Development of a compact mouse MRI using a yokeless permanent magnet.

A compact mouse MRI has been developed using a 1.0T yokeless permanent magnet and portable MRI console. The entire system was installed in a space measuring 2 m x 1 m. The imaging region was the cylindrical volume (35 mm diameter, 50 mm length) at the center of the magnet and was used for whole-brain or body imaging of mice. Whole-brain imaging took less than 90 min for T1- and T2-weighted 3D images with 2-mm slice thickness and 200-microm in-plane resolution. Body imaging took less than 30 min for T1-weighted spin-echo and FLASH 3D images with 0.5- to 1.0-mm slice thickness and 250- to 300-microm in-plane resolution. In addition to the compactness of the system, the mouse MRI has several advantages over high-field superconducting animal MRI systems in its accessibility to the specimen, similarity to clinical MRI in image contrast, capacity for biological isolation, and maintenance. The results obtained demonstrate the potential of this new system for routine imaging in biomedical laboratories.     

Analysis of metastatic ovarian tumors from extragenital primary sites

AIMS AND BACKGROUND: The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. METHODS: The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. RESULTS: Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. CONCLUSIONS: Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.     

Combined therapy of teicoplanin and caffeic acid phenethyl ester (CAPE) in the treatment of experimental mediastinitis in the rat

Post-sternotomy mediastinitis affects 1-3% of patients undergoing cardiac surgery and is lethal in 10-47% of these patients. We investigated the effect of an antioxidant/anti-inflammatory agent, caffeic acid phenethyl ester (CAPE), in the attenuation of inflammatory response induced by methicillin-resistant Staphylococcus aureus (MRSA) infection in a rat experimental mediastinitis model. Rats, divided into six equal groups, received MRSA precolonized stainless steel wire pieces implanted into their mediastinal spaces. Control group and CAPE control group received saline and CAPE 10 micromol/kg.day(-1 )respectively, where Group A received a single dose of teicoplanin 24 mg/kg i.m. for the first day and then 12 mg/kg.day(-1) . Group B received teicoplanin as in Group A plus CAPE 10 micromol/kg. day(-1 )intra-peritoneally. Group C received teicoplanin 60 mg/kg i.m. for the first day and then 30 mg/kg.day(-1 )and Group D received teicoplanin as in Group C plus CAPE 10 micromol/kg.day(-1) . By the end of 14 days rats were sacrificed and serum malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), urea and creatinine levels were evaluated. Mediastinal organ tissues were collected for histopathological analysis. Infection rates in all the drug-treated groups were lower than the control groups ( P=0.002) but statistical significance was attained only between the groups A and D ( P=0.018). In connective tissues and the peribronchial area polymorphonuclear leukocytic (PNL) infiltration in the treatment groups, although becoming very close, did not reach statistical significance (P =0.053, P=0.075, respectively). PNL infiltration especially in the peribronchial tissues of the Group B animals was found to be significantly less than the Control and CAPE Control groups with P values of 0.013 and 0.010, respectively. MDA and MPO levels were significantly lower in the treatment groups ( P<0.001 and P<0.001 respectively). Levels of the degradation products of NO were lower in treatment groups compared to two control groups (P=0.003, P= 0.005). NO levels in Group D were lowest among all treatment groups ( P=0.001). It has been demonstrated that although bacterial colonization can be controlled in mediastinitis, the inflammatory response persists. The combination of an antioxidant / anti-inflammatory agent, CAPE, added to standard antibiotic therapy might be effective in the treatment of post-sternotomy mediastinitis due to MRSA.     

Depression and anxiety levels of the mothers of children and adolescents with left ventricular assist devices

Ozbaran B, Kose S, Yagdi T, Engin C, Erermis S, Yazici KU, Noyan A, Ozbaran M. Depression and anxiety levels of the mothers of children and adolescents with left ventricular assist devices. Abstract: VADs have been used to provide treatment for end‐stage heart failure. Parents may feel overwhelmed with the VAD regimes responsibility and be affected from this process beside children. In this study, we aimed to evaluate the depressive and anxiety symptoms of mothers of the first eight children equipped with a VAD in Turkey. The mothers of eight pediatric patients living with VADs were filled BDI and STAI at first month of VAD implantation (E.I) and secondly six months after their first evaluation (E.II). In E.I, the BDI mean score of mothers was 20.87, in E.II 14.37. STAI‐S mean score was 53.37 in E.I and 43.62 in E.II. The Wilcoxon nonparametric‐paired t‐test revealed significant difference between baseline and end‐point STAI‐S scores (Z: ?2.035; p: 0.042), and for BDI scores (Z, ?1.965; p, 0.049). Prolonged usage of VAD may increase distress in parents. Psychiatric evaluation and support of the primary caregiver is important for the well‐being of the pediatric patients.     

Isolated medial cuneiform fractures: report of two cases and review of the literature

Although fractures of the midfoot are common, cuneiform fractures are rarely seen. These fractures are frequently associated with other fractures of the midfoot such as Lisfranc fracture-dislocations. However, isolated cuneiform fractures are extremely rare, with few cases reported in the relevant literature. Herein, the authors report 2 cases of isolated medial cuneiform fractures. One of the patients was treated with headless screw fixation due to displacement in fracture configuration, and the other was treated conservatively. Fractures were united without any complication in both patients. In this report, the authors discuss the mechanism of injury, diagnostic challenges, and treatment options of isolated medial cuneiform fractures.     

A permanent junctional reciprocating tachycardia with an atypically located accessory pathway successfully ablated from within the middle cardiac vein

Permanent form of junctional reciprocating tachycardia (PJRT) is an uncommon form of atrioventricular re-entrant tachycardia due to an accessory pathway characterized by slow and decremental retrograde conduction. The majority of accessory pathways in PJRT are localized in the posteroseptal zone. Despite the high success rate, failure may occur during endocardial radiofrequency catheter ablation due to epicardial insertion of the accessory pathway. We report a case of PJRT in a 25-year-old man in whom the accessory pathway was located epicardially in the posteroinferior region and ablated from within the middle cardiac vein by radiofrequency catheter ablation.     

Safety of gadodiamide mixed with a small quantity of iohexol in patients with impaired renal function undergoing coronary angiography

Gadolinium-based contrast agents can be used in diagnostic and interventional angiography, and are safe in recommended doses in patients with impaired renal function, but the image quality is usually unsatisfactory. The objective of the present study is to evaluate the safety of gadolinium mixed with a small quantity of iodine-based contrast agent and the image quality of this mixture in patients with renal insufficiency undergoing diagnostic coronary angiography. Forty-two patients with baseline creatinine level >1.5 mg/dl were randomized into gadolinium or iodine groups. In the gadolinium group gadodiamide was mixed with 1 : 3 iohexole and in the iodine group only this agent was used as contrast material. Peak creatinine levels 48–72 h after the procedure were measured. The primary end point was the development of contrast-induced nephropathy (CIN), defined as >25% increase of baseline creatinine levels, and the secondary end points were absolute and relative changes in baseline creatinine levels. Total contrast volumes used were not different between groups (57 ± 11 ml in gadolinium and 55 ± 10 ml in iodine; P = 0.68). Mean creatinine level did not increase significantly in the gadolinium group (from 1.9 ± 0.3 to 1.9 ± 0.4 mg/dl; P = 0.06), but did in the iodine group (from 2.0 ± 0.4 to 2.3 ± 0.5 mg/dl; P = 0.001). No patient had CIN in the gadolinium group whereas 5 (23%) patients had this phenomenon in the iodine group (P = 0.048). Contrast regimen was very well tolerated in the gadolinium group, with only transient headache in two patients. Gadodiamide mixed with a small quantity of iohexol is safe in patients with azotemia undergoing diagnostic coronary angiography. The image qualities obtained with this combination are also satisfactory in all of the cases. Further evaluation of the safety of this technique is warranted, especially in other types of diagnostic and interventional procedures in which a higher amount of contrast dye is needed.