Inhibition of iNOS with S-methylisothiourea was impaired in wound healing in caustic esophageal burn

OBJECTIVE: Stricture formation is a late complication of caustic esophageal burn, which is a common problem in childhood. For this reason, this experimental study was designed to observe the possible effect of nitric oxide on healing and fibrosis formation in caustic esophageal burns. MATERIALS AND METHODS: The rats were divided into five groups. Group A (n=12) received sham burn and treatment with saline injection. Group B (n=34) received caustic burn. Rats in group C (n=31), were given water supplement with 10 g/L L-arginine that was started 24 h preoperatively and continued until postoperative day 4. In group D (n=21), S-methylisothiourea (SMT, specific inducible nitric oxide synthase (iNOS) inhibitor), was injected at a dose of 3 mg/kg i.p. at 30 min before caustic burn, and similar dose was reinjected immediately after caustic burn. SMT 6 mg/kg/day injections continued for 4 days long. In group E (n=22), Nomega-nitro-L-arginine (L-NNA, nonspecific nitric oxide synthase (NOS) inhibitor) was injected at a dose of 15 mg/kg i.p. at 30 min before caustic burn, and similar dose was reinjected immediately after caustic burn. L-NNA 30 mg/kg/day continues for 4 days. RESULTS: Dead rates were significantly higher in group E than in groups A-D. The mean hydroxyproline levels in esophageal tissue were significantly lower in groups A and B than in group D. Histopathologically, tissue damage scores in the esophageal tissue were higher in group D than in groups A-C. CONCLUSIONS: Inhibition of iNOS with SMT was impaired in wound healing due to caustic esophageal burn and provoked collagen accumulation at a later period. Those effects may due to inhibition of antioxidant, immunomodulatory and antifibrotic effects of NO.     

Paradoxically developed optochiasmatic tuberculoma and tuberculous lymphadenitis: a case report with 18-month follow up by MRI

We report the first case ofextracranial tuberculous lymphadenitis which paradoxically developed during treatment of intracranial tuberculoma. Our patient, a 15-year-old girl who initially presented with meningitis and intracranial tuberculomas, developed extracranial tuberculomas during treatment for central nervous system tuberculosis. She was followed clinically with cerebrospinal fluid (CSF) studies and magnetic resonance imaging (MRI) at three monthly intervals. Within 18 months of specific antituberculous treatment, the patient had fully recovered. The course and response to therapy are discussed in light of the current literature.     

Technical and clinical evaluation of a glucose meter employing amperometric biosensor technology

The objective of this study was to assess accuracy and precision of the Optimum H System for measuring glucose in fresh venous whole blood samples. Ninety-one whole blood specimens were analyzed duplicate on two optimum blood glucose meter and compared to YSI reference analyser and Beckman LX20 laboratory analyser. The study demonstrated that the Optimum H System gives clinically accurate, plasma equivalent glucose results for venous samples, compared to the YSI*1.12 reference method. All results were within the clinically acceptable A and B zones of the Parkes error grid, with 98.6% falling within zone A. The mean bias of the Optimum H System versus the YSI*1.12 reference was +5.39%, which is consistent with the strip claim that slightly higher results may be observed when using venous samples. The Optimum H System results showed good precision, with an overall mean CV of 3.0%. Plasma results from the Beckman laboratory analyser correlated well with the YSI*1.12 whole blood reference with a slightly higher mean bias of +3.92%. The study demonstrated the Optimum H System to give clinically accurate and precise results for glucose in fresh venous whole blood samples.     

Subclavian artery pseudoaneurysm in Behcet’s disease

Behcet’s disease (BD) is an autoimmune, multisystemic, and chronic inflammatory disease. Although it affects all systems, involvement of the vascular system is of vital importance. Pseudoaneurysm ruptures in the arteries are the major causes of sudden deaths in BD. Although pseudoaneurysms in aorta and pulmonary arteries are rare, it is even more rare in the subclavian arteries. In our case, a pulsatile mass in the right clavicular area was determined to be associated with BD and this case is presented because subclavian artery pseudoaneurysm is seen rarely in BD.     

Effect of blood donation-mediated volume reduction on regional right ventricular deformation in healthy subjects

Strain (S) and strain rate (SR) are known to be altered in diseases associated with right ventricular (RV) pressure/volume overload and RV myocardial dysfunction; however determinants of S/SR are incompletely understood. The aim of this study was to examine the effect of blood donation-mediated volume reduction on regional RV deformation in healthy young adults. Study population was composed of 61 consecutive healthy subjects who were volunteers for blood donation. All underwent standard echocardiography and two-dimensional S and SR imaging by speckle tracking before and after 450 mL blood donation. We found no change in RV lateral wall SR in all three segments. However, the S in the apical and mid segments of the RV lateral wall immediately decreased after blood donation [?26.2 ± 3.3 vs. ?23.2 ± 3.3 % (p < 0.0001) and ?28.2 ± 3.4 vs. ?27.1 ± 3.2 % (p = 0.009), respectively], whereas no change was observed in the basal segment. Moreover, changes in systolic S on the apical segment of the RV lateral wall before and after blood donation were significantly correlated with the changes in the RV size [end-diastolic area index, r = ? 0.369 (p = 0.003) and end-systolic area index, r = ? 0.319 (p = 0.012)] and changes in the stroke volume index [r = ? 0.436 (p < 0.001)]. Blood donation-mediated volume reduction in healthy subjects caused a regional difference in RV longitudinal deformation with the lower mid and apical S that was related to parameters of volume load severity. However, RV systolic SR was found to be resistant to the effects of volume depletion.     

Overexpression of cyclooxygenase-2 in multiple myeloma: association with reduced survival

Cyclooxygenases (COX) are key enzymes in the conversion of arachidonic acid to prostaglandins. Several studies have shown a relation between angiogenesis and COX-2 expression. Elevated expression of cyclooxygenase-2 (COX-2), however, has not been reported in multiple myeloma (MM) in the literature. The aim of this study is to investigate COX-2 expression in MM as well as its correlation with prognostic factors and estimated survival rates. Immunohistochemical staining of the paraffin-embedded bone marrow biopsy tissues (n = 51) was performed using isoform-specific COX-2 polyclonal antisera (Santa Cruz Biotechnology, Santa Cruz, CA). Results were correlated with recognized clinical parameters, which were retrospectively obtained from patients' files. There were 15, 19, and 17 bone marrow biopsy specimens with negative, weak-moderate, and strong COX-2 immunostaining, respectively. According to univariate analysis, beta2-microglobulin, age, stage, COX-2 expression, and serum lactate dehydrogenase levels were significant prognostic factors for survival in patients with multiple myeloma. COX-2 expression, age, and serum lactate dehydrogenase levels (greater than 1x normal level) were significant prognostic factors by multivariate analysis. Kaplan-Meier overall survival estimate of those patients with negative or weak-moderate COX-2 immunoreactivity in myeloma cells was significantly better than that of patients with strong COX-2 immunoreactivity (log-rank chi(2) = 21,43, P < 0.001). COX-2 overexpression was associated with reduced estimated survival. Poor prognostic factors such as LDH, age, and beta2-microglobulin were also correlated with COX-2 expression. Potent, specific COX-2 inhibitors showing evident antiangiogenic and antitumor effects on cancers could provide new therapeutic strategies in the treatment of MM.     

Redox potentials of primary electron acceptor quinone molecule (QA)- and conserved energetics of photosystem II in cyanobacteria with chlorophyll a and chlorophyll d

In a previous study, we measured the redox potential of the primary electron acceptor pheophytin (Phe) a of photosystem (PS) II in the chlorophyll d-dominated cyanobacterium Acaryochloris marina and a chlorophyll a-containing cyanobacterium, Synechocystis. We obtained the midpoint redox potential (E(m)) values of -478 mV for A. marina and -536 mV for Synechocystis. In this study, we measured the redox potentials of the primary electron acceptor quinone molecule (Q(A)), i.e., E(m)(Q(A)/Q(A)(-)), of PS II and the energy difference between [P680·Phe a(-)·Q(A)] and [P680·Phe a·Q(A)(-)], i.e., ΔG(PhQ). The E(m)(Q(A)/Q(A)(-)) of A. marina was determined to be +64 mV without the Mn cluster and was estimated to be -66 to -86 mV with a Mn-depletion shift (130-150 mV), as observed with other organisms. The E(m)(Phe a/Phe a(-)) in Synechocystis was measured to be -525 mV with the Mn cluster, which is consistent with our previous report. The Mn-depleted downshift of the potential was measured to be approximately -77 mV in Synechocystis, and this value was applied to A. marina (-478 mV); the E(m)(Phe a/Phe a(-)) was estimated to be approximately -401 mV. These values gave rise to a ΔG(PhQ) of -325 mV for A. marina and -383 mV for Synechocystis. In the two cyanobacteria, the energetics in PS II were conserved, even though the potentials of Q(A)(-) and Phe a(-) were relatively shifted depending on the special pair, indicating a common strategy for electron transfer in oxygenic photosynthetic organisms.     

Left main coronary artery thrombosis in a 19 year-old patient

Left main coronary artery occlusion is a very rare entity that often results in death. It usually manifests as acute myocardial infarction (MI) with cardiogenic shock and fatal arrhythmias. Here, we report the case of a 19 year-old patient who presented with acute anterior MI secondary to left main coronary artery thrombosis. There were no classical risk factors for coronary heart disease in the anamnesis of the patient. Leukaemia was regarded to be the most probable predisposing condition in the patient.     

Serum levels of neopterin and interleukin-2 receptor in women with severe preeclampsia

Preeclampsia continues to be a major cause of maternal and perinatal mortality and morbidity worldwide. The etiopathogenesis of preeclampsia is not fully understood. Neopterin and interleukin-2 (IL-2) production reflects cellular immunity. Our purpose was to determine the levels of neopterin and interleukin-2 receptor (IL-2R) in pregnant women with severe preeclampsia, and assess the implications of these findings in the pathophysiology of preeclampsia. Fourteen women with preeclampsia were compared with 14 healthy pregnant women. Serum levels of neopterin were measured by an enzyme-linked immunoassay (ELISA), and IL-2R levels were determined by an immunoassay method with an Immulite analyzer. The levels of neopterin and IL-2R were significantly higher in the preeclamptic subjects than in normotensive women (P<0.05). There was a significant correlation between neopterin and IL-2R. We found that serum neopterin and IL-2R levels are increased in women with severe preeclampsia. The results of this study suggest that a T-helper 1 (Th1) type immune mechanism is involved in the pathogenesis of preeclampsia.     

Anxiety and depression in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) mostly follows a painful, progressively disabling course, and individuals with RA experience more psychological distress than healthy individuals. The objective of the present study is to examine the prevalences of accompanying anxiety and depression in RA cases. The study included 82 RA cases and 41 age- and sex-matched healthy volunteers as the control group. Psychiatric examinations of all cases of the patient and control groups were performed according to DSM-IV criteria. Hamilton Anxiety Scale or Hamilton Depression Scale was applied to those who were found to have anxiety or depression. Total prevalence of anxiety, depression, and mixed anxiety-depressive disorder was found to be 70.8% (n=58) in the patient group and 7.3% (n=3) in the control group, and the difference was significant (p<0.001). Of the RA patients, 41.5% (n=34) was found to have depression, 13.4% (n=11) anxiety, and 15.9% (n=13) mixed anxiety-depressive disorder. The disease duration in patients with anxiety was shorter than the RA patient with depression (p<0.05). The disease duration was positively correlated with the degree of depression and negatively correlated with the degree of anxiety (r=0.341, p<0.05; r=−0.642, p<0.05, respectively). The results of our study suggest that prevalences of anxiety and mainly depression, increase in RA cases. When the clinical picture in RA cases becomes complicated with anxiety or depression, some problems at patients’ adaptation and response to treatment may be possible. RA cases should be monitored for accompanying anxiety or depression during follow-up.