Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment.

BACKGROUND & AIMS: Autoimmune pancreatitis (AIP) is an immune-mediated disease of the pancreas with distinct pathophysiology and manifestations. Our aims were to characterize type 1 AIP in a large pan-European cohort and study the effectiveness of current treatment regimens. METHODS: We retrospectively analyzed adults diagnosed since 2005 with type 1 or not-otherwise-specified AIP in 42 European university hospitals. Type 1 AIP was uniformly diagnosed using specific diagnostic criteria. Patients with type 2 AIP and those who had undergone pancreatic surgery were excluded. The primary end point was complete remission, defined as the absence of clinical symptoms and resolution of the index radiologic pancreatic abnormalities attributed to AIP. RESULTS: We included 735 individuals with AIP (69% male; median age, 57 years; 85% White). Steroid treatment was started in 634 patients, of whom 9 (1%) were lost to follow-up. The remaining 625 had a 79% (496/625) complete, 18% (111/625) partial, and 97% (607/625) cumulative remission rate, whereas 3% (18/625) did not achieve remission. No treatment was given in 95 patients, who had a 61% complete (58/95), 19% partial (18/95), and 80% cumulative (76/95) spontaneous remission rate. Higher (≥0.4 mg/kg/day) corticosteroid doses were no more effective than lower (<0.4 mg/kg/day) doses (odds ratio, 0.428; 95% confidence interval, 0.054-3.387) and neither was a starting dose duration >2 weeks (odds ratio, 0.908; 95% confidence interval, 0.818-1.009). Elevated IgG4 levels were independently associated with a decreased chance of complete remission (odds ratio, 0.639; 95% confidence interval, 0.427-0.955). Relapse occurred in 30% of patients. Relapses within 6 months of remission induction were independent of the steroid-tapering duration, induction treatment duration, and total cumulative dose. CONCLUSIONS: Patients with type 1 AIP and elevated IgG4 level may need closer monitoring. For remission induction, a starting dose of 0.4 mg/kg/day for 2 weeks followed by a short taper period seems effective. This study provides no evidence to support more aggressive regimens.

Evaluation of quality and readability of internet information on voice disorders.

OBJECTIVES: The purpose of this study is to evaluate the readability and quality of Internet information related to vocal health, voice disorders and voice therapy. STUDY DESIGN: This is a cross-sectional study. METHODS: Eighty-two websites were included. Websites were then analyzed; their origin (clinic/hospital, non-profit, government), quality (Health On the Net [HON] certification and DISCERN scores) and readability (Atesman readability formula and Bezirci-Yilmaz new readability formula) were assessed. Statistical analysis was used to examine differences between website origin and quality and readability scores and correlations between readability instruments. RESULTS: Of the 82 websites, 93% were of private clinic/hospital, 6% were of non-profit organisation and 1% were of government. None of the 82 websites were HON certification, and the mean score of the item determining the general quality measure in DISCERN was 1.83 in a five-point scale. The mean of Atesman readability formula value was calculated as 50.46 (±8.16). This value is defined as 'moderately hard' according to the readability scale. The average of Bezirci-Yilmaz new readability formula value is 13.85 (±3.48). This value is defined as 13th and 14th grade. CONCLUSIONS: The quality of Internet-based health information about the voice is generally inadequate, and the sites examined in this study may be limited due to high readability levels. This may be a problem in people with poor literacy skills. For this reason, it is very important for speech and language therapists and other health professionals to evaluate and monitor the quality and readability of Internet-based information.

Piezosurgery versus conventional rotary surgery for impacted third molars: A randomised, split-mouth, clinical pilot trial.

BACKGROUND: Few studies have compared the effects of piezosurgery and conventional rotary surgery for impacted wisdom teeth on the quality of life. Among these studies, the inclusion parameters and evaluation methods have varied. MATERIAL AND METHODS: This study aimed to compare the effects of piezosurgery and conventional rotary instruments on the quality of life using a standardised method. Patients with bilateral and symmetric mandibular impacted wisdom teeth were included based on the Winter and Pell-Gregory scale and Yuasa difficulty index criteria. The primary objective was to assess the effects of the methods on the quality of life using the Oral Health Impact Profile-14 questionnaire. Secondary objectives included comparisons of swelling, trismus, pain, and total operative times. The study was conducted between October 2021 and March 2022. The clinical trial protocol was recorded in the United States National Library of Medicine clinical trial registry (NCT05545553). RESULTS: We enrolled 20 patients (40 wisdom teeth) and found that the removal of impacted teeth using the piezosurgery method positively affected the quality of life and considerably improved swelling, trismus, and pain scores. However, piezosurgery may affect postoperative morbidities such as increased total operative times. CONCLUSIONS: Piezosurgery appears to have advantages over conventional rotary surgery for impacted wisdom tooth extraction in terms of quality of life and postoperative symptoms. However, further research should investigate potential drawbacks and confirm these findings.

The prevalence of developmental delay among children aged 3-60 months in Izmir, Turkey.

BACKGROUNDS: Developmental delay is defined as delays in speech and language development, motor development, social-emotional development and cognitive development. On a global scale, the prevalence estimations in paediatric population range between 5% and 15%. However, no prevalence studies on developmental delay have been conducted in primary care in Turkey. The aim of this study was to determine the prevalence of developmental delay among children aged 3-60 months in Izmir. METHODS: This cross-sectional, descriptive study involved 1514 children aged 3-60 months, who were at 12 primary health centres for various reasons in Izmir between 1 November 2013 and 31 January 2014. The questionnaire and age-specific Turkish version of the Ages and Stages Questionnaires were applied to mothers via face-to-face interview. RESULTS: The prevalence of developmental delay was 6.4% (95% confidence interval 5.2-7.7). The prevalence for age groups varied between 3.3% and 12.1%. Significant associations were found between developmental delay and maternal age, maternal/paternal education, socio-economic level of the family and the presence of consanguineous marriage. CONCLUSIONS: Identifying developmental delay in children earlier by a validated, reliable, parent-completed questionnaire like Ages and Stages Questionnaires and detecting risk factors for delay are crucial for primary care where their growth and development are monitored. Identifying developmental delay and early referral to rehabilitation services may help improve children's quality of life.

[Effects of Vibrax (Mechanical Vibrations) on the Arterial Blood Gases of Patients in the Intensive Care Unit after Cardiac Surgery]. / Effekte der Vibraxanwendung (mechanische Vibration) auf die Blutgaswerte von Patienten auf der Intensivstation nach einem kardiochirurgischen Eingriff.

OBJECTIVE: Respiratory physiotherapy is an integral part of the care of patients in intensive care units (ICU) after cardiac surgery. One of the most commonly used techniques in ICU to prevent pulmonary complications are mechanical vibrations, which can be applied with a tool called Vibrax.The aim of this study was to investigate the effects of Vibrax (mechanical vibrations) on the arterial blood gases of patients in ICU during the 1. or 2. day after cardiac surgery. METHODS: A randomized controlled pilot study was conducted with 23 patients. The participants of the control group (CG) received a cardiovascular training with mobilization to the edge of the bed and active breathing exercises. On the patients of the intervention group (IG) additionally Vibrax was applied for 5 minutes. As primary outcome parameter the PaO2/FiO2 ratio was measured. RESULTS: In the CG no significant changes over time were observed (p ≥ 0.06). The IG showed a significant (p = 0.009) increase in the PaO2/FiO2 ratio from before the physiotherapy intervention (M = 296.52, SE = 34.94 mmHg) to 60 minutes after completion of the physiotherapy intervention (M = 331.39, SE = 48.14 mmHg). There was no significant difference between the CG and IG at any measuring time (p ≥ 0.09). CONCLUSION: The results of this pilot study indicate that the application of Vibrax has positive effects on the arterial blood gases of patients in ICU on the 1. or 2. day after cardiac surgery. But whether the effects are clinically relevant could not be clarified.

Radiation exposure of patient and surgeon in minimally invasive kidney stone surgery.

OBJECTIVE: Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are the standard treatments used in the endoscopic treatment of kidney stones depending on the location and the size of the stone. The purpose of the study was to show the radiation exposure difference between the minimally invasive techniques by synchronously measuring the amount of radiation the patients and the surgeon received in each session, which makes our study unique. MATERIALS AND METHODS: This is a prospective study which included 20 patients who underwent PNL, and 45 patients who underwent RIRS in our clinic between June 2014 and October 2014. The surgeries were assessed by dividing them into three steps: step 1: the access sheath or ureter catheter placement, step 2: lithotripsy and collection of fragments, and step 3: DJ catheter or re-entry tube insertion. RESULTS: For the PNL and RIRS groups, mean stone sizes were 30mm (range 16-60), and 12mm (range 7-35); mean fluoroscopy times were 337s (range 200-679), and 37s (range 7-351); and total radiation exposures were 142mBq (44.7 to 221), and 4.4mBq (0.2 to 30) respectively. Fluoroscopy times and radiation exposures at each step were found to be higher in the PNL group compared to the RIRS group. When assessed in itself, the fluoroscopy time and radiation exposure were stable in RIRS, and the radiation exposure was the highest in step 1 and the lowest in step 3 in PNL. When assessed for the 19 PNL patients and the 12 RIRS patients who had stone sizes≥2cm, the fluoroscopy time in step 1, and the radiation exposure in steps 1 and 2 were found to be higher in the PNL group than the RIRS group (P<0.001). CONCLUSION: Although there is need for more prospective randomized studies, RIRS appears to be a viable alternate for PNL because it has short fluoroscopy time and the radiation exposure is low in every step. LEVEL OF EVIDENCE: 4.

Comparison of immunogenicity for Sinovac-CoronaVac vaccine vs. natural infection during cancer treatment.

OBJECTIVE: Efficacy of the COVID-19 vaccines in cancer patients, especially during their active treatment, are lacking. Most of the studies in the literature compared the immunity in cancer patients with a cross-sectional cohort or retrospectively. Our study investigated Sinovac-CoronaVac COVID-19 vaccine immunogenicity and compared it with natural COVID-19 disease in cancer patients during their cancer therapy. PATIENTS AND METHODS: A total of 111 patients with cancer and who are on active treatment were included in the study. This is a single-center study and was designed prospectively. Two group of patients were included in the study, natural disease and vaccinated group. RESULTS: A total of 111 patients were included in the study, 34 of whom had natural COVID-19 disease. Antibody levels following the first dose vaccine were 0.4 (0-1.9) U/ml while after the second dose of vaccine were 2.6 (1.0-7.25) U/ml. Immunogenicity levels were 82.4% in the natural disease group and 75.8% in the vaccinated group after the second shot of the vaccine. Immunogenicity rate was significantly higher in non-chemotherapy (receiving immunotehrapy/targeted therapy or biologic agent) group compared to chemotherapy drug (92.9% vs. 63.3%, p=0.004). There was a difference between the antibody levels following the first and second vaccination [median (IQR): 0.3 (0-1.0) and 3.3 (2.0-6.7), p=0.001, respectively]. CONCLUSIONS: The present study revealed that the Sinovac-CoronaVac vaccine showed an acceptable immunogenicity following two shots in cancer patients who were receiving active systemic therapy. On the other hand, natural disease immunogenicity was higher than vaccinated group.

Evaluating the effect of tumor size and sidedness on prognosis in stage 2 colon cancer: a retrospective population study.

OBJECTIVE: In this study, we aimed to evaluate the effect of tumor size and tumor sidedness on prognosis in patients with stage 2 colon cancer. PATIENTS AND METHODS: Data of 501 patients diagnosed with stage 2 colon cancer were evaluated retrospectively. It was evaluated whether the patients' age, gender, tumor differentiation, tumor node metastasis (TNM) stage, overall survival rate, and disease-free survival rate had any correlation with horizontal tumor diameter and tumor sidedness. In the ROC analysis performed to determine the cut-off value for the tumor diameter, which we think will predict survival, no significant results were obtained with maximum sensitivity and specificity. Therefore, the median value of the tumor diameter, which is 5 cm, was accepted as the cut-off value.  Kaplan-Meier method and Cox regression analysis were used for survival analysis and determination of prognostic factors. RESULTS: When the patients were evaluated in terms of tumor localization, 189 (37.7%) patients had right colon tumors and 312 (62.3%) patients had left colon tumors. There was no statistically significant difference in terms of disease-free survival and overall survival according to tumor localization. When the patients were analyzed by dividing them into two groups according to the horizontal tumor size (<5 cm and ≥5 cm), no statistically significant difference was found between the groups in terms of disease-free survival (DFS) and overall survival (OS) p=0.085, p=0.699, respectively. CONCLUSIONS: Our results suggest that the management of patients with stage 2 colon cancer requires a better understanding of tumor biology rather than features such as tumor size and localization.

The significance of a novel inflammatory biomarker, presepsin, in predicting disease prognosis in patients with COVID-19.

OBJECTIVE: This study aims at determining the significance of a novel inflammatory biomarker, presepsin, in predicting disease prognosis in patients with COVID-19. PATIENTS AND METHODS: This retrospective study was concluded at the University Hospital between April and August 2020. The study involved 88 COVID-19 patients (48 men and 40 women). The patients were categorized into two groups: the patients admitted to the COVID-19 clinic, described as the moderate COVID-19 patients (Group-1; n=44), and those admitted to the internal medicine outpatient clinic, who were the mild COVID-19 patients (Group-2; n=44). The groups were compared using inflammatory markers: presepsin, C-Reactive Protein to Albumin Ratio, Neutrophil to Lymphocyte Ratio, and procalcitonin. RESULTS: Serum presepsin levels (195.29 vs. 52.12 pg/ml) were significantly higher in the Group-1 compared to the Group-2 (p=0.001). The gender distribution and average age were similar in both groups (p > 0.05). While ferritin, lactate dehydrogenase, D-Dimer, platelet lymphocyte ratio, C-Reactive Protein to Albumin Ratio (p=0.001), erythrocyte sedimentation ratio, C-Reactive Protein and presepsin were significantly higher in the Group-1 compared to Group-2 (p<0.05), while hemoglobin and lymphocyte were significantly lower in the Group-1 than in Group-2 (p<0.05). CONCLUSIONS: Serum presepsin levels were found to be significantly higher in moderate clinical group COVID-19 patients compared to mild group. Presepsin, a new inflammatory biomarker, may be useful in predicting the prognosis and early treatment of COVID-19 infection.

The role of neutrophil albumin ratio in predicting the stage of non-small cell lung cancer.

OBJECTIVE: Inflammation forms the basis of cancer development and progression. It causes changes in complete blood count parameters, such as neutrophil counts. Low albumin levels are associated with poor prognosis in cancer patients. We aimed to investigate the association between neutrophil to albumin ratio (NAR) and the stage of non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: 257 NSCLC patients (24 females and 198 males) were included in the study. Patients were divided into two groups. Group 1 (n=61) included patients with early stage cancer (stage 1 and 2), while group 2  (n=196) included those with advanced stage cancer (stage 3 and 4). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin and albumin levels at the time of diagnosis were recorded. The NAR of 2 groups were compared. RESULTS: There were no significant differences between the lymphocyte count (2.0 vs. 2.0 103/mm3) and platelet count (291 vs. 311 103/mm3) of the two groups (p > 0.05). ESR (38.8 vs. 57.5 mm/h), CRP (158 vs. 57 mg/l), ferritin (85 vs. 261 ng/ml), WBC count (8.6 vs. 10.6 103/mm3), neutrophil count (5.6 vs. 7.5 103/mm3), albumin values (2.9 vs. 3.7 gr/dl), and (p < 0.05) NAR levels (1.6 vs. 2.3) (p < 0.05) were significantly higher in group 2. CONCLUSIONS: NAR can be used in predicting the stage of NSCLC.

The efficacy of pulsed ultraviolet light processing for table and hatching eggs.

In the United States, every year an average of 287.1 eggs are consumed per person, and over 14.1 billion eggs are set in hatchery incubators to produce chicks destined for the egg and meat bird industries. By reducing the microbial load on eggs, food-borne-associated outbreaks can be reduced while good chick health is maintained. Pulsed ultraviolet (PUV) light system delivers an energy-intense broad spectrum (100-1,100 nm) pulse derived from a xenon flashlamp. In recent years, PUV light has been shown to reduce microbial pathogens on the surface of shell eggs by using a static PUV light system. In this study, shell eggs were surface inoculated with Escherichia coli or Enterococcus faecium and treated with PUV light using a modified egg candling conveyor that provided complete rotation of eggs under a flashlamp. Pulsed UV light treatment inactivated both microbial strains, with greater energy resulting in a greater germicidal response (P < 0.05). Treatments of 1.0, 2.4, 3.1, and 4.9 J/cm2 resulted in microbial reductions (Log10 CFU/cm2) of 3.83, 4.26, 4.28, and 4.62 for E. coli and 2.04, 3.12, 3.11, and 3.82 for E. faecium, respectively. This study also evaluated the effects of PUV light treatment of hatching eggs (commercial Leghorn hybrids) on both embryo and chick growth parameters. Using the same system, 4 replicates of 125 fertile eggs per rep were treated with 0 (control), 4.9, 24.4, or 48.8 J/cm2 of PUV light. After processing, eggs were placed in a commercial incubator under normal incubation conditions. There was no significant effect of the PUV light treatment on percent fertility, hatchability, or hatch (P > 0.05). Furthermore, there were no significant effects on posthatch observations, including livability and average bird weight at hatch or at 42 d of age (P > 0.05). In conclusion, this study supports the application of PUV light as an effective antimicrobial intervention for both table and hatching eggs.

Decontamination of unpackaged and vacuum-packaged boneless chicken breast with pulsed ultraviolet light.

The effectiveness of pulsed UV light on the microbial load of boneless chicken breast was investigated. Unpackaged and vacuum-packaged samples inoculated with an antibiotic-resistant strain of Salmonella Typhimurium on the top surfaces were treated with pulsed UV light for 5, 15, 30, 45, and 60 s at 5, 8, and 13 cm distance from the quartz window in the pulsed UV light chamber. The log(10) reductions of Salmonella (cfu/cm(2)) on unpackaged samples varied from 1.2 to 2.4 after a 5-s treatment at 13 cm and a 60-s treatment at 5 cm, respectively. The log(10) reductions on vacuum-packaged samples varied from 0.8 to 2.4 after the 5-s treatment at 13 cm and the 60-s treatment at 5 cm, respectively. The optimum treatment conditions were determined to be 5 cm-15 s for unpackaged samples and 5 cm-30 s for vacuum-packaged samples, both of which resulted in about 2 log(10) reduction (approximately 99%). The total energy and temperatures of samples increased with longer treatment time and shorter distance from the quartz window in the pulsed UV light chamber. The changes in chemical quality and color of samples were determined after mild (at 13 cm for 5 s), moderate (at 8 cm for 30 s), and extreme (at 5 cm for 60 s) treatments. Neither malonaldehyde contents nor color parameters changed significantly (P > 0.05) after mild and moderate treatments. Mechanical properties of the packaging material were analyzed before and after pulsed UV light treatments. The elastic modulus at both along-machine and perpendicular-to-machine direction and yield strength at perpendicular-to-machine direction changed significantly (P < 0.05) after extreme treatment. Overall, these results clearly indicate that pulsed UV light has a potential to be used for decontamination of unpackaged and vacuum-packaged poultry.

Nonlinear modulation of periodic waves in the cylindrical Gardner equation.

The propagation of dispersive shock waves (DSWs) is investigated in the cylindrical Gardner (cG) equation, which is obtained by employing a similarity reduction to the two-space one-time (2+1) dimensional Gardner-Kadomtsev-Petviashvili (Gardner-KP) equation. We consider the steplike initial condition along a parabolic front. Then, the cG-Whitham modulation system, which is a description of DSW evolution in the cG equation, in terms of appropriate Riemann-type variables is derived. Our study is supported by numerical simulations. The comparison is given between the direct numerical solution of the cG equation and the DSW solution obtained from the numerical solution of the Whitham system. According to this comparison, a good agreement is found between the solutions.

PrescrAIP: A Pan-European Study on Current Treatment Regimens of Auto-Immune Pancreatitis.

Introduction: Treatment of autoimmune pancreatitis (AIP) is based solely on consensus and has yet to become standardized. Consequently, therapeutic regimens vary greatly between countries and centers, and largely depend on the experience of the physician. At this moment, the optimal regimen for inducing disease remission and preventing relapse is unknown. Objectives: The primary objective of this study is to describe current treatment regimens used in Europe, and to compare their effectiveness in inducing remission and preventing and treating relapse. The secondary objectives are: to identify risk factors for relapse; to assess the diagnostic accuracy of the Unified-AIP criteria; to assess the performance of the M-ANNHEIM score for predicting relapse; and to assess long-term outcomes including pancreatic exocrine insufficiency and pancreatic cancer. Methods: This is an international, retrospective, observational cohort study, performed in over 40 centers from 16 European countries. Eligible are all patients diagnosed with AIP from 2005 onwards, regardless of the used diagnostic criteria. Data on study subjects will be retrieved from the hospital's electronic medical records and registered with a standardized, web-based, electronic case report form (eCRF). To compare the effectiveness of treatment regimens in inducing remission, preventing relapse, and treating relapse, subjects will be stratified in groups based on: type of therapy; initial therapy dose; cumulative therapy dose; therapy tapering speed and duration; and having received maintenance therapy or not. Ethics and Dissemination: Ethical and/or institutional review board approvals are obtained by all participating centers according to local regulations. The study complies with the General Data Protection Regulation (GDPR). All manuscripts resulting from the study will be submitted to peer-reviewed journals. Conclusion: This is the first pan-European retrospective registry for AIP. It will produce the first large-scale data on treatment of European patients with AIP, providing answers on the use and effectiveness of treatment regimens. In the future, this collaboration may provide a network for continuation into a prospective European registry.

Magnetic resonance imaging measurement of left ventricular blood flow and coronary flow reserve in patients with chronic heart failure due to coronary artery disease.

BACKGROUND: Coronary sinus flow reflects global cardiac perfusion and has been used for the assessment of myocardial flow reserve, which is reduced in chronic heart failure(CHF). Coronary flow reserve (CFR) can be measured by using phase-contrast (PC)velocity-encoded cine (VEC) magnetic resonance imaging (MRI). PURPOSE: To quantify and compare global left ventricular (LV) perfusion and CFR inpatients with CHF and in a healthy control group by measuring coronary sinus flow with PC VEC MRI, and to correlate this with global LV perfusion, segmental first-pass perfusion, and viability in the same patients. MATERIAL AND METHODS: Cardiac MRI was performed in 20 patients with CHF of ischemic origin and in a control group of healthy subjects (n=11) at rest and after pharmacological stress induced by i.v. dipyridamole. The MRI protocol included cine MRI, VEC MRI, first-pass perfusion, and delayed contrast-enhanced MRI for viability.Global LV perfusion was quantified by measuring coronary sinus flow on VEC MRI at rest in all subjects. CFR was determined as the ratio of global LV perfusion before and after pharmacologic stress. RESULTS: At rest, global LV perfusion was not significantly different in patients with CHF and the control group. After administration of dipyridamole, global LV perfusion and CFR were significantly lower in patients with CHF compared to the control group(P<0.001). An inverse correlation was observed between CFR and the number of infarcted and/or ischemic segments (P=0.083, P=0.037). CONCLUSION: A combined cardiac MRI protocol including function and perfusion techniques together with VEC MRI can be used to evaluate global LV perfusion and CFR in patients with CHF. Global LV perfusion and CFR measurements may have potential in the monitoring of CHF. Impaired CFR may contribute to progressive decline in LV function in patients with CHF.

Intrathoracic goiter with hyperthyroidism, tracheal compression, superior vena cava syndrome, and Horner's syndrome.

Intrathoracic goiter is an important cause of mediastinal masses. We present a patient with hyperthyroidism, tracheal compression, superior vena cava syndrome (SVCS) and Horner's syndrome due to intrathoracic goiter. To our knowledge, this is the first case in the literature with all of these combined findings.

MR imaging of renal vein occlusion in dogs.

RATIONALE AND OBJECTIVES: MR findings of renal vein thrombosis are not consistent in the literature. Our goal was to evaluate MR findings of kidneys after renal vein occlusion in dogs. METHODS: Surgical ligation of renal veins was performed in seven dogs. Of these, five dogs were examined with MRI before surgery, on the day of the renal vein ligation, and on the 1st, 4th, 8th, 15th, and 30th days. The other two dogs underwent nephrectomy on the 4th and 8th days for histopathologic correlation. RESULTS: On T1-weighted images, corticomedullary differentiation was lost in all dogs by the 15th day. On T2-weighted images, the signal intensity of the renal cortex was significantly decreased beginning on the first day. The kidneys showed no medullary enhancement in the postcontrast period. The volume of the kidney began increasing at the time of renal vein ligation, started to decrease after the 4th day, and developed significant atrophy by the 30th day. CONCLUSIONS: After renal vein ligation, the renal cortex appears hypointense on T2-weighted images, corticomedullary differentiation is lost within 2 weeks on T1-weighted images, and the kidney becomes atrophic by 1 month.

MR of parenchymal neurocutaneous melanosis.

Two cases of neurocutaneous melanosis are presented. MR showed hyperintense areas in the brain on short-repetition-time/short-echo-time sequences, compatible with intraparenchymal melanin deposits. No leptomeningeal abnormality was seen.

Bone mineral density measurement by quantitative computed tomography in a normal Turkish population.

PURPOSE: To observe the trabecular and cortical bone mineral density values of a normal Turkish population, to examine the effect of age in males, and age and duration of menopause in a female population on bone mineral density. Also to compare Turkish population bone mineral density values with the reference values in developed countries. MATERIALS AND METHODS: Trabecular and cortical bone mineral densities were measured by the quantitative CT method in 255 (110 male and 145 female) normal cases. RESULTS: According to the linear regression test results, loss of bone mineral density per year was 1.97 mg/ml and 2.09 mg/ml for females and 1.37 mg/ml and 1.04 mg/ml for males in the trabecular and cortical bone compartments, respectively. A 70-year-old female loses 56.7% and 31.3% of the bone mass at 20 years of age for the trabecular and cortical compartments, respectively. These ratios were 41% and 16.1% for the male population. Most loss in bone mass was observed in the premenopausal and early postmenopausal period. In the postmenopausal period, duration of menopause had more effect on bone mass than age. Loss of trabecular bone mass per year in the postmenopausal period was 2.36 mg/ml and 2.84 mg/ml with respect to age and duration of menopause, respectively. CONCLUSIONS: Quantitative CT is a valuable method to determine bone mass because it allows to detect bone mass of trabecular and cortical bone separately. Loss in trabecular bone was found to be higher than in cortical bone for both sexes, while overall bone loss was higher in females. Rate of loss increases in the menopause period. Duration of menopause had more effect on bone mass than age. Bone mineral density values in Turkey were similar to reference values of western countries.

Enhanced organically bound chromium yeast production.

This paper describes continuous and fed-batch fermentation protocols for enhanced production of organically bound chromium yeast. During continuous fermentation, several inorganic chromium compounds were evaluated. Sodium chromate demonstrated the best chromium incorporation into yeast biomass without any precipitation in the fermentation medium. During fed-batch fermentation, several sodium chromate concentrations were evaluated at 1.1, 3.5, 5.9, 7.1, 8.3, and 10.8 g/L with continuous or single-dose addition. For single-dose addition of sodium chromate, some precipitation was observed for all concentrations, which reduced the available chromium in the fermentation medium. Adapted strain C11-1, obtained during continuous fermentation, produced higher biomass than the wild type but significantly lowered chromium incorporation. Pilot-scale fermentation demonstrated similar total chromium incorporation (2966 ppm) with lower biomass production compared to benchtop fermentation performed at the same sodium chromate addition.