Objective: Facial synkinesis is one of the most complications of facial paralysis. Synkinetic movements are commonly occurs with the abnormal syncronization of the muscles that are innervated from the facial nerve. In this study, we aimed to evaluate the effect of gabapentin usage on the development of synkinesis after peripheral facial paralysis (PFP).
Material and Method: In our study, 76 patients who had acute peripheral facial paralysis between 2008-2010 in the Emergency Neurology Polyclinic and the Neurology Polyclinic of the Neurology Department of Şişli Etfal Research and Education Hospital were included. Forty-two patients were received standard corticosteroid therapy and 800 mg per day gabapentin treatment because of periauricular pain. The control group of 34 patients were received the standard corticosteroid therapy of peripheral facial paralysis. All the patients were graded with the House-Brackmann scale. The groups were followed for the development of synkinesis.
Results: Mean±SD age of the patients who were received gabapenthin treatment was 43,1±14,9 and 16 of 42 were female. Mean±SD age of the control group patients was 45,9±16,5 and 25 of 34 were female. Synkinesis was developed in 7 patients (%16,7) who were received gabapenthin treatment and 13 patients (%38,2) in the control group. The development of clinical synkinesis was statistically different between two groups (p<0,034). No significant difference was noted in the timing of synkinesis development and follow-up period between two groups (p: 0,816)(p: 0,303).
Conclusion: Synkinesis is an important complication of peripheral facial paralysis. Prevention and improvement of treatment modalities of PFP are important. This study shows that gabapentin is effective in the treatment of synkinesis. We conclude that our study will form a basis for advanced double blind randomized controlled trials.

Pediatric supracondylar femur fractures are uncommon and only few publications regarding this subject are available in the current literature. Between 1990 and 2009, 279 pediatric femur fractures were retrospectively analyzed and 16 (5.7%) supracondylar femur fractures were detected. Predisposing musculoskeletal diseases were determined in three of these 16 patients [(osteogenesis imperfecta (2), cerebral palsy (1)]. Six patients who had non-displaced fracture were performed direct casting; after 3 weeks following traction under anesthesia, four patients underwent pelvipedal cast treatment. Percutaneous crossed K-wire fixation and a long-leg cast was applied in six patients. Fusion related problem and infection were not observed in any of the patients. During the postoperative follow-up, claudication was detected in two patients. One of them with cerebral palsy had concomitant high hip dislocation on the same side. Range of motion was normal in all except two patients who had claudication. Of these, one with 30° and the other with 10° extension loss were observed.

Objective: Istanbul Okmeydanı Research and Training Hospital is one of the most common health care centers in where declaration of brain death is documented. In this paper, we would like to share our experience about brain death determination, problems, and the role of trauma in this issue.
Method: Between September 2007 and January 2012, 62 brain death and 18 multiorgan donors were detected in Okmeydanı Research and Training Hospital. All patients record were retrospectively reviewed. The patient’s age, gender, hospitalization time, the cause of death, brain death detection method and the blood groups were recorded.
Results: Totally 62 brain deaths and 18 organ donors were detected. There were 45 males and 17 womens with a mean age of 41 (range: 2-84) years old. The mean time for determination of brain death was 106,2 hours (range: 16- 600 hours). Apnea test was performed in all patients. Trauma cases were found at 36 (%58) patients and non-trauma cases were 26 (%42). Traumatic subarachnoid hemorrhage was the most frequently identified pathogenesis. Other problems were spontaneous
subarachnoid hemorrhage and intracerebral hemorrhage.
Discussion: The approach of health care personnel approach is one of the most important factors for brain death determind This is the responsibility of the health care team. In particular, brain death should be kept in in patients with head injury. The medical team should act in professional way and give attention to increase the number of organ donations.

Objective: Intoxications occurs generally accidentally, due to suicide attempts or related to drug abuse. We aimed to analyze intoxicated patients admitted to our intensive care unit (ICU) during three years period.
Materials and methods: Between 2007 and 2009, 66 ICU patients treated due to intoxication were retrospectively analyzed considering demographic variables, active ingredient associated with intoxication, hospital stay and ventilation time.
Results: There were 43 women and 23 men. The mean age of cases was 24,92±10,26 years and 11 of them were ≤14 years old. The mean hospitalization time of cases was 2,48±0,76 days. The mechanical ventilation was applied to 8 of cases with a mean mechanical ventilation time of 2,28±1,58 days. One of the cases died on the 3rd day of hospitalization and other 65 cases were uneventfully discharged. Hemodiafiltration was applied in two cases intoxicated due of whom one was intoxicated by fungi and the other was intoxicated with methyl alcohol. Intoxication cases were 15% all subjects treated in ICU during three years period. In 45% of patients, an antidepressant medication was found to be associated with suicide attempts and amitriptyline (63%) was the most commonly used.
Conclusion: Good prognosis and the low mortality rate were supposed to be related to young age and healthy condition of the patients in addition to low dosage of the medicine-below the toxic level- being conscious and adequate respiratory functions at fist admission. We concluded that both marketing control necessity of control over, sales of amitriptyline, which is presently available without prescription and in the major intoxication group, is as important as treatment on time.

Objective: To compare abilities of urology residents with attending surgeons in performing percutaneous nephrolithotomy (PCNL) in a clinic where PCNL procedures are performed.
Material and Methods: A total of 533 PCNL procedures between November 2004 and January 2012 were divided into two groups: Group 1 (n=431): PCNL procedures performed by experienced urologists and group-2 (n=102): PCNL procedures performed by urology residents under supervision of experienced specialists. Patient’s age, gender, body mass index, fluoroscopy and operation times, stone burden, rate of blood transfusion, number of access, hospital stay, stone free-status and major
complication rates were statistically compared between these two groups. Data were provided as mean +/- SD. Chi-square, student-t and Mann-Whitney U tests were used for statistical analyze and a p-value of ≤0.05 was considered statistically significant.
Results: When compared two groups, there were no significant difference with regards to demographic variables, stone burden, rate of blood transfusion and major complication rates (p>0,05). However, mean hospital stay and stone free rates in group-2 were better than group-1 (p<0,05). Also, mean fluoroscopy and operation time in group-2 were significantly shorter than in group-1.
Conclusions: These data demonstrated that the ability of urology residents for performing PCNL operation was found to be sufficient in a clinic where PCNL procedures are routinely performed.

Background: Recently, total thyroidectomy (TT) has been performed and suggested in benign thyroid disease. But it was reported that the complications of total thyroidectomy was more than bilateral subtotal thyroidectomy (BST) this is still a topic of debate. Purpose of the present study is comparison of complications of BST and TT operations in treatment of benign thyroid disease.
Materials and Methods: Early and late complications of TT and BST operations were retrospectively evaluated, which were performed in General Surgery Clinic of Konya Training and Research Hospital inbetween 2004-2008.
Results: The study involved 96 patients in BST group and 110 patients in TT group. Follow-up period was 69.4±8.3 months in BST group, 52.7±5.3 months in TT group. Transient hypocalcemia were detected in 10 patients (9.1%) in BST group and 7 patients (7.3%) in TT group. Transient recurrent laryngeal nerve paralysis developed in 12 patients (7.2%); 5 patients (5.2%) in BST group and 7 patients (6.4%) in TT group. Hematoma in 4 patients (4.2%), seroma in 3 patients (3.1%), flap edema in 5 patients (5.2%) occured in BST group. In TT group, there had been; hematoma in 1 patients (1.0%), seroma in 5 patients (4.5%), flap edema in 4 patients (4.5%).
Permanent hypocalcemia occured in 2 patients (2.1%) in BST group and 3 patients (2.7%) in TT group. Permanent recurrent laryngeal nerve paralysis developed in 1 patient (1.0%) in BST group and 2 patients (1.5%) in TT group. There was no statistically significant difference inbetween the groups about complications and demographic characteristics. Recurrence was seen in 6 patients (6.3%) in BST group.
Discussion and Conclusion: TT not increase early and late complications in bengn thyroid diease requiring sugery. BSThas arisk of recurrenceaftersurgeryand thereforemust be carried outagain. Complications in secondary thyroidectomy in patients with prior thyroid surgery are very high.Therefore, if surgery is necessary in benign thyroid diseases should be TT.

Objective: Hip is a relatively rigid and deep located joint. The role of arthroscopy in diagnosis and treatment of hip and surrounding tissue pathologies has been evaluated along with our clinical experience.
Material and Method: Fifteen hip arthroscopy cases who had admitted to our clinic with antalgic limp and groin pain between 2011 and 2012 were evaluated. Mean age was 35.8 (17-58) years. Three of the patients were female and 12 were male. Preoperative and postoperative Harris hip scores were recorded.
Results: Mean preoperative Harris Hip Score of the cases was 62.7 (54-86) and mean postoperative Harris Hip score was 92.5 (82-100). In three patients CAM type femoro-acetabular impingement was diagnosed and excessive portion of the femoral neck was shaved. In five patients, labral tears were detected. Two were repaired and three were debrided. One patient was diagnosed with osteochondral lesion and treated with reverse mosaicoplasty. Localised avascular necrosis of the femoral head was diagnosed in one patient and anterior mini-open mosaicoplasty was performed. Loose bodies were excised in two patients and intraarticular bullet was extracted in one patient. In two patients, no intraarticular pathology was detected.
Conclusion: When performed by experienced surgeons, hip arthroscopy is a minimal invasive diagnostic and treatment method which has successful results in intraarticular and periarticular hip disorders. Despite the high success rate, neurologic compromise must be avoided by paying meticulous attention in portal selection and by keeping the traction time as short as possible.

Objective: To analyze the results of arthroscopic Bankart repair for recurrent anterior shoulder dislocations.
Material and Method: 16 patients who were performed arthroscopic Bankart repair due to recurrent anterior shoulder dislocation were included in the study. There were four females and 12 males. X ray and Magnetic resonans imaging was admitted for all patients. Results were evaluated according to Rowe and Constant scores.
Results: The mean number of dislocations was 10.2, mean Rowe score was 90.6 and mean Constant score was 94.3. Concomitant superior labral anterior and posterior repair was performed for two patients. Three patients had Hill Sachs defects and three patients had defects on the glenoid rim. One patient was detected with traumatic redislocation 15 months after the operation and was reoperated. One patient was reoperated because of intraarticular penetration of the anchor. Mean follow up time
was 32.6 months.
Conclusion: Arthroscopic bancart repair has good clinical outcome. Increased number of preoperative dislocations may increase the frequency of redo surgery; this should be kept in mind for these patients.

Cytogenetic studies have revealed more number of females in spontaneous abortion. Family history, analysis of pedigree, and karyotypes of the parents are the basic factors at estimating the risks. In this study, the clinical feature of the rob(14;21)(q10;q10) with mother is presented based on the literature. Family members were sent to laboratory of medical genetics because of habitual abortus. Conventional cytogenetic techniques were performed for these patients. The karyotype of the mother was found as 45,XX, rob(14;21)(q10q10). The karyotypes of the father was normal (46,XY).

In this report, a 28-year-old patient who had idiopathic intracranial hypertension with rapidly progressive visual loss was reported. Etiological factors were polycystic ovarian disease, short-term oral contraceptive use and iron deficiency. She was administrated oral acetozolamid and metilprednizolon IV 1g/day. In addition to drug therapy, the patient underwent repeat lumbar punctures and lumboperitoneal shunt. In idiopathic intracranial hypertension, it is very rare but loss of vision may rapidly develop. In this case, high-dose intravenous corticosteroid therapy might be a god option in terms of save time to improve vision.