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Bircan Alan,1 Murat Kapan,2 Memik Teke,1 Salih Hattapoğlu,1 Zülfü Arıkanoğlu2 1Department of Radiology, 2Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey Objective: The objectives of this study were to investigate the relationship between the segmental localization of liver hydatid cyst by computed tomography (CT) and the presence of cystobiliary communication (CBC) and to identify the risk factors for CBC.Patients and methods: One hundred and eleven of 163 patients who underwent liver hydatid surgery between January 2011 and September 2014 were included in this study and analyzed retrospectively. The size, number, stage, and segmental and lobar localization of the cysts were investigated by CT. The presence of CBC and preoperative laboratory findings were recorded from operation notes. Results: CBC was more frequent in single large cysts. CBC was most commonly detected in segment 1 (50%), 8 (48.3%), 7 (41.2%), and 4 (40%). CBC was more frequent in the right lobe (40.4%) and Gharbi stage 3 (41.8%) and 4 (55.6%) lesions. There were no differences in CBC according to distance from the hilus. In addition, preoperative total bilirubin, direct bilirubin, alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) elevations were associated with higher CBC frequency (P

Renewable energy sources, which use natural sources to generate energy, are currently replacing conventional energy sources to fulfil the world's expanding energy demands. However, photovoltaic and wind energy, which are among these types of energy sources, are not steady and not available for 24 hours in a day. As an alternative, it is possible to extract and use hot water from the earth all the time. Therefore, this study proposes a thermoelectric generator that uses hot water from the hot spring area to generate free electricity as a new renewable energy source in a microgrid application. In this system, the microgrid is standalone without a battery storage system because the thermoelectric generator is in operation for 24 hours in a day (day and night). In this way, the cost of the battery is eliminated by removing it from the system. In this paper, a novel generation method is proposed in microgrid applications as a renewable energy source. In addition, load management system was implemented to control three types of residence loads. The main advantage of this study is to generate electricity from renewable sources like photovoltaic and thermoelectric to demand without much wasting energy by controlled loads according to the proposed load management algorithm. In this study, the microgrid and energy management control is modeled with MATLAB/Simulink. The results showed that the essential load is always active through thermos electric generator besides the absence of battery storage system. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Vasovagal syncope (VS) has a significant place in the etiology of syncope; tilt table (TT) test is used for identification of patients with vasovagal syncope (VS); however, the repeatability of the TT test is low. Upon repeated administration of TT test to patients with a positive result, the test may reveal a negative result. This feature of the test renders it inadequate particularly in evaluating therapeutical efficacy in patients receiving treatment. The left ventricular (LV) volume changes are important in the pathology of VS; in addition, LV volume changes are directly affected by the changes in the arterial system and therefore, the present study investigated arterial distensibility (AD) in this patient population. PATIENTS AND METHODS: A total of 142 VS patients with a positive TT test result (A group) and 93 healthy individuals (B group) were enrolled in the study. The patients received tilt training treatment for 6 months. VS patients were further classified into two: syncope (+) or syncope (-) subgroup according to having at least one or more syncope episode during the 6 months of training program. All patients and controls underwent Doppler echocardiography and AD measurement which were repeated at the end of 6th month in syncope (+) and (-) subgroups. RESULTS: The mean AD value of patients in group A was significantly lower than that of participants in group B (0.39 ± 0.1 vs. 0.42 ± 0.1, p = 0.025). In Group A, AD was significantly correlated with left ventricular diastolic filling time (DFT), isovolumetric relaxation time and right ventricular DFT (r = 0.38, p < 0.05; r = -0.42, p < 0.05; r = 0.35, p < 0.05, respectively). Syncope (+) subgroup had lower mean AD value compared to syncope (-) subgroup (0.38 ± 0.1 vs. 0.44 ± 0.1, p < 0.001). CONCLUSIONS: AD may have valuable contribution to understanding the pathophysiology underlying VS and AD may be used in evaluating therapeutical efficacy for vasovagal syncope. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 64-year-old Caucasian male with red left eye for years with symptomatic painless diminution of vision. The patient undergone episcleral flourescein angiography which indicates a diagnosis of idiopathic episcleral engorgement and glaucoma or Radius-Maumenee syndrome. Furthermore, it offers a discussion on idiopathic episcleral veins and its causes.

Background: Historically, surgical biopsy (SB) for diagnosis of pediatric solid tumors was considered necessary to provide adequate tissue for histologic and molecular analysis. Less invasive biopsy techniques such as image-guided core needle biopsy (CNB), have shown comparable accuracy with decreased morbidity in some adult studies. However, data regarding the safety and efficacy of CNB in pediatric tumors is limited. This study's aim was to assess the overall rate of successful diagnosis and safety of CNB compared to SB in children with malignancies., Methods: A PRISMA compliant systematic review was performed in MEDLINE via PubMed, Embase and CINAHL Plus database searches from 2010 to 2023. Studies were included with relevance to the following clinical question: For children with concern for malignancy requiring biopsy for diagnosis, how does CNB compare to open or laparoscopic/thoracoscopic SB in terms of safety and diagnostic efficacy? Data for patients ≤21 years requiring biopsy for diagnosis of liver tumors, neuroblastoma (NB), soft tissue sarcoma (STS), and lymphoma were included., Results: Twenty-seven studies including 2477 patients met inclusion criteria, with 2065 undergoing CNB and 412 SB. Of the 2477 patients, 820 patients had NB, 307 liver tumors, 96 STS, 151 lymphoma, and 1103 patients were from studies that included multiple diagnoses. The average complication rate for CNB was 2.9% compared to 21.4% for SB (p < 0.001). Bleeding was the most common complication in both groups, but significantly higher after SB (22.1% vs 2.3%) (p < 0.001). CNB was diagnostic in 90.8% of patients compared to 98.8% who underwent SB (p < 0.001)., Conclusions: Rates of successful diagnosis were greater than 90% for both CNB and SB, though significantly higher for SB. Conversely, complication rates were close to ten times higher after SB compared to CNB. Given its relatively lower risk profile, CNB can be a safe and useful diagnostic tool for children with solid malignancies. Research focused on enhancing CNB's diagnostic accuracy while maintaining low morbidity should be further explored., Level of Evidence: Treatment study, Level III., Competing Interests: Declaration of competing interest The authors have nothing to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: To report the ocular manifestations, multimodal imaging characteristics and genetic testing results of six patients with autosomal recessive bestrophinopathy (ARB)., Methods: This was an observational case series including 12 eyes of 6 patients who were diagnosed with ARB. All patients underwent a complete ophthalmic examination including refraction, slit-lamp biomicroscopy, dilated fundus examination, fundus autofluorescence, optical coherence tomography and electrooculography. BEST1 gene sequencing was also performed for all patients., Results: The mean age was 22.8years and the male-female ratio was 0.50. All ARB patients had a hyperopic refractive error. A spectrum of fundus abnormalities, including multifocal yellowish subretinal deposits in the posterior pole, subfoveal accumulation of vitelliform material and cystoid macular edema, was observed. Fundus autofluorescence imaging demonstrated marked hyperautofluorescence corresponding to the yellowish subretinal deposits. Optical coherence tomography revealed serous retinal detachment, intraretinal cysts, brush border appearance caused by elongation of the outer segments of photoreceptors, and hyperreflective dome-shaped deposits at the level of the retinal pigment epithelium. Fundus fluorescein angiography showed hyperfluorescence with staining of the yellowish subretinal deposits. Electrooculography showed reduced Arden ratio in all patients. In addition, biallelic pathogenic variants in the BEST1 gene were detected in all patients., Conclusion: ARB is a rare autosomal recessive inherited retinal disorder with biallelic pathogenic variants in the BEST1 gene and may present with a wide range of ocular abnormalities that may not be easily diagnosed. Multimodal retinal imaging in conjunction with EOG is helpful to establish the correct diagnosis., (Copyright © 2024. Published by Elsevier Masson SAS.)

Resistance to antibiotics by pathogenic bacteria constitutes a health burden and nanoparticles (NPs) are being developed as alternative and multipurpose antimicrobial substances. Magnetite (Fe 3 O 4 np), manganese ferrite (MnFe 2 O 4 np) and nickel ferrite (NiFe 3 O 4 np) NPs were synthesized and characterized using thermogravimetric analysis, transmission electron microscopy, Fourier transformed infra-red, and X-ray diffraction. The minimal inhibitory concentrations (MIC) ranged from 0.625 to 10 mg/mL against gram-positive (Staphylococcus aureus ATCC 25923 and Enterococcus faecalis ATCC 29212), gram-negative (Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853) and candida (Candida albicans ATCC 10239 and Candida tropicalis ATCC 13803) species. The NPs exhibited violacein inhibition against Chromobacterium violaceum CV12472 of 100% at MIC and reduced to 27.2% ± 0.8% for magnetite NPs, 12.7% ± 0.3% for manganese ferrite NPs and 43.1% ± 0.2% for nickel ferrite NPs at MIC/4. Quorum-sensing (QS) inhibition zones against C. violaceum CV026 were 12.5 ±0.6 mm for Fe 3 O 4 np, 09.1 ± 0.5 mm for MnFe 3 O 4 NP and 17.0 ± 1.2 mm for NiFe 3 O 4 np. The NPs inhibited swarming motility against P. aeruginosa PA01 and biofilm against six pathogens and the gram-positive biofilms were more susceptible than the gram-negative ones. The NiFe 2 O 4 np had highest antibiofilm activity against gram-positive and gram-negative bacteria as well as highest QS inhibition while Fe 3 O 4 NP had highest biofilm inhibition against candida species. The synthesized magnetic NPs can be used in developing anti-virulence drugs which reduce pathogenicity of bacteria as well as resistance., (© 2023 International Union of Biochemistry and Molecular Biology, Inc.)

Objective: The purpose of this study was to investigate the prevalence of intestinal parasites and head lice in primary school-aged children and to determine a possible relationship between the co-occurrence of ecto-endoparasites., Methods: The study were conducted in three schools in the center of Sivas: Sivas Karşıyaka Primary School, Kılavuz İMKB Primary School, and Karşıyaka 27 June Middle School. The presence of head lice and intestinal parasites was investigated in a total of 563 children aged 6 to 17, with 294 girls and 269 boys. Classroom teachers and students were provided with information about intestinal parasites, head lice, and methods of transmission and prevention, and a questionnaire was administered. During the head lice examination, students were inspected with a comb, and samples with nits were examined under a microscope in the laboratory. Cellophane tape and stool samples obtained from the participants were examined on the same day using the native-lugol, flotation, and trichrome staining methods under a light microscope (x10, x40, x100)., Results: Five hundred sixty-three children were evaluated for head lice and 15 (2.6%) were found to be positive. During the examination, only nits were found in 11 students (1.9%), and both adult lice and nymphs were seen in 4 students (0.7%). Head lice were found positive in 2 out of 269 boys (0.7%), while 13 out of 294 girls (4.2%) positive (p<0.05). As a result of stool examination in children, Entamoeba coli was found in 11 (1.95%), Giardia intestinalis in 4 (0.71%), Blastocystis sp. in 14 (2.48%), Enterobius vermicularis in 8 (1.42%) and Taenia spp. in 2 (0.35%). Head lice infestation and Taenia spp. were found to coexist in 2 (0.35%) children., Conclusion: In conclusion, although there has been a noticeable decrease in head lice and intestinal parasites among primary school-aged children in Sivas province, these conditions are still present, as evidenced by previous studies conducted in our region.

Background and Objectives: In 2003, the Society of Surgical Oncology (SSO) initiated a breast surgical oncology fellowship, which has now grown to 60 SSO accredited programs as of 2021. Limited knowledge exists on the traits of successful applicants and the factors influencing the rank list., Methods: A web-based, anonymous survey was sent to all SSO Breast Surgical Oncology Fellowship program directors. The survey consisted of 26 questions. Descriptive statistics were used to analyze survey responses and evaluate impact on applicant interview and rank list., Results: Thirty-four programs (57% response rate) completed the survey. Programs received an average of 70 applications and granted 24 interviews. Most programs reported a minimum ABSITE cut-off score (n = 28, 82%) and a defined publication requirement (n = 22, 65%), including a first-author requirement (n = 18, 53%) to extend an invitation to interview. For postinterview rank, applicant interpersonal skills were highly valued. The interview was the most important aspect for the rank list., Conclusions: Many programs have ABSITE and publication thresholds before offering an interview. Upon receiving interview invitation, the applicant's interview performance, interpersonal skills, and letters of recommendation were the most important aspect in rank list decision making., (© 2022 Wiley Periodicals LLC.)

In this study, cellulose acetate (CA)/polyvinylpyrrolidone (PVP) and CA/PVP/Mn 2+ nanofibers were produced by the electrospinning method, and these cellulose-derived membranes were used as carriers for arginase immobilization for the first time. The structural and morphological analysis of these cellulose-derived nanofibers were determined by attenuated total reflection-Fourier to transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), X-ray diffraction (XRD), and scanning electron microscopy (SEM). After the immobilization process, it was observed that the thermal properties of the cellulose-derived nanofibers especially improved. The optimum temperature value for free arginase was found to be 35 °C, and this value was found to be 40 °C for arginase immobilized cellulose-derived nanofibers. When the free arginase retained only about 35% of its activity at 50 °C and 60 °C after 60 min, arginase immobilized nanofibers protected 65% of their activity under the same conditions. In addition, arginase immobilized CA/PVP and CA/PVP/Mn 2+ nanofibers managed to retain 50% of their activity even after 9 and 12 reuses, respectively., (© TÜBİTAK.)

This study was aimed at synthesizing polyethyleneimine-coated magnetic nanoparticles and evaluating their effect on pathogenic bacteria. Polyethyleneimine-coated magnetite (PEIMnF) and nickel ferrite (PEINF) nanoparticles were succesfully synthesized and their surface groups, morphology and chemical structures were characterized using ATR-FTIR (Attenuated Total Reflectance Fourrier Transformed Infra-Red) and SEM (Scanning Electron Microscopy). TGA (Thermogravimetric analysis) was used to analyse the thermal behaviour and stability of synthesized nanomaterials. The minimal inhibitory concentration (MIC) values of the polyethylene imine coated magnetite and nickel ferrite nanomaterials against Staphylococcus aureus , Escherichia coli and Candida albicans was found to be 10 mg/mL. Both nanomaterials (PEIMnF and PEINF) showed very excellent and concentration-dependent biofilm inhibition especially at the highest test concentration of 10 mg/mL at which PEIMnF inhibited biofilm formation on E. coli (89.04 ± 0.50%), S. aureus (82.85 ± 2.42%) and C. albicans (91.37 ± 0.66%). At this concentration, PEINF equally inhibited biofilm formations of E. coli (90.48 ± 2.05%), S. aureus (87.04 ± 1.59%) and C. albicans (90.94 ± 1.03%). Only PEINF showed a concentration-dependent violacein inhibition with highest inhibition of 51.2 ± 3.5% at MIC and quorum sensing with inhibition zones of 16.3 ± 1.0 mm at MIC and 11.5 ± 0.5 mm at MIC/2 which could be attributed to the presence of nickel. The nanomaterials inhibited swimming and swarming motilities in Pseudomonas aeruginosa PA01 and it was found that at the same concentration, swimming inhibition was greater than swarming inhibitions and PEINF showed better inhibition than PEIMnF in both models. Polyethyleneimine-coated magnetite and nickel ferrite nanomaterials could be used in overcoming health problems associated with microbial infections and resistance., Competing Interests: Conflict of interestThe authors have no conflict of interest to declare., (© King Abdulaziz City for Science and Technology 2020.)

Cancer-associated fibroblasts (CAFs) are indispensable architects of the tumor microenvironment. They perform the essential functions of extracellular matrix deposition, stromal remodeling, tumor vasculature modulation, modification of tumor metabolism, and participation in crosstalk between cancer and immune cells. In this review, we discuss our current understanding of the principal differences between normal fibroblasts and CAFs, the origin of CAFs, their functions, and ultimately, highlight the intimate connection of CAFs to virtually all of the hallmarks of cancer. We address the remarkable degree of functional diversity and phenotypic plasticity displayed by CAFs and strive to stratify CAF biology among different tumor types into practical functional groups. Finally, we summarize the status of recent and ongoing trials of CAF-directed therapies and contend that the paucity of trials resulting in Food and Drug Administration (FDA) approvals thus far is a consequence of the failure to identify targets exclusive of pro-tumorigenic CAF phenotypes that are mechanistically linked to specific CAF functions. We believe that the development of a unified CAF nomenclature, the standardization of functional assays to assess the loss-of-function of CAF properties, and the establishment of rigorous definitions of CAF subpopulations and their mechanistic functions in cancer progression will be crucial to fully realize the promise of CAF-targeted therapies.

Electrospun polyvinyl alcohol (PVA)/Chitosan nanofibers were successfully prepared and were used as carriers for the first time in urease immobilization. Also, urease immobilized electrospun PVA/Chitosan nanofibers were applied for the removal of urea from artificial blood serum by recycled reactor. The nanofibers were optimized and synthesized by electrospinning technique according to the operational parameters. The morphology and structure of the nanofibers were characterized by scanning electron microscopy (SEM), attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) and thermogravimetric analysis (TGA). Urease was immobilized on the nanofibers by adsorption and crosslinking methods. According to immobilization results, nanofiber enhanced urease stability properties like thermal stability, pH stability, and reusability. Urease immobilized electrospun PVA/Chitosan nanofiber protected its activity by 85% after 10 uses and 45% after 20 uses. Urea removal rates of artificial blood serum were as follows: 100% at 1st cycle, 95% at 2nd, 3rd and 4th cycles; 85% at the 5th cycle; 76% at the 6th cycle, and 65% at the last three cycles.

Polyvinyl alcohol (PVA)/Zn 2+ electrospun nanofibers that were a kind of polymer/ionic metal composite was successfully embedded in the hybrid fibers for the first time in the literature, due to chemical interactions between PVA and Zn 2+ . Also, the nanofibers were used as carriers for the first time in enzyme immobilization. The nanofibers were optimized and synthesized by electrospinning technique according to the operational parameters like as PVA concentration (%), Zn 2+ concentration (%), voltage (kV), needle tip-collector distance (cm) and injection speed (ml/h). The morphology and structure of the nanofibers were characterized by SEM, XRD, ATR-FTIR and TGA. Lipase was immobilized on the nanofibers by adsorption and crosslinking methods. According to immobilization results, nanofiber enhanced enzyme stability properties like as thermal stability, pH stability and reusability. Lipase immobilized nanofiber protected 90% of its activity after 14 reuses., (Copyright © 2019. Published by Elsevier B.V.)

Objective: The purpose of this study is to present mammography and ultrasound findings of male breast lesions and to investigate the ability of diagnostic modalities in estimating the evolution of gynecomastia., Materials and Methods: Sixty-nine male patients who admitted to Taksim and Bakirkoy Education and Research Hospitals and underwent mammography (MG) and ultrasonography (US) imaging were retrospectively evaluated. Duration of symptoms and mammographic types of gynecomastia according to Appelbaum's classifications were evaluated, besides the sonographic findings in mammographic types of gynecomastia., Results: The distribution of 69 cases were as follows: gynecomastia 47 (68.11%), pseudogynecomastia 6 (8.69%) primary breast carcinoma 7 (10.14%), metastatic carcinoma 1 (1.4%), epidermal inclusion cyst 2 (2.8%), abscess 2 (2.8%), lipoma 2 (2.8%), pyogenic granuloma 1 (1.4%), and granulomatous lobular mastitis 1 (1.4%). Gynecomastia patients who had symptoms less than 1 year had nodular gynecomastia (34.6%) as opposed to dendritic gynecomastia (61.5%) (p<0.01) based on mammography results according to Appelbaum's classifications. In patients having symptoms for 1 to 2 years, diffuse gynecomastia (70%) had a higher rate than the dendritic type (20%). Patients having the symptoms more than 2 years had diffuse gynecomastia (57.1%) while 42.9% had dendritic gynecomastia (p<0.001). With sonographic examination patients who had symptoms less than 1 year had higher rates of dendritic gynecomastia (92.3%) than noduler type (1.9 %). Patients having symptoms for 1 to 2 years had more dentritic gynecomastia (70%) than diffuse type (30%). Patients having symptoms more than 2 years had diffuse gynecomastia (57.1%) comparable to dendritic gynecomastia (42.9 %)., Conclusion: Diagnostic imaging modalities are efficient tools for estimation of gynecomastia evolution as well as the diagnosis of other male breast diseases. There seems to be an incongruity between duration of clinical complaints and diagnostic imaging classification of gynecomastia. The use of these high resolution US findings may demonstrate an early phase fibrosis especially in patients visualized by mammography as with nodular phase., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

In this study, lipase was successfully immobilized on polyvinyl alcohol/alginate and polyethylene oxide/alginate nanofibers that were prepared by electrospinning. Results showed that nanofibers (especially polyvinyl alcohol/alginate) enhanced the stability properties of lipase. When the free lipase lost its all activity after 40-60min at high temperatures, both lipase immobilized nanofibers kept almost 65-70% activity at the same time. The lipase immobilized poly vinyl alcohol/alginate and polyethylene oxide/alginate nanofibers protected approximately all of their activities until pH 9. Lipase immobilized polyvinyl alcohol/alginate and polyethylene oxide/alginate nanofibers maintained 60% of their activities after 14 and 7 reuses, respectively. The morphology of nanofibers was characterized by Scanning Electron Microscope, Fourier Transform Infrared Spectroscopy and Thermal Gravimetric Analyzer. As a result, this nanofiber production method, electrospinning, is simple, versatile and economical for preparing appropriate carrier to immobilize the enzymes., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Purpose: Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast., Methods: Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group., Results: There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001)., Conclusion: The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.

Aim: Posterior epidural migration of a sequestered lumbar intervertebral disc fragment (PEMSLIDF) is an extremely rare condition published so far only as case reports or small case series (ranging between 2 to 8 cases). Diagnosing this condition is often challenging and the diagnosis is usually made intraoperatively. The affected patients usually suffer cauda equina syndrome (CES). In the present study, we aimed to discuss the clinical and radiological findings, types and features of surgical therapies, and outcomes of 9 patients with PEMSLIDF., Material and Methods: This study included 9 (0.36%) patients with PEMSLIDF among 2470 patients who underwent lumbar disc hernia surgery between August 2002 and September 2012. The preoperative clinical and radiological properties of the patients were evaluated. The postoperative outcomes were assessed using neurological examination, radiological imaging, visual analog scale (VAS) and modified Odom criteria., Results: As far as we know, this study is the largest case series examining the characteristics of PEMSLIDF. Seven (77.8%) of our patients were male and 2 (22.2%) were female and they had a mean age of 49.5 years (range 28-70 years). The mean duration from symptom onset to hospital admission was 7.4 days. Seven patients had CES. All patients underwent sequestrectomy and discectomy via posterior microsurgery. The patient outcomes were evaluated by the Modified Odom criteria and the outcome was excellent in two (22.2%) patients, good in 4 (44.5%), fair in 2 (22.2%), and poor in 1 (11.1%)., Conclusion: The entire free fragment can usually be excised via the posterior microsurgery technique. Early surgical treatment is of great importance to prevent more serious neurological deficits.

Objectives: The aim of our study was to evaluate the shear wave velocity (SWV) of parathyroid lesions by point shear wave elastography (SWE) and to compare their stiffness with that of thyroid nodules and normal thyroid parenchyma quantitatively., Methods: Thirty-six patients considered to have parathyroid disorders by clinical and laboratory tests and scintigraphy were enrolled in the study between January 2012 and February 2015. Conventional sonography, Doppler sonography, and the Virtual Touch tissue quantification (VTQ) method of point SWE (Siemens Medical Solutions, Mountain View, CA) were conducted with a linear transducer (4-9 MHz) while the patients were in the supine position. Then we compared our VTQ measurements with pathologic results., Results: The 36 patients included 31 female and 5 male patients with a mean age ± SD of 49 ± 15.7 years (range, 15-79 years). The mean SWV of parathyroid hyperplasia lesions (n = 4) was 1.46 ± 0.23 m/s, whereas the mean SWV of parathyroid adenomas (n = 32) was 2.28 ± 0.50 m/s. The mean SWV of normal thyroid parenchyma (n = 36) was 1.62 ± 0.20 m/s, and the mean SWV of benign thyroid nodules (n = 21) was 2.25 ± 0.51 m/s. A significant difference was found between SWV values of normal thyroid parenchyma and parathyroid adenoma (P < .001). A cutoff value of 1.73 m/s for adenomas led to 90.0% sensitivity and 80.6% specificity., Conclusions: The VTQ method of point SWE may contribute to the discrimination of parathyroid adenomas from the thyroid gland. However, more comprehensive studies are needed.

We reported natural polymer-conjugated magnetic featured urease systems for removal of urea effectively. The optimum temperature (20-60 °C), optimum pH (3.0-10.0), kinetic parameters, thermal stability (4-70 °C), pH stability (4.0-9.0), operational stability (0-250 min), reusability (18 times) and storage stability (24 weeks) were studied for characterisation of the urease-encapsulated biocompatible polymer-conjugated magnetic beads. Also, the surface groups and chemical structure of the magnetic beads were determined by using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). The all urease-encapsulated magnetic beads protected their stability of 30-45 % relative activity at 70 °C. A significant increase was observed at their pH stability compared with the free urease for both acidic and alkaline medium. Besides this, their repeatability activity were approximately 100 % during 4(th) run. They showed residual activity of 50 % after 16 weeks. The importance of this work is enhancement stability of immobilised urease by biocompatible polymer-conjugated magnetic beads for the industrial application based on removal of urea.

Objective: We aimed to evaluate placental stiffness measured by acoustic radiation force impulse (ARFI) elastography in pregnant women in the second trimester with a normal fetus versus those with structural anomalies and non-structural findings., Materials and Methods: Forty pregnant women carrying a fetus with structural anomalies diagnosed sonographically at 18-28 weeks of gestation comprised the study group. The control group consisted of 34 healthy pregnant women with a sonographically normal fetus at a similar gestational age. Placental shear wave velocity (SWV) was measured by ARFI elastography and compared between the two groups. Structural anomalies and non-structural findings were scored based on sonographic markers. Placental stiffness measurements were compared among fetus anomaly categories. Doppler parameters of umbilical and uterine arteries were compared with placental SWV measurements., Results: All placental SWV measurements, including minimum SWV, maximum SWV, and mean SWV were significantly higher in the study group than the control group ([0.86 ± 0.2, 0.74 ± 0.1; p < 0.001], [1.89 ± 0.7, 1.59 ± 0.5; p = 0.04], and [1.26 ± 0.4, 1.09 ± 0.2; p = 0.01]), respectively., Conclusion: Placental stiffness evaluated by ARFI elastography during the second trimester in pregnant women with fetuses with congenital structural anomalies is higher than that of pregnant women with normal fetuses.

Aim: To investigate the clinical features, prognostic factors and survival times of cervical cancer patients with brain metastasis., Material and Methods: We retrospectively reviewed the medical records of 820 patients with cervical cancer. Data were analyzed using SPSS version 12.0 statistical software (SPSS, Chicago, IL, USA). Overall survival, time interval from diagnosis of cervical cancer to identification of brain metastasis, and median survival time after diagnosis of brain metastasis were calculated using Kaplan-Meier curve analysis. The log-rank test was used to compare differences in survival. Differences were assumed statistically significant when p-values were < 0.05., Results: The incidence of brain metastases from cervical cancer in our institution was 1.82% (15/820) over a ten-year period. The median time interval from diagnosis of cervical cancer to detection of brain metastasis was 12.5 months (range: 2.9-91.9 months). Stage and tumor diameter were found to be significant relating to the interval from diagnosis of cervical cancer to detection of brain metastasis (p=0.001 for both)., Conclusion: This study provides much information about the prognosis of patients with brain metastases from cervical cancer and highlights the importance of initial stage and tumor diameter when determining the time interval until development of brain metastasis.

In the present study, we immobilized acetylcholinesterase (AChE) enzyme onto acetylcholine removed imprinted polymer and acetylcholine containing polymer. First, the polymers were produced with acetylcholine, substrate of AChE, by dispersion polymerization. Then, the enzyme was immobilized onto the polymers by using two different methods: In the first method (method A), acetylcholine was removed from the polymer, and then AChE was immobilized onto this polymer (acetylcholine removed imprinted polymer). In the second method (method B), AChE was immobilized onto acetylcholine containing polymer by affinity. In method A, enzyme-specific species (binding sites) occurred by removing acetylcholine from the polymer. The immobilized AChE reached 240% relative specific activity comparison with free AChE because the active enzyme molecules bounded onto the polymer. Transmission electron microscopy results were taken before and after immobilization of AChE for the assessment of morphological structure of polymer. Also, the experiments, which include optimum temperature (25-65 °C), optimum pH (3-10), thermal stability (4-70 °C), kinetic parameters, operational stability and reusability, were performed to determine the characteristic of the immobilized AChE., (Copyright © 2015 John Wiley & Sons, Ltd.)

We aimed to evaluate the effectiveness of acoustic radiation force impulse (ARFI) elastography in differentiating between hepatic lesions. The prospective study included 117 patients with liver masses. Shear wave velocity (SWV) values for lesions were determined by ARFI imaging and compared statistically. The difference between SWV values for benign and malignant hepatic masses was significant (p < 0.01). The threshold SWV value for malignant hepatic lesions was established at 2.52 m/s, and the sensitivity and specificity of this cut-off value were 97% and 66%, respectively. We concluded that ARFI elastography provides supplementary data that aid in the differential diagnosis of liver masses., (© The Author(s) 2015.)

Objectives: Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions., Methods: We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography, BI-RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions) were calculated., Results: The marginal SWV values were statistically higher in malignant lesions (mean ± SD, 5.41 ± 1.37 m/s) than benign lesions (2.91 ± 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy., Conclusions: Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI-RADS category 4 assessment covers a wide range of likelihood of malignancy (2%-95%). This wide range reflects the necessity for a more specific imaging modality. The combination of VTI and VTQ could increase the diagnostic performance of conventional sonography., (© 2015 by the American Institute of Ultrasound in Medicine.)

Purpose: The aim of the present study was to evaluate thyroid nodules using virtual touch quantification (VTQ) of force impulse acoustic radiation (ARFI) imaging and to investigate a cutoff value for the differentiation of malignant thyroid nodules., Materials and Methods: Ninety-five patients with quantitatively-assessed (VTQ) thyroid nodules were evaluated with ARFI imaging in this prospective study. ARFI imaging with VTQ was performed only on the nodules which were expected to undergo fine-needle aspiration biopsy (FNAB). All of the thyroid lesions were examined histopathologically., Results: The mean shear wave velocity (SWV) value of the malignant nodules (3.18 ± 0.39 m/s) was higher than that of the benign nodules (2.11 ± 0.53 m/s). There was a statistically significant difference between the mean SWV values of benign and malignant nodules (p < 0.001). A SWV cutoff value of greater than 2.66 m/s yielded sensitivity and specificity values of 100 and 82.3 %, respectively, for diagnosis of malignant nodules., Conclusion: VTQ of ARFI imaging has high sensitivity and specificity for discriminating between benign and malignant thyroid nodules and may positively contribute to clinical evaluation of these nodules.

Purpose: The main objective of this study was to describe the characteristic imaging features of cerebral and spinal hydatid disease (HD) in magnetic resonance imaging (MRI) and computed tomography (CT) in order to provide more effective differential diagnoses in endemic regions. We also aimed to use MRI and CT to evaluate whether the World Health Organization's (WHO) new classification of hepatic cystic echinococcosis (CE) could be used in the classification of cerebral HD., Materials and Methods: We retrospectively reviewed the CT and MR images of 30 patients who were diagnosed with cerebral and spinal HD between 1990 and 2014. The imaging findings were noted. All hydatid cysts were classified according to the WHO classification of hepatic CE, consisting of six types., Results: The study group consisted of 49 CEs in 27 patients with cerebral HD and 12 CEs in three patients with spinal HD. Of the cysts, 14 were type CL (cystic lesion), 29 were type CE1, 11 were type CE2 and seven were type CE3. In other words, 54 cysts were in the active group and seven were in the transition group. Most of the cysts were type CL and CE1., Conclusions: Even though characteristic imaging features could be used in the differential diagnosis of HD, sometimes the differentiation of HD from other cystic lesions may be difficult. The use of WHO classification will provide standardisation of uniform treatment modality, as the treatment of HD, according to the stage of the disease, may be surgical or medical.

Purpose: The purpose of this preliminary study was to prospectively evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging for differentiating benign lesions from malignant renal tumours., Materials and Methods: Sixty patients with renal lesions were enrolled in the study; mean patient age was 49.52 ± 20.46 years (range 1-83 years) and patients included 30 men and 30 women. Lesions were categorised as benign (n = 19), malignant (n = 36) and infectious (n = 5) in origin. The shear wave velocities (SWVs) of the tumours and the intact parenchyma were determined by ARFI quantification, and the differences in the SWVs were compared among groups. The final diagnoses were determined via pathologic (n = 33), clinical (n = 13) and imaging findings (n = 14). The SWV values of the renal tumours were analysed according to the final diagnoses., Results: The mean SWV value of the normal renal parenchyma was significantly different from that of all other lesions (p < 0.01). There was a significant difference between the SWV values of benign renal lesions including haematomas and the malignant renal lesions (p = 0.033). However, the SWV values of the infectious lesions and leiomyoma corresponded well with the malignant lesions. A Receiver operating characteristic (ROC) analysis demonstrated a cut-off value of 2.34 m/s between benign and malignant lesions, while sensitivity and specificity were determined to be 88 and 54 %, respectively., Conclusion: ARFI elastography with ARFI quantification may be useful for differentiating benign renal lesions from malignant renal tumours.

Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/ CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous., Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study., Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDG- PET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. κ statistics were calculated for 18F-FDGPET/CT and BS. The κ-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the κ-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The κ-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the κ-values suggested good agreement in the hormone receptor (-) group., Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.

Background: Acoustic radiation force impulse (ARFI) imaging is a promising method for noninvasive evaluation of the renal parenchyma., Objective: To investigate the contribution of ARFI quantitative US elastography for the detection of renal damage in kidneys with and without vesicoureteral reflux (VUR)., Materials and Methods: One hundred seventy-six kidneys of 88 children (46 male, 42 female) who had been referred for voiding cystourethrography and 20 healthy controls were prospectively investigated. Patients were assessed according to severity of renal damage on dimercaptosuccinic acid (DMSA) scintigraphy. Ninety-eight age- and gender-matched healthy children constituted the control group. Quantitative shear wave velocity (SWV) measurements were performed in the upper and lower poles and in the interpolar region of each kidney. DMSA scintigraphy was performed in 62 children (124 kidneys). Comparisons of SWV values of kidneys with and without renal damage and/or VUR were done., Results: Significantly higher SWV values were found in non-damaged kidneys. Severely damaged kidneys had the lowest SWV values (P < 0.001). High-grade (grade V-IV) refluxing kidneys had the lowest SWV values, while non-refluxing kidneys had the highest values (P < 0.05). Significant negative correlations were found between the mean quantitative US elastography values and DMSA scarring score (r = -0.788, P < 0.001) and VUR grade (r = -0.634, P < 0.001). SWV values of the control kidneys were significantly higher than those of damaged kidneys (P < 0.05)., Conclusion: Our findings suggest decreasing SWV of renal units with increasing grades of vesicoureteric reflux, increasing DMSA-assessed renal damage and decreasing DMSA-assessed differential function.

The purpose of the present work is improving stability properties of porcine pancreatic lipase (triacylglycerol lipase, E.C.3.1.1.3) by immobilization on chitosan/TiO2 composite beads. The immobilization parameters were initial enzyme concentration (0.5-2 mg/ml), adsorption time (5-25 min), and glutaraldehyde concentration (1-4 % v/v). The optimum temperature (20-60 °C), optimum pH (3.0-10.0), kinetic parameters, thermal stability (4-70 °C), pH stability (4.0-9.0), and reusability (9 times) were investigated for characterization of immobilized lipase system. The optimum temperatures of free and immobilized lipase were 30 °C. The temperature profile of the immobilized lipase was spread over a large area. The optimum pH values for the free lipase and immobilized lipase were found to be 6.5 and 7.5, respectively. The thermal stability of immobilized lipase was evaluated, and it maintained 45 % activity at 70 °C. But, at this temperature, soluble lipase protected only 15 % activity. Also, the structural characterization of chitosan/TiO2 composite beads was analyzed with scanning electron microscope (SEM), X-ray diffraction (XRD), thermal gravimetric analysis (TGA), and attenuated total reflection Fourier transform infrared spectroscopy analysis (ATR-FTIR). The significance of this study is improving of stability properties of lipase for the industrial usage especially production of biodiesel and dairy products.

Aim of the Study: The aim of this retrospective chart review was to determine the long-term outcomes and identify prognostic factors that impact the survival of patients with cervical cancer., Material and Methods: A retrospective chart review of 739 patients with International Federation of Gynaecology and Obstetrics (FIGO) stage I-IV cervical cancer treated with surgery, radiation or chemoradiation was performed. Patient charts were evaluated in terms of demographics, clinical outcomes, and survival. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan-Meier method, and differences in survival were compared with the log-rank test. Multivariate analysis was performed with a Cox proportional hazards model to determine the estimated hazard ratios (HR) with 95% confidence intervals (CI) for each prognostic factor., Results: The Cox proportional hazards model demonstrated that pelvic nodal metastasis (p = 0.018), parametrial invasion (p = 0.015), and presence of disease in the surgical margin (p = 0.011) were all independent prognostic factors for OS. The 5-year OS rate of patients with negative pelvic lymph nodes was 67.1%, which was higher than the rate for those with positive nodes at 49.0% (p < 0.05). The 5-year OS rate was 54.3% for patients with metastasis to the parametrium, 79.2% with a cancer-free parametrium, 60.9% with a cancer-positive surgical margin, 85.4% with a cancer-negative surgical margin, and 64.3% with a 1-3 mm close surgical margin (p < 0.05)., Conclusions: Assessing pelvic lymph nodes, the parametrium, and surgical margins is important for survival and may aid in better identifying patients who would derive greater benefits from receiving adjuvant therapies and more aggressive treatments.

The aim of this study was enhancing of stability properties of catalase enzyme by encapsulation in alginate/nanomagnetic beads. Amounts of carrier (10-100 mg) and enzyme concentrations (0.25-1.5 mg/mL) were analyzed to optimize immobilization conditions. Also, the optimum temperature (25-50°C), optimum pH (3.0-8.0), kinetic parameters, thermal stability (20-70°C), pH stability (4.0-9.0) operational stability (0-390 min), and reusability were investigated for characterization of the immobilized catalase system. The optimum pH levels of both free and immobilized catalase were 7.0. At the thermal stability studies, the magnetic catalase beads protected 90% activity, while free catalase maintained only 10% activity at 70°C. The thermal profile of magnetic catalase beads was spread over a large area. Similarly, this system indicated the improving of the pH stability. The reusability, which is especially important for industrial applications, was also determined. Thus, the activity analysis was done 50 times in succession. Catalase encapsulated magnetic alginate beads protected 83% activity after 50 cycles.

Objectives: The aim of the study was to describe the sonographic findings of hepatobiliary fascioliasis with extrahepatic expansion and ectopic lesions., Methods: The study included 45 patients with fascioliasis. All diagnoses were confirmed via serologic enzyme-linked immunosorbent assays. Sonographic findings in the hepatobiliary system, extrahepatic expansion, and ectopic lesions were defined., Results: The most common hepatic lesions were subcapsular localized, small, confluent, multiple hypoechoic nodules with poorly defined borders. We also detected ectopic lesion in 5 patients (11.1%) and live parasites in the gallbladder and bile duct in 11 (24.4%)., Conclusions: The large spectrum of entities in the differential diagnosis of hepatobiliary fascioliasis may lead to misdiagnosis and incorrect treatment. However, the diagnosis can be made when the characteristic sonographic features are seen, such as heterogeneity of the liver with multiple poorly defined hypoechoic-isoechoic lesions and multiple echogenic nonshadowing particles in the gallbladder or common bile ducts. Nonetheless, the differential diagnosis of fascioliasis versus other hepatic lesions may still be difficult. In these situations, pathologic confirmation should be performed to exclude the possibility of malignancy., (© 2013 by the American Institute of Ultrasound in Medicine.)

Our aim in this study was to evaluate the efficiency of preoperative temporal bone computed tomography (CT) in detecting pathologic conditions in patients with chronic suppurative otitis media (CSOM). The intraoperative findings and temporal bone CT results of 350 patients who were diagnosed with CSOM between September 1, 2010, and June 1, 2013, were compared. Comparison parameters were as follows: the presence of cholesteatoma, erosion of the outer ear bone canal, erosion of the middle ear chain, erosion of the dural plate, erosion of the lateral semicircular canal, erosion of the sigmoid sinus wall, and dehiscence of the facial canal. The contribution of CT was limited in showing the outer ear canal destruction, dural plate destruction, facial canal destruction, lateral semicircular canal destruction, and destruction of the sigmoid sinus wall. However, CT was more sensitive in detecting cholesteatoma and erosion of the ossicular chain. These results indicate that preoperative CT of patients with CSOM serves as an important guide for otolaryngologists, although there are limitations in the evaluation of the CT results.

Purpose: The aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) imaging to diagnose acute appendicitis., Methods: Abdominal ultrasonography (US) and ARFI imaging were performed in 53 patients that presented with right lower quadrant pain, and the results were compared with those obtained in 52 healthy subjects. Qualitative evaluation of the patients was conducted by Virtual Touch™ tissue imaging (VTI), while quantitative evaluation was performed by Virtual Touch™ tissue quantification (VTQ) measuring the shear wave velocity (SWV). The severity of appendix inflammation was observed and rated using ARFI imaging in patients diagnosed with acute appendicitis. Alvarado scores were determined for all patients presenting with right lower quadrant pain. All patients diagnosed with appendicitis received appendectomies. The sensitivity and specificity of ARFI imaging relative to US was determined upon confirming the diagnosis of acute appendicitis via histopathological analysis., Results: The Alvarado score had a sensitivity and specificity of 70.8% and 20%, respectively, in detecting acute appendicitis. Abdominal US had 83.3% sensitivity and 80% specificity, while ARFI imaging had 100% sensitivity and 98% specificity, in diagnosing acute appendicitis. The median SWV value was 1.11 m/s (range, 0.6-1.56 m/s) for healthy appendix and 3.07 m/s (range, 1.37-4.78 m/s) for acute appendicitis., Conclusion: ARFI imaging may be useful in guiding the clinical management of acute appendicitis, by helping its diagnosis and determining the severity of appendix inflammation.

Background: To compare retrobulbar blood flow in patients with central serous chorioretinopathy (CSC) and healthy subjects using color Doppler ultrasonography., Methods: Thirty patients (age 23-54 years) with a first episode of acute CSC and 30 healthy controls (age 30-44 years) were evaluated. The peak systolic blood flow velocity, end-diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) were measured in the ophthalmic, posterior ciliary, and central retinal arteries., Results: The posterior ciliary and central retinal artery EDV were lower in the patient group than in the control group, whereas RI and PI values were significantly higher (p < .05). The ophthalmic artery peak systolic blood flow velocity and EDV were lower in the CSC than in the control group (p < .05) without significant difference in RI and PI., Conclusions: Color Doppler ultrasonography provides additional insights into the pathophysiology of CSC and may support the vasospasm hypothesis., (© 2014 Wiley Periodicals, Inc.)

Purpose: To evaluate the anatomy of the sphenoid ostium (SO), which has so far only been investigated with the aid of two-dimensional computed tomography (CT) or using a cadaver, from a new point of view through the use of 3D CT for the first time., Methods: We have evaluated 50 patients who had CT angiography done for different reasons. The sphenoid sinus types and the SO were evaluated three dimensionally. The average diameters of the sphenoid ostia, and their distances to the midline, as well as to each other and the choana have been measured. In addition, the SO were categorized according to their shapes., Results: The average age of the patients was 48.5. No SO was found in seven cases (14 %). The average distance of the SO to the midline was 2.78 mm on the right side and 2.77 on the left. Four different shapes of SO were determined; round, oval, irregular and linear. The average distance of the right and left SO to the choana was 15.22 ± 0.95 and 14.87 ± 1.11 mm, respectively. No statistically significant difference was found between the male and female sexes with regard to the calculated diameters and shapes of the SO (p > 0.05)., Conclusion: The anatomy of the sphenoid sinus and the SO varies widely from individual to individual. We have demonstrated in our study that these anatomic variations could be evaluated pre-operatively. Using this imaging technique, surgeons can make a pre-operative 3D evaluation of the sphenoid ostium, encountered in the surgery and thus achieve better orientation.

The aim of the present study is to synthesize TiO2 beads for urease immobilization. Two different strategies were used to immobilize the urease on TiO2 beads. In the first method (A), urease enzyme was immobilized onto TiO2 beads by adsorption and then crosslinking. In the second method (B), TiO2 beads were coated with chitosan-urease mixture. To determine optimum conditions of immobilization, different parameters were investigated. The parameters of optimization were initial enzyme concentration (0.5; 1; 1.5; 2mg/ml), alginate concentration (1; 2; 3%), glutaraldehyde concentration (1; 2; 3% v/v) and chitosan concentration (2; 3; 4 mg/ml). The optimum enzyme concentrations were determined as 1.5mg/ml for A and 1.0mg/ml for B. The other optimum conditions were found 2.0% (w/v) for alginate concentration (both A and B); 3.0mg/ml for chitosan concentration (B) and 2.0% (v/v) for glutaraldehyde concentration (A). The optimum temperature (20-60°C), optimum pH (3.0-10.0), kinetic parameters, thermal stability (4-70°C), pH stability (4.0-9.0), operational stability (0-230 min) and reusability (20 times) were investigated for characterization. The optimum temperatures were 30°C (A), 40°C (B) and 35°C (soluble). The temperature profiles of the immobilized ureases were spread over a large area. The optimum pH values for the soluble urease and immobilized urease prepared by using methods (A) and (B) were found to be 7.5, 7.0, 7.0, respectively. The thermal stabilities of immobilized enzyme sets were studied and they maintained 50% activity at 65°C. However, at this temperature free urease protected only 15% activity., (Copyright © 2014 Elsevier B.V. All rights reserved.)