The Prevalence of Heterotopic Gastric Mucosa of the Proximal Esophagus and the Relationship Between Clinical and Endoscopic Findings

PurposeIn this study, we aimed to investigate the prevalence of HGMPE and the relationship between clinical and endoscopic findings. Patients and MethodsBetween December 2013 and February 2018, a total of 4126 patients, 2091 women and 2035 men, who underwent esophagogastroduodenoscopy in the gastroenterology unit of Acıbadem Kayseri Hastanesi were retrospectively screened.Totally, 122 patients, 54 women and 68 men found to have heterotopic gastric mucosa and a control group of age and sex matched 241 patients, 107 women and 134 men who do not have heterotopic gastric mucosa were included the study.ResultsWe found the prevalence of HGMPE 2.96 % in our study. Dysphagia was significantly higher in the case group, whereas abdominal pain was higher in the control group.Conclusion Because of the controversies among the studies we think that HGMPE may be a frequent finding if the endoscopist be aware of this entity. Although the controversies remain regarding the clinical significance of this entity, increasing number of cases of neoplastic transformation has further increased the importance of HGMPE

IDENTIFICATION OF PLANT FIGURES ON STONE STATUES AND SARCOPHAGUSES AND THEIR SYMBOLS: THE HELLENISTIC AND ROMAN PERIODS OF THE EASTERN MEDITERRANEAN BASIN IN THE ISTANBUL ARCHAEOLOGY MUSEUM

Throughout time, plants have been central to human life; plants have provided humans with food, wood, fuel, cosmetics, medicine, and humans have attributed symbolism to plants, including fertility, power, and purity. The Istanbul Archaeology Museum houses many stone statues and sarcophaguses featuring a variety of figures. Among other things, these figures depict fighting, richness, fertility, peace, gods, and plants. Plants are represented as whole trees, cones, leaves, fruits and flowers. These figures help us to understand both the cultural history of these plants and ancient human relationships with plants. The purpose of this study is to identify the genera and species of the plant figures on the stone statues, reliefs and sarcophaguses from the Hellenistic and Roman periods in the Istanbul Archaeology Museum and to discuss their historical importance. To this end, a list was created to record the inventory number, original location where the remains were found, and the age and historical time period of 47 Roman and Hellenistic statues and sarcophaguses. A total of 24 different types of plants were identified: acanthus leaves, apple, apricot, bay laurel, common grape wine, common fig, a whole eastern plane tree, eggplants, a globe of artichoke, oak leaves and fruits, olive, opium poppy, pear, a cone of umbrella pine, pine leaves and cones, pomegranate, quince, walnut, wheat, strawberry fruit, and date palm leaves, fruit, and stems

Diagnostic performance of clinical tests in patients with shoulder pain

Amaç: Çalışmamızın amacı, fzik tedavi polikliniğine başvuran omuz ağrılı hastalarda manyetik rezonans görüntüleme (MRG) bulguları esas alınarak klinik testlerin tanısal performans düzeylerini araştırmaktır. Ayrıca MRG bulguları ile ağrı ve omzun fonksiyonel durumu arasındaki ilişki de incelenmiştir. Gereç ve Yöntemler: Çalışmaya omuz ağrısı nedeniyle polikliniğimize başvuran 76 hasta alındı. Tüm hastaların fzik muayeneleri ve farklı omuz patolojilerine yönelik özel klinik testleri yapıldı. Hastaların ağrı düzeyleri ‘Vizüel Analog Skala’ (VAS) ile değerlendirildi. Omzun fonksiyonel değerlendirilmesi ‘Omuz Özürlülük Sorgulaması’ (OÖS) formu kullanılarak yapıldı. Tüm hastalar MRG ile değerlendirildi. Manyetik rezonans görüntüleme bulguları esas alınarak, uygulanan klinik testlerin seçiciliği, duyarlılığı, pozitif ve negatif ve tahmini değerleri ile doğruluğu Ki-kare tablosu kullanılarak hesaplandı. Bulgular: İmpingement ve rotator kaf patolojilerini değerlendiren testlerin genel olarak duyarlılıkları yüksekken, seçicilikleri düşük bulundu. Supraspinatusta rüptürleri değerlendirmede Drop Arm; subakromial- subdeltoid efüzyonu saptamada Yocum testi, infraspinatus patolojilerini saptamada Patte ve dış rotasyon yetmezlik belirtisi, biseps patolojilerini saptamada Speed testi, akromiyoklaviküler eklem patolojilerini saptamada horizontal addüksiyon testi ile ağrılı ark testinin tanısal performansı istatistiksel olarak anlamlı bulundu. Ağrı şiddeti ile omuz patolojileri arasında anlamlı ilişki bulunamadı. Fonksiyonel durum açısından sadece bisipital tendiniti olan grupta fonksiyonel skorların anlamlı olarak yüksek olduğu saptandı. Sonuç: Omuz ağrılı hastaların büyük çoğunluğunda MRG’de çoklu patolojik lezyon olması ve klinik testlerin çoğunun patolojiyi saptamada düşük seçicilik oranlarına rağmen yüksek duyarlılık oranlarına sahip olması, tedaviyi planlama ve eşlik eden patolojileri belirleme açısından klinik testlerin önemli bir role sahip olduğunu göstermektedir.Objective: This study aimed to investigate the diagnostic performance of clinical tests applied to patients with shoulder pain at a physical therapy outpatient clinic. Magnetic resonance imaging (MRI) fndings were the major determinants to evaluate the accuracy of the clinical tests. Also, the relationship between the MRI fndings and the pain and functional status of the shoulder were evaluated. Material and Methods: Seventy-six patients, referred to a physical therapy outpatient clinic with shoulder pain, were included in the study. Physical examination of all patients and specifc clinical tests were performed for different shoulder pathologies. Pain levels of patients were evaluated with the visual analog scale and functional status of the shoulder with the Shoulder Disability Questionnaire. All patients were evaluated with MRI. Sensitivity, specifcity, and positive and negative predictive values of the clinical tests were evaluated on the basis of the MRI fndings. Results: The sensitivity of the tests evaluating impingement and rotator cuff pathologies was found to be high, but specifcity was low. Diagnostic performance of the drop arm test to determine the supraspinatus ruptures; Yocum test to determine the subacromial and subdeltoid effusion; Patte test and external rotation lag sign to determine infraspinatus tendon pathologies; speed test to determine biceps pathologies; and horizontal adduction test and painful arc test to determine acromioclavicular joint pathologies were found to be statistically signifcant. In this study, the severity of pain and shoulder pathologies showed no statistically signifcant correlation. In terms of functional status, high scores were achieved only in the bicipital tendinitis group. Conclusion: MRI fndings show that patients with shoulder pain may have multiple pathological lesions. Despite the coexistence of multiple pathologies and low specifcity of clinical tests, clinical tests evaluating shoulder pathologies have great importance in directing the clinicians to diagnose and plan treatments because of high sensitivity

Alcoholic Neuropathy with Superimposed Focal Entrapment Neuropathies

Bu yazıda fokal tuzaklanma nöropatileri ile birlikte olan alkolik nöropatili bir hasta sunulmuştur. Elli beş yaşında erkek hasta sol ulnar nöropati tanısı ile kliniğimiz elektrofizyoloji ünitesine kabul edildi. Hasta anamnezde önceye ait kronik alkol alışkanlığı öyküsü veriyordu. Sinir iletim çalışmaları hastada bilateral karpal tünel sendromu, dirsekte bilateral ulnar nöropati, solda fibula başı bölgesinde peroneal nöropati, distal motor latanslarda uzama ve orta derecede azalmış motor iletim hızları, çok sayıda duyusal sinir ileti hızlarında yavaşlama ve çok sayıda uzamış F yanıtı latansı varlığını ortaya koydu. Genetik analizlerde 17p11.2-12 kromozomda delesyon saptanmadı. Bulgularımızı hastanın muhtemel tanısı hakkındaki görüşlerini almak için diğer klinisyenlerle paylaşmak istedik.We reported here a case of alcoholic polyneuropathy with superimposed focal entrapment neuropathies. A 55-year-old male patient was admitted to the electrophysiology unit with the diagnosis of left ulnar neuropathy. He had a previous history of chronic alcoholism. Nerve conduction studies revealed bilateral carpal tunnel syndrome, bilateral ulnar neuropathy at the elbow, left peroneal neuropathy at the fibular head, prolonged distal motor latencies and moderately reduced motor conduction velocities in multiple motor nerves, slowed conduction velocities in multiple sensory nerves and multiple prolonged F-waves. Gene analysis did not reveal deletion on chromosome 17p11.2-12. We wanted to share our findings with other clinicians to get their opinion regarding possible diagnosis of the case

Alcoholic Neuropathy with Superimposed Focal Entrapment Neuropathies

We reported here a case of alcoholic polyneuropathy with superimposed focal entrapment neuropathies. A 55-year-old male patient was admitted to the electrophysiology unit with the diagnosis of left ulnar neuropathy. He had a previous history of chronic alcoholism. Nerve conduction studies revealed bilateral carpal tunnel syndrome, bilateral ulnar neuropathy at the elbow, left peroneal neuropathy at the fibular head, prolonged distal motor latencies and moderately reduced motor conduction velocities in multiple motor nerves, slowed conduction velocities in multiple sensory nerves and multiple prolonged F-waves. Gene analysis did not reveal deletion on chromosome 17p11.2-12. We wanted to share our findings with other clinicians to get their opinion regarding possible diagnosis of the case

Codeine-Induced Syndrome of Inappropriate Antidiuretic Hormone: Case Report

Background: The syndrome of inappropriate antidiuretic hormone was first described in 1957 by Schwartz, and is characterised by hyponatraemia, inappropriately increased urine osmolality and urine sodium, and decreased serum osmolality in a euvolemic patient without edema. A patient with the syndrome of inappropriate antidiuretic hormone should have normal cardiac, renal, adrenal, hepatic, and thyroid functions and should not take any diuretics. Case Report: We present a case of the syndrome of inappropriate antidiuretic hormone caused by codeine and associated with reduced urine volume, increased urine sodium, and decreased serum sodium concentration. Conclusion: The syndrome of inappropriate antidiuretic hormone is a disease that can lead to morbidity and even mortality. Clinicians should measure serum electrolytes intermittently in order to avoid missing the diagnosis of the syndrome of inappropriate antidiuretic hormone in patients using opioid. (Balkan Med J 2014;31:107-109)

The Role of Mediterranean Fever Mutation in the Clinical Course and Pathogenesis of Ankylosing Spondylitis

Objectives: This study aims to investigate the role of Mediterranean fever (MEFV) gene mutations in the pathogenesis and clinical progression of disease in ankylosing spondylitis patients. Patients and methods: The study included 88 patients (60 males, 28 females; mean age 38.7±8.7 years; range 19 to 56 years) diagnosed with ankylosing spondylitis according to modified New York criteria. The patients were evaluated for peripheral joint and hip joint involvement and treatment characteristics. Using multiplex/polymerase chain reaction reverse hybridization method, the presence of 12 different MEFV mutations was investigated. Results: Of 29 patients, heterozygote mutation was detected in 24 (83%), mutations in both alleles were detected in three (10%), and combined heterozygote mutations were detected in two patients (7%). Three most common mutations were M694V (11.3%), E148Q (8%), and V726A (4.5%). In the group with mutations, symptoms had started earlier than in the other group, and the number of peripheral joints involved was higher. When both characteristics were compared with the characteristics of the group that did not have any gene mutations, the differences were statistically significant (p<0.001 and p=0.044, respectively). The highest correlation with the number of peripheral joints involved was determined for M694V mutation (p=0.034), while onset of symptoms at younger age was correlated with E148Q mutation (p=0.010). Conclusion: Based on the findings of this study and our clinical experience, it can be said that the clinical progression of ankylosing spondylitis patients with MEFV gene mutations is more severe, and this suggests that MEFV gene mutations may be contributive to ankylosing spondylitis pathogenesis.Objectives: This study aims to investigate the role of Mediterranean fever (MEFV) gene mutations in the pathogenesis and clinical progression of disease in ankylosing spondylitis patients. Patients and methods: The study included 88 patients (60 males, 28 females; mean age 38.7±8.7 years; range 19 to 56 years) diagnosed with ankylosing spondylitis according to modified New York criteria. The patients were evaluated for peripheral joint and hip joint involvement and treatment characteristics. Using multiplex/polymerase chain reaction reverse hybridization method, the presence of 12 different MEFV mutations was investigated. Results: Of 29 patients, heterozygote mutation was detected in 24 (83%), mutations in both alleles were detected in three (10%), and combined heterozygote mutations were detected in two patients (7%). Three most common mutations were M694V (11.3%), E148Q (8%), and V726A (4.5%). In the group with mutations, symptoms had started earlier than in the other group, and the number of peripheral joints involved was higher. When both characteristics were compared with the characteristics of the group that did not have any gene mutations, the differences were statistically significant (p<0.001 and p=0.044, respectively). The highest correlation with the number of peripheral joints involved was determined for M694V mutation (p=0.034), while onset of symptoms at younger age was correlated with E148Q mutation (p=0.010). Conclusion: Based on the findings of this study and our clinical experience, it can be said that the clinical progression of ankylosing spondylitis patients with MEFV gene mutations is more severe, and this suggests that MEFV gene mutations may be contributive to ankylosing spondylitis pathogenesis