Surgical removal of a self-expanding metallic stent from jejunum in a patient with Roux-en-Y esophagojejunostomy

Self-expanding metallic stent is useful in esophageal perforations, trachea-esophageal fistulas, benign esophageal strictures, and unresectable esophageal cancers. However, self-expanding metallic stent itself has the risk of mucosal necrosis with subsequent perforation and /or trachea-esophageal fistula development –particularly- in long-term usage. Further, gastro-esophageal reflux, stent occlusion, stent migration and intestinal obstruction are other common complications. We report surgical management of a case whose self-expanding metallic stent migrated from the esophagojejunostomy anastomosis towards to the jejunal Y-limp

The role of L-carnitine in treatment of a murine model of asthma.

Leukotrienes, one of the mediators of inflammation in asthma, have a strong bronchoconstrictive effect. L-carnitine has been reported to influence respiratory functions. It has also been reported that L-carnitine inhibits leukotriene synthesis. To evaluate the effects of L-carnitine on oxygen saturation, urine leukotriene E4 levels and lung histopathology in a murine model of asthma, high IgE responder BALB/c mice (n = 24) were systemically sensitized to ovalbumin and chronically challenged with low particle mass concentrations of aerosolized ovalbumin, and then they were divided into 3 groups (study groups A, B, and C) each including eight mice. After methacholine-induced bronchoconstriction, the mice in groups A and B were given intraperitoneal L-carnitine (250 and 125 mg/kg, respectively), while the mice in group C were given placebo. Oxygen saturation of the mice was measured by pulse oxymeter before and after methacholine and after L-carnitine/ placebo application. In addition, urine leukotriene E4 levels were measured before asthma development, and 24-h after L-carnitine injection in asthmatic mice. Inflammation in the lung tissues of the sacrificed animals was scored histopathologically to determine the effect of L-carnitine on tissue level. A control group of non-sensitized mice (n = 8) treated with placebo only was used for comparison of urine leukotriene E4 levels and of histopathological parameters. Oxygen saturation of the mice in the study groups tended to decrease after methacholine and to improve after L-carnitine injection, although these changes were not significant at all time points. Urine leukotriene E4 levels of all 3 study groups increased significantly after asthma development. The rate of increment was smallest in the group given the highest L-carnitine dose (group A). Inflammation at the tissue level was also mildest in group A, and severest in the group that was not given carnitine (group C). All of the study groups and the control group differed significantly with respect to inflammation scores. In conclusion, L-carnitine improved oxygen saturation, and decreased urine leukotriene E4 levels and inflammation in lung tissues in the present murine model of asthma.</p

Učestalost epilepsije među studentima Sveučilišta Canakkale Onsekiz Mart, Turska

The aim of this study was to investigate the frequency of epilepsy among students of the Canakkale Onsekiz Mart University. This cross sectional epidemiological study was performed on 4762 of 19,988 Canakkale Onsekiz Mart University students in the academic year 2007-2008. Participants that answered “epilepsy” to the question “Do you have any disease diagnosed by a doctor?” in a questionnaire including 4 subgroups were identified. Data were transferred to the Epi-Info Version 6.0 statistics program and controlled data were analyzed in the SPSS 15.0 statistics program. There were 53.1% of female and 46.9% of male students, mean age 20.4±2.1 (range 17-43) years. Twelve (0.25%) students had epilepsy diagnosis, eight (66.7%) female and four (33.3%) male, mean age 20.8±1.8 years. In our study, epilepsy was detected in 0.25% of students (n=12). Age specific prevalence studies related to epilepsy epidemiology are extremely rare, especially in university students with average intelligence. Thus, we considered that it would be epidemiologically significant to share the results of our cross sectional study with all those involved in epilepsy epidemiology and management.Cilj istraživanja bio je ispitati učestalost epilepsije među studentima Sveučilišta Canakkale Onsekiz Mart, Turska. Ova presječna epidemiološka studija provedena je na 4762 od 19.988 studenata ovoga Sveučilišta u školskoj godini 2007.-2008. Identificirani su sudionici koji su na pitanje “Imate li kakvu bolest koju vam je dijagnosticirao liječnik?” odgovorili “epilepsija” u anketnom upitniku s 4 podskupine pitanja. Podaci su preneseni u statistički program Epi-Info verzija 6.0, a provjereni podaci su potom analizirani pomoću statističkog programa SPSS 15.0. Bilo je 53,1% studentica i 46,9% studenata srednje dobi 20,4±2,1(17-43) godina. Dijagnozu epilepsije je imalo 12 (0,25%) ispitanika, osam (66,7%) studentica i četvorica (33,3%) studenata srednje dobi 20,8±1,8 godina. U ovoj studiji epilepsija je utvrđena u 12 (0,25%) ispitanika. Epidemiološke studije učestalosti epilepsije u određenim dobnim skupinama vrlo su rijetke, poglavito među studentima kao populaciji s prosječnom inteligencijom. Stoga smatramo da je važno rezultate ove naše presječne studije podijeliti sa svima koji se bave epidemiologijom i liječenjem epilepsije

Export Competitiveness of Turkiye Agri-food Products in the European Union and The Shanghai Cooperation Markets

The purpose of this study was to investigate the competitive advantage and long-term viability of Turkiye agri-food exports to the European Union (EU) and Shanghai Cooperation Organization (SCO) markets. The Lafay index and trade ratios were utilized to investigate comparative and competitive advantage, while the survival function was employed to estimate export competition for the EU and SCO markets. The results indicate that Turkiye has a competitive edge in the export of fruits and vegetables to the EU and SCO states. However, the period of comparative advantage experienced by EU and SCO countries was not similar, nor was the benefit consistent. Despite fluctuations in Turkiye's international trade balance with SCO members, its foreign trade with EU members has increased. Hence, Turkiye should continue to trade in agri-food with the EU while simultaneously expanding business networks with SCO countries.Peer reviewe

Bilateral congenital horizontal gaze palsy: MR findings

Congenital horizontal gaze palsy is a rare disorder that is considered to be due to either the absence of or a lesion in the abducens nucleus. Magnetic resonance (MR) imaging of two cases with isolated congenital bilateral horizontal gaze palsy showed a lack of the normal protrusion of both abducens nuclei on the anterior wall of the fourth ventricle, These MR findings, with the support of the clinical picture of the cases, are consistent with the absence of bilateral abducens nuclei, To the best of our knowledge, this is the first report of MR evidence of the absence of abducens nuclei in horizontal gaze palsy

Outcomes of Baked Milk and Egg Challenge in Cow’s Milk and Hen’s Egg Allergy: Can Tolerance Be Predicted with Allergen-Specific IgE and Prick-to-Prick Test?

Background: Adding baked food into the diets of patients with cow's milk allergy (MA) and hen's egg allergy (EA) has several benefits. Objective: We aimed to determine baked and unbaked food tolerance and evaluate the effectiveness of laboratory findings on the prediction of baked and unbaked food tolerance in patients with MA and EA. Methods: Clinical outcomes of the patients with MA and EA who had been exposed to oral food challenge with baked food were retrospectively analyzed. Results: Ninety-one patients were evaluated. The median age of the study group was 22 months. Forty-nine and 42 patients had IgE-mediated MA and EA, respectively. While all patients with EA tolerated baked egg, 24.5% patients with MA could not tolerate baked cow's milk (BM). In patients with MA, BM tolerance showed negative association with milk-specific IgE, skin prick test (SPT), and prick-to-prick test (PTP), and the PTP was the most significant parameter (sensitivity 83.8%, specificity 91.7% for PTP <= 7 mm). Negative association was seen between milk-specific IgE, SPT, PTP, and unbaked milk (UBM) tolerance, and PTP was the most significant parameter (sensitivity 100%, specificity 55% for PTP <= 4 mm). In patients with EA, at the end of 6 months of baked hen's egg (BE) consumption, scrambled egg tolerance showed negative association with egg white-specific IgE level, egg white SPT and PTP. Egg white PTP was the most significant parameter (sensitivity 82.4%, specificity 96.0% for PTP <= 5 mm). Conclusion: Specific-IgE, SPT, and PTP should be kept in mind as parameters that can be used to predict tolerance to BM and BE for patients with MA and EA

A neglected problem of developing countries: Noncystic fibrosis bronchiectasis

Background:Bronchiectasis has been defined as the abnormal and permanent dilation of the bronchi. It is still an important problem in many developing countries. Aim:The aim of this study was to identify the chacteristics and underlying etiology of children followed with the diagnosis of noncystic fibrosis bronchiectasis. Materials and Methods:Children with bronchiectasis confirmed with high-resolution computed tomography were enrolled into the study. The data of the patients, including symptoms of the disease, age at the onset of symptoms, findings of physical examination, labrotory investigations performed in order to identify the etiology of bronchiectasis, etiology of bronchiectasis if found, radiologic findings and treatment modalities were noted. Results: Sixty-six children between 1 and 17 years were included in the study retrospectively. Forty-four of them were males (66.7) and 22 (33.3) were females. The most common presenting symptoms were cough (100) and sputum expectoration (50). An underlying etiology was identified in 44 (66.7) of the study subjects. The four most common underlying causes were found as infections (21.2), asthma (16.7), aspiration syndromes and/or gastroesophageal reflux disease (9.1) and immunodeficiency syndromes (7.6), respectively. Conclusion:Identifying an underlying etiology will have a significant effect on the management of noncystic fibrosis bronchiectasis. Defining the cause of bronchiectasis may also decrease its incidence, progression and complications