Evaluation of preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy: preliminary results.

OBJECTIVES: Upper air obstruction leads hypoxia, it is also known that S-100B levels increase by glial activations indicate cerebral hypoxic injury. This study aimed to evaluate the preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy. PATIENTS AND METHODS: The study comprised 40 patients with indications for tonsillectomy and/or adenoidectomy following a diagnosis of chronic adenotonsillar hypertrophy and 40 age-gender matched control patients. Blood samples were taken from the patients preoperatively and at four weeks postoperatively. Preoperative and postoperative serum S-100B levels were analyzed. RESULTS: The serum S-100B levels in the preoperative period were found to be significantly higher compared to those of the control group (p < 0.05). The S-100B levels were significantly decreased in the postoperative period (p < 0.05). CONCLUSIONS: The development of chronic adenotonsillar hypertrophy would play a role in increased S-100B levels. This indicates that neuronal damage would exists in patients with chronic adenotonsillar hypertrophy.

An evaluation of neuropeptide Y status in subacute sclerosing panencephalitis patients.

AIM: This study aimed to evaluate the neuropeptide Y values of patients with subacute sclerosing panencephalitis. MATERIALS AND METHODS: The study comprised 38 patients diagnosed with subacute sclerosing panencephalitis at our clinic, who were being routinely followed-up, together with a control group of 36. Using the Risk and Haddad classification for clinical staging, 16 patients were determined as Stage II and 22 patients as Stage III. Neuropeptide Y values were measured by Enzyme Immunoassay methods. RESULTS: The neuropeptide Y values of the all patients with subacute sclerosing panencephalitis were found to be significantly high compared to the control group (p<0.01). The neuropeptide Y values of the Stage III group were found to be significantly high compared to the Stage II and control groups (p<0.05). The neuropeptide Y values of the Stage II group were not determined to be significant compared to the control group (p≤0.05). CONCLUSIONS: Neuropeptide Y can be considered a useful parameter to confirm diagnosis at advanced stages and to establish differences between stages in patients with subacute sclerosing panencephalitis.

The preoperative and postoperative oxidative status of children with chronic adenotonsillar hypertrophy.

AIM: This study aimed to evaluate the preoperative and postoperative oxidative status of children with chronic adenotonsillar hypertrophy. MATERIALS AND METHODS: The study comprised 25 patients with indications for tonsillectomy and/or adenoidectomy following a diagnosis of chronic adenotonsillar hypertrophy and 25 age-gender matched control patients were included to the study. Blood samples were taken from the patients preoperatively and at four weeks postoperatively. Preoperative and postoperative serum total oxidant (TOS) and total antioxidant (TAS) levels were measured and the oxidative stress index (OSI) was calculated. RESULTS: The serum total oxidant level and oxidant stress index values in the preoperative and postoperative periods of the patients were found to be significantly high compared to those of the control group. While the preoperative serum total oxidant level values were found to be significantly high compared to the postoperative values, no statistical significance was found between the total antioxidant and oxidative stress index values. CONCLUSION: The development of chronic adenotonsillar hypertrophy plays a role in oxidative status and therefore, to neutralize high levels of oxidants in patients, the use of antioxidants for a period preoperatively and postoperatively is thought to be necessary.

An evaluation of subacute sclerosing panencephalitis patients with diffusion-weighted magnetic resonance imaging.

PURPOSE: This study aimed to evaluate the contribution of diffusion weighted magnetic resonance imaging to the diagnosis and staging of subacute sclerosing panencephalitis. MATERIAL AND METHOD: The study comprised 26 patients diagnosed with subacute sclerosing panencephalitis at our clinic who were undergoing regular follow-up, and a control group of 18 subjects. Clinical staging was determined by Risk and Haddad classification; 12 at Stage II and 14 at Stage III. Diffusion weighted magnetic resonance images were taken of six areas (frontal, parieto-occipital, cerebellar, deep white matter, thalamus and basal ganglia) and by calculating the apparent diffusion coefficient (ADC) values, and a comparison was made between the stages and with the control group. RESULTS: The ADC values of all the areas of the subacute sclerosing panencephalitis patients were found to be significantly higher compared to the control group (p < 0.05). While the mean ADC values of the deep white matter, basal ganglia, frontal and parieto-occipital areas of the Stage II patients were found to be significant compared to the control group (p < 0.05), there was no significance in the other areas (p > 0.05). The ADC values of all the areas of the Stage III patients were found to be significantly high compared to the Stage II values (p < 0.05). CONCLUSION: Diffusion weighted magnetic resonance imaging can be used with other diagnostic criteria to confirm diagnosis of subacute sclerosing panencephalitis and to reveal differences between the stages.

Ophthalmo-acromelic syndrome in a Turkish infant: case report.

Ophthalmo-acromelic syndrome (OAS) is an extremely rare autosomal recessive disorder characterised by eye malformations ranging from true anophthalmia to mild microophthalmia and acromelic malformations. In this article, we report a newborn infant with OAS because of its rare presentation. He was the fourth sibling affected in the family. The parents were healthy but there was a close blood relationship between the parents. Physical examination revealed bilateral true anophthalmia and oligodactyly (bilateral four toes) on the feet. He had no other additional abnormalities. We consider that this rare syndrome could be relatively more common in our country because six Turkish cases of OAS have been reported in the English literature to date.

Dural arteriovenous malformation: a rare cause of epilepsy in childhood.

A 3 year and 6 month old girl with epilepsy associated with dural arteriovenous malformation (DAVM), diagnosed on the MRI, is presented to emphasise the importance of DAVM in the aetiology of childhood epilepsy.

Cutaneous anthrax in eastern Turkey.

Anthrax, caused by the spore-forming bacterium Bacillus anthracis, is rarely seen in industrial nations but is common in developing countries. Cutaneous anthrax (CA), the most common form of the disease, accounts for 95% of cases and usually develops on exposed sites. This study reviews the clinical and laboratory findings of 21 patients diagnosed with CA during 2 separate epidemics in the Van region of Turkey. All patients had a history of direct contact with infected cattle. The patients, aged 1.5 to 64 years, included 13 females and 8 males. Of the patients, 9 were 15 years or younger. Skin lesions were localized on the hands and fingers in 15 patients, on the face in 3 patients, on the face and finger in 1 patient, on the chest and finger in 1 patient, and on the eyelid in 1 patient. Gram-positive bacillus were noted on Gram stains of material obtained from skin lesions in 2 patients. All but one patient was successfully treated with penicillin; the unresponsive patient was treated with cefuroxime and required plastic reconstructive surgery because of a skin defect on the eyelid.

Asymptomatic bacteriuria in infants in eastern Turkey.

In this study, the prevalence of asymptomatic bacteriuria (ABU) was investigated in the 146 infants without symptoms suggesting urinary tract infection, age ranged from 29 days to 15 months (mean 4.56 +/- 3.30 months). Our purpose was to determine the prevalence ofABU in infants living in Eastern Turkey and to define the relationship between pyuria and ABU in infants. Of 146 infants, 77 (52.7%) were males, and 69 (47.3%) were females. Although we would like to select randomized healthy infants for the study, 47 (32.1%) infants had a mild to severe malnutrition. While various microorganisms were cultured in 41 (28%) infants in the first urinary culture, only 18 (12.3%) infants had a positive culture in the second urinary culture. The prevalence of ABU was 12.3%. Although ABU prevalence was higher in the infants with malnutrition than those without malnutrition (14.8% 1 vs. 11.1%), there was not a difference between the groups (p>0.05). There was a positive relation between urinary culture positiveness and pyuria (p < 0.001). The prevalence of ABU was much higher (12.3%) than the literature data, which was probably related to very low socioeconomic status of our region where malnutrition and its related disorders are commonly seen. The high ratio might also be related to the method of urine collection, because we used sterile collecting bag, but not suprapubic aspiration method.

Hyponatremic dehydration: an analysis of 78 cases.

Our purpose was to determine the frequency of convulsion in children with hyponatremic dehydration (HD). We also investigated whether or not there was a relationship between the severity of hyponatremia and the degrees of malnutrition in our region (Eastern Anatolia of Turkey) in where malnutrition is frequently observed. In this study, the clinical and laboratory findings of 78 patients with diarrhoea (acute, persistent or chronic diarrhoea) and HD were studied. When diarrhoea lasts longer than 2 and 4 weeks they were accepted as persistent and chronic diarrhoea, respectively. Patients were said to have HD if they had the clinical findings of dehydration associated with hyponatremia [Serum sodium (SNa) <130 mmol/L)]. Nutritional status of the children was assessed by the Gomez classification using weight for age; it was accepted as normal those were between 90%-110%, mild malnutrition 75%-89%, moderate malnutrition 60%-74% and severe malnutrition <60%. Of 78 patients, 40 were boys, 38 were girls. The age and weight of the patients ranged from 40 days to 36 months (8.94 +/- 5.49 months) and from 2000 to 10,300 g (5535.25 +/- 1702.10 g) respectively. All patients except four had malnutrition; 15 (20.3%) had mild malnutrition, 30 (40.5%) had moderate malnutrition and 29 (39.2%) had severe malnutrition. Forty-seven patients had acute, 16 patients had persistent, and 15 patients had chronic diarrhoea. SNa levels were between 104 and 129 mmol/L (121.21 +/- 6.12 mmol/L). There was not statistically a significant difference between SNa level and the degree of malnutrition, and SNa level and the types (acute, persistent or chronic) of diarrhoea (p > 0.05). Of 78 patients, 12 (15.3%) patients had convulsion, of whom eight had convulsion associated with fever. Convulsion was noted in nine (19.1%) and three (18.7%) patients with acute and persistent diarrhoea, respectively (p > 0.05). Also, we observed that when hyponatremia was severer, convulsions tended to be more occuring (p < 0.05). Five (6.4%) children died and all of them had severe malnutrition and septicemia. We determined that the frequency of convulsion in HD was 15.3% (12/78), and there was not a difference between the cases of acute, persistent and chronic diarrhoea for the frequency of convulsion. We also found a significant difference was not present between SNa level and the degree of malnutrition, and between SNa level and the types (acute, persistent or chronic) diarrhoea. However, we observed that when hyponatremia was severer, convulsions tended to be more occuring.

Splenic abscess, pleural effusion and severe anemia caused by Salmonella typhi.

Various complications related to gastrointestinal system, central nervous system, and skeletal system may be observed during typhoid fever, but splenic abscess and pleural effusion are rarely encountered. A 12-year-old boy was admitted with fever, fatigue and pallor. On examination he had hepatosplenomegaly and severe anemia. He was diagnosed as having Salmonella typhi infection complicating with splenic abscess, pleural effusion and severe anemia, and successfully treated with percutaneous drainage with ultrasonography and antibiotics. In conclusion we would like to emphasize that typhoid fever should also be considered in patients with hepatosplenomegaly and severe anemia, and percutaneous drainage with ultrasonography may successfully be used in management of splenic abscess in typhoid fever.