Epidural ropivacaine versus ropivacaine plus tramadol in postoperative analgesia in children undergoing major abdominal surgery: a comparison

Purpose  

In this study, we aimed to compare the effects of ropivacaine alone and ropivacaine plus tramadol administered epidurally for postoperative analgesia in children.     

Curcumin ameliorates impaired insulin/IGF signalling and memory deficit in a streptozotocin-treated rat model

Increased serum insulin levels and reduced peripheral insulin activities seen in insulin resistance syndrome are associated with age-dependent cognitive impairment and Sporadic Alzheimer’s Disease (SAD), suggesting a disturbance in the insulin signalling system in the brain and possibly being one of the causes of dementia. Therefore, the streptozotocin (STZ)-induced animal may be an appropriate model for the investigation of SAD and related dementia. This study was designed to investigate the beneficial effect of Curcumin (CUR), a neuroprotective agent, on intracerebroventricular (ICV) STZ-induced cognitive impairment in rats. For this purpose, adult male Wistar rats were bilaterally ICV injected with STZ (3 mg/kg). An artificial cerebrospinal fluid (aCSF) was given to the control group (SHAM) instead of STZ on days 1 and 3. Learning and memory performance were assessed using the “passive avoidance task” and the “Morris water maze test”. After confirmation of acquisition impairment with these tests, the STZ group was divided into two subgroups: STZ + vehicle (Vh) and STZ + CUR. The rats in the SHAM and STZ + Vh groups were administered intraperitoneally with 0.5 ml Vh and the rats in the STZ + CUR group were treated intraperitoneally with CUR (300 mg kg⁻¹ day⁻¹ in Vh) for 10 days starting from the 25th day after STZ injection. The Morris water maze test was reapplied on the 35th day after STZ injection and all of the rats were sacrificed on day 36 for quantitation of IGF-1 and for histopathological evaluation. Rats in the STZ + CUR group were found to have a higher performance in cognitive tests than rats in the STZ + Vh group (P < 0.01). In parallel with the cognitive tests, IGF-1 levels were decreased in all of the STZ-injected groups (1.78 ± 0.34) compared to the SHAM group (3.46 ± 0.41). In contrast, CUR treatment significantly increased IGF-1 levels (P < 0.001). The degree of neuronal loss decreased after CUR treatment compared to the SHAM group (P < 0.02). These results clearly indicate that CUR treatment is effective in reducing the cognitive impairment caused by STZ in rats, and may be a potential therapeutic agent for altering neurodegeneration in SAD.     

Aromatase cytochrome P450 enzyme expression in prolactinomas and its relationship to tumor behavior

The aim of the study was to evaluate the presence of aromatase cytochrome P450 enzyme (P450AROM) expression in normal pituitary tissues and tumor tissues of patients with prolactinoma and to examine the impact of the P450AROM expression on clinical outcome. Twenty-six consecutive human pituitary tissue samples were obtained from autopsies performed at the Institute of Forensic Medicine. Sixty-four patients who had an adenomectomy between 2000 and 2009 after prolactinoma diagnosis with histologically confirmed pituitary tumor tissues were retrospectively included in this study. The slices from the pituitary tissues were subjected to immunohistochemical staining for evaluation of P450AROM and estrogen receptor beta (ER beta) subunit. Immunohistochemistry results were compared according to age, gender, remission rate, resistance and invasion status of the patients. Higher than normal P450AROM expression was found in the pituitary tissues of the patients with prolactinoma (p < 0.001). P450AROM intensity had no relation to resistance or remission in patients with prolactinoma (p = 0.44, p = 0.45, respectively). The subgroup analysis showed that compared to males without invasive adenoma, males with invasive adenoma had higher P450AROM expression (p = 0.048). ER beta was found to have an impact on resistance (p = 0.049). This study shows that P450AROM expression is present in the pituitary tissues of patients with prolactinoma and that this presence could be important in development and tumor behavior of prolactinomas.     

Juvenile subcorneal pustular dermatosis: a case report

Subcorneal pustular dermatosis is a chronic, relapsing, pustular dermatosis that usually develops in elderly women. It is rarely seen in childhood and adolescence. The hallmark of the disease is formation of a subcorneal pustule detected on histopathologic examination. Herein we present a 13-year-old girl diagnosed with subcorneal pustular dermatosis based on the typical clinical and histologic findings. Direct and indirect immunofluorescence and serum protein electrophoresis had negative results. The patient partially recovered after 5 weeks of treatment consisting of oral dapsone and a topical steroid ointment.     

Vertical growth changes after adenoidectomy

The purpose of this retrospective investigation is to compare vertical growth component of craniofacial structure of subjects with early and late adenoidectomy history. The study consisted of 93 lateral cephalometric radiographs of three groups of randomly selected patients. The first group was made up of 12 patients (10 male and two female) with an average age of 11.16 +/- 2.08 years, who had been operated upon between 1.5-4 years of age. The second group was made up of 54 patients (25 maleand 29 female) with an average age of 12.18 +/- 2.6 years, who had been operated upon after four years of age. The third group of 27 patients (7 male and 20 female) with clear airway with an average age of 11.18 +/- 2.35 years was used as the control. The data obtained from two adenoidectomy groups were compared and because no statistically significant difference was found except for ANSMe/NMe, the two groups were pooled and compared with the growth pattern in the control sample. There were statistically significant differences in the following parameters: SNGoMe, PPGoMe angle, Gonial angle, Gonial ratio, sigma of inner angles, ANSMe/NMe ratio, Jarabak ratio, PNS-adl distance, PNS-ad2 distance, OAW1 distance. When compared with the control group, the adenoidectomy group showed a more vertically directed growth pattern, however, there were no vertical growth pattern differences between the two groups of children who had adenoidectomy before and after four years of age.     

Selective management of high risk patients with an ascending aortic dilatation during aortic valve replacement

BACKGROUND: The ascending aortic dilatation secondary to aortic valve disease may be a risk for rupture or dissection unless it is not corrected with a graft replacement during valve surgery. This additional procedure requires prolonged operation time that can be harmful for the critical patient. External reinforcement of diseased aorta is an old but simple method with debated long term results, providing brief duration and lower complication rate of the aneurysm operation for critically ill patients whose life expectancy is poor. METHODS: Twenty-two patients underwent aortic valve replacement and external aortic wrapping procedure in our clinic. All of the patients had severe associated risk factors to complicate the classical aortic graft replacement procedure. In this prospective clinical study, the follow-up period of the patients is 79.91 patient-years. RESULTS: There was no operative mortality. The average hospital stay was 8.6+/-2.6 days. There was no late death or cardiac morbidity. All of the patients were in NYHA Class 1 at postoperative 3rd month and thereafter. In CT scans the mean preoperative ascending aortic diameter was 5.12+/-0.38 cm while the mean diameter at 3rd month postoperatively was 3.19+/-0.25 cm. The reduction in diameter showed a significant difference (p<0.0001). The time related changes in luminal diameters showed some enlargement within the first year of the operation (p=0.03) that remained the same thereafter. CONCLUSIONS: The early results and 4 years follow-up suggest that the technique can be regarded as safe and effective in selected high risk patients.     

In vitro immunomodulatory activity of verbascoside from Nepeta ucrainica L

Nepeta ucrainica L. is used as a herbal tea in Kazakhistan. Phytochemical investigations of the aerial parts of the plant resulted in the isolation of verbascoside (1) and 1,5,9-epi-deoxyloganic acid (2). The structures of the compounds were elucidated by spectral (UV, IR, (1)H-NMR and (13)C-NMR) methods and HPLC analysis. The in vitro immunomodulatory activity of verbascoside was investigated by assessing neutrophil function; chemotaxis and intracellular killing activity. Verbascoside showed an increased chemotactic activity in all doses applied compared with the medium used as a negative control and had a positive effect on respiratory burst of neutrophils, but there was an opposite effect with increasing doses, pointing to a possible suppression of neutrophil intracellular killing activity.