Effects of ischemia-reperfusion on NMDA receptor subunits 2a and 2b level in rat hippocampus

The authors investigated the effects of ischemia and reperfusion on the N-methyl-D-aspartate receptor (NMDAR) subunits 2A and 2B concentration in rat hippocampus. At the protein level, significant increase in the amounts of NMDAR 2A and NMIDAR 2B in the rat hippocampus was observed at 1 h after reperfusion compared with control group. These results suggested that the alteration in hippocampal NMDAR2 subunit concentrations after ischemia-reperfusion might be invovlved in cognitive dysfunction and excitotoxicity.     

Supracricoid partial laryngectomy with cricohyoidopexy and cricohyoidoepiglottopexy: functional and oncological results

Sixty-eight patients who presented with glottic and glottosupraglottic squamous cell carcinoma and who were managed in this department with supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP), were retrospectively reviewed. The authors analysed the functional and oncological results of the patients. The median follow-up period was 62 months. The average times until decannulation and nasogastric feeding tube removal were 27.7 and 26.4 days, respectively. All patients were successfully decannulated. All patients were able to swallow, but one patient was unable to swallow and had recurrent aspiration. Better functional results were achieved in patients managed with CHEP procedure than the patients managed with CHP procedure. The five-year absolute and cause-specific actuarial survival rates (Kaplan-Meier method) were 78.6 per cent and 93.9 per cent, respectively. The five-year actuarial local control and nodal control rates were 89.5 per cent and 90.4 per cent, respectively. Local recurrence was statistically more likely in patients with positive resection margins (p <0.006). Overall, local control and laryngeal preservation were achieved in 95.6 per cent and 89.7 per cent, respectively. Supracricoid partial laryngectomy procedures (CHEP and CHP) are possible alternatives to total laryngectomy in the treatment of selected advanced glottic and glottosupraglottic carcinomas.     

Can endoscopic injection of epinephrine prevent surgery in gastroduodenal ulcer bleeding? An analysis of 107 cases

BACKGROUND: Gastroduodenal ulcers are still a common cause of severe upper gastrointestinal bleeding. Endoscopy has gained popularity worldwide over conventional open surgery for the treatment of upper gastrointestinal bleeding. This study aims to assess the efficacy of endoscopic injection of epinephrine in the treatment of gastroduodenal ulcer bleeding. METHODS: This study was conducted between March 2000 and March 2003. We analyzed 107 consecutive patients admitted to our department of trauma and emergency surgery with upper gastrointestinal bleeding. Endoscopy was performed on all 107 patients and bleeding ulcers were treated with injection of diluted epinephrine. RESULTS: Recurrent bleeding was seen in 21 patients (19.6%), all of whom underwent a second endoscopy. Four patients (3.7%) required a third endoscopy session and nine patients (8.5%) needed surgery after endoscopy failed. There were two mortalities (1.9%). The nine patients who required surgery and the two patients who died were all in the Forrest Ia and Ib groups of acute UGI hemorrhage. DISCUSSION: Endoscopic injection therapy with epinephrine reduces operation rates and can be used safely in adequate hemostasis of gastroduodenal ulcers.     

Effect of middle ear effusion on distortion product otoacoustic emission

OBJECTIVES: It is well documented that children, particularly between the ages of about 2 and 6 years, exhibit a high prevalence and incidence of otitis media. Distortion product otoacoustic emissions (DPOAEs) offer great potential for clinical testing of cochlear function in children. The aim of the present study was to determine the influence of middle ear effusion and physical properties of the effusion on the recording of DPOAE. METHODS: Nineteen children (38 ears) undergoing myringotomy and/or tympanostomy tube insertion for secretory otitis media were studied. Pre-operative and post-operative first day DPOAE signal to noise ratios were compared. The results were analyzed by paired samples test and ANOVA statistical methods. RESULTS: We were found significant differences between pre-operative and post-operative first day DPOAE signal to noise at 1, 1.5, 2 and 4kHz. In addition, comparison of the pre-operative DPOAE signal to noise ratio and per-operative middle ear findings are shown significant differences between glue (thick mucous) and the other three groups (mucous, serous and no-effusion groups) at 2 and 4kHz, and between glue and no effusion group at 8kHz. Also post-operative DPOAE signal to noise ratio in relation to per-operative middle ear findings were significantly different at 2, 4 and 8kHz. The most increase of emissions at the post-operative first day was seen in ears with glue effusion at 1 and 2kHz. CONCLUSIONS: Otitis media with effusion can be monitored by DPOAE measurement pre-operatively and post-operatively. In the pre-operative evaluation, glue effusion may cause a reduction in the emissions at 2, 4 and 8kHz more than the other kind effusions.     

Nitric oxide levels of aqueous humor after photorefractive keratectomy

PURPOSE: To measure the nitric oxide (NO) levels of aqueous humor in rabbits after photorefractive keratectomy (PRK) and to evaluate the alterations of NO levels according to the PRK surgery steps, ablation depth, and time. METHODS: Fifty eyes of 25 New Zealand white rabbits were included in the study. One eye was later randomly excluded from the study in order to equalize the number of eyes in groups. Eyes were divided into seven groups, each comprising seven eyes: unwounded control (Group 1), epithelial scrape (Group 2; aqueous humor samples taken at the 4th hour), superficial PRK (Group 3; samples taken at the 4th hour), deep PRK (Group 4; samples taken at the 4th hour), epithelial scrape (Group 5; samples taken at the 24th hour), superficial PRK (Group 6; samples taken at the 24th hour), and deep PRK (Group 7; samples taken at the 24th hour). The corneal epithelium was mechanically removed in surgical groups. The authors performed superficial corneal ablation (59 microm) in Groups 3 and 6 and deep corneal ablation (99 microm) in Groups 4 and 7. Aqueous humor samples were taken at the 4th hour (Groups 2-4) or 24th hour (Groups 5-7) after corneal surgeries. NO measurements were performed indirectly by using the Griess reaction with a spectrophotometer. RESULTS: Aqueous humor NO levels 4 hours after corneal surgery were statistically significantly lower than the control group (p<0.05). However, there was no difference among the surgical groups at the 4th hour (p>0.05). At the 24th hour, the deep PRK group had significantly lower NO levels than both the control group and Groups 5 and 6 (p<0.05). NO levels were normalized at the 24th hour in epithelial scrape and superficial PRK groups (p>0.05) but remained stable at lower levels in deep PRK groups (p<0.05). CONCLUSIONS: Corneal surgery caused low NO levels in aqueous humor 4 hours after surgery. However, 24 hours after surgery, NO levels normalized following epithelial scrape and superficial PRK and were stable at lower levels in the deep PRK group. Complications of deep PRK application are possibly induced by low NO existence in the aqueous humor.     

Maternal erythrocyte malondialdehyde level in preeclampsia prediction: a longitudinal study

We aimed to determine the value of maternal erythrocyte malondialdehyde levels in the prediction of preeclampsia. 110 healthy women were included in this prospective study. Maternal erythrocyte malondialdehyde levels were measured at each trimester of pregnancy (10-14, 20-25 and 30-35 gestational weeks). On follow-up, patients were assigned to two groups as normotensive women and preeclamptic patients. Preeclampsia had developed in eight (8.9%) of the 90 pregnant women who completed the study. Preeclamptic patients were diagnosed between 36 and 39 gestational weeks (36.8 +/- 1.0 weeks). Malondialdehyde levels of preeclamptic patients increased significantly in the third trimester (p < 0.05), while there was no difference between values of malondialdehyde in the first and second trimester. Malondialdehyde levels were significantly higher in the patients who developed preeclampsia than in those who did not in the third trimester (p < 0.05). With the use of the receiver operating characteristics (ROC) 35.98 nmol malondialdehyde/gm hemoglobin was found to be a cut-off value predictive for the development of preeclampsia in the third trimester. However, cut-off values in the first and second trimesters could not be found. The sensitivity, specificity, positive and negative predictive values were 89, 75, 29 and 98%, respectively. Preeclampsia risk was found to increase nearly 24 times in values above 35.98 nmol malondialdehyde/ gm hemoglobin. Our results showed that maternal erythrocyte malondialdehyde could predict patients within a few weeks prior to onset of clinical symptoms of preeclampsia in the third trimester. There is no evidence of enhanced early lipid peroxidation in pregnancies with late onset preeclampsia.     

Serum leptin levels are associated with tamoxifen-induced hepatic steatosis

PURPOSE: Tamoxifen, used in breast cancer treatment, may induce hepatic steatosis. It has been suggested that leptin, which has a relationship with body fat stores, may be involved in the pathogenesis of hepatic steatosis. In this study, we compared serum leptin levels in tamoxifen-treated patients with and without hepatic steatosis. METHODS: Thirty-four women with breast cancer receiving tamoxifen were included in the study. Serum samples were obtained from the patients before and 3 months after tamoxifen therapy. RESULTS: Increased hepatic steatosis was detected in 15 of 34 (44%) patients after 3 months of tamoxifen therapy. Serum leptin levels were found to be significantly elevated in patients with increased hepatic steatosis (37.3 +/- 17.7 to 50.5 +/- 22.4 ng/ml, p = 0.023) compared to (48.2 +/- 20.2 to 42.6 +/- 14.9 ng/ml, p > 0.05) after tamoxifen treatment. CONCLUSION: Leptin may play a role in tamoxifen-induced hepatic steatosis. The exact mechanism involved should be investigated in further studies.