Plasma osteopontin levels are elevated in non-ST-segment elevation acute coronary syndromes

BACKGROUND: The regions of ruptured atherosclerotic plaques have numerous macrophages. Osteopontin that modulates macrophage function has been shown in atherosclerotic plaques. We aimed to study the plasma levels of osteopontin in patients with unstable angina or non-ST-seg ment elevation myocardial infarction (NSTEMI) and the rela tionship between osteopontin and the extent of the coronary artery disease (CAD). METHODS: We studied 65 patients with unstable angina or NSTEMI, 25 patients with stable angina and 18 patients as the control group. The extent of coronary artery stenosis was determined by the number of vessels with >50% stenosis. Plasma osteopontin concentrations were measured from the blood samples that were drawn immediately after admission to the emergency department in unstable angina/NSTEMI patients and before the coronary angiograph in the stable angina and control groups. RESULTS: The plasma osteopontin concentration was (495 118 ng/ml) significantly higher in the patients with unstable angina/NSTEMI compared to the stable angina group (319 106 ng/ml) and control group (125+/-54 ng/ml) (p=0.0001 The plasma osteopontin levels were lower in the patients with stable angina pectoris who had one-vessel disease compared to those with two-vessel disease (p=0.01). How ever, in the unstable angina/NSTEMI group, the plasma osteopontin levels were statistically not different among the patients with one-vessel, and two-vessel and three-vessel disease (p=NS). There was no correlation between the plasma osteopontin levels and the extent of coronary stenosis. CONCLUSIONS: The plasma osteopontin levels are elevatedin patients with unstable angina/NSTEMI, but there appears to be no correlation with the extent of CAD. These results ma suggest that osteopontin may have a role in the pathobiology of ACS.     

Preservatives and fragrances in selected consumer-available cosmetics and detergents

Background. Preservatives and fragrances are important and frequent skin sensitizers, found in a wide range of products intended for personal and occupational use. Objectives. To examine the use of preservatives and fragrances in certain cosmetics and detergents on the market. The product types studied were shampoos, hair conditioners, liquid soaps, wet tissues, washing‐up liquids, and multi‐purpose cleaners. Materials/methods. Ingredient labels of 204 cosmetic products and ingredient data sheets of 97 detergents, available on company websites, were examined. Results. The preservatives most frequently identified were phenoxyethanol, methylparaben, sodium benzoate, propylparaben, and methylchloroisothiazolinone/methylisothiazolinone. Parabens were found in 44% of cosmetics and 9% of detergents; formaldehyde‐releasers in 25% of cosmetics and 8% of detergents; and isothiazolinones in 23% of cosmetics and 28% of detergents. The fragrances most frequently identified were linalool, limonene, hexyl cinnamal, butylphenyl methylpropional, and citronellol. Eighty‐eight per cent of the products contained fragrances, and any of the 26 fragrances requiring labelling were found in half of the cosmetics and one‐third of the detergents. Conclusions. Several preservatives and fragrances with well‐known skin‐sensitizing potential were common in the examined product types. Such products may be used several times a day by consumers and workers.     

Temporalis muscle flap for craniofacial reconstruction after tumor resection

Temporalis muscle flap provides a good solution for the reconstruction of craniofacial defects after tumor resection. Nine patients with complicated defects located at the upper two thirds of the face, anterior cranial base, or mastoid region are presented. Five patients had orbital exenteration, two with total maxillectomy and two with anterior craniofacial resection. Temporalis muscle flap provided profuse well-vascularized tissue for the obliteration of orbital exenteration and total maxillectomy cavities and coverage of surface defects. Cranial, oral, and nasal spaces were separated successfully in all patients. Temporalis muscle flap is a very reliable technique with low complication rates and few donor site problems. This safe and technically easy flap can be preferred for the reconstruction of craniofacial defects after ablative tumor surgery, especially in older and debilitated patients.     

Evaluation of oxidative stress in cutaneous leishmaniasis

Oxidative stress occurs when there is excessive free-radical production or a low antioxidant level. The role of free radicals in the pathogenesis and in the progression of many diseases has often been discussed, but it has not been widely investigated in leishmaniasis. However, measurement of oxidants and antioxidants in the serum seems to be of great value. In this study, we aimed to determine lipid peroxidation levels as markers of oxidative stress in the serum of patients suffering from cutaneous leishmaniasis, which is a common health problem in our region of Southern Anatolia, Turkey. Forty patients aged between 5-50 years and forty controls aged between 5-50 years were included in the study. The LPO levels of the patients with active cutaneous leishmaniasis were significantly higher (p<0.001) than those of healthy controls. As a result, it is possible to conclude that patients with cutaneous leishmaniasis are affected by oxidative stress, which may contribute to the progression of the disease.     

Stent Graft Infection in the Lower Limb

Background : Pore wound healing can occur after limb amputation.

Case Report : We describe the case of a patient with a persistent fistula after below-knee amputation. The fistula is maintained due to an infected stent graft. After removal of the stent graft and adequate antibiotic treatment the wounds healed and extended amputation was avoided.

Conclusion : The diagnosis of stent graft infection is challenging and requires aggressive treatment to prevent further amputation.     

Spontaneous thrombosis of vein of Galen aneurysmal malformation after ventriculoperitoneal shunting.

Aneurysmal dilatation of the vein of Galen (AVG) is a common finding in vascular malformations that involve the Galenic system and spontaneous thrombosis is very rare. Although the presentation of the cases may differ with the age, the mortality and morbidity is high in all age groups. Here, we present a case of AVG in a six-month-old boy. The patient underwent insertion of a ventriculoperitoneal shunt. Surveillance of the lesion with subsequent MRI revealed spontaneous thrombosis of the AVG with excellent clinical outcome. Proposed mechanisms of spontaneous thrombosis include slow flow shunts, obstruction of the venous outflow or obstruction of the feeding artery. The case is discussed with the relevant literature.