Ultrastructural changes in pneumocyte type II cells following traumatic brain injury in rats.

OBJECTIVE: We aimed to demonstrate the time-dependent ultrastructural changes in pneumocyte type II cells following brain injury, and to propose an electron microscopic scoring model for the damage. METHODS: Forty Wistar-Albino female rats weighing 170-200 g were used. The rats were allocated into five groups. The first group was the control and the second was the craniotomy without trauma. The others were trauma groups. Weight-drop method was used for achieving head trauma. Samples were obtained from the right and left pulmonary lobes at 2-, 8-, and 24-h intervals after transcardiac perfusion. An electron microscopic scoring model was used to reveal the changes. RESULTS: There were no ultrastructural pathological findings pointing to lung injury in any rat of the control groups. There was intense intracellular oedema in type II pneumocyte and interstitial oedema in the adjacent tissue in trauma groups. Oedema in mitochondria and dilatation in both smooth endoplasmic reticulum and Golgi apparatus was more evident in the 8- and 24-h trauma groups. The chromatin dispersion was disintegrated in the nucleus in all trauma groups. Scores of all trauma groups were significantly different from the controls (P<0.05). All trauma groups were different from each other at significant levels (P<0.05 for each trauma groups). CONCLUSIONS: The data suggested that ultrastructural damage is obvious at 2 h and deteriorates with time. The electron microscopic scoring model worked well in depicting the traumatic changes, which were supported by lipid peroxidation. Further experiments are needed to determine the exact outcome after brain death model.     

Sensitization to common allergens, especially pollens, among children with respiratory allergy in the Trakya region of Turkey

Asthma and allergic rhinitis are common problems in children and the causative pollen allergens vary according to the geographical area. The aim of this study was to investigate patterns of sensitization to common inhalant allergens, especially pollens, in Turkish children living in the Trakya region and to determine differences between rural and urban areas. Allergen skin testing was prospectively performed on 539 children aged between 4 and 17 years with respiratory allergy. The reaction was considered to be positive if the mean wheal diameter was at least 3 mm greater than that of the negative controls. We detected positive skin reactions in 420 (77.9%) children. Two hundred and eighty-one (52.1%) mite, 277 (51.4%) pollen, 174 (32.3%) mold, 65 (12.1%) animal dander, 12 (2.2%) cockroach and 6 (1.1%) latex skin sensitivities were detected. Among the pollen allergies 173 were cereal pollen (32.1%), 170 grass pollen (31.5%) and 144 tree pollen allergies (26.7%). The most common positive skin test among the pollens was to cultivated wheat (Titicum vulgare) (n = 116, 21,5%), followed by rye grass (Lolium perenne) and orchard grass (Dactylis glomerata). Positive skin reactions to Alternaria, to Candida albicans, and to all pollens except Ulmus competris, Pinus sylvetris, Platanus vulgaris and Tilia platyphyllos, were higher in children with allergic rhinitis than in those with asthma. In children from rural areas, allergic skin reactivity was found to be more common against Candida albicans, sheep dander and all pollens except Corylus avellana, Fraxinus excelsior, Populus alba, Pinus sylvetris, Platanus vulgaris and Chenopodium album, than in urban children. Although Trakya is close to Greece and other Mediterranean countries, this study suggests that the pollens, which sensitize children, are not similar.     

The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients

Objectives   To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases.
Methods   We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups.
Results   Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum ( P  < 0.001 and P  < 0.05, respectively) and pleural effusion ( P  < 0.001 and P  < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera ( P  < 0.001 and P  < 0.05, respectively) and pleural effusions ( P  < 0.001 and P  < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher ( P  < 0.001 and P  < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST.
Conclusion   We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.     

Surface dose and build-up region measurements with wedge filters for 6 and 18 MV photon beams

Purpose  

High-energy photons are most commonly used in radiotherapy to treat cancer. Wedge filters are required to obtain homogeneous dose distribution in the patient. Different wedge filter types create different surface doses. In this study, the effect of the virtual and physical wedge filters on the surface and build-up region doses was examined for 6- and 18-MV high-energy photon beams.     

The rare coexistence of high titer inhibitor development and gastrointestinal stromal tumor in a patient with severe hemophilia: A case report

Hemophilia is a hereditary disease with impaired blood coagulation due to a genetic deficiency of blood coagulation factors. The development of inhibitors further complicates the course of the disease and management. The case is here reported of a haemophilia patient who presented with coexisting development of high titer inhibitor with Gastrointestinal Stromal Tumor (GIST) diagnosis and was admitted with upper gastrointestinal system bleeding. The patient had no prior history of inhibitor presence. During all procedures including surgery, excellent hemostasis was achieved with rFVIIa treatment and no hemorrhagic complication was observed. To the best of our knowledge, this constitutes the first reported case of GIST associated with inhibitor development in a hemophilia A patient.     

Extra-axial cavernomas of the cerebellopontine angle involving the seventh-eighth nerve complex

Extra-axial cavernous malformations (cavernomas) of the central nervous system are rare. Although occasional cases located in different parts of the central nervous system have been reported, only five cases of extra-axial cavernous malformation in the cerebellopontine angle are to be found. We describe here two additional cases of cavernomas in the cerebellopontine angle causing hearing loss and tinnitus presenting as vestibular schwannoma. Electronic Publication     

Erythropoietin exerts neuroprotection after acute spinal cord injury in rats: effect on lipid peroxidation and early ultrastructural findings

Lipid peroxidation has been reported to play an important role in spinal cord injury (SCI). Erythropoietin (EPO) is a hematopoietic growth factor that stimulates proliferation and differentiation of erythroid precursor cells and is also known to exert neurotrophic activity in the central nervous system. The purpose of this study was to investigate the effectiveness of recombinant human EPO in attenuating the severity of experimental SCI. Rats were divided into seven groups. Controls (1) received only laminectomy. The trauma-only group (2) underwent 50-g/cm contusion injury and had no medication. In group 3, 30 mg/kg of methylprednisolone was introduced. The vehicle group (4) received vehicle solution containing human serum albumin, which is a solvent of EPO. Groups 5, 6, and 7 received 100 IU/kg, 1,000 IU/kg, and 5,000 IU/kg of EPO, respectively. All treatments were given as single doses, intraperitoneally, immediately after injury. Thiobarbituric acid-reactive substances were estimated to demonstrate lipid peroxidation, and ultrastructure was evaluated by electron microscopy. The results showed that lipid peroxidation by-products increased after injury. Administration of EPO and methylprednisolone sodium succinate (MPSS) reduced thiobarbituric acid-reactive substances after trauma. The best biochemical results were obtained with 5,000 IU/kg of EPO. Electron microscopic findings showed that EPO protected the spinal cord from injury. Although 1,000 IU/kg and 5,000 IU/kg of EPO inhibited lipid peroxidation better than MPSS, ultrastructural neuroprotection was similar.     

Pott's disease after heart transplantation: a case report

The incidence of tuberculosis among patients undergoing antirejection therapy is considerably higher than in the general population. Heart transplant recipients have been found to carry the highest risk of tuberculosis. There are no reported data about Pott's disease in heart transplant recipients. The authors present a case of Pott's disease seen after heart transplantation (HTx).