Subphrenic abscess resulting in resection of the lower basal segment of the right lung: a severe complication following laparoscopic appendectomy

We report the case of an 18-year-old boy who developed an intrathoracic abscess with rupture of the diaphragm following a laparoscopic appendectomy (LA) for a perforated appendicitis. LA is an established procedure in the treatment of appendicitis. It is a safe and efficacious technique, but several complications can occur with this procedure, and surgeons should be aware of the potential dangers. Herein, we present a previously unreported thoracic complication following an LA.     

Sarcoidosis Presenting as Cold Thyroid Nodules: Report of Two Cases

Sarcoidosis is a systemic disease characterized by noncaseating granulomas. Thyroid involvement is rare in sarcoidosis. In this paper, two sarcoidosis patients who demonstrated cold thyroid nodules are presented. A 42-year-old woman presented with multinodular goiter and was diagnosed as having sarcoidosis when noncaseating granulomas were observed during the pathological examination of the thyroidectomy specimen. Enlarged mediastinal lymph nodes were observed in the routine preoperative chest X-ray in another 53-year-old woman, while she was being prepared to undergo a thyroidectomy. The pathological examination of the thyroid specimens showed noncaseating granulomas in both patients, and the diagnosis was confirmed by either hepatic biopsy or chest X-ray findings. In conclusion, thyroid involvement should be suspected in sarcoidosis patients who present with cold nodules in the thyroid. Furthermore, if noncaseating granulomas are observed in thyroid specimens after a thyroidectomy in an otherwise healthy person, the patient should be evaluated further for sarcoidosis.     

The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey: a multicenter study

 The purpose of this study was to investigate the associations of tooth loss with skeletal bone mass, years since menopause, educational level, current smoking status, dietary calcium intake, and number of pregnancies in postmenopausal osteoporotic women in Turkey. The study population consisted of 1171 postmenopausal women aged 40–86 years (mean age, 61.19 ± 7.28 years). A detailed history was obtained from all women, including relevant lifestyle parameters, risk factors, and measurements of weight and height. Women were separated into three groups according to the number of teeth remaining as group 1 (edentulous, 457 women), group 2 (10 or fewer teeth, 232 women), and group 3 (more than 10 teeth remaining, 482 women). There was no significant difference among the three groups in mean age and menopausal age (P < 0.05). Body mass index of group 1 was significantly higher than that of group 2 (P < 0.01). Educational level was significantly different between three groups: groups 1 and 2 (P < 0.001), groups 1 and 3 (P < 0.0001), and groups 2 and 3 (P < 0.001). Educational level was lowest in group 1 and highest in group 3. Despite a low ratio of cigarette smoking in general, a smoking habit was most prevalent in group 3 and least in group 2. The ratio of women receiving adequate calcium was significantly lower in group 1 than in other groups (P < 0.001); mean calcium intake was similar in all groups. The number of pregnancies was significantly higher in group 1 than in other groups (P < 0.001). Lumbar bone mineral density (BMD) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001). Although no significant difference was found between groups 1 and 3, femoral neck BMD of group 2 was less than in others, and differences between groups 1 and 2 and between groups 2 and 3 (P < 0.001) were significant. Lumbar bone mineral content (BMC) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001), and lumbar BMC in group 2 was significantly higher than in group 3 (P < 0.05). Femoral neck BMC in group 1 was significantly higher than in groups 2 and 3 (P < 0.001). In conclusion, lumbar BMD and BMC in the edentulous group were significantly lower, whereas femoral neck BMD and BMC were significantly higher in edentulous group compared with the others. Our findings indicated that improvement in lifestyle factors and nutritional strategies for the treatment and prevention of osteoporosis may have additional benefit in reducing tooth loss. Received: February 18, 2002 / Accepted: June 21, 2002 Offprint requests to: A. Gur     

Bilateral hearing loss during vincristine therapy: a case report

Vincristine sulfate is a chemotherapeutic agent used in different cancer therapies. It is also the first choice of treatment for peripheral T-cell lymphoma with cyclophosphamide and adriamycin. Sudden hearing loss during vincristine therapy is a very rare event. This is a case of a 16-year old girl who developed sudden bilateral hearing loss related to vincristine therapy.     

Tissue plasminogen activator in the treatment of experimental retinal vein occlusion

The thrombolytic effect of recombinant tissue plasminogen activator was studied in 28 randomly selected rabbit eyes to lyse photochemically induced retinal vein occlusion. Occlusion was confirmed histologically and assessed by fluorescein angiography. Sixteen eyes were treated with recombinant tissue plasminogen activator given intravenously and 12 control eyes were given similar volumes of normal saline solution. Fluorescein angiography was performed before and at various intervals after treatment. Four hours after treatment, the retinal vein was patent in 16 eyes (100%) treated with recombinant tissue plasminogen activator, as opposed to one eye (8.3%) treated with normal saline. The results indicate that tissue plasminogen activator is effective in lysing experimentally induced retinal vein thrombi.     

Giant arachnoid granulation in a patient with benign intracranial hypertension (2009: 1b)

We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation 7(GAG) in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify GAG and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of GAGs can be used to evaluate the lesion as the cause of the patient’s symptoms.     

The opinions of employed mothers about their own nutrition during lactation: a questionnaire survey

OBJECTIVES: The main purpose of the study was to identify the changes employed mothers of infants aged 0-24 months made in their nutrition with the aim of increasing their milk production and extending their breastfeeding period. METHODS: The 135 full-time employed mothers enrolled in this study came to the Well-Child Clinic at Akdeniz University Hospital. Dietary data were collected from the mothers via a questionnaire prepared by the researchers to elicit details about what kind of foods or nutrition supplements women added, avoided or were recommended to avoid or add to their diets and why. RESULTS: All the mothers made changes in their diets while breastfeeding. The number one change that mothers made in their diet in order to increase milk production was to increase their fluid intake (38.6%) while the second was to increase their consumption of sweets (25.3%). The main type of food mothers were advised to avoid were dried legumes and grains (28.9%). The most important reason for this was the belief that they increased the chance of newborn colic (89.4%). There were statistically significant differences between foods avoided by breastfeeding mothers related to their age (chi(2)=6.88, p=.009), education level and those who mentioned increasing their consumption of fluid while breastfeeding (chi(2)=13.12, p=.000). CONCLUSIONS: All of the mothers espoused specific practices, and had been given recommendations by others about their nutrition while breastfeeding. Mothers need to be informed about the factors that increase and decrease milk production and affect infant colic, and should be encouraged that they can successfully breastfeed without increasing their consumption of sweets or avoiding dried legumes and some vegetables.     

Right coronary artery to left ventricle fistula—Effective diagnosis with 64-MDCT

Coronary artery fistula is a rare congenital anomaly in which a communication is present between a cardiac chamber or another vascular structure. In this paper, we describe a 52-year-old asymptomatic male patient with a right coronary artery to left ventricle fistula. We demonstrate the effectiveness of 64-MDCT (Multi-detector row computed tomography) in demonstrating the precise anatomy of this fistula in which transthoracic echocardiography was inadequate for evaluation.     

A cross-sectional,mono-centric pilot study of insulin resistance in enzyme replacement therapy patients with Gaucher type I without overweight

Insulin resistance have been demonstrated in untreated patients with Gaucher type I disease. It was implied in overweight enzyme replacement therapy (ERT) treated patients with Gaucher type I disease. In present study we investigate whether insulin resistance is presented in fourteen ERT treated patients with Gaucher type I disease and without overweight in comparison to normal subjects. This work illustrates the presence of insulin resistance in non-overweight ERT treated patients with Gaucher type I disease.     

A demographic analysis of the fitness cost of extended longevity in Caenorhabditis elegans

We monitored survival and reproduction of 1000 individuals of Caenorhabditis elegans wild type (N2) and 800 individuals of clk-1 and daf-2, and used biodemographic analysis to address fitness as the integrative consequence of the entire age-specific schedules of survival and reproduction. Relative to N2, the mutants clk-1 and daf-2 extended average life span by 27% and 111%, respectively, but reduced net reproductive rate by 44% and 18%. The net result of differences in survival and fertility was a significant differential in fitness, with both clk-1 (lambda = 2.74) and daf-2 (lambda = 3.78) at a disadvantage relative to N2 (lambda = 3.85). Demographic life table response experiment (LTRE) analysis revealed that the fitness differentials were due to negative effects in mutants on reproduction in the first 6-7 days of life. Fitness costs in clk-1 and daf-2 of C. elegans are consistent with the theory of antagonistic pleiotropy for the evolution of senescence.