INTRODUCTION: To evaluate the effect of smoking on microalbuminuria levels in patients with type 2 diabetes mellitus.
METHODS: Microalbumin levels in urine of 51 smoking and 58 non smoking 108 patients with type 2 DM were compared. The patients with hypertension, hyperthyroidism, hypothyroidism, any kidney disease, congestive heart failure and habit of heavy exercise were excluded from the study. Two groups were composed. Age, gender, BMI, arterial blood pressure, cholesterol levels, diabetes, age, and the regulation of the two groups were not statistically significant difference between them.
RESULTS: Study groups were composed of smokers (group1) and non smokers (group 2). There were no statistically significant difference between groups in terms of age, gender, body mass index, starving glucose levels, HbA1c levels,total cholesterol, LDL, HDL, blood urea nitrogen and creatinine levels. The mean microalbuminuria levels were found to be higher in smokers group (41.66+-6.37 mg/gün) than non smokers group (28.71+-3.10 mg/gün). This was statistically significant (p=0.004).
DISCUSSION AND CONCLUSION: Smoking increases microalbuminuria levels in patients with type 2 diabetes mellitus independently from the other factors.

INTRODUCTION: Lip cancer is a common malignancy of the head and neck region that comprises 12% of all noncutaneous head and neck cancers. It is more curable than other head and neck cancers if it is diagnosed early and treated properly.
METHODS: Medical records of the patients, who were treated between 2004 and 2010 in Plastic and Reconstructive surgery clinic of Haydarpasa Numune Training and Research Hospital, were reviewed retrospectively concerning age, gender, location and size of lesion, cervical metastasis at presentation, histological grade, and reconstruction type.
RESULTS: The mean age was 65,4. Most common histopathological diagnosis was well differentiated (61 %) squamous cell carcinoma. Smoking history was present in 85 % of patients. Local recurrence was observed in 12 patients (23,5 %) there was no statistically significant relation between tumor size and recurrence.
DISCUSSION AND CONCLUSION: Our findings are similar to literature except the relation between tumor size and recurrence rate. Wide local excision, regular follow-up and rapid intervention to local and regional recurrences are crucial to obtain best possible result.

INTRODUCTION: The goal of this study is to evaluate the relationship between metabolic disorders and calcanel spur.
METHODS: We evaluated patients retrospectively who were diagnosed calcaneal spur desease between the years of May 2011 and November 2011 in the orthopeadics department of Private Zübeyde Haným Medical Outpatient Center. We were able to find 130 patients records (19 male, 111 female). All patients’ lateral foot x-ray views and detailed blood parameters including fasting glucose level(FGL), total cholestrol, trigliseride(TG), LDL, HDL were evaluated. We compared our study group with the control group patients (130 patients in each group).
RESULTS: Regarding the FGL and HDL there was no significant difference between the study and control group (p>0.05). Whereas; there was a significant increased total cholestrol, LDL, TG levels with the study group (p<0.05).
DISCUSSION AND CONCLUSION: We determined the aetiopatological role of high serum lipid levels in the development of calcaneal spur desease.

INTRODUCTION: The aim of this study is to evaluate the relationship between femoral anterior notching(FAN) and other risk factors of fracture.
METHODS: We evaluated patients retrospectively who were performed total knee arthroplasty between the years of 1997 and 2005 in the orthopeadics department of Eskiþehir Osmangazi University. We were able to find 66 patients records(60 female, 6 male) and evaluated risk factors such as arthroplasty due to romatoid arthritis, revision knee arthroplasty, osteoporosis, and steroid use. In order to provide significant study standardization, lateral knee x-ray views were evaluated by the same surgeon.
RESULTS: 46 patients had no risk factors. The risk factors of 20 patients were distributed as fallowed (7 patients had romatoid arthritis, 4 patients had revision knee arthroplasty, 6 patients had steroid use). There were 14 patients with FAN whereas 4 of these patients had additional risk factor. We compared the following groups each other (group without risk factor, group with risk factor, group with FAN and group with FAN and risk factor). We have found two patients with fracture which one of them related to FAN and one of the patient had risk factor, and treated with surgically and conservatively, respectively.
DISCUSSION AND CONCLUSION: There was no reported fracture in the highest risk group which included FAN and risk faktors. However; the two patients who had fracture was thought to be related to trauma. As summary; this study suggests that FAN is not only a predisposan factor for fracture but also additional risk factor could also simplify the development of femoral fracture.

INTRODUCTION: We aimed to evaluate retrospectively the patients who had been followed in our intensive care unit for 2 years in terms of types of nosocomial infection, effective pathogens, risk factors and antibiotic susceptibility of effective microorganisms.
METHODS: When 506 patients who were in intensive care of our hospital between September 2009 and January 2012 were analyzed retrospectively, 58 patients with diagnosis of nosocomial infection were evaluated. Identification of microorganisms and tests of antibiotic susceptibility were carried out in microbiology laboratory of our hospital. Effective microorganisms were identified through microbiological methods and their antibiotic susceptibilities were determined through disc diffusion method in accordance with ‘National Committee for Clinical Laboratory Standarts (NCCLS)’.
RESULTS: It was seen that 135 nosocomial infections developed in patients. While the most frequently developing infection was Ventilator Associated Pneumonia (VAP) (84), it was seen that 30 bacteremia, 14 nosocomial urinary system infections, 5 soft tissue infections and 2 nosocomial pneumonia developed. While the number of gram negative agents isolated in devoloping nosocomial infections was 105, acinetobacter spp (36;%34,3) was isolated as the most frequent agent.13 out of acinetobacters isolated in accordance with resistance pattern of microorganisms were determined as XDR and 20 of them were MDR.
DISCUSSION AND CONCLUSION: Antibiotic resistance among nosocomial infection agents is increasing in intensive care units. We have the opinion that determination of microorganism profile by following closely in intensive care units might be a guide in empiric treatment.

INTRODUCTION: Obstructive Sleep Apnea Syndrome (OSAS), is a disease that common in the community.
METHODS: Our study is a descriptive study that analyse 114 patients who applied to Erzurum Nihau Kitapçý Chest Hospital and underwent polysomnographic evaluation. Consecutive 114 patients with snoring complaint were included the study. The patients’ personal information, BMI, additional diseases, smoking history, Sleepiness Epworth Scale (ESS), AHI were recorded.
RESULTS: Our study has been conducted on 114 cases 86(75%) of which were male and 28(25%) female. The mean age was 47,6±1.8 (19-83). According to AHI, 6 of them were diagnosed with habitual snoring (AHI< 5),9 with mild obstructive sleep apnea syndrome (OSAS) (AHÝ: 5-14), 4 with moderate OSAS (AHÝ: 15-29), and 70 with severe OSAS ( AHI: ≥ 30), 12 with positional OSAS, 3 with REM dependent OSAS, 10 with REM dependent and positional OSAS together. 35 cases were (30%) smoker.
DISCUSSION AND CONCLUSION: Daytime sleepiness was seemed in 61(53%) cases, apnea in 56(49%) cases and snoring in 104(91%) cases. Three symptoms were seemed in 34 (29.8%) cases. The mean value of ESS was 14. The mean value of BMI was 33.4(21.5-58.6). 7(5%) cases had obstructive lung disease, 14(12%) cases hypertension, 7(6%) cases diabetes mellitus.

INTRODUCTION: We planned to investigate the role of PET-CT in mediastinal staging that one of the most important conditions deciding surgery. We included in the study 152 patients between August 2008 and March 2010.
METHODS: We comprared the mediastinal lymph node results of 76 potential operable patients with thorax tomography, PET-CT and mediastinoscopy.
RESULTS: We found the sensitivity of PET- CT in detecting mediastinal lamp node metastasis as 80%, the specifity as 78%, positive predictive value as 57 %, negative predictive value as 91%. For thorax tomography the values were (in order) 68%, 82%,57% and 87%. So that we found no distinct supriority of PET-CT than thorax tomography.
DISCUSSION AND CONCLUSION: We detected no distinct superiority of PET-CT than thorax tomography in mediastinal staging. We think that all patienst have to be evaluated with mediastinoscopy to consider mediastinal lymp nodes before surgery because of the false negativity and positivity of PET-CT.

INTRODUCTION: Pseudomonas aeruginosa frequently lead to infections in the hospital settings. They have high rate of morbidity and mortality since they are widely resistant to several antibiotics. Thus, it’s important that reveal the rate of antibiotic resistance and considering this rate for empiric treatment. We aimed to evaluate the antibiotic resistance of P. aeruginosa strains isolated from our hospital during last two years, and it’s changing according to the years.
METHODS: A total of 289 P. aeruginosa specimens isolated between January 2010 and December 2011 were assessed. Resistance to amikacin, ceftazidime, ciprofloxacin, colistin, cefepime, gentamycin, imipenem, levofloxacin, meropenem ve piperacillin-tazobactam were investigated. The rates of antibiotic resistance were compared according to the years. The results were evaluated with statistical analysis.
RESULTS: We found that the most susceptible antibiotics were colistin and amikacin, and the most resistant antibiotic was piperacillin-tazobactam. In addition, decreasing the resistance rate of cefepime in 2011 compared to the previous year was statistically significant (p<0.05).
DISCUSSION AND CONCLUSION: The rate of antibiotic resistance are different from one center to another. Thus, every clinic should follow its own rate of antibiotic resistance, and it should benefit from this data for empiric treatment.

Lung cancer is the leading cause of cancer mortality. Despite aggressive treatment with surgery, radiation and chemotherapy, the long-term survival for lung cancer patients remains low which underscored the need to develop new therapeutic strategies like anti-timor immunotherapy.

Choanal stenosis is a well known rate complication of nasopharyngeal carcinoma after radiotherapy. The management of velopharyngeal stenosis after radiotherapy for nasopharyngeal carcinoma is a challenging with high risk of restenosis (1). We report a case of choanal stenosis and velopharyngeal stenosis after radiotherapy for nasopharyngeal carcinoma.

Anthrax, which is the disease of herbivorous animals, is transmitted to humans by the infected animals. In Turkey, although the incidence has been decreased through the last years, it is presented in people who are dealing with animals. The most commonly seen form is cutaneous one. Periorbital presentation seen in cutaneous form is important because of complications scar and ectropion unless treated well. In this case, 8 years old female with periorbital anthracis is presented. The patient was taken to our emergency policlinic with periorbital edema, erythematous lesion in hands and fever. The lesion in hands was seen necrotizing and hyperemic. Typical presentation of lesions reminded the anthrax. No pathogen was isolated in the specimen removed from the lesion. But negative culture results do not keep away the diagnosis of the antrax. Treatment started with Procaine Penicillin 800.000 U intramuscular and Vancomycin (60 mg/kg). No complication was seen. We presented this case, because anthrax should be kept in mind in the differential diagnosis of preseptal cellulitis in endemic regions and appropriate treatment should be managed as quickly as possible.

Acute disseminated encephalomyelitis (ADEM), is an acute inflammatory demyelinated disease of the central nervous system, usually following viral infections or vaccinations. Seven years old girl was admitted to our clinic with dysfunction in talking and swallowing, and focal seizure. She had history of immunization two weeks ago. Cranial magnetic resonance imaging (MRI) revealed acute inflammatory changes but didn’t support ADEM because of focal involvement of brain white matter. However, because of persisting symptoms we repeated cranial MRI in the third day. This cranial MRI revealed multifocal lesions in the white matter. We reported this patient with ADEM after vaccination who showed atypical neuroradiologic finding in the first cranial MRI but persistence of the sypmptoms forced us to serial MRI examination so that there can be a delay in involvement of neuroradiologic findings at the previous stage of the ADEM. It’s important that consecutive neurologic evaluation is necessary if the clinical picture is suggestive for ADEM.