Aim: Large-for -gestational age (LGA) babies, especially those whose birth weight is greater than 4000g, have elevated risk perinatal mortality and morbidity. The purpose of this study is to evaluate the incidence of macrosomia, risk factors and morbidity of the macrosomie babies.
Study Design: Clinical records of the newborn in Sisli Etfal Teaching Hospital between January 1999-December 1999 were reviewed retrospectively. Macrosomia was defined as a birth weight of4000 g or greater.
Results: A total of 3431 babies were born during the study period and 248 (7.2%) were weighing more than 4000 g at birth and 17 (0.8%) of these babies were weighing more than 4500 g. Of the 248 macrosomie babies 65.2% was male. Among macrosomie newborns the caesarean delivery rate was 31% (n: 77), whereas in the appropriate gestational age group (AGA) was 21.8% (n: 636). In the macrosomie group the incidence of hypoglycemia, polycythemia and birth trauma were higher than AGA group however, meconium stained amniotic fluid incidence was lower.
Conclusion: Macrosomia was associated with increased cesarean rate. It is important to recognise the morbidity of macrosomie infants and so to decrease the morbidity in these infants.

Objective: Aim of this study was to compare the onset duration of action and adverse effects of local anaesthetic mixture used in spinal anaesthesia.
Study Design: Spinal anaesthesia was applied to 17 patients, ASA 1-2 undergoing onthopaedic surgery. 4 ml 2% prilocain and 3 ml 0.5% bupivacain were used for spinal anaeshesia. Postoperative analgesic need and postoperative complications till postoperative 48 h were recorded. Data (onset of duration, motor and sensorial block time) were assessed according to standard deviation and arithmetical mean.
Results: Mean age ahr weight of patients were 40.55±15.87 years and 70.10±13.5 kg, respectively. Level of sensorial block was T 8-10 and motor block bromage 3 in all patients. Mean onset of duration was 3.831.38 min, duration of analgesia was 261.38±55.75 min, duration of motor block was 268.83±68.32 min. Peroperative complications were vomiting (n: 2), nausea (n: 2), shivering (n: l), hypotension (n: l), bradycardia (n: 2). Six patients did not require analgesic need during the postoperative period. But 1 gr metimazol (I.M) was used for 10 patients while 20 mg proksikam (l.M) was used for one patient.
Conclusions: Onset of duration is shortened if pH of local anaesthetic is close to 7 in this study; alkalinization is made by mixturing bupivacaine and prilocaine short onset of duration and long duration of (alcalinic) mixture of drugs can be explained by their enhancement of bioavailability. Local anaesthetic mixture in spinal anaesthesia provides rapid onset of action, long duration, reduced toxisity and low postoperative analgesic consumption.

In this study, patients that came to our clinic with soft tisse sarcoma have been investigated to determine factors effecting metastasis retrosspectively. 144 patients have been followed up between the years 1990-2000. The average age is 43. 76 of the patients are male and 68 are female. The most often seen fist is leiomyosarcoma (20%,n=29), 2nd is malignant fibrous histiocytoma (15%,n=21), 3rd is liposarcoma (12%), 56 were stage III (39%), and 55 were stage IV (38%). Factors effecting metasis were found as: histopathological type (p=0.0496), grade (p=0.0363) and location (p=0.0210).

Objective: We studied 65 cases with astrocytoma who came t our clinic between 01.01.1988 and 08.09.1996. Study Design: All 65 patients wer evaluated according to age, sex, histology, symptoms, tumor localization, and diagnosis.
Results: Out of 56 patients, 29 were male (44.6%), 36 were female (55.3%). Youngest was 6, oldest was 72 years of age. Low Grade Astrocytomas were seen with younger age group (children/early adult). 75.4% of the patients had tumors supratentorial, 24.6% had infratentorial. Cerebellum is found to be the most common localization for tumors. Alla patients had received external radiotherapy.
Median follw-up period calculated to be 25 months average follow-up 31.4 months and 5 years survival rate were 32.2%.
Conclusion: Primer intracranial neoplazma account for 1.5% of all malignities and low grade constitutes approximately 15-20% of this group. Although our results show a positive outlokk, due to still happening death case, it is advisable to search for new (advanced) methods of treatment. Primer treatment is still surgery, besides operation, hystological grade, performanca status, type of and technique of radiotherahpy, and dosage of radiotherapy plays a major role.

Objective: To evaluake the result of treatement methods of the patient who were treated at our clinic between 01.01.1988 and 08.09.1996 with Low Grade Asrocytomas diagnosis.
Study Design: Patient group were studied in post and preoperation findings with regard to application of radiotherapy. This was left out as our purpose was to evulate the resluts of radiotherapy. Ki-sq test and Mann-Whitney U test were used for statistical calculations.
Results: 78.4% of patients were complaing from headaches when they come to our clinic, 58.4% had epileptical synptoms. 56.7% of the patient were grouped as falling into stage I, All the patient had a operational treatments and all had been diagnosed as hystopathological. 9 patients received primer radiotherapy,56 patients had postoperative radiotherapy, grade 1 pat ie nets, were followed for up to 40 months, grade II for 25.6 months,. Average follow-up of the patients between grade I and grade II show a remarkable difference (p>0.05)
Conclusion: Low Grade Astrocytomas Form the 15-20% of intracrainal neoplasms, primer treatments is considered as “ Operative’’ and our patients had been obsereved to be 15- 35% operative rezeciton. Before, the treatment was made using parallel-oposite ray applications over the whole of the brain but recently, the developments in tomography and MR allows us to use localy concetrated Rays.

Introduction: Between the years 1977-1989, we have performed anesthesia for patients undergoing neurosurgical procedures. The 2456 patients who has been given anesthesia in this period are reviewed to recevalvate daily practises and to do self critics of our department.
Material and Methods: Data including patients’ age, sex, operation conditions, anesthetic techniques, application of blood and colloid infusions and intraoperative mortality ratios were retrospectevely researched from anesthetical records.
Results: 2456 patients were included in this study. 173 of them (7%) wer under 1 year of age, 431 of them (17.5%) wer between 1-13 years of age; 1757 of them (71.5%) were between 14-65 years of age and 95 of them (4%) were over 65 years of age. Ratio between female and male was 0.52. 1133 of the cases (46.1%) were emergency and 1323 of the cases were elective. Regional anesthesia technique was chosen only in 0.51 percent of the cases, while general anesthesia was chosen in 99.49 of them. Intraoperative mortality was (0.48%) with 12 cases.
Conclusions: Almost half of the patients who underwent neurosurgical operations were emergency cases and intraoperative mortality ratio was found to be 0.48%.

Objective: Ovarian cancer is the most important cancer in deaths related to the gynecological cancers. The patients applying with the diagnosis of pelvic mass should be evaluated for differentiation of malignancy; so the choose of referance hospital and even insicion type of operation could be determined easily.
Study Design: In our study 83 patient applying Sisti Etfal Education and Training Hospital, 2nc Gynecology and Obstetrics Clinic with the diagnosis of adnexal mass were examined prospectively between November 1996 and November 1999. The differential diagnosis of the adnexal masses were made on the basis of transvainal ultrasonography, CA-125 and MRI.
Results: All of the malignant masses had high CA-125 levels, with ultrasonographic score greater than 9 and with the malignancy risk index above 200.
Conclusion: At the time of desicionfor the treatment serum CA-125 levels, ultrasonography and the malignancy risk index will be helpfull. Nevertheless the false positive predictivity of CA-125 and ultrasonography must be remembered but MRl has higher confidence.

Objective: The death rate in ovarian cancer is greater than the sum of servical and endometrial cancer. In this study, adnexal masses were searched for the effectiveness of the new clinical scorring system in treatment plans and prediction of malignancy.
Study Design: The accompanying patients were taken to questioneire about family history and menses anamnesis; physical and gynecological examination, abdominal and vaginal ultrasonography. By the addition of serum CA-125 levels Adnexal Tumor Clinical Scores Calculated.
Results: Scores greater than 9, indicates malignancy with 100% sensitivity, 98% spesifisity, 87% positive predictive value. Conclusion: In the future with the help of the clinical scorring system new treatment and following protocoles can be developed.

Objective: We aimed to evaluate general characteristics of the patients who wer treated at our clinic between the years of 1989-1997. Study Design: In our study between the years of 1989-1997, 112 patients with small cell lung cancer who were followed for at least 6 months were evaluated retrospectively.
Results: The youngest patient was 35 years old and the oldest one was 78 years old. The median age was 55. 107 patients were male, 5 patients wer female. 101 patients were used to smoke. The major symptom was cough. 76 patients had higher than %70 performance status according to Karnofsky Performance Status. According to stages;39 patients had limited disease, 73 patients had disseminated disease. The most common distant mekastases was obseiwed at brain. The most common tumor location was santral region. Chemoteraphy and radiotheraphy was used in treatment of small cell lung cancer.
Conclusion. Small cell lung cancer is the second most common histologic type after epidermoid carcinoma of lungs. Although all treatment methods, it has poor prognosis. Median survival is approximately one year.

Objective: Our purpose was to evaluate the results of our treatments of patients with small cell lung cancer between the years 1989-1997.
Study Design: We studied retrospectively 112 patients who were treated at our clinic between 1989-1997 with small cell lung cancer. All the patients were followed-up for more than 6 months and results of treatment methods were compared in relation to their corresponding stages. Ki-square statistical method was utilized in this study.
Results: 107 patients were male and 5 patients were female. Primary tumoric cells were found to be with 58 patients in right lung and with 54 patients in the left lung. 62 patients had métastasés, 9 patients had multiple organs métastasés and the most common métastasés were observed to be in brain. Chemotherapy and radiotherapy was used with 25 patients (64.2%9 with limited-spread of carcinoma, and with 31 patients (42.4%) in advanced-spread of disease. 56 patients after chemo-radiotherapy had 7.4 months of survival rate without disease, general survival rate was calculated to be 13.8 months. The other 56 patients who had only chemotherapy, survived for 6.1 months; and with these patients general survival rate was 9.8 months. Between these 2 methods statistical comparison calculated to be (p: 0.005). patients shown limited -spread responded with 63.5%, advanced-spread was 22.1%.
Conclusion: With small cell lung cancer, application of multiagent systemic chemotherapy, Chemotherapy¦‘cLocal radiotherapy found to be increasing survival rates.

Objective: Our aim was to evaluate the retrospective of the cases of Supraglottic Larynx Carcinoma at our clinic.
Material-Method: 97 patients were evaluated during our study who were treated and followed up between the years 1989-1997. The cases were studied according to sex, age group, operations they have received, histological type, differentiation degree and stages they were in.
Results: 94 patients were male, 3 were female, 76.2% had total larengectomi, 23.7% had partial larengectomi. 46.3% Ipsilateral, 45.3 had bilateral dissection. Only 47 patients had differentiation determined and from these, 8 case were well differentiated, 28 case were average differentiated, 11 were badly differentiated. According to stages: 2% were 1 stage, 7.3% cases were of stage 2, 42.3% were stage 3, 48.5% were stage 4. Smoking and drinking were observed positive with 85% of the cases.
Conclusion: Head/Neck carcinoma accounts for 2% of all cancer cases in the world and larynx carcinoma is the most common among them. It is also known that Larynx Carcinoma is close correlation with smoking anrd drinking. This type of carcinoma is often seen with male patients of middle or old age who smokes and drinks.

Sneddon syndrome is characterized by ischemic serebrovascular disease and livedoreticularis. This syndrome was described by Sneddon in 1965
Case: 40 years old man was admitted at the hospital with complaints numbness of his right arm and leg and slurred speech. His clinical examination was revealed livedoreticularis both lowers extremities and gluteal reginos. Neuroimaging evaluation was appeared chronic lacuner infarct on left capsula interna posterior leg and right talamus and subacute infarct near frontal horn. In our study, we amied to review clinical laboratory characteristics of Sneddon syndrome which is a seldom disease due to a case.