Under what conditions is the intra-articular steroid injection superior to nonsteroidal anti-inflammatory drugs for treating sacroiliac joint pain?

OBJECTIVE

The purpose of this prospective study was to determine the conditions under which intra-articular injection therapy may be superior to nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with sacroiliac joint pain in the outpatient setting at our hospital.

PATIENTS AND METHODS

Patients with sacroiliac pain were divided into two groups: NSAID and the sacroiliac injection group. The NSAID group received 25 mg of indometacin orally once a day and 750 mg of naproxen orally once a day. In the sacroiliac injection group, 5 mg of betamethasone were injected into the sacroiliac joint. The patients' history of lumbar surgery, whether they had sacroiliitis, and the duration of pain were recorded. The patients' VAS (Visual analogue scale) scores at week 1 and month 1 were evaluated.

RESULTS

VAS scores were decreased after the first week and first month in the sacroiliac injection group compared to the NSAID group (p<0.001). Sacroiliac steroid injection was found to be superior to NSAIDs in reducing VAS scores in patients with sacroiliitis, a history of lumbar surgery, and pain lasting more than 30 days (p<0.001). In patients without sacroiliitis, without a history of lumbar surgery, and with less than 30 days of pain, no difference was observed between the groups in reducing VAS scores at the end of the first month.

CONCLUSIONS

In patients with sacroiliac joint pain, sacroiliac joint injection is superior to NSAIDs in pain relief in patients with pain for more than 30 days, those with MRI-diagnosed sacroiliitis, and those who have undergone lumbar surgery.

Making stereotactic radiosurgery decisions by calculating the probability of perilesional edema in cavernomas

OBJECTIVE

Stereotactic radiosurgery is a therapeutic modality for cavernomas that is associated with certain adverse effects, such as perilesional edema. In this study, we aimed to estimate the presentation of perilesional edema using imaging techniques, considering its location, proximity to major venous and arterial structures, size, depth, and eloquent location.

PATIENTS AND METHODS

The radiographic evaluation included their sizes, localization of the lobes, whether they were in the deep or superficial regions, eloquent areas, and their proximity to the major arteries and venous sinuses.

RESULTS

As the size increased, the time to edema increased at the same rate (r=0.972, p=0.001). We determined that the duration of edema increases as it attaches to the great venous structures, and edema occurs over a longer time (r=-0.761, p=0.001). Cavernomas >13 mm had a high probability of causing edema (p=0.0014). Edema occurred with a high probability in patients with an arterial distance <5.69 mm and a venous/arterial distance ratio >8.93 (specificity 100%, selectivity 98.2%).

CONCLUSIONS

When recommending stereostatic radiosurgery treatment, the possibility of edema formation should be calculated based on the location, size, and proximity of the cavernoma to the vascular structures, and the choice of treatment should be made accordingly.

The necessity and timing of exercise after lumbar disc herniation surgery

OBJECTIVE

Physical therapy and rehabilitation may improve low back pain and quality of life after lumbar disc herniation. However, there is no agreement on its optimal start time and rehabilitative methods. This study evaluates the effects of early and late rehabilitation on low back pain and quality of life following unilateral microdiscectomy.

PATIENTS AND METHODS

A total of 204 patients who underwent surgery for lumbar disc herniation were included and subsequently randomized into five groups: 1. No exercise, 2. The 2nd-week walking group, 3. 1st-month walking group, 4. 2nd-week waist exercise, 5. 1st-month waist exercise. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were assessed at the 1st week, 1st, 3rd, and 6th, and 12th-month follow-up after surgery.

RESULTS

1st-month VAS scores were analyzed, and a significant difference was found between the VAS scores of the 2nd-week walk (3.60±0.78) and 2nd-week waist exercise (3.38±0.67) groups and the other groups (p<0.001). 3rd-month VAS results were analyzed, and the VAS scores of the 1st-month walk group (2.67±0.48) were significantly higher than those of the 2nd-week walk group (1.73±0.45) (p<0.001). A significant difference was observed between the no-exercise group (2.93±0.91) and the other groups according to the 12-month VAS scores, with the VAS scores of the no-exercise group being significantly higher than the other groups (p<0.001). There was a significant difference between the ODI scores of both the 2nd-week walk (38±8.55) and the 2nd-week waist (33.8±6.61) exercise groups and the other groups according to the 1st-month ODI scores (p<0.001). A significant difference was observed between the no-exercise group (35.2±8.25) and the other groups according to the 12-month ODI scores, and the ODI scores of the no-exercise group were significantly higher than the other groups (p<0.001).

CONCLUSIONS

Regular exercise is highly recommended for long-term pain relief, as well as for achieving a speedy recovery after surgery, which is crucial to maintaining a high quality of life and preventing loss of earning potential. We believe that early implementation of exercises is ideal, but even if initiated later, standard back exercises can still expedite rehabilitation.

Is neutrophil-to-lymphocyte ratio a prognostic marker for traumatic brain injury in the pediatric population?

OBJECTIVE

The neutrophil-to-lymphocyte ratio (NLR) is used for the prognosis of diseases characterized by inflammatory processes. This study aims to discuss the long-term outcomes and NLR in pediatric traumatic brain injury cases.

PATIENTS AND METHODS

This study investigated traumatic brain injury patients younger than 18 years. Patients were grouped into 5 groups according to their Glasgow outcome scores (GOS). Initial admission Glasgow coma scale (GCS) values, neurological examinations, pupil conditions, cardiopulmonary resuscitation (CPR) administration, and seizure occurrence were recorded. Neutrophil counts and lymphocyte counts, derived from complete blood count (CBC) values taken during the patient's first 8 hours of admission, were used to calculate the NLR value.

RESULTS

A total of 150 patients, 54 (36%) females and 96 (64%) males, were assessed in the study. The most frequent accident type was falling from a height [84 patients (56%)]. The GCS, CPR, pupillary reflex, anisocoria, surgical procedure, and neutrophil counts were significantly different between the GOS scores. There was no statistically significant difference between the GOS and the NLR (p=0.400). There was a significant difference in NLR value according to CPR, seizures, and brain injury type (p<0.05).

CONCLUSIONS

NLR values are not correlated with 1-year outcome scores in pediatric traumatic brain injury patients, unlike proven parameters such as initial GCS scores and neurological status.

Effect of omega-3 fatty acid use on sepsis and mortality in patients with Covıd-19

Background

This study aimed to investigate the effects of omega-3 fatty acid use on sepsis and mortality in patients treated for COVİD-19 disease in the intensive care unit (ICU) based on clinical and laboratory results.

Aim

To determine the effect of omega-3 fatty acid use on sepsis and mortality in patients with COVİD-19.

Patients and Methods

A total of 80 patients with confirmed COVİD-19 infection who were hospitalized in the ICU of Ankara City Hospital, received (n = 40) or did not receive (n = 40) omega-3 fatty acid dietary supplementation, were included in this single-center, retrospective study. The clinical and laboratory data of eligible patients were extracted from the hospital records.

Results

The mean age was 65.5 (13.6). The mean length of stay in the intensive care unit was 11.5 (6.3) days. Mortality and sepsis development rates were similar in the groups. The frequency of patients who received pulse steroid therapy was higher in the group of patients who did not receive omega-3 (P < 0.05). Hypertension was more common in the patient group receiving omega-3 supplements (P < 0.05). Mean procalcitonin and interleukin-6 (IL-6) levels were significantly lower in patients who received omega-3 supplements compared to those who did not receive supplements (P < 0.001 and P < 0.05). Mean prothrombin time (PT) was shorter in patients receiving omega-3 supplementation (P < 0.05).

Conclusions

Study results obtained in this study indicate that providing omega-3 fatty acid supplements may be beneficial to patients with severe COVİD-19, however further research with large-scale randomized controlled trials is necessary.

Are preoperative CT parameters predictive for the outcome of septoplasty?

Background

Despite successful septoplasty surgery, some patients still complain of nasal obstruction (NO).

Aim

Our aim in the present study is to determine whether preoperative computed tomographic (CT) parameters have prognostic significance for the success of septoplasty.

Material and Methods

Retrospective data from 61 patients in a secondary care hospital who had undergone septoplasty met the inclusion and exclusion criteria. The effects of demographic and preoperative CT parameters (internal nasal valve [INV], external nasal valve area, angle of septal deviation, choana area, aperture pyriformis area, high septal deviation [HSD], transverse diameter of midnose, anterior/posterior deviation, concha and meatus diameter [superior, middle, inferior]) were studied in relation to the change in NOSE scores and the success of surgery.

Results

Of the 61 patients studied, 31 were male (51%) aged 18-55 years with a mean age ± SD (26.59 ± 9.41). It was found that the changes in NOSE scores were significantly different from each other (P < 0.01). Male gender, trauma history, moderate septal deviation, HSD, mucosal pathology, posterior deviation, bullous turbinate (right and left middle, right superior), and in the absence of allergy, paradoxical turbinate (right and left middle and superior), S-shaped deviation were found to have a significant correlation in the change of NOSE scores (P < 0.05). Age and internal valve differed with respect to outcome (P < 0.05). Variables in multiple linear regresion models of all parameters were found to be insignificant (P < 0.05).

Conclusion

Preoperative CT parameters are informative, but do not predict the postoperative success of septoplasty.

PLASMA INTERLEUKIN-6 LEVELS MAY BE ASSOCIATED WITH THE LENGTH OF STAY TIME OF ADULT HYPERGLYCEMIC PATIENTS IN AN INTENSIVE CARE UNIT

Context

Estimation of intensive care unit (ICU) length of stay time (LOS) may be challenging, and pro-inflammatory cytokines can be used as a marker for this purpose.

Objective

The current study aimed to investigate the association between pro-inflammatory cytokine levels and LOS in hyperglycemic patients admitted to adult ICU.

Design

This is a prospective observational study.

Subjects and Methods

All adult ICU patients with a blood glucose level higher than 250 mg/dL, during the study period were included. Hospitalization day demographics were recorded, and plasma IL-6, IL1-ß, and TNF-α concentrations were measured.

Results

A total of 74 patients were enrolled in the study. Diabetic ketoacidosis (DKA) was positive in 31 patients, and the remaining 43 were in the non-DKA (NDKA) group. There was no difference between the two groups in terms of age, gender, LOS, hemoglobin, hematocrit, lactate levels, and platelets count. IL-6, IL-1ß, and TNF-α levels did not show any difference between DKA and NDKA groups (p=0.784, 0.413, and 0.288, respectively). There was a positive correlation between IL-6 levels and LOS (n=74, Pearson correlation=0.330; p=0.004).

Conclusions

Among pro-inflammatory cytokines, IL-6 showed a better performance for the prediction of LOS than IL-1ß, TNF-α, and CRP.

Comparison of the protective effects of selective endothelin-a receptor antagonist, ambrisentan, and dual endothelin-A/B receptor antagonist, bosentan, in experimental renal ischemia reperfusion injury

AIM

This study aims to compare the protective effects of ambrisentan, a selective endothelin typeA receptor antagonist, and bosentan, a dual endothelin typeA/B receptor antagonist, on experimental renal ischemia reperfusion injury.

METHOD

The study sample consisted of 21 female rats, which were divided into 3 groups: Control, Ambrisentan and Bosentan. For the ischemia-reperfusion injury model, left‑kidney nephrectomy was performed after sacrificing the animals. In the immunohistochemical examination, caspase-3 was examined, and then the apoptotic index was determined. In the biochemical examination, the activities of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase, and the levels of nitrite (NOx), TNF-α, and IL-1β were determined.

RESULTS

There were statistically significant differences between the groups in terms of total injury score grade in range of 0‒3 (p=0.001).The glomerular and tubular apoptotic indices were higher in the control group as compared to those of the ambrisentan and bosentan groups (p=0.001).There were no statistically significant differences in terms of SOD, CAT, GPx, MDA, IL-1β and TNF-α measurements among the groups (p>0.05).

CONCLUSIONS

In the experimentally created renal ischemia reperfusion model, both ambrisentan and bosentan increased the NOx level, decreased the apoptosis, and protected the kidney from renal ischemia reperfusion injury. However, no significant superiority was found between ambrisentan and bosentan in terms of their protective effects (Tab. 3, Fig. 2, Ref. 31).

Calvarial bone defects in ovariectomised rats treated with mesenchymal stem cells and demineralised freeze-dried bone allografts

BACKGROUND

The aim of the study was to investigate the ability of a combination of bone marrow mesenchymal stem cells (BM-MSCs) with and without demineralised freeze-dried bone allografts (DFDBAs) to induce bone regeneration in calvarial defects in ovariectomised rats.

MATERIALS AND METHODS

Critical size defects were filled with a combination of DFDBAs and BM-MSCs or BM-MSCs alone. Eight weeks after calvarial surgery, the rats were sacrificed. The samples were analysed histologically and immunohistochemically.

RESULTS

No difference was observed in vascularisation between groups C1 (animals with cranial defect only, control group) and O1 (animals with cranial defect only, ovariectomy group). Intramembranous ossification was observed at a limited level in groups C2 (animals with cranial defect with MSCs, control group) and O2 (animals with cranial defect with MSCs, ovariectomy group) compared to C1 and O1. In group C3 (animals with DFDBAs with MSCs, control group), the fibrous structures of the matrix became compact as a result of a bone graft having been placed in the cavity, but in group O3 (animals with DFDBAs with MSCs, ovariectomy group), the fibrous tissue was poorly distributed between the bone grafts for the most parts.

CONCLUSIONS

We conclude that the insertion of BM-MSCs enhances bone healing; however, the DFDBA/BM-MSC combination has little effect on overcoming impaired bone formation in ovariectomised rats.

Evaluation of the relationship between neutrophil lymphocyte ratio and the most common bacterial urinary tract infections after transplantation

OBJECTIVE

We aimed to evaluate the relationship between neutrophil lymphocyte ratio and the most common bacterial urinary tract infections after transplantation. We also assessed the frequency of bacterial infections, e.g. Escherichia coli, Klebsiella, and Enterococcus in the urinary tract, and determined the important factors affecting neutrophil/lymphocyte ratio (N/L).

METHODS

We compared the percentage of neutrophils (NE%), percentage of lymphocytes (Lym%), and N/L, along with blood urea nitrogen (BUN), creatinine, and white blood cells (WBC) in all patients before and after renal transplantation.

RESULTS

The Lym% and WBC significantly increased after surgery while N/L%, BUN, and creatinine levels were significantly decreased. Postoperative infections were evaluated by measuring WBC, NE%, Lym%, N/L%, serum urea and creatinine levels, and no significant differences were seen compared to the preoperative values. Univariate analysis also did not show any significant differences between pre- and post-operative parameters. However, a significant difference in N/L% ratio was seen between the E. coli infected and uninfected recipients.

CONCLUSIONS

Any significant difference in NE%, Lym%, and N/L%, BUN, creatinine, and WBC parameters among infected and non-infected renal transplant patients were not found. The steps should be taken to prevent pre-transplantation infection and patients should be continuously monitored for infections post-transplantation (Tab. 6, Fig. 1, Ref. 24).

Microleakage of glass ionomer based restorative materials in primary teeth: An In vitro study

Aim

Using AutoCAD, we examined the microleakage of dye at the edges of primary-teeth restorations using three glass ionomer-based restorative materials.

Materials and Methods

A total of 30 extracted noncarious primary molars were used. Class V cavities were adjusted on the buccal surfaces. The teeth were randomly divided into three groups of 10 teeth each as follows: Group A (Ketac Molar), Group B (Photac Fil), and Group C (Dyract XP). All specimens were stored for 24 h at 37°C in distilled water. The teeth were thermocycled 1000 times between 5°C ± 2°C and 55°C ± 2°C before immersion in 0.5% basic fuchsin for 24 h. Two mesiodistal cuts of each tooth were photographed under a stereomicroscope equipped with a digital camera. The dye-infiltrated surface area was measured. Statistical evaluations were performed by the Kolmogorov-Smirnov test, Levene test, one-way analysis of variance, and Tukey's honestly significant difference test.

Results

The mean microleakage ratio differed significantly among the groups (P < 0.05). Group C exhibited a significantly smaller area (P < 0.001) than the other groups. Group A had a nonsignificantly higher mean microleakage value than Group B (P > 0.05).

Conclusions

Polyacid-modified composite resin may be a useful restorative material in primary teeth in terms of minimizing microleakage.

Increase in Body Mass Index After Renal Transplantation

The aim of this study was to determine the changes in body mass index (BMI) of patients after renal transplantation regarding causes like steroid use, lower necessity for dietary restrictions, and changes in eating habits. Ninety-seven patients were enrolled in this retrospective study; they had undergone cadaver or living donor renal transplantation between 2011 and 2013. Demographic features of patients, height, weight, and BMI were evaluated before and 6 and 12 months after surgery. The patients were grouped as malnutritioned, normal, overweight, and obese. Statistical analyses were performed using the SPSS 11.0 statistics program. Mean age of patients was 39.1 ± 10.7 years. Twenty-six (26.8%) were female and 71 (73.1%) were male. Mean BMI before surgery was 22.52 ± 3.97 kg/m(2). Six months post-transplantation the mean BMI was 24.40 ± 4.1 kg/m(2) and after 12 months it was 25.56 ± 4.14 kg/m(2) (P < .05). Also, 68% of patients showed improvement 12 months after surgery; they were in the preoperative malnutrition group. There is a significant increase in the BMI of patients in the first year who undergo renal transplantation, and the reason is multifactorial. BMI is relevant to diabetes, hypertension, and allograft nephropathy. BMI should be carefully considered in the follow-up of patients who have undergone renal transplantation, and early nutritional changes with dietary and exercise programs should be performed in overweight cases.

Morphological Changes Caused by Streptozotocin-Induced Diabetes in the Healthy Gingiva of Rats

BACKGROUND AND OBJECTIVE

Epidemiologic and clinical studies have indicated that diabetes is a risk factor for periodontal disease progression. The aim of the present study was to evaluate the morphological changes of gingiva in streptozotocin diabetic rats.

MATERIAL AND METHODS

30 male Wistar rats that weighed 250-300 g were used in this study. The animals were randomly divided into 2 groups, one with streptozotocin-induced diabetes and another one with healthy (non-diabetic) animals. All rats were sacrificed after 21 days, and their maxillary first molars with surrounding tissues were observed morphological analyses.

RESULTS

In this study, it was observed that the epithelial thickness was greater in the diabetes group, compared to the control group. The statistical comparison of the diabetes and control groups for the thickness of each of the layers of the epithelium demonstrated that the thickness of the keratinized (corneum), granular and basal layers had significantly increased in the diabetic animals. Furthermore, the diabetes group displayed a decrease in the height of the connective tissue papillae, which was found to be statistically insignificant. Another important finding detected in the diabetes group was the congestion of the gingival capillaries, which showed that blood circulation is impaired in diabetes cases.

CONCLUSION

On the basis of the results obtained in this study, it was concluded that streptozotocin-induced diabetes may increase predisposition to periodontal disease by causing morphological changes in the periodontal tissues.

Evaluation of renal transplantations performed in the Transplantation Center at Sanko University Medical School

INTRODUCTION

Renal transplantation is the optimum treatment to improve the quality and length of life in end-stage renal disease. The aim of this study is to evaluate patients who underwent renal transplantation in our transplantation center and to present our clinical experience.

METHODS

Living donor and cadaveric renal transplants performed in the Transplantation Center of Sanko University Medical School between 2011 and 2014 were evaluated retrospectively. In our study, important parameters, such as delayed graft function, early and late phase infections and urologic complications after the operation, results of renal transplants with marginal donors with high creatinine levels, and increase in posttransplant body mass index were evaluated regarding to the living donor and cadaveric renal transplants performed in our transplantation center.

RESULTS

We included 136 patients were (92 males [68%] and 44 females [32%]), with an average age of 38.9 ± 9.8 years (range, 17-67). There were 63 living donor renal transplantations (43%) and 73 cadaveric renal transplantations (57%). The youngest cadaveric donor was 3 years old, and the oldest was 86. Fifteen of the cadaveric donors had blood creatinine levels around 1.5 g/dL. The highest level of creatinine from cadaveric donors was 5.1 g/dL.

CONCLUSIONS

Living donor renal transplantations have higher success rate than cadaveric renal transplantations. Ureteroneocystostomy and native ureteropyelostomy seem to be safe and efficient treatment methods for ureteral complications. High creatinine levels in marginal donors do not affect graft function in early stages.

Uterine extra gastrointestinal stromal tumor presenting as intramural leiomyoma

Extra gastrointestinal stromal tumors (EGIST) are reported in different sites and organs. This tumors are rare in gynecologic apparatus. Here the authors report an uterine unique tumor represented as intramural leiomyoma. Because of different treatment options, clinicians should be aware of this rare tumor which may be located in uterus and confused with a smooth muscle tumor.

Incisor trauma in a Turkish preschool population: prevalence and socio-economic risk factors

OBJECTIVE

This study aimed to assess the prevalence of traumatic injuries of the primary incisors in preschool children from 2 to 5 years old in South-Eastern Anatolia, Turkey. Additionally, the relationship between traumatic dental injuries, parents' education level, family income, size of incisal overjet and the presence of anterior open bite were examined.

BASIC RESEARCH DESIGN

A cross-sectional survey

CLINICAL SETTINGS

Data were collected through oral examinations and structured interviews, and included socio-economic indicators.

PARTICIPANTS

A total of 727 children of both genders were included in the study. 122 of these children were aged 2; 183 aged 3; 178 aged 4 and 186 aged 5.

RESULTS

The prevalence of dental injuries was 8.0% (n = 58). The highest frequency of trauma in the primary teeth was observed at the age of 4. Boys experienced more dental injuries than girls, 12.2% and 4.0%, respectively. The most common crown fracture was in enamel only (57%) followed by crown fracture of enamel and dentin (19%).

CONCLUSION

The prevalence of dental injuries in Turkish preschool children was very low. The children with incisal overjet greater than 5mm and anterior open bite experienced more dental injuries in primary teeth than their counterparts with normal occlusion. Socio-economic indicators were not statistically significantly associated with the occurrence of traumatic dental injuries.

Stenting of vertebral artery origin with the buddy wire technique in tortuous subclavian artery. A case report

Tortuous vasculature is a common reason for failure to stabilize a guiding catheter in an appropriate position and is associated with a higher incidence of vascular complications. In such a case, the guiding catheter often buckles into the aorta during an attempt to place the balloon or stent. In this report, we used the buddy wire technique to support the guiding catheter, and we passed through the vertebral artery origin stenosis with the help of a microcatheter-microguidewire combination which enabled stent deployment. We kept the buddy wire through the guiding catheter throughout the procedure and the 6F guiding catheter allowed passages of both buddy wire and stent system.

Intracranial hemorrhage in Kimura's disease: coincidence or consequence?

OBJECTIVE

To report an unusual case of Kimura's disease associated with intracranial hemorrhage, the first such report in the literature.

CASE REPORT

A 38-year-old man presented with chronic neurological disorders and a 10-year history of left cervical soft tissue swellings. Magnetic resonance imaging (MRI) of the cranium showed a subacute/chronic hematoma in the left occipitotemporal lobe and a chronic infarct in the right parietal lobe. Cervical computed tomography (CT) and MRI showed multiple masses on the left side of the neck and parotid gland. Histopathologic examination revealed lymphocyte and eosinophil infiltration, proliferation of hyalinated blood vessels, and interstitial fibrosis. Steroid therapy (2 mg/kg per day) was started and the lesions regressed partially. The masses and some enlarged regional lymph nodes were resected.

CONCLUSIONS

Intracranial hemorrhage can either be a coincidental finding or complication of Kimura's disease. MRI and CT are effective modalities in radiologic diagnosis of this condition.

Three-year clinical evaluation of endodontically treated anterior teeth restored with a polyethylene fibre-reinforced composite

BACKGROUND

Polyethylene fibre-reinforced composites (FRCs) have been under development for some time. However, there is a lack of data on the clinical performance of these restorations. The purpose of this descriptive study was to evaluate the clinical performance of endodontically treated anterior teeth restored using polyethylene FRCs.

METHODS

Eighty-seven endodontically treated anterior teeth in 65 patients were restored with polyethylene FRCs. The restorations were placed by three operators. The patients were recalled for examinations every year for up to three years. The restorations were evaluated using modified Ryge and USPHS criteria.

RESULTS

A statistical analysis showed no significant difference in marginal irregularity, marginal discolouration, surface texture, wear/anatomic form, fracture and retention, radiographic appearance, or debonding between the baseline and three-year results.

CONCLUSIONS

Based on our three-year examination results, polyethylene FRC restorations appear to be clinically successful.

Cypermethrin-induced histopathological and biochemical changes in Nile tilapia (Oreochromis niloticus), and the protective and recuperative effect of ascorbic acid

The objective of this study was to investigate the effects of ascorbic acid on the toxicity of cypermethrin's on histopathological lesions in tissues and protein, glycogen levels in Oreochromis niloticus. Nile tilapia was exposed to 0.22 and 0.44 μg/l cypermethrin+control diet, 0.22 and 0.44 μg/l cypermethrin+ascorbic acid supplemented diet for 20 days. The fish were allowed recuperation period of 15 days in pesticide-free water and fed with ascorbic acid suplementation diet. In light microscopic investigation, histopathological lesions were observed in the gill, liver and kidney. The severity of lesions accreted depending on increased pesticide concentration and control diet. Some of the lesions were reversible or at least were less pronounced after recuperation period. Protein levels decreased in some groups after treatment period according to control groups (p<0.05). The highest depletions in liver, muscle and gill protein levels were found in 0.44 μg/l cypermethrin+ascorbic acid supplemented diet group (62.23%), in 0.22 μg/l cypermethrin+control diet group (53.12%) and in 0.44 μg/l cypermethrin+control diet group (61.87%) after 10 days, respectively. These levels increased at the end of the recuperation period. The highest depletion in liver glycogen levels was found in 0.22 μg/l cypermethrin+control diet group (50.50%) after 10 days (p<0.05). At the end of recuperation period, there was no difference between the groups (except 0.22 μg/l cypermethrin+ascorbic acid supplemented diet group) and controls. The decrease of muscle glycogen, except 0.22 μg/l cypermethrin+ascorbic acid supplemented diet group, was recorded at the end of 10 and 20 days. In the recuperation period, an increase was observed at all groups. These results revealed that the histopathology, protein and glycogen can work as good indicators of stress of a toxicant on fish. Ascorbic acid serves fish as an antitoxic agent against pesticide toxicity.

US, CT and MRI findings in a case of diffuse lymphangiomatosis and cystic hygroma

Lymphangiomatosis is a rare disease with multifocal lymphatic proliferation that typically occurs during childhood and involves multiple parenchymal organs including the lung, liver, spleen, bone, and skin. Lymphangiomatosis may occur synchronously or metachronously with cystic hygroma of the neck. We present US, CT, and MRI findings of cystic hygroma of the neck associated with generalized lymphangiomatosis affecting bones and spleen in a 2-year-old girl.

Persistent Hypoglossal Artery Associated with a Ruptured Ipsilateral Posterior Inferior Cerebellar Artery Aneurysm

A rare case of persistent hypoglossal artery in conjuction with a ruptured aneurysm at the left proximal posterior inferior cerebellar artery (PICA) is presented. A ruptured PICA aneurysm was successfully treated by endovascular occlusion of the aneurym with coiling.

Effects of seasonal and physiological variations on the serum chemistry, vitamins and thyroid hormone concentrations in sheep

The aim of this study was to investigate the possible effects of the reproductive status and seasonal variations on the serum chemistry and vitamin status and their relationships with the thyroid hormones in Sakiz-Awassi crossbreed sheep. The sheep (n = 34) were divided into two groups. The first group (n = 22) was mated; the second group (n = 12) was not mated. Their serum samples were collected four times a year at the each season and under reproductive status. The periods are 1, early pregnancy (October); 2, late pregnancy (January); 3, lactation (April); and 4, dry season (July). The results of this study indicated that (1) total protein (TP), globulin, cholesterol, creatinine, uric acid and T4/T3 vary with reproductive status but not seasonal variations; (2) alanine aminotransferase, T4, fT4 concentrations in serum vary only with reproductive status; (3) the urea, creatine kinase, lactate dehydrogenase, alkaline phosphatase, aspartate aminotransferase, amylase, albumin, triglyceride, VLDL, Vit A-E, T3 and fT3 concentration could vary with both reproductive status and seasonal variations; (4) the glucose, gamma-glutamyl transpeptidase, folate concentrations were altered neither season of the year nor the reproductive status; (5) a single reference interval for folate, gamma-glutamyl transpeptidase (GGT), glucose, TP, globulin, cholesterol, creatinine, uric acid and T4/T3 can be used for both mated and non-mated sheep because of no differences were found due to the reproductive status. Taking the results together suggests that reproductive status and seasonal variations have to be taken into consideration for a correct interpretation of the serum chemistry values of sheep. Nutritional supplements are required for sheep during certain periods to avoid a decline of their performance, which would then represent consequent economic, loses.

Factors affecting morbidity and mortality in gangrenous cholecystitis

INTRODUCTION

Gangrenous cholecystitis is a serious complication of acute cholecystitis. Male gender, older age, leukocytosis, cardio-vascular diseases and diabetes were reported as factors that increase the risk of gangrenous cholecystitis. The aim our study was to determine variables affecting morbidity and mortality as well as to define the independent risk factors in Gangrenous Cholecystitis.

METHODS

Fifty three patients who had been treated for Gangrenous Cholecystitis were reviewed. The variables are defined as follows: age, gender, systemic diseases, Mannheim Peritonitis index, aspartate aminotransferase, alanine aminotransferase, white blood cell count and type of surgery. In order to determine the independent risk factors that might affect morbidity and mortality in Gangrenous Cholecystitis, we made use of multivariate logistic regression analysis.

RESULTS

The independent risk factors affecting on morbidity were age (P = 0.037), existing systemic disease (P = 0.047) and > or = 29 Mannheim Peritonitis index (P = 0.008), and the independent risk factors affecting on mortality were age (P = 0.046), white blood cell count (P = 0.035). Pre-operative and post-operative third day aspartate amino-transferase and alanine aminotransferase average values were compared, there was a significant difference (P < 0.0001, P < 0.0001 respectively).

CONCLUSIONS

We found that older age, > or = 29 Mannheim Peritonitis index and existence of systemic diseases were independent risk factors affecting morbidity. Older age and lower of white blood cell count were independent risk factors affecting mortality. We believe that further comprehensive studies, involving prospective, multi-center and a large number of patients, are needed.

Multivoxel magnetic resonance spectroscopy in gliomatosis cerebri

Gliomatosis cerebri is a rare entity with non-specific clinical and conventional magnetic resonance imaging (MRI) findings; accurate diagnosis is a differential diagnostic challenge. MR spectroscopy has recently been introduced as a useful diagnostic tool for detection of this entity. We present a gliomatosis cerebri case in which we made the radiological diagnosis using the MR spectroscopy findings; the diagnosis was confirmed by subsequent biopsy and histopathologic evaluation. Multivoxel spectroscopy (CSI, PRESS, 1500/135) shows a marked increase in Cho/NAA (6.6), normal to mild increase in Cho/Cr (1.2), and marked decrease in NAA/Cr (0.2) compared with the normally appearing contralateral side (Cho/NAA: 0.8, Cho/Cr: 0.9, NAA/Cr: 1.2).