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OBJECTIVE: The aim of this study was to determine the frequency of germline variants in BRCA1, BRCA2, CDH1, PALB2, PTEN and TP53 in patients admitted to a medical genetics clinic with breast cancer and to assess these identified variants according to published genetic, surgical and oncological perspectives. MATERIALS AND METHODS: Medical history, and cancer diagnosis information for 195 independent probands with operated breast cancer were collected from requisition forms and medical records. The exonic regions and exon-intron junctions in BRCA1, BRCA2, CDH1, PALB2, PTEN and TP53 genes were sequenced. Analysis of fastq files was performed on the Qiagen Clinical Insight-Analyse Universal with panel-specific pipeline and vcf files were interpreted clinically using Qiagen Clinical Insight-Interpret. RESULTS: Gene variants (pathogenic, likely pathogenic and variants of unknown significance) were detected in 53 (27.2%). Detailed information about the patients (age of diagnosis, family history, gender), cancer stage, tumour characteristics (ER, PR, human epidermal growth factor receptor 2 status) and all information related to the detected variants (gene, location, nucleotide and amino acid change, exon number, impact, mutation classification, dbSNP number and HGMD variant class) were assessed. In total, 58 mutations were identified including 14 novel, previously unreported variants. CONCLUSION: Molecular characterization and identification of mutations have important implications for predictive, preventive, and personalized medicine, including genetic counseling and development of specific treatment protocols. We emphasize variants of unknown significance (VUS) as the clinical significance of VUS changes over time and variant classification is important for clinical molecular genetic testing and clinical guidance. This study may provide new insights into risk assessment for variants in CDH1, PALB2, PTEN and TP53, in addition to BRCA1 and BRCA2, which may prove useful for clinical management of breast cancer patients. Further studies are needed to identify the common gene variants in the Turkish population and evaluate the pathogenity of VUS.

Purpose: Laparoscopic adrenalectomy, which was performed successfully for the first time in 1992, has become the preferred method in adrenal surgery especially in adrenal diseases. In this study, our aim is to compare the demographic and operative data of laparoscopic and open adrenalectomies performed in the general surgery clinic of our hospital. Methods: The records of the patients who were operated in hospital due to a surrenal mass between August 2006 and December 2012 have been retrospectively assessed. Demographic characteristics of the patients, such as age, sex, the size and location of tumors were included. Surgical indications were classified in terms of their radiologic and biochemical investigations. Type of the surgery (lateral transperitoneal laparoscopic or open approach), the incision used in these surgeries (midline, subcoastal and paramedian), the length of operation, the length of hospital stay, postoperative complications and the final pathology results were all examined. Results: During the afformentioned period, adrenalectomy was performed in 106 patients. Eighty of these patients (%75,4) were operated by open and 26 of them (%24,6) by lateral transperitoneal laparoscopic surgery. Subcostal incision was used 61 of 80 patients (% 82,4), whereas 17 patients (% 22,9) were operated by midline incision and 2(% 2,7) were by paramedian incision. No mortality was encountered. Operation time was statistically significantly shorter in the open group (p

Purpose: Laparoscopic adrenalectomy, which was performed successfully for the first time in 1992, has become the preferred methodin adrenal surgery especially in adrenal diseases. In this study, our aim is to compare the demographic and operative data of laparoscopicand open adrenalectomies performed in the general surgery clinic of our hospital.Methods: The records of the patients who were operated in hospital due to a surrenal mass between August 2006 and December 2012have been retrospectively assessed. Demographic characteristics of the patients, such as age, sex, the size and location of tumors wereincluded. Surgical indications were classified in terms of their radiologic and biochemical investigations. Type of the surgery (lateraltransperitoneal laparoscopic or open approach), the incision used in these surgeries (midline, subcoastal and paramedian), the length ofoperation, the length of hospital stay, postoperative complications and the final pathology results were all examined.Results: During the afformentioned period, adrenalectomy was performed in 106 patients. Eighty of these patients (%75,4) wereoperated by open and 26 of them (%24,6) by lateral transperitoneal laparoscopic surgery. Subcostal incision was used 61 of 80 patients(% 82,4), whereas 17 patients (% 22,9) were operated by midline incision and 2(% 2,7) were by paramedian incision. No mortalitywas encountered. Operation time was statistically significantly shorter in the open group (p

Amaç: İnflamatuar barsak hastalıkları (İBH) gastrointestinal kanalın çeşitli bölgelerini tutabilen, remisyon ve alevlenmelerle seyreden, kronik inflamatuar hastalıklardır. Hastalığın majör belirtilerinden biri aşırı yorgunluktur. Hastalar remisyonda olsalar dahi yorgunluk şikayetiyle sıklıkla hastaneye başvurmaktadırlar. Bu çalışmada, İBH Yorgunluk Ölçeği’nin (İBH-Y) (Inflammatory Bowel Disease Fatigue) Türkçe geçerlilik ve güvenirlik çalışmasının yapılması amaçlanmıştır.Çalışma Planı: Metodolojik türde planlanan araştırma245 İBH tanılı hasta ile yürütülmüştür. Örneklem içerisinden 50 hastaya tekrar test uygulaması yapılmıştır.İBH-Y Ölçeği üç bölümden ve toplam 40 maddeden oluşmakta; her bölüm kendi içerisinde puanlanmaktadır. Orijinal ölçekte olduğu gibi ilk iki bölüm Türkçe uyarlama çalışmasına dahil edilmiştir. Verilerin değerlendirilmesinde SPSS 25.0 ve LISREL 8.727 programlarıyla psikolinguistik ve psikometrik incelemeler yapılmıştır. Araştırmanın yürütülebilmesi için etik kurul izni alınmıştır. Bulgular: Ölçeğin, çoğul uzman görüşüne göre kapsam geçerliliği Davies tekniğiyle değerlendirilmiş, her bir maddenin KGO değeri 0.99, KGİ değeri 0.99 olarak saptanmıştır. Özgün ölçeğe göre açımlayıcı faktör analizinin ardından, yeniden doğrulayıcı faktör analizi (DFA) yapılmış; T değeri 1.96’dan küçük değer olmadığından herhangi bir madde atılmamıştır. DFA analizi sonucunda, uyum iyiliği indekslerinin kabul edilebilir düzeyde uyumlu olduğuna, ölçeğin daha önce belirlenen yapısının toplanan verilerle genel olarak kabul edilebilir düzeyde uyum sağladığına karar verilmiştir. Ölçeğin güvenirlik analizlerinde, Spearman Brown katsayı değeri (0.906)ve Cronbach's Alpha split-half (0.971 ve 0.928) değerlerinin 0.70’ten büyük olması nedeniyle ölçeğin iç tutarlılığı yüksek olarak değerlendirilmiştir.Sonuç: İBH-Y Ölçeği’nin Türkçe uyarlamasının yapıldığı bu araştırmada; ölçeğin kabul edilebilir düzeyde uyumlu olduğu, ülkemiz için üç faktörlü olmasının uygun olduğu ve iç tutarlılığının yüksek olduğu sonucuna varılmıştır. İBH-Y ölçeği, ülkemiz için geçerli ve güvenilir bir ölçektir., Objectives: Inflammatory bowel diseases (IBD) are chronic inflammatory diseases that can involve various areas of the gastrointestinal tract, progress with remission and exacerbations. One of the major symptoms of the diseases is over-fatigue. Patients often have recourse to the hospital with complaints of fatigue, even if they are in remission. In this research, it was aimed to carry out the Turkish validity and reliability study of the Inflammatory Bowel Disease Fatigue Scale (IBD-F).Study Design:The research which is planned methodological type was conducted with 245 patients with IBD. Test re-test reliability used with 50 patients which are from in sampling. The IBD-F Scale consists of three sections and 40 items, each section is scored within itself. As in the original scale, the first two sections were included in the Turkish adaptation study. In the evaluation of the data, SPSS 25.0 and LISREL 8.727 programs were performed. Ethics committee approval was obtained to conduct the research.Results: Scope validity of the scale was evaluated using the Davis technique, according to the opinion of the plural expert, the CVR value of each item was .99 and the CVI value was .99. After the exploratory factor analysis based on the original scale, confirmatory factor analysis (CFA) was performed, any item wasn't discarded because the T value wasn’t less than 1.96. As a result of the CFA analysis, it was decided that the goodness of fit indices were at an acceptable level, and the previously determined structure of the scale was generally compatible with the data collected. In the reliability analysis of the scale,since the Spearman Brown coefficient value (.906) and Cronbach's Alpha split-half (.971 and .928) values were higher than .70, the internal consistency of the scale was evaluated as high.Conclusion: In this research where the adaptation to Turkish of the IBD-F Scale, it was concluded that the scale was at an acceptable level, compatible with three factors and had high internal consistency for our country. The IBD-F scale is a valid and reliable scale for our country.

Endometriosis is characterized by the presence of endometrial glands and stroma outside the uterine cavity. Appendiceal endometriosis, which is very rare, may have nonspecific presentation such as chronic pelvic pain, but sometimes it can masquerade clinically as acute appendicitis. Also appendiceal diverticulum may be congenital or acquired and is an infrequently encountered lesion. They are often asymptomatic but when diverticulitis or perforation develops, it may clinically mimic acute abdomen of acute suppurative appendicitis. Herein we report a case with a unique combination of appendiceal diverticulosis and endometriosis in a 39-year-old woman that was diagnosed preoperatively as acute appendicitis., Endometriozis, endometriyal bez ve stromanın uterin kavite dışında görülmesi ile karakterlidir. Oldukça nadir görülen apendisyel endometriozis, kronik pelvik ağrı gibi nonspesifik bulgularla seyredebileceği gibi bazen klinik olarak akut apandisiti de taklit edebilir. Apendisyel divertikül konjenital veya edinsel olabilir ve görülme sıklığı nadirdir. Genellikle asemptomatiktir; ancak divertikülit veya perforasyon geliştiğinde, akut süpüratif apandisitin akut batın tablosunu taklit edebilir. Bu çalışmada preoperatif olarak akut apandisit tanısı konulan 39 yaşındaki kadın hastada apendisyel divertikülozis ve endometriozis birlikteliğinin özgün olması nedeni ile olgumuz sunulmuştur.

Amaç: Küratif amaçlı gastrektomi uygulanan hastaların klinikopatolojik özelliklerini irdelemek ve ameliyat sonrası sağkalıma etki eden faktörleri araştırmakGereç-Yöntem: Ocak 2007- Ocak 2017 tarihleri arasında, İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği'nde gastrektomi uygulanan 644 hastanın dosyaları retrospektif olarak incelendi. Küratif amaçlı gastrektomi yapılan 359 mide adenokanseri tanılı hasta çalışmaya dahil edildi. Bu hastalarda, çeşitli faktörlerin sağkalıma etkisi araştırıldı.Bulgular: Hastaların ortalama yaşı 59.2±11.6 olup (29-83), % 48.2'si 60 yaş üzerindeydi. Median yaş ise 60 olarak bulundu. Hastaların 244'ü (%68) erkek, 115'i (%32) ise kadındı. Ortalama takip süresi 29.9±26.9 ay (2-128) olarak hesaplandı. Median sağkalım 23±2.3 ay (18.388-27.612) olarak hesaplandı. İleri yaş, A kan grubu, koroner arter hastalığı varlığı, sigara kullanımı, ameliyat öncesi protein ve albumin düşüklüğü ile karsinoembriyonik antijen ve kanser antijen 19-9 yüksekliği, total gastrektomi, splenektomi, R1 rezeksiyon, tümörün proksimal yerleşimi, büyük tümör boyutu, lenfovasküler invazyon ve perinoral invazyon varlığı, diffüz tip, poorly cohesive tip, kötü differansiye histolojik derece, ileri T evresi, ileri N evresi, 15 ve üstünde lenf nodu çıkarılan hasta grubunda ileri N oranı, ileri TNM evresi, nüks hastalık varlığı univaryant analizde sağkalımı anlamlı şekilde azaltan kötü prognostik faktörler olarak bulundu (p< 0.05).Sonuç: R1 rezeksiyon, splenektomi, ileri TNM evresi ve nüks hastalığın gelişmesi, kötü prognoz açısından bağımsız risk faktörleridir. Background: Gastric cancer is the fifth most common cancer and the third most common cause of cancer-related deaths in the world.Aim: To investigate the clinicopathological features of the patients who underwent curative gastrectomy and to evaulate factors affecting postoperative overall survival (OS).Methods: The medical records of 644 patients who underwent gastrectomy in İzmir Katip Çelebi University Atatürk Training and Research Hospital General Surgery Clinic between January 2007 and January 2017 were retrospectively reviewed. Among these patients, 359 gastric adenocarcinoma patients who underwent curative gastrectomy were included in the study. Several prognostic factors were investigated in these patients.Results: The mean age of the patients was 59.2±11.6 (29-83), and 48.2% of the patients were over 60 years of age. Median age was 60. 244 (68%) of the patients were male and 115 (32%) were female. The mean follow-up time was calculated as 29.9±26.9 months (2-128). Median OS was calculated as 23±2.3 months (18,388-27,612). In univariate analysis, advanced age, A blood group, coronary artery disease, smoking, preoperative low protein and albumin levels, preoperative elevated levels of carcinoembryonic antigen and cancer antigen 19-9, total gastrectomy, splenectomy, R1 resection, proximal tumor, large tumor size, lymphovascular invasion, perineural invasion, diffuse type, poorly cohesive type, poorly-differentiated histological grade, advanced T, N and TNM stage, advanced N ratio, recurrent disease were obtained as poor prognostic factors and associated with decreased OS (p