The effect of mannose-binding protein gene polymorphisms in recurrent respiratory system infections in children and lung tuberculosis

Mannose-binding lectin (MBL) is able to bind pathogens as an opsonin and plays an important role in the innate immunity. The aim of the present study was to determine the frequencies of the MBL gene variants in the Turkish population and to examine the presence of any association between MBL variants and development of tuberculosis (TB) in adults and recurrent respiratory tract infections in children. Two structural gene mutations in exon 1 of MBL gene (codon 54 and codon 57) were studied. The overall distribution of genotypes did not significantly differ between controls and TB patients/children with recurrent respiratory system infections. The frequency of allele B was calculated as 0.14, 0.09 and 0.06 for control, TB patients and children with recurrent respiratory system infections, respectively. It was found to be significantly lower in children with recurrent respiratory system infections than in controls (chi2: 4.68, d.f: 1, p: 0.030).     

Encouraging result of tamoxifen in a retinoblastoma patient with central nervous system metastasis

Extraocular retinoblastoma occurs more frequently in developing countries as a delayed diagnosis and prognosis of patients with conventional therapy is very poor. Metastatic retinoblastoma, especially in the central nervous system (CNS), is a highly lethal disease. Tamoxifen has been used in some previous studies with variety of responses to therapy in patients with unresectable recurrent brain tumors. A 7-year-old girl with recurrent metastatic retinoblastoma received 60 mg/m 2 tamoxifen in addition to chemotherapy and CNS radiotherapy. She was in remission until she has died in a traffic accident at week 114. The authors think that tamoxifen can be added to treatment protocols of metastatic retinoblastoma to provide longer and at least higher quality of life for these patients.     

Effect of tibolone treatment on intima-media thickness and the resistive indices of the carotid arteries

OBJECTIVE: To assess the effect of tibolone treatment on the intima-media thickness (IMT) of the common carotid artery (CCA) and the resistive indices (RIs) of the CCA and internal (ICA) and external (ECA) carotid and the vertebral arteries (VAs) in postmenopausal women as sonographic markers of atherosclerosis. DESIGN: A prospective study. SETTING: University hospital. PATIENT(S): Twenty postmenopausal women who had no cardiovascular disease. INTERVENTION(S): Noninvasive measurements of the IMT of the CCA and the RI of the CCA, ICA, ECA, and VA were made with ultrasound at baseline and after 12 weeks of tibolone treatment. MAIN OUTCOME MEASURE(S): IMT of the CCA and RI of the CCA, ICA, ECA, and VA. RESULT(S): Three months of tibolone treatment decreased the IMT of the CCA (mean +/- SD) from 0.70 +/- 0.22 mm (95% confidence interval [CI], 0.60-0.80) to 0.47 +/- 0.17 mm (95% CI, 0.39-0.55) by 28%. Resistive indices of the CCA, ICA, and VA also decreased significantly. CONCLUSION(S): The present study showed that tibolone treatment decreases both the IMT of the CCA and RI of the CCA, ICA, and VA, which appears to be related to its anti-atherosclerotic effect. Nevertheless, the clinical implications of these findings are yet to be investigated.     

Carcinosarcoma of the stomach

In the gastrointestinal tract, carcinosarcomas are most frequently seen in the esophagus. Carcinosarcoma in the stomach is a rare tumor. We report a carcinosarcoma of the antrum of stomach. The tumor was polypoid and exophytic in appearance and located in the antrum. Immunohistochemical studies showed positivity for cytokeratin, epithelial membrane antigen and cytoplasmic carcinoembryonic antigen in the epithelial component. Positive staining with vimentin, desmin and focal smooth muscle actin and negative staining with chromogranin were observed in spindle cells. Nuclear positive staining was observed with p53 and Ki-67 in both glandular and spindle atypical cells.     

Vascular tumors of the orbit

Eighty-five vascular lesions of the orbit examined and treated between 1963–1993 were reviewed retrospectively to reveal the types of vascular tumors, age and sex distribution, clinical characteristics, treatment options and prognosis. Capillary hemangioma was the most frequent orbital vascular tumor accounting for 37 of 85 cases making up 43.5% of the entire orbital masses. Cavernous hemangioma accounted for 35 cases (41.2%), varices for 3 cases (3.5%), anteriovenous malformations for 3 cases (3.5%), angiosarcomas for 3 cases (3.5%), lymphangiomas for 3 cases (3.5%) and hemangiopericytoma for one case (1.2%). Of the 85 vascular tumor cases 43 were encountered in children aged 18 years or less. Capillary hemangioma was the most frequent pediatric orbital vascular lesion, making up 86% of the vascular tumors in this age group. Capillary hemangiomas have been treated with observation and intralesional corticosteroid injections. Cavernous hemangiomas, vascular malformations, lymphangiomas and two cases of angiosarcomas received orbitotomy. One case each of angiosarcoma and hemangiopericytoma underwent exenteration because of the advanced stage of the lesion. There was one tumor-related death who was a 9-year-old boy diagnosed with angiosarcoma. Vascular tumors with the exception of angiosarcomas and hemangiopericytoma behaved as benign lesions.     

Alterations by captopril of pain reactions due to thermal stimulation of the mouse foot: interactions with morphine, naloxone and aprotinin

The effects of Captopril (SQ 14,225) were studied in mice both by measuring the reaction time and observing the number of jumping mice in the 'hot-plate' test. Subcutaneous injections of captopril (0.1--0.4 mg/kg) produced a significant increase in the reaction time at the 4th hour after the injection while no difference in the reaction time was observed at other times. Captopril caused a clear-cut increase in the number of jumping mice which was found to be greater with lower doses of the compound. Morphine alone did not cause an increase in the number of jumping mice, but increased the reaction time which reached a maximum 1 h after administration and gradually returned to the control level after 6 h. Injection of morphine to the captopril-pretreated mice caused a highly significant increase in reaction time remaining above the control values for 3 h. This effect of morphine was antagonized by naloxone (2 mg/kg, s.c.). Captopril, when given together with morphine, prevented the increase in reaction time over 2 h, but caused a progressive and significant increase within 6 h. Morphine also prevented the jumping behaviour induced by captopril. Aprotinin (50,000 KIU/kg i.p.) when given together with captopril, produced a significant increase in reaction time but almost completely blocked the jumping reaction. Aprotinin also prevented the captopril-induced increase in the number of jumping mice. The possible mechanisms of analgesia and jumping behaviour due to thermal stimulation are discussed in the light of these findings.     

Therapeutic efficacy of endostatin exhibits a biphasic dose-response curve

We show here that recombinant endostatin protein has a biphasic effect on the inhibition of endothelial cell migration in vitro. In tumor-bearing animals, there is a similar biphasic effect on the inhibition of tumor growth and on circulating endothelial cells after once-daily s.c. injections. This biphasic effect is revealed as a U-shaped curve in which efficacy is optimal between very low and very high doses depending on the tumor type. This result may be applicable to other inhibitors of endothelial growth and to angiogenesis. Furthermore, these results have important implications for clinicians who administer angiogenesis inhibitors for cancer or other angiogenesis-dependent diseases. When these results are taken together with two previous reports of angiogenesis inhibitors with a U-shaped dose-response, they suggest that other regulators of endothelial growth may display a similar pattern.     

Spontaneous pneumomediastinum: A report of five cases

Conclusion SPM is a self-limiting disease in which symptoms subside with conservative management in most cases. However, drainage of mediastinal air may be inevitable when vital structures of the mediastinum are severely compromised. In the presence of symptoms which are highly suggestive of SPM, obtaining a CT of the chest will confirm the diagnosis. If not suspected clinically, more invasive diagnostic tools such as oesophagoscopy and/or bronchoscopy may not be warranted in order to rule out perforation of an air containing mediastinal organ.     

Aortic arch reconstruction with pulmonary autograft patch in coarctation and interruption of the aorta

The surgical management of the aortic arch pathologies is still subject to discussion. Primary end-to-end anastomosis has some complications such as bronchial compression, tension in the suture lines, and probability of recurrence. On the other hand, patch aortoplasties combined with end-to-end anastomosis carry the risk of aneurysm formation and recurrence. Considering the growth potential, pulmonary autograft patch use in aortic arch reconstructions has recently been introduced into clinical practice. In this study, we present the early findings of combined end-to-end anastomosis and pulmonary autograft patchplasty procedure in six patients. According to our experience the technique applied in this report seems to be more advantageous than other conventional approaches.