Coronary sinus dilatation is associated with left ventricular systolic dysfunction and poor functional status ın subjects with chronic heart failure

Background and aims: Reliable echocardiographic markers additional to plasma biomarkers that would establish prognosis of chronic heart failure and guide therapeutic approach would be beneficial. In our hypothesis, echocardiographic assesment of coronary sinus anatomic alteration, which has been ignored, may be part of remodeling process in heart failure. We also aimed to evaluate relationship between coronary sinus anatomic alteration and left ventricular systolic dysfunction. We echocardiographically analysed 112 patients with heart failure and 61 normal subjects. Left/right ventricular volumes, left atrial area and mean coronary sinus were measured. Coronary sinus diameter was significantly higher in patients than in control group. Statisticallly positive correlation were present between coronary sinus measurements and left/right ventricular volumes (R = 0.5, P < 0.001; R = 0.4, P < 001, respectively), left atrial area (R = 0.6, P < 0.001), NYHA class (R = 0.3, P < 0.001), mitral regurgitation (R = 0.329, P < 0.001), tricuspid regurgitation (R = 0.215, P < 0.02) and left ventricular mass (R = 0.482, P < 0.001). Statistically negative correlation were present between coronary sinus measurements and left ventricle ejection fraction (R = ?0.4, P < 0.001). However, coronary sinus diameter was not correlated with body surface area and pulmonary artery pressure. Tricuspid and mitral regurgitation, left ventricular mass, ejection fraction and functional classs were included in multivariate analysis and only ejection fraction was independent predictor of coronary sinus diameter (P = 0.012). We demonstrated that, dilated coronary sinus is possibly a part of entire process of cardiac remodeling and echocardiographic assessment of dilated coronary sinus may provide useful additional information, predicting the severity of chronic heart failure and poor functional class.     

Effects of erytropoietin treatment and hemodialysis on the serum endothelin level and intraocular pressure of hemodialysis patients

Aim The aim of this study is to evaluate the effect of erythropoietin and hemodialysis (HD) on serum Endotheli-1 (ET-1) and intraocular pressure (IOP) levels in HD patients. Methods The study group was composed of 34 chronic HD patients undergoing erythropoietin (EPO) treatment, while the control group was composed of 16 chronic HD patients without EPO treatment. Serum samples for measuring levels of ET-1 were taken 1 h before and after HD. Endothelin-1 levels were determined using a commercially available Elisa kit. IOP was measured with a calibrated Goldmann applanation tonometer in the right eyes of patients 1 h before and after HD just after blood samples were taken. Results In the EPO group, serum ET-1 levels were significantly higher than those of the control group both before and after HD. Despite increased ET-1 levels in the EPO group, there was no statistically significant difference in pre- and post-dialysis IOP measurements between the erythropoietin and control groups (P > 0.05). In both the HD and control groups, the IOP levels significantly decreased following HD (P < 0.05). Conclusion EPO treatment caused an increase in plasma ET-1 concentration compared to the control group, while there was no related increase in IOP with EPO treatment. The role of ET-1 in glaucoma development must involve a mechanism other than increased IOP.     

Effect of aqueous extracts of Ecballium elaterium rich, in the rabbit model of rhinosinusitis

This study was designated to investigate anti-inflammatory effect of aqueous extract of Ecballium elaterium, which is topically applied for treatment of rhinosinusitis as a traditional folk medicine in Turkey. Therapeutic potential of E. elaterium as an anti-inflammatory agent was examined by measurement of NO* metabolites in a rabbit model of rhinosinusitis. The results showed that both activity of NOS enzyme and concentration of NO* metabolites were significantly reduced by topical administration of E. elaterium extract in therapy group as compared to the control. Thus, the data suggest E. elaterium extract may have the potential to be used as anti-inflammation agent, and can be used in the treatment of rhinosinusitis diseases.     

Effect of WEB 2170 BS, platelet activating factor receptor inhibitor, in the rabbit model of sinusitis

Platelet activating factor (PAF), a potent inflammatory mediator, is a biologically active phospholipid. Recent studies have shown that PAF may play an important role in the pathogenesis of inflammation. WEB 2170 BS has been shown to be a PAF antagonist both in vitro and in vivo. Nitric oxide (NO) is present in the mammalian nasal airways and originates primarily from the paranasal sinuses. Measurement of NO is thought to be a surrogate marker of upper airway inflammation. In this study, the antiinflammatory effects of WEB 2170 BS were investigated in a rabbit model of sinusitis. To induce experimental sinusitis, we applied killed Staphylococcus aureus percutaneously to the maxillary sinus of rabbits without occlusion of the natural ostium. Either WEB 2170 BS solution or placebo was administered intraperitoneally 2 hours before sinus inoculation, and this procedure was repeated twice daily for 4 days. The outcome of the treatment was determined by the measurement of NO metabolite levels and NO synthase activity in the samples of sinus mucosa and by histopathologic evaluation of sinus mucosa. The pathological grading was determined by the number of inflammatory cells found in the sinus mucosa. The levels of NO metabolites and NO synthase activity were found to be significantly lower in the WEB 2170 BS-treated group than in the control group. Histopathologic analysis of the sinus mucosa indicated decreased inflammation in the treated group as compared to the controls. These results demonstrate that WEB 2170 BS may produce significant anti-inflammatory effects in this model of sinusitis.     

Effect of novel restorative materials and retention slots on fracture resistance of endodontically-treated teeth

Objectives. The aim of this study was to evaluate the fracture resistance of endodontically-treated teeth restored with nano-hybrid composite resin, bulk-fill flowable and short fibre-reinforced-composite in the absence/presence of retention slots. Materials and methods. One hundred and ten extracted non-carious human mandibular molars received endodontic treatment followed by mesio-occlusodistal (MOD) cavities with 3 ± 0.2 mm thicknesses of buccal and lingual walls. Teeth were divided into two main groups according to the retention slot preparation. The dove-tail retention slots were prepared on the middle of opposite buccal and lingual walls to create mechanical interlocking. Each group was further divided into four sub-groups according to restorative material types: control (no restoration), nano-hybrid composite resin (Filtek^TM Z550), bulk-fill flowable (Filtek^TM Bulk Fill) and short fibre-reinforced-composite (everX Posterior^TM). Restored teeth were subjected to compressive load at a strain rate of 1 mm/min. The data were statistically analysed using two-way ANOVA and Tukey’s test for multiple comparisons. Results. The fracture resistance was significantly affected by the presence of the retentive slots and restorative material (p < 0.05). Restored teeth with retentive slots significantly increased the fracture resistance compared with restored teeth without retentive slots (p < 0.05). Short fibre-reinforced-composite with retentive slot cavities had significantly higher fracture resistance values compared with the other test groups (p < 0.05). Conclusions. The preparation of retention slots may increase the fracture resistance of endodontically-treated teeth, especially, when restored with short fibre-reinforced composite. The use of short fibre-reinforced composite with retentive slots could be an alternative technique to prevent cuspal fracture on endodontically-treated teeth with MOD cavity.     

Magnetic resonance imaging findings of breast juvenile papillomatosis

Juvenile papillomatosis is a rare disease affecting young women. Here we present magnetic resonance imaging features of two cases with histopathologically proven juvenile papillomatosis of the breast and review some of the relevant literature. Case 1 exhibited bilateral, well-bordered breast masses, with complex cystic and solid components. The kinetic evaluation showed continuous and plateau patterns. Case 2 featured a giant mass with a few cystic and many solid nodular components and filled the entire right breast. The kinetic evaluation showed a continuous curve.     

Breast lesions with high signal intensity on T1-weighted MR images

Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.     

Neuropad® indicator test for diagnosis of sudomotor dysfunction in type 2 diabetes

Neuropad is a new indicator test used to diagnose sudomotor dysfunction, a component of autonomic neuropathy. In this cross-sectional study, Neuropad is evaluated and compared with corrected QT (QT c), another test used in the diagnosis of autonomic neuropathy. The indicator test measures sweat production on the basis of a color change of cobalt (II) chloride solution from blue to pink upon absorption of water. This study involved 105 patients (43 men, 62 women) with type 2 diabetes with a mean age of 56.2+/-11.5 y and a mean disease duration of 10.0+/-6.3 y. Age, sex, disease duration, glycosylated hemoglobin, and QT c were compared between patients with normal and abnormal test results. The QT c interval was measured and the new indicator test was applied in all patients. The 2 tests were compared, and the sensitivity, specificity, positive predictive value, and negative predictive value for the indicator test were calculated. Autonomic neuropathy was diagnosed in 40 patients (38.1%) with QT c interval measurement and in 72 patients (68.6%) with the new indicator test (P=.001). The sensitivity, specificity, positive predictive value, and negative predictive value for the indicator test were 87.5%, 43.1%, 48.6%, and 84.8%, respectively. Patients with abnormal test outcomes had longer QT c than those whose test results were normal (0.433 vs 0.398 s; P=.002). Study results suggest that the new indicator test has an acceptable sensitivity but a low specificity and is not superior to other tests in the diagnosis of sudomotor dysfunction.