Immediate ultrastructural effects of endothelin-1 on rabbit basilar artery

Summary In this study intra-arterial Endothelin-1 was applied to rabbit basilar arteries and morphological findings were compared between two groups who were either perfusion fixed or immersion fixed. We planned to establish the quantitative dimension of the drug-induced morphological alterations, independent of the fixation technique's effect.There was an abundance of collagenous fibres deposited among the smooth muscle cells which was not observed in control arteries and after immersion fixation. These degenerative changes are similar to the finding following subarachnoid haemorrhage. The only fixation-related difference was the fact that lamina elastica interna was not corrugated in the perfusion fixation group.It is concluded that, the observed changes in the connective tissue of the arterial wall alter the passive elastic properties and so affect the degree of the response to the vasoactive messengers.     

The modification of the new type of end-to-side anastomosis between carotid arteries in rats: A technical and Scanning Electron Microscopic study

Summary Modification of a type of end-to-side anastomosis that has been described before is studied. The recipient artery is occluded for only 3–4 minutes to complete the anastomosis by using only the running suture. The anastomotic site was studied by inspection and Scanning Electron Microscope (SEM) at different times after the operation on 30 rats.     

Human lymphocyte antigens (HLA) and Graves' disease in Turkey

To evaluate the association of HLA types with Turkish patients with Graves' disease, HLA typing, clinical findings, and thyroid antibodies were correlated. The HLA types, clinical findings (ophthalmopathy and age at onset), and thyroid stimulating hormone (TSH) receptor (TRAb) and antithyroid microsomal antibodies (MAb) were analyzed. Seventy Turkish patients with Graves' disease and 306 control subjects were assessed. Serological HLA typing was performed in HLA A, B, C, DR, and DQ loci. There was a significantly increased prevalence of HLA B8, B49, DR3, DR4, and DR10 in Graves' disease. The association of Graves' disease with HLA DR3 was found to be less strong than previously described. The HLA DR4 antigen may contribute to the predisposition of Graves' disease in Turkey. The results suggest that HLA B7, B13, DR7, DQw2, and DQw3 may confer a protective effect for Graves' disease in Turkey. Patients carrying HLA B12, B18, and B44 haplotypes had a tendency to develop the disease at a later age. The difference from the other studies may be the result of the selection of the controls; in part, of the variability in serological typing reagents; and, also, of the rather weak HLA associations with the disease.This study was presented in part at the Annual Meeting of the National Endocrinology and Diabetes Association, Bursa, Turkey, May 25–28, 1992.     

Comparative toxicity,protective, histamine sensitizing and leucocytosis promoting activities in mice ofBordetella pertussis culture fluid,bacterial cells and cell extracts

Bordetella pertussis bacterial cells, bacterial extracts, and concentrated culture supernatant fluid were comparatively examined for histamine sensitizing and leucocytosis promoting activities, toxicity (mouse weight gain test), immunoprotective potency and lipopolysaccharide bioassay. The activity of histamine sensitizing factor always paralleled that of leucocytosis promoting factor. In contrast, important differences were demonstrated regarding the toxicity and protective activity of the three preparations. Culture supernatant was more toxic and less protective than either bacterial cells or cell extract. Although the latter had lower protective potency than whole cells, its lower toxicity might lead to its consideration as a possible potential vaccine.     

Neuroimaging of typical and atypical development: a perspective from multiple levels of analysis

To date, research involving functional neuroimaging of typical and atypical development has depended on several assumptions about the postnatal maturation of the brain. We consider evidence from multiple levels of analysis that brings into question these underlying assumptions and advance an alternative view. This alternative view, based on an "interactive specialization" approach to postnatal brain development, indicates that there is a need to: obtain data from early in development; focus more on differences in interregional interactions rather than searching for localized, discrete lesions; examine the temporal dynamics of neural processing; and move away from deficits to image tasks in which atypical participants perform as well as typically developing participants.     

Impact of anxiety,stress and depression related to COVID-19 pandemic on the course of hereditary angioedema with C1-inhibitor deficiency

Background

Hereditary angioedema (HAE) attacks can be provoked with psychological factors. The aim of this study was to assess the effects of anxiety, depression and stress related to COVID-19 pandemic on disease activity of HAE patients during the quarantine period (QP) and the return to normal period (RTNP).

Methods

This study was conducted between March 2020 and September 2020 in four allergy centres. Demographic, clinical features and mental health status were evaluated in QP (from March to the beginning of June) and RTNP (from June to the beginning of September) applied by the government. The 10-point visual analogue scale (VAS10) was used to define the severity of HAE attacks. Depression, Anxiety and Stress Scales-21 (DASS-21) and Fear of COVID-19 (FC-19) scale were performed to assess mental health status.

Results

139 HAE patients were included in the study. In QP, median attack numbers and median VAS10 scores were 5 (min-max: 0–45) and 6 (min-max: 0–10), respectively. HAE attack numbers, DASS-21 stress, anxiety, depression and total DASS-21 scores, and FC-19 scores were higher in QP than RTNP (p = 0.001, p < 0.001, p = 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). However, there was no difference in attack severity scores between the two periods (p > 0.05).

Conclusions

This study revealed that the restriction measures during COVID-19 outbreak cause an increase in the number of HAE attacks in relation to anxiety, depression, stress and fear of COVID-19 pandemic. Therefore, it is important to provide psychological support to HAE patients during the pandemic.

     

Use of high frequency jet ventilation in extracorporeal shockwave lithotripsy

High frequency jet ventilation (HFJV) was used in 68 patients which were treated with extracorporal shock wave lithotripsy (ESWL) because of stone diseases in the upper urinary tract. The question was whether HFJV in combination with a semiclosed conventional circle system offered a practicable and safe technique to minimize the oscillations which are proportional to the applied tidal volume and to the diaphragmatic movements. With IPPV the mean distance of the stone movement was 32 mm, whereas with the application of HFJV the stones oscillated around their resting position within limits of 2 to 3 mm (ventilation frequency: 200-300/min, driving pressure: 0.6-1.1 bar, tidal volume: 3-8 1/min). The effectiveness of HFJV was monitored by the end-tidal carbon dioxide tension (PeCO2) during intermittently conventional ventilation with "adequate" tidal volumes (TV 15 ml/kg bw). The correlation between PeCO2 and simultaneous measured PaCO2 was r = 0,91. The application of HFJV enhances the efficiency of ESWL. So the treatment of stones of the upper urinary tract can be varied by more subtle dosage of the incoming shock wave energy and by stabilisation of the stones in the underlying ellipsoid of the energy focus.     

Carbamazepine-induced sperm disorders can be associated with the altered expressions of testicular KCNJ11/miR-let-7a and spermatozoal CFTR/miR-27a

Male infertility is a global health problem, and the underlying molecular mechanisms are not clearly known. Ion channels and microRNAs (miRNAs), known to function in many vital functions in cells, have been shown to play a significant role in male infertility through changes in their expressions. The study aimed to evaluate the alterations of testicular and/or spermatozoal potassium voltage-gated channel subfamily J member 11 (KCNJ11), Cystic fibrosis transmembrane conductance regulator (CFTR), miR-let-7a and miR-27a expressions in carbamazepine-related male infertility. Here, we showed that carbamazepine reduced sperm motility, increased abnormal sperm morphology, and impaired hormonal balance as well as increased relative testis weight and decreased relative seminal vesicle weight. On the other hand, downregulated KCNJ11 and upregulated miR-let-7a expressions were determined in testis (p < .05). Also, downregulated KCNJ11 and upregulated CFTR and miR-27a expressions were found in spermatozoa (p < .05). Interestingly, altered testicular KCNJ11 and miR-let-7a expressions were correlated with decreased sperm motility and elevated sperm tail defect. Besides, spermatozoal CFTR and miR-27a expressions positively correlated with sperm tail defects. The results indicated a significant relationship between ion channel and/or miRNA expression alterations and impaired sperm parameters due to carbamazepine usage.     

Is ‘Omega Sign’ anatomical endoscopic enucleation of the prostate technique reproducible?

We aimed to evaluate the learning curve of the surgically standardised ‘Omega Sign’ anatomical endoscopic enucleation (AEEP) of the prostate surgery technique for junior surgeons. This study is a retrospective comparison of cases that underwent AEEP by a mentor surgeon and three junior surgeons who have completed their learning curve. A video-based laser enucleation of the prostate assessment tool (LEAT) composed of 8 steps of the technique was used to assess a senior surgeon and junior surgeons’ surgical compatibility and consistency. The surgeon who defined Omega Sign technique was determined as group 1, and cases by three junior surgeons were identified as group 2. The end points were to assess the reproducibility and repeatability and operative post-operative outcomes of the technique. 55 patients’ videos were rated by five experienced endourologists. There was no significant difference in LEAT scores between the groups among all steps. The most symmetry was found in the 1st and 3rd steps. Inter-rater consistency was also high for each step, with no statistically significant difference between the evaluators. The standardised anatomical ‘Omega Sign’ technique is reproducible for the junior surgeons. The operative steps can be performed with high consistency, and the functional and perioperative outcomes are comparable with the senior surgeon.     

Reconnecting with relational values in highly conflicted separating couples: A narrative therapy-informed relational interviewing teamwork-based supervision approach

This article outlines a new supervision practice of narrative therapy-informed reflecting team-based relational interviewing for a high-conflict stuck case of a separated middle-aged couple. The article demonstrates the supervision method consisting in five parts. First, the supervisor interviews the couples' relationship while the team watches from behind the one-way mirror. Second, the team responds to the interview while the couple and the supervisor witness their conversation. The couple is then invited to respond back to the team. Furthermore, there is a meta-conversation about the supervision in collaboration with the couple. The intervention ends with therapeutic letter writing to the relationship. The couple showed a meaningful shift in their positioning towards a more relational awareness and found valuable ways for continuing their therapy. The theoretical elements of the approach underpinning practice to tackle high conflict are considered through the illustration of the case.