Objective: In our study we aimed to compare the residual curarization after extubation with clinical observation using either rocuronium or atracurium which were antagonized with neostigmine.
Methods: Sixty patients in ASA I-II physical status undergoing abdominal hysterectomy operation were randomly assigned to two groups as: planned to apply rocuronium 0.6 mg.kg-1 to extubate with clinical observation (Group R); atracurium 0.5 mg.kg-1 to extubate with clinical observation (Group A). At the end of the operation all patients were antagonized with neostigmine. TOF values at extubation and at 1., 3., 5., 10. minutes after extubation, operation and anaesthesia times, total fentanyl, neuromuscular blocker agent and neostigmine doses were recorded.
Results: Demographic characteristics of the patients, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker, neostigmine doses were similar in four groups. TOF ratio was <0.7 in all patients extubated according clinical observation at the extubation. TOF values were significantly lower in Group RK compared to Group RT at all intervals, in Group AK compared to Group AT at extubation, 1. and 3. minutes (p<0.05). Although TOF ratio was significantly lower in Group RK compared to Group AK at extubation (p<0.05), there were no significant differences at the other intervals. When all patients were considered, time to have TOF ratio ≥0.7 and ≥0.9 were 5.min and 10.min respectively in patients extubated according to clinical observation and time to have TOF ratio ≥0.9 was 5.min in patients extubated with using TOF monitorization (p<0.05)
Conclusion: In our study we concluded TOF monitorization is a useful method in determination and prevention of residual curarrization and the incidence of residual block was found similar after administration of either rocuronium or atracurium after reversal with neostigmine.

Objective: Multinodular goiter (MNG) is the most frequent indication for thyroid surgery in our country which is endemic for goiter. In this study we aimed to examine the cases that were operated for MNG, and diagnosed as “incidental papillary microcarcinoma” with the pathological examination.
Methods: A total of 362 patients that were operated for benign MNG between June 2006 and January 2010 were evaluated retrospectively. The patients with unilateral nodules were excluded from the study. The cases that were known to have tumor preoperatively, that were asked for frozen examination pathologically after fine needle aspiration biopsy (FNAB), > 1cm of tumor diameter postoperatively, and papillary microcarcinomas that accompany to tumors that are > 1cm were also excluded from the study. The demographic characteristics,
histopathologic results, and postoperative treatments of the patients with papillary microcarcinoma pathological diagnose were evaluated.
Results: A total of 347 patients were treated with total thyroidectomy, and 15 patients were operated with near-total thyroidectomy. At the histopathological examination, 14 (4%) patients were diagnosed with papillary microcarcinoma. All of 14 patients were women. The mean age was 58,07 (36-73). The mean tumor diameter was 3,7 (1-8) mm. Only one case had capsule invasion and, at the same case, multicentricity was detected. The other cases had no additional surgical treatment becasue they had total thyroidectomy. All cases had supression treatment; only one case had capsule invasion and was multifocal, therefore this case was treated with radioisotope treatment.
Conclusion: Although the papillary microcarcinoma had a fairly good clinical course, it may cause distant metastases rarely. We think that the total thyroidectomy is the appropriate treatment of choice in MNG prediagnosed patients to prevent to skip papillary microcarcinoma and a second surgery.

Aim: The aim of this study was to examine the frequency of shortness, overweight and obesity among primary school students in three different regions of Turkey during the course of a program of medical screening in town and village schools located in the provinces of Istanbul, Iðdýr and Muðla.
Material and Method: A total of 1,134 students were studied. These subjects were students of a village primary school in the district of Þile-Istanbul, 6 village schools in the district of Karakoyunlu-Iðdýr and another primary school in the district of Göcek-Muðla; they were reviewed in terms of short stature, overweight, and obesity.
Results: It was seen in the study that a total of 116 (10.2%) of the children reviewed were below the third percentile in terms of height relative to age. In all of the regions analyzed, 123 children (10.8%) were found to be overweight, 60 (5.3%) were obese. The frequency of overweight by regions was 16.1% in Þile-Istanbul, 3.7% in Karakoyunlu-Iðdýr and 17.5% in Göcek-Muðla. Frequencies of obesity in the respective regions were 5.4%, 0.9%, and 10.1%.
Conclusion: The frequency of shortness and obesity was found to differ in three different regions of Turkey. In assessing the frequency of short stature and obesity in Turkey, we believe it will be useful to review similarities and differences in socio-economic data separately for the various regions of the country.

Objective: Mandibular fractures which are the second most common facial injuries after nasal fractures in maxillofacial traumas not only effect mastication and speech functions but also important for the lower 1/3 facial aesthetic appearance. The aim of our study is evaluation of patients about demographic properties, diagnosis and treatment modalities.
Method: A retrospective study on mandibular fractures was carried out in Þiþli Etfal Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery between January 2002 and May 2008 regarding their age, sex, etiology, fracture types, treatment modalities and treatment outcomes.
Results: Female-male ratio was 1/2.8 and average age was 27.6. In the 65% of patients etiology of injury was traffic accidents and 27% of patients have isolated symphisis fracture. 80% of patients treated with open reduction and miniplate fixation and remaining 20% of patients that have condyle, subcondyle, alveolar and nondisplaced symphisis fractures were treated with closed reduction and intermaxillary fixation procedure. The complication rate of patients that were treated with closed reduction was 18% and patients that were treated with open reduction was 8,8%. The most common complications were malocclusion, plate infection and nonunion.
Conclusion: The success of treatment in mandible fractures depends on the detailed evaluation of the patients and rapid and accurate therapy. Open reduction and fixation will cause less complication rates with experienced surgeons.

Anaphylaxis is a rare cause of prematurity at during pregnancy period. It can have serious effects for both mother and fetus. Anaphylaxis is a rare but potentially life-threatening event for mother and baby in during pregnancy. Anaphylaxis can be prevented maternal and fetal mortality and morbidity by cesarean section application and appropriate resuscitation by epinephrine. Anaphylaxis is a good choice vasopressor agents,
although it can pose a risk in pregnancy for placental-fetal circulation in non-pregnant person. 28 year old mother was hospitalized with the diagnosis of anaphylactic reaction and fetal disstress. Emergency treatment with epinephrine and steroids to the mother, cesarean delivery was in the 33 weeks of gestation for fetal disstress. Mother’s induce anaphylactic reactions caused by the birth was not found. In patients with idiopathic anaphylaxis during pregnancy, delivery time, delivery method continues to be controversial today, but in cases can affect the newborn and maternal survival positive of rapid and effective management practices.

Distal renal tubular acidosis (dRTA) is a genetic disease characterized by metabolic acidosis, alkaline urine, hypokalemia or hyperkalemia, and hypercalciuria. Clinically develpomental delay signs are polyuria, dehydration, vomiting, and psychomotor retardation with hypotonia may be seen. Nephrocalcinosis and urolithiasis are among the complications of hypercalciuria which may lead to renal failure.. A three days old newborn was admitted with complaints of fever and fatigue. The blood gas analysis revealed: pH: 6.89, PCO2: 32.8, PO2: 40.7, HCO3: 6.2, BD: - 2.26. Anion gap was normal. Urine pH was 7. In urinary ultrasonography, grade 2-3 nephrocalsinosis was observed. Right sided hearing loss was found in BAER test. By this way, the early diagnosis and treatment of RTA cases may be possible.When metabolic acidosis is encountered in a neonate during the first days of life after birth, serum electrolyte values,anion gap and urine pH should be determineted.

Intramuscular hemangioma is an uncommon benign lesion and contributes % 0.8 of all hemangiomas. Diagnosis can only be done with histopathological evaluation in this type of tumor which presents clinically with pain, swelling and restriction of movements depending on its anatomical localization. 13 year old boy was admitted to the hospital with a history of pain, swelling in his right calf, presenting for the last five years. His major complaint was clinically increasing unilateral toe-walking. After having done the radiological evaluation, the diagnosis of intramuscular hemangioma was verified with tru-cut biopsy. This benign tumor caused contracture of the gastrocnemius muscle and lead to unilateral secondary equinism deformity of the foot. Tumor was excised by radical surgery. The gastrocnemius muscle was lengthened by the Vulpius procedure. No local recurrence was observed in the three year follow up. The patient had a normal gait pattern in his last follow up physical examination. We wanted to share our experience with this unique tumor presenting with unique symptoms.