Reclamation of real textile wastewater by sequential advanced oxidation and adsorption processes using corn-cob based materials

Wastewater management has become crucial for sustaining biological life in the near future. One of the key aspects is integration of treatment processes aiming reuse of treated water for many purposes instead of water discharge. This study focused on combining two different methods, photo-Fenton-like oxidation, and adsorption, for treatment of real textile wastewater to improve water quality to be reused for irrigation. The real textile wastewater was collected from a local plant and subjected to photo-Fenton-like oxidation and adsorption as hybrid process. The operational parameters were optimized for each step by assessing the water quality according to the domestic regulations for irrigation water. The photo-Fenton-like oxidation itself was not successful to achieve the targeted water quality for reuse whereas adsorption as an additional step made the treated water reusable in terms of organic content. But the treated water still contained a certain amount of salinity due to extreme salt usage in textile processing. It was concluded that the treated water at the end of hybrid process could be used for salinity resistant plants such as sugar beet, barley, and cotton which demonstrates a promising contribution to the circular economy for biomass.

Photo-degradation of sugar processing wastewater by copper doped bismuth oxyiodide: Assessment of treatment performance and kinetic studies

In this study, photo-Fenton-like oxidation method was evaluated for synthetic sugar industry wastewater using visible-light driven Cu-BiOI photocatalyst. Reaction conditions including initial pH, catalyst loading, initial hydrogen peroxide (H₂O₂) concentration, and temperature, were optimized. At these optimized conditions, the total saccharide concentration (TSC) and total organic carbon (TOC) removals were 56.20% and 30.67%, respectively whereas the maximum TSC and TOC removal reached up to 93.35% and 74.72% respectively by decreasing initial sucrose concentration. The kinetic study showed that the reaction order for sucrose and TOC oxidation was determined as 2 for pseudo-homogeneous power law models with respect to sucrose concentration and TOC, respectively.For heterogeneous models, Langmuir-Hinshelwood model based on the mechanism of adsorbed pollutant and oxidant on different catalytic sites was the best fit for oxidation of sucrose and other organic intermediates. According to the catalyst characterization studies, incorporation of copper was successful and Cu-BiOI possesses high photocatalytic activity accomplished by acid-assisted synthesis method.

Two-year follow-up of a dose reduction strategy trial of biologics adalimumab, etanercept, and ustekinumab in psoriasis patients in daily practice

BACKGROUND/OBJECTIVES

Tightly-controlled dose reduction was possible during 1 year in psoriasis patients on adalimumab, etanercept or ustekinumab with low disease activity (CONDOR trial). Extended observation is needed to ensure long-term effectiveness and safety of the strategy. With prolonged follow-up, we investigated the clinical effects and safety of the strategy, the proportion of patients with successful dose reduction, and assessed if patients with a disease flare regained remission.

METHODS

Two-year follow up of a subgroup of patients previously included in a randomized pragmatic study comparing usual care (UC) with stepwise dose reduction (DR). Effectiveness (Psoriasis Area and Severity Index, PASI), Dermatology Life Quality Index (DLQI), adverse events, proportion of patients with successful DR and proportion of persistent disease flares were analyzed.

RESULTS

DR leads temporarily to a slightly increased PASI groupwise, but on the long-term patients regained low PASI. DLQI scores remained stable during follow-up. No serious adverse events due to DR were reported. Forty-one percent of patients remained on a low dose up to 2 years. The number of persistent flares was low in DR and UC.

CONCLUSIONS

The proposed dose reduction strategy is effective for a significant part of patients and remains safe up to 2 years of follow-up.

Bioinspired metal oxide particles as efficient wet air oxidation and photocatalytic oxidation catalysts for the degradation of acetaminophen in aqueous phase

The catalytic performances of the biomimetic metal oxides were tested in photo Fenton-like oxidation and catalytic wet air oxidation processes. Biomimetic copper oxide, iron oxide, and cobalt oxide catalysts were prepared by using pollen grains as biotemplate. The surface characteristics of the biomimetic metal oxides were characterized. SEM micrographs of the biomimetic catalysts demonstrated that pollen grains were successfully mimicked by metal oxide structures. The influences of UV light intensity, catalyst loading, and the initial hydrogen peroxide concentration on acetaminophen degradation were investigated in the photo Fenton-like oxidation process whereas the effects of reaction temperature and catalyst loading were investigated in catalytic wet air oxidation process. The biomimetic copper oxide was the most effective catalyst for the removal of acetaminophen in both of the advanced oxidation processes. The highest acetaminophen degradation efficiency was 86.9% in photo Fenton-like oxidation process when the initial acetaminophen concentration, catalyst loading, and the initial H₂O₂ concentrations were 10 mg/L, 0.1 g/L and 1 mM, respectively, at room temperature. In the catalytic wet air oxidation process, 98.3% degradation was achieved for the treatment of 100 mg/L acetaminophen solutions at 180 °C and 10 bar by using 1 g/L of catalyst loading at the same reaction time as photo Fenton-like oxidation. Mineralization analysis and the toxicity tests indicated that the biomimetic copper oxide catalysts were promising for the acetaminophen removal in catalytic wet air oxidation processes.

Visible light assisted Fenton oxidation of tartrazine using metal doped bismuth oxyhalides as novel photocatalysts

This research focused on the abatement of the model food dye, tartrazine, using visible light photo-Fenton oxidation with novel bismuth oxyhalide catalysts. Bismuth-oxyhalide and metal doped bismuth oxyhalide catalysts (BiOCl, Cu-BiOCl, and Fe-BiOCl) were synthesized via the facile co-precipitation method. The catalysts were characterized by SEM-EDX, XRD, BET, and DRS analyses and the results showed that Cu-BiOCl possess a unique flower-like nanostructure with narrow band gap (2.53 eV) which enhanced its visible light photocatalytic activity remarkably which was proven by catalyst screening experiments. A detailed experimental study was carried out to investigate the effects of operating parameters on the degradation and decolorization of the dye and from this the optimum values were determined as 0.25 g/L for photocatalyst loading, 100 W for visible light power, 6 for initial pH, 6 mM for initial H₂O₂ concentration, and temperature of 70 °C. Approximately 91% degradation, 95% decolorization, and 59% TOC reduction were obtained at optimum conditions. The results for the kinetic study showed that the degradation and decolorization reactions are in the pseudo-first order and obey the simplified Langmuir-Hinselwood kinetic model. The activation energies were calculated as 86.54 and 69.39 kJ/mol for degradation and decolorization, respectively.

Catalytic wet air oxidation of Reactive Black 5 in the presence of LaNiO3 perovskite catalyst as a green process for azo dye removal

The removal of textile azo dye, Reactive Black from the aqueous solutions by catalytic wet air oxidation in the presence of LaNiO₃ perovskite catalyst has been investigated. The most suitable reaction conditions were determined by testing various the catalyst loadings, reaction temperature and pressure values, and the initial pH of the Reactive Black 5 solutions. The most suitable reaction conditions with 0.61 L/min of air flow rate were found to be 1 g/L of LaNiO₃ loading, 50 °C of reaction temperature, 1 atm of reaction pressure, and, pH = 3 for the oxidation of 100 mg/L Reactive Black solutions. Under these conditions the degradation and the decolorization efficiencies were evaluated as 65.4% and 89.6%, respectively. The phytotoxicity analyzes were carried out by using Lepidium sativum. According to the toxicity tests a remarkable decrease in the growth inhibition was achieved by the catalytic wet air oxidation in the presence of LaNiO₃ catalyst. The growth inhibition in the untreated and treated dye solutions were calculated as 49.3% and 23.7%, respectively.

Kinetic Study of Combustion of Isopropanol and Ethyl Acetate on Monolith-Supported CeO2 Catalyst

The complete catalytic combustion kinetics of isopropanol and ethyl acetate were investigated using a CeO2 catalyst coated on a monolith support. The combustions were carried out at low temperatures and atmospheric pressure, on a fixed-bed monolithic reactor. The Mars and van Krevelen model, power rate law model and Langmuir – Hinshelwood model were used to analyse the experimental results. The differential reactor assumption was used to fit the kinetic models. Due to the low activation energies of the reactions, both the Mars – Van Krevelen and power rate law models showed good agreement between the measured and calculated reaction rates, with the Mars – Van Krevelen model being slightly better.

Treatment of aniline by catalytic wet air oxidation: comparative study over CuO/CeO2 and NiO/Al2O3

The treatment of aniline by catalytic wet air oxidation (CWAO) was studied in a bubble reactor. The experiments were performed to investigate the effects of catalyst loading, temperature, reaction time, air flow rate, and pressure on aniline removal. The catalytic effects of the prepared nanostructured catalysts, CuO/CeO(2) (10% wt) and NiO/Al(2)O(3) (10% wt), on the CWAO treatment efficiency were also examined and compared. The prepared catalysts seem to be active having an aniline removal of 45.7% with CuO/CeO(2) and 41.9% with NiO/Al(2)O(3). The amount of N(2) formed was approximately the same for both of the catalysts.

Effect of selenium on anthracycline induced cardiotoxicity in children that treated for cancer: Correlation with pro-brain natriuretic peptide levels

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Background: High cumulative doses of an anthracyclin (300–500 mg/m2) are used in the several treatment protocols of children with Cancer. Probrain natriuretic peptit (Pro-BNP), is relased by cardiac cells and elevated even before overt cardiac distress symptoms. Selenium, is an antioxidant which its’ absence cause cardiomyopathy in people living in the poor selenium soil area. Aim 1: Assesment of anthracycline-induced cardiotoxicity with Pro-BNP levels, correlated with echo-cardiographic (ECHO) findings. Aim 2: Determine possible effects of selenium levels and supplemantation on cardiac toxicity. Methods: Plasma levels of Pro-BNP have been measured in 58 pediatric cancer patients (leukemias, lymphomas,solid tumors; 38 boys, 20 girls; between 2–18 years, median:12) after completed their anthracycline containing regimens. Serum selenium levels examined in 12 patients (six patients were with high and other six with normal pro-BNP levels). Three of four Patients with low level of selenium showed cardiac failure according to ECHO and supplemanted with selenium besides digoxine, ACE inhibitors. Results: Eleven patients have found with high pro-BNP levels (120–8022 pg/ml; normal: lower than 120 pg/ml).Six of these patients (with 170–8022 pg/ml, median:798pg/ml pro-BNP) and other six patients with normal levels of pro-BNP (10–74pg/ml, median: 67pg/ml) examined for their serum selenium levels. All patients with normal pro-BNP levels have found in normal levels of selenium levels (71–150 μg/L,median:125 μg/L). Four patients in high pro-BNP group showed low levels of selenium (52–129 μg/L; median:67.5 μg/L). Since three of that four patients have cardiac failure, treated accordingly and supplemented with 100 μg/day selenium to maintain normal levels. During follow-up periods of 27; 8 and 2 months, all 3 patients are doing well with normal ECHO finding. Two patients reached normal Pro-BNP levels while one of them has 80 % decrease. Conclusions: Serum Pro-BNP levels can be used as a marker for anthracycline toxicity and as follow-up marker for protective agents. Selenium suplemantation may have a potential role to protect and/or overcome the difficulties related anthracyclin-induced toxicities.

No significant financial relationships to disclose.

Low-pressure catalytic wet-air oxidation of a high-strength industrial wastewater using Fenton's reagent

Wastewater from the Afyon Alkaloids Factory (Afyon, Turkey) was subjected to low-pressure catalytic wet-air oxidation (CWAO) using Fenton's reagent, and the optimal reaction conditions were investigated. The CWAO using Fenton's reagent was applied to the factory effluent, diluted factory effluent, and aerobically pretreated wastewater. To find the optimum quantities of reagents, ferrous iron (Fe(+2))-to-substrate ratios of 1:10, 1:25, and 1:50 and hydrogen peroxide (H2O2)-to-Fe(+2) ratios of 1, 5, and 10 were investigated, and the treatment was carried out at different temperatures. High chemical oxygen demand (COD) removals were obtained at 50 degrees C, with the Fe(+2)-to-substrate ratio range between 1:10 and 1:25. The change in H2O2-to-Fe(+2) ratios did not cause any considerable effect. Also, the percentages of COD removals were nearly the same, so the ratio H2O2:Fe(+2):1 is recommended. Aerobic pretreatment seems to be effective. On the other hand, no enhancement was observed in the case of the diluted wastewater.

The effect of p.Arg25Cys alteration in NKX2-5 on conotruncal heart anomalies: mutation or polymorphism?

Heterozygous mutations in the NKX2-5 gene of patients with various congenital heart defects have been reported. Most of the congenital heart defects associated with the mutations in the NKX2-5 gene are conotruncal heart anomalies, primarily the tetralogy of Fallot. In this study, the authors screened 72 Turkish children with conotruncal heart anomalies and 185 healthy control subjects to find the NKX2-5 alterations. They found one previously documented NKX2-5 missense alteration, heterozygous c.73C>T (p.Arg25Cys), in a 10-year-old boy with tetralogy of Fallot. The same heterozygous alteration was found also in the patient's healthy father and in two unrelated persons in the healthy control group. The current study shows for the first time the presence of p.Arg25Cys in healthy control subjects other than African Americans. These results show that no genetic support exists for the pathogenecity of this alteration, although a previous in vitro study and theoretical predictions suggest a structural/functional difference in the altered protein region.

First pulmonary valve replacement with Freedom Solo stentless valve in an adolescent. A case report

Tetralogy of Fallot (TOF) is a common form of cyanotic heart disease. Complete surgical correction in younger age group offers good long-term results with reasonable morbidity and improved prognosis in patients with TOF. However, following corrective surgery pulmonary valve replacement (PVR) might be required for residual pulmonary regurgitation in order to avoid irreversible right ventricular remodeling. Otherwise, residual uncorrected pulmonary regurgitation may lead to right ventricular dilatation, impaired biventricular function, ventricular arrhythmias and limited exercise capacity. We report the first case of Freedom Solo stentless valve (Sorin Group, Saluggia, Italy) implantation in the pulmonary position in an adolescent with severe pulmonary insufficiency 12 years after the repair of TOF. Pericardial stentless valves may be an alternative choice for pulmonary valve replacement to improve right ventricular contractile recovery and remodeling after PVR and may have impact on long-term survival.

The value of the levels of acute phase reactants for the prediction of familial Mediterranean fever associated amyloidosis: a case control study

In order to determine the role of levels of acute phase proteins (APPs) for the development of amyloidosis in familial Mediterranean fever (FMF) patients, the levels of serum amyloid A (SAA), C reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate were measured in paired sera of 36 FMF patients during and in between acute attacks, 39 of their healthy parents (obligate heterozgotes), and 15 patients with FMF associated amyloidosis. To compare the levels of APPs, 39 patients with chronic infections or inflammatory diseases who may develop secondary amyloidosis, 20 patients with acute infections who are known to have elevated acute phase response but will never develop amyloidosis and 19 healthy controls were included. The median levels of all APPs are increased in the patients with FMF during attacks and a significant decrease was observed after the attack was over. The level of SAA was above reference range in all FMF patients during the attack free period and the level of at least one other APP was also above normal in 64% of the patients. Both CRP and SAA levels were found to be higher in obligate heterozygotes compared to controls. The levels of SAA in patients with FMF during the attack-free period, obligate heterozygotes and patients with FMF-amyloidosis were found to be similar. The levels in each group were found to be higher than SAA levels found in healthy controls yet lower than the levels measured in the patients with acute infections and patients with chronic inflammation or chronic infections. In conclusion, our results show that SAA level reflects subclinical inflammation with high sensitivity but its value for the prediction of amyloid formation process seems to be low.

Prevalence of interatrial septal aneurysm in newborns and their natural course

The objective of this study was to evaluate the prevalence of atrial septal aneurysm (ASA) in newborns, to define the natural course of ASA, and to investigate its role on closure of associated interatrial septal opening (IASO). A total of 1072 consecutive neonates were examined with echocardiography in the early postnatal period. The length of the interatrial septum, the diameter of IASO, the excursion and base of aneurysm, and the width of the related atrium were measured and the excursion ratio and the basal ratio were calculated for each neonate. Aneurysms with an excursion ratio > or = 25% were diagnosed as ASA. There were 81 neonates (7.6%) with ASA. The prevalence of ASA was 11.1% in preterm (14 of 126) and 7.1% in full-term newborns (67 of 946). All of the ASAs disappeared at the end of the first year of life, and there were no complications related to the lesion during the follow-up period. Although overall IASO prevalence was 78.6% (843 of 1072), it was 72.8% (59 of 81) among the cases with ASA. Although the disappearance time of interatrial septal shunt was not significantly different between the cases with and without ASA, spontaneous closure was less frequent in the cases with ASA than in those without ASA 77.7 and 96.1%), respectively (p < 0.001). The prevalence of ASA is high among newborns, with a high resolution rate. Therefore, it can be considered that it is benign and transient observation. Less frequent spontaneous closure of IASO in cases with ASA indicates that ASA may have a deleterious effect on spontaneous closure.

Bilateral coronary artery dilatation and supravalvular pulmonary stenosis in a child with noonan syndrome

Noonan syndrome is the second most frequent congenital malformation syndrome, after Down syndrome, associated with cardiovascular abnormalities. The most prevalent cardiovascular abnormalities in Noonan syndrome are pulmonary stenosis and hypertrophic cardiomyopathy. We report the case of a 12-year-old girl with Noonan syndrome who had multiple cardiovascular abnormalities, including extensive bilateral coronary artery dilatation, valvular and supravalvular pulmonary stenosis, atrial septal defect, and mitral valve prolapse. Both coronary artery dilatation and supravalvular pulmonary stenosis, although rarely reported, are abnormalities of the cardiovascular system that may occur in Noonan syndrome.

Microleakage and SEM evaluation of fissure sealants placed by use of self-etching priming agents

OBJECTIVES

This study evaluated the microleakage and internal seal of fissure sealants placed by use of self-etching priming agents in comparison to phosphoric acid etching of enamel.

METHODS

Seventy-two caries-free extracted human molars were divided into six groups with 12 teeth each. Occlusal surfaces were cleansed by either pumicing (Groups I, III, V) or by 15-s air-abrasion treatment with 25 microm aluminum oxide particles (Groups II, IV, VI). Fissures were sealed with the self-etching priming systems, Clearfil Liner Bond 2 (Groups I, II) or Resulcin AquaPrime (Groups III, IV). In Groups V and VI, sealants were placed after phosphoric acid etching. Half of the teeth in each group were thermocycled. After staining with 0.5% methylene blue, the teeth were sectioned for evaluation of microleakage. Internal adaptation of the fissure sealants was analyzed by SEM on replicas of cross sections.

RESULTS

Independent of the methods used for cleansing of the occlusal surfaces, fissure sealants in Groups I and II showed significantly more microleakage and less sufficient internal seal as compared to sealants placed in Groups III to VI. Sealants placed by Resulcin AquaPrime (Groups III, IV) leaked significantly more than sealants applied after phosphoric acid etching (Groups V, VI) of the enamel. However, statistical analysis (H-test) did not reveal significant differences concerning the internal adaptation of sealants placed in Groups III, IV, V and VI.

CONCLUSIONS

Concerning the microleakage data, use of the self-etching bonding systems, Clearfil Liner Bond 2 and Resulcin AquaPrime, cannot be recommended for fissure sealing, since the sealing ability is less effective as compared to the conventional acid-etching technique.

Factor V 1691 G-A mutation in children with intracardiac thrombosis: a prospective study

The objective of this study was to determine the association between intracardiac thrombosis and hereditary causes of thrombophilia, including factor V 1691 G-A (factor V Leiden, FVL) and prothrombin 20210 G-A mutations. Over a period of 3 y, genetic risk factors were evaluated in 13 consecutive children (mean age 6.27 +/- 5.44 y) with intracardiac thrombosis, diagnosed by cross-sectional echocardiography. Thrombi were localized in the left heart in four patients and the right heart in nine patients. All children had predisposing factors for thrombus formation: ventriculoatrial shunt for hydrocephalus (n = 3), indwelling catheter for chemotherapy (n = 5), cardiomyopathy (n = 2), sepsis (n = 1), homocystinuria (n = 1) and tetralogy of Fallot (n = 1). Six of the 13 children with intracardiac thrombosis were heterozygotes for FVL mutation. Three of these six children with FVL mutation had ventriculoatrial shunt for hydrocephalus, two children had cardiomyopathy and one had sepsis. None of the patients carried the prothrombin 20210 G-A mutation.

CONCLUSION

It is recommended that FVL mutations should be investigated in all cases of intracardiac thrombosis irrespective of whether or not a predisposing factor is identified. When a predisposing factor is found antithrombotic prophylaxis may be considered in patients carrying the FVL mutation.

Catalytic combustion of carbon tetrachloride

The catalytic combustion of carbon tetrachloride (CCl4) by metal oxide catalysts coated on the monolith support was investigated. The prepared catalysts were tested at temperatures between 300 and 800 degrees C and at varying gas hourly space velocity (GHSV) values with an excess air ratio of 3100%. The catalyst, whose composition was 18% Cr2O3, 2% Ce2O3 and 80% gamma-Al2O3, was found to almost completely oxidize CCl4. The operating conditions proposed are 5702 h(-1) for GHSV, 3100% excess air and a temperature slightly higher than 800 degrees C. The reaction rate expression was found to be independent of oxygen partial pressure but strongly dependent on CCl4 partial pressure.

QRS axis in isolated perimembranous ventricular septal defect and influences of morphological factors on QRS axis

To detect the frequency of left axis deviation (LAD) in isolated perimembranous ventricular septal defects (VSD) we retrospectively analyzed electrocardiograms of 59 patients, aged 8 months to 15 years. Patients were grouped into those having ventricular septal aneurysm (VSA) formation (n:20) and those who did not have VSA (n:39). Patients with VSA were then stratified into 2 groups according to the presence of left ventricular-to-right atrial (LV-RA) shunt. Four hundred healthy children served as the control group. We found that 12 (20.3%) of 59 patients with isolated perimembranous VSD had a LAD. Five of 6 patients with perimembranous outlet VSD and 6 with perimembranous inlet VSD had abnormal LAD with a qR pattern in I and aVL and rS in aVF. Abnormal LAD was more prevalent in patients with VSA (40%) than without VSA (7.7%) (P <.01). We also found that mild right ventricular hypertrophy (RVH) with the rsR' or rSR' pattern in V1 was more frequent in patients with VSA, especially those who had LV-RA shunt. However, we could not find significant difference between patients with or without LV-RA shunt for the incidence of abnormal LAD and mild RVH. Localization of perimembranous VSD was not found to have an effect on frequency of abnormal LAD and mild RVH in this patient group. In patients with clinical findings of VSD, the existence of abnormal LAD especially if it is associated with mild RVH, should raise the possibility of perimembranous VSD with VSA formation.

Impact of dialysis adequacy on cardiac function in pediatric CAPD patients

BACKGROUND

Left ventricular hypertrophy is a major cause of morbidity and mortality among patients with chronic renal failure. Uremia-related risk factors play a fundamental role in its occurrence, thus better prognosis and prolonged survival can be attained by successful dialytic therapies.

OBJECTIVE

To investigate whether dialysis adequacy has a beneficial effect on cardiac structure and function in children receiving continuous ambulatory peritoneal dialysis (CAPD).

DESIGN

Cross-sectional study in the Pediatric Peritoneal Dialysis Unit of a university hospital.

PATIENTS

Eighteen children, aged 13.3 +/- 2.8 years, being treated with CAPD, and 20 healthy age- and sex-matched control subjects were enrolled in this study.

MAIN OUTCOME MEASURES

Echocardiographic evaluation was performed in all subjects. Dialysis adequacy indices [weekly urea (Kt/V) and creatinine clearance (TCCr)] were calculated in the dialysis group.

RESULTS

Interventricular septal thickness, left ventricular (LV) posterior wall thickness, LV mass index (LVMI), and LV end systolic and diastolic dimensions were all found to be significantly higher in the CAPD group compared to the control subjects (p < 0.01). Ejection fraction and fractional shortening of the LV were not significantly different between the two groups. Mean Kt/V was 2.02 +/- 0.71 and mean TCCr was 58 +/- 33 L/wk/1.73 m2. There were significant negative correlations between dialysis adequacy indices and LV end systolic and diastolic dimensions (p < 0.05 and p < 0.001). Ejection fraction and fractional shortening were positively correlated with Kt/V (p < 0.01). Systolic and diastolic blood pressures were positively correlated with LVMI (r= 0.501 and r = 0.523). Significant inverse correlations between mean arterial pressure and both Kt/V and TCCr (r = -0.555 and r = -0.520) were detected.

CONCLUSION

These data clearly document that cardiac structure and function are remarkably influenced by the uremic state and dialysis therapy in pediatric CAPD patients. The close relationships between echocardiographic findings and dialysis adequacy indices suggest that adequate dialysis has a beneficial effect on cardiac function via effective removal of toxic substances.

Mobius syndrome associated with ventricular septal defect

We report a 10-year-old boy with Mobius syndrome (MS) associated with ventricular septal defect who was delivered after an unsuccessful curettage before the 10th week of gestation. Methylergobasine which is an ergot alkaloid was also applied during the curettage procedure. Despite of the curettage procedure, the pregnancy was continued and he was delivered. His developmental milestones were delayed. On account of this case, we think that direct mechanical fetal trauma and vasoconstriction or both may cause MS. But, further extensive studies are needed to verify this hypothesis.