Shielding features, to non-ionizing and ionizing photons, of FeCr-based composites.

This paper has been focused on the a detail study on non-ionizing and ionizing electromagnetic (EM) shielding features and build-up factors of reinforced with ferrochrome (FeCr) composites. The non-inozing electromagnetic shielding performance quantities of composites have been determined in the frequency range between 12.4 and 18.0 GHz. Also, the experimental mass attenuation coefficients (MAC) have been estimated using gamma spectrometer and various radioactive point, and compared to those of theoretical and simulation (MCNPX) results. With help of the obtained linear attenuation coefficients, several attenuation quantities, i.e., effective atomic number (Zeff), half value layer (HVL), and mean free path (MFP) have been discussed. In addition, buildup factors (EBF and EABF) values have been estimated utilizing the G-P fitting method. The results showed that composite encoded FeCr(15%) is superior shielding attenuation properties among the investigated samples.

Lytic Activity of Various Phage Cocktails on Multidrug-Resistant Bacteria.

PURPOSE: A bacteriophage is a virus that infects and replicates within a bacterium following the injection of phage genome into the bacterial cytoplasm. They are seen as a possible therapy for multi-drug-resistant strains of many bacteria. The aim of this study is to evaluate the lytic activity of the Pyo, Intesti and Fersisi bacteriophage cocktails on P. aeruginosa and S. aureus. METHODS: Ten different S. aureus and P. aeruginosa strains, which were isolated from hospitalized patients in Turkey, were used in the study. The identification and antibiotic susceptibility of the isolates were performed using Vitec 2 system. The identities of the isolates were confirmed by a species-specific Polymerase Chain Reaction (PCR) assay. Lytic activity of the bacteriophage cocktails on bacteria was determined by spot test and plaque assay methods. RESULTS: The lytic activity of the Pyo phage cocktail was evaluated on P. aeruginosa and S. aureus strains. It was found that eight isolates of MDR S. aureus were susceptible to Pyo phage cocktail and two isolates were resistant. Nine isolates of antibiotic-resistant P. aeruginosa were found to be susceptible to this phage cocktail and one isolate was resistant. Thus, the Pyo, Intesti and Fersisi cocktails are very effective in treating clinical strains of multidrug-resistant P. aeruginosa and S. aureus isolated in Turkey. CONCLUSION: The Pyo, Intesti and Fersisi cocktails may prove useful in the treatment of various infections caused by those bacteria.

[Neurogenic pulmonary edema: a prospective study based on observation]. / Nörojenik pulmoner ödem: Gözleme dayali prospektif bir çalisma.

BACKGROUND: In this study, we evaluated the cause and the clinical course of neurogenic pulmonary edema which has developed abruptly in some of the patients in the neurosurgical intensive care unit. METHODS: We evaluated 223 patients in the neurosurgical ICU (116 males; 107 females; mean age 44.4+/-19.5). Five of these had worsening in neurological evaluation and oxygenation and were diagnosed as having a neurogenic pulmonary edema. Patients with pneumonia were excluded from the study. RESULTS: We identified acute hydrocephaly in three patients and re-bleeding of an aneurysm in one as the cause of neurogenic pulmonary edema. No cause could be identified in the remaining patient. Although four patients could be discharged from the ICU, one died due to multiorgan failure. CONCLUSION: Physicians should be careful about neurogenic pulmonary edema, a life-threatening clinical condition, that develops within hours of a neurologic event and usually resolves with neurologic recovery.

Duplex sonography of retro-orbital and carotid arteries in patients with normal-tension glaucoma.

PURPOSE: To evaluate retrobulbar and carotid arterial hemodynamics in patients with normal-tension glaucoma using Doppler sonography. MATERIALS AND METHODS: Duplex sonography was performed in 41 patients with normal-tension glaucoma and 30 control subjects to evaluate resistance indices (RIs) in retro-orbital and carotid arteries. Mean values were compared using the independent t-test. The ratios of the RI in retro-orbital to RIs in the carotid arteries (CCA and ICA) and interocular and intercarotid differences in RI (DeltaRI) were also calculated. RESULTS: Is in the central retinal (CRA) and temporal and nasal posterior ciliary arteries (TPCA and NPCA) were statistically significantly greater in glaucomatous eyes (p < 0.001). Plaque formation in carotid arteries without significant stenosis was noted in 12% of patients and 10% of control subjects. Ratios of RI of CRA or TPCA or NPCA to that of CCA and the ratios of RI of CRA or NPCA to that of ophthalmic arteries (OA) were significantly greater in glaucomatous eyes. We also found that ratios of the RI of CRA or TPCA or NPCA to that of ICA and the ratio of the RI of OA to CCA were nearly equal to 1 in both patients and control subjects. We found no significant difference between interocular and intercarotid DeltaRIs in patients and control subjects. CONCLUSIONS: In patients with symmetric normal-tension glaucoma, duplex sonography showed an elevated RI in CRA and PCA. The Doppler evaluation of carotid arteries was useful.

Bleomycin induces alveolar epithelial cell death through JNK-dependent activation of the mitochondrial death pathway.

Exposure to bleomycin in rodents induces lung injury and fibrosis. Alveolar epithelial cell death has been hypothesized as an initiating mechanism underlying bleomycin-induced lung injury and fibrosis. In the present study we evaluated the contribution of mitochondrial and receptor-meditated death pathways in bleomycin-induced death of mouse alveolar epithelial cells (MLE-12 cells) and primary rat alveolar type II cells. Control MLE-12 cells and primary rat alveolar type II cells died after 48 h of exposure to bleomycin. Both MLE-12 cells and rat alveolar type II cells overexpressing Bcl-X(L) did not undergo cell death in response to bleomycin. Dominant negative Fas-associating protein with a death domain failed to prevent bleomycin-induced cell death in MLE-12 cells. Caspase-8 inhibitor CrmA did not prevent bleomycin-induced cell death in primary rat alveolar type II cells. Furthermore, fibroblast cells deficient in Bax and Bak, but not Bid, were resistant to bleomycin-induced cell death. To determine whether the stress kinase JNK was an upstream regulator of Bax activation, MLE-12 cells were exposed to bleomycin in the presence of an adenovirus encoding a dominant negative JNK. Bleomycin-induced Bax activation was prevented by the expression of a dominant negative JNK in MLE-12 cells. Dominant negative JNK prevented cell death in MLE-12 cells and in primary rat alveolar type II cells exposed to bleomycin. These data indicate that bleomycin induces cell death through a JNK-dependent mitochondrial death pathway in alveolar epithelial cells.

Effects of body temperature on ventilator-induced lung injury.

PURPOSE: To evaluate the effects of body temperature on ventilator-induced lung injury. MATERIAL AND METHODS: Thirty-four male Sprague-Dawley rats were randomized into 6 groups based on their body temperature (normothermia, 37 +/- 1 degrees C; hypothermia, 31 +/- 1 degrees C; hyperthermia, 41 +/- 1 degrees C). Ventilator-induced lung injury was achieved by ventilating for 1 hour with pressure-controlled ventilation mode set at peak inspiratory pressure (PIP) of 30 cmH2O (high pressure, or HP) and positive end-expiratory pressure (PEEP) of 0 cmH2O. In control subjects, PIP was set at 14 cmH2O (low pressure, or LP) and PEEP set at 0 cmH2O. Systemic chemokine and cytokine (tumor necrosis factor alpha , interleukin 1 beta , interleukin 6, and monocyte chemoattractant protein 1) levels were measured. The lungs were assessed for histological changes. RESULTS: Serum chemokines and cytokines were significantly elevated in the hyperthermia HP group compared with all 3 groups, LP (control), normothermia HP, and hypothermia HP. Oxygenation was better but not statistically significant in hypothermia HP compared with other HP groups. Cumulative mean histology scores were higher in hyperthermia HP and normothermia HP groups compared with control and normothermia HP groups. CONCLUSIONS: Concomitant hyperthermia increased systemic inflammatory response during HP ventilation. Although hypothermia decreased local inflammation in the lung, it did not completely attenuate systemic inflammatory response associated with HP ventilation.

A case of macrocephaly-cutis marmorata telangiectatica congenita and review of neuroradiologic features.

Macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) is characterized by macrocephaly, cutis marmorata, capillary malformations, toe syndactily, joint laxity and pre-natal overgrowth. Cerebral abnormalities might also be seen. We reported cerebral magnetic resonance imaging (MRI) findings of a case with M-CMTC, who had giant atrial septal aneurysm and atrial septal defect. Cerebral alterations determined by MRI were bilateral prominent lateral ventricles, bilateral cortical dysplasia, cavum septi pellucidum cyst and calvarial hemangioma. At 17th day of his life he suddenly developed cardiorespiratory arrest and died.

Intratesticular arterial resistance and testicular volume in infertile men with subclinical varicocele.

PURPOSE: The aim of this study was to evaluate whether intratesticular arterial resistance and testicular volume differed between infertile men with subclinical varicoceles and infertile men without varicoceles. MATERIALS AND METHODS: Fifty-eight infertile men were examined by gray-scale and color Doppler sonography for presence of varicocele, testicular volume, and arterial resistance. For men in the study group, mean testicular volume and resistance index (RI) in testes with varicoceles were compared with those in the contralateral testis by the paired t-test; statistical analyses between the study and control groups were performed by independent t-tests. RESULTS: Twenty-seven men had left-sided varicoceles (96% of which were subclinical), and 31 infertile men without varicoceles served as controls. Mean volumes of the right and left testes of study subjects were 14.8 ml and 14.6 ml, respectively, and in controls were 14.2 ml and 13.6 ml, respectively. Mean RI values for the right and left testes of study subjects were 0.61 and 0.58, respectively, and in controls were 0.61 and 0.58, respectively. There were no statistically significant differences in volume or RI, either between the right and left testes within patient groups or between the control and study groups' combined mean values. While the mean intertesticular volume differences for the study and control groups were 2.2 ml and 3.4 ml, respectively, the mean intertesticular RI differences were 0.04 and 0.07, respectively. These values also did not differ significantly between the 2 groups. CONCLUSIONS: Subclinical varicocele is not associated with ipsilateral testicular atrophy, and does not affect the intratesticular arterial RI.

Doppler sonography in the diagnosis of urinary tract obstruction by stone.

PURPOSE: This study was conducted to evaluate the accuracy of Doppler sonography in renal colic due to obstruction and to assess whether the resistance index (RI) and interrenal RI difference (DeltaRI) are time-dependent parameters. SUBJECTS AND METHODS: Obstructed and unobstructed contralateral kidneys in 28 patients with renal colic and normal kidneys in 27 control subjects were prospectively evaluated with Doppler sonography. Mean RI, mean DeltaRI, and duration of pain were evaluated. Statistical analysis was done using paired and independent t-tests. RESULTS: Mean RIs of the control-group, obstructed, and contralateral kidneys were 0.60, 0.71, and 0.61, respectively; mean DeltaRI values of the obstructed and control-group kidneys were 0.10 and 0.03, respectively. Differences in mean RI between obstructed and contralateral or control-group kidneys were statistically significant (p < 0.001). There was a statistically significant difference in DeltaRI between patients and controls (p < 0.001). The difference between the RI values of kidneys with low-grade (0.70) and high-grade obstructions (0.72) was not statistically significant. The difference between the DeltaRI values of kidneys with low-grade (0.08) and high-grade obstructions (0.13) was statistically significant (p < 0.05). Differences in the mean RI and mean DeltaRI values between 3 groups of patients categorized according to the duration of pain were not statistically significant. CONCLUSIONS: Along with gray-scale sonography and intravenous urography, Doppler sonography can be used in the evaluation of renal obstruction. RI and DeltaRI are not time-dependent parameters.

Reactive oxygen species are required for hyperoxia-induced Bax activation and cell death in alveolar epithelial cells.

Exposure of animals to hyperoxia results in respiratory failure and death within 72 h. Histologic evaluation of the lungs of these animals demonstrates epithelial apoptosis and necrosis. Although the generation of reactive oxygen species (ROS) is widely thought to be responsible for the cell death observed following exposure to hyperoxia, it is not clear whether they act upstream of activation of the cell death pathway or whether they are generated as a result of mitochondrial membrane permeabilization and caspase activation. We hypothesized that the generation of ROS was required for hyperoxia-induced cell death upstream of Bax activation. In primary rat alveolar epithelial cells, we found that exposure to hyperoxia resulted in the generation of ROS that was completely prevented by the administration of the combined superoxide dismutase/catalase mimetic EUK-134 (Eukarion, Inc., Bedford, MA). Exposure to hyperoxia resulted in the activation of Bax at the mitochondrial membrane, cytochrome c release, and cell death. The administration of EUK-134 prevented Bax activation, cytochrome c release, and cell death. In a mouse lung epithelial cell line (MLE-12), the overexpression of Bcl-XL protected cells against hyperoxia by preventing the activation of Bax at the mitochondrial membrane. We conclude that exposure to hyperoxia results in Bax activation at the mitochondrial membrane and subsequent cytochrome c release. Bax activation at the mitochondrial membrane requires the generation of ROS and can be prevented by the overexpression of Bcl-XL.

[Case report: Ovarian torsion in inguinal canal]. / Inguinal kanalda torsiyone over.

Inguinal and scrotal hernias are two most common congenital anomalies observed by clinicians. The possibility of ovarian torsion following recurrent inguinal hernia is well known. Ultrasound examination of the inguinal region of a female infant showed a spherical, enlarged ovary with multiple tiny cysts. After the diagnosis of ovarian torsion, the patient underwent oopherectomy. It is possible to diagnose inguinal emergencies by high resolution ultrasonography.

Effects of inpatient rehabilitation on health-related quality of life in breast cancer patients.

BACKGROUND: Major endpoint for the assessment of a complex inpatient rehabilitation program is the health-related quality of life. In a prospective longitudinal study we evaluated the subjective well-being of breast cancer patients by different methods. PATIENTS AND METHODS: 183 breast cancer patients were asked to complete six different questionnaires at three different time points: t1: start of treatment, t2: end of treatment, t3: 3 months after t2. RESULTS: In the Hospital Anxiety and Depression Scale (HADS-D) we observed high mean scores for anxiety (8.73) and depression (5.55), as compared to a healthy control population (5.8 and 3.34, respectively). There was a significant improvement for both scores at t2 (6.84 and 4.77, respectively) and for anxiety at t3 (7.68). This was confirmed by the FBK questionnaire showing a significant decrease of the psychological distress in the t1/t2 and t1/t3 time periods as well. The global health score of the QLQ-C30 instrument increased significantly at the end of the rehabilitation and was maintained at the 3-month follow-up. This was true for most of the functional subscales as well. Older widowed women with 3-4 accompanying diseases had the most profit from the program. Using the Perceived Adjustment to Chronic Illness Scale (PACIS), we observed significantly less effort of coping with the illness at t2 and t3. CONCLUSIONS: At the end of a complex rehabilitation program for breast cancer patients, the health-related quality of life improved in several domains. While after a 3-month follow-up the scores were still better than before the treatment, anxiety and depression increased again. Therefore, the good results of the rehabilitation program should be maintained by continuous ambulatory treatment.

Neonatal tetanus: a continuing challenge in the southeast of Turkey: risk factors, clinical features and prognostic factors.

Neonatal tetanus (NT) still causes significant mortality in developing countries, although in 1989 WHO adopted the goal of eliminating the disease by 1995-2000. To characterize the regional characteristics, clinical charts of 55 neonates (42 males and 13 females) admitted to the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, Turkey with the diagnosis of NT from 1991 to 1997 were reviewed. Mean age at admittance was 8.9+/-4.3 days with a range of 3-25 days. Mean period for the appearance of first symptoms was 5.8 days ranging between 1 and 21 days. Mean birth weight of the patients was 3369+/-560g. All patients were from rural areas and were delivered at home by untrained traditional birth attendants with no prior antenatal healthcare services. Razor blade (55%), scissors (27%), and knife (18%) were the instruments used to cut the cord in non-hygienic conditions. No mothers had prior vaccination with tetanus toxoid during their pregnancy. Spasticity (76%), lack of sucking (71%), trismus (60%), fever (49%), omphalitis (44%), irritability (24%), risus sardonicus (22%), and opithotonus (15%) were the most common presenting signs and symptoms. Age at admission < 7.5 days and symptoms of onset <4.9 days, risus sardonicus and opisthotonus were associated with fatal outcome. All patients were treated with human tetanus immunglobulin or equine tetanus antitoxin where available, antibiotic therapy by penicillin G (100.000 U/kg/day) and intravenous high dose diazepam (40 mg/kg/day). Overall mortality rate was 40% (22 cases), without any equipment for mechanical ventilation. Health education of mothers and birth attendants, promotion of hospital delivery and prenatal tetanus immunization of all pregnant women particularly in rural areas are recommended, if NT is to be prevented.

Direct in vivo gene transfer to healing rat patellar ligament by intra-arterial delivery of haemagglutinating virus of Japan liposomes.

BACKGROUND: Manipulation of ligament healing has been a major focus of orthopaedic research. In recent years, gene transfer to healing ligament appears to be a feasible method for manipulating the healing process. In this study, we investigated the feasibility of gene transfer to healing rat patellar ligament by intra-arterial delivery. METHODS: An attempt was made to transfer a reporter gene (Escherichia coli, beta-galactosidase gene) to healing rat patellar ligament using the haemagglutinating virus of Japan (HVJ) liposome-mediated gene transfer method. Three days after cutting the patellar tendons of 25 14-week-old male Wistar rats, HVJ-liposome complexes containing beta-galactosidase (beta-gal) cDNA were injected into the femoral artery of 15 Wistar rats as the experimental group. HVJ liposomes without DNA were injected into the femoral artery of 10 Wistar rats as the control group. Three rats from the experimental group and two control rats were killed 3, 7, 14, 28 and 56 days after the injection. RESULTS: After X-gal staining, the rate of transfection in the experimental group (mean +/- SEM) was found to be 12.1% +/- 0.590%, 8.7% +/- 0.217%, 10.2% +/- 0.227%, 3.2% +/- 0.247% and 0.7% +/- 0.060% at post-injection days 3, 7, 14, 28 and 56 respectively. In control sections the number of blue-stained cells were very few at any point. CONCLUSION: We succeeded in introducing a reporter gene into healing rat patellar ligament by infra-arterial delivery of HVJ-liposome complexes. This method appears to have the potential to be applicable for soft-tissue healing studies and also healing studies of other tissues and organs.

Tumoral calcinosis: a case report.

Tumoral calcinosis is a rare disorder with the calcified masses in subcutaneous tissues. We report herein a nine-year-old girl, in whom the calcified lesions bilaterally involved the soft tissues in the anterior part of the knee joint. Serum calcium and phosphorus levels were in normal ranges and there was no family history. Surgical excision was performed and recurrence was not observed in early follow-up. Review of the literature shows that only clinical and radiological appearance of tumoral calcinosis are generally agreed while its epidemiology, etiology and treatment are still under discussion.

Avulsion fracture of the anteromedial bundle of the anterior cruciate ligament.

The avulsion fracture of the tibial attachment site of the anterior cruciate ligament is relatively rare among adults. Although partial avulsion fracture of this site is very rare, complex forces exerted on the knee joint could produce this type of fracture. We report on an adult patient with an avulsion fracture of the attachment site of anteromedial bundle of the anterior cruciate ligament associated with injuries of lateral and medial collateral ligament and fibular fracture. We speculate varus stress in a flexed knee coupled with rotation between the femur and tibia caused this type of injury.