Bilateral Multilevel Cervical Rib and Bilateral Omovertebra in Klippel-Feil Syndrome

BACKGROUND

Klippel-Feil syndrome was first described in 1912; a short neck, low posterior hairline, and decreased cervical joint range of motion are the classical triad of this disease. In this syndrome, which is rarely observed, the characteristics that have been reported include the following: scoliosis; Sprengel deformity; cervical rib; ear, nose, oral, and laryngeal abnormalities; structural abnormalities of the urinary system; and congenital heart diseases. However, bilateral omovertebra and bilateral multilevel cervical ribs have not been reported.

CASE DESCRIPTION

We aimed to present this rare syndrome via radiologic findings from cases with bilateral multilevel cervical rib and bilateral omovertebra.

CONCLUSIONS

Cases of Klippel-Feil syndrome may be accompanied by multiple abnormalities. We want to highlight the need for detailed examination of patients and lifestyle modification at an early age, before symptom appearance, as well as adaptation to habitual exercise.

Jarcho-Levin Syndrome and Concomitant Carotid Glomus Tumor: First Reported Case

BACKGROUND

Jarcho-Levin syndrome (JLS) is a rare congenital disorder characterized by different clinical and radiologic findings. The disease was first reported by Jarcho and Levin in 1938, and it was described as the presence of various malformations or abnormal fusion in the thoracic vertebrae and ribs, short trunk, and respiratory distress.

CASE DESCRIPTION

In our case, fusion at the thoracic and cervical vertebrae, butterfly vertebrae, and a crablike-shaped thorax was present. The patient had a short trunk, short stature, and long extremities. Moreover, he had a syndromic face and restrictive-type respiratory distress. There was a glomus tumor in the carotid space. In our literature review, we found that neural tube defects are frequently present in this syndrome. However, we could not identify any cases with affected neural crest cells.

CONCLUSIONS

JLS may affect cells derived from the neural crest located between the neural tube and surface ectoderm. Therefore patients with JLS should be screened for other tumors located in this area.

Comparison of blood gas and acid-base measurements in arterial and venous blood samples in patients with uremic acidosis and diabetic ketoacidosis in the emergency room

BACKGROUND/AIMS

The aim of this study was to examine a plausible correlation between venous and arterial blood gas values in acidotic patients with chronic uremia or diabetic ketoacidosis (DKA).

METHODS

A total of 152 arterial and 152 venous blood samples from uremic patients (n = 100), DKA patients (n = 21) and healthy controls (n = 31) were analyzed for measurements of blood gas and acid-base status.

RESULTS

The means of arterial and venous pH, and arterial and venous HCO(-)(3) values for the uremic patients were 7. 17 +/- 0.14, 7.13 +/- 0.14, 10.13 +/- 4.26 and 11.86 +/- 4.23 mmol/l, respectively. The respective mean differences between arterial and venous pH values and arterial and venous HCO(-)(3) values were 0.04 +/- 0.02 and -1.72 +/- 0.42 mmol/l, respectively, for these patients. The means of the laboratory findings of DKA patients were arterial pH, 7.15 +/- 0.15; venous pH, 7.10 +/- 0.15; arterial HCO(-)(3), 8. 57 +/- 5.71 mmol/l and venous HCO(-)(3), 10.46 +/- 5.73 mmol/l. The respective mean differences between arterial and venous pH and arterial and venous HCO(-)(3) for this group were calculated to be 0. 05 +/- 0.01 and -1.88 +/- 0.41 mmol/l. In the healthy controls, the means of arterial and venous pH, and arterial and venous HCO(-)(3) values were 7.39 +/- 0.02, 7.34 +/- 0.02, 24.91 +/- 0.82 and 26.57 +/- 0.83 mmol/l, respectively. For the healthy controls the mean differences between the respective values in arterial and venous pH, and arterial and venous HCO(-)(3) were 0.05 +/- 0.01 and -1.66 +/- 0. 58 mmol/l. Although in healthy controls the correlation between arterial and venous pH values (r(2): 0.595) and arterial and venous HCO(-)(3) values (r(2): 0.552) were moderate, these correlations were significantly increased in both the acidotic patient group (r(2): 0.979 and 0.990) and the DKA group (r(2): 0.989 and 0.995)

CONCLUSION

A venous blood sample can be used to evaluate the acid-base status in uremic and DKA patients.

Prevalence of childhood allergic diseases in Adana, Southern Turkey

A study to determine the prevalence of childhood asthma and other allergic diseases was done in Adana, during the period between January 1993 and January 1994. The study has been carried out on 2334 children (48.5% boys). Asthma and the other allergic diseases were recognized in 23.6% of the children. The prevalence of asthma, rhinoconjunctivitis, wheezing, and atopic dermatitis were found to be 12.9, 8.8, 8.4, and 5.0%, respectively. The symptoms of respiratory allergic diseases (asthma, rhinoconjunctivitis, wheezing) seemed to be significantly associated with the environmental factors. In conclusion, asthma and other allergic diseases constituted a major health problem for school children in Adana.

Comparison of four different denture cushion adhesives--a subjective study

Four cushion adhesives (Fittydent I; Fittydent II, introduced as an advanced formula; Protefix; and Seabond) were compared clinically through patients subjective evaluations. Maxillary dentures of 32 patients were relined and the mandibular dentures were scored by Kapur index before the application of different treatments. The cushion adhesives were used only with the existing mandibular prosthesis. The four treatments were applied to the patients in groups of 8 by allocating each group randomly to one of the four sequences of treatments determined by latin square design. Each patient took each treatment only once. The adhesives were applied by the authors as recommended by the manufacturers. Patients used each material for 24 h and, through a questionnaire, they evaluated the seven following aspects of each different cushion material: retention, duration of retention, effects on ability to chew, effects on other oral functions, cleansing of dentures, cleansing of gums, and an overall evaluation of materials. Both Fittydent products significantly improved denture retention and the ability to chew. The patients who expressed 'much better' chewing with Fittydent products, had mandibular dentures rated poor or fair.

Inhalant allergens: as a cause of respiratory allergy in east Mediterranean area, Turkey

Inhalant allergens were identified by analyzing the positive skin tests of 614 respiratory allergic patients. The important indoor allergens causing skin test positivity were house dust, Dermatophogoides pteronyssinus, cockroach, mosquito and Dermatophogoides farinea. Johnson grass, cultivated wheat, rye, orchard, and cultivated corn were among important grass pollens. Animal allergens like cow hair, cat and dog dander, bird and chicken feathers and horse hair caused skin test positivity in our allergic patients. Weeds and garden plants were also among important inhalant allergens in this region. Common cocklebur, narcissus, rose, mugworth, and daisy caused skin test positivity in decreasing frequencies. Carob, willow, poplar, olive and cypress pollens were among important inhalant allergens causing skin test positivity that may be important cause of respiratory allergy in this region.

Serum interleukin-1 beta in neonatal sepsis

Serum levels of interleukin-1 beta (IL-1 beta) in newborn infants with septicaemia were measured and possible relationships between the clinical course of the infants, causative micro-organisms and IL-1 beta levels were investigated in a prospective study. The study groups comprised 49 newborn infants (25 mature, 24 premature) with proven sepsis and 40 healthy newborn infants (20 mature, 20 premature). Serum IL-1 beta levels were measured using the IL-1 beta immunoradiometric assay. The levels were found to be lower in neonates with sepsis (median 0.1 pg/ml) than in healthy controls (median 27.9 pg/ml) (p < 0.001). Non-significant trends towards lower levels were observed in children with shock and in non-survivors. No correlation was found between IL-1 beta and postnatal age, gestational age or the study weight of the patients. There was no significant difference in the serum IL-1 beta level in septic patients infected with Gram-positive bacteria and those infected with Gram-negative bacteria. The results show that the concentration of IL-1 beta is significantly decreased in preterm and term neonates with sepsis.

Influence of smoke exposure on serum IgE levels of atopic patients

The effect of environmental tobacco smoke on serum total immunoglobulin E (IgE) of respiratory allergic patients was evaluated in this study. A total of 558 patients with respiratory allergies (311 boys and 248 girls) aged between 1 and 17 years (mean 6.92 +/- 3.81 years) were included. None of the subjects were active smokers. IgE levels were significantly higher in children with smoking parents compared with non-smokers (P < 0.05). Children with smoking mothers were found to have higher levels of IgE than children with smoking fathers. The highest level of IgE was found in children when both parents were smokers (P < 0.005).

Effects of indoor environmental factors on respiratory systems of children

Effects of indoor environmental factors on children's respiratory system and pulmonary function tests were investigated in this study. A total of 617 primary school children aged between 9-12 years were included. A standard questionnaire, which includes questions about respiratory symptoms and illness, indoor environmental determinants, family history of respiratory diseases, and smoking habits of the parents, was sent to homes of all children and information was obtained from parents. Children with a family history of asthma, bronchitis, or other chest troubles suffered morning and day/night coughs, shortness of breath, wheezing and asthma, bronchitis, or pneumonia more frequently. Children whose mothers smoked complained of blocked-runny nose and sinusitis more frequently. Pulmonary function levels were diminished in passive smokers and in children whose houses were heated by a wood-burning stove. As a result, passive smoking, using a wood-burning stove for heating, and family history of respiratory diseases are to be considered risk factors for the respiratory system.