Pericardial involvement in diseases of the heart and other contiguous structures: part I: pericardial involvement in infarct pericarditis and pericardial involvement following myocardial infarction

Active contiguous abnormalities can frequently involve the pericardium. Prominent among these are cardiac conditions which encroach on the pericardium, particularly transmural myocardial infarction (newly always with Q-waves). Complications of infarctions, notably myocardial pseudoaneurysm, have one wall which is pericardium. Furthermore, dissecting aneurysm of the aorta and the intramural aortic hemorrhage may rupture into the pericardium with tamponade, or, if limited, mimic acute pericarditis. Diseases of the lungs and pleura, including the diaphragmatic pleura, also result in pulmonary embolism which can produce several syndromes. Many mediastinal diseases, notably inflammation and malignancy, especially involving the lymph nodes, induce mediastinal inflammation and fibrosis. Many esophageal disorders can penetrate or produce a fistula usually with pneumopericardium. Rarely, primarily pericardial disorders like purulent pericarditis, malignancies, and rough pericardial calcifications affect the contiguous tissues. We discuss the many syndromes and disorders under each of these topics.     

Study of chaotic behavior of tremor of some Parkinsonians under deep brain stimulation

Deep Brain Stimulation, functional neurosurgery for Parkinson’s disease treatment, has three parameters: frequency, pulse width, and voltage. They should be selected appropriately to achieve an effective treatment. In this research, we studied some nonlinear dynamics of Parkinsonian tremor under Deep Brain Stimulation. We recorded finger tremor signals of 8 patients at different voltages as data. To study tremor behavior variation at different voltages, we extracted some nonlinear dynamic features of the data. These features were: embedding space, correlation dimension, largest Lyapunov exponent, entropy and variance of embedding space along x, and y axes. We found that the largest Lyapunov exponents were positive and correlation dimensions of data were not integer, and also all embedding spaces at different voltages had attractors. These observations show that the tremor signal has chaotic behaviors. Also, embedding space variance along x, and y axes in all cases and entropy in the most of them had minimum values at highest voltages in comparison with other voltages. We plotted bar graphs of embedding space variances along x, and y axes at every patient’s recorded voltages. A reduction procedure was seen after a threshold in all graphs. As a result, all the chaotic features change with the voltage variation. In the future, it could be possible to select the optimum stimulation voltages by using chaotic features of tremor.     

Effects of arsenic on porcine dendritic cells in vitro

Exposure to arsenic (As) is an ongoing, and in some places increasing, health problem. Still, however, the effects of As exposure on the immune system are not well understood. Dendritic cells (DC) are a critical immune cell that bridges the innate and adaptive immune systems. To determine the impact of inorganic (i)As exposure on DC, the effects of (geo)anthropogenically relevant levels of NaAsO₂ on the function of porcine monocyte-derived DC (MoDC) were evaluated in an in vitro model. The results showed a low dose of iAs reduced the phagocytic capacity of MoDC. Furthermore, although surface expression of DC activation markers, such as major histocompatibility complex (MHC)-II, CD80/86, CD40 and CD25, were only slightly changed, MoDC T-cell proliferation-inducing capacity was remarkably diminished by iAs treatment. Additionally, iAs induced significant interleukin (IL)-6 secretion by MoDC after 12- or 24-h incubation, whereas IL-1β secretion was only significantly up-regulated after 12?h. The secretion patterns of IL-8, tumor necrosis factor α (TNFα and IL-10 by iAs-treated MoDC were almost similar to that by mock-treated MoDC. Considering the broad roles of DC in immunobiology, this finding deepens the understanding of molecular mechanisms/functional consequences underpinning the immunopathology, inflammation, and increases in infection arising from As exposure.     

Aortic arch vessel anomalies associated with persistent trigeminal artery

Developmental anomalies of the aortic arch vessels and persistent trigeminal artery that is the most common of the four anomalous carotid-basilar anastomoses are repeatedly reported in the literature as separate entities. Herein we report a previously undescribed variant including the coexistence of persistent trigeminal artery, truncus bicaroticus and direct origin of left vertebral artery from aortic arch.     

Non Alcoholic Fatty Liver Disease in Southern Iran: A Population Based Study

Background

Population based studies on prevalence and risk factors of NAFLD in Iranian population are few. The prevalence of NAFLD and non alcoholic steatohepatitis (NASH) in Iranians varies from 2.9% to 7.1% in general population and 55.8% in patients with type 2 diabetes mellitus.

Objectives

To determine the prevalence and determinants of non alcoholic fatty liver disease (NAFLD) in a sample of adult Iranian general population.

Patients and Methods

This was a cross-sectional study being performed in Shiraz, southern Iran during a 10-month period from November 2010 to September 2011 through cluster random sampling of Iranian general population in Shiraz region. All individuals undergone anthropometric, blood pressure measurements, thorough medical history and physical examinations. Laboratory measurements included fasting blood glucose (FBS), lipid profile, complete blood count (CBC) and liver function tests. NAFLD was diagnosed by transabdominal ultrasonography.

Results

819 subjects were included in this study among which were 340 males (41.5%) and 479 females (58.5%) with the mean age of 43.1 ± 14.1 years. NAFLD was diagnosed in 176 (21.5%) subjects. Patients with NAFLD were significantly older (P < 0.001), had higher proportion of male gender (P = 0.004) and had higher BMI (P < 0.001). They also had higher prevalence of hypertension (P < 0.001), high FBS (P < 0.001), high cholesterol (P = 0.026), high triglyceride (P < 0.001) and high waist circumference (P < 0.001). Taking all these together, patients with NAFLD had significantly higher prevalence of metabolic syndrome when compared to healthy subjects (P < 0.001).

Conclusion

The prevalence of NAFLD in this group of Iranian adult general population is 21.5%. NAFLD in Iranian population is associated with male gender, old age, obesity, and features of metabolic syndrome.     

In vitro anti-leishmanial activity of methanolic extracts of Calendula officinalis flowers,Datura stramonium seeds,and Salvia officinalis leaves

AIM： The anti-leishmanial activity of methanolic extracts of Calendula officinalis flowers, Datura stramonium seeds, and Salvia officina- lis leaves against extracellular （promastigote） and intracellular （amastigote） forms of Leishmania major were evaluated in this study. METHOD： In the first stage, promastigote forms of L. major, were treated with different doses of the plant extracts in a 96-well tis- sue-culture microplate and IC50 values for each extract were measured with colorimetric MTT assay. In the second stage, macrophage cells were infected with L. major promastigotes. Infected macrophages were treated with plant extracts. Then the macrophages were stained with Gimsa and the number of infected macrophages and amastigotes were counted with a light microscope. RESULTS： The results indicated that the plant extracts inhibited the growth of promastigotes and amastigotes of L. major. Inhibi- tory concentrations （ICs0） for promastigote assay were 108.19, 155.15, and 184.32 μg-mL ^-1 for C. officinalis flowers, D. stramo- nium seeds and S. officinalis, respectively. The extracts also reduced the number of amastigotes in macrophage cells from 264 for control group to 88, 97, and 102 for test groups. Although the anti-leishmanial activity of the extracts were not comparable with the standard drug, miltefosine; but they showed significant efficiency in reducing the number of amastigotes in macrophages, in com- parison with the control group （P 〈 0.001）. These plant extracts had lower toxicity compared with miltefosine. CONCLUSION： This study demonstrates the potential efficacy of the methanolic extracts of C. officinalis flowers, D. stramonium seeds, and S. officinalis leaves to control of cutaneous leishmaniasis.     

Comparison of Clinical Characteristics of Opium-Induced and Independent Major Depressive Disorder

Psychiatric disorders and among them depression are common in substance dependant patients. The aim of this study is to compare the clinical characteristics of those that appear to have substance-induced depression and those that have independent major depression. One-hundred eighty-four independent and 187 opium-induced (OID) depressed male patients that met the DSM-IV criteria for major depressive disorder were randomly selected. Standard demographic data, including age, marital, employment and education status, were collected. The primary measure of depressive signs and symptoms was Hamilton Depression Scale (HAMD-21).The two groups were compared with each other for the HAMD total and subscales scores. The two groups were matched regarding age, educational level and marital status. Opium-induced depressed patients were more severely depressed and motor retarded and also they had more social and occupational problems. Gastrointestinal, sexual and somatic complaints were more common among them too. MDD patients had better insight than the other group. The results demonstrate that it is possible to differentiate between substance-induced and independent depression. Such differentiation might be important for establishing prognosis and optimal treatment.     

Comparison of magnetic resonance urography with ultrasound studies in detection of fetal urogenital anomalies

PurposePrenatal ultrasonography detects the vast majority of urogenital anomalies, but in some cases the diagnosis remains in doubt. We assessed the potential of magnetic resonance urography (MRU) in the evaluation of different urogenital anomalies in fetuses when ultrasound study was equivocal.Patients and methodsWe retrospectively reviewed the medical records of 46 fetuses in whom the presence of urogenital anomalies was suspected at ultrasound studies, but remained inconclusive. Fetal MRU was performed within the same week as ultrasound studies. All patients underwent MRU, comprising overview, fast, thick-slab, heavily T2-weighted sequences, followed by focused, high-resolution T2-weighted sequences obtained in sagittal, axial and coronal planes. T1-weighted sequences were obtained in selected cases for assessment of the gastrointestinal tract. All MRU results were compared with ultrasound findings. Sensitivity of each imaging modality was estimated based on definite diagnoses made after birth or abortion.ResultsThe mean (range) gestational age was 27 (18–36) weeks. The final diagnosis was ureteropelvic junction obstruction in 12, ureteral dilation (due to vesicoureteral junction obstruction) in five, ureterocele in five, posterior urethral valve in 16, multicystic dysplastic kidney in six, mesenteric cyst in one and abdominoscrotal hydrocele in one. Overall diagnostic sensitivity of fetal MRU was 96% compared to sonography with 58% sensitivity (p < 0.05). Fetal MRU studies provided additional information to sonography in 17 (37%) cases, and were especially more sensitive in evaluation of ureteral anatomy.ConclusionsFetal MRU can accurately diagnose a wide variety of urinary tract disorders and must be regarded as a valuable complementary tool to ultrasound in the assessment of the urinary system, particularly in cases of inconclusive ultrasound findings. The present study had a selection bias, as only fetuses with possible anomalies proposed by sonography were referred for MRU; however, this is the population that probably benefits most from MRU studies.