The role of diagnostic radiology in pancreatitis

Acute pancreatitis is a frequent inflammatory and necrotic process of pancreas and peripancreatic field. To detect the presence of infected or sterile necrotic components and hemorrhage of the pancreatic paranchyma is important for therapeutic approach. Chronic pancreatitis is characterized by irreversible exocrine dysfunction, progressive loss of pancreatic tissue and morphological changes of the pancreatic canal. Imaging modalities play a primary role in the management of both acute and cronic pancreatitis. CT and MR imaging confirm the diagnosis and detect the severity of disease. In chronic pancreatitis, MRCP after Secretin administration, Spiral CT and endoscopic US seems to replace diagnostic ERCP. However differentiation of pseudotumor of chronic pancreatitis from the pancreatic carcinoma is difficult with either imaging modalities.     

The effect of skin expansion on acellular dermis in an experimental model

Objective: Although acellular dermis is widely used in prosthesis-based breast reconstruction, there is no study evaluating its expandability and histological, ultra-structural related changes. The purpose of this study is to determine whether acellular dermis could be expanded and whether the histological changes occurring in the skin with tissue expansion is different from normal when acellular dermis is used.

Methods: Twenty-two male Wistar rats were used in this study. In group 1 (n?=?6), a rectangular-shaped tissue expander with final volume of 35?ml was placed subcutaneously. In group 2 (n?=?6) tissue expander was placed submuscularly. In group 3 (n?=?6), a 4?×?5?cm, acellular dermis was inserted and sutured in place, tissue expander was placed underneath acellular dermis. Group 4 (n?=?4) was control, no procedure was done after creation of a pocket. After day 30, tissue expanders were inflated with 2?ml every 2 days with saline solution. On day 66, midvertical, midhorizontal surface expansion measurements were recorded. Samples were examined macroscopically. Biopsies were taken from mid-point of the expanded full-thickness flap. Histological evaluation, total skin thickness, epidermal thickness, and the amount of vascularisation were measured.

Results: There was no expansion noted on the acellular dermis; however, acellular dermis increased vascularity and decreased the thinning of the overlying skin and thickening of the epidermis when compared to other groups.

Conclusion: Acellular dermis use can be beneficial in implant-based breast reconstruction in terms of morbidity and its tissue support.     

Ginkgo biloba (EGb 761) usage attenuates testicular injury induced by testicular ischemia/reperfusion in rats

Introduction  We investigated the effect of ginkgo biloba on testicular ischemia-reperfusion (IR) injury. Materials and methods  Thirty-two Wistar Albino rats were randomly assigned into four groups. Torsion/detorsion (T/D) performed to the rats in group 1, group 2 received ginkgo biloba (50 mg/day) for a month before T/D, group 3 received only gingko biloba (50 mg/day) for a month and group 4 was defined as sham group. After 1 month the testes were removed. Results  Mean testicular malondialdehyde, nitrate and nitrite levels were significantly increased in group 1 compared to groups 2, 3 and 4 (P < 0.05). The rats in group 3 provided basal histological appearance. In group 1, edema, congestion and hemorrhage between seminiferous tubules were predominant. In group 2, histopathologic features were markedly less than group 1. Conclusions  Malondialdehyde, nitrate and nitrite levels were increased after unilateral testicular torsion. EGb 761 has a protective effect on testicular injury induced by IR.     

Catalase and alpha-tocopherol attenuate blood-brain barrier breakdown in pentylenetetrazole-induced epileptic seizures in acute hyperglycaemic rats.

Experimental data indicate that acute hyperglycaemia can aggravate the consequences of epileptic seizures on the permeability of the blood-brain barrier (BBB). The purpose of this study was to examine the effects of chronic administration of alpha -tocopherol (vitamin E) and acute catalase administration on the disrupted BBB during experimentally pentylenetetrazole-induced status epilepticus in acute hyperglycaemic rats. The integrity of the BBB was tested using the Evans Blue (EB) dye extravasation. The concentration of EB dye was measured in four regions of the brain. Epileptic seizures induced a significant increase in EB dye extravasation in the brain regions compared with that of the groups of rats treated with saline, glucose, catalase and alpha -tocopherol (P< 0.01). The content of EB dye in the brain regions of animals in the acute hyperglycaemia plus epileptic group was higher than that of the saline, glucose, catalase, alpha -tocopherol and epileptic groups (P< 0.01). The increased EB dye transfer from blood to the brain in status epilepticus and acute hyperglycaemia plus status epilepticus was attenuated by the treatment with catalase and alpha -tocopherol. These data suggest that a partial reduction in the production of reactive oxygen species by catalase and alpha -tocopherol contributes to decreases in the content of EB dye across the BBB during pentylenetetrazole-induced status epilepticus in acute hyperglycaemic rats.     

Expression of growth factors in fetal human olfactory mucosa during development

The olfactory epithelium is one of the unique sites in the mammalian nervous system at which there is continual neurogenesis. Constant turnover of primary sensory neurons in the periphery results in remodeling of neuronal circuits and synapses in the olfactory bulb throughout life. Most of the specific mechanisms and factors that control this process are still unknown. Recent studies suggest that growth factors and their receptors may play a significant role in the development and continuous regeneration of olfactory neurons. In this study, standard immunohistochemical methods were used to detect the presence of epidermal growth factor-receptor, transforming growth factor-alpha and nerve growth factor-beta in the human olfactory epithelium of different developmental stages (7 to 30 weeks) in formalin-fixed tissue specimens. Immunoreactivity to epidermal growth factor-receptor was seen in basal cells, supporting cells, neurons, apical cytoplasmic region of olfactory epithelium, lamina propria and gland's cell cytoplasm. Similarly transforming growth factor-alpha immunoreactivity was recognized in basal cells, supporting cells, apical cytoplasmic region of olfactory epithelium, lamina propria and gland's cell cytoplasm but not in neurons. Nerve growth factor-beta detection was restricted on olfactory nerve cells, dentritic knob and basal cell layer. So, this study confirms the development of human olfactory mucosa and shows epidermal growth factor-receptor, transforming growth factor-alpha and nerve growth factor-beta proteins are reliable markers for developing olfactory epithelium.     

The use of liposomal enrofloxacin for intracellular infections in Kangal dogs and visualization of phagocytosis of liposomes

It is difficult to treat intracellular infections because of the intrinsic resistance of the microorganism to most antibiotics. Moreover, these microorganisms can survive in phagocytic cells (macrophages and neutrophils). In this study, our aims were to encapsulate an antibiotic in liposomes, which will be phagocytized as well as the microorganisms in the phagocytic cell (because liposomes were prepared using lipids which have an antigenic activity and they can be phagocytized, thus, the active substance can be transferred into the cell), and to visualise with microscopy the phagocytic activity of macrophages and neutrophils to liposomes. MLV (multilamellar vesicles) fluorescein-labeled liposomes were prepared and incubated with isolated Kangal shepherd dog macrophages and neutrophils. The phagocytosis of liposomes by monocytes was visualized step by step under the microscope. Liposomes were also observed phagocytized after incubation with neutrophils. Enrofloxacin was chosen as a model drug. Neutrophils and macrophages were isolated from Kangal shepherd dogs and infected with Staphylococcus aureus, and their phagocytic activities (PA) and microbicidal activities (MA) were determined. PA and MA values were redetermined and compared when enrofloxacin formulations were used. Liposomal enrofloxacin was found to be more effective.     

Enhanced coagulation activation by in vitro lipopolysaccharide challenge in patients with ventricular fibrillation complicating acute myocardial infarction

BACKGROUND: Indicators of coagulation and inflammation are elevated in patients with coronary heart disease. A role of coagulation activation in ventricular fibrillation during acute myocardial infarction has not been described. METHODS AND RESULTS: Whole blood samples of 21 patients with a history of acute myocardial infarction complicated by ventricular fibrillation and whole blood samples of 18 patients without ventricular fibrillation were incubated with lipopolysaccharide (LPS). In both groups, the in vitro blood coagulation time was measured with the ReoRox, a viscometric whole blood coagulometer. CD62P expression on platelets, tissue-factor binding on monocytes, and platelet-monocyte aggregates were measured with flow cytometry. Without LPS, no difference in the coagulation times were observed in both patient groups. After incubation with LPS, patients with a history of ventricular fibrillation showed a significantly decreased coagulation time compared to patients without ventricular fibrillation. The decrease of coagulation time after incubation with LPS also differed significantly in both groups. Expression of CD62P on platelets was significantly higher in patients with a history of ventricular fibrillation after incubation with LPS. Although in each patient group incubation with LPS induced a significantly increased amount of tissue factor on monocytes and a significantly increased the number of platelet-monocyte aggregates, the two groups did not differ significantly concerning tissue factor binding on monocytes and the amount of platelet-monocyte aggregates. CONCLUSIONS: After in vitro LPS challenge, patients with a history of ventricular fibrillation during myocardial infarction show an enhanced coagulation activation, which may partly be due to an enhanced platelet activation.     

Usefulness of pulsed-wave tissue Doppler echocardiography for the assessment of the left and right ventricular function in patients with clinical hypothyroidism

Clinical hypothyroidism (HT) is often associated with cardiovascular disorders, such as endothelial and myocardial dysfunction. Previous studies have explored left ventricular (LV) function using pulsed-wave tissue Doppler echocardiography (TDE) in HT. However, no study has utilized this technique in the assessment of right ventricular (RV) function in HT. Accordingly, we investigated the effects of clinical HT on LV and RV function by TDE. The study subjects included 35 newly diagnosed HT patients and 32 healthy normal controls. For each subject, serum FT3, FT4, TT3, TT4, and thyroid stimulating hormone (TSH) levels were measured, and standard echocardiography and TDE were performed. No statistically significant difference was found between patients and controls with regard to age, gender, body mass index, heart rate, and blood pressure. Compared to controls, TSH levels were significantly higher, and TT4 and FT4 levels were significantly lower. TDE showed that patients had significantly lower early diastolic tricuspid annular velocity (Ea) and early/late (Ea/Aa) diastolic tricuspid annular velocity ratio (P < 0.001 and P < 0.001, respectively), and significantly longer isovolumetric relaxation time (P < 0.001) than those of the controls. Aa, Sa, isovolumetric contraction time, and ejection time did not significantly differ. In addition, a significant relationship between some TDE indexes, and thyroid hormones (TT4 and FT4) and TSH was observed. We showed that patients with clinical HT are associated with impaired RV diastolic function, in addition to impaired LV diastolic function using TDE.     

Cutaneous manifestations of COVID‐19: A review of the published literature

COVID‐19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID‐19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020. The infection has been reported to demonstrate different types of cutaneous manifestations including urticarial, maculopapular, papulovesicular, purpuric, livedoid, and thrombotic‐ischemic lesions. Given the high mortality rate of the infection, timely and accurate identification of relevant cutaneous manifestations may play a key role in the early diagnosis and management. In this study, we provide a review with a focus on the reported cutaneous manifestations of COVID‐19.