Central pontine myelinolysis secondary to cytomegalovirus hepatitis in a 10-month-old child

We present a 10-month-old child with central pontine myelinolysis (CPM) secondary to chronic active hepatitis due to cytomegalovirus (CMV) infection. A total of 35 paediatric cases of pontine and/or extrapontine myelinolysis are reported and, to our knowledge, CPM secondary to CMV hepatitis in an infant has not been previously reported. The MRI findings are highlighted.     

Malignant pleural mesothelioma in a child: long-term survival with ICE-WAC chemotherapy regimen

Malignant mesothelioma is a very rare tumor in childhood. Presently, treatment of this disease continues to be frustrating and prognosis remains poor. We here report a pediatric case of malignant pleural mesothelioma who gave a complete response to ICE-VAC chemotherapy regimen and achieved a long-term survival. An eight-year-old girl underwent exploratory thoracotomy and decortication because of a unilateral loculated and multicystic pleural effusion. Histopathological diagnosis was sarcomatoid pleural malignant mesothelioma. After decortication, chemotherapy with ICE (ifosfamide, carboplatin, etoposide) - VAC (vincristine, adriamycin, cyclophosphamide) combination was started. Six courses of chemotherapy resulted in complete clinical and radiological tumor response. She did not receive any further therapy and remains disease-free three years after the first remission. ICE-VAC chemotherapy combination resulted in a complete tumor response and a long-term disease-free survival for the presented case. The efficacy of this chemotherapy regimen in malignant mesothelioma needs to be documented in future trials.     

Variable E-cadherin expression in a MNU-induced colon tumor model in rats which exposed with 50 Hz frequency sinusoidal magnetic field

Inactivation of the E-cadherin system by multiple mechanisms, including both genetic and epigenetic events, plays a significant role in multistage carcinogenesis. We have investigated the effects of sinusoidal electromagnetic fields (SMF) on E-cadherin expression in an MNU (N-methyl-N-nitrosurea)-induced colon tumor model. Male wistar albino rats were used for the study. The rats were classified into four groups: I (MNU), II (SMF+MNU), III (SMF) and IV (control). After administered at MNU in 1st and 2nd groups, 2nd and 3rd groups were exposed to a sinusoidal magnetic field (SMF, 50 Hz, 5 mT) for 6 hours/day for 8 months. The expression of E-cadherin were examined in four groups of rat colon tissues by immunohistochemistry on paraffin sections. For immunohistochemical analysis, the labeled streptavidin biotin method was performed using a Vectastain Universal Quick Kit with microwave accentuation. Fisher's exact test was used for statistical analysis between proportions. Immunohistochemical studies of E-cadherin expression in this model demonstrated significant differences for cytoplasmic expression pattern. These results suggest that the electromagnetic fields result in significant alterations in cell adhesion mechanisms. This study has implications for understanding the role of fields in cell detachment in cancer metastasis. Further work is required to determine the relative effect of the magnetic fields on these phenomena.     

Acute iron ingestion

OBJECTIVE: Intoxication is one of the most common causes of admissions to emergency department in pediatric age group. Incidence of iron poisoning gradually increased because of wide spread use of iron containing drugs. METHOD: In this report, we present five cases of iron ingestion who were admitted to our emergency department within a year. RESULT: Whole bowel irrigation in addition to gastric lavage with an iron dose of over 50 mg/kg as well as deferoxamine treatment for patients in whom clinical and laboratory indications are present. CONCLUSION: The prompt recognition and treatment of children with acute iron poisoning is the single and the most critical point for decreasing the morbidity and mortality associated with iron containing products.     

Surveillance of Haemophilus influenzae among respiratory tract samples of Turkish children

We conducted three prospective studies of Haemophilus influenzae in different groups of children. Pharyngeal swab samples were taken (i). from 1382 healthy infants and children between 0 and 10 years of age (group 1), attending well child clinics (n=438), day care centres (n=440) and elementary schools (n=504), and (ii). from 322 children aged 2-10 years (group 2), clinically diagnosed as having upper respiratory tract infection. Pharyngeal swab samples and sinus aspirates were obtained from 49 children between 2 and 9 years of age (group 3), clinically diagnosed as having sinusitis. H. influenzae was isolated in similar rates from 315 (22.7%) of children in group 1, 72 (22.3%) of children in group 2 and 12 (24.4%) of children in group 3. Serotype b comprised 7, 5.2 and 2% of all H. influenzae isolates for group 1, 2 and 3, respectively. Production of beta-lactamase was detected in 1.0% of H. influenzae type b isolates in group 1, 1.2 and 6.1% of all isolates in group 2 and 3, respectively. There were no beta-lactamase negative ampicillin-resistant strains.     

Ophthalmic artery color Doppler ultrasonography in mild-to-moderate preeclampsia

OBJECTIVE: To evaluate the hemodynamic changes in mild-moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. METHODS: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild-moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. RESULTS: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild-moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. CONCLUSION: In patients with mild-moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.     

Benzoylalanine-derived ketoamides carrying vinylbenzyl amino residues: discovery of potent water-soluble calpain inhibitors with oral bioavailability

Novel benzoylalanine-derived ketoamides were prepared and evaluated for calpain I inhibition. Derivatives carrying vinylbenzyl amino residues in the P(2)-P(3) region inhibited calpain in nanomolar concentrations and thus represent a novel class of nonpeptidic calpain inhibitors. Selected examples exhibited an improved pharmacokinetic profile including improved water-solubility and metabolic stability. In particular, these calpain inhibitors showed oral bioavailability in rats as demonstrated by N-(1-benzyl-2-carbamoyl-2-oxoethyl)-2-[E-2-(4-diethylaminomethylphenyl)ethen-1-yl]benzamide (5d). The closely related derivative N-(1-carbamoyl-1-oxohex-1-yl)-2-[E-2-(4-dimethylaminomethylphenyl)-ethen-1-yl]benzamide (5b) was evaluated for neuroprotective efficacy after experimental traumatic brain injury in a fluid percussion model in rats. When administered after injury, 5b reduced the number of damaged neurons by 41%, and this result would be in line with the suggested neuroprotective efficacy of calpain inhibition.