Primary catastrophic antiphospholipid syndrome in an 8 year-old girl

Antiphospholipid syndrome (APS) is a disease characterized by recurrent arterial and venous thromboses. Rapidly progressive multiple thromboses leading to multiorgan failure occur in less than 1% of patients and named as catastrophic antiphospholipid syndrome (CAPS). We, hereby, describe an 8 year-old-girl with erythematous skin lesions progressing into purpura fulminans. The patient developed CAPS with the findings including proteinuria, microangiopathic hemolytic anemia, thrombocytopenia, arterial and venous thromboses demonstrated on skin biopsies. She was admitted to intensive care unit and received empirical antibiotics, anticoagulants, antiaggregants, steroids and intravenous immunoglobulins. The diagnosis of APS was confirmed by positive lupus anticoagulants, elevated anti beta-2 glycoprotein IgG and antiphospholipid IgG titers. Moreover, other than MTHFRA1298C, MTHFR-C677T, factor V H1299R, beta fibrinogen-455 G>A heterozygosity indicating low risk for thrombophilia, no infectious, rheumatological or malignant etiologies were identified. Family history revealed Raynaud’s phenomenon in a sister, interstitial lung disease, proteinuria and hematuria in paternal grandmother in addition to lupus anticoagulant positivity in father and 2 elder sisters. Her treatment included debridement of necrotic skin tissue, grefting and local mesenchymal stem cell application to upper thigh and lower leg region following oral azathioprine administration

Peripheral osteoma of mandibular angulus: Analysis of the literature and report of a new case

Osteoma is a benign osteogenic neoplasm originating from the continuous proliferation of compact and/or cancellous mature bone. The tumor can be classified as peripheral, central or extra-skeletal regarding location and it commonly seen in the cranio-facial region especially at the skull and paranasal sinuses. The exact etiology of the tumor is still controversial; however, it is considered that infection, trauma, muscle activity contributes the occurrence of the tumor. Due to the slow growing nature of osteoma, it is coincidentally detected on radiographs or when the tumor reaches a large size enough to trigger symptoms and cause facial disfigurement. Although mainly detected in the craniofacial bones, osteomas are rarely located in the jaw bones.  The purpose of this review, is to present the diagnosis and treatment plan of a peripheral osteoma in the mandibular angulus region of an 8-year-old boy together with a review of published cases of peripheral osteomas of mandibular angulus.El osteoma es una neoplasia osteogénica benigna que se origina de la proliferación continua de hueso maduro compacto y/o esponjoso. El tumor se puede clasificar como periférico, central o extraesquelético con respecto a la ubicación y se ve comúnmente en la región craneofacial, especialmente en el cráneo y los senos paranasales. La etiología exacta del tumor sigue siendo controvertida; sin embargo, se considera que la infección, el trauma y la actividad muscular contribuyen a la aparición del tumor. Debido a la naturaleza de crecimiento lento del osteoma, se detecta casualmente en las radiografías o cuando el tumor alcanza un tamaño grande lo suficiente como para desencadenar síntomas y causar desfiguración facial. Aunque se detecta principalmente en los huesos craneofaciales, los osteomas rara vez se localizan en los huesos de la mandíbula. El objetivo de esta revisión es presentar el diagnóstico y el plan de tratamiento de un osteoma periférico en la región angular mandibular de un niño de 8 años junto con una revisión de casos publicados de osteomas periféricos de angulación mandibular

Holmes' Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

WOS: 000411402900004PubMed ID: 28415166A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery

Enhanced Magnetic Levitation and Guidance Force in MgB2 Bulks by Synthetic Engine Oil Immersion

Ozturk, Kemal/0000-0002-8847-1880; GUNER, SAIT BARIS/0000-0001-7487-4817WOS: 000469476200006We have used Synthetic engine oil' as a rich easily accessible carbon source and investigated the effect of engine oil on the microstructure, critical current density (J(c)), vertical levitation force (F-z) and guidance force (F-x) properties of MgB2 superconductor. the polycrystalline disk-shaped MgB2 bulk samples have been prepared using two-step solid-state reaction process. After the first heating process, MgB2 bulk samples immersed in the engine oil for different durations (30, 120, 300 and 1440 min). XRD analysis indicated the decreasing of lattice parameters of samples and confirmed C substitution in boron sites. Vertical levitation and guidance force measurements were carried out with both Field-cooling (FC) and zero-field-cooling (ZFC) regimes at different temperatures of 20, 24 and 28 K. It was found that engine oil addition slightly increases the levitation and guidance force properties. the Fz values were obtained as 11.17 and 11.58 N for pure and MgB2 sample immersed for 30 min at 20 K in ZFC regime. in addition, the MgB2 sample immersed for 300 min in engine oil showed the highest Jc value of 5.3x104 A cm(-2) at 15 K and self-field and showed the highest guidance force value of 4.14 N at 20 K. These finding suggest that synthetic engine oil is a cost-effective and promising method to improve the levitation and guidance force performance as well as the critical current density of MgB2 bulk superconductor.Scientific Research Coordination Unit of Karadeniz Technical University of Turkey [13182]; Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [110T622]All the authors would like to thank Prof. Dr. Ekrem Yanmaz (Karadeniz Technical University, Turkey); Assoc. Prof. Akiyasu Yamamoto (Tokyo University of Agriculture and Technology) and Prof. Dr. Ali Gencer (Ankara University, Ankara, Turkey) for his support and encouragement and Dr. Canan Aksoy for her good effort to contribute on microstructure imaging to this paper (during her visit to Department of Materials at the University of Oxford). This study was supported by the Scientific Research Coordination Unit of Karadeniz Technical University of Turkey, with project no: 13182. Magnetic levitation force measurements at low temperatures were carried out at solid-state research laboratory in Recep Tayyip Erdogan University by using the system which was designed by the project supported by the Scientific and Technological Research Council of Turkey (TUBITAK), with contract number 110T622

Comparing Finger-stick β-Hydroxybutyrate with Dipstick Urine Tests in the Detection of Ketone Bodies

SUMMARY: Objectives: Blood ketone (beta-hydroxybutyrate) measurements are suggested instead of urine ketone (acetoacetate) measurements in the diagnosis of diabetic ketoacidosis. Urine ketone examination is difficult and time consuming, and may result in an incorrect interpretation. Studies performed in emergency departments on blood ketones are limited. Our objective is to compare urine ketones and capillary blood ketones in patients whose serum glucose levels were ≥150 mg/dl. Methods: In our cross-sectional prospective study, finger-stick blood beta-hydroxybutyrate, arterial blood gas and urine ketone measurements of patients whose serum glucose levels were 150 mg/dL and higher were performed in the emergency department. Results: A total of 265 patients were included in the study. The mean age of the patients was 62.4±14.9 years, and 65.7% of them were female. The mean of the capillary blood ketone levels of the patients was determined to be 0.524±0.9 mmol/L (min: 0 mmol/L, max: 6.7 mmol/L). In 29 (13.1%) of the 221 patients whose urine ketone levels were negative, the finger-stick blood ketone levels were positive. Three of these patients were severely ketonemic, six were moderately ketonemic, and 20 were mildly ketonemic. Conclusions: In patients admitted to the emergency department with a blood glucose level of 150 mg/dL or higher, performing a capillary blood ketone measurement instead of a urine ketone measurement was a better predictor of ketonemia. ÖZET: Amaç: Diyabetik keto asidoz tanısında idrar ketonu (asetoasetat) yerine kan ketonu (beta-hidroksibütirat) ölçümü önerilmektedir. İdrar ketonu bakılması zahmetli, zaman alıcı ve yanlış yorumlara yol açabilen bir testtir. Acil servislerde kan ketonu ile ilgili yapılan çalışmalar sınırlıdır. Bu çalışmadaki amacımız serum glikoz düzeyi ≥150 mg/dl tespit edilen hastalarda idrar ketonu ile kapiller kanda keton varlığını karşılaştırmaktır. Gereç ve Yöntem: İleriye yönelik kesitsel çalışmada, acil serviste serum glikoz düzeyi 150 mg/dL ve üzerinde olan hastaların parmak ucu kan beta-hidroksibütirat, venöz kan gazı ve idrar ketonu ölçümü yapıldı. Bulgular: Bu çalışmaya toplam 265 hasta dâhil edildi. Hastaların yaş ortalaması 62.4±14.9 yıl, %65.7'si kadındı. İdrar ketonu negatif olan 221 hastanın 29'unda (%13.1) parmak ucundan kan ketonu pozitif olarak saptandı. Bu hastaların üçü ağır, altısı orta düzeyli, 20'si hafif düzeyli ketonemikti. Olguların kapiller kan keton düzeyleri ortalaması 0.524±0.9 mmol/L (min.: 0 mmol/L, maks.: 6.7 mmol/L) tespit edildi. Sonuç: Acil servise başvuran ve kan glikoz değeri 150 mg/dL üzerindeki hastalar içinde, idrar keton ölçümü yerine kapiller kan keton ölçümünün kullanılması hastaların yönetiminde önemli değişikliğe yol açabilir. Key words: Diabetic ketoacidosis, hydroxybutyrates, ketosis, Anahtar sözcükler: Diyabetik ketoasidoz, hidroksibütirat, ketozi