Skrotal mezenterik kist olgusu

Mesenteric cysts are rarely seen intraabdominal mass lesions which can manifest themselves with different clinical signs, and symptoms. They can locate in the mesenterium from duodenum down to rectum, and also in the retroperitoneal space. Herein we present a very rare case of a scrotal mesenteric cyst which resembled an epididymal cyst in a 6-year-old boy. Ultrasonographic examination revealed a multiloculated cyst completely filling the scrotal sac, and the cyst was excised surgically. Histopathological examination described the surgical specimen as chylolymphatic mesenteric cyst, and during one year follow-up any recurrence was not observed

Küçükçekmece Lagünü'nde (İstanbul) "Küçük Buzul Çağı" ve "Orta Çağ Ilık Dönemi" çökel kayıtları

This study focuses on the sedimentary records of climatic changes in the Küçükçekmece Lagoon over the last 1300 a. The main objective of the study is to investigate the envirenmental conditions in Istanbul during the Little Ice Age (LIA, 600-100 a BP) and Medieval Warm Period (MWP, 1000-600 a BP), which occurred in Europe during the last millenia. The Küçükçekmece Lagoon is situated on the northern shoreline of the Sea of Marmara, west of İstanbul. It has a surface area of 15 km2, maximum depth of 20 m and water volume of 145x106m3. The lagoon is connected to Sea of Marmara via a 2 km long natural narrow channel. The main freshwater input is mainly from small sterams and groundwater springs (Altun el al., 2009). The Little Ice Age was a period of mountain glacier expansion during 16th–mid 19th century period during which European climate was strongly impacted (Bradley and Jones, 1993; Jones et al., 1998; Mann et al., 1998, 1999; Mann, 2002). This period begins with a trend towards enhanced glacial conditions in Europe following the warm conditions of the so-called MWP. The LIA terminated with a dramatic retreat of the Alpine glaciers during the 20th century. During this period the temperature was 0.5-0.7ºC lower than 1950’s avarage. The previous Holocene climate studies in Turkey are rare and mostly confined to the Black Sea and Central Anatolia regions (e.g., Jones et al. 2006; Fleitmann et al, 2009; Kuzucuoğlu et al, 2011). In view of the variability of the present-day climate of Turkey mainly because of its geographic location and topography, and scarcity of data in NW Turkey, the recovery of late Holocene climate records from Küçükçekmece Lagoon (İstanbul) is very important. For this prupose we collected one short interface core (0.6 m) and one 4.5 m long piston core from the Küçükçekmece lagoon. The cores were analyzed for physical properties (magnetic susceptibilty: MS, gamma density, and resistivity) at 5 mm resolution using Multi Sensor Core Logger (MSCL), and multi-elemental analyis at 0.2 mm resolution using XRF (X-Ray Fluoresance) core scanner. The cores were then sampled at 50 mm intervals for total inorganic carbon (TIC), total organic carbon (TOC), and micropaleontological (ostracoda and benthic foraminifera) analysis. The micropaleontological analysis was made in the sand size fraction under binocular microscope. The ostracoda and benthic foraminifera individuals are identified. Suitable species of ostracoda (Loxoconcha sp.) and benthic foraminifera (Ammonia sp.) were picked and analyzed for the stable oxygen and carbon isotope analysis. Four samples were dated using AMS 14C analysis. The ages were calibrated to calendar year by CALIB 6.0 software using INTCAL 9.0 and MARINE 9.0 options. The short and long cores were correlated using the MS profiles and a continuous composite section was constituted. The lithology of the composite core section in general consists of homogenous olive green mud that rarely includes layers of plant remains and laminated intervals. The benthic foraminifera and ostracoda distribution suggests that the lagoon has been brackish over the last 1300 a. The age model was obtained from the calibrated AMS C-14 datings of two total bulk organic carbon and two plant remain layers. The multiproxy data were used to analyze the evaporation/precipitation changes in sediment cores. Increasing MS (SI), Ti (cps) values and decreasing of d18O-d13C (‰ VPDB), Ca/Ti, Sr/Ca ratio and TOC (%wt) values were interpreted to show wet conditions. We also modified the Leng and Marshall’s (2004) d18O-d13C model for the Küçükçekmece Lagoon. The multi-proxy physical properties, geochemical and stable O- and C-isotope data in Küçükçekmece Lagoon show that wet conditions prevailed during ca 220-70 a BP, 1300-750 a BP and dry conditions during ca 70- 0 a BP, 750-220 a BP. The late (250-100 a BP) and early episodes (600- 250 a BP) of the Little Ice Age period was wet and and dry, respectively. During the the Medieval Warm Period (1000-600 a BP) wet conditions occurred in the region. The climate records also show that decadal-scale wet periods occurred during 340-270 a BP and 680-610 a BP, and dry periods during ca 1050 – 1000 a BP, 1130-1080 a BP and 1260-1210 a BP. Climatic records of Küçükçekmece Lagoon shows similarity with European records in Little Ice Age and Medieval Warm Period. Keywords: Küçükçekmece Lagoon (İstanbul), Little Ice Age, Medieval Warm Period.Küçükçekmece Lagünü çökellerinde Günümüzden Önce (GÖ) 1300 yıldaki iklim değişimleri ile Avrupa’da soğuk dönem olan Küçük Buz Çağı (GÖ 600-100) ve öncesinde yaşanan Orta Çağ Ilık Dönemi’in (GÖ 1000-600) İstanbul’daki koşulların karşılaştırmasını amaçlamaktadır. Bu nedenle Küçükçekmece Lagünü’nden uzunlukları 0.6 ve 4.5 m olan iki çökel karotunda; 5 mm çözünürlükle Çok Sensörlü Karot Logu Alıcısı (Multi Sensor Core Logger, MSCL) ile manyetik duyarlılık, P-Dalga hızı, yoğunluk ve öz direnç; 0.2 mm çözünürlükle XRF (X -Ray Fluorescence) tarayıcısı ile 25 elementin analizi ve 50 mm çözünürlükle toplam inorganik (TIC)–organik (TOC) karbon analizleri yapılmıştır. Ayrıca 50 mm aralıkla örnekler yıkanıp elenerek elde edilen çökeller içinden belirlenen ostrakod (Loxoconcha sp.) ve bentik foraminifer (Ammoniasp.) türleri toplanarak duraylı oksijen ve karbon analizleri yapılmıştır. Karotlar AMS 14C yöntemleri ile yaşlandırılmıştır. Elde edilen sonuçlara göre Küçük Buz Çağı’nın (GÖ 600-100) GÖ 250-100 yılları arasındaki son bölümünde yağışlı; ilk bölümünde (GÖ 600-250 yılları arası) ise bölgede kurak koşulların egemen olduğu anlaşılmıştır. Buna göre, Ortaçağ Ilık Dönemi (GÖ 1000-600 yılları) ve Karanlık Çağ Soğuk Dönemi’nin (GÖ 1500-1000 yılları) son evresini içeren GÖ 1200-600 yılları arasında yağışlı ve GÖ 1300-1200 yılları arasında ise kuraktır. Anahtar Kelimeler: Küçükçekmece Lagünü (İstanbul), Küçük Buz Çağı, Ortaçağ Ilık Dönemi

Our experiences on retrograde intrarenal surgery

Objective: To evaluate outcomes of the cases who had undergone retrograde intrarenal surgery (RIRS) in our clinics. Methods: Outcomes of 100 cases who had undergone RIRS because of renal stones between February 2012, and May 2013 were retrospectively evaluated. Results: Study population consisted of 35 female and 65 male patients with a mean age of 36.81(1-76) years. RIRS was performed with the indication of rest double J (D-J) stent (n=1), and renal stone (n=99). Mean stone size was 15.26 (5-27) mm. Preoperatively, 61 cases (61%) had preexisting D-J stents, while 39 (39%) cases were stentless. Access sheaths were used in 86 (86%) cases, while in 14 (14%) cases the procedure was applied without using an access sheath. Mean operative, and fluoroscopy times were 52.72 (10-120) minus, and 57.32 (10-180) seconds, respectively. Postoperatively D-J stents were implanted in 88 (88%) cases, and 12 (12%) cases were stent-free. Mean hospital time was 1.3 (1-7) days. After one month postoperatively, stone-free rate was achieved in 87 (87%) patients. Clinically insignificant residual stone fragments (CIRF) 6 (6%), and residual stones 7 (7%) were also detected. The latter group consisted of cases with horseshoe kidney (n=1), pelvic kidney (n=1), and kyphoscoliosis (n=1). Also in two case procedure was terminated prematurely, because of blurring of the vision secondary to bleeding. Apart from these patients, any preoperative complication did not develop. During follow-up period, urinary tract infection developed in 3 patients with resultant renal parenchymal damage in one patient. In one patient, D-J stent migrated into ureter. Conclusion: Retrograde intrarenal surgery is an effective and safe technique in the management of renal stones

Laparoscopic adrenalectomy: Our clinical experiences with the first 10 patients

Objectives: The aim of this study is to present the resultsof our first ten laparoscopic adrenalectomy cases whichwere performed in our clinic.Materials and methods: Between December 2010 andSeptember 2012 the standard transperitoneal laparoscopicadrenalectomy was performed on 10 patients.Data of patients such as age, weight, height, operationtime, hospitalization time, complications, size of adrenalmass and pathological diagnosis were retrospectively reviewedand recorded from the hospital records.Results: Three of ten patients were male and seven ofthem were female. The mean age of the patients was42.12±11.4 (21-55) years. Mean operation time was recordedas 136±23.6 (100-190) min. Mean tumor size was7.1±2.7 (5-12) cm. None of the patients required bloodtransfusion. Mean hospital stay was 2.3±1.2 (2-6) days.Pathological diagnoses of masses were pheocromacytomain two patients, adrenal adenoma in six, myelolipomain one and pseudocist in one.Conclusions: According to our experience with the limitednumber of the first ten cases, transperitoneal laparoscopicadrenalectomy is a safe and effective treatmentmodality, associated with minimal morbidity. To obtainmore reliable information larger series with long-term resultsof laparoscopic adrenalectomy is needed.Key words: Laparoscopy, adrenalectomy, experience,transperitonea