Endovascular stent-graft treatment of type A dissection: case report and review of literature.

We report a successful endovascular stent-graft treatment of a patient with type A dissection with primary entry tear at the ascending aorta. Simultaneous coronary stenting was performed. A literature review was performed and the possible use of endovascular treatment for ascending aortic dissections is discussed.     

Apoptosis in brain biopsies of subacute sclerosing panencephalitis patients

Subacute sclerosing panencephalitis (SSPE) is associated with inflammatory infiltration, neuronal loss, and demyelination. The pathogenesis of these changes is unclear. We examined DNA fragmentation and Bcl-2 expression in brain biopsies of nineteen SSPE patients to investigate the role of apoptosis in tissue damage. DNA fragmentation was present in oligodendroglia, and, in tissues with neuronal loss, in neurons. Reactive astrocytes had no DNA fragmentation, but strong Bcl-2 expression. These results suggest apoptosis as one of the mechanisms for oligodendroglial and neuronal death in SSPE.     

Activity of adenosine deaminase in mothers who have conceived a fetus with central nervous system malformations

OBJECTIVE: To establish the adenosine deaminase (ADA) activity in women who had been pregnant with a child suffering from central nervous system (CNS) anomaly. METHODS: The study group comprised 68 women who had been pregnant with an affected child, and 68 controls matched for age, gestational age and body mass index. Maternal venous blood was collected for measurement of ADA levels. We defined the diagnostic sensitivity, specificity and area under receiver-operating characteristic curve for ADA. RESULTS: Plasma ADA activity was significantly higher in the study group (12.3 U/L, range 1.7-33.3) compared to the median value of 3.3 U/L (range 1.1-34.4) in normal pregnancies (P<0.05). The cut-off point of ADA >5.9 U/L was associated with the highest combination of specificity (58.8%) and sensitivity (86.8%). CONCLUSION: ADA activity in women who have conceived a fetus with CNS malformations was significantly higher than that in normal pregnant women.     

Giant arachnoid granulation in a patient with benign intracranial hypertension

We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms.     

Management of post-traumatic arterial priapism in children: Presentation of a case and review of the literature

In this article, a 9-year-old boy with arterial priapism is presented. The patient was managed with the conservative measures including imipramine hydrochloride and a favorable outcome was achieved after 2 months of follow-up. The pathophysiology, diagnostic tools and treatment alternatives are discussed.     

The role of helical CT in the diagnostic work-up for pulmonary embolism

The clinical diagnosis of pulmonary embolism remains an important challenge despite the multitude of imaging modalities and variety of diagnostic schemes available. Contrast-enhanced helical CT has recently gained favor as an alternative primary imaging modality in the noninvasive diagnosis of pulmonary embolism. This essay reviews the role of helical CT in diagnostic work-up for pulmonary embolism with special emphasis on scan interpretation and diagnostic pitfalls.     

p53 and mitogen‐activated protein kinase pathway protein profiles in fresh and frozen spermatozoa

Sperm or testicular tissue cryopreservation is performed in cases of male infertility as a treatment for the preservation of fertility. When these sperm cells are used in assisted reproductive techniques, fertilisation rates, developmental and implantation potential of embryos decrease and the abortion rates increase. In the present work, differences of both phosphorylation and expression levels of p53 and Mitogen‐activated protein kinases (MAPK) proteins were analysed in 61 individual sperm samples before and after cryopreservation. We observed that p53 protein residue at Ser 15 was phosphorylated after cryopreservation. Because MAPK pathway activations may be involved in p53 phosphorylation, MAPK/ERK, Stress‐activated protein kinases (SAPK)/JNK and p38MAPK proteins were also investigated. Analysis showed that p38MAPK phosphorylations increased significantly. However, ERK and JNK expressions and phosphorylations decreased, although the differences were not statistically significant. According to our results, it may be suggested that cryopreservation process activates p53 via p38 MAPK pathway that subsequently causes apoptosis, which may be related to sperm parameters.     

Effects of montelukast on the healing of ischemic colon anastomoses

Background

The aim of this study was to examine whether treatment with montelukast, a selective leukotriene antagonist, would affect anastomotic healing in a reperfused colon rat model with remote ischemia/reperfusion injury.

Methods

Rats (n = 12 per group) were intraperitoneally administered normal saline or 10 mg/kg montelukast sodium 60 minutes before and for 5 days after surgery. Ischemia was induced for 45 minutes through superior mesenteric artery occlusion. A left colon anastomosis was made. Blood and perianastomotic tissue samples were obtained on postoperative day 5.

Results

Mean anastomotic bursting pressures of the control and montelukast groups were 159.17 ± 29.99 and 216.67 ± 26.40, respectively (P < .001). Compared with saline, montelukast treatment increased the mean tissue hydroxyproline level (2.46 ± .30 vs 3.61 ± .33 μmol/L) and decreased tissue caspase-3 activity (36.06 ± 5.72 vs 21.78 ± 3.87) and malondialdehyde levels (3.43 ± .34 vs 2.29 ± .34 nmol/g) (P < .001 for all). Other plasma markers of injury also showed differences.

Conclusions

Montelukast prevented ischemia/reperfusion-induced damage in a rat model of colonic anastomotic wound healing.