Investigation of micronucleus frequencies in lymphocytes of inhabitants environmentally exposed to chrysotile asbestos

Exposure to asbestos minerals has been associated with a wide variety of adverse health effects including lung cancer, pleural mesothelioma, and cancer of other organs. Many of the regions of Turkey have asbestos deposits. People in Do?anl? village – one of these regions – have been environmentally exposed to chrysotile asbestos since they were born. In this study the effects of asbestos on micronucleus (MN) frequencies of inhabitants exposed to chrysotile asbestos have been examined. Thirty subjects who had been environmentally exposed to chrysotile asbestos and living in Do?anl? village, and 25 controls were studied to assess the MN frequency. The control group was selected from healthy individuals with no exposure to asbestos and living in similar geographic conditions to Do?anl? village. Peripheral blood samples were collected from each subject and cultured for MN assay. Cytochalasin-B was added to lymphocyte cultures for evaluation of MN in binucleated (BN) cells. The differences between those exposed to chrysotile asbestos and controls were not statistically significant in terms of BN cells with MN (p > 0.05). There was not a significant relationship between MN frequencies and age, sex, smoking, both in chrysotile asbestos-exposed subjects and in controls (p > 0.05). Although the detection of calcified pleural plaques found in the inhabitants has indicated environmental exposure to chrysotile asbestos, our results show that chrysotile asbestos was not an inducer of MN in subjects exposed to chrysotile asbestos.     

Preliminary report: Effect of cobaltous ion on cerebral vasospasm in a rabbit subarachnoid hemorrhage model

Experimental studies have suggested what the primary role is of free radical products in the development of vasospasm. It has been suggested that the degradation products of hemolysis trigger free radical reactions leading to lipid peroxidation is subarachnoid hemorrhage (SAH). Therefore, Fe²⁺, a degradation product of hemoglobin, seems to be the most important substance in the pathogenesis of vasospasm. Cobaltous ion was shown to be a powerful inhibitor of lipid peroxidation in biological membrane. Eleven rabbits were anesthetized and received 5 ml of autologous arterial blood into the cisterna magna. Group 1 (n=6) received 0.1 mg/kg cobalt solution intratecally via the cisterna magna simultaneously with blood. Group 2 (n =5) underwent sham operation as a control group. Forty-eight hours later the rabbits were deeply anesthetized and the brainstem was quickly removed and put under the operating microscope to measure the basilar artery diameter. Afterwards, the upper part of the brainstem was used for lipid peroxidation measurement and the lower part for the histopathological examination. Significant vasospasm was observed in four and moderate vasospasm in one rabbit of group 2; mild vasospasm was seen in five rabbits and moderate vasospasm was seen in one rabbit of group 1. There was no vasospasm in the control group. A statistically significant increase in the levels of lipid peroxide was found in the brainstem of group 2. These data demonstrate that cobaltous ion represents a promising therapeutic tool in vasospasm after SAH.     

Neuroprotective effects of racemic ketamine and (S)-ketamine on spinal cord injury in rat

BackgroundThe aim of this study was to investigate and to compare the potential neuroprotective effects of racemic ketamine, (S)-ketamine and methylprednisolone after an experimental spinal cord injury model in rats.MethodsFifty-nine Wistar albino rats were divided into three main groups as acute stage (A), subacute stage (SA) and sham groups and then acute and subacute stage groups were divided into four groups regarding the used drug as control (CONT), racemic ketamine (RK), (S)-ketamine (SK) and methylprednisolone (MP) groups. A dorsal laminectomy was performed; and spinal cord injury was induced by using a temporary aneurysm clip. Four hours later from the clip compression, except those of the sham and control groups, the drugs (60 mg/kg racemic ketamine, 60 mg/kg (S)-ketamine or 30 mg/kg methylprednisolone) were administered intraperitoneally. At 72th h and 7th days of the study, the spinal cords of rats were removed from T8 level to the conus medullaris level. The specimens were and evaluated histopathologically, tissue lipid peroxidation (LPO) and myeloperoxidation (MPO) levels were measured and biochemically.ResultsThe histopathological results were similar both in the acute and in the subacute stage groups. There was a statistically significant difference among all groups regarding the tissue LPO levels (p < 0.001). There was a statistically significant difference between the CONT-A group and the MP-A, RK-A and SK-A groups (p = 0.004, p < 0.001 and p = 0.007, respectively) in acute stage and between the CONT-SA group and SK-SA group (p = 0.002) in subacute stage. There was a statistically significant difference among all groups regarding the tissue MPO levels (p = 0.001). The median MPO levels were similar among acute stage groups (p = 0.057), but there was a statistical difference among subacute stage groups (p = 0.046).Conclusion(S)-ketamine is more effective than methylprednisolone and racemic ketamine to reduce the LPO levels in subacute stage of spinal cord injury in rats. And, it is as effective as methylprednisolone in preventing secondary spinal cord injury histopathologically.     

Changes in the dermoscopic appearance of melanocytic naevi after photochemotherapy or narrow-band ultraviolet B phototherapy

BACKGROUND: Although phototherapeutic modalities are commonly used for the treatment of skin diseases, the effects of therapeutic ultraviolet (UV) irradiation on the dermoscopic appearance of melanocytic naevi are unknown. OBJECTIVES: We aimed to analyse the effects of photochemotherapy (psoralen plus ultraviolet A, PUVA) and narrow-band ultraviolet B phototherapy (NB-UVB) on the dermoscopic appearance of naevi. PATIENTS AND METHODS: We monitored 187 melanocytic naevi of 38 patients receiving NB-UVB or PUVA treatment for miscellaneous skin diseases. Dermoscopic images of naevi were taken before, shortly after, and after a median of 31 weeks after the UV therapy. A random selection of naevi was covered during UV treatment, the others remained uncovered. Baseline and follow-up images of naevi were viewed side by side on a computer screen to compare size, pigmentation, and dermoscopic structure of naevi. RESULTS: Twenty-one patients received NB-UVB treatment, and 17 patients received PUVA treatment. Of 187 naevi, 70 (37%) were covered and 117 (63%) were uncovered during UV treatment. When NB-UVB- and PUVA-treated patients were analysed together, an increase in size of uncovered lesions was seen in both treatment groups. Pigmentation appeared darker at the end of UV treatment in 67.5% (n=79) of uncovered naevi compared with 41.4% (n=29) of covered naevi (P<0.001). In patients receiving NB-UVB therapy, a significant increase in the number of dots or globules in 20.3% (n=14) of uncovered naevi compared with only 5.0% (n=2) of covered naevi (P=0.03) was found. This effect was not observed after PUVA therapy. With the exception of four naevi with continuous enlargement and seven naevi with a persisting increase in dots and globules, the observed changes were reversible. All naevi with persistent changes belonged to the NB-UVB group. CONCLUSION: In general, PUVA and NB-UVB therapy cause reversible dermoscopic changes in melanocytic naevi. Increase in dots and globules is more frequent with NB-UVB.     

Giant Prostatic Hyperplasia: Case Report

The giant hyperplasia of the prostate is extremely rare pathology of prostate gland. Here, we report the successful removal of the 9th heaviest prostate ever reported in the literature.     

A novel flap to repair medial and lateral malleolar defects: anterior tibial artery perforator-based adipofascial flap

Soft tissue coverage of the ankle is a difficult challenge. The adipofascial flap based on perforators of the anterior tibial artery was harvested from the dorsum of the foot and used for repairing of soft tissue defects either on the lateral or medial malleolar region in 7 patients. Two medial and 5 lateral malleolar defects were covered using the flap described. The size of flaps varied from 3.5 x 10 cm to 4.5 x 12 cm. All flaps had good perfusion and survived completely. Donor-site morbidity was minimal in all cases. Both functional and esthetical results were satisfactory. Because of thin and pliable features, this flap is suitable for repair of defects around the ankle region. In addition, donor-site morbidity of this flap is minimal, with an acceptable scar hidden in the shoe-wearing area.     

Relationship between oxidative stress in cord blood and route of delivery

OBJECTIVE: To investigate the effect of route of delivery on the antioxidant system of newborns. METHODS: We used the cord blood taken during labor of 56 vaginal deliveries and 50 elective cesarean sections. The specimens were analyzed for the plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glucose 6-phosphate dehydrogenase (G6PD) activity and leukocyte count. RESULTS: SOD and CAT activities were significantly higher in the elective cesarean group than the vaginal delivery group (p < 0.01 and p < 0.005, respectively), but G6PD activity was similar between the groups. Plasma MDA level was lower in the cesarean group compared to the vaginal delivery group (p < 0.001). Leukocyte count was higher in the vaginal delivery group (p < 0.005). CONCLUSION: Our findings suggest that the route of delivery has an effect on oxidative stress in newborns exposed to oxidative stress during delivery. It can be suggested that the antioxidant system works more efficiently to overcome oxidative stress in newborns delivered via cesarean section.     

Iron chelation with deferasirox in adult and pediatric patients with thalassemia major: efficacy and safety during 5 years' follow-up

Patients with β-thalassemia require lifelong iron chelation therapy from early childhood to prevent complications associated with transfusional iron overload. To evaluate long-term efficacy and safety of once-daily oral iron chelation with deferasirox, patients aged ≥ 2 years who completed a 1-year, phase 3, randomized trial entered a 4-year extension study, either continuing on deferasirox (deferasirox cohort) or switching from deferoxamine to deferasirox (crossover cohort). Of 555 patients who received ≥ 1 deferasirox dose, 66.8% completed the study; 43 patients (7.7%) discontinued because of adverse events. In patients with ≥ 4 years' deferasirox exposure who had liver biopsy, mean liver iron concentration significantly decreased by 7.8 ± 11.2 mg Fe/g dry weight (dw; n = 103; P < .001) and 3.1 ± 7.9 mg Fe/g dw (n = 68; P < .001) in the deferasirox and crossover cohorts, respectively. Median serum ferritin significantly decreased by 706 ng/mL (n = 196; P < .001) and 371 ng/mL (n = 147; P < .001), respectively, after ≥ 4 years' exposure. Investigator-assessed, drug-related adverse events, including increased blood creatinine (11.2%), abdominal pain (9.0%), and nausea (7.4%), were generally mild to moderate, transient, and reduced in frequency over time. No adverse effect was observed on pediatric growth or adolescent sexual development. This first prospective study of long-term deferasirox use in pediatric and adult patients with β-thalassemia suggests treatment for ≤ 5 years is generally well tolerated and effectively reduces iron burden. This trial was registered at www.clinicaltrials.gov as #NCT00171210.     

Nasal tip contouring using lower lateral cartilages

Nasal tip management is the most important and challenging part of rhinoplasty surgery. For nasal tip management, optimal nasal tip projection and rotation must be maintained. For this reason, several methods have been developed to obtain optimal results. In this article, we share with the rhinoplasty surgeons how we use cartilage grafts for nasal tip projection, nasal tip shaping, and maintaining natural and symmetric appearance and avoid “visible cartilage” problem by using a simple and easily applicable method. After performing standard open rhinoplasty techniques, we used the cephalic portion of the lower lateral cartilages to overgraft the already placed numerous layers of shield or onlay grafts. All the cartilage grafts are sutured in their place to prevent malpositions or undesired angularities. We operated on 1480 patients between September of 2002 and September of 2009 for rhinoplasty. Ages of the patients range from 18 to 58 years with nasal tip ptosis. We performed 1235 primary rhinoplasties and 245 secondary rhinoplasties. Of 365 patients, who were followed up regularly, 330 (approximately 90%) were operated on according to this technique and were included in the study. By using such an overgrafting technique for nasal tip, we obtained satisfactory results both by the patients and by the surgeons. Satisfactory results and being a facilitating method for shaping of nasal tip are the advantages of this technique.