Subureteric polydimethylsiloxane injection in the treatment of vesico-ureteric reflux

Endoscopic treatment of vesico-ureteric reflux is a viable alternative to open surgery. We evaluated the effectiveness of polydimethylsiloxane in the endoscopic treatment of vesico-ureteric reflux. In the period between September 1994 and March 1996, 30 ureteral units of 20 children with vesico-ureteric reflux were treated by means of subureteric polydimethylsiloxane injection. Median age was 8 years in the group including 8 female and 12 male patients. Of the 30 ureteral units, 26 had no reflux at the end of the first injection. Two of the remaining four units were not refluxing after the second injection procedure. Contralateral reflux was observed postoperatively in two of the eleven patients who were treated for unilateral disease. It seems that endoscopic polydimethylsiloxane injection is an effective procedure in the treatment of vesicoureteric reflux.     

Effectiveness of prophylactic levosimendan in high-risk valve surgery patients

Background

Levosimendan has anti-ischaemic effects, improves myocardial contractility and increases systemic, pulmonary and coronary vasodilatation. These properties suggest potential advantages in high-risk cardiac valve surgery patients where cardioprotection would be valuable. The present study investigated the peri-operative haemodynamic effects of prophylactic levosimendan infusion in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension.

Methods

Between May 2006 and July 2007, 20 consecutive patients with severe pulmonary arterial hypertension (systolic pulmonary artery pressure ≥ 60 mmHg) and/or low ejection fraction (< 50%) who underwent valve surgery in our clinic were included in the study and randomised into two groups. Levosimendan was administered to 10 patients in group I and not to the 10 patients in the control group. Cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR) and mean pulmonary artery pressure (MPAP) were recorded for each patient preoperatively and for 24 hours following the operation.

Results

CO and CI values were higher in the levosimendan group during the study period (p < 0.05). MPAP and PVR values were significantly lower in the levosimendan group for the 24-hour period (p < 0.05) and SVR values were significantly lower after 24 hours in both groups. When clinical results were considered, no difference in favour of levosimendan was detected regarding the mortality and morbidity rates between the groups.

Conclusion

Levosimendan improved the haemodynamics in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension, and facilitated weaning from cardiopulmonary bypass in such high-risk patients when started as a prophylactic agent.     

Vascular malformation in the infrapatellar (Hoffa's) fat pad

A 16-year-old girl presented with pain and swelling of her right knee for 2 years. Magnetic resonance imaging disclosed a mass in the infrapatellar fat pad. Arthroscopic removal of the lesion led to a histopathologic diagnosis of vascular malformation, which has not been reported exclusively in this location.     

Olea europaea leaf extract improves the treatment response of GBM stem cells by modulating miRNA expression

The stem-like cells of Glioblastoma multiforme (GBM) tumors (GSCs) are one of the important determinants of recurrence and drug resistance. The aims of the current study were to evaluate the anticancer effect of Olea europaea leaf extract (OLE) on GBM cell lines, the association between OLE and TMZ responses, and the effect of OLE and the OLE-TMZ combination in GSCs and to clarify the molecular mechanism of this effect on the expression of miRNAs related to cell death. The anti-proliferative activity of OLE and the effect of the OLE-TMZ combination were tested in the T98G, U-138MG and U-87MG GBM cell lines using WST-1 assay. The mechanism of cell death was analyzed with Annexin V/FITC and TUNEL assays. The effects of OLE on the expression levels of miR-181b, miR-153, miR-145 and miR-137 and potential mRNA targets were analyzed in GSCs using RT-qPCR. OLE exhibited anti-proliferative effects via apoptosis and necrosis in the GBM cell lines. In addition, OLE significantly induced the expression of miR-153, miR-145, and miR-137 and decreased the expression of the target genes of these miRNAs in GSCs (p < 0.05). OLE causes cell death in GBM cells with different TMZ responses, and this effect is synergistically increased when the cells are treated with a combination of OLE and TMZ. This is the first study to indicate that OLE may interfere with the pluripotency of GSCs by modulating miRNA expression. Further studies are required, but we suggest that OLE may have a potential for advanced therapeutic cancer drug studies in GBM.     

Can standing knee radiographs predict chondral lesions in young- and middle-aged population?

Purpose

The aim of the study is to investigate the correlation between arthroscopic findings and joint space width on the standing knee radiographs at various flexion degrees in the young- and middle-aged patients with complaints of knee pain.

Methods

Middle-aged patients with complaint of knee pain ongoing more than 6 months and failure in conservative treatment methods were included. Weight-bearing full extension, 30 and 45° of flexion radiographs were obtained. Joint space width was calculated on radiograms. Arthroscopy was performed to evaluate the chondral pathologies. Correlation analysis was performed.

Results

Fourty-three patients (18 female, 25 male) with a mean age of 44.6 (20–63) were included. Mean joint space width was 4.87 mm ± 1.45 (2–10) mm in medial and 5.43 mm ± 1.47 (1–9) in lateral on standing extension radiographs. In 30° flexion radiographs, mean joint space width was 4.33 mm ± 1.25 (1.5–7.5) in medial and 5.36 mm ± 1.69 (1–9) in lateral. In 45° flexion radiographs, medial joint space was 4.28 mm ± 1.59 (2–9) in medial and 5.15 mm ± 1.59 (1.5–9) in lateral. In arthroscopic evaluation, one knee had grade 1 (2.3 %), three knees had grade 2 (7 %), nine knees had grade 3 (20.9 %), and twelve knees had grade 4 (27.9 %) lesions in the medial compartment. In the lateral compartment, two knees had grade 3 (4.7 %) and one knee had grade 4 lesion (2.3 %). Radiological data did not correlate with the arthroscopic findings.

Conclusion

Standing knee radiographs do not correlate with the arthroscopic findings in the middle-aged population with chondral lesions in knee joint.

Level of evidence

Case series with no comparison group, Level IV.     

Marked Narrowing of Right Heart Chambers Due to Compression by Giant Hepatic Hydatid Cyst

External compression of the heart may be presented as valvular heart disease. A 50‐year‐old woman with signs and symptoms of tricuspid stenosis was diagnosed with giant hepatic hydatid cyst. Symptoms were resolved after surgical excision. Echinococcosis should be in mind while evaluating patients with external cardiac compression.     

Effects of hippocampal histone acetylation and HDAC inhibition on spatial learning and memory in the Morris water maze in rats

In recent years, it has been pointed out that epigenetic changes affect learning and memory formation. Particularly, it has been shown that histone acetylation and DNA methylation work in concert to regulate learning and memory formation. We aimed to examine whether acetylation of H2B within the rat hippocampus alters by trainings in the Morris water maze test. Male, 2–3 months old, Sprague Dawley rats were trained in Morris water maze task. Animals were given four trials per day for five consecutive days to locate a hidden platform. On the sixth day, the platform was removed and the animals were swum for 60 s. The effects of sodium butyrate, histone deacetylase inhibitor, were tested on normal and scopolamine-induced memory-impaired rats. The histone deacetylase inhibitor, sodium butyrate, increased histone H2B acetylation in normal rats. Sodium butyrate had no effect on learning and memory performance of normal rats; however, it partially ameliorated learning and memory disruption induced by scopolamine. So, the histone deacetylase inhibitors can be new treatment agent for cognitive disorders.     

Retrospective evaluation of patients diagnosed solid pseudopapillary neoplasms of the pancreas

Purpose

Solid pseudopapillary neoplasm (SPN) is a rare, low-grade neoplasm with excellent prognosis. In this study, we evaluated clinicopathological characteristics of patients diagnosed with SPN retrospectively.