Boosting Tetracycline Degradation with an S-Scheme Heterojunction of N-Doped Carbon Quantum Dots-Decorated TiO2

N-doped carbon quantum dots (N-CQDs) derived from the Rumex crispus L. plant were incorporated into TiO₂ via a facile hydrothermal method. As-prepared materials were characterized and used in the photocatalytic tetracycline (TC) degradation under UVA light irradiation by examining several operational parameters involving the N-CQDs amount, initial TC concentration, pH, and photocatalytic reaction time. XRD analysis revealed the conversion of the rutile phase to the anatase phase after the incorporation of N-CQDs into the TiO₂ structure. The results revealed that the N-CQDs/TiO₂ photocatalysts demonstrated the highest efficiency in TC degradation compared to other processes of adsorption, photolysis (UVA), and photocatalysis with TiO₂ (TiO₂/UVA). Under optimized conditions, 10 mg/L TC at pH 5.15 with 0.2 g/L N-CQDs/TiO₂ catalyst showed 97.7% photocatalytic degradation for 120 min under UVA irradiation. The formation of an S-scheme heterojunction between N-CQDs and TiO₂ provided enhanced charge separation and strong redox capability, causing significant improvement in the photocatalytic performance of N-CQDs/TiO₂. Trapping experiments showed that O₂^•- and h⁺ are the predominant reactive species for the TC elimination in an aqueous solution.

Investigation of some acute phase proteins, cytokines and hepcidin values in feline enteric corona virus antibodies and feline infectious peritonitis antigen positive cats

Feline Infectious Peritonitis (FIP) is a fatal disease caused by feline coronaviruses. The causative agent is Feline Infectious Peritonitis Virus, a mutation of Feline Enteric Coronavirus. Feline Corona Virus is very common in the cat population. In Feline Corona Virus infected cats, the development of FIP depends on the cat's immune response. FIP disease is more common in young and old cats because young and old animals have a weaker immune system. The acute phase response is a complex systemic reaction that occurs as a response to acute or chronic inflammatory processes such as infection, neoplasia or immunological disorders, tissue damage, trauma and surgery. The study material included 15 cat with presumptive FIP (study group) and 10 healthy cats (control group). Of the 15 cats, 9 (60%) showed dry and 6 (40%) effusive form. Serum amyloid A (SAA), haptoglobin (Hp),  α1-acid glycoprotein (AGP), albumin, interleukin-6 (IL-6), hepcidin, alanine-amino transferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), blood urea nitrogen(BUN), and creatinine levels were measured in the serum collected from both groups. There were no difference between the wet and dry FIP in albumin values; haptoglobin, α1-acid glycoprotein, SAA and hepcidin values were significantly different between the two groups. IL-6, showed significant difference in both wet and dry FIP groups. It was also concluded that hepcidin may be used as a biomarker in Feline Infectious Peritonitis disease like other acute phase proteins.

Cardio-protective effect of dapagliflozin against doxorubicin induced cardiomyopathy in rats

OBJECTIVE

Cancer is the second most common non-communicable disease group in the world and its frequency is increasing. In parallel, side effects of drugs used in cancer treatment are frequently encountered. Doxorubicin (DOX) is one of the most effective multi-purpose anticancer drugs. However, its use is significantly limited due to the risk of cardiotoxicity. Sodium-glucose cotransporter-2 inhibitors are a group of antidiabetic drugs that have been shown to reduce cardiovascular events. Our aim is to examine the preventive effect of dapagliflozin on DOX-induced cardiac damage.

SUBJECTS AND METHODS

We used 30 albino rats. 20 of 30 rats were administered doxorubicin for cardiomyopathy model. The rats in the DOX arm were divided into two groups: those given penicillin and placebo. After the rats were terminated, tissues were prepared for histopathological and immunohistochemical examination. TNF-α, pro-BNP, troponin T and plasma FGF-21 levels were also measured in plasma.

RESULTS

The mean concentrations of cTnT and pro-BNP in the plasma of the DOX treated rats demonstrated a significantly higher value compared to the control group. Treatment with dapagliflozin caused a significant reduction in plasma cTnT, pro-BNP and TNF-α levels concentrations compared to the DOX control group (p < 0.001). The group of rats treated with dapagliflozin was effective in significantly decreasing the FGF-21 concentration and the percentage of fibronectin immunoexpression compared to the DOX control group (p  < 0.0001).

CONCLUSIONS

This study revealed, for the first time, that dapagliflozin can improve DOX-induced cardiac dysfunction and pathological changes in non-diabetic rats. This result has shown that dapaglifozin, may be promising in terms of preventing cardiac damage that may develop in cancer treatment.

Preparation of magnetite nanoparticles by high-energy planetary ball mill and its application for ciprofloxacin degradation through heterogeneous Fenton process

In this study, the heterogeneous Fenton oxidation of ciprofloxacin (CIP) in an aqueous solution was examined over the nano-sized magnetite (Fe₃O₄) as a catalyst supplied through high-energy planetary ball milling process. To characterize the magnetite samples after and before ball milling operation, the X-ray diffraction (XRD), High-resolution scanning electron microscopy (HR-SEM), energy-dispersive X-ray spectroscopy (EDX), Brunauer-Emmett-Teller (BET) and Fourier transform infrared spectroscopy (FTIR) analysis were applied. The catalytic properties of the magnetite were considerably improved because of the enhancement in its physical properties, resulted from milling process. The findings also indicated that 6 h ball-milled magnetite demonstrated better properties for elimination of CIP of about 89% following 120 min reaction at optimal conditions of H₂O₂ 12 mM, Fe₃O₄ 1.75 g L^-1, CIP 10 mg L^-1 and pH 3.0. The effects of various operational parameters, including the initial pH of the solution, H₂O₂ initial concentration, catalyst dosage, milling time and CIP initial concentration was investigated. Application of organic and inorganic scavengers considerably decreased the CIP removal efficiency. Correspondingly, with respect to the leached iron values at pH 3, it was concluded that CIP elimination was mainly occurred through heterogeneous Fenton procedure. This process included the adsorption and oxidation phases in which the hydroxyl radicals (OH) played a significant role. GC-MS analysis was used for recording of the generated intermediates of the CIP removal in the course of heterogeneous Fenton process.

Sonocatalytic removal of naproxen by synthesized zinc oxide nanoparticles on montmorillonite

ZnO/MMT nanocomposite as sonocatalyst was prepared by immobilizing synthesized ZnO on the montmorillonite surface. The characteristics of as-prepared nanocomposite were studied by scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HR-TEM) and X-ray diffraction (XRD) techniques. The synthesized samples were used as a catalyst for sonocatalytic degradation of naproxen. ZnO/MMT catalyst in the presence of ultrasound irradiation was more effective compared to pure ZnO nanoparticles and MMT particles in the sonocatalysis of naproxen. The effect of different operational parameters on the sonocatalytic degradation of naproxen including initial drug concentration, sonocatalyst dosage, solution pH, ultrasonic power and the presence of organic and inorganic scavengers were evaluated. It was found that the presence of the scavengers suppressed the sonocatalytic degradation efficiency. The reusability of the nanocomposite was examined in several consecutive runs, and the degradation efficiency decreased only 2% after 5 repeated runs. The main intermediates of naproxen degradation were determined by gas chromatography-mass spectrometry (GC-Mass).

Prediction of early postoperative atrial fibrillation after cardiac surgery: is it possible?

Background

Postoperative atrial fibrillation is common after cardiac surgery. In this study, we aimed to investigate the value of interatrial conduction time for the prediction of early postoperative atrial fibrillation, using intra-operative transoesophageal echocardiography.

Methods

A total of 65 patients undergoing cardiac surgery in our hospital between January and March 2007 were prospectively evaluated, and 59 patients with sinus rhythm were included in the study. We performed transoesophageal echocardiography on all patients, and intra-operatively measured the interatrial conduction time, as recently described. The patients with episodes of atrial fibrillation during the post-surgery hospitalisation period were defined as group 1 and those without episodes were defined as group 2.

Results

Mean interatrial conduction time was 74 ± 15.9 ms in group 1 and 54 ± 7.9 ms in group 2. The difference in interatrial conduction time between the two groups was statistically significant (p < 0.05). In this study we found a statistically significant interatrial conduction delay between the groups. Postoperative atrial fibrillation was more frequent in patients with a longer interatrial conduction time.

Conclusion

Increased interatrial conduction time may cause postoperative atrial fibrillation and it can be measured intraoperatively by transoesophageal echocardiography.

Simulation of ¹³⁷Cs transport and deposition after the Chernobyl Nuclear Power Plant accident and radiological doses over the Anatolian peninsula

The Chernobyl Nuclear Power Plant (CNPP) accident occurred on April 26 of 1986, it is still an episode of interest, due to the large amount of radionuclides dispersed in the atmosphere. Caesium-137 ((137)Cs) is one of the main radionuclides emitted during the Chernobyl accident, with a half-life of 30years, which can be accumulated in humans and animals, and for this reason the impacts on population are still monitored today. One of the main parameters in order to estimate the exposure of population to (137)Cs is the concentration in the air, during the days after the accident, and the deposition at surface. The transport and deposition of (137)Cs over Europe occurred after the CNPP accident has been simulated using the WRF-HYSPLIT modeling system. Four different vertical and temporal emission rate profiles have been simulated, as well as two different dry deposition velocities. The model simulations could reproduce fairly well the observations of (137)Cs concentrations and deposition, which were used to generate the 'Atlas of Caesium deposition on Europe after the Chernobyl accident' and published in 1998. An additional focus was given on (137)Cs deposition and air concentrations over Turkey, which was one of the main affected countries, but not included in the results of the Atlas. We estimated a total deposition of 2-3.5 PBq over Turkey, with 2 main regions affected, East Turkey and Central Black Sea coast until Central Anatolia, with values between 10 kBq m(-2) and 100 kBq m(-2). Mean radiological effective doses from simulated air concentrations and deposition has been estimated for Turkey reaching 0.15 mSv/year in the North Eastern part of Turkey, even if the contribution from ingestion of contaminated food and water is not considered, the estimated levels are largely below the 1 mSv limit indicated by the International Commission on Radiological Protection.

Pancreatic polypeptide regulates glucagon release through PPYR1 receptors expressed in mouse and human alpha-cells

BACKGROUND

Plasma levels of pancreatic polypeptide (PP) rise upon food intake. Although other pancreatic islet hormones, such as insulin and glucagon, have been extensively investigated, PP secretion and actions are still poorly understood.

METHODS

The release of PP upon glucose stimulation and the effects of PP on glucagon and insulin secretion were analyzed in isolated pancreatic islets. Expression of PP receptor (PPYR1) was investigated by immunoblotting, quantitative RT-PCR on sorted pancreatic islet cells, and immunohistochemistry.

RESULTS

In isolated mouse pancreatic islets, glucose stimulation increased PP release, while insulin secretion was up and glucagon release was down. Direct exposure of islets to PP inhibited glucagon release. In mouse islets, PPYR1 protein was observed by immunoblotting and quantitative RT-PCR revealed PPYR1 expression in the FACS-enriched glucagon alpha-cell fraction. Immunohistochemistry on pancreatic sections showed the presence of PPYR1 in alpha-cells of both mouse and human islets, while the receptor was absent in other islet cell types and exocrine pancreas.

CONCLUSIONS

Glucose stimulates PP secretion and PP inhibits glucagon release in mouse pancreatic islets. PP receptors are present in alpha-cells of mouse and human pancreatic islets.

GENERAL SIGNIFICANCE

These data demonstrate glucose-regulated secretion of PP and its effects on glucagon release through PPYR1 receptors expressed by alpha-cells.

Identification of mutations and evaluation of cardiomyopathy in Turkish patients with primary carnitine deficiency

Primary systemic carnitine deficiency (SCD) is an autosomal recessive disorder caused by defective cellular carnitine transport. Patients usually present with predominant metabolic or cardiac manifestations. SCD is caused by mutations in the organic cation/carnitine transporter OCTN2 (SLC22A5) gene. Mutation analysis of SLC22A5 gene was carried out in eight Turkish patients from six families. Six patients presented with signs and symptoms of heart failure, cardiomyopathy, and low plasma carnitine levels, five of them with concurrent anemia. A patient with dilated cardiomyopathy had also facial dysmorphia, microcephaly, and developmental delay. Tandem MS analyses in siblings of the patients revealed two more cases with low plasma carnitine levels. SCD diagnosis was confirmed in these two cases by mutation screening. These two cases were asymptomatic but echocardiography revealed left ventricular dilatation in one of them. Carnitine treatment was started before the systemic signs and symptoms developed in these patients. Mean value of serum carnitine levels of the patients was 2.63±1.92μmol/L at the time of diagnosis. After 1year of treatment, carnitine values increased to 16.62±5.11 (p<0.001) and all responded to carnitine supplementation clinically. Mutation screening of the OCTN2 gene study in the patients revealed two novel (p.G411V, p.G152R), and four previously identified mutations (p.R254X, p.R282X, p.R289X, p.T337Pfs12X). Early recognition and carnitine supplementation can be lifesaving in this inborn error of fatty acid oxidation.

A giant cervical nabothian cyst compressing the rectum, differential diagnosis and literature review

Nabothian cysts generally being small-sized and multiple are common gynecopathological conditions of women in reproductive age. We report a case of a giant nabothian cyst compressing the rectum apparently without gynecologic symptoms. Initial symptoms of pain and difficulty in defecation due to compression on the rectal wall because of the huge size of the cyst might be the first case in the literature. We made the differential diagnosis from adenoma malignum (minimal-deviation adenocarsinoma) by using immunhistochemical and histopathological techniques.

Dasatinib inhibits site-specific tyrosine phosphorylation of androgen receptor by Ack1 and Src kinases

Activation of androgen receptor (AR) may play a role in the development of castration resistant prostate cancer. Two intracellular tyrosine kinases, Ack1 (activated cdc42-associated kinase) and Src, phosphorylate and enhance AR activity and promote prostate xenograft tumor growth in castrated animals. However, the upstream signals that activate these kinases and lead to AR activation are incompletely characterized. In this study, we investigated AR phosphorylation in response to non-androgen ligand stimulation using phospho-specific antibodies. Treatment of LNCaP and LAPC-4 cells with epidermal growth factor (EGF), heregulin, Gas6 (ligand binding to Mer receptor tyrosine kinase and activating Ack1 downstream), interleukin (IL)-6 or bombesin stimulated cell proliferation in the absence of androgen. Treatment of LNCaP and LAPC-4 cells with EGF, heregulin, or Gas6 induced AR phosphorylation at Tyr-267; IL-6 or bombesin treatment did not. AR phosphorylation at Tyr-534 was induced by treatment with EGF, IL-6 or bombesin, but not by heregulin or Gas6. siRNA-mediated knockdown of Ack1 or Src showed that Ack1 mediates heregulin- and Gas6-induced AR Tyr-267 phosphorylation whereas Src mediates Tyr-534 phosphorylation induced by EGF, IL-6, and bombesin. Dasatinib, a Src inhibitor, blocked EGF-induced Tyr-534 phosphorylation. In addition, we show dasatinib also inhibited Ack1 kinase. Dasatinib inhibited heregulin-induced Ack1 kinase activity and AR Tyr-267 phosphorylation. Dasatinib inhibited heregulin-induced AR-dependent reporter activity. Dasatinib also inhibited heregulin-induced expression of endogenous AR target genes. Dasatinib inhibited Ack1-dependent colony formation and prostate xenograft tumor growth in castrated mice. Interestingly, Ack1 or Src knockdown or dasatinib did not inhibit EGF-induced AR Tyr-267 phosphorylation or EGF-stimulated AR activity, suggesting the existence of an additional tyrosine kinase that phosphorylates AR at Tyr-267. These data suggest that specific tyrosine kinases phosphorylate AR at distinct sites and that dasatinib may exert anti-tumor activity in prostate cancer through inhibition of Ack1.

Effect of chronic arsenic exposure from drinking waters on the QT interval and transmural dispersion of repolarization

This study investigated the effects of chronic arsenic exposure on QT- and QTc-interval prolongation, QTc dispersion (QTcd) and transmural dispersion of repolarization (TDR). We compared cardiac parameters from 40 male subjects chronically exposed to arsenic (group A) with those of 40 male subjects not exposed to arsenic (group B). Although subjects in both groups had non-corrected QT intervals within normal limits, subjects in group A had significantly longer QTc and QTcd intervals compared with group B. A total of 70% of group A compared with 10% of group B had QTcd values > 50 ms. The mean TDR value was also significantly higher in group A compared with group B. Although non-corrected QT intervals were within normal limits, those subjects chronically exposed to arsenic had a slight QT prolongation and a higher prevalence of subtle repolarization abnormalities, which might be clinically relevant.

Does the copper intrauterine device affect serum cancer antigen 125 levels?

PURPOSE

This study aimed to reveal the effect of the copper IUD, if any, on serum CA-125 levels in patients who use the device as a contraceptive.

METHODS

Blood samples were obtained two times from 20 healthy volunteers before and after IUD insertion, and sera were isolated. The sera, centrifuged at 2000 G and kept at -70 degrees C in a deep freezer until analyzed, were processed for CA-125 levels by the CA-125 kit using VIDAS PC analyzer (Biomerieux, France) and results were compared.

RESULTS

The CA-125 level of the serum obtained from the first blood samples was significantly higher than that of the second sample (24.63 +/- 25.40 mIU/ml and 14.44 +/- 10.08 mIU/ml, respectively) (p < 0.05).

CONCLUSION

The results of this study indicate that the serum level of CA-125 may be lower in patients using copper IUDs which may be helpful in evaluation of ovarian masses in women in reproductive age.

Comparison of lornoxicam with tramadol in patient-controlled analgesia after gynecological surgery

BACKGROUND

The aim of this study was to compare the effects of lornoxicam and tramadol in patient-controlled analgesia (PCA) after gynecological surgery.

METHODS

Forty-four patients were randomly allocated to one of two groups after elective gynecological surgery. Patients in group I (n = 22) received IV tramadol, and group II patients (n = 2) received IV lornoxicam with a PCA pump. A visual analogue scale (VAS) (0 = no pain, 10 = worst pain), hemodynamic parameters and side-effects were assessed before starting the infusion (baseline), at the 15th and 30th min, 1st, 2nd, 3rd, 4th, 6th, 8th, 12th, 18th, 24th, 36th and 48th hour thereafter, and results were compared.

RESULTS

Adequate analgesia was achieved in both groups. VAS values in the tramadol group were lower than those of lornoxiacam at the 15th and 30th minute, 1st, 2nd, 4th, 6th, 8th and 12th hour measurements (p < 0.05). Eight patients (36.3%) in group I and six patients (27.2%) in group II suffered from nausea (p > 0.05).

CONCLUSIONS

Tramadol and lornoxicam may be used for pain control after gynecological surgery via PCA. However, we conclude that tramadol has better analgesic efficacy than lornoxicam during the first 12 hours postoperatively.

Cyproterone acetate and ethinylestradiol-induced pill oesophagitis: a case report

Although there are many cases of oesophagitis related to pill in medical literature, there are only a few reports concerning oesophagitis related to oral contraceptives, and none about cyproterone acetate and ethinylestradiol combination (Diane-35). In this report, we describe a female patient who suffered from odynophagia and retrosternal pain after taking Diane-35 for hirsutism. The endoscopic examination revealed two well-demarcated circumferential ulcers of 1 cm diameter surrounded by relatively normal mucosa in mid-oesophagus. The patient had gone to bed immediately after taking the pill. Oral intake was stopped, and intravenous fluids and omeprazole were administered as part of treatment. The patient benefited from this approach very quickly and was discharged from hospital in 5 days. The oesophagus was completely normal in control endoscopy after 2 months. Diane-35 should be added to the list of drugs causing pill oesophagitis, and physicians should inform the patients that the pills should be taken with enough water and they should not lie down right after ingesting the pills.

Comparison of clinical diagnosis and microbiological test results in vaginal infections

Lower genital tract infections continue to be a problem due to the fact that the clinical diagnosis is usually inadequate, and subsequent care is suboptimal. This study aimed at evaluating the accuracy of clinical diagnosis by comparing it with microbiologic test results, and to determine the causative agents of vaginal infections. Sixty-seven nonpregnant women (18-45 years of age) with the clinical diagnosis of lower genital tract infection were enrolled in the study. Patients were not included if they had a history of vaginal infection during the previous three-month period or intrauterine device. The clinical diagnosis was based on the combinations of symptoms, direct observation of wet mount, homogeneous discharge, vaginal pH > 4.5, and detection of the amine odor after exposure of vaginal secretions to 10% KOH. Vaginal samples were taken with two cotton swabs, one was used for pH determination, and the second was utilized for microbiological tests. Gram staining and cultures with Sabouraud agar and chocolate agar were performed for microbiological diagnosis, and the results were compared. The clinical diagnoses included 26 (38.8%) candidiasis, 18 (26.8%) bacterial vaginosis, three (4.5%) trichomoniasis, and 20 (29.9%) mixed vaginal infections. Of the 26 patients with clinical diagnoses of candidiasis, 12 (46.1%) revealed Candiada albicans, nine (34.6) patients revealed microorganisms other than candida species, and five (19.2%) patients had no growth. Five (27.8%) bacterial vaginosis patients revealed Gardnarella vaginalis and 12 patients (66.6%) did not grow any microorganism. The overall rate of accurate clinical diagnoses confirmed by microbiological test results was 43.2%. Seventeen (43.6) of the 39 microbiological test results correlated with clinical diagnosis, and no growth was observed in 28 (41.8%) cultures. We conclude that the clinical diagnosis of vaginal infection is inadequate and should be confirmed with microbiological testing if the resources are avaliable.

Effect of hysterosalpingography on serum cancer antigen (CA-125) levels

OBJECTIVE

The aim of our study was to detect any rise in serum levels of CA-125 after hysterosalpingography (HSG) as a result of irritation of the peritoneum.

STUDY DESIGN

Serum levels of CA-125 were assessed before HSG and at the 2nd and 6th hours after HSG in 32 infertile patients who were admitted to our clinic from April 2002 to September 2002. Patients who showed tubal occlusion or Asherman Syndrome were excluded from the study. The levels of serum CA-125 were compared statistically. Statistical analysis was performed with SPSS 10.0 statistical software and the paired-sample t-test was applied.

RESULTS

The mean levels of serum CA-125 before HSG, and at the 2nd and 6th hours after HSG were; 14.11 +/- 5.97 mIU/ml, 13.96 +/- 5.80 mIU/ml, and 14.06 +/- 5.80 mIU/ml, respectively. There was no statistically significant difference between serum levels of CA-125 before HSG and at the 2nd or 6th hours after HSG, and also between the 2nd and 6th hours after HSG (p > 0.05).

CONCLUSION

We have not found any reports up to date about the levels of serum CA-125 after HSG. In our study we did not detect any increase in levels of serum CA-125 at the 2nd and 6th hours after HSG in spite of peritoneal irritation. We propose that this finding is because leakage of radioopaque material to the abdominal cavity is minimal during the HSG procedure.

Proliferation of ovarian theca-interstitial cells is modulated by antioxidants and oxidative stress

BACKGROUND

Maintenance of ovarian homeostasis requires precise regulation of proliferation of thecal- interstitial (T-I) cells. Recent evidence indicates that oxidative stress and antioxidants modulate proliferation of various tissues under both physiological and pathological conditions. This study evaluated the effects of oxidative stress and antioxidants on T-I proliferation.

METHODS

Rat T-I cells were cultured in serum-free medium and proliferation was assessed by determination of DNA synthesis using the thymidine incorporation assay, by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and by direct counting of steroidogenically active cells and steroidogenically inactive cells.

RESULTS

Antioxidants and reactive oxygen scavengers induced a dose-dependent decrease of T-I proliferation. Vitamin E succinate was inhibitory at 10-100 micro mol/l, ebselen was inhibitory at 0.3-30 micro mol/l, and superoxide dismutase was inhibitory at 300-1000 IU/ml. In contrast, oxidative stress resulted in a biphasic effect. Modest oxidative stress induced by 1 mmol/l hypoxanthine and xanthine oxidase (3-30 micro U/ml) stimulated proliferation of T-I cells, while greater oxidative stress induced by xanthine oxidase (1 mU/ml) profoundly inhibited proliferation. Direct cell counting demonstrated comparable effects on steroidogenically active and inactive cells.

CONCLUSIONS

Reactive oxygen species may play a role in the regulation of growth of ovarian mesenchyme. Under pathological conditions, such as those encountered in polycystic ovary syndrome, excessive oxidative stress and depletion of antioxidants may contribute to ovarian mesenchymal hyperplasia.

Postoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+fentanyl combination

PURPOSE

The aim of this study was to compare the effects of IV tramadol, IV fentanyl, epidural tramadol, and an epidural ropivacaine+fentanyl combination in patient-controlled analgesia (PCA) after lower abdominal surgery.

METHODS

Eighty adult patients undergoing lower abdominal surgery were randomly allocated to one of four groups to receive analgesics with PCA pumps. Patients in group I received IV tramadol, group II patients IV fentanyl, group III patients epidural tramadol, and group IV patients an epidural infusion of 0.125% ropivacaine + 2 microg ml(-1) fentanyl combination. Analgesic effectiveness and side-effects were assessed at 1, 2, 3, 4, 5, 6, 8, 12, 16, 20, and 24 hours after surgery.

RESULTS

Adequate analgesia was achieved in all groups. The analgesia was highest in group IV (p < 0.05), and lowest in group III patients (p < 0.05). Eleven patients (55%) in group I and eight patients (40%) in group II suffered from nausea/vomiting.

CONCLUSION

Although adequate pain relief was achieved with all regimens that were used in the study, intravenous tramadol and intravenous fentanyl are associated with a high incidence of nausea and vomiting.

Left anterior descending coronary artery occlusion after left lateral free wall accessory pathway ablation: what is the possible mechanism?

We describe a complication after radiofrequency (RF) ablation of a left free wall accessory pathway that resulted in acute occlusion of proximal left anterior descending (LAD) coronary artery in a 32-year-old male non-cocaine abuser. An interesting feature is the site of coronary artery occlusion which is remote from the RF application site. The RF energy applications were performed in the left lateral annulus remote from the LAD. The occlusion was successfully treated with placement of an intracoronary stent.

The effects of add-back therapy with tibolone on myoma uteri

In this prospective, randomized, double-blind study, we evaluated the effects of tibolone therapy in association with preoperative gonadotropin releasing hormone agonist (GnRHa) therapy on the reduction of myoma volume. Twenty patients with myoma uteri were divided into two groups. Group I was given monthly triptoreline (3.75 mg every 28 days IM) treatment for six months. As for group II, tibolone was added on to this treatment. For all of the patients, physical examinations, pelvic ultrasonography, and hormone analyses were carried out and the myoma volume was measured by ultrasonography. The patients were called every month and physical examination, ultrasonography and hormone analyses were repeated. Side-effects were recorded. The SPSS/PC 6.0 program was used for statistical analysis. Statistical significance was defined as a p < 0.05. The results are expressed as means +/- SD. While the average volume of myoma was 72.97 +/- 68.5 cm3 in group I, 78.83 +/- 74.1 cm3 in group II before treatment; it was reduced to 29.91 +/- 27.8 cm3 in group I at the end of six months of treatment. Reductions of 59.6% in group I and 63.9% in group II were determined, however the difference was not statistically significant (p > 0.05). At the beginning the level of serum estradiol was 65.4 +/- 22.3 pg/ml in group I which decreased to 37.2 +/- 4.2 pg/ml by the end of the first month. Amenorrhea occurred in six patients after the second injection and four patients after the third injection in group I. Whereas the level of estradiol was 60.9 +/- 19.5 pg/ml in group II at the beginning, it was reduced to 40.5 +/- 6.2 pg/ml by the end of the first month. Amenorrhea occurred in four patients after the second injection and four patients after the third injection in group II. In group I the patients had the problem of flushing (80%), vaginal dryness (50%), and night sweats (30%). In group II these rates were 30%, 20%, and 20%, respectively. Triptoreline is a GnRHa which has been found to be effective in reducing myoma volume, but this effect could not be deactivated with tibolone. However, a decrease was observed in the side-effects resulting from hypoestrogenism.

A ruptured ovarian endometrioma mimicking ovarian malignancy: case report

A 24-year-old single woman was referred to our department due to intermittent abdominal pain. Because her serum CA 125 concentration was extremely elevated an ovarian malignancy was suspected. At the laparoscopic examination, it was determined to be a ruptured endometrioma and serum CA 125 concentrations rapidly decreased after surgery.

Simple sequence repeat (SSR) markers linked to the Ligon lintless (Li(1)) mutant in cotton

Ligon lintless (Li(1)) is a monogenic, dominant mutant in cotton, whose expression results in extreme reductions in fiber length on mature seed. The objectives of this research were to compare fiber initiation between the Li(1) mutant and TM-1 to reveal the fiber initiation differences between normal and mutant phenotypes, to develop a linkage map of simple sequence repeat (SSR) markers with the Li(1) locus, and to identify the chromosomal location of the Li(1) locus. Comparative scanning electron microscopy studies of fiber development in a normal TM-1 genotype and the near-isogenic Li(1) mutant at 1 and 3 days postanthesis revealed little differences between the two during early stages of development, suggesting that Li(1) gene expression occurs later, probably during the elongation phase. Thirty-eight SSR loci were found to be polymorphic between TM-1 and Li(1) and were used for mapping in an F(2) population. Twenty-two SSR loci, along with Li(1), were located on eight linkage groups, covering a total genetic distance of 218.3 cM. Analysis of individual monosomic and monotelodisomic plants indicated that two SSR loci (MP4030 and MP673) from the Li(1) linkage group were located on chromosome 22.

HOXA10 expression is repressed by progesterone in the myometrium: differential tissue-specific regulation of HOX gene expression in the reproductive tract

HOX genes are essential regulators of development in all multicellular organisms, including humans. We have previously shown that HOXA10 is expressed in the developing uterus and later in the adult human endometrium. HOX genes regulate endometrial development in response to sex steroids. Here, we demonstrate that HOXA10 is expressed in the myometrium as well. In situ hybridization reveals abundant HOXA10 expression, and Northern analysis demonstrates differential HOX gene expression in the myometrium throughout the menstrual cycle. HOXA10 expression decreases in the midsecretory phase, coinciding with high serum progesterone levels. Treatment of primary myometrial cell cultures with progesterone decreases HOXA10 expression in vitro-paralleling the expression seen in vivo. Despite the presence of progesterone receptors in the endometrium and myometrium, HOXA10 is differentially regulated in each tissue by progesterone. HOXA10 expression is induced in the stroma and decreased in the myometrium by progesterone. The differential tissue-specific response of this gene in response to progesterone is likely mediated by sex steroid receptor coactivators or corepressors. Decreased myometrial expression of developmental regulatory genes such as HOXA10 in the nonpregnant uterus may dedifferentiate the myometrium and allow growth in preparation for pregnancy.

Genetic line and major histocompatibility complex effects on primary and secondary antibody responses to T-dependent and T-independent antigens

The effects of MHC and nonMHC (background) genetics on the kinetics of primary and secondary antibody responses to T-cell-dependent (SRBC) and T-cell-independent [Brucella abortus (BA)] antigens were investigated. Eight genetic groups were represented, with four homozygous MHC haplotypes [B1-IrGATlow (IrGAT = immune response to GAT locus); B1-IrGAThigh; B19-Ir-GATlow; B19-IrGAThigh] on two genetic backgrounds, the S1 and G lines. Birds were injected simultaneously with BA and SRBC at 4 and 7 wk of age, and blood samples were taken weekly from 4 to 10 wk of age for measurement of total agglutinating serum antibody levels. A quadratic equation and its first derivative were computed for each bird to approximate individual curve parameters: y max, the maximum titer; t max, the time required to achieve y max; and c coefficient, the rate of decline in the titer. Curve parameters of birds from different lines were analyzed separately by using the General Linear Model procedure. A second analysis that included line effect evaluated the nonMHC gene effects and their interactions with erythrocyte antigen B locus (Ea-B) or IrGAT. In the S1 line, there was an interaction (P < 0.05) between MHC haplotypes and sex for primary response to BA. In contrast, there were no significant main effects nor interactions in the G line background for primary and secondary responses to BA and SRBC. There was an effect (P < 0.05) of line background on y max for primary BA and for secondary SRBC responses. A positive correlation (P < 0.05) was found between the c coefficients of BA and SRBC secondary responses, suggesting that the rate of decline in the secondary response is similar between these T-dependent and T-independent responses. The overall results of this study indicate complex interactions between specific MHC alleles and the nonMHC background of the lines in which they are studied.

Dimethly sulphoxide lowers ICP after closed head trauma

Ten patients with closed head trauma and elevated intracranial pressure (ICP) ranging from 40-127 mm Hg were treated with intravenous dimethyl sulphoxide (DMSO) every 6 h for 1-10 days. Four patients received DMSO and intermittent oxygen. All patients showed a reduction of ICP after 24 h and 7 had normal ICP after 6 days of treatment. Two patients died of their injuries. Neurological assessment at the time of discharge showed 2 patients with severe neurological deficits and 6 patients with mild to no deficit. After a 3 month follow-up, 1 patient remained severely impaired and 7 patients showed mild to no deficit. It appears that intravenous DMSO can rapidly reduce elevated ICP in severe closed-head injury and that it improves neurological outcome.

Laser or razor? A novel experimental peripheral nerve repair technique

An operative repair technique for crushed sciatic nerve in the rat was used to examine whether removal of the damaged tissue could be better achieved with a low wattage CO2 laser or a blade. This approach was compared to results in rats undergoing conventional end-to-end nerve anastomosis using a microsurgical approach. Crushed sciatic nerves were exposed bilaterally 24 hours after injury and treated as follows. A longitudinally split polyethylene catheter was placed under the nerve, which was fixed to the catheter with 9-0 stitches placed away from lesion area; the nerve was bathed in ice-cold polyvinyl alcohol/chlorpromazine (PVA/CPZ) solution. After the nerve was crushed, the lesioned tissue was removed using laser pulses or a thin blade. A collagen matrix was used to fill the gap, and the preparation was covered and allowed to recover for 6 weeks. End-to-end anastomosis was done following same parameters, but with omission of the nerve catheter, PVA/CPZ solution, and collagen matrix; these nerves were reunited using epineurial stitches. High performance liquid chromotography (HPLC) analysis of each group showed that the laser approach reduced the levels of norepinephrine distal to the lesion, least, suggesting better regeneration of proximal axonal growth. Morphological and neuroelectric findings, although suggestive, showed no significant differences between laser and blade repair, a finding that reinforces the idea that such endpoints are not as sensitive as chemical assays of tissue transmitter levels such as HPLC. Laser or blade repair using nerve-catheter fixation and collagen bridge matrix was superior to end-to-end nerve anastomosis when morphological, neuroelectric, and HPLC values were compared in this model.(ABSTRACT TRUNCATED AT 250 WORDS)