The use of pulmonary autograft patch for type A aortic interruption and Swiss-cheese ventricular septal defect (VSD)

The surgical management of the aortic arch pathologies is controversial. Primary anastomosis and patch aortoplasties combined with end-to-end anastomosis have some complications like recurrence and aneurysm formation. Surgical repair of apical muscular (Swiss-cheese) defects is also still under debate. A 6-year-old patient with diagnosis of type A aortic arch interruption and Swiss-cheese ventricular septal defect (VSD) underwent successful intracardiac repair and aortic arch reconstruction. Aortic arch reconstruction was done by end-to-side anastomosis of distal aortic archus and thoracic aorta without cardiopulmonary bypass. The anterior side of the anastomosis was augmented by using pulmonary autograft patch and this patch was extended to the inferior surface of the archus aorta. Swiss-cheese VSD was repaired with a single patch using septal obliteration technique via transatrial approach. Pulmonary autograft patch aortoplasty and end-to-side anastomosis may be an alternative surgical management for surgical repair and it may be done without the need for cardiopulmonary bypass. In these patients associated multiple apical muscular VSDs can be repaired with a single patch, septal obliteration technique.     

Determination of environmental exposure to asbestos (tremolite) and mesothelioma risks in the southeastern region of Turkey

In this study, the authors examined the concentrations and mineralogical analyses of asbestos, and investigated mesothelioma risk in southeastern Anatolia, Turkey. They used a gravimetric dust sampler to collect samples from 2 villages and 2 asbestos mines (1 active). Samples were then evaluated by an X-ray diffractometer and an electron microscope. The authors found high concentrations of asbestos in an active mine (4.9 fibers[f]/cm3) and at a house that was plastered with asbestos (1.24 f/cm3) and had a very active population. They found a low concentration (0.0042 f/cm3) in indoor measurements taken in Armutova village, and an even lower concentration (0.000081 f/cm3) in the inactive mine environment. Outdoor measurements included a low concentration of 0.007 f/cm3 in the village environment, and a high concentration of 1.17 f/cm3 on the mine road during the passing of a sheep herd. The people in the region are continuously exposed to asbestos during normal activities. This cumulative exposure to asbestos carries sufficient risks for mesothelioma development.     

Comparison of effects of cyclooxygenase inhibitors on myometrial contraction and constriction of ductus arteriosus in rats

The aim of this study was to compare the tocolytic effect of a selective cyclooxygenase-2 inhibitor, DFU (5,5-dimethyl-3(3-fluorophenyl)-4-(4-methylsulphonyl)phenyl-2(5H)-furanone), indomethacin and nimesulide on myometrial strips isolated from rats in both lipopolysaccharide-induced preterm labour and term labour. We also compared the constrictor effects of DFU and indomethacin on the fetal ductus arteriosus. Myometrial strips were obtained from preterm and term labour Wistar albino rats and were mounted in organ baths for the recording of isometric tension. DFU, nimesulide and indomethacin significantly inhibited KCl-, oxytocin-, prostaglandin E(2)- and prostaglandin F(2 alpha)-stimulated contractions of myometrial strips isolated from rats in preterm and term labour. The E(max) value of indomethacin was significantly lower than those for DFU and nimesulide (P<0.05), with no change-log (10) EC(50) values. There was no significant difference between in -log (10) EC(50) and E(max) values of DFU and nimesulide for any of the tissues (P>0.05). In addition, there was no significant difference between -log (10) EC(50) and E(max) values for each of these three agents in myometrial tissues isolated from rats in preterm and term labour (P>0.05). Fetal ductus arteriosus was significantly constricted by DFU (10 or 100 mg/kg) in preterm and term rats, although DFU (10 or 100 mg/kg)-induced constriction ratios were significantly lower than those for indomethacin (P<0.05). These data demonstrate that DFU, a specific cyclooxygenase-2 inhibitor, could be considered as a new therapeutic agent for preterm labour. However, careful attention should be given to constriction of the fetal ductus arteriosus.     

Chemical composition and antimicrobial activity of the essential oils of Anthemis xylopoda O. Schwarz from Turkey

The chemical composition and the antimicrobial activity of the essential oils isolated from the leaves (LEO) and flowers (FEO) of Anthemis xylopoda, an endemic taxon of Turkey, were investigated. Borneol was the major constituent of both the oils studied (30.15 and 31.85%, respectively). The antimicrobial activities of both oils were separately evaluated against 13 microorganisms. The disc diffusion method was used for the antimicrobial activity test. Results showed that both oils of Anthemis xylopoda exhibited a significant antimicrobial activity.     

Congenital hypothyroidism associated with Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome is a genetic syndrome characterized by broad thumbs and big toes, growth retardation, mental deficiency and dysmorphic facies. We report the association of Rubinstien-Taybi syndrome with congenital hypothyroidism.     

Methotrexate for cervical pregnancy. A case report

BACKGROUND: The incidence of cervical pregnancy is 1:1,000-95,000 pregnancies and represents < 1% of all ectopic pregnancies. Evacuation of the pregnancy by curettage does not always stop the bleeding because there is little contractile muscle in the cervix. If there is uncontrollable bleeding, hysterectomy is necessary. In selected cases, nonsurgical management offers high success rates. Among medical treatments, the most common is systemic or local administration of methotrexate. CASE: A 36-year-old woman, gravida 2, para 2, presented with vaginal bleeding and subacute pain in the lower abdomen. The patient was 7 weeks' pregnant according to her last menstrual period. Transvaginal ultrasonography showed a gestational sac of approximately 5 weeks' gestational age implanted in the wall of the cervix. Fifty milligrams of methotrexate was injected into the gestational sac and another 50 mg administered intramuscularly. The hCG level decreased continuously and was no longer detectable after 35 days. CONCLUSION: The use of methotrexate for cervical pregnancy is safe and effective and preserves fertility.     

The comparison of clinical and hormonal parameters in PCOS patients treated with metformin and GnRH analogue

In this study, our aim was to compare the effects of metformin and gonadotropin releasing hormone (GnRH) analogues in clinical and hormonal parameters in women with polycystic ovary syndrome (PCOS). There were 50 women with PCOS who were included in our study and they were divided into two groups. In this randomized trial, metformin (850 mg, two times per day) was administered to the first group and GnRH analogue (goserelin 3.6 mg, every 28 days) was given to the second group for 3 months. Because of the previous treatments, PCOS patients served as their own controls. The results of 42 women who completed the study were evaluated. Insulin resistance was not ascertained in patients. Metformin treatment resulted in a significant decline in mean body mass index, body weight, circumferences of waist and hip and total hirsutismus score. There was a significant decrease in luteinizing hormone (LH) levels and a significant increase in follicle stimulating hormone (FSH), progesterone, and sex hormone binding globulin (SHBG) concentrations. No changes in fasting glucose and insulin levels were observed. The GnRH analogue resulted in a significant increase in FSH and SHBG levels and a significant decrease in LH, total testosterone, dehydroepiandrosterone sulfate (DHEAS) levels and LH to FSH ratio and an improvement in hirsutism scores. Metformin and GnRH analogues had effects upon the abnormal steroid-gonadotropin metabolism and the clinical findings of hyperandrogenism with different mechanisms.     

A method for off-line nasal nitric oxide measurement

We conducted a study to test the accuracy of an immediate and delayed off-line technique for measuring nasal nitric oxide (NO) by comparing it with on-line measurements. With the assistance of one volunteer, we obtained these measurements during 30 sessions over a period of 2 months. Off-line measurements were made immediately following the acquisition of NO samples and 1, 2, and 4 hours later. NO samples were obtained from nasal air collected in syringes. We found that the correlation between on-line measurements and the immediate and delayed off-line measurements ranged from 95 to 98%, according to a Bland-Altman analysis. We conclude that off-line nasal NO measurements can be reliably used in clinical practice and research projects, thus obviating the need for patients/subjects to be in close proximity to the analyzer. Off-line nasal NO measurements can effectively substitute for on-line measurements when the latter technique is not practical.     

Specific tissue Doppler predictors of preserved systolic and diastolic left ventricular function after an acute anterior myocardial infarction

The degree of left ventricular (LV) dysfunction determines the outcome of patients suffering an acute anterior myocardial infarction (AAMI). Many recent studies have utilized tissue Doppler echocardiography (TDE) parameters in the assessment of LV function. We sought to investigate whether some variables easily obtained from TDE profiles of mitral annulus corners would predict a relatively preserved LV global function traditionally assessed with ejection fraction (EF) and deceleration time (DT), within the acute phase of AAMI. Included were 50 consecutive patients with a first AAMI. Standard echocardiography and TDE of mitral annulus were performed within 36 hours of admission. Pulsed wave sample volumes were set at the septal, lateral, anterior, and inferior corners of the mitral annulus. Preserved LV function was defined as an EF > 40% together with a DT > or = 140 ms and < 220 ms. An inferior annular systolic velocity of > 7.5 cm/s predicts preserved global left ventricular function with a sensitivity of 81% and specificity of 71%. An anterior mitral annular early diastolic velocity of > 8cm/s had a sensitivity of 69% and specificity of 85%. When these two velocities both exceed the limits above, such a combined index yielded a sensitivity of 69%, specificity of 94%, and an overall diagnostic accuracy of 86% for the estimation of preserved LV global function. The parameters derived from TDE profiles of inferior and anterior mitral annulus comers provide valuable information to predict preserved global left ventricular function during the early period of AAMI.