Repair of aortic coarctation and aneurysm of ductus arteriosus in the presence of right-sided arch and descending aorta

Association of right aortic arch and coarctation of the aorta is rare. A patient with aortic coarctation was presented to our clinic. Detailed radiological work-up revealed aortic coarctation, aneurysm of ductus arteriosus, mirror image brachiocephalic vessels, right-sided arch, and right-sided descending aorta. The patient underwent successful operative repair through a right thoracotomy. She is normotensive and doing well two years postoperatively.     

A new flap for reconstruction of pilonidal sinus: lumbar adipofascial turnover flap

BACKGROUND: "Adipofascial turnover flap" is a well-known procedure, but it is generally not used for the surgical treatment of pilonidal sinus disease. The "lumbar adipofascial turnover flap" has been used in this study for the reconstruction of uncomplicated pilonidal sinus disease. METHODS: Ten cases (8 male and 2 female patients) were operated on by this technique. The reconstruction was performed with the lumbar adipofascial turnover flap. The flap sizes ranged from 4 x 7 cm to 5 x 9 cm (mean, 4.5 x 8 cm), and they were elevated with length-to-base ratio below 2:1. The follow-up period was 14 to 26 months. RESULTS: Postoperative magnetic resonance imaging, computed tomography scan, and power Doppler ultrasound examinations revealed viability of the flaps in all patients. There was no distortion of anatomic landmarks in any of the cases. The esthetic results were satisfying for all patients as well. There was no recurrence in any cases. CONCLUSIONS: The hospital stay and mean time off work were shorter compared with other methods of reconstruction and there was no recurrence. We advocate that the lumbar adipofascial turnover flap is an excellent choice for reconstruction of cases with uncomplicated pilonidal sinus disease.     

Studies on 1,2,4-triazole derivatives as potential anti-inflammatory agents

The reaction of acetic or propionic acid hydrazides with various aryl/alkyl isothiocyanates gave thiosemicarbazides which furnished the 1,2,4-triazoles by alkali cyclization. The 4-aryl/alkyl-5-(1-phenoxyethyl)-3-[N-(substituted)acetamido]thio-4H-1,2,4-triazole derivatives were synthesized by reacting the triazoles with 2-chloro-N-(substituted)acetamide. The chemical structures of the compounds were elucidated by IR, (1)H-NMR, FAB(+)-MS spectral data and elemental analysis. In the pharmacological studies, anti-inflammatory activities of these compounds have been screened and significant activities were observed.     

Microleakage and micromorphology of the resin-dentin interface in primary molars following different endodontic irrigation regimens

The aim of this study was to evaluate the effect of two endodontic irrigants (2.5% sodium hypochlorite and 17% Ethylenediamintetraacetic acid) on the microleakage and micromorphology of the resin-dentin interface in pulpectomized primary molars. Standardized Class-II cavities were prepared in extracted, non-carious primary molars after which chemo-mechanical preparation of the root canals were performed in conjunction with K-Files and 2.5% sodium hypochlorite (NaOCl) between each file size. Final irrigation of the specimens were made with either 2.5 NaOCl, 17% Ethylenediamintetraacetic acid (EDTA) or with saline (control). The root canals were filled with a calcium hydroxide paste and the cavities were sub-grouped to be restored with one of the following materials: a: Amalgam, b: Prime&Bond NT (with prior total etch) and TPH resin-based composite, c: Prime&Bond NT and Dyract d: Prime&Bond NT (with Non-Rinse Conditioner pre-treatment); and e:Prompt L-Pop and F2000. Following thermocycling and 90-day water storage, the occlusal and gingival microleakage of restorations were assessed with dye penetration and image analysis. Separate specimens were processed for scanning electron microscopic investigation of the resin-dentin interface. The occlusal and gingival microleakage of the tested restorative systems was not affected by different irrigation regimens (p>0.05), while final restoration with Prime&Bond NT+TPH and Prompt L-Pop+F2000 resulted in the lowest microleakage values (p<0.05). Following the use of 17% EDTA for final flush, the latter two groups produced relatively thicker hybrid zones, when compared to the saline-irrigated specimens.     

Assessment of genotoxicity in rats treated with the antidiabetic agent, pioglitazone

Pioglitazone (PIO), a member of the thiazolidinedione class of antidiabetic agents, specifically targets insulin resistance. Drugs of this class act as ligands for the gamma subtype of the peroxisome proliferator-activated receptor. Although troglitazone, another drug in this class, displayed unacceptable hepatotoxicity, PIO was approved for human use by the U.S. Food and Drug Administration. To our knowledge, there are no published reports on the genotoxicity of PIO; however, the package insert indicates that it has minimal genotoxicity. In this study, we used the comet assay to investigate the DNA damage in the peripheral blood and liver cells of rats treated with PIO. Sixteen male Sprague-Dawley rats were randomly distributed into four groups, and dosed daily for 14 days by oral gavage with 0, 10, 20, and 40 mg/kg/day PIO. A dose-dependent increase in DNA damage, as assessed by % tail DNA, was observed in both hepatocytes and blood lymphocytes of the PIO-treated groups, with significant increases detected between the rats treated with all the doses of PIO and the control, and between the rats treated with different PIO doses (P < 0.005 to P < 0.0001). Treating nuclei from the exposed animals with an enzyme cocktail containing Fpg and Endonuclease III prior to performing the comet assay increased the level of DNA damage, which reflects oxidized purine and pyrimidine. Taken together, our data indicate that PIO is able to dose-dependently induce DNA damage in both the liver and blood lymphocytes of rats, which is partially due to the generation of oxidative lesions.     

Time-dependent Decalcifying Effects of Endodontic Irrigants with Antibacterial Properties

The aim of this study was to investigate the extent of calcium ion (Ca²⁺) removal on root dentin after treatment with 1.25% NaOCl, 2.5% NaOCl, 5.25% NaOCl, 2% chlorhexidine (CHX), 2% iodine potassium iodide (IKI), and MTAD in 3 immersion time periods. Extracted human mandibular premolars were bisected longitudinally, and the root halves (n = 70) were isolated with nail varnish, leaving the root canal exposed. The specimens were immersed in the test solutions, during which the amount of Ca²⁺ release into the solutions was determined at 5, 10, and 15 minutes by flame photometry. The decalcifying effect of 5%, 2.5%, and 1.25% NaOCl and 2% IKI significantly increased within time (P < .05), with 5% NaOCl extracting the greatest amount of Ca²⁺ at all treatment times. For 2% CHX and distilled water, a significant increase in the amount of Ca²⁺ extraction from root dentin was only evident at 10 minutes (P < .05) and did not change at 15-minute readings. Between the 5- to 10-minute and 10- to 15-minute intervals, the greatest amount of increase in the rate of Ca²⁺ extraction from root dentin was observed in the 2.5% NaOCl group. At 15 minutes, 2% CHX and distilled water showed the least amount of change. Among the test solutions, MTAD extracted the least amount of Ca²⁺ at 5 minutes.     

<Emphasis Type="Italic">Bordetella Pertussis</Emphasis> Infection in Hospitalized Infants with Acute Bronchiolitis

Objective

To assess the frequency of B. pertussis infection among young infants hospitalized with acute bronchiolitis and to determine whether B. pertussis infection affects the clinical course of acute bronchiolitis.

Methods

A total of 172 infants <6 months of age hospitalized with acute bronchiolitis were tested for B. pertussis and respiratory viruses with real-time PCR. Cases were divided into 2 groups according to B. pertussis positive or negative. Clinical parameters, clinical severity scores and laboratory characteristics of the pertussis-positive and pertussis-negative cases were compared.

Results

Bordetella pertussis infection was detected in 44 (25.6%) of the 172 infants hospitalized for acute bronchiolitis, and as co-infection with respiratory viral agents in 27 (61.4%) infants. Of the 44 pertussis-positive infants, only 17 (38.6%) experienced a paroxysmal cough, 13 (29.5%) had whooping and 15 (34.1%) had post-tussive vomiting. There was no significant difference between pertussis-positive and pertussis-negative infants according to Wang clinical score at admission (4.9 ± 1.5 vs. 5.2 ± 2.5; p = 0.689). The overall disease severity score was also similar between the two groups (6.5 ± 1.4 vs. 6.9 ± 1.6; p = 0.095).

Conclusions

Bordetella pertussis infection is common in young infants hospitalized for acute bronchiolitis, mostly as co-infection with respiratory viruses. The clinical features of pertussis in the infants are not characteristic. Viral bronchiolitis and pertussis cases could not be differentiated by clinical findings. Co-infection with pertussis did not affect the clinical outcome in infants hospitalized with acute bronchiolitis.

     

Extrapulmonary small-cell carcinoma compared with small-cell lung carcinoma: a retrospective single-center study

BACKGROUND: The study was conducted with the aim of reviewing the clinical features, therapy, and natural course of patients with extrapulmonary small-cell carcinoma (EPSCC) and small-cell lung carcinoma (SCLC) to better define current concepts regarding EPSCCs. METHODS: The medical records of patients with proven diagnosis of small-cell carcinoma (SmCC) between January 1999 and May 2006 were retrospectively reviewed. A total of 65 SmCC cases were included in the study (11 [17%] cases of EPSCC and 54 [83%] cases of SCLC). RESULTS: Progression-free survival of all patients with EPSCC and patients with extensive EPSCC disease was 7 months (95% confidence interval [CI], 0.58-13.42) and 7 months (95% CI, 4.71-13.29), respectively. Overall survival of all patients with EPSCC and patients with extensive EPSSC disease was 32 months (95% CI, 18.74-45.26) and 28 months (95% CI, 12.24-43.76), respectively. Progression-free survival and overall survival for all patients with SCLC were 5 months (95% CI, 2.26-7.74) and 10 months (95% CI, 5.95-14.05), respectively. Progression-free survival and overall survival for patients with extensive disease were 3 months (95% CI, 4.71-13.29) and 5 months (95% CI, 3.33-6.67), respectively. Overall survival was significantly better in all patients with EPSCC and in patients with extensive EPSCC disease compared with all patients with SCLC and patients with extensive SCLC disease (P = .014, P = .004, respectively). Early death and brain metastasis were observed in a higher number of patients with SCLC compared with EPSCC; however, these results were not statistically significant (P = .33 and P = .076, respectively). Smoking history was significantly less in the EPSCC group (P < .0001). CONCLUSIONS: EPSCC is usually treated similarly to SCLC. However, this study suggests some differences such as etiology, clinic course, survival, frequency of brain metastases, and early death between these entities. These possible differences may influence the choice of therapeutic approach.