Successful localisation of recurrent thyroid cancer using preoperative patent blue dye injection.

PURPOSE: In the follow-up of patients with thyroid cancer, recurrences are often detected, posing challenges in locating and removing these lesions in a reoperative setting. This study aimed to assess the effectiveness of preoperative ultrasound (US)-guided injection of patent blue (PB) dye into the recurrences to aid in their safe and efficient removal. METHODS: In this retrospective analysis, we reviewed the records of the patients in a tertiary care centre between February 2019 and March 2023 who underwent US-guided PB injection in the endocrinology outpatient clinic before reoperative neck surgery. The duration between the injection of PB and the initiation of surgery was recorded. The complications and effectiveness of the procedure were evaluated using ultrasonographic, laboratory, surgical, and pathologic records. RESULTS: We reached 23 consecutive patients with 28 lesions. The recurrences averaged 8.8 mm (4.1-15.6) in size and were successfully stained in all cases. The median time between the PB injection and the incision was 90 (35-210) min. There were no complications related to the dye injection. The blue recurrences were conveniently identified and removed in all cases. CONCLUSIONS: A preoperative US-guided injection of PB is a safe, readily available and highly effective technique for localising recurrent tumours, even in small lesions within scarred reoperative neck surgeries.

Managing atypical and typical herpetic central nervous system infections: results of a multinational study.

There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection.

Volume calculation of the cattle (Bos taurus L.) and the water buffalo (Bos bubalis L.) metapodia with stereologic method.

In this study, stereological volume estimations using 26 cattle metapodia (26 metacarpal and 26 metatarsal bones) and 8 water buffalo metapodia (8 metacarpal and 8 metatarsal bones) were made. For this purpose metapodia were parallel sectioned at 1 cm intervals according to Cavalieri principle. Grids with 0.4 cm probe intervals were superimposed on top of these sections and the matching points were counted. All of the bone structures and medullar cavity volumes were calculated with the data obtained from a formulation (V = t × a(p) × ΣP) as a spreadsheet using Microsoft Excel® Windows XP. In addition, percent ratio of this volume to whole bone volume was calculated. The mean ratio of bone marrow space to whole bone structure volume equals 15% in all of the cattle and buffalos. The difference between whole bone volumes of cattle and water buffalo was significant (p < 0.05) while the difference in volume of medullary cavity (cavum medullare) was not significantly different between the two investigated species. The aim of current study is to present a new method that can be used for the volumes calculation of whole bones and medullary cavity in metapodial bones and their percentages.

Spatio-spectral characterization of local field potentials in the subthalamic nucleus via multitrack microelectrode recordings.

Deep brain stimulation of the subthalamic nucleus (STN) is a highly effective treatment for motor symptoms of Parkinson's disease. However, precise intraoperative localization of STN remains a procedural challenge. In the present study, local field potentials (LFPs) were recorded from three tracks during microelectrode recording-based (MER) targeting of STN, in five patients. The raw LFP data were preprocessed in original recording setup and then data quality was compared to data with common average derivation. The depth-frequency maps were generated according to preprocessing results for each patient and spectral characteristics of LFPs were explored at each depth across different tracks and different subjects. Spatio-spectral analysis of LFP was investigated to see whether LFP activity can be used for optimal track selection and STN border identification. Analysis show that monopolar derivation suffer from various artifacts and/or power line noise which makes the interpretation of target localization very difficult in most of the subjects. Unlikely, bipolar derivation helps to recover the neurological signals and investigation of signal characteristics. The frequency-vs-depth maps using a modified Welch periodogram with robust statistics, demonstrated that a median-based spectrum estimation approach eliminates outliers pretty well by preserving band-specific LFP activity. The results indicate that there is a clear oscillatory beta activity around 20 Hz in all subjects. 1/f normalization reveals the high frequency oscillations (HFOs) between 200-to-350 Hz in two subjects. It's noted that the optimal track selection is not consistent with the track having highest beta band oscillations in two out of five subjects. In conclusion, microelectrode-derived LFP recordings may provide an alternative approach to single unit activity (SUA)-based MER, for localizing the target STN borders during DBS surgery. Despite the small number of subjects, the present study adds to existing knowledge about LFP-based pathophysiology of PD and its target-based spectral activities.

The effects of using the Internet on the health-related quality of life in people with spinal cord injury: a controlled study.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To compare the health-related quality of life (HRQoL) in people with spinal cord injury (SCI) who use the Internet versus those who don't and with a control group of able-bodied individuals. To investigate the frequency of Internet usage before and after injury. To evaluate the differences in terms of demographic features of both groups, analyze the variation in the Internet usage pattern of people with SCI before and after the injury. SETTING: Istanbul, Turkey. METHODS: A total of 60 people with SCI (38 Internet users, 22 nonusers) were included in the study. The control group consisted of 33 healthy persons of similar age and sex. The HRQoL was evaluated with the SF-36 Health Survey. RESULTS: The scores of all the subscales of the SF-36, except vitality, were significantly lower in people with SCI than those of the controls'. The bodily pain subscale and physical component scores were found to be significantly higher in people with SCI using the Internet than the nonuser group with SCI (P<0.05). The Internet usage frequency increased significantly in people with SCI after injury (P<0.05). A significant correlation was found between time since injury and Internet use (r=0.365, P=0.007). CONCLUSION: Although HRQoL scores were lower in people with an SCI, the physical status component score was better in the Internet user SCI group. As there is a significant increase in the time spent online after injury, the Internet could be an effective modality to contact and educate people with an SCI.

Localization of subthalamic nucleus borders using macroelectrode local field potential recordings.

Deep brain stimulation of the subthalamic nucleus (STN) is a highly effective treatment for motor symptoms of Parkinson's disease. However, precise intraoperative localization of STN remains a procedural challenge. In the present study, local field potentials (LFPs) were recorded from DBS macroelectrodes during trajectory to STN, in six patients. The frequency-vs-depth map of LFP activity was extracted and further analyzed within different sub-bands, to investigate whether LFP activity can be used for STN border identification. STN borders identified by LFPs were compared to border predictions by the neurosurgeon, based on microelectrode-derived, single-unit recordings (MER-SUA). The results demonstrate difference between MER-SUA and macroelectrode LFP recording with respect to the dorsal STN border of -1.00 ±0.84 mm and -0.42 ±1.07 mm in the beta and gamma frequency bands, respectively. For these sub-bands, RMS of these distances was found to be 1.26 mm and 1.06 mm, respectively. Analysis of other sub-bands did not allow for distinguishing the caudal border of STN. In conclusion, macroelectrode-derived LFP recordings may provide an alternative approach to MER-SUA, for localizing the target STN borders during DBS surgery.

New method for estimating the volume and volume fractions of the nasal structures in the goose (Anser anser domesticus) using computed tomography images.

1. The conchae within the nasal cavity of poultry are important for water and energy conservation, but have not been experimentally evaluated. The aim of the present study was to determine the accuracy of volume and volume fraction estimates of the conchae, nasal septum and nasal cavity. 2. The nasal cavities of 7 adult goose heads were scanned using computed tomography (CT), with images sampled randomly at a 1/5 sampling fraction. Physical sections were obtained from the same samples, using an electric saw that had an adjustable section range, and provided 14 to 15 sections with a thickness of 2.5 mm. The section surface areas of the nasal cavity, nasal septum and conchae were estimated using the Cavalieri principle. Results obtained using the CT and physical section images were compared. Volumes and volume fractions obtained from the physical sections were accepted as the gold standard and differences in the CT images were determined. 3. Multiplication of the data obtained on the CT images with the deviation percentage of the physical sections produced normalised values. No differences were observed between the gold standard data and the CT images. While it was possible to normalise the obtained data using the gold standard values, the raw data could also be used for comparative studies because the deviations from normal would be similar for all groups. 4. Our study showed that the nasal structures could be estimated in vivo using CT images.

Prediction of pharmacologically induced baroreflex sensitivity from local time and frequency domain indices of R-R interval and systolic blood pressure signals obtained during deep breathing.

Pharmacological measurement of baroreflex sensitivity (BRS) is widely accepted and used in clinical practice. Following the introduction of pharmacologically induced BRS (p-BRS), alternative assessment methods eliminating the use of drugs were in the center of interest of the cardiovascular research community. In this study we investigated whether p-BRS using phenylephrine injection can be predicted from non-pharmacological time and frequency domain indices computed from electrocardiogram (ECG) and blood pressure (BP) data acquired during deep breathing. In this scheme, ECG and BP data were recorded from 16 subjects in a two-phase experiment. In the first phase the subjects performed irregular deep breaths and in the second phase the subjects received phenylephrine injection. From the first phase of the experiment, a large pool of predictors describing the local characteristic of beat-to-beat interval tachogram (RR) and systolic blood pressure (SBP) were extracted in time and frequency domains. A subset of these indices was selected using twelve subjects with an exhaustive search fused with a leave one subject out cross validation procedure. The selected indices were used to predict the p-BRS on the remaining four test subjects. A multivariate regression was used in all prediction steps. The algorithm achieved best prediction accuracy with only two features extracted from the deep breathing data, one from the frequency and the other from the time domain. The normalized L2-norm error was computed as 22.9% and the correlation coefficient was 0.97 (p=0.03). These results suggest that the p-BRS can be estimated from non-pharmacological indices computed from ECG and invasive BP data related to deep breathing.

Classification of multichannel ECoG related to individual finger movements with redundant spatial projections.

We tackle the problem of classifying multichannel electrocorticogram (ECoG) related to individual finger movements for a brain machine interface (BMI). For this particular aim we applied a recently developed hierarchical spatial projection framework of neural activity for feature extraction from ECoG. The algorithm extends the binary common spatial patterns algorithm to multiclass problem by constructing a redundant set of spatial projections that are tuned for paired and group-wise discrimination of finger movements. The groupings were constructed by merging the data of adjacent fingers and contrasting them to the rest, such as the first two fingers (thumb and index) vs. the others (middle, ring and little). We applied this framework to the BCI competition IV ECoG data recorded from three subjects. We observed that the maximum classification accuracy was obtained from the gamma frequency band (65200 Hz). For this particular frequency range the average classification accuracy over three subjects was 86.3%. These results indicate that the redundant spatial projection framework can be used successfully in decoding finger movements from ECoG for BMI.

Hypertension in leather tanning workers working in Istanbul, Turkey.

INTRODUCTION: Leather tanning may result in various occupational diseases. The aim of this study was to compare the relation between blood pressure levels and vocations in leather tanning. METHODS: Our study was conducted in Turkey's leading leather process plant located in Tuzla organised industry zone, between March 11 and May 30, 2005. All leather plants that consented to participate in our study were included. The blood pressure, height and weight of the workers were measured. Their ages, educational levels, smoking habits and hypertension history were obtained via interviewing the subjects. The relation between three main factors, i.e. age, body mass index (BMI), working period, and hypertension were analysed through multiple logistic regression analysis. RESULTS: 40.4 percent (295) of 730 workers' blood pressure values were found to be within normal limits. 59.6 percent (435) were found to be hypertensive. The hypertension correlation remained significant, along with BMI and their working period (p-values were 0.0001 and 0.035, respectively). CONCLUSION: Our study demonstrated that BMI and working period have a key influence on the increased risk of hypertension, which leads us to consider the importance of occupational exposure. Different hypertension studies to be conducted in various occupational fields would likely be able to confirm our findings.

Catalysis of advanced oxidation reactions by ultrasound: a case study with phenol.

The present study is about the enhancement in ozone-mediated degradation and UV (254nm) photolysis of phenol in aqueous solutions by 300kHz acustic cavitation and the selection of operating parameters for optimum phenol removal efficiency. The method was based on monitoring of the concentration of phenol during 90min exposure to ozonation, sonication, UV photolysis, O(3)/ultrasound, UV/ultrasound and O(3)/UV/ultrasound operations. It was found that ozonation at alkaline pH was an effective method of phenol destruction, but it was considerably more effective when applied simultaneously with ultrasonic irradiation. The observed synergy particularly at alkaline pH was attributed to combined effects of: (i) increased ozone mass transfer (upon hydrodynamic shear forces created by ultrasonic bubbles) and (ii) excess hydroxyl radical formation (upon thermal decomposition of ozone in the gaseous cavity bubbles). Degradation of phenol by photolysis alone was negligible, while combination of UV-irradiation and ultrasound rendered considerable degrees of decay. The synergy here was explained by excess hydroxyl radicals that are formed by photolysis of ultrasound-generated H(2)O(2). Maximum rate of phenol degradation was observed in case of combined application of ozone, UV and ultrasound at basic pH.

Prevalence and antibiotic susceptibility of genital Mycoplasma hominis and Ureaplasma urealyticum in a university hospital in Turkey.

This study aimed to assess the colonization prevalence and antibiotic susceptibility of genital Ureaplasma urealyticum and Mycoplasma hominis in a teaching hospital, in Turkey. A total of 382 sexually active women with abnormal vaginal discharge were included in the study. Samples that were obtained with cotton swabs were microbiologically analyzed for U. urealyticum and M. hominis, together with antimicrobial susceptibility to doxycycline, ciprofloxacin, ofloxacin, erythromycin, josamycin, pristinamycin, and tetracycline. Ureaplasma urealyticum was detected in 185 (48.4%) cultures, and M. hominis in 17 (4.4%). Eight (2.1%) cultures were positive for both. Resistance of M. hominis to doxycycline, ciprofloxacin, ofloxacin, erytromycin, josamycin, pristinamycin and tetrascycline was 5.9%, 17.6%, 41.2%, 88.2%, 5.9%, 5.9% and 11.8%, respectively. Resistance to doxycycline, ciprofloxacin, ofloxacin, erytromycin, josamycin, pristinamycin and tetrascycline in U. urealyticum isolates was 1.6%, 40.5%, 58.4%, 54.0%, 1.6%, 8.1% and 13.5%, respectively. Both U. urealyticum (94.1%) and M. hominis (96.2) were most sensitive to josamycin, and most resistant to erytromycin (U. urealyticum 54.0%, M. hominis 88.2) and ofloxacin (U. urealyticum 58.4%, M. hominis 41.2%). As a result, the rate of U. urealyticum and M. hominis was found to be 48.4% and 4.4%, respectively. We conclude that doxycycline may be used in empirical treatment of genital tract infections in sexually active women.

Effects of operating parameters on sonochemical decomposition of phenol.

Ultrasonic removal of phenol under irradiation at 20, 300 and 520 kHz was investigated to assess the impacts of operating parameters on the efficiency of the systems. It was found under our experimental conditions that 20 kHz was the least effective frequency for ultrasonic decomposition of phenol, owing to the low volatility of phenol and the slow rate of OH radical ejection to the bulk solution at this frequency. Assessment of relative rates of destruction and ultrasonic yields showed that maximum efficiency was accomplished with 300 kHz employed in a reactor enclosed with an ultrasonic energy of 14.7 W. The same reactor and frequency was found to provide maximum ejection of hydroxyl radicals to the solution. Impacts of pH and initial concentration on the efficiency of phenol removal were such that acidic pH and high concentrations accelerated the process as related to the increased likelihood of phenol at these conditions to approach the cavity sheath. Separate injection of equivalent volumes of air and argon into the reactors showed that the decomposition was enhanced in the presence of air by virtue of the production of additional reactive species via the reaction of nitrogen with molecular oxygen.

Degradation of aryl-azo-naphthol dyes by ultrasound, ozone and their combination: effect of alpha-substituents.

Lab-scale degradation of azo dyes with ultrasound (300 kHz), ozone and both was investigated using an aryl-azo-naphthol dye-C.I. Acid Orange 8. It was found that in all schemes color decay was faster than UV absorbance, and the rates followed pseudo-first-order kinetics except for the decay of UV-254 band by ozone. Sonication alone was sufficient for decolorization, but not for UV absorption abatement or mineralization. Ozonation was more effective than ultrasound in bleaching, but not as much for the mineralization of the dye. Combined operation of ultrasound and ozone improved the rate of bleaching and UV absorption decay and remarkably enhanced the mineralization of the dye. This was attributed to increased mass transfer of ozone in solution and its decomposition in the gas phase to yield hydroxyl radicals and other oxidative species. The effect of alpha-methyl substituent at the aryl carbon of the dye was found to decelerate the rate of degradation as a result of weakened intramolecular hydrogen bonding.

Tuberculous meningitis in adults--experience from Turkey.

BACKGROUND: The annual incidence of tuberculous meningitis (TM) is unknown. TM is a disease that still often results in residual sequelae, and has a mortality rate ranging between 15 and 51%. Experience of countries such as Turkey where drug-resistant tuberculosis and TM are prevalent is important. METHODS: Clinical and laboratory findings of 42 patients with TM, followed between 1991 and 2002, were evaluated retrospectively. RESULTS: Twenty-eight female and 14 male patients were included in this study. The mean age of the patients was 33.9 +/- 13.2 years (range, 16-60 years). Fourteen had a history of pulmonary tuberculosis; 12 reported close contact with a person with active pulmonary tuberculosis; three were diagnosed with active pulmonary tuberculosis; two, with HIV infection; two, with Pott's disease; and one, with systemic lupus erythematosus. On admission, 17 patients were diagnosed with stage I; 15, with stage II; and 10, with stage III disease. Hemiparesis (35.7%), cranial nerve palsy (30.9%), and altered consciousness (26.9%) were the most common neurological deficits. Prolonged duration of pre-existing symptoms and female gender were found as significant risk factors in those who develop neurological sequelae (p < 0.01 and p < 0.05, respectively). Cranial computerised tomography revealed various pathological findings in all but five patients. Sulcus effacement was the most common radiological finding. Enlargement of ventricles, focal cerebral oedema/shunt, calcification of meninges, tubercle, and infarction were other common abnormal radiological findings. CONCLUSIONS: Prolonged duration of pre-existing symptoms and female gender are predictors of neurological sequelae of TM. Early identification of such patients and prompt initiation of anti-tuberculosis therapy may improve their outcome.

Individual and combined effects of ultrasound, ozone and UV irradiation: a case study with textile dyes.

Comparative degradation of azo dyes by 520 kHz ultrasonic irradiation and its combinations with ozone and/or ultraviolet light (UV) was investigated using a probe dye C.I. Acid Orange 7. Operation parameters such as ultrasonic power density, ozone flow, UV intensity, and type and injection mode of the bubbling gas were optimized based on the rate of absorption decay in the visible and UV bands as estimated by regression analysis of absorption-time data. At equivalent initial dye concentrations and contact times, individual effects of UV irradiation, ultrasound and ozone were "no effect", "bleaching", and "bleaching/organic carbon degradation", respectively. UV irradiation, however, was found to induce a catalytic effect when applied in combination with either ultrasound or ozone schemes; and the overall degradation process was most rapid under simultaneous operation of the three in the presence of a continuous flow of a gas mixture made of argon and oxygen. The synergy observed in combined schemes was attributed to enhanced ozone diffusion by mechanical effects of ultrasound, and the photolysis of ultrasound-generated H(2)O(2) to produce hydroxyl radicals.

Analysis and visualization of ERD and ERS with Adapted Local Cosine Transform.

We apply Adapted Local Cosine Transform to movement EEG, which is a local spectral representation of the signal. It includes best basis method obtained by entropy minimization. The algorithm yields to adaptive time segmentation, where these segments correspond to ERD and ERS events. The algorithm provides short segments in ERD and ERD to ERS transitions. Then we use averaged DCT coefficients to extract the ERD ERS structure of a person.

Degradation and toxicity reduction of textile dyestuff by ultrasound.

Degradability of four textile dyes was investigated in deionized water solutions during 520 kHz ultrasonic irradiation. It was found that for all dyes, the rate of color decay was first order in the visible absorption of the dye, and related to the type of functional groups that characterized the chromophore in the dye molecules. The destruction of aromatic/olefinic carbons in azo dyes was slower than that of color--to be attributed to the priority of hydroxyl radical attack on the N=N bonds, and to the formation of numerous oxidation intermediates of organic character during the course of dye degradation. Toxicity analysis of the dye solutions prior to sonolysis revealed that "reactive" dyes were non-toxic, but "basic" ones were toxic at the test concentrations employed in the study. Significant degrees of toxicity reduction were accomplished along with color and aromatic carbon degradation.

The use of family planning methods in an administrative district of Istanbul.

In Turkey, the first population and family planning law was accepted by the government in 1965, and this law was revised in 1982. This study was carried out to evaluate the family planning methods of women who applied to rural health centers of Küçükçekmece and were willing to use the health-care service and consultancy about birth control methods. The data of the study were gathered by means of an appropriate inquiry form and face-to-face interview with the women willing to use the family planning service between September 1998 and June 1999 at the health-care centers of Küçükçekmece of Istanbul. There were 699 women participants in the study. The last pregnancy of 27.2% (n = 175) of the women had been undesired; 86.8% of all the women who participated in the study declared that they did not desire any more children, but only 81.3% (n = 568) out of these were using a method to protect from pregnancy. The most frequently known (84.8%) and used (45.9%) method of the participants was an intrauterine device (IUD), and 80.8% of the women using an IUD wanted to continue using that method. A total of 223 women (39.3%) using any method protecting from pregnancy became pregnant. Approximately half (57.8%) of those occurred during the use of withdrawal. According to the findings of this study, the level of knowledge about family planning and the consequent behavior of the women within the fertile age group are better than the average of Turkey, but still not satisfactory.

Combinative dyebath treatment with activated carbon and UV/H2O2: a case study on Everzol Black-GSP.

Treatability of textile dyebath effluents by two simultaneously operated processes comprising adsorption and advanced oxidation was investigated using a reactive dyestuff, Everzol Black-GSP (EBG). The method was comprised of contacting aqueous solutions of the dye with hydrogen peroxide and granules of activated carbon (GAC) during irradiation of the reactor with ultraviolet light (UV). Control experiments were run separately with each individual process (advanced oxidation with UV/H2O2 and adsorption on GAC) to select the operating parameters on the basis of maximum color removal. The effectiveness of the combined scheme was tested by monitoring the rate of decolorization and the degree of carbon mineralization in effluent samples. It was found that in a combined medium of advanced oxidation and adsorption, color was principally removed by oxidative degradation, while adsorption contributed to the longer process of dye mineralization. Economic evaluation of the system based on total color removal and 50% mineralization showed that in the case of Everzol Black-GSP, which adsorbs relatively poorly on GAC, the proposed combination provides 25% and 35% reduction in hydrogen peroxide and energy consumption relative to the UV/H2O2 system. Higher cost reductions are expected in cases with well adsorbing dyes and/or with less costly adsorbents.