grupta YBÜ’de yatýþ süresi anlamlý olarak düþük bulunmuþtur. Gruplar arasýnda 1, 3, 5, 7 ve 9. gün lökosit sayýlarý arasýnda anlamlý fark tespit edilmemiþtir. TH uygulanan grubun 1. gün CRP deðeri TH uygulanmayan gruptan anlamlý olarak düþük bulunmuþtur. Diðer günlerdeki CRP deðerleri arasýnda anlamlý fark bulunmamýþtýr.
Sonuç: Gruplar arasýnda mortalite oranlarý arasýnda anlamlý fark bulunmamasýna karþýn, TH uygulanmýþ grupta YBÜ’de yatýþ süresi daha kýsa bulunmuþtur. Bu nedenle biz, nörolojik açýdan birçok olumlu etkisi olduðu ispatlanmýþ TH uygulamasýnýn KPR sonrasý yoðun bakýmda takip edilen hastalarda uygulanmasý gerektiðini düþünmekteyiz.

Objective: Our study aims at determining infection frequency in patients receiving or not receiving therapeutic hypothermia (TH) after cardiopulmonary resuscitation (CPR), detecting the microorganisms most frequently isolated, and measuring the effect of TH on mortality and morbidity.
Material and Method: We examined retrospectively the files of 44 patients receiving successful CPR. Patients were separated into two groups: the ones receiving (n=20) and not receiving (n=24) TH. Their leucocyte numbers and C- reactive protein (CRP) values were recorded in the 1st, 3rd, 5th, 7th and 9th day. Their demographic data, hospitalization period in intensive care unit (ICU), the first
day that culture positivity occurred, in which culture(s) reproduction occured, which microorganisms reproduced in these cultures, and discharge state of the patients from ICU were recorded.
Results: No significant difference was found in patients’ demographic data, and Glasgow coma score (GCS) averages. Culture positivity observed in the first 10 days after intensive care follow-ups, blood, deep tracheal aspiration (DTA), urine culture growth rate, and leukocyte numbers were not significantly different between the groups. Although there was no significant difference between the mortality
rates of the groups, hospitalization time in the ICU was significantly lower in the group receiving TH. No significant difference was observed between the groups in terms of leucocyte numbers in the 1st, 3rd, 5th, 7th and 9th day. The CRP value in the 1st day in the group receiving TH was significantly lower than those not receiving TH. There was no significant difference between the CRP values in other days.
Conclusion: Although mortality rates are not significantly affected, hospitalization period in ICU was found to be shorter in the group receiving TH. For this reason, we think that TH which was proved to have favorable neurologic advances, should be applied to post CPR patients in ICU practice.

Amaç: Hipotiroidi hastalarýnda obezite ve beraberinde hiperlipidemi görülmektedir. Bu çalýþmada Haseki Eðt. Arþ. Hastanesi lipit polikliniðinden takip edilen hipotirodi hastalarýnýn laboratuar verileri deðerlendirilerek hipotiroidik hastalarda obezite ile lipit deðerleri iliþkisi araþtýrýldý.
Gereç ve Yöntem: Haseki Eðt. Arþ. Hastanesi lipit polikliniðinde 2003-2006 yýllarýnda takip edilen 37 hipotiroidi hastasýnýn dosyasý retrospektif olarak incelendi ve hastalar, baþvuru sýrasýndaki vücut kitle indeksleri (VKÝ) (≥30=obez) dikkate alýnarak obez (vaka) ve nonobez (kontrol) olarak 2 gruba ayrýldý. Çalýþmada hastalarýn yaþ, cinsiyet, VKÝ, glukoz, TSH, total kolesterol, LDL, HDL, trigliserit deðerleri dikkate alýndý.
Bulgular: Çalýþmaya alýnan 37 hipotiroidi hastasýndan 19’u obez (vaka grubu), 18’i nonobez (kontrol grubu) olarak deðerlendirildi. Vaka grubu 1 erkek, 18 kadýn, kontrol grubu ise 6 erkek, 12 kadýn hastadan oluþtu. Vaka grubunun HDL deðerleri anlamlý olarak düþük saptandý (p<0.01). Glukoz deðerleri de anlamlý olarak yüksek saptandý (p<0.01). Vaka grubunun trigliserit deðerleri kontrol grubuna kýyasla
yüksek olmakla birlikte istatistiksel anlamlý bir fark yoktu (p=0.31). Gruplar arasýnda LDL ve total kolesterol açýsýndan anlamlý bir farklýlýk saptanmadý.
Sonuç: Hipotiroidili hastalarda obezite sýk görülmekte olup, bu grupta hiperlipidemi ve glukoz intoleransýna da daha sýk rastlanmaktadýr. Yaptýðýmýz çalýþmada VKÝ’lerine göre obez ve nonobez olarak ikiye ayrýlan hipotiroidi hastalarýnýn total kolesterol ve LDL deðerleri arasýnda anlamlý bir fark saptanmadý. Obez grubun trigliserit ve glukoz deðerleri yüksek, HDL deðerleri düþük saptandý. Hipotiroidi hastalarýnýn tedavisi sýrasýnda hiperlipidemi gözden kaçýrýlmamalý ayný zamanda tek baþýna hiperlipidemisi olan hastalarda tedavi öncesi tiroid hormonlarý görülmelidir.

Objective: In hypothyroidic patients obesity and hyperlipidemia is more often. In this study hypothroid patients followed by Haseki Hospital lipid polyclinic evaluated and hyperlipidemia-obesity relation investigated.
Material and Method: Files of 37 hypothyroidic patients followed up by lipid polyclinic of Haseki Hospital between 2003-2006 years are evaluated retrospectively. Patients divided into two groups as obese (case) and nonobese (control) according to their body mass indexes (BMI) (≥30=obese) at the time they refer. Age, sex, BMI, glucose, TSH, total-cholesterol, LDL, HDL, triglyceride values of patients evaluated.
Results: 19 were obese (case group), 18 were nonobese (control group) from 37 patients with hypothyroidism admitted to our study. Case group had 1 male, 18 female, control group had 6 male, 12 female patients. In case group, HDL was lower (p<0.01) and glucose was higher (p<0.01) than control group. Triglycerides of case group was higher than control group, but this difference wasn’t significant (p=0.31). There wasn’t difference between groups in the levels of total and LDL-cholesterol.
Conclusion: We evaluated hypothroidic patients by dividing them to obese and nonobese groups according to their BMI. Total and LDL cholesterol levels of groups showed no significant difference. Trigliceryde and glucose levels of obese group was high and HDL-cholesterol was low. During therapies of hypothyroidic patients, hyperlipidemia have to be investigated and also when beginning of an antihyperlipidemic treatment thyroid hormones have to be evaluated.

Amaç: Ýþe baðlý kas iskelet sistemi hastalýklarý toplumda sýk görülen saðlýk problemlerinden biridir. Hastanemizde çalýþan yardýmcý personelin saðlýðýný korumak, iþ memnuniyetini artýrmak ve iþ kaybýna neden olabilecek durumlarý önleyebilmek için iþe baðlý üst ekstremite problemlerinin sýklýðý ve bu problemleri oluþturabilecek etmenleri belirlemeyi amaçladýk.
Gereç ve Yöntem: Çalýþmamýza, hastanemizde çeþitli bölümlerinde çalýþan toplam 125 saðlýk personeli dahil edildi. Çalýþmanýn verileri kiþisel özellikleri, iþ ve çalýþma ortamý ile ilgili bilgiler literatürlerden derlenerek oluþturulan bir anket formuyla sorgulandý. Ýskandinav Kas-Ýskelet Sistemi Anketi (The Nordic Musculoskeletal Questionnaire) ile aðrý bölgeleri belirlendi.
Bulgular: Çalýþmaya katýlan 125 olgunun, 74’ü (%59.2) kadýn ve 51’i (%40.8) erkek idi. Olgularýn yaþ ortalamalarý 31.56±7.09 yýldý. Katýlýmcýlarýn 53 (%50.3)’ü hastanede temizlik personeli olarak, 25 (%23.8)’i sekreter, 16 (%15.2)’sý teknisyen ve 11 (%10.6)’i hemþire olarak çalýþmaktaydý. Çalýþanlarýn 61 (%58.1)’i iþ sýrasýnda üst ekstremitesi ile ilgili aðrýsý olduðu saptandý. Yapýlan logistik analizde erkek
olmak sadece el bileði aðrýlarý için risk faktörü, VKÝ’nin büyük olmasý sýrt, dirsek ve el bileði için; evde geçen sürenin az olmasý sýrt ve elbileði aðrýsý için risk faktörü olarak saptandý.
Sonuç: Hastane çalýþanlarýnda iþe baðlý oluþabilecek üst ekstremite problemleri ve risklerinin önceden belirlemek iþ verimi ve çalýþanlarý saðlýðýný korumak için önemlidir.

Objective: The work-related musculoskeletal disorders are one of the most common health problems in the community. The aim of the our study was to determine the incidence of work-related upper extremity problems and to asses the risk factors in order to protect the health of our hospital employees, to improve job satisfaction and to avoid situations that could lead to job.
Material and Method: A total of 125 hospital employees were included in our study. The personal characteristics of the participants, information about the work and the working environment were questioned by a questionnaire that was collected from the literature. The Nordic Musculoskeletal Questionnaire was used to identify areas of pain.
Results: 125 cases participated in the study, 74 (59.2%) were female and 51 (40.8%) were male. The mean age of patients was 31.56±7: 09 years. 53 participants (50.5%) were cleaning staff, 25 participants (23.8%) were secretary, 16 participants (15.2%) were technician and 11 participants (10.6%) were nurse. 61 employees (58.1%) had upper limb pain during business. When logistic analysis was performed we found that male gender is a risk factor for wrist pain; high BMI is a risk factor for back, elbow and wrist; less time spent at home is a risk factor for back and wrist pain.
Conclusion: To determine the work-related upper extremity problems and risk factors in hospital employees is important to improve work efficiency and protect the health of employees.

Amaç: Posterior dolaþým infarktlarý (PDÝ) yüksek mortalite ve morbidite riski taþýyan hastalýklar olarak bilinmektedir. PDÝ’larýnýn tanýnmasý bu mortalite ve morbiditenin azaltýlmasý ve tromboliz gibi yeni tedavi yaklaþýmlarýna olanak saðlamasý açýsýndan önemlidir. Bu çalýþmamýzda serebellar iskemik inmelerin damar alanlarýna göre daðýlýmýný, klinik, etiyolojik ve fonksiyonel karakteristiklerini araþtýrmayý amaçladýk.
Gereç ve Yöntem: Çalýþmamýza 90 hasta dahil edildi. Tüm hastalarýn kaydedilmiþ vasküler risk faktörleri, giriþ tansiyonlarý, elektrokardiyogram, kranial görüntüleme yöntemleri, baþvuru sýrasýndaki belirti ve nörolojik muayene bulgularý, etiyolojiyi saptamak amacýyla yapýlmýþ olan transtorasik ekokardiyografi, bilateral karotis ve vertebral arter doppler ultrasonografi, servikal bilgisayarlý tomografi veya manyetik rezonans anjiografi tetkikleri incelendi.
Bulgular: Serebellar infarktlarýn damar alanlarýna göre daðýlým sýklýðý deðerlendirildiðinde: en sýk medial Posterior inferior serebellar arter (PÝSA) damar alanýnda infarkt olduðu saptandý. Bunu medial Süperior serebellar arter (SSA) ile lateral PÝSA damar alanlarý takip etmekteydi. Anterior inferior serebellar arter (AÝSA) dýþýnda tüm damarlarda en sýk baþvuru belirtisi bulantý kusmaydý. AÝSA infarktlarýnda ise en sýk belirti
dengesizlikti. Damar alanlarýna göre bulgular deðerlendirildiðinde de tüm damar alanlarýnda en sýk ataksi, dismetri-disdiadokinezi, hipotoni en sýk bulgulardý. En sýk saptanan risk faktörleri hipertansiyon (HT), sigara kullanýmý, diyabetes mellitustu. Etiyolojik faktör olarak: Kardiyoemboli (KE) hastalarýn %22.2’sinde ve vertebrobaziller ateroskleroz (VBA) %61.1’inde saptandý. VBA AÝSA, medial PÝSA, lateral PÝSA alanlarýný içeren infarktlarda, KE ise medial SSA, lateral SSA, lateral PÝSA alanlarýný içeren infarktlarda en sýktý.
Sonuç: Çalýþmamýzda serebellar infarklarýn en sýk medial PÝSA sulama alanýnda olduðunu saptadýk. En sýk belirti bulantý-kusma ve en sýk muayene bulgusu ataksiydi. HT en sýk saptanan risk faktörü ve VBA en sýk etiyolojik faktördü.

Objective: Posterior circulation stroke syndromes are known to have high risk of mortality and morbidity. The recognition of posterior circulation infarcts are important for decreasing this mortality and morbidity, and can make it possible to administer thrombolysis treatment. In this study, our goal was to evaluate distribution of cerebellar infarcts, and to determine the clinical, aetiological and functional characteristics.
Material and Method: 90 patients were included in our study. All recorded vascular risk factors, blood pressure measurements, electrocardiograms, signs and symptoms during the application, results of cranial imaging and the results of studies done to reveal aethiology such as transthoracic ecocardiography and bilateral doppler ultrasonography of carotid arteries, cervical computed tomography or magnetic resonance angiography imaginings were examined.
Results: The most common vascular territories were medial posterior inferior cerebellar artery (PICA), medial superior cerebellar artery (SCA) and lateral PICA. Nausea and vomiting were the most common symptom, except for anterior inferior cerebellar artery (AICA). At AICA infarcts, it was derangement. The most common finding in all vascular territories were ataxia, dysmetria-disdiadokinezia and hypotonia. The
most common risk factors were hypertension (HT), smoking and diabetes mellitus. Cardioembolism was found in 22.2% and vertebrobasillar atherosclerosis (VBA) was found in 61.1% of the cases as aetiological factors. VBA was more common in infarcts that involved the territories of AICA, medial PICA and Iateral PICA. Cardioembolism was the most common in infarcts that involved the territories of medial SCA, Iateral
SCA and Iateral PICA.
Conclusions: In our study we found that the most commonly affected territory was medial PICA. The most common signs were nausea and vomiting, and the most common symptom was ataxia. HT was the predominant risk factor and the most common aetiological factor was VBA.

Ýnfantil hemanjiom bebeklik döneminin en sýk görülen selim tümörüdür. Tedavi endikasyonlarý arasýnda; havayolu týkanýklýklarý, ülserasyon, enfeksiyon, görme bozukluðu, emme bozukluðu gibi fonksiyon kayýplarýna yol açmasý durumlarý sayýlabilir. Ýnfantil hemanjiomun tedavisinde kortikosteroidler uzun yýllardýr ilk tercih olmakla beraber son yýllarda oral propranolol de kullanýlmaya baþlanmýþtýr. Yüzün sað tarafýnda geniþ hemanjiomu bulunan 3 aylýk hastada, propranolol tedavisi ile belirgin iyileþme saðlanmýþ ve güncel tedavi ile ilgili çalýþmalar tartýþýlmýþtýr.

Infantile hemangioma is the most common bening tumors of infancy. Common treatment indications include airway obstruction, ulceration, infection, visual impairment or feding difficulties. Besides the steroids were the first choice in treatment of infantile hemangiomas for years, propranolol was also used in recent years.. This report presents a 3-month-old patient with infantile hemangioma in the right side of her face has been treated with oral propranolol therapy, accompanied by brief review of literature with treatment options.

Wolf-Hirschhorn sendromu (WHS), 4. kromozomun kýsa kolunun distal kýsmýnda delesyon (4p-) sonucu oluþan, psikomotor geriliðe genellikle prenatal ve postnatal büyüme geriliðinin eþlik ettiði, aðýr mental retardasyon, tipik yüz anomalileri, orta hat defektleri, iskelet anomalileri, hipotoni ve nöbet varlýðý ile karakterize nadir görülen bir genetik hastalýktýr. Burada, intrauterin büyüme geriliði, atipik yüz görünümü, nöbet ve anormal elektroensefalografi bulgularý olan karyotip analizi ile kesin taný alan 16 aylýk WHS’li bir kýz olgu sunulmaktadýr.

Wolf-Hirschhorn syndrome (WHS) is a rare well-known genetic condition resulting from a distal deletion of the short arm of chromosome 4, is usually associated with marked prenatal and postnatal growth retardation with psychomotor delay, profound mental deficiency, typical facial anomalies, midline defects, skeletal anomalies, hypotonia and seizures. We herein report a 16-month-old girl with severe intrauterin-growth-retardation, atypical facial anomalies, seizures and abnormal electroencephalography that was diagnosed with karyotype analysis.

Parenteral ilaç uygulamalarý tüm týbbi disiplinlerde rutin olarak yapýlan bir iþlemdir. Ýntramusküler, intravenöz, intraartriküler uygulamalar ve infüzyonlar apse, eklem enfeksiyonu gibi lokal komplikasyonlara yol açabilmektedir. Bu tip lokal komplikasyonlar mortalitesi ve morbiditesi oldukça yüksek bakteriyemi, sepsis ve çoklu organ yetmezliði gibi ciddi komplikasyonlara yol açabilir. Biz bu yazýda intramusküler enjeksiyon sonrasý Escherichia coli’nin neden olduðu uyluk apsesi geliþen ve yaygýn panniküliti olan bir hastayý sunuyoruz.

The parenteral drug application is a routinely used method in all medical disciplines. Intramuscular, intraarticular, intravenous injections and infusions can cause local complications such as abscesses and articular infections. These local complications can lead to bacteraemia, sepsis and may lead to multiple organ failure associated with high morbidity and mortality. We present a patient with thigh abscess and wide paniculitis caused by Escherichia coli after intramuscular injections.

Duodenumun peptik ülser nedeniyle posteriordan perforasyonuna baðlý retroperitoneal apse klinik pratikte oldukça ender görülen bir problemdir. Literatürde klinik belirti ve bulgularýna dair oldukça az bilgi yer almaktadýr. Bu olgu sunumunda literatür verileri derlenerek peptik ülsere baðlý posterior duodenal perforasyon ile iliþkili retroperitoneal apse vakasý sunulmuþtur.

Retroperitoneal abscess associated with a posterior perforation of the duodenum due to peptic ulcer disease is extremely rare problem in clinical practice. There are scarce data about its clinical signs and symptoms in the literature. We report a case of retroperitoneal abscess associated with a posterior perforation of the duodenum due to peptic ulcer disease and review the literature.