Single-session percutaneous ethanol sclerotherapy in simple renal cysts in children: long-term follow-up

Background: Simple renal cysts are rare in children and managed conservatively unless symptomatic. Objective: To demonstrate the efficacy and long-term results of single-session ethanol sclerotherapy in symptomatic simple renal cysts in children. Materials and methods: Three simple renal cysts in three children (age 1, 5 and 16 years) were included in the study. Indications for treatment were flank pain (n=1), hypertension (n=1), and increasing cyst size and urinary tract infection (n=1). The mean follow-up period was 5.5 years (range 3–7 years). The procedures were performed with the guidance of US and fluoroscopy and under IV sedation. After the cystogram, 95% ethanol with a volume of 40% of the cyst volume (but not more than 100 ml) was used as the sclerosing agent. Results: Two cysts disappeared completely, while the volume reduction was 99% for the third cyst at the end of the first year. CT demonstrated calcification of the cyst without an enhancing soft-tissue component in the third one 7 years after sclerotherapy. After the procedures, hypertension and pain resolved without any medication. There were no complications during the procedures or during follow-up. Cytological examination was unremarkable in all patients. Conclusions: Percutaneous treatment of symptomatic simple renal cysts in children with single-session ethanol sclerotherapy is a safe, effective and minimally invasive procedure. Calcification owing to sclerotherapy can be observed on follow-up.     

The prevalence of stress urinary incontinence among women operated on for abdominal wall hernias

The high co-occurrence of an abdominal wall hernia (AWH) and stress urinary incontinence (SUI) suggests that there is a common factor in the etiopathogenesis of these disorders in these patients.     

Combination of extremity computed tomography angiography and abdominal imaging in patients with musculoskeletal tumors

PURPOSE: To introduce a comprehensive computed tomography (CT) protocol for the evaluation of patients with musculoskeletal tumors by combining extremity CT angiography and abdomen CT in a dynamic multidetector CT study. METHODS: Single contrast bolus was used for each study in 4 patients with musculoskeletal tumors involving the lower extremities. Extremity CT angiography and abdominal CT were acquired sequentially by 4-channel multidetector CT. Technical parameters for extremity CT angiography were as follows: detector collimation, 4 mm x 1 mm; pitch, 1.75; slice thickness, 1.25 mm; reconstruction interval, 1 mm; coverage, 42 cm; and table speed, 14 mm/s. Thick and thin maximum intensity projections, volume renderings, and multiplanar reformats with or without bone subtraction were used to display vascular supply of the extremity mass and adjacent vascular structures. RESULTS: Satisfactory images of the extremity arterial system and abdomen were obtained in all patients. The mean delay time for CT angiography was 25 seconds. Extremity CT angiography demonstrated feeding arteries of a fibular giant cell tumor and a large lymphomatous mass. The same protocol was used for the evaluation of a distal tibial osteosarcoma and a fibular chondrosarcoma. In 2 patients, early venous return was noted, indicating vascularity of the tumors. In all patients, the relation of osseus masses to adjacent vascular structures was visualized as well as the bony anatomy. CONCLUSION: Extremity CT angiography and abdominal staging CT can be combined in a single dynamic multidetector CT protocol in patients with musculoskeletal tumors, resulting in a reduction of costs, acquisition time, and contrast dose as well as an improvement in patient management. The same protocol can also be used in trauma patients.     

Lipopolysaccharide fever is initiated via a capsaicin-sensitive mechanism independent of the subtype-1 vanilloid receptor

As pretreatment with intraperitoneal capsaicin (8-methyl-N-vanillyl-6-nonenamide, CAP), an agonist of the vanilloid receptor known as VR1 or transient receptor potential channel-vanilloid receptor subtype 1 (TRPV-1), has been shown to block the first phase of lipopolysaccharide (LPS) fever in rats, this phase is thought to depend on the TRPV-1-bearing sensory nerve fibers originating in the abdominal cavity. However, our recent studies suggest that CAP blocks the first phase via a non-neural mechanism. In the present work, we studied whether this mechanism involves the TRPV-1. Adult Long-Evans rats implanted with chronic jugular catheters were used. Pretreatment with CAP (5 mg kg(-1), i.p.) 10 days before administration of LPS (10 microg kg(-1), i.v.) resulted in the loss of the entire first phase and a part of the second phase of LPS fever. Pretreatment with the ultrapotent TRPV-1 agonist resiniferatoxin (RTX; 2, 20, or 200 microg kg(-1), i.p.) 10 days before administration of LPS had no effect on the first and second phases of LPS fever, but it exaggerated the third phase at the highest dose. The latter effect was presumably due to the known ability of high doses of TRPV-1 agonists to cause a loss of warm sensitivity, thus leading to uncontrolled, hyperpyretic responses. Pretreatment with the selective competitive TRPV-1 antagonist capsazepine (N-[2-(4-chlorophenyl)ethyl]-1,3,4,5-tetrahydro-7,8-dihydroxy-2H-2-benzazepine-2-carbothioamidem, CPZ; 40 mg kg(-1), i.p.) 90 min before administration of LPS (10 microg kg(-1), i.v.) or CAP (1 mg kg(-1), i.p.) did not affect LPS fever, but blocked the immediate hypothermic response to acute administration of CAP. It is concluded that LPS fever is initiated via a non-neural mechanism, which is CAP-sensitive but RTX- and CPZ-insensitive. The action of CAP on this mechanism is likely TRPV-1-independent. It is speculated that this mechanism may be the production of prostaglandin E(2) by macrophages in LPS-processing organs.     

Antibacterial effects of electrically activated vertebral implants

Bio-implants in the human body act as passive surfaces that are prone to bacterial adhesion potentially leading to deep body infections. Pedicle screws made of uncoated or silver-coated titanium alloy were used both in vitro and in vivo to determine whether silver-coated materials have antimicrobial properties when they are anodized. Twenty-four New Zealand Albino rabbits were divided into four groups with six in each. In Group 1, the rabbits were exposed to 8 muA direct current (DC) via silver-coated screws. In Group 2, the rabbits were not exposed to any electrical current, but silver-coated screws were used. In Group 3, the rabbits were exposed to 8 muA DC using uncoated screws. In Group 4, the rabbits were not exposed to any electrical current, but uncoated screws were used. Staphylococcus aureus (106 cfu) was inoculated into the rabbits before any electrical current was applied. All the animals were killed, and the areas surrounding the screws were histologically and microbiologically examined. Silver-coated titanium screws prevented implant-associated deep bone infections when they were polarized anodically. The antibacterial effects of the same screws with the same bacterium were confirmed in in vitro experiments on agar plates. When the screws were anodized with the same electrical parameters in vitro, a marked inhibition zone was detected around the silver-coated screws but not around the uncoated screws. Our findings suggest that silver-coated titanium implants can be used to prevent implant-associated deep bone infections when they are polarized anodically.     

Portomesenteric venous gas: imaging findings with an emphasis on sonography.

OBJECTIVE: Portomesenteric venous gas is a rare condition with an unclear pathogenesis. Most studies in the medical literature mention computed tomography (CT) as the primary imaging tool for this entity. The objective of this study was to outline the advantages and disadvantages of sonography in the evaluation of patients with portomesenteric venous gas. METHODS: We describe 7 patients (3 female and 4 male; age range, 47-83 years) with portomesenteric venous gas. Both CT and sonographic examinations were performed in each patient. Our patient population consisted of 2 patients with superior mesenteric artery occlusion, 3 with ischemia of the colon, small bowel, or both, 1 with gastric ulcer perforation, and 1 with ischemic bowel disease presumably secondary to complications of continuous ambulatory peritoneal dialysis. RESULTS: Portal venous gas was observed in all 7 patients with sonography and in 6 patients with CT. Computed tomography was unable to show gas in the portal venous system in 1 patient. Sonography showed patchy hepatic gas accumulation (likely within small peripheral portal vein branches) with no correlative findings on CT. Computed tomography showed important associated findings, including pneumatosis intestinalis. CONCLUSIONS: In cases with portomesenteric gas, CT is the preferred modality for showing the underlying etiology. However, with its real-time imaging capability, sonography may also be a very valuable imaging modality in the evaluation of this entity.     

Axillary lymph node dissection in pT1 breast cancer: a retrospective analysis of 315 patients and review of the literature.

Axillary lymph node status and pathologic features of the primary tumor are used to predict the prognosis and select appropriate adjuvant therapy for individual patients with breast cancer. The goal of our study is to identify a group of breast cancer patients who would not benefit from axillary dissection. We researched medical literature and conducted retrospective analyses of 315 consecutive postmenopausal women with breast tumors under 2.0 cm in diameter (pT1) in relation to the extent of axillary lymph node involvement. None of the 39 patients with pT1a tumors had axillary lymph node metastases (ALNM). Of the remaining 276 patients, the ALNM rate in the subgroup pT1b and grading 1 was 5.9%. As expected, the frequency of positive lymph nodes increased the larger the tumor and the higher the grading. Our data corresponds with some of the literature reviewed, although the percentage of axillary involvement described, especially in the subgroup of pT1a tumors, varies within a wide range (0-28%). Our data indicates that it is unlikely that invasive breast cancer pT1a (< or = 0.5 cm) is associated with axillary lymph node metastases in women older than 50 years. The authors conclude that the parameter tumor size, combined with age, can help to assess the risk for axillary lymph node metastases.     

Evaluation of Oxidative Stress Parameters and Antioxidant Status in Plasma and Erythrocytes of Elderly Diabetic Patients with Sarcopenia

The journal of nutrition, health & aging - Oxidative stress may play a role in the pathogenesis of both sarcopenia and diabetes. Although the risk of sarcopenia is increased in people with type...     

Effects of some 1,3,5-trisubstitued-2-pyrazoline derivatives on depression and anxiety parameters of mice

The aim of the present study was examining the effects of some 1,3,5-trisubstituted-2-pyrazoline derivatives on depression, anxiety and spontaneous locomotor activity parameters of mice. None of the compounds was effective at 50 mg/kg dose whereas at 100 and 200 mg/kg, pyrazoline-benzoxazole derivative test compound 4a and pyrazoline-benzimidazole derivative test compound 4d in the series were exhibited significant antidepressant effects in modified forced swimming tests. These two pyrazolines decreased the immobility and increased the swimming times of mice without any change in climbing durations suggesting the antidepressant-like effects of the test compounds. In spite of significant antidepressant effect, none of the compounds changed the exploratory parameters in hole-board tests or total numbers of spontaneous locomotor activities in activity cage measurements at any of the applied doses. In other words, neither anxiolytic nor sedative effects induced by the test compounds. The results obtained from this study supported the previous findings reporting the antidepressant activities of pyrazoline derivative compounds. Exact mechanism of the antidepressant action exhibited in the present study need to be clarified with further detailed investigations.