The aim of the present study was to evaluate diagnostic value of glycogen and mucin-staining features of aspirated cyst fluid, and carbonhydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) levels in the blood and cyst fluid in differentiating benign from malignant lesions. A total of 13 patients, who were referred to the General Surgery Clinics due to pancreatic lesion between January 2013 and November 2013, were included in the study. In the preoperative period, CA 19-9 and CEA were obtained from all patients. The cyst fluid was aspirated in the guidance of radiological imaging methods in 6 methods and using laparoscopic or surgical methods in 7 patients. CA 19-9 and CEA levels were evaluated in the aspirated cyst fluids, and immunohistochemical tests were performed using PAS (glycogen) and mucin staining in patients with sufficient cyst fluid. The pancreatic tissue was macroscopically evaluated in patients who underwent an operation, and appropriate procedure was selected depending on the location of the lesion. The pathological examination of the 13 patients revealed malignant lesion in 5, benign-inflammatory cyst (IC) in 5, serous cystic neoplasm (CSN) in 1, mucinous cystic neoplasm (MCN) in 1, and non-functional cystic neuroendocrine tumor (CNT) in 1. The blood tests performed in 5 patients with malignant findings on pathological examination revealed elevated CEA levels in 1 patient and elevated CA 19-9 levels in 3 patients. In the aspirated cyst fluids, CA 19-9 levels were high in 3 patients with malignant lesion and in patients with MCN and CNT. The immunohistochemical examination revealed positive staining for PAS and mucin in 2 patients with malignant lesion and one patient with MCN, and another patient with malignant lesion showed PAS-positive staining. Immunohistochemical examination involving PAS and mucin could not be performed in two patients one of which had malignant lesion due to insufficient aspiration fluid. In the present study, CA 19-9 levels in the blood and aspirated cyst fluids were found to be higher in patients with malignant pancreatic lesions. Of patients with malignant lesions, 3 showed positive PAS staining. However, long-term studies on larger series of patients are warranted in order to establish the diagnostic value of PAS-staining and mucin-staining in immunohistochemical examination of the cyst fluids and the value of CEA levels in the blood and aspirated cyst fluid.

Lateral preferences in humans may be a key to many important topics in biology and physiology. However, less information is known about genetic and environmental factors for lateral preference. Comparisons of MZ (monozygotic) and DZ (dizygotic) twins can indicate which characters are hereditary or environmental. The aim of this study is to investigate morphological, functional and cognitive lateralities in twins in terms of hereditary and environmental factors. For this aim, the handedness, body laterality (motor), IQ (mental), hemispheric dominance (cognitive) and morphological properties such as head diameter, hand and foot dimensions (anatomical) were measured to determine asymmetry traits on 100 MZ, 92 DZ twin pairs. As compared with DZ twins, the correlations among the studied traits (IQ, visual memory, anatomical features, brain lateralization and handedness) were found higher in MZ twins.

The aim of this study was to determine the association among ultrasound findings, biochemical markers, and Down syndrome A retrospective analysis was conducted of the files and electronic records of 70 Down syndrome patients who were diagnosed in the prenatal or postnatal periods between July 2006 and May 2013. Forty-nine of the 70 Down syndrome patients had prenatal ultrasound findings (70%). Thirty-five patients had 1st trimester nuchal translucency (NT) measurements, 17 of whom had elevated values, above the 95th percentile of the gestational week. Twenty-nine patients had first-trimester biochemical markers; the median PAPP-A was 0.53 MoM (±0.27) and the median fB-HCG was 1.87 MoM (±1.55). Twenty-six patients had second-trimester biochemical markers; the median AFP was 0.67 MoM (±0.27), the median uE3 was 0.79 MoM (±0.33), and the median HCG was 2.09 MoM (±1.33). Two or more minor anomalies were found in 45% of the patients, and 20% had at least one major anomaly. In this retrospective analysis, prenatal ultrasonographic examination detected minor or major anomalies in 70% of the patients. Eighteen patients had normal NT values, ten patients showed increased biochemical risk in the combined test, and 12 patients had ultrasonographic anomalies in the second trimester. In expert hands, mid-trimester ultrasound markers are highly sensitive for Down syndrome detection.

An ethnobotanical research conducted in Pýnarbaþý, Kayseri, revealed that Sanguisorba minor Scop. Subsp. Muricata (Spach) Briq. (Smm) is commonly used for wounds and burns and Cirsium libanoticum DC. Subsp. Lycaonicum (Boiss. & Heldr.) Davis & Parris (Cll) is used especially to treat pressure wounds suffered by bedridden patients. This study was performed to assess any possible anti-inflammatory effect of these two folk medicinal plants. Aqueous extracts of Smm and Cll were prepared at room temperature with maceration. Extracts were given at doses of 25, 50 and 100mg/kg to rats. Anti-inflammatory test was performed to animals after 30 minutes of intraperitoneal injection. Smm and Cll extracts exerted anti-inflammatory activity in a dose dependent fashion. Control group shows 1.1% (mL) paw edema following lambda-carrageenan injection. Aqueous extracts of Smm showed 41.9, 76.4 and 83.4% anti-inflammatory activity at 25, 50 and 100 mg/kg doses respectively. Similarly aqueous extracts of Cll showed 20.9, 34.2 and 53.5% anti-inflammatory activity at 25, 50 and 100mg/kg doses respectively. In addition, Smm was more potent anti-inflammatory plant than Cll. These findings suggest that traditional use of these subspecies of Smm and Cll for anti-inflammatory activity have an ethnopharmacological relevance.

Single umbilical artery (SUA) is one of the most common abnormality of umbilical cord. SUA is associated with congenital anomalies, chromosomal abnormalities and adverse perinatal outcomes including preterm birth and small for gestational age (SGA). In this case series study, we presented the management and perinatal outcomes of cases with SUA. Fifteen patients with SUA were enrolled to the study. SUA was diagnosed by detailed ultrasonographic examination in the 2nd trimester. We diagnosed SUA when a cross-sectional image of the umbilical cord demonstrated only 2 vessels and/or in oblique transverse section the use of color flow mapping to visualize the one of two umbilical arteries at adjacent to the fetal bladder. Entire fetuses with SUA underwent to detailed ultrasonographic examination. Demographic characteristics and perinatal outcomes were recorded. Fetal karyotyping was performed to the cases with additional ultrasonographic findings or risk factors. The median maternal age was 26.4 years (21-33 years). Of the 15 cases with SUA, one case had major anomaly and another case had two umbilical cord cysts. Fetal karyotyping was performed to 4 cases. No abnormal finding was observed in fetal karyotyping. Thirteen patients had isolated SUA. Of the 13 cases, 1 case was resulted with medical abortion, 1 case underwent to preterm birth, 1 case had oligohydramnios, three cases were resulted with SGA. In conclusion, vast majority of SUA cases are isolated. There is not adequate evidence about the association of isolated SUA with chromosomal abnormalities. However patients with isolated SUA should be followed up for possible adverse perinatal outcomes.

Malaria is a parasitic infectious disease caused by the Plasmodium species, seen especially in tropical and subtropical regions. Generally, the Plasmodium (P.) vivax species is seen within Turkey. However, the P. Falciparum and P. Malariae species may also be seen in patients with a history of travel abroad. Cases have been detected in the city of Van, and the patients were found to be individuals who had worked abroad. As this disease is not very common within Turkey, three patients diagnosed with malaria, who had formerly traveled to different countries of Africa for work but who normally live in Van, are presented in this study.

The aim of the study was to compare the percutaneous nephrolithotomy (PCNL) complications according to the modified clavien classification during and after the learning curve. In our study, PCNL procedures were applied to 275 patients between May 2010 and June 2014. The complications were retrospectively compared according to the Modified Clavien Classification during and after the learning curve. The first 50 cases were defined as the learning curve and referred to as Group-1 and the following cases as Group-2. We performed 294 PCNL applications on a total of 275 patients. The average duration of surgery was 120 (65-230 min.-max.) minutes and 80.2 (20-140 min.-max.) minutes in Group-1 and in Group-2, respectively (p<0.05). When complications, following PCNL, were evaluated according to the modified Clavien classification, grade I, II, IIIa, IIIb, Iva, Ivb, and V complications were observed in 12 (15%), 54 (67.5%), 10 (12.5%), 4 (5%), 0 (0%), 0 (0%), and 0 (0%) patients of group 1, respectively. When group 2 was evaluated, grade I, II, IIIa, IIIb, Iva, Ivb, and V complications were observed in 24 (12.4%), 132 (68.4%), 30 (15.5%), 6 (3.1%), 1 (0.5%), 1 (0.5%), and 0 (0%) patients, respectively. Grade-5 complication was not observed in any of our patients. The Modified Clavien Classification may be useful for the comparison of PCNL complications during and after the learning curve for reporting outcomes.

The aim of this study is to compare the uric acid and leptin levels in preeclamtic and normal pregnants and to investigate the relationship between these levels and the severity of the disease. This study was performed on 40 (20 severe, 20 mild) patients who had received a diagnosis of preecclampsia and on 30 normal healthy pregnant women, a total of 70 singleton pregnancies, at 34-42nd gestational weeks who had recourse to obstetric and gynecology clinic from February to September. Plasma leptin levels were determined by using ELISA method. Levels of those parameters were compared in preeclamptic and normal pregnant woman. Leptin levels were found as 9.6±7.2ng/mL in severely preeclamptic group, 5.4±3.0ng/mL in mildly preeclamptic group and 3.1±3.1ng/mL in control group. In severe preeclampsia group, leptin levels were statistically significantly higher (p=0.001). Uric acid levels were found as 6.3±1.8mg/mL in severe preeclamptic group, 5.0±1.4mg/mL in mildly preeclamptic group and 4.02±0.73mg/mL in control group. When uric acid levels of preeclamptic groups were compared with the control, statistically significant difference was determined among the groups (p=0.001). The highest uric acid level was found in severely preeclamptic group. A weak, positive correlation was determined between serum uric acid and leptin levels (r=0.039). Increased uric acid values were found with increasing serum leptin levels. In preeclamptic patients it was found that uric acid levels were increased with increasing serum leptin levels. We consider that leptin hormone which has various functions may have some role in etiopathogenesis of preeclampsia and may be a useful marker of preeclampsia.

We presented two brothers with craniosynostosis, severe mental retardation, atypical facial appearance, camptodactyly and hypogonadism. In the literature, Lin-Gettig syndrome has been identified in 3 patients so far. To date, only one novel case was reported in 2002 since 1990 when Lin-Gettig syndrome was first identified. These cases have diverse characteristics. The patient who presented with growth failure and his brother with similar clinical characteristics who recently died were considered as compatible with Lin-Gettig syndrome. In addition, our cases have differential clinical characteristics compared to all previous 3 cases in some degree and double nuchal fold and nail hypoplasia were novel features. We will discuss these cases as it is an extremely rare entity.

The Ewing’s sarcoma family of tumors is an uncommon group of malignant neoplasms that may be located in both skeletal and extraskeletal regions. Extraskeletal Ewing’s sarcoma (EES) is quite rare and predominantly involves the soft tissues of the trunk or the extremities. There are few patients reported as EES involving the head and neck, from previous studies. We present a case of EES involving the posterior cervical neck and its subsequent surgical excision.

Gossypiboma is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. We report the laparoscopic management of gossypiboma after cesarean section for placenta previa. A 29 year- old women presented with a history of emergency cesarean section for placenta previa, performed seven days ago. Abdominal computerized tomography scan showed a heterogeneous and low density mass, with peripheral calcifications. The patient was submitted to laparoscopic surgery. An aseptic plastic material was used to wrap for laparoscopic removal of gossypiboma. Minimal invasive surgery for removal of gossypiboma is successful within a few weeks after the original operation as demonstrated in our case. However, the dissection technic is difficult and depends on an experienced laparoscopic surgeon.

Turner syndrome (TS) is classically characterized by complete or partial absence of one X chromosome. A Y chromosome can be detected in some of the TS patients called mosaicism. In this study we report three cases of TS with a female phenotype and a 45,X/46,XY karyotype. All of the cases were referred or applied to our hospital for gonadectomy at third decade of their lives. They had many of the stigmata of TS. We performed gonadectomy to our patients. In one of them histopathology was suggestive for gonadoblastoma. Further genetic evaluation must be made in patients with TS for revealing a probable Y chromosome and these patients should be informed for gonadectomy.