GÝRÝÞ ve AMAÇ: Ýnvolüsyonel entropiumun cerrahi yolla tamirinde lateral tarsal þerit tekniði ve/veya döndürücü sütürlerin kullanýlmasýnýn iþlem baþarýsýzlýðý ve komplikasyon oranlarýný saptamaktýr.
YÖNTEM ve GEREÇLER: Kasým 2010 ve Mart 2012 dönemleri arasýnda iki merkezde alt kapak entropionu tanýsý ile cerrahi tedavi uygulanan 20 hastanýn (65-75 yaþlar arasý, ortalama 70.85) 27 göz kapaðýna ait kayýtlarý geriye dönük olarak taranmýþtýr. Operasyon sonrasý hastalar 4-18 ay takip edilmiþlerdir. Baþarýsýzlýk ameliyattan sonra entropionun tekrarlamasý olarak deðerlendirilirken komplikasyonlar ise yetersiz düzelme, sütür açýlmasý, skleral açýklýk, subkonjonktival hemoraji ve/veya ektropium geliþmesi olarak deðerlendirilmiþtir.
BULGULAR: Hastalar uygulanan cerrahi tekniðe göre 3 gruba ayrýldý: Grup 1 sadece lateral tarsal þerit tekniði uygulanan (n=11 hastada 11 göz kapaðý), Grup 2 sadece döndürücü sütür uygulanan (n=3 hastanýn 6 göz kapaðý) ve Grup 3 ise hem lateral tarsal þerit hem de döndürücü sütür uygulanan (n=6 hastanýn 10 göz kapaðý) hastalar yer aldý. Baþarýsýzlýk oranlarý sýrasý ile Grup 1’de 0/11 göz kapaðý; Grup 2’de 2/6 göz kapaðý (ayný hastada) ve Grup 3’de 0/ 10 göz kapaðý olarak saptanmýþtýr. Komplikasyonlar ise þöyledir: Grup 1, 2 ve 3 için sýrasý ile yetersiz düzeltme (1/11, 0/6 ve 0/10), sütür açýlmasý ve fistül oluþumu (1/11, 0/6 ve 0/10), subkonjonktival hemoraji (0/11, 2/6 (ayný hastada) ve 0/10) olay/göz kapaðý olarak kaydedilirken skleral açýklýk ve ektropion geliþmesi hiçbir grupta saptanmadý.
TARTIÞMA ve SONUÇ: Ünvolüsyonel entropion tamirinde lateral tarsal þerit tekniði ve döndürücü sütürün birlikte uygulanmasýnýn her iki tekniðin tek baþýna kullanýldýðý duruma göre iþlem baþarýsýný artýrdýðý gibi postoperatif dönemde komplikasyon geliþme sýklýðýný da azaltabileceði gösterilmiþtir.

INTRODUCTION: To evaluate the success and complication rate of lateral tarsal strip procedure and /or everting sutures in the treatment of involutional entropion.
METHODS: Medical records of 27 eyelids of 20 patients (65-75 years, mean 70.85 years) who underwent surgical repair of involutional lower eyelid entropion between November 2010- March 2012 from two different hospital were retrospectively reviewed in the study. The patients were followed up 4 -18 months after the procedures. Faliure is defined as recurrence of the involutional entropion. Complications are incomplete recovery, suture failure, scleral exposure, subconjunctival hemorrhage and/or ectropion development.
RESULTS: Patients were divided into three groups based on surgical procedures performed: Group 1 who underwent lateral tarsal strip (n=11, 11 eyelids); Group 2 who underwent everting sutures (n=3, 6 eyelids); and Group 3 who underwent combination of lateral tarsal strip and everting sutures (n=6, 10 eyelids). Failure rate was 0/15; 2/6 (same patient) and 0/ 10 events per eyelid for Grup 1, 2 and 3 respectively. Complication rates of the groups were as following: in group 1 incomplete repair (1/11, 0/6 ve 0/10); suture failure and fistule formation (1/11, 0/6 and 0/10) subkonjunctival hemorage (0/11, 2/6 (same patient) ve 0/10) events per eyelid for Grup 1, 2 and 3 respectively. No scleral exposure and ectropion development was defined.
DISCUSSION AND CONCLUSION: The combination of lateral tarsal strip prosedure and everting sutures not only could increase the success rate but also reduce the rate of complications in the repair of involutional entropion with respect to either of these procedures performed alone.

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GÝRÝÞ ve AMAÇ: Çalýþanlarýn kurumda baþarýlý, mutlu ve üretken olabilmesinin önemli etkenlerinin baþýnda, kuruma baðlýlýðý ve iþinden duyduðu tatmin yer alýr.
YÖNTEM ve GEREÇLER: Bu araþtýrma; hastane çalýþanlarýnýn kurumsal baðlýlýðý ile iþ tatmini düzeylerini, bunlar arasýndaki iliþkiyi, sosyodemografik özelliklerin kurumsal baðlýlýk ve iþ tatmini üzerine etkilerini belirlemek amacýyla yapýlmýþtýr. Araþtýrma Ýstanbul’da Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesinde 2010 yýlýnda yapýlmýþ olup, tanýmlayýcý ve çýkarýmsal niteliktedir.
BULGULAR: Veriler yüzyüze anket yöntemi ile toplanmýþ ve ankette beþli Likert ölçeði kullanýlmýþtýr. Tesadüfi örnekleme yöntemiyle, 1350 çalýþandan oluþan araþtýrma evreninden 460 çalýþan örneklem olarak seçilmiþ ve eksiksiz yanýtlanan 451 anket deðerlendirmeye alýnýmýþtýr. Verilerin analizinde SPSS for Windows 15.0 paket programý kapsamýnda baðýmsýz örneklerde T testi, tek yönlü varyans analizi uygulanmýþ, farklýlýklarýn tespitinde Tukey ve Scheffe yararlanýlmýþtýr. Deðiþkenler arasýndaki iliþki korelasyon analizi ile test edilmiþtir. Çalýþanlarýn kurumsal baðlýlýklarý ile iþ tatminleri incelendiðinde; ortalama olarak duygusal baðlýlýðý 2.96, devamlýlýk baðlýlýðý 2.91, normatif baðlýlýðý 3.2, genel kurumsal baðlýlýðý 3.05 ve içsel iþ tatmini 3.24, dýþsal iþ tatmini 2.70, genel iþ tatmini 3.03 bulunmuþtur.
TARTIÞMA ve SONUÇ: Hastane çalýþanlarýnýn kurumsal baðlýlýklarý ile iþ tatminleri orta düzeyde olup, birbirleri arasýnda iliþki ve etkileþim vardýr. Hastanede, çalýþanlarýn kurumsal baýlýlýðýný ve iþ tatminini arttýrýcý çalýþmalar yapýlmasý gerekmektedir. Araþtýrmanýn benzer araþtýrmalara yön vereceði ve üst yönetimin kararlarýný destekleyeceði tahmin edilmektedir.

INTRODUCTION: One of the most important thing that affects the employees’ success, happiness and productivity in the organisation is their loyalty to the organisation and their job satisfaction.
METHODS: This research was conducted in order to determine the level of the instutional loyalties and the job satisfaction of the employees who work in the hospitals, the relationship between them and the effects of the sociodemographic characteristics on institutional loyalty and job satisfaction.The research was conducted in Haydarpafla Numune Training and Research Hospital in 2010 and has descriptive and inferential nature.
RESULTS: The data was collected by face to face questionnaire method and 5-Likert Scale was used.With random sampling method 460 employees were chosen as a sample among the research group consisting of 1350 employees and 451 questionnaires which were fully answered were evaluated. In the analysis of the data for independent samples, T –test and one- way analysis of variance were used in the scope of SPSS for Windows 15.0 software, and in order to determine the differences Tukey and Scheffe were used. The relationship between the variables was tested by Correlation analysis. When employees’ organisational loyalty and job satisfaction are examined, the average of emotional loyalty is approximately 2.96, continuance loyalty is found as 2.91, normative loyalty is 3.2, general institutional loyalty (overall corporate commitment) as 3.05, internal job satisfaction is approximately 3.24, external job satisfaction is 2.70 and general (overall) job satisfaction is found as 3.03. The average level of job satisfaction and organisational loyalty of the hospital staff is moderate and there is a relationship and interaction between them.
DISCUSSION AND CONCLUSION: In the hospitals, studies should be made to increase organisational loyalty and job satisfaction. We expect that the research will have a lot of contributions to the similar researches and will support the top management decisions.

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GÝRÝÞ ve AMAÇ: Küçük hücreli dýþý akciðer kanseri (KHDAK) tanýsý almýþ olgularda beyin metastazý taramasý öncesinde yapýlan nörolojik semptom sorgulamasýnýn tanýya katkýsýný araþtýrmayý planlandý.
YÖNTEM ve GEREÇLER: Küçük hücreli dýþý akciðer kanseri tanýsý konulan 152 olgu çalýþmaya alýndý. Tüm hastalar nörolojik açýdan sorgulandý. Tüm hastalara beyin MR çektirildi. Beyin metastazý olanlar tespit edilerek nörolojik semptomla beyin metastazý arasýndaki iliþkiye bakýldý.
BULGULAR: Olgularýn 17’sinde (%11.2) beyin metastazý saptandý. Olgularýn 134’ünde (%88.2) nörolojik semptoma rastlanmazken; 18’inde (%11.8) nörolojik semptom mevcuttu. Nörolojik semptomlarýn varlýðýnýn beyin metastazý için duyarlýlýðý %44, özgüllüðü %90, negatif prediktif deðeri %92, pozitif prediktif deðeri %47 olarak saptandý.
TARTIÞMA ve SONUÇ: Nörolojik semptom varlýðýnýn negatif prediktif deðerinin yüksek olmasýna raðmen nörolojik semptomu olamyan erken evre akciðer kanserlerinde tek metastaz yerinin beyin olabilmesi nedeniyle KHDAKevrelendirmesinde beyin MR’ýn semptomlu, semptomsuz tüm evrelerde rutin olarak kullanýlmasý gerektiðini düþünüyoruz.

INTRODUCTION: We planned to investigate the contribution of neurological symptoms on the diagnosis of brain metastasis before scanning.
METHODS: We included 152 patients with NSCLC in the study. We interrogated all patienst about neurological symptoms. We performed brain MRI to all patients. We detected patients with brain metastasis and experienced the relation between neurological syptoms.
RESULTS: We detected brain metastasis in 17 of all (11.2%). There was no neurological symptoms in 134 patients (88.2%) but there were neurological symptoms in 18 patients (11.8%). The sensitivity of presence of neurological symptoms on detecting brain metastasis was 44% and the specifity was )90%; negative predictive value was 92 % and the positive predictive value was 47%.
DISCUSSION AND CONCLUSION: The negative predictive value of neurological syptoms is high but in patients with early NSCLC brain is the only metastasis region.

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GÝRÝÞ ve AMAÇ: Tüberküloz, uzun süre tedavi gerektiren kronik bir hastalýktýr ve tüm dünyada önemli bir halk saðlýðý sorunu olmayý sürdürmektedir. Tüberküloz basilinin kaynaðý hasta kiþilerdir. Basilin solunum yoluyla bulaþmasý nedeniyle hastalýðýn kontrolü zordur. Tüberkülozun kontrolünde önemli olan, hastalýðýn erken teþhis edilmesi, taný konulan olgularýn tedavi edilmeleri ve kür saðlanmasýdýr. Çalýþmamýzda merkezimize baþvuran basil pozitif olgularýn tedavi sonuçlarýný deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýza Þubat 2002 Mayýs 2003 tarihleri arasýnda Süreyyapaþa Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi’ne tüberküloz tanýsý ile yatýrýlan, balgamda ARB (+) olan 145 hasta dahil edildi. Her hasta için demografik veriler ve 6 aylýk takipte hastalýðýn klinik, radyolojik ve bakteriyolojik gidiþini gösteren takip formlarý dolduruldu. Daha sonra hastalar ilgili servislerin takip ve tedavilerine býrakýlarak tedavilerinin 2. ve 6. aylarýnda yeniden görüldü. Tedavi sonuçlarýnýn raporlanmasýnda ortak bir terminoloji kullanmak adýna WHO tarafýndan belirlenen 6 temel tedavi sonuçlarý kullanýldý.
BULGULAR: Hastalarýn 99’u erkek (%68,3), 46’sý kadýndý (%31,7). Yaþ ortalamasý 35,6 ± 13,7 (1572) idi. Hastalarýn %64.1’i (n=93) evli, %35,9’u (n=52) ise bekar yada dul idi. Eðitim düzeylerine bakýldýðýnda, büyük bir bölümü ilkokul mezunu idi. Hastalarýn %49’u (n=71) düþük gelirli olup %11.7’sinde (n=17) eski tüberküloz öyküsü vardý. Hastalardan birinin tedavisinin üçüncü ayýnda iken septik flok ile ex olduðu saptandý. Onun için tedavi sonuçlarýnýn deðerlendirilmesinde çalýþma dýþý býrakýldý. Hastalarýn % 70,1’i (n=101/144) tedavilerini merkezimizde tamamladýlar. Bu hastalarýn % 42,7’sinde (n=68/144) mikrobiyolojik kür saðlanýrken % 22,9 (n=33/144) hasta tedavilerini tamamladýlar. Merkezimizde takip edilen hastalarda tedavi baþarýsý % 70,1 (n=101/144) olarak saptandý. % 7,6 (n=11/144) hastanýn tedavilerini terk ettikleri görüldü. Nakil giden 23 hastaya telefonla ulaþýldýðýnda tadavilerini tamamladýklarý öðrenildi. Bu hastalar da dikkate alýndýðýnda merkezimizde yapýlan bu çalýþmada tedavi baþarýsý % 86,1 (n=124/144) olarak saptandý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda hedeflenen tedavi baþarýsý yakalanmýþ olmakla birlikte özellikle riskli gruplarda doðrudan gözetimli tedavi uygulamasý ile daha baþarýlý sonuçlar alýnacaðý kanýsýndayýz.

INTRODUCTION: Tuberculosis is a chronic disease that requires long-term treatment and continues to be an important health problem throughout the world. The source of tuberculosis bacillus is individuals with the disease. It is difficult to control the disease since it is transmitted through respiration. Important issues in controlling tuberculosis are early diagnosis of the disease, treatment of the diagnosed cases and providing cures. In our study we aimed to evaluate the treatment results of bacillus positive cases that had applied to our center.
METHODS: A total of 145 new patients admitted to Süreyyapafla Chest Diseases and Chest Surgery Training and Research Hospital between February 2002-May 2003 with the diagnosis of tuberculosis and having ARB (+) in the sputum were included in the study. Demographical data and follow-up forms showing the clinical, radiological and bacteriological course of the disease within six months of follow-up were filled out for each patient. Then, patients were left to the follow- up and treatment of related services and were seen again during the second and six months of their treatment. In order to use a common terminology in the reporting of treatment results, six basic treatment results specified by WHO were used.
RESULTS: A total of 99 of the patients were male (68.3%) and 46 of the patients were (31.7%) female. Age average was 35.6 ± 13.7 (15-72). A total of 64.1% of the patients (n=93) were married, 35.9% (n=52) were single or widowed. When educational levels were checked, most patients had a primary school education level. A total of 49% (n=71) of the patients were from low-income families and 11.7% (n=17) had a previous history of tuberculosis. One patient was determined to be ex due to septic shock during the third month of his/her treatment. Therefore he/she was exclu- ded from the study during the evaluation of treatment results. A total of 70.1% (n=101/144) of the patients completed their treatment in our center. A microbiological cure was provided for 42.7 (n=68/144) of these patients. A total of 22.9% (n=33/144) of the patients completed their treatment. The treatment success of the patients who were followed-up in our centre was determined to be 70.1% (n=101/144). A total of 7.6% (n=11/144) of the patients abandoned their treatment. When 23 patients who were transferred to other centers were contacted by telephone, it was understood that they had completed their treatment. When these patients are also considered, the treatment success of this study conducted in our center was determined to be 86.1% (n=124/144).
DISCUSSION AND CONCLUSION: As a result, though we have reached the targeted treatment success rate in our study, we believe that more successful results can be obtained with the application of directly observed therapy, particularly in risky groups.

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GÝRÝÞ ve AMAÇ: Bronþektazi, orta çaplý bronþlarýn duvarlarýndaki elastik ve musküler yapýlarýn destrüksiyonuna baðlý olarak kalýcý dilatasyonu ve distorsiyonu ile karakterizedir.
YÖNTEM ve GEREÇLER: Çalýþmamýzda 2008-2010 yýllarý arasýnda Süreyyapaþa Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi 3. klinikte yatýþý yapýlan bronþektazi tanýlý 48 olgunun dosya verileri geriye dönük olarak deðerlendirildi.
BULGULAR: Hastalarýn yaþlarý, cinsiyetleri, baþvuru yakýnmalarý, fizik muayene, laboratuvar, radyolojik bulgularý, ek hastalýklarý ve tedavileri kaydedildi.
TARTIÞMA ve SONUÇ: Yaþ ortalamasý 44.60±18.1, K/E oraný 22/26 (sýrasýyla %45.8, %54.2) olan olgularýn en sýk baþvuru yakýnmalarý nefes darlýðý (%79.2), öksürük (%77.1), balgam (%66.7), en sýk fizik muayene bulgusu raller (%68.7), yüksek çözünürlüklü toraks bilgisayarlý tomografide (YÇBT) en sýk tutulan bölge sol alt lob (%29.2), en sýk komplikasyon enfekte bronflektazi (%54.2) idi. Günümüzde; uygun aþýlama programlarý, tüberküloz kontrolü, solunum yollarý enfeksiyonlarýnýn erken taný ve tedavisi ve iyileþen yaþam koþullarý ile bronþektazi prevalansýnýn giderek azalacaðý kanýsýndayýz.

INTRODUCTION: Bronchiectasis is characterized by irreversible dilatation and distortion of the medium-sized bronchi due to destruction elastic and muscular structures of the bronchial walls.
METHODS: In our study, data files of 48 cases diagnosed with bronchiectasis who hospitalized at Süreyyapafla Thoracic Diseases and Thoracic Surgery Training and Research Hospital clinic 3 between 2008-2010 were retrospectively evaluated.
RESULTS: Age, sex, symptoms, physical, radiological examination, additional diseases and treatment of the cases were recorded.
DISCUSSION AND CONCLUSION: Mean age 44.60±18.1, female/male ratio 22/26 (respectively %45.8, %54.2), most common symptoms were dyspnea (%79.2), cough (%77.1), sputum (%66.7), most common physical examination finding was crackles (%68.7), most affected region was the left lower lobe in the high resolution computed tomography (%29.2), most common complication was effective bronchiectasis (%54.2). Nowadays, we think appropriate vaccination programs, tuberculosis control, early diagnosis and treatment of respiratory tract infections and improving the living conditions may be decreased the prevalence of bronchiectasis.

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GÝRÝÞ ve AMAÇ: Seftriakson çocukluk çaðýnda sýk olarak kullanýlan bir üçüncu jenerasiyon sefalosporindir.
YÖNTEM ve GEREÇLER: Seftriakson kullanan hastalarda biliyer psododolitiyazis (geçici safra taþý) olüflümu bildirilmektedir.
BULGULAR: Çalýþmamýzda menenjit ve pyelonefrit nedeni ile seftriakson tedavisi baþlanan ve ultrasonda safra taþý saptanan 8 hasta (2 erkek, 6 kýz, ortalama yaþlarý 4,5 yaþ) deðerlendirildi.
TARTIÞMA ve SONUÇ: Tüm hastalar 50- 100 mg/kg/gün 2 eþit doza bölünmüþ seftriakson ile tedavi edildi. Psödolitiyazis geliþtikten sonra seftriakson tedavisi kesildi, takiplerinde bütün olgularda 25-38 gün arasýnda psödolitiyazis tamamen düzeldi. Sadece 3 hastada kusma ve karýn aðrýsý vardý, diðer hastalar asemptomatik idi. Seftriakson kullanýmýna baðlý psödolitiyazis nadir deðildir, gereksiz ameliyat ve konsultasiyonlarý kaçýnmak amacý ile pediatri ve radyoloji uzmanlarý tarafýndan akýlda tutulmalýdýr.

INTRODUCTION: Ceftriaxone is a widely used third generation cephalosporin during childhood.
METHODS: Biliary pseudolithiasis (transient galbladder stone) has been reported in patients who received ceftriaxone therapy.
RESULTS: In our study we evaluated 8 patients (2 boys and 6 girls with mean age of 4.5 years) with gallstones in Ultrasound examination during administration of ceftriaxone for treatment of pyelonephritis and meningitis.
DISCUSSION AND CONCLUSION: All of them were treated with ceftriaxone 50?100mg/kg/day divided into 2 equal intravenous doses. Pseudolithiasis completely resolved in 25-38 days after discontinuation of seftriakson therapy. Only three patient had vomiting and abdominal pain, other patients were asymptomatic. Development of pseudolithiasis after ceftriaxone administration is not uncommon and should be keep in mind by paediatrician and radiologists in order to avoid unnecessary surgery or consultations.

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GÝRÝÞ ve AMAÇ: Varis dýþý akut üst gastrointestinal sistem (GÝS) kanamasý öntanýsýyla yatýrýlan, Rockall skorlama sistemine göre sýnýflanan hastalarýn prognozlarýnýn bu sýnýflama sistemi ile korelasyonunu ve bu sistemin klinik kullanýlabilirliðini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýza, hastanemiz iç hastalýklarý servisine varis dýþý akut üst GÝS kanama tanýsýyla yatýrýlan 16 yaþ ve üzeri 111 hasta dahil edildi. Hastalarýn tamamý ayaktan baþvuran ve yatarak tedavi edilen hastalardý. Hastalarýn genel özellikleri, baþvuru þikayetleri, fizik muayene bulgularý, endoskopi bulgularý, eþlik eden hastalýklarý, kullandýklarý ilaçlar, laboratuar bulgularý ve endoskopik tedavisi kaydedildi. Hastanede yatýþ süresi, yapýlan kan transfüzyonu miktarý, endoskopik ve/veya cerrahi tedavi uygulanan hasta sayýlarý kaydedildi.
BULGULAR: Çalýþmaya alýnan 111 hastanýn % 38’i (42) kadýn, %62’si (69) erkekti. Yaþ ortalamalarý kadýnlarda 64,21 yýl, erkeklerde 55,42 yýl ve toplam hastada 58,74 yýl idi. Hastalardan 2 tanesi ex oldu. Rockall skoruna göre hastalarýn ortalama yatýþ süresi (Rockall 1’de 2,83 gün; 2’de 3,56 gün; 3’de 4,15 gün; 4’de 5,12 gün; 5’de 5,83 gün; 6’da 7 gün; 7’de 11,13 gün), ortalama eritrosit süspansiyonu replasmaný sayýsý (Rockall 1’de 2,29 ünite; 2’de 2,20 ünite; 3’de 3,06 ünite; 5’de 3,08 ünite; 6’da 3,67 ünite; 7’de 5,25 ünite; 8’de 6,50 ünite; 11’de 14 ünite), endoskopik müdahale sayýsý (Rockall 1’de 1; 2’de 1; 3’de 2; 5’de 3; 7’de 6 müdahale) olup bu parametreler Rockall skoru artýþ ile paralel artýþ göstermiþtir.
TARTIÞMA ve SONUÇ: Rockall skorlama sisteminin varis dýþý akut üst gastrointestinal kanama tanýsý ile klinikte takip edilen hastalarýn prognoz ve mortalitelerini belirlemede yararlý,klinik uygulamada kullanýlabilir bir sistem olduðunu gördük.

INTRODUCTION: In this study we aimed to investigate the correlation in prognosis of patients hospitalized with diagnosis of acute nonvariceal upper gastrointestinal bleeding classified according to Rochall Scoring System and its clinical utility.
METHODS: 111 Patients who were older than 16 years old and hospitalized in internal medicine clinics for acute novariceal upper gastrointestinal bleeding were enrolled to the study. All of the patients admitted to emergency department and hospitalized. Patients’ clinical characteristics, admittance complaints, physical examination findings, endoscopic findings, mediacations, comorbid illnesses, laboratory data and endoscopic treatment methods were recorded. Duration of hospitalization, number of blood transfusions, number of people treated endoscopically and surgically was noted.
RESULTS: Number of women was 42(%38) and men was 69 (%62) in total 111 patients. The medium age was 64,21 years in women; 55,42 years in men and was 58,74 years totally. 2 patients died. Duration of hospitalisation according to Rochall Scoring System (2,83 days in score 1; 3,65 days in score 2; 4,15 days in score 3; 5,12 days in score 4; 5,83 days in score 5; 7 days in score 6; 11,1 days in score 7), mean number of transfusions (2,29 units for score 1; 2,20 units for score 2; 3,06 units in score 3; 3,08 units in score 5; 3,67 units for score 6; 5,25 units for score 7; 6,50 units for score 8; 14 units for score 11), number of endoscopic treatment procedures (1 in score 1; 1 in score 2; 2 in score 3; 3 in score 5; 6 in score 7) rose as Rochall score increased.
DISCUSSION AND CONCLUSION: We concluded that Rochall scoring system is useful in predicting prognosis and mortality of inpatients with acute nonvariceal upper gastrointestinal bleeding and it is feasible in clinical practice.

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GÝRÝÞ ve AMAÇ: Apendektomi dünyada en sýk uygulanan cerrahi operasyonlardandýr. Minimal invaziv bir yöntem olan keyhole apendektomi tekniðini 25 hastaya baþarý ile uyguladýk. Bu çalýþmamýzýn sonuçlarýný sunuyoruz.
YÖNTEM ve GEREÇLER: Akut apandisit tanýsý alan hastalar çalýþma süresince opere edildi. Obez hastalar ile preoperatif dönemde perforasyon ya da plastron tesbit edilen hastalar çalýþma dýþý býrakýldý. Tüm hastalarda akut apandisit tanýsý anamnez, fizik muayene, laboratuar tetkikleri, tüm batýn USG ve tüm batýn tomografisi tetkiklerinin sonuçlarýna göre kondu.
BULGULAR: Keyhole apendektomi tekniði 27 hastaya uygulandý. Hastalarýn 18’si erkek, 9’u kadýn idi. Ortalama yaþ 28 olup 15 ile 32 arasýnda deðiþmekteydi. Toplam 27 hastanýn 25’inde keyhole apendektomi tekniði baþarý ile uygulandý. Ýki hastada yara yeri enfeksiyonu 1 hastada cilt altýnda hematom görüldü.
TARTIÞMA ve SONUÇ: Keyhole apendektomi genç, nonobez hastalarda estetik avantajlarý yüksek bir apendektomi tekniðidir.

INTRODUCTION: Appendectomy is one of the most commonly performed operations worldwide. We performed keyhole appendectomy technique successfully in 25 patients. We are presenting results of this technique.
METHODS: Patients with acute appendicitis were operated with keyhole appendectomy technique. Patients with obesity perforated or plastron appendicitis were excluded. The diagnosis of acute appendicitis was established with history, physical examination, laboratory findings, ultrasonography and abdominal tomography.
RESULTS: The keyhole appendectomy technique performed in 27 patients. There were 18 male and 9 female. Mean age was 28 (15-32). The keyhole appendectomy was successful in 25 patients. There were wound infection in 2 and hepatoma in one patient.
DISCUSSION AND CONCLUSION: Keyhole appendectomy can be performed in young and non-obese patients with cosmetic advantages.

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Behçet hastalýðý, nedeni bilinmeyen, vaskülit ile seyreden multisistemik inflamatuar bir hastalýktýr. Arteriyel tutulum daha nadir olup, sýklýkla anevrizma þeklindedir. Vasa vasorumlarýn inflamatuar obliterasyonuna sekonder psödoanevrizma geliþebilir. Behçet hastalýðýnda minör travmalar dahi psödoanevrizma oluþturabileceði için olabildiðince invaziv iþlemlerden kaçýnmak gerekir. Sunumumuzda, yüzeyel femoral arterinde psödoanevrizma bulunan bir Behçet hastalýðý olgusunun Renkli Doppler Ultrason (RDUS) ve Bilgisayarlý Tomografik Anjiyografi (BTA) gibi noninvaziv yöntemlerle konulan tanýsý tartýþýlmýþtýr.

Behcet’s disease is a multi systemic inflammatory disease of unknown cause, presenting with vasculitis. Arteriel involvement is less common and it is frequently in the form of an aneurysm. Pseudo aneurysm may develop secondary to obliterative endarteritis of the vasa vasorum. Even minor trauma can create a pseudo aneurysm in Behcet’s disease. Therefore, invasive procedures should be avoided as much as possible. We evaluated the case of Behcet’s disease with radiological findings that had superficial femoral artery (SFA) pseudoaneursym with non-invasive methods such as Color Doppler Ultrasound (CDU) and Computed Tomographic Angiography (CTA).

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Eozinofilik fasit (EF) nadir görülen ve etiyolojisi tam olarak bilinmeyen inþamatuvar bir hastalýktýr. Periferal kanda eozinofili ve özellikle ekstremitelerde skleroderma benzeri deri endurasyonlarý bu hastalýðýn karakteristik özellikleridir. Genellikle genç erkeklerde, nadiren yaþlý kadýnlarda ve çocuklarda görülür. Bu yazýda üst ekstremitelerinde aðrý ve sertlik þikayetleri ile baþvuran, karakteristik klinik özellikleri ve histopatolojik bulgularý ile EF tanýsý konulan ve sistemik steroid tedavisine iyi yanýt veren 45 yaþýndaki kadýn olgu sunulmuþtur.

Eosinophilic fasciitis (EF) is a rare inflammatory disease of unknown etiology. The characteristic features of this inflammatory disease include scleroderma-like skin indurations, predominantly on the extremities, and peripheral blood eosinophilia. It is usually seen in young males, rarely in elderly women and in children. In this paper, we present a 45-year-old female patient who presented with complaints of pain and tightness of the skin in the upper extremities. She was diagnosed as EF with the characteristic clinical features and histopathological findings and responded well to systemic steroid therapy.

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Henoch-Schönlein purpurasý primer olarak deri, eklem, gastrointestinal ve renal tutulum gösteren, çocukluk çaðýnýn en sýk görülen vaskülitik hastalýðýdýr. Nadiren atipik ve progresif seyir gösterebilir. Renal ve gastrointestinal tutulumu olmayan 14 yaþýndaki erkek hastamýzýn hýzla ilerleyen dermatolojik bulgularý romatolojik ve trombotik süreçleri düþündürmüþtür. pANCA, cANCA, ENA ve tromboz panellerinin negatif bulunmasý yaný sýra cilt biyopsisinin lökositoklastik vaskülitle uyumlu bulunmasý progresif seyirli Henoch Schönlein Purpurasý tanýsýný destekledi. 3 gün pulse steroid metil prednizolon (30 mg/kg), 2 seans hiperbarik oksijen tedavisiyle lezyonlar hýzla gerilemiþtir. Sonuç olarak olgumuzda olduðu gibi progresif seyirli vakalarda yüksek doz steroid ve hiperbarik oksijen tedavisiyle olumlu yanýt alýnabileceðini düþünmekte ve önermekteyiz.

Henoch-Schonlein purpura has primarily the skin, joints, gastrointestinal and renal involvement, and the most common vasculitic disease of childhood. It has rarely, atypical, and progressive course. 14-years-old male patient, has no renal and gastrointestinal involvement, with rapidly progressive dermatologic manifestations suggested rheumatologic and thrombotic processes. Negative pANCA, cANCA, ENA results and negative thrombosis panel with leukocytoclastic vasculitis in skin biopsy, supported the diagnosis of Henoch Schonlein purport. After three days pulse steroid methyl prednisolone (30 mg / kg), 2 sessions of hyperbaric oxygen therapy, lesions recovered rapidly. As a result, we recommend high doses of steroids and hyperbaric oxygen therapy in the treatment of progressive cases.

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Rektus kýlýfý hematomu, nadir görülen ancak akut karýn ile karýþtýrýlabilen klinik bir durumdur. Ýyi bir anamnezi takiben yapýlacak dikkatli bir fizik muayene ve uygun görüntüleme yöntemleri ile doðru taný konulmasý gereksiz laparotomilerin önlenmesinde önemlidir. Bu yazýda atrial fibrilasyon nedeniyle 3 ay önce oral antikoagülan tedavi baþlanan ve rektus kýlýfý hematomu geliþen 80 yaþýnda bir olgu sunulmaktadýr.

Rectus sheath hematoma is a rare entity often misdiagnosed as acute abdomen. Prompt history with careful physical examination and appropriate imaging studies are helpful for achieving the correct diagnosis, which is important for avoiding unnecessary laparotomies. In this article, we report a 80-year-old female patient on oral anticoagulant therapy due to atrial fibrilation who developed rectus sheath hematoma.

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