Traumatic Globe Subluxation and Intracranial Injury Caused by Bicycle Brake Handle

Introduction: Penetration of a bicycle brake handle into the orbit is a rare and serious type of trauma. Globe subluxation due to such trauma has not been previously reported. Case Presentation: A 10-year-old girl presented after falling from a bicycle, which resulted in the handbrake penetrating her right upper eyelid. On examination, the globe was subluxated anteriorly, there was no light perception, and the pupilla was fixed and dilated. Radiologic studies revealed orbitonasal fractures, hemorrhage, emphysema in the orbit and cranium, and rupture of the extraocular muscles. The globe was replaced into the orbit with the help of lateral cantholysis and orbital septotomy. During 22 months of follow-up, the globe remained intact, but total loss of vision, blepharoptosis, and extraocular motility restriction persisted. Conclusions: This case and previous reports show that bicycle brake handles can cause severe, penetrating orbital and cerebral traumas that can result in vision loss or fatality. Brake handles should be designed to protect bicyclists from such injuries

Patients With Kidney Cancer

To develop a preoperative prognostic model in order to predict recurrence-free survival in patients with nonmetastatic kidney cancer.A multi-institutional data base of 1889 patients who underwent surgical resection between 1987 and 2007 for kidney cancer was retrospectively analyzed. Preoperative variables were defined as age, gender, presentation, size, presence of radiological lymph nodes and clinical stage. Univariate and multivariate analyses of the variables were performed using the Cox proportional hazards regression model. A model was developed with preoperative variables as predictors of recurrence after nephrectomy. Internal validation was performed by Harrells concordance index.The median follow-up was 23.6 months (1222 months). During the follow-up, 258 patients (13.7) developed cancer recurrence. The median follow-up for patients who did not develop recurrence was 25 months. The median time from surgery to recurrence was 13 months. The 5-year freedom from recurrence probability was 78.6. All variables except age were associated with freedom from recurrence in multivariate analyses (P 0.05). Age was marginally significant in the univariate analysis. All variables were included in the predictive model. The calculated c-index was 0.747.This preoperative model utilizes easy to obtain clinical variables and predicts the likelihood of development of recurrent disease in patients with kidney tumors

Multicomponent bi-superHamiltonian KdV systems

It is shown that a new class of classical multicomponent super KdV equations is bi-superHamiltonian by extending the method for the verification of graded Jacobi identity. The multicomponent extension of super mKdV equations is obtained by using the super Miura transformation

Fossa posterior fossa yerleşimli glioblastoma

A 63-year-old woman operated eight months ago for glioblastoma (GB) located in posterior fossa was admitted to emergency room for stuporous, nausea, vo-miting and headache. CT and MR showed recurrence of posterior fossa cystic-necrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF) fistula from the incision was occurred and contaminated by multidrug resistant Acinetobacter ba-umannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and child-ren; and it appears as two different subsets: de novo (primary type) and secondary glioblastomas. Although our patient's immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour was de novo because of no other brain involvement, staining with GFAP, vimentin, and nearly absent p53 mutation