Partial seizure: an unusual cause of recurrent vomiting

Partial seizure is a rare cause of nausea and vomiting. We report an adult patient with abdominal discomfort lasting 15 years accompanied by nausea and vomiting at least twice a week. On admission, physical examination and detailed laboratory tests were normal. Abdominal ultrasound examination, upper gastrointestinal endoscopy and CT scanning of the brain did not reveal any evidence of disease. Electroencephalography revealed bilateral synchronous sharp wave discharges and spike wave activities. The diagnosis of partial seizure was considered and the patient was administered sodium valproate. The patient's symptoms subsided and he has been asymptomatic for the past 20 months. We conclude that partial seizure should be considered in patients suffering from abdominal complaints who do not have any underlying gastrointestinal disorder.     

Ketotifen ameliorates development of fibrosis in alkali burns of the esophagus

An experimental study was performed to investigate the efficacy of ketotifen, which is a mast cell stabilizer and histamine H₁-receptor antagonist, on the prevention of stricture development after esophageal caustic injuries in the rat. Caustic esophageal burn was created by applying 37.5% NaOH to the distal esophagus. Forty rats were divided into four equal groups. Group A (sham) animals were uninjured. Group B rats were injured but untreated. Group C rats were injured and received ketotifen (1 mg/kg/day) via the oral route. Group D rats were injured and received ketotifen (1 mg/kg/day) via the intraperitoneal route. Efficacy of the treatment was assessed on day 28 by measuring the stenosis index and histopathologic damage score and biochemically by determining tissue hydroxyproline content. The stenosis index in group B (0.93±0.22) was significantly increased compared with group A (0.39±0.06, p <0.05), group C (0.42±0.09, p <0.05), and group D (0.35±0.07, p <0.05). The hydroxyproline level (µg/mg wet tissue) was significantly increased in group B (1.31±0.08, p <0.05) compared with group A (0.69±0.16, p <0.05), group C (1.06±0.16, p <0.05), and group D (0.95±0.12, p <0.05). In group B the histopathologic damage score was significantly higher than in groups C (p <0.05) and D (p <0.05). There was no significant difference between group C and group D in terms of all parameters evaluated. Treatment with ketotifen decreased tissue hydroxyproline levels, histological damage, and the stenosis index. We conclude that ketotifen has a preventive effect in the development of fibrosis in an experimental model of corrosive esophagitis in rats.     

Laparoscopic treatment of a bilobed gallbladder: a case report and review of the literature

A double or bilobed gallbladder is a rare congenital anomaly. Because other congenital vascular and biliary duct anomalies may accompany this pathology, open cholecystectomy was thought to be the best treatment of symptomatic patients. In this paper, we report a patient with a bilobed gallbladder whose symptoms were successfully treated with laparoscopic cholecystectomy. We also discuss the characteristics and the embryology of this rare anomaly.     

Thymidine Labeling Index in Breast Cancer Prognosis

Abstract: In addition to primary prognostic factors (tumor size, axillary lymph node status, histological and nuclear grade, estrogen receptor status, etc.), cell kinetics may help to predict outcome and determine for breast cancer. Thymidine labeling index (TLI), which is a kinetic parameter showing tumor aggressivity and cell proliferation rate, is shown among the secondary group of prognostic factors. At Istanbul University, Istanbul Faculty of Medicine, Breast Diseases Research and Treatment Unit, TLI was determined in tumor tissues of 154 patients with primary breast cancer. TLI values varied in the range of 0%–23.59% with a mean of 4.31% ± 0.36% and a median of 3.10%. TLI levels were compared with age, menopause status, axillary involvement, tumor diameter, histological and nuclear grade, estrogen receptor level, and tumor histology. There was no statistically significant correlation between TLI and prognostic factors (p > 0.05). One hundred and eleven patients were followed up for an average of 14.0 months. Twenty-nine patients (26.1%) relapsed and there were 11 (10%) deaths. On the one hand, the low TLI group (<3%) demonstrated the highest relapse and the lowest mortality rate with 29% and 8%, respectively. The relapse rate for the moderate TLI group (3–7%) was 26% with the mortality rate being 12%. One the other hand, the relapse rate for the high TLI group was 20% and the mortality was 12%. Fourteen (48%) of the recurrences and 7 (64%) of the total of 11 deaths were observed at higher TLI levels (TLI > 3%). Nevertheless, these results were not statistically significant (p < 0.05). Thus, TLI appears to be independent of the known prognostic factors for breast carcinoma. According to preliminary results, high TLI levels seem to be associated with higher mortality rates.     

Simple electrodiagnostic method for morton neuroma

Introduction: We describe a simple and quickly applied electrodiagnostic method for confirming the diagnosis of interdigital neuropathy caused by Morton neuroma (MN). Methods: Interdigital nerves II–III and III–IV were stimulated with surface electrodes simultaneously touching the lateral side of 1 toe and the medial side of the other. Recording was also made with surface electrodes. The results of 20 normal controls and 14 patients with MN were evaluated. Results: The amplitude and peak latency values elicited in the patients as well as the interside differences revealed an acceptable abnormality rate between 57.1% and 71.4%. Conclusions: Although the most popular and effective method of MN diagnosis is clinical evaluation supported by imaging, electrophysiological studies can, in selected patients, provide valuable information. Muscle Nerve 49 : 193–197, 2014