Case report: seizures in a child caused by a large venous angioma

Cerebral venous angioma is a congenital anomaly of the medullary vein, the vessel that drains into the transparenchymal venous stem. This lesion is also referred to as a developmental venous anomaly. A few reports in the literature have documented developmental venous anomaly-related epilepsy, neurologic deficits, and intracranial hemorrhage. A 3-year-old boy was referred to our hospital after he sustained an afebrile, tonic-clonic, focal seizure of 15 minutes' duration that affected his right arm, leg, and eyebrow. Cerebral digital subtraction angiography showed a bilateral, large periventricular developmental venous anomaly. This report describes the clinical and radiologic findings for this large venous angioma that caused seizures in a child.     

The effect of budesonide mouthwash on oral chronic graft versus host disease

Oral chronic graft versus host disease (cGVHD) is common and a major cause of morbidity and loss of quality of life in long term survivors. Cyclosporine with prednisone remains the first line therapy for oral manifestations of cGVHD. However, even with routine administration of systemic agents, many patients with oral manifestations of cGVHD do not have resolution of their disease and may benefit from incorporation of local therapy. Budesonide is a highly potent steroid which has minimal systemic side effects and being used for oral cGVHD. We designed a retrospective study to compare treatment results of patients with oral cGVHD who received topical budesonide in addition to systemic therapy that consists of combined prednisone and cyclosporine (Group A, n = 12), with the treatment results of patients who were administered the same systemic therapy alone (Group B, n = 11) to determine whether budesonide mouthwash had any advantage on response rates. Three mg topical budesonide/10 ml saline was used 3-4 times a day for up to 6 months in group A. Diagnosis, clinical staging, and treatment response scoring for cGVHD were performed according to National Institutes of Health (NIH) consensus criteria. At the baseline examination, there were no statistically significant differences in terms of median oral cGVHD examination scores between two groups. After treatment, there was statistically significant decrease in median oral cGVHD examination scores compared to baseline (P < 0.001 and 0.021), and significant differences were found between two groups (P < 0.032). Overall response rate was 83% and 36% for group A and B, respectively (P = 0.036). However, no statistically significant differences were found between median pain scores of two groups before and after treatment (P = 0.740 and P = 0.091). No major systemic side effects and oral candidiasis were observed in two groups of patients. We concluded that topical budesonide might be added to systemic therapy to obtain better response rates in patients with oral cGHVD.     

Effect of Oxidized Fibrinogen on Aggregation of Activated Platelets and Neutrophils

The effect of oxidized fibrinogen on platelet-neutrophil complex formation was evaluated by studying the platelet aggregation (changes in light transmission and turbidimetric assay). Activation of cells by thrombin (0.015 U/ml) in the presence of oxidized fibrinogen was accompanied by the formation of larger intermolecular aggregates of platelets and leukocytes as compared to those detected in experiments with non-oxidized fibrinogen. Addition of thrombin (0.2 U/ml) in the presence of oxidized fibrinogen was followed by the formation of more stable complexes of platelets and leukocytes as compared to those revealed in experiments with non-oxidized fibrinogen. An increase in the width of aggregation curves was most pronounced in the system of 10⁻⁴ M Fe²⁺ and 10⁻⁴ M H₂O₂ with oxidized fibrinogen. Our results indicate that oxidized fibrinogen contributes to the “floating” or suspension of platelet-leukocyte complexes. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 147, No. 3, pp. 284–290, March, 2009     

Anticonvulsant activity of 3,5-dimethylpyrazole derivatives in animal models

A series of 3,5-dimethylpyrazole derivatives, structurally related to the previously described potent ameltolide analogues, were synthesized and evaluated for their anticonvulsant activity. Ten compounds were prepared by reacting the 4-amino-3,5-dimethylpyrazole with appropriate substituted carboxylic acids, benzoyl chlorides and benzaldehydes to obtain amide and imine derivatives. Initial anticonvulsant screening was performed using intraperitoneal pentylenetetrazole (PTZ) and maximal electroshock (MES) induced seizure tests in mice. Among the 10 tested compounds, N-[1-(4-methoxybenzoyl)-3,5-dimethylpyrazole-4-yl]-4-methoxybenzamide 2 and N-[1-(2,6-dichlorobenzoyl)-3,5-dimethylpyrazole-4-yl]-2,6-dichlorobenzamide 3 decreased seizure severity and the mortality rate in the PTZ test. Hence, compound 3 was tested in an animal model of absence epilepsy, Genetic Absence Epileptic Rats from Strasbourg (GAERS). There were no significant changes in the duration or number of spike-and-wave discharges in this model.     

An evaluation of quality of life of mothers of children with enuresis nocturna

The aim of this study was to evaluate the impact of enuresis nocturna on quality of life of the mothers. Mothers who have a child with monosymptomatic nocturnal enuresis (n = 28) and mothers who have a child without any health problems (n = 38) were enrolled in the study. Groups were in balance for background variables (child’s age, gender, and number of siblings; mother’s age, marital status, highest year of education completed, and occupation; presence of health insurance; and type of residence). Short-Form Health Survey (SF-36) Questionnaire, the Beck Depression Inventory (BDI), and Spielberg’s State-Trait Anxiety Inventory (STAI) were applied to all mothers. The mothers of children with enuresis had significantly lower quality-of-life scores in the SF-36 for the bodily pain (p = 0.015) and role emotional (p = 0.014) subscales. We observed significant difference between groups according to BDI; mean score was higher in mothers who have a child with enuresis nocturna (p = 0.017). There was no significant difference between groups according to the STAI. Significant differences according to bodily pain and role emotional subscales of SF-36, and the BDI scores, show that the mothers were negatively affected by having a child with monosymptomatic nocturnal enuresis.     

Frequency of electrocardiographic changes indicating myocardial ischemia during elective cesarean delivery with regional and general anesthesia: detection based on continuous Holter monitoring and serum markers of ischemia

STUDY OBJECTIVE: To determine the frequency of electrocardiographic (ECG) changes and to assess the occurrence of myocardial ischemia during elective cesarean delivery with either regional or general anesthesia. DESIGN: Randomized, prospective, single-blinded clinical trial. SETTING: Large referral hospital. PATIENTS: 40 ASA physical status I and II term parturients. INTERVENTIONS: Patients were divided randomly into two groups as follows: the regional anesthesia group (group 1, n = 20) and the general anesthesia group (group 2, n = 20). MEASUREMENTS: In each case, continuous ECG was done using a 7-lead Holter monitor in the operating room, continuing for 24 hours after surgery. All Holter traces were analyzed by a study-blinded cardiologist. Blood samples were collected preoperatively (baseline) and at one, 5, and 24 hours postoperatively. Serum troponin T, creatinine kinase-MB, and myoglobin levels were measured. MAIN RESULTS: Two patients in group 1 (10%) and one patient in group 2 (5%) showed one mm ST-segment depression for two to 5 minutes. In all 40 cases, troponin T levels were in the normal range at all time points studied. In both groups, mean serum creatinine kinase-MB and myoglobin levels at one and 5 hours postoperatively were significantly higher than at baseline (P < 0.05). These high CK-MB and myoglobin levels were returned to normal ranges at the end of the study period; none of these women showed ST-segment changes. CONCLUSION: The ST-segment changes are not frequent in healthy women undergoing elective cesarean delivery during either regional or general anesthesia, and we found no evidence of myocardial injury.     

Levels of oxidative stress parameters and the protective effects of melatonin in psychosis model rat testis

Aim： To evaluate the effects of melatonin on antioxidant enzyme levels and histopathologic changes in dizocilpine （MK-801）-induced psychosis model rat testis. Methods： A total of 24 adult male Wistar-Albino rats were divided into three groups with 8 in each. Group I was used as control. Rats in Group II were injected with MK-801 （0.5 mg/kg body weight i.p. for 5 days）. In addition to MK-801, melatonin （50 mg/kg body weight i.p. once a day for 5 days） was injected into the rats in Group Ⅲ. The testes were harvested bilaterally for biochemical and histopathological examinations. Antioxidant enzyme activities, malondialdehyde, protein carbonyl and nitric oxide （NO） levels in testicular tissues were analyzed using spectrophotometric analysis methods. Histopathological examinations of the testes were also performed. Results： MK-801 induced testicular damage, which resulted in significant oxidative stress （OS） by increasing the levels of antioxidant enzymes. The malondialdehyde, protein carbonyl and NO levels were increased in testicular tissues of rats. Treatment with melatonin led to significant decrease in oxidative injury. Administration of melatonin also reduced the detrimental histopathologic effects caused by MK-801. Conclusion： The results of the present study showed that MK-801 cause OS in testicular tissues of rats and treatment with melatonin can reduce the harmful effects＇of MK-801. （Asian JAndro12008 Mar; 10： 259-265）     

Macular and peripapillary vessel density alterations in a large series of patients with systemic lupus erythematosus without ocular involvement

Graefe's Archive for Clinical and Experimental Ophthalmology - The aim of this study was to investigate changes in both macular and peripapillary retinal microcirculation in the subclinical...     

Paradoxical embolism in Ebstein’s anomaly

A 26-year-old man with Ebstein’s anomaly had cerebellar infarction due to paradoxical embolism. Ebstein’s anomaly is characterized by a downward displacement of the tricuspid valve into the right ventricle due to anomalous attachment of the tricuspid leaflets. Echocardiography is the method of choice to diagnose Ebstein’s anomaly on its own or in association with other heart defects. Paradoxical embolism is a potential complication whenever a right to left shunt exists (for example, atrial septal defect). Ebstein’s anomaly diagnosed in adult life is a benign and stable disease, particularly if the patient is asymptomatic; surgical correction must be performed if the patient becomes symptomatic because of either paradoxical embolism or worsening of the tricuspid regurgitation.