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We report a case of posterior circulation stroke that presented with a unique ocular vestibular sign called Ocular Lateral Deviation (OLD). OLD is eye deviation to one side that is made more prominent by brief eye closure. OLD has been reported to occur ipsilesional in a third of medullary strokes, and occasionally in other posterior fossa strokes. Here we report a case of acute stroke that presented with contralesional eye deviation consistent with OLD due to inferior vermis stroke. To our knowledge, this presentation has not been reported before. Clinicians should be aware of potential ocular manifestations of posterior circulation strokes, as these syndromes may not generate significant NIHSS scores and may be missed.
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Accidente Cerebrovascular , Vestíbulo del Laberinto , Arterias , Ojo , Humanos , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/etiología , Visión OcularRESUMEN
UV-C exposure is an effective disinfectant for a range of bacteria and viruses. As such, UV-C treatment, in combination with a chemical wipe, is a common cleaning protocol in medical facilities. Given the increase in severe bacterial and viral agents in society, having access to environmentally friendly disinfectant methods is of increasing interest. In response, we designed, constructed, and validated a UV-C disinfection system from readily accessible components. To improve the UV-C intensity, the enclosure interior was coated with chrome paint. The system is validated using Bacillus cereus, a gram-positive endospore-forming bacteria.
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OBJECTIVE: This study was conducted to evaluate the protective effect of dexmedetomidine on nephrotoxicity and the mechanism of renoprotection following vancomycin-induced nephrotoxicity in rats. METHODS: Thirty-two albino Wistar rats were divided into four groups. The control group received intraperitoneal (IP) physiological saline solution, the vancomycin (VMC) group received IP 200 mg/kg vancomycin, the dexmedetomidine (DEX) group received IP 5 µg/kg dexmedetomidine, and the vancomycin and dexmedetomidine (VMC+DEX) group received IP 200 mg/kg vancomycin followed by IP 5 µg/kg dexmedetomidine 20 min after the vancomycin injection. On the 8th day of the experiment, histopathological and biochemical parameters were assessed. RESULTS: Creatinine levels were significantly higher in VMC and VMC+DEX groups. The endothelin-1 level was significantly higher in VMC group. Nitric oxide levels were statistically lower in VMC and VMC+DEX groups. Histopathologic assessments revealed that the extent of renal damage was significantly higher in group VMC (n = 4 with damage of Grade 3) compared to group VMC+DEX (n = 0 with damage of Grade 3). CONCLUSION: It was determined that dexmedetomidine can reduce the extent of renal damage by preventing the elevation of vasoconstrictor agents (Tab. 2, Fig. 1, Ref. 36).
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Lesión Renal Aguda , Agonistas de Receptores Adrenérgicos alfa 2 , Antibacterianos , Dexmedetomidina , Vancomicina , Lesión Renal Aguda/inducido químicamente , Agonistas de Receptores Adrenérgicos alfa 2/farmacología , Animales , Antibacterianos/toxicidad , Dexmedetomidina/farmacología , Ratas , Ratas Wistar , Vancomicina/toxicidad , Vasoconstricción/efectos de los fármacosAsunto(s)
Colangiocarcinoma/diagnóstico por imagen , Colangiocarcinoma/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Hígado/diagnóstico por imagen , Hígado/patología , Linfoma/diagnóstico por imagen , Linfoma/patología , Adulto , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
CONTEXT: In pediatric clinic practice, bulk fill composite is gaining importance for shortened clinical time with a limited shrinkage. AIMS: The present study evaluated the 1 year clinical performance of bulk fill composite and conventional composite material in occlusal caries of primary molars. SETTINGS AND DESIGN: The study was designed as randomized single blind clinical trial and a total of 160 restorations were placed in the cavities of the 80 patients. MATERIALS AND METHODS: Each patient received two restorations: one with Filtek Z250 (3M ESPE, St Paul, MN 55144, USA); the other restored with Filtek Bulk-Fill Restorative (FBF) (3M ESPE, St Paul, MN, USA). All restorations were clinically evaluated after baseline, 6 months, and 1 year in terms of retention, color matching, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form, and postoperative sensitivity. STATISTICAL ANALYSIS USED: Besides the descriptive statistical methods, the Friedman test and the Wilcoxon Signed Ranks were used. RESULTS: Bulk fill was found to be worse compared to control with regard to postoperative sensitivity at baseline without statistical significance (P > 0.05). All of the evaluated restorations were retained and were still in function after 1 year (P > 0.05). With respect to marginal discoloration and marginal integrity, there were no significant differences between bulk fill and composite restorations at all intervals (P > 0.05). CONCLUSIONS: Based on this short term data, restoration of Class I cavities with both bulk fill and conventional composite restorations can be performed successfully. Postoperative sensitivity can be an issue with the restorations completed with Bulk fill restorative.
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Resinas Compuestas/uso terapéutico , Restauración Dental Permanente/métodos , Diente Molar , Niño , Caries Dental , Femenino , Humanos , Masculino , Método Simple Ciego , Diente PrimarioRESUMEN
OBJECTIVE: Standard triple therapy for Helicobacter pylori has a low eradication rate in Turkey. The aim of this study was to evaluate and compare the effectiveness of 7-day and 14-day lansoprazole, amoxicillin, clarithromycin, and bismuth subsalicylate (LACB) treatment regimens as first-line H. pylori eradication therapies. MATERIALS AND METHODS: This study included 70 patients with symptoms of dyspepsia and a positive H. pylori stool antigen test (SAT). Thirty-five patients received the modified quadruple therapy regimen for 7 days (LACB-7) whereas the remaining 35 patients received the treatment for 14 days (LACB-14). Eradication was assessed by SAT 1 month after the end of therapy. RESULTS: A total of 64 patients completed the therapy. The cumulative per-protocol (PP) and intention-to-treat (ITT) eradication rates were 89% (n = 57/64) and 81.4% (n = 57/70), respectively. Both the PP and ITT eradication rates were superior in the LACB-14 group, compared with the LACB-7 group (PP: 90.6% vs. 87.5%; ITT: 81.4% vs. 80%, respectively), but these differences were not statistically significant (P = 0.689). CONCLUSIONS: Both the 7-day and 14-day first-line LACB therapies provided a high cure rate, were well tolerated, and were equally effective against H. pylori infection in Turkey.
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Antibacterianos/administración & dosificación , Antidiarreicos/administración & dosificación , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Inhibidores de la Bomba de Protones/administración & dosificación , Adulto , Amoxicilina/administración & dosificación , Bismuto/administración & dosificación , Claritromicina/administración & dosificación , Esquema de Medicación , Quimioterapia Combinada , Dispepsia/microbiología , Femenino , Infecciones por Helicobacter/complicaciones , Humanos , Lansoprazol/administración & dosificación , Masculino , Persona de Mediana Edad , Compuestos Organometálicos/administración & dosificación , Estudios Prospectivos , Salicilatos/administración & dosificaciónRESUMEN
The Le Fort I osteotomy is widely used to correct dentofacial deformities. Benign paroxysmal positional vertigo (BPPV) is a common vestibular end organ disorder characterized by short, often recurrent episodes of vertigo. Head trauma is one of the known causes of BPPV. During pterygoid osteotomy, the surgical trauma induced by percussion with the surgical mallet and osteotomes can displace otoliths into the semicircular canal, resulting in BPPV. The aim of this study was to evaluate the potential risk of occurrence of BPPV in individuals undergoing Le Fort I osteotomy. Twenty-three patients were included in this study. The Dix-Hallpike manoeuvre, positional tests using electronystagmography, and vestibular evoked myogenic potential (VEMP) tests were performed 1 week before surgery (T0), 1 week after surgery (T1), and 1 month after surgery (T2). The results were compared statistically. BPPV was observed in three patients. Eleven patients had nystagmus at the T1 evaluation and seven at the T2 evaluation. The difference between the T0 and T1 time points was statistically significant (P=0.001). BPPV is a possible complication of Le Fort I osteotomy. Surgeons should be aware of this complication, and the diagnosis of BPPV should be considered in patients who have undergone Le Fort I osteotomy.
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Vértigo Posicional Paroxístico Benigno/diagnóstico , Anomalías Craneofaciales/cirugía , Osteotomía Le Fort , Complicaciones Posoperatorias/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Resultado del Tratamiento , TurquíaRESUMEN
We here report two successful pregnancies obtained by converting an in vitro fertilization (IVF) cycle to an intrauterine insemination (IUI) cycle in five poor responder patients whose oocyte pick-up (OPU) procedures were canceled due to documented premature ovulation immediately before OPU. To our knowledge, this is the first article that demonstrates that switching an IVF cycle to an IUI cycle when premature ovulation occurs on the day of OPU can produce successful pregnancies, even in poor responder patients.
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Despite the proved safety and efficacy of Woven EndoBridge (WEB) flow disruption in conventional intracranial saccular aneurysms, the literature on its use in partially thrombosed intracranial aneurysms is scarce. We report a series of 4 patients in whom partially thrombosed intracranial aneurysms were treated with the WEB. The 2 patients who received additional intraluminal treatment with conventional stents made a good clinical recovery. Meanwhile, those patients who were treated with the WEB alone had fatal rupture of the aneurysm at short- to medium-term follow-up. This small, select case series demonstrates that WEB placement with adjunctive stent placement may be an effective treatment in the management of partially thrombosed intracranial aneurysms, which merits further validation. However, exclusive intrasaccular flow disruption may have an adverse influence on the natural history of this disease.
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Procedimientos Endovasculares/instrumentación , Aneurisma Intracraneal/patología , Aneurisma Intracraneal/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Stents/efectos adversos , Trombosis/etiología , Trombosis/cirugía , Resultado del TratamientoRESUMEN
Neonatal hemochromatosis (NH) is a form of neonatal liver failure caused by maternal-fetal alloimmune injury to hepatocytes. The etiology of neonatal hemochromatosis is not exactly understood. However, according to one theory neonatal hemochromatosis is believed to be an alloimmune disorder causing liver injury in the fetus. In order to diagnose neonatal hemochromatosis there are some criteria that should be taken into account, such as positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderosis demonstrated by histology or with magnetic resonance.We present a case of a monochorionic newborn twin who applied to our hospital with sepsis clinical symptoms like clinics, was diagnosed with NH and immediately treated with antioxidant therapy while the other twin with same clinical symptoms did not respond to therapy and passed away. NH should be considered in the differential diagnosis of cases with sepsis-like clinical symptoms that do not respond to antibiotics; early antioxidant therapy in these cases is lifesaving.
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Hemocromatosis/diagnóstico , Hemocromatosis/tratamiento farmacológico , Sepsis/diagnóstico , Gemelos , Antioxidantes/uso terapéutico , Quelantes/uso terapéutico , Diagnóstico Tardío , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Recién NacidoRESUMEN
Epidermolysis bullosa with pyloric atresia (EB-PA) is a rare autosomal recessive disease that is characterized by fragility of the skin and mucous membranes. The course of EB-PA is usually severe and often lethal in the neonatal period. In most cases, prenatal diagnosis of this syndrome is considered in pregnancies at risk for recurrence. EB-PA can be described during pregnancy with sonographic signs such as polyhydramnios with a dilated stomach, the "snowflake sign", which are echogenic particles in the amniotic fluid, and several other anomalies. In this report, we present three cases of EB-PA suggested by the results of prenatal sonography, and describe a new ultrasonographic sign, i.e., complete chorioamniotic membrane separation, which can be helpful for the diagnosis. The prenatal diagnoses were confirmed postnatally. Two of the three cases had no family history, and one of these two cases was the product of a non-consanguineous couple.
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Displasia Ectodérmica/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Ultrasonografía Prenatal , Adulto , Diagnóstico Diferencial , Displasia Ectodérmica/patología , Displasia Ectodérmica/cirugía , Resultado Fatal , Femenino , Enfermedades Fetales/patología , Humanos , Embarazo , Adulto JovenRESUMEN
Liver tumors seldom occur in the perinatal period. Hepatic hemangiomas are the most common tumors of the liver diagnosed during fetal and neonatal life. The diagnosis can be suspected antenatally by ultrasound and MR scan. The differential diagnosis is often challenging. While small hepatic hemangiomas are usually asymptomatic, large tumors can lead to complications such as high-output congestive heart failure, consumptive thrombocytopenic coagulopathy and hemorrhage after tumor rupture. We describe a case of hepatic hemangioma presenting as a solid abdominal mass with several cystic areas on an obstetric ultrasound and report on the contribition fetal MR imaging to the diagnosis.
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Hemangioma Cavernoso/diagnóstico , Neoplasias Hepáticas/diagnóstico , Diagnóstico Prenatal/métodos , Adulto , Femenino , Muerte Fetal/etiología , Hemangioma Cavernoso/congénito , Hemangioma Cavernoso/diagnóstico por imagen , Humanos , Hidropesía Fetal/etiología , Neoplasias Hepáticas/congénito , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Embarazo , Ultrasonografía PrenatalRESUMEN
AIM: This study was to investigate whether the use of hormonotherapy after concurrent radiotherapy (RT) and trastuzumab (T) has a contribution to the development of radiation fibrosis in the lungs. MATERIALS AND METHODS: Seventy Wistar Albino rats were divided into seven groups as follows: Group C: control, Group RT: RT only; Group T: trastuzumab only; Group RT+T+Tam: tamoxifen following concurrent RT and trastuzumab; Group RT+T+Le: letrozole following concurrent RT and trastuzumab; Group RT+T+An: anastrazole following concurrent RT and trastuzumab; Group RT+T+Exe: exemestane following concurrent RT and trastuzumab. Trastuzumab was prepared at an equivalent dose of 6 mg/kg. RT was administered 2 hours after T to the thoracic region at a dose of 12 Gy. Hormonotherapy was initiated one week after RT and administered by oral gavage once daily for 6 months. At the end of 24 weeks, the rats were sacrificed after being sedated with anesthesia. Both lungs were removed en bloc and blocked in paraffin. The level of fibrosis in each cross-section was assessed with the help of a scale. RESULTS: Significant differences were observed between the groups in terms of pulmonary fibrosis scoring. Statistically significant differences were observed when the radiotherapy group was compared to the C, T, T+RT+An, T+RT+Le and T+RT+Exe groups (p<0.05). Significant differences were found between the T+RT+Tam group and the C, T, T+RT+An, T+RT+Le and T+RT+Exe groups (p<0.05). CONCLUSIONS: This study showed that the sequential administration of aromatase inhibitors following concurrent thoracic irradiation and T decreases radiation-induced pulmonary fibrosis. However, tamoxifen was found to have an opposite effect.
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The aim of this study was to evaluate changes to the Eustachian tube and middle ear function and hearing level in individuals undergoing Le Fort I osteotomy. 20 consecutive patients underwent Le Fort I maxillary osteotomy with advancement, impaction or a combination of both. All individuals underwent hearing sensitivity tests, including pure tone audiometry and acoustic impedance measurements (middle ear pressure and compliance), which were carried out by an audiologist 1 week before surgery (t(0)), and then again 1 week (t(1)) and 4 weeks (t(2)) after surgery. Regarding pure tone audiometry, the differences between t(0) and t(2) at a frequency of 125Hz (P=.002), between t(0) and t(1) and between t(0) and t(2) at a frequency of 250Hz, and between t(0) and t(1) at a frequency of 1000Hz (P=.006) were statistically significant. There was no statistically significant difference at any other frequency. Regarding middle ear pressure, no statistically significant difference was observed between t(0) and t(1), and t(0) and t(2). Following Le Fort I osteotomy, mild changes in hearing sensitivity and middle ear pressure are possible, but these changes were clinically insignificant.
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Audición/fisiología , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/métodos , Pruebas de Impedancia Acústica , Adolescente , Adulto , Audiometría de Tonos Puros , Mentón/cirugía , Adaptabilidad , Oído Medio/fisiología , Trompa Auditiva/fisiología , Femenino , Estudios de Seguimiento , Pruebas Auditivas , Humanos , Masculino , Osteotomía Sagital de Rama Mandibular/métodos , Presión , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: Evaluation of the laryngeal cartilages is essential for the treatment strategy of patients with laryngeal carcinoma. Our aim was to assess the accuracy of preoperative clinical examinations and CT for preoperative evaluation. MATERIALS AND METHODS: A prospective comparative study was performed at a university department on 30 patients with advanced laryngeal carcinomas. All patients were men and underwent total laryngectomy. The preoperative mobility of vocal folds was evaluated and classified as mobile, impaired, or fixed. CT was performed by using multidetector row CT. Cricoarytenoid units (CAUs) from the laryngectomy specimens were cut into sections. Histologic findings were compared with the clinical and radiologic findings. RESULTS: The accuracy of combined clinical and CT staging in CAUs with normal mobility, impaired mobility, and absent mobility and negative CT findings was 96.5%, 50%, and 80%, respectively. These scores were 40%, 54.5%, and 83.3% for CAUs with normal mobility, impaired mobility, and absent mobility and positive CT findings, respectively. CONCLUSIONS: Arytenoid mobility and >1 cartilage abnormality on CT were found to be reliable indicators of neoplastic cartilage invasion in patients with laryngeal carcinoma.
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Carcinoma de Células Escamosas/diagnóstico por imagen , Neoplasias Laríngeas/diagnóstico por imagen , Neoplasias de los Músculos/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Pliegues Vocales/diagnóstico por imagen , Biopsia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Reacciones Falso Positivas , Humanos , Músculos Laríngeos/diagnóstico por imagen , Músculos Laríngeos/patología , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringectomía , Masculino , Persona de Mediana Edad , Neoplasias de los Músculos/patología , Neoplasias de los Músculos/cirugía , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Estudios Prospectivos , Estándares de Referencia , Reproducibilidad de los Resultados , Tomografía Computarizada por Rayos X/normas , Pliegues Vocales/patologíaRESUMEN
Desmoplastic fibroma is a primary bone tumour which occurs exceedingly rarely in the cranial bones. We report a histopathologically confirmed example in a 21 year old man with a painless swelling over the sagittal suture. In the light of our experience and reports of previous examples, we review the features of the condition and its management.
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Fibroma Desmoplásico/diagnóstico por imagen , Fibroma Desmoplásico/patología , Neoplasias Craneales/diagnóstico por imagen , Neoplasias Craneales/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/metabolismo , Niño , Preescolar , Suturas Craneales/diagnóstico por imagen , Suturas Craneales/patología , Suturas Craneales/cirugía , Femenino , Fibroma Desmoplásico/cirugía , Humanos , Lactante , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/diagnóstico por imagen , Invasividad Neoplásica/patología , Invasividad Neoplásica/fisiopatología , Procedimientos Neuroquirúrgicos , Hueso Parietal/diagnóstico por imagen , Hueso Parietal/patología , Hueso Parietal/cirugía , Neoplasias Craneales/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare tumor type distinct from classical Hodgkin lymphoma and its familial form is unusual. The two cases (mother at age 48 and son at age 30 years) of NLPHL in advanced clinical stage are described. The patients were successfully treated with an immunochemotherapy schedule consisting CHOP plus rituximab (CHOP-R). This chemotherapy was well tolerated and the patients reached complete remission. These remissions were for 34 and 40 months for mother and son, respectively. In patients with NLPHL, CHOP-R regimen should be used as an alternative treatment regimen to obtain a good long-lasting response without any adverse events.
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Anticuerpos Monoclonales/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/patología , Linfocitos/patología , Adulto , Anticuerpos Monoclonales de Origen Murino , Ciclofosfamida/uso terapéutico , Doxorrubicina/uso terapéutico , Salud de la Familia , Femenino , Humanos , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Prednisolona/uso terapéutico , Inducción de Remisión/métodos , Rituximab , Vincristina/uso terapéuticoRESUMEN
Mullerian duct remnants presenting in childhood are often diagnosed incidentally and when symptomatic, typically present with recurrent infection and/or voiding disturbances. We present a rare unusual case of a male neonate who presented with a prenatally detected large pelvic cyst that turned out to be a giant prostatic utriculus.