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Item Acaricidal activity of Origanum bilgeri PH Davis (Lamiaceae) essential oil and its major component, carvacrol against adults Rhipicephalus turanicus (Acari: Ixodidae)(Elsevier, 2013-03) Koç, Samed; Öz, Emre; Cinbilgel, İlker; Çetin, Hüseyin; Aydın, Levent; Uludağ Üniversitesi/Veterinerlik Fakültesi/Parazitoloji Anabilim Dalı.; 55808198600The acaricidal activity of an essential oil obtained from aerial parts of Origanum bilged P.H. Davis (Lamiaceae), an endemic species in Turkey, and its major constituents, carvacrol was evaluated against unfed adults Rhipicephalus turanicus Pomerantzev (Acari: Ixodidae) collected from Kepez, Antalya. The composition of the essential oil was analyzed by GC/MS. The major compound identified in the oil was carvacrol (93.02%). Generally, tick mortalities to the O. bilged distillate and carvacrol increased with concentrations. O. bilged oil produced >83% mortality at 48 h at a concentration of 0.8% and mortality was higher than 63% at a carvacrol concentration of 0.4%. Our results have shown that O. bilged essential oil and its major component, carvacrol, may have potential as acaricidal agents against R. turanicus.Item Acaricidal activity of the essential oils from three lamiaceae plant species on rhipicephalus turanicus pom. (acari: ixodidae)(Springer, 2012-10) Koç, Samed; Öz, Emre; Çetin, Hüseyin; Aydın, Levent; Uludağ Üniversitesi/Veteriner Fakültesi/Parazitoloji Anabilim Dalı.; 0000-0002-2875-8003; 55808198600Acaricidal effects of three Labiatae essential oils extracted from ariel parts of Thymus sipyleus Boiss. subsp. sipyleus, Mentha longifolia L., and Dorystoechas hastata Boiss. & Heldr. ex Bentham on 10-day-old Rhipicephalus turanicus Pom. (Acari: Ixodidae) larvae were evaluated by using the larval packet test bioassay. Serial dilutions of the three essential oils were tested from a starting concentration of 1-0.1 % (1.0, 0.5, 0.25, and 0.1 % w/v). Results showed that all essential oils had very similar activity, producing complete mortality (100 %) in all tested concentrations on 10-day-old R. turanicus tick larvae.Item Accuracy of anatomical references used for rotational alignment of tibial component in total knee arthroplasty(Springer, 2012-03) Şahin, Namık; Öztürk, Alpaslan; Özkan, Yüksel; Avcu, Bülent; Atıcı, Teoman; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; A-5095-2018; 7801647288; 16316866500This study aimed to research which was the most reliable of the four techniques based on local anatomic markers used to determine tibial component rotation in total knee arthroplasty, and whether the markers varied in knees with varus deformity. The study included 33 knees with a normal anatomic axis and 32 knees with a varus deformity and osteoarthritis. On the MR images, the femoral transepicondylar axis (TEA) was determined and transposed to the standard tibial resection level. At this level, four axes were drawn on the axial sections: tibial posterior condylar line (PC), tibial plateau anterior line (AC), a vertical line (AA) drawn to Akagi's line, and the maximal mediolateral distance (MMLD). The relationships of these lines and the transposed TEA were compared between two groups. In all the knees, the mean values of the PC, AA, and MMLD axes compared to TEA reference were 5.5A degrees A A +/- A 5.7 (mean +/- A SD), 7A degrees A A +/- A 3.2, and 6.7A degrees A A +/- A 8.1 internal rotation, respectively, and the AC axis was 8.9A degrees A A +/- A 6.7 external rotation. In the AC, AA, and MMLD axes, the change occured because of varus deformity was statistically meaningful. For all the observers, the axis with the least SD and the most accuracy was the AA axis. Of the four axes used to determine tibial component rotation, only the PC axis is not affected by varus deformity, and the least affected axis according to the observers was the AA axis, and thus the AA and PC axes can be used for guidance in determining the rotation of the tibial component. Prognostic studies-investigating natural history and evaluating the effect of a patient characteristic: High-quality prospective cohort study with > 80% follow-up, and all patients enrolled at same time point in disease, Level I.Item Acitretin-induced subungual hemorrhage(Wiley, 2007-04-30) Aydoğan, Kenan; Karadoğan, Serap Köran; Tunalı, Şükran; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; 0000-0002-0193-1128; 9739755800; 9738885800; 7004191748A 20-year-old woman with a 2-year history of histologically confirmed palmoplantar keratoderma due to psoriasis, resistant to several topical agents, was admitted to the Department of Dermatology, Uludag University, Bursa, Turkey. Therapy with oral acitretin (0.5mg/kg/day, 35mg/day) was initiated. A month after starting acitretin treatment, she noted slight reddening of the second left fingernail. Clinical examination revealed red-brown discoloration of the second fingernail associated with subungual hemorrhage involving the proximal nail bed (lunula region) (Fig. 1). The nail change was asymptomatic. The patient complained only of discoloration underneath the nail plate. No abnormalities were detected on the skin, mucous membranes, or toenails/ other fingernails. The patient denied exposure to microtrauma or any other drugs. The erythrocyte sedimentation rate, full blood cell count, electrolytes, renal and hepatic tests, and serum lipids were normal. Coagulation tests, including blood clotting time, international normalized ratio, activated partial thromboplastin time, thrombin time, platelet number, and function tests, were within normal levels. Treatment with acitretin was discontinued, and the nail change resolved completely after 3 weeks. A similar episode of subungual hemorrhage recurred, however, within 48 h after re-challenge with a lower dose of acitretin (25 mg/day). The drug was definitively stopped and the eruption faded again within a week. An objective causality assessment suggests that subungual hemorrhage was probably related to acitretin in this patient.Item Acroangiodermatitis in a below-knee amputation stump(Wiley, 2011-07) Turan, Hakan; Başkan, Emel Bülbül; Adım, Şaduman Balaban; Sarıcaoğlu, Hayriye; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-0144-3263; AAH-1388-2021; 6602518817; 15730076300; 6603722836Item Active and total ghrelin concentrations increase in breast milk during lactation(Wiley, 2007-11) İlçöl, Yeşim Özarda; Hızlı, Banu; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; AAL-8873-2021; 35741320500; 14019332100Aim: To assess ghrelin status in breast milk and maternal serum for up to 180 days during lactation and to determine relationships between the concentrations of ghrelin in mother's milk and in serum of breastfed infants. Methods: Blood and breast milk samples were collected from 159 breastfeeding women enrolled either in the first 3 days, or in days 4-14, 15-30, 31-90 and 91-180 postpartum. Blood samples were also collected from 49 breastfed infants at 4-30 days of age. Milk and serum active and total ghrelin concentrations were measured by radioimmunoassay. Results: Active and total ghrelin concentrations in breast milk were lowest (450 ± 25 and 880 ± 80 pg/mL, respectively) at 0-3 days, whereas they increased progressively during 180 days of lactation period to 801 ± 43 and 3250 ± 380 pg/mL at 91-180 days postpartum. Milk total ghrelin concentrations correlated with serum concentrations of active (r = 0.503; p < 0.001) and total ghrelin (r = 0.331; p < 0.05) in breastfed infants at 4-30 days of age. In breastfeeding women, serum total ghrelin concentrations increased whereas serum active ghrelin concentrations decreased significantly during the next 4-180 days. Conclusion: Active and total ghrelin concentrations in breast milk increase with time during lactation and show significant relations with serum ghrelin concentrations in breastfed infants.Item Acute lasalocid poisoning in calves associated with off-label use(Wiley, 2011-04) Oruç, Hasan Hüseyin; Cangül, İbrahim Taci; Cengiz, Murat; Yılmaz, Rahşan; Uludağ Üniversitesi/Veterinerlik Fakültesi/Farmakoloji ve Toksikoloji Anabilim Dalı.; Uludağ Üniversitesi/Veterinerlik Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-5399-2395; 0000-0002-0944-2230; 0000-0003-0537-2113; ABE-5935-2020; AAI-2212-2021; ABG-8940-2020; AAB-4360-2021; 55944769400; 6602486125; 16635026700; 15057258600Item Adrenomedullin-a new marker in febrile neutropenia: Comparison with CRP and procalcitonin(Taylor & Francis, 2015-10-03) Tuğcu, Deniz; Akçay, Arzu; Aydoğan, Gönul; Akıcı, Ferhan; Salcıoğlu, Zafer; Ekmekçi, Hakan; Sevinir, Betül; Ekmekçi, Özlem Balcı; Demirkaya, Metin; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; EUG-4353-2022; 24331130000In this study, we aimed to determine serum adrenomedullin levels and compare them with levels of C-reactive protein (CRP) and procalcitonin (PCT). Cancer patients aged 0-18years who experienced febrile neutropenia attacks were included in the study. Adrenomedullin, CRP, and PCT were analyzed at admission, day 3, and days 7-10 later. Fifty episodes of febrile neutropenia that developed in 37 patients were analyzed in this study. The mean age of the patients was 7.5 +/- 4.7 (1-18) years. The patients had leukemia (73%), solid tumors (19%), and lymphoma (8%). The percentages of the patients in the clinically documented infection (CDI), fever of unknown origin (FUO), sepsis, and microbiological documented infection (MDI) categories were 34%, 34%, 20%, and 12%, respectively. During the study period, four patients were lost. In the MDI group, adrenomedullin levels on day 3 were significantly higher than those in the CDI and FUO groups. PCT levels were significantly higher in the sepsis group than those in the CDI group at admission, day 3, and days 7-10. In the sepsis group, PCT levels on days 7-10days were significantly higher than those in the sepsis group. PCT values from the deceased patients on days 7-10 were significantly higher than those from patients who survived. CRP levels did not differ significantly among the febrile neutropenia groups. First, in our study, adrenomedullin was used as a biomarker in the febrile neutropenia episodes of children with cancer. Among adrenomedullin, CRP, and PCT, procalcitonin demonstrates the highest correlation with the severity of infection.Item Advances and highlights in biomarkers of allergic diseases(Willey, 2021-12) Ardıçlı, Özge; Bursa Uludağ Üniversitesi/Karacabey Meslek Yüksekokulu/Gıda İşleme Bölümü; AAG-7421-2021; 57219362332During the past years, there has been a global outbreak of allergic diseases, presenting a considerable medical and socioeconomical burden. A large fraction of allergic diseases is characterized by a type 2 immune response involving Th2 cells, type 2 innate lymphoid cells, eosinophils, mast cells, and M2 macrophages. Biomarkers are valuable parameters for precision medicine as they provide information on the disease endotypes, clusters, precision diagnoses, identification of therapeutic targets, and monitoring of treatment efficacies. The availability of powerful omics technologies, together with integrated data analysis and network-based approaches can help the identification of clinically useful biomarkers. These biomarkers need to be accurately quantified using robust and reproducible methods, such as reliable and point-of-care systems. Ideally, samples should be collected using quick, cost-efficient and noninvasive methods. In recent years, a plethora of research has been directed toward finding novel biomarkers of allergic diseases. Promising biomarkers of type 2 allergic diseases include sputum eosinophils, serum periostin and exhaled nitric oxide. Several other biomarkers, such as pro-inflammatory mediators, miRNAs, eicosanoid molecules, epithelial barrier integrity, and microbiota changes are useful for diagnosis and monitoring of allergic diseases and can be quantified in serum, body fluids and exhaled air. Herein, we review recent studies on biomarkers for the diagnosis and treatment of asthma, chronic urticaria, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food allergies, anaphylaxis, drug hypersensitivity and allergen immunotherapy. In addition, we discuss COVID-19 and allergic diseases within the perspective of biomarkers and recommendations on the management of allergic and asthmatic patients during the COVID-19 pandemic.Item Aetiological role of viruses in puppies with diarrhoea(Wiley, 2007-08-04) Özkul, Aykut; Pratelli, Alberto; Yılmaz, Zeki; Yeşilbağ, Kadir; Uludağ Üniversitesi/Veteriner Fakültesi/Mikrobiyoloji Bölümü.; 0000-0001-9836-0749; 00424900; 6602912127; 35944810500Item Air-soil exchange of PCBs: Seasonal variations in levels and fluxes with influence of equilibrium conditions(Elsevier Science, 2012-10) Taşdemir, Yücel; Salihoğlu, Güray; Salihoğlu, Nezih Kamil; Birgül, Aşkın; Uludağ Üniversitesi/Mühendislik-Mimarlık Fakültesi/Çevre Mühendisliği Bölümü.; 0000-0002-7718-0340; AAG-9413-2021; AAG-9468-2021; AAG-9399-2021; F-7879-2015; 6603118338; 8551769300; 55665111200; 12795386100The variations in the occurrences of PCB congeners both in soil and air were investigated in conjunction with each other, and the changes in the fugacity fractions and flux levels were examined on a seasonal basis. Air and soil samples were collected concurrently two or three times in a month during a one-year monitoring at two different locations in Bursa, located in the northwestern Turkey. Fugacity fractions and net flux levels of PCB congeners were calculated. Air and soil PCB levels increased together as the soil temperature increased, suggesting the influence of instantaneous air-soil exchange towards the equilibrium conditions. The flux levels and fugacity fractions also showed a positive significant correlation with soil temperature. Flux levels were positive for the dates with fugacity fractions above 0.5, indicating volatilization from soil to air.Item Allosteric modulation of α4β2* nicotinic acetylcholine receptors: Desformylflustrabromine potentiates antiallodynic response of nicotine in a mouse model of neuropathic pain(Blackwell Publishing, 2018-01) Ergün, D.; Jackson, A.; Toma, W.; Schulte, M. K.; Damaj, M. I.; Bağdaş, Deniz; Uludağ Üniversitesi/Tıp Fakültesi/Deney Hayvanları Yetiştirme ve Araştırma Merkezi.; 15062425700BackgroundNeuronal nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels. The 42 subtype of nAChRs plays an important role in the mediation of pain and several nicotine-evoked responses. Agonists and partial agonists of 42 nAChRs show efficacy in animal pain models. In addition, the antinociceptive properties of nicotine, a non-selective nAChR agonist with a high affinity for 42 nAChRs, is well-known. There is a growing body of evidence pointing to allosteric modulation of nAChRs as an alternative treatment strategy in experimental pain. Desformylflustrabromine (dFBr) is a positive allosteric modulator (PAM) at 42 nAChRs that enhances agonist responses without activating receptors. We hypothesized that dFBr may enhance nicotine-induced antinociception. MethodsThe present study investigated whether dFBr could attenuate mouse chronic constriction injury (CCI)-induced neuropathic pain by increasing endogenous cholinergic tone or potentiating the nicotine-evoked antiallodynic response. ResultsWe found that subcutaneous administration of dFBr failed to reduce pain behaviour on its own. However, the combination of dFBr with nicotine significantly reversed neuropathic pain behaviour dose- and time-dependently without motor impairment. Our data revealed that this effect was mediated by the 42 nAChRs by using competitive 42 antagonist dihydro--erythroidine. In addition, dFBr failed to potentiate the antiallodynic effect of morphine, which shows the effect of dFBr is unique to 42 nAChRs. ConclusionsThe present results suggest that allosteric modulation of 42 nAChR may provide new strategies in chronic neuropathic pain. Significance42 nAChRs are involved in pain modulation. dFBr, a PAM at 42 nAChRs, potentiates the nicotine response dose-dependently in neuropathic pain. Thus, the present results suggest that allosteric modulation of 42* nAChR may provide new strategies in chronic neuropathic pain.Item Ambient air levels and trends of polychlorinated biphenyls at four different sites(Springer, 2010-11) Taşdemir, Yücel; Cindoruk, Sabahattin Sıddık; Uludağ Üniversitesi/Mühendislik Fakültesi/Çevre Mühendisliği Bölümü.; 0000-0001-7536-0332; AAG-9468-2021; 10339194600; 6603118338In this study, samples were collected in order to determine atmospheric levels of polychlorinated biphenyls (PCBs) in four different sites by using a high-volume air sampler (HVAS). Eighty-three congeners of gas and particle- phase PCBs were investigated in air samples. The total (gas + particle) concentrations for Mudanya (coastal), Butal (traffic/urban), the Uludag University Campus (semirural), and Yavuz Selim (residential) were determined as 570, 394, 412, and 316 pg/m(3), respectively. These levels coincide with the values reported for the sites having similar characteristics. In terms of homolog groups, 3-chlorinated biphenyls (3-CBs) and 4-CBs constituted at least 47% of the total PCB concentration. PCBs in all sites were determined mostly in the gas phase, with a percentage from 85 to 95%. Obtained atmospheric PCB data were correlated with meteorological parameters and a significant relationship was obtained between coastal and semirural sites (p < 0.05). With the movements of air transportation and wind rose possible data sources of PCBs were enlightened. Partitioning of gas/particle was examined with available models; significant relationships were determined for coastal and semirural sites especially.Item Analysis of diffracted fields with the extended theory of the boundary diffraction wave for impedance surfaces(Optical Soc Amer, 2011-06) Yalçın, Uǧur; Uludağ Üniversitesi/Mühendislik Fakültesi/Elektrik ve Elektronik Mühendisliği Bölümü.; AAG-8951-2021; 16023664100Uniform diffracted fields from impedance surfaces are investigated by the extended theory of boundary diffraction wave (ETBDW). The new vector potential of the ETBDW is constructed by considering the pseudoimpedance boundary condition. The method is applied to the diffraction problem from an impedance half-plane. It is shown that the total fields from an impedance half-plane reduce to the case of a perfectly electric or magnetic conducting and opaque half-plane for special values of surface impedance. The total and diffracted fields are compared numerically with the exact solution for the impedance half-plane and modified theory of physical optics (MTPO) solution for an impedance wedge. The numerical results show that the field expressions are in very good agreement with the exact and MTPO solutions.Item Analysis of intracranial pressure changes during early versus late percutaneous tracheostomy in a neuro-intensive care unit(Springer, 2008-12) Kocaeli, Hasan; Korfali, Ender; Taşkapilioğlu, Özgür; Özcan, Tekin; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; V-1196-2018; 6603500567; 7004641343; 6506852772; 25636374000Background We aimed to investigate intracranial pressure (ICP) changes during early versus late bedside percutaneous tracheostomy (PT) in a neuro-intensive care unit (NICU). Methods This study included 30 patients admitted to our NICU for head trauma, subarachnoid haemorrhage, intracerebral haematoma or brain tumour with a Glasgow Coma Score (GCS) less than 8. These patients also underwent ICP monitoring. Bedside PT was performed either early (within 7 days of ventilation) or late (after 7 days of ventilation) via the Griggs system. In all patients; ICP, systemic blood pressure, heart rate, oxygen saturation (Sat O(2)) and arterial blood gases were recorded 5 min before the procedure, during skin incision, during tracheal cannulation, as well as 5 min and 10 min after the procedure. Findings Thirty patients, 18 male and 12 female, with various intracranial pathologies between ages 18 and 78 (mean 38.7 +/- 20) were identified. The admission GCS ranged between 4 and 11 (median 7). Physiological variables did not differ significantly between the two groups. In the early group, ICP values measured 5 min before the procedure, during skin incision, during tracheal cannulation, as well as 5 min and 10 min after the procedure were 15.1 +/- 5.2, 22 +/- 10.1, 28.4 +/- 13.7, 17.3 +/- 7.1, 13.8 +/- 5.0 mmHg, respectively. In the late group, these values were 14.2 +/- 4.5, 17.2 +/- 5.5, 21.5 +/- 8.0, 15.1 +/- 5.3 and 12.4 +/- 4.1 mmHg. There was no significant difference between the early or late groups in terms of ICP increases during these predetermined 5 time points. Conclusions In patients with decreased intracranial compliance, a relatively minimally invasive procedure such as PT may lead to significant increases in ICP. The timing of PT does not seem to influence ICP, mortality, pneumonia or early complications. During the PT procedure, ICP should be closely monitored and preventive strategies should be instituted in an attempt to prevent secondary insult to an already severely injured brain.Item Analysis of the fracture morphology of polyamide, polyester, polypropylene, and silk sutures before and after implantation in vivo(Wiley, 2008-11) Karaca, Esra; Hockenberger, Aslı Şengönül; Uludağ Üniversitesi/Mühendislik Fakültesi/Tekstil Mühendisliği Bölümü.; 0000-0003-1777-3977; AAS-8480-2020; GWA-4691-2022; 17344029200; 6507435813This study has analyzed fracture morphology of four nonabsorbable commercially available sutures before and after implantation in rats. Also, tensile and knot strength retention have been evaluated after 3 and 8 weeks in vivo. Scanning electron and optical light microscopes were used for analysis of fracture morphologies and surface changes of the sutures. A clear effect of in vivo on the tensile and knot strength changes, and the fracture mechanism was seen for braided sutures. The suture size was also important for braided sutures, as fibrous tissue formation plays an important role in terms of the size. The fiber's surface properties were also important for the fracture morphology. A smooth and even surface was not suitable for the fibrous tissue formation as seen in monofilament sutures. Therefore, the polymer type was very important for the monofilament sutures, as it was the most important parameter to determine the fracture morphology and was not affected by the implantation and the implantation time. The size of the suture was also important for the polypropylene in terms of axial splitting before and after implantation. This, however, was not the case for knot strength tests. The knot was undone regardless of the size. Surface characteristics were very important for braided sutures, as they have a rough surface that supports tissue formation on the fracture mechanism, tensile and knot strength. Silk suture has single filaments with no regular diameter and smooth surface. Therefore, silk suture has more tissue formation postimplantation compared to polyester suture.Item Anaphylaxis in Turkish children: A multi-centre, retrospective, case study(Wiley, 2011-12) Orhan, Fazıl; Bakırtaş, Arzu; Yılmaz, Özge; Boz, Ayşen Bingöl; Can, Demet; Kuyucu, Semanur; Harmancı, Koray; Tahan, Fulya; Reisli, İsmail; Karakaş, Taner; Baki, Ali Erdem; Çokuğraş, Haluk; Çakır, Murat; Canıtez, Yakup; Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Alerji ve İmmünoloji Anabilim Dalı.; 8988954700Background Anaphylaxis is a serious and potentially lethal systemic reaction affecting more than one organ or system. Objective We aimed to describe the demographic characteristics, clinical features, causes, settings, and administered therapy in Turkish children. Methods This retrospective, case note study included all children referred to the outpatient clinics of the Pediatric Allergy Departments of the participating study centres from 1 July 1999 to 30 June 2009 for investigation of anaphylaxis or who were seen by us at the moment of the reaction during the same period and who met the clinical criteria of anaphylaxis. Results Two hundred and twenty-four cases of anaphylaxis were reported in 137 children (88 boys, P = 0.0001). The mean +/- SD age at the referral was 7.7 +/- 4.2 years (range: 4 months-17 years). Ninety-eight episodes (43.8%) occurred at home. The symptoms were cutaneous in 222 (99.1%) episodes, respiratory in 217 (96.9%), neuro-psychiatric in 118 (52.7%), cardiovascular in 92 (41.1%), and gastrointestinal in 88 (39.3%). Biphasic reaction was reported in seven episodes (3.1%, 95% CI: 1.5-6.3). Death occurred in one case (0.4%, 95% CI: 0.08-2.4). Treatment was available in 158 episodes (70.5%). Of them, 148 (93.7%) received antihistamines, 132 (83.5%) corticosteroids, 51 (32.3%) epinephrine, and 17 (10.8%) beta-2-mimetics. The causative agents were foods in 86 (38.4%) episodes, hymenoptera venom in 84 (37.5%), drugs and medications in 47 (21.0%), and latex in 5 (2.2%). In two episodes (0.9%), the causative agent was unidentified. Allergy to the trigger was known prior to anaphylaxis in 116 (51.8%) episodes. An epinephrine autoinjector had been prescribed for 70 children (51.1%). Conclusions and Clinical Relevance Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.Item Anatomical aspects in the transsphenoidal-transethmoidal approach to the optic canal: An anatomic-cadaveric study(Churchill Livingstone, 2012-10) Yılmazlar, Selçuk; Saraydaroğlu, Özlem; Korfalı, Ender; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirurji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-3633-7919; AAH-5070-2021; AAH-9701-2021; 6603059483; 15074395500; 7004641343Background: Determining anatomic landmarks during a transsphenoidal-transethmoidal approach to the optic canal region is of critical importance. Methods: Sella-parasella sphenoid bone blocks were extracted from adult cadavers. Anatomic dissections were performed in the optic canal region using a surgical microscope in 30 samples. Quantitative measurements were done using photographic techniques. For histological evaluation, coronal and longitudinal cross-sections were taken from the bilateral optic canal in seven decalcified samples. Results: Optic protuberance (OP), carotid protuberance (CP), medial opticocarotid recess (MOCR) and lateral opticocarotid recess (LOCR) were defined as lateral landmarks determining the width of the opening in the extended transsphenoidal-transethmoidal approach. Among all anatomic markers, LOCR was the most determinant lateral marker with tubercular recess the most prominent central marker. OPs showing the optic canal direction and inter-recessal sulci had similar distinguishing rates in the sphenoid sinus base. Inter-recessal sulci formed by OPs and CPs were observed between MOCR and LOCR in most samples. In histologic sections, the dural sheath was thicker inferolaterally to the optic nerve compared to superiorly and medially; collagen arrangement was dense and irregular. Conclusion: Although LOCRs and tubercular recesses are safe and prominent markers in extended transsphenoidaletransethmoidal approaches, other anatomic markers should also be taken into consideration to perform an efficient optic canal approach and optic canal decompression. Other factors for safe dissection are the length of the optic canal, bone thickness, adherence of dural structures and the course of the intradural ophthalmic artery.Item Anatomical restrictions in the transsphenoidal, transclival approach to the upper clival region: A cadaveric, anatomic study(Churchill Livingstone, 2013) Aktaş, Ulaş; Yılmazlar, Selçuk; Uǧraş, Nesrin; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-3633-7919; AAH-2716-2021; AAH-5070-2021; 55122917500; 6603059483; 55386535600Objective: Tumours in the clival region are difficult to remove surgically. Before the 1970s, clival tumours had very high mortality and morbidity rates. Methods: An anatomic dissection was performed on 24 spheno-occipital bone blocks obtained from 28 adult cadavers. The internal carotid artery, paraclival carotid tubercle, sixth cranial nerve and dorsum sellae in the upper clival region were analyzed qualitatively and quantitatively. For the histological evaluation, 4 samples were decalcified and sagittal sections were cut. From the eight blocks obtained, 32 incisions were made in the axial plane, and the tissue was analyzed. Results: Using microscopy, a clival recess was clearly identified in 15 of the 24(62.5%) samples. Paraclival carotid tubercles were observed in 19 (79.16%) of the samples. In the upper clival and petroclival region, the sixth cranial nerve had directional changes at the dural porus, the petrous apex and the lateral wall of the cavernous segment of the internal carotid artery. At the dorsum sellae level, the distance between the medial surfaces of both internal carotid arteries was a mean of 15.33 +/- 2.12 mm. This distance at the pharyngeal tubercle was a mean of 38.95 +/- 4.67 mm. On all the histological sections, the distance of the sixth cranial nerve from the dural porus to the cavernous sinus was within the basilar plexus, along with the subarachnoid membranes around it. On the petrous apex level, the sixth cranial nerve was fixed to the petrous apex and the internal carotid artery with connective tissue formed by dense collagen fibres. The sixth cranial nerve and the internal carotid artery are tightly surrounded by dense collagen connective tissue, and the relative proximity between the carotids on the dorsum sellae level can be easily damaged during the transsphenoidal-transclival approach. Similarly, due to the ligamentous fixation on the dural porus and the petrous apex surfaces, there is a high risk of injury to the carotid artery and sixth cranial nerve. Conclusion: This study determines the relationship between the sixth cranial nerve and the internal carotid artery at the upper clivus and to provide morphologic details that is essential for the risks of transclival surgery.Item Another small supernumerary marker chromosome derived from chromosome 9 in a Klinefelter patient(Univ West Indies Faculty Medical Sciences, 2012-12) Gülten, Tuna; Görükmez, Orhan; Karkucak, Mutlu; Türe, Mehmet; Yakut, Tahsin; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; 6505944216; 56681045900; 35388323500; 6602186133; 6602802424Marker chromosomes are very rare in Klinefelter patients and phenotypic findings are related to the affected chromosomal region. The phenotypic effects of small supernumerary marker chromosomes (sSMC) range from multiple malformations/mental retardation to no effect (le a normal phenotype). This wide spectrum of phenotypes is due to the origin, structure and gene content of the marker chromosome. The first Klinefelter case with sSMC 9 was published by Liehr et al in 2005. The present case was referred for chromosomal analysis because of dysmorphic features, speech delay and mild mental retardation. Conventional cytogenetic analysis revealed the 47 XXY karyotype in 17 metaphases and the 48 XXY + marker karyotype in eight metaphases. Fluorescence in situ hybridization (FISH) analysis to identify the marker chromosome was performed using the LSI p16 (9p21) Spectrum Orange/CEP 9 SpectrumGreen Probe (Vysis CDKN2A/CEP 9 FISH Probe) and partial trisomy 9 mosaicism was confirmed in this patient. To our knowledge, this is the second case of Klinefelter syndrome with a small supernumerary marker chromosome derived from chromosome 9.