Aim: Maxillofacial (MF) traumas are most challenging group of patients in emergency departments (ED) due to occurrence of varying degrees of injury. The aim of this study was aid to ED clinicians in establishing correct diagnosis and to aid decision making process; to identify etiology of MF trauma presented to ED and to assess comorbid injuries. Materials and Methods: In this study, we retrospectively analyzed patients with MF trauma presented to ED between January, 2014 and July, 2017. The study included 73 patients among those with MF trauma admitted to ED. Data regarding age, gender, trauma mechanism, treatment modalities, presence of mandibular, zygomatic orbital base, zygomatic arch, frontal sinus and nasal sinus fracture were recorded and analysed.Results: Mean age was 36.18 years (min-max: 7-81 years). It was found that MF was significantly more prevalent in men than women. In our study, traffic accidents were observed to be the most common cause just like in developing countries.73 patients were surgically operated. 45 of the patients underwent open reduction and fixation with miniplates and screws. Conclusion: Maxillofacial trauma is common in our society. The most common causes are traffic accident and falls; followed by assault, head trauma and firearm injury.

The basic principle in the clinical use of Platelet Rich Plasma (PRP) is to increase the innate repairability of the human body and accelerate recovery after injury. PRP, a source of natural growth factors, emerges as a treatment method to reduce the side effects related to radiotherapy. PRP exerts its radioprotector effect by stimulating angiogenesis, epithelialization, cell differentiation and extracellular matrix formation in aged and poorly regenerated tissues. Additional studies are needed to confirm the promising effect of PRP in beam therapy.

In conclusion, in our study the seasons have not effect on the diagnosis of skin cancer. Studies with larger series are warranted in order to elucidate effects of the seasons on the diagnosis of skin cancer.

Objective: To present technical details and experiences regarding the use of a Tubbs-Logan mitral valve dilator for the closed reduction of zygomatic arch fractures. Method: Over a period of about three years, closed reduction was indicated and performed in 22 patients with a zygomatic arch fracture. In all patients, depressed fracture segments were reduced using a Tubbs-Logan mitral valve dilator via the Gillies' temporal approach. Results: The majority of the injuries were due to motor vehicle collisions (n=8, 36.4%). The zygomatic arch fracture was isolated in 12 patients (54.5%). However, it was a component of a zygomatic complex fracture in 10 patients (45.5%). Of those, rigid internal fixation of the zygomatic body was performed in 8 and the zygomatic body was only closely reduced by a bone hook in 2 patients. Repair of a concomitant orbital floor fracture was performed in 2, a mandibular angle fracture in 1 and a frontal sinus fracture in 1 patient. The reduction status of the zygomatic arch was excellent in 12 (54.5%), good in 8 (36.4%) and fair in 2 patients (9.1%). During the follow-ups, no functional or cosmetic sequelae regarding repaired fractures of the zygomatic arch, zygomatic body or other facial bones were recorded. Conclusion: We suggest that the Tubbs-Logan mitral valve dilator is a safe and effective alternative in terms of closed reduction of zygomatic arch fractures, whether they are isolated or not. We think that further ergonomic modifications would be beneficial to improve the positioning of the instrument in restricted areas observed due to severe depression of the zygomatic arch.

It is well-known that invasive lobular breast carcinoma has a greater propensity to metastasize to the gastrointestinal (GI) tract compared with other breast cancer subtypes [1]. Montagna and colleagues investigated the treatment and outcomes of breast cancer patients with GI tract involvement diagnosed at the European Institute of Oncology. They analyzed the clinicopathologic features of the GI metastases and compared them with those of the primary tumors according to their histologic type (ductal or lobular carcinoma). They reported that lobular breast carcinoma has a greater propensity to metastasize to the GI tract compared with other breast cancer subtypes and concluded that in the presence of GI symptoms, even if nonspecific, the GI tract should be thoroughly studied and systemic treatment, including hormonal therapy, should be considered [2]. However, in clinical practice, we see some cases with primary gastric cancer (GC) following breast cancer diagnosis or misdiagnosed as primary GC instead of metastatic breast cancer and treated accordingly. Mahar et al. [3] evaluated the population-risk of developing GC following breast cancer and they found that GC rates were similar to the general population for ductal breast cancer. Women aged 35-75 with lobular breast cancer had a significantly higher incidence of GC; women aged 40-44 had the highest risk. In conclusion, careful pathological revision of the breast cancer cases presenting as diffuse growth pattern and the endoscopic and clinical features of linitis plastica in stomach to exclude primary GC is needed, especially in younger lobular breast cancer patients.

Aim: This study was planned to determine the demographic, etiological and clinical characteristics and the treatment costs of the patients with open isolated hand and/or wrist injuries. Material and Methods: In this study, the data of 127 patients who were admitted to the adult emergency department due to hand and / or wrist trauma between 01.01.2018 and 06.30.2018 were examined. Data on demographic data, shape and clinic of injury were summarized as number and percentage. Shapiro Wilk test was used to determine whether the numerical measurements were compatible with the normal distribution and Kruskal Wallis test was used for comparison of cost between groups. Results: Of the patients, 81.1% were male and the most common injury was seen in the age group of 19-64 and workers. Fingers were the most frequently injured areas and the most common injured finger was the index finger. The first two reasons in the aetiology were home and occupational accidents. Penetrating/cutting was the most common injury mechanism. There was no significant difference between occupation groups in terms of cost (p>0.05) but there was a significant difference between diverse treatment methods (p<0.0001). Conclusion: Hand and / or wrist open injuries not only represent a significant part of all injuries but also represent a significant economic burden with high health costs. Measures to prevent such injuries could contribute to lowering health expenditures.

According to the recent information, it was revealed that adipose tissue derived mesenchymal stem cells have ability to turn into proliferation and differentiation cells.As a result, in the treatment of many disorders such as cleft lip and cleft palate, burn scars, progressive hemifacial atrophy, myocardial infarction, spinal cord injuries, neurological deficits and many congenital or post-traumatic defects, autogene fat graft has been started to use.With successful results of clinical and experimental publications, new projects have been put together exponentially.Adipose tissue derived stem cells were reported to either reduce or prevent RT related toxicity with angiogenic, anti-apoptotic and multipotent cellular activity properties.Today, in the treatment of radiation induced toxicity, autologous fat grafting has also been started to use.However irritated tissue is counted as ischemic, either to what extent fat cells in these tissues differentiate or how they are affected are not known.Despite current use of fat graft to reduce complications, further studies examining fat graft viability under radiation therapy are needed.

Breast prostheses are made for cosmetic reasons and in order to reduce defective body perception and psychosocial trauma caused by the absence of breast tissue.Silicone breast prostheses are frequently used in breast reconstruction after breast augmentation or mastectomy.Safety and efficacy criteria are considered when applying silicone breast prostheses.Non-toxic, immunogenic, teratogenic, carcinogenic, and lack of potential effect on mammography determine its reliability; development of capsular contracture, deflation, palpation and the possibility of folding in the anatomical pouch is determined by its effectiveness.The fillers and implant options used in consideration of these criteria are also limited in time and the ideal ones are introduced in medicine (1-4).The most common complication after reconstruction or augmentation with silicone implant is the formation of constrictive fibrous capsules around the implant.This causes fibrous tissue capsule contraction.The contraction is caused by pain in the breast, hardening, and asymmetry in the breast.It has been reported that between 1.3% and 30% of the patients with implant have developed capsular contractures.Approximately 92 percent of contracture occur within the first 12 months after surgery.The longer the implants settle, the higher the risk of contracture occurring cumulatively.Although bacterial colonization, implant surface characteristics, hematoma formation and radiation are found to be associated with etiopathogenesis, the cause and pathogenesis is still not known.In order to prevent the formation of capsule contracture, various methods the prosthesis pouch with various substances, using fibrin glue, preventing hematoma, using silicone outer surfaces in different tissues and placing the prosthesis in different anatomical locations were tried.However, the exact treatment is not available at present (3-8).Nowadays, mastectomy is applied to the patients concurrently with surgery, 2 weeks after mastectomy or in patients who will receive RT after 3 months.In breast cancer cases, subcutaneous mastectomy with simultaneous expander and implant and breast reconstruction are common methods.It is not clear yet which of these three applications is a more reliable method.When radiotherapy (RT) is applied in breast cancer patients with silicone prosthesis, it is very important for the treatment of prosthesis in the treatment area and the complications that may occur.It has been reported that silicone breast prostheses have no negative effect on photon and electron dose distribution.In addition, it was determined that the silicone elastomer used in breast prostheses did not reduce the radiation transmission (9).There is not enough information in the literature regarding the prevention / treatment of complications in prostheses after RT.In studies performed, it was shown that complications of complications such as capsular contracture (1.3-15%) and worse cosmetic results and reconstruction after radiotherapy treatment have increased in patients with breast reconstruction with silicone implant (2,3,(6)(7)(8).However, most of the current studies are retrospective cohort studies and there is no prospective study.The effects of radiation on the formation of capsules are tried to be explained.Recent studies have shown that the transforming growth factor-β (TGF-β1) is an important factor in the formation of fibrosis and radiation-induced capsule formation.Positive results have been reported in studies to prevent these effects by inhibition of TGF-β signal transduction (3).Evans et al. (4) performed breast reconstruction with implants and compared the contracture stage, pain and extrusion in patients with RT without RT.They reported that radiotherapy increased the capsular contracture stage (Baker III, IV) and had significant negative consequences for the clinical appearance and patient satisfaction.Azzi et al. (5) reported that radiotherapy accelerated the process of capsular contracture around the silicone implant in a study of 105 patients.

Objective: The aim of this study was to determine whether oak root extract has protective role on burn injuries by using quantitative and histopathological approaches. Methods: The study was conducted on 16 adult Sprague-Dawley rats aged 8 weeks (weighing 350 g). The rats were assigned into 2 groups including: group 1 consisting of rats employed as controls and group 2 in which rats received oak root extract. After shaving dorsum of rats, second degree burn injury was created at the right and left sides of the line representing vertebral column in both groups. Wound care was provided by using normal saline in group 1, while it was provided by using oat root extract in group 2. The right side was used for macroscopic evaluations, while left side was used for histopathological examination through biopsy samples obtained on the days 1, 3, 7 and 17. On the day 17, the rats were sacrificed under ketamine anesthesia. Cutaneous tissue samples were taken and macroscopic measurements were made by using a grid paper. Edema, neovascularization, inflammatory cell infiltration and re-epithelization were assessed on the histopathological examination. Results: When compared to the control group, it was seen that the extent of burn area was reduced and that degree of neovascularization, inflammatory cell infiltration and re-epithelization was increased with decreased edema was (p<0.001). Conclusions: It was seen that oak root extract was effective in the healing of burns.

Atopic dermatitis (AD), genellikle cocukluk caginda baslayan tekrarlayici, kronik, hayat tarzindaki degisikliklere bagli olarak insidansi giderek artmakta olan, yasam kalitesini olumsuz yonde etkileyen bir hastaliktir. Bu calismaya, Selcuk Universitesi Meram Tip Fakultesi Dermatoloji poliklinigine basvuran atopik dermatit tanisi almis 30 hasta ile, atopi bulgusu olmayan 20 saglikli kontrol dahil edilmistir. Ev tozlari, agac polenleri, cim ve ot polenleri, hayvan tuy epitelleri, gidalar ,bocekler ve mantarlardan olusan 51 maddelik prick test maddesi hasta ve kontrol grubuna uygulandi. Pozitif kontrol olarak histamin solusyonu, negatif kontrol olarak da serum fizyolojik kullanildi. Hasta grubunda en cok pozitif cikan alerjenler, ev tozlari, cim polenleri, cavdar poleni ,yabani ot polenleri ve mantarlar olarak tesbit edildi. Kontrol grubunda ise sadece 1 kiside ev tozu ve candidaya karsi prick test pozitifligi tesbit edildi. Hasta grubundaki 30 kisiden 17 sinde total IgE yuksek bulunurken (%56.7) kontrol grubundaki 20 kisinin 2 sinde total IgE yuksekti (%10). Total IgE yonunden iki grup arasinda anlamli fark bulundu (p

Renal hücreli karsinom yetişkinlerde görülen böbrek tümörlerinin en yaygın formudur. Böbrek hücrelerinin adeno karsinomu veya hipernefroma olarak adlandırılır. Çoğunlukla %60 oranında görülen tipi clear cell karsinomadır. En sık 50-60 yaş arasında görülür. Deri metastazları oldukça nadirdir fakat görüldüğünde prognozun kötü olduğunu ve lezyonun sistemik yayılımının olduğunu göstermektedir. Göğüs cerrahi kliniğinde görülen hastada, skalpte frontal bölgede kanamalı büyük bir kitle bulunmakta idi. Hastanın Renal hücreli karsinom nedeniyle 3 yıl önce sağ böbreği alınmıştı. Enfeksiyon hastalıkları kliniğinde pnömoni tedavisi almış fakat düzelme olmayınca göğüs cerrahi kliniğine biyopsi için yatırılmıştı. Yapılan biyopsiden renal hücreli karsinom tanısı almıştı. Hasta Dermatoloji ve Plastik cerrahi kliniğine frontal bölgedeki lezyon nedeniyle konsülte edildi. Pyojenik granülom ön tanısıyla eksizyon yapıldı. Patolojik tanı renal hücreli karsinom metastazı olarak geldi. Renal hücreli karsinomun sıklıkla akciğerler, kemik, deri, karaciğer ve beyne metastaz yaptığı literatürde gösterilmektedir. Bu hastalarda prognoz oldukça kötüdür. Hasta şifa ile taburcu edildi fakat yakınlarından alınan bilgiye göre hastaneden çıktıktan 3 ay sonra eksitus olduğu öğrenildi.

Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Etofenamate is a non-steroidal anti-inflammatory drug and a non-selective cyclooxygenase inhibitor. Cutaneous adverse findings caused by etofenamate are uncommon. Herein, we present a case with diagnosis of Nicolau syndrome due to etofenamate injection, which is a rare occurrence.

Epidermal kist insanlarda yaygin olarak skalp, yuz, boyun ve govdede yerlesmektedir. Cogunlukla subkutan olarak yerlestigi icin tanisi ve tedavisi cok kolaydir. Superfisyal temporal arter anevrizmasi nadir gorulur, travma oykusu bulunmaktadir ve yalanci anevrizma seklinde karsimiza cikmaktadir. Ozellikle temporal ve frontal bolgede, altta kemik yapinin bulunmasi, ustte ise kas yapisinin zayif olmasi nedeniyle travmatik temporal arter anevrizmasi ile karisabilmektedir. Superfisyal temporal arter travmatik anevrizmalarinin etiyolojik hikâyesinde bircok farkli etkenler bulunmaktadir. Savas yaralanmalari, atesli silah yaralanmalari, kunt travmalar, motorlu tasit yaralanmalari ve spor yaralanmalari sik karsilasilan nedenlerdir. Bu bolge lezyonlarinda operasyon oncesini arastirmadan mudahalede bulunmamak gerekir.

Intraorbital and periorbital foreign bodies may occur after direct trauma, metallic injuries and occupational accidents. Foreign bodies penetrated into the ethmoid sinus are not common and most cases occur after traumas. We presented a case with a foreign body penetrated into the right ethmoid sinus by pneumatic screw gun, a rarely reported etiology in the literature and we presented treatment approach.

Sigaranin yara iyilesmesi ve flep yasami uzerine zararli etkileri iyi bilinmektedir. Sigara bu zararli etkilerini ihtiva ettigi nikotin, karbonmonoksit ve hidrojen siyanid uzerinden olusturmaktadir. Sigara dumaninda katran damlaciklari uzerinde tasinan nikotin, respiratuvar sistemden hizla emilir. Nikotin sakizi cigneyenlerde oral mukozadan, ciplak elle ugrasanlar ve nikotin bantlari kullananlarda deri yolu ile vucuda emilmektedir. Emilen nikotin hizla tum vucuda dagilir. Akciger, dalak, karaciger ve beyinin nikotine olan afinitesi yuksektir. Yag dokusunun afinitesi dusuktur. Tutun dumaninda, insanlar ve hayvanlar icin kanserojen olan 4000’den fazla kimyasal madde belirlenmistir. Cevresel dumanda zararli maddeler, ice cekilen dumana gore daha fazladir. Pasif olarak sigara dumanina maruz kalan kisiler, hem inhale-ekspire edilen dumana hem de sigaranin kendi kendine yanarken cikan dumanina maruz kalirlar. Bu durum, pasif iciciligin de insan sagligi acisindan oldukca onemli oldugunu gostermektedir. Sigara kullanimina bagli olarak, insan sagligi onemli olcude bozulmaktadir. Basta akcigerler olmak uzere, oral, larinks ve ozafagus kanseri ile direk iliskili iken, bobrek ve mesane kanserleri, mide kanseri, serviks ve hematopoetik sistem kanserlerinde de etken olabilmektedir. Sigaranin sistemik etkilerine bagli olusabilecek postoperatif komplikasyonlar da goz onunde tutulmalidir. Sigara icenlerde postoperatif pulmoner komplikasyon riski yaklasik 6 kat artmistir. Bu pulmoner komplikasyonlarin azaltilmasi icin en az 6-8 haftalik sigarasiz bir donem gerektigi de bilinmektedir.

Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Etofenamate is a non-steroidal anti-inflammatory drug and a non-selective cyclooxygenase inhibitor. Cutaneous adverse findings caused by etofenamate are uncommon. Herein, we present a case with diagnosis of Nicolau syndrome due to etofenamate injection, which is a rare occurrence.

Nekrotizan fasiit yumusak doku ve fasyalari tutan, hayati tehdit eden bir enfeksiyondur. Nadir gorulmesine ragmen hizli ilerleyen fasiyal nekroza ilerlediginden yuksek olum riskine sahip olabilir. Hastamiz acil servise sol dizinde sisme ve kizariklik nedeniyle olusan agri nedeniyle kabul edildi. Yapilan fizik muayenesinde sol diz fleksor yuzeyinde isi artisi ile birlikte olan iki adet kucuk ekimotik, bulloz lezyon ve hiperemi gozlendi. Venoz doppler tanida nekrotizan fasiiti dusundurdu. Hastanin acil serviste takipleri esnasinda bacagindaki kizarikligin genisleyince plastik ve rekonstruktif cerrahi tarafindan ameliyat edilmesine karar verildi. Ameliyat sonrasi hasta yogun bakimdaki yatisinin 14. gununde sepsis nedeniyle kaybedildi. Nekrotizan fasiit nedeniyle olumle sonuclanan vakamizla ilgili tecrubelerimizi aktarmak amaciyla bu vakayi sunmayi amacladik.