Risk of internal carotid injury due to peritonsillar abscess drainage

OBJECTIVE

Peritonsillar abscess (PTA) is one of the most commonly seen ear nose and throat (ENT) emergencies. The most catastrophic complication that may occur due to surgical treatment of PTA is injury of internal carotid artery. The aim of this study is to determine distance and angle between PTA with ICA; and to prevent possible complications.

METHODS

A total of 34 adult patients with PTA were enrolled in this study. Neck computed tomographies of the patients with PTA were evaluated by a radiologist. The distance between PTA and ICA (DIP), and contralateral tonsil side and ICA (DIT) were measured and compared with each other. Also angle between PTA and ICA (AIP) was examined.

RESULTS

This study contained 20 (58.8%) males and 14 (41.2%) females with a mean age of 32.20 ± 12.75 years (range 18-60 years). Mean DIP and DIT scores were 13.39 ± 3.7 mm (min: 5.32, max: 19.07) and 9.61 ± 3.17 mm (min: 4.95, max: 16.35) respectively, and the difference was statistically significant (p<0.05). Mean distance between anterior border of PTA and ICA was 36.18 ± 6.42 mm (min: 17.12 max: 47.43). The AIP was 33.40 ± 2.29° (min: 30.10° and max: 40.71°). According to risk classification system, the 28 (82.4%) patients constituted low risk, and 6 (%17.6) patients constituted moderate risk.

CONCLUSION

According to the distance between the PTA and ICA, the risk of ICA injury was found to be mild and moderate in PTA patients. It is crucial for the surgeon to pay attention to the depth and angle of the incision during drainage of the abscess.

Effect of leucine on NF-κB pathway in liver regeneration after partial hepatectomy in rats, as determined by miniarray analysis

BACKGROUND

Although some amino acids are recognized to have favorable effects on the liver regeneration after partial hepatectomy (PH), molecular mechanisms underlying these effects are barely known.

OBJECTIVE

Our study was aimed to investigate the effects of valine, glutamine, and leucine amino acids on PH-induced NF-κB signal pathway. The research team studied Leucine in a rat model in vivo. The study took place in the medical and surgical experimental research center at the Eskisehir Osmangazi University in Eskisehir, Turkey. The animals were Wistar albino male rats.

RESULTS

Group I, the sham group, was administered phosphate buffered saline (PBS) after laparotomy. After 70 % PH procedure, group II, III, IV, and V received single intraperitoneal doses of PBS, valine, glutamine, and leucine amino acids, respectively. At hour 6 after PH, expressions of 88 genes involving in NF-κB signal pathway were examined by RT-PCR mini array method in the liver tissue specimen. Fold values below 0.5 and above 2 were regarded as significant.

CONCLUSIONS

Our results suggested that valine, glutamine, and leucine amino acids may alter expressions of the genes of NF-κB signal pathway. In addition, among these amino acids, glutamine and valine proved to be much more effective on NF-κB signal pathway after the PH (Tab. 1, Ref. 41).

Apoptosis induced by boric anhydrite (B2O3) after partial hepatectomy in rat liver

Boron is one of the important elements that have a cell-growth suppressing effect. The apoptotic effects of B(2)O(3) that were investigated in rats on liver regeneration following 70 % partial hepatectomy (PH). Wistar albino male rats were used and divided into 4 groups (n = 7). The Saline control groups were given only a single dose of saline; the B(2)O(3)-treated groups that were only given a single dose of 1800 mg.kg(-1) B(2)O(3) by means of intraperitoneal injections following hepatectomy. Three and 6 hours after surgical procedures, all the groups were dissected and liver tissue samples were taken from the groups for NF-κB for caspase-3 gene and protein levels investigation by RT-PCR and TaqMan Protein Assay and histological analyses by TUNEL assay. B(2)O(3)-treated animals were examined and it was observed that NF-κB levels were decreased; however, caspase-3 gene expression and protein levels were increased significantly. This study demonstrated that B(2)O(3) induces caspase-3 and inhibits NF-κB at the early stage of liver regeneration (Fig. 4, Ref. 26).

The examination of protective effects of gallic acid against damage of oxidative stress during induced-experimental renal ischemia-reperfusion in experiment

AIM

In this study, probable effects of gallic acid were investigated in experimentally induced renal I/R injury in rats.

MATERIAL AND METHODS

For this purpose, each group consisted of 7 Spraque dawley male albino rats. Groups were defined as follows; Group I: control group; Group II: I/R group; Group III, IV and V: I/R+Gallic acid (50, 100 and 200 mg.kg-1 respectively-i.p.). Left kidney was removed by nephrectomy except for Group I. I/R was induced in the other kidney. Gallic acid was given 15 mins before ischemia induction. SOD, CAT and Gpx activities were determined by electrophoresis. MDA, MPO levels were determined spectrophotometrically. Histopathological investigations were also performed in kidney tissues. BUN and Creatinine levels in serum were determined.

RESULTS

BUN, Creatinine and MDA levels were statistically significant but MPO level was not statistically significantly increased in Group II. For SOD, CAT, Gpx activities in Group II, an increase was determined with respect to Group I. Histopathological investigations revealed widespread hyperemia in glomerulus, expansion of the structure between tubules and cell disruptions in Group II. In Group V (200 mg.kg-1 gallic acid), in terms of biochemical parameters, in spite of the significant decrease in BUN, Creatinine and MDA levels; a decrease was determined in SOD, CAT and Gpx isoenzyme activities. Group V showed histologically that I/R injury had been prevented to a greater extent and appearances were close to the control.

CONCLUSION

As a result, in terms of our study, evaluations regarding kidney functions and histopathology have shown that gallic acid has protective effects in renal I/R injury (Tab. 2, Fig. 5, Ref. 36).

Vitamin D as an adjunct to subcutaneous allergen immunotherapy in asthmatic children sensitized to house dust mite

BACKGROUND

We aimed to investigate the efficacy, safety, and T regulatory cell response of vitamin D as an adjunct to allergen-specific immunotherapy (IT).

METHODS

Fifty children with asthma and receiving pharmacotherapy were randomized into three groups as: subcutaneous IT (SCIT) along with vitamin D supplementation (650 U/day; n: 17), SCIT alone (n: 15), and pharmacotherapy alone (n: 18). All patients were evaluated at baseline, 6th and 12th months for scorings of symptoms and medication, skin prick testing, total IgE, specific IgE, and Der p 1-specific IgG4. In addition, D. pteronyssinus-induced CD4(+) CD25(+) FOXP3(+) T regulatory cell percentage, intracellular Foxp3 expression, and peripheral blood mononuclear cell IL-10 and TGF-β responses were assessed.

RESULTS

In the SCIT + vitamin D and SCIT alone groups, total asthma symptom score (TASS), total symptom score (TSS), and total medication scores (TMS) were significantly lower than pharmacotherapy group at the end of 1 year. While the comparison of delta values (Δ 6th and Δ 12th month - baseline) of those scores revealed no significant differences between the two IT groups, TASS at the 6th month was lower in the SCIT + vitamin D group compared with others. There was a significant and positive trend in the levels of Der p 1-specific IgG4 in both IT groups throughout the study period. Whereas the levels of Der p 1-induced IL-10 and TGF-β were similar between IT groups, the mean fluorescence intensity of Foxp3 was highest in the SCIT + vitamin D group compared with others at the 12th month. The rate of discontinuation of inhaled corticosteroid (ICS) was 6/17 in SCIT + vitamin D, 3/15 in SCIT, and 0/18 in the pharmacotherapy group (P = 0.02).

CONCLUSION

Both SCIT groups fared better than pharmacotherapy alone at the end of 1 year. Although the clinical and immunologic outcomes were mostly similar between the two IT groups, some favorable outcomes of vitamin D warrant further investigation in more selected populations with varying doses as adjunct to IT.

Predictors of atopic dermatitis phenotypes and severity: roles of serum immunoglobulins and filaggrin gene mutation R501X

BACKGROUND

Atopic dermatitis (AD), the most common chronic relapsing skin condition of infancy and childhood, is a complex multifactorial disease, which arises from the interaction between strong genetic and environmental factors.

OBJECTIVE

To investigate the roles of several factors on the severity of AD including FLG R501X gene mutation, serum immunoglobulin (Ig) levels, atopy and accompanying allergic disorders.

METHOD

Children were genotyped for the mutation in FLG R501X gene. Serum levels of major Ig isotypes, atopy and accompanying allergic disorders were assessed.

RESULTS

Study group consisted of 49 patients (M: 26, F: 23) with a mean age of 4.9±3.6 years and control group consisted of 50 children (M: 30, F: 20) with a mean age of 3.8±2.8 years. Genotyping of R501X mutation revealed risk alleles in none of the children in study group or control group. IgG z-scores were significantly higher in patients with AD compared to controls (-0.97±1.13 vs 1.48±1.02, p=0.026). There was a positive trend in IgG z-scores and a negative trend in IgA z-scores across the severity of AD. History of recurrent infections was significantly associated with asthma and/or AR (47.8% in patients with asthma/AR vs 3.8% in those without). Children with low IgG or IgA levels presented at an earlier age with lower rates of atopy and mild type AD.

CONCLUSION

In a sample of Turkish children, FLG R501X genotyping revealed no risk alleles in variable severities of AD or healthy controls. Our data suggest that IgG and IgA levels might have a role in phenotypic features of AD in terms of severity and atopic sensitisation.

Pretreatment parameters obtained from peripheral blood sample predicts invasiveness of bladder carcinoma

PURPOSE

To predict the invasiveness of urothelial bladder carcinoma using a logistic regression model on preoperative peripheral blood samples.

PATIENTS AND METHODS

Hospital data of patients operated for urothelial carcinoma were reviewed retrospectively. Preoperative blood samples were collected before the first cystoscopic examination. Any kind of infection or inflammation was an exclusion criterion. Patients were grouped as having a non-muscle-invasive or muscle-invasive urothelial carcinoma. The mean age was 69 years and was determined as the cut-off value. According to receiver operating characteristic curves, threshold points were determined for lymphocytes, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), thrombocytes and mean platelet volume. Demographic specialties, parameters obtained from blood samples, tumor size and multiplicity were evaluated and significant parameters were put into a logistic regression model.

RESULTS

The study group consisted of 80 non-muscle-invasive and 102 muscle-invasive patients. Age (≤69 vs. >69), female gender, NLR (2.57), mean platelet volume (7.9/fl) and platelet count (400,000/µl) were significant parameters and put in a model. Using odds ratios, the probability of tumor invasiveness was calculated by a formula.

CONCLUSION

Age, female gender, NLR and platelet count were found to be the predictors of invasiveness of urothelial carcinoma.

Impact of early weight loss on growth of Caesarean delivered babies: how long does it last?

BACKGROUND

We hypothesized that Caesarean delivered babies might experience excessive weight loss during neonatal period.

AIM

To investigate amount of weight loss among Caesarean delivered babies with exclusive breastfeeding and to identify role of relative weight change (RWC) in early postnatal period on the growth of infants in subsequent months.

METHODS

We studied healthy infants born ≥36 completed weeks, by Caesarean section between September 2008 and August 2009, with Apgar scores >7. Weight measurements were performed at birth, at 24 h postpartum and at days 2, 4, 7, 14, 30 and monthly up to 6 months. Predictive roles of RWC at each assessment on detecting excessive weight loss and poor weight gain in 1st month, as well as bodyweight z scores in subsequent months were assessed.

RESULTS

We studied 160 infants (88 female, 72 male) with a mean gestational age of 38.01 ± 1 weeks and birthweight of 3239 ± 421 g. Overall, 22.5% of infants lost >10% of birthweight; 11.9% at day 2, 16.9% at day 4 and 6.6% at day 7. Degree of weight loss was not related with parity, gestational age, birthweight or type of anaesthesia. Predictive values of RWCs in detecting poor weight gain in 0-30 days were: 2nd day; limit =-9.4%, specificity = 91.5%, 4th day; limit =-10.2%, specificity = 89.4%, 7th day; limit =-6.3%, specificity = 85%, sensitivity = 78%, 14th day; limit =+0.8%, specificity = 91.5%, sensitivity = 83.3%. Adjusting for birthweight z scores, RWC at 14th day had a significant influence on 1st and 2nd month bodyweight z scores. Bodyweight z scores were significantly correlated with the z scores of bodyweight in 1-5 months but not with that of 6 months.

CONCLUSION

Incidence of excessive weight loss is very high among Caesarean delivered babies. RWC at earlier measurements proves satisfactory in predicting poor infant growth. Management strategies based on identifying infants at risk could prevent excessive weight loss and improve future growth of those infants.

Can radiation-induced chronic oxidative stress in kidney and liver be prevented by dimethylsulfoxide? Biochemical determination by serum and tissue markers

PURPOSE

To investigate the protective effects of dimethylsulfoxide (DMSO) on chronic oxidative stress in the liver, kidney and serum with biochemical parameters such as malondialdehyde (MDA), advanced oxidation protein product (AOPP), catalase, glutathione (GSH), and free-thiols (F-SH).

METHODS

Thirty Wistar albino female rats were randomly divided into 3 groups: group I (control, n=10), group II (irradiation-alone group, n=10) and group III (DMSO and irradiation group, n=10). Rats in groups II and III were irradiated with a single dose of 6 Gy to the entire liver and right kidney. Group III received DMSO 4.5 g/kg by intraperitoneal injection 30 min before irradiation. At the end of the 24th week, the rats were sacrificed and their trunk blood, kidney and liver tissues were collected.

RESULTS

Group II rats showed increased levels of lipid peroxidation and protein oxidation, with decreased GSH, FSH and catalase levels in all specimens when compared with group I. Serum and kidney MDA and AOPP levels were significantly lower in group III when compared with group II. However, serum and kidney GSH and F-SH levels were significantly higher in group III when compared with group II. The additive effect on catalase was seen only in the serum.

CONCLUSION

DMSO is a protective agent on chronic oxidative stress in the serum and kidney tissue. No oxidant or antioxidant effect of DMSO in the liver was seen.

Acute radiation effect in the brain in infant rats: Neurocognitive and histopathological examination

PURPOSE

The aim of the present study was to evaluate the radiation-induced cognitive dysfunction and the radioprotective effect of amifostine (AMI) in the brain of infantile rats.

METHODS

Thirty 2-week-old rats were randomly assigned into 3 groups of 10 rats each. Group 1: control (CONT), group 2: radiation alone (RT), and group 3: AMI before radiation (AMI+RT). The rats in the RT and AMI+RT groups were irradiated individually with a single dose of 20 Gy. All animals were evaluated by using the Morris water maze test to evaluate of their cognitive functions. Histopathological analyses of the hippocampus were also carried out after euthanasia.

RESULTS

The study showed that the place navigational function and the spatial probe test were not significantly different between the groups.

CONCLUSION

It can be said that it is very important to determine when the radiation-induced brain injury is formed. From a clinical perspective, the patients can be intervened before irreversible functional deficits are formed and may be amenable to treatment.

Efficacy of intravenous immunoglobulin treatment in children with common variable immunodeficiency

BACKGROUND

Children with common variable immunodeficiency (CVID) have increased susceptibility to infections.

OBJECTIVE

We evaluated the role of intravenous immunoglobulin (IVIG) replacement therapy on the clinical outcome of patients with CVID.

METHODS

We studied children diagnosed with CVID and treated with IVIG (500 mg/kg every 3 weeks).

RESULTS

The study population comprised 29 children with CVID (mean [SD] age, 11.8 [6.1] years) with at least 1 year of follow-up before IVIG replacement therapy. Mean follow-up duration was 5.6 (3.5) years (range, 15 months-14 years). During therapy, median serum IgG levels increased from 410 to 900 mg/dL. The mean number of respiratory infections per patient per year decreased significantly from 10.2 to 2.5. The annual number and length of hospital stays decreased significantly from 1.36 to 0.21 and 16.35 to 6.33 days per patient, respectively. The mean annual number of antibiotics used decreased significantly from 8.27 to 2.50 per patient. Twelve patients had developed bronchiectasis before initiation of IVIG; 3 patients were cured of this condition. Age at diagnosis, diagnostic delay, number of respiratory tract infections, and number of antibiotics were found to be significantly higher in patients with bronchiectasis, as was lower B-cell percentage. However, gastrointestinal involvement due to noninfectious causes did not improve significantly after IVIG replacement therapy.

CONCLUSION

CVID patients treated with IVIG (500 mg/kg every 3 weeks) had satisfactory serum IgG levels, fewer respiratory tract infections, fewer and shorter hospital stays, and reduced antibiotic usage. However, no effect on gastrointestinal involvement was observed. Early IVIG replacement therapy is important in preventing bronchiectasis.

Ultrastructure of pancreatic alpha and beta cells in young quails (Coturnix coturnix japonica) fed aflatoxin

The present investigation was undertaken to assess the effects of aflatoxin (AF) containing diets on alpha and beta cells of the endocrine pancreas in young quails by means of light and electron microscopy. A total of thirty quails were divided into 3 groups, each comprising 10 animals. Total AF was incorporated into the diet of these groups, at dosages of 0 (control, group 1), 2.5 (group 2), and 5.0 (group 3) mg AF/kg feed. The chicks were housed in electrically heated battery cages and exposed to light for 24 h from hatching to 3 weeks of age. Quails consumed the diets and water ad libitum. Electron microscopic examinations demonstrated degranulation of alpha cells, decrease in the size and number of secreting granules, and increase in the number of free ribosomes and polisomes in the animals of group 2 and 3. In beta cells, the numbers of free ribosomes and polisomes decreased, whereas the number of mature granules increased in the animals of group 3. Mononuclear cell infiltrates were observed in the periphery of capillaries and around endocrine islets in the experimental groups. Furthermore, capillaries of the animals in group 2 and 3 were dilated at all sides of both alpha and beta islets. According to the results of this study, the addition of aflatoxin to the diets of quails at dosage of 2.5 and 5 mg AF/kg leads to significant changes in pancreatic alpha and beta cells. These changes may exhibit adverse effect on the metabolism of carbohydrates in poultry.

The effect of economic status on height, insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations in healthy Turkish children

OBJECTIVES

The effect of economic status (ES) on growth, insulin-like growth factor (IGF)-I and IGF-binding protein (IGFBP)-3 in healthy children is not well characterized. We aimed to study the interrelationship between height, weight, IGF-I, IGFBP-3, mid-parental height (MPH) and ES.

DESIGN/SUBJECTS

Eight hundred and fourteen healthy children (428 boys, 386 girls; age 3-18 years) were classified according to income of the families as low, middle and high. Standard deviation scores (SDSs) of height, weight, MPH, IGF-I and IGFBP-3 were compared between the groups. The combined effect of these parameters and ES on height SDS was investigated with complex statistical models.

RESULTS

There was a significant trend for height and weight SDSs to increase with higher income levels in boys, but not in girls. Body mass index (BMI) SDSs were similar in three groups. There was a general trend for MPH SDS to increase with income levels in both sexes. In boys, IGF-I SDS was significantly higher in high ES group than low ES. In girls, IGFBP-3 SDSs were significantly higher in high ES group than in middle ES group. For both genders, height SDS was highly correlated with weight SDS and moderately correlated with BMI SDS, MPH SDS and IGF-1 SDS. All correlations were significant and positive. Complex models showed that MPH (19%), IGF-I (13%) and ES (3%) in boys, and MPH (16%) and IGF-I (7%) in girls have significant contribution to height SDSs.

CONCLUSIONS

ES per se, independent of overt malnutrition, affects height, weight, IGF-I and IGFBP-3 with some gender differences in healthy children. Influence of income on height and weight show sexual dimorphism, a slight but significant effect is observed only in boys. MPH is the most prominent variable effecting height in healthy children. Higher height and MPH SDSs observed in higher income groups suggest that secular trend in growth still exists, at least in boys, in a country of favorable economic development.

Light and electron microscopic studies on mast cells of the bovine oviduct

This study was conducted to determine the staining properties, the light and electron microscopic appearance and numerical distribution of mast cells from different regions of the bovine oviduct during the estrous phase and luteal phase. Ten oviducts from bovines in the estrous phase, and 10 from bovines in the luteal phase were used as study samples. In three regions of the oviduct (infundibulum, ampulla, isthmus), mast cells that showed metachromasia with toluidin blue and Ab(+), SO(-) with the combined Ab/SO stains were encountered. Electron microscopic studies of the mast cells showed them to contain two types of granules; a dense homogeneous type and a tiny particulate type. In all three regions of the oviduct, the luteal phase was observed to have a higher number of mast cells per mm2 area than the estrual phase with the isthmus having the most dense population.

Electron microscopic studies on conjunctiva associated lymphoid tissue (CALT) in Angora goats

The purpose of this study was to investigate the electron microscopic structure of conjunctiva associated lymphoid tissue (CALT) and to determine the uptake of macromolecules from follicle associated epithelium (FAE) of Angora goats. The sample tissues taken from lower and upper eyelids of ten 5-6 month-old healthy Angora goats were used in this study. The conjunctiva associated lymphoid tissue of Angora goats was formed by solitary or aggregate lymphoid follicle and follicle associated epithelium which cover these follicle. FAE was formed by flattened epithelial cells, lymphocytes, monocytes and polymorph nuclear leukocytes but no goblet cells. Ferritin particles were seen on the apical surface, in the invaginations, vesicles, vacuoles of flattened epithelial cells. It was concluded that these epithelial cells were specialized to uptake macromolecules.

Light and electron microscopic studies on alpha naphthyl acetate esterase activity of peripheral blood T lymphocytes in chicken

The purpose of this study was to determine the percentage of peripheral blood T lymphocytes and the localization of Alpha Naphthyl Acetate Esterase (ANAE) enzyme at the electron microscopic level in healthy adult chickens by an alpha naphthyl acetate esterase procedure. Peripheral blood samples taken from 30 adult Leghorn breed chickens were used. The percentage of ANAE positive lymphocytes was 56.4 +/- 2.82% (SD). Pseudoeosinophil and eosinophil granulocytes showed a granular positivity. In the electron microscopic examination, ANAE positive reactions were seen in lysosomal granules found in T lymphocytes, pseudoeosinophil, and eosinophil granulocytes.

Acute bacterial meningitis in adults: analysis of 218 episodes

A retrospective study was conducted to examine the laboratory, clinical features and outcome of 206 adult acute bacterial meningitis patients (218 episodes) during the years 1985-1996. Pneumonia (8.7 per cent), head trauma (7.8 per cent) and chronic otitis media (6.0 per cent) were identified as the main predisposing factors for acute bacterial meningitis. Aetiology was described only in 61 episodes (28.0 per cent). Streptococcus pneumonia was the most commonly identified pathogen overall, causing 33 of the 218 episodes (15.2 per cent). Antibiotic treatment before admission was given to 48.4 per cent of patients. On admission, the following symptoms of meningitis were predominant: 83 per cent had neck stiffness, 81 per cent had a headache and 73 per cent had fever. Case fatality rate was 27.1 per cent (59 patients). The important factors in mortality were as follows: old age, a long duration of symptoms before admission, a lack of neck stiffness, obtunded mental state on admission, low glucose levels in first CSF, low CSF/blood glucose ratio, and abnormality in computerised tomography scanning.