Standart Cordes tekniğine göre kalbin sağ/sol ekseninin ve malpozisyonlarının prenatal ekokardiyografik tanısı

Objective: The aim of this study was to evaluate distinguishing the right/left side of the fetus, cardiac axis and position according to the standardized Cordes technique in 20 cases with cardiac malposition. Methods: We studied retrospectively 1536 cases whose fetal echocardiographic examinations were performed between 1999 and 2006 in prenatal cardiology unit. Among these, cardiac malpositions were determined in 20 cases. The cardiac axis and position were determined according to the Cordes technique. All cases were followed-up by serial fetal echocardiograms until birth or intrauterine death occurred. In cases of intrauterine death, an autopsy was performed. After birth, physical and echocardiographic examinations were done and prenatal and postnatal diagnoses were compared. Results: Of 1536 fetal echocardiograms performed, 144 revealed congenital heart diseases (9.4%), among these cases 20 were diagnosed with cardiac malposition. Of cases with cardiac malposition, 16 had congenital heart disease, and four had extracardiac malformation. There were six cases of isolated dextrocardia, three cases of situs inversus totalis, six cases of situs ambiguous, and one case of situs inversus with isolated levocardia. Of four cases with extracardiac malformations, two cases had mesoposition, one had dextroposition, and one had extreme levoposition. In six cases the autopsy findings were the same as that their prenatal echocardiographic findings. When postnatal echocardiographic results of the remaining cases with cardiac malposition due to congenital heart disease were compared with prenatal diagnoses, the same echocardiographic findings were verified. Conclusion: The fetal right/left axis must be determined correctly for the accurate diagnosis of cardiac malpositions. Therefore, we recommend that Cordes technique provides a simple and reliable determination of the fetal right/left axis and fetal situs.Bu çalışmada, standart Cordes tekniğine göre fetüsün sağ/sol tarafının, kalbin aksının ve pozisyonunun ayrımı ve bu teknikle kardiyak malpozisyon tanısı konulan 20 olgunun değerlendirilmesi amaçlandı. Yöntemler: Çalışmamızda, 1999-2006 yılları arasında prenatal Kardiyoloji ünitesinde fetal ekokardiyografi yapılan 1536 olguyu retrospektif olarak değerlendirildi. Bu olguların 20’sinde kardiyak malpozisyon saptandı. Kalbin aksı ve pozisyonu Cordes tekniğe göre saptandı. Tüm olgular seri fetal ekokardiyografik çalışmalar ile doğuma veya intrauterinde ölüm meydana gelene kadar izlendi. İntrauterin ölen olgulara otopsi yapıldı. Doğumdan sonra fizik muayene ve ekokardiyografik değerlendirme yapıldı, prenatal ve postnatal tanılar karşılaştırıldı. Bulgular: Fetal ekokardiyografi yapılan 1536 olgunun 144’ ünde konjenital kalp hastalığı saptandı ve bu olguların 20’sine kardiyak malpozisyon tanısı konuldu. Kardiyak malpozisyonlu olguların 16’sında konjenital kalp hastalığı ve 4’ünde kalp dışı nedenlere bağlı malpozisyon mevcuttu. Altı olguda izole dekstrokardi, 3 olguda situs inversus totalis, 6 olguda situs ambigus ve 1 olguda izole levokardi ile birlikte situs inversus saptandı. Kalp dışı nedenlere bağlı malpozisyonlu 4 olgunun 2’sinde mezopozisyon, 1’inde dekstropozisyon ve 1’inde ileri levopozisyon mevcuttu. Altı olguya yapılan otopsi bulguları prenatal ekokardiyografik bulgular ile benzerdi. Konjenital kalp hastalığına bağlı kardiyak malpozisyonlu diğer olguların doğum sonrası ekokardiyografik sonuçları prenatal tanılarıyla karşılaştırıldığında aynı sonuçlar elde edildi. Sonuç: Kardiyak malpozisyonun doğru tanısı için fetüsün sağ/sol aksı doğru saptanmalıdır. Bu nedenle fetal situs ve fetüsün sağ/sol aksının saptanmasında kolay ve güvenilir bir teknik olan Cordes tekniğini öneriyoruz

Different features of lung involvement in Niemann-Pick disease and Gaucher disease

SummaryBackgroundNiemann-Pick disease (NPD) and Gaucher disease (GD) are well-known lysosomal storage diseases. Respiratory system involvement is an important cause of morbidity and mortality in patients with NPD and GD.ObjectivesWe tried to assess the clinical, radiological, and histological features of GD and NPD patients with lung involvement.MethodsWe reviewed medical history, physical examination, radiological, and histological data of 10 NPD and 7 GD patients.ResultsThe most common respiratory symptoms were recurrent lung infection and dyspnea. Although lung examination results in 6 NPD patients were normal, they had lung involvement; 3 patients were diagnosed as NPD directly via lung biopsy during investigation of recurrent lung infection or interstitial lung disease. All GD patients but 1 had respiratory system symptoms at the time of diagnosis. Hepatopulmonary syndrome was present in 4 GD patients. A ground-glass pattern and atelectasis were 2 important high-resolution computed tomography features in the NPD and GD patients. Flexible bronchoscopy and bronchoalveolar lavage were used for emergency extraction of bronchial casts in 1 NPD patient.ConclusionsLung involvement in NPD and GD patients should be included in the differential diagnosis of interstitial lung disease. Besides interstitial appearance on HRCT, atelectasis related to bronchial cast and bronchiectasis are other radiological findings in these group of patients. Analysis of bronchoalveolar fluid and lung biopsy provide very important clues for diagnosis. Hepatopulmonary syndrome is an important vascular complication observed in GD patients

Effects of Dietary Yeast Cell Wall Supplementation on Performance, Carcass Characteristics, Antibody Production and Histopathological Changes in Broilers

This study was carried out to determine the effects of dietary yeast cell wall supplementation on growth performance, carcass traits, antibody production to sheep red blood cells (SRBC) and histopathological changes in broilers. A total of 272 Ross 308 male broiler chicks aged one day were allocated into one control group and three treatment groups each containing 68 chicks. A basal diet was supplemented with 0, 1, 2 and 3 g/kg yeast cell wall (InteMos) to obtain dietary treatments. The experimental period lasted 6 weeks. Dietary yeast cell wall increased body weight gain during the first three weeks (P<0.001). Feed conversion during the first three weeks (P<0.001) and during the overall experimental period (P<0.01) were improved with the dietary supplementation of yeast cell wall. No differences were observed in feed intake, carcass yield and the relative weights of gizzard, liver and heart. Yeast cell wall supplementation decreased the relative weight of abdominal fat (P<0.05) and increased antibody titres to SRBC (P<0.01) in broilers. Control and treatment groups had similar histological grade; hepatic lobular inflammation, steatosis and cell ballooning scores and, cardiac steatosis. It is concluded that yeast cell wall was an effective feed additive in broiler feeding due to the increased growth performance, increased humoral immune response and the reduction in abdominal fat.WoSScopu