First branchial cleft sinus presenting with cholesteatoma and external auditory canal atresia

First branchial cleft abnormalities are rare. They may involve the external auditory canal and middle ear. We describe a 6-year-old girl with congenital external auditory canal atresia, microtia, and cholesteatoma of mastoid and middle ear in addition to the first branchial cleft abnormalities. Clinical features of the patient are briefly described and the embryological relationship between first branchial cleft anomaly and external auditory canal atresia is discussed. The surgical management of these lesions may be performed, both the complete excision of the sinus and reconstructive otologic surgery.     

Bacteriemia in septoplasty and septorhinoplasty surgery

This study was conducted in an attempt to investigate whether bacteriemia developed in patients with septoplasty and septorhinoplasty in the postoperative period during which an anterior nasal pack was in their nose. Fifty-three patients who went through septoplasty or septorhinoplasty operations were followed in this study. Nasal smear cultures were obtained from all the subjects before the operation. After the packs were retrieved, smears were also obtained from the pack material. Venous blood samples were obtained from the patients immediately before the operation, after the operation and immediately following the retrieval of the pack. When preoperative nasal smear cultures and postoperative pack material cultures of the patients that were obtained at 48 hours were compared, it was seen that different microorganisms were present in 66% of the patients. Bacterial growth was not observed in any of the preoperative blood cultures; whereas 8 patients (15.0%) had bacteriemia in the blood samples obtained immediately after the operation and 9 (16.9%) had growth in the blood samples obtained following the retrieval of the pack. With these results we have seen that bacteriemia can develop in patients with septoplasty and septorhinoplasty. It did not cause serious clinical problems. However, in patients with cardiovascular problems, this possibility should be taken into consideration and relevant preoperative precautions should be implemented.     

Reversible postictal MRI change mimicking structural lesion

A reversible change on magnetic resonance imaging (MRI) following generalised seizure mimicking a tumour-like structural lesion is reported in a 15-year-old patient. MRI revealed a left fronto-parietal cortico-subcortical lesion on T2 weighted images. The control MRI after 5 weeks from the onset revealed no pathological finding. The reversible MRI changes may be the result of a local brain swelling, and a defect of cerebral autoregulation during seizure at the site of activity. The transient nature of such neuroradiological findings have to be taken into consideration in the differential diagnosis because of their similar appearance on imaging to intrinsic brain tumours.     

Self-biting induced by activation of L-type calcium channels in mice: dopaminergic influences

The L-type calcium channel activator +/-Bay K 8644 induces repetitive self-biting and self-injurious behavior in young mice. Since dopaminergic systems have been implicated in prior studies of these behaviors in both humans and animals, the present experiments were designed to test whether drugs influencing the dopaminergic systems could modify the behavioral responses to +/-Bay K 8644. The ability of +/-Bay K 8644 to provoke self-biting and self-injurious behavior was increased by amphetamine and GBR 12909, drugs that augment synaptic dopaminergic concentrations by blocking the reuptake and/or stimulating the release of dopamine. Conversely, self-biting and self-injurious behavior were decreased by tetrabenazine or reserpine, two drugs that deplete vesicular stores of dopamine. These results suggest that dopaminergic systems may play a role in the ability of +/-Bay K 8644 to provoke self-biting and self-injurious behavior.     

The quality of groundwater for certain chemicals in military fields in Ankara

OBJECTIVE: The goal of this study was to determine the quality of groundwater for certain chemicals from all wells for the military units in Ankara (the capital city of Turkey) to evaluate special situations like a nuclear, biological, and chemical attack. METHOD: The quality of underground water has been evaluated chemically by examining 34 different water specimens. Various chemical parameters and heavy metals have been assessed in these samples by using an ion meter and atomic absorption spectrophotometer. RESULTS: Nitrate and chloride have been assessed at a higher rate with the levels exceeding maximum contaminant levels. Mercury, arsenic, aluminum, iron, conductivity, and salinity have also had levels exceeding maximum contaminant levels for each of them according to the levels set by the World Health Organization. CONCLUSION: This study has given us some powerful clues that underground water in Ankara is at a growing risk to be contaminated mainly with nitrate and chloride. Although more detailed investigations are necessary for a better evaluation, it is clear that preventive measures should be implemented or improved.     

Pulmonary alveolar proteinosis in a patient with acute lymphoid leukemia regression after G-CSF therapy

Pulmonary alveolar proteinosis (PAP) is the intra-alveolar accumulation of periodic-acid schiff (PAS) positive material. PAP is one of the underrecognized causes of pulmonary infiltrates in patients with hematologic malignancies. Here, we present a patient with acute lymphoid leukemia (ALL) in first remission that developed fever and diffuse pulmonary infiltrates during the neutropenic stage of consolidation chemotherapy. The histopathologic examination of bronchoalveolar lavage (BAL) fluid and transbronchial biopsy specimen demonstrated the presence of PAS-positive eosinophilic material. Empirical antibiotherapy and granulocyte-colony stimulating factor (G-CSF) were given. After the correction of neutropenia with G-CSF, the patient's fever disappeared, acute phase reactants decreased, pulmonary infiltrates resolved. We present this case because it was the first patient in whom the correction of neutropenia with G-CSF was followed by resolution of PAP.     

Brucellosis and uveitis

A 30-year-old-lady, (Case 1) was found to have brucella uveitis in her left eye. Serum agglutination (SAT) and SAT/Coombs titers were positive at 1:320 and 1:160, respectively. In Case 2, a 12-year-old-girl diagnosis of left brucellosis uveitis was made. Both SAT and SAT/Coombs titers were positive at 1:1280. This report confirms that Brucellae organisms as a cause of uveitis.     

The value of somatosensory-evoked potentials and bulbocavernosus reflex in patients with impotence

In 14 normal male adults and 97 male patients having impotence alone or together with systematic and/or neuro-psychiatric symptoms and signs, the somatosensory cerebral-evoked potentials were obtained by glans penis stimulation (penile SEP); by peroneal nerve stimulation (peroneal SEP) and by electrically-induced bulbocavernous (BC) reflex. In normal subjects, the configurations of both SEPs were basically similar, except that the onset of latency was 10-15 msec longer and the amplitude in the P1-N1 component was higher in penile SEP. BC-reflex latency was abnormally prolonged, especially in diabetic impotence and in patients with cauda/conus lesions, while the abnormalities on the penile and peroneal SEP were more frequent in patients with spinal cord injuries. MS and parkinsonism. In impotent patients with epilepsy, chronic prostatis and psychogenic problems, all the tests were generally normal.