Evaluation of Intestinal Microbiota in Children With Sickle Cell Disease.

BACKGROUND AND AIMS: Sickle cell disease (SCD) is a chronic hemolytic anemia that may be life-threatening due to multisystemic effects. Identification of the factors which affect the pathophysiology of the disease is important in reducing mortality and morbidity. This study aimed to determine gut microbial diversity in children and adolescents with SCA compared with healthy volunteers and to evaluate the clinical impact of microbiota. MATERIALS AND METHODS: The study included 34 children and young adolescents with SCD and 41 healthy volunteer participants. The microbiome was assessed by 16S rRNA sequencing in stool samples. Laboratory parameters of all participants, such as complete blood count and C-reactive protein values and clinical characteristics of SCD patients, were determined and compared, as well as clinical conditions of the patients, such as vascular occlusive crisis and/or acute chest syndrome, frequency of transfusions, intake of penicillin, hydroxyurea, and chelation therapy were recorded. RESULTS: White blood cell count, hemoglobin, immature granulocyte and C-reactive protein levels were significantly higher in the patient group ( P <0.05). Microbiota analysis revealed 3 different clusters among subjects; controls and 2 clusters in the SCD patients (patient G1 and G2 groups). Bacteroides spp. were more prevalent, while Dialester spp. and Prevotella spp. were less prevalent in SCD compared with controls ( t =2.142, P <0.05). Patient G2 (n=9) had a higher prevalence of Bacteroides and a lower prevalence of Prevotella than patient G1 (n=25). CONCLUSION: In our study, there was a difference between SCD patients and the control group, while 2 different microbiota profiles were encountered in SCD patients. This difference between the microbiota of the patients was not found to affect the clinical picture (such as vascular occlusive crisis, acute chest syndrome).

Axillary Lymph Nodes in Breast Cancer Patients After COVID-19 Vaccine.

One of the side effects of vaccines used to end the COVID-19 epidemic is non-specifically enlarged axillary lymph nodes. Such lymphadenopathy detected during clinical examination of breast cancer patients may require additional imaging or interventional procedures that should not normally be performed. This study has been designed to estimate the incidence of palpable enlarged axillary lymph node in breast cancer patients who had received COVID-19 vaccination in the past 3 months in the same arm as compared to those without vaccination. Breast cancer patients admitted to M.U. Medical Faculty Breast polyclinic between January 2021 and March 2022 were screened, and clinical staging was performed after thorough clinical examination. Among these patients with suspected enlarged axillary lymph node and those undergoing sentinel lymph node biopsy (SLNB), they were divided into two groups as vaccinated and unvaccinated. Age, menopausal status, tumor size, tumor location, surgery, pathology results, hormonal receptor status, and SLNB results were statistically compared with groups. There was no significant difference between groups in terms of age, menopause, tumor size, tumor location, surgery, pathological results, and hormone receptor status. The SLNB being reported as reactive only was 89.1% in the vaccinated group and 73.2% in the non-vaccinated group which was statistically significant different. Reactive lymph nodes were commonly found with an excess of 16% in patients who had received COVID-19 vaccination in the past 3 months. This required caution and additional examination of the axillary lymph nodes in this period.

Impact of injectable chitosan cryogel microspherescaffolds on differentiation and proliferation of adiposederived mesenchymal stem cells into fat cells.

Difficulty in the clinical practice of stem cell therapy is often experienced in achieving desired target tissue cell differentiation and migration of stem cells to other tissue compartments where they are destroyed or die. This study was performed to evaluate if mesenchymal stem cells (MSCs) may differentiate into desired cell types when injected after combined with an injectable cryogel scaffold and to investigate if this scaffold may help in preventing cells from passing into different tissue compartments. MSCs were obtained from fat tissue of the rabbits as autografts and nuclei and cytoplasms of these cells were labeled with BrdU and PKH26. In Group 1, only-scaffold; in Group 2, only-MSCs; and in Group 3, combined stem cell/scaffold were injected to the right malar area of the rabbits. At postoperative 3 weeks, volumes of the injected areas were calculated by computer-tomography scans and histopathological evaluation was performed. The increase in the volume of the right malar areas was more in Group 3. In histopathological evaluation, chitosan cryogel microspheres were observed microscopically within the tissue and the scaffold was only partially degraded. Normal tissue form was seen in Group 2. Cells differentiated morphologically into fat cells were detected in Groups 2 and 3. Injectable chitosan cryogel microspheres were used in vivo for the first time in this study. As it was demonstrated to be useful in carrying MSCs to the reconstructed area, help cell differentiation to desired cells and prevent migration to other tissue compartments, it may be used for reconstructive purposes in the future.

The Predictability Precision of Superior Semicircular Canal Through Radiological Assessment and Microanatomical Dissection.

OBJECTIVE: There is still ongoing research on the relationship of arcuate eminence (AE) and superior semicircular canal (SSC). We aimed to evaluate the precision of predictability of SSC through the morphology of AE via radiological means. MATERIALS AND METHODS: This investigation is performed on 12 dry skulls belonging to Mersin University Medical Faculty department of anatomy. Computed tomography (CT) assessment is performed with 0.5-mm-thin sections temporal bone algorithm on dry skulls which were marked with fixated copper wire by scotch tapes on the most prominent part of the middle fossa floor assuming the location of AE. The data are reformatted on the workstation with vitrea 2.0. The distances of the determined three points including lateral (A), apical (B), and medial (C) of the SSC and the copper wire are measured radiologically. Also, the height between the most apical part of the SSC to the floor of the skullbase (H) is measured. The angles between the placed copper wires and the SSC (E) are calculated. The angle between SSC and the midpoint of the IAC (F) and SSC to the sulcus of the greater GSPN (G) were measured. The nearest distance was measured between the most posterior part of the SSC and the point marked by the perpendicular line drawn from the medial border of the petrous bone to the most posterior part of the internal auditory canal (IAC) (D). RESULTS: The right and left A, B, and C distances are 2.54+/- 2.75, 3.67+/-3.16, 5.85+/-3.77; 2.92+/-2.24, 3.68+/-2.93, 6.09+/-3.40, respectively. We could not find any statistical significance when the right A, B, and C distances were compared with the left values. Examination of the values revealed that C distance is greater than the A distance of the same side both for right (p=0.040) and left (p=0.022) measurements. The calculated left and right E angles are 30.313+/-12.838, and 35.558+/-18.437 degrees, respectively. Statistical significance was not found between the right and left angles. The right and left F, G angles were 53.17, 47.25; 93.58, 100.92 degrees; and D distances are 8.01, 8.13 millimeters, respectively. Statistical significance was not found when right and left E, F, G angles and D distances were compared. Among 12 left and 12 right sides, the copper wire was found to be nearly overlapping to SSC in two in the right and only one in the left. CONCLUSION: This study reveals that there is a great variability predicting the exact location of SSC through the prominence of AE. Complementary studies are needed with greater number of dry skulls and cadavers. Comparison of different hypothesis including the effect of temporal lobe sulcus is to be discussed to better enlighten the exact relationship of the aforementioned anatomical structures.

The Measurement of Various Anatomical Structures and Assessment of Morphometric Development of Fetal Skull Base.

BACKGROUND: As the skull base has a complex anatomy, we underline the importance of anomalies for side asymmetry. It is useful to investigate relationship between anatomical structures for the surgical procedure orientations. Dural adherence, enlarged superior petrosal sinus, influence of neural crest cells, and cranial base ossification are among the factors in morphometric growth on skull base. MATERIAL AND METHODS: Twenty-five fetuses of an estimated gestational age ranging from 17 to 34 weeks were studied in the Anatomy Laboratory of Mersin University Medical Faculty. Craniotomy was made to each fetus and brain hemispheres were dissected. We put plates, passing from the external points of lateral and anterior-posterior borders of fetus heads that are perpendicular to each other. An analytical calculation was formulated for the angle of foraminae to the root of zygoma by using different formulations depending on their posterior or anterior location to the root of zygoma. Statistical method was based on correlation analysis, simple regression, independent 2 group t tests, SPSS20.0, and MedCalc 11.5 (MedicReS, New York, NY). RESULTS: Neither side dominance for the jugular foramen, nor the differences of foramen rotundum, spinosum, and ovale to anterior skull wall, root of zygoma, and to midline were found to be significant. CONCLUSION: There is a debate on asymmetry of foramina of the skull base. No certain consensus about the initiation time and the causes of asymmetry in the past was documented. Studies are to be encouraged to further enlighten pre-postnatal factors affecting the fetal skull base morphometrism.

Radiological management of the exiting points of supraorbital region neurovascular bundles / Manejo radiológico de los puntos de salida de los haces neurovasculares de la región supraorbitaria

SUMMARY: A preoperative computed tomography scan is useful to determine neurovascular exit points from orbit to supraorbital region. Determining the structure of exiting points (absence or presence, if present, being in form of foramen or notch) is important to plan the surgical approach. The aim of the study was to provide the radiological data by multi-detector computed tomography for estimating exiting points of the neurovascular bundles of the supraorbital region whether through foramen or notch in living subjects related to side (right/left), sex and age. Computed tomography examinations of 214 (102 male and 112 female) adult patients, aged average 44.2 ± 14 years, were evaluated, retrospectively. Presence or absence, number and nature (foramen/notch) of exiting points of neurovascular bundles were noted in each side regarding sex and age groups. The distance of foramen/notch to the midline of the face was recorded. Single notch was seen on the right in 123 and in 134 on the left, single foramen was seen in 62 on the right and in 56 on the left side and double foramen was seen in 13 on the right and in 6 on the left. The absence was seen in 16 on the right and 18 on the left side. No significant difference was seen on frequency compared between the sexes and age groups. Foramen was seen in 58 sides unilaterally and in 39 sides bilaterally. Notch was unilateral in 75 sides and bilateral in 95 sides. It was shown that males had a wider distance between right side foramen and left side notch to midline. Age groups did not show a significant difference in terms of side. Absence and foramen presence made up about 30-40 % of cases. Notch was the most common form. Foramen/notch presence was statistically unaffected by the sex and age factors. In terms of surgery, preoperative assessment of orbital exit points with computed tomography is essential.

RESUMEN: Una tomografía computarizada preoperatoria es útil para determinar los puntos de salida neurovascular en la región supraorbitaria. Para la planificación del abordaje quirúrgico es importante determinar la estructura de los puntos de salida (ausencia o presencia en forma de foramen). El objetivo de este estudio fue proporcionar los datos radiológicos mediante tomografía computarizada de detectores múltiples, para estimar los puntos de salida de los haces neurovasculares de la región supraorbitaria, ya sea a través del foramen o incisura en sujetos vivos relacionados con lado (derecho/izquierdo), sexo y edad. Se evaluaron retrospectivamente los exámenes de tomografía computarizada de 214 adultos (102 hombres y 112 mujeres), edad 44,2 ± 14 años. Se observó, en cada lado, presencia o ausencia, número y naturaleza (foramen / incisura) de los puntos de salida de los haces neurovasculares en cuanto a sexo y grupos de edad. Se registró la distancia del foramen / incisura al plano mediano de la cara. Se observó un foramen a la derecha en 123 de las tomografìas y en 134 a la izquierda, se observó un foramen simple en 62 a la derecha y en 56 en el lado izquierdo y se visualizó forámenes doble en 13 tomografías a la derecha y en 6 a la izquierda. Se observó ausencia en 16 casos a la derecha y 18 casos a la izquierda. No existió diferencia significativa en la frecuencia comparada entre los sexos y los grupos etarios. El foramen se detectó en 58 lados unilateralmente y en 39 lados bilateralmente. Se demostró que los hombres tenían una distancia mayor entre el foramen del lado derecho y el foramen del lado izquierdo hasta el pno mediano. No se observó una diferencia significativa en los diferentes grupos etarios en términos de lado. La ausencia y la presencia de los forámenes constituían alrededor del 30-40 % de los casos. Los factores de sexo y edad no afectaron estadísticamente la presencia del foramen / incisura. En términos de cirugía, la evaluación preoperatoria de los puntos de salida orbitales con tomografía computarizada es esencial.