Extreme Calvarial and Upper Cervical Hyperpneumatization: A Case Report

The pneumatization of bones of cranial base other than the mastoid process and temporal bone is a pathologic and rare condition, and it may cause some serious complications. Extension of the pneumatization to the cranial vault and upper cervical bones is extremely rare. A 67 year-old man was admitted with complaint of chronic nonspecific headache for a long time. He had no history of head trauma or otologic infection. Physical examination not revealed fever, any palpable swelling, rhinorrhea or otorrhea. There was only a slight right sensorineural hearing loss. Brain computerized tomography (CT) revealed hyperpneumatization in the right mastoid process and right temporal bone, bilateral occipital, parietal and frontal bones, and right side of the atlas. There was no pneumocephalus, but there was free air under the scalp of the right suboccipital region and around the right condyle, right transverse process of the atlas and right paravertebral region of the upper cervical vertebrae. Extrathecal cerebrospinal fluid (CSF) leakage was not detected by CT cisternography with intrathecal contrast administration and by the radionuclide cisternogram

Role of autophagy in midgut stem cells of silkworm Bombyx mori, during larval-pupal metamorphosis

Autophagy is a critical mechanism for the self-renewal, proliferation, and differentiation of stem cells. Bombyx mori midgut has stem cells that play a role in the regeneration of the larval epithelium in larval stages and the formation of the pupal midgut epithelium during larval-pupal metamorphosis. In this study, the role of the autophagy mechanism in midgut stem cells during the formation of the pupal midgut was investigated. For this purpose, two different doses of autophagy inhibitor chloroquine were administered to B. mori larvae on days 7 and 8 of the fifth larval stage. Morphological changes during the formation process of the pupal epithelium, expression levels of autophagy-related genes Atg8 and Atg12 in stem cells, and the amounts of lysosomal enzyme acid phosphatase were determined after the application. The obtained findings were evaluated in comparison with the control groups. Abnormalities in the formation of the pupal midgut after inhibition of autophagy showed the significance of the autophagy mechanism during this period.Ege University Scientific Research Projects Coordination Unit, Grant/Award Numbers: 18-FEN-027, ID 506Ege University Scientific Research Projects Coordination Unit [18-FEN-027, 506

VFR travel interactions through the lens of the host

Visiting friends and relatives (VFR) travel is a substantial segment of tourism globally. In many countries, VFR travel represents a large proportion of visitor movement. The size of the segment is often underestimated because official data only reveal VFR by purpose of visit or VFR by accommodation, contributing to the underestimation of the size of VFR travel. Similarly, there is a lack of research that considers the role of the VFR host in VFR travel which results in a lack of understanding. Clearly, the role of the host is critical in VFR travel and it is what centrally defines VFR. This study contributes to the research in VFR travel through providing research related to hosting VFRs. Of note, this study was undertaken in Turkey, which makes a significant contribution to scholarship given the lack of research that has been undertaken outside of Australia, New Zealand, Canada, the United Kingdom and the United States, which are the areas in which VFR travel research has dominated. This study determined the profiles and characteristics of 423 VFR travellers to Nevsehir, Turkey, and their hosts. Accordingly, this study provides a significant contribution to the scholarship of tourism by providing rich data on an area of tourism (hosting VFRs) that had to date, been overlooked. © The Author(s) 2020

Pancreatic Metastasis of High-Grade Papillary Serous Ovarian Carcinoma Mimicking Primary Pancreas Cancer: A Case Report

Introduction. Reports of epithelial ovarian carcinomas metastatic to the pancreas are very rare. We herein present a metastasis of high grade papillary serous ovarian cancer to mid portion of pancreas. Case. A 42-year-old patient was admitted with a non-specified malignant cystic lesion in midportion of pancreas. She had a history of surgical treatment for papillary serous ovarian adenocarcinoma. A cystic lesion was revealed by an abdominal computerized tomography (CT) performed in her follow up . It was considered as primary mid portion of pancreatic cancer and a distal pancreatectomy was performed. The final pathology showed high-grade papillary serous adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. Discussion. Metastatic pancreatic cancers should be considered in patients who present with a solitary pancreatic mass and had a previous non-pancreatic malignancy. Differential diagnosis of primary pancreatic neoplasm from metastatic malignancy may be very difficult. A biopsy for tissue confirmation is required to differentiate primary and secondary pancreatic tumors. Although, the value of surgical resection is poorly documented, resection may be considered in selected patients. Conclusion. Pancreatic metastasis of ovarian papillary serous adenocarcinoma has to be kept in mind when a patient with pancreatic mass has a history of ovarian malignancy

An Unusual Presentation of Charcot Arthropathy Caused by Syringomyelia Mimicking a Soft Tissue Tumor

Charcot arthropathy is a chronic, degenerative condition and is associated with decreased sensorial innervation. Numerous causes of this arthropathy have been described. Here we report a case of neuropathic arthropathy secondary to syringomyelia which was misdiagnosed as a soft tissue tumor and treated surgically and additionally with radiotherapy at another institution. The patient had clinical and radiological signs of syringomyelia, associated with a limited range of motion, swelling, and pain in the affected joint. Neuropathic arthropathy, although less common, should be considered in cases of unexplained joint swelling, pain, and limited range of motion of the affected joint

A rarely seen multilevel thoracic vertebral fracture after a nocturnal hypoglycemic convulsion attack.

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack

Case Report A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulininduced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack

Effectiveness of computed tomography-guided nasotracheal intubation procedure on predicting tube advancement difficulty and preventing epistaxis: a prospective case-control study

Objective: To evaluate the effectiveness of computed tomography-guided nasotracheal intubation procedure in predicting tube advancement difficulty and preventing epistaxis. Methods: The prospective study was conducted at Erciyes University Faculty of Dentistry from April 2018 to June 2019 and comprised maxillofacial surgery patients of either gender aged 18-50 years who were due to undergo bimaxillary orthognathic surgery, which was defined as American Society of Anaesthesiology grade I or II. The space where the tube was to be passed in the internal nasal valve region was measured horizontally and vertically using computed tomography. A single experienced anaesthesiologists intubated all the patients who were later divided into 'easy' group A and 'difficult' group B on the basis of the effort required to advance the tube through the nasal passage. Data was analysed using JASP version 0.14.1.0). Results: Of the 60 patients, 42(70%) were females and 18(30%) were males. The overall mean age was 29.0±10.5 years and the mean body mass index value was 23.6±4.0kg/m2 (p>0.05). There were 28(46.6%) patients in group A, and 32(53.3%) in group B. Median distances were significantly shorter and epistaxis was significantly higher in group B compared to group A (p<0.001).  The cut-off values to reveal the distance at which difficulty may be experienced while advancing the tube, determined through receiver operating characteristic analysis, were 1.09cm for vertical and 0.39cm for horizontal distances. Conclusion: The nasotracheal intubation procedure under the guidance of computed tomography could help predict the difficulty of tube advancement, and could thus prevent epistaxis and other related nasal intubation complications. Clinical trial number: NCT05525754. Key Words: Tomography, X-Ray Computed, Epistaxis, Orthognathic surgical procedures, Intubation

The Diagnostic Value of Semmes-Weinstein Monofilaman Test in Diagnosis of Carpal Tunnel Syndrome

The aim of the current study was to investigate the sensitivity and spesificity of Semmes-Weinstein monofilament test in diagnosis of carpal tunnel syndrome. Totally fifty patients and their eighty five hands were included in this study. Carpal tunnel syndrome was diagnosed as electroneuromyographic study in fifty five hands of thirty patients and it wasn't diagnosed at thirty hands of eighteen patients. The patients were evaluated by two different protocols of Semmes-Weinstein monofilament test that are used in diagnosis of carpal tunnel syndrome. At the end of the study, we found that sensitivity of Semmes-Weinstein monofilament test was %85,5 and spesificity was %10 according to first protocol, it's sensitivity was %43,6 and spesificity was %90 according to second protocol. In conclusion, we think that Semmes-Weinstein monofilament test is insufficient alone in diagnosis of carpal tunnel syndrome