Standardized weaning of infants <32 weeks of gestation from continuous positive airway pressure – a feasibility study

The practice of weaning premature infants from continuous positive airway pressure (CPAP) varies considerably and is usually performed without written standards. In this study, the feasibility of a standardized weaning approach was evaluated. In a quasi-experimental design, data from a prospective, post-intervention cohort (n=41) were compared to data from a pre-intervention cohort (n=36). Standardized weaning was feasible but no significant differences in short-term respiratory outcomes were observed. Weaning from CPAP was achieved at 32.1?±?1.6 (post-intervention) versus 32.5?±?2.3 weeks (pre-intervention) postmenstrual age. More rigorous, large-scale clinical trials are necessary before firm recommendations on distinct weaning regimens can be made.     

Evaluation of the position of the hyoid bone in relation to vertical facial development

Evaluation of the position of the hyoid bone in relation to vertical facial development and comparative evaluation of the relation of this position with the dentofacial system was made on 25 patients with hyperdivergent vertical growth, 25 patients with hypodivergent vertical growth, and 25 patients with normal vertical facial development. SN-Go-Gn, Gonion, ANS-PNS/Go-Gn angles and S-Go, N-Me, S-Go/N-Me measurements from lateral cephalometric films were used as identification parameters. Seven horizontal, five vertical and five angular cephalometric measurements were made in order to determine the position of the hyoid bone. SN plane was used as the reference plane. Results were evaluated through "t" test. No significant relation was found between hyoid bone position and gender. When gender distinction was disregarded, and the group with normal facial development was compared with the hyperdivergent group, statistically significant differences were observed for CVT-H distance in horizontal measurements and for H-SN, H-F, H-PD, H-OD distances in vertical measurements. When the group with normal facial development was compared with the hypodivergent group, only the horizontal measurement Pg-H was statistically significant. The hyoid bone location in the hyperdivergent group was in a more of a posterior and superior position. The hyoid bone location in the hypodivergent group was not changed vertically, however, it had more of a posterior placement with the increase of Pg-H distance.     

Ekkrine Hidradenitis Kasuistik und Literaturübersicht

Zusammenfassung Die neutrophile ekkrine Hidradenitis ist eine selbstlimitierende Dermatose mit spontaner Heilungstendenz. Das klinische Bild und die Lokalisation der L?sionen sind vielf?ltig. Histopathologisch ist diese Dermatose durch ein Infiltrat von neutrophilen Granulozyten im Bereich von ekkrinen Schwei?drüseng?ngen in Assoziation mit Nekrosen der Schwei?drüsen charakterisiert. Als pathogenetische Ursachen werden maligne h?matologische Erkrankungen, maligne Tumoren, Nebenwirkungen von Chemotherapeutika sowie bakterielle Noxen diskutiert. Wir berichten über eine 16 Monate alte Patientin mit idiopathischer Neutropenie unter G-CSF Therapie, bei der pl?tzlich zahlreiche papul?se Hautver?nderungen am Bauch und an den Extremit?ten auftraten und nach 6 Wochen spontan abheilten. Zus?tzlich werden in dieser Arbeit die klinischen und histopathologischen Ver?nderungen der 45 bisher publizierten F?lle zusammengefa?t. Eingegangen am 17. Dezember 1996 Angenommen am 15. Januar 1997     

Endoscopic treatment of multiple prostatic calculi causing urinary retention

Although prostatic calculi are relatively common, the etiology of these stones is not clear. We report a case with multiple prostatic calculi causing urinary obstruction and a concomitant bladder stone. We treated these stones endoscopically. We found a lot of different sized stones endoscopically, some protruding into the urethra, some filling different cavities on the prostate. So these cavities suggest prostatic calculi may occur related to intraprostatic reflux in the congenital or acquired diverticulum of the prostatic tissue. In addition, the stone composition of the bladder and prostatic stones was the same. All of these results show that the origin of bladder and prostatic stones can be the same. This case also supports a theory of intraprostatic reflux and urine stasis.     

Role of Interface Sign and Diffusion-Weighted Magnetic Resonance Imaging in Differential Diagnosis of Exophytic Renal Masses

PurposeWe aimed to investigate the role of interfaces of exophytic solid and cystic renal masses on magnetic resonance imaging (MRI) and the added value of diffusion-weighted imaging in differentiating benign from malignant lesions.MethodsThe Institutional Review Board approved this retrospective study, and informed consent was waived. A total of 265 patients (109 [41%] women and 156 [59%] men) with a mean age of 57 ± 12 (standard deviation) years were enrolled in this study. Preoperative MRI (n = 238) examinations of patients with solid or cystic renal masses and MRI (n = 27) examinations of patients with Bosniak IIF cysts without progression were reviewed. Solid/cystic pattern, interface types and apparent diffusion coefficient (ADC) values were recorded by 2 radiologists. The diagnostic performance of combining normalized ADC values with interface sign were evaluated.ResultsAmong 265 renal lesions (109 cystic and 156 solid), all malignant lesions (n = 192) had a round interface. No malignant lesions showed an angular interface. For prediction of benignity in cystic lesions, sensitivity (82.86% vs 56.16%), negative predictive value (92.50% vs 85.71%), and accuracy (94.50% vs 87.92%) ratios of angular interface were higher compared to all (solid plus cystic) lesions. The best normalized ADC cutoff values for predicting malignancy in lesions with round interface were as follows: for all (solid plus cystic), ≤ 0.75 (AUROC = 0.804); solid, ≤ 0.6 (AUROC = 0.819); and cystic, ≤ 0.8 (AUROC = 0.936).ConclusionsAngular interface can be a predictor of benignity for especially cystic renal masses. The evaluation of interface type with normalized ADC value can be an important clue in differential diagnosis especially in patients avoiding contrast.     

Iron in kidney and heart failure: from theory to practice

There is evidence that serum iron levels, regardless of the presence of anemia, directly impact outcomes in congestive heart failure (CHF) including quality of life, hospitalization rate and overall survival. Despite modern medical treatments, the prognosis of CHF remains grim. Ironically, simple iron replenishment may serve as a powerful tool in the armamentarium. This review will start from fundamental concepts of iron in oxygen delivery and analyze evidence-based outcomes in CHF iron-directed therapeutic trials. Imaging rationale that dovetails with this pathophysiology will also be detailed in a clinician-directed fashion.     

Pneumopericardium due to invasive pulmonary aspergillosis

We describe a 59-year-old female patient with leukemia who developed pneumopericardium as a complication of invasive pulmonary aspergillosis. Spiral computed tomography (CT) was very helpful for the detection of such complications.     

Antioxidants but not Doxycycline Treatments Restore Depressed Beta-Adrenergic Responses of the Heart in Diabetic Rats

Reactive oxygen species (ROS) play important roles in the development of diabetic cardiomyopathy. Matrix metalloproteinases (MMPs) can get activated by ROS and contribute to loss of myocardial contractile function in oxidative stress injury. Previously we have shown that either a MMP-2 inhibitor doxycycline or an antioxidant selenium treatment in vivo prevented diabetes-induced cardiac dysfunction significantly. In addition, there is an evidence for impaired cardiac responsiveness to β-adrenoceptor (βAR) stimulation in experimental animals with diabetes. The exact nature of linkage between the functional depression in cardiac responses to catecholamines and the variations in uncoupling of βAR in diabetes has not been clearly defined. Therefore, we aimed to evaluate the effect of in vivo administration of doxycycline on βAR responses of isolated hearts from diabetic rats and compare these data with two well-known antioxidants; sodium selenate and (n−3) fatty acid-treated diabetic rats. We examined the changes in the basal cardiac function in response to the βAR stimulation, adenylate cyclase activity, and βAR affinity to its agonist, isoproterenol. These results showed that antioxidant treatment of diabetic rats could protect the hearts against diabetes-induced depression in βAR responses, significantly while doxycycline did not have any significant beneficial action on these parameters. As a summary, present data, in part, demonstrate that antioxidants and MMP inhibitors could both regulate MMP function but may also utilize different mechanisms of action in cardiomyocytes, particularly related with βAR signaling pathway.     

Onychomadesis in Two Sisters Induced by Varicella Infection

Onychomadesis is separation of the nail plate from the nail matrix due to arrest of nail growth for a certain period. Here we describe two patients with onychomadesis on the hands after varicella infection. To our knowledge, this is the first case of onychomadesis reported after varicella infection.     

Efficacy of 5-aminolevulinic acid-based photodynamic therapy in different subtypes of canine mammary gland cancer cells

Lasers in Medical Science - Canine mammary gland tumors (CMGTs) are heterogeneous disease and subclassified [sarcomas (S), carcinomas (C), and carcinosarcomas (CS)] according to histopathological...