Superior mesenteric artery syndrome causing growth retardation

Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexi

A Rare Recurrent Hydatid Cyst Complication: Cystoduodenal Fistula

Karaciğer kist hidatiği dünya çapında görülen bir hastalıktır. Kist ciddi boyutlara ulaştığı zaman dispepsi, karın ağrısı gibi spesifik olmayan bası semptomlarına yol açabilir. Sık görülen komplikasyonlar rüptür ve sekonder enfeksiyondur. Bununla birlikte hidatik kistin gastrointestinal sisteme fistülizasyonu oldukça nadir görülen bir komplikasyondur. Altı yıl önce hidatik kist nedeni ile kistektomi yapılan 56 yaşında erkek hasta dispeptik yakınmaları olması üzerine kliniğimize başvurdu. Batın ultrasonografisinde nüks kiste rastlanan hastaya ileri tetkik olarak BT, MRCP görüntüleme ve üst gastrointestinal sistem endoskopisi yapıldı. Nüks hidatik kist ve kistoduodenal fistül tespit edildi. Cerrahi müdahale planlandı ve perikistektomi ile beraber fistül traktı eksize edildi. Ameliyat sonrası dönemde herhangi bir komplikasyon gelişmeyen hastaya antihelmitik tedavi uygulandı. Primer ve nüks hidatik kist olgularında kistoduodenal fistül gibi çok nadir komplikasyonlar görülebileceği akılda tutulmalıdır.A Rare Recurrent Hydatid Cyst Complication: Cystoduodenal Fistula Hepatic hydatid cyst is a disease seen worldwide. The cyst may cause non-specific pressure symptoms like dyspepsia and abdominal pain when it grows into significant sizes. Rupture and secondary infections are the frequently seen complications. Nonetheless, the fistulization of the hydatid cyst into the gastrointestinal system is a very rare complication. A 56-year-old male patient had had cystectomy because of hydatid cyst 6 years ago. He presented to our clinic with dyspeptic complaints. The patients abdominal ultrasonography showed recurrent mass and CT and MRCP imaging and upper gastrointestinal system endoscopy procedures were performed for the patient as advanced diagnostic techniques. The patient was seen to have recurrent hydatid cyst and cystoduodenal fistula. The case was followed-up for two years and did not have any other recurrences. It should be noted that very rare complications like cystoduodenal fistula may be seen in primary and recurrent hydatid cyst cases

A Case Of Sporadic Mesenteric Fibromatosis Mimicking Pancreatic Mass

Abdominal fibromatozis sporadik, pelvik, mezenterik lezyonlar ile garder sendromunda görülen fibromatozis lezyonlarının hepsi için kullanılmaktadır. Sporadik fibromatozis ise çok daha nadirdir ve literatürde az sayıda vaka bildirilmiştir. 14 yaşında kadın hasta, 2 aydır olan epigastrik bölgede müphem karın ağrısı, dispeptik yakınmalar ve yemeklerden sonra olan kusma nedeni ile başvurdu. Yapılan gastroskopide mideye dıştan bası yapan kitle lezyonuna rastlanması üzerine endoskopik ultrasonografi yapıldı. Pankreas kuyruğundan kaynaklandığı düşünülen 9x5 cm ebadında hiperekoik kitle lezyonu görüldü.Cerrahi olarak kitle eksize edildi. Mezenterik fibromatozis patolojik olarak benign bir tümör özelliği göstermesine rağmen klinik olarak ileri derecede agresif ve nüks oranı oldukça yüksektir.Bu hastalara malign gibi davranıp mümkün olduğunca geniş cerrahi rezeksiyon uygulanmalıdır.The term abdominal fibromatosis refers to sporadic, pelvic, and mesenteric lesions and to all the fibromatosis lesions seen in Gardner's syndrome. Sporadic fibromatosis, however, is very rarer and literature offers a limited number of cases. The 14-year-old female patient presented to our clinic with complaints of indefinite abdominal pain in the epigastric area for the last 2 months, dyspeptic problems, and vomiting after eating. Upon the patient's gastroscopy revealed a mass lesion pressuring the stomach, endoscopic ultrasonography was performed. A hyperechoic mass lesion of 9x5 cm thought to have originated from the pancreatic tail was detected. The mass was surgically excised. Although mesenteric fibromatosis shows the characteristics of a benign tumor pathologically, it is extremely aggressive clinically and has a very high rate of recurrence. These patients should be treated like they have malign tumors and surgeons should perform surgical resection as wide as possible

Inclusive knowledge production at an elementary school through family-school-university partnerships: A formative intervention study

Students from racially minoritized backgrounds have been disproportionately subject to exclusionary school discipline in the United States. Utilizing cultural-historical activity theory and the formative intervention methodology, we conducted a yearlong formative intervention, Learning Lab, in an elementary school with significant racial disproportionality in school discipline. Teachers, family members, administrators, support staff, and community members with diverse and often opposing histories and goals worked together to critically examine their existing behavioral support system and racial disparities in practices, assumptions, processes, and outcomes from multiple perspectives. We utilized the method of expansive learning actions to analyze qualitative data from ten subsequent sessions. Our findings showed that local stakeholders successfully formed and sustained a diverse working group that represented families, educators, researchers, and community members. Learning Lab members worked collaboratively to question their existing school practices and to examine the root causes of racial disproportionality through historical and empirical analyses. We discuss both possibilities and challenges regarding inclusive knowledge production and the systemic transformation process at local schools

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Archaic Periods Greek İnvestigate and Comtemporary İnterparations

İnsanoğlu var olduğundan beri, günlük ihtiyaçlarını karşılamak için kap kacak türü seramik malzemeler üretmiştir. Zaman ilerledikçe sade bir şekilde yapılan seramikler yerini sanatsal ve estetik kaygı ön planda tutularak hem form hem de süsleme açısından gelişme göstermiştir. Seramik sanatı geçmişten günümüze gelene kadar birçok dönemden geçmiştir. Bu dönemlerin her biri seramik sanatı için çeşitli yenilikler getirerek seramiğin bugünlere gelmesinde en önemli katkıyı sağlamışlardır. Gelişmelerden biri süsleme ve teknikleridir. Seramik form yüzeylerini süslemede astar ile yapılan çalışmalar neolitik çağdan bu yana gelişimini göstermiş ve Yunan seramik sanatı “terra sigillata” astar süslemeleri ile doruğa ulaşmıştır. Araştırmanın birinci bölümünde, Ege Uygarlıkları diye bilinen Yunan sanatının başlangıcı olarak tanımlanan Minos, Miken seramik sanatının gelişimi, ikinci bölümde, Yunan seramik sanatının dönemleri, gelişimi, yenilikleri ve özellikleri anlatılmıştır. Üçüncü bölümde ise Yunan sanatının vazo süslemeciliğinde en parlak dönemi olan arkaik dönem seramiklerinin gelişimi, form ve süsleme özellikleri ele alınmıştır. Dördüncü bölümde ise Yunan arkaik dönem seramiklerinden yola çıkarak form, süsleme ve renkli astar çeşitleri ile uygulamaları yapılmıştır.The Human being has been producing ceramic materials like pots and pans to provide their daily wants since their existence.In the course of the time,ceramics made as simple have progressed both in form and in decoration by considering artistic and aesthetic care. Ceramic art has many period from past to present.Each of these periods has provided a significant contribution to ceramic coming to these days by bringing several innovations to the ceramic art.One of these developments is decoration and it’s techniques.Works with slip to decorate the surfaces of the ceramic form have demonstrated developments since Neolithic era and Greek ceramic art has reached its peak with “ terra sigillata” decorations slip. In the first part of the research, known as Ageon civilizations and regarded as beginning of Greek art Minos, the development of Miken ceramic art, in the second part, the periods of Greek art, its developments,innovations and features are described.In the third part, archaic period,which is the most successful period in vase decoration for Greek art, form and decoration features are discussed.In the fourth part,applications in form, decoration and colourful slip types have been realized based on archaic form of Greek ceramics of the period

Archaic Periods Greek İnvestigate and Comtemporary İnterparations

İnsanoğlu var olduğundan beri, günlük ihtiyaçlarını karşılamak için kap kacak türü seramik malzemeler üretmiştir. Zaman ilerledikçe sade bir şekilde yapılan seramikler yerini sanatsal ve estetik kaygı ön planda tutularak hem form hem de süsleme açısından gelişme göstermiştir. Seramik sanatı geçmişten günümüze gelene kadar birçok dönemden geçmiştir. Bu dönemlerin her biri seramik sanatı için çeşitli yenilikler getirerek seramiğin bugünlere gelmesinde en önemli katkıyı sağlamışlardır. Gelişmelerden biri süsleme ve teknikleridir. Seramik form yüzeylerini süslemede astar ile yapılan çalışmalar neolitik çağdan bu yana gelişimini göstermiş ve Yunan seramik sanatı “terra sigillata” astar süslemeleri ile doruğa ulaşmıştır. Araştırmanın birinci bölümünde, Ege Uygarlıkları diye bilinen Yunan sanatının başlangıcı olarak tanımlanan Minos, Miken seramik sanatının gelişimi, ikinci bölümde, Yunan seramik sanatının dönemleri, gelişimi, yenilikleri ve özellikleri anlatılmıştır. Üçüncü bölümde ise Yunan sanatının vazo süslemeciliğinde en parlak dönemi olan arkaik dönem seramiklerinin gelişimi, form ve süsleme özellikleri ele alınmıştır. Dördüncü bölümde ise Yunan arkaik dönem seramiklerinden yola çıkarak form, süsleme ve renkli astar çeşitleri ile uygulamaları yapılmıştır.The Human being has been producing ceramic materials like pots and pans to provide their daily wants since their existence.In the course of the time,ceramics made as simple have progressed both in form and in decoration by considering artistic and aesthetic care. Ceramic art has many period from past to present.Each of these periods has provided a significant contribution to ceramic coming to these days by bringing several innovations to the ceramic art.One of these developments is decoration and it’s techniques.Works with slip to decorate the surfaces of the ceramic form have demonstrated developments since Neolithic era and Greek ceramic art has reached its peak with “ terra sigillata” decorations slip. In the first part of the research, known as Ageon civilizations and regarded as beginning of Greek art Minos, the development of Miken ceramic art, in the second part, the periods of Greek art, its developments,innovations and features are described.In the third part, archaic period,which is the most successful period in vase decoration for Greek art, form and decoration features are discussed.In the fourth part,applications in form, decoration and colourful slip types have been realized based on archaic form of Greek ceramics of the period

Giant primary adrenal hydatid cyst

Adrenal bezin kistik lezyonları nadir görülür ve bunların ancak %6'sını hidatik kistler oluşturur. Adrenal bezi tutmuş dev hidatik kist olgusunu literatür eşliğinde sunmayı amaçladık. 30 yaşında kadın hasta, 3 aydır karın şişliği ve ağrısı mevcuttu. Fizik muayenede batın sağ yarısın da belirgin bir asimetri ve düzgün yüzeyli kitle lezyonu palpe edilmekte idi. Yapılan tetkiklerde sağ sürrenal hidatik kist tanısı kondu. Laparoskopik parsiyel kistektomi işlemi uygulandı ve hasta ameliyat sonrası 3. günde 20 mg/kg albendazol tedavisi ile sorunsuz şekilde taburcu edildi. Adrenal kaynaklı kistlerin ayırıcı tanısında, özellikle endemik olduğu bölgelerde hidatik kist de mutlaka akılda tutulmalıdır.Cystic lesions of the adrenal gland are rarely seen and only 6% of these account for hydatid cysts. We aim at presenting a case of giant hydatid cyst involving the adrenal gland alongside with literature. 30-year-old female patient was presented with abdominal distensi- on and pain present for 3 months. The patient's physical examination revealed a distinctive asymmetry and a palpable mass lesion with a smooth surface on the right side of the abdomen. The patient was diagnosed with right surrenal hydatid cyst through the imaging techniques. Laparoscopic partial cystectomy was performed and the patient was discharged without any problems on post-op 3rd day with 20 mg/kg albendazole treatment. Hydatid cyst should be kept in mind of the differential diagnosis of adrenal cyst, especially in areas where it is endemi

A meta-analysis on the association of ACE and PPARA gene variants and endurance athletic status

INTRODUCTION: Genetics has an important role in determining the athletic ability and endurance performance potential. This study aimed to investigate the variable results obtained from endurance athletes and control participants in terms of angiotensin-converting enzyme (ACE) and peroxisome proliferator-activated receptor alpha (PPARA) polymorphism distributions. EVIDENCE ACQUISITION: Multiple electronic databases were investigated independently by two researchers. A meta-analysis was conducted on the association of ACE insertion/deletion (I/D) polymorphism and PPARA G/C polymorphisms with endurance athletes. Odds ratios (OR) and 95% confidence intervals (CI) were estimated. Twenty-six studies were identified for the ACE I/D for 2979 endurance athletes and 10048 control participants while seven studies were identified for PPARA G/C for 901 endurance athletes and 2292 control participants. EVIDENCE SYNTHESIS: There was a significant difference in ACE genotype distribution between endurance athletes and control (II vs. ID+DD: OR=1.48; 95% CI=0.30-2.67; P=0.001). On the other hand, there was not a significant difference in PPARA G/C polymorphism geno-type distribution between endurance athletes and control (GC+CC vs. GG: OR=0.93; 95% CI=-0.46-2.32; P=0.192; GC+GG vs CC: OR=0.62; 95% CI=-1.75-2.99; P=0.604). CONCLUSIONS: The results have shown that ACE I/D polymorphism may be associated with endurance performance in sports and that the predominance of the ACE II genotype in a person may play an advantageous role in being an endurance athlete. However, this effect has not been observed in PPARA G/C polymorphism. (Cite this article as: Ipekoglu G, Bulbul A, Cakir HI. A meta-analysis on the association of ACE and PPARA gene variants and endurance athletic status. J Sports Med Phys Fitness 2022;62:795-802. DOI: 10.23736/S0022-4707.21.12417-X

Inclusive future making: building a culturally responsive behavioral support system at an urban middle school with local stakeholders

This article presents a formative intervention study, called Learning Lab that facilitated the collective design of a culturally responsive behavioral support system at an urban middle school in the United States. Learning Lab united parents, teachers, support staff, education leaders, and researchers, specifically those who have been historically excluded from schools’ problem-solving activities to address an inner contradiction that they face—racial disproportionality in school discipline. Learning Lab members excavated and analyzed the school’s discipline system with its activities and disturbances and designed a new school-wide behavioral support system that is responsive to diverse experiences, perspectives, practices, and goals of their school community. A qualitative analysis of the Learning Lab process was conducted related to the development of the new system. Members examined outcomes in the existing discipline system, identified daily manifestations of the inner contradiction and collectively designed a culturally responsive system. The study showed the “how” of a systemic design and transformation process that helped develop a deeper understanding of educational change as a form of collective learning. The study demonstrated how a secondary artifact (system mapping) might facilitate movement from problem-definition to envisioning new possibilities. Given the inability of top-down education policies to impact sustained systemic transformation in schools, Learning Lab provides an ecologically valid collective knowledge-production and systemic design process that shows the possibilities of transforming marginalizing systems from the ground-up and collectively envisioning schools as spaces of solidarity, emancipation, and innovation