Interleukin-1alpha, interleukin-1beta, and interleukin-1Ra polymorphisms in febrile seizures

Febrile seizures are the most common form of childhood seizures. The exact mechanism promoting convulsions during a common febrile illness remains unknown, but it is accepted that genetic influences are likely to account for at least some of the cases. Previous studies reported high interleukin-1beta levels in the cerebrospinal fluid of patients with febrile seizures. Recently, an association between a regulatory polymorphism in the genes encoding interleukin-1beta and interleukin-1Ra and febrile seizures was reported. In this study, we attempted to confirm these findings. We analyzed the cytokine gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra of 73 children with febrile seizure and 152 healthy controls. The distribution of interleukin-1beta -511, interleukin-1alpha -889, and interleukin-1Ra genotypes and alleles did not differ significantly between cases and controls. Our data suggest that the studied gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra do not have a significant role in the pathogenesis of febrile seizures.     

Spinal granulocytic sarcoma (chloroma) presenting as acute cord compression in a nonleukemic patient

The case of a previously healthy 24-year-old man diagnosed with extradural thoracic granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was removed totally by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcomas are most commonly found in the context of an acute myelogenous leukemia or in chronic myelogenous leukemia. They rarely have been reported in otherwise healthy patients without any evidence of systemic disease. A review of the literature revealed only 14 more nonleukaemic cases with granulocytic sarcoma causing thoracic spinal cord compression.     

Plasma testosterone response at 1st and 4th day after short- and long-term hCG stimulation test

Human chorionic gonadotropin (hCG) stimulation test is a reliable dynamic test for the evaluation of testicular function during childhood. Several protocols have been recommended but their reliability is controversial. In order to decide the best timing to measure stimulated testosterone levels in short- and long-term hCG protocols, we evaluated 83 prepubertal patients in two group. In group A, 34 patients with isolated micropenis and in group B, 49 inguinal cryptorchidic patients were enrolled. In group A short-term hCG protocol (3000 IU/m2/im/3 days) and in group B long-term hCG protocol (1500 IU/m2/im; thrice a week for 3 weeks) was administered. Blood samples were drawn at the initiation of the test and then at the 1st and 4th days after the last hCG injection. Each case's peak stimulated testosterone (Tmax) and the incremenet in plasma testosterone (deltaT) were calculated and compared with the 1st and 4th day responses within the group. In the short-term protocol the 4th day responses were higher than the 1st day responses (p<0.01). Interestingly, while four patients had insufficient responses at the 1st day, three had sufficient Leydig cell response at the 4th day. In the long-term protocol group, in contrast to the short-term group, the 1st day responses were higher than the 4th day (p<0.01). According to our results, while performing hCG test in a patient, if a short-term protocol is planned, it is more convenient to check the 4th day testosterone response. On the other hand, in a long-term protocol it is best to check the 1st day response. We suggest that even if a patient's 1st day response is inadequate, the 4th day response should be checked in order to avoid misdiagnosis.     

Optimal Timing for Surgery After Adriamycin Treatment in Rats

Purpose To determine the optimal timing of surgery after adriamycin treatment, we investigated the time-related effect of adriamycin on wound healing over a long period.Methods We divided 119 female Sprague-Dawley rats into seven treatment groups. Group 1 was subjected to laparatomy only. All the other groups were given 8mg/kg adriamycin intravenously followed by laparotomy on the same day (group 2), 7 days later (group 3), 14 days later (group 4), 21 days later (group 5), 28 days later (group 6), or 35 days later (group 7). On postoperative day 7, the sutures were removed, abdominal bursting pressure was measured, and tissue samples were taken for histopathological evaluation and analysis of hydro-xyproline content.Results Bursting pressures were significantly lower in groups 3, 4, 5, and 6 than in group 1. The hydroxyproline content and histopathological evaluation supported these findings.Conclusions Our results showed that the optimal timing for surgery after adriamycin treatment is before the 7th day or after the 35th day. If surgery is performed between these days, there is a high risk of impaired wound healing.A preliminary study on this subject was accepted as a poster presentation at the Congress of the European Surgical Society of Oncology (ESSO) in 2002     

A comparison of nebulized budesonide, and intramuscular, and oral dexamethasone for treatment of croup

OBJECTIVES: Croup or acute laryngotracheobronchitis is the most common cause of the upper airway obstruction. Cool mist, nebulized racemic epinephrine and steroids are commonly used for therapy. Although steroid treatment can be applied orally, in nebulized form, or parenterally, no study has compared these three regimens yet. In this study, the efficacy of nebulized budesonide, and oral and intramuscular dexamethasone are compared for treatment of croup. STUDY DESIGN: Sixty children aged 6-36 months were randomly allocated into four groups. The first three study groups (15 children in each) took nebulized budesonide, oral dexamethasone and intramuscular dexamethasone, respectively, in addition to salbutamol and other supportive measures and these were compared with the placebo group. All patients were evaluated with "Westley Croup Score" on admission to pediatric emergency department (0h) and at 24, 48 and 72h. RESULTS: At the end of the study, the croup scores of all steroid treatment groups were significantly lower than the placebo group, but there was no statistical difference among them. CONCLUSIONS: Nebulized budesonide, oral and parenteral dexamethasone have the same effectiveness for treatment of croup and the choice depends on conditions of the patient and the physician.     

Histopathological evaluation of the connective tissue of the vaginal fascia and the uterine ligaments in women with and without pelvic relaxation

This study aimed to compare connective tissue components within the uterine ligaments histopathologically in women with and without pelvic relaxation. The tissue samples obtained from the histopathologic specimens of 24 patients with uterine descensus who underwent vaginal hysterectomy and from twenty-one patients with no pelvic relaxation, in whom total abdominal hysterectomies were performed for benign reasons, were used as the study and control groups, respectively. From each hysterectomy material, samples for histological examination were taken from the vaginal fascia and from the cardinal, the uterosacral and the round ligaments (4 samples for each patient). The amount of collagen, cellularity and elastic fibers within the connective tissue were evaluated and scored by the co-author pathologist. Mann-Whitney U and Student t tests were used for the statistical analysis. The patients with pelvic relaxation had significantly higher scores of collagen and fewer scores of cellularity within the connective tissue samples, compared with the ones without relaxation (p<0.01, p<0.01). It was concluded that decreased fibroblasts and increased collagen content might be the key factors associated with pelvic support disorders. Received: 8 January 2001 / Accepted: 19 March 2001     

Tensile strength of type IV dental stones dried in a microwave oven

STATEMENT OF PROBLEM: It is known that drying dental stones in a microwave oven can save time, but the strength of the material may be affected by different drying methods. PURPOSE: This study evaluated the diametral tensile strength (DTS) of 5 type IV gypsum products at different time intervals using microwave and air-drying methods. MATERIAL AND METHOD:. A total of 300 cylinder specimens were prepared from 5 type IV dental stones (Moldano, Amberok, Herastone, Shera-Sockel, and Fujirock; n = 60 per stone) in accordance with the manufacturers' recommendations. Half of the specimens of each stone (n = 30) were dried in open air within a temperature range of 20 +/- 2 degrees C; the other half (n = 30) underwent initial setting in a silicone rubber mold in open air for 10 minutes and then were dried in a microwave oven for 10 minutes. Within these groups, 10 specimens were tested under diametral compression at each of the following time periods: 30, 60, and 120 minutes after drying. Three-way analysis of variance and Scheffe's post hoc test were performed for statistical comparisons at a significance level of P<.05. RESULTS: At all time intervals, the diametral tensile strength values for dental stones dried in a microwave oven (mean 2.99 MPa) were significantly higher (P<.01) than the values for specimens dried in open air (mean 2.53 MPa). CONCLUSION: Within the limitations of this study, microwave oven drying had a positive effect on the diametral tensile strength of 5 type IV dental stones.     

Comparisons of oral calcium,high dose vitamin D and a combination of these in the treatment of nutritional rickets in children

Nutritional rickets remains a common child health problem in Turkey and many other developing countries. Although vitamin D deficiency is accepted as the basic problem underlying the disease, others postulate that a deficiency of dietary calcium, rather than vitamin D, is often responsible for the nutritional rickets in sunny countries. We conducted a placebo-controlled study to determine the best treatment regimen for nutritional rickets in children residing in lower socioeconomic regions of a sunny city, Istanbul. Forty-two infants (aged 6-30 months) with rickets were divided into three groups and included in the study. In a randomized fashion vitamin D (300 000 units, intramuscularly), calcium lactate (3 g daily) or a combination of vitamin D and calcium were given to the children. Alkaline phosphatase, calcium, albumin, ionized calcium and phosphorus levels were measured each week. X-ray examinations of the left wrist and left knee were undertaken at the beginning of the study and were repeated at the 2nd and 4th weeks and were scored in order to assess the response to treatment. Treatment produced an increase in serum calcium and a decrease in alkaline phosphatase concentration in all three groups, but the most important increase was reached in the vitamin D plus calcium group. We conclude that vitamin D deficiency appears to be the primary etiologic factor of rickets in our study group, but a better response to treatment with vitamin D or in combination with calcium was obtained than to treatment with calcium alone.     

Effects of forced diuresis achieved by oral hydration and oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms

INTRODUCTION: We studied the impact of diuresis forced by oral hydration or single-dose oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms. PATIENTS AND METHODS: A total of 58 patients with a mean age of 59 (range 41-77) years who presented with lower urinary tract symptoms were included in the study. The patients were grouped with respect to their International Prostate Symptom Scores as having mild, moderate, or severe symptoms. The prostatic volumes of the patients were calculated using transrectal ultrasound. Uroflowmetric measurements were performed on 3 consecutive days. On the 1st day, the test was performed without diuretic stimulation; on the 2nd day, oral hydration was applied, and on the 3rd day, the patients received 20 mg of furosemide orally. Voiding time, maximum flow rate, voided volume, and the time elapsed in minutes until voiding (waiting time) were recorded. RESULTS: Diuretic stimulation did not significantly alter the uroflowmetric parameters in each symptom group, but the waiting time was significantly reduced. Forced diuresis caused acute urinary retention in 5 of 20 (25%) severely symptomatic patients. CONCLUSIONS: Forced diuresis with oral hydration or oral administration of diuretics improves patient comfort and test applicability by shortening clinical waiting time and reducing the number of attempts to reach the sufficient urine volume for reliable measurements and can be applied safely for mild and moderately symptomatic patients. On the other hand, the risk of 25% of acute urinary retentions should be reconsidered, and the decision about diuretic stimuli should be made carefully by the clinician in severely symptomatic patients.