Augmentation cystoplasty was first described at the end of the 19th century, but it was popular for the small contacted tuberculous bladder, indications to this procedure are schistosomiasis, interstitial cystitis, neurogenic bladder dysfunction, detrusor instability, undiversions, various congenital conditions and correction of the lower urinary tract dysfunction before renal transplantation. Stomach, ileum and colon can he used as natural grafts. There are also synthetic grafts for bladder augmentation. Complications of this procedure are metabolic disturbance, diverticularization, mucus production, bacteriuria, stone formation, perforation and increased risk for carcinoma development. Augmentation cystoplasty is an attractive alternative for the minority failing conservative management.

Objective: In this study, the distribution of wound and abscess samples according to clinics and isolated bacteria antibiotic susceptibility were examined which were sent to Microbiology and Clinical Microbiology Laboratory.
Study Design: 388 wound and abscess samples which were sent to Þiþli Etfal Training and Research Hospital were inoculated 5% blood agar, chocolate agar and Eozin-Methylen Blue agar. In these media, reproduced bacteria were defined and antibiotic susceptibility was determined by using disc diffusion test.
Result: The samples were usually from Surgical departments, mostly belong to Ortopedics Clinics. Although 239 (61.5%) of samples were reproduced, 149 (38.4%) of them were not reproduced. Among the 239 of samples, 122 (51%) were Gram positive bacteria, 117 (48.9%) were Gram negative bacteria. Although methicillin resistant Staphylococcus aureus and methicillin resistant coagulase negative staphylococcus which were isolated from Gram positive bacteria were found to be 100% sensitive to vancomycin and teicoplain, they found less sensitive (17%- 65%) to other antibiotics. Methicillin sensitive Staphylococcus aureus and methicillin sensitive coagulase negative staphylococcus were found I2%-38% sensitive to other antibiotics. Alfa hemolytic streptococcus were determined 75% sensitive to penicillin G and beta hemolytic streptococcus were ¡00% sensitive to penicillin G. From Gram negative bacteria, Pseudomonas spp. were found to be 89% susceptible to imipenem and 75% susceptible to amikacin, Acinetobacter spp. 90% susceptible to imipenem, 76% susceptible to ciprofloxacin and 75% susceptible to amikacin, Klebsiella spp. 100% susceptible to imipenem, 90% susceptible to ciprofloxacin and ofloxacin, 80% susceptible to ceftriaxone, 76% susceptible to cefoxitin but they found to be 20%-70% susceptible to other antibiotics. E.coli and Proteus spp. were found to be 35%-55% susceptible to ampicillin but 65%-100% susceptible to other antibiotics.
Conclusions: Wound infections and abscess were encountered mostly at Surgical departments. The factors that were occured in infections showed difference to clinics. For an effective treatment, clinicians have to start empirical treatment on the necessary situations and it is useful for them to know the antibiotic susceptibility of agent bacteria.

Objective: Patients who had pituitary tumors were investigated using patern visuel evoked, potentials to show the tumors invasion to paracellar region.
Study Design: In 27 patients P-VEP examinations were compared with neuropthalmologic findings and magnetic resonance imaging.
Results: In patients who had pituitary tumor we found that PI00 amplitudes were decreased. In 25 patients P-VEP examinations were pathologic.
Conclusion: The results showed that it was a quick way of searching supracellar invasion and testing of optic pathways.

Objective: In this study, the diagnostic value of TNF-alpha in myocardial infarction and the effect of thrombolytic therapy on TNF-alpha is assessed.
Study Design: Eight female and 22 male patients were enrolled in this study, who had attended to Sisli Etfal Hastanesi emergency service within the first eight hours of initiation of chest pain, in whom AMI was diagnosed with clinical evaluation and laboratory workup. The patients were, then, referred to coronary care unit. TNF-alpha concentrations, before thrombolytic therapy and in the 48th hour of thrombolytic therapy, were evaluated in the patients with ages ranging between 24 and 69, who had the indication of thrombolytic therapy.
Results: TNF-alpha concentration within the hours of 0 and 8, was high in all patents who had the diagnosis of AMI. No significant difference was found between the anterior and inferior AMI subgroups. TNF-alpha concentrations in the 48th hour of the thrombolytic therapy was apparently lower when compared with the concentrations in the first eight hours (p=O.OI6 in anterior AMI, p=0.03 in inferior AMI). There was a significant parallel correlation between the 48th hour of TNF-alpha and CRP concentrations of anterior AMI group (p=0,003), and the first eight hours of CRP concentrations in the inferior AMI group (p=0,028)
Conclusions: Plasma TNF-alpha concentrations can be accepted as both a valuable diagnostic indicator of myocardial necrosis and an indicator of reperfusion provided by thrombolytic therapy, as well.

Objective: We investigated the usage of P-Vep examinations to detect the lesions on the visual pathways comparing them with, neuroophtalmologic tests
Study Design: 23 patients were included. Their P-VEP study was made and compared with clinical evidence.
Results: In 23 patients, 14 has ophtalmologie evidence and 16 has P-VEP pathology.
Conclusion: In the optic neuropathies P-VEP latencies were longer but essentially, P100 amplitudes were more lower than normals. Neuroophtalmologic examination can appear as normal while P-VEP reveal pathology.

Objective: We aimed to bring up the predictive value of uterin artery, middle cerebral (MCA) and umbilical arteries (UA) doppler measurements to diagnosis of intrauterin growth retardation (IUGR) of the third trimestr.
Study Design: To evaluate the analysis of uterin artery and MCAIUA resistance index (RI) measurements using by color wave doppler ultrasound in 45 cases of third trimestr pregnancies who are at high risk of IUGR
Results: We estabilished in 5 cases that resulted with IUGR have bilateral diastolic notch of uterin arteries and MCA/UA<1 resistance index values.
Conclusions: We found that bilateral diastolic notch of uterin arteries in IUGR; sensitivity 60%, spesificity 95%, accuracy 91.1% and MCAIUA RI<1; sensitivity 80%, spesificity 97.5%, accuracy 97.5%.

Objectives: Many studies state that the serum creatinine phosphokinase-MB (CPK-MB) values increase during cardiac stress test. We aimed to determine the diagnostic importance of CPK-MB values and the results of coronary angiography in patients who have positive cardiac stress test, by comparing CPK-MB results before and after the exercise during the cardiac stress test.
Study design: Our study contained 40 patients who were admitted first Internal Medicine department between January and June 2001; that were thought to have coronary arterial disease. 10 of these had coronary angiography. 24 of these patients were male and 16 were female. The mean age was 56,23±10,5 years. The patients were performed Treadmill test using the standart Bruce protocole. Blood samples for CPK- MB were obtained from these patients before and after the first two hours of the test and the results were compared.
Results: When we evaluated the datas, there was a significant difference between CPK-MB values before and after the stress test in the patients who had positive stress test; but there wasn’t in those who had negative stress test. Coronary angiography and ventriculography results of 10 patients, who had positive cardiac stress test, were found normal in two patients, three vessel diseased in four of the remaining eight patients, two vessel diseased in three and one vessel diseassed in one of them.
Conclusions: CPK-MB values in various degrees of ischemia were found different at studies in literature; also increased after the stress test in patients who had positive test results. As a conclusion, we think that these results support the ideas indicating that CPK-MB could be a predictor for the degree of ischemia.

Objectives: It is important to define rise factors for both primary and secondary prevention of coronary heart disease. An increase on microalbuminuria during acute myocardial infarction is known but mechanism of this isn’t determined. In our study, we studied variation in microalbuminuria levels and efficacy of thrombolytic treatment on it during acute myocardial infarction.
Study design: 40 patients who were put on thrombolytic treatment because of acute myocardial infarction and other 40 patients who were also diagnosed as acute myocardial infarction but were not thought to have an indication for thrombolytic treatment, were included into the study. Blood samples for biochemical parameters were obtained in the first hour and 7th day after hospitalization of the patients. Also, total urine in the first 24 hours were collected after obtaining a spot urine. Quantitative microalbuminuria measurements was made in 24 hours urine samples.
Results: Albuminuria levels were 423.21 ±276. 3 mg!day in 24 hours urine of the first day and 238.78±154.2 mg/day of 7th day. There was a statistically significant difference between albuminuria levels of the first and 7th day urine samples (p<0. 0001). Also, there was a statistically significant difference between patients who were put on thrombolytic treatment and not, according to 24 hours urine albuminuria levels of the first day (p<0.00l). But there was no statistically significant difference between these groups according to albuminuria levels of 7th day (p<0.05).
Conclusions: The presence of an increase in urinary protein extraction rate is supporting hypothesis which suggets that an increase in systemic vascular permeability is caused by ischemia. It is thougt that increase of proteinuria is depending on hemodynamic changes like activation in reninangiotensin system, damage on vascular endotelial wall and increase of vascular permeability.

Objective: This study aimed to determine the antibiotic susceptibility of Gram-negative enteric bacilli isolated from nosocomial infections.
Study Design: Gram-negative enteric bacilli that caused nosocomial infections between June 1998-June 1999 in The Sisli Etfal Training and Research Hospital were taken in to the study. The anitibiotic susceptibility of these bacilli were determined by disc diffusion method.
Results: The distribution of Gram-negative bacilli were; K. pneumoniae 26 (32.5%), E. coli 23 (28.7%), E. aerogenes 9 (11.2%), E. cloacea 7 (8.7%), K. oxytoca 4 (5.0%), enterobacter spp 2 (2.5%), P. mirabilis 2 (2.5%), P. vulgaris 2 (2.5%), C. diversus 1 (1.2%), C. freundii 1 (1.2%), H. alvei I (1.2%), M. morganü 1 (1.2%), E. sakazakii 1 (1.2%). The nosocomial agents were isolated from the specimens as follows; 57 (71.2%), from urine 15 (18.7%) from wound-abscess, 5 (6.2%) from trakeal aspirate, 2 (2.5%) from blood, 1 (1.2%) from cerebrospinal fluid. The susceptibilities of the strains against the antibiotics were as follows; amoxicillin clavulanic acid 20%, cefazolin 28%, cefodizim 53%, ceftriaxone 60%, cefotaxime 60%, cefepim 68%, gentamicin 61%, tob¬ramycin 63%, netilmicin 64%, amikacin 76%, ofloxacin 76%, ciprofloxacin 82%, imipenem 98%, meropenem 97%.
Conclusions: In our study we determined that the most effective antibiotics were carbapenems, followed by quinolones and aminoglycosides.

In this case report, 55 years old woman with a mass in transverse colon that invades stomach was evaluated. Patient complains abdominal pain and vomiting for three years and 5 kg weight loss for two months. A fistula in stomach with faeces and a mass in transverse colon was determined with endoscopic studies. During the operation a colonic mass that invades the stomach was found out and transverse colon resection, hemigastrectomy was carried out and operation was finished with gastroduodenostomy, colonic anastomosis. The case was evaluated because of gastrocolic fistula of colonic carsinoma is a rare situation.

Breast cancer is mostly seem in white and juwish race, consisting nearly 25 % at the female neoplasms, whichs incidance is increasing by age and has a long survival, it is a disease in which epidemiological rise factors are blamed in forming it such as family anamneses, early menarch, late menapouse, being the first pregnancy at late ages or never been pregnant uptake of exogen estorogen, radiation, diet and alcohol and may cause death, it can cause to some symptoms like: Clinically painless mass in breast, oedema in skin and prange-like apperence, iilsertaion, aksillary lymphadenophaty. sometimes it can cause to bloody discharge the nipllse or skin retraction, it can spreads directly, lymphatically and hematologically to several parts of the body. It is tried to cure by surgery, chemotherapy, hormonal therapy(related to estrogen, progesterone receptors), radiotherapy. Metastases can occur also under the treatment. Metastases are generally to bone, liver but sometimes also to atypical parts. We aimed to publish a breast cancer, with metastazes in our clinical in the path of current literature.

Métastasés to the mandibula is a rare phenomenon. It accounts only 1% of all malignant tumors of the oral cavity. In this article, presented is a case of adenocarcinom of the rectum metastatic to the mandible of a woman aged 62 aud¬its palyatif treatment.

Idiopathic Atrophoderma of Pasini and Pierini (IAPP) is characterized by round or ovoid, blue-brown depressed atrophic plaques with typical cliff- borders. The lesions are lokalized on trunk symmetrically. Many patients are women and is seen usually in second-third decades. Because of IAPP is a very rare disease, we decided to present a patient who was diagnosed as IAPP.