The relationship between temporal muscle thickness and disease activity in Cushing's disease.

OBJECTIVE: This study aimed to investigate the relationship between hypercortisolism and temporal muscle thickness (TMT) in Cushing's disease (CD). METHODS: A retrospective review of medical records was conducted for patients with CD who presented to our clinic between 2012 and 2022. Biochemical data and TMT measurements from sella imaging were evaluated during diagnosis and the first postoperative year. RESULTS: A total of 44 patients were included in the study, with an average age of 43.9 years, of which 38 were female. The mean TMT at the time of diagnosis was 19.07 ± 1.71 mm, with no significant difference between males and females (p = 0.097), and no correlation between the TMT and age at diagnosis (p = 0.497). There was an inverse relationship between TMT and serum cortisol levels, 24-h UFC, and midnight salivary cortisol at the time of diagnosis of CD (p < 0.05, for all). One year after surgery, TMT significantly increased in all patients compared to baseline (p < 0.001). Furthermore, patients who achieved postoperative remission had significantly higher TMT values compared to those who did not achieve remission (p = 0.043). Among the patients who achieved remission, those who achieved remission through surgery had significantly higher TMT compared to those who could not reach remission with surgery and patients who started medical treatment and achieved biochemical remission (p = 0.01). Patients with severe myopathy and sarcopenia had significantly lower TMT values than the others (p < 0.001). CONCLUSION: Temporal muscle thickness was found to be associated with disease activity and disease control in Cushing's disease.

Prognostic significance of the metastatic lymph node ratio compared to the TNM classification in stage III gastric cancer.

BACKGROUND: We aimed to evaluate a comparative analysis of the prognostic value of the metastatic lymph node ratio (LNR) and pN (TNM) in stage III gastric cancer. PATIENTS AND METHODS: A total of 159 stage III gastric cancer patients with curative gastrectomy were retrospectively analyzed. Cutoff values for LNR were designated according to 25%, 50% and 75% percentiles, 0.07, 0.20 and 0.44 respectively. The LNR was divided into four groups as 0 > LNR1 ≤ 0.07; 0.07 > LNR2 ≤0.20; 0.20 > LNR3 ≤0.44; 0.44 > LNR4 ≤1. RESULTS: The mean age of the patients was 61.1 ± 11.3 years. Male predominance was apparent (73.6%). The 1-year overall survival and recurrence rates were 73.6% and 33.6%, respectively. The univariate cox regression analysis demonstrated age and LNR were the main variables that affected overall survival (OS) (p < 0.05). Harvested lymph nodes less than 16 did not affect OS (p = 0.255). The results of the multivariate cox regression analysis revealed that only LNR was an independent prognostic factor (P < 0.001), while pN was not (p > 0.05). Similar results, as with overall survival, could not be revealed clearly for disease free survival (DFS). CONCLUSIONS: LNR was an independent significant prognostic factor and superior to pN staging in predicting OS but not for DFS in stage III gastric cancer patients. The high LNR levels in our research were found to be associated with poor survival rates. The percentile system we used to determine cutoff values may be considered as a reliable method. Similarly, LNR also provides a reliable prognostic parameter in future staging systems to help guide treatment algorithm plans.

A randomized, controlled clinical trial to evaluate the immunogenicity of a PreS/S hepatitis B vaccine Sci-B-Vac™, as compared to Engerix B®, among vaccine naïve and vaccine non-responder dialysis patients.

BACKGROUND: Dialysis patients have a suboptimal response to hepatitis B (HBV) vaccination. This study aimed to compare the immunogenicity of two vaccines: the third-generation Sci-B-Vac™ vs. the second-generation Engerix B®. The cohort included two groups of dialysis patients: naïve and previously vaccinated non-responders. Primary endpoints were antibody titers ≥10 IU/L at 3 and 7 month post-vaccination. Secondary objectives were seroprotection rates in vaccine-naïve patients and in previously vaccinated non-responders. METHODS: Eighty-six patients were assigned to vaccine (Sci-B-Vac™ or Engerix B®) using computer-generated randomization, stratified by age, gender, diabetes, and previous HBV vaccination. Sci-B-Vac™ was administered in three doses, 10 µg, at 0, 1, and 6 months in naïve patients; or 20 µg in previously vaccinated non-responders. Engerix B® included four doses, 40 µg at 0, 1, 2, and 6 months. RESULTS: Each group had 43 patients. Seroconversion was 69.8% with Engerix B® vs. 73.2% with Sci-B-Vac™. Antibody titers at 7 months were higher with Sci-B-Vac™ (266.4 ± 383.9, median 53.4) than with Engerix® (193.2 ± 328.9, median 19). However, these differences were not significant, perhaps due to a suboptimal sample size. CONCLUSIONS: This study suggests comparable immunogenicity for both vaccines. Thus, we cannot reject the null hypothesis that there is no difference in seroconversion by vaccine type. It is noteworthy that naïve patients were vaccinated with a standard dose of Sci-B-Vac™, while Engerix B® was administered at a double dose. Similarly, although mean antibody titer levels in the Sci-B-Vac™ group were higher than in the Engerix® group, this difference did not reach significance. Consequently, a future clinical trial should recruit a larger cohort of patients, using a standard double-dose protocol in both groups.

Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

OBJECTIVE: The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. MATERIALS AND METHODS: Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. RESULTS: Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. CONCLUSIONS: Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.

Comparison of arch width changes following orthodontic treatment with and without extraction using three-dimensional models.

OBJECTIVE: To compare the arch width changes in patients treated fixed orthodontic mechanics without extraction (Group 1), with upper and lower first premolar extractions (Group 2), and with upper first premolar extraction only (Group 3). MATERIALS AND METHODS: The study was conducted with pre- and post-treatment digital models from 240 patients. Anterior, middle, and posterior distances were measured on pre- and post-treatment models. At T1 measurements, the distance among the canine cusp tips, the second premolar buccal cusp tips, and the first molar mesiobuccal cusp tips were measured. In addition, the distance (D) between the intercanine and intermolar lines and the distance (D') between the interpremolar and intermolar lines were defined on the anatomic y-axis, and this distance was maintained in calculating posttreatment measurements (T2). Mandibular and maxillary arch width changes were evaluated within and between groups. RESULTS: Anterior, middle, and posterior arch widths increased significantly in Groups 1 and 3. Maxillary anterior and middle arch widths also increased in Group 2, but the increases were not statistically significant. Changes in maxillary anterior and middle arch widths were higher in Groups 1 and 3 when compared to Group 2. However, there was no statistically significant difference in mandibular arch changes between the groups. CONCLUSION: Extraction treatment mechanics did not cause narrow dental arches, but nonextraction treatment increased arch width in all 3 measurements. Treatments with only upper arch extraction showed similar results with nonextraction treatment.

The Diagnosis and Management of Multiple Supernumerary Teeth Involving Both Jaws.

Supernumerary teeth are frequently seen anomalies however its occurrence in both jaws is rare without being associated with complex syndromes. This case report describes the orthodontic and surgical treatment of a 13-year-old boy with nonsyndromal multiple and abnormal supernumerary teeth. The patient had several erupted and unerupted supernumerary teeth involving both jaws. Two abnormal tuberculate type erupted supernumerary teeth were present at the site of upper central incisors which leads to the impaction of the permanent incisors. In this report, clinical and radiographic evaluation as well as the treatment alternatives of this rare case was presented.

Stenotrophomonas maltophilia Pseudo-outbreak at a University Hospital Bronchoscopy Unit in Turkey.

OBJECTIVE: Stenotrophomonas maltophilia is an opportunistic pathogen found predominantly in the environment and hospital setting. Invasive procedures and treatment methods, instruments used for diagnosis and irrational antibiotic use play major roles in the spread of this pathogen. The study aimed to evaluate consecutive S maltophilia isolation from bronchoalveolar lavage samples during bronchoscopy procedure during a week. METHODS: Four patients consecutively had S maltophilia isolated during bronchoscopy between September 8 and 15, 2012. The identification of the isolates and their antibiotic susceptibility were studied by automated Vitek version 2.0 (Biomerieux, France) system. The clonal relationship between the isolates was studied by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR). RESULTS: Four consecutive S maltophilia isolates had identical band patterns and showed clonal relatedness. CONCLUSION: Bronchoscopy is a common invasive procedure that is utilized in chest diseases departments and intensive care units (ICUs). Contamination may take place due to inappropriate use and cause spread of infectious pathogens. In the current study, we detected consecutive S maltophilia strains with identical band patterns isolated within a week. After appropriate disinfection and cleaning procedures, no further isolation was detected.

[The effect of fluoroquinolone use in the respiratory intensive care unit on the development of hospital-acquired MRSA infection and its prognosis]. / Solunumsal yogun bakim ünitesinde florokinolon kullaniminin hastane kökenli MRSA enfeksiyonu gelisimine ve prognoza etkisi.

Methicillin-resistant Staphylococcus aureus (MRSA) which exhibits a worldwide spread, has become a serious public health problem. There are several studies indicating that there may be a relationship between the high rate of MRSA infections and long-term use of fluoroquinolones. The aim of this study was to investigate the effect of fluoroquinolone (FQ) use in the respiratory intensive care unit (ICU) on the development of the hospital-acquired MRSA infection and mortality. This was a single center experience, in which the clinical and laboratory data of the patients who were hospitalized in the respiratory ICU for two years, were retrospectively evaluated. The relationship between FQ use and the development of MRSA infection was evaluated with correlation analysis, and its relationship with the mortality was evaluated with regression analysis. A total of 302 patients were included in the study and 93 (30.7%) of them were found to be treated with FQs. Sixty-four of those 93 patients were male and the mean age was 71.1 ± 12.5 years. During the follow-up, MRSA infections developed in 11.9% (36/302) of the patients, and the rate of MRSA infection in FQ using patients was 15.1% (14/93), of them eight were ventilator-associated pneumonia (VAP) and six were secondary bacteremia. Although a positive correlation was found between FQ use and the development of MRSA infection, it was not statistically significant [P= 0.521 (Spearman), p= 0.037 (Pearson)]. In addition cut-off values for CRP and leukocyte counts, which were checked when a patient with FQ use admitted to the ICU, were determined as 7.85 mg/L and 7.650/mm3, respectively. The analysis of the relationship between CRP, leukocyte counts and the development of MRSA infection revealed a statistically significant positive relationship between high leukocyte levels (> 7.650/mm3) and the development of MRSA infection (P= 0.017, p= 0.246), but no such relationship for the CRP levels (P= 0.121, p= 0.178). The mortality rate in patients with FQ use was found as 42% (39/93), and it was determined that malignancy, history of admission to hospital in the previous six months and the presence of a hospital-acquired infection increased the risk of mortality (p= 0.020, p= 0.038 and p= 0.024, respectively). In the multivariate analysis, four independent risk factors related to the mortality in patients under FQ treatment were determined, namely malignancy (OR: 2.280, p= 0.002), re-intubation practices (OR: 4.071, p= 0.005), VAP (OR: 5.097, p= 0.009) and the use of FQ > 7 days (OR: 3.63, p= 0.003). In conclusion, our data indicated that the use of FQs in the ICU did not increase the development of hospital-acquired MRSA infection significantly, and FQ use for more than seven days was an independent risk factor for mortality. Additionally, it was thought that high leukocyte counts might be a predictive marker for the development of MRSA infection.

The correction of maxillary defciency with internal distraction devices: a multidisciplinary approach.

AIM: The purpose of this case report is to present the orthodontic, surgical and restorative treatments in the case of an operated cleft lip and palate and severe maxillary defciency in a 14-year-old female patient. BACKGROUND: Only orthodontic treatment could be ineffcient for cleft lip and palate patients characterized with maxillary hypoplasia. Orthodontic and surgical treatment shows suffcient results, especially with severe skeletal defciency. CASE REPORT: A cleft lip and palate patient required complex multidisciplinary treatment to preserve health and restore esthetics. Dental leveling and alignment of the maxillary and mandibular teeth were provided before the surgery. Maxillary advancement and clockwise rotation of the maxillary-mandibular complex was applied by a Le Fort 1 osteotomy with two internal distraction devices. After the active treatment including orthodontic treatment and orthognathic surgery, upper full mouth ceramic restoration was applied. CONCLUSION: This report shows the efficiency of internal distraction devices in cleft lip palate patients and exemplifes the multidisciplinary care required for such diffcult cases. Clinical signifcance: Stable improved occlusion and skeletal relations were observed after a follow-up examination period of 12 months.

Buccolingual Inclination Effects of Self-Ligating and Conventional Premolar Brackets: A Cone Beam Computed Tomography Study.

OBJECTIVE: This study aimed to compare the effects of passive self-ligating (PSL) and conventional ligating (CL) of brackets on the buccolingual inclination (BLINC) of the maxillary premolars. METHODS: This in vitro study included a PSL bracket group and a CL bracket group. Acrylic teeth on typodonts were aligned using 0.014-inch heat-activated nickel titanium (HANT) (T1) and 0.019×0.025-inch HANT (T2) and 0.021×0.025-inch stainless steel (SS) (T3) archwires in a sequence. Standardized cone beam computed tomography (CBCT) images were taken immediately after each archwire stage. The differences of premolar teeth BLINC values in the 0.019×0.025-inch and 0.014-inch HANT archwires (T2-T1) and 0.021×0.025-inch SS and 0.019×0.025-inch HANT archwires (T3-T2) were compared between PSL and CL groups. The value of p < 0.05 was considered statistically significant. RESULTS: The BLINC change of the second premolar (SPM) showed a statistically significant difference (p=0.008), but the BLINC change of the first premolar (FPM) (p=0.056) between the groups showed no statistically significant difference during the T2-T1 stage. However, there were statistically significant differences between two groups in the BLINC of the FPM (p=0.032) and SPM (p=0.032) in the T3-T2 stage. The angular changes in the buccal direction in the PSL group were higher than those in the CL group. CONCLUSION: The PSL upper premolar brackets used with the 0.021×0.025-inch SS archwire produced more buccal crown movement of the upper PM teeth compared with that of the CL brackets.

SSR analysis demonstrates that olive production in the southern Marmara region in Turkey uses a single genotype.

The southern Marmara region in Turkey was surveyed to determine the olive cultivars that are used for olive production. Genetic diversity analysis using simple sequence repeat (SSR) markers indicated that the cultivar Gemlik is the major olive cultivar grown in this region, while other olive cultivars are grown only for use as pollinators of Gemlik or for growers' own exotic consumption. Although the quality of Gemlik is widely accepted in Turkey, its tendency toward alternate bearing is a major drawback. Twenty-four genotypes were selected within the cultivar Gemlik because of their tolerance to alternate bearing. These selected genotypes have the same SSR alleles as Gemlik, making them good candidates for developing a Gemlik olive with reduced alternate bearing. About 8% of samples did not share the same SSR alleles with Gemlik, though these genotypes were identified as Gemlik by the growers. Some other standard cultivars that are grown in other regions of Turkey were mistakenly called Gemlik in this region, probably due to the popularity of this cultivar in the southern Marmara region. In conclusion, as indicated by SSR analysis, Gemlik has become the standard cultivar in this region; future research should be focused on techniques to improve the production and quality of table olives and olive oil from this cultivar.

Effect of occlusal splint on interleukin 6, malondialdehyde and 8-hydroxydeoxyguanosine levels in the synovial fluid of patients with temporomandibular disorders.

The actual role of splint therapy in preventing excessive loading of the temporomandibular joint (TMJ) is still debated. Lower intra-articular pressure levels have been measured in patients wearing occlusal splints, which may also reduce oxidative stress in the articular spaces. The aim of this study was to determine whether splint therapy reduces oxidative stress and inflammation in TMJ internal derangement patients by measuring interleukin 6 (IL-6), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) levels in the synovial fluid (SF). Twenty-four patients with a temporomandibular disorder (TMD) were included in the study. TMJ SF samples were obtained prior to arthrocentesis. Twelve patients used a 2-mm hard acrylic, maxillary stabilization-type splint for 3 months after arthrocentesis. Twelve patients had no treatment after the SF aspiration. Second SF samples were obtained from all patients at 3 months post arthrocentesis. IL-6, MDA, and 8-OHdG levels in the samples were evaluated. All patients showed a significant symptomatic improvement after treatment (P < 0.005). No statistical correlation was found between the two groups concerning pre-treatment and 3-month SF levels of MDA, 8-OHdG, and IL-6. Although splint therapy was found to be successful in eliminating clinical symptoms of TMD, the results showed no beneficial effect on inflammation and oxidative stress markers in the synovial fluid.

Effects of quercitrin on bacterial translocation in a rat model of experimental colitis.

BACKGROUND: This study aimed to analyze the effects of quercitrin, which has anti-inflammatory properties, on bacterial translocation in inflammatory bowel diseases by using an experimental colitis model. METHODS: Forty male Wistar-Albino rats were used in the study. Rats were divided into 4 groups (control, colitis, treatment 1 and 2 groups). The rats in the control group were given normal drinking water. In the colitis group, colitis was induced by 5% DSS in drinking water. The control and colitis groups underwent operation on Day 7. In the 2 treatment groups, 5% DSS was added to drinking water for the first 7 days and the groups were treated with quercitrin at the doses of 1 and 5 mg/kg/day for the following 10 days. Treatment groups operated on Day 18. Blood samples were taken for blood culture and left colectomy was performed. The inflammation in the colon was macroscopically and microscopically evaluated and graded. Tissue samples were taken (liver, spleen and mesenteric lymph nodes (MLN)) for tissue culturing in order to assess bacterial translocation. Tissue myeloperoxidase (MPO), serum tumor necrosis factor-alpha (TNF-α) and plasma endotoxin levels were measured. RESULTS: When the control and colitis groups were compared, observed that colitis was induced by DSS (p < 0.05). When the colitis and treatment groups were compared, it was found that quercitrin had a significant therapeutic effect (p < 0.05). CONCLUSION: In the experimental colitis model established by using DSS, treatment with quercitrin resulted in a histopathological improvement and reduction in biochemical parameters, inflammation and in bacterial translocation (p < 0.05).

Renal artery Doppler investigation of the etiology of oligohydramnios in postterm pregnancy.

OBJECTIVE: To investigate the etiology of oligohydramnios in postterm pregnancy using Doppler velocimetry. METHODS: Renal and umbilical artery Doppler velocimetry were performed in women with singleton postterm (287 days' or more gestation) pregnancies. The renal and umbilical artery Doppler resistance index (RI) and end-diastolic velocity were measured. Stepwise logistic regression and the two-tailed t test were used to determine whether the Doppler indices correlated with oligohydramnios (amniotic fluid index less than 5 cm). RESULTS: We studied 147 well-dated, singleton, postterm pregnancies, of which 21 (14.3%) had oligohydramnios. For the study cohort, the mean (+/-standard deviation) gestational age at Doppler was 41.4 +/- 0.45 weeks and at delivery 41.8 +/- 0.47 weeks. Stepwise logistic regression using renal and umbilical artery Doppler indices found the renal RI to be the only significant predictor of oligohydramnios: beta = -10.4186, P <.05 (odds ratio [95% confidence interval (CI)] = 0, 0.88). The renal artery RI was significantly higher in cases with oligohydramnios (RI: mean (+/-standard error) = 0.8843 +/- 0.11 versus 0.8601 +/- 0.05, P

The effects of hormone replacement therapy type on pulmonary functions in postmenopausal women.

OBJECTIVE: To study whether hormone replacement therapy (HRT) or Tibolone has an effect on pulmonary function in postmenopausal women. METHODS: Seventy-five postmenopausal women without any risk factor for pulmonary disease were included in this randomized, prospective study. Fifty women had undergone natural menopause and 25 had had a hysterectomy/ooforectomy. Twenty-five natural menopause women were randomly allocated to two groups: 25 patients (Group I) were treated with Tibolone 2.5 mg/day, 25 patients (group II) with Estradiol Hemihidrate 2 mg+Norethindron Asetate 1 mg/day. Twenty-five induced menopause women were treated with 17 beta-estradiol 2 mg/day. Lung function tests including forced vital capacity (FVC), forced expiratory volume (FEV(1)), FEV(1)/FVC, forced expiratory flow rate over the 25-75% of the forced vital capacity volume (FEF(25-75%)), and peak expiratory flow rate (PEF) were evaluated at the beginning and 3 months after the treatment to assess the effects of HRT and Tibolone on respiratory function. RESULTS: Regardless of HRT types a significant difference was observed in FVC and FEV(1) after 3 months of the therapy (P=0.001, 0.0001, respectively). No significant difference was found between pre and post therapy values in the other parameters (P>0.05). CONCLUSIONS: We determined a significant increase in FVC and FEV(1) parameters of pulmonary functions after 3 months of the therapy regardless of HRT types. Therefore, we think that HRT regimens have modifying effects on pulmonary function in postmenopausal women.

Appendectomy in the surgical staging of ovarian carcinoma.

OBJECTIVES: Extensive debulking is accepted as the primary method of operative management for carcinoma of the ovary. However, there is no consensus regarding the role of appendectomy in primary surgical treatment. The aim of this study was to assess the role of appendectomy in the surgical staging and cytoreduction of ovarian carcinoma. METHODS: The study was a retrospective review of 90 primary malignant ovarian carcinoma patients who had an appendectomy in addition to primary cytoreductive surgery. RESULTS: Out of 90 patients, 10 (11.1%) had metastasis to the appendix. The rate of metastasis to the appendix was 11.5% (9/78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non-epithelial ovarian tumors. Of the patients with metastasis in the appendix, malignant epithelial ovarian tumors were identified in 90% (serous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metastases to the appendix in the other histological types. Although metastasis to the appendix was not observed in early stage ovarian carcinomas, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all patients with metastasis to the appendix. CONCLUSION: Appendectomy for stage I and II patients was not beneficial and did not affect final staging. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytoreductive surgery in early stage (stage I and II) malignant epithelial ovarian tumors. Appendectomy would contribute to the cytoreduction of advanced stage disease if it is macroscopically involved.

Pelosi-type vs. traditional cesarean delivery. A prospective comparison.

OBJECTIVE: To determine the effect of a simplified method of cesarean delivery on postoperative febrile morbidity, operative time, blood loss, total cost and length of hospital stay at Yale New Haven Hospital. STUDY DESIGN: From March 22, 1997, until September 26, 1997, 304 consecutive primary low transverse cesarean deliveries were evaluated at Yale New Haven Hospital. The patient age, duration of ruptured membranes, use of prophylactic antibiotics, operative times, blood loss, major complications, analgesic use, diet advancement, length of hospital stay and total cost of hospitalization were recorded for 275 eligible cases. RESULTS: The Pelosi technique was employed in 101 cases, while 174 were performed with Yale's traditional methods. Both groups were comparable regarding demographic characteristics. Two women in the Pelosi group (1.98%) developed postoperative fevers as compared with 17 (9.77%) in the traditional group (relative risk, 4.93; confidence interval, 1.16, 20.91; P = .05). The mean operating time was 27 minutes in the Pelosi group versus 45 minutes in the traditional group (P = .01). The mean costs were $7,623.55 in the experimental group versus $8,613.28 in the controls (P = .001). No significant differences were seen between the use of prophylactic antibiotics, duration of membrane rupture, analgesic use or hospital stay between the two groups. No serious maternal or fetal outcomes occurred in either group. CONCLUSION: Pelosi-type cesarean delivery resulted in significantly decreased operative time, blood loss and overall cost and improved patient outcome over traditional cesarean section.

Consumer perceptions of meat. Understanding these results through descriptive analysis.

Consumer perceptions of meals are investigated through qualitative and quantitative consumer studies. Qualitative studies add value and meaningful information to quantitative studies of meat. Among the important issues to consider in designing a quantitative consumer test for meats is the selection of terms to be used in a questionnaire. Additional terms besides tenderness, juiciness and flavor liking should be used to fully investigate consumer perceptions of meats. The limitations of consumer language is discussed. These limitations may be overcome through consumer-descriptive studies. These studies combine descriptive/sensory laboratory data with consumer information to decode consumer responses. The applications of this approach are: to achieve a more thorough interpretation and understanding of consumer responses, to provide more specific product guidance, to enable the prediction of consumer responses based on internal data (e.g. descriptive, instrumental), and to study different consumer segments.

Primary undifferentiated embryonal sarcoma of the liver misdiagnosed as hydatid cyst in a child: a case report and review of the literature.

Primary undifferentiated embryonal sarcoma (UES) of the liver is a highly malignant mesenchymal origin tumor and has a peak incidence between the ages of 6 and 10 years. We hereby report a case of primary UES of the liver in a 7-year-old male patient who initially was misdiagnosed and treated as hydatid cyst of the liver. The tumor was occupying almost the entire right lobe of the liver and had a mostly cystic appearance with some solid components in it. Because hydatid disease is endemic in this region, it can often lead to misdiagnosis. The correct diagnosis was established after a biopsy and following neo-adjuvant chemotherapy the patient underwent a successful right hepatic lobectomy with complete resection of the tumor. The patient also received adjuvant chemotherapy and is currently disease-free in the present six month period. Primary UES of the liver has a predominantly solid appearance on US in contrast to its mostly cystic appearance on CT and MRI. These paradoxical imaging findings should be kept in mind in order to be able to distinguish this rare tumor from other entities, especially hydatid cyst. Thus, early diagnosis and prompt surgical resection of these tumors together with adjuvant and/or neo-adjuvant chemotherapy can provide complete remission.