AMAÇ: Kliniğimizde uygulanan tip I timpanoplasti (miringoplasti) olgularýnýn greft tutmasý ve işitme kazancý açý­sýndan değerlendirilmesi.
MATERYAL VE METOD: Ağustos 1994 ile Nisan 1997 tarihleri arasýnda kliniğimizde miringoplasti uygulanan ve kontrollere gelen toplam 24 hasta postoperatif dönemde greft tutmasý ve işitme kazancý açýsýndan değerlendirildi.
BULGULAR: Miringoplasti sonrasý greft tutma oraný %84 olarak hulundu. Greft tutan olgularýn %71’inde 10dB'den fazla işitme kazancý sağlandý.

OBJECTIVE: To investigate the results of myringoplasty operations performed in our clinic.
MATERIAL AND METHOD: Between August 1994 and April 1997, 24 myringoplasty operations were performed in our clinic. The patients were evaluated for graft take rate and audiologic improvement in the postoperative period.
RESULTS: Graft take rate after myringoplasty was 84%. An audiologic improvement more than 10 dB was seen in 71% of the patients with successful graft take.

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AMAÇ: Kanserli hastalarda fosfoheksoz izomeraz (PHI) ve Aldolaz (ALD) serum düzeylerinin araştýrýlmasý.
MATERYAL VE METOD: Kliniğimize müracaat eden ve histopatolojik olarak tanýsý konulmuş 100 kanser hastasý ile klinik olarak herhangi bir hastalýğýya da yakýnmasý olmayan saðlýklý 50 kişi kontrol grubu olarak çalýşmaya alýndý. 100 hastanýn yaş dağýlýmý 12-79, yaş ortalamasý 50'dir. %51’i erkek, %49'u kadýndýr. Kontrol grubunun yaş daðýlýmlarý 16-71, yaş ortalamasý 42.6'dýr. %46'sý erkek, %54’ü kadýn hastadýr. Tedavi altýnda olan hastalarýn ve kontrol grubunun serumlarýnda ticari kit kullanýlarak PHI ve ALD tayinleri yapýldý. Tesbit edilen PHI ve ALD değerlerinin Levene Testine göre istatistiksel olarak analizleri yapýldý. 100 hastanýn kanser türlerine göre dağýlýmý şöyledir: Akciðer %27, meme %25, gastrointestinal sistem %15, genitoüriner sistem %9, nazofarenks-larenks %6, sarkoma %6, lenfoma %3, diğerleri %9.
BULGULAR: Çalýşmanýn kontrol grubunu oluşturan 50 saðlýklý insanda elde edilen PHI değerleri 10-59 U/L, ALD değerleri ise 1.2-6.8 U/L arasýndaydý. Hasra grubumuzda ise PHI değerleri 18-492 U/L, ALD değerleri 1.4-61.3 U/L arasýndaydý.
SONUÇ: Serum glikolitik enzimlerinden PHI ve ALD, akciğer ve meme kanseri gibi hazý spesifik kanser türlerinde oldukça yüksek sensitivite ve spesifite göstermektedir. Ancak birer tümör belirleyici olarak kullanýlmakdan ziyade özellikle metastazlý ve/veya lenfadenopatili hastalarýn izlenmesinde ve hastalýğýn seyrinde oldukça yararlý hirer gösterge olabilir.

PURPOSE: in this study, we invastigated serum levels of phosphohexose isomerase (PHI) and aldolase (ALD) in cancer patients.
MATERIALS AND METHODS: The study included 100 cancer patients with histopathologic diagnosis and 50 healthy control subjects. The patients' ages ranged from 12 to 79 years with an average of 50 years. Of 100 patients 51 were males and 49 were females. The control groups' ages ranged from 16 to 70 years with an average of 42.6 years and %46 years and %46 were males and %54 were females. Analysis of PHI and ALD levels were made by using commercially available kits. Result were evaluated using levene's test. Cancer types included lung cancer (27%), breast cancer (25%), gastrointestinal cancers (15%), geni­tourinary system cancers (9%), nasopharynx-larynx cancers (6%), sarcoma (6%), lymphoma (3%) and the others (9%).
RESULTS: PHI and ALD values obtained in the control group ranged between 10-59 U/L and 1.2-6.8 U/L, respectively. in the patients, these values were found between 18- 492 U/L and 1.4-61.3 U/L, respectively.
CONCLUSION: PHI and ALD, which are among serum glycolytic enzymes, show considerable sensitivity aýýd specificity in some specific cancer types, including lung and breast cancers. They can he regarded as useful indicators in the follow-up of patients with metastasis and/or lymphadenopathy.

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AMAÇ: Bu çalýşma, hemodiyalize giren son dönem kronik renal yetersizlikli hastalarda, pruritus ve plazma histamin düzeyi arasýndaki ilişkiyi araştýrmak amacýyla planlandý.
MATERYAL VE METOD: Çalýşmamýza yaşlarý 20-68 arasýnda değişen 6 kadýn, 8 erkek olmak üzere toplam 14 hemodiyaliz hastasý ve yaşlarý 24-65 arasýnda değişen 6 kadýn, 8 erkek olmak üzere sağlýklý 14 kontrol hastasý alýn­dý. Hemodiyalize giren hastalar pruritusu olanlar (n: 8) ve pruritusu olmayanlar (n: 6) olmak üzere iki gruba ayrýldý. Bu hastalarda RIA metodu ile plazma histamin düzeylerine bakýldý.
BULGULAR-SONUÇ: Pruritusu olan ve olmayan hemodiyaliz hastalarý arasýnda plazma histamin düzeyi açýsýn­dan istatistiksel olarak anlamlý bir sonuç bulunamadý. Bu hastalar ile kontrol grubu arasýnda da anlamlý bir sonuç saptanmadý.
Sonuç olarak yaptýğýmýz bu çalýşmada, hemodiyaliz hastalarýnda pruritus ile plazma histamin düzeyi arasýnda istatistiksel olarak anlamlý bir ilişki olmadýğý gösterildi.

OBJECTIVE: This study is planned to investigate the relation between pruritus and plasma histamine levels in cases with end stage renal failure who is treated with hemodialysis.
STUDY DESIGN: 14 patients who have treated with hemodialysis (6 females and 8 males; aged between 20-68 years) were included to our study. As for the control group 14 healthy people selected (6 females, 8 males aged between 24-65 years).
Patients who have treated with hemodialysis were separated 2 groups who have pruritus(Group A) and who haven't (Group B). The levels of plasma histamine determined with the method of RIA.
RESULTS: There was no statistically significant changes found between Group A and Group B. Also no significant changes was found between patients who have treated with hemodialysis and control group.
CONCLUSION: These results may show us there is no relation between pruritus and plasma histamin levels at patients who have treated with hemodialysis.

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AMAÇ: Bu çalýşmada neoadjuvan kemoterapi ve radyoterapinin lokal ileri evre nazofarenks kanserlerinde sağ kalým üzerindeki etkisi incelenmiştir.
MATERYAL VE METOD: Şişli Etfal Hastanesi Radyasyon Onkolojisi Kliniği'ne, 1991-1997 yýllarý arasýnda müracaat eden 42 hasta çalýşma kapsamýna alýndý. Hastalarýn tümüne neoadjuvan kemoterapi ve radyoterapi uygulandý. 42 hastanýn 40'ýnda sağ kalým oranlarý retrospektif olarak analiz edildi.
BULGULAR: Hastalarýmýzýn 10'u erkek (%70.1), 12'si kadýndýr (%29.9). Mediyan yaş 51'dir (12-66 yaş). 29 hastada indiferansiye karsinom (%69), 13 hastada skuamöz hücreli karsinom (%31) tespit edilmiştir.
SONUÇ: Çalýşma grubumuzda minimum izlem süresi 6 ay, maksimum izlem süresi 66 aydýr, aritmetik ortalama 29 ay ve medyan ortalama 40 aydýr. İndiferansiye karsinomalý hastalarda 2 ve 3 yýllýk sağ kalým oranlarý daha yüksek bulunmuştur.

PURPOSE: We evaluated the effect of neoadjuvant chemotherapy and radiotherapy on survival in locally advanced nasopharynx cancers.
MATERIAL AND METHOD: The study included 42 patients who applied to the Radiation Oncology Clinics of Şişli Etfal Hospital between 1991 and 1997. All the patients received neoadjuvant chemotherapy and radiotherapy. Survival rates of 40 patients were retrospectively assessed.
RESULTS: Thirty patients were males (70.1%) and 12 were females (29.9%). Average age was 51 years (range, 12- 66 years). Twenty-nine patients (69%) had indifferentiated carcinoma and 13 patients (31%) had squamous cell carcinoma.
CONCLUSION: Follow-up period ranged from 6 months to 66 months, with mean and median follow-up periods being 29 and 40 months, respectively. Two and three year survival rates were higher in patients with indifferentiared carcinoma.

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AMAÇ: Fissür ve hemoroidlerde anal kanal manometrik ölçümleri yaparak etyolojik faktörleri tartýşmak.
MATERYAL VE METOD: Eylül 1996-Eylül 1997 tarihleri arasýnda Şişli Etfal Hastanesi 1. Genel Cerrahi Polikliniğinde 20 Hemoroit, 20 fissür ve 20 kontrol grubu olmak üzere 60 hastada anal kanal manometrik ölçümleri yapýl­dý. Ýşlem Dantec-Menuet cihazýna balonlu kateter takýla­rak gerçekleştirildi.
BULGULAR: Maksimal dinlenme basýncý kontrol grubunda 68.18±3.09 cm H2O, akut fýssürlerde 110.5±9.75 cm H2O (p<0.0/), nonprolahe hemoroidlerde 98.3±6.14 cm H2O (p<0.01) olmak üzere anlamlý farklýlýk göstermekte idi. Maksimal sýkma basýnçlarýndaki artýş kontrol grubuna oranla istatistiki anlamlýlýkta bir farklýlýk göstermiyordu.
SONUÇ: İstirahat basýnçlarýnýn yüksekliği etyolojide internal sfinkterinin rolünü destekler özellikteydi.

OBJECTNE: Argue that the etiological factors by obtaining anal canal manometric measures in fýssuras & hemorrhoids.
STUDY DESIGN: Anal canal manometric measures are realized in 20 patients with hemorrhoids, 20 patients with fissuras and 20 out of total 60 patients in ŞEH 1. General Surgery Clinic between years 1996 and 1997.
RESULTS: While resting manometric measures in patients with fýssuras are highest, in both patients with fýssuras and hemorroids were higher than in control patients. Maximal resting pressure in control group was 68.18±3.09 cm H20, Hemorhoid group 87.1 ±1.30 cm H20 (p<0.01), fissur group was 101.7±8.23 cm H2 0 (p<0.01 ), but no significant changes was found between maximal squzee pressure.

CONCLUSION: Being high of resting manometric measures support the role of internal spinchter in etiology.

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AMAÇ: Çalýşmamýzda 15 Mayýs ve 15 Temmuz 1996 tarihleri arasýnda hastanemiz Kadýn Hastalýklarý ve Doğum Kliniklerinde doğan bebeklerde fetal malnutrisyon oraný ve fetal malnütre bebeklerin ACA ve SCA bebekler arasýndaki dağýlýmýnýn CANSCORE kullanarak araştýrýlmasý.
MATERYAL VE METOD: Çalýşmamýzda yukarýda belirtilen 3 aylýk dönemde hastanemiz Kadýn Hastalýklarý ve Doğum Kliniklerinde canlý doğan 1082 bebekte gestasyon yaşý tayini yapýlarak koşullara uygun 902 YD a CANSCORE uygulandý.
BULGULAR: CANSCORE'e göre, YD’lar değerlendiril­diklerinde çalýşmaya alýnan 902 YD'dan 152 (%16.9)'sinde CANSCORE toplam puaný 24'ün altýnda bulundu. Bu bebekler FM kabul edildi. ACA olan 836 (%88.04)'da FM yokken; 100 (%11.96)'da 24 ve altýnda olup bunlar FM kabul edildi.
SGA olan 66 YD'ýn 14 (%21.2)'inde FM yokken, 52'sinde (%78.7) CANSCORE 24 ve altýnda bulundu, hunlar FM kabul edildi.
SONUÇ: Çalýşmamýzda uygulamasý kolay olan klinik skorlama yöntemiyle (CANSCORE) YD’larýn nutrisyonel durumu değerlendirilmiştir. Çalýşma grubunun koşullarýna uygun 902 YD'da 152'sinde (%16.9) FM saptanmýştýr. Denver intrauterin gelişme eğrilerine göre ACA ve YD’lardan %11.96'sýnda FM saptanýrken SCA YD’larýn %21.21’inde FM bulunmamasý dikkat çekicidir.

OBJECTIVE: We searched the ratio of fetal malnutrition and the percentage of fetal malnutrition in AGA and SGA newborns using CANSCORE among the babies borned in Şişli Etfal Hospital Obstetrics and Gynecology Clinics between 15 May and 15 July 1996.
STUDY DESIGN: in 3 months period, the gestational ages of 1082 live born babies were determined and 902 newborns having the optimal conditions were estimated by estimated by CANSCORE.
RESULTS: By evaluating 902 newborns using CANSCORE total score was found below 24 in 152 newborns (%16.9) and accepted FM. Among 836 AGA newborns, 100 new borns (%11.96) have CANSCORE below 24 and accepted FM while 736 of them (88.04) were not FM. Among 66 SGA newborns, 52 newborns have (%78.7) CANSCORE below 24 accepted FM while the remaining 14 (%21.2) were not FM.
CONCLUSION: In our study, nutritional of status of new­ borns was evaluated by using simple clinical scoring method, CANSCORE. in the appropriate study group of 902 newborns, 152 were determined FM. According to Denver Intrauerin development curves, in 11.96% of ACA new- borns FM was detected, while the 21.21% of SGA newborns were not FM.

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Amaç: Prospektif bir çalýþmayla Caesarean Sectio operasyonlerýnda genel veya spinal anestezi alan kadýnlarda postoperatif ilk 24 saatteki analjezik gereksinimlerini karþýlaþtýrdýk.
MATERYAL VE METOD: Genel grubuna 5-7 mg/kg Thiopental 0.5 mg/kg Atracurium, 1 mg/kg Meperidine, %50 O21%50 N2O verildi. Spinal grubuna L2-3 veya L3-4 mesafesinden 2 G spinal iðne ile %2’lik Prilocaine’den 5 cc uygulandý. Postoperatif analeji ihtiyacý: VAS>4 olduðunda 1 gramýný Dipyrone yapýlarak saðlandý. Postoperatif analjezik gereksinim zamaný ve miktarý kaydedildi. Sonuçlar unpaired t-testi ile deðerlendirildi. p<0.05 anlamlý kabul edildi.
BULGULAR: Gruplarýn yaþ, aðýrlýk, gestasyonel hafta ve operasyon süreleri karþýlaþtýrýldýðýnda aralarýnda anlamlý farklýlýk yoktu (p>0.05). Her iki grupta da postoperatif ortalama miktarý birbirinin ayný ve 1.5 gr Dipyrone idi ancak postoperatif ilk analjezik gereksinim zamaný spinal grubunda genel grubuna göre derecede uzundu (p<0.05).
SONUÇLAR: Caesarean operasyonunda spinal veya genel anestezi almanýn tüketilen postoperatif analjezik miktarýný etkilemediðini gördük.


OBJECTIVE: In this prospective study, the postoperative analgesic need after Caesarean Sections performed either under general or spinal anesthesia were compared.
STUDY DESIGN: The patients receiving general anesthesia were given thiopental 5-7 mg/kg, 0.5 mg/kg, meperidine 1 mglkg and a mixture of 02 and N2O (50% each). The group of patients spinal anesthesia were administered 2% Prilocaine, 5 cc each, by the L2-3 route with 22 gauge spinal needles. The amount and frequency of postoperative analgesic need was recorded separately in the two groups and the were with unpaired t-test. p<0.05 was accepted as meaningful.
RESULTS: When the age, weight, gestational week and operation time parameters were compared the two groups, there was no significant difference (p>0.05). in both groups total amount of analgesic needed was the same and in study it was J.5gm Dipyrone given ým. However, the mean time until the first analgesic dose needed, was longer for the spinal anesthesia group (p<0.05).
CONCLUSION: The administration of anesthesia either generally or by the spinal route, did not influence ehe amount of analgesic drug needed after Caesarean Sections.

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AMAÇ: Çocuklarda kronik sinonazal semptomlarýn tedavisinde adenoidektominin etkinliğini belirlemek.
GEREÇ VE YÖNTEM: Eylül 1996 ile Aralýk 1997 tarihleri arasýnda kronik sinonazal semptomlara sahip olup, kliniðimizde adenoidektomi operasyonu uygulanan 40 hasta çalýşmaya alýndý. Yaş ortalamasý 6.2 olan hastalarýn yaş aralýğý 3 ile 12 arasýnda değişmekteydi. Operasyon öncesinde ve sonrasýnda her çocuğun öyküsünden sinonazal semptomlarý belirlendi ve karşýlaştýrýldý.
BULGULAR: Operasyon öncesi en sýk belirlenen semptomlar; burun akýntýsý (%92), burun týkanýklýğý (%77), ağýz solunumu (%70) ve geniz akýntýsýydý (%62). Operasyon sonrasý sýrasýyla bu oranlar %22, %25, %15 ve %10'a düştü. Hastalarýn %60'ýnda semptomlarýn tamamen düzeldiği,%12'sinde ise düzelme olmadýğý saptandý.
SONUÇ: Adenoidektomi, olgularýn çoğunda kronik sinonazal semptomlarýnýn düzelmesinde etkili olmuştur.

OBJECTIVE: To determine the efficacy of adenoidectomy in relieving chronic sinonasal symptoms in children.
STUDY DESIGN: Fourty patients, who had chronic sinonasal symptoms and underwent adenoidectomy in our clinic between September 1996 and December 1997 were studied. Patients ages ranged from 3 to 12, with a median age of 6.2 years. Before and after operation, sinonasal symptoms taken from their family were identified and compared.
RESULTS: The most frequently reported symptoms before surgery were rhinorrhea (92%), nasal congestion (77%), mouth breathing (70%), and postnasal drainage (62%). These proportions decreased following adenoidectomy to 22%, 25%, 15% and 10% respectively. Complete resolution was reported in 60% of patients. No improvement was reported in 12% of patients.
CONCLUSION: in the majority of cases, adenoidectomy effectively treats chronic sinonasal symptoms.

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AMAÇ: Metastatik beyin tümörlerinde cerrahi tedavi endikasymýlarýnýn ve radyoterapinin rolünün tartýşýlmasý.
MATERYAL VE METOD: Son iki yýl içinde Şişli Etfal Hastanesi Beyin ve Sinir Cerrahisi Kliniğine 123 olgu intraserebral tümör nedeni ile opere edildi. Bu çalýşmada metastatik tümörü olan 20 olgu tartýşýldý. Onbeş olgu (%75) erkek ve beş olgu (%25) ise kadýn idi. Beyin metastazýnýn tesbit edildiği ortalama yaş 49.75 idi. Onbeş olguda sadece tek lezyon, ikisinde iki, ikisinde üç ve de birinde üçten fazla lezyon saptandý.
BULGULAR: Beyin metastazlarýnýn primer odağa göre daðýlýmý şöyle idi: Akciğer (7), Gastrointestinal Sistem (GİS) (3), Meme (2), Böbrek (2), Prostat (2), Malign Melanom (2), Üriner yollar (1), Uterus (1). Uterus leyomiyosarkom metastazýnýn beyinde son derece nadir görülmesi nedeni ile, bu olgu ayrýca vurgulandý. Onbir olguda, intraserehral metastaz teşhis edildikten sonra primer odak ortaya çýkartýlabildi. Hiçbir olguya preoperatif radyoterapi uygulanmadý. Tüm olgular opere edildi. Cerrahi tedavinin amaýcý öncelikle hayatý tehdit eden ve nörolojik tabloyu bozan lezyona müdahale etmek idi. Lezyonun arka çukurda olmasý kesin endikasyon olarak kabul edildi. Operasyon sonrasý ortalama yaşam süresi 7.5 ay olarak teshil edildi. Postoperatif radyoterapi yirmi olgudan on tanesine uygulandý.
SONUÇ: Hayatý tehdit eden, nörolojik tabloyu bozan ve çýkarýlmasý kolay olan tüm lezyonlar opere edilmelidir. Bu çalýşmada, ortalama yaşam süresi açýsýndan postoperatif radyoterapi uygulanan ve uygulanmayan olgular arasýnda anlamlý bir fark tesbit edilmedi.

OBJECTIVE: To discuss the surgical indications and the role of the radiotherapy in metastatic brain tumors.
STUDY DESIGN: Hundred and twenty-three patients underwent surgical treatment due to a intracerebral tumor in Şişli Etfal Hospital, Department of Neurosurgery during last two years. Twenty of them who had metastatic brain tumor were discussed in this study. Fifteen (75%) were male and five (25%) were female. The median age at the time of the initial diagnosis of brain metastasis was 49.75. Fifteen patients were presented with only one intracranial metastasis, two with two, two with three and one with more than three.
RESULTS: Seven patients with lung metastases, three with gastrointestinal, two with breast, two with kidney, two with prostate ýwo with malignant melanoma, mýe with urinary tract and one with uterus (This rare case had ýýterine lelomyosarcoma metastasis) had the primary site of their tumor. lýý eleven patients the systemic caný.: er was estcýblis­ hed after diagnosing the intracerebral metastasis. Preoperative radiotherapy was applied to none of the patients. All patients were treated with surgery. The aim ol the surgical treatment was to remove the life threatening lesion or lesion that deteriorates the patients neurological status. The presence of a tumor in the posterior fossa was a certain in­dication. Median survival time after the operation was 7.5 months. Postoperative radiotherapy was performed to 10 of 20 patients.
CONCLUSİON: The life-threatening lesions, lesions which deteriorate the patients neurological status, and all lesions which are easy to remove should he operated. There is no significant dfference between the median survival time of the patients treated with and without postoperative radioterapy in this study.

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AMAÇ: Bu çalýşmamýzda Abdomino-perineal rezeksiyon (miles operasyonu) uygulanan 70 rektum kanserli olguda yaş, histopatolojik sýnýflama, adjuvan kemo-radyoterapi uygulanmasý ve ortalama takip süreleri irdelenmiştir.
MATERYAL VE METOD: Kliniğimize 1988-1995 yýllarý arasýnda başvuran 70 rektum kanserli olgunun hepsine miles operasyonu uygulanmýş olup hastalara postopertif dönemde kemo-radyoterapi verilmiştir. Bulgular retrospektif olarak analiz edildi.
BULGULAR: 70 olgumuzdan Erkek-Kadýn oraný (35135) eşittir. Median yaş 55 (17-83 yaş). Adenokarsinom 50 olgu (%71.4, musinöz adeno karsinom 13 olgu (%18.5), papiller adeno karsinom 1 olgu(%1.4),taşlý yüzük hücreli karsinom 1 olgu (%1.4) malign melenom 3 olgu (%4.2), nonkeratinize epidermoid ca 1 olgu (%1.4), indiferansiye malign tümör 1 olgu (%1.4) bulunmuştur.
SONUÇ: 70 olgudan 40 olgu 6 ay ve üzeri takip edildi, bu 40 olgunun ortalama takip süreleri 23.1 ay (6-60 ay) olarak tespit edilmiştir. Kemoterapi ve radyoterapi uygulanan olgularda ortalama takip süresi daha uzun bulunmuştur (26.1 ay).

PURPOSE: We reviewed age, histopathologic classification, adjuvant chemoradiotherapy and mean follow-up periods in 70 patients with rectum cancer who underwent abdomino-perinenal resection (Mile's operation).
MATERIALS AND METHODS: A total of 70 patients with rectum cancer were admitted to our clinics between 1988 and 1995, all of whom underwent Mile's operation. All patients received chemo radiotherapy during the postoperative period. The cases were retrospectively reviewed.
RESULTS: There were 35 males and 35 females, with mean age being 55 years (range 17-83 years). Tumors included adenocarcinoma (n=50; 71.4%), mucinous adenorcarcinoma (n=13; 18.5%), papillary adenocarcinoma (n=1; 1.4%), signet-ring celi carcinoma (n=1; 1.4%), malignant melanoma (n=3; 4.2%), non-karatinized epidermoid carcinoma (n=I; 1.4%), and indifferentiated malignant tumor (n=1; 1.4%).
CONCLVSION: Forty patients were followed-up for six months or more. Mean follow-up period was 23.1 months (range 6-60 months). in patients receiving chemotherapy and radiotherapy follow-up period was found to he longer (26.1 months).

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