Adherent leukocytes capture sickle erythrocytes in an in vitro flow model of vaso-occlusion

Recent in vivo studies suggest that adherent leukocytes bind RBCs and contribute to the microvascular pathology that characterizes sickle cell disease (SCD). A parallel-plate flow assay was used: to investigate the capture of RBCs by adherent neutrophils, monocytes, and T-lymphocytes; to examine whether RBC capture is elevated in patients with SCD; and to determine whether hydroxyurea (HU) therapy affects these interactions. Four measures of cell-cell adhesion were used: adhesion of leukocytes to TNF-alpha-treated human umbilical vein endothelial cells (HUVECs), percent of adherent leukocytes that captured RBCs, number of RBCs captured per interacting leukocyte, and duration of RBC capture. Leukocyte subpopulations from sickle patients were more adherent to activated ECs and captured more RBCs per interacting leukocyte than the corresponding subpopulations from healthy controls. While HU did not affect leukocyte adhesion to activated ECs, it reduced the proportion of adherent leukocytes that captured RBCs, as well as the number of RBCs captured per neutrophil. T-lymphocytes demonstrated elevated adhesion in all measures, and may be the leukocyte subpopulation whose behavior is most altered in SCD. Our findings suggest that neutrophils, monocytes, and T-lymphocytes could all be involved in adhesive interactions with autologous RBCs in patients with SCD.     

Biatrial compression caused by intrapericardial hematoma secondary to ruptured type I acute aortic dissection following aortic valve replacement

Ruptured aortic dissection after aortic valve replacement (AVR) is uncommon and rarely diagnosed premortem. We report a patient with a ruptured type I aortic dissection and biatrial tamponade 2 months after AVR caused by loculated intrapericardial hematoma.The diagnosis was made by transthoracic echocardiography and confirmed at operation.     

Use of prazosin in the treatment of scorpion envenomation

Although scorpion bite is usually lethal in children under 6, sometimes it might cause death for those over 6. Acute lethal systemic seizures (cardiovascular and central nervous systems) have been frequently reported from the countryside of developing countries. Numerous researchers have suggested quite different approaches to the treatment of scorpion bites. In this report, we describe a case brought to the emergency service after the patient had been bitten by a scorpion and had significant sympathetic nervous system symptoms. The patient was treated with prazosin successfully.     

Propranolol for infantile hemangiomas: a preliminary report on efficacy and safety in very low birth weight infants

Despite the relatively recent introduction of propranolol in the treatment of infantile hemangiomas, there can be little doubt of its efficacy. With regard to safety issues, there are no prior data for very low weight infants. In this study, we used propranolol in preterm and very low weight infants. We used clinical criteria to assess the response to the therapy. We noted all side effects expected from beta-adrenergic blocking drugs, and followed the patients' weight gain during propranolol treatment. Objective, clinical evidence of hemangioma regression was seen after two months in all patients. None of the patients required treatment discontinuation due to adverse side effects. During the propranolol treatment, weight gain was normal in all patients. To the best of our knowledge, this is the first report on the use of propranolol in preterm and very low weight infants, and also the first report from Turkey on the use of propranolol in infantile hemangiomas.     

The Effect of Alprazolam on Acoustic Stapedius Reflex Thresholds in Healthy Volunteers

Alprazolam, a widely used drug, has widespread, nonspecific depressant effects on the central nervous system, similar to other benzodiazepines. This inhibitor effect may cause changes in reflex thresholds by affecting the acoustic stapedial reflex (ASR) arc. This study was performed on 31 healthy volunteers. Initially, the basal ASR thresholds were measured and measured again 2 h after oral intake of 1 mg of alprazolam; by measuring the reflex thresholds once again the mean values of thresholds before and after the drug were compared. Only the left ipsilateral and contralateral 2,000 Hz increases were significantly different. The left ipsilateral and contralateral 500, 1000, and 4000 Hz, and the right ipsilateral and contralateral 500, 1000, 2000, and 4000 Hz measurements showed no differences. Although an increase in ART thresholds was generally observed after the intake of alprazolam, it was not significant. Its use in healthy adults does not statistically produce an additional risk of acoustic trauma at most of the frequencies, but its use with the agents potentiating the effect of alprazolam may increase this risk.     

Diffusion of HEMA through Human Carious and Non‐Carious Dentin In Vitro

Purpose : The aim of this study was to evaluate the diffusion of 2‐Hydroxyethyl methacrylate (HEMA) from resin cement through dentin both affected and unaffected by caries through high‐performance liquid chromatography (HPLC) at two time intervals. Materials and Methods : Ten freshly extracted restoration‐free, caries‐free and ten extracted carious human third molar teeth were used in this study. Standardized box‐shaped Class I inlay cavities (6 mm long, 3 mm wide, 2 mm deep) were prepared in all teeth with a high‐speed handpiece mounted on a standard cavity machine. In teeth affected by caries, after preparation, the remaining carious lesions were removed, with their removal guided by a proprietary caries detector dye. The remaining dentin thickness (RDT) between the pulpal wall of the cavity and the roof of the pulp chamber was measured at multiple points for each tooth so that groups of 10 teeth each were prepared with RDT 1.2 ± 0.5 mm. Lithium disilicate‐based ceramic inlays were manufactured to restore the prepared cavities. A polypropylene chamber was attached to the cementoenamel junction of each tooth to contain 1 ml distilled water. Then, ceramic inlays were cemented with chemically polymerized resin cement (Multilink Automix) according to the manufacturer's instructions. Water elutes were analyzed by HPLC at 4.32 minutes and 24 hours. HEMA diffusion amounts were analyzed using two‐way ANOVA and Tukey HSD tests (p < 0.05). Results : HEMA was detected in the pulp chamber elutes of all the teeth. The diffused HEMA amounts were not significantly different between the affected caries and the unaffected groups (p= 0.80) or between time periods (p= 0.44). The carious dentin did not influence the amount of HEMA diffused through the dentin to the pulp space. Conclusions : The highest amount of eluted HEMA concentration detected was not viewed as critical for pulp tissue since the diffused HEMA amounts were below the level of cytotoxicity, according to the literature.     

The protective effect of nitroglycerin on gastrointestinal and renal side effects of lornoxicam in rats

The aim of this study is firstly, to determine the preventive effect of chronic usage of combination of nitroglycerin and lornoxicam on gastrointestinal and renal side effects and secondly, to investigate the oxidative and antioxidative effects of this combination in rats. METHODS: Thirty-seven Wistar male rats were divided into five groups for 15 days; isotonic group (n = 8, sodium chloride 0.09, Group ISO), lornoxicam group (n = 8, lornoxicam 1.3 mg/kg, Group L), nitroglycerin group (n = 6, nitroglycerin 1 mg/kg, Group NTG), lornoxicam-nitroglycerin combination group (n = 8, 1.3 mg/kg lornoxicam + 1 mg/kg nitroglycerin, Group L-NTG), and control group (n = 7, no drug was administered, Group C). Nitric oxide, malondialdehyde, reduced glutathione (GSH), catalase, interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha concentrations were measured before drug injection and on fifteenth day in all blood samples. Gastrointestinal and renal biopsies were performed on fifteenth day. RESULTS: Two rats died on tenth and twelfth days in Group L. There were significant differences in Group L compared to the other groups for the lesions of stomach and kidney (p = 0.01, p = 0.028 respectively). Gastric ulceration was occurred in a rat in Group L. Malondialdehyde, TNF-alpha, and IL-6 levels decreased in NTG and L-NTG groups, whereas catalase and glutathion levels increased in NTG, L and L-NTG groups compared to control group (p < 0.05). CONCLUSION: Lornoxicam may cause gastrointestinal and renal side effects without oxidative stress. Adding nitroglycerin to lornoxicam for chronic treatment may prevent these side effects and enhance antioxidative effect compared to the use of lornoxicam alone in rats.     

Expression of anger and alexithymia in patients with psychogenic excoriation: a preliminary report

OBJECTIVE: Psychogenic excoriation (PE), which is characterized by lesions formed by self-picking, has a significant place among the dermatoses related to psychological factors. Emotions, particularly anger that cannot be expressed, may be important in the etiology. The objective of this study was to evaluate the sociodemographic characteristics of patients with PE and with another psychodermatosis, and compare them in terms of anger, manner of anger expression, and alexithymia. METHODS: Thirty-one consecutive subjects with PE and thirty-one patients with chronic urticaria were recruited from an outpatient dermatology clinic. All of the subjects completed Toronto Alexithymia Scale and Trait Anger and Anger Expression Scale. RESULTS: PE patients had higher levels of anger (p < .01), tended not to show their anger (p < .05), and were more alexithymic (p < .05). There was also a positive correlation between anger and alexithymia scores (r = .49, p < .05). DISCUSSION: PE, a severe and chronic psychiatric and dermatological problem, may be related to affect-regulation, particularly anger and alexithymia. Due to the fact that it has a different place among psychodermatoses, individuals with PE might benefit from learning how to regulate their affects other than by excoriation.