Nematode-citrus plant interactions: host preference, damage rate and molecular characterization of Citrus root nematode Tylenchulus semipenetrans.

Citrus plants are host to several plant parasitic nematodes (PPNs), which are microscopic organisms. Among PPNs, the citrus root nematode, T. semipenetrans (Cobb 1913) (Tylenchida: Tylenchulidae), causes significant damage to citrus plantations worldwide. Understanding citrus nematode populations, precise identification, host preference among citrus species, and damage threshold are crucial to control T. semipenetrans. The minutiae of citrus plant-nematode interactions, nematode density and molecular nematode identification are not well understood. In this study, nematode species and density in citrus orchards, host specialization, molecular and morphological characteristics of nematodes were assessed. Molecular and morphological methods, host-nematode interactions, host (citrus species) preference, damage economic threshold (ET), and economic injury level (EIL) were determined using laboratory methods and field sampling. Citrus plantations in different provinces in the Mediterranean region of Turkey were investigated. Nematode species were identified molecularly and morphologically. ITS sequences revealed that samples were infected by citrus root nematode T. semipenetrans. The lowest nematode density was in C. reticulata in Mersin (53 2nd stage juveniles (J2s) 100 g-1 soil), while the highest density was from Hatay in C. sinensis (12173 J2s 100 g-1 soil). Highest citrus nematode population density was on roots of C. reticulata, followed by C. sinensis, C. limon, and C. paradisi. The citrus nematode is more common than was thought and population fluctuations change according to specific citrus species. Environmental conditions, host and ecological factors, such as temperature, soil pH, and soil nutrients, might influence nematode populations in citrus orchards. Investigating nematode density in diverse soil ecologies and the responses of different resistant/tolerant citrus species and cultivars to nematode populations is essential in future studies.

Assessment of nail findings in children with atopic dermatitis.

BACKGROUND: Cutaneous findings are well known in atopic dermatitis (AD), but nail changes have not received as much attention. AIM: To determine the clinical and disease-related capillaroscopic findings of nail findings in paediatric patients with AD. METHODS: In total, 100 participants aged 2-16 years were sourced from the dermatology outpatient clinic: 50 of these had been diagnosed with AD according to the Hanifin-Rajka criteria, and the others were 50 healthy controls (HCs) without AD. The AD severity score (SCORing Atopic Dermatitis; SCORAD) was calculated for all patients with AD. A digital epiluminescence device was used for nailfold capillaroscopy. RESULTS: The nail findings detected in patients with AD were pitting, punctate leuconychia, trachyonychia, onycholysis and onychomadesis. Pitting was significantly (P < 0.01) more frequent in the patient group (26%) than in the HC group (6%). Similarly, the patient group had significantly higher rates for capillary density decrease (P < 0.01), capillary array irregularity (P < 0.001), capillary dilatation increase (P < 0.001), tortuosity (P = 0.04), ramification increase (P = 0.02), bush-like appearance (P = 0.02) and avascular areas (P < 0.01). Significant correlations were determined between pitting and trachyonychia (P < 0.05, r = 0.21), capillary density decrease (P < 0.05, r = 0.25), avascular areas (P < 0.001; r = 0.29) and SCORAD (P < 0.05, r = 0.35). CONCLUSION: The nailfold capillaroscopic images of children with AD were similar to those of scleroderma spectrum disorder. Thus, we believe it would be beneficial to support detailed clinical examination of patients with a capillaroscopic examination.

Diagnostic performance of real-time strain sonoelastography in BI-RADS 4 and 5 breast masses.

PURPOSE: The purpose of this study was to evaluate the diagnostic performance of sonoelastography by using real-time strain ratio and qualitative 5-stage elasticity score in breast lesions for which ultrasonographic evaluation suggested malignancy (BI-RADS 4 and 5 lesions). MATERIALS AND METHODS: From January 2012 to October 2012, 168 solid breast lesions were investigated using sonoelastography. The strain ratios and the elasticity scores were calculated. Final diagnosis was made by histopathological analysis. Areas under the curve and cut-off points were used to assess diagnostic performance of sonoelastography. The sensitivity, and specificity of these two imaging tests were compared using McNemar test. RESULTS: The strain ratios of malignant lesions (mean value=9.3) and benign lesions (mean value=3.75) were significantly different (P<0.00001). Using a cut-off value of 4.79, strain ratio had 78.8% sensitivity, 78.3% specificity, 86.7% positive predictive value (PPV) and 67% negative predictive value (NPV). Using a 5-stage elasticity score system, a 83.3% sensitivity, 74.6% specificity, 85.7% PPV and 71.0% NPV were obtained. CONCLUSION: Our study indicates that sonoelastography has good clinical value to discriminate between benign and malignant breast lesions. There are no differences in terms of diagnostic performance in differentiating malignant from benign lesions when strain ratio or color scoring are used alone. However the diagnostic performance is increased when strain ratio and color scoring evaluations are used in combination.

Nailfold capillaroscopy in Behçet disease, performed using videodermoscopy.

BACKGROUND: Nailfold capillaroscopy is used for the identification of microvascular involvement in many rheumatic and extrarheumatic diseases. AIM: To determine the nailfold capillary changes in patients with Behçet disease (BD) by videodermoscopy, i.e. nailfold videocapillaroscopy (NVC). METHODS: We used a videodermatoscope (Molemax II, × 30 magnification) to perform nailfold capillaroscopy on 40 patients with BD and 40 healthy controls (HC). All nailfold images were evaluated for capillary density, distribution and morphology, assessing features such as enlargement or tortuosity of the capillaries, microhaemorrhages and avascular areas. RESULTS: Enlarged capillaries were detected in 14 patients, microhaemorrhages in 6 patients, and avascular area in 3 patients. There was a statistically significant difference between patients with BD and healthy controls for capillary dilatation and microhaemorrhages (P < 0.05). Capillaroscopic changes were not associated with sex or clinical characteristics. CONCLUSIONS: Using NVC, nailfold capillary changes were apparent in patients with BD, but not in HC. NVC could be a useful technique for evaluating microvascular damage in BD.

An oropharyngeal pH monitoring device to evaluate patients with chronic laryngitis.

BACKGROUND: Diagnostics for gastro-esophageal reflux disease (GERD) are suboptimal because of limited sensitivity. We performed in vitro and in vivo studies to systematically assess the performance characteristics of an oropharyngeal pH probe. METHODS: In vitro studies compared the oropharyngeal probe with a standard pH catheter in liquid and aerosolized solutions, pH 1-7. The accuracy of measurements, deviation from target pH, and time to equilibrium pH were determined. Simultaneous distal esophageal pH measurements were obtained in 11 patients with GERD. Oropharyngeal and distal esophageal reflux parameters were measured for controls (n = 20), patients with GERD (n = 17), and patients with chronic laryngitis (n = 10). KEY RESULTS: In the liquid phase, at pH 4-5, the oropharyngeal probe had less deviation from the target value than the standard catheter; deviation in the vapor phase was similar (0.4 pH units). Median (interquartile) time to reach equilibrium pH was significantly (P < 0.001) faster with the oropharyngeal than the standard probe. In comparing simultaneous distal esophageal pH characteristics, 96% of recordings with the new and standard probes were in agreement to within ± 1.0 pH unit; 71% of recordings were in agreement within ± 0.5 pH units. Patients with chronic laryngitis had significantly higher levels of oropharyngeal acid exposure at pH <4, <5, and <6, in the upright position than patients with GERD or controls (P < .001). CONCLUSIONS & INFERENCES: Oropharyngeal pH monitoring appears to be more sensitive than traditional pH monitoring in evaluation of patients with extraesophageal reflux. It is a promising tool in evaluation of this difficult group of patients.

Chorioretinectomy for perforating eye injuries.

PURPOSE: To report the outcomes of chorioretinectomy in severe ocular injuries where a foreign body penetrated the choroid or perforated the globe. METHODS: The study sample consisted of a retrospective, non-comparative, consecutive interventional case series of 13 perforating or severe intraocular foreign body ocular injuries that were treated at a single institution from March 2008 to March 2010. All the patients were operated with 20-gauge three-port pars plana vitrectomy (PPV) by removing the choroid and/or retina with scar tissue at the perforation site of the foreign body. The reports of patients were examined for best-corrected visual acuity, globe survival, retinal detachment status, and proliferative vitreoretinopathy. RESULTS: A total of 13 eyes of 13 patients with a mean age of 25.8 ± 9.0 years (range, 11-38 years) were followed for a median of 13.8 ± 5.4 months (range, 8-29 months). The mean time period between injury and the vitreoretinal surgery was 13.6 ± 9.3 days. All had an exit/impact site wound, eight of which were located in the posterior pole, which caused choroidal and retinal incarceration in the macular area. PPV together with chorioretinectomy, endolaser applications, silicone oil tamponade, with/without encircling band, and lensectomy surgery was applied to all of them. Final best-corrected visual acuity (BCVA) ≥20/200 occurred in 4 of 13 (30.76%) patients. Globe survival rates were 100% (13 of 13), and final retinal attachment rate was 84.6% (11 of 13). The proliferative vitreoretinopathy rate was 2 of 13 (15.3%). CONCLUSION: Chorioretinectomy is a surgical option that may decrease post-traumatic proliferative vitreoretinopathy and tractional retinal detachment rates, thus improving final BCVA and increasing globe survival rates when a foreign body penetrates the choroid and perforates the globe.

The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases.

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P < 0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P < 0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

Vitamin D receptor gene polymorphisms and male breast cancer risk in Turkish population.

PURPOSE: Male breast cancer (MBC) is a rare disease. However, as global populace ages, there is a trend for MBC increase. Although its etiology is still unclear, constitutional, environmental, hormonal (abnormalities in estrogen/androgen balance) and genetic (positive family history, Klinefelter syndrome, mutations in BRCA1 and BRCA2) risk factors are already known. One potential target is the vitamin D receptor (VDR). We have investigated whether polymorphisms in the VDR gene are associated with altered MBC risk in a Turkish population. METHODS: We recruited 25 men with known breast cancer and 96 men selected from blood donations. Polymorphic sites in VDR gene ApaI (rs7975232), TaqI (rs731236) and FokI (rs10735810) were determined by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) analysis. RESULTS: The unconditional logistic regression analysis demonstrated no significant association for the VDR ApaI (p=0.70), TaqI polymorphism (p=0.88) and FokI polymorphism (p=0.075). CONCLUSION: Our results do not support potential effects of VDR polymorphisms on MBC risk and possible differential effects of receptor status of the tumor. However, further studies focusing on the influence of polymorphisms and haplotypes on VDR functionality, activity and concentration are needed.

Axillary hair removal with 1064-nm Nd:YAG laser increases sweat production.

BACKGROUND: Laser-assisted hair removal has become a popular treatment for eradication of body hair. Many studies have been published concerning the safety and efficacy of several laser systems. Adverse events are hyperpigmentation, hypopigmentation, erythema, oedema, scarring, pain and blistering. Changes in sweating have not previously been reported. AIM: To investigate the effects on axillary sweating of hair removal by a 1064-nm neodymium:yttrium-aluminium-garnet (Nd:YAG) laser. METHODS: The sweating function of both axillae was evaluated objectively by the iodine starch test for planimetry measurement and subjectively using a visual analogue scale (VAS) before the treatment, and 1 month and 1 year after the last session. RESULTS: The difference in hyperhidrotic activity before and after treatment was significant (P < 0.05), and these differences persisted 1 year after the last evaluation. CONCLUSIONS: The results of this study confirm that treatment of axillary hair using the 1064-nm Nd:YAG laser can cause hyperhidrosis, and this effect is not transient. We did not evaluate the eccrine glands histologically, which is a limitation of the study.

Role of magnetic resonance imaging in evaluating sphenoid sinus and internal carotid artery.

OBJECTIVE: This study aimed to determine whether magnetic resonance imaging has a role in the evaluation of the sphenoid sinus and internal carotid artery. In addition, we aimed to establish reference measurements for the minimal distance between the internal carotid arteries. METHOD: The sphenoid sinuses and neighbouring internal carotid arteries of 90 patients were evaluated using sagittal T1-weighted and axial and coronal T2-weighted magnetic resonance images. RESULTS: Sphenoid sinus pneumatisation was categorised as occipitosphenoidal (0 per cent), conchal (3.3 per cent), presellar (14.4 per cent) or sellar (82.2 per cent). The internal carotid artery protruded into the sphenoid sinus in 32.8 per cent, with a septum in 9.4 per cent. The incidence of sellar-type sphenoid sinus pneumatisation was higher in patients with protrusion of the internal carotid artery into the sphenoid sinus (p < 0.001). The incidence of presellar pneumatisation was higher in patients without internal carotid artery protrusion (p < 0.001). The minimal distance between the internal carotid arteries varied between 9.04 and 24.26 mm (mean, 15.94 mm). CONCLUSION: Magnetic resonance imaging can provide useful information about the sphenoid sinus and internal carotid artery, prior to endoscopic sphenoidotomy and trans-sphenoidal hypophysectomy.

Infiltration of the sternotomy wound and the mediastinal tube sites with 0.25% levobupivacaine as adjunctive treatment for postoperative pain after cardiac surgery.

BACKGROUND AND OBJECTIVE: This study aimed to investigate the effect of 0.25% levobupivacaine infiltration of the sternotomy wound and the mediastinal tube sites on postoperative pain, morphine consumption and side-effects in patients undergoing cardiac surgery. METHODS: After obtaining Ethics Committee approval and informed consent,50 patients aged 18-65 yr, undergoing coronary artery bypass grafting, were included in this study. Anaesthesia was induced with 5 microg kg (-1) fentanyl, 0.3 mg kg (-1) etomidate, 1 mg kg (-1) lidocaine, 0.1 mg kg (-1) vecuronium and maintained with 1-2% sevoflurane, 50% oxygen in air and fentanyl. Patients were randomized into two groups before sternal wire placement: sternotomy and mediastinal tube sites were infiltrated with either 60 mL 0.25% levobupivacaine (infiltration group, n = 25) or 60 mL saline placebo (control group, n = 25). All patients received intravenous morphine patient-controlled analgesia (bolus dose: 2 mg, lock-out time: 15 min, 4 h limit: 20 mg) after extubation. Postoperative pain at rest and on coughing was assessed by a visual analogue scale (0-10). Pain scores,sedation scores (Ramsay scale), haemodynamic and respiratory parameters, arterial blood gases and morphine consumption were recorded. RESULTS: The times to extubation and visual analogue scale scores were similar between groups. Morphine consumption at 24 h was significantly lower in the infiltration group compared with the control group (29.5 +/- 5.1 vs. 42.8 +/- 4.7 mg, respectively, P < 0.05). The sedation scores were found to be significantly higher in the control group when compared with the infiltration group at 1, 2 and 4 h after extubation (P < 0.05), whereas sedation scores after 4 h were similar between groups. CONCLUSION: Infiltration of the median sternotomy incision and the mediastinal tube insertion sites with 0.25% levobupivacaine in addition to morphine patient-controlled analgesia was found to be effective in reducing postoperative morphine consumption when compared with morphine patient-controlled analgesia alone during the initial 24 h after cardiac surgery.

Spontaneous remission of acute lymphoblastic leukemia with mediastinal mass.

Spontaneous remission/regression of cancer is defined as partial or complete disappearance of malignant disease temporarily or permanently in the absence of medical treatment. This event is named as spontaneous regression for solid tumors and spontaneous remission for leukemia. The authors report the case of a girl aged 4 years and 3 months, who presented with mediastinal mass and leukemic findings in the bone marrow both of which reappeared after spontaneous regression and remission, respectively.

Nasal septal deviation and concha bullosa coexistence: CT evaluation.

PROBLEMS/OBJECTIVES: The discussion of the incidence of sinusitis in patients with nasal septal deviation and concha bullosa has been accompanied by some controversy. In this study, we assess the incidence, in conjunction with concha bullosa and nasal septal deviation, of sinus, ostiomeatal and frontal recess disease on either side in the same patients. METHODOLOGY: We reviewed the CT studies conducted between 2003 and 2005 of the paranasal sinuses of 130 patients. All examinations were performed for the evaluation of a symptom referable to the sinonasal region. Fifty-eight patients had both nasal septal deviation and concha bullosa. We recorded the presence and degree of septal deviation, the direction of septal deviation, and sinus, ostiomeatal and frontal recess disease. RESULTS: Twenty-six patients had deviation to the right. Of these patients, nine had sinusitis on the left and ten had sinusitis on the right. Thirty-two patients had deviation to the left. Of these patients, 14 patients had sinusitis on the left and 17 had sinusitis on the right. No statistical difference was found (p > 0.05). Likewise, no correlation was found with frontal recess or ostiomeatal disease. CONCLUSIONS: The incidence of the coexistence of nasal septal deviation and concha bullosa is high (44.6%). There does not appear to be a statistically significant difference between the laterality of sinus, ostiomeatal and frontal recess disease (p > 0.05). The incidence of sinusitis in severe nasal septal deviation is higher when compared with mild (p = 0.001) and moderate groups (p < 0.001).

Quantitative and diffusion MR imaging as a new method to assess osteoporosis.

BACKGROUND AND PURPOSE: The role of advanced MR imaging techniques in demonstrating the microarchitectural changes in osteoporosis has been recently investigated. Our aim was to determine the role of quantitative and diffusion MR imaging in the diagnosis of osteoporosis compared with dual-energy x-ray absorptiometry (DEXA). MATERIALS AND METHODS: Fifty-one subjects underwent both DEXA and conventional MR imaging with diffusion and apparent diffusion coefficient (ADC) mapping. T1, T2, diffusion signal intensity, and ADC values were calculated and compared with bone mineral attenuation (BMD). Results were obtained from L1 to L4 of each patient with a total of 204 lumbar vertebrae. RESULTS: Both T1 and T2 signal intensities tended to increase when both diffusion and ADC values decreased with reducing BMD. CONCLUSIONS: An inverse relationship between BMD and T1 and T2 signal intensities and a direct relationship between diffusion and ADC values were present in this pilot group. The T1/diffusion signal-intensity ratio could be a reliable diagnostic indicator of osteoporosis.

Diffusion-weighted magnetic resonance imaging in rhombencephalitis due to Listeria monocytogenes.

We present diffusion-weighted imaging findings of a case of rhombencephalitis due to Listeria monocytogenes. It is a rare, life-threatening disorder. The diagnosis is difficult by clinical findings only. In this report, we aim to draw attention to the role of conventional and diffusion-weighted magnetic resonance imaging findings. To our knowledge, this is the first case report in the literature with apparent diffusion coefficient values of diseased brain parenchyma.

Complete androgen insensitivity syndrome: report of a case with solitary pelvic kidney.

Complete androgen insensitivity syndrome, commonly known as the testicular feminization syndrome, is characterized by a 46, XY karyotype, bilateral testes, absent or hypoplastic Wolffian ducts, and female-appearing external genitalia with diminished axillary and pubic hair development. Although initial diagnosis in the child is difficult, the syndrome must be suspected after puberty if primary amenorrhea is present. Coexistence of genital defects with urologic abnormalities is expected in these cases because of close embryologic origin. However, unilateral renal agenesis with pelvic ectopia of the contralateral kidney does not seem so common. We report a case of testicular feminization syndrome with a solitary kidney located in bony pelvis on the left side.

Quality of the bottom sediment prior to dredging in the Golden Horn of Istanbul.

The Golden Horn has experienced severe pollution due to uncontrolled domestic and industrial wastewater discharges until recent years. A restoration project has been developed by our universities, upon a request from Istanbul Metropolitan Municipality. Two principal alternatives for the dredging and disposal of the bottom sediments were considered: disposing on the land and disposing in the sea. Both of these alternatives include several sub-alternatives. Characterization of the sediment quality is crucially important for selecting the best alternative considering the cost, environmental impact and public acceptance. However, only a few and rather old studies were present with which it was not possible to get a comprehensive information on the critical sediment characteristics. Therefore, the aim of this study was determination of spatial distribution of sediment characteristics. The project area, at which the sediment quality determined, covers the part of the Golden Horn remaining at the upstream of Valide Sultan Bridge. The number of sampling stations were thirteen and the sediment samples were collected from 0.0m, 5.0m and 10.0m from the bottom surface. The following parameters were measured on each sample: Total solids, organic matter, total phosphorus, TKN, oil and grease, total sulphur, and sediment oxygen demand (SOD). Sediment oxygen demand parameter was further divided into three fractions, namely, biological (SOD-B) and chemical (SOD-C). Average organic content of the bottom sediment was around 10% while ammonia and sulfur exhibit very high levels. It is found that the bottom sediment is well stabilized with very low organic content below 5.0m from the bottom surface. It can be said that, removing the upper 5m of the bottom sediment will be enough for creating a relatively stable bottom surface which will cause oxygen depletion in the overlaying water at acceptable levels. High SOD values of the bottom sediment makes the alternatives considering disposal in the Marmara Sea and Black Sea inapplicable. High SOD-C values, especially, indicate that the sediment will cause a tremendous reduction in the oxygen concentration in a very short time at any marine environment, and even it may create anaerobic conditions. Therefore, disposal of dredged sediment into abandoned mines 4km from the Golden Horn by a pressure pipeline has been chosen as the best applicable alternative.

Joint operation of small wastewater treatment plants in southern Turkey.

In this study, joint operation of several small wastewater treatment plants (SWWTPs) by the same operation company is proposed to avoid operational problems such as unqualified personnel, inadequate maintenance and laboratory services. Some case studies from Antalya province of Turkey are presented. Several SWWTPs are operated by the companies formed with the proportional shares of the owners such as ALTAS and TURAS. The performance data of the five treatment plants operated by ALTAS and two treatment plants operated by TURAS are presented. The status of wastewater treatment with emphasis on the small sized plants is also presented and evaluated. The percentage of small settlements served with sewer and wastewater treatment facilities is very low (3%) indicating that high volumes of investment are needed to increase the level of service to those of the developed countries. At present, the total number of the treatment plants in Antalya region is 409 with capacities ranging from 73 to 175 m3 d(-1). Package activated sludge type SWWPs built especially in the coastal regions meet the local effluent standards.

Direct filtration with preozonation for small water treatment systems.

The possibility of applying preozonation followed by direct filtration without the use of a coagulant is investigated. Filtration experiments have been carried out using four different water sources within Istanbul. A 1 m deep bed of 0.8-1.2 mm silica sand was used as the filter medium. The filter was operated at a rate of 11.5 m/hr. Raw water turbidities ranged from 2.3 NTU to 10.0 NTU. Effluent turbidity and particle count values were monitored using an on-line turbidimeter and an on-line particle counter. With all the waters studied in this work, preozonation improved particle removal in direct filtration. With three of the mentioned waters, it was possible to achieve turbidity values below 1.0 NTU without a coagulant by applying ozone at a rate between 1.7-1.8 mg/L. It was not possible to reduce the turbidity of one of the waters to below 2.7 NTU even with very high ozone dosages. The need for pilot testing before deciding if this treatment method is applicable to a given water is underlined.