Hemoptysis and massive focal alveolar hemorrhage after successful biventricular pacemaker implantation.

During and after cardiac resynchronization therapy (CRT) implantation, many adverse events may occur. We present an interesting and important patient with hemoptysis and massive focal alveolar hemorrhage in a patient after a successful CRT implantation. CRT implantation was completed without any problems. In the follow-up, complaints of cough and hemoptysis began 1 h after the procedure. On the PA chest X-ray, a ground glass image was found in the left upper zone. Thorax CT revealed focal alveolar hemorrhage in the left upper lobe anterior segmental lung parenchyma. The patient was followed up with medical treatment and discharged in good health.

Results of Liquid Biopsy Studies by Next Generation Sequencing in Patients with Advanced Stage Non-small Cell Lung Cancer: Single Center Experience from Turkey.

Several studies demonstrated the utility of plasma-based cell-free circulating tumor DNA (ccfDNA) in determination of mutations in non-small cell lung cancer (NSCLC). We aimed to report our results of next generation sequencing (NGS) using liquid biopsy in patients with NSCLC. Patients with advanced stage NSCLC were enrolled and their genomic profiling results were recorded. Next generation sequencing targeted panel includes 19 hot-spot genes. The plasma was separated from the peripheral blood sample and ccfDNAs were isolated for NGS. We performed genomic profiling in 100 patients (20 females and 80 males) with a median age of 59.3 (range 26-79). A second liquid biopsy was performed in eight patients who developed progressive disease after the first treatment. The study population had adenocarcinoma (AC) (n = 73), squamous cell carcinoma (SCC) (n = 14), or NSCLC-NOS (not otherwise specified) (n = 13). In the SCC group, three of 14 patients had variants on EGFR and MET genes. In the AC and NSCLC-NOS groups, 39 out of 86 patients (45.3%) had variants. The most common one was in the EGFR gene (n = 27, 31.4%) including seven mutations related to drug resistance and two were polymorphisms. Three patients had both driver and resistance mutations (EGFR T790M, n = 2; KRAS exon 2 G12S and MET exon 14 E1012K, n = 1). Fifteen patients (17.4%) had an activating EGFR mutation and eight patients (9.3%) had variants in the KRAS gene. We reported our results regarding genomic profiling related to treatment using liquid biopsy in patients with NSCLC. Advantages of this method are the non invasiveness and reproducibility.

Ultrasonographic diagnosis of acute pancreatitis caused by ruptured hydatid disease to the biliary system.

Acute pancreatitis is a rare complication of hydatic disease which occurs following the rupture of a cyst to the intrahepatic bile ducts. Herein, we report a case of a 34-year-old Turkish man, who presented with upper abdominal pain. In laboratory examination, amylase and lipase levels were elevated. Ultrasound examination showed a cystic hypoechoic mass lesion located in the right lobe of the liver with dilated intrahepatic bile ducts, and germinative membranes were detected originating from the ruptured hydatid cyst to the common bile duct. The pancreas was found to be diffusely hypoechoic, consistent with acute pancreatitis. Contrast enhanced CT and MRI were also performed for further evaluation of the primary lesion and its complications.

Phytochemical analysis of the essential oils of 10 endemic Cephalaria species from Turkey.

The volatile composition of 10 endemic Cephalaria (Dipsacaceae) species (Cephalaria gazipashensis, Cephalaria lycica, Cephalaria paphlagonica, Cephalaria elmaliensis, Cephalaria stellipilis, Cephalaria scoparia, Cephalaria isaurica, Cephalaria cilicica, Cephalaria elazigensis var. purpurea and Cephalaria davisiana) was investigated. The essential oil mixtures were obtained by steam distillation in a Clevenger-type apparatus. Twenty-eight components were identified by GC-FID and GC-MS techniques. While total volatile percentages ranged from 68.99% to 84.57%, the total essential oil yields ranged between 38.15% and 64.05%. Geraniol, α-cedrene and p-cymene were determined as the main components. Geraniol was detected as a major component in C. cilicica (14.64%), and α-cedrene was detected as a major component with 26.03% for C. lycica, 16.93% for C. scoparia, 13.01% for C. davisiana and 10.94% for C. paphlagonica. Cephalaria scoparia, C. davisiana and C. gazipashensis have considerable amount of p-cymene as 12.86%, 12.70% and 11.16%, respectively. This was the first essential oil report concerning the Cephalaria genus.

Larvicidal activity of some secondary lichen metabolites against the mosquito Culiseta longiareolata Macquart (Diptera: Culicidae).

The larvicidal activity of some lichen metabolites, (+)-usnic acid, atranorin, 3-hydroxyphysodic acid and gyrophoric acid, against the second and third instar larvae of the mosquito Culiseta longiareolata were studied. All metabolites caused high larvicidal activities. When metabolites were compared on the basis of their LC(50) values, the order of increasing toxicity was as follows: gyrophoric acid (0.41 ppm) > (+)-usnic acid (0.48 ppm) > atranorin (0.52 ppm) > 3-hydroxyphysodic acid (0.97 ppm). However, when LC(90) values were compared, the order of toxicity was (+)-usnic acid (1.54 ppm) > gyrophoric acid (1.93 ppm) > 3-hydroxyphysodic acid (4.33 ppm) > atranorin (5.63 ppm). In conclusion, our results found that lichen secondary metabolites may have a promising role as potential larvicides.