Regulatory neuropeptides (ghrelin,obestatin and nesfatin-1) levels in serum and reproductive tissues of female and male rats with fructose-induced metabolic syndrome

Although, the exact mechanisms underlying the development of the metabolic syndrome (MetS) are not still completely understood, obesity, circulated peptide hormone levels and their interaction with genetic factors are considered largely responsible. The purpose of this study is to explore how the levels of ghrelin, obestatin (OBS) and NUCB2/nesfatin-1 (NES)/NUCB2 change in serum and the reproductive tissues of female and male rats with fructose-induced metabolic syndrome, and whether the levels of each hormone is correlated with the hormones involved with fertility. Experiments were conducted on 5-week-old Sprague–Dawley male and female rats assigned to either a control group or a MetS group. Controls were fed standard rat food and water ad libitum, while the MetS group was fed standard food with 10% (v/v) fructose solution added to their drinking water for 12 weeks with a 12/12 h photoperiod circle. Then, all animals were sacrificed after a one night fast. Peptides levels in the serum and reproductive tissues of rats were studied using the ELISA method while the immunoreactivity of reproductive system peptide hormones were shown by immunohistochemical staining method. Furthermore, the other biochemical parameters were measured using Konelab-60 equipment and infertility hormones were measured with Immulite2000. Fasting serum insulin, glucose, triglyceride, alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) levels were statistically significantly higher, and the amount of high density lipoprotein cholesterol (HDL-C) was significantly lower, in the MetS groups. Serum and tissue supernatant NES levels were significantly higher in the rats with MetS than the control group. Ghrelin, OBS and NES were expressed in the cytoplasm, concentrated around the apical parts of the epithelial cells in the reproductive tissues of the rats. The amounts of ghrelin were lower in the reproductive tissues of the animals with MetS, while NES levels in the same tissues increased. Obestatin also decreased, though not in the seminal glands.     

Is auditory function affected after Le Fort I osteotomy?

The aim of this study was to evaluate changes to the Eustachian tube and middle ear function and hearing level in individuals undergoing Le Fort I osteotomy. 20 consecutive patients underwent Le Fort I maxillary osteotomy with advancement, impaction or a combination of both. All individuals underwent hearing sensitivity tests, including pure tone audiometry and acoustic impedance measurements (middle ear pressure and compliance), which were carried out by an audiologist 1 week before surgery (t(0)), and then again 1 week (t(1)) and 4 weeks (t(2)) after surgery. Regarding pure tone audiometry, the differences between t(0) and t(2) at a frequency of 125Hz (P=.002), between t(0) and t(1) and between t(0) and t(2) at a frequency of 250Hz, and between t(0) and t(1) at a frequency of 1000Hz (P=.006) were statistically significant. There was no statistically significant difference at any other frequency. Regarding middle ear pressure, no statistically significant difference was observed between t(0) and t(1), and t(0) and t(2). Following Le Fort I osteotomy, mild changes in hearing sensitivity and middle ear pressure are possible, but these changes were clinically insignificant.     

Atypical presentation of primary giant nasal septal mucopyocele

Mucoceles are expansile, encapsulated, benign cystic lesions with the potential for adjacent bony remodeling and resorption. Previous nasal surgery, recurrent infections, allergies, and facial traumas are all possible causes of mucoceles involving mainly paranasal sinuses. When the mucocele is infected, it is referred to as mucopyocele. Nasal septal mucoceles seen in only very seldom cases might develop from pneumatized and infected nasal septa. In the current article, we present an interesting primary giant septal mucopyocele that destroys all paranasal cells as a tumoral lesion. The perpendicular plate of ethmoidal bone, vomer, and bilateral anterior and posterior ethmoidal cells were destroyed by mucopyocele. The nasal cavity was totally obstructed by lesions on both sides. On the left side, the lesion also eroded the left lateral nasal wall causing external swelling at the medial canthal region. This is the first case of a giant septal mucopyocele of its kind in the literature. Although nasal septal mucocele is very rare, it should be considered in differential diagnosis of intranasal masses.     

Idiopathic synchronous central giant cell granulomas involving both the maxilla and mandible: a case report

The central giant cell granuloma is a well-defined lesion of the jaws and reports of multiple lesions are very uncommon. The authors report the case of a patient with idiopathic synchronous multiple central giant cell granulomas involving both the maxilla and the mandible. Surgical curettage of the lesions was performed. At the end of the 24 months follow-up, no recurrence was detected.     

Molecular epidemiology and the clinical significance of <Emphasis Type="Italic">Acinetobacter baumannii</Emphasis> complex isolated from cerebrospinal fluid in neurosurgical intensive care unit patients

Objective  

This study was intended to investigate the clinical significance and molecular epidemiology of Acinetobacter baumannii complex (ABC) isolated from cerebrospinal fluid (CSF) in neurosurgical intensive care unit (NSICU) patients, particularly comparing isolates from healthcare workers’ (HCW) hands.     

Epicardial mass causing cardiac compression: an unusual involvement in lymphomatoid granulomatosis

Lymphomatoid granulomatosis is a rare, diffuse, large B-cell lymphoma that is positive for Epstein-Barr virus. A multiorgan process, it manifests itself chiefly in the lungs but can also affect the skin, nervous system, and kidneys. Cardiac involvement and pericardial effusion are very unusual. We report the case of a 62-year-old man with lymphomatoid granulomatosis involving the heart and lungs. Diagnosis was confirmed with wedge biopsy at pericardiotomy, and the patient was treated with cyclophosphamide, prednisolone, and vincristine. Although the patient was still symptomatic at 6-month follow-up, he was in partial remission with improved functional capacity.     

Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: compared in heart-failure prognostication

Carbohydrate antigen-125 (CA-125) is emerging as a prognostic biomarker of risk in heart failure. In a prospective study, we compared the prognostic values of CA-125 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable heart failure.We enrolled 102 consecutive chronic, stable, systolic-heart-failure patients (68 men and 34 women; median age, 71 yr) from November 2008 through February 2010. We measured baseline NT-proBNP and CA-125 levels and compared their prognostic values. The primary endpoint was all-cause death and other major adverse events, defined as hospitalization for decompensated heart failure or acute coronary syndrome.During a mean follow-up period of 14 ± 2 months, 12 patients died and 35 others sustained major adverse events. We found that CA-125 level significantly correlated with New York Heart Association functional class, pulmonary artery pressure, microalbuminuria, creatine kinase-MB fraction, and hemoglobin, albumin, and NT-proBNP levels. Upon receiver operating characteristic curve analysis, CA-125 and NT-proBNP had similar accuracy in predicting major adverse events and death: for major adverse events, area under the curve (AUC) was 0.699 for CA-125 (P=0.002) and 0.696 for NT-proBNP (P=0.002); for death, AUC was 0.784 for CA-125 (P=0.003) and 0.824 for NT-proBNP (P=0.001). Multivariate Cox regression analysis showed that CA-125 levels greater than 32 U/mL and NT-proBNP levels greater than 5,300 pg/mL had independent prognostic value for major adverse events and death.We conclude that baseline CA-125 and NT-proBNP levels are comparably reliable as heart-failure markers, and that CA-125 can be used for prognosis prediction in heart failure.     

Surgical treatment of lower limb ischemia in diabetic patients – long-term results

Introduction

Lower limb ischemia may cause nonhealing ulcers, infection, amputation and even mortality in diabetic patients. In this study, we review our data of ischemic lower limb revascularization procedures in diabetic patients and present the early, mid- and long-term results.

Material and methods

From March 2004 to September 2008, 83 patients with lower limb ischemia in Fontaine class III and IV underwent distal arterial bypass procedures. Saphenous vein grafts were used for below-knee arterial bypasses in all patients. In 16 (19%) patients femoropopliteal bypasses were performed with PTFE grafts. Short-term and long-term surgical results were evaluated.

Results

Ulcer recovery was determined in 36% of patients. Graft patency was 95% and 1 death (1%) occurred in short-term follow-up. In long-term follow-up the total effectiveness rate was 74%. Graft patency was 79% and 6 deaths (7%) occurred during the follow-up.

Conclusions

Lower limb ischemia is a serious event in patients with diabetes mellitus. The consequences may include increased mortality and morbidity in this particular patient population. However, distal arterial revascularizations are considerably effective procedures to avoid amputation, to eliminate symptoms, to promote ulcer recovery and to help the patient participate in social life with acceptable short, mid- and long-term follow-up results.