Background: After chondrogenic potential of perichondrium was recognized, perichondrial grafts have been used in reconstruction of cartilage defects. Enhancing neochondrogenesis has many advantages, in this regard. This experimental study was done in the aim of identifying whether the heterologous collagen has an accelerating effect on neochondrogenesis from perichondrial grafts or not.
Methods: We placed perichondrial grafts, onto the dorsal muscles of twelve white New-Zealand rabbits, on both sides. On one side, heterologous collagen sponge was inserted between the graft and the muscle, the other side served as a control.
Results: As a result of histological assessment on days 45, 120 and 180, we obtained that heterologous collagen enhanced the neochondrogenesis.
Conclusion: We believe that, if any cartilage defect would be reconstructed with a Perichondrial graft, additional use of heterologous collagen will be helpful.

Background: To determine whether conservative treatment in blunt abdominal solid organ injuries associated with extraabdominal trauma is safe or not.
Methods: Between December 1998 and December 2001, 49 patients were admitted with blunt abdominal trauma, 34 of whom were hemodynamically stable. These 34 patients were divided into two groups. Seventeen patients had isolated abdominal solid organ injuries (Group I) and 17 patients had associated extraabdominal injuries (Group II). The results of conservative treatment, blood pressure values, pulse rates, ages, gender, abdominal solid organ injury scores, the etiologies of trauma, the number of the blood transfusions, morbidity and mortality rates, and hospital stays were compared.
Results: The blood pressure values and pulse rates as measured in our emergency room, abdominal solid organ injury scores, ages, gender, the results of conservative treatment, the etiologies of trauma, morbidity and mortality rates were similar in both groups. Comparisons between hospital stays and numbers of the blood transfusion
have show statistically significant differences in favour of group II. No patients had hollow viscus injury.
Conclusion: Conservative tratment is safe for hemodynamically stable blunt abdominal trauma patients with solid organ injury but no hollow viscus injury, even if they have extraabdominal injuries. The existence of extraabdominal injuries, however, prolongs the hospital stay and increases the need of the blood transfusion.

Background: Cardiac penetration wounds have high mortality which need a rapid diagnosis and surgical intervention.
Methods: Between May 1999 to May 2002, 196 thoracic penetration cases who were admitted to emergency department were examined and in 12 (6.1%) of them cardiac penatration was diagnosed. In this retrospective study, the cardiac penetration cases were evaluated.
Results: All the cases were male, 11 of them were injured by stab wounds, and one case by a gunshot wound. We perfomed left anterolateral thoracotomy in nine of the cases, right anterolateral thoracotomy in two cases and a median sternotomy in one case. Two of the cases died.
Conclusion: The survival chance of the cases can be increased with rapid diagnosis and surgical intervention.
Key Words: Cardiac penetration, rapid diagnosis, surgical intervention

Background: This study designed to evaluate the results of the patients with severe burns treated in the intensive care unit.
Methods: Between May 1997 and May 2002, fifty-four patients who had thermal and electrical burns managed at the Intensive Care Unit of General Surgery of Istanbul University Medical Faculty.
Results: Forty-five of patients were males and nine were females with mean age of 39 years. The mean hospital stay was 26 days. The mean total body surface area burns was 60%. Pseudomonas aeruginosa was detected in wound cultures at the 68% of patients. 83% of cases died. Mortality was due to sepsis in 66% of patients.
Conclusion: Besides early debridmant, early enteral feeding, woundcare and intensive care unit support, establishing of specific burncenters may reduce morbidity and mortality rates in severe burns.
Key Words: Severe burn, burn, burn center, thermal, electrical, intensive care unit, mortality.

Background: In our study we aimed to evaluate, retrospectively, the bleeding and the Venousthrombo Emblism (VTE) complications in trauma patients in Intensive Care Unit (ICU) under the prophylaxis of enoxaparin sodium. The results will guide us to establish a protocol for use of Enoxaparin Sodium in trauma patients. In trauma patients, Low Molecular Weight Heparine (LMWH) has better efficiency than unfractionned heparin and intermittant pneumatic compression for VTE prophylaxis.
Methods: 457 polytraumatized patients treated in ICU are included to the study group. All patients received 40 mg/day of Enoxaparin Sodium. Severity of trauma was assessed with Apache II Scoring System and bleeding diagnosed by observing a sudden drop of 2 g/dl in hemoglobin concentration and pulmonary embolism was diagnosed by a sudden change in blood gases and deterioration of the clinical outlook which was confirmed by a spiral CT scan. Statistical correlation was made by Pearson's correlation test.
Results: Mean Apache II score was 13.8 with a total mortality of 41%. 42 patients (9,2%) had bleeding due to Enoxiparine Sodium prophylaxis. 12 patients (2,6%) had pulmonary embolism and 8 of them (1,7%) had died.
Conclusion: Verified by the literature and our study, LMWH prophylaxis significantly reduces the Pulmoner Embolism (PE) incidence in polytraumatized patients (p<0,05). On the other hand, the bleeding risk has slightly increased without showing any significance (p>0.05). Prophylaxis with LMWH is safe and efficient in polytraumatized ICU patients.

Background: Foreign bodies (FB) in the airway require prompt removal in children. We reviewed our experience in patients with suspected airway FB.
Methods: A retrospective study was conducted in 189 consecutive children who admitted to the Department of Pediatric Surgery, SSK Tepecik Training Hospital between 1997-2001. Patients data on presentation, bronchoscopy findings and results were obtained. Of the 189 bronchoscopies, 127 (67.2%) showed FB which are commonly located in the right mainstem bronchus. Most of FB were nonradiopaque.
Pips and hazelnuts were the most common FB. Mean hospital stay was 2.5 days. Many
patients (151 out of 189; 79.9%) had transient stridor or fever that ceased within 24 hours after bronchoscopy. No mortality was observed rin relation with bronchoscopy.
Conclusion: Chest radiographs of the children with FB in the airways are inconclusive. Children with a history of small particles in their mouths and subsequently showing wheezing, or choking episode should undergo prompt bronchoscopy. Complications related to bronchoscopy are uncommon.

Background: The study investigated clinical, radiological findings and treatment methods used in patients who developed intraabdominal hemorrhage due to chronic warfarin use. Patients and methods: Eight patients receiving warfarin for cardiac valve replacement, pulmonary thromboemboli, and atrial fibrillation were admitted to our hospital. The patients had abdominal pain, nausea, and vomiting although there was no hematemesis and melena.
Results: Abdominal ultrasonography and computerized tomography identified the individuals’ problems as intraabdominal hemorrhage (n=2), intestinal intramural and intraabdominal hemorrhage (n=2), bleeding into the sheath of the rectus abdominus muscle (n=1), subcapsular splenic hemorrhage (n=1), and bleeding due to ruptured ovarian cyst (n=2).
Conclusions: Clinicians must be alert for intraabdominal bleeding in patients who are prescribed warfarin treatment. Abdominal ultrasonography and computerized tomography should be used to investigate all such cases of suspected hemorrhage. Blood and plasma replacements are first line of supportive treatment and surgery should be avoided if possible.

Bacground: Patients diagnosis as penil fracture and treated with surgical methods were evaluated retrospectively between January 1990-February 2002.
Methods: Patients were evaluated by age, trauma type, time passed after the trauma, physical examination and radiologic data.
Results: The cause of trauma was blund trauma in all patients. 14 trauma (60.8%) were durig sexual activity, 6 trauma (26%) were during handling the erective penis in morning erection, 3 of trauma (13%) were due to the rolling on to the penis. Urethral bleeding was seen in 1 patient and microscopic hematuria was detected in 5 patients. Subcoronal circuler incision was carried out in 16 patients (69.5%), semicircular
incision was done directly on the injury in 6 patients (26%) and from penis radix to scrotum was done in 1 patient (4.3%). There was unilateral corpus cavernosum injury in 21 patients. Bilateral corpus cavernosum injury in 1 patient, corpuscavernosum, corpus spongiosum and incomplent urethral injury in 1 patient. Wound infection was detected only in 2 patients at postoperativly early period. After evaluating
20 patients with medical history and physical examination in postoperative control penil curvature permiting sexual activity was detected in 3 patients.
Conclusion: We concluded that patients with penil fracture may be treated with low complication rate by early surgical procedure.
Key Words: Penil fracture, genitourinary trauma, surgical treatment

Background: This study investigated the incidence, prediction, and treatment principles of anterior dural laseartion due to thoracolumbar burst farcture.
Methods: Three anterior dural tears were found during anterior decompressive spine surgery. The average age was 42. Preoperative neurologic status and radiologic datas of the patients were analyzed retrospectively. The average follow-up was 20 months.
Results: Anterior dural tears detected in 3 (8.2%) of 35 burst fractures. Primary repair were performed in two patients. There were no cerebro-spinal fluid leakage perioperatively and all patients were neurologically intact at the final follow-up.
Conclusion: It is too difficult to detect anterior dural tear before surgery. Anterior dural tear should be suspected in patient with neurologic deficit and asimetric bony retropulsion into the spinal canal.

Bacground: Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in childhood. They require close follow-up subsequent to successful treatment, because of having a great risk of many complications. Many treatment methods have been described for the treatment of displaced supracondylar fractures of the humerus, however it has not been reached a consensus for the choice of the
treatment. The purpose of this study is to investigate the late results of three different treatment methods; closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires. We also aimed to compare these methods with the results of current literature.
Methods: Fifety-three (41 boys and 12 girls) displaced supracondylar humerus fractures were treated between January 1986 and March 1999. The average age was 8.0 years. We evaluated the results of patients according to Flynn’s criterias.
Results: According to the results of the study, we obtained 31 excellent, 9 good, 5 fair and 8 poor results. The ratio of poor results of closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires were 28.6%, 14.3% and 12.8%, respectively.
Conclusion: The datas in our study show that closed reduction+cast immobilization results in the most poorest outcome in the treatment of displaced supracondylar humerus fractures.

Torsion of the testis is the most common urological emergency and should be included in the differential diagnosis of scrotal trauma. Clinical suspicion of testicular torsion is a serious indication for prompt surgical exploration of post-traumatic acute scrotum. A case of post-traumatic testicular torsion, which resulted in orchiectomy, is presented and literature is reviewed.

58-year-old male comatose patient following a motor vehicle accident with a history of coronary bypass surgery 5 years ago has been presented. The patient was awake after the accident and he became comatose 30 minutes after the accident. The early diagnostic investigations showed no responsible cranial or spinal lesion. At the 2nd day of the accident, diffusion weighted magnetic resonance scans, magnetic resonance arteriography and digital subtraction arteriography revealed bilateral vertebral artery dissection at the second part of the vertebral arteries. Clinical, radiological features and treatment options of the vertebral artery dissection has been discussed with the ertinent literature.

Prevention of sudden neck movements is vital in patients with ankylosing spondylitis of the cervical spine. We present a case of ankylosing spondylitis who sustained a cervical fracture. He presented with paraplegia after a minor car collision and died of pulmonary embolism after the operation for anterior stabilisation. We believe that the most important matter in a patient with advanced ankylosing spondylitis is the prevention
of the fractures and complications. The need for neck protection in automobiles was emphasized and the literature reviewed about the occurrences of neurological deficits following trauma.

A 12 year old boy was admitted to emergency service with loss of consciousness, convulsions and anisocoria of the right eye along the history of upper respiratory tract infection for the last four days. Two months ago he was hospitalized at the intensive care unite due to motorcycle accident with frontal fracture and minimal frontal pneumocephalus. He was treated for ten days and discharged without any neurological
impairment. The last computerized tomography showed right frontal air of 5x5x7 cm. multiple airs in the ventricular system and in the upper central canal of the cervical region. The air was removed immediately through a right frontal burr-hole with a bedside procedure. The patient’s neurological status rapidly improved and ten days after computerized tomography showed clearly resolution of the air. The presented case is an interesting example of post traumatic pneumocephalus due to herniation and
widespread intracranial air. The situation can be explained with acute penetration of huge amount of air into the cranium through the frontobasal fracture and torn dura by strong Valsalva ‘s maneuver resulting from coughing and sneezing in the course of upper respiratory tract infection. We suggest close follow up, frequent control computerized tomography scans, preventive and effective treatment respiratory
tract infections along 3-6 months in similar cases.

Although the metastases from extra- abdominal tumors to the small bowel are rare, cutaneous melanoma is the most common source. A 78 year old man with occult intestinal bleeding due to malign melanoma of the small bowel was admitted to our clinics. The patient was managed successfully by small bowel resection with end to end anastomosis. Patient is alive three months after the surgery and is in pretty good condition.