Hepatic pseudocyst as a result of ventriculoperitoneal shunts: case report and review of the literature

Hepatic pseudocyst formation is a rare intra-abdominal complication of ventriculoperitoneal shunts. The presence of an intracranial tumor and a history of central nervous system infection are major risk factors for the development of this complication. Hepatic pseudocysts secondary to ventriculoperitoneal shunts can be classified as intra- and extra-axially growing cysts. On abdominal computed tomography images, extra-axially growing pseudocysts are typically surrounded by a fine annulus that shows continuity to hepatic parenchyma. For treatment of extra-axially growing hepatic pseudocysts, surgical unroofing of the cyst and repositioning of the catheter is an effective method if there is no shunt infection and/or dysfunction.     

Does Obstructive Sleep Apnea Increase the Risk for Periodontal Disease? A Case‐Control Study

Background: A possible association between periodontitis and obstructive sleep apnea (OSA) has been suggested. The aim of this study is to compare periodontitis prevalence between controls and patients with OSA by assessing clinical periodontal parameters and gingival crevicular fluid (GCF) levels of interleukin (IL)‐1β, tumor necrosis factor (TNF)‐α, and high‐sensitive C‐reactive protein (hs‐CRP); serum hs‐CRP was also sampled. Methods: A case‐control study was performed that included 163 individuals: 83 individuals (18 females and 65 males) with OSA and 80 non‐OSA individuals (23 females and 57 males) as controls. The test group was classified according to OSA severity. Clinical periodontal measurements were recorded, and GCF samples were collected. GCF hs‐CRP, IL‐lβ, and TNF‐α levels were analyzed using an enzyme‐linked immunosorbent assay method. Serum hs‐CRP was measured by latex‐enhanced immunoturbidimetric assay. Results: Prevalence of periodontitis in the OSA group (96.4%) was significantly higher than in the control group (75% [P <0.001]). Severe periodontitis prevalence was higher in the OSA group than control group. All periodontal clinical parameters and GCF IL‐lβ concentrations were significantly higher in patients with OSA than in controls (P = 0.001). No significant differences were found between the mild OSA and moderate‐to‐severe OSA groups. Additionally, there was no significant difference in GCF TNF‐α and hs‐CRP levels between the groups (P >0.05). Serum hs‐CRP levels were significantly higher in patients with OSA. A significant correlation was found between GCF IL‐1β and all clinical parameters. Conclusions: Results demonstrated higher prevalence of periodontitis and higher levels of GCF IL‐1β and serum hs‐CRP in patients with OSA. However, there is still a need for randomized clinical trials testing oral care interventions.     

A model for testing recombinogenic sequences in the mouse germline

Homologous recombination is a conserved process of genetic exchange generated by homologous pairing of nucleotides. Species diversity and gene evolution are dependent on the outcomes of recombination during germ cell development, yet systems to study mammalian germline recombination, especially those with applications to human genetics, are not well developed. We report on a transgenic mouse system designed to study recombination within test sequences in the male germline utilizing an intron-interrupted lacZ reporter gene. beta-galactosidase positive sperm are detected and quantitated by flow cytometry using fluorogenic substrates. Examination of recombination within a 1.7 kb repeat of test sequences derived from the human glycophorin breakpoint cluster region detects approximately 0.04-0.09% fluorescent sperm. Confirmation that these sperm result from recombination in the germline comes from histochemical staining of testicular cells, examination of spliced mRNA, and PCR analysis of sorted sperm populations. The system is readily adaptable to studies of other sequences reported to have elevated levels of recombination, including those implicated in human genetic disease. Investigations of the molecular basis for genomic instability at specific chromosomal locations may yield important insights into mechanisms of chromosomal loss and rearrangements.      

Single dose of preoperative analgesia with gabapentin (600 mg) is safe and effective in monitored anesthesia care for nasal surgery

This study was aimed to compare the intraoperative sedative and perioperative analgesic drug requirements and the incidences of postoperative side effects on the patients who received preoperative gabapentin or placebo. Sixty patients undergoing nasal septal or nasal sinus surgery were included. The patients received either 600 mg gabapentin (Group G) or placebo (Group P) orally, 1 h before surgery. The scores for sedation and pain were recorded at 5, 15, 30, 45 and 60 min, intraoperatively and at 30 min, 1, 2, 4, 6, 9, 12, 16, 20, 24 h, postoperatively. Sedation was achieved with an IV bolus of propofol and continuous infusion of remifentanil. There were significant differences between gabapentin and placebo groups with regard to total consumptions of remifentanil (171.42 ± 68 vs. 219.17 ± 95 μg, respectively; P = 0.033) and propofol (59.45 ± 36.08 vs. 104.14 ± 54.98 mg, respectively; P = 0.001). Group G patients had significantly lower intraoperative VAS scores at all time points (P < 0.05). The anxiety score of Group G was better at all times (P < 0.05). All postoperative pain scores were lower in the Group G (P < 0.05). Time to first request for analgesic was 12.7 ± 2.3 h in Group G, and 7.8 2.1 h in Group P (P < 0.0001). Total consumption of lornoxicam was lower in Group G (P < 0.004). We concluded that monitored anesthesia care combined with preoperative analgesia with a low dose of (600 mg) oral gabapentin is an efficient option with tolerable side effects for patients undergoing ear, nose and throat ambulatory surgery.