POSSIBLE CURATIVE EFFECT OF INTENSIVE CHEMOTHERAPY ON ASTHMA IN CHILDREN

The authors report rare and different types of lung tumors in 4 children. The first case is an 8-year-old boy with mucoepidermoid carcinoma, the second case is a 9-year-old girl with neuroendocrine carcinoma, the third is a 14-year-old girl with fetal lung adenocarcinoma (FLAC), and the last is a 16-year-old girl with bronchioloalv eolar carcinoma. Among these tumors, FLAC has not been reported in children so far. Each tumor type displayed a different prognosis in the follow-up period. In the differential diagnosis of primary lung tumors, carcinoid tumor, bronchogenic carcinoma, and pulmonary blastoma are frequently encountered, but these rare tumor types should be borne in mind.     

Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey

This study examined the incidence of posttraumatic stress disorder (PTSD) and depression in 586 earthquake survivors living in prefabricated housing sites a mean of 20 months after the 1999 earthquake in Turkey. The estimated rates of PTSD and major depression were 39% and 18%, respectively. More severe PTSD symptoms related to greater fear during the earthquake, female gender, older age, participation in rescue work, having been trapped under rubble, and personal history of psychiatric illness. More severe depression symptoms related to older age, loss of close ones, single marital status, past psychiatric illness, previous trauma experience, female gender, and family history of psychiatric illness. These findings suggest that catastrophic earthquakes have long-term psychological consequences, particularly for survivors with high levels of trauma exposure. These findings lend further support to the need for long-term mental health care policies for earthquake survivors. Outreach service delivery programs are needed to access non-treatment-seeking survivors with chronic PTSD.     

Neuron-specific enolase levels and neuroimaging in asphyxiated term newborns

The study was designed to investigate the cerebrospinal fluid and serum levels of neuron-specific enolase, along with cranial ultrasonography, magnetic resonance imaging (MRI), and electroencephalography (EEG), for predicting the clinical state and neurologic outcome of 26 asphyxiated term newborns. The babies were graded according to the Sarnat and Sarnat classification. Cerebrospinal fluid neuron-specific enolase levels of the 18 babies in the whole hypoxic-ischemic encephalopathy group were higher than the 8 babies in the "no encephalopathy" group. Cerebrospinal fluid neuron-specific enolase levels of 13 cases in the hypoxic-ischemic encephalopathy grade 2 and 3 groups (high-risk group) were higher than both the no encephalopathy and hypoxic-ischemic encephalopathy grade 1 groups when pooled. Cerebrospinal fluid neuron-specific enolase levels of the 7 newborns in the hypoxic-ischemic encephalopathy grade 3 group were also significantly higher than the 5 in the hypoxic-ischemic encephalopathy grade 1 group. The findings of cranial MRI, EEG, and cerebrospinal fluid neuron-specific enolase levels were correlated with each other and the clinical grade of the patients and also were predictive of the neurologic outcome at 1 year of age. Cerebrospinal fluid neuron-specific enolase levels, cranial MRI, and EEG are predictive of outcome of hypoxic-ischemic brain damage in asphyxiated newborns, and this predictivity would increase with the combination of these diagnostic parameters.     

Intracellular deposition,microtubule destabilization,and transport failure: an "early" pathogenic cascade leading to synaptic decline

Protein deposition is a common event in age-related neurological diseases that are characterized by neuronal dysfunction and eventual cell death. Here, cultured hippocampal slices were infused with the lysosomal disrupter chloroquine to examine the link between abnormal protein processing/deposition and early synaptopathogenesis. Tau species of 55 to 69 kDa increased over several days of treatment with chloroquine, while the protein and message levels of synaptic markers were selectively reduced. Neurons of subfields CA1, CA3, and dentate gyrus accumulated protein deposits recognized by antibodies against paired helical filaments and ubiquitin, and this was accompanied by tubulin fragmentation and deacetylation. The deposition filled the basal pole of pyramidal neurons, encompassing the area of the axon hillock and initial dendritic branching but without causing overt neuronal atrophy. Neurons containing the polar aggregates exhibited severely impaired transport along basal dendrites. Transport capability was also lost along apical dendrites, the opposite direction of deposited material in the basal pole; thus, perpetuating the problem beyond physical blockage must be the associated loss of microtubule integrity. These data indicate that transport failure forms a link between tau deposition and synaptic decline, thus shedding light on how protein aggregation events disrupt synaptic and cognitive functions before the ensuing cellular destruction.     

99mTc-MIBI SPET in non-small cell lung cancer in relationship with Pgp and prognosis

Higher technetium-99m methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) has been reported to be associated with a positive response to chemotherapy. It has previously been found that in tumour cells, P-glycoprotein (Pgp) expression is of importance for tracer uptake. However, some studies have indicated that Pgp expression does not play an important role in (99m)Tc-MIBI uptake in NSCLC; indeed, a negative correlation between (99m)Tc-MIBI uptake and Pgp expression has been reported. Against the background of conflicting results, our aim was to evaluate the relationship between (99m)Tc-MIBI uptake, prognosis and Pgp expression in NSCLC. A total of 37 patients with NSCLC underwent (99m)Tc-MIBI single-photon emission tomography (SPET) before chemotherapy. In 19 patients both Pgp and p53 expression, and in two patients only p53 expression (due to the limited biopsy material), were measured with immunohistochemical staining. (99m)Tc-MIBI uptake was significantly higher in responders than in non-responders: 3.09+/-1.14 vs 2.24+/-0.88 ( P<0.03) and 3.09+/-1.08 vs 2.37+/-1.06 ( P<0.05) for the early ratio (ER) and the delayed ratio (DR), respectively. The wash-out rate (WR) of responders was not significantly different from that of non-responders. We found no significant differences in ER, DR and WR among the groups positive or negative for Pgp and p53 status. There was a significant positive correlation between the survival rate and both ER and DR: r=0.49 ( P=0.003) and r=0.40 ( P=0.018), respectively. Patients with ER and DR values above 3 showed significantly longer survival than those with values below 3: 14.7+/-8.5 months vs 7.3+/-5.1 months ( P<0.009) and 13.2+/-8.4 months vs 7.4+/-5.3 months ( P<0.04) for ER and DR, respectively. However, interestingly, and in contrast to expectations, patients with a Pgp score of +2 showed significantly longer survival (12.9+/-6.7 months) than those with Pgp scores of +1 (4.4+/-3.0 months) or - (negative) (3.8+/-2.2 months) ( P<0.009 and P<0.02, respectively). Our results suggest that in NSCLC, patients with higher (99m)Tc-MIBI uptake tend to show a positive response to chemotherapy, and patients with ER and DR values above 3 have a significantly better prognosis. We also found that Pgp expression seems to play only a minor role in (99m)Tc-MIBI uptake. Our finding that patients with ER and DR values above 3 have a better prognosis needs to be confirmed in larger series of patients.     

Cortical inhibition in first-degree relatives of schizophrenic patients assessed with transcranial magnetic stimulation

Although cortical inhibition deficit has been shown in schizophrenia patients by transcranial magnetic stimulation (TMS), some controversies remain, possibly due to confounding factors such as medication use and clinical state at the time of assessment. First-degree relatives of schizophrenia patients, who share various degrees of genetic vulnerability with the patients, but are free from confounds related to medication and/or florid psychosis, have not been studied to date. We compared 12 relatives with 14 controls on several paradigms with TMS. Three of the 12 healthy relatives lacked transcallosal inhibition (TI) in one or more of the stimulation levels. There were no significant differences in other parameters. The lack of TI in 25% of the relatives is an important finding that needs to be replicated in larger samples that are heterogeneous in terms of psychosis-proneness.     

Ketamine sedation during spinal anesthesia for arthroscopic knee surgery reduced the ischemia-reperfusion injury markers

We studied the effect of ketamine sedation on oxidative stress during arthroscopic knee surgery with tourniquet application by determining blood and tissue malonyldialdehyde (MDA) and hypoxanthine (HPX) levels. Thirty ASA I-II patients undergoing arthroscopic knee surgery with tourniquet were randomly divided into two groups. Spinal anesthesia induced with 12.5 mg bupivacaine was administered to all patients. In the ketamine group, after IV administration of 0.01 mg/kg midazolam, a continuous infusion of ketamine (0.5 mg . kg(-1) . h(-1)) was used until the end of surgery whereas the placebo group received a volume-equivalent placebo infusion. Ramsey Sedation Scale (RSS) was used for assessing the sedation level. Venous blood and synovial membrane tissue samples were obtained before ketamine infusion, at 30 min of tourniquet ischemia, and at 5 min after tourniquet deflation for MDA and HPX measurements. Tissue MDA and HPX levels were significantly less in the ketamine group than the control group after reperfusion. RSS scores were higher in the ketamine group without any adverse effect. We conclude that ketamine sedation attenuates lipid peroxidation markers in arthroscopic knee surgery with tourniquet application.