Aortoenteric fistulas - our experiences with surgeons' nightmare.

BACKGROUND: Aortoenteric fistula (AEF) is a rare medical emergency, but one of the most difficult and threatening complications of gastrointestinal (GI) bleeding. METHODS: A retrospective observational study was performed on patients hospitalised with GI bleeding and a definitive AEF diagnosis. We collected operative reports and medical records of patients operated on with an AEF diagnosis. The literature data and our data were analysed and discussed. RESULTS: We admitted eight patients who were definitively diagnosed with AEF after reviewing our hospital records. All patients were male except one. Their ages ranged from 28 to 82, with a mean of 64. All but two patients had secondary AEF (SAEF). Four SAEF cases had open aortic surgery and three had a history of endovascular procedure. The main complaints of the patients on admission were poor general condition, abdominal pain, and GI bleeding. Melena was found in all patients. Hematemesis and hematochezia were other significant GI bleeding findings. Infected grafts were removed in all but one patient; extra-anatomical bypass surgery and bowel repairs were performed. One patient underwent endovascular repair. In all patients, the 30-day in-hospital mortality rate was 50%. CONCLUSION: In patients presenting with GI bleeding, an aortoenteric fistula should be considered. The outcome depends on early diagnosis, the patient's medical status, the severity of infection, and the anatomic location of the affected aorta. A multidisciplinary approach, appropriate treatment planning and close follow-up after treatment lead to positive outcomes.

Purification and characterization of polyphenol oxidase from corn tassel.

In this study, polyphenol oxidase (PPO) from corn tassel  was extracted and partially purified through  (NH4)2SO4 precipitation and gel filtration chromatography. Optimal temperatures for subsrates catechol and 4-methyl catechol were 40 °C and 30 °C, respectively. The optimal pH values were 8.0 for catechol and 6.0 for 4-methyl catechol. Catechol was the most suitible substrate (Km: 3.48 mM, Vmax: 1.0 Abs./ min.). The moleculer mass of PPO was determined as 158 kDa. In this work, sodium azide, ethylenediaminetetraacetic acid (EDTA) and sodium dodecyl sulfate (SDS) were found to inhibit the enzyme activity as 26.6 %,  22.2 % and 12.2 % ratio, respectively. Besides, the effects of carbohydrates such as sucrose, fructose, ribose and glucose on PPO activity were investigated. The enzyme was found to be activated 17 % by fructose and ribose, 16 % by glucose and 4 % by sucrose.

Production and purification of novel thermostable alkaline protease from Anoxybacillus sp. KP1.

In this study, an extracellular novel alkaline protease (EC 3.4.21-24, 99) from a thermophilic and aerobic strain of Anoxybacillus sp. KP1 has been studied. Maximum protease activity was obtained at 50 degC at pH 9.0 after 24 hours of incubation. Among the carbon and nitrogen sources used; the optimum protease production was with soluble starch, maltose, urea and casamino acid. The enzyme was purified by ammonium sulphate precipitation and Sephadex G-75 gel chromatography. Molecular weight of purified enzyme was determined as 106 kDa by SDS-PAGE. Purified protease was stable at 50-60 °C and at pH 9.0 for 1 h. The enzyme activity was increased in the presence of Ca2+, Cu2+, Tween 80 and Triton X-100, however the enzyme activity was inhibited in the presence of Hg2+, ethylene diamine tetra acetic acid (EDTA) and H2O2. Proteolytic activity was completely inhibited by phenyl methyl sulfonyl fluoride (PMSF). The enzyme seems to be a serine alkaline protease. In the presence of detergents, the protease was clearly stable and residual activity was between 73-82%.

Cloning, purification and characterization of a thermostable ß-galactosidase from Bacillus licheniformis strain KG9.

A thermo— and alkalitolerant Bacillus licheniformis KG9 isolated from Taşlıdere hot water spring in Batman/Turkey was found to produce a thermostable β—galactosidase. Phylogenetic analysis showed that the 16S rRNA gene from B. licheniformis strain KG9 was 99.9% identical to that of the genome sequenced B. licheniformis strain DSM 13. Analysis of the B. licheniformis DSM 13 genomic sequence revealed four putative β—galactosidase genes. PCR primers based on the genome sequence of strain DSM 13 were used to isolate the corresponding β—galactosidase genes from B. licheniformis strain KG9. The calculated molecular weights of the β—galactosidases I, II, III, and IV using sequencing data were 30, 79, 74, and 79 kDa, respectively. The genes were inserted into an expression vector and recombinant β—galactosidase was produced in Escherichia coli. Of the four β—galactosidase genes identified in strain KG9, three of them were expressed as active, intracellular enzymes in E. coli. One of the recombinant enzymes, β—galactosidase III, was purified and characterized. Optimal temperature and pH was determined to be at 60 ºC and pH 6.0, respectively. Km was determined to be 1.3 mM and 13.3 mM with oNPG (ortho—nitrophenyl—β—D—galactopyranoside) and lactose as substrates, respectively, and Vmax was measured to 1.96 μmol/min and 1.55 μmol/min with oNPG and lactose, respectively.

Can exposure to manganese and extremely low frequency magnetic fields affect some important elements in the rat teeth?

BACKGROUND: Length and level of exposure to electromagnetic fields (EMFs) is increasing in association with the widespread use of electrical and electronic devices and technological progress. The undesirable effects of extremely low frequency magnetic fields (ELF-MFs) on health have attracted considerable interest. MATERIALS AND METHODS: Sixty-four four-month-old male Wistar rats divided into eight groups of eight rats each were used. Seven groups were exposed to varying dosages of manganese (Mn) and a 50 Hz magnetic field (MF) of approximately 1 mT, while the last group was set aside as the cage control group and not subjected to any procedure. This study was intended to investigate the interactions between the application of MF and Mn and the elements Ca, Zn, Mg, and P thought to be involved in caries, in rat teeth. RESULTS: Levels of Ca, Mg, Zn, and P in the experimental group rats were different to those in the control group. CONCLUSIONS: The results demonstrate that ELF-MF and Mn can have significant effects on levels of elements in rat teeth. Further experimental and epidemiological studies of ELF-MF and Mn are needed in order to evaluate their dental effects.

Diagnostic accuracy of cone beam computed tomography and conventional multislice spiral tomography in sheep mandibular condyle fractures.

OBJECTIVES: the aim of this study was to compare diagnostic accuracy of cone beam CT (CBCT) and multislice CT in artificially created fractures of the sheep mandibular condyle. METHODS: 63 full-thickness sheep heads were used in this study. Two surgeons created the fractures, which were either displaced or non-displaced. CBCT images were acquired by the NewTom 3G CBCT scanner (NIM, Verona, Italy) and CT imaging was performed using the Toshiba Aquillon multislice CT scanner (Toshiba Medical Systems, Otawara, Japan). Two-dimensional (2D) cross-sectional images and three-dimensional (3D) reconstructions were evaluated by two observers who were asked to determine the presence or absence of fracture and displacement, the type of fracture, anatomical localization and type of displacement. The naked-eye inspection during surgery served as the gold standard. Inter- and intra-observer agreements were calculated with weighted kappa statistics. The receiver operating characteristics (ROC) curve analyses were used to compare statistically the area under the curve (AUC) of both imaging modalities. RESULTS: kappa coefficients of intra- and interobserver agreement scores varied between 0.56 - 0.98, which were classified as moderate and excellent, respectively. There was no statistically significant difference between the imaging modalities, which were both sensitive and specific for the diagnosis of sheep condylar fractures. CONCLUSIONS: this study confirms that CBCT is similar to CT in the diagnosis of different types of experimentally created sheep condylar fractures and can provide a cost- and dose-effective diagnostic option.

Active control of focal length and beam deflection in a metallic nanoslit array lens with multiple sources.

We propose an all-optical method to actively control the transmission of nanoslit arrays for scanning and lensing applications. We show that by utilizing two lateral control slits, the transmitted beam can be actively steered.

Treatment of chronic type B aortic dissection by endovascular grafting in a previously CABG patient. Case report.

High mortality rates resulting from the surgical treatment of Type B aortic dissections have played an important role in seeking newer alternative therapy modalities for the treatment of the pathology. Especially since the early 1990s, endovascular grafting has become a popular option in the treatment of aortic diseases and with the increasing experience and advances in technology, it has, in recent years, become an alternative approach for the treatment of aortic dissections. In this report, we present the treatment of a 56-year-old male patient with a history of a coronary artery bypass grafting who presented with chronic type B aortic dissection. Endovascular stent graft implantation was performed with a hybrid therapy type of preliminary right subclavian artery to left subclavian artery bypass, followed by endovascular stent graft implantation to the dilated aneurismal segment of the descending aorta, for the treatment of chronic type B aortic dissection. The procedure and the postoperative course were uneventful; moreover, they were very comfortable for the patient undergoing an investigation of the descending aorta, when compared with the conventional surgical treatment modalities.

Endovascular therapy in the management of moderate and massive haemoptysis.

The aim of this study was to retrospectively evaluate 140 patients with severe (97 massive, 43 moderate) haemoptysis treated by bronchial artery embolisation. Between January 1997 and April 2005, 140 patients (120 males and 20 females, aged 23-71 years) with severe haemoptysis considered surgically inoperable because of limited pulmonary reserve were treated by embolisation. The cause of haemoptysis was tuberculosis in 136 patients and malignancy in four. Embolisation succeeded in controlling haemoptysis immediately after the intervention in 138 patients (98.5%) and at 1 month in 126 patients (90%). Severe haemoptysis recurred in 11 patients with prior massive haemoptysis and 3 patients with prior moderate haemoptysis in a mean time of 3.7 months (1-7 months) after the last intervention. The bleeding source was detected during angiography and embolised in 12 of these patients. Two patients with malignant tumour died because of abundant bleeding, following an asymptomatic period of 30 days. There were no procedure-related major complications. Bronchial artery embolisation is a safe and effective palliative treatment alternative in moderate and massive haemoptysis.

The effects of organic pesticides on inner membrane permeability in Escherichia coli ML35.

We have tested whether some pesticides might cause inner membrane leakage in ML35 Escherichia coli cells, which express beta-galactosidase (lacZ; EC 3.2.1.23) constitutively but lack the permease (lacY) required for substrate entry. The activity of beta-galactosidase (indicative of substrate leakage through the inner membrane) was increased by various concentrations of pesticides, including the organometallic fungicides maneb and mancozeb, the insecticide Thiodan, and the herbicide Ally, as well as by antibiotics such as ampicillin, gramicidin D, and the calcium ionophore A23187. The enzyme activity was increased by up to approximately 30% when the E. coli ML35 strain was exposed to various concentrations (between 50 and 250 ppm) of both fungicides. Thiodan had only a slight effect on beta-galactosidase activity (increase of 12.8%), whereas, among the antibiotics, the calcium ionophore at 20 microg/ml caused a significant increase in enzyme activity by up to 61.8%. This effect is similar to that of sodium dodecyl sulfate, used as positive control ( approximately 70% increase). Accumulation of maneb and mancozeb by bacterial cells was also studied taking advantage of their metal content and using atomic absorption spectrophotometry. In parallel with the increase in enzyme activity, both fungicides accumulated in the cells as a function of their concentration. Time course experiments (3, 6, and 9 h) of fungicide accumulation and of bacterial growth at various pesticide concentrations were also carried out. Maneb seems to inhibit the bacterial growth better than mancozeb. In addition, maneb uptake increases with time up to 9 h at all tested concentrations, whereas the accumulation of mancozeb is similar at all the exposure times tested. This indicates a different uptake and/or metabolizing strategy by E. coli cells for the two fungicides.

Case report: Foreign body granuloma mimicking liver metastasis.

In this study, foreign body granuloma mimicking liver metastasis diagnosed on routine follow-up examination in a 41-year-old woman with rectal adenocarcinoma is reported. To our knowledge, this is the first study in English-language literature reporting foreign body granuloma indistinguishable from liver metastasis on radiological examination.

Integration of Biological Control Agents and Systemic Acquired Resistance Inducers Against Bacterial Spot on Tomato.

Two strains of plant growth-promoting rhizobacteria, two systemic acquired resistance inducers (harpin and acibenzolar-S-methyl), host-specific unformulated bacteriophages, and two antagonistic bacteria were evaluated for control of tomato bacterial spot incited by Xanthomonas campestris pv. vesicatoria in greenhouse experiments. Untreated plants and plants treated with copper hydroxide were used as controls. The plant growth-promoting rhizobacteria or a tap water control were applied as a drench to the potting mix containing the seedlings, while the other treatments were applied to the foliage using a handheld sprayer. The plant growth-promoting rhizobacteria strains, when applied alone or in combination with other treatments, had no significant effect on bacterial spot intensity. Messenger and the antagonistic bacterial strains, when applied alone, had negligible effects on disease intensity. Unformulated phage or copper bactericide applications were inconsistent in performance under greenhouse conditions against bacterial spot. Although acibenzolar-S-methyl completely prevented occurrence of typical symptoms of the disease, necrotic spots typical of a hypersensitive reaction (HR) were observed on plants treated with acibenzolar-S-methyl alone. Electrolyte leakage and population dynamics experiments confirmed that acibenzolar-S-methyl-treated plants responded to inoculation by eliciting an HR. Application of bacteriophages in combination with acibenzolar-S-methyl suppressed a visible HR and provided excellent disease control. Although we were unable to quantify populations of the bacterium on the leaf surface, indirectly we determined that bacteriophages specific to the target bacterium reduced populations of a tomato race 3 strain of the pathogen on the leaf surface of acibenzolar-S-methyl-treated plants to levels that did not induce a visible HR. Integrated use of acibenzolar-S-methyl and phages may complement each other as an alternative management strategy against bacterial spot on tomato.

Morphological changes in diseased cementum layers: a scanning electron microscopy study.

The aim of this study was to compare the morphological changes that occurred in root cementum layers due to periodontal disease by using scanning electron microscopy (SEM). Ninety-two periodontally hopeless teeth extracted from 29 patients were studied. Measurements of probing depth (PD) and clinical attachment loss (CAL) were taken prior to extractions. After the longitudinal fracturing process of root specimens, healthy and diseased cementum layers of roots were evaluated by SEM for the thickness of the cementum and the morphological changes in collagen fibers. The result of SEM evaluation revealed a significant ( P < 0.001) decrease in the thickness of cementum layer on the diseased root surfaces compared to the healthy surfaces. There were denser and conspicuous collagen fibers with their interfibrillar matrix in cementum layers on the healthy root surfaces compared to the diseased surfaces. Within the limits of this study, the thickness of cementum layers in diseased areas was found to be significantly less than that in the healthy areas of root surfaces. However, there exist variations in the density and visibility of cemental fibers between individuals and within the individual.

MRI cisternography with gadolinium-containing contrast medium: its role, advantages and limitations in the investigation of rhinorrhoea.

Our purpose was to evaluate the utility of intrathecal gadopentetate dimeglumine -enhanced magnetic resonance cisternography (GdMRC). We injected 0.5 ml contrast medium into the subarachnoid space via lumbar puncture in 20 patients with suspected cerebrospinal fluid (CSF) rhinorrhoea. MRC showed CSF leakage in 14 patients with rhinorrhoea at the time of the examination, into the ethmoid air cells in nine, the sphenoid sinus in three and the frontal sinus in two cases. In 12 of these the site leakage was confirmed during surgical repair of the fistula. No leakage was observed in four patients with intermittent rhinorrhoea, not present at the time of the examination. GdMRC showed leakage in two patients with negative CT cisternography. GdMRC may prove better than CT cisternography, especially with slow CSF flow. We also showed low-dose GdMRC to be a feasible and relative safe way of confirming the presence of and localising active CSF leaks prior to surgical repair.

Heavy metal monitoring of marine algae from the Turkish Coast of the Black Sea, 1998-2000.

Concentrations of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn were determined in macroalgae samples collected from the Turkish Coast of the Black Sea. Certain algae species were chosen among the green, brown and red algae species at Sile and Sinop sampling stations from 1998 to 2000. In general, as regards the influence of the collection sites on the whole metal accumulation, Sinop is considered to be more polluted than Sile. The concentrations of the heavy metals in Cystoseira barbata algae are compared with previous studies in the same stations. The results showed that all metal levels have gradually decreased during past years. At the same time, Cd, Co, Cr, Cu, Fe, Ni and Pb levels in the present study are lower than in Bosphorus and Marmara Sea algae. However, Mn and Zn concentrations are higher than Bosphorus but lower than at Marmara. According to these findings the heavy metal pollution decreased in Turkish Coast of the Black Sea during the years investigated.

A new MRI method for the quantitative evaluation of extraocular muscle size in thyroid ophthalmopathy.

In cross section, extraocular muscles are more or less elliptical, with short and long diameters. We studied the ratio (R) of short to long diameter and investigated its use in quantitative assessment of the extraocular muscles in patients with Graves's disease. We measured the diameters on T1-weighted axial and coronal MRI and computed R for each extraocular muscle in 80 patients without and 40 with Graves's disease. We compared the measurements and R of the right and left orbits, and of men and women. The short diameter of all extraocular muscles apart from the superior oblique showed significant differences between men and women, and that of the inferior rectus varied significantly with age. R, however, was unrelated to sex or age. All patients with Graves's disease and an increased short diameter also had an increased R, but 6% of the muscles showed an increase in R, even though their short diameter was within the normal range.

A facile synthesis of 2-aryl-4,5-di(2-thienyl)imidazoles under microwave irradiation and their antimicrobial activities.

In this study, some 2-aryl-4,5-dithienylimidazoles were synthesized by reacting di-(2-thienyl)ethandione and a suitable aromatic aldehyde in the presence of ammonium acetate in acetic acid. Either the classical reflux method or microwave irradiation method were applied as alternative reaction conditions. The antimicrobial activities of the compounds obtained were investigated in vitro and appreciable activities were obtained.

Bis(triethanolamine)cadmium(II) and -mercury(II) saccharinates: seven-coordinate complexes containing both tri- and tetradentate triethanolamine ligands.

The structures of the title triethanolamine (tea) complexes of Cd(II) and Hg(II) saccharinates, bis(triethanolamine)-kappa3O,N,O';kappa4O,N,O',O"-cadmium(II) 1,2-benzisothiazol-3(2H)-onate 1,1-dioxide, [Cd(C6H15NO3)2](C7H4NO3S)2, (I), and bis(triethanolamine)-kappa3O,N,O';kappa4O,N,O',O"-mercury(II) 1,2-benzisothiazol-3(2H)-onate 1,1-dioxide, [Hg(C6H15NO3)2](C7H4NO3S)2, (II), or [M(tea)2](sac)2, where M is Cd(II) or Hg(II) and sac is the saccharinate anion, reveal seven-coordinate metal ions in both complexes. Both complex cations, [M(tea)2]2+, adopt a monocapped trigonal prism geometry in which the two tea ligands exhibit different coordination modes to achieve seven-coordination. One tea ligand acts as a tetradentate ligand using all its donor atoms, while the other behaves as a tridentate O,N,O'-donor ligand, with one of its ethanol groups remaining uncoordinated. The H atoms of the free and coordinated hydroxyl groups of the tea ligands are involved in hydrogen bonding with the amine N atom, and with the carbonyl and sulfonyl O atoms of neighbouring sac ions, forming an infinite three-dimensional network. A weak pi-pi interaction between the phenyl rings of the sac ions also occurs.