Three-Dimensional Echocardiographic Assessment of Lambl's Excrescences on the Aortic Valve

The present case reports demonstrate the incremental value of three-dimensional echocardiography over multiplane transesophageal two-dimensional imaging in the assessment of Lambl's excrescences (strands) involving the aortic valve.     

Artificial oocyte activation after intracytoplasmic morphologically selected sperm injection: A prospective randomized sibling oocyte study

This study aimed to evaluate the effect of artificial oocyte activation (AOA) by calcium ionophore after intracytoplasmic morphologically selected sperm injection (IMSI) on fertilization, cleavage rate and embryo quality. A total of 194 oocytes from 21 cycles from women with a history of low fertilization rate accompanying teratozoospermia were enrolled over a 3-month period. Mature oocytes from each patient were randomly allocated into two groups after IMSI. In the study group, half of the patients’ oocytes (n?=?97) were exposed to AOA, and in the control group (n?=?97), AOA was not applied. The mean number of mature oocytes, fertilization and cleavage rates were similar between the study and control groups (p?>?0.05 for each). However, fertilized oocytes of the AOA group were less likely to produce top quality embryos when calculated per fertilized oocyte (28/80; 35.0% versus 38/71; 53.5%, respectively; p?=?0.024) and also per cycle (13/21; 61.9% versus 20/21; 95.24%, respectively; p?=?0.006). Our study indicates that AOA may not improve fertilization rates after IMSI and may even reduce the ability of a successfully fertilized oocyte to develop into a top quality embryo. AOA should, therefore, be applied to cases with a defined oocyte activating deficiency.     

Antenatal magnesium sulfate and neurodevelopmental outcome of preterm infants born to preeclamptic mothers

Objective: Previous studies demonstrated that magnesium sulfate is associated with better neurological outcome and decreased cerebral palsy rates in preterm newborns. The aim of this study is to assess the effects of antenatal magnesium sulfate on neurodevelopmental outcomes of preterm infants.

Methods: Preterm newborns with a gestational age of <32 weeks whose mothers were diagnosed with preeclampsia were extracted from the hospital records and files retrospectively. The neurodevelopmental assessment was performed at 2 years of age by developmental pediatrician. The results of the infants exposed to antenatal magnesium sulfate were compared with the control group.

Results: Between the years 2010 and 2012, 387 preterm babies were born to preeclamptic mothers. Fifty-nine (15.2%) of them were exposed to antenatal magnesium sulfate. The main clinical characteristics did not differ between the groups. On the other hand, cerebral palsy was significantly lower in preterm infants exposed to magnesium sulfate compared to the control group (3.3% and 12.2%, respectively, p?=?0.004). On multinominal logistic regression analysis, magnesium sulfate was not an independent significant factor to reduce CP on its own.

Conclusion: Antenatal magnesium sulfate can be used as a neuroprotective strategy especially for the prevention of cerebral palsy in preterm infants. Future studies should be designed to support the positive effect of antenatal magnesium sulfate on neurologic development.     

New Directions in Gaucher Disease

In Gaucher disease (GD), mutant lysosomal acid β‐glucocerebrosidase fails to properly hydrolyze its substrate, glucosylceramide, which accumulates in the lysosomes. Due to its phenotypic heterogeneity, GD has been classified into type 1, non‐neuronopathic, and types 2 and 3, the neuronopathic forms, based on the primary involvement of the central nervous system. Neuroinflammation and necroptotic death may appear in the neuronopathic forms of GD, whereas type 1 GD patients may develop Parkinson disease (PD), a prototype of protein misfolding disorders of the nervous system. PD is significantly more prevalent among GD carriers and patients than among the non‐GD populations. It is apparent that the amount of mutant enzyme present in lysosomes depends on the amount of mutant enzyme recognized as correctly folded in the endoplasmic reticulum (ER) for physiologically correct transport through the Golgi apparatus to the lysosome. Mutant enzyme recognized as misfolded is retained in the ER, inducing the Unfolded Protein Response. In the current review, we present three discrete areas of interest: molecular and cellular mechanisms underlying the association between GD and PD; the clinical and genetic associations between GD and PD; and treatment options for GD. We also discuss the relevance of induced pleuripotent stem cells to the above associations.     

Endosulfan splenic pathology and amelioration by vitamin C in New Zealand rabbit

Endosulfan, a chlorinated hydrocarbon insecticide/acaricide, is a member of a cyclodiene sub-group of poisons to a wide variety of insects and mites. It is also toxic to humans and animals, but there is limited knowledge about endosulfan-related splenic and overall immunotoxicity. The aim of this study was to review pathological findings of endosulfan toxicity in the spleen and to examine potential protective effects of the anti-oxidant Vitamin C (Vit C). Here, after 6-week exposures, the spleens of New Zealand White rabbits were examined grossly and histopathologically and tissue caspase-3 activity was assessed immunohistochemically. Rabbits in four groups were used: Group END were given by oral gavage a sub-lethal dose of endosulfan (1?mg/kg) in corn oil daily for 6 weeks; Group END?+?C received the same dose of endosulfan daily and Vit C (20?mg/kg) every other day by gavage during this period; Group Vit C received oral corn oil daily and 20?mg/kg Vit C every other day; and Group OIL received corn oil daily for 6 weeks. Analyses of the tissues collected 1 week after the final dosing revealed lymphocyte depletion and necrosis in spleens of the hosts that received the pesticide (END only and END?+?C); hemorrhage and slight neutrophilic infiltration was also noted. Caspase-3 immunoreactivity was marked in lymphocytes in all spleens of rabbits in both END groups. Overall, these toxicities were mitigated by Vit C co-treatment; in END?+?C hosts, markedly decreased depletion of lymphocytes, inflammation and caspase-3 immunoreactivity were observed. However, even with mitigation, the level of toxicity present was still greater than any seen in the spleens of hosts that received OIL or Vit C alone. These results revealed endosulfan could cause toxicity in the rabbit spleen, characterized by depletion of lymphocytes, inflammation, necrosis and hemorrhage, and that this toxicity could begin to be mitigated by Vit C co-treatment.     

Refractive Errors in Patients with Migraine Headache

Purpose: To evaluate refractive errors in patients with migraine headache and to compare with healthy subjects. Materials and Methods: This prospective case-control study includes patients with migraine and age- and sex-matched healthy subjects. Clinical and demographic characteristics of the patients were noted. Detailed ophthalmological examinations were performed containing spherical refractive error, astigmatic refractive error, spherical equivalent (SE), anisometropia, best-corrected visual acuity, intraocular pressure, slit lamp biomicroscopy, fundus examination, axial length, anterior chamber depth, and central corneal thickness. Spectacle use in migraine and control groups was compared. Also, the relationship between refractive components and migraine headache variables was investigated. Results: Seventy-seven migraine patients with mean age of 33.27?±?8.84 years and 71 healthy subjects with mean age of 31.15?±?10.45 years were enrolled (p?=?0.18). The migraine patients had higher degrees of astigmatic refractive error, SE, and anisometropia when compared with the control subjects (p?=?0.01, p?=?0.03, p?=?0.02, respectively). Conclusion: Migraine patients may have higher degrees of astigmatism, SE, and anisometropia. Therefore, they should have ophthalmological examinations regularly to ensure that their refractive errors are appropriately corrected.