Foreign body ingestion is a common clinical situation that is primarily diagnosed by emergency clinicians. Most foreign bodies can be evacuated without difficulty. Although rare, magnets that reach the lower intestinal tract may cause complications such as intestinal fistula formation, perforation, volvulus or appendicitis. We report herein a two-yearold girl who was admitted to our department 3 days ago with abdominal pain and non-bilious vomiting. Upon admission direct abdominal roentgenogram revealed a foreign body consisting of multiple spheric parts bound together forming a circle in the lower quadrants of the abdomen. Her family, unaware of this ingestion, stated that a magnetic toy matching the object present on the plain radiograph was lost several days ago. Surgical intervention showed a magnetic toy in the proximal part of the ileum causing multiple perforations in the intestinal wall and the neighboring mesentery. The ileal portion containing the magnet toy was seen folded over itself forming a blind loop. The patient was discharged uneventfully in the 7th postoperative day. Our case highlights a well known fact that foreign body ingestion in children may not have eye witnesses and should be taken into consideration when evaluating children with abdominal pain.Key Words: Ingested magnets in children; ingested foreign body.Yabancı cisim yutulması sıklıkla acil hekimlerinin karşılaş-tığı bir klinik durumdur. Çoğu yabancı cisim kendiliğinden çıkar. Ancak nadiren de olsa, distal intestinal sisteme ulaşabilen yabancı cisimler fistül, perforasyon, volvulus veya apandisit gibi komplikasyonlara yol açabilir. Bu yazıda, kliniğimize üç günlük karın ağrısı ve safrasız kusma şika-yeti ile başvuran iki yaşındaki kız hasta sunuldu. Başvuru esnasında çekilen ayakta direkt karın grafisinde, karın sağ alt kadranda halka yapısında birbirine bağlı birden fazla sayıda yabancı cisim izlendi. Aile yabancı cisim yutulması ile ilgili herhangi bir öykü vermedi ancak karın grafisinde izlenen yabancı cisme benzer bir oyuncak mıknatısın birkaç gün önce evde kaybolduğunu belirttiler. Cerrahi girişimde proksimal ileumda bağırsak duvarında ve komşu mezenterde çoğul bağırsak delinmesine yol açan halka şeklinde mıknatıslı oyuncak izlendi. Bu yabancı cismin yer aldığı ileal parça yabancı cismin şeklini alarak kendi üstüne katlanmış ve o da halka şeklini almıştı. Hasta ameliyat sonrası yedinci günde sorunsuz olarak taburcu edildi. Bu olgu ile çocuklarda yabancı cisim yutulmasında herhangi bir şahitin olmayabileceği ve karın ağrılarının değerlendirilmesinde bu durumun da hatırlanması gerektiğinin bir kere daha altı çizilmelidir.Anahtar Sözcükler: Çocuklarda yutulmuş mıknatıs; yutulan yabancı cisimler.

The study aims to clarify how the type of organic substrate in a wastewater affects the production and composition of extracellular polymeric substances (EPS) and hydrophobicity and surface charge of activated sludges. For this purpose, three activated sludge reactors were operated in parallel with feeds composed of the organics (i) peptone, glucose, and acetate and (ii) peptone and (iii) glucose. EPS extracted from sludges were fractionated into very loosely bound, loosely bound, and tightly bound fractions and analyzed for protein and polysaccharide. Also, molecular weight distribution of proteins was determined by using high-pressure size exclusion chromatography (HPSEC). Regardless of the type of organic substrate, in each sludge, tightly bound EPS (TB-EPS) prevailed. The type of organic substrate affected the relative proportion of protein and polysaccharide and had an impact on hydrophobicity and surface charge. The sludge fed with peptone was distinctly more hydrophobic and had a lower negative surface charge than others. HPSEC fingerprints revealed that the variety and size of proteins were dependent on the type of feed. HPSEC also pointed to a shift of high molecular weight (MW) proteins from TB-EPS to others. In addition, results of a parallel study examining the inhibitory effect of Ag(+) on three sludges were interpreted along with feed composition, EPS, and surface measurements. The response of each sludge to toxic Ag(+) ion seemed to change with the type of feed.

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BACKGROUND: Sensitivity of activated sludge to heavy metals may depend on the strength and type of organics in the feed. However, literature data are usually derived from systems with an unknown or variable composition. To fill this gap, this study examined whether in activated sludge systems the inhibitory effect of Ag + depended on the carbon to nitrogen (COD/TKN) ratio and the type of organic matter in the feed. RESULTS: Different activated sludges reactors were operated at steady-state conditions. Regularly, sludge samples taken from reactors were contacted with Ag + in a respirometer and the inhibitory effect was determined by the relative decreases in O 2 consumption and CO 2 generation. The inhibitory property of Ag + drastically increased as the COD/TKN ratio became lower. While sludges fed with acetate, glucose and peptone or glucose alone were equally inhibited when exposed to Ag + , the peptone-fed sludge proved to be much more resistant. It was also clarified whether indicated Ag + doses had an effect on nitrification, organic carbon removal or both processes. CONCLUSION: To date, comparative evaluations have rarely been made between different activated sludge systems in under-standing the response to silver input. Overall, this study pointed to the need to consider the characteristics of the feed to explain the discrepancies between different activated sludge systems.

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