Goldenhar's Syndrome (oculo-auriculo-vertebral dysplasia) with congenital facial nerve palsy

Goldenhar's Syndrome (oculo-auriculo-vertebral dysplasia) is a wide spectrum of congenital anomalies that involves structures arising from the first and second branchial arches. In this report, a case of a male infant, with the features of hemi facial microsomia, anotia, vertebral anomalies, congenital facial nerve palsy and lagophthalmos is described. Although the syndrome itself is not uncommon, the presence of congenital facial nerve palsy, which has been reported in rare cases, prompted this case report.     

Does Low Molecular Weight Heparin Impair Anastomotic Wound Healing?

Background  Enoxaparin is an important molecule which had been using in prophylaxis and treatment of deep venous thrombosis. Also, it is showed that it prevents postsurgical peritoneal adhesions in rats. It is aimed to evaluate its effects on gastrointestinal wound healing. Methods  Thirty Wistar albino rats were divided into three groups as control, subcutan, and intraperitoneal enoxaparin groups. Left colon anastomoses were performed. On postoperative seventh day, anastomotic healing was evaluated by measuring anastomotic bursting pressure, tissue hydroxyproline levels, and histopathological examination. Results  The anastomotic bursting pressure was highest in subcutan enoxaparin group (p < 0.001), intraperitoneal enoxaparin group (p < 0.01) came the second, and the control group has the worst value. The hydroxyproline results were found nearly similar to the bursting pressure values (subcutan (p < 0.001) > intraperitoneal (p < 0.05) > control). Neovascularization in subcutan group (p < 0.001) has a statistically significant difference to other groups. Conclusion  Enoxaparin did not interfere with colonic anastomotic resistance but improved the intestinal wound healing.     

Structural-metabolic changes in histaminergic neurons of the rat hypothalamus in conditions of loss of bile

The aim of the present work was to evaluate structural and metabolic changes in histaminergic neurons in hypothalamic nucleus E2 in rats in conditions of complete external drainage of bile. Studies were performed on male Wistar rats (n = 45). Controls consisted of animals subjected to sham surgery with preservation of physiological bile flow throughout the experiment. Quantitative histological and histochemical methods were used. Serial frontal cryostat sections cut from the posterior hypothalamus were used for detection of the activity of the following enzymes: monoamine oxidase B, succinate dehydrogenase, NADH dehydrogenase, NADPH dehydrogenase, glucose-6-phosphate dehydrogenase, lactate dehydrogenase, and acid phosphatase. Morphological studies of histaminergic neurons were performed on preparations stained with thionine. These studies showed that complete external drainage of bile led to transient size reductions and rounding of cell perikarya. Metabolic changes were seen within a day of bile loss and subsequently progressed. All energy metabolic pathways were suppressed and acid phosphatase activity was increased on day 5. __________ Translated from Morfologiya, Vol. 132, No. 6, pp. 22–25, November–December, 2007.     

Lack of Chlamydophila pneumoniae and predominance of Alloiococcus otitidis in middle ear fluids of children with otitis media with effusion

Objective

To investigate the presence of Chlamydophila pneumoniae and other bacterial pathogens in middle ear effusion samples obtained from children with otitis media with effusion (OME).

Materials and methods

Twenty-eight children (mean age 7.03; standard deviation 2.18) with OME unresponsive to medical therapy were included in the study. All of the children underwent ventilation tube insertion under general anesthesia. Eighteen patients were bilaterally affected whereas 10 children had unilateral disease. The middle ear fluids (46 samples in total) were collected during ventilation tube insertion, and were evaluated subsequently for the presence of C. pneumoniae and other bacterial pathogens using polymerase chain reaction (PCR).

Results

Although all samples were negative for C. pneumoniae, bacterial DNA was detected in 21 of 46 samples. Overall 40% of the patients (4/10) with unilateral involvement, and 61% of the patients (11/18) with bilateral involvement were positive for bacterial DNA. In 6 patients with bilateral OME bilateral samples were positive, whereas 5 patients with bilateral OME showed only unilateral positivity. According to the results of DNA sequencing analysis, all of the positive samples harbored only one bacterial species. In 12 of 46 samples Alloiococcus otitidis DNA (26%), in 7 Haemophilus influenzae DNA (15%), in one Streptoccoccus pneumoniae DNA (2%) and in one Moraxella catarrhalis DNA (2%) were present.

Conclusions

Our findings support that C. pneumoniae does not seem to have a role in OME in children whereas A. otitidis was found to be more frequent than the other common pathogens. Further studies are required to elucidate the exact pathogenetic role of these microorganisms in OME.     

DNA methylation or histone modification status in metastasis and angiogenesis-related genes: a new hypothesis on usage of DNMT inhibitors and <Emphasis Type="Italic">S</Emphasis>-adenosylmethionine for genome stability

Metastasis is a leading cause of mortality and morbidity in cancer. This process needs angiogenesis. The biology underlying cancer, metastasis, and angiogenesis has been investigated so as to determine the therapeutic targets. Invasive and metastatic cancer cells have undergone numerous genetic and epigenetic changes, manifested by cytoskeletal changes, loss of adhesion, and expression of proteolytic enzymes that degrade the basement membrane. Additionally, in endothelial cells, some epigenetic modifications occur during the formation of angiogenesis. Researchers have used some methylation inhibitors, histone deacetylase inhibitors, or methylating agents (such as S-adenosylmethionine, SAM) against cancer and angiogenesis. Although they are effective to beat these diseases, each one results in differentiation or changes in genome structure. We review epigenetically modified genes related with angiogenesis and metastasis in cancer and endothelial cells, and suggest a new proposal. This hypothesis has discussed the importance of the usage of DNA methylation inhibitors together with SAM to prevent tumor progression and genome instability or changes resulting in additional diseases.     

Optimal timing and temperature for hyperthermic preconditioning in an animal model of fecal peritonitis.

The impact of immune parameters in the mechanism of hyperthermia is yet to be explained. In this study, the optimal timing and temperature of thermal treatment for reversing the abnormal immunologic parameters obtained in a rat model of peritonitis were planned to be determined. Male Sprague-Dawley rats were grouped as sham, control peritonitis, and thermally treated rats at the time of peritonitis or 4 h prior to induction of peritonitis both at 40 and 42 degrees C. Peritonitis was induced by the cecal ligation and perforation model. Eight hours after the induction of peritonitis, rats were sacrified and samples were taken for measurements of CD4+, CD8+, CD(11b), B cells, NK cells, and tumor necrosis factor alpha (TNFalpha) and thiobarbituric acid-reactive substances (TBARS) levels. CD4+ expression and B cell amount were decreased whereas TNFalpha levels, CD8+ and CD(11b) expression, and NK cell amount were found to be increased in the control peritonitis group when compared to the sham group. Peritonitis induction also increased TBARS levels in liver tissue. Hyperthermic preconditioning at either 40 or 42 degrees C applied 4 h prior to peritonitis induction returned all parameters to their normal levels, which is similar to the results of the sham laparotomy group. The results of TNFalpha values in preconditioned rats were varied according to the temperature that was applied. The levels were increased at 40 degrees C, whereas they showed a decline at 42 degrees C. Hyperthermic preconditioning prevented the oxidative damage in liver as well as TNFalpha elevation, particularly at 42 degrees C. Results from this study suggest that hyperthermic preconditioning 4 h prior to the onset of septic events may improve the adverse outcome in sepsis.     

Comparison between pulmonary and hepatopulmonary hydatidosis.

OBJECTIVES: To compare the clinical features and the surgical approaches between single pulmonary (SPH) and hepatopulmonary hydatidosis (HPH). METHODS: The hospital and follow-up records of 141 patients who had undergone surgery for pulmonary hydatidosis in our clinic between January 1991 and January 2001 were reviewed. Forty-nine patients (34.8%) had concomitant liver cysts in addition to the pulmonary cysts and they were regarded as HPH (Group I). The remaining 92 (65.2%) patients had SPH (Group II). Both groups were compared according to their clinical, radiological and surgical features. RESULTS: Seventeen (34.7%) male and 32 (65.3%) female patients had HPH. The mean age of the patients with HPH was significantly higher than the age of those with SPH (P<0.05) and the frequency of hepatopulmonary localization, which is contrary to single pulmonary cyst, was significantly higher in females (P<0.05). The majority (67.3%) of the cysts located in the liver were solitary. Multiple pulmonary cysts were in higher ratio in Group II, compared to Group I (45.7 vs. 22.8%) and bilateral pulmonary cyst ratio was higher in Group II, as well (26.5 vs. 13%) (P<0.05). In 14 patients (28.6%), the concomitant cysts localized in the dome of liver were extirpated via right thoracophrenotomy, and in one of them sternophrenotomy was performed. There was no statistically significant difference associated with the postoperative complications and hospital stay between groups. No recurrence and mortality were recorded in Group II. CONCLUSIONS: Multi-organ localizations (especially liver) should be examined in all patients with pulmonary hydatid cysts. HPH is more frequent in female patients over 40 years of age. The pulmonary cysts in HPH show a tendency to be bilateral and multiple. HPH should be regarded as a different entity since it can cause either economic or labour loss due to the multi-operations and prolonged postoperative care. The operative strategy and approach should be different in hepatopulmonary cysts especially if they locate in the right or bilateral lung. One-session operation with the improvements of its techniques and methods should be considered in selected cases.     

Psychological distress in chronic obstructive pulmonary disease patients

Stress is defined as the exposure of an individual to a threatening stimulus or overwhelming event. Increased rates of psychological distress have been established in patients with chronic diseases compared to healthy individuals. The objective of the present study is to assess the indicators and correlates of psychological distress in chronic obstructive pulmonary disease (COPD) patients. We evaluated the stress exposure (stressful events that COPD patients and control subjects had been exposed) by a life events checklist and psychological distress by General Health Questionnaire in 74 COPD patients and 30 control subjects. Serum adrenocorticotropic hormone (ACTH) and cortisol levels were measured as biochemical indicators of stress. Distress score was higher in COPD group compared to age‐matched controls, although the stress exposure score were not statistically different; indicating that COPD itself is a source of distress. 92% of COPD patients and 87% of control subjects had varying degrees of distress. Severe distress was more frequent in COPD group. Distress score was further increased in patients with severe COPD and severe hypoxemia.There was no significant difference in serum ACTH and cortisol levels of COPD patients and control subjects and distress scores were not correlated to serum ACTH and cortisol levels. However, serum cortisol was higher in patients with severe hypoxemia. These findings support the importance of screening for psychological distress symptoms in COPD outpatients. Since high degree of distress contributes to impaired quality of life and added morbidity, patients with COPD need a comprehensive care including a psychological evaluation. Copyright © 2008 John Wiley & Sons, Ltd.