Amaç: Gestasyon haftasýna göre büyük, özellikle 4000g üzerinde olanlar bebeklere 4000g altýnda olan bebeklere oranla daha fazla morbiditeye sahip olduðu bilinmektedir. Çalýþmamýzda, makrosomi oranýný, risk faktörlerini ve nýorbiditelerini saptamaya çalýþtýk.
Materyal-metod: Ocak 1999 Aralýk 1999 tarihleri arasýnda hastanemizde doðan bebeklerin dosyalarýný retrospektif olarak inceledik. Doðum tartýsý 4000g üzerinde olan bebekleri makrosomik olarak deðerlendirdik.
Bulgular: Canlý doðan 3431 bebekten %7.22’si (248) olgu 4000g, %0.8’ i (17) olgu ise 4500 gramýn üzerinde saptandý. Makrosomik bebeklerin %65.2’si (n=163) erkek bebeklerdi. Makrosomik bebeklerde sezaryenle doðum %31, makrosomik olmayanlarda ise %21 oranýnda saptadýk. Makrosomik bebeklerde hipoglisemi %0.8, polisitemi %2.8, doðum travmasý %2.8 ve amnios mayinin mekonyumla boyanma %4.8 oranýnda bulundu.
Sonuç: Makrosomik doðumlarda sezaryen oranýnýn daha yüksek olduðu, ancak sorunlarýnýn bilinmesi ile postnatal izlemlerin dalýa özenli yapýlarak, morbiditenin azaltýlabilmesinin mümkün olacaðýný saptadýk.

Aim: Large-for -gestational age (LGA) babies, especially those whose birth weight is greater than 4000g, have elevated risk perinatal mortality and morbidity. The purpose of this study is to evaluate the incidence of macrosomia, risk factors and morbidity of the macrosomie babies.
Study Design: Clinical records of the newborn in Sisli Etfal Teaching Hospital between January 1999-December 1999 were reviewed retrospectively. Macrosomia was defined as a birth weight of4000 g or greater.
Results: A total of 3431 babies were born during the study period and 248 (7.2%) were weighing more than 4000 g at birth and 17 (0.8%) of these babies were weighing more than 4500 g. Of the 248 macrosomie babies 65.2% was male. Among macrosomie newborns the caesarean delivery rate was 31% (n: 77), whereas in the appropriate gestational age group (AGA) was 21.8% (n: 636). In the macrosomie group the incidence of hypoglycemia, polycythemia and birth trauma were higher than AGA group however, meconium stained amniotic fluid incidence was lower.
Conclusion: Macrosomia was associated with increased cesarean rate. It is important to recognise the morbidity of macrosomie infants and so to decrease the morbidity in these infants.

Giriþ: Spinal anestezide lokal anestezik karýþýný kullanýmýnýn etki baþlama ve etki süresi ile yan etkilerinin araþtýrýlmasý amaçlandý. Materyal ve Metod: Ortopedik giriþim yapýlmasý planlanan ASA 1-2 grubunda 17 kiþiye spinal anestezi uygulandý. Spinal anestezi 4 ml %2 prilokain ve 3 ml %0.5 bupivakaiýý ile saðlandý. Postop 48 saate dek komplikasyonlar ve postop aneljezik gereksinimi kaydedildi. Sonuçlar (etki baþlama, sensorial ve motor blok zamaný) aritmetik ortalama ve standart sapma ile deðerlendirildi.
Bulgular: Vakalarýn yaþ ortalamasý 40.55+15.87, aðýrlýklarý 70.10±13.15 kg idi. Tüm hastalarda sensorial blok seviyesi T 8-10’da, motor blokaj Bromage 3 idi. Intraoperatif ilave aneljezik gerekmedi. Ortalama etki baþlama zamaný 3.83±1.38 dk, analjezi süresi 261.38+55.75 dk, motor blokaj süresi 268.83±68.32 dk idi. Peroperatuvar komplikasyonlar; kusma (n: 2), bulantý (n: 2), titreme (n: l), hipotansiyon (n: l), bradikardi (n: 2) idi. Postoperatif 6 vakada hiç aneljezik gereksinimi olmadý, ilk 24 saatte 10 vakada 1 gr IM metamizol, 1 vakada 20 nýg IM piroksikaný kullanýldý.
Tartýþma: Lokal anestezik solüsyon pH’sý 7‘ye yakýn ise etki baþlama zamaný kýsalýr (1). Çalýþmada bupivakaiýý ile prilokaini karýþtýrarak alkalinizasyoýý saðlanmýþtýr. Etki baþlama zamanýnýn kýsa ve etki süresinin uzun olmasý alkalen karýþýmda birbirlerinin biyoyararlanýmlarým artýrmalarý ile açýklanabilir.
Sonuç: Spinal anestezide lokal anestezik karýþýný hýzlý etki baþlama zaman, uzun etki süresi, azalmýþ toksisite ve düþiik postoperatif analjezik tüketimi saðlamýþtýr.

Objective: Aim of this study was to compare the onset duration of action and adverse effects of local anaesthetic mixture used in spinal anaesthesia.
Study Design: Spinal anaesthesia was applied to 17 patients, ASA 1-2 undergoing onthopaedic surgery. 4 ml 2% prilocain and 3 ml 0.5% bupivacain were used for spinal anaeshesia. Postoperative analgesic need and postoperative complications till postoperative 48 h were recorded. Data (onset of duration, motor and sensorial block time) were assessed according to standard deviation and arithmetical mean.
Results: Mean age ahr weight of patients were 40.55±15.87 years and 70.10±13.5 kg, respectively. Level of sensorial block was T 8-10 and motor block bromage 3 in all patients. Mean onset of duration was 3.831.38 min, duration of analgesia was 261.38±55.75 min, duration of motor block was 268.83±68.32 min. Peroperative complications were vomiting (n: 2), nausea (n: 2), shivering (n: l), hypotension (n: l), bradycardia (n: 2). Six patients did not require analgesic need during the postoperative period. But 1 gr metimazol (I.M) was used for 10 patients while 20 mg proksikam (l.M) was used for one patient.
Conclusions: Onset of duration is shortened if pH of local anaesthetic is close to 7 in this study; alkalinization is made by mixturing bupivacaine and prilocaine short onset of duration and long duration of (alcalinic) mixture of drugs can be explained by their enhancement of bioavailability. Local anaesthetic mixture in spinal anaesthesia provides rapid onset of action, long duration, reduced toxisity and low postoperative analgesic consumption.

Bu çalýþmada kliniðimize baþvuran yumuþak doku sarkomlu hastalar metastaz üzerine etkili faktörleri belirleyebilmek için retrospektif olarak deðerlendirilmiþtir. 1990-2000 yýllan arasýnda takip edilen 144 hasta mevcuttur. Ortalama yaþ 43’tür. Erkek hasta 76. kadýn lýasta 68’dir. En sýk leiomiyosarkoný (%20, n=29), 2. sýklýkta malign fibröz histiositom (%15,n=2J ), 3.sýklýkla liposarkom (%12,n=17) görülmüþtür. 23 hasta (%23) stage I-II, 56 hasta stage III (%39), 55 hasta stage IV (%38) idi. Metastaza etkili faktörler olarak; histopatolojik tip (p=0.0496), gracle (p=0.363)ve yerleþim yeri (p=0.0210) tespit edilmiþtir.

In this study, patients that came to our clinic with soft tisse sarcoma have been investigated to determine factors effecting metastasis retrosspectively. 144 patients have been followed up between the years 1990-2000. The average age is 43. 76 of the patients are male and 68 are female. The most often seen fist is leiomyosarcoma (20%,n=29), 2nd is malignant fibrous histiocytoma (15%,n=21), 3rd is liposarcoma (12%), 56 were stage III (39%), and 55 were stage IV (38%). Factors effecting metasis were found as: histopathological type (p=0.0496), grade (p=0.0363) and location (p=0.0210).

Amaç: 01.01.1988-08.09.1996 tarihleri arasýnda kliniðimize müracaat eden low grade astrositoma tanýsý almýþ 65 vakanýn deðerlendirilmesini amaçladýk.
Materyal ve Metod: 65 hasta yaþ, cinsiyet, histopatoloji, semptomlarýn görülme sýklýðý, tümör lokalizasyonu ve taný yöntemlerine göre deðerlendirilmiþtir.
Bulgular: Hastalarýn 29’ u erkek (%44.6), 36’sý kadýndýr (%55.6). en genç hasta 6 yaþýnda en yaþlýsý 72 yaþýndadýr. Low grade astrositomalar en çok çocukluk ve genç eriþkin yaþ grubunda görülmektedir. Hastalarýn %75.4’ii supratentorial; %24.6’sý infratentorial yerleþimlidir. Serebellum en sýk infratentorial yerleþim yeridir. Hastalarýn tümüne external radyoterapi primer veya postoperatif olarak uygulanmýþtýr. Median takip süresi 25 ay; ortalama takip 31.4 aydýr. 5 yýllýk survi %32.2 bulunmuþtur.
Sonuç: Tüm maligniteler içinde %1.5 paya sahip, primer intrakranial neoplazmlarýn yaklaþýk %15-20’sitýi teþkil eden low grade astrositomalarda tedavi sonuçlarý iyimserlik yaratmaktaysa da; halen bu hastalýktan ölen hastalarýn bulunmasý daha ileri tedavi yöntemlerinin araþtýrýlmasýný gerektirmektedir. Primer tedavisi cerrahidir. Cerrahinin yanýnda surviyi etkileyen majör faktörler; histolojik grade, performans statüsü, uygulanan radyoterapi tekniði ve dozudur.

Objective: We studied 65 cases with astrocytoma who came t our clinic between 01.01.1988 and 08.09.1996. Study Design: All 65 patients wer evaluated according to age, sex, histology, symptoms, tumor localization, and diagnosis.
Results: Out of 56 patients, 29 were male (44.6%), 36 were female (55.3%). Youngest was 6, oldest was 72 years of age. Low Grade Astrocytomas were seen with younger age group (children/early adult). 75.4% of the patients had tumors supratentorial, 24.6% had infratentorial. Cerebellum is found to be the most common localization for tumors. Alla patients had received external radiotherapy.
Median follw-up period calculated to be 25 months average follow-up 31.4 months and 5 years survival rate were 32.2%.
Conclusion: Primer intracranial neoplazma account for 1.5% of all malignities and low grade constitutes approximately 15-20% of this group. Although our results show a positive outlokk, due to still happening death case, it is advisable to search for new (advanced) methods of treatment. Primer treatment is still surgery, besides operation, hystological grade, performanca status, type of and technique of radiotherahpy, and dosage of radiotherapy plays a major role.

Amaç: 01.01.1988 / 08.09.1996 tarihleri arasýnda kliniðimize baþvuran low grade astrositoma tanýsý almýþ hastalarýn tedavi sonuçlarýnýn deðerlendirilmesini amaçladýk.
Materyal Metod: Hasta grubunun özelliði primer veya postoperatif radyoterapi uygulanmýþ olmasýdýr. Niiks veya rezidiv sebebiyle kemoterapi uygulanan hastalar; primer amacýmýzýn radyoterapi etkinliðini incelemek olduðu için çalýþma dýþý býrakýlmýþtýr, lstatistiki olarak Ki-kare testi ve Mann-Whitney U testi kullanýlmýþtýr.
Bulgular: Hastalarýn ilk baþvuru semptomlarý içinde baþ aðrýsý ( %.78.4) birinci sýrada, epileptik nöbet (%58.4) ikinci sýradadýr. Hastalarýn %56.7’sinin stage 1 hastalar oluþturmaktadýr. Çalýþmamýza alýnan hastalarýn tümüne cerrahi bir prosedür uygulanmýþ ve histopatolojik olarak taný konulmuþtur Hastalarýn 9’una primer radyoterapi, 56’sýna ise postoperatif radyoterapi uygulanmýþtýr. Grade 1 hastalarda ortalama takip süresi 40 ay, grade II hastalarda 25.6 aydýr. Ortalama takip süresi açýsýndan grade 1 ve grade II hastalar arasýnda istatistiki olarak anlamlý bir farklýlýk vardýr. (U: 311, p>0.05)
Sonuç: Low grade astrositomalar intrakraýýyal neoplazmalarýn yaklaþýk %15-20’siniýý teþkil ederler Primer tedavisi cerrahi olup, hastalann % 15-35’i cerrahi rezeksiyona uygundur Daha önceleri paralel karþýlýklý lateral iki sahadan yapýlan tüm beyin ýþýnlamasý, bugün beyin tomografisi ve magnetik rezonans tekniklerindeki geliþmelerle birlikte yerini lokal ýþýnlamaya býrakmýþtýr.

Objective: To evaluake the result of treatement methods of the patient who were treated at our clinic between 01.01.1988 and 08.09.1996 with Low Grade Asrocytomas diagnosis.
Study Design: Patient group were studied in post and preoperation findings with regard to application of radiotherapy. This was left out as our purpose was to evulate the resluts of radiotherapy. Ki-sq test and Mann-Whitney U test were used for statistical calculations.
Results: 78.4% of patients were complaing from headaches when they come to our clinic, 58.4% had epileptical synptoms. 56.7% of the patient were grouped as falling into stage I, All the patient had a operational treatments and all had been diagnosed as hystopathological. 9 patients received primer radiotherapy,56 patients had postoperative radiotherapy, grade 1 pat ie nets, were followed for up to 40 months, grade II for 25.6 months,. Average follow-up of the patients between grade I and grade II show a remarkable difference (p>0.05)
Conclusion: Low Grade Astrocytomas Form the 15-20% of intracrainal neoplasms, primer treatments is considered as “ Operative’’ and our patients had been obsereved to be 15- 35% operative rezeciton. Before, the treatment was made using parallel-oposite ray applications over the whole of the brain but recently, the developments in tomography and MR allows us to use localy concetrated Rays.

Giriþ: 1977-1989 tarihleri arasýnda beyin cerrahi kliniði hastalarýna kliniðimiz tarafýndan anestezi verilmiþtir. Bu dönemde ameliyat olan 2456 hasta günlük pratiðimizde yaptýklarýmýzýn deðerlendirilmesi ve bölümün özeleþtirisini yapmak amacý ile sunuldu.
Materyal ve Metod: Anestezi kayýtlarýndan retrospektif olarak; vakalarýn yaþ gruplarý, cinsiyetleri, operasyon endýkasyonlarý, seçilen anestezi tekniði, kan ve kolloid infiizyon uygulamalarý, intraoperatif mortalite oraný araþtýrýldý.
Bulgular: 2456 hastanýn 173’ü (%7) bir yaþ altý, 431’i (%17.5) bir-on üç yaþ arasý, 1757’si (%71.5) on dört- altmýþ beþ yaþ, 95’i (%4) altmýþ beþ yaþ üstü idi. Kadýn!Erkek oraný 0.52 bulundu. Vakalarýn 1133’ii (%46.1) acil, 1323’ü (%53.9) elektif koþullarda anestezi almýþtý. Vakalarýn yalnýzca %0.51’ inde rejyonel anestezi tekniði kullanýlmýþken %99.49‘unda genel anestezi seçilmiþti. Ýntraoperatif mortalite 12 vaka ile %0.48 idi.
Sonuç: 1977-1989 yýllarý arasý beyin cerrahisi kliniðinde öpere edilen vakalarýn yarýsýna yakýnýnýn acil koþullarda operasyona alýnmýþ olduðunu, intraoperatif mortalite oranýnýn %0.48 olduðunu gördük.

Introduction: Between the years 1977-1989, we have performed anesthesia for patients undergoing neurosurgical procedures. The 2456 patients who has been given anesthesia in this period are reviewed to recevalvate daily practises and to do self critics of our department.
Material and Methods: Data including patients’ age, sex, operation conditions, anesthetic techniques, application of blood and colloid infusions and intraoperative mortality ratios were retrospectevely researched from anesthetical records.
Results: 2456 patients were included in this study. 173 of them (7%) wer under 1 year of age, 431 of them (17.5%) wer between 1-13 years of age; 1757 of them (71.5%) were between 14-65 years of age and 95 of them (4%) were over 65 years of age. Ratio between female and male was 0.52. 1133 of the cases (46.1%) were emergency and 1323 of the cases were elective. Regional anesthesia technique was chosen only in 0.51 percent of the cases, while general anesthesia was chosen in 99.49 of them. Intraoperative mortality was (0.48%) with 12 cases.
Conclusions: Almost half of the patients who underwent neurosurgical operations were emergency cases and intraoperative mortality ratio was found to be 0.48%.

Amaç: Över kanserleri, jinekolojik kanserler arasýnda en önemli ölüm sebebidir. Bütün kanserlar arasýndaysa, kadýnlarda ölüm nedeni olarak, meme ve barsak kanserinden sonra üçüncü sýradadýr. Pelvik kitle tanýsýyla baþvuran hastalarda, benign ve malign ayrýmýnýn operasyon öncesi yapýlabilmesi, hastalarýn cerrahi giriþimin uygulanabileceði merkezlere þevkine olanak saðlayacak, operasyon sýrasýnda evreleme içiýý uygun insizyoýý seçiminde bize yol gösterici olacaktýr.
Materyal ve metod: Çalýþmamýzda, Þiþli Etfal Hastanesi 2. Kadýn Hastalýklarý ve Doðum Kliniðine Kasým 1996 ve Kasým 1999 tarihleri arasýnda adneksal kitle ön tanýsýyla yatýrýlan 83 hasta prospektif olarak gözlendi. Adneksal kitlelerin ayýrýcý tanýsýnda vaginal ultrasonogra.fi, CA-125 ve MRl‘nýn tanýsal etkinliði araþtýrýldý.
Bulgular: Malign pelvik kitleli hastalarýn tamamýnda CA- 125 deðerleri yüksek bulundu; %94‘iinde ultrasonografi skoru 9‘un üzerindeydi ve malignansi risk indeksi 200‘itn üzerindeydi.
Sonuç: Uygulanacak yöntem hakkýnda karar verilmesi sürecinde, CA-125 düzeyleri, ultrasonografi ve malignansi risk indeksi yol gösterici olacaktýr. CA-125 düzeylerinin ve ultrasonografinin yalancý pozitifliði daha fazla olduðundan, MRl karar verme konusunda da daha güvenilir bulunmuþtur.

Objective: Ovarian cancer is the most important cancer in deaths related to the gynecological cancers. The patients applying with the diagnosis of pelvic mass should be evaluated for differentiation of malignancy; so the choose of referance hospital and even insicion type of operation could be determined easily.
Study Design: In our study 83 patient applying Sisti Etfal Education and Training Hospital, 2nc Gynecology and Obstetrics Clinic with the diagnosis of adnexal mass were examined prospectively between November 1996 and November 1999. The differential diagnosis of the adnexal masses were made on the basis of transvainal ultrasonography, CA-125 and MRI.
Results: All of the malignant masses had high CA-125 levels, with ultrasonographic score greater than 9 and with the malignancy risk index above 200.
Conclusion: At the time of desicionfor the treatment serum CA-125 levels, ultrasonography and the malignancy risk index will be helpfull. Nevertheless the false positive predictivity of CA-125 and ultrasonography must be remembered but MRl has higher confidence.

Amaç: Över kanserinden ölüm oram servikal ve endometrial kanserden ölümlerin toplamýndan daha fazladýr. Bu çalýþmada, adneksal kitle tanýsý konmuþ hastalarda bu yeni klinik skor sisteminin tedavi planlarýmýzdaki etkinliði ve her parametrenin malignité tanýsýndaki deðeri araþtýrýlmýþtýr.
Materyal ve ýnetod: Çalýþmaya dahil edilen olgular menses anamnezi, fizik muayene, jinekolojik muayene, abdominal ve vaginal ultrasongrafi ve CA-125 ölçümünden elde edilen ve maligýýiteye iþaret eden parametrelerle oluþturulan Adneksal Tümör Klinik Skorlama tablomuza göre deðerlendirildi.
Bulgular: Total skor 9 ve yukarýsýnýn adneksal tümörlerde malignité bakýmýndan seýýsitivitesi %100, spesifitesi %98, pozitif prediktif deðeri %87 bulunmuþtur.
Sonuç: Gelecekte klinik skorlama sisteminden faydalanarak adneksiyal tümörlerin tedavisinde yeni tedavi ve takip planlarýnýn geliþtirilmesi mümkün olmaktadýr.

Objective: The death rate in ovarian cancer is greater than the sum of servical and endometrial cancer. In this study, adnexal masses were searched for the effectiveness of the new clinical scorring system in treatment plans and prediction of malignancy.
Study Design: The accompanying patients were taken to questioneire about family history and menses anamnesis; physical and gynecological examination, abdominal and vaginal ultrasonography. By the addition of serum CA-125 levels Adnexal Tumor Clinical Scores Calculated.
Results: Scores greater than 9, indicates malignancy with 100% sensitivity, 98% spesifisity, 87% positive predictive value. Conclusion: In the future with the help of the clinical scorring system new treatment and following protocoles can be developed.

Amaç: 1989-1997 yýllarý arasýnda kliniðimize baþvuran küçük hücreli akciðer kanseri tanýsý alymýþ hastalarýn genel özelliklerinin deðerlendirilmesini amaçladýk.
Materyal ve Metod: Çalýþmamýzda 1989-97 yýllarý arasýnda Þþli Etfal Hastanesi Radyasyon Onkolojisi Kliniðine müracaat eden ve altý aydan uzun süreli takibi olan, küçük hücreli akciðer kanseri tanýsý almýþ 112 hastanýn genel özellikleri retrospektif olarak deðerlendirilmiþtir.
Bulgular: Çalýþmamýza alýnan 112 hastanýn en genci 35 yaþýnda, en yaþlýsý 78 yaþýndadýr. Yaþ ortalamasý 55’tir. Hastalarýn 5’i kadýn, I07’si erkektir. Sigara içen hasta sayýsý 101, içmeyen ise l’dir. Hastalarýn doktora müracaatlarýnda en sýk semptom öksürük bulunmuþtur. Evrelere göre daðýlýmda; 39 hasta sýnýrlý hastalýk, 73 hasta yaygýn hastalýk evresindedir. Taný yöntemlerinden en sýk kullanýlan balgam sitolojisidir. 76 hastada Karnofsky Performans Statüsü 70 ve üzerindedir. En sýk görülen metastaz yeri beyin olarak tespit edilmiþtir. 99 hastada primer tümör yerleþim yeri santraldir. Tedavide tek baþýna kemoterapi veya kemoterapi ve radyoterapi kombine olarak kullanýlmýþtýr.
Sonuç: Santral yerleþimli primer akciðer kanserlerinden olan küçük hücreli akciðer kanseri, epirdermoid karsinom histolojisinden sonra en sýk görülen ikinci histolojik tiptir. Uygulanan tüm tedavi modalitelerine raðmen; mediaýý survinin 12 ay civarýnda olmasý prognozu kötü hastalýklardan olduðunu göstermektedir.

Objective: We aimed to evaluate general characteristics of the patients who wer treated at our clinic between the years of 1989-1997. Study Design: In our study between the years of 1989-1997, 112 patients with small cell lung cancer who were followed for at least 6 months were evaluated retrospectively.
Results: The youngest patient was 35 years old and the oldest one was 78 years old. The median age was 55. 107 patients were male, 5 patients wer female. 101 patients were used to smoke. The major symptom was cough. 76 patients had higher than %70 performance status according to Karnofsky Performance Status. According to stages;39 patients had limited disease, 73 patients had disseminated disease. The most common distant mekastases was obseiwed at brain. The most common tumor location was santral region. Chemoteraphy and radiotheraphy was used in treatment of small cell lung cancer.
Conclusion. Small cell lung cancer is the second most common histologic type after epidermoid carcinoma of lungs. Although all treatment methods, it has poor prognosis. Median survival is approximately one year.

Amaç: 1989-1997 yýllarý arasýnda klinðimize müracaat eden küçük hücreli akciðer kanseri tanýsý almýþ hastalarýn takibi ve tedavi sonuçlarýnýn deðerlendirilmesini amaçladýk.
Materyal ve Metod: Çalýþmanýzda 1989-1997 yýllan arasýnda Þiþli Etfal Hastanesi Radyasyon Onkolojisi Kliniðine müracaat eden ve altý aydan uzun süreli takibi olan küçük hücreli akciðer kanserli 112 hasta retrospektif olarak deðerlendirilmiþtir. Hastalarýn evrelerine göre uygulanan tedavi modalitelerinin sonuçlan karþýlaþtýnlmýþtýr. Kullanýlan istatistiki yöntem, Ki-kare metotudur.
Bulgular: Hastalann 107 (%95.5)’si erkek, 5(%4.5’i kadýndýr. Primer tümör yerleþimi 58 hastada sað akciðer, 54 hastada sol akciðerdedir. 62 hastada metastaz gözlenmiþ olup; 9 hastada (%14.5) mutipl organ metestazý tespit edilmiþtir. En sýk metastaz saptanan organ beyindir. Hastalarýn tedavi seçiminde sýnýrlý hastalýk evresine sahip olanlarýn %64.2’sinde (25 hasta); yaygýn hastalýk evresindekilerin ise %42.4’ünde (31 hasta) kemoterapi ve radyoterapi kombine kullanýlmýþtýr. Hastalann 56’sýna radyoterapi+kenýoterapi uygulanmýþ olup hastalýksýz saðkalým 7.4 ay; genel saðkalým ise 13.8 aydýr. Sadece kemoterapi yapýlan 56 hastada ise saðkalým 6.1 ay, genel saðkalým ise 9.8 aydýr. Bu iki tedavi grubu arasýnda istatistiksel olarak anlamlý farklýlýk bulunmuþtur (p: 0.005). sýnýrlý hastalýkta complete cevap oraný %63.5, yaygýn hastalýkta %22.17dir.
Sonuç: Küçük hücreli akciðer kanseri tedavisinde multiajan sistemik kemoterapi+lokal radyoterapi kombinasyonu ile hastalýksýz yaþam oraný artmaktadýr.

Objective: Our purpose was to evaluate the results of our treatments of patients with small cell lung cancer between the years 1989-1997.
Study Design: We studied retrospectively 112 patients who were treated at our clinic between 1989-1997 with small cell lung cancer. All the patients were followed-up for more than 6 months and results of treatment methods were compared in relation to their corresponding stages. Ki-square statistical method was utilized in this study.
Results: 107 patients were male and 5 patients were female. Primary tumoric cells were found to be with 58 patients in right lung and with 54 patients in the left lung. 62 patients had métastasés, 9 patients had multiple organs métastasés and the most common métastasés were observed to be in brain. Chemotherapy and radiotherapy was used with 25 patients (64.2%9 with limited-spread of carcinoma, and with 31 patients (42.4%) in advanced-spread of disease. 56 patients after chemo-radiotherapy had 7.4 months of survival rate without disease, general survival rate was calculated to be 13.8 months. The other 56 patients who had only chemotherapy, survived for 6.1 months; and with these patients general survival rate was 9.8 months. Between these 2 methods statistical comparison calculated to be (p: 0.005). patients shown limited -spread responded with 63.5%, advanced-spread was 22.1%.
Conclusion: With small cell lung cancer, application of multiagent systemic chemotherapy, Chemotherapy¦‘cLocal radiotherapy found to be increasing survival rates.

Amaç: 1989-1996 tarihleri arasýnda ÞEH Radyasyon Onkolojisi kliniðinde tedavi ve takipleri yapýlan Supraglottik larenks kanserli olgularýn retrospektif deðerlendirilmesi amaçlandý.
Materyal-Metod: Boyun disseksiyonu ile birlikte olan veya olmayan total veya parsiyel larenjektomi sonrasý baþvuran ve postoperatif radyoterapi uygulanan supraglottik larenks kanserli 97 hasta cinsiyet, yaþ grubu daðýlýmlarý, uygulanan cerrahi yöntem, histopatolojik tip, differansiasyon derecelen ve evreleri göz önüne alýnarak incelendi.
Bulgular: Hastalann 94’ü erkek, 3’ü kadýndý. Olgularýn %76.2’sine total larenjektomi, %23.7’sine parsiyel larenjektomi uygulanmýþtýr, %46.3’üne ipsilateral, %45.37iine ise bilateral boyun disseksiyonu uygulanmýþtýr. Differansiasyon derecesi saptanmýþ 47 olgunun 8’i iyi differansiye, 28’i orta derecede differansiye, 11’i kötü differans‘ýye idi. Olgularýn %2’si evre 1, %7.3’ü evre 2, %42,3’ü evre 3, %48.5’i evre 4’tür. Sigara anamnezi %85 olguda saptanmýþtýr.
Sonuç: Tüm kanser vakalarýnýn %2’sini oluþturan, baþ- boyun kanserleri içinde en sýk rastlanan lokalizasyon olan larenks kanserlerinin etyolojisinde sigara ve alkol kullanýmý önemli bir rol oynamaktadýr. Hastalýk sýklýkla sigara ve alkol kullanan orta yaþ ve yaþlý erkeklerde görülmektedir.

Objective: Our aim was to evaluate the retrospective of the cases of Supraglottic Larynx Carcinoma at our clinic.
Material-Method: 97 patients were evaluated during our study who were treated and followed up between the years 1989-1997. The cases were studied according to sex, age group, operations they have received, histological type, differentiation degree and stages they were in.
Results: 94 patients were male, 3 were female, 76.2% had total larengectomi, 23.7% had partial larengectomi. 46.3% Ipsilateral, 45.3 had bilateral dissection. Only 47 patients had differentiation determined and from these, 8 case were well differentiated, 28 case were average differentiated, 11 were badly differentiated. According to stages: 2% were 1 stage, 7.3% cases were of stage 2, 42.3% were stage 3, 48.5% were stage 4. Smoking and drinking were observed positive with 85% of the cases.
Conclusion: Head/Neck carcinoma accounts for 2% of all cancer cases in the world and larynx carcinoma is the most common among them. It is also known that Larynx Carcinoma is close correlation with smoking anrd drinking. This type of carcinoma is often seen with male patients of middle or old age who smokes and drinks.

Sneddon sendromu, beyni ve deriyi tutan nadir bir týkayýcýyý arteriyel hastalýktýr, ilk kez 1965 yýlýnda Ýngiliz dermatolog Sneddon tarafýndan tanýmlanmýþtýr.
Olgu: 40 yaþýndaki erkek hasta, sað kol ve bacaðýnda uyuþukluluk ve tutuk konuþma yakýnmasý ile gelmiþti. Fizik bakýsýnda her iki alt ekstremitede ve gluteal bölgelerde livedo retikülarisler göze çarpýyordu. Kraniyal MR’ýnda sol internal kapsül arka bacaðýnda ve sað talamusda kronik ve saðfrontal horn komþuluðunda subakut infarktla uyumlu görünüm saptandý. Bu sunumda amacýmýz; Sneddon sendromunun nadir rastlanýlan bir sendrom olmasýnýn yanýsýra, genç olgularda livedo retikülarisle birlikte giden inme nedenleri araþtýrýlýrken göz ardý edilmemesi gereken tanýlardan biri olmasýdýr.

Sneddon syndrome is characterized by ischemic serebrovascular disease and livedoreticularis. This syndrome was described by Sneddon in 1965
Case: 40 years old man was admitted at the hospital with complaints numbness of his right arm and leg and slurred speech. His clinical examination was revealed livedoreticularis both lowers extremities and gluteal reginos. Neuroimaging evaluation was appeared chronic lacuner infarct on left capsula interna posterior leg and right talamus and subacute infarct near frontal horn. In our study, we amied to review clinical laboratory characteristics of Sneddon syndrome which is a seldom disease due to a case.