Laparoscopic cholecystectomy is gold standart technique for treatment of cholelithiasis. In last years the procedure has performed with single incision. In 2009 December, single incision (single port) laparoscopic cholecystectomy was performed in two cases. Elastic port was entered just through the umbilicus. Roticulating devices were entered through the elastic port. Gallbladder fundus was fixed to the posterior ot the abdominal wall and laparoscopic cholecystectomy was achieved. This technique was determined as a safe, efficient and less painful operation. However it has been required to proved with randomized studies.

Purpose: In our study, we aimed to investigate the effects of mean platelet volume on graft patency in patients with coronary artery bypass surgery.
Material and Methods: We investigated the registeries of 323 patients with coronary artery bypass surgery who were hospitalizated for coronary angiography between January 2004 and May 2009. Participants were divided into 2 groups. Patent-Graft Group was consisted of 199 patients (151 male, 48 female), and Occluded-Graft Group consisted of 124 patients (104 male, 20 female). In the occluded-graft group, at least one graft occlusion was detected. We investigated the relationship between the effects of the mean platelet volume, age, sex, smoking, diabetes mellitus, obesity, hypertension, hyperlipidemia, medicine usage, blood chemistery and the time after bypass surgery on the graft patency.
Results: Between two groups, no significant difference was noted for age (p=0,091), sex (p=0,087), hypertension (p=0,180), diabetes mellitus (p=0,204), hyperlipidemia (p=0,644) and smoking (p=0,856) But for obesity there was a significant istatistical difference on behalf of the first group (p=0,035). Time after bypass surgery was 8,75 ± 4,35 and 10,56 ± 6,02 years for the first and the second groups, respectively (p=0,006).Mean platelet volume was significantly higher in the graft occluded group (10.5 ± 5.6 fl and 8.8 ± 1.4 fl, p<0,001). Nitrate
usage was higher in the first group (p=0,01) and warfarin usage was higher in the second group (p=0,040)
Conclusion: In this study, we have shown that mean platelet volume was significantly higher in occluded-graft group than the patent-graft group. This finding shows us that patients with occluded grafts may need more aggressive anti-platelet therapy.

Mesenchymal tumors of the breast, including benign and malignant lesions are rare. The presenting feature is often a palpable solid mass, however they may be diagnosed incidentally by radiological methods. Mesenchymal tumors of the breast diagnosed in our clinic have been evaluated in this study.
Material and Methods: Mesenchymal tumors localized in the breast, diagnosed between the years 1991-2009 are included in this study. Clinical findings, pathology reports and slides of the cases are evaluated retrospectively.
Results: A total of 23 patients (20 female, 3 male) were included in the study. According to their sites of involvement, 12 lesions were in the left and ten were in the right breast. The location of one of the cases is unknown. Histopathological diagnosis of the lesions were as 12 cases of lipoma, 2 cases of hemangioma, 2 cases of myofibroblastoma and one case of hemangiopericytoma, angioleiomyoma, chondrosarcoma, fibromatosis, angiosarcoma, metastatic rhabdomyosarcoma and liposarcoma each. Two of the male cases were lipoma and one case was myofibroblastoma. 19 cases (85%) were benign and 4 cases (15%) were malignant.
Conclusion: Although very rare, mesenchymal tumors can be encountered in the breast. Benign lesions are diagnosed more often, however malignant and metastatic mesenchymal tumors may also arise. Possibility of a mesenchymal tumor should be taken into consideration. especially when evaluating small biopsy specimens and immunohistochemical methods should be applied whenever necessary.

Objective: Differential diagnosis of melanocytic skin lesions and early detection of malignant changes in nevi are important in determining the treatment modality. Dermoscopy is an useful technique in both establishing early changes. of malignant and in distinguishing melanocytic pigmented skin lesions from non-melanocytic pigmented skin lesions Therefore, two benefits of this method are early diagnosis in malignant nevi and to eliminate needless surgical interventions in the follow up of common nevi. Our objective was to evaluate the data of the patients who had admitted our dermoscopy outpatient clinic for nine years and to document the results.regarding sociodemoghrafic, clinical and histopathological characteristics.
Method: Sociodemographic features of a total 810 dermoscopy outpatients and the dermoscopic results of 1967 lesions were recorded in digitalized media. Lesions were categorized in three groups (melanoma, nevus and non-melanocytic lesions) according to diagnosis and in five groups (head-neck, trunk, upper-lower extremities and nail) according to localization. Dermoscopic diagnosis and histopathologic results were evaluated.
Results: Total 810 patients, 531 women (age range 1-85 and mean age 41.7), 279 men (age range 1-93 and mean age 43.3) and dermoscopic diagnosis of 1967 lesions were evaluated. Trunk was the most common site of localization (881 patients, 44.8%). The most common dermoscopic diagnoses were dermal nevus (503 patients, %25.5), congenital melanocytic nevus (268 patients %13.6) and junctional nevus (263 patients %13.3). Histopathological results of 55 patients’ excision materials were reached. The dermoscopic diagnoses of 33 (%60) lesions out of a total 55 lesions were concordant with their histopathologic diagnoses
Conclusion: Digital dermoscopy offers advantages as a reliable and acceptable method for daily routine in the diagnosis and therapy of melanocytic and non-melanocytic lesions in the existence of educated staff and adequate technical equipment.

Physiological intracranial calcifications without a relationship with a particular disease or pathology and accepted as normal, are seen most common in pineal gland, choroid plexus, habenular commissure basal ganglia, dura and arachnoid. Computed tomography (CT) is the most sensitive radiological method in detection of intracranial calcifications. In our study 401 unenhanced cranial CT that obtained between April 2009 and August 2009, are evaluated as retrospectively for physiological intracranial calcification fields. Of the 401 cases, 69,3% had choroid plexus calcification, 66,1% had pineal gland calcification, 35,2% had habenular commissure calcification, 25,2 % had other (basal ganglia, dura and arachnoid) calcifications. Of the cases 51,9% had pineal gland and choroid plexus, 28,7% had pineal gland and habenular commissure, 28,4% had choroid plexus and habenular commissure calcilfication co-existence. Significant increase in the prevalence of the pineal gland, choroid plexus and habenular commissure calcifications was found with increased age (p<0.001). Also co-existence of pineal gland and choroid plexus, pineal gland and habenular commissure, choroid plexus and habenular commissure was significant (p<0.001).

Objective: Paragangliomas are intense vascular tumors originated from neural crest and they involve the vascular wall or spesific nerves in the head and neck region. In this study, we aim to present the experiences of the cases in which the preoperative embolisation and the surgical approach is combined for the paraganliom treatment.
Materials and methods: PVA (polivynil alcohol) particle embolisation directed to the hypervascular mass and preoperative angiography were performed in totally 12 paraganglioma cases (8 male, 4 female) referred to our clinic in 2006-2009. Bilateral carotis angiography, embolisation of tumor nidus in several degrees and then cerebral angiography (to show that Willis poligon is patent) were performed in all cases. The surgical resection was performed within 48 hours after embolisation.
Results: Carotid body paraganglioma was the most common tumor among all cases (84.6%). Glomus timpanicum was observed in one case (%8,3), and glomus jugulare was observed in other case (%8,3) Multicentrity was observed in only one case (8.3%) and the bilateral carotid body tumor was followed. There was a familial relationship in two cases (father and son). No complication was observed during and after
embolisation and angiography in the cases subjected to endovascular process. The cranial nerve injury after surgical resection was developed in two cases. Cerebellar hemorrhage was observed in one case at the post-op CT assessment of the mass that involve posterior fossa.
Conclusion: The combination of the preoperative embolisation and the surgical approach is a safe, effective and acceptable treatment approach for the paragangliomas. The surgical resection combined with endovascular treatment is important to obtain complete tumor resection and decrease morbidity.

Anophtalmia /microphthalmia is a major but a very rare congenital anomaly of the eye. The frequency is not known exactly but has been reported to be 1-3/10000. In the etiology, chromosomal anomalies, congenital infections and teratogens have been blamed. Here in this case report, we describe a female infant delivered by cesarean section with the 40th week of gestation, born with a birth weight of 3200 gr. Parental consanguinity was not found. During pregnancy, she was not on regular, routine visits and did not have the history of any drug and/or teratogen use. Physical examination revealed multiple congenital anomalies, including microphtalmia of the right eye, anophtalmia of the left eye, hypertelorism, micrognathia and low-set ears. A 2/6 systolic mesocardiac murmur was found. Severe, general hypotonia with decreased tendon reflexes were also detected. Other systems were found to be normal. Right ocular hypoplasia and absence of left bulbus oculi were detected in cranial tomography. Echocardiographic examination showed patent ductus arteriosus of 2.5 mm. Postnatally on the 32nd day, she died because of heart failure and sepsis. We concluded that, any patient with anophtalmia needs to be investigated systematically for other associated anomalies and followed up closely for possible complications with a multidisciplinary approach and genetic counseling should be advised for the future pregnancies.

The intrauterine device (IUD) is a safe and effective method for contraception. Complications and side effects can be encountered as a result of widespread use of IUDs. We aimed to present the case which has localized IUD in to the bladder.

An 60 years-old female patient suffered from knotting of a Seldinger wire during femoral artery puncture. We try to remove guide wire by arterial dilator under floroscopic guidance, but it did not work. In this case, guide wire was removed surgically. Although femoral artery catheterization with the Seldinger technique is a commonly performed procedure, it may result in numerous complications, including kinking and rarely complete knotting of the guidewire. We discuss the steps to approach these kind of procedural complications.

Calcium channel blockers are commonly used in the treatment of hypertension, angina pectoris, coronary arter spasm and supraventriculer arrhythmia. Because of sustained retain and long half life, the toxication which is due to high dose usage is more fatal than other cardiovascular druge. ‹n this study, it is aimed to check out the clinical signs, symptoms and their solutions which can be encountered in toxication of diltiazem which is one of the calcium channel blockers.