Occipitocervical synostosis: case report

Fusion of atlas with the occipital bone is a rare congenital anomaly known as occipitocervical synostosis, occipitalization of atlas,assimilation of atlas or atlanto-occipital fusion. We describe two cases of occipitocervical synostosis identified amongst one-hundred dry adult human occipital bones from the collection of Ege University, School of Medicine, Department of Anatomy (incidence 0.5%). The synostosis was complete type for both cases. Occipitocervical synostosis is clinically important as it may causenarrowing of foramen magnum which may compress the brainstem, vertebral artery and cranial nerves, and during surgicalapproaches to the craniovertebral region.Fusion of atlas with the occipital bone is a rare congenital anomaly known as occipitocervical synostosis, occipitalization of atlas,assimilation of atlas or atlanto-occipital fusion. We describe two cases of occipitocervical synostosis identified amongst one-hundred dry adult human occipital bones from the collection of Ege University, School of Medicine, Department of Anatomy (incidence 0.5%). The synostosis was complete type for both cases. Occipitocervical synostosis is clinically important as it may causenarrowing of foramen magnum which may compress the brainstem, vertebral artery and cranial nerves, and during surgicalapproaches to the craniovertebral region

Plasma homocysteine, folate and vitamin b12 levels in patients with lung cancer

Aim: Disorders in the metabolism of homocysteine and B vitamins, which are involved in a one-carbon transfer reaction and important for DNA synthesis and methylation, have been hypothesized to be associated with carcinogenesis. The purpose of this study is to evaluate the levels of homocysteine, vitamin B12 and folic acid in patients with newly diagnosed lung cancer and determines whether they might be used as an accurate tumor marker for monitoring the patients if they are found to be elevated in lung cancer. Materials and Methods: Forty male patients with lung cancer were included in this study. Age-matched forty healthy males who had not malignant disease or had not received any drug affecting plasma homocysteine levels were selected as control group. Homocysteine, vitamin B12 and folate levels were measured in the samples obtained from the patients and controls. Results: Mean age of the patients with lung cancer was 58.7 ± 9.9 years. All the patients were cigarettes smokers. Mean daily consumption of cigarettes was 2.0±0.7 packs and mean duration of smoking was 30 ± 11 years. Histologic type of carcinoma was found to be squamous cell carcinoma in 55%, adenocarcinoma - in 35%, and small cell carcinoma - in 10% of the cases. Clinical stage was stage IA in 20%, stage IB - in 20%, stage IIA - in 2.5%, stage IIB - in 10%, stage IIIA - in 12.5%, stage IIIB - in 20%, and stage IV - in 15% of the cases. Mean homocysteine level was 15.3 ± 7.3 µmol/l in the patients with lung cancer while 9.8 ± 2.6 µmol/l in controls. Homocysteine level was significantly higher in the patients with lung cancer compared to control group (p < 0.001). Mean folate level was 4.3 ± 1.8 pg/ml in cancer cases while 6.1 ± 2.3 pg/ml in controls. That is to say, plasma folate levels were significantly lower in cases of lung cancer compared to controls (p < 0.001). There was no significantly difference between groups with regard to B12 levels (mean B12 level was 234 ± 99 and 240 ± 104 ng/ml in the patients with lung cancer and controls, respectively, p = 0.78). Plasma homocysteine, vitamin B12 and folate levels did not show significant difference with respect to histologic type of carcinoma. No significant correlation was found between plasma homocysteine, vitamin B12, folate levels and number of cigarettes smoked per day, duration of smoking, age of the patient, and clinical stage of carcinoma. There was also no correlation between number of cigarettes smoked per day, duration of smoking, age of the patient and clinical stage of carcinoma. A possible inverse correlation between plasma homocysteine, vitamin B12 and folate levels was not observed. Conclusion: In conclusion, high plasma homocysteine and low folate levels could be associated with lung cancer. However, further studies performed on large patient population are needed

Can Periosteal Reactions of the Jaws Help Us with the Diagnosis?

Objective: The objective of this study is to investigate If there is any corellation between the periosteal reactions (PRs) radiologic characteristics and prognosis.Material and Methods: 7000 Patient’s CBCT datas were evaluated with regards to PRs and 130 PRs were found. In order to find whether there is a correlation between the PRs reactions’ characteristic and prognosis, the pathological analysis were made. Each lesions’ grade of malignanciess or infection were sorted.Results: As the degree of infection or malignancies get more aggresive PRs tend to show more irregular paterns. If there is a low-grade infectious condition such as early chronic osteomyelitis or secondarily infected cystic lesion the PRs tend to have lamellated or single parallel line paterns. The most aggresive malign tumours PRs tend to show different paterns such as spiculated (as in osteosarcoma) and Codman’s triangle (as in squamous cell carcinoma). Metastatic lesions demonstrated irregular paterns which could not be put in any patern group. This is a thesis study of one of the author’s ,Gürkan Ünsal, and the study is still in progress with adding new patient datas.Conclusion: PRs can help the clinician at diagnosis and prognosis If it can be interpreted with other diagnostic signs

Lipoid Pneumonia for Two Cases

Lipoid pnömoniler pnömoninin nadir bir formudur. Eksojen ve endojen olmak üzere iki tipi vardır. Ekso- jen formu genellikle yağlı maddelerin (hayvansal, bitkisel ya da mineral yağlar) kaza ile aspirasyonu sonucu meydana gelir. Özellikle yaşlı hastalarda yağlı burun damlaları, laksatif amaçlı hint yağı gibi maddelerin kullanılması en sık sebeplerdir. Hidrokar- bonlar ve hidrojen içeren bileşiklerdir. En yaygın örneği olan petrol; parafin, olefin, aromatikler ve asetilen serisinden oluşan bileşimidir. Petrol ürünle- rinde bulunan yüksek viskoziteli hidrokarbonların aspirasyonuna bağlı lipoid pnömoni gelişebilir. Ayrıca hidrokarbon bileşiklerinin kaza sonucu aspirasyonu ateş yiyenlerin pnömonisi gibi akut bir hastalığa ne- den olabilir. Hidrokarbon bileşiklerinin özellikle ev içinde su, meyve suyu veya gazlı içecek şişesi gibi farklı ambalajlarda saklanması çocukların bu madde- yi yanlışlıkla içmesini kolaylaştıran faktörlerdir. Spesi- fik klinik ve radyolojik bulgularının olmaması nedeniy- le güçlü şüphe yoksa ve anamnezde bilgi elde edile- memişse tanıda zorluklara yol açabilir. Daha çok çocukluk çağının ciddi zehirlenmeleri arasında olma- sına rağmen burada erişkin yaşta tanı koyduğumuz iki lipoid pnömoni olgusunu sunuyoruz.Lipoid pneumonia is a rare form of pneumonia. There are two types; exogenous and endogenous. The exogenous form often occurs due to accidental aspiration of fatty substances (such as; animal, vege- table or mineral fats). For elderly patients inparticular, the most common causes are oily nose drops and the use of oily substances for laxatives, such as castor oil. They are compounds containing hydrocarbons and hydrogen. The most common example is the oil found in paraffin, olefins, aromatics and the the acet- ylene series. Aspiration of high viscosity petroleum hydrocarbons may cause lipoid pneumonia. The accidental aspiration of hydrocarbon compounds can also cause acute illnesses such as fire eaters' pneu- monia. In particular, the storing of hydrocarbon compounds in inappropriate packaging in the home, such as water, fruit juice or carbonated beverage bottles, are important factors facilitating the acci- dental drinking of these compounds by children. Since it does not have any specific clinic and radio- logical finding, it may be difficult to diagnose it, un- less there is strong suspicion, or data is derived from anamnesis. Though a more common form of serious poisoning in childhood, in this study we, present two cases of lipoid pneumonia, diagnosed in adults