Vitamin D Deficiency Rickets Mimicking Pseudohypoparathyroidism

Vitamin D deficiency rickets (VDDR) is a disorder biochemically characterized by elevated serum alkaline phosphatase (ALP) activity, normal or decreased serum calcium (Ca) and inorganic phosphate concentrations, secondary hyperparathyroidism and decreased serum 25−hydroxyvitamin D (25(OH)D) levels. In stage 1 VDDR, urinary amino acid and phosphate excretion are normal with minimal or no findings of rickets on radiographs. Pseudohypoparathyroidism (PHP) is an inherited disorder characterized by end−organ resistance to parathormone (PTH). VDDR occasionally resembles PHP type 2 in clinical presentation and biochemical features, creating difficulties in the differential diagnosis of these two entities. Here we report an infant diagnosed with VDDR. In addition to inadequate vitamin D intake, usage of antiepileptic drugs (AED) may have led to the worsening of the vitamin D deficiency. The patient presented with a history of febrile convulsions, for which he received phenobarbital treatment. The initial findings of hypocalcemia, hyperphosphatemia and normal tubular reabsorption of phosphate, mimicking PHP 2, responded well to vitamin D and oral Ca treatment with normalization of serum Ca, phosphorus (P), ALP and PTH level

Fabrication of polymer nanofiber-conducting polymer fabric and noncontact motion sensing platform

10th Japanese-Mediterranean Workshop on Applied Electromagnetic Engineering for Magnetic, Superconducting, Multifunctional and Nano Materials, JAPMED’10 2017; Izmir; Turkey; 4 July 2017 through 8 July 2017Conductive polymer-electrospun polymer nanofiber network was combined to host iron oxide nanoparticles providing micrometer thick sensing interface. The sensor has fabricated as freestanding fabric exhibiting 10 to 100 KOhm base resistivity upon bias applied. The moving object has been sensed through the electrostatic interactions between fibers and object. The sensing range has been found to be 1-5 cm above the surface of fabric. By the controlled combination of conductive polymers electrospun polymer nanofibers effective device miniaturization has been provided without loss of performance. The noncontact motion sensor platform has unique flexibility and light weight holding a potential for wearable sensor technology

Impact of Spleen Size on Outcomes in Laparoscopic Splenectomy in Children

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens. Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay. Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05). Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens

Clinical Outcomes and Effectiveness of Renal Artery Stenting in Patients With Critical Atherosclerotic Renal Artery Stenosis: Does it İmprove Blood Pressure Control and Renal Function Assessed by Estimated Glomerular Filtration Rate?

INTRODUCTION: Atherosclerotic renal artery stenosis (ARAS) is associated with uncontrolled hypertension and chronic renal failure. AIM: To evaluate the influence of gender and presence of chronic renal failure on the outcomes of percutaneous transluminal renal artery stenting (PTRAS) due to atherosclerosis. MATERIAL AND METHODS: A total of 28 ARAS patients underwent PTRAS and 36 stents were placed. Basal characteristics, laboratory data and blood pressure of patients were recorded. The differences between genders and improvement/deterioration of renal functions and blood pressure were analyzed. The predictors of outcomes were determined. RESULTS: Baseline characteristics were similar between men and women. Significant improvement of systolic and diastolic blood pressure control was achieved after PTRAS (153.04 ±17.07 mm Hg vs. 124.75 ±11.40 mm Hg, p = 0.001 and 92.50 ±10.76 mm Hg vs. 77.54 ±8.23 mm Hg, p < 0.001, respectively). Although mean estimated glomerular filtration rate (eGFR) and creatinine levels did not significantly improve at the 6-month follow-up visit compared to baseline values, of the 28 patients 13 (46.4%) patients had improvement of renal functions. CONCLUSIONS: Our results suggest that PTRAS is a safe procedure and may offer blood pressure control but beneficial effects of PTRAS on renal function may be anticipated in a selected group of patients, especially those with a low eGFR

Measurements of tumor size using CT and PET compared to histopathological size in non-small cell lung cancer

PURPOSEIn this study, we aimed to compare the tumor sizes determined by maximum morphological computed tomography (CT) and functional positron emission tomography (PET) with the histopathological size to determine which method provides the best correlation with the histopathological size in lung carcinoma patients.MATERIALS AND METHODSForty lung carcinoma patients (39 males, one female) diagnosed histopathologically from surgical resection materials were included in this retrospective study. The mean age (±standard deviation, SD) of the patients was 67.8±10.3 years with a range of 44 to 81 years. The PET scans were performed within the same week as the CT scan. In the CT scans, the morphological tumor sizes were measured three-dimensionally by the longest transaxial section in the parenchymal and mediastinal screening window. The functional tumor sizes were also measured three-dimensionally in the PET scans. These two measurement values were compared with the histopathological size using Bland-Altman plotting. Bland-Altman plotting was also performed to define the 95% limits of agreement, which was presented as the bias ±1.96 SD.RESULTSThe histopathological sizes were measured in a range of 1.2 to 7.5 cm. The maximum measurement of the tumors on the CT scans showed a lower concordance (mean difference, -0.30) than that obtained from PET, and the SD was found to be larger than the PET (1.96 SD was 3.50 for CT and 2.50 for PET).CONCLUSIONThe PET measurements of tumor size were more compatible with the histopathological sizes than the CT measurements in patients with non-small cell lung cancer

Investigation of the PD-1/PD-L1 Expression in the Lesional Skins of Patients with Psoriasis

Introduction: Psoriasis is an immune-mediated, chronic and inflammatory disease whose pathogenesis is affected by the interactions of several immune cells and cytokines. PD-1 is an inhibitor receptor that is expressed to a large extent in T lymphocytes and responsible for regulating autoimmunity and self-tolerance. Objectives: In this study, we aimed to investigate the expression of PD-1/PD-L molecules in the lesioned skins of psoriasis patients. Methods: The study included 30 psoriasis patients, and 15 healthy volunteers as the control group. Anti PD-1 and PD-L1 antibodies were applied to the skin biopsy samples that were collected from the patient and control groups. Cytoplasmic and membranous staining of PD-1 and PD-L1 were considered positive. The number of stained immune cells that was examined for each case. Results: The percentage of the tissues with high PD-1 (+) and PDL-1 (+) immune cell counts were significantly higher in the psoriasis patients compared to healthy controls (P values = 0.004 and 0.002, respectively). A negative and statistically significant correlation was detected between PDL-1(+) immune cell numbers and PASI scores (P = 0.033, r=-0.57). Conclusions: In the lesioned skin samples of psoriasis patients, the PD-1 and PD-L1 expressions were significantly higher in immune cells than that in the skin samples of the healthy controls. This study was the first investigation of the expression of PD-1/PD-L molecules in the immune cells in found the lesioned skins of psoriasis patients

Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure

Objective: Atrial functions are relatively suppressed in heart failure (HF). We aimed to investigate the associations of intra- and inter-atrial electromechanical conduction delay (EMCD) with functional class and mortality over a 12-month follow-up period. Methods: The prospective study included 65 patients with systolic HF and 65 healthy subjects with normal sinus rhythm. Left ventricular (LV) systolic functions and left atrial (LA) dimensions and volumes were evaluated by transthoracic echocardiography. Tissue Doppler imaging (TDI) signals at the lateral border of the mitral annulus (lateral PA’), septal mitral annulus (septal PA’), and tricuspid annulus (tricuspid PA’) were measured. Intra- and inter-atrial EMCD were calculated. Results: Mitral inflow velocities were studied using pulsed-wave Doppler after placing the sample volume at the leaflets’ tips. The peak early (E wave) and late (A wave) velocities were measured. The septal annular E/E’ ratio was relatively higher and lateral, septal, and right ventricular S, E’, and A’ waves were significantly lower in the HF group than in the control group (12.49±6.03 - 7.16±1.75, pE/E’ <0.0001). Intra-atrial EMCD was detected as 117.5 ms and inter-atrial EMCD as 127.5 ms in patients with prolonged atrial EMCD. A significant increase was found in prolonged intra- and inter-atrial EMCD according to functional capacity increase (p=0.012 and p=0.031, respectively). The incidence of mortality was significantly higher in patients with prolonged atrial EMCD (p=0.025), and 5 patients in the HF group died during the study over the 12-month follow-up period. Conclusions: In this study, we found a relationship between prolonged atrial conduction time and increased functional class and mortality in patients with systolic HF. © 2016 by Turkish Society of Cardiology

The effects of antitrombin ııı on lung injury in a model of experimental acute pancreatitis

Acute pancreatitis, especially in the severe form, is a well-known disease causing both local intraabdominal and remote organ disturbances, including lungs. As a natural inhibitor of serine proteases, antithrombin was previously shown to attenuate the tissue damage after ischemia-reperfusion, sepsis, and shock in several organ systems. Here, we examined the effects of antithrombin on pulmonary injury in a rat acute pancreatitis model. Thirty male Wistar-Albino rats underwent median laparotomy and randomized into three groups: group I (control) bilio-pancreatic duct was dissected but not ligated (n=10), group II (acute pancreatitis group) bilio-pancreatic duct was ligated (n=10), and group III (AT treated group) AT III 250 U/Kg was injected following bilio-pancreatic duct ligation (n=10). After observation time (48 hours) animals were sacrificed and myeloperoxidase activity together with tissue wet/dry ratio in the lung parenchyma were assessed and compared. There was a statistically significant increase in the quantity of myeloperoxidase activity and tissue wet/dry ratio of lungs in the acute pancreatitis group when compared to the control group. Treatment of animals with antithrombin partly reduced the pulmonary injury characterized by increased tissue wet/dry ratio and myeloperoxidase activity. But this reduction was not found to be statistically significant. Beneficial effects of AT in preventing pulmonary injury following experimental models of sepsis and ischemia-reperfusion have been reported previously. In our model of experimental acute pancreatitis, AT showed some attenuating effect on pulmonary injury despite it was limited when compared to that of ischemiareperfusion and sepsis models. This result suggests that some other confounding factors may be involved in the mechanisms of pulmonary injury related to acute pancreatitis. We believe that further detailed studies are needed to elucidate the exact mechanisms of that injury.Akut pankreatitte gelişen akciğer hasarına Antitrombin III'ün etkisi araştırıldı. 30 adet rat üç gruba ayrıldı ( n=10). Grup I (Kontrol grubu): Laparotomi ve bilio-pankreatik kanal hazırlığı yapıldı. Grup II (Akut pankreatit grubu):Bilio-pankreatik kanal bağlanarak akut pankreatit ve akciğer hasarı oluşturuldu. Grup III (Tedavi grubu): Bilio-pankreatik kanal bağlandı ve Antitrombin III verilerek akciğer dokusunun ıslak/kuru ağırlık oranı ve miyeloperoksidaz aktivitesindeki değişimler ölçüldü. Grup II ve III de miyeloperoksidaz aktivitesi ve ıslak/kuru ağırlık oranındaki artış kontrol grubuna göre anlamlı derecede yüksek saptandı (p<0.0001). Grup III de miyeloperoksidaz ve ıslak/kuru oranında azalma görüldü. Fakat bu değişim istatistiksel olarak anlamlı bulunmadı. Literatürde deneysel iskemi-reperfüzyon ve sepsis modellerinde gelişen akciğer hasarı üzerine olumlu etkileri bildirilen Antitrombin III'ün, çalışmamızda oluşturulan pankreatite bağlı akciğer hasarını kısmen azalttığı, fakat bu etkinin iskemi-reperfüzyon ve sepsis modellerine göre çok daha sınırlı kaldığı görülmektedir. Bu da pankreatite bağlı akciğer hasarının oluşum mekanizmasında etkili başka faktörlerin olabileceğini düşündürmektedir. Bu konuda altta yatan mekanizmaları aydınlatmak için ileri çalışmalara ihtiyaç vardır