Objective: The aim of this retrospective trial is to investigate the anaesthetic records of the 133 operations of 111 patients undergoing spinal surgery with general anaesthesia from January.1990 to June.2001 at Þiþli Etfal Research and Education Hospital.
Study design: The demographic data of the patients, indications, preanaesthetic assessment and premedication, duration of anaesthesia-operation, anaesthetic techniques were investigated. Methods which was used for observation of vital parameters and amount of blood loss, products used for blood transfusion and fluid replacement, complications, the postoperative analgesic methods were searched.
Results: 54 female, 57 male patients aged between 1.5-78 years were investigated. The most frequent indication for surgery was fractures (in 73 patients-66%). In 7 cases (6%) anterior, 71 cases (64%) posterior, and 33 cases (30%) combined anterior- posterior approaches were preferred. Mean duration of anaesthesia and operation were 305.71 and 256.65 minutes respectively. Balanced anaesthetic technique was used in 80 procedures (60%). Induced hypotension in 25 procedures (19%) and wake-up test in 10 procedures (8%) were used. In 108 procedures (81%) patients were monitorized invasively. Homologous blood transfusion in ¡11 procedures (83%), ototransfusion technique in 10 procedures (8%) were used. Crystalloid solutions alone in 85 procedures (64%) and combined with colloid solutions in 48 procedures (36%) were infused. In 20 procedures (15%) patients were transferred to the intensive care unit. The postoperative analgesia was provided with classical methods in 100 procedures (75%).
Conclusion: The preanaesthetic assessment should include neurological examination in patients undergoing spinal surgery. The anaesthetic technique should minimize the peroperative bleeding and allow the neurophysiological tests to be done safely. Also invasive monitorization should be performed, adequate postoperative analgesia should be provided. The patients should be interned in intensive care unit for 24-48 hours to follow up and apply supportive treatment.

Objective: We aimed to compare the effects of midazolam, meperidine and morphine combined with atropine that used in adult premedication intramuscularly (im) on hemodynamics changes, sedation and anxiety.
Study Design: 200 patients with 17-74 years of age range from ASA I-II groups having elective operation were involved into study. Patients were divided into 4 equal groups with 50 persons, randomly. We determined the four groups as Group 1 (midazolam 0.07 mglkg+atropine 0.01 mg/kg), Group 2 (meperidine 1 mglkg+atropine 0. 01 mg/kg), Group 3 (morphine 0.01 mglkg+atropine 0.01 mg/kg) and group 4 (atropine 0.01 mg/kg). Drugs were given intramuscularly 45-60 minutes before operation. Sedation score, anxiety score, heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR) and adverse effects were recorded.
Results: Sedation and anxiety scores siginificantly decreased in all groups except for Group 4 (p<0.05). HR was increased significantly in these groups except for Group 3 (p<0.05). MAP in Group 3, RR in Group 1 and 3 were siginificantly decreased (p<0.05). In all groups, the most frequently seen adverse effect was the dry mouth.
Conclusions: We determined that im midazolam, meperidin and morphine were sufficient to abolish anxiety in adult premedication. We thought that the appropriate use of atropine should be whenever indication was present.

Objective: In this study we aimed to evaluate the antibiotic susceptibility of staphylococci isolated from different clinical materials.
Study Design: From January 1999 to January 2000 the antibiotic susceptibility of staphylococcal strains isolated from different clinical materials at Sisli Etfal Training and Research Hospital was determined by disc diffusion test.
Results: Totally 257 ( 7.17% ) staphylococci were isolated out of the 3582 samples sent by different clinics. Among the 257 staphylococcal strains, 73 ( 28.4%) were coagulase positive (S.aureus), 184 ( 71.6 %) were coagulase negative. Among the evaluated 73 S. aureus strains 38 (52.1%) were found to be oxacillin resistant and 35 (47.9%) were oxacillin susceptible. Among the evaluated 184 coagulase negative staphylococci 110 (59.8%) were found to be oxacillin resistant and 74 (40.2%) oxacillin susceptible. All staphylococci were susceptible to glycopeptides. Conclusions: In order to prevent the development of resistance to glycopeptides among staphylococci in the future, the infections caused by these microorganisms should be treated by proper antibiotic.

Objective: To supply a safe and confidential document to the persons who are interested in the history of anesthesia and our hospital,we have presented 1092 case who had taken anesthesia for cardiothorasic surgery.
Study Design.This study was retrospectively worked from our clinic documentation.Data were expressed as mean,median(range) or number.
Results: The age group of the patients was;27.7% pediatric and 6.31 %geriatric,the ratio of FIM was found 0.62. 41.75% of the operation was short duration intervention ander was used in six cases.Massive blood transfusion was performed to 2.47% of the patients.At least one unite blood was transfused to 48.07% of the cases.As a volume expander,dextran 70 was chosen for the 1.28% of the cases.
Conclusion: While the intraoperative mortality rate was 1.09%,postoperative mortality rate in the first 24 hour was found 0.55%.Our results were similar to literature.

Objective: In this study, rectus abdominis muscle and myocutaneus flaps which were applied in our clinic are evaluated.
Study design: Rectus abdominis muscle and myocutaneus flaps which were applied on 22 patients between 1990-2000 are evaluated.
Results: The mean age of the 12 female and 10 male patients was 40. Main etiologies were tumor resection, trauma, infection and congenital anomalies. Reconstructed sites were head and neck, genital area, breasts and lower extremity. Anterior rectus sheet was primarily repaired in all cases. Partial flap necrosis and abdominal hernia were noticed in one patient and we saw fat necrosis in one patient.
Conclusions: Rectus abdominis muscle and myocutaneous flaps are frequently used for the reconstruction of many anatomic regions in patients with wide tissue defects. These easily prepared flaps have a long and reliable pedicle and low donor area morbidity.

Objective: Occlusion, pharmacological penalisation and optical penalisation have been used in the treatment of amblyopia. Occlusion, the first choice of treatment, continues to be a problem for the child and his family. In this study, the efficacy of optical and pharmacological penalisation with atropine in the treatment of amblyopia has been evaluated.
Study Design: Penalisation with one of atropine sulphate 1% was peiformed on the non-amblyopic eyes of 14 children, aged between 2 and 7. Fixation of the amblyopic eye was enhanced by replacing the glass of the non-amblyopic eye with a piano glass. Patients were examined eveiy three weeks throughout an average follow-up period of 2.6 months. The treatment was discontinued provided stable vision was observed on three successive examinations and the outcome was evaluated.
Results: Visual acuity of the amblyopic eyes was 0.39 on the first examination and 0.71 on the last examination (p<0.001). It was observed that the patients tolerated penalisation and piano glass perfectly.
Conclusions: Penalisation may be a an efficient alternative in the treatment of amblyopia in patients for whom occlusion therapy is a problem.

Objective: In this study the affect of a high dose of vitamin A as adjuvant treatment for cases with acute lower respiratory tract infection was tested in infants.
Study design: We conducted a randomized, double-blind, placebo- controlled clinical trial of high-dose vitamin A supplements among children aged 2 to 24 months (N - 40) admitted to hospital with bronchopneumonia or bronchiolitis. Vitamin A (100,000 IU for children less than 1 year of age, and 200,000 IU for older children) or placebo were given to the children in addition to standard treatment regimens. The children were assessed with clinical findings four times a day and with laboratory tests at the begining and fifth days of the treatment.
Results: There were not significant differences between placebo and vitamin A groups in the rate of normalization of clinical and laboratory findings.
Conclusion: These data show that supplementation of high doses of vitamin A has no additional advantage in the treatment of lower respiratory tract infections of infants.

Objective: CT imaging findings in temporal bones of the patients with secondary cholesteatomas were studied.
Study Design: This retrospective study is carried out in 25 patients with acquired cholesteatoma who were underwent otological surgery in Sisli Etfal Research and Education Hospital between March 1999 and May 2001.In all cases, axial and coronal images with 2 mm slice thickness was taken.Ossicles, tegmen, labyrinth, sigmoid sinus plate and fascial canal was evaluated.
Results: In 20 cases ossicular destruction, in 5 cases labyrinthine fistula, in 4 cases facial canal destruction, in3 cases sigmoid s inuse plate erosion and in 2 cases tegmen destruction was detected on CT scans.In 1 case, there is extension of chlolesteatoma into the petrous apex.
Conclusion: Erosion of the tegmen, labyrinth, sigmoid sinus plate, facial nerve canal and ossicles can be best evaluated on CT scans

Objective: We aimed to study the results of local-regional control, survival, and prognostic factors, after operation and postoperative radiotherapy.
Study Design: 97 patients who were followed for at least 6 months had been "ed for our study. These patients had been with neck dissection or without they had total or partial larengectomi and all and postoperative radiotherapy. These patients were studied retrospectively with regard to localregional recurrence, distant metastazes and survival rates.
Results: The patient group were observed to be: 14.4% regional recurrence, if the patient of stage 3 type this becomes 5.2%, if it of stage 4, it becomes 21.8%, With N-0-1 types it is 7.4%, N-2-3 types it is 36%. Distant métastasés is found to be 11.3% the most common metastas is obser\>ed at lungs. 90.2% of Stage 3 patients 2-year- survival rate, stage 4 type had found to be 67.4%.
Conclusion: N stage is found to be deciding factor in recurrence of local-regional carcinoma and distant metastazes.

Fournier gangrene is an acute, synergistic necrotizing fasciitis of scrotum, penis and perianal region. In this particular case who is 41-years old, pathogenesis is secondary to decubitus ulcer. The conservative and surgical therapy which was applied to the patient were described. We have decided to report this case for its rare ethiopathogenesis and to point out importance of conservative treatment in such patients.

Three patients aged 20-30 years old who have acute visual loss and unconsciousness after the ingestion of eau de cologne were admitted to our department. All of three patients’ arterial blood gas analysis showed severe metabolic acidosis which was corrected with bicarbonate and ethanol. Emergency hemodialysis and mechanical ventilation was appiled. After three-eigth days of treatment, Two of three patients died. The reminder one can be discharged with visual loss. In case of methanol intoxication, in spite of promptly corrected metabolic imbalance, visual loss may persist.