Objective: The aim of this study was to investigate radiotherapy effects on carotid intima-media thickness in patients with head and neck tumor.
Material and methods: 30 patients (aged between 20 and 74 years) and a group of 30 age and sex matched controls were studied by ultrasound. The intima-media thickness (IMT) at the far wall of the CCA (common carotid arter) was measured three times and the average value taken in each subject. The IMT of both groups were compared. Risk factors for IMT, including hypertension, smoking, hyperglycemia, history of cerebrovascular accidents and cardiovascular disease were also studied.
Results: The mean value of carotid intima-media thickness in patients with the head and neck cancer group (1.8+1-1.3 mm) was greater than that in normal controls (0.7+1-0.2 mm) and there was statistically significant difference between them (p<0.05). There was no statistically significant difference between the IMT in the right and left CCA within each group of patients (p>0.05). Among all other risk factors, there was no statistically significant difference between two groups (p >0.05).
Conclusion: The findings suggest that patients with irradiation have increased carotid IMT.

Recently, It has been achieved so high cure rate and survival time due to some new methods of diagnosis and treatment took part in the challenge of the malignant bone tumours. In therapy, amputations and palliative approach was replaced by new surgical techniches and modified chemoteraphy methods. According to our opion recent adaptations of the modalities in radiology has one of the most important role in these developments. In our study 40 patient’s radiologic findings were rewieved by the help of the classical diagnostic criterions.

Variations of the nasolacrimal duct are optimally evaluated by dacryocystography, CT, MR imaging and nuclear scintigraphy.In this study morphometric measurements of the lacrimal drainage system were performed with thin- section axial computed tomography (CT) examinations in 30 patients with no signs of pathology related to the lacrimal drainage system. We also tried to demonstrade a correlation between nasolacrimal variations of duct and osteomeatal complex disase, opacification of paranasal sinuses, concha bullosa and nasal septal deviations.

Objective: In this study our aim was to investigate nasal Staphyloccocus aureus colonization among patients and hospital staff of hemodialysis unit and the rate of rnethicillin resistant S. aureus (MRSA) at Şişli Etfal Training and Research Hospital.
Study Design: During 2002 112 hemodialysis patients and 28 hospital staff persons were investigated for nasal S.aureus colonization. Nasal swab samples were investigated by conventional bacteriological methods. The antibiotic susceptibility were measured according to NCCLS standards by using disc diffusion method.
Results: Among 112 hemodialysis patients 24 (%21.4) had S.aureus, 3 (2.6%) rnethicillin resistant S. aureus (MRSA); among 28 hospital staff 3 (10.7%) S.aureus colonizaion was found. There was not found any resistant strain against glicopeptides.
Conclusions: Patients and hospital staff of hemodialysis unit at our hospital had lower rates of S.aureus nasal colonisation compared with other units in our country. MRSA carriage was not found among hospital staff.

Objective: Identification and research of resistance to antibiotics of 88 enterococcus species isolated from wound and urine specimens in Şişli Etfal Training and Research Hospital Microbiology Laboratory is aimed.
Material and Methods: The species that are sent to our laboratory between the dates of 1999 and 2002 were identified by growth in bile esculin agar and 6.5% NaCl, hemolysis characteristics in sheep blood agar, catalase test, Gram stain and API 20 Strep (Bio-Merioux, France) tests. For the search of hetalactamase activity, Beta-lactamase (nitrocefin) Identification Sticks (Oxoid) were used. The antibiotic sensitivities of the enterococcus species isolated from wound and urine specimens were found by disc diffusion method to vancomycin, teicoplanin, penicilin, am- picillin, ciprofloxacin, erythromycin,‘ tetracycline, nitrofurantoin according to antibiotic groups recommended by NCCLS. High level gentamycin (120 pg) disc was used to show high level aminoglycoside resistance.
Results: 28 of 88 enterococcus species (32%) were isolated from wounds and abscesses, 60 (68%) from urine specimens. It is found that 54 (61%) of them were Efaecalis, 27 (30%) E.faecium, four (4.5%) E.avium, two (2.2%) E.durans and one (1.1%) E.raffinosum. Resistance ratio to antibiotics were 56% to penicillin, 52% to ampicillin, 68% to ciprofloxacin, 61% to erythromycin, 54% to tetracycline and 77% to nitrofurantoin. High level genta- micin resistance was found in 26 of88 (29%) enterococcus species. There weren‘t any resistant species against vancomycin or teicoplanin and no beta-lactamase enzyme in enterococci isolated in our study.
Conclusion: Identification and antibiotic sensitivity tests must be searched because resistance pattern change according to species in treatment regimens in enterococci infections.

Objective: To present the result of the urgent surgical treatment of spontaneous cerebellar hematoma.
Study Design: The data of 27 patients with spontaneous cerebellar hematoma were analyzed retrospectively, between January 1995 and October 2003. The patients were grouped according to computed tomography appereances and Glasgow> coma scale score. All cases were operated by suboccipital craniectomy. Volüme of hematomas and preoperative Glasgow coma scale scores were compared with postoperative neurologic status. Mean follow-up was 16 months (range 6 to 25 months).
Results: 17 patients (%63) were male and the remaining 10 (%27) female. The age of the cases was ranged 42-87. 7 patients who died had two or more general risk factors. Positive correlation was established between preoperative Glasgow> coma scale score and postoperative neurologic status (p=0.001). Voliime of hematoma which was more than 20 milliliter influnced the postoperative result negatively (p<0.01).
Conclusions: It was concluded that volume of hematoma and Glasgow coma scale score were the main determinant in the postoperative prognosis of these cases

Background: To present the results of the treatment of chronic subdural hematoma by burr holes and closed system drainage. Methods: The data of 138 patients with chronic subdural hematoma were analyzed between January 1994 and December 2002.
Results: 103 patients (74,6 %) were male and the remaining 35 (25,4 %) female. The average age was 58,6 years (range; 22 to 76). Burr - holes and closed - system drainage were performed in all patients. 99 of all patients (%72) had history of head trauma. According to computed tomography appearances, lesions in 122 patients (%88.4) were located at the one side, in 16 patients (% 11.6) both sides. Hematomas located in the frontoparietal subdural space in % 71 of all cases. According to Markwalder Grading system, negative correlation was established between degree of grade and prognosis. Complication’s rate was % 2.9 in our series. There were recurrens in 6 of 138 patients (4,34 %). Permenant morbidity and mortality were not seen.
Conclusions: This surgical technique is easily applicaple, cost effective, has fewer complications and preferred method of treatment in cases of chronic subdural hematoma.

Objective: Our aim is to determine the effectiveness of combined low dose BCG and interferon-alfa 2b (IFN-alfa 2b) in patients, in whom BCG previously failed, and also the importance of tumor p53 expression and serum p53 antibodies on follow-up.

Materials and Methods: Between September 1999 and November 2003, 10 patients ages between 51-74 years (median 63) who previously failed intravesical BCG treatment are included in this study. These patients were undertaken to transurethral tumor resection and they were given 27 mg’s of Connaught BCG (1/3 dose) and 50 million units of IFN-2b once a week for 6 weeks. Serum anti-p53 abs were detected by enzyme linked immunosorbent assay (ELISA). During subsequent evaluation, each specimen in its entirety was examined with accepted positive cut-off criteria of 20% nuclear stainig. Median follow-up was 41 (32-50 months) months.

Results: 7 of 10 patients (70%) had no tumor recurrence and 3 had recurrence during follow-up. Patients with recurrences in cystoscopic controls were treated with transuretral resection (TUR-BT) and no additional intracavitary chemotherapy given these patients. No stage and grade progression was observed. This combination therapy is tolerated well by all patients and no side effects were observed. Three patients (30%) had positive tissue p53 and one of these patients (10%) had positive serum anti-p53 antibody. Both tumor p53 protein and serum anti-p53 protein were positive in one of the patients with recurrence.

Conclusions: The results of combined intravesical BCG and IFN-alfa 2b immunotherapy for superficial bladder cancer, in whom BCG previously failed, were encouraging. Tumor p53 and serum anti p-53 antibody positivity were not seen as a indicator of progression in these limited number of patient with long term follow-up.

Between February 2000 and November 2003 we treated 22 stomach and 10 pancreas cancer patients with definitive, adjuvant or palliative radiation and concurrent chemotherapy in the Department of Radiotherapy, Akdeniz University. Median age of the gastric cancer patients was 53 (27-69); 15 were men and 7 were women. Median age of the patients with pancreas cancer was 60 (48-78); 6 were men and 4 were women. The gastric and pancreas cancer patients received external beam radiation with linear accelerator to a median total dose of4729 (4140-5400) cGy and 4896 (4140-5400) cGy, respectively. The gastric and pancreas cancer patients received 5FU+leucovarin and 5FU, respectively. Median follow- up of the gastric cancer patients was 20,6 months (5-46). Of the 22 patients with gastric cancer, fourteen patients (64%) died due to local-regional recurrence + metastasis, 4 patients (18%) were alive with local-regional recurrence, and the other 4 (18%) were alive free of disease. Median follow-up of the patients with pancreas cancer was 14,1 months (6-22). Of the 10 patients with pancreas cancer, 8 (80%) died due to local-regional recurrence, and 2 (20%) died due to local- regional recurrence + metastasis. A multidisciplinary treatment approach for pancreas and stomach cancer, where modern radiotherapy techniques are used to minimize normal tissue complications was established in our institute, and the preliminary results were presented in this study.

Objectives: To identify the diagnostic effectiveness of ultrasonographic morphologic scoring (UMS), serum CA125 level, color Doppler sonography (CDS) and peritoneal cytology for malign-benign differentiation of the adnexal mass.
Study design: The outcomes of UMS, CA125, CDS and peritoneal cytology of 74 patients with adnexal mass (46 premenopausal and 28 postmenopausal) administered Taksim Tra¬ining and Research Hospital, Gynecology and Obstetrics Clinic was compared with histopatologic outcomes. Diagnostic effectiveness of each method was assesed with sensitivity, specifity, negative predictive value, positive predictive value and total diagnostic value.
Results: It was found that UMS, serum CA125 level and CDS had very high sensitivity. Because of lower positive predictive values with UMS and CA125, combination of these méthodes with CDS gets higher the diagnostic effectiveness.
Conclusions: CDS alone was found enough to identify post¬menopausal adnexal malignity. Also CA125 was found very effective. UMS should combine with CA125 or CDS in this group. As a result of lower positive predictivity of CAI25, CDS should add to UMS in premenopausal group. Peritoneal cytology was not defined as an effective method in this study.

Meninjionılar gliomalardan sonra ikinci en sık görülen tümörlerdir ve tüm santral sinir sistemi tümörlerinin yaklaşık % 20’sini meydana getirirler. Mültipl meninjiomlar %5.9 ile %I0.5 arasında değişen bir insidaıısa sahiptirler. Biz olgu bildirimizde, sağ frontal meninjiom nedeniyle öpere edilmiş olan 73 yaşındaki bir kadın hastayı sunduk. Operasyondan 8 yıl sonra hastada en az 6 yeni tiimör gelişmesi, bizi daha önce öpere edilen tümörden bir subaraknoid yayılım olduğu kanısına yöneltti. Olgu sunumumuzda operasyonu takip eden yeni meninjiom gelişmesinin mekanizması, sıklığı ve ortaya çıkışını tartıştık.

Optic pathway and hypothalamic gliomas are account for 25 to 30 % of pediatric suprasellar neoplasms. The ma jority of these tumors are diagnosed in the first decade and two-thirds in the first 5 years of life. These tumors may become quite large prior to diagnosis. We have presented a huge mass involving both the left optic nerve and the suprasellar region which showed imaging characteristics of typical of these tumors on magnetic resonance. Following biopsy and partial resection of the tumor, histopathologic examination revealed optic - hypothalamic glioma as the primary diagnosis.