Acute aortic dissection with painless paraplegia: report of 2 cases

Acute aortic dissection is often a life-threatening event that usually presents as a sudden, severe, exquisitely painful, ripping sensation in the chest or back. There are a few reports of atypical findings or no pain in the literature. We report 2 patients with painless acute aortic dissection who presented to the emergency department (ED) with sudden onset paraplegia.     

Reattachment of subgingivally fractured central incisor with an open apex

Abstract –  A case report of a 6-year-old girl with a fractured maxillary left central incisor with an open apex is presented. The procedure used to repair the fracture included flap surgery with an intrasulcular incision and endodontic treatment. The patient was called for 3 months regular follow-up to check the root formation. At the end of 32 months just before the root was obturated by guttaperka, she fractured the same tooth. Flap surgery was repeated and the tooth was restored. The root canal was obturated with a root filling paste and guttaperka as the apex was closed. Examination 10 months after treatment revealed good periodontal health, aesthetics and normal function.     

Abdominal insufflation-deflation injury in small intestine in rabbits.

OBJECTIVE: To investigate the effect of increased intra-abdominal pressure followed by abdominal deflation on small intestine with or without previous intestinal ischaemia. DESIGN: Randomised experimental study. SETTING: University hospital, Turkey. ANIMALS: 78 male New Zealand white rabbits. INTERVENTIONS: Experiment 1: 30 rabbits (10 in each group) were subjected to intra-abdominal pressure of 0 mmHg (controls), 15 mmHg or 25 mmHg for 60 minutes. Experiment 2: 48 rabbits were divided into four groups (n = 12 in each). The first comprised sham-operated controls. In the other 3, the superior mesenteric artery was occluded for 60 minutes. Reperfusion was started and maintained under intra-abdominal pressure of 0 mmHg, 15 mmHg, or 25 mmHg for one hour. Intestinal specimens were obtained five and 60 minutes after abdominal deflation in the pressure groups and at identical times in the other groups in both experiments. MAIN OUTCOME MEASURES: Intestinal malondialdehyde concentration, wet:dry intestinal weight ratio, and mucosal injury score under light microscopy. RESULTS: In experiment I the malondialdehyde concentration, wet:dry weight ratio, and mucosal injury scores were higher in the 25 mmHg group than in the other groups in both specimens. There was a significant increase in malondialdehyde concentration in the 15 mmHg group in only the 5-minute specimen. In experiment 2, except for the wet:dry weight ratio in the 5-minute specimen in the 15 mmHg group, there were significant increases in malondialdehyde concentration, wet:dry weight ratio, and mucosal injury score in all groups except controls in both specimens. Malondialdehyde concentration and wet:dry weight ratio were higher in the 25 mmHg group than in the 0 mmHg group in the 60-minute specimen, and higher than the 15 mmHg group in both specimens. Wet:dry weight ratio was less in the 15 mmHg group than the 0 mmHg group in both specimens. Mucosal injury score was higher in the 25 mmHg group than the other groups in both specimens. CONCLUSION: Increased intra-abdominal pressure for 60 minutes followed by abdominal deflation led to an ischaemia-reperfusion-like injury in normal small intestine in rabbits, and added to reperfusion injury in the ischaemic small intestine at an intra-abdominal pressure of 25 mmHg.     

Biochemical assessments of retinol, alpha-tocopherol, pyridoxal--5-phosphate oxidative stress index and total antioxidant status in adolescent professional basketball players and sedentary controls

Physical training is known to increase the antioxidant defence system and reduce exercise-induced oxidative stress. However, intense physical aerobic and anaerobic training with competition, such as those imposed on young professional basketball players can induce an increase of oxidative stress, which can be implicated with overtraining. The aim of this study was to test the effect of training and competition load on oxidative stress, antioxidant status, and vitamin levels in basketball players. Oxidative Stres Index (OSI 1), Total Peroxide (TPx) antioxidant (vitamin E, A and The total antioxidant status (TAC 1)), biochemical lipid parameters, as well as training results were measured. Results showed that all plasma vitamin levels were significantly higher in basketball players (vitamin A: 1.61 +/- 0.05 mmol/l, vitamin E: 26.45 +/- 0.72 mmol/l, vitamin B6: 10.58 +/- 0.7 mgr/l) than sedentary controls (vitamin A: 1.22 +/- 0.04 mmol /l, vitamin E: 19.24 +/- 0.73 mmol/l, vitamin B6: 6.0 +/- 0.35 mgr/l) (p < 0.01). In addition TAC 1 was 2.06 +/- 0.02 and 1.89 +/- 0.01 mmol Trolox eq/L in basketball players and controls, respectively (p < 0.01). Conversely OSI was 0.89 +/- 0.09 arbitrary unit and 0.88 +/- 0.071 arbitrary unit in basketball players and controls, respectively (p > 0.05). However, total plasma peroxide level (TPx) of basketball players and controls was not statistically different (18.55 +/- 2.07 and 17.18 +/- 1.61 micromol H2O2/L, respectively; p > 0.05). We conclude that physical exercise increase antioxidant levels and cause balance of the homeostasis. Training can not have positive or negative effects on oxidative stress depending on training load. The results suggested that oxidative stress and antioxidant measurement are significant in the biological follow-up of young basketball players.     

The Missense Alteration A5T of the Thyroid Peroxidase Gene is Pathogenic and Associated with Mild Congenital Hypothyroidism

Congenital hypothyroidism (CH) occurs with a prevalence of approximately 1:4000 live births. Defects of thyroid hormone synthesis account for 15-20% of these cases. Thyroid peroxidase (TPO) gene is the most common cause for dyshormonogenesis. So far, more than 60 mutations in the TPO gene have been described, resulting in a variable decrease in TPO bioactivity. We present an 8-day-old male with mild CH who was identified to have a G to A transition in the fifth codon of the TPO gene (c.13G>A; p.Ala5Thr). The unaffected family members were heterozygous carriers of the mutation, whereas 400 healthy individuals of the same ethnic background did not have the mutation. Mutation analysis of 11 known causative CH genes and 4 of our own strong candidate genes with next-generation sequencing revealed no mutations in the patient nor in any other family members. The results of in silico functional analyses indicated partial loss-of-function (LOF) in the resulting enzyme molecule due to mutation. The patient’s clinical finding s were consistent with the effect of this partial LOF of the mutation. In conclusion, we strongly believe that A5T alteration in the TPO gene is actually pathogenic and suggest that it should be classified as a mutation.     

Does Helicobacter pylori infection play a role in lung cancer?

BACKGROUND: Helicobacter pylori infection is a world-wide common disease and leads to many gastrointestinal and respiratory illnesses. It is suggested that one of these respiratory illnesses is lung cancer. METHODS: Forty-three patients with non-small cell lung cancer and 28 control subjects have been included to this study. H. pylori status of the patients and controls was determined by immunoblot for the detection of IgG (RIDA Blot Helicobacter). All subjects were examined to evaluate the presence of VacA and CagA gene. RESULTS: Seropositivity of anti H. pylori IgG was significantly higher in cancer patients than in control groups, 40 (93%) and 12 (42%), respectively (P<0.01). Although both VacA and CagA seropositivity was high in lung cancer patients, only VacA positivity was statistically significant when compared with control subjects, 35 (81%) and 11 (42%), respectively (P<0.05). CONCLUSION: H. pylori infection may be associated with development of lung cancer.