The effect of various alpha1-adrenergic receptor antagonists on pupillary dilation

We prospectively evaluated the effect of various systemic alpha1 adrenergic receptor antagonists on pupillary dilation in patients with benign prostatic hyperplasia. Patients who are at risk for intraoperative floppy iris syndrome cannot be elucidated simply by judging preoperative dilation.     

Determination of the antimicrobial properties of oligo-2-hydroxy-1-naphthaldehyde

Oligo-2-hydroxy-1-naphthaldehyde (OHNA) was synthesized by oxidative polycondensation using H2O2 (35%, aqueous solution), air O2 and NaOCl (34%, aqueous solution) by Kaya and Senol and the products were characterized by spectral techniques. Antimicrobial activities of the first and second fractions of OHNA were tested against Corynobacterium xerosis CCM 2824, Proteus vulgaris ATCC 6897, Staphylococcus epidermidis NRRL B-4877, S. aureus ATCC 6538, Enterobacter aerogenes ATCC 13048, Salmonella thyphimurium CCM 5445, Pseudomonas aeroginosa ATCC 27853, Escherichia coli ATCC 11230, E. coli ATCC 23998, Bacillus cereus ATCC 7064, B. cereus ATCC 99, B. subtilis ATCC 6633, Yersinia spp., Neisseria canis, Rhodotorula rubra, Kluyveromyces fragilis NRRL 2415, Saccharomyces cerevisiae ATCC 9763, S. ovarum, Debaryomyces hensenii, Hansenula anamola, Candida albicans, C. utilis, Aspergillus niger, A. fumigates, A. versicolor, A. flavus, A. parasiticus, Penicillium granulatum, P. chrysogenum, and P. herque. OHNA demonstrated antimicrobial activity against various bacteria and yeast, but did not affect filamentous fungi.     

Nasal bone measurement during the 1st trimester: is it useful?

The aim of this study was to present our preliminary data about nasal bone measurements at 11-14 weeks of pregnancy. This study was conducted in our prenatal unit between 2000 and 2003. A total of 642 pregnant women (single pregnancies) were enrolled into the study. During the first trimester of pregnancy, crown-rump length, nuchal translucency thickness, and fetal nasal bone length measurements and ductus venosus Doppler images were evaluated. The distribution of absent or small nasal bones in both normal fetuses and in those having some pathological conditions was compared by statistical analysis. p < 0.05 was considered significant. Nasal bone evaluation was successful in 600 of 642 (93.4%) ultrasound examinations. The linear regression line showed a significant positive slope with increasing crown-rump length (r=0.54, p < 0.001). Absent or small nasal bones were more common in abnormal than in normal fetuses (p=0.007). It is clear that the fetal nasal bone is becoming a powerful tool in prenatal screening for aneuploidy. Larger studies to be performed in a low-risk population are needed to assess whether the measurement of the nasal bone length provides additional benefits beyond the assessment of the presence or absence of the nasal bone.     

Normalization of coronary fractional flow reserve with successful intracoronary stent placement to a myocardial bridge

Although myocardial bridge is asymptomatic in most patients, it can lead to myocardial ischemia, myocardial infarction, cardiac arrhythmias, and sudden death. We successfully treated a myocardial bridge, which caused a severe stenosis in left anterior descending (LAD) artery together with myocardial ischemia and disturbance in intracoronary hemodynamics, with stent implantation.     

The functional and oncologic effectiveness of near-total laryngectomy

PURPOSE: To investigate the oncologic efficiency of near-total laryngectomy for advanced laryngeal and neighboring organ cancers and to evaluate the functional results. MATERIALS AND METHODS: A retrospective review of 135 cases of near-total laryngectomy carried out in a tertiary university hospital between 1989 and 2000 was undertaken. The original operation was carried out in 3 groups: classic "near-total laryngectomy" for endolaryngeal lesions; "near-total laryngectomy and partial pharyngectomy" for lesions originating from the pyriform sinus or lesions with extension to the pharynx or tongue base but reconstructed primarily; and "near-total laryngopharyngectomy" for lesions requiring pedicled flap reconstruction after resection. Oncologic success was evaluated according to the location and extent of the tumor and the particular operation. Functional outcome was evaluated according to phonation and its quality as well as to the severity of aspiration. RESULTS: Of the 135 cases, 121 were men, and 14 were women (age range, 33-80 years; mean, 56.2 years). Mean phonation time was 35.2 days, and mean onset of oral intake was 18.5 days. Of the 135 cases of the series, 124 were evaluated for survival. Thirteen of 26 (50.0%) cases of T2, 34 of 53 (64.2%) cases of T3, and 33 of 45 (73.3%) cases of T4 carcinomas survived by the end of the evaluation period. Likewise, 46 of 77 (59.7%) cases of N0, 16 of 19 (84.2%) cases of N1, and 18 of 27 (66.7%) cases of N2 survived the same period; however, none with N3 metastatic neck disease survived. The probability of survival with regard to the T and N stages of the disease did not reveal a statistically significant result (P =.15 and.49, respectively). CONCLUSIONS: According to these results, near-total laryngectomy is a valid alternative for extended laryngeal and neighboring organ cancers with an acceptable morbidity and a high success rate for voice preservation. Near-total laryngectomy should be offered as a surgical treatment alternative for these patients.     

Coincidental adrenal ganglioneuroma – a case presenting with enuresis nocturna

A 9-year-old boy presenting with primary enuresis nocturna was discovered to harbour a large left adrenal mass which produced no hormonal abnormalities. He was undergone an exploration and the mass was removed completely. It was found to be an adrenal ganglioneuroma weighing 240 g. Though no cause-and-effect relationship is established, the case no long suffered from enuresis soon after surgery and free of recurrence after 5 years.     

The effect of Plantago major Linnaeus on serum total sialic acid, lipid-bound sialic acid, some trace elements and minerals after administration of 7,12-dimethylbenz(a)anthracene in rats

The present study was designed to evaluate the effect of Plantago major Linnaeus (PM) extract on serum total sialic acid (TSA), lipid-bound sialic acid (LSA), some trace elements (copper (Cu), zinc (Zn) and iron) and mineral levels (magnesium, calcium and sodium) in Wistar albino rat administrated 7,12-dimethylbenz(a)anthracene (DMBA). Rats were divided into three equal groups (n = 6). Group I comprised the control group, group II was treated with DMBA (100 mg/kg, single dose) and group III was treated with DMBA (100 mg/kg single dose) and aqueous extract of PM 100 mg/kg/day for 60 days. After 60 days, statistical analyses showed that TSA and LSA levels in DMBA and DMBA + PM groups were significantly higher compared to the control group (TSA: p < 0.01, p < 0.05; LSA: p < 0.05, p < 0.05, respectively). Serum Zn levels were decreased in subjects treated with DMBA (p < 0.01) and DMBA + PM (p < 0.05) compared to the control group values. Serum Cu levels were increased in DMBA group and PM-treated group compared to the control group values. The results of this investigation showed that the levels of TSA and LSA changed significantly, which are sensitive markers for detecting the toxic effects of DMBA. On the other hand, observed decline in Zn levels in rats from DMBA + PM group might be due to decreased generation of free radicals and oxidative stress. Results from this study suggest that PM may be partially effective in preventing carcinogenesis initiated by environmental carcinogen DMBA.     

Midazolam vs. Diphenhydramine for the Treatment of Metoclopramide-induced Akathisia: A Randomized Controlled Trial

Objectives To compare the effects of midazolam, which is a fast and short-acting benzodiazepine, and diphenhydramine, which is a widely used anticholinergic agent, in clinical practice for the treatment of metoclopramide-induced akathisia.
Methods All adults older than 17 years given metoclopramide for nausea and vomiting or for headache and who had akathisia were eligible for this clinical, randomized, double-blind trial. Patients were randomized to receive diphenhydramine or midazolam. Subjective, objective, and total akathisia scores and modified Ramsay Sedation Scale scores were recorded. Repeated-measures analysis of variance was used to compare the efficacy and side effects of the medications.
Results Forty-one (73.3%) of the 56 enrolled patients were women. The mean (±SD) age was 39.9 (±15.7) years in the diphenhydramine group and 40.9 (±16.2) years in the midazolam group. Mean subjective, objective, and total akathisia scores in the first 5 minutes declined considerably in the midazolam group compared with the diphenhydramine group (p < 0.001). However, the mean Ramsay Sedation Scale score in the first 15 minutes increased significantly in the midazolam group compared with the diphenhydramine group (p < 0.001).
Conclusions Midazolam can correct the symptoms of metoclopramide-induced akathisia faster than diphenhydramine, but it causes more sedation.