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Psychological Flexibility in Individuals With Substance Use Disorder: The Mediating Effect of Distress Tolerance and Stress
(Wiley, 2024) Yıldız, Erman; Büyükfırat, Emine
IntroductionPsychological flexibility is posited to aid individuals with substance use disorder (SUD) in managing stress and tolerating distress. However, the intricacies of this mechanism remain obscure.AimThis study investigates the potential mediating role of psychological flexibility in the relationship between distress tolerance and perceived stress among individuals with SUD.MethodThis cross-sectional study evaluated 187 individuals with SUD, selected through non-probability convenience sampling, using the Introductory Information Form, the Perceived Stress Scale, the Distress Tolerance Scale and the Acceptance and Action Questionnaire-Substance Abuse. Data analysis was conducted using SPSS 25 and further refined with Jamovi 2.4.14, employing advanced mediation analysis techniques.ResultsSignificant relationships were found between distress tolerance, perceived stress and psychological flexibility. Mediation model analysis showed that psychological flexibility mediated the relationship between distress tolerance and perceived stress.DiscussionThis study revealed that higher distress tolerance, higher psychological flexibility and lower perceived stress were associated. As individuals adopt a more flexible and accepting attitude towards distressing situations, they perceive stressful events as less threatening and more manageable.Implications for PracticeThe study suggests the need for psychiatric and mental health nursing practice and education to incorporate strategies to increase psychological flexibility.
Value of Glut-1 and Koc Markers in the Differential Diagnosis of Reactive Mesothelial Hyperplasia, Malignant Mesothelioma and Pulmonary Adenocarcinoma
(De Gruyter Open Ltd, 2013) Ucer, Ozlem; Dagli, Adile Ferda; Kilicarslan, Ahmet; Artas, Gokhan
Objective: Malignant mesothelioma (MM) is a primary malignant tumor developing from mesothelial cells lining the serosal surfaces and particularly the pleura, and has a very poor prognosis. It may display a variety of histological patterns and has a wide spectrum of cytomorphological characteristics, causing problems in its differential diagnosis from lung adenocarcinomas and sometimes from benign mesothelial proliferations. Immunohistochemical examination is the most useful method for this distinction. In our study, we aimed to determine the value of glucose transporter isoform-1 (GLUT-1) and K homology domain-containing protein (KOC) markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and lung adenocarcinoma. Material and Method: Our study included 30 samples of malignant mesothelioma, 30 samples of pulmonary adenocarcinoma and 30 samples of reactive mesothelial hyperplasia selected from the archives of the Firat University Hospital's Pathology Department Laboratory. The samples were applied GLUT-1 and KOC markers by immunohistochemistry and the place of these markers in the differential diagnosis was examined. Results: GLUT-1 was found positive in 80% of malignant mesothelioma cases, 83.3% of adenocarcinoma cases and 6.6% of reactive mesothelial hyperplasia cases. KOC was positive in 83.3% of malignant mesothelioma cases, 76.6% of adenocarcinoma cases and 46.6% of reactive mesothelial hyperplasia cases. There was no statistically significant difference between malignant mesothelioma and lung adenocarcinoma cases in terms of the diffuseness and intensity of staining with GLUT-1, whereas a significant difference was established when these groups were compared with reactive mesothelial hyperplasia cases. However, the KOC staining diffuseness and intensity results were similar to those obtained with GLUT-1. Conclusion: In conclusion, GLUT-1 and KOC markers do not differentiate malignant mesotheliomas from pulmonary adenocarcinomas but can be useful in differentiating reactive mesothelial hyperplasia from malignant mesothelioma and lung adenocarcinoma.
Alterations in the pulmonary function tests of inflammatory bowel diseases
(Aves, 2011) Ates, Fehmi; Karincaoglu, Melih; Hacievliyagil, Suleyman Savas; Yalniz, Mehmet; Seckin, Yuksel
Background/aims: We aimed to determine the changes in the pulmonary function tests of the patients with inflammatory bowel diseases. Methods: Forty inflammatory bowel dieases patients; 30 ulcerative colitis and 10 Crohn's disease, and age- and sex-matched control group, consisting of 30 healthy persons, were included in the study. Disease activity in patients with ulcerative colitis was assessed by Truelove and Witts Criteria and in Crohn's disease patients by Chron's Disease Activity Index. Results: Pulmonary function tests were found abnormal at least in. one parameter in, 17 / 30 ulcerative colitis patients (56%) and in 5/10 Crohn's disease patients (50%) in the activation period and in 5/30 ulcerative colitis patients (17%) and in 2/10 Crohn's disease patients (20%) in the remission period of the diseases of the same patients. Forced vital capacity, first second, residual volume 1 total lung capacity, diffusing capacity of the lung for carbon monoxide and diffusing capacity of the lung for carbon monoxide per liter alveolar volume values were found significantly impaired in the activation period in comparison with the values of the same patients in the remission period (p<0.01). It was found that pulmonary function test values in patients with inflammatory bowel dieases were not affected by either the type of disease or treatment with 5-aminosalicylic acid. However, they were affected notably by the disease activity. Conclusion: Pulmonary function test abormalities were found frequently in patients with inflammatory bowel dieases without presence of any respiratory symptoms and lung radiograph findings. The severity and frequency of these pulmonary function test abnormalities which were detected even in the remission periods increase with the activation of the disease. Therefore, pulmonary function test may be used as a non-invasive diagnostic procedure in determining the activation of inflammatory bowel dieases and might aid to the early diagnosis of the latent respiratory
Barolith as a rare cause of acute appendicitis: a case report
(Turkish Assoc Trauma Emergency Surgery, 2013) Ince, Volkan; Isik, Burak; Koc, Cemalettin; Baskiran, Adil; Onur, Asim
A barolith consists of inspissated barium associated with feces and is seen, rarely, after barium studies for imaging the gastrointestinal system. The barium used in such studies can enter the appendiceal lumen and, rarely, cause appendicitis by obliterating or narrowing the lumen of the appendix. The appendix fills with barium and the entire appendix is visualized in 80-90% of barium swallow or enema studies, and this is accepted as a reliable sign of a non-diseased appendix Post-examination retention of barium in the appendix is very common (90 similar to 95%), and 10% of the patients retain barium in the appendix beyond 72 hours. If the barium is retained for more than two months, complicated appendicitis can result. We present a 46-year-old male who was diagnosed with acute appendicitis due to a barolith and required an appendectomy three months after a double-contrast barium enema study. After barium studies, patients should be informed regarding retention of barium in the appendix and the possibility that it can cause acute appendicitis. Thus, if abdominal pain develops, the patient can be referred quickly to a medical center for the appropriate treatment and the complications of acute appendicitis can be prevented with early intervention.
Clinical outcome of B2/C type isolated proximal LAD disease treated with drug-eluting stents
(Aves Yayincilik, 2011) Cicek, Davran; Pekdemir, Hasan; Kalay, Nihat; Muderrisoglu, Haldun
[Abstract Not Available]
The approach of smokers to the new tobacco law and the change in their behaviour
(Turkish Assoc Tuberculosis & Thorax, 2012) Atilla, Nurhan; Koksal, Nurhan; Ozer, Ali; Kahraman, Hasan; Ekerbicer, Hasan
Introduction: The aim of our study is; to assess the approach of smokers to tobacco law, examine changes in their smoking related behaviors after the new law and determine the factors associated with these changes. Materials and Methods: Data collected by questionnaire including 30 question. We applied the questionnaire to 1509 current smokers, and ex-smokers who quitted smoking after the law. SPSS packet programme was used for analyses. Results: Participants consisted of 419 (28.0%) female, 1090 (72.0%) male with an average age of 33.6 +/- 10.5 years. Although 80% of them knew that passive smoking is harmful to non-smokers, rate of smoking at home and in the car were very high. 869 (58.0%) of participants supported the law. 87 (5.8%) smokers quitted smoking after the law, 316 (20.9%) reduced. While health problems (37.3%) were the most frequent reason for quitting, restriction of smoking area had the most effect to reduce (54.2%). Conclusion: We satisfied that; the new tobacco law encouraged smokers to quit smoking. In addition, the majority of smokers supported the law.
XPD and XRCC1 gene polymorphism in patients with normal and abnormal cervical cytology by pap smear
(Verduci Publisher, 2012) Yilmaz, E.; Celik, O.; Celik, E.; Turkcuoglu, I.; Simsek, Y.; Karaer, A.; Otlu, B.
AIM: The purpose of the present study was to identify the role of abnormalities in DNA repair pathways by measuring the XPD and XRCC1 gene polymorphisms. MATERIALS AND METHODS: Thirty-five patients with abnormal cervical cytology (study group) and 10 women with normal cytology (control group) were included in the study. The polymorphisms of XRCC1 Arg194Trp, XRCC1 Arg399Gln and XPD Lys751Gln genes were investigated from the blood samples. RESULTS: There was no statistically significant difference in allele frequencies of XPD gene among the groups (p = 0.097), while XRCC1R399Q gene polymorphism was strikingly more frequent in the study group than that of control cases (p = 0.029). The prevalence of XRCC1R194W gene polymorphism on the other hand, was similar between the groups (p = 0.579). CONCLUSIONS: Patients with abnormal and normal cervical cytology have similar XPD gene polymorphism. However, the frequency of gene polymorphism in XRCC1 Arg 399 Gln codon was significantly higher in abnormal cervical cytology group.
y COL4A1-related autosomal recessive encephalopathy in 2 Turkish children
(Lippincott Williams & Wilkins, 2020) Yaramis, Ahmet; Lochmueller, Hanns; Topf, Ana; Sonmezler, Ece; Yilmaz, Elmasnur; Hiz, Semra; Yis, Uluc
Objective This study presents the neurologic phenotypes of 2 brothers with a novel homozygous COL4A1 mutation that was identified in a large Turkish consanguineous cohort of neurogenetic diseases. Methods Whole-exome sequencing and bioinformatic analysis of consanguineous families with children affected by early-onset, neurogenetic disorders was performed using the RD-Connect Genome-Phenome Analysis Platform. We also performed clinical, EEG, and neuroimaging analyses in unaffected siblings and parents. Results We have identified a homozygous missense mutation in COL4A1 (p.Gly1278Ser, NM_ 001845.5:c.3832G>T) in 2 siblings affected by small vessel brain disease with periventricular leukoencephalopathy and ocular defects. Presenting symptoms included mild weakness, hemiparetic gait, pyramidal findings, and seizures, whereas their intellectual and behavioral functions were normal. Both parents and 5 of the siblings (3 boys and 2 girls) were heterozygous for the variant. They did not show any clinical or laboratory signs of small vessel disease. Conclusions COL4A1 has previously been associated with dominant small vessel disease of the brain and other organs, manifesting with high penetrance in heterozygous mutation carriers. Our findings provide evidence that COL4A1-related encephalopathy can be inherited in an autosomal recessive manner, which is important for counseling, prognosis, and treatment. Genotypephenotype correlations remain to be established.
Xanthogranulomatous appendicitis: A comprehensive literature review
(Baishideng Publishing Group Inc, 2021) Akbulut, Sami; Demyati, Khaled; Koc, Cemalettin; Tuncer, Adem; Sahin, Emrah; Ozcan, Mehmet; Samdanci, Emine
BACKGROUND Xanthogranulomatous inflammation is characterized histologically by a collection of lipid-laden macrophages admixed with lymphocytes, plasma cells, neutrophils, and often multinucleated giant cells with or without cholesterol clefts. AIM To review the medical literature on xanthogranulomatous appendicitis (XGA). METHODS We present a patient with XGA and review published articles on XGA accessed via the PubMed, MEDLINE, Google Scholar, and Google databases. Keywords used were appendix vermiformis, appendectomy, acute appendicitis, and XGA. The search included articles published before May 2020, and the publication language was not restricted. The search included letters to the editor, case reports, review articles, original articles, and meeting presentations. Articles or abstracts containing adequate information about age, sex, clinical presentation, white blood cells, initial diagnosis, surgical approach, histopathological and immunohistochemical features of appendectomy specimens were included in the study. RESULTS A total of 29 articles involving 38 patients with XGA, were retrospectively analyzed. Twenty (52.6%) of the 38 patients, aged 3 to 78 years (median: 34; IQR: 31) were female, and the remaining 18 (47.4%) were male. Twenty-five patients were diagnosed with acute appendicitis, ruptured appendicitis, or subacute appendicitis, and the remaining 13 patients underwent surgery for tumoral lesions of the ileocecal region. Twenty-two of the patients underwent urgent or semi-urgent surgery, and the remaining 16 patients underwent interval appendectomy. CONCLUSION Xanthogranulomatous inflammation rarely affects the appendix vermiformis. It is associated with significant diagnostic and therapeutic dilemmas due to its variable presentation. It is often associated with interval appendectomies, and a significant number of patients require bowel resection due to the common presentation of a tumoral lesion. XGA is usually identified retrospectively on surgical pathology and has no unique features in preoperative diagnostic studies.
Utility of blind forceps biopsy of the main carina and upper-lobe carina in patients with non-small cell lung cancer
(Elsevier, 2001) Gunen, H; Kizkin, O; Tahaoglu, C; Aktas, O
Background and objective: Preoperative detection of non-small cell lung cancer (NSCLC) metastasis to the main carina and upper-lobe carina can alter the operative approach, preclude further staging procedures, and save many patients from thoracotomy. This stum assessed whether bronchoscopic forceps biopsy of the normal-appearing main carina and upper-lobe carina (blind biopsy) ipsilateral to the primary NSCLC lesion improved the accuracy of cancer staging and helped guide the management of these patients. Patients and methods: A prospective study of 52 patients was carried out at the SSK Surveyypasa Center for Chest Disease and Cardiothoracic Surgery. Over a 6-month period, we bronchoscopically evaluated 52 consecutive NSCLC patients who were radiologically classified as operable. At least five blind forceps biopsy specimens were obtained from the main carina and/or upper-lobe carina during each patient's initial fiberoptic bronchoscopic examination. Biopsy specimens were collected from the main carina and upper-lobe carina in 51 and 17 patients, respectively. Initially, all patients were staged and evaluated for operability in standard fashion, without histologic assessment of the blind biopsy specimens. We then restaged the disease and reassessed the patients' operability in light of the biopsy findings. Results: Metastasis was histologically diagnosed in seven patients (13.7%) who underwent main carina biopsy and in four patients (23.5%) who underwent upper-lobe carina biopsy. Cancer-positive blind biopsy results changed the status of 25% (6 of 24) of patients from operable to inoperable, and changed the surgical approach in 11.1% (2 of 18) of patients who ultimately did undergo surgery. We found no statistical relationship between metastasis to either carina and tumor type, stage of disease, visibility of the tumor on fiberoptic bronchoscopy, primary tumor location, T status, or N status (p > 0.05). Conclusions: A blind forceps biopsy of the main carina and upper-lobe carina ipsilateral to the lesion site should be done routinely at initial bronchoscopic examination of all radiologically operable patients with suspected lung cancer. This type of screening can save a significant number of NSCLC patients from inappropriate or unnecessary thoracotomy and further staging procedures with their associated morbidity and risk.
Using artificial intelligence to improve the diagnostic efficiency of pulmonologists in differentiating COVID-19 pneumonia from community-acquired pneumonia
(Wiley, 2022) In, Erdal; Geckil, Aysegul A.; Kavuran, Gurkan; Sahin, Mahmut; Berber, Nurcan K.; Kuluozturk, Mutlu
Coronavirus disease 2019 (COVID-19) has quickly turned into a global health problem. Computed tomography (CT) findings of COVID-19 pneumonia and community-acquired pneumonia (CAP) may be similar. Artificial intelligence (AI) is a popular topic among medical imaging techniques and has caused significant developments in diagnostic techniques. This retrospective study aims to analyze the contribution of AI to the diagnostic performance of pulmonologists in distinguishing COVID-19 pneumonia from CAP using CT scans. A deep learning-based AI model was created to be utilized in the detection of COVID-19, which extracted visual data from volumetric CT scans. The final data set covered a total of 2496 scans (887 patients), which included 1428 (57.2%) from the COVID-19 group and 1068 (42.8%) from the CAP group. CT slices were classified into training, validation, and test datasets in an 8:1:1. The independent test data set was analyzed by comparing the performance of four pulmonologists in differentiating COVID-19 pneumonia both with and without the help of the AI. The accuracy, sensitivity, and specificity values of the proposed AI model for determining COVID-19 in the independent test data set were 93.2%, 85.8%, and 99.3%, respectively, with the area under the receiver operating characteristic curve of 0.984. With the assistance of the AI, the pulmonologists accomplished a higher mean accuracy (88.9% vs. 79.9%, p < 0.001), sensitivity (79.1% vs. 70%, p < 0.001), and specificity (96.5% vs. 87.5%, p < 0.001). AI support significantly increases the diagnostic efficiency of pulmonologists in the diagnosis of COVID-19 via CT. Studies in the future should focus on real-time applications of AI to fight the COVID-19 infection.
Uterine metastasis from infiltrating ductal carcinoma of breast in a patient receiving tamoxifen
(Churchill Livingstone, 2002) Meydanli, MM; Karadag, N; Ataoglu, O; Kafkasli, A
The established relationship between tamoxifen and the development of endometrial cancer causes differential diagnostic problems between metastatic and primary uterine neoplasms. A 45-year-old woman underwent modified radical mastectomy because of left-breast cancer. She presented with abnormal vaginal bleeding 6 years later, while still on tamoxifen therapy. The endometrial curettage revealed undifferentiated adenocarcinoma. She underwent total abdominal hysterectomy, bilateral salphingoopherectomy as well as pelvic and periaortic lymphadenectomy. Microscopic examination revealed neoplastic cells which formed sheets and duct-like structures in the endometrium. The pattern was not that of a primary endometrial tumour and an immunohistochemical staining was performed using human breast gross cystic disease fluid protein-15 (GCDFP-15) which was found out to be positive in the tumour cells. A diagnosis of metastatic ductal carcinoma of the breast in the uterus was rendered. Uterine metastasis should be kept in mind in patients with a history of breast cancer who are on tamoxifen therapy. (C) 2002 Elsevier Science Ltd. All rights reserved.
Utility of ADC measurement on diffusion-weighted MRI in differentiation of prostate cancer, normal prostate and prostatitis
(Ame Publishing Company, 2013) Esen, Meltem; Onur, Mehmet Ruhi; Akpolat, Nusret; Orhan, Irfan; Kocakoc, Ercan
To determine the utility of apparent diffusion coefficient (ADC) values in differentiation of prostate cancer from normal prostate parenchyma and prostatitis we obtained ADC values of 50 patients at b 100, 600 and 1,000 s/mm(2) diffusion gradients. The ADC values of prostate cancer group were significantly lower than normal prostate and prostatitis group at b 600 and 1,000 s/mm(2) gradients. The ADC values at high diffusion gradients may be used in differentiation prostate cancer from normal prostate and prostatitis.
Use of Silver Nitrate Application as Mini-Invasive Treatment of Pilonidal Sinus Disease
(Editura Celsius, 2020) Kanat, Burhan Hakan; Yazar, Fatih Mehmet; Kutluer, Nizamettin; Solmaz, Ozgen Arslan; Bozan, Mehmet Bugra; Cay, Ferhat; Eroz, Erhan
Objective: To investigate the cure rate and adverse effects of silver nitrate application for treatment of pilonidal sinus disease (PSD). Methods: Number of sinus pit orifices, and complications with silver nitrate application and debridement for sacrococcygeal PSD between January 2015 and July 2018 were analyzed in this retrospective study. Data were obtained from surgical, discharge, and outpatient follow-up records. Among 56 patients who were treated with silver nitrate stick, 11 patients with incomplete hospital records were excluded from the study. Demographic data including age, gender, length of follow-up, number of silver nitrate applications, number of involved sinuses and recurrence and complication rates were recorded. Results were expressed as frequencies, means, and range of values. The Mann Whitney U and chi square tests were used to evaluate significance. Results: Mean age was 24.3 +/- 5.18 (range, 14-36) years, and recurrence occurred in 4 (8.9%) patients. Complications developed in 10 (22.2%) patients and included abscess, erythema, and necrosis in 5 (11.1%), 2 (4.4%), and 3 (6.6%) patients, respectively. The recurrence rate was significantly higher in patients who developed abscesses during the follow-up period (p=0.001) than those who did not. There was no statistically significant correlation between the recurrence rate and number of sinuses or the number of silver nitrate applications. Conclusion: Low morbidity and high healing rates achieved with silver nitrate provide support for this application as a feasible and effective conservative outpatient treatment for PSD in certain patients.
Use of caffeic acid phenethyl ester to prevent sodium-selenite-induced cataract in rat eyes
(Elsevier Science Inc, 2002) Doganay, S; Turkoz, Y; Evereklioglu, C; Er, H; Bozaran, M; Ozerol, E
Purpose: To investigate whether caffeic acid phenethyl ester (CAPE) prevents sodium-selenite-induced cataract. Setting: Department of Ophthalmology and Biochemistry, Inonu University Medical Faculty, Turgut Ozal Medical Center, Research Hospital, Malatya, Turkey. Methods: Sixty Spraque-Dawley rat litters were randomized into 3 groups. In Group 1 (n = 18), sodium selenite (30 nmol/g body weight) was injected subcutaneously on postpartum day 10. In Group 2 (n = 22), subcutaneous CAPE (15 mumol/kg) and sodium selenite (30 nmol/g body weight) were injected on postpartum day 10. The CAPE dose was continued subcutaneously for 3 days after the initial injection. Only subcutaneous saline was injected in Group 3 (control, n = 20). The development of cataract was assessed weekly, and its density was graded by slitlamp biomicroscopy and photography. Removed rat lenses were analyzed for glutathione (GSH) and malondialdehyde (MDA, marker of lipid peroxidation). Results: Group 2 rats had clear lenses or minor cataract. All Group 1 rats developed more severe cataract or complete opacification. The between-group difference was statistically significant (P < .05). All control lenses (Group 3) were clear. The mean GSH level in Group 1 (4.49 mumol/g wet weight +/- 0.93 [SD]) was significantly lower than that in Group 2 (8.63 +/- 0.88 mumol/g wet weight) (P < .05) and controls (10.76 +/- 1.97 mumol/g wet weight) (P < .05). The mean MDA level in Group 1 (8.54 +/- 1.31 nmol/g wet weight) was significantly higher than that in Group 2 (5.23 +/- 0.84 nmol/g wet weight) (P < .05) and controls (4.19 +/- 0.81 nmol/g wet weight) (P < .05). Conclusion: Caffeic acid phenethyl ester effectively suppressed cataract formation in rats. The protective effect was supported by lower GSH and higher MDA levels in Group 1 than in Group 2, suggesting the antioxidant efficacy of this agent. Since CAPE has no known harmful effect on normal cells, it may be beneficial in clinical use in humans. (C) 2002 ASCRS and ESCRS.
Upper and lower gastrointestinal endoscopical investigation in elderly patients with iron deficiency anaemia
(Vsp Bv, 2002) Sari, R; Aydogdu, I; Sevinc, A; Karincaoglu, M
Iron deficiency anaemia is frequently observed in male adults and postmenopausal women due to chronic occult bleeding, usually from the gastrointestinal tract. Practically, as endoscopical investigation of the gastrointestinal system is an invasive procedure, iron replacement treatment was generally started without investigation of the underlying aetiology even in first-line health institutions. This study evaluates the role of endoscopy in the investigation of the aetiology of anaemia in 95 patients (51 males, 44 females), aged 64.9 +/- 12.5 years (range 50-90 years). All patients having iron deficiency anaemia were investigated by upper gastrointestinal endoscopy and colonoscopy. Upper and lower gastrointestinal pathologies were seen in 10 (10.6%) and 55 (57.8%) patients, respectively. However, no gastrointestinal lesion was found in 30 (31.6%) patients with iron deficiency anaemia. Out of the 95 patients, 16 (16.9%) had erosive gastritis, 15 (15.8%) duodenal ulcer, 8 (8.4%) gastric ulcer, 7 (7.3%) gastric tumours, 7 (7.3%) oesophagitis, 5 (5.4%) colon tumours, 3 (3.2%) haemorrhoids, 2 (2.1%) non-tropical sprue, I (1%) colonic polyp, and I (1%) colitis. In the majority of elderly patients with iron deficiency anaemia, upper gastrointestinal system disease was found. In 12 (12.7%) patients in the study group, malignancies were detected. In elderly patients with iron deficiency anaemia, the aetiology should be highlighted before giving iron supplementation.
Unusual Root Canal Morphology of the Maxillary Second Molar: A Case Report
(Hindawi Ltd, 2013) Simsek, Neslihan; Keles, Ali; Bulut, Elcin Tekjn
Introduction. This clinical case report presents the successful endodontic treatment of a maxillary second molar that has a mandibular molar- like anatomy with no palatal root and with each of its roots containing two separate root canals. Cone-beam computed tomography (CBCT) was used to confirm this unusual anatomy. Methods. A 34-year-old male patient was referred to the Department of Endodontics at Inonu University's Faculty of Dentistry because of severe pain in his right maxillary second molar. Clinical and radiographic examinations identified unusual roots and root canals anatomy, and CBCT was planned in order to understand the nature of these variations. Cleaning and shaping procedures were performed using the crown down technique with Sybron Endo (Glendora, CA, USA) rotary instruments, and endodontic treatment was completed with gutta-percha cones and AH Plus resin sealers using the cold lateral compaction technique. Conclusions. The maxillary second molar exhibits aberrations and variations in terms of the numbers and configurations of its roots and root canals, and CBCT can be a useful imaging technique in endodontics.
Unilateral versus bilateral peri-ilial pelvic osteotomies combined with proximal femoral osteotomies in children with cerebral palsy: Perioperative complications
(Lippincott Williams & Wilkins, 2006) Inan, Muharrem; Senaran, Hakan; Domzalski, Marcin; Littleton, Arron; Dabney, Kirk; Miller, Freeman
The purpose of this study is to evaluate if bilateral peri-ilial pelvic osteotomies (PIPO) combined with proximal femoral varus derotation osteotomies (VDRO) influenced postoperative complications in children with spastic quadriplegia. Bilateral and unilateral hip subluxation or dislocation secondary to spasticity was present in 29 and 61 patients, respectively. The children were divided into 2 groups: group I were to be performed a surgery for unilateral PIPO associated with bilateral VDRO, and group 2 were to be performed a surgery for bilateral PIPO and VDRO. The average age of patients at initiation Of Surgery was 11.7 years (range 5-20 years) for group 1 and 10.7 years (range, 5-19 years) for group 2. The hospital stay was similar for group 1 and 2 (P = 0.797), which was 9 days. In group 1, 11 (18%) of 61 children needed an average of 2 days (range, 1-7 days) in the intensive care unit postoperatively, and 4 of these 11 patients were reintubated because of respiratory problems. In group 2, 6 (20%) of 29 children were transferred to the intensive care unit postoperatively for all average of 2 days (range, 1-4 days) and 3 of these 6 children were reintubated because Of respiratory problems. In conclusion, respiratory problems and anemia were the most common early postoperative complications. which occur with a similar rate in children with spastic quadriplegia who underwent bilateral or unilateral peri-ilial pelvic osteotomy(ies) combined with proximal femoral osteotomies. We believe that bilateral hip procedures including PIPO, proximal femoral osteotomies, and soft-tissue release call be performed safely in I stage and, based on this data, the staged procedure would probably have the same risk as the first procedure.
Two possible cases of Trichosporon infections in bone-marrow-transplanted children
(Natl Inst Infectious Diseases, 2008) Agirbashi, Handan; Bilgen, Hulya; Oezcan, Sema Keceli; Otlu, Baris; Sinik, Gulce; Cerikcioglu, Nilguen; Durmaz, Riza
Trichosporon spp. are emerging as opportunistic agents that cause systemic diseases in immuno-compromised hosts. Trichosporonosis carries a poor prognosis in neutropenic patients. Trichosporon japonicum was isolated from the air and named by Sugita et al. Here we present the first case of T. japonicum isolated from a clinical specimen. Two cases of acute myeloid leukemia who had Trichosporon isolates are discussed because of their rarity and growing importance. T. asahii was isolated from the throat, feces and urine of the first patient. T. japonicum was isolated from the sputum of the second patient. Both cases produced high MICs to itraconazole, and low MICs to fluconazole and voriconazole. In virulance factor investigations there was (++) biofilm formation in T. japonicum but not in T. asahii. Conventional mycological studies were not adequate for the identification of the isolate at the species level. In our second case as in the first one, the isolate was identified as T. asahii with 99.9% accuracy by API20C AUX. Although two T. asahii isolates from the same patient yielded identical typing profiles by arbitrary primed-PCR, the isolates of the two different patients showed different arbitrary primed-PCR typing profiles. However, the genetic identification of the other patient's strain gave the result of T. japonicum.
Tularemia
(Excerpta Medica Inc, 1999) Senol, M; Özcan, A; Karincaoglu, Y; Aydin, A; Özerol, IH
Tularemia is an arthropod-borne infectious disease caused by Francisella tularensis, a gram-negative microorganism that normally resides in a wide range of wild and domestic animals, The disease is characterized by a sudden onset with high fever, headache, malaise, chills, myalgia, and arthralgia, A short time after exposure, an inflamed and ulcerated lesion rapidly appears at the site of entry, A regional lymphadenopathy follows the cutaneous presentation. Cultures from the lesions or blood generally give negative results. Histopathologic examination reveals either a nonspecific inflammatory infiltrate or an infectious granuloma, The most useful laboratory procedure in the diagnosis of tularemia is serologic tests. Streptomycin, gentamicin, and tetracycline are the drugs of choice in the treatment, Quinolones are also effective. Tularemia is fairly rare in Turkey. We present a typical case of ulceroglandular tularemia transmitted from a sheep to a young man.

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