Effects of long-term passive smoking on the diameter of glomeruli in rats: Histopathological evaluation

BACKGROUND AND AIMS: Long-term smoking increases the risk of renal diseases and it also causes the progression of the diseases. The aim of this study was to evaluate the effects of smoking on glomeruli in healthy rats exposed to long-term passive smoking for a short period of time after birth. METHODS: Sixty-five rats were randomly assigned into four groups. Groups 1 (18 males) and 2 (18 females) were exposed to smoke, whereas groups 3 (15 males) and 4 (14 females) were not exposed to smoke. Overall, 130 renal units were evaluated, and diameters of 10 different glomeruli were measured. The renal and bodyweights of the rats were measured. RESULTS: The diameter of the glomeruli was 95.51 +/- 9.25 and 100.91 +/- 4.06 microm in groups 1 and 3, respectively (P < 0.05). It was 97.32 +/- 4.06 and 98.86 +/- 6.25 microm in groups 2 and 4, respectively (P > 0.05). Irrespective of the sex, the diameter of the glomeruli was 96.42 +/- 7.15 microm in smokers and 99.92 +/- 5.56 microm in non-smokers (P < 0.05). The renal weights of the male rats affected by smoke were significantly lower than that of those that were not affected by smoke (P < 0.05). Bodyweights of male rats affected by smoke were significantly lower that of those not affected (P < 0.05). There was a weak correlation between the diameter of the glomeruli and the bodyweights of male rats affected by smoke (r = 0.474, P < 0.05). CONCLUSION: We conclude that passive smoking might have a negative affect on renal morphometry and body growth.     

Intraorbital encephalocele: an important complication of orbital roof fractures in pediatric patients

Orbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2-4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging.     

Cervical hematomyelia: a rare entity in a neonate with cesarean section and surgical recovery

Spinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to In?nü University Turgut Ozal Medical Center because of respiratory distress and brachial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intramedullary lesion extending from C3 to D1 on magnetic resonance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct puncture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the patient's neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are discussed in the light of recent literature.     

Unilateral Purtscher-like retinopathy after weight-lifting

PURPOSE: To report a case of Purtscher-like retinopathy after weightlifting. METHODS: A 17-year-old man presented with a sudden visual loss in his left eye after weightlifting two weeks ago. Fundus examination of the left eye showed cotton-wool spots and scattered retinal hemorrhages in the posterior pole. Fluorescein angiography and indocyanine green angiography with a scanning laser ophthalmoscope were performed. RESULTS: Angiography showed hypofluorescent areas adjacent to the optic disc and in the posterior pole and partial filling insufficiency in the inferior and inferotemporal branch retinal veins. Complete venous filling was noted in late phases of angiography. CONCLUSIONS: The pathogenesis of weightlifting suggests the Purtscher-like changes as a result of Valsalva maneuver in our case. To our knowledge, this is the first reported case of Purtscher-like retinopathy associated with weightlifting.     

Pituitary metastasis mimicking a macroadenoma from carcinoma of the larynx: a case report

Metastatic tumors of the pituitary gland are not commonly diagnosed during life in cancer patients. The occurrence of symptomatic lesions is also very unusual and difficult to differentiate clinically and radiologically from pituitary adenomas. Furthermore, a single intrasellar metastasis from laryngeal carcinoma mimicking a pituitary adenoma is an extremely rare pathological finding. We report on the clinical, radiological, and pathological findings in a patient with laryngeal carcinoma who had a symptomatic solitary pituitary gland metastasis that was recognized antemortem.     

Wilson's disease with hepatic presentation in childhood

OBJECTIVE: To evaluate clinical, laboratory findings, treatment and long-term follow-up of children with Wilson's disease with hepatic presentation. DESIGN: Retrospective study with a median follow-up period of 9 years. SETTING: University medical center. SUBJECTS: Thirty-four children with hepatic involvement, ranging in age from three to fifteen years, were diagnosed as Wilson's disease over an eighteen year period. METHODS: The diagnosis was based on the presence of family history and Kayser-Fleischer rings, low serum ceruloplasmin levels and increased urinary and hepatic copper concentrations. RESULTS: Four patients had also neurological manifestations. Eight patients were diagnosed as fulminating hepatic failure resulting in death in a few days. The most common symptoms were abdominal distension and abdominal pain. Hepatomegaly was the predominant physical finding and serum transaminases were elevated in most of the patients. Twenty patients had cirrhosis and six had chronic hepatitis histopathologically. All patients with fulminating hepatic failure had hyperbilirubinemia with normal alkaline phosphatase and higher aspartate aminotransferase than alanine aminotransferase. Patients were treated with D-penicillamine and zinc sulphate. Three patients underwent liver transplantation. Four more patients besides patients with fulminating hepatic failure died due to end stage liver disease. Twenty-two patients were followed for median 9 years. Four patients with poor compliance progressed to decompensated cirrhosis and the others were stable. CONCLUSIONS: Liver disease with unknown origin with positive family history and parental consanguinity should imply Wilson's disease strongly.     

A Novel Approach to Improving Fat Delivery in Neonatal Enteral Feeding

Continuous infusion systems used for enteral nutrition support in the neonatal intensive care unit deliver as little as 60% of the fat in human milk to the neonate. This study determined the effect of mixing common feedings for preterm infants in the feeding bag and tubing on fat losses during enteral feeding. Laboratory models were developed to assess the contribution of various mixing techniques to delivered fat content. Fat content was measured periodically during feeding and compared to baseline measurements. A multistage approach incorporating a feeding bag inverter and a tubing circulation loop delivered >90% of milk fat when used in conjunction with a commercial continuous infusion system. With unfortified human milk, this approach delivered 91.9% ± 1.5% of fat content over a one hour feed, significantly greater (p < 0.01) than 77.5% ± 2.2% delivered by continuous infusion controls (Mean ± SEM). With fortified human milk, this approach delivered 92.1% ± 2.4% of fat content, significantly greater (p < 0.01) than 79.4% ± 1.0% delivered by a non-adapted infusion system (Mean ± SEM). Mixing human milk during continuous infusion improves fat delivery, which may improve nutrition and growth outcomes in low birth weight neonates.     

角膜厚度对三种不同眼压计测量的影响

目的:比较采用Goldmann压平眼压计(Goldmann applanation tonometer,GAT)、非接触眼压计(non-contact tonometer,NCT)和Schiotz眼压计(Schiotz tonometer,ST)的眼压(intraoeular pressure,IOP)测量,评估角膜中央厚度(central corneal thickness,CCT)对读数的影响。方法:使用GAT、NCT和ST对所有患者的右眼进行眼压测量。超声角膜厚度测量法测定CCT。所有IOP及CCT测量由同一检查者进行。计算CCT25%(Q1)百分位数和75%(Q3)百分位数值,并通过这种方法将该组分为薄、中、厚角膜亚组。使用Statplus软件进行统计分析。结果:全系列144眼,GAT测量平均IOP为17.4±4.9mmHg,NCT为16.0±5.8mmHg,ST为14.0±4.0mmHg(Friedman方差分析P<0.01)。IOP水平和CCT之间的相关系数NCT为0.787(P<0.01),GAT为0.630(P<0.01),ST为0.565(P<0.01)。ST测量中,纠正的IOP误差和CCT之间的相关性在厚角膜明显弱(r=0.381,P=0.022)。结论:NCT是最易受不同CCT影响的设备。ST读数似乎比GAT和NCT读数受CCT的影响小。特别是在厚角膜,与NCT和GAT相比,ST可以被认为是一个更可靠的仪器。     

放射状角膜切开术在轻中度圆锥角膜病例中视觉康复的疗效

目的：探讨放射状角膜切开术在轻中度圆锥角膜治疗中光学和视力康复的效果。
　　方法：回顾性分析应用放射状角膜切开术治疗圆锥角膜的病例22例31眼并进行了至少12 mo的随访。测量并分析术前术后裸眼视力,最佳矫正视力,自动屈光计值,角膜曲率,角膜不规则指数以及并发症。
　　结果：在最后一次随访中,平均裸眼视力( logMAR)由0.86±0.34显著提升至0.30±0.29(P<0.0001),平均最佳矫正视力由0.47±0.21提升至0.17±0.23(P<0.0001)。平均角膜曲率由48.69±3.68 D 降低至44.33±3.09 D ( P<0.0001)。自动屈光计测得平均等效球镜值由-5.61±2.85D显著提升至-2.29±1.95D(P<0.0001)。在整个随访过程中,中央角膜厚度和3mm,5mm区域的角膜不规则指数均无变化。术中和术后没有观察到严重并发症。
　　结论：在本组病例中,放射状角膜切开术是轻中度圆锥角膜视觉康复的有效治疗方法。