ISSN: 2149-2247 | E-ISSN: 2149-2549

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Erciyes Med J: 39 (1)

Volume: 39  Issue: 1 - 2017

1.AUTHOR INDEX

Page 
Abstract

ORIGINAL ARTICLE
2.Culex (Culex) Pipiens Mosquitoes Carry and Harbor Pathogenic Fungi during Their Developmental Stages
Fatma Hossein Galal, Amany Abuelnasr, Ibtesam Abdallah, Omaima Zaki, Alaaeddeen M Seufi
doi: 10.5152/etd.2017.16067  Pages 1 - 6
Objective: Fungi are the main source of aflatoxin contamination in nature. The present study aimed to assess the role of the cosmopolitan mosquito species, Culex pipiens, in the circulation and dissemination of pathogenic fungi in nature, and to evaluate its capability to harbor these fungi.
Materials and Methods: Fungi were isolated and identified from both, the external surface and the internal organs of the developmental stages and from the breeding environment of Cx. pipiens.
Results: A total of 35 fungal isolates were isolated from both, the internal organs and the external surface of the developmental stages and from the breeding environment of Cx. pipiens. These isolates were identified as eleven Penicillium notatum isolates, eleven Aspergillus flavus isolates, six Rhizopus stolonifer isolates, four Candida albicans isolates, two Fusarium solani isolates, and one Aspergillus niger isolate. Antagonistic activity showed that the P. notatum growth inhibited the growth of the bacteria, Staphylococcus aureus.
Conclusion: This study revealed that the different developmental stages of Cx. pipiens mosquito were capable of harboring many fungal species. Subsequently, this mosquito will be incriminated in the mechanical dissemination, circulation, and transmission of these fungi in nature, during its life cycle.

3.Amputations in Burn Patients with a Special Emphasis on Pediatric Patients
Burhan Özalp, Abdulkadir Calavul
doi: DOI: 10.5152/etd.2017.16103  Pages 7 - 11
Objective: Digit and extremity amputations are unwanted complications in burn injuries. Although some amputations cause only cosmetic and psychological problems in burn patients, they can lead to serious loss in functionality and impairment in the quality of life. The aim of this study was to investigate the epidemiologic features of amputations among burn patients in the southeastern region of Turkey.
Materials and Methods: We conducted retrospective chart reviews of patients hospitalized in Dicle University Burn Center between January 2011 and January 2016 and evaluated patient demographics
Results: A total of 3315 (2063 male and 1252 female) patients were treated, and 41 patients (36 males and 5 females) with a mean age of 21.95 years (range: 3-58 years) underwent amputation. The amputation incidence was 1.23% over the 5-year period. In total, 19 of 41 patients were under 16 years, while 16 were male workers. There was a significant male dominance (p<0.05), with electrical burns being the most common etiological agent (p<0.001). The mean burned total body surface area was 12.4±7.9% (range: 2-60%), and major amputations were significantly higher (p<0.05) if the area exceeded 10%.
Conclusion: Electrical burns were the most common etiological factor, and pediatric patients were the most affected group. Educating parents and taking safety measures for protecting children from electrical contact points are as important as educating workers for diminishing the incidence of electrical burn-related amputations.

4.Clinical and Cytogenetic Evaluations of Patients with Turner Syndrome: Are We Aware Enough?
Semra Gürsoy, Özge Aksel Kılıçarslan, Özlem Giray Bozkaya, Elçin Bora, Nurettin Ünal, Derya Erçal
doi: 10.5152/etd.2017.15070  Pages 12 - 15
Objective: The objective of the present study was to describe the phenotypic features of Turner syndrome (TS) and to investigate the relationship between the genotype and the phenotype.
Materials and Methods: We studied 26 female patients who were enrolled between 2006 and 2015. Physical features, clinical history, laboratory findings, and imaging test results were recorded. Chromosomal analysis was performed on peripheral blood lymphocyte cultures of the patients.
Results: The mean age of the study population was 10.4±5.6 years (range, 1 day to 17 years). Three patients were diagnosed in the neonatal period. Although the most common phenotypic feature was short stature (92.3%), the characteristic stigmatas were usually seen in the 45, X karyotype. Among the 26 patients, monosomy 45, X was detected in 7 (26.9%) of them. Eleven percent of our patients had 46,X,i(X) (isochromosome Xq), while the rest demonstrated mosaic karyotypes [45,X/46,XY (19.2%); 45,X/46,XX (11.5%); 45,X/46,X,i(X) (11.5%); 45,X/46,XX,r(X) (7.7%); 45,X/46,X,i(Y) (3.8%); 45,X/47,XXX (3.8%); and 45,X/46,XX del(Xp) (3.8%)].
Conclusion: TS is one of the most common sex chromosome abnormalities, but it is frequently underdiagnosed. The frequency of the monosomy 45, X karyotype in TS is less than previously thought. Therefore, patients should be evaluated by chromosome analysis in case there is clinical suspicion.

5.An Important Question That Needs to Be Proved: Is There Any Relationship between the Epicardial Fat Thickness and the Coronary Artery Complexity in Patients with Acute Non-ST Elevation Myocardial Infarction?
Ahmet Karakurt, Cennet Yıldız
doi: 10.5152/etd.2017.16081  Pages 16 - 23
Objective: In this study, we aimed to investigate the association of epicardial fat thickness (EFT) and coronary artery lesion complexity with patients having acute non-ST elevation myocardial infarction (NSTEMI).
Materials and Methods: The patients (n=328) were divided into low syntax score (SS) group (SS≤17; Low-SSG), intermediate SS group (SS=18-28; In-SSG), and high SS group (SS≥29; High-SSG) based on the SS value. EFT, SS, distributions of the critical coronary artery lesions, and the neutrophil-lymphocyte ratio (NLR) were determined for all the groups. EFT was measured by transthoracic echocardiography and was recorded on a digital storage device.
Results: High-SSG had a significantly higher mean of EFT (6.65±0.82 mm) when compared to Low-SSG (5.12±1.13 mm) and In-SSG (5.79±0.83 mm) (p<0.001). EFT showed a significant positive correlation with SS (r=0.607, p<0.001). Further, a significant positive correlation was revealed with the distributions of critical coronary artery lesions of the left anterior descending (LAD), circumflex artery (Cx), and right coronary artery (RCA) (r=0.260, p<0.001; r=0.213, p=0.001; and r=0.275, p<0.001, respectively). However, no correlation was demonstrated between EFT and NLR (r=0.081, p=0.145) in patients with NSTEMI.
Conclusion: These results showed that EFT is significantly associated with coronary artery lesion complexity in patients with NSTEMI and can work as a risk marker in these patients.

6.Identification and Phylogenetic Analyses of Two Isoforms of the Antibacterial Gene Diptericin from the Larval Tissue of Musca domestica (Diptera: Muscidae)
Alaaeddeen M Seufi, Abada A Assar, Magda M Aboelmahasen, Shaymaa H Mahmoud
doi: 10.5152/etd.2017.16074  Pages 24 - 31
Objective: Insect immune system has a potent arsenal of antimicrobial peptides (AMPs) that cooperate to clear microbial invasions. Here we aimed to explore the immune response of Musca domestica larvae when bacterially challenged and pick up induced antibacterial genes. These genes can be used in the production of novel antibiotics to compensate for the increasing demand of antibiotics in the era of resistant bacterial strains.
Materials and Methods: Hemolymph and whole body of third instar larvae were collected at 2-h intervals for 24 h postinfection. Integer and pure total RNA were transcribed into cDNA. Differential display technique was used to identify differentially expressed genes. Ten reproducible bacterial-induced bands were sequenced. Sequenced DNA fragments were deposited in GenBank under KM205630 and Hl205631 accession numbers.
Results: Sequence analyses indicated that two DNA fragments designated as MdDipWB and MdDipHL were identified as diptericin-related sequences, for which single open reading frame (orf) encoding 99 and 80 amino acids were detected, respectively. Signal peptide was predicted only for MdDipWB. Meanwhile, prosequence was predicted only for MdDipHL. Calculated molecular masses of mature MdDipWB and MdDipHL were 8.8 and 6.97 Kilo Daltons (KDa), respectively. Propeptides of MdDipWB and MdDipHL were more stable than mature peptides. Comparing MdDipWB and MdDipHL nucleotide sequences, 26 substitutions and 4 deletions were observed in MdDipWB. Despite the 90% identity between MdDipWB and MdDipHL nucleotide sequences, no significant similarity was observed between their deduced amino acids. Nucleotide and deduced
amino acids of MdDipWB and MdDipHL created significant similarity with other diptericins isolated from M. domestica. On
comparing amino acid sequences of our putative polypeptides to their corresponding sequences, overexpression of many
specific amino acid residues was observed.
Conclusion: Our findings suggested that MdDipWB and MdDipHL are two isoforms of the same gene.

CASE REPORT
7.An Asymptomatic, Supratentorial, Remote Epidural Hematoma Following Posterior Fossa Surgery
Yaşar Öztürk, Sait Öztürk, Mesut Emre Yaman, Gıyas Ayberk
doi: 10.5152/etd.2017.16121  Pages 32 - 34
An epidural hematoma (EDH) following posterior fossa surgery is extremely rarely reported. We report the case of a 49-yearold woman diagnosed with cerebellar lesions and hydrocephalus. The patient underwent left paramedian suboccipital craniotomy, and total resection of the lesion was performed. After the surgery, the patient was transferred to the intensive care unit with a Glasgow coma score of 15. Because the patient was neurologically stable, computed tomography (CT) was performed on the first postoperative day. A right, frontal, large EDH was seen on the CT image without any complaint and neurological deterioration. EDH evacuation was performed by right frontal craniotomy, and the patient was discharged with full recovery. This case reinforces the importance of a close follow-up and the early imaging of posterior fossa tumors, particularly with hydrocephalus, for not overlooking this rare, but serious, complication, even if a patient is clinically silent.

8.Sugammadex and Genaral Anesthesia in Two Pediatric Patients with Joubert Syndrome: Case Report
Dilek Günay Canpolat, Mustafa Denizhan Yıldırım, Salih Doğan, Fatma Doğruel, Hüseyin Per, Mehmet Canpolat
doi: 10.5152/etd.2017.16108  Pages 35 - 36
Joubert syndrome (JS) is a rare genetic disorder that affects the cerebellum, controlling balance, and coordination, and it usually presents a molar tooth sign on magnetic resonance imaging. It is characterized by ataxia, an abnormal breathing pattern referred to as hyperpnea, sleep apnea, hypotonia, and abnormal eye and tongue movements. Because of sensitivity to respiratory depressant agents, including opiates, nitrous oxide, and neuromuscular blockers, and potential difficult airways, anesthetic management requires attention. Sugammadex binds to rocuronium and is a reverse neuromuscular blocker. In this study, two cases of JS where sugammadex was used for general anesthesia are presented. Sugammadex may be a safe general anesthetic for patients with JS.

9.Paramedian Ectopic Thyroid Gland and Unusual Origin of Superior Thyroid Artery-A Case Report and Review of Literature
Srinivasa Rao Sirasanagandla, Satheesha B Nayak, Narendra Pamidi
doi: 10.5152/etd.2017.16105  Pages 37 - 39
Ectopic thyroid is considered as one of the developmental anomalies of the thyroid gland. It is usually found in the midline, along the line of descent of thyroid diverticulum. Ectopic thyroid is very rarely found in the lateral part of the neck. Duringthe routine dissection classes for undergraduate medical students, we came across the presence of a laterally placed ectopic thyroid gland. An oval-shaped mass of thyroid tissue was situated on the left side of the neck. It was located superficial to the inferior constrictor muscle, close to its origin from the oblique line of the thyroid cartilage. It was supplied by a branch of superior thyroid artery. Superior thyroid artery arose from the common carotid artery just before its bifurcation into external and internal carotid arteries.

LETTER TO THE EDITOR
10.Importance of Neuropathological Examination in “Unexplained Stillbirths”
Anna Maria Lavezzi
doi: 10.5152/etd.2017.16122  Pages 40 - 41
Abstract | Full Text PDF

11.Multiparametric MRI at 3 T of Usual Prostatic Carcinoma with Neuroendocrine Differentiation: First Case Report
Michele Scialpi, Luca Roncati, Teresa Pusiol
doi: 10.5152/etd.2017.16083  Pages 42 - 43
Abstract | Full Text PDF

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