Prognostic Factors and Long-Term Results in Patients Who Underwent Videothoracoscopic Bronchogenic Cyst Excision

Background: Our aim in this study was to compare the results of video-assisted thoracoscopic surgery with those of open surgery regarding efficacy, morbidity, and long-term recurrence of bronchogenic cysts in light of the literature.Methods: This study comprises the data of 51 patients whose pathological diagnosis revealed bronchogenic cyst after surgical excision between January 2010 and December 2016. There were two groups according to the type of resection: video-assisted thoracoscopic surgery (VATS) and thoracotomy.Results: Of the patients included in the study, 25 (49%) were male and 26 (51%) were female. Their average age was 41.7 ± 14.1 years. While 14 patients (27.5%) were asymptomatic in the preoperative period, 37 patients (72.5%) had symptoms. The Charlson Comorbidity Index was 0 in 35 patients (68.6%) and 1 and above in 16 patients (31.4%). While 22 (43.1%) patients underwent cyst excision via VATS, 29 (56.9%) patients underwent thoracotomy. The average length of hospital stay was 1.77 ± 0.68 days for patients who had VATS, whereas it was 3.82 ± 3.3 days for patients who had thoracotomy (p <0.001).Conclusion: VATS procedure is a safe method in the surgical treatment of bronchogenic cysts, with less hospitalization and similar recurrence rates.     

Shoulder impingement syndrome: relationships between clinical, functional, and radiologic findings

OBJECTIVE: Although there has been much research about imaging methods for shoulder impingement syndrome, the clinical information and upper limb level of disability have been generally ignored. The purpose of this study was to detect the relationships between clinical, functional, and radiologic variables in patients with shoulder impingement syndrome. DESIGN: A cross-sectional, clinical, and radiologic study was planned and 59 shoulders of 58 consecutive patients waiting for physical therapy because of a clinically suspected shoulder impingement syndrome were included into this study. Comprehensive clinical examination, radiography, shoulder ultrasonography, and magnetic resonance imaging were performed in the same month. RESULTS: Despite the high sensitivities of ultrasonography for diagnosing rotator cuff tears (98.1%) and biceps pathologies (100%), magnetic resonance imaging was superior to ultrasonography in many important shoulder structures such as a glenoid labral tear and subacromial bursal effusion/hypertrophy (P < 0.01). These structures were the determinants of the shoulder's disability measured by disabilities of the arm, shoulder, and hand questionnaire. CONCLUSION: Ultrasonography and magnetic resonance imaging had comparable high accuracy for identifying the biceps pathologies and rotator cuff tears. The basic clinical tests had modest accuracy in both disorders. The choice of which imaging test to perform should be based on the patient's clinical information (regarding lesion of glenoid labrum, joint capsule, muscle, and bone), cost, and imaging experience of the radiology department.     

Management of acquired bronchobiliary fistula: 3 case reports and a literature review

Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and requires a well-planned management strategy. Although hydatid disease is still the leading cause, extensive surgical interventions and invasive procedures of the liver have altered the profile of patients in recent decades. This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.     

Turkish Validity-Reliability Study of the Celiac Disease-Specific Pediatric Quality of Life Scale

BackgroundCeliac disease is an autoimmune enteropathy triggered by the presence of gluten. There are Celiac Disease Dutch-Child Quality of Life Scale, Celiac-Specific Pediatric Quality of Life Scale for children/adolescents patients to measure the quality of life. In this study, due to lack of quality of life scales for children with celiac in Turkey, we aimed at Turkish adaptation of the Celiac-Specific Pediatric Quality of Life Scale.MethodsThis methodological study was conducted in Ankara University Faculty of Medicine, Cebeci Hospital Hospital between July 2019 and July 2020. A total of 192 children were included. Reliability was demonstrated by the Cronbach’s alpha coefficient. Structural validity was evaluated using explanatory factor analysis and confirmatory factor analysis. The Statistical Package for Social Sciences (SPSS) 22.0 and Amos were used in analyses.ResultsIn 8-12 age groups; Cronbach’s alpha was 0.92 in negative emotions dimension, 0.88 in school dimension, and 0.74 in enjoyment dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy value was 0.698, Bartlett’s test of sphericity was significant (P < .001). Variance explained was 75.8%. In confirmatory factor analysis, X²/df was 3.26, root mean square error of approximation value was 0.07, comparative fit index value was 0.96. In 13-18 age groups; Cronbach’s alpha was 0.87 in social dimension, 0.84 in uncertainty dimension, 0.78 in isolation dimension, and 0.83 in limitations dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy was 0.684, Bartlett’s test of sphericity was significant (P < .001). Variance explained was 68.6%. In confirmatory factor analysis, X²/sd value was 3.78, root mean square error of approximation value was 0.061, and comparative fit index value was 0.961.ConclusionCronbach’s alpha values of the groups were found to be above 0.70. Kaiser-Meyer-Olkin values were above 0.5 in terms of sample size, Bartlett’s tests for sphericity were significant in terms of correlations between variables, root mean square error of approximation values were below 0.08, comparative fit index and goodness of fit index values were above 0.95 in terms of model fit. If the scales have been found to be valid and reliable, it is recommended for use in Turkey.     

Femtosecond Laser-Based Micromachining of Rotational-Symmetric Sapphire Workpieces

Sapphire is a robust and wear-resistant material. However, efficient and high-quality micromachining is still a challenge. This contribution demonstrates and discusses two novels, previously unreported approaches for femtosecond laser-based micromachining of rotational-symmetric sapphire workpieces, whereas both methods are in principal hybrids of laser scanning and laser turning or laser lathe. The first process, a combination of a sequential linear hatch pattern in parallel to the workpiece’s main axis with a defined incremental workpiece rotation, enables the fabrication of sapphire fibers with diameters of 50 μm over a length of 4.5 mm. Furthermore, sapphire specimens with a diameter of 25 μm over a length of 2 mm can be fabricated whereas an arithmetical mean height, i.e., S_a parameter, of 281 nm is achieved. The second process combines a constant workpiece feed and orthogonal scanning with incremental workpiece rotation. With this approach, workpiece length limitations of the first process are overcome and sapphire fibers with an average diameter of 90 µm over a length of 20 cm are manufactured. Again, the sapphire specimen exhibits a comparable surface roughness with an average S_a value of 249 nm over 20 cm. Based on the obtained results, the proposed manufacturing method paves an innovative and flexible, all laser-based way towards the fabrication or microstructuring of sapphire optical devices, and thus, a promising alternative to chemical processes.     

Is the choice of anesthesia during gastrointestinal endoscopic procedures a result of anxiety?

Background and study aimsEsophagogastroduodenoscopy (EGD) and colonoscopy (CS) are vital endoscopic procedures in the diagnosis and follow-up of gastrointestinal tract diseases. Endoscopic procedures can be performed with or without anesthesia as per patient preferences. These procedures can cause some anxiety in almost all patients, and the degree of anxiety differs for each individual. Thus, we aimed to evaluate the trait and state anxiety levels of the patients and assess the relationship between the preference of anesthesia and anxiety levels.Patients and methodsTo investigate this issue, 723 patients who underwent elective endoscopy (EGD and/or CS) were enrolled. The researchers collected sociodemographic data and medical history records as reported by the patients. State and trait anxiety levels of the patients were evaluated using the State and Trait Anxiety Inventory (STAI).ResultsThe patients were divided into two groups as with anesthesia and without anesthesia. Of the respondents, 43.4% requested anesthesia during endoscopic procedure. Sociodemographic data, except sex, showed similar characteristics. The STAI trait scores of the two groups were similar; however, there was a significant difference in the STAI state scores of the groups (p = 0.018). A significant difference was observed in the anesthesia preference and the type of endoscopic procedure (EGD, CS, or both) (p < 0.001). Type of endoscopic procedure, STAI state scores, and sex were determined as the predictors of the anesthesia choice.ConclusionEndoscopic procedures are known to cause anxiety among many patients. Our findings suggest that the anesthesia preferences of patients are an important factor in preventing these situational concerns. However, this study found that being a woman and undergoing a CS procedure are important factors related to anesthesia preferences. Thus, more detailed assessments on this subject are required.     

IGG4-related giant lymphoproliferative-inflammatory left atrial mass

Cardiac masses are rare entities that can be challenging in clinical diagnosis and management. Cardiac masses can be detected incidentally in patients with an asymptomatic course or may cause systemic inflammation findings due to inflammatory cytokine release or symptoms such as shortness of breath, chest pain, syncope, sudden cardiac death, and mortality due to the location of the mass. Cardiac masses associated with systemic inflammatory disorders are uncommon in this disease group. This case report will present a case with an asymptomatic IgG4-related left atrial mass detected in routine echocardiographic control imaging due to rheumatic valve disease.     

VEXAS syndrome with severe multisystem involvement: Rapid recovery after splenectomy

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined disorder in which treatment is still unclear. Herein, a patient with VEXAS syndrome who had atypical findings and an interesting treatment course is presented as a case report. He had fatigue, recurrent fever, pulmonary infiltrates, proteinuria, anemia, leucopenia, transient skin rush and increased acute phase reactants. The patient, who could not tolerate corticosteroid tapering, recovered rapidly after diagnostic splenectomy and the pathological examination of the spleen revealed significant findings.     

Lutein/zeaxanthin isomers regulate neurotrophic factors and synaptic plasticity in trained rats

Background/aim This study was conducted to elucidate the effects of lutein/zeaxanthin isomers (L/Zi) on lipid metabolism, oxidative stress, NF-κB/Nrf2 pathways, and synaptic plasticity proteins in trained rats.Materials and methods Wistar rats were distributed into four groups: 1) control, 2) L/Zi: rats received L/Zi at the dose of 100 mg/kg by oral gavage, 3) exercise, 4) exercise+L/Zi: rats exercised and received L/Zi (100 mg/kg) by oral gavage. The duration of the study was eight weeks. Results Exercise combined with L/Zi reduced lipid peroxidation and improved antioxidant enzyme activities of muscle and cerebral cortex in rats (p < 0.001). In the Exercise + L/Zi group, muscle and cerebral cortex Nrf2 and HO-1 levels increased, while NF-κB levels decreased (p <0.001). Also, L/Zi improved BDNF, synapsin I, SYP, and GAP-43 levels of the cerebral cortex of trained rats (p < 0.001). The highest levels of BDNF, synapsin SYP, and GAP-43 in the cerebral cortex were determined in the Exercise+L/Zi group.Conclusion These results suggested that exercise combined with L/Zi supplementation might be effective to reduce neurodegeneration via improving neurotrophic factors and synaptic proteins, and oxidative capacity in the cerebral cortex.