The role of smooth muscle cell differentiation in the mechanism of obliteration of processus vaginalis

Background/Purpose

Development of indirect inguinal hernia and hydrocele in childhood is readily explained by the persistence of smooth muscle component around the processus vaginalis (PV) after the descent of the testis into the scrotum. The aim of this study was to investigate the expression of smooth muscle myosin heavy chain (SM MHC) isoforms as the markers of smooth muscle cell (SMC) differentiation in childhood inguinal hernia and hydrocele and in age-matched controls.

Methods

The authors analyzed sacs from patients with inguinal hernia (male, 10; female, 10) and hydrocele (n = 10) immunohistochemically using monoclonal antibodies against α-smooth muscle actin, SM1, SM2 and SMemb. Peritoneal samples (male, 5; female, 5) obtained from age-matched patients served as controls. Immunostaining was evaluated with semiquantitative scoring and χ² test.

Results

The expression pattern of SM MHC isoforms did not differ among sacs obtained from female inguinal hernia when compared with that of controls. However, strong expression of SMemb within the sac walls of male inguinal hernia and SM1 in hydrocele groups were observed.

Conclusions

Our results indicate that SMC differentiation may play an important role in the obliteration of processus vaginalis in male inguinal hernia and hydrocele after the descent of the testis.     

N-Acetylcysteine for Preventing Pump-Induced Oxidoinflammatory Response During Cardiopulmonary Bypass

Purpose To investigate the effect of N-acetylcysteine on preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass (CPB).Methods Forty patients undergoing coronary artery bypass grafting (CABG) were randomly divided into a study group (n = 20), given 50mgkg^–1 N-acetylcysteine intravenously for 3 days, and a control group (n = 20) given saline. Serum samples were collected for measurement of myeloperoxidase (MPO), malondialdehyde (MDA), interleukin-6, ₁-acid glycoprotein (AAGP), and C-reactive protein (CRP) during surgery and postoperatively.Results The MPO and MDA values showed a similar pattern during and after CPB in the study group, with significantly less variance than in the control group. Interleukin-6 showed similar patterns in the two groups, but the data from 30min after the start of CPB and from 6h post-CPB were significantly different. The AAGP and CRP values were both elevated during CPB in the two groups without a significant difference, but 6 and 24h post-CPB, the values were significantly higher in the control group than in the study group.Conclusions N-Acetylcysteine decreased pump-induced oxidoinflammatory response during CPB, suggesting that it could be a novel therapy for assisting in the prevention of CBP-induced oxidoinflammatory damage.     

Evaluation of paranasal sinus mucosa in coal worker's pneumoconiosis: a computed tomographic study

OBJECTIVE: To evaluate by computed tomographic scanning the paranasal mucosal changes of coal workers with and without pneumoconiosis. METHODS: Examination of images and scores from paranasal computed tomographic scans. The study participants were 26 coal workers with pneumoconiosis, 29 coal workers without pneumoconiosis, and 20 controls. All were men. The extent and patterns of inflammatory paranasal sinus disease were evaluated on computed tomographic scans by 2 radiologists using the terminology and definitions of Newman and associates. RESULTS: Interobserver agreement for the presence of abnormalities was from good to excellent (kappa, 0.63-0.89). The mucosal scores of individuals and groups were higher for coal workers than for control subjects. Both scores were significantly higher in the pneumoconiosis group than in the 2 other groups. CONCLUSIONS: This study shows that paranasal sinuses were affected more severely in coal workers than in control subjects. In coal workers with pneumoconiosis, the affection was most severe. The relationship between coal dust exposure and paranasal mucosal changes needs further study.     

Effect of intra-abdominal pressure level on gastric intramucosal pH during pneumoperitoneum

The present study was designed to examine the effect of intra-abdominal pressure level on gastric intramucosal pH using gastric tonometry during pneumoperitoneum. One hundred patients were prospectively randomized into 5 equal groups (N = 20 each). Intra-abdominal pressure levels were 8, 10, 12, 14, and 16 mm Hg in groups I, II, III, IV, and V, respectively. Intramucosal pH measurement was done 2 times: 30 minutes following insufflation and 1 hour after the ending of the surgery. In the first and second measurements, intramucosal pH values were found as 7.39 +/- 0.02 and 7.36 +/- 0.03 in group I; 7.41 +/- 0.03 and 7.38 +/- 0.03 in group II; 7.37 +/- 0.03 and 7.37 +/- 0.03 in group III; 7.36 +/- 0.03 and 7.37 +/- 0.03 in group IV; and 7.39 +/- 0.03, 7.36 +/- 0.03 in group V, respectively. Statistical significance was not found in the comparison of these values within the groups and between the groups (P > 0.005, for each). In conclusion, intra-abdominal pressure between 8 and 16 mm Hg did not cause significant difference in gastric intramucosal pH.     

Intravitreal taurolidine against experimental Staphylococcus epidermidis endophthalmitis in rabbits

PURPOSE: Taurolidine is a broad spectrum, non-antibiotic antimicrobial agent, not previously tested against infectious endophthalmitis. The efficacy of intravitreal taurolidine in the treatment of experimental Staphylococcus epidermidis endophthalmitis was evaluated and compared with vancomycin in a rabbit model. METHODS: The right eyes of 34 albino rabbits were infected with an intravitreal inoculum of S. epidermidis (10(5) colony-forming units/0.1 ml). The right eyes of four rabbits (group 7) were not infected and served as uninfected controls. 24 hours after inoculation of bacteria the animals were divided into the following treatment groups: group 1 (7 rabbits) received intravitreal taurolidine at 24 hours and group 2 (7 rabbits) received at 48 hours. Group 3 (7 rabbits) received vancomycin at 24 hours and group 4 (7 rabbits) at 48 hours. Group 5 (3 rabbits) received polyvinylpyrrolidone at 24 hours and group 6 (3 rabbits) at 48 hours. Clinical scoring was performed at 24, 48 and 72 hours. At 72 hours post inoculation, vitreous samples were collected for quantitative microbiological studies and then, the eyes were enucleated for histopathological scorings. RESULTS: The clinical and histopathological examinations revealed significant amelioration of inflammation in eyes treated with taurolidine and vancomycin when compared with polyvinylpyrrolidone. The eyes treated with taurolidine also had significantly lower colony forming units than the eyes treated with polyvinylpyrrolidone and taurolidine rendered many eyes sterile. CONCLUSION: Taurolidine is expected to be a potential agent for treatment of S. epidermidis endophthalmitis.     

Inter-alpha inhibitor proteins in infants and decreased levels in neonatal sepsis

OBJECTIVE: Adjunctive tests are needed to predict sepsis in the newborn and to lower the rate or duration of unnecessary antibiotic use. We evaluated the normal Inter-alpha inhibitor protein (IaIp) values in infants and the association of plasma levels of IaIp with sepsis in term and preterm newborns. METHODS: Plasma IaIp levels were measured by enzyme-linked immunosorbent assay in samples from 135 newborn infants at a wide range of gestational ages (24-42 weeks). IaIp levels were also determined in 19 infants undergoing prospective evaluation for sepsis. RESULTS: IaIp levels in umbilical cord blood and circulating peripheral blood of healthy newborn infants (525+/-66 mg/L) were not significantly different from the level in healthy adults (691+/-80 mg/L). IaIp levels were similar in infants between 24 and 42 weeks gestational age. There was a significant reduction in IaIp levels in infants with sepsis compared with nonseptic controls (169+/-126 mg/L vs 613+/-286 mg/L, P<.0001). CONCLUSIONS: IaIp levels in the blood of newborns are independent of gestational age and similar to adults. IaIp levels are significantly reduced in infants with bacterial sepsis and might serve as an adjunctive diagnostic marker to allow prospective reduction of antibiotic use.     

Role of perineal sonography in the evaluation of patients with stress urinary incontinence

OBJECTIVE: The aim of the study was to determine the role of perineal sonography in diagnosis of stress urinary incontinence. MATERIALS AND METHODS: Thirty patients with stress urinary incontinence and 17 age-matched control patients were included in the study. Perineal sonography was carried out in both groups to evaluate the role of this technique in the diagnosis of stress urinary incontinence. By using the posterior edge of the symphysis pubis as a reference point, posterior urethra-vesical angle (beta angle) and the angle between the vertical axis and urethral axis(alpha angle) were measured at rest and on straining. Bladder neck mobility was evaluated only at the cephalocaudal plane by measuring the desensus diameter. RESULTS: Posterior urethro-vesical angle (beta angle) was found to be significantly different between the study and control groups both at rest and on straining (P < 0.05). The angle between the vertical axis and urethral axis (alpha angle) was found to be significantly different between study and control groups only on straining (P < 0.05). Cephalocaudal distance (desensus diameter) was longer in patients with stress urinary incontinence (P < 0.05). CONCLUSION: Perineal sonography has an important role in diagnosing patients with stress urinary incontinence.     

Serum, pleural effusion, and ascites CA-125 levels in ovarian cancer and nonovarian benign and malignant diseases: a comparative study

OBJECTIVES: Cancer antigen-125 (CA-125) is not a specific tumor marker and it is synthesized by normal and malignant cells of different origins. Recently it has been shown that various diseases are associated with increased CA-125 levels, especially in the presence of serosal fluid. The aim of this study is to investigate serum and fluid CA-125 levels in patients with different diseases. METHODS: A total of 133 patients and 23 healthy control cases were included in the study and divided into eight groups on the basis of disease and the presence of fluid in the serosal cavities. Serum and serosal fluid CA-125 levels were measured by a commercial enzyme immunoassay kit at the same time. Comparisons among the groups were made. RESULTS: Abnormal levels of serum CA-125 were observed in 76% of ovarian cancer patients; 96% in patients with ascites and 56% in patients without ascites. Moreover, elevated serum CA-125 levels were detected in 52% of patients with hepatic diseases, in 100% of patients with nongynecologic peritoneal carcinomatosis, and in 87% of patients with pleural effusion. Serum and fluid CA-125 levels were significantly higher in cases of ovarian cancer with ascites than in the other groups (P < 0.01). A positive correlation between serum CA-125 levels and ascites amounts was observed in cases of ovarian cancer with ascites (P < 0.01, r = 0.81). Furthermore, no correlation was observed between ovarian mass volume and serum CA-125 levels in ovarian cancer patients with stage I disease without ascites (P = 0.08, r = 0.48). CONCLUSIONS: Although CA-125 levels may be considered a sensitive tumor marker in patients with epithelial ovarian cancer, it was determined that high serum CA-125 levels were closely related to the presence of serosal fluids and serosal involvement, whatever the origin is. These results should be considered in the interpretation of CA-125 elevation in patients with ovarian cancer.