Neurosurgery training camp for medical student: experience of the Turkish neurosugery academy and Bursa Uludag University.

Introduction: To highlight the importance of hands-on experiences and mentorship in shaping the future workforce of specialized medical professionals via a Neurosurgery Training Camp. Methods: Responses of the questionnaire regarding the Neurosurgery Training Camp organized by Bursa Uludag University's Faculty of Medicine and the Turkish Neurosurgery Academy were reviewed retrospectively. A one-day program was organized to introduce neurosurgery to medical students. During the camp, the students participated in interactive presentations delivered by faculty members, had lunch together, became acquainted with neurosurgical tools and technologies, and performed interventions. With pre and postworkshop questionnaire, student's expectations and thoughts about camp was evaluated. Results: Forty-one students from 10 medical schools, spanning every year of study, attended the camp. Approximately 39% of the attendees (n = 16) were women and 61% (n = 25) were men. The post-workshop survey results demonstrated that 73% of the students (n = 30) were inclined to pursue a career in neurosurgery after the camp, 21.9% (n = 9) remained undecided, and 4.8% (n = 2) chose not to pursue neurosurgery. Feedback from the post-workshop questionnaire highlighted that all students perceived the camp as beneficial in providing insights into their future careers and aiding in making a decision regarding their career paths. Discussion: The neurosurgical training camp effectively inspired and educated medical students about the discipline of neurosurgery. Furthermore, the camp effectively altered the career aspirations and perceptions of neurosurgery among the participating students.

Enhanced electrokinetic properties and antimicrobial activities of biodegradable chitosan/organo-bentonite composites.

In this study, chitosan (CS), Na+-bentonite (Na+-BNT) and chitosan/organo-bentonite (CS/O-BNT) biodegradable composites having three different compositions were investigated. Electrokinetic measurements were examined in aqueous medium by taking the effects pH, electrolytes (NaCl and BaCl2), surfactants (CTAB and SDS), and temperature into account. It was noticed that the initial ζ-potential of Na+-BNT shifted from negative (ζ=-35mV) to positive region (ζ=+13mV) with increasing polycationic CS content in the composite structure as aimed. Divalent 2:1 electrolyte (BaCl2) caused to shift the ζ-potentials of all the dispersions to more positive regions. While the most negative effect on ζ-potential of the composites was reached with SDS, which reduced the value of ζ-potential to -39mV for CS(1)/O-BNT composite, the most positive effect was monitored with CTAB (ζ=+40mV) for CS(3)/O-BNT composite. Further, the composites were tested against various bacterial (Gram-positive and Gram-negative) and fungal microorganisms at various concentrations and results obtained were compared with the reference antibiotics and fungicide. According to inhibition zone values accomplished, antibacterial and antifungal activities of the CS/O-BNT composites are increased with increasing CS content as proportional with their positive ζ-potential values.

The role of early colonoscopy in CMV colitis of transplant recipients.

Cytomegalovirus (CMV)-associated diseases remain a major problem in transplant recipients. Early diagnosis is critical. Presentation of early CMV colitis can be mild and nonspecific in transplant recipients. Although serology is helpful in the diagnosis, sometimes it is inadequate. Because the endoscopic features of CMV colitis are specific, colonoscopy facilitates the histopathologic examination. We present the clinical properties and advantages of early colonoscopy in transplant recipients with CMV colitis. The study group included seven patients (six men, one woman of mean age, 36.7 years (range, 22 to 64 years) whose mean transplant duration was 12.3 months (range, 1 to 72 months). Six of the seven patients experienced an acute graft rejection treated with high doses of steroids; one patient had a herpes simplex virus infection. All patients were on steroid treatment with a various combinations of immunosuppressive agents, including cyclosporine, mycophenolate mofetil, and tacrolimus. All patients presented with mild diarrhea without any blood or mucous discharge. Four patients had fever exceeding 38 degrees C; two had abdominal pain. Stool examinations revealed normal findings in six patients, while one patient had white blood cells and amoebic cysts. Serum CMV IgM and CMV pp65 antigenemia were negative in five of seven patients and two had positive results. All patients showed typical colonoscopic and histopathologic findings compatible with CMV colitis. Standard ganciclovir treatment was successful in all patients. Early and rapid colonoscopy is beneficial for the early diagnosis and management of CMV colitis in transplant recipients.

Evaluation of Infectious Complications in the First Year After Kidney Transplantation.

Kidney transplantation (KT) is the best available therapy for patients with end-stage renal disease. Infectious complications are a common cause of morbidity and mortality. In this study, we evaluated the risk factors and outcomes of infectious complications in the first year after transplantation. This is a retrospective and observational study of kidney transplant recipients at Ankara University's Ibni Sina Hospital between January 2009 and August 2013. A total of 206 kidney transplant recipients were evaluated. In 129 patients, 298 infectious episodes occurred: 55 (26.7%) had 1; 33 (16%) 2; 19 (9.2%) 3; 7 (3.4%) 4; and 15 (7.3%) had 5 or more infectious episodes. The most common bacterial infection was urinary tract infection (128, 42.9%). Only 4 urinary tract infection episodes (3.1%) were associated with bacteriemia. Seventeen patients (5.7%) had bacteremia. Viral infections after transplantation were CMV infection (10.1%), BK virus infection (5.7%), and zona zoster (1.1%). Deceased donor kidney transplantation was the independent risk factor. Mean follow-up period was 66 months and was the same for the patients with and without infections. There was no significant difference in 5-year survival and creatinine levels at the last follow-up (logrank P = .409). Infections are the second most common cause of mortality in KT patients. The successful treatment of these complications and effective prophylaxis may decrease these complications.

Detection of c-erbB-2 mRNAs using dig-labelled oligonucleotide probe with in situ hybridisation in human breast carcinoma: comparison with immunohistochemical results.

Amplification and overexpression of the c-erbB-2 oncogene are of prognostic significance in human breast cancer. Overexpression of c-erbB-2 is the result of gene amplification. However, increased transcript levels of c-erbB-2 are also detected in the absence of gene amplification. In this study for the detection of the overexpression mRNA in situ hybridisation (ISH) and immunohistochemistry (IHC) were used. Our aim was to develop the suitable mRNA ISH protocol for formalin-fixed paraffin-embedded material and to compare the localisation of transcripts and protein products in 20 primary breast carcinomas. Sections were immunostained with monoclonal c-erbB-2 antibody. In ISH method digoxigenin-labelled oligoprobe was used for the detection of c-erbB-2 mRNAs. We determined optimal condition for the ISH procedure (e.g., probe concentration, digestion, post washing). c-erbB-2 protein overproduction was detected in 11/20 cases with IHC. The mRNA signals were observed in malignant cell cytoplasm in 6/20 cases by ISH. ISH positive signals were found in only one case without detected overexpression of the protein. There were cell to cell variations in the hybridisation signals even within individual tumours. The ISH and IHC positive signals for c-erbB-2 was observed mostly in infiltrating ductal carcinomas that belong to aggressive lesions.

The effect of ligation of the inferior thyroid artery upon thyroid remnant function.

The cause of hypothyroidism after subtotal thyroidectomy for primary thyrotoxicosis is not precisely understood. Activity is not just related to the size of the thyroid remnants, and ischemia of the remnants has been suggested as a factor which might contribute to the development of hypothyroidism. A prospective study has been carried out to look for evidence that ischemia is implicated. In 55 patients undergoing subtotal thyroidectomy for primary thyrotoxicosis, the inferior thyroid artery (ITA) was ligated on one side but preserved on the opposite side. All of the patients had postoperative isotope scans. We predicted that, if ITA ligation produced significant ischemia of the remnant, then the remnant with the intact ITA ought to show greater activity on the postoperative scan. This was not the case. The remnant with the intact ITA was dominant in only 15 of 55 patients, the remnant with the ligated ITA was dominant in the same proportion, 15 of 55 patients, while in the remaining 25 patients, activity was equally distributed between the two remnants. The results of this study provides no evidence to support the contention that nonligation of the inferior thyroid arteries will reduce ischemia of the thyroid remnants and thereby discourage postoperative hypothyroidism.

Management of intrabiliary rupture of hydatid cyst of the liver.

Thirty-six patients with intrabiliary rupture of hepatic echinococcal cysts were managed between 1974 and 1993. Clinical findings, skin tests, serologic tests, and imaging techniques were used to establish the diagnosis. Twenty-five (69.4%) patients had pain, 24 (66.6%) jaundice, 22 (61.1%) fever, 20 (55.5%) chills, 10 (27.7%) malaise, and 7 (19.4%) other symptoms as the major causes of admission. All patients underwent choledochotomy and T-tube drainage. Treatment directed to the cyst was cystectomy and capittonage, cystectomy and drainage, and partial hepatectomy in 22, 12, and 2 patients, respectively. Omentoplasty was added to the treatment in 10 patients. Seven (19.4%) patients had complications. The period of hospitalization for patients with and without complications was 34.6 +/- 18.1 and 15.1 +/- 2.7, days, respectively. This study indicates that better results are obtained in patients with cystic lesions of the liver by avoiding percutaneous puncture or biopsy, the early use of ultrasonography and computed tomography, evacuation of the cyst together with its germinative membrane and the involved biliary tract under adequate care to avoid spillage into the peritoneal cavity, treating the remaining cavity according to its location, size, and the presence of infection, and decreasing the pressure in the biliary tract by T-tube drainage.