Can impairments of thyroid function test affect prognosis in patients with respiratory failure?

Thyroid function test (TFT) impairments can be detected in extrathyroidal dysfunction, primarily in chronic obstructive pulmonary disease (COPD) with acute respiratory failure (RF). The aims of this study were to: (i) evaluate TFT impairments in patients with RF, (ii) compare TFT results to a control group without RF and (iii) assess the effects of thyroid dysfunction on clinical outcome and prognosis of RF. The TFT parameters were assessed in 65 patients (65.0 +/- 10.0 years, 49 males) with RF and compared to 18 patients (64.4 +/- 9.8 years, 13 males) with lung disease and no RF (p> 0.05). Arterial blood gas analysis, free T3 (FT3), free T4 (FT4) and TSH levels were all measured. The impairments of TFT were demonstrated in 34 (52.3%) patients with RF and 8 (44.4%) patients without RF (p> 0.05). The most common finding was a decrease in at least one of the TFT parameters in both groups (43.1% vs. 44.4%, respectively). In RF group, there was no significant association between TFT results and gender, age, diagnosis and co-morbid disease. However, need for invasive mechanical ventilation was higher both in patients with low FT3 and low FT4 when compared to those with normal TFT results (p= 0.001 and p= 0.003, respectively). In-hospital mortality rate was also higher both in the patients with low FT3 and low FT4 than the others (p= 0.006 and p= 0.01, respectively). We conclude that TFT impairments are not observed more frequently in patients with RF when compared to the patients without RF. However, low FT3 and FT4 levels increase the rates of invasive mechanical ventilation and mortality.     

Ventricular septal rupture and mitral regurgitation caused by trauma

We present a young patient with traumatic septal rupture following traffic accident in whom transthoracic echocardiography allowed comprehensive noninvasive assessment of location and size of the septal defect and structure atrioventricular valve apparatus.     

Removal of clival chordoma in an adolescent thorough combned pterional transsylvian and anterior temporal approach

Extensive and aggressive surgical removal is treatment of choice for patients who have chordomas of the cranial base. Well-developed microsurgical techniques, as well as good surgical judgment learned from experience are essential to avoid major morbidity. A 14-year-old female presented with progressive headaches and diplopia for three months. Cranial magnetic resonance imaging demonstrated a well-circumscribed mass in the clival region. The mass was totally excised via right combined pterional transsylvian and anterior temporal approach (+ orbitozygomatic osteotomy). The tumor was located extradurally. The resected tumor had the typical histological and immunohistochemical characteristics of chordoma. No radiation therapy or chemotherapy was administered.     

Management of a retained catheter in an arteriovenous malformation. Case report

The long-term effects of retained catheters in patients are not well known; therefore, the clinical presentation may differ. The authors present the case of a 21-year-old man with a pseudoaneurysm of the left common femoral artery, which developed 3 months after a transfemoral microcatheter embolization of a cerebral arteriovenous malformation (AVM) in which the catheter was inadvertently glued into the AVM and was retained at the groin.     

Antioxidant responses and metal accumulation in tissues of Nile tilapia Oreochromis niloticus under Zn,Cd and Zn + Cd exposures

We investigated the effects of Zn, Cd and a Zn + Cd mixture on antioxidant parameters and metal accumulation in Oreochromis niloticus. Fish were exposed to 0.5 and 5.0 mg l^?1 Zn, 0.1 and 1.0 mg l^?1 Cd, and 0.5 mg l^?1 Zn + 0.1 mg l^?1 Cd and 5.0 mg l^?1 Zn + 1.0 mg l^?1 Cd mixtures for 7 and 28 days to determine Zn and Cd accumulation, reduced glutathione (GSH) level and glucose‐6‐phosphate dehydrogenase (G6PD) activity in gill and liver. There was increasing accumulation of the metals in the tissues with increasing concentrations of metals in the exposure medium and with increasing duration of exposure (except at the lower concentration of Zn). Concentration of metals in the tissues of fish exposed to the Zn + Cd combination were significantly lower than in fish exposed to the single metal. The highest metal accumulation was observed in the liver. Exposure to the heavy metals affected the antioxidant parameters in the tissues, with both GSH level and G6PD activity in the gill and liver being increased under Zn, Cd and Zn + Cd exposures, especially in their higher concentrations. These increases in the antioxidant responses were higher with the Cd alone, and in combination with Zn, than with Zn alone. Furthermore, GSH level and G6PD activity increased with increasing exposure period only for Cd alone, and in Cd combination with Zn. The results indicate that O. niloticus resisted oxidative stress induced by heavy metal exposure by antioxidant mechanisms. Copyright © 2008 John Wiley & Sons, Ltd.     

Increased myocardial collagen turnover in patients with progressive cardiac conduction disease

Background: Histopathologically, progressive cardiac conduction disease (PCCD) is characterized by progressive fibrosis and sclerodegenerative changes in the proximal and distal conduction system of the heart. Therefore, we sought to determine the serum levels of myocardial collagen turnover markers, extracellular matrix components, transforming growth factor β₁ (TGFβ₁), and bone morphogenic protein‐7 (BMP‐7) in this population. Methods: Study population included 20 patients (6 M/14 F, mean age 76 ± 8 years) with acquired, permanent 2:1, or complete atrioventricular block and compared with age‐ and sex‐matched, asymptomatic, healthy control subjects (n = 18, 6 M/12 F, mean age 75 ± 7 years). Serum myocardial collagen turnover markers:matrix metalloproteinases (MMP‐1, 2, 9), tissue inhibitor of matrix metalloproteinase (TIMP‐1), amino‐terminal propeptide of procollagen type I (PINP) and type III (PIIINP), carboxy‐terminal telopeptide of collagen type I (CITP), and carboxy‐terminal propeptide of procollagen type I (PICP), serum extracellular matrix components (laminin and fibronectin), TGFβ₁, and BMP‐7 levels were measured in both groups. Results: Serum PICP (849 ± 396 vs 631 ± 294 ng/mL, P = 0.04), PIIINP (3.7 ± 1.3 vs 3 ± 1 μg/L, P = 0.03), CITP (0.68 ± 0.35 vs 0.48 ± 0.25 ng/mL, P = 0.037), and plasma MMP‐9 (58.8 ± 56 vs 25.9 ± 17.3 ng/mL, P = 0.006) levels were higher in patient population compared to control subjects. Serum MMP‐1 (24.1 ± 20.5 vs 13.6 ± 7.5 ng/mL, P = 0.045) and MMP‐2 (1310 ± 139 vs 1186 ± 163 ng/mL, P = 0.01) levels were higher in control subjects compared to patient population. There was no difference in serum TIMP‐1, PINP, laminin, fibronectin, TGFβ₁, and BMP‐7 levels between two groups. Conclusion: Our findings demonstrate the presence of increased myocardial collagen turnover and active fibrotic process in patients with PCCD compared to control subjects.     

Is microRNA 1910-3p (miR-1910-3p) a really distinctive marker for psoriasis?

Background/aimAlthough the cause of immune activation in the pathogenesis of psoriasis is still unclear, miRs are thought to have an effect on psoriasis. This work aimed to evaluate the role of miRs (miR-4649-3p, miR-6867-5p, miR-4296, miR-210, and miR-1910-3p) that target the FOXP3 mRNA and IL-17A mRNA in psoriasis. Materials and methods Forty-four psoriasis patients and 44 healthy controls were included in the study. Quantitative real-time PCR (qRT-PCR) was used for the measurement of miRs. Serum IL-17A levels were determined by an enzyme-linked immunosorbent assay (ELISA) method. Results Plasma miR-1910-3p levels were significantly lower in the patient group than the controls (P = 0.000, fc: 0.10). ROC analysis showed that plasma miR-1910-3p levels could significantly differentiate psoriasis patients from healthy controls [AUC = 0.912 (0.848–0.975), P = 0.000]. The plasma miR-4649-3p level was significantly higher in the psoriasis group compared to the controls (P = 0.000, fc: 2.99). Conclusion Decreased expression of miR-1910-3p increases the risk of developing psoriasis by approximately 50-fold and was able to use for the significant differentiation of psoriatic patients from healthy controls.     

Poly (ADP-ribose) polymerase as a potential target for the treatment of acute renal injury caused by lipopolysaccharide

Recent studies have clearly reported that there is a relationship between endotoxemia and acute renal injury. The aim of this study was to investigate whether treatment with the new potent PARP inhibitor PJ34 could prevent the acute renal injury induced by lipopolysaccharide (LPS). Endotoxemia was induced by LPS injection (10 mg/kg, i.v.). LPS increased blood urea nitrogen (BUN) levels from 22 +/- 0.54 mg/dL to 45.7 +/- 5.79 mg/dL (p < 0.05). The plasma creatinine levels were 0.38 +/- 0.02 mg/dL and 0.47 +/- 0.03 mg/dL for the control and LPS groups, respectively. In addition, urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG, a marker of renal tubular damage) was increased after LPS injection. By light microscopy, structural renal damage was observed in the LPS-treated group. However, PJ34 treatment (10 mg/kg, i.p.) attenuated LPS-induced renal injury, as indicated by plasma BUN and creatinine levels, urinary NAG excretion, and renal histology. These results indicated that the overactivation of the PARP pathway may have a role in LPS-induced renal impairment. Hence, pharmacological inhibition of this pathway might be an effective intervention to prevent endotoxin-induced acute renal injury.     

An atypically localized atrial myxoma: a case report

Atypical cardiac myxomas are rare occurrences and may present with a variety of clinical manifestations depending on the location and morphology. A 46-year-old woman had a 4 x 3 x 2-cm myxoma originating from the superior wall of the left atrium, found by echocardiography and multislice tomography. The tumor was successfully treated by surgical excision. The resected tumor was a well-defined encapsulated mass with a narrow-base stalk originating from the right wall of the left atrium in between the right upper and lower pulmonary vein. The patient recovered without complication and was discharged 6 days after the operation. At 1-year follow-up, echocardiography revealed normal cardiac function without reccurence in terms of mass. Although up to 80% of myxomas are localized in the left atrium, of which 75% involve in the interatrial septum, it should not be forgotten that myxomas can appear in an atypical localization, as occurred in our case.