Endoscopic dacryocystorhinostomy appears to impair nasal mucociliary clearance

We conducted a prospective study of 50 adults to investigate changes in nasal mucociliary clearance following endoscopic intranasal dacryocystorhinostomy (DCR). Each operation was performed with the use of a drill to perforate the lateral nasal wall in order to reach the lacrimal sac. Each patient's mucociliary clearance time (MCT) was determined by the saccharin test on both the operated and nonoperated sides; the preoperative times were compared with postoperative measurements made 1 and 3 months following DCR. Preoperatively, the mean MCTs were 14.48 minutes on the operated side and 14.50 minutes on the nonoperated side-not a statistically significant difference (p > 0.05). Postoperatively, the corresponding MCTs were 25.22 and 14.98 minutes at 1 month and 18.44 and 15.62 minutes at 3 months. On the operated side, both postoperative MCTs were significantly longer than the preoperative value (p < 0.001), while on the nonoperated side, neither postoperative MCT was significantly different from the preoperative value (p > 0.05). Also, the postoperative MCTs were significantly longer on the operated side than on the nonoperated side at both 1 month (p < 0.001) and 3 months (p < 0.05). Only 1 of the 50 operations was considered to be unsuccessful; the reason for this surgical failure was the patient's ongoing complaints of chronic postoperative dacryocystitis. We conclude that endoscopic DCR disturbs mucociliary clearance. Changes in MCTs may be attributable to injury to the nasal mucosa or to the continuous flow of tears through the nasal mucosa.     

Sequelae of postpartum sterilization

This study was designed to investigate the menstrual, psychosexual, psychological and somatic sequelae in a group of women who may be more prone to express regret following postpartum sterilization. The follow-up was conducted by questionnaire at six months and five years following the procedure. Data were available from 242 patient; 76.8% were below the age of 30. Of all patients, 21.9% expressed regrets. About one third had various menstrual disturbances. Patients rated their sex life as generally more enjoyable in many aspects. The most common psychological symptoms were irritability, nervousness and depression; while the common somatic symptoms were pelvic/abdominal pain and backache and tiredness. Received: 9 October 1997 / Accepted: 25 March 1998     

In-vitro modulation of plasminogen activator activity, prostaglandin E and nitric oxide production by interleukin-1 in pregnant mare serum gonadotrophin-primed theca-interstitial cells

To examine the participation of the theca-interstitial (TI) compartment in cytokine modulation of ovarian function, the effects of interleukin- 1beta (IL-1) on plasminogen activator (PA) activity and on prostaglandin E (PGE) and nitric oxide (NO) production were examined in cultures of pregnant mare serum gonadotrophin (PMSG)-primed rat TI cells. Exposure to IL-1 (10 ng/ml) resulted in a 25% reduction (P < 0.001) in PA activity, concurrent with a 4.6-fold increase in the ability of the corresponding conditioned media to inhibit exogenous urokinase activity. IL-1 also produced a 4.7-fold increase in PGE content and a 2.8-fold increase in NO generation. These effects of IL-1 were abolished by the IL-1 receptor antagonist, suggesting specific IL- 1 receptor-mediated effects. Transforming growth factor (TGF)-beta1 (10 ng/ml) significantly attenuated the IL-1-stimulated PGE production and NO generation but did not affect the ability of IL-1 to suppress PA activity and stimulate urokinase inhibitor production. The NO synthase inhibitor N-nitro-L-arginine attenuated the IL-1-induced NO generation but had no effect on PA activity or PGE production. Thus, NO is not an obligatory mediator of IL-1 effects on plasminogen activation and PGE generation in rat ovary. The present observations attest to a pleiotropic response of PMSG-primed TI cells to IL-1, and suggest a paracrine/autocrine function for the TI compartment in ovulation and corpus luteum formation.      

Oxidative and Apoptotic Effects of Fluoxetine and Its Metabolite Norfluoxetine in Daphnia Magna

The aim of this study was to investigate the oxidative and apoptotic potential of fluoxetine, a widely used antidepressant in Turkey and the world, and of its metabolite norfluoxetine on a model non-target organism, Daphnia magna to see how exposure to this group of antidepressants (specific serotonin reuptake inhibitors) could affect the aquatic environment in which they end up. Juvenile D. magna specimens were chronically exposed to fluoxetine and norfluoxetine alone and in combination at concentrations found in the aquatic environment (0.091 and 0.011 μg/L, respectively) and to their 10-fold environmental concentrations for 21 days. Another group of 17-day-old animals were subacutely exposed to 100-fold environmental concentrations for four days. After exposure, we measured their glutathione peroxidase (GPx) and cholinesterase (ChE) activities, thiobarbituric acid-reactive substances (TBARS), and total protein content spectrophotometrically, while mitochondrial membrane potential (MMP) was analysed by fluorescence staining, and cytochrome c and ERK1/2 protein content by Western blotting. This is the first-time cytochrome c and ERK1/2 were determined at the protein level in D. magna. We also measured their carapace length, width, and caudal spine length microscopically. At environmental concentrations fluoxetine and norfluoxetine caused an increase in ChE activity and brood production. They also caused a decrease in juvenile carapace length, width, and caudal spine length and depolarised the mitochondrial membrane. At 10-fold environmental concentrations, GPx activity, lipid peroxidation levels, cytochrome c, and ERK1/2 protein levels rose. The most pronounced effect was observed in D. magna exposed to norfluoxetine. Norfluoxetine also decreased brood production. Similar effects were observed with subacute exposure to 100-fold environmental concentrations. However, total protein content decreased. All this confirms that fluoxetine and norfluoxetine have oxidative and apoptotic potential in D. magna. Daphnia spp. have a great potential to give us precious insight into the mechanisms of environmental toxicants, but there is still a long way to go before they are clarified in these organisms.     

Vascularization pattern of c6 glioma is modified with medroxyprogesterone acetate and ibuprofen in Wistar rat brain

Beneficial effects of medroxyprogesterone acetate (MPA) in cancer therapy is partly mediated via its antiangiogenic activity. The same is true for the antitumoral action of non-steroidal antiinflammatory drugs. We have studied two liposoluble drugs, MPA and the analgesic ibuprofen, on glioma vascularization in vivo. In this study we have shown that, until the sacrifice at 27. day after tumor inoculation in the right hemisphere, MPA had a slight though insignificant activity to reduce the fatality of C6 glioma, growing in right cerebral hemisphere of male Wistar rats. But ibuprofen both alone or with MPA had no effect on survival with gavage application of a 30 mg/kg/day dosing regime. On histological analysis, intra- and peritumoral vessels were counted. Progesterone seemed to lower intratumoral, but to increase peritumoral vessels, especially glomeruloids, around the tumor mass. Coadministration of ibuprofen acted to suppress the peritumoral vessel increase, and to enhance lymphomonocytic infiltration around tumor vessels.     

Placebo-controlled cross-over study of effects of tibolone on premenstrual symptoms and peripheral beta-endorphin concentrations in premenstrual syndrome

Central nervous system hormones have been linked to premenstrual syndrome (PMS) and beta-endorphin (beta-EP) is thought to be involved in the pathophysiology. We have tested the efficacy of the synthetic steroid Org OD 14 (tibolone) in the treatment of PMS. This prospective, randomized, placebo-controlled, double-blind cross-over study included 18 ovulatory women with PMS as ascertained by a visual linear analogue scale (VLAS). The women in each group received either 2.5 mg per day Org OD 14 (n = 9) or a multi-vitamin pill as placebo (n = 9) for 3 months. Treatments were then crossed over to a placebo for a further 3 months. VLAS ratings were evaluated at the end of each menstrual cycle throughout the study. Peripheral beta-EP concentrations were determined by radioimmunoassay on days 7 and 25 of each menstrual cycle. Changes in VLAS score and beta-EP concentrations from baseline were calculated and analysed by Student's paired t-test. Improvements in VLAS scores and beta-EP concentrations were evident during the second and third months of tibolone treatment. At the end of the third month, there was a significant improvement in VLAS scores of all symptom categories compared with pretreatment and placebo during treatment with tibolone (P < 0.05). Similar results were obtained in the first placebo group when switched to tibolone. Beta-EP concentrations were not significantly different between the study groups at the initial cycle (15.9 +/- 3.6 versus 17.2 +/- 2.3 pg/ml). The increase in beta-EP concentration was significantly greater on day 25 of the menstrual cycle in women treated with tibolone compared with baseline and placebo group (22.5 +/- 4.4 versus 15.9 +/- 3.6 and 17.2 +/- 2.3 pg/ml respectively, P < 0.05). Our data confirm the clinical efficacy of tibolone in PMS-related symptoms, as well as its effects on serum beta- EP concentrations in patients with PMS.      

The relationship between blood eosinophil count and disease activity in ankylosing spondylitis patients treated with TNF-α inhibitors

Aim

Anti-tumor necrosis factor-alpha (Anti-TNF-α) therapy has achieved an important position, are widely used for ankylosing spondylitis (AS) patients. TNF-α inhibition improves clinical outcomes and has differential effects on haematopoiesis. Information about effects on eosinophils is limited. The aim of our study is to determine the relationship between blood eosinophil counts in AS patients treated with TNF-α inhibitors.

Partial preoperative reduction of inguinal hernia through compression with an ultrasound transducer

Sonography and CT are effective tools in early diagnosis of asymptomatic inguinal hernia. Sonography can be used not only for the diagnosis of hernia but also for its treatment. Real-time sonographically guided hernia reduction may avoid tissue damage that can arise from misguided compression. We report a unique case in which an incarcerated omental hernia in a 50-year-old woman was diagnosed and subsequently reduced via compression with an ultrasound transducer.     

Tracheal carinal angle and left atrial size.

Left atrial enlargement is a significant finding, usually indicating elevated left ventricular end-diastolic pressure. An increased tracheal carinal angle has been reported as one indicator on chest radiography of left atrial enlargement. This study retrospectively compared echocardiographically determined left atrial size with carinal angle on plain films. Enlarged left atria and paired, age-matched normal left atria by echocardiography were selected. The carinal angle was measured on roentgenogram (standard and portable films) by goniometer. The left atrium could be accurately predicted to be larger than 5.0 cm in diameter if the carinal angle was 100 degrees or greater. A carinal angle greater than 100 degrees is an easy, inexpensive, reliable method of predicting left atrial enlargement.