Pan-immune-inflammation value could be a new marker to differentiate between vascular Behçet's disease and non-vascular Behçet's disease.

OBJECTIVE: Behçet's disease etiology is uncertain, and no specific diagnostic markers exist in the laboratory. This retrospective study aimed to evaluate the role of inflammatory and hematological parameters, mainly Pan-Immune-Inflammation-Value (PIV), in predicting vascular Behçet's disease (VBD). PATIENTS AND METHODS: A total of 85 patients with VBD and 92 patients without vascular involvement (non-VBD) were included in this study. Neutrophil, monocyte, platelet, and lymphocyte subsets are all included in the PIV, a new blood-based biomarker. RESULTS: The optimal cut-off values for the PIV were determined to be ≥261.6. White blood cell, neutrophil, monocyte, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), red cell distribution, platelet, plateletcrit, PIV, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, sedimentation, c-reactive protein (CRP) values were significantly associated with VBD in univariate analysis. After multivariate analysis, PIV [odds ratio (OR): 2.758; 95% confidence interval (CI): 1.327-5.736; p=0.007] and CRP (OR: 4.029; 95% CI: 1.924-8.438; p<0.001) were found to be a positive predictor for VBD, while MCHC (OR: 0.722; 95% CI: 0.530-0.983; p=0.039) was seen as a negative predictor. CONCLUSIONS: Based on our results, PIV, an easily accessible, cost-effective, and new composite biomarker, has a significant predictive value in VBD.

The role of chest X-ray in coronavirus disease 2019 (COVID-19) infection: findings and correlation with clinical outcome.

OBJECTIVE: It is possible to diagnose coronavirus disease 2019 (COVID-19) faster and more accurately with chest X-ray (CXR) and chest computed tomography (CT) than with reverse transcriptase PCR (RT-PCR) tests. The aim of this study was to verify the possibility of reducing the use of CT in diagnosis and follow-up of COVID-19 infection by using CXR. PATIENTS AND METHODS: A total of 326 COVID-19 patients who were hospitalized in Ankara City Hospital were included in this retrospective study. RESULTS: A total of 326 patients were RT-PCR positive for COVID-19 infection; 178 were male (54.6%) and 148 were female (45.4%), with a median age of 45. Considering the results, the baseline CXR sensitivity in our experience was approximately 72%. The CXRs of 113 patients with abnormal CT were divided into 2 groups, the CXR normal and abnormal groups, and were then compared. In the 1st group with abnormal CXR, the mean age, the number of patients over 65 years old, and the comorbidity rate were higher. Additionally, it was determined that the number of patients requiring respiratory support and intensive care unit (ICU) admission in this 1st group was higher than in the 2nd group (with normal CXR). Most of the patients who died (91%, 10/11) were in Group 1. In the group with normal CXR, no patients in the critically ill category needed invasive or non-invasive mechanical ventilators. CONCLUSIONS: CXR can help in detecting clinically moderate and severe cases of COVID-19. CXR can assist clinicians in patient management and treatment planning regarding the clinical course, respiratory support, ICU need, and mortality and can help them prepare for potential negative outcomes.

The role of oxidative stress in chemotherapy-induced gonadotoxicity in a rat model, and the protective effects of Nigella Sativa oil on oxidative stress, the anti-Müllerian hormone level, and apoptosis.

OBJECTIVE: This study aimed to determine the role of oxidative stress (OS) in carboplatin-induced gonadotoxicity and whether Nigella Sativa oil (NSO), an herbal antioxidant, has a protective effect on ovarian apoptosis, OS, and the anti-Müllerian hormone (AMH) level in a rat model. MATERIALS AND METHODS: The study included 24 adult female rats that were divided into 4 treatment groups. Group A saline + saline (sham group); group B: NSO + saline; group C: saline + carboplatin; group D: NSO + carboplatin. Saline, NSO, and carboplatin were administered intraperitoneally 24 and/or 48 h before sacrification as 4 mL/kg, 4 mL/kg, and 80 mg/kg, respectively. Apoptosis, OS parameters, and AMH were measured. RESULTS: Oxidant levels and apoptosis were higher, whereas AMH and the antioxidants were lower in group C than in group A. Apoptosis, OS parameters, and AMH levels were negatively affected by chemotherapy (CTx) in group C whilst improvement in those parameters was observed in group D following NSO pretreatment. The levels of apoptosis and malondialdehyde (MDA), an OS parameter, in group D were lower than in group C as they declined from 34.3% to 8.65% (p = 0.002) and from 199.4 nmol/g tissue to 136.4 nmol/g tissue (p = 0.002), respectively. However, the slight increase in AMH level from 2.7 ng/mL to 3.5 ng/mL due to the NSO effect was not significant between groups C and D. CONCLUSIONS: The present findings show that carboplatin has adverse effects on AMH, ovarian tissue apoptosis, and OS parameters. NSO pretreatment might protect ovarian tissue and decrease CTx-induced ovarian injury by decreasing OS and apoptosis, but the protective effect of NSO on AMH is limited.

Comparison of clinicodemographic characteristics and pattern of vascular involvement in 126 patients with Takayasu arteritis: a report from Iran and Turkey.

Takayasu arteritis (TA) is an extremely uncommon vasculitis that primarily affects the aorta and its branches. Due to the genetic and ethnicity effect, a diverse array of TA clinical manifestations has been reported worldwide. The purpose of the present study was to compare the clinicodemographic characteristics and pattern of vascular involvement of Iranian and Turkish TA patients. This study was a retrospective, cross-sectional investigation of 126 TA patients in Iran and Turkey. All of the variables analyzed were extracted from historical medical records. In 126 TA patients, the ratio of females to males was 8.6:1, and the average age at onset of disease was 30.5±11.1 years. Fatigue (49.2%) and a weak or absent pulse (79.4%) were the most prevalent symptoms and signs, respectively. The most prevalent angiographic classifications were types V and I in Iranian patients (41.09%) and type I in the Turkish population (47.7%) The left subclavian artery was the vessel most frequently affected by TA (66.6%). Our findings indicated that there were no significant differences between the two countries in terms of clinicodemographic characteristics or vascular involvement. Some clinical manifestations, such as claudication, were more prevalent in the Turkish population due to a higher incidence of occlusive lesions in the right subclavian artery.

Identification of transformation products during Doxylamine chloramination for NDMA mitigation.

N-nitrosodimethylamine (NDMA) is a disinfection byproduct that forms at the presence of an organic nitrogen precursor. Doxylamine, an antihistaminic pharmaceutical, is a precursor of NDMA and has been shown to form NDMA in the presence of chloramine. In this study, the effect of Doxylamine as an NDMA precursor has been further studied during chloramination. The end product and byproducts during chloramination were investigated using a high-resolution mass spectrometer by taking samples at different time intervals. Results suggest that NDMA is not the only end product forming during chloramination of Doxylamine and several transformation products that do not end up as NDMA may form. A group of these transformation products have been selected based on their relative amounts during chloramination with time and notated as Focus Tentative Transformation Products (FTTPn). The identification of these byproducts will make it easier to study the conditions during chloramination that may favour these 'known' transformation products with the use of less sophisticated analytical instruments. Then, it might lead to the establishment of chloramination protocols that will minimise the formation of NDMA from its precursors.

The effect of flurbiprofen oral spray and ibuprofen vs ibuprofen alone on postoperative tonsillectomy pain: An open, randomised, controlled trial.

OBJECTIVE: This prospective clinical study was carried out to evaluate the analgesic efficacy and safety of oral spray form of flurbiprofen in the treatment of postoperative pain in tonsillectomy patients. STUDY DESIGN: Open, randomised, controlled clinical study. SETTING: Tertiary care training and research hospital. PARTICIPANTS: One hundred (53 males, 47 females) with an age range of 18-53 years old (mean 27.4 ± 9.3 SD) undergoing tonsillectomy were enrolled in this prospective controlled study. MAIN OUTCOME MEASURES: Patients receiving oral ibuprofen and flurbiprofen as spray form were enrolled as study group (53), whereas patients receiving only oral ibuprofen were enrolled as control group (47) in postoperative period. Postoperative pain was evaluated through visual analogue scale on 12th hour, first, third and seventh days after surgery. RESULTS: The mean maximal pain score of patients who have received flurbiprofen spray and ibuprofen was 3.36 ± 1.93 SD that was statistically lower than the mean maximal pain score of patients who were medicated with only ibuprofen which was 4.06 ± 1.29 SD on postoperative seventh day (P = .013). CONCLUSION: This study revealed that addition of flurbiprofen spray to oral ibuprofen is effective in the management of postoperative pain in tonsillectomy patients with no notable complications.

Flow Diversion with Low-Profile Braided Stents for the Treatment of Very Small or Uncoilable Intracranial Aneurysms at or Distal to the Circle of Willis.

BACKGROUND AND PURPOSE: The endovascular treatment of aneurysms located at or distal to the circle of Willis and not amenable to coiling remains a challenge. We report our experience with flow-diversion treatment using low-profile braided stents as a stent monotherapy procedure for treating distally located very small or uncoilable aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our data bases to identify patients with aneurysms located at or distal to the circle of Willis who were treated with stent monotherapy using low-profile braided stents. The immediate and follow-up angiographic findings and clinical status of the patients were assessed. RESULTS: Twenty aneurysms in 19 patients were included in the study. The mean size of the aneurysms was 4.7 ± 2.4 mm. Patients were treated via telescopic implantation of 2 stents for 11 aneurysms; single-stent placement was used for the remaining aneurysms. The technical success rate was 95%. We observed a technical complication in 1 case (5.3%) and a late ischemic event in another (5.3%). The final angiographies during a mean follow-up of 14.7 months showed complete aneurysm occlusion in 73.7%. The complete occlusion rate of the aneurysms treated with telescopic stent placement was 81.8%. The modified Rankin scale scores of all patients at the last follow-up were between 0 and 2. CONCLUSIONS: Flow diversion with low-profile braided stents as a stent monotherapy procedure for very small or uncoilable intracranial aneurysms located at or beyond the circle of Willis is a promising, relatively safe, and durable endovascular procedure.

Risk Factors Affecting Graft and Patient Survivals After Transplantation From Deceased Donors in a Developing Country: A Single-Center Experience.

AIM: The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. METHODS: We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used. RESULTS: The characteristics of both groups were similar except renal resistive index at the last follow-ups. When graft survival and mortality at the first, third, and fifth years were analyzed, tacrolimus (Tac)-based regimens were superior to cyclosporine (CsA)-based regimens (P < .001). Risk factors associated with graft survival at the first year included cardiac cause of death (versus cerebrovascular accident [CVA]; hazard ratio [HR], 6.36; 95% confidence interval [CI], 1.84-22.05; P = .004), older transplant age (HR, 1.05; 95% CI, 1.02-1.08; P < .001), and high serum creatinine level at 6 months post-transplantation (HR, 1.74; 95% CI, 1.48-2.03; P < .001), whereas younger donor age decreased risk (HR, 0.97; 95% CI, 0.95-1.00; P = .019). Also, the Tac-based regimen had a 3.63-fold (95% CI, 1.47-8.97; P = .005) lower risk factor than the CsA-based regimen, and 2.93-fold (95% CI, 1.13-7.63; P = .027) than other regimens without calcineurin inhibitors. When graft survival at 3 years was analyzed, diabetes mellitus was lower than idiopathic causes and pyelonephritis (P = .035). In Cox regression analysis at year 3, older transplantation age (HR, 1.20; 95% CI, 1.04-1.39; P = .014) and serum creatinine level at month 6 post-transplantation (HR, 1.65; 95% CI, 1.42-1.90; P < .001) were significant risk factors for graft survival. Hemodialysis (HD) plus peritoneal dialysis (PD) treatment was 2.22-fold (95% CI, 1.08-4.58; P = .03) risk factor than only HD before transplantation. When graft survival and mortality at year 5 were analyzed, diabetes mellitus was lower compared with all other diseases. In Cox regression analysis at year 5, younger donor age (HR, 0.73; 95% CI, 0.62-0.86; P < .001) was protective for graft survival, whereas older transplantation age (HR, 1.40; 95% CI, 1.20-1.64; P < .001) and serum creatinine level at month 6 of post-transplantation (HR, 1.39; 95% CI, 1.19-1.61; P < .001) were significant risk factors. PD increased 3.32 (95% CI, 1.28-8.61; P = .014) times the risk than HD. In Cox regression analysis at year 1, cardiac cause of death (versus CVA; HR, 5.28; 95% CI, 1.37-20.31; P = .016), CsA-based regimen (versus Tac; HR, 4.95; 95% CI, 1.78-13.78; P = .002), HD plus PD treatment (versus alone HD; HR, 3.26; 95% CI, 1.28-8.30; P = .013), older transplantation age (HR, 1.08; 95% CI, 1.04-1.11; P < .001), serum creatinine level at month 6 post-transplantation (HR, 1.34; 95% CI, 1.11-1.62; P = .003), and low HLA mismatches (HR, 1.67; 95% CI 1.01-2.70; P = .044) were risk factors for mortality. At year 3, CsA-based regimen (versus Tac; HR, 3.54; 95% CI, 1.32-9.47; P = .012), PD (versus HD; HR, 5.04; 95% CI, 1.41-18.05; P = .013), HD plus PD treatment (versus alone HD; HR, 3.51; 95% CI, 1.37-9.04; P = .009), and older transplantation age (HR, 1.27; 95% CI 1.05-1.53; P = .015) were risk factors for mortality. At year 5, older age at transplantation (HR, 1.47; 95% CI, 1.23-1.77; P < .001), PD (versus HD; HR, 9.21; 95% CI, 3.09-27.45; P < .001), and CsA-based regimen (versus Tac; HR, 2.75; 95% CI, 1.04-7.23; P = .041) were risk factors for mortality, whereas younger donor age decreased risk (HR, 0.71; 95% CI, 0.56-0.86; P < .001). CONCLUSION: Death of donor with cardiac cause, CsA-based immunosuppressive regimen, donor age, serum creatinine level at month 6 post-transplantation, and renal replacement therapy before transplantation affected mortality and graft survival in deceased donors.

Local and systemic effects of low-dose transtympanic methotrexate: in vivo animal study.

OBJECTIVE: To evaluate the safety of low-dose transtympanic methotrexate in a rat model. DESIGN: Experimental animal study. SETTING: Tertiary training and research hospital. METHODS: Twenty-four rats were randomly divided into three study groups. Diluted methotrexate solution was administered transtympanically to fill the middle-ear cavity, twice a week in group one and three times a week in group two. Ringer lactate solution was administered transtympanically three times a week in the control group. MAIN OUTCOME MEASURES: Local and systemic effects of low-dose transtympanic methotrexate. RESULTS: In the methotrexate groups, middle-ear mucosal oedema was present in all animals. Auditory brainstem response thresholds indicated no inner-ear dysfunction in any group. Liver function and serum haemoglobin levels showed no statistically significant difference in any group. However, liver biopsies from groups one and two showed mild portal hyperaemia. CONCLUSION: These findings are encouraging, and support further investigation of the topical application of methotrexate in autoimmune hearing diseases, as an alternative or adjunct to transtympanic steroids.

MR dacryocystography in the evaluation of patients with obstructive epiphora treated by means of interventional radiologic procedures.

BACKGROUND AND PURPOSE: Most imaging techniques used for the evaluation of obstructive epiphora, such as DS DCG, rely on undesired ionizing radiation. We evaluated the efficacy of topical contrast-enhanced MR DCG in comparison with DS DCG in patients with obstructive epiphora who underwent balloon DCG or stent placement. MATERIALS AND METHODS: Thirty-six LDSs of 21 patients treated with balloon DCG (n = 11) or stent placement (n = 11) were examined with MR DCG and DS DCG. Contralateral LDSs (n = 14) were also evaluated in patients with unilateral disease. A sterile 0.9% NaCl solution containing 1:100 diluted gadolinium chelate was instilled into conjunctival sacs. The 3D FSPGR sequence was used with a 1.5T scanner. MR and DS DCG findings were scored and compared according to morphology of the lacrimal sac, junction, and NLD and the presence of contrast media in the nasal cavity. RESULTS: Comparison of MR DCG and DS DCG findings showed no significant statistical differences in reference to anatomic locations according to the McNemar test (P > .05). Good or very good agreement (κ value > 0.61) was observed according to the κ statistics. CONCLUSIONS: Topical contrast-enhanced MR DCG is an effective and reliable noninvasive method for evaluation of the LDS in patients treated with IR procedures. This method avoids both cannulation and ionizing radiation and can, therefore, be repeated as often as is necessary in these complex patients.

Lowering the dose in head CT using adaptive statistical iterative reconstruction.

BACKGROUND AND PURPOSE: While CT has found wide use in medical practice, it is also a substantial source of radiation exposure and is associated with an increased lifetime risk of cancer. There is an urgent need for new approaches to reduce the radiation dose in CT. In this regard, ASIR is an alternative method to FBP. We assessed the effect of ASIR on dose reduction in adult head CT. MATERIALS AND METHODS: We retrospectively evaluated a sample of 149 adult head CT examinations that were divided into 2 groups, STD and LD. We lowered the tube current and used ASIR in the LD group. SNR and CNR were analyzed. Dose parameters were recorded while subjective image noise, sharpness, diagnostic acceptability, and artifacts were graded. The Student t test, the Mann-Whitney U test, and κ statistics were used for statistical analyses. RESULTS: We achieved a dose reduction of 31% in the LD group (STD, 2.3 ± 0.1 mSv; LD, 1.6 ± 0.1 mSv; P < .001). There was no significant difference in the noise measured in the air between the 2 comparison groups (P = .273). Noise in the CSF was higher in the STD group (P < .001), while the noise in the WM was higher in the LD group (P < .001). Differences in the CNR between groups were insignificant, but the STD group displayed better SNR values. There was no significant difference in the modal scores of diagnostic acceptability (P = .062) and the artifacts (P = .148) between the 2 groups. Better scores for subjective image noise (P < .001) and sharpness (P = .04) were observed in the STD group. CONCLUSIONS: ASIR appears to be useful in reducing the dose in adult head CT examinations. While the effect of ASIR on noise reduction observed in the present study of head CT is less than that reported previously in abdomen and chest CT, these findings encourage further prospective studies in larger patient samples.

Effects of Echinacea extract on the performance, antibody titres, and intestinal histology of layer chicks.

1. This research was conducted to determine the effect of diet supplementation with Echinacea extract (cichoric acid) on the growth performance, antibody titres and intestinal tissue histology of layer chicks. 2. White, 1-d-old, Hy-Line hybrid chicks (n = 540) were divided into three treatments, each consisting of 6 groups of 30 chicks (n = 180): (1) control; (2) 2·5 mg/kg cichoric-acid-fed; and (3) 5 mg/kg cichoric-acid-fed. The trial lasted 60 d. 3. While the growth performance of the chicks was depressed between d 1 and 45, it was found to improve between d 45 and 60. 4. Feed consumption was lower in both of the cichoric-acid-fed groups than in the control group between d 1-15 and 15-30, but was higher between d 30 and 45. Overall, mean feed consumption did not differ between the control and cichoric-acid-fed groups during the 60 d study period. 5. During the 60 d evaluation period, live weight gain, feed utilisation rate and final live weight were higher in the control group than in both of the cichoric-acid-fed groups. 6. Antibody titres against infectious bronchitis and infectious bursal disease did not differ between the three groups, but those for Newcastle disease were higher in the 2·5 mg/kg cichoric-acid-fed group than in the control group after 45 d. 7. Height and width of the jejunal villus and the thickness of the muscle layer were lower in the 5 mg/kg cichoric-acid-fed group than in both the control and the 2·5 mg/kg cichoric-acid-fed groups. The height of the ileal villus was also lower in the 5 mg/kg cichoric-acid-fed group than in the other two groups. 8. Echinacea extract supplementation for layer chicks appears not to benefit growth performance and intestinal histology during the growing period.

Combined therapy of teicoplanin and caffeic acid phenethyl ester (CAPE) in the treatment of experimental mediastinitis in the rat.

Post-sternotomy mediastinitis affects 1-3% of patients undergoing cardiac surgery and is lethal in 10-47% of these patients. We investigated the effect of an antioxidant/anti-inflammatory agent, caffeic acid phenethyl ester (CAPE), in the attenuation of inflammatory response induced by methicillin-resistant Staphylococcus aureus (MRSA) infection in a rat experimental mediastinitis model. Rats, divided into six equal groups, received MRSA precolonized stainless steel wire pieces implanted into their mediastinal spaces. Control group and CAPE control group received saline and CAPE 10 micromol/kg.day(-1 )respectively, where Group A received a single dose of teicoplanin 24 mg/kg i.m. for the first day and then 12 mg/kg.day(-1) . Group B received teicoplanin as in Group A plus CAPE 10 micromol/kg. day(-1 )intra-peritoneally. Group C received teicoplanin 60 mg/kg i.m. for the first day and then 30 mg/kg.day(-1 )and Group D received teicoplanin as in Group C plus CAPE 10 micromol/kg.day(-1) . By the end of 14 days rats were sacrificed and serum malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), urea and creatinine levels were evaluated. Mediastinal organ tissues were collected for histopathological analysis. Infection rates in all the drug-treated groups were lower than the control groups ( P=0.002) but statistical significance was attained only between the groups A and D ( P=0.018). In connective tissues and the peribronchial area polymorphonuclear leukocytic (PNL) infiltration in the treatment groups, although becoming very close, did not reach statistical significance (P =0.053, P=0.075, respectively). PNL infiltration especially in the peribronchial tissues of the Group B animals was found to be significantly less than the Control and CAPE Control groups with P values of 0.013 and 0.010, respectively. MDA and MPO levels were significantly lower in the treatment groups ( P<0.001 and P<0.001 respectively). Levels of the degradation products of NO were lower in treatment groups compared to two control groups (P=0.003, P= 0.005). NO levels in Group D were lowest among all treatment groups ( P=0.001). It has been demonstrated that although bacterial colonization can be controlled in mediastinitis, the inflammatory response persists. The combination of an antioxidant / anti-inflammatory agent, CAPE, added to standard antibiotic therapy might be effective in the treatment of post-sternotomy mediastinitis due to MRSA.

Alcohol-induced lung damage and increased oxidative stress.

BACKGROUND: Alcohol-induced lung damage may be associated with increased oxidative stress. OBJECTIVE: Our aim was to investigate alcohol-induced changes in the biochemistry and histopathology of the lung. METHODS: Rats were divided into two groups, a control group and an ethanol group. The ethanol group received 2 g/kg ethanol (total: 3 ml) intraperitoneally. The controls were given the same amount of saline via the same route. Three hours later, the rats were sacrificed, and blood and lung tissue samples were obtained. Oxidative stress was assessed by measuring the levels of erythrocyte reduced glutathione (GSH), tissue malondialdehyde (MDA), myeloperoxidase (MPO) and Na(+)-K(+) ATPase. Histopathologic evaluation of the lung tissues was also performed. RESULTS: In the ethanol group, serum and tissue MDA levels and MPO activities were increased (p = 0.007, p = 0.001 and p = 0.000), and lung tissue Na(+)-K(+) ATPase activities and erythrocyte GSH were decreased (p = 0.001 and p = 0.000) compared to the controls. Histopathologic examination demonstrated alveolocapillary thickening, alveolar degeneration, leukocyte infiltration and erythrocyte extravasation in the lungs of the ethanol group (p < 0.05). CONCLUSION: These results suggest that high-dose acute alcohol administration aggravates systemic and local oxidative stress leading to acute lung injury, ranging from mild pulmonary dysfunction to severe lung injury. It should be borne in mind that rapid onset of the acute respiratory distress syndrome (ARDS) may also be due to increased oxidative stress following alcohol abuse, especially when ischemic disturbances, e.g. coronary heart disease, acute ischemia of the extremities and traumatic accidents, are concomitantly present. Therefore, precautions against ARDS may prevent morbidity and mortality in alcohol-induced lung damage in at-risk patients.

Sepsis induces early phrenic nerve neuropathy in rats.

The aim of the present study was to investigate the electrophysiology of the phrenic nerve and the diaphragm muscle during sepsis. In total, 26 rats underwent either sham laparotomy or caecal ligation and puncture (CLP). Electrophysiology was evaluated via a phrenic nerve conduction study and needle electromyography of the diaphragm, prior to CLP, 6 and 24 h post-CLP and on day 7. The histopathology of the diaphragm muscle and phrenic nerve was also examined on day 7. In the sepsis group, the phrenic nerve conduction study showed decreased amplitude of compound action potential (CMAP), and prolongation in the duration and the latency of CMAP. The diaphragmatic needle electromyography showed decreased amplitude and frequency of the motor unit action potential (MUP), and prolongation in the duration of MUP, at all time points, compared with the pre-CLP values. The electrophysiological abnormalities were consistent with axonal and demyelinating phrenic nerve neuropathy. Electrophysiological abnormalities were present at 6 h with worsening at 24 h and on day 7. Histopathological examination showed normal muscular fibres and focally slight myelin degenerations of the phrenic nerve fibres. In conclusion, sepsis induced phrenic nerve neuropathy as early as the 6th h in rats.

Are erythema nodosum-like lesions and superficial thrombophlebitis prodromal in terms of visceral involvement in Behcet's disease?

Erythema nodosum (EN)-like lesions and superficial thrombophlebitis (ST) are skin symptoms that are frequently observed in Behcet's disease. In most of the patients, skin symptoms precede serious visceral involvement. The study included 78 patients whose mean age was 33.48 +/- 6.16 (21-48). Of the cases, 37 were females and 41 were males. Forty-two patients (53.8%) had EN-like lesion and 12 (15.3%) had ST. Six of 54 patients, who had EN-like lesion and ST, were found to have no visceral involvement. In six of the remaining 48 patients, it was established that visceral involvement developed before lesions. It was found in 42 patients that these two lesions preceded visceral involvement. In addition, 18 of 24 patients who did not have these two lesions, do not still have visceral involvement. Therefore, we think that EN-like lesion and ST can be guiding in predicting serious visceral involvement and complications that can develop in advanced stages of Behcet's disease.

Reiter syndrome accompanied by Terry nail.

We present a case of Reiter syndrome (RS) associated with Terry nail in a 32-year-old male patient who also had subungual keratosis and onycholysis. The case had all the characteristic findings of complete RS including urethritis, conjunctivitis, arthritis and skin lesions, and based on these findings a clinical diagnosis was established. The patient complained of milky-white coloured leakage that was more frequent in the mornings, and dysuria. Urinary analysis revealed leucocytes and erythrocytes. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were high. The case was considered as RS due to gonococcic urethritis. However, there was no growth in the culture. Self-report of the patient revealed that he had had continued symptoms and 9 months after the development of RS he developed Terry nail. To the best of our knowledge this is the first case of RS associated with Terry nail.

Effects of dietary copper on production and egg cholesterol content in laying hens.

1. This experiment was carried out to determine the effects of diets supplemented with different amounts of copper on egg production, food intake, food conversion ratio, egg weight, damaged egg ratio, specific gravity, mortality and cholesterol concentration in yolk. The experiment lasted 90 d and 400 Hisex-Brown hens, aged 27 weeks at the start of the study, were used. 2. There were no statistically significant effects of supplementary copper on egg production, food intake or food conversion efficiency. 3. There were no statistically significant differences between the groups in terms of damaged eggs, egg weight, specific gravity and live weight. 4. At the end of the experiment, the lowest yolk cholesterol concentrations were obtained in the 150 kg/kg copper group and the greatest concentrations were in the control group. 5. Consequently, the use of supplementary copper to provide 150 kg/kg in poultry diets was concluded to decrease yolk cholesterol concentrations without any effect on production performance.

Treatment and follow-up of persistent granulomatous cheilitis with intralesional steroid and metronidazole.

Granulomatous cheilitis (GC) is a chronic edema which frequently affects the upper lip due to granulomatous inflammation. Its etiology is currently unknown. This rare disease is generally accompanied by Melkersson-Rosenthal syndrome (MRS), characterized by scrotal tongue, orofacial edema and facial paralysis. However, it is also known to develop only with orofacial edema. Granulomatous cheilitis is a difficult disease to treat because of recurrences. There are contradictory reports about the results of treatment without surgical intervention and the rates of recurrence. Our case was a 57-year-old female patient who was characterized by orofacial edema only. The edema and erythema had persisted for 1 year before admission. In the present case, application of intralesional corticosteroid treatment as a total of three injections over 3 consecutive months (one injection per month) and the accompanying metronidazole treatment brought about successful results. No recurrence was observed in the follow-up.

Addition of fusidic acid impregnated bone cement to systemic teicoplanin therapy in the treatment of rat osteomyelitis.

We compared the efficacy of the combination of fusidic acid impregnated bone cement and systemic teicoplanin to systemic teicoplanin alone in implant-related osteomyelitis model in the rats. Foreign bodies were implanted into the medullary channels of 30 rat tibias after intramedullary inoculation of methicillin-resistant Staphylococcus aureus. Following proof of induction of osteomyelitis in the rats on the 21st day, a bone cement rod including 1/40 ratio of fusidic acid was inserted into the medullary channel of the tibias in the study group. Teicoplanin was administered i.m. at 20 mg/kg/day for 14 days to both the study and control groups. At the end of the treatment, the tibias were examined macroscopically, microbiologically and histopathologically. The elimination rate with the teicoplanin+fusidic acid combination was 81.8%, while with teicoplanin alone was 55.6% (p=0.33). Although the difference between the two groups was not statistically significant, the combination treatment had a positive effect in eliminating the microorganism.