The prevalence of asthma and allergic diseases in children of school age in Adana in southern Turkey

The aim of this study was to determine the prevalence of asthma and other allergic disorders as well as the factors affecting these disorders in school-children in Adana. This cross-sectional population-based study using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was carried out on 3164 school-children aged between 6-18 years during March to June 1997. There were 1521 (48.1%) boys and 1643 (51.9%) girls. The prevalence of asthma, allergic rhinitis and eczema in the 6-18 year-old children was found to be 12.6%, 13.6% and 8.3%, respectively. The prevalence of asthma was highest in 6-10 year-old school-children (14.7%), and lowest (6.0%) in 15-18 year-old children. The prevalence of asthma diagnosed by a doctor was 5.0%. The cumulative and current prevalences of wheezing were found to be 19.0% and 13.5%, respectively. The cumulative prevalence of allergic disorders was found to be 23.4%. The presence of domestic animals at home and dampness of the home were found to be important risk factors for asthma. Family histories of asthma, eczema, and diagnosis made by a doctor, and history of frequent sinusitis were found to be significantly higher in asthmatics. In conclusion, asthma is an important chronic disease of childhood in Adana in southern Turkey.     

Deletion analysis and clinical correlations in patients with Xp21 linked muscular dystrophy

We carried out molecular deletion analysis on 142 patients with Duchenne/Becker muscular dystrophy which covered 25 exons of the dystrophin gene. We also evaluated the results by comparing with the clinical findings and examples in the literature. A deletion ratio of 63.7% was achieved. Exon 46 was the most frequently affected region. Interestingly we also observed four cases with muscle promoter (Mp) region deletions which have been rarely reported in the literature.     

Multi-resistant viridans streptococcal pneumonia and sepsis in the ventilated newborn

Mechanical ventilation increases the frequency of nosocomial infections. This study describes the frequency of multi-resistant viridans streptococcal colonisation, the clinical course of nosocomial sepsis and ventilator-associated pneumonia in mechanically ventilated neonates in the neonatal intensive care unit of Ankara University Hospital. Seventy-nine ventilated newborns were enrolled. Broncho-alveolar lavage culture and blood cultures were positive in 44 (56%) and 17 (22%) patients, respectively. The most predominant micro-organisms in broncho-alveolar lavage cultures were multi-resistant viridans streptococci (29, 66%). Viridans streptococci were also one of the predominant organisms in blood cultures (5/17, 29%). In 29 patients with broncho-alveolar lavage positive for viridans streptococci, nine (31%) had colonisation, 15 (52%) had ventilator-associated pneumonia and five (17%) had sepsis owing to viridans streptococcus. Ventilator-associated pneumonia was encountered in 52/1000 ventilation days. Mortality was caused by infection in three (10%) of them. Mechanically ventilated neonates in our neonatal intensive care unit had a high rate of both multi-resistant viridans streptococcus airway colonisation and subsequent ventilator-associated pneumonia and sepsis.     

Primary Peritracheal Schwannoma: Report of a Case

Posterior mediastinal tumors of neurogenic origin commonly arise from the sympathetic or intercostal nerves. However, anterior mediastinal tumors rarely originate from the vagus nerve, and primary neurogenic tumors of the trachea are extremely uncommon. A 19-year-old man was admitted to an emergency department in sudden acute respiratory distress. A tracheostomy was performed and he was transferred to our Ear Nose and Throat Department for further investigation. A bronchoscopic biopsy was taken of a mass occupying the tracheal lumen and intraoperative frozen section examination suggested a schwannoma, so tracheal resection was performed. Although rare, primary tracheal schwannoma should be considered in the differential diagnosis of sudden respiratory distress of unknown origin.     

Magill forceps technique for removal of safety pins in upper esophagus: a preliminary report

OBJECTIVE: Foreign body ingestion is not an uncommon problem in children. Children can ingest various foreign objects. One of such objects is safety pin, which is not widely reported in the literature. The purpose of this study is to consider the efficacy of Magill forceps for removal of safety pins from upper esophagus. METHODS: A retrospective chart review was conducted for all children admitted to our hospital with safety pin ingestion from 1995 to 2003. In 58 children who had been found to ingest safety pin, the attachment site was gastrointestinal tract. In 12 of the cases, safety pins were located in the upper end of the esophagus. In seven of the children safety pin extraction was achieved by using a Magill forceps with the assistance of a laryngoscope maintaining general anesthesia with mask inhalation. RESULTS: Safety pins were successfully removed with Magill forceps without any complications in seven patients whom they were located in the upper esophagus. Upper esophageal safety pins in the other five patients were extracted with rigid esophagoscopy for they were not seen under direct laryngoscopy. There were no complications. CONCLUSIONS: This is a preliminary report, but we believe that the Magill forceps technique for the removal of safety pin in the upper end of the esophagus is safe and minimally invasive method compared to rigid esophagoscopy.     

Serum bcl-2 and survivin levels in melanoma

This study was conducted to investigate the serum levels of bcl-2 and survivin in patients with melanoma and the relationship with tumour progression and known prognostic parameters. Forty-four patients with cutaneous melanoma were investigated. Serum samples were obtained on first admission before adjuvant and metastatic treatment were given and at follow-up. Serum bcl-2 and survivin levels were determined using enzyme immunometric assay (EIA) and enzyme-linked immunosorbent assay (ELISA). The baseline serum bcl-2 levels were significantly higher in patients with melanoma than in the control group (P=0.01). For the serum survivin levels, no difference was found (P=0.6). No significant correlations were found between the prognostic parameters analysed and the serum survivin concentrations. The same was true of the serum bcl-2 values, except for the age of the patient (P=0.025) and nodal involvement (P=0.003). No significant relationship was found between the serum levels of bcl-2 and survivin (r=-0.13, P=0.4). In node-positive patients (n=8) both of these anti-apoptotic substances were unchanged after interferon-alpha-2b therapy. However, serum survivin concentrations were significantly increased in 10 patients with metastatic melanoma who underwent dacarbazine (DTIC)-based cytotoxic chemotherapy (P=0.047). A similar finding was not determined for the serum bcl-2 levels. In conclusion, the results of this study suggest that decreased apoptosis is associated partly with an increase in serum bcl-2. However, much research continues in this field, and exciting new knowledge will ultimately emerge.     

Frequency of Mycoplasma pneumoniae among atypical pneumonia of childhood

We aimed to investigate the frequency of Mycoplasma pneumoniae among atypical pneumonia of childhood that is acquired from the community and to determine a practical approach to the diagnosis of these patients. In this prospective study, 55 patients (31 male and 24 female) with atypical pneumonia were investigated with conventional laboratory and radiological methods as well as culture and polymerase chain reaction (PCR) on throat swab. In addition, serum of the patients was tested for M. pneumoniae specific IgM. The patients were reevaluated clinically at 3-5 days and 3-4 weeks and serologically at 3-4 weeks. The data on patients with M. pneumoniae pneumonia were compared with the other patients with atypical pneumonia and controls. All patients were treated with macrolide antibiotics. The mean age of the patients was 7.8+/-2.9 years. The frequency of M. pneumoniae by this method was 34.5%. Neither clinical, laboratory, or epidemiological data nor response to macrolide antibiotics was useful in detecting the etiology of atypical pneumonia. Diagnostic sensitivity and specificity of IgM+IgG antibodies plus PCR on throat swab were estimated as 100%. M. pneumoniae was an important microorganism in the etiology of atypical pneumonia of childhood in our community. In order to prevent loss of time with beta-lactamase antibiotics, which are usually started in severe pneumonia, serologic tests and PCR must be done during the initial evaluation of the patient for the reliable diagnosis of M. pneumoniae, which will increase the chance of early and appropriate therapy.     

Experimental fascial flap model in the dog: free flap of the dorsal thoracic fascia

For years, various types of fascial flaps have been used in clinical practice; however, there are many unanswered questions regarding their basic physiology, anatomy and histopathologic changes occurring after transfer. Simple and reliable flap models are needed to investigate these questions, but very few of these flap models have been described in experimental animals to date. The purpose of this study was to describe a new reliable fascia flap model in the dog-the dorsal thoracic fascia flap. This fascia is defined as the anatomic layer that contains the blood supply to the scapular and parascapular fasciocutaneous flaps. Fourteen adult dogs were used in this experiment. The vascular anatomy of the dorsal thoracic fascia was studied by anatomic dissection and microangiography. Anatomic dissection revealed that the main axial vessel supplying the dorsal thoracic fascia was the superficial branch of the thoracodorsal vessel. Based on the vascular pedicle, fascia flaps generally measuring 15 x 24 cm were created. At gross observation, all of these large flaps based solely on the vascular pedicle were observed to be well-perfused. Microangiographic examination revealed the intense vascularity of the superficial branches of the thoracodorsal vessels in the whole area of all flaps. It was concluded that this is a simple and reliable fascial flap model which can be prepared as a free or pedicled flap. It has a consistent, long vascular pedicle with large vessel diameters supporting a large fascial flap.     

The effects of ageing and sulfur dioxide inhalation exposure on visual-evoked potentials,antioxidant enzyme systems,and lipid-peroxidation levels of the brain and eye

The effects of ageing and 10 ppm sulfur dioxide (SO(2)) inhalation exposure on visual-evoked potentials (VEPs), thiobarbituric acid reactive substances (TBARS), a product of lipid peroxidation, and the activities of Cu, Zn superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) of brain and eye were investigated in young (3-month), adult (12-month), and mature (24-month) Swiss male albino rats. The experimental groups were placed in an exposure chamber containing a constant level of 10 ppm SO(2), while control groups were placed in an exposure chamber, which was continually pumped with filtered air, for 1 h/day x 7 days/week for 6 weeks. SO(2) inhalation exposure caused increased levels of brain, retina, and lens Cu, Zn SOD activity, and decreased levels of brain and lens GSH-Px activity in all experimental groups with respect to their corresponding control groups, whereas no change was observed in the level of retina GSH-Px activity. No alterations were observed in brain CAT activity. On the other hand, retina CAT activity was slightly decreased in SO(2)-exposed rats, but no change was observed in their lens CAT activity. The brain and lens TBARS levels of all SO(2)-exposed groups were significantly increased in comparison with their respective control groups. The amount of TBARS was only increased in the retina of the SO(2)-exposed 3-month group compared with its control. Of the SO(2)-exposed rats, the mean latencies of the P(1), N(1), P(2), and P(3) components of the 3-month group, P(1), N(1), and N(2) components of the 12-month group, and only P(3) of the 24-month group were significantly prolonged in comparison with those of their control groups. The amplitudes of N(1)P(2) and P(2)N(2) in the 12- and 24-month control groups were significantly decreased compared with those of the 3-month group. On the other hand, no differences were observed among those of SO(2)-exposed groups.These findings suggest that ageing and SO(2) inhalation exposure have the potential to induce antioxidant enzymes in the brain and eye, and VEP alterations, which are the primary target for air pollutants. It could be concluded that lipid peroxidation could play a critical role in the mechanism responsible for VEP alterations with ageing.