The year 2003 started with violence and fire. Under the pretext of restitutio ad integro and the so called establishment of peace, the word peace itself is under the risk of being scattered into misery and despair! The sounds of drums are increasing in intensity and the imminent war in Iraki territories will certainly initiate a new era of chaos and pain with starvation and illness. It is very sad that throughout centuries the weapons created to exterminate human lives have been used under pretext of reestablishing the well-being of humans, to act in the name of peace for humans whose future is said to be under severe threat. But who are these people whose endangered life will be severed at the cost of other innocent lives? This is a contradiction, a mystery which has had no answer throughout history and will possibly never have one in the future. What we have learnt from the past however, is that the search for power has always reigned over reason and the most powerful has always reasoned, although not justifiably in theory!
We start therefore an unfortunate year, expected to generate monsters, with premises of carnage everywhere in the world.
Whatever the 'novus ordo seclorum' (the new order of the world) imposes upon us, science will remain our gold standard, not only in terms of standards but also as an infallible set up in our personal or common lives.
Science is still keeping pace with the turbulence and moral issues created by cloning and artificial methods of fertilisation. Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world. Science is the highest personification of the nation because that nation will remain first which carries farthest the works of thought and intelligence.*
In this issue of MMJ, Oktar et al. discuss the effect of α-melanocyte stimulating hormone on burn induced injury caused by neutrophil generated oxydants in their rat model. Alterations in cellular responses in various organ systems contribute to trauma-, burn-, and sepsis-related multiple organ dysfunction syndrome. MSH, a hormone present mainly in the pituitary, brain and skin and known to have anti-inflammatory effects was found to antagonize the effects of local cytokines and block the accumulation of neutrophils, hence exert a favorable effect on burn injury. One of the pathways, argue the authors could be the NO mechanism as a mediator to the injury.
Gerçek et al. in their article address the issue of clinically difficult intubation, the nightmare of the anesthesiologist as to whether bedside scoring systems, laryngoscopic view and patients characteristics would be of value in predicting this clinical condition.
Cochlear implants (CI) opened a new area of research and improved the quality of life in congenitally deaf children and profoundly deaf people by restoring partial hearing by means of a prosthetic device which can be implanted in the inner ear. Some individuals with implants can now communicate without lip-reading or signing, and some can communicate over the telephone. This is a great advancement since for centuries, people believed that only a miracle could restore hearing to the deaf. Better auditory performance and speech intelligibility are achieved in children who had strong family support, hearing aid before CI and early implant age according to the study of iprut et al.
In the analysis of their five cases of cerebellar venous infarction after suptratentorial craniotomy, Konya et al. discuss various reasons leading to this complication. The authors state that excessive CSF drainage, hyperextension of the neck during the operation could be the culprits of such a situation.
This issue also brings to our attention interesting case studies.
Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by the proliferation of specialized bone marrowderived Langerhans cells (LCs) and mature eosinophils. Lesions are usually asymptomatic, but bone pain and a soft tissue mass may occur. Arvanitakis et al. report a rare case of Langerhans cell histiocytosis of the bone presenting as a localized bone lesion in the anterior aspect of the right 9th rib in a heavy smoker male admitted with pain at the right lower hemithorax. An ongoing debate exists in the literature over whether this is a reactive or neoplastic process. But as the authors state in their elegant article surgical excision is the best treatment when feasible in such cases.
Gestational diabetes which complicates about 7% of pregnancies can be so severe as to require insulin. For the mother with GDM there is a higher risk of hypertension, preeclampsia, urinary tract infections, cesarean section, and future diabetes. Unfortunately, screening based solely on risk factors will only identify approximately 50% of women with GDM. Gökaslan H et al. attack this serious health problem in their review article and draw attention to the algorithms leading to its diagnosis and the benefits of early management.
Difficult surgery is the challenge of cardiovascular surgeons. S. Arsan reports his personal experience on aortic root replacement in elderly patients with aortic root aneurysm, a procedure previously judged to have a high morbidity and mortality rate. The experience of the surgeon coupled with the selection of the right patient at the right time will increase the success of this bold intervention, suggests the authors paper.
Experience is the most important weapon we all have against ignorance and weakness. Nothing can be declared as scientific without being tested and reproduced several times. Nowadays scientific rules are more demanding. We need that each of our statements or applications be evidence-based and preferentially of type A or B. Experience teaches however at the expense of mistakes. But one has to remember that We learn more from our defeats than from our glories and the the nights of the defeats prepare the days of the glories.