Ischemic necrosis of the right colon in a patient with a ventricular assist device system

Despite improvements in medical therapy, the annual high mortality rate from end-stage heart failure continues. Although cardiac transplantation is a succesful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD) technology is applied to a broader population of heart failure patients, and clinicians are confronted with the specialized perioperative and chronic care of patients who receive these devices. VAD implantation is now an acceptable means of bridging to heart transplantation. We report a case of isolated right colon necrosis in a patient with VAD, who was successfully treated with right hemicolectomy and ileocolostomy.     

The effects of somatostatin and ursodeoxycholic acid in preventing the ischemic injury of the liver following Pringle maneuver in obstructive jaundice-rat model

BACKGROUND/AIMS: In our study, the effects of somatostatin (SS) and ursodeoxycholic acid (UDCA) on ischemic liver injury were studied in (obstructive) jaundice-rat model. METHODOLOGY: For this purpose, jaundice was produced in the first four groups by binding of their choleducts. We performed just laparotomy to the other four groups of animals. To groups 1 and 5, SS was given 15 mcg/kg/day intraperitoneally, and to groups 2 and 6, UDCA was given 20 mg/kg/day enterally. No drugs were given to any other group. At the end of one week, a procedure with ischemia of the liver for 60 minutes followed by reperfusion for 2 hours, was performed to each rat except for groups 4 and 8. Following this procedure, they were sacrificed. The blood samples were taken to measure SGOT, SGPT, ALP, LDH, total and direct bilirubin levels, while liver biopsies were taken for histopathological evaluation. RESULTS: Under normothermic conditions, following 60-minute liver ischemia period, no irreversible histopathological changes were detected. However, increases in liver necrosis parameters were noted biochemically. SS and UDCA were thought to be effective in preventing the injury by decreasing the liver enzymes levels to a significant degree. The damage of the hepatic ischemic injury was found to be more meaningful and prominent in liver with jaundice. CONCLUSIONS: In this study, it was noted that SS and UDCA decrease the effects of cholestatic hepatic injury especially and improve the condition.     

Neuronal SIRT1 regulates endocrine and behavioral responses to calorie restriction

Mammalian life span can be extended by both calorie restriction (CR) and mutations that diminish somatotropic signaling. Sirt1 is a mediator of many effects of CR in mammals, but any role in controlling somatotropic signaling has not been shown. Since the somatotropic axis is controlled by the brain, we created mice lacking Sirt1 specifically in the brain and examined the impacts of this manipulation on somatotropic signaling and the CR response. These mutant mice displayed defects in somatotropic signaling when fed ad libitum, and defects in the endocrine and behavioral responses to CR. We conclude that Sirt1 in the brain is a link between somatotropic signaling and CR in mammals.     

Is second-line enuretic alarm therapy after unsuccessful pharmacotherapy superior to first-line therapy in the treatment of monosymptomatic nocturnal enuresis?

INTRODUCTION: We aimed at comparing the success rates of primary enuretic alarm therapy with those of secondary alarm therapy after failed pharmacotherapy in the treatment of monosymptomatic nocturnal enuresis (MNE). PATIENTS AND METHODS: We randomly applied enuretic alarm therapy in 35 MNE patients (group 1) and desmopressin therapy in 49 MNE patients (group 2). The success and rebound rates after 3 and 6 months were determined. We also applied enuretic alarm therapy as a secondary treatment in 19 group 2 patients with complete rebound after 6 months (group 3). The success rates of patients who have received primary and secondary enuretic alarm therapy were compared. RESULTS: The success rates for groups 1 and 2 were 82.65 and 81.63%, respectively (p = 0.885), at 3 months and 54.28 and 26.53%, respectively (p = 0.007), at 6 months. The success rates in group 3 were 84.21 and 52.63%, respectively, at 3 and 6 months. When these success rates were compared between groups 1 and 3, no statistically significant difference was found (p = 1.000). CONCLUSION: Prior pharmacotherapy did not increase success rates of alarm therapy in our MNE patients.     

The effect of cycloplegia on the ocular biometry and intraocular lens power based on age

BackgroundTo investigate the effect of cycloplegia on the ocular biometry and intraocular lens (IOL) power in different age groups.MethodsThis cross-sectional study enrolled 240 right eyes of 240 healthy volunteers. Three groups were formed (range to years; group 1: 50–60, group 2: 30–40 and group 3: 10–20, respectively). We measured keratometry, central corneal thickness (CCT), white-to-white (WtW) distance, anterior chamber depth (ACD), and axial lentgh (AL) both before and after cycloplegia. The IOL powers were calculated using Sanders–Retzlaff–Kraff/theoretical (SRK/T), Holladay 1 and Haigis formulas. AL-Scan (Nidek Co., Gamagori, Japan) was used for all measurements.ResultsThere was a significant increased in keratometry, CCT, ACD, AL, and Holladay 1 after cycloplegia (p < 0.05), whereas WtW, SRK/T, and Haigis were not changed significantly in group 1 (p > 0.05). Keratometry, SRK/T, Haigis, and Holladay 1 significantly decreased; ACD and WtW significantly increased postcycloplegia (p < 0.05) but AL and CCT did not change significantly in group 2 (p > 0.05). Significant increased in ACD, CCT, WtW, and AL, significant decreased in SRK/T and Haigis were observed postcycloplegia (p < 0.05), while the changes in keratometry and Holladay 1 were not significant in group 3 (p > 0.05).ConclusionsThis study demonstrated there is significant difference in many ocular parameters and IOL power formulas before and after cycloplegia. Especially, ACD showed significant changes in all age groups. Therefore, to avoid refractive prediction errors the IOL power calculation formulas using the ACD should be considered.Subject terms: Medical research, Diseases     

Relationship between histologic grading and serum prostate specific antigen in prostatic carcinoma

Prostate specific antigen (PSA) is the most important tumour marker which, used routinely, proved to have a positive correlation with tumour volume and pathological stage. To evaluate the relationship between serum PSA and histologic grading of prostatic carcinoma, preoperative PSA determinations were made in 25 patients with prostatic cancer. Biopsy materials were evaluated and the Gleason scores were adjusted for histologic grading. The higher values of PSA were proportional to the Gleason scores of the primary prostatic biopsy.     

Attachment and coping as facilitators of posttraumatic growth in Turkish university students experiencing traumatic events

This study was designed to explore the role of attachment and coping as facilitators of posttraumatic growth (PTG) in a sample of Turkish university students who experienced traumatic life events. Participants who reported a traumatic event from a list were asked to choose the most distressing one; to answer questions related to the impact of the trauma; and to fill out measures of attachment styles, ways of coping, and PTG. PTG was regressed on gender, trauma-related factors, attachment styles, and coping styles in order to examine the associations with PTG. Felt helplessness and horror, fatalistic coping, and optimistic coping were significant predictors of PTG. Fatalistic coping partially mediated the relationship between attachment anxiety and PTG.     

Acute Unilateral Anterior Ischemic Optic Neuropathy Secondary to Optic Nerve Head Drusen: Report of a Rare Coexistence

A 45-year-old white male noticed on awakening the painless loss of inferior vision in the left eye 2 days ago. He was otherwise well and his medical history was unremarkable. Visual acuity was 20/20 in OD and 20/32 in OS with a left inferior altitudinal defect and right blind spot enlargement demonstrable on visual field test. On fundus examination, both disc margins were blurred and the left disc was diffusely oedematous, with linear haemorrhages in the adjacent nerve fibre layer. Radiologic imaging and laboratory tests were unremarkable. Bilateral optic nerve head drusen (ONHD) was demonstrated by optical coherence tomography and fundus autofluorescence imaging. Unilateral acute non-arteritic anterior ischemic optic neuropathy (NAION) and concomitant bilateral ONHD were diagnosed. NAION may develop secondary to ONHD. Therefore, clinicians should be aware of this rare association and inform the patients about this risk. Patients with ONHD should be followed-up periodically in terms of possible ischemic complications.