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Günümüzde tıbbi uygulama hatalarındaki artış sebebiyle hasta güvenliği ve tıbbi hata kavramları daha yoğun bir şekilde karşımıza çıkmaktadır. Hasta güvenliğinin sağlanması ve tıbbi hataların önlenmesi, sağlık hizmet sunucularının hasta güvenliği ve tıbbi hata (malpraktis) konularında eğitimli olmalarına bağlıdır. Hemşirelerin sağlık hizmeti sundukları varlığın insan olması nedeniyle hataları asgari düzeyde tutmaları ve hatta sıfır hata ile çalışmaları esastır. Ancak hem kişilerden kaynaklı hem de sistem kaynaklı hatalar olabilmektedir. Tıbbi hata meydana gelmeden tüm önlemlerin alınması gerekmektedir. Hata meydana geldiyse bu hatanın örtbas edilmemesi ve hata bildiriminin yapılması gerekir. Bu hata bildirimi daha sonra gelişebilecek hataların önüne geçilmesinde faydalı olacaktır. Bu çalışmada, Gülhane Eğitim ve Araştırma Hastanesi'nde çalışan hemşirelerin tıbbi hata yapma eğilimlerinin belirlenmesi amaçlanmıştır. Araştırma kapsamında kullanılacak veriler; literatür doğrultusunda (Altunkan ve Özata, 2010) geliştirilen `Tıbbi Hataya Eğilim Ölçeği` kullanılarak toplanmıştır. Araştırmada hemşirelerin, `Tıbbi Hataya Eğilim Ölçeği` boyutlarına katılım düzeyleri ile demografik özellikleri arasında herhangi bir ilişki olup olmadığına bakılmıştır. Araştırmada elde edilen sonuçlara göre genel olarak hemşirelerin tıbbi hata yapma eğilimlerinin düşük olduğu saptanmıştır. Nowadays, because of the increase in medical practice errors, the concepts of patient safety and medical error appear more intensively. Ensuring patient safety and preventing medical errors depend on the fact that healthcare providers are trained in patient safety and medical malpractice. It is essential that nurses keep the errors at a minimum level and work with zero error because of the existence of the health service they offer. However, there may be errors caused by both people and system. All precautions must be taken before a medical error occurs. If an error has occurred, this error should not be overwritten and should be reported. This error notification will be useful in preventing errors that may develop later. In this study, it was aimed to determine the tendency of the nurses working in Gülhane Training and Research Hospital to make a medical mistake. The data to be used within the scope of the research; In accordance with the literature (Altunkan and Özata, 2010), it was collected by using the) Medical Error Tendency Scale literatür. In the study, it was examined whether there was any relationship between the levels of participation of nurses in the leri Tendency of Medical Error Scale ografik dimensions and demographic characteristics. According to the results obtained in the study, it was found that the tendency of the nurses to make a medical mistake was low. 113

Akciğerin nadir görülen benign tümörlerinden olan hamartomlar intraparankimal veya endobronşialyerleşim gösterirler. İntraparankimal olan hamaratomlar asemptomatik oldukları süreceradyolojik olarak takip edilirken, daha çok semptomatik olan endobronşial hamartomların eksizyonugerekir. Girişimsel bronkoskopik uygulamalar bu hastalarda tedavi seçeneklerinden biridir.Burada sol ana bronşa yerleşim gösteren ve rijit bronkoskopi ile tedavi edilen bir hamartomolgusu sunulacaktır.Anahtar Sözcu¨kler: Hamartom; Bronkoskopi; EndobronşialABSTRACTHamartomas which rare benign tumors of lung are located in intraparenchymal orendobronchial. While intraparenchymal hamartomas are recognized radiologically as longas they are asymptomatic, endobronchial hamartomas which are more symptomatic mustbe excised. Interventional bronchoscopy application is one of the treatment option in thesepatients. Here, a hamartoma case that it is located in the left main bronchus and treated withrigid bronchoscopy will be presented.Keywords: Hamartoma; Broncoscopy; Endobronchial

Esophageal foreign bodies (OYC) are common in children and prevention and timely treatment is not a current problem that can cause serious morbidity and mortality. In the United States, depending on' OYC people a year die of approximately 1500-1600 . Gastrointestinal esophageal stricture at the narrowest point of destination, and contains in itself three. First stenosis at the level of the cricoid cartilage, the second stenosis, nearby the left main bronchus crosses the diaphragm and passes in the region and third place. This is due to the properties of 28-ie 68% esophageal foreign bodies are seen in the digestive tract. OYC anticipated or hidden for a long time the clinical diagnosis can be difficult and serious complications. OYC the removal of rigid esophagoscopy under general anesthesia is a safe and effective method. OYC the early diagnosis and treatment is very important for the prevention of life-threatening complications, Özofagus yabancı cisimleri (ÖYC) çocuklarda sık karşılaşılan ve önlem alınmaz ve zamanında müdahale edilmezse ciddi morbidite ve mortaliteye neden olabilen güncel bir sorundur. Sadece Amerika Birleşik Devletleri'nde ÖYC'ne bağlı olarak bir yılda yaklaşık olarak 1500-1600 kişi kaybedilmektedir . Özofagus gastrointestinal kanalın en dar yeridir ve kendi içinde de üç darlık noktası içermektedir. Birinci darlık krikoid kıkırdak hizasında, ikinci darlık sol ana bronşu çaprazladığı bölgede ve üçüncü darlık diafragmayı geçtiği yerdedir. Bu özelliklerinden dolayı sindirim sistemindeki yabancı cisimlerin %28-68'ine özofagusta rastlanılmaktadır. Uzun süre beklenmiş veya gizli kalmış ÖYC' nin klinik tanısı zor ve komplikasyonları ciddi olabilmektedir. ÖYC\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\' nin çıkarılmasında genel anestezi altında uygulanan rijit özofagoskopi güvenli ve etkili bir yöntemdir. ÖYC\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\' nin erken tanı ve tedavisi hayatı tehdit eden komplikasyonların önlenmesi için çok önemlidir

Purpose: The aim of this study was to evaluate and compare preoperative and postoperative one year-cost analyses of endobronchial valve and enbronchial coil practices and volume-reduction surgical methods applied for the purpose of reducing volume in the patients with emphysema. Material and Methods: All the data regarding the one-year-preoperative and postoperative hospital costs of the patients in our hospital, 11 of whom received an endobronchial valve, 9 of whom received an endobronchial coil and 7 of whom underwent a volume reduction-surgery due to emphysema, were obtained along with the data of the respiratory function test and 6-minute walking test results by accessing into the database of our hospital. Results: The entire research group consisted of 27 patients. Following valve and coil and the volume reduction-surgical intervention, there had been an increase in SFT FEV1% values of the patients with emphysema by 54.0%, 44.4% and 24.6%, respectively, whereas another increase was observed in their six-minute walking distances values by 85.7%, 78.7% and 34.1%, respectively. When the costs of the interventions on emphysema were analyzed, valve ($12943.6) and coil ($11328.9) practices were seen to be almost 5 times more costly than the Volume-reduction surgical treatment ($2444.3). Conclusions: The most economical method in terms of transaction costs is the volume-reduction surgery., Amaç: Amfizem hastalarında volüm küçültme amacıyla uygulanan endobronşial valf, endobronşial coil uygulaması ve volüm küçültücü cerrahi yöntemlerinin işlem öncesi ve işlem sonrası bir yıllık süreçteki maliyet analizleri yapılarak, birbirleri ile karşılaştırması amaçlandı.Gereç ve Yönem: Hastanemizde amfizem nedeni ile endobronşial valf uygulanan 11, endobronşial Coil uygulanan 9 ve volüm küçültücü cerrahi uygulanan 7 hastanın prosedürden önceki bir yıl, prosedür ve prosedür sonrası 1 yıllık süreçte ki tüm hastane maliyetleri, solunum fonksiyon testi ve 6 dakika yürüme testi sonucu verileri hastanemiz veri tabanından girilerek elde edildi. Bulgular: Araştırma grubunun tamamı 27 hasta olup, yaş aralığı 40-72, median yaş 57, yaş ortalaması 57.1 ± standart sapması 8.8 yıldır. valf, coil ve volüm küçültücü cerrahi müdahale sonrasında Amfizem hastalarının; SFT FEV1% değerlerinde sırasıyla %54.0, 44.4 ve 24.6 (total %41.1) artış, 6 MWT değerlerinde sırasıyla %85.7, 78.7 ve 34.1 (total %69.8) artış görülmüştür. Amfizem hastalarına yapılan müdahalelerin maliyeti incelendiğinde, Valf (12943.6 $) ve Coil (11328.9 $)’in Volüm Küçültücü cerrahi (2444.3 $) yönteme göre yaklaşık 5 kat daha pahalı olduğu görülmüştür. Sonuç: İşlem maliyeti olarak en ekonomik metod volüm küçültücü cerrahidir.

The main purpose of this research is to demonstrate the alternative training programs applied to professional national athletes performing athletics in Agri and the effects of such training programs upon the athletes’ success. For this purpose, the related literature has been examined in order to give detailed information about the research problem. Within the scope of the research, an alternative training program was applied to national athletes performing athletics and a solution to the research problem is sought through the obtained findings. 10 male national team athletes among 23-25 age group, regularly exercising the alternative training program developed by M. Sirin Gonen participated in the study. The study is divided into 2 phases. The first phase is taken as the Preparation Phase while the second one is the Competition Phase. 1st and 2nd phases continued for three months (November-December-January) during which same training programs were repeated by the athletes each month. At the end of January, the athletes were given a 5.000 meters of a test run and the results obtained were recorded. In the Competition Phase, a new training program for the competition period was developed and applied to the athletes through the obtained data. The grades obtained before and after the practice have been determined, compared and evaluated. The Preparation Periods and the Competition Periods of the training athletes and the time intervals they have achieved after the training are shown in Table 1-2-3-4. The results of the competition has been announced on Turkish Athletics Federation official web page.

Amaç: Kronik obstrüktif akciğer hastalığının (KOAH) sürecinde ortaya çıkan komorbiditeler hastalığın şiddetini ve mortalitesini etkilemektedir. Osteoporozis KOAH'ın önemli bir sistemik komplikasyonudur. Çalışmamızda, hafif ve orta şiddet ki KOAH hastalarının kemik mineral yoğunluğunu (KMY) kontrol hastalarıyla karşılaştırmayı ve osteopeni/osteoporoz ile KOAH ilişkisini göstermeyi amaçladık.Gereç ve Yöntem: Çalışmada alınan hastaların dosyaları geriye dönük incelendi. KOAH tanı ve evreleri gulus-lararası KOAH klavuzuna göre yapıldı. Hastaların KMY parametreleri dual-enerji X-ray absorbtiometri yöntemi ile ölçüldü. Sistemik ve inhale glukokortikosteroid kullanmayan hastalar çalışmaya dahil edildi. KOAH ve kontrol grubu hastaların yaş, cinsiyet, vücut kitle indeksleri ve sigara içimi durumları eşleştirildi.Bulgular: Çalışmaya 68'i (51,1%) KOAH ve 65'i (48,9%) kontrol olmak üzere toplam 133 hasta alındı. KOAH gru-bunda 36 (52,9%)hasta hafif ve 32 (47,1%) hasta orta evredeydi. KOAH grubunda kontrol hastalarına göre tüm KMY değerleri anlamlı derecede düşüktü (p=0,001). Kontrol grubunda osteopeni/osteoporoz saptanmazken KOAH grubunda 48 (70,6%) hastada osteopeni ve 20 (29,4%) hastada osteoporoz mevcuttu. İki grup arasında istatistiksel olarak anlamlı fark mevcuttu (p=0,001). Hafif ve orta evre KOAH hastaları arasında KMY değerlerine göre anlamlı fark saptanmadı. Her iki evre arasında osteopeni ve osteoporoz sıklığı açısından istatistiksel olarak anlamlı fark saptanmadı (p=0,45).Sonuç: KOAH hastalarında KMY değerleri anlamlı derecede düşüktü ve osteopeni/osteoporoz sıklığı artmışbulundu. Hafif ve orta evrede ki KOAH hastalarında osteopeni/osteoporoz sıklığı yönünden fark bulunmamak- tadır.Anahtar kelimeler: Kemik mineral yoğunluğu; KOAH; Osteopeni; OsteoporozABSTRACTBackground: Comorbidities emerging during the progress of chronic obstructive pulmonary disease (COPD) have affect on developing disease' severity and mortality.Osteoporosis is an important systemic complication of COPD. In our study, we aimed to compare bone mineral density (BMD) of control patients with mild and moderate stage of COPD patients and relationship between COPD and osteopenia/osteoporosis.Method and Method: Records of the patients taken in the study were reviewed retrospectively. Diagnosisand severity of COPD was made according to the global initiative for chronic obstructive lung disease guidelines. BMD of patients were measured with dual energy x-ray absorptiometry method. Patients who were not using inhaled or systemic glucocorticosteroid were included in the study. COPD and control group patients were matched according to age, gender, body mass index and smoking status.Results: A total number of 133 patients were included in the study which was consist of 68 (51,1%) COPDand 65 (48,9%) control patients. Mild stage patients were 36 (52,9%) and moderate were 32 (47,1%) in COPD group. All values of BMD of COPD patients were significantly lower than control group (p=0,000). Osteopenia / osteoporosis were not seen in control group while 48 (70,6%) patients had osteopenia and 20 (29,4%) patients had osteoporosis in COPD group. There was a statistically significant difference between two groups (p=0,000). BMD values were not significantly different between mild and moderate stages of COPD. Statistically significant difference was not detected between two stages according to incidince of osteopenia and osteoporosis (p=0,45).Conclusion: Values of BMD were significantly lower in COPD and incidence of osteopenia/osteoporosiswas increased. There was no difference between mild and moderate stages of COPD for the incidence of osteopenia/osteoporosis.Key words: Bone mineral density; COPD; Osteopenia; Osteoporosis

Today, sport is a phenomenon that almost everyone deals with. Athletics is the oldest sport of history and accepted as the base of all other sports. By establishing Turkish Republic athletics has continually grown up in our country, and it has been become locus of interest of a large number of people both dealing actively and following by. The purposes of this article are to share knowledge about the history of athletics in Agri province, to take attention to the importance and place of the contributions of this province in Turkish sport, and finally to make suggestions on improving athletics for this province. There is no written source containing detailed information about the history of athletics in Agri. We obtained the data by interviews with athletes, managers and workers. Athletics has been the most influential branch of sports and almost become a passion in Agri from 1930s to now. Almost everyone from 7 to 70 has great interest in athletics in Agri. The province has had very significant success at athletics and it has been a special region that caused athletics to gain successful sportsmen/sportswomen both nationally and internationally up to now. In brief we recommend that scientific methods should be used in detection and training of athletes and collaboration of institutions and organizations is needed to improve athletics in the province. Extended English summary is in the end of Full Text PDF (TURKISH) file . Ozet Spor, bugun hemen herkesi ilgilendiren bir fenomendir. Atletizm ise dunyanin en kadim sporu ve diger tum sporlarin temeli olarak kabul edilmektedir. Turkiye’de Cumhuriyet Doneminden sonra gelisen atletizm, bir yandan bireylerin aktif olarak yaptigi diger taraftan toplumun buyuk bir kesimi tarafinda ilgiyle izledigi bir spordur. Bu calismanin amaci Agri’da atletizm tarihi hakkinda bilgi vermek, Agri’nin atletizme yaptigi katkilarin Turk sporundaki yeri ve onemine dikkat cekmek ve ayrica Agri’da atletizm sporunun daha ileriye goturulmesi hususunda oneriler sunmaktir. Agri’da atletizm tarihi ile ilgili olarak detayli bilgi iceren yazili kaynaga rastlanmamistir. Bu calismadaki bilgiler mulakat teknigi ile elde edilmistir. Cesitli donemlerde spor yoneticiligi yapan sahislar, sporcular ve calisanlar veri kaynagini olusturmuslardir. Agri'da atletizm 1930’lu yillardan gunumuze gelinceye kadar en etkili spor dali olmus ve neredeyse bir tutku haline donusmustur. Yediden yetmise hemen herkes Agri'da atletizme buyuk bir ilgi duymaktadir. Gerek ulusal gerekse uluslararasi duzeyde Agri ili atletimde onemli basarilara imza atmis ve cok onemli sporcular yetistirmistir. Bolgede atletizmin ilerlemesi icin sporcu tespiti ve yetistirilmesinde bilimsel yontemler kullanilmali, kurum ve kuruluslar arasinda isbirligi saglanmalidir.

This study was conducted to evaluate the relationship between total intrahepatic hepatitis B virus (HBV) DNA levels and liver histology in terms of the degree of histological activity index (HAI) that yields necroinflammation (HAI-NI) and fibrosis (HAI-F) of the liver.Prospectively, Tru-cut needle biopsy samples were obtained from the livers of 42 patients with chronic hepatitis B. Levels of serum and liver HBV DNA were determined by quantitative real-time PCR. Demographic data of patients, together with hepatitis B serology, alanine aminotransferase levels, and HAI-NI and HAI-F scores, were recorded.Twenty of the patients were hepatitis B e antigen (HBeAg) positive, while 22 patients were positive for antibody to HBeAg (anti-HBe). Serum and liver total HBV DNA levels were found to correlate directly with each other in the two groups (r = 0.669, p = 0.001; and r = 0.880, p0.001; respectively) and the correlation was more marked in anti-HBe-positive patients. Although serum HBV DNA levels correlated positively with HAI-NI and HAI-F scores in HBeAg-positive and HBeAg-negative patients, total liver HBV DNA levels correlated with HAI-NI and HAI-F scores in anti-HBe-positive patients only.Quantitative measurement of intrahepatic HBV DNA is a valuable marker of the histological status of the liver in anti-HBe-positive patients with chronic hepatitis B, and it may give an insight into the prognosis and the ideal time for the cessation of antiviral treatment.

Objectives: The aim of this study was to investigate the effect of Transarterial Chemoembolization (TAKE) on tumor response survival in patients with hepatocellular carcinoma (HCC) between January 2002 and December 2008. Materials and methods: In 33 unresectable HCC pa­tients TACE treatment was administered 59 times. Lipi­odol + epirubycin hidrochlorur emulsion and lipiodol were administered to HCC for 1-4 times (mean 1.78) via the hepatic artery, selectively. Patients were examined at 1st, 2nd, and 4th months with abdomen CT, serum albumin, bilirubin, PT, AFP levels. Procedure was repetaed in case of growth in the initial mass size or enhancing solid por­tion of tumor on the CT images. Results: In our study, tumor size above 5 cm, diffuse involvement, ascites, serum albumin level below 2.8 g/dl, bilirubin level above 3 mg/dl, Child C stage, Okuda III stage, serum AFP level above 400 IU/dl and low lipiodol involvement were considered as poor prognostic factors. Tumor size below 5 cm, nodularity, absence of ascites, serum albumin levels above 3.5 g/dl, bilirubin levels be­low 1 mg/dl, Child A stage, Okuda I stage and high lipiodol involvement were found as good prognostic factors. Conclusion: In present study, we found that repetitive TACE procedures improved the survival in selected unre­sectable HCC patients, Amaç: Bu çalışmanın amacı, Ocak 2002-Aralık 2008 ta­rihleri arasında karaciğer tümörü tanısı alan ve Transar­teryel Kemoembolizasyon (TAKE) tedavisi uygulanan he­patoselüler karsinom (HCC) tanılı hastalarda tümör yanıtı ve tedavinin sağkalıma etkisini araştırmaktır. Gereç ve yöntem: Cerrahi tedavi yapılamayan 33 HCC tanılı olguya 59 defa TAKE tedavisi uygulandı. Hastalara 1-4 defa (ortalama 1.78 kez) lipiodol+epirubicin hidroklo­rür emülsiyonu ile lipiodol hepatik arter yoluyla selektif ola­rak verildi. Hastalar 1, 2 ve 4. ayda abdomen bilgisayarlı tomografi (BT) ve serum albumin, bilirubin, protrombin zamanı (PT), a-fetoprotein (AFP) değerleri ile takip edildi. BT\' de kontrastlanan solid tümör varlığı ve kitle çapı artışı durumlarında işlem tekrar edildi. Bulgular: Çalışmamızda HCC hastalarının tedavi önce­si tümör çapının 5 cm\'den büyük olması, diffüz tutulum olması, asit olması, serum albumin değerinin 2.8 g/dl\'nin altında olması, bilirubin değeri 3 mg/dl\'nin üstünde olma­sı, Child-C evresinde olması, Okuda III evresi ve serum AFP değerinin 400 IU/dl üstünde olması ve lipiodolün az tutulumu kötü prognoz göstergesi olarak saptandı. Tümör boyutu 5 cm\'nin altında olması, nodüler olması, asitin olmaması, hastanın serum albuminin >3.5 mg/dl ve bilirubinin

Amaç: Hastanede çalışmakta olan yardımcı sağlık personelleri çoğu zaman hastaların şikayetlerine göre baş-vurmaları gereken branş hakkında danıştıkları kişilerdir. Bu çalışmanın amacı hekim dışı sağlık personelleriningöğüs cerrahisinin ilgi alanları açısından bilgi düzeylerini ortaya koymaktır.Gereç ve Yöntemler: Hastanemizde çalışan yardımcı sağlık personellerine gönüllük esasına dayanarak anketyapıldı. Anketler çalışmaya katılmayı kabul eden 35 kişiye dağıtıldı ve cevaplandıktan sonra toplandı. Elde edi-len veriler IBM SPSS Statistics 15.0 ile analiz edildi.Bulgular: Ankete katılan 35 hastane çalışanının %62.9’u (n:22) sekreter ve %37.1’i (n:13) hemşire idi. Çalışma-ya katılanların çoğu (n:31,%88.6) hastanede çalışan göğüs cerrahisi uzmanını tanıdığını belirtmekteydi. Katılım-cılara göğüs kafesi bölgesindeki organlar sorulduğunda %94.3’ü (n:33) akciğerin, %91.4’ü (n:32) kalbin, %100’ü (n:35) böbreğin, %94.3’ü (n:33) dalağın ve %88.6’sı (n:31) safra kesesinin lokalizasyonunu doğru bilmekteydi. Timusun göğüs kafesinde olduğunu bilenlerin oranı ise %20 (n:7) idi. Göğüs cerrahisi tarafından tedavi edilen hastalıklara verilen cevaplar değerlendirildiğinde göğüs travmaları, kaburga kırıkları ve göğüs kafesi deformi- teleri yüksek oranda doğru bilinmişti. Özofagus, mediasten, timus bezi ve diafragma hastalıkları ile bölgesel hiperhiroziste doğru cevap oranları düşüktü. Akciğer operasyonlarının göğüs cerrahisi tarafından yapıldığının bilinme oranı %68.6 (n:24) iken, hemşire grubunda bu oran %100 (n:13), sekreter grubunda ise %50 (n:11) idi. Meme ameliyatları ayrı olarak branş bazında sorgulandığında tüm katılımcıların %82.9 (n:29)’u genel cerrahi cevabını vermekteydi. Bu oran sadece hemşire grubunda çalışıldığında %100 olarak bulundu. Çalışma genelin- de hemşire grubunun doğru yanıt oranlarının sekreter grubuna göre daha fazla olduğu gözlemlendi.Sonuç: Bu çalışma hekim dışı sağlık çalışanları arasında göğüs cerrahisi konusunda bilgi ve farkındalık dü-zeyinin yeterli olmadığını, özellikle hasta yönlendirmede görevli sekreterlerin bu konuda eğitime ihtiyaçlarıolduğunu ortaya koymaktadır.Anahtar kelimeler: Göğüs cerrahisi, Anket, İlgi alanları, Sekreter, HemşirelerABSTRACTBackground: Allied health personnel are inviduals who is working in hospital and consulted by the patientswho needs to learn about which department they should apply according to their complaints.Material and Methods: A questionaire was performed to allied health personel working our hospital basedon voluntary. The questionnaires were distributed to the 35 people who agreed to participate in the study andwere collected after answered. Obtained data was analyzed using IBM SPSS Statistics version 15.0 software program.Results: 62.9% (n = 22) of the 35 participants were secretary and 37.1% (n = 13) were nurses. Most of thestudy participants (n = 31, 88.6%) said to know thoracic surgery specialists working in the hospital. Whenasking to participant about organs in region of thorax, of 94.3% (n:33) for lung, of 91.4% (n:32) for heart, of100% (n:35) for kidney, of 94.3% (n:33) for spleen and of 88.6% (n:31) for gallbladder knew correctly region of organs in thorax. The percentage of Participants who knew the location of timus in the thorax was 20%(n:7). When assesment the answering to question on disease being treated by thoracic surgery, chest trauma, rib fractures and chest deformities were known highly accurate. the correct response rate to answering to question about esophagus, mediastinum, diaphragm and thymus gland diseases and regional hiperhiroz were low.68.6% (n = 24) of the participants knew that lung operations were performed by thoracic surgery and the ratio was 100% (n = 13) for nurses, and 50% (n = 11) for secretary group.When questioned about breast surgery, %82.9 (n:29) of all participants answered as general surgery, this ratio was %100 for nurses. The correct response rate to o questions was higher in nurses compared to secretaries.Conclusion: This study reveals that knowledge and awareness of non-physician health personnels aboutThoracic Surgery is insufficient and especially secretarias triaging patients need to be educated on this subject.Key words: Thoracic surgery, questionnaire, State Interest, Secretary, nurses., Background: Allied health personnel are inviduals who is working in hospital and consulted by the patients who needs to learn about which department they should apply according to their complaints.Material and Methods:A questionaire was performed to allied health personel working our hospital based on voluntary. The questionnaires were distributed to the 35 people who agreed to participate in the study and were collected after answered. Obtained data was analyzed using IBM SPSS Statistics version 15.0 software program.Results: 62.9% (n = 22) of the 35 participants were secretary and 37.1% (n = 13) were nurses. Most of the study participants (n = 31, 88.6%) said to know thoracic surgery specialists working in the hospital. When asking to participant about organs in region of thorax, of 94.3% (n:33) for lung, of 91.4% (n:32) for heart, of 100% (n:35) for kidney, of 94.3% (n:33) for spleen and of 88.6% (n:31) for gallbladder knew correctly region of organs in thorax. The percentage of Participants who knew the location of timus in the thorax was 20%(n:7). When assesment the answering to question on disease being treated by thoracic surgery, chest trauma, rib fractures and chest deformities were known highly accurate. the correct response rate to answering to question about esophagus, mediastinum, diaphragm and thymus gland diseases and regional hiperhiroz were low.68.6% (n = 24) of the participants knew that lung operations were performed by thoracic surgery and the ratio was 100% (n = 13) for nurses, and 50% (n = 11) for secretary group.When questioned about breast surgery, %82.9 (n:29) of all participants answered as general surgery, this ratio was %100 for nurses. The correct response rate to o questions was higher in nurses compared to secretaries.Conclusion:This study reveals that knowledge and awareness of non-physician health personnels about Thoracic Surgery is insufficient and especially secretarias triaging patients need to be educated on this subject

We performed color Doppler sonographic examination on 4 patients, 3 of whom had preliminary diagnoses of penile fracture and 1 of whom had undergone an operation due to penile fracture a year previously. Color Doppler sonography helped evaluate the relationships between the hematoma and the vascular structures and aided in differential diagnosis of the vascular injuries that may accompany tunical rupture (or have similar clinical presentations) and Mondor's disease; thus, this method has a crucial role in choosing the treatment approach. Color Doppler sonography may also assist in the follow-up of patients after surgical or conservative treatment. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 33:38–42, 2005

Purpose: To evaluate signs of atherosclerosis in carotid and brachial arteries in patients with aortic regurgitation (AR). Material and Methods: The sonograms of 33 patients (24 M and 9 F, 16-67 years old) with pure AR and 20 control subjects (15 M and 5 F, 19-49 years old) were evaluated. Patients with AR and control subjects completed a questionnaire with SMART risk score based on pre-existing vascular disease and risk factors. AR patients and control subjects were assessed for intima-media thickness (IMT) of common carotid artery (CCA), IMT of brachial artery (BA), CCA diameter, and resistivity index (RI) of CCA and RI of internal carotid artery (ICA). Results: There was no significant difference in the cardiovascular risk score between the patients with AR and control subjects. All measured parameters were statistically significantly greater in AR patients than in control subjects with P values 0.0233 for CCA IMT, 0.0034 for BA IMT, 0.0429 for CCA diameter, Conclusion: AR is associated with signs generally considered to represent atherosclerosis, such as increased CCA and BA IMT, CCA diameter, and CCA and ICA RI.

l-2 hydroxyglutaric aciduria is a rare, autosomal recessively inherited metabolic disorder of organic acid metabolism. A 5-year-old boy presented with eyelid myoclonia with absences that proved difficult to control with first-line anticonvulsants. An electroencephalogram produced profoundly abnormal results, with generalized spike-and-wave discharges. The patient became seizure-free with a combination therapy of clonazepam, levetiracetam, and lamotrigine. Magnetic resonance imaging demonstrated subcortical white matter and basal ganglia alterations. Urinary organic acid analysis demonstrated increased excretion of l-2 hydroxyglutaric acid. Although rare, seizures can occur as a presenting sign of slowly progressing organic acidurias, e.g., l-2 hydroxyglutaric aciduria. Both eyelid myoclonia with absences and l-2 hydroxyglutaric aciduria comprise rare disorders. To our knowledge, this case report is the first of l-2 hydroxyglutaric aciduria presenting with symptomatic eyelid myoclonia with absences.

Amaç: Hastanede çalışmakta olan yardımcı sağlık personelleri çoğu zaman hastaların şikayetlerine göre baş- vurmaları gereken branş hakkında danıştıkları kişilerdir. Bu çalışmanın amacı hekim dışı sağlık personellerinin göğüs cerrahisinin ilgi alanları açısından bilgi düzeylerini ortaya koymaktır. Gereç ve Yöntemler: Hastanemizde çalışan yardımcı sağlık personellerine gönüllük esasına dayanarak anket yapıldı. Anketler çalışmaya katılmayı kabul eden 35 kişiye dağıtıldı ve cevaplandıktan sonra toplandı. Elde edi- len veriler IBM SPSS Statistics 15.0 ile analiz edildi. Bulgular: Ankete katılan 35 hastane çalışanının %62.9u (n:22) sekreter ve %37.1i (n:13) hemşire idi. Çalışma- ya katılanların çoğu (n:31,%88.6) hastanede çalışan göğüs cerrahisi uzmanını tanıdığını belirtmekteydi. Katılım- cılara göğüs kafesi bölgesindeki organlar sorulduğunda %94.3ü (n:33) akciğerin, %91.4ü (n:32) kalbin, %100ü (n:35) böbreğin, %94.3ü (n:33) dalağın ve %88.6sı (n:31) safra kesesinin lokalizasyonunu doğru bilmekteydi. Timusun göğüs kafesinde olduğunu bilenlerin oranı ise %20 (n:7) idi. Göğüs cerrahisi tarafından tedavi edilen hastalıklara verilen cevaplar değerlendirildiğinde göğüs travmaları, kaburga kırıkları ve göğüs kafesi deformi- teleri yüksek oranda doğru bilinmişti. Özofagus, mediasten, timus bezi ve diafragma hastalıkları ile bölgesel hiperhiroziste doğru cevap oranları düşüktü. Akciğer operasyonlarının göğüs cerrahisi tarafından yapıldığının bilinme oranı %68.6 (n:24) iken, hemşire grubunda bu oran %100 (n:13), sekreter grubunda ise %50 (n:11) idi. Meme ameliyatları ayrı olarak branş bazında sorgulandığında tüm katılımcıların %82.9 (n:29)u genel cerrahi cevabını vermekteydi. Bu oran sadece hemşire grubunda çalışıldığında %100 olarak bulundu. Çalışma genelin- de hemşire grubunun doğru yanıt oranlarının sekreter grubuna göre daha fazla olduğu gözlemlendi. Sonuç: Bu çalışma hekim dışı sağlık çalışanları arasında göğüs cerrahisi konusunda bilgi ve farkındalık dü- zeyinin yeterli olmadığını, özellikle hasta yönlendirmede görevli sekreterlerin bu konuda eğitime ihtiyaçları olduğunu ortaya koymaktadır. Background: Allied health personnel are inviduals who is working in hospital and consulted by the patients who needs to learn about which department they should apply according to their complaints. Material and Methods: A questionaire was performed to allied health personel working our hospital based on voluntary. The questionnaires were distributed to the 35 people who agreed to participate in the study and were collected after answered. Obtained data was analyzed using IBM SPSS Statistics version 15.0 software program. Results: 62.9% (n 22) of the 35 participants were secretary and 37.1% (n 13) were nurses. Most of the study participants (n 31, 88.6%) said to know thoracic surgery specialists working in the hospital. When asking to participant about organs in region of thorax, of 94.3% (n:33) for lung, of 91.4% (n:32) for heart, of 100% (n:35) for kidney, of 94.3% (n:33) for spleen and of 88.6% (n:31) for gallbladder knew correctly region of organs in thorax. The percentage of Participants who knew the location of timus in the thorax was 20%(n:7). When assesment the answering to question on disease being treated by thoracic surgery, chest trauma, rib fractures and chest deformities were known highly accurate. the correct response rate to answering to question about esophagus, mediastinum, diaphragm and thymus gland diseases and regional hiperhiroz were low.68.6% (n 24) of the participants knew that lung operations were performed by thoracic surgery and the ratio was 100% (n 13) for nurses, and 50% (n 11) for secretary group.When questioned about breast surgery, %82.9 (n:29) of all participants answered as general surgery, this ratio was %100 for nurses. The correct response rate to o questions was higher in nurses compared to secretaries. Conclusion: This study reveals that knowledge and awareness of non-physician health personnels about Thoracic Surgery is insufficient and especially secretarias triaging patients need to be educated on this subject. Key words: Thoracic surgery, questionnaire, State Interest, Secretary, nurses.

WOS: 000376565500040, Parabronşiyal ya da midözefagiyal divertiküller, özefagusun orta kesiminin periözefagiyal alana doğru kese şeklinde büyümesi sonucu ortaya çıkar. Bu büyüme genellikle mediastinel inflamasyona sekonder olarak oluşur. Biz, midözefagiyal divertikülü olan yirmibir yaşında erkek hastayı sunuyoruz. Literatür bilgileri eşliğinde bu özefagiyal patolojiyi tartışmayı amaçladık., Parabronchial or midesophageal diverticulum is a saclike bulging of the midesophageal wall into the periesophageal space. This bulging usually occur secondary to mediastinal inflammation. We report a case of a midesophageal diverticulum in a 21-year-old man. We discuss midesophageal diverticulum and review the literature findings.

Endoscopic endonasal surgery has been performed in children. Therefore, we need to know the precise anatomy and anatomic variations of the lateral nasal wall. This is important in order to achieve better surgical results and avoid complications. We also need to know the relationship between the anatomic variations and sinonasal disease. For the purpose of this study we assessed the anatomic variations of the lateral nasal wall and the association of these variations with chronic sinusitis in children. Forty-seven children with chronic sinus disease were included in the study. There were 25 female and 22 male patients with ages ranging from 2 to 16 years (mean 10.5+/-3.8 years). On coronal and axial computed tomographic (CT) scans, the anatomic variations of the lateral nasal wall and sinusitis were assessed. A pneumatized middle concha (MC) was the most common anatomic variation, followed by pneumatization of the superior concha (SC), Haller cell and agger nasi cell. Secondary MC, large ethmoidal bulla, maxillary sinus hypoplasia, Onodi cell, and uncinate process pneumatization were relatively rare. Maxillary sinusitis was the most common sinus infection, followed by ethmoidal, sphenoidal and frontal sinusitis in that order. There was no significant relationship between the sinusitis and anatomic variations except for some minor associations. In conclusion, anatomic variations in the lateral nasal wall are common in children. Local, systemic or environmental factors appear to be more important in pediatric sinusitis than the anatomic variations. Due to the absence of a definitive relationship between the anatomic variations and sinus disease, aggressive surgical interventions should be avoided while performing endonasal endoscopic surgery in the children.

Bu calismanin amaci; elit gurescilerde uygulanan aerobik ve anaerobik antrenman programinin, vucut kompozisyonu uzerine etkilerini arastirmaktir. Arastirmaya katilan, yas ortalamasi (deney; 15.20 ± 4.61, n=10, kontrol; 15.90 ± 2.08, n=10) olan, 20 elit guresci ogrenci, rastgele yontemle 10 kisilik iki gruba ayrildi. Deney grubuna 8 hafta devam eden, hafta da 6 gun “bir gun aerobik-bir gun anerobik” olmak uzere antrenman prensiplerine uygun olarak belirlenen, kuvvet ve dayaniklilik antrenman programi uygulandi. Kontrol grubu ise normal rutin gures teknik antrenmanina devam etti. Deney grubundan ve kontrol grubundan 8 haftalik antrenman periyodu oncesinde ve 8 haftalik egzersiz periyodu sonlandiktan sonra, vucut analizi olcumleri alindi (Tanita-TBF 300A). Calismanin sonuclarina gore; deney grubunun beden kompozisyonu gostergelerinden empedans, beden yag yuzdesi, yag kutlesi, ontestten son teste anlamli olarak azalirken, yagsiz beden kutlesi ve toplam vucut suyu anlamli olarak artmistir (p 0.05). Kontrol grubunun ise, beden kompozisyonu gostergelerinden vucut agirligi, yagsiz beden kutlesi ve toplam vucut suyu degerleri ontestten sonteste anlamli olarak artmistir (p 0.05). Sonuc olarak; her iki gruptaki ontest ve sontest degisimleri benzer olup, gruplar arasinda anlamli bir farklilik bulunamamistir (p>0.05). Istatistiksel analizlerde grup ici karsilastirmalar icin es-orneklem t testi (paired-samples t test), gruplararasi karsilastirmalar icin bagimsiz orneklem t testi (independent sample t test) kullanildi. Anlamlilik seviyesi p

Intramuscular hemangiomas are rare benign tumors and are mainly affecting the extremity muscles. If they do not cause pain or excessive, the diagnosis may require quite a long time. We present a 23 year old male patient who was admitted to our clinic with a slowly enlarging lession in the left lateral chest wall. Magnetic resonance imaging reported a vascular mass measuring 10x5x4 cm. in the left latissimus dorsi muscle. We performed a complete resection of the tumor with safe margins of the surrounding tissue and the histopathologic examination demonstrated an intramuscular hemangioma of the cavernous type. The patient has been free of recurrence for 1 year after surgery., ÖZETİntramüsküler hemanjiomlar nadir görülen ve esas olarak ekstremite kaslarında sapta- nan selim tümörlerdir. Ağrı şikayeti veya aşırı büyümeye neden olmadıkları durumlarda tanı konulması için geçen süre oldukça uzun olmaktadır. Kliniğimize sol yan göğüs du- varında yavaş büyüme gösteren lezyonu nedeniyle başvuran 23 yaşında bir erkek hasta olgusu sunmaktayız. Manyetik rezonans görüntülemesi sol latissimus dorsi kası içinde 10x5x4 cm. boyutlarında vasküler bir kitle olduğunu raporladı. Çevre dokulardan güvenli sınırlar dahilinde eksiksiz tümör rezeksiyonu uyguladık ve histopatolojik inceleme kaver- nöz tip intramüsküler hemanjiom olduğunu gösterdi. Hastada ameliyat sonrasındaki 1 yılda nüks saptanmadı.Anahtar kelimeler: Hemanjiom, Göğüs kafesi, TanıABSTRACTIntramuscular hemangiomas are rare benign tumors and are mainly affecting the extremity muscles. If they do not cause pain or excessive, the diagnosis may require quite a long time. We present a 23 year old male patient who was admitted to our clinic with a slowly enlarging lession in the left lateral chest wall. Magnetic resonance imaging reported a vascular mass measuring 10x5x4 cm. in the left latissimus dorsi muscle. We performed a complete resection of the tumor with safe margins of the surrounding tissue and the histopathologic examination demonstrated an intramuscular hemangioma of the cavernous type. The patient has been free of recurrence for 1 year after surgery.Keywords: Hemangioma; Chest wall; Diagnosis

Cystic hygroma is an anomaly which is usually located on lateral or back side of neck and originated from lymphatic system. These lesions are mostly detected in infants or children younger than two years of age. Occurence in adults is so uncommon and fewer than 100 cases of adult lymphangioma have been reported in the literature. Here; we present a 60 years old patient whose cystic hygroma was exended to the posterior of the right clavicle and relapsed despite the drainage by aspiration twice.Cystic hygroma is an anomaly which is usually located on lateral or back side of neck and originated from lymphatic system. These lesions are mostly detected in infants or children younger than two years of age. Occurence in adults is so uncommon and fewer than 100 cases of adult lymphangioma have been reported in the literature. Here; we present a 60 years old patient whose cystic hygroma was exended to the posterior of the right clavicle and relapsed despite the drainage by aspiration twice., Kistik higroma, genellikle boyun arka veya yan bölümünde yer alan, lenfatik sistemden kaynaklanan bir anomalidir. Bu lezyonlar çoğunlukla infantlarda ya da iki yaşından küçük bebeklerde bulunmaktadır. Erişkin yaşlarda çok nadir görülürler ve literatürde 100’den az erişkin lenfanjioma vakası bildirilmiştir. Burada; 60 yaşında, sağ klavikulanın postero- runa uzanım gösteren ve iki defa aspire edilerek boşaltılmasına rağmen nüks eden bir kistik higromalı olguyu sunuyoruz.Kistik higroma, genellikle boyun arka veya yan bölümünde yer alan, lenfatik sistemden kaynaklanan bir anomalidir. Boyunda veya aksiller bölgede yumuşak doku içinde tek veya septumlarla ayrılan çoğul kistler mevcuttur. Kistler değişik boyut ve büyüklüklerde olabilir. Kistik higromanın görülme sıklığı 1/6000 canlı doğumdur. Düşüklerden sonra yapılan araştırmalarda ise 1/750 oranında kistik higromaya rastlandığı bildirilmiştir (1-2). Burada erişkin hastada, atipik olarak klavikulanın posterioruna uzanım gösteren kistik higromanın tedavi yöntemi açısından literatüre katkısı olacağını düşünerek yayınlamak istedik.

ÖZET:Amaç: Hastanede çalışmakta olan yardımcı sağlık personelleri çoğu zaman hastaların şikayetlerine göre başvurmaları gereken branş hakkında danıştıkları kişilerdir. Bu çalışmanın amacı hekim dışı sağlık personellerinin göğüs cerrahisi açısından bilgi düzeylerini ortaya koymaktır.Gereç ve yöntem: Hastanemizde çalışan yardımcı sağlık personellerine gönüllük esasına dayanarak anket yapıldı. Anketler çalışmaya katılmayı kabul eden 35 kişiye dağıtıldı ve cevaplandıktan sonra toplandı. Elde edilen veriler IBM SPSS Statistics 20.0 ile analiz edildi.Bulgular: Ankete katılan 35 hastane çalışanının %62.9’u (n:22) sekreter ve %37.1’i (n:13) hemşire idi. Çalışmaya katılanların çoğu (n:31,%88.6) hastanede çalışan göğüs cerrahisi uzmanını tanıdığını belirtmekteydi. Katılımcılara göğüs kafesi bölgesindeki organlar sorulduğunda %94.3’ü (n:33) akciğerin, %91.4’ü (n:32) kalbin, %100’ü (n:35) böbreğin, %94.3’ü (n:33) dalağın ve %88.6’sı (n:31) safra kesesinin lokalizasyonunu doğru bilmekteydi. Timusun göğüs kafesinde olduğunu bilenlerin oranı ise %20 (n:7) idi. Göğüs cerrahisi tarafından tedavi edilen hastalıklara verilen cevaplar değerlendirildiğinde göğüs travmaları, kaburga kırıkları ve göğüs kafesi deformiteleri yüksek oranda doğru bilinmişti. Özofagus, mediasten, timus bezi ve diafragma hastalıkları ile bölgesel hiperhiroziste doğru cevap oranları düşüktü. Akciğer operasyonlarının göğüs cerrahisi tarafından yapıldığının bilinme oranı %68.6 (n:24) iken, hemşire grubunda bu oran %100 (n:13), sekreter grubunda ise %50 (n:11) idi. Meme ameliyatları ayrı olarak branş bazında sorgulandığında tüm katılımcıların %82.9 (n:29)’u genel cerrahi cevabını vermekteydi. Bu oran sadece hemşire grubunda çalışıldığında %100 olarak bulundu. Çalışma genelinde hemşire grubunun doğru yanıt oranlarının sekreter grubuna göre daha fazla olduğu gözlemlendi.Sonuç: Bu çalışma hekim dışı sağlık çalışanları arasında göğüs cerrahisi konusunda bilgi ve farkındalık düzeyinin yeterli olmadığını, özellikle hasta yönlendirmede görevli sekreterlerin bu konuda eğitime ihtiyaçları olduğunu ortaya koymaktadır.

Background: The aim of this study is to share the experience we gained in the patients with thoracic trauma and to compare our data with the literature.Material And Method: One hundred and ninety-five patients who were presented to emergency unit with chest trauma between January 2010 and August 2012 were analy­sed retrospectively by age, gender, type of trauma, method of treatment and time of hospital stay.Results: Thirty-nine (20%) patients were female an one hundred and fifty-five (80%) patients were male. The mean of the patients’ ages was 40,2 (3-93 years). 139 (71,2%) patients had blunt and 56 (29,8%) patients had penetrating chest trauma. The most seen thoracic injury was rib fracture (47,1%). Accompanying traumas were observed in 41 (21%) patients and they were in extremity in 23 (56%), head in 16 (39%) and heart in 2 (5%) cases. In relation with the type of injury, 89 (45,6%) patients were conservatively treated while 80 (41%) patients were treated with tube thoracostomy while thoracoscopy was performed on 7 (%3,6) and thoracotomy on 19 (9,8%) patients. The mortality rate was calculated as 2% (n=4).Conclusion: The high rate of mortality recognised in thoracic trauma can be reduced by true and fast decisions in diagnosis and treatment of the patients., Amaç: Çalışmanın amacı toraks travmasına uğramış hastalardan edindiğimiz deneyimin paylaşılması ve elde ettiğimiz verilerin literatür ile karşılaştırılmasıdır.Gereç ve Yöntem: Ocak 2010 ve Ağustos 2012 tarihleri arasında toraks travması sonrası acil servise başvuran 195 hasta yaş, cinsiyet, travma şekli, yapılan tedavi biçimi ve hasta­nede kalış süreleri açısından retrospektif olarak incelendi.Bulgular: İncelenen olguların 39’u (%20) kadın, 156’sı (%80) erkekti. Yaş ortalaması 40,2 yaş (3-93 yaş) olarak saptandı. Künt göğüs travması sonrası başvuran hastaların sayısı 139 (%71,2) iken hastaların 56’sında (%29,8) etken penetran yaralanma idi. En sık sap­tanan toraks yaralanması kot fraktürü (%47,1) olarak belirlendi. 41 hastada (%21) eşlik eden yaralanma saptandı ve bunların 23’ü ekstremite (%56), 16’sı kafa (%39) ve 2’si kar­diak (%5) yaralanma olarak hesaplandı. Yaralanma biçimine bağlı olarak 89 hasta (%45,6) konservatif tedavi ile takip edilirken 80 hastaya (%41) tüp torakostomi, 7 hastaya(%3,6) torakoskopi ve 19 hastaya (%9,8) torakotomi ameliyatları uygulandı. Mortalite oranı %2 (n=4) olarak hesaplandı.Sonuç: Toraks travmalarında saptanan yüksek mortalite oranı ancak doğru ve hızlı biçim­de yapılan tanı ve tedavi ile azaltılabilir.

Penetran göğüs yaralanmalarına bağlı olarak gelişen hemotoraks, acil serviste dahi resüsitatif torakotomi gerektirebilecek kadar hızlı gelişebilen ve ivedilikle değerlendirilip, müdehale edilmesi gereken bir patolojidir. Yaralanmanın şekline göre medyan sternotomi ya da eşzamanlı bilateral torakotomi uygulanabilmektedir.

Chiari III malformation is an extremely rare condition, and is characterized by the hindbrain herniation into a low occipital or high cervical encephalocele together with the pathologic and imaging features of the Chiari II malformation. In this report, an unusual variant of the Chiari III malformation was diagnosed in an 11-year-old girl. She had an encephalocele operation when she was a newborn, and has been asymptomatic since then. The clinical and imaging findings of this case were presented.

Purpose: The presence of hernia was investigated prospectively by US in both groins of children with clinically suspected or apparent unilateral inguinal hernia. Material and Methods: One hundred and twenty-eight (103 boys, 25 girls) were classified into three groups according to age: 0-2, 3-5 and 6-15 years. The widest diameter of the inguinal canal was measured in the longitudinal plane while the children were in the supine position and at rest. The patent processus vaginalis (PPV) values of 4 mm and higher were accepted as hernia. The groins diagnosed clinically and/or ultrasonographically as hernia were explored surgically. The clinical and US findings were compared with surgical results. The relations between hernia diameters and the age groups, sex, right/left and inguinal/scrotal hernias were analyzed statistically. Results: In 128 children, 138 groins were treated with surgery. One hundred and eleven cases were unilateral hernia (73 right, 38 left) and 10 were bilateral. Seven cases were found to be normal. Ten cases with clinically unilateral hernia were bilateral at US and surgery. One hundred and thirty-one of 138 groins were correctly diagnosed by US. The accuracy, specificity and sensitivity of US were 94.9%, 85.7% and 95.4%, respectively. The accuracy of physical examination was 87.7%. There were no significant differences between hernia diameters and the age groups, sex and right/left side except the difference between inguinal and scrotal hernia diameters ( p Conclusion: US can be used routinely in the pre-operative diagnosis of inguinal hernia in children. PPV values higher than 4 mm, with a high accuracy indicate hernia.

Purpose Brucellosis is an enzootic disease that is frequently transmitted from Brucella-infected animals and their products to humans through the gastrointestinal tract. Genitourinary complications are seen in 2–10% of cases. We used sonography to investigate such complications in patients from a Brucella-endemic area. Methods Between 1992 and 1996, 246 patients were clinically and serologically diagnosed as having brucellosis and were examined by sonography. Results Genitourinary complications were identified by sonography in 26 patients. Fifteen of these patients had unilateral epididymo-orchitis, 6 had diffuse orchitis, and 5 had a focal hypoechoic testicular lesion. An increase in the vascularity of the lesions was seen in the 14 patients who also underwent color Doppler examination. Spectral waveform analysis showed a decrease in the resistance index in 9 patients. After medical treatment, all but 1 of the lesions disappeared within 2 months; the last lesion persisted for 6 months. Conclusions In areas in which brucellosis is endemic, when scrotal abnormalities are seen with gray-scale or color Doppler sonography, the possibility of genitourinary tract complications of brucellosis should be considered. Simple Brucella tests may prevent unnecessary surgery. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound25: 443–447, 1997.

In this pa per, a ne\v technique to recognize and process Barcodes is introduced. The technique employs Inductive Learning. It is suitable to use, for example, in a factory to control the \\'Orkers, staff, stock ete. In this technique only vert.ical lines are considered \\·hile the spaces in bet,veen are ignored. This results faster processing. Each Barcode is considered to represent an iteın. For each Barcode a rule is ex1.racted from the necessary information using Inductive Learning. So the unnecessary information is eliminated. This causes faster processing time and less amount of memory. In order to use this technique no special hard\:vare is required. Only a PC and a Barcode reader _is enough

2Department of Radiology, Medical Faculty, Gaziantep University, Gaziantep, Turkey. ommunication of a hydatid disease with the biliary tree has been described in up to 90% of hepatic hydatid cysts [1]. This is due to the incorporation of biliary radicles into the pericyst [2]. However, frank rupture into the biliary tree occurs in only 5–15% of cases [1]. Although the communication with the intrahepatic bile ducts is common, its occurrence between a hepatic hydatid cyst and the gallbladder is rare [3]. We present an unusual case of a fistulous communication between a hepatic hydatid cyst and the gallbladder. The MR cholangiopancreatography (MRCP) features have been discussed.

The congenital absence of the right radius, scaphoid, trapezium, thumb and hypoplasia of the lunate are described in a 9-year-old boy. He had full extension of his elbow, while flexion motion was limited to 90 degrees. His hand was radially deviated. The thumb was absent. The index and middle fingers were united and immobile. The ring finger had movement only at the metacarpophalangeal joint, while the little finger had full motion. Complete blood count fell within normal ranges. He had no other malformations or mental retardation. No hereditary family history was found and there was no consanguineous marriage. This case is different from cases mentioned in the literature due to lunate hypoplasia and the anomalies of the index, middle and ring fingers.

The infrapatellar fat pad of Hoffa is a structure that is located in the space between the back side of the patellar ligament and the real capsule. It is routinely visualized on magnetic resonance (MR) images of the knee. The purpose of this study was to determine the prevalence and shape of a fluid-like indentation at the inferior posterior margin of the infrapatellar fat pad of the knee (recess) and to look for a relation between the liquid image in the fat pad and joint effusion. Three hundred and fifty consecutive MR imaging examinations of the knee were evaluated for the presence, location, size and shape of a recess in the infrapatellar fat pad and existence of joint effusion. The study population consisted of 145 females and 205 males aged between 5 and 80 years old (mean age 37.5 years). The recess in the infrapatellar fat pad was revealed on MR imaging in 54 of 350 knees (15.43%) and had a variable shape, consisting of 35 linear or ovoid (64.81%), five pipe-shaped (9.26%) and 14 globular (25.92%). Additionally, one ganglion cyst was observed in the infrapatellar fat pad. Globular and pipe-shaped recesses may be confused with cystic infrapatellar fat pad pathologies such as ganglion cyst, meniscal cyst, loose body or nodular synovitis. The existence of an infrapatellar fat pad may not be related to the presence of joint effusion.