Bronchogenic cyst associated with pericardial defect: Case report and review of the literature

Partial defect of the pericardium combined with bronchogenic cyst is a very rare congenital anomaly. We describe the case of a 32-year-old man with a partial defect of the left pericardium and a bronchogenic cyst arising from the border of the pericardial defect. The cyst was successfully resected with the harmonic scalpel by three-port videothoracoscopic approach

Of the importance of a leaf: the ethnobotany of sarma in Turkey and the Balkans

BACKGROUND: Sarma - cooked leaves rolled around a filling made from rice and/or minced meat, possibly vegetables and seasoning plants - represents one of the most widespread feasting dishes of the Middle Eastern and South-Eastern European cuisines. Although cabbage and grape vine sarma is well-known worldwide, the use of alternative plant leaves remains largely unexplored. The aim of this research was to document all of the botanical taxa whose leaves are used for preparing sarma in the folk cuisines of Turkey and the Balkans. Methods: Field studies were conducted during broader ethnobotanical surveys, as well as during ad-hoc investigations between the years 2011 and 2014 that included diverse rural communities in Croatia, Bosnia and Herzegovina, Serbia, Kosovo, Albania, Macedonia, Bulgaria, Romania, and Turkey. Primary ethnobotanical and folkloric literatures in each country were also considered. Results: Eighty-seven botanical taxa, mainly wild, belonging to 50 genera and 27 families, were found to represent the bio-cultural heritage of sarma in Turkey and the Balkans. The greatest plant biodiversity in sarma was found in Turkey and, to less extent, in Bulgaria and Romania. The most commonly used leaves for preparing sarma were those of cabbage (both fresh and lacto-fermented), grape vine, beet, dock, sorrel, horseradish, lime tree, bean, and spinach. In a few cases, the leaves of endemic species (Centaurea haradjianii, Rumex gracilescens, and R. olympicus in Turkey) were recorded. Other uncommon sarma preparations were based on lightly toxic taxa, such as potato leaves in NE Albania, leaves of Arum, Convolvulus, and Smilax species in Turkey, of Phytolacca americana in Macedonia, and of Tussilago farfara in diverse countries. Moreover, the use of leaves of the introduced species Reynoutria japonica in Romania, Colocasia esculenta in Turkey, and Phytolacca americana in Macedonia shows the dynamic nature of folk cuisines. Conclusion: The rich ethnobotanical diversity of sarma confirms the urgent need to record folk culinary plant knowledge. The results presented here can be implemented into initiatives aimed at re-evaluating folk cuisines and niche food markets based on local neglected ingredients, and possibly also to foster trajectories of the avant-garde cuisines inspired by ethnobotanical knowledge

Post tracheostomy and post intubation tracheal stenosis: Report of 31 cases and review of the literature

<p>Abstract</p> <p>Background</p> <p>Severe post tracheostomy (PT) and post intubation (PI) tracheal stenosis is an uncommon clinical entity that often requires interventional bronchoscopy before surgery is considered. We present our experience with severe PI and PT stenosis in regards to patient characteristics, possible risk factors, and therapy.</p> <p>Methods</p> <p>We conducted a retrospective chart review of 31 patients with PI and PT stenosis treated at Lahey Clinic over the past 8 years. Demographic characteristics, body mass index, co-morbidities, stenosis type and site, procedures performed and local treatments applied were recorded.</p> <p>Results</p> <p>The most common profile of a patient with tracheal stenosis in our series was a female (75%), obese (66%) patient with a history of diabetes mellitus (35.4%), hypertension (51.6%), and cardiovascular disease (45.1%), who was a current smoker (38.7%). Eleven patients (PI group) had only oro-tracheal intubation (5.2 days of intubation) and developed web-like stenosis at the cuff site. Twenty patients (PT group) had undergone tracheostomy (54.5 days of intubation) and in 17 (85%) of them the stenosis appeared around the tracheal stoma. There was an average of 2.4 procedures performed per patient. Rigid bronchoscopy with Nd:YAG laser and dilatation (mechanical or balloon) were the preferred methods used. Only 1(3.2%) patient was sent to surgery for re-stenosis after multiple interventional bronchoscopy treatments.</p> <p>Conclusion</p> <p>We have identified putative risk factors for the development of PI and PT stenosis. Differences in lesions characteristics and stenosis site were noted in our two patient groups. All patients underwent interventional bronchoscopy procedures as the first-line, and frequently the only treatment approach.</p

Tamoxifen mechanically deactivates hepatic stellate cells via the G protein-coupled estrogen receptor

Tamoxifen has been used for many years to target estrogen receptor signalling in breast cancer cells. Tamoxifen is also an agonist of the G protein-coupled estrogen receptor (GPER), a GPCR ubiquitously expressed in tissues that mediates the acute response to estrogens. Here we report that tamoxifen promotes mechanical quiescence in hepatic stellate cells (HSCs), stromal fibroblast-like cells whose activation triggers and perpetuates liver fibrosis in hepatocellular carcinomas. This mechanical deactivation is mediated by the GPER/RhoA/myosin axis and induces YAP deactivation. We report that tamoxifen decreases the levels of hypoxia-inducible factor-1 alpha (HIF-1α) and the synthesis of extracellular matrix proteins through a mechanical mechanism that involves actomyosin-dependent contractility and mechanosensing of tissue stiffness. Our results implicate GPER-mediated estrogen signalling in the mechanosensory-driven activation of HSCs and put forward estrogenic signalling as an option for mechanical reprogramming of myofibroblast-like cells in the tumour microenvironment. Tamoxifen, with half a century of safe clinical use, might lead this strategy of drug repositioning.Peer reviewe

Transient Peripheral Leukocytosis in Children With Afebrile Seizures

The purpose of this Study was (1) to demonstrate whether peripheral blood leukocytosis accompanies first afebrile seizures without bacterial infection, (2) to investigate the duration of leukocytosis, and (3) to assess the relationship between peripheral blood leukocytosis and seizure characteristics. Complete blood count was routinely obtained from all the patients. Blood and urine cultures were obtained from patients with leukocytosis. On the 24th hour of admission, a second complete blood count was obtained from patients with initial leukocytosis. Sixty-two children aged 4.0 +/- 3.6 years (range, 6 months-13 years)-31 boys (50%) and 31 girls (50%)-enrolled in the study. The findings showed that peripheral blood leukocytosis was found in 8% of afebrile children without status epilepticus and 41.6% of afebrile children with status epilepticus. An interesting finding of the study was that peripheral blood leukocytosis accompanied by afebrile seizures subsided in 24 hours. Transient leukocytosis could be found in children with afebrile seizures without bacterial infection

THE CEREBROVASCULAR PERMEABILITY AND EPILEPSY - THE ROLE OF BLOOD-PRESSURE

This study was designed to evaluate the role of elevated blood pressure on cerebrovascular permeability and brain tissue specific gravity during epileptic seizures induced by Pentylenetetrazole (PTZ). The experiments were carried out on Wistar rats. Specific gravity was measured bilaterally in 10 regional brain areas and Evans-blue passage (across blood-brain barrier) was spectrophotometrically measured in 6 brain areas. Animals were divided into four groups: they received i.v. either saline, 80mg/kg PTZ (convulsive dose), 40mg/kg PTZ (subconvulsive dose) or 80mg/kg PTZ+phentolamine. 80 mg/kg PTZ induced significantly an increase in blood pressure, in specific gravity and in Evans-blue passage. 40mg/kg PTZ induced an increase in blood pressure and caused small changes in specific gravity but not in Evans-blue passage. The last group, in which the rise in blood pressure was prevented with Phentolamine, also showed a significant increase in brain specific gravity and in Evans-blue passage. The results clearly show that the increased blood pressure may contribute to but is not entirely responsible for the changes in the cerebrovascular permeability induced by epileptic seizures

Undergraduate training in occupational health at Kocaeli University Medical School: A Turkish experience

Processes and conditions of production may produce unhealthy effects. Both must therefore be included in the education of health care personnel. Vocational training in occupational health at Kocaeli University Medical School, Turkey aims to demonstrate students that occupational health is a specific and important area of work within the context of primary health care. This research is a cross-sectional study. It was planned as a three stage study: 1- reviewing literature and grouping of countries according to their occupational health curricula; 2- reviewing the occupational health programs of medical schools in Turkey, and 3- recommendations for an occupational health curriculum to include an occupational health vocational training period of one week in the two month public health education program for medical interns. During this experience, senior students would be assigned to workplace health units. Of 283 medical schools found on the web, with occupational health teaching, only 20 have a curriculum that includes training in workplace health care units. In Turkey, there is no structured practical education on occupational health. In the third part of this study, we initiated at Kocaeli University School of Medicine's curriculum, a new occupational health education model applied in the workplace health units of factories. Practical experience of occupational health in the workplace is useful in introducing the community-based approach to occupational health in undergraduate medical education and understanding the determinants of health in industry

Smoking prevalence and related factors among the medical students of Trakya University

Amaç: Bu çalışmada Tıp Fakültesi öğrencilerinde sigara içme prevalansları ve ilişkili faktörleri saptamak amaçlandı. Yöntem: Fakültemizde 1998-1999 döneminde eğitim gören 1117 öğrenciden 515'ine (%46) (E/K=275/240) önceden denenmiş anket uygulandı. Bulgular: Öğrencilerin %30.5'inin her gün en az. bir sigara içtiği (günlük içici); % 1.7'sinin günde birden az haftada en az bir sigara içtiği (haftalık içici); %7.6'sının sigarayı bıraktığı, %8.5'inin sigarayı denediği ve % 51.7'sinin hiç içmediği saptandı. Erkeklerin kızlara göre yaklaşık 2 kat daha fazla günlük içici olduğu (%40.4'e karşılık %21.8; Pearson ?2=20.92, p<0.001) saptandı. Dönem 1'de %6.7, Dönem 2'de %30.4, Dönem 3'te %41.7, Dönem 4'te %51.5, Dönem 5'te %26.8, Dönem 6'da %18 günlük içicilik olduğu, dönemin sigara içme davranışını anlamlı derecede etkilediği (Pearson ?2=41.47, p<0.001); Dönem 1'de en az. olan içme oranının Dönem 4'e doğru giderek arttığı ve Dönem 5 ve 6'da yeniden giderek azaldığı saptandı. Bekar evinde kalanlarda (%37.5) yurtta (%13.4) veya ailesinin (%18) yanında kalanlara göre, günlük içicilik belirgin şekilde daha yüksekti (Pearson ?2=27.38,p<0.001). Sonuç: Sigara içme davranışının Dönem 1 'de çok düşük oranlarda iken giderek artması ve Dönem 3 ve 4'te en üst düzeye çıkması Dönem 1'de eğitim çalışmalarına başlanması gerektiğini düşündürdü. Dönem 5 ve 6'da sigara içiminin azalması bu dönemlerdeki eğitimin yoğun olmasına ve kısmen de olsa başarılı olmasına bağlandı.Aims: In this study, we aimed to investigate smoking prevalence and some related factors amongst the medical students. Methods: In our faculty, we surveyed 515 of 1117 (46%) students (M/F=275/240) in curriculum year 1998-1999 with a pre-examined questionnaire. Results: It was found that 22% of the students were daily smoker, 1.7% was weekly smoker (occasional smoker). 7.6% were exsmokers, 8.5% had experienced the smoking and 51.7% had never smoked. Smoking prevalence was nearly twice more in males than females (40.4% vs. 21.8, Pearson &amp;chi;2=20.92, p&lt;0.001). Daily smokers were 6.7% in the first year of the school, 30.4% in the 2nd year, 41.7% in the 3rd year, 51.5% in the 4th year, 26.8% in the 5th year and 18% in the 6th year. The curriculum year was important in smoking prevalence's of the students (Pearson &amp;chi;2=41.47, p&lt;0.001). The smoking prevalence was the least in the 1st year, increasing towards to 4th year and then decreasing towards to 6th year. Daily smoking was significantly higher in living with friends (37.5%) than living with family (18%) or staying in the hostels (13.4%; Pearson &amp;chi;2=27.38, p&lt;0.001). Conclusion: Low smoking prevalence in the first year increasing towards to 4th year and decreasing towards to 6th year suggested us that the smoking education must be started in the first year immediately. Decreasing smoking prevalence in the last two years right now suggested us that the education in these years was effective