Beneficial Effect of Etanercept on Hyperoxic Lung Injury Model in Neonatal Rats

Purpose: To determine whether prophylaxis with etanercept, an anti-inflammatory drug, would decrease the severity of lung injury in a neonatal rat model of bronchopulmonary dysplasia (BPD); Materials and Methods: Rat pups were divided into three groups: pups exposed to room air (group 1; n = 10), to hyperoxia + placebo (group 2; n = 9), and to hyperoxia + etanercept (group 3; n = 8). Lung morphology was assessed by alveolar surface area percentage, which is a measure of alveolar size. The severities of lung inflammation and antioxidant capacity were assessed by quantifying tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), malondialdehyde (MDA), and superoxide dismutase (SOD) from lung homogenate; Results: The percentage of alveolar surface areas were significantly higher in group 3 compared to group 2 (p = .004) and similar in both group 1 and group 3 (p = .21). The mean level of lung MDA was significantly higher in group 2 compared to group 1 and group 3 (p < .05 for both). Lung homogenate SOD activities in group 3 was significantly higher than group 2 (p < .001). Furthermore, group 3 pups had lower levels of TNF-α and TGF-β in lung homogenate than that in group 2 (p < .05 for both) but similar in both group 1 and group 3; Conclusion: Etanercept has favorable effects on alveolarization as well as inflammation and oxidative stress markers in a neonatal rat model of BPD.     

Thermal therapy, Part III: ablation techniques

Ablative treatments are gaining increasing attention as an alternative to standard surgical therapies, especially for patients with contraindication or those who refuse open surgery. Thermal ablation is used in clinical applications mainly for treating heart arrhythmias, benign prostate hyperplasia, and nonoperable liver tumors; there is also increasing application to other organ sites, including the kidney, lung, and brain. Potential benefits of thermal ablation include reduced morbidity and mortality in comparison with standard surgical resection and the ability to treat nonsurgical patients. The purpose of this review is to outline and discuss the engineering principles and biological responses by which thermal ablation techniques can provide elevation of temperature in organs within the human body. Because of the individual problems associated with each type of treatment, a wide range of ablation techniques have evolved including cryoablation as well as ultrasound, radiofrequency (RF), microwave, and laser ablation. Aspects of each ablation technique, including mechanisms of action, equipment required, selection of eligible patients, treatment techniques, and patient outcomes are presented, along with a discussion of limitations of the techniques and future research directions.     

Classification of carotid artery Doppler signals in the early phase of atherosclerosis using complex-valued artificial neural network

In this study, carotid arterial Doppler ultrasound signals were acquired from left carotid arteries of 38 patients and 40 healthy volunteers. The patient group had an established diagnosis of the early phase of atherosclerosis through coronary or aortofemoropopliteal angiographies. Results were classified using complex-valued artificial neural network (CVANN). Principal component analysis (PCA) and fuzzy c-means clustering (FCM) algorithm were used to make a CVANN system more effective. For this aim, before classifying with CVANN, PCA method was used for feature extraction in PCA-CVANN architecture and FCM algorithm was used for data set reduction in FCM-CVANN architecture. Training and test data were selected randomly using 10-fold cross validation. PCA-CVANN and FCM-CVANN architectures classified healthy and unhealthy subjects for training and test data with about 100% correct classification rate. These results shown that PCA-CVANN and FCM-CVANN classified Doppler signals successfully.     

Long-term benefits of aggressive treatment for primary colorectal cancer

The long-term follow up of 128 colorectal cancer patients is reported. Seventy-nine percent (101/128) of the patients had curative resections: 70 patients had radical lymphadenectomies with wide removal of tumor-adjacent nodes, and 31 patients had standard resections. The 5-year overall survival rates for Dukes' stage B and C patients and for all rectosigmoid cancer patients significantly favored radical resection (60% vs. 38%, 57% vs. 29%, respectively, P < 0.05). Tumor-free survival rates were also higher after radical lymphadenectomy but did not reach statistical significance. Eleven percent (14/128) of the patients required multiorgan resections, and/or preoperative radiation to render fixed cancers resectable, and these patients had a 10-year tumor-free survival rate of 45%, compared to zero % 5-year survival for the 27 patients who underwent palliative procedures (P < 0.01). These results confirm that many colorectal cancer patients will be cured with aggressive treatment and they support the need for a controlled trial for evaluation of lymphadenectomy for this disease. © 1996 Wiley-Liss, Inc.     

Apport de la simulation dans l'apprentissage de l'examen du fond d'œil.

Introduction: Simulation is emerging as an essential part of health sciences training programs as it provides safer patient care by reducing the risk of error. In the healthcare environment, simulation continues to spread in emergency specialties, but it is still underdeveloped in ophthalmology and there is a shortage of publications on this subject in Tunisia. Objective: To evaluate the effectiveness of procedural simulation as a teaching tool for funduscopic examination training. Methods and population studied: This was a prospective study including students who underwent procedural simulation training sessions during their ophthalmology internship. The included students were assessed at the initiation and end of each session by a pre-test and post-test. The procedure for performing the funduscopic examination was evaluated by a specific performance score. Student satisfaction was assessed at the end of each session. Results: During the study period, four groups of 12 students were included, for a total of 48 participants spread over 4 simulation sessions. Simulation training improved post-test. assessment scores with an overall median delta of +4.00. It also provided specific skills for performing the funduscopic examination, with an overall median specific performance score of 5.5/8 (5/8 to 7/8). The majority of students were satisfied upon completion of the simulation session. Conclusion: The training of fundus examination using an ophthalmoscopic simulator can improve the skills and knowledge of ophthalmic learners. This type of training can be an innovative addition to traditional learning. methods.     

3D PSIR MRI at 3 Tesla improves detection of spinal cord lesions in multiple sclerosis

Journal of Neurology - Spinal imaging in multiple sclerosis remains challenging because of its small size and numerous artifacts. To compare 3D Phase-Sensitive Inversion Recovery (PSIR) to a...     

Carcinoma of the fourth part of the duodenum: Report of a case

Primary carcinoma of the duodenum is rare, accounting for only 0.35% of all gastrointestinal carcinomas, and carcinoma of the fourth part of the duodenum constitutes approximately 10% of duodenal carcinomas. Since the predominant symptoms of tumors in this part of duodenum are related to upper intestinal obstruction, the diagnosis is usually made late. We report the case of a 66-year-old man who presented with anemia, weight loss, and upper intestinal obstruction, and was found to have advanced primary carcinoma of the fourth part of the duodenum by upper gastrointestinal series and computed tomography (CT). A review of the literature indicates that survival, which is related to nodal status, the grade of the tumor, and surgical results, seems to be longer in patients with carcinoma in this part of the duodenum compared to those with carcinomas in other parts of the duodenum. Moreover, segmentary resection has been reported to achieve a favorable outcome.     

Atlanto‐odontoid pyogenic arthritis revealing a Jugular Vein Thrombosis

Pyogenic arthritis of the atlantoaxial joint is scarce. It can lead to several complications, such as spinal cord compression and cerebral vein thrombosis. A 51‐year‐old man presented with a twenty‐day history of inflammatory neck pain. Physical examination revealed paravertebral muscle contracture, restricted neck movement, and fever. Spine magnetic resonance imaging (MRI) showed synovitis of atlanto‐odontoid joint, anterior epidural collection, and cerebral vein thrombosis. Transthoracic echocardiography was unremarkable. The patient was successfully treated with anti‐staphylococcal antibiotic treatment for 12 weeks associated with immobilization of the cervical spine. MRI performed one month after the initiation of the treatment showed disappearance of the epidural collection. The diagnosis of septic arthritis of the atlantoaxial joint should be considered in a patient with inflammatory neck pain. MRI findings are relevant in making the diagnosis of a septic atlanto‐odontoid joint. Conservative treatment, including antibiotic and neck immobilization, can be sufficient for the treatment of pyogenic arthritis of the atlantoaxial joint. Cerebral vein thrombosis is a rare complication due to septic arthritis of the atlantoaxial joint.     

Some biological effects of scorpion envenomation in late pregnant rats

Scorpion envenoming is less studied during gestation; however, it may induce various biological disturbances in maternal organism and hypothetical ones on their fetuses. The scope of this report was to elucidate some biological effects of such poisoning in late pregnant rats. Hence, TBARS levels in maternal lung, placental and fetal pulmonary and hepatic tissues and dam's biochemical blood parameters (glucose, creatinine, 17-β estradiol, progesterone, blood nitrogen urea, sodium and potassium maternal plasma concentrations) had been evaluated after saline (G1), and scorpion venom (G2: 30 min and G3: 60 min) injections in 22nd day pregnant rats. Histological microscopic examination of these tissues was also carried out in HE-stained paraffin sections. In addition, the mean arterial blood pressure following the envenomation variations was measured in three rats from the same pool. Our results showed that Buthus occitanus tunetanus crude venom induced significant increase in maternal, placental and fetal tissues lipid peroxidation, concomitant with blood pressure elevation. Maternal plasma creatinine, estradiol and progesterone concentrations levelled up significantly after 30 min or later (60 min) after the venom injection. Except for a probable pronounced oedema and few congestions in maternal lungs and degenerative aspects of trophoblast cells, all examined tissues showed a conserved structure. These results suggest that scorpion envenomation may induce gestation process disturbances and threatens both mother's and fetus’ well-being.