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Biotransformation enzymes are stimulated or inhibited depending on the exposure to xenobiotics and widely used as a biomarker. In this study, EROD activity, GST activity, reduced GSH amount, amount of lipid peroxidation product MDA as oxidative stress parameter, and ACHE inhibition as a neuromuscular parameter were measured in liver and muscle tissues of rainbow trout (Oncorhynchus mykiss) produced in aquaculture of Kemer Dam and in concrete ponds located in Fethiye. Samples were collected in January and July from fish farming in net cages in Kemer Dam and concrete cages in Fethiye in order to evaluate seasonal changes. Also, physicochemical properties of water samples collected from trout farms were measured and evaluated together with five biomarkers. Significant ACHE inhibition was observed in both stations in parallel with the increase in ammonium nitrogen in the July period (p ≤ 0.05). In parallel with the increase in turbidity in the Kemer Dam, a significant increase in GSH, MDA level, and GST activity was detected (p ≤ 0.05). As a result of the assessment of all data, significant increases were detected in EROD induction, GST activity, MDA level, and ACHE inhibition in concrete cages in Fethiye when compared to Kemer Dam (p ≤ 0,05). It was observed that pollution was at a lower level in July compared to January, and in Kemer Dam compared to Fethiye.

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Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago. There is no consensus in the treatment of periprosthetic salmonella infections. We prefer two-step revision surgery for these infections as previously described in the literature.

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PURPOSE: Four patients with intraorbital foreign bodies admitting to our clinic between 2001 and 2011 are presented. Their clinical and radiologic findings and surgical strategies are discussed. OBJECTIVE: The success of surgery for the intraorbital foreign bodies largely depends on the determination of the exact localization of them. Radiologic examination should follow clinical diagnosis. Computed tomographic views are especially required to demonstrate the foreign body. MATERIALS AND METHODS: Four patients with different etiologies of trauma are presented. Each had computed tomography views for foreign body localization. All but 1 had surgery for removal of the object under general anesthesia. RESULTS: No complications were observed postoperatively. Only 1 patient is followed up without an operation due to the risk of damaging delicate structures that the foreign body is close to. He has no loss of function. CONCLUSION: Early removal of foreign bodies in orbital region is usually preferred due to the risk of neurologic damage and other complications. Surgical removal is quite challenging for foreign bodies like wood. Magnets can be used for metallic bodies.

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BACKGROUND: Isolated rectus muscle ruptures are rare ophthalmic emergencies which may result in permanent diplopia. OBJECTIVE: To highlight updates on clinical features, surgical treatment options and potential complications for isolated inferior rectus ruptures. CASE: A 39-year-old man came to our emergency department complaining of diplopia and upward deviation of the right eye after experiencing an animal injury. Extraocular movements were limited in the right eye in the downgaze position. The alternate prism and cover test, both at distance and near testing, showed hypertropia of 40 prism diopters (PD) of the right eye. The right eye had periorbital swelling and conjunctival haematoma. An inferior rectus rupture repair was performed under local anesthesia and monitored sedation. Follow-up examination revealed a 20 PD hypertropia, causing diplopia in all gazes. A second surgical intervention was planned six months after the initial surgery, an inferior rectus 6 mm resection was performed, after which orthophoria was achieved in the primary position both at distance and near testing.

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OBJECTIVES: To investigate the correlation of visual field (VF), pattern electroretinography (PERG) and Fourier domain optical coherence tomography (FD-OCT) results in patients with ocular hypertension (OHT) and early primary open-angle glaucoma (POAG). MATERIALS AND METHODS: The study included 72 eyes of 37 patients with early POAG, 76 eyes of 38 patients with OHT, and 60 eyes of 30 controls. All subjects underwent full ophthalmologic examination, VF assessment with 24-2 Humphrey standard automated perimetry (Swedish Interactive Thresholding Algorithm (SITA)-Standard), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness measurement with FD-OCT, and PERG P50 and N95 wave latency and amplitude measurements with electroretinography (Nihon Kohden). RESULTS: With the exception of the nasal quadrant, all GCC parameters and RNFL results were significantly lower in the POAG group compared to the OHT and control groups. There was no statistically significant difference between the OHT and control group. PERG amplitudes were lower in the POAG and OHT groups than in the control group. Reduction in N95 amplitude was greater than that of P50 amplitude. No difference was detected in PERG latencies among groups. GCC was significantly correlated with VF and RNFL in the POAG group. CONCLUSION: Significant thinning of the GCC and RNFL occurs in addition to VF pathologies in patients with early POAG, and these examinations should be concomitantly evaluated. During diagnostic assessment of patients with early POAG, GCC and RNFL analysis by FD-OCT are highly effective. GCC is as reliable as RNLF in the early diagnosis of glaucoma and there is a highly significant correlation between them. Dysfunction of ganglion cells in patients with OHT may be detected earlier using PERG amplitude analysis.

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PURPOSE/AIM: To evaluate the use of 2-0 polypropylene suture for frontal suspension in ptosis patients with poor levator function. MATERIALS AND METHODS: This retrospective study included 20 eyelids of 16 patients (5 female, 11 male) with 4 mm or less levator function. The operation was considered successful when the difference between the two upper lids was ≤ 1 mm, and the upper lid covered the upper limbus by <3 mm. RESULTS: Median patient age was 22.94 years (2 to 59). Mean follow-up time was 18.06 months (12-29). A successful result was obtained in 14 patients (87.5%). Ptosis recurrence was observed in two patients (12.5%). Lagophthalmos with punctate epithelial keratitis and subsequent spontaneous recovery occurred during the first postoperative week in six patients (37.5%). Two patients with hypocorrection underwent revision surgery in the first postoperative week. Granuloma and material exposition at the forehead incision site observed in one patient at the postoperative fifth month were repaired by excision of the granuloma and suture reposition. CONCLUSIONS: Polypropylene suture as a frontalis suspension material in ptosis patients with poor levator function maintained satisfactory results at follow-up. This material allows easy and repeatable eyelid height adjustment and does not obviate future eyelid procedures.

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BACKGROUND: The aim of this study was to compare the effect of W-shaped skin (WS) and linear skin (LS) incisions on cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy. METHODS: Sixteen patients (14 females and two males) with acquired bilateral nasolacrimal duct obstruction were included in this prospective, interventional comparative study. LS incision was applied to one side and WS skin incision to the other side. The skin incisions were assessed 6 months after each procedure by the patients themselves and by two ophthalmologists who were unaware of the skin incision shape and side. Scar tissue that was not recognized under the same light conditions and in the same room from a 100 cm distance was recorded as grade 1. Minimally visible scar tissue was assessed as grade 2, moderately visible scar tissue as grade 3, and easily visible scar tissue as grade 4. RESULTS: The mean scar assessment scores recorded by the first ophthalmologist were 2.50±0.82 for the LS group and 1.25±0.45 for the WS group (P<0.001). The second ophthalmologist's assessment scores were 2.25±0.86 for the LS group and 1.25±0.45 for the WS group (P<0.001). The mean patient self-assessment score for the incision scars was 2.44±1.03 for the LS group and 1.56±0.73 for the WS group (P<0.001). CONCLUSION: Compared with LS incision, WS incision resulted in less cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy.

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BACKGROUND: The aim of this study was to evaluate the clinical and epidemiological features of 132 patients with orbital wall fracture who were treated at Sisli Etfal Teaching and Research Hospital, Istanbul, between 2005-2012. METHODS: The medical records of the patients with a diagnosis of orbital fracture were reviewed and analyzed. The patients were evaluated by age, gender, etiology, symptoms, examination findings, fracture location, associated injuries, treatment, and complications. RESULTS: The mean follow-up time was 9 (6-16) months. The male-to-female ratio was 5.3-1. The average age was 32 (6-82) years. The leading causes of orbital fractures were traffic accidents (36%) followed by assaults (32%). The most frequently affected orbital wall was the medial wall (33%). The main symptom was throbbing pain in the traumatized area (100%), and the main examination finding was periorbital edema and ecchymosis (100%). The most frequent associated injury was cerebral trauma (14%). Sixty-seven patients (50.1%) were managed with medical treatment, and 65 patients (49.9%) underwent surgical treatment. The most common complication in the late period was dermatomal sensory loss (11%). CONCLUSION: This study makes clear that the frequency of orbital injuries may be decreased by preventing traffic accidents, by taking precautions in the event they occur, and by promulgating social and educational work against violence.

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OBJECTIVE: To determine the effect of "W incision" instead of classical vertical incision at external DCR on scar formation. MATERIALS AND METHODS: Patients with acquired nasolacrimal duct obstruction (NLDO) who were treated with external DCR with classical vertical incision, and patients who were treated with external DCR with "W incision" were included in the study. The first 39 eyes were operated with a vertical incision, and the remaining 37 eyes were operated with a "W incision". All the skin incision scars of the patients were assessed and scored by at least the 6th month. The assessment was made by both the patients themselves, and by an ophthalmologist other than the surgeon himself, each scored the incision scar separately (single-masked study). Scores for both groups were compared, and statistical analyses were performed. RESULTS: Self-assessment scores for the incision scar were Grade 2.28 ± 0.94 in the Vertical incision group, and Grade 1.68 ± 0.57 in the "W incision" group (p < 0.01). The "W incision" scar formation was significantly less noticable than the Vertical incision scar formation. Similarly, the assessment scores of the ophthalmologist other than the surgeon himself were significantly lower for the "W incision" group than for the Vertical incision group. The mean scar assessment scores were Grade 2.13 ± 0.95 in the Vertical incision group, and Grade 1.57 ± 0.68 in the "W incision" group (p < 0.01). CONCLUSION: Skin scar tissue was found to be significantly reduced with a "W incision" in external DCR operations.

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Cadmium pollution resulted from fertilizer applications were studied by determining cadmium levels in agricultural and non-agricultural soils of Bafra and Carsamba plains. Soil samples of 68 were collected from agricultural (34) and non-agricultural (34) areas. The sample of 2 g was placed in a test tube and digested with hydrochloric acid and nitric acid mixture (3:1, v/v) in an aluminum block. Taking up the evaporated residue was dissolved in 1% nitric acid and total cadmium concentrations were determined with GF-AAS. Mean level of cadmium contents were found in agricultural areas 0.162 +/- 0.078 for Carsamba and 0.433 +/- 0.288 mg kg(-1) for Bafra. The accuracy of the method was tested with determining cadmium contents of standard reference material and cadmium spiked soil samples.

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