Methylene blue increases contralateral testicular ischaemia-reperfusion injury after unilateral testicular torsion

1. Testicular ischaemia-reperfusion injury is commonly seen in childhood. Infertility occurs in 25% of patients after unilateral testicular ischaemia. It is has been reported that methylene blue has a positive effect in the reparation of ischaemia-reperfusion injury in different tissues. Therefore, we hypothesized that methylene blue may prevent the hazardous effects of ischaemia-reperfusion injury in testicular tissue after unilateral testicular torsion. 2. Thirty-two prepubertal Wistar-albino rats were divided into four groups. Testicular torsion was created by rotating the right testis 720 degrees in a clockwise direction for 5 h in all groups except for Group C, which was the sham control group. In Group T, bilateral orchiectomy was performed following the torsion period. In Group TD, both testes were removed 5 days after the torsion period. In Group MB, methylene blue (1 mg/kg, i.p.) was administered 40 min before detorsion and once daily over 5 days; then, both testes were harvested. Tissue levels of malondialdehyde (MDA), serum levels of creatine kinase (CK), mean testicular biopsy score (MTBS) and mean seminifer tubule diameter (MSTD) were determined. 3. There was a significant difference in MTBS between Groups T and TD (P < 0.05) in both ipsilateral and contralateral testes. In the contralateral testis, treatment with methylene blue decreased MTBS and MSTD (P < 0.05) and increased MDA levels (P < 0.05). In Group T, mean serum CK concentrations were higher than in any of the other groups (P < 0.05). 4. After 5 h of unilateral testicular torsion and a 5 day reperfusion period, serious tissue damage occurred on both the ipsilateral and contralateral sides. Serum CK concentrations may be an indicator for ischaemia, but not for ischaemia-reperfusion injury. Contrary to our hypothesis, methylene blue increased contralateral testicular damage after unilateral testicular torsion and exacerbated oxidative events.     

Exanthema medicamentosum as a side effect of promazine

Dermatological side effects of psychopharmacological drugs are fortunately not so often. They are mostly presented in the group of mood stabilizers and antiepileptic drugs, particularly the carbamazepine and lamotrigine, and can be manifested through the Stevens Johnson syndrome, Toxic Epidermal Necrolysis (TEN)/Lyell's syndrome with about 30% lethality. According to the literature the group of phenothiazines is the category of drugs with rare appearances of skin reactions. Promazine, aliphatic phenothiazines antipsychotic, including less frequent side effects in the leaflet states increased skin sensitivity to sun, skin rash-associated with contact dermatitis, allergic reactions, cholestatic icterus. The only reported dermatological side effect of promazine is its metabolites deposition in the cornea. Analyzing the e-data basis we have not found references connecting the Exanthema medicamentosum as a side effect of promazine. A forty-two years old female patient was admitted to the Dermatological Clinic because of suspected exanthema, undoubtedly caused by promazine as a medication for Sy. Borderline.     

Thermal crush injury of the hand caused by roller type ironing press machine

Industrial garment machines may cause occupational hand injuries. However, combined thermal and crush injuries are uncommon, and their etiologies are varied. We present a case of thermal crush injury of the hand caused by laundry roller type ironing press machine. The circumstances of this injury and preventive measures are discussed.     

Accuracy of frozen sections for intraoperative diagnosis of complex atypical endometrial hyperplasia

Objective: The purpose of this study was to correlate the histological diagnosis made during intraoperativefrozen section (FS) examination of hysterectomy samples with complex atypical endometrial hyperplasia (CAEH)diagnosed with definitive paraffin block histology. Methods: FS pathology results of 125 patients with a preoperativebiopsy showing CAEH were compared retrospectively with paraffin block pathology findings. Results:Paraffin block results were consistent with FS in 78 of 125 patients (62.4%). The FS sensitivity and specificityof detecting cancer were 81.1% and 97.9%, with negative and positive predictive values of 76.7%, and 98.4%,respectively. Paraffin block results were reported as endometrial cancer in 77 of 125 (61.6%) patients. Finalpathology was endometrial cancer in 45.3% patients diagnosed at our center and 76.9% for patients who hadtheir diagnosis at other clinics (p=0.018). Paraffin block results were consistent with FS in 62.4% of all casesConsistence was 98.4% in patients who had endometrial cancer in FS. Conclusion: FS does not exclude thepossibility of endometrial cancer in patients with the preoperative diagnosis of CAEH. In addition, sufficientendometrial sampling is important for an accurate diagnosis     

The effect of photodynamic therapy on retrobulbar blood flow parameters

Purpose: To investigate the effect of photodynamic therapy (PDT) on retrobulbar blood flow parameters. Methods: Twenty‐four patients with choroidal neovascular membrane of at least four MPS disc area in one eye due to age‐related macular degeneration scheduled for PDT were recruited. Peak systolic and end diastolic velocity of ophthalmic, central retinal and posterior ciliary artery of both eyes were measured with colour Doppler imaging and resistivity index were computed before, at the first and fourth weeks following PDT. Results: Following PDT, the mean peak systolic velocity of posterior ciliary artery increased significantly to a value of 31.90 ± 13.44 at the first (P = 0001), then returned to an insignificant value of 29.95 ± 13.03 at the fourth week (P = 0.360), when compared with pre‐PDT mean measurement (30.16 ± 13.15). Resistivity index of posterior ciliary artery also increased significantly to a value of 0.740 ± 0.77 at the first (P = 0.046), then returned to an insignificant value of 0.666 ± 0.14 at the fourth week (P = 0.407), when compared with pre‐PDT mean measurement (0.709 ± 0.90). All the other measured data (peak systolic velocity, end diastolic velocity, resistivity index of ophthalmic and central retinal artery; end diastolic velocity of posterior ciliary artery of the treated eyes; all colour Doppler imaging measurements of untreated eyes) did not show any significant change at the first and fourth week following PDT, when compared with the pre‐PDT values. Conclusion: The peak systolic velocity and resistivity index of the posterior ciliary artery appear to increase in the first week and return to their baseline values at the fourth week following PDT.     

Annular and central heavy pigment deposition on the posterior lens capsule in the Pigment dispersion syndrome

Purpose To report annular and central heavy pigment deposition on the posterior lens capsule in a case of pigment dispersion syndrome. Methods Case report. Results A 36-year-old female with bilateral pigment dispersion syndrome presented with progressive decrease in visual acuity in the right eye over the past 1–2 years. Clinical examination revealed the typical findings of pigment dispersion syndrome including bilateral Krunkenberg spindles, iris transillumination defects, and dense trabecular meshwork pigmentation. Remarkably, annular and central dense pigmentation of the posterior lens capsule was noted in the right eye. Conclusion Annular pigment deposition on the posterior lens capsule may be a rare finding associated with pigment dispersion syndrome. Such a finding suggests that there may be aqueous flow into the retrolental space in some patients with this condition. The way of central pigmentation is the entrance of aqueous to Berger’s space. In our case, it is probable that spontaneous detachment of the anterior hyaloid membrane aided this entrance.