Complications among premature neonates treated with beractant and poractant alfa

Objective  

To compare the complications among preterm infants treated with two different natural surfactants.     

Can Vero cell co-culture improve in-vitro maturation of bovine oocytes?

This study was carried out to evaluate the effect of Vero cell co-culture on developmental competence of immature oocytes. Bovine cumulus-oocyte complexes (COC) were matured in presence or absence of Vero cells. Matured oocytes were inseminated and cultured for up to 9 days. Cleavage percentages were recorded on day 2 after insemination and embryos were evaluated on a daily basis. Expanding/expanded and hatching/hatched blastocysts were used for cell number assay. Results indicated a significantly greater cleavage percentage in oocytes matured in presence of Vero cells than control (86% versus 76%, P < or = 0.05). The percentages of advanced embryos appear to be greater on a daily basis in COC matured in presence of Vero cells compared with control. However, these differences were not significant. Blastocysts derived from COC matured in the presence of Vero cells had a significantly higher (P < or = 0.05) number of inner cell mass, trophectoderm and total cell number in expanding/expanded (65.25, 224.5 and 289.7 respectively) and hatching/hatched (67.75, 289.75 and 357.5) embryos in comparison to the control (42, 203.5, 245.5 and 51.3, 265, 316.3 respectively). Results confirm that co-culture of bovine COC during in-vitro maturation, enhances their ability for cleavage and for producing blastocysts with higher quality.     

Interactions among different genetic loci in age-related macular degeneration

Purpose: To evaluate the possible synergistic effect of at risk genotypes of ARMS2/LOC387715 (A69S), DNA repair SMUG1 rs3087404, CCL2–2518, C3 (R102G), CFH Y402H, complement factor B (L9H), and complement factor I (CFI) (G119R) in advanced age-related macular degeneration compared to those of healthy controls. Elucidation of synergistic effects between different genetic loci may clarify their pathogenetic pathways.

Methods: We calculated relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S) to estimate the additive or supra-additive effects of the mentioned genotypes.

Results: ARMS2-CFH [RERI = 4.78 (95% CI 2.17–10.61), AP = 0.65 (95% CI 0.33–0.83), S = 4.11 (95% CI 1.40–12.06)], and CFH-C3 combinations [RERI = 2.71 (95% CI 0.04–7.01) AP = 0.47 (95% CI ?0.03–0.7) S = 2.30 (95%CI 0.97–5.45)] have the most significant levels of synergism and C3-CFI combination [RERI = ?1.65 (95%CI ?4.34–0.06), AP = ?0.92(95%CI ?3.09 – ?0.09), S = 0.32 (95%CI 0.09 = 1.20)] has the most significant level of antagonism.

Conclusion: Among different genotype combinations ARMS2-CFH and CFH-C3 combinations have the most significant levels of synergism and C3-CFI combination has the most significant level of antagonism in AMD patients.     

New morphometric findings in adhesive otitis media: Petroclival angle and eustachian tube-tympanic cavity ventilation angle

Objective

Observations during adhesive otitis media (OM) surgery led us to consider that morphometric variations might cause formation of the middle ear cavity with smaller bony boundaries during developmental process. Among the various factors mentioned in the literature, we thought that angle of the petrous bone relative to the midsagittal line and the eustachian tube-tympanic cavity ventilation angle might be factors in the course of adhesive otitis media.

Methods

Axial computerized tomography scans from 14 patients with adhesive OM and 19 cases (control group) with normal middle ear-tympanic membrane were retrospectively examined in terms of petroclival angle and eustachian tube-tympanic cavity ventilation angle. Measurements of these two angles were compared between the two groups. A correlation was also investigated between these two angles.

Results

The petroclival angle (54.5° vs 62.3°) and the eustachian tube-tympanic cavity ventilation angle (156° vs 162.6°) in the adhesive OM group were narrower than those of controls (p < 0.01). The correlation analysis showed that there was a strong association between two angles (r, 0.803; p < 0.01).

Conclusions

More medially positioning of the petrous bone and acutely angled-eustachian tube-tympanic cavity ventilation axis were observed in this study. It would be reasonable to conclude that these findings might take part in development of adhesive OM. We should also admit that these results do not decline the previous theories that account for development of the adhesive otitis media.     

Surgical treatment of asymptomatic popliteal aneurysms using midline posterior incision

The authors report eight cases of surgical treatment of popliteal aneuryms via a strictly posterior approach. The aneurysm was asymptomatic in each case and was diagnosed during assessment of a symptomatic contralateral popliteal aneurysm treated by a conventional technique (exclusion—interposition of a femoropopliteal vein graft or prosthetic tube via a medial incision). The operation was performed with the patient in the ventral supine position and consisted of excision graft with direct anatomical interposition of a femoropopliteal prosthetic tube. This approach has limitations as it cannot be extended superiorly and is therefore indicated in saccular or short fusiform aneurysms whose superior pole does not extend beyond Hunter's canal. In all eight cases, the prosthesis consisted of a 8 mm PTFE spiral tube. All patients underwent postoperative bilateral dynamic angiography and all were asymptomatic. During the same period, four postoperative thromboses of the grafts requiring embolectomy were observed in four cases of conventional repair of symptomatic contralateral aneurysms. The use of the posterior approach for popliteal aneurysm surgery, considering very precise criteria, appears to be a very attractive alternative, decreasing the morbidity, restoring a strictly anatomical course, and allowing a reduction in the incidence of the graft's thrombosis, ensuring a better long-term patency.Presented at the 37th Annual World Congress of The International College of Angiology, Helsinki, Finland, July 1995     

Troponin T and NT ProBNP Levels in Gestational,Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants

This study compares NT proBNP and troponin T levels in umbilical cord arterial blood and postnatal echocardiographic findings for infants of gestational and pregestational diabetic mothers and macrosomic infants. Twenty-seven infants of pregestational diabetic mothers, 61 infants of gestational diabetic mothers and 37 macrosomic infants of nondiabetic mothers were prospectively enrolled in this study along with a control group of 58 healthy infants of mothers without any pregestational or gestational disorders as the control group. All enrollees were born after 34 weeks of gestation. For this study, umbilical cord blood was drawn during delivery to determine NT proBNP and troponin T levels. Echocardiography was performed 24–72 h after the delivery. Umbilical cord troponin T and NT proBNP levels were found to be higher in the diabetic and macrosomic groups than in the control group (all of them p < 0.001). NT proBNP levels were positively correlated with interventricular septum thickness in the pregestational and gestational infants of diabetic mothers groups (r = 0.564 and r = 0.560, respectively, p < 0.01). Both pregestational and gestational diabetic mothers were divided into two groups according to HbA1c levels in the third trimester as good (<6.1 %) and suboptimal (>6.1 %) metabolic control. In the good and suboptimal metabolic control diabetic groups, NT proBNP levels were also positively correlated with interventricular septum thickness (r = 0.536 and r = 0.576, respectively, p < 0.01). In the suboptimal metabolic control diabetic group, NT proBNP was only found to be positively correlated with the left ventricular mass index (r = 0.586, p < 0.01). While there was no correlation in the myocardial performance index between infants of diabetic mothers and the control group, the myocardial performance index of macrosomic infants was lower than that of the control group (p = 0.017). Cardiac biomarkers (NT proBNP and troponin T) were elevated in infants of diabetic mothers and macrosomic infants. While there was a positive correlation between NT proBNP levels and cardiac structure in infants of pregestational and gestational diabetic mothers, there was no relationship between NT proBNP levels and cardiac function.     

Prevalence of IVS1+1G>A mutation among Iranian Azeri Turkish patients with autosomal recessive non-syndromic hearing loss (ARNSHL)

Objective

Mutations in the GJB2 gene has been reported as a main cause for autosomal recessive non-syndromic hearing loss (ARNSHL) all over the world. IVS1+1G>A which is splice site mutation have been detected in several populations as disruptive mutation. This study has intended to assess the significance of this mutation, IVS1+1G>A, to the autosomal recessive non-syndromic genetic load among Iranian Azeri Turkish patients.

Methods

Following our previous study, one hundred and seventy four unrelated patients with prelingual ARNSL were included in this study. Thirty nine patients had only one identified mutated allele, whereas hundred and thirty five patients were negative for coding region of GJB2. All these patients were screened for IVS1+1G>A by applying PCR-RFLP assay.

Results

Among studied patients nine compound heterozygote with 35delG, delE120, 235delC were identified. Additionally, six patients were detected with only one IVS1+1G>A mutated allele. In these patients, the other mutated allele was left unidentified. One patient was identified to be homozygous for IVS1+1G>A. Further studies carried out on parents of positive cases, showed that one of the healthy parents (mother) to be homozygous for IVS1+1G>A mutation. By self-report, this person had no hearing impairment, although it is possible that she has mild or moderate hearing loss, which she is unable to detect. Her child was compound heterozygous (IVS1+1G>A/35delG) with profound deafness.The frequency of IVS1+1G>A was found to be about 4.9%, however the parental consanguinity was observed in 37.5% of IVS1+1G>A-mutated families.

Conclusions

Our results support founder effect regarding these mutations and the presence of an ancient ancestor is strengthened in comparison to hot spot hypothesis. Also the results suggest variable expressivity of IVS1+1G>A mutation with respect to hearing loss.