The Effect of Immersive Virtual Reality Application on Anxiety, Pain, and Parental Satisfaction in the Perioperative Process of Children: A Randomized Controlled Trial.

PURPOSE: To determine the effects of virtual reality (VR) interventions on pre- and postoperative anxiety, pain, and parental satisfaction in children. DESIGN: A randomized controlled trial. METHODS: Children undergoing surgery for the first time and their families were randomly assigned to the control or VR group. The control group received conventional education regarding the perioperative process. The VR group watched a VR video illustrating the operating theater and explaining the perioperative process. The primary outcome of interest was preoperative anxiety, evaluated using the Children's State Anxiety Scale. Secondary outcomes of interest included postoperative pain ratings using the Wong-Baker Faces Pain Rating Scale and parental satisfaction scores using the PedsQL Health Care Satisfaction Scale. RESULTS: The analysis included 70 children and their families (control = 35, VR = 35). Demographic characteristics were similar between the groups. Children in the VR group had significantly lower preoperative anxiety scores (p < .001) and postoperative anxiety scores (p = .010) compared to the control group. Parental satisfaction scores were significantly higher in the VR group (p < .001). The VR group had lower postoperative pain scores, but this difference was not statistically significant (p > .05). CONCLUSIONS: Preoperative education using VR tours may reduce preoperative anxiety and increase parental satisfaction. However, the lack of baseline measurements limits our ability to definitively attribute these effects to the VR intervention. Despite this, VR is a promising nonpharmacological strategy for managing children's anxiety and increasing parental satisfaction. CLINICAL IMPLICATIONS: Virtual reality interventions offer an effective nonpharmacological strategy for perioperatively managing children's anxiety and increasing parental satisfaction.

Evaluation of moral intelligence of healthcare professionals via the "Survey for Measuring Moral Intelligence in the Provision of Healthcare Services" / Evaluación de la inteligencia moral de profesionales de la salud a través de la "Encuesta para medir la inteligencia moral en la prestación de servicios de salud" / Avaliação da inteligência moral de professionais de saúde via "Levantamento para Medir a Inteligência Moral na Provisão de Serviços de Cuidados à Saúde"

Abstract: Moral intelligence -through which an individual makes mental evaluation before taking action about a decision- is important in individual-centered healthcare. Using Lawshe Method, we designed the "Survey for Measuring Moral Intelligence in the Provision of Healthcare Services" with "equality", "empathy", "moral intelligence", "justice", "tolerance", "self-control", and "politeness" dimensions (α=.966). Age of the population (physicians and nurses) was 36.44±9.52, consisting 517 (65.5%) women, 538 married participants, 653 employed in public hospitals, and 352 had work experience of 8 hours/day. Using dimensions of this survey as skills is expected to ensure due diligence about rights and dignity in healthcare services.

Resumen: La inteligencia moral, mediante la cual un individuo realiza una evaluación mental antes de tomar medidas sobre una decisión, es importante en la atención médica centrada en el individuo. Usando el método Lawshe, diseñamos la "Encuesta para medir la inteligencia moral en la provisión de servicios de salud" con dimensiones de "igualdad", "empatía", "inteligencia moral", "justicia", "tolerancia", "autocontrol" y "cortesía" (α=.966). La edad de la población (médicos y enfermeras) era de 36.44±9.52, que consistía en 517 (65,5%) mujeres, 538 participantes casados, 653 empleados en hospitales públicos y 352 tenían una experiencia laboral de 8 horas/día. Se espera que el uso de las dimensiones de esta encuesta como habilidades garantice la debida diligencia sobre los derechos y la dignidad en los servicios de atención médica.

Resumo: Inteligência moral -através da qual um individuo faz uma avaliação mental antes de agir frente a uma decisão- é importante em cuidados à saúde centrados na pessoa. Usando o Método Lawshe, nós elaboramos o "Levantamento para Medir a Inteligência Moral na Provisão de Serviços de Cuidados à Saúde" com as dimensões "igualdade", "empatia", "inteligência moral", "justiça", "tolerância", "autocontrole" e "polidez (α=.966). A idade da população (médicos e enfermeiras) foi 36.44±9.52 anos, consistindo de 517 (65.5%) mulheres, 538 participantes casados, 653 empregados em hospitais públicos e 352 tinham experiência de trabalho 8 horas/dia. Usando dimensões deste levantamento como habilidades, espera-se que garanta a devida presteza sobre direitos e dignidade em serviços de cuidados à saúde.

New concept in clinical care: proposal of a moral intelligence scale / Nuevo concepto en atención clínica: propuesta de una escala de inteligencia moral / Novo conceito em atenção clínica: proposta de uma escala de inteligência moral

Abstract: Effective communication, especially of those health professionals in management positions, contributes to the entire process of treating patients and can transform the quality of service into the processes of diagnosis, treatment and care. Managers with moral intelligence are able to distinguish right from wrong and can facilitate the relationship between health professionals and patients. The purpose of this study is to develop a scale to measure moral intelligence. The measurement tool created by the Lawshe method was applied to 789 health professionals. Following the calculations of the Content Validity Ratio and the Content Validity Index, the scale included 77 items. After applying it, with the subsequent exploratory and confirmatory factor analysis, the scale received its final form with 47 items. The Cα value of the scale is 0.966. The scale has seven dimensions, and they have been defined as "equality", "empathy", "moral intelligence", "justice", "tolerance", "self-control" and "kindness". The Cα values for these dimensions are determined respectively as 0.922, 0.910, 0.874, 0.859, 0.799, 0.840 and 0.772; demonstrating that the scale allows to study the moral intelligence of nurses and doctors. The scale developed had high Cronbach alpha values for each component and element, indicating that the scale provides a survey with high validity to measure the moral intelligence of doctors and nurses. Factor analysis shows a statistically valid distribution of items and components. Taking into account the moral intelligence parameters in the provision of health services will contribute to accurately diagnose disorders, reduce patient anxiety, ensure a shorter hospital stay, reduce the number of patients transferred to other health centers, to prevent negligence, save time and achieve better workforce planning.

Resumen: La comunicación efectiva, especialmente de aquellos profesionales de la salud en puestos directivos, contribuye a todo el proceso de tratamiento de los pacientes y puede transformar la calidad del servicio en los procesos de diagnóstico, tratamiento y atención. Los gerentes con inteligencia moral son capaces de distinguir lo correcto de lo incorrecto y pueden facilitar la relación entre los profesionales de la salud y los pacientes. El propósito de este estudio es desarrollar una escala para medir la inteligencia moral. La herramienta de medición creada por el método Lawshe se aplicó a 789 profesionales de la salud. Siguiendo los cálculos de la Relación de Validez del Contenido y el Índice de Validez del Contenido, la escala incluyó 77 ítems. Después de aplicarlo, con el posterior análisis factorial exploratorio y confirmatorio, la escala recibió su forma final con 47 ítems. El valor Cα de la escala es 0,966. La escala tiene siete dimensiones, y se han definido como "igualdad", "empatía", "inteligencia moral", "justicia", "tolerancia", "autocontrol" y "amabilidad". Los valores de Cα para estas dimensiones se determinan respectivamente como 0.922, 0.910, 0.874, 0.859, 0.799, 0.840 y 0.772; demostrando que la escala permite estudiar la inteligencia moral de enfermeras y médicos. La escala desarrollada tenía altos valores alfa de Cronbach para cada componente y elemento, lo que indica que la escala proporciona una encuesta con alta validez para medir la inteligencia moral de médicos y enfermeras. El análisis factorial muestra una distribución estadísticamente válida de ítems y componentes. Tomar en cuenta los parámetros de inteligencia moral en la provisión de servicios de salud contribuirá a diagnosticar trastornos con precisión, reducir la ansiedad de los pacientes, garantizar una estadía más corta en el hospital, reducir el número de pacientes transferidos a otros centros de salud, prevenir la negligencia, ahorrar tiempo y lograr una mejor planificación de la fuerza laboral.

Resumo: A comunicação efetiva, especialmente dos profissionais da saúde em cargos diretivos, contribui com todo o processo de tratamento dos pacientes e pode transformar a qualidade do serviço nos processos de diagnóstico, tratamento e atenção. Os gerentes com inteligência moral são capazes de distinguir o certo do errado e podem facilitar a relação entre os profissionais da saúde e os pacientes. O propósito deste estudo é desenvolver uma escala para medir a inteligência moral. A ferramenta de mensuração criada pelo Método Lawshe foi aplicada a 789 profissionais da saúde. Seguindo os cálculos da Relação de Validade de Conteúdo e o Índice de Validade de Conteúdo, a escala incluiu 77 itens. Depois de aplica-la, com a análise fatorial exploratória e confirmatória posterior, a escala recebeu sua forma final com 47 itens. O valor C! da escala é 0,966. A escala tem sete dimensões que foram definidas como "igualdade", "empatia", "inteligência moral", "justiça", tolerância", "autocontrole" e "amabilidade". Os valores de C! para estas dimensões foram, respectivamente, determinados como 0,922, 0,910, 0,874, 0,859, 0,799, 0,840 e 0,772, demonstrando que a escala permite estudar a inteligência moral de enfermeiras e médicos. A escala desenvolvida tinha altos valores de alfa de Cronbach para cada componente e elemento, o que indica que proporciona uma pesquisa com alta validade para medir a inteligência moral de médicos e enfermeiras. A análise fatorial mostra uma distribuição estatisticamente válida de itens e componentes. Ter em conta os parâmetros de inteligência moral na provisão de serviços de saúde contribuirá para diagnosticar transtornos com precisão, reduzir a ansiedade dos pacientes, garantir uma permanência mais curta no hospital, reduzir o número de pacientes transferidos para outros centros de saúde, prevenir a negligência, salvar tempo e lograr um melhor planejamento da força de trabalho.

Diffuse large B-cell lymphoma presenting with masses in the pineal and adrenal glands.

Magnetic resonance imaging (MRI) may offer several potential advantages in the evaluation of lymphoma with the additive value of H1-MRS for differential diagnosis. Even though lymphoma has unique imaging findings on CT and multiparametric MRI, definite diagnosis must be thoroughly established by histopathological examination.

Carvacrol attenuates histopathogic and functional impairments induced by bilateral renal ischemia/reperfusion in rats.

BACKGROUND: Renal ischemia/reperfusion injury is the most common cause of acute kidney injury, which frequent occurrence in critically ill patients. OBJECTIVES: The aim of this study was to investigate the role of Carvacrol (CARV) against bilateral ischemia reperfusion (I/R) in rats. METHODS: Renal I/R injury were induced by clamping of the left and right renal arteries for 45 min followed by 24 h of reperfusion. Thirty male Sprague-Dawley rats were randomly allocated to three groups (n = 10): the sham-control group, the renal I/R-untreated (I/R-untreated) group, and the I/R-CARV-treated group. At 2 h before reperfusion, the rats in the I/R- CARV -treated group rats received an i.p. injection of 75 mg/kg CARV. Renal function and histological changes were compared and the relevant parameters of oxidative stress and inflammation were detected. RESULTS: Compared to the sham-control group, I/R led to renal dysfunction as evidenced by higher plasma urea and creatinine along with increase in oxidative stress and histological changes in renal tissues. Treatment with CARV decreased urea, creatinine, and renal MDA and MPO levels, and increased SOD, CAT, GSH activity and eNOS expression in the kidney. In the I/R-CARV-treated group, minimal hydropic changes in the tubular epithelial cells and regeneration of tubular epithelium were observed. CONCLUSION: These results suggest that CARV treatment could reduce renal injury induced by bilateral renal I/R via anti-inflammatory, antioxidant and cytoprotective effects.

A rare malformation of the alimentary tract, tailgut cyst : a case report.

Tailgut cyst (cystic hamartoma) is a rare congenital pathology that arises -from post-natal primitive gut remnants in the retrorectal-presacral space. Because of the rarity of the lesion and the variability of the anatomical position, its diagnosis and surgical treatment are often difficult. Complete surgical excision of the multilocular and multicystic process prevents recurrent draining sinuses and eliminates the possibility of malignant change. We describe a case in which a tailgut cyst localized in the retrorectal and presacral space was characterized by abscess, repeated urinary tract infection, and rectal pain.

A case of laryngeal leiomyosarcoma and review of the literature.

Leiomyosarcoma (LMS) of the larynx is a very rare malignancy that originates from blood vessel, smooth muscle or from the heterotopic mesenchymal tissue in the larynx. The histological diagnosis of LMS depends on the immunohistochemical investigation. The case is here presented of an 82-year-old man with shortness of breath and hoarseness. Indirect laryngoscopy showed a pedunculated large glottic lesion causing airway obstruction. Direct laryngoscopy was performed and biopsies were taken. From the pathological examination, the diagnosis of LMS was made. This case is presented of laryngeal LMS with the clinical, radiological, and histological findings.

The polypeptide transport-associated (POTRA) domains of TpsB transporters determine the system specificity of two-partner secretion systems.

The two-partner secretion (TPS) systems of Gram-negative bacteria secrete large TpsA exoproteins by a dedicated TpsB transporter in the outer membrane. TpsBs contain an N-terminal module located in the periplasm that includes two polypeptide transport-associated (POTRA) domains. These are thought to initiate secretion of a TpsA by binding its N-terminal secretion signal, called the TPS domain. Neisseria meningitidis encodes up to five TpsA proteins that are secreted via only two TpsB transporters: TpsB1 and TpsB2. Of these two, the TpsB2 recognizes the TPS domains of all TpsAs, despite their sequence diversity. By contrast, the TpsB1 shows a limited recognition of a TPS domain that is shared by two TpsAs. The difference in substrate specificity of the TpsBs enabled us to investigate the role of the POTRA domains in the selection of TPS domains. We tested secretion of TPS domains or full-length TpsAs by TpsB mutants with deleted, duplicated, and exchanged POTRA domains. Exchanging the two POTRA domains of a TpsB resulted in a switch in specificity. Furthermore, exchanging a single POTRA domain showed that each of the two domains contributed to the cargo selection. Remarkably, the order of the POTRA domains could be reversed without affecting substrate selection, but this aberrant order did result in an alternatively processed secretion product. Our results suggest that secretion of a TpsA is initiated by engaging both POTRA domains of a TpsB transporter and that these select the cognate TpsAs for secretion.

Carbon dioxide insufflation causes upper urinary tract injury in the early period of an experimental vesicoureteral reflux model.

PURPOSE: Ureteral reimplantation via pneumovesicum is a new aspect of vesicoureteral reflux management. We aimed to determine the effects of carbon dioxide (CO2) insufflation on the upper urinary tract in an experimental model. MATERIALS AND METHODS: Thirty New Zealand rabbits were allocated into five groups of six rabbits each. Right ureters were cannulated for CO2 insufflation in four groups. The pressures and durations of CO2 insufflation in the respective groups were as follows: Group A (10 mm Hg, 2 h); B (12 mm Hg, 2 h); C (10 mm Hg, 4 h); and D (12 mm Hg, 4 h) and control (E). Blood gas analysis, urea and creatinine levels were measured from renal veins and aorta. Histopathological evaluation of the renal parenchyma and ureters was scored. RESULTS: Significant histopathological changes were detected in the ipsilateral ureter and renal parenchyma exposed to CO2 insufflation, predominantly observed in groups insufflated for longer durations, p < 0.05. Blood gases drawn separately from renal veins were significantly more acidotic, and serum urea and creatinine levels were increased in all the groups, p < 0.05. CONCLUSIONS: CO2 causes significant histopathological and biochemical changes in the early period. Long-term results are required to determine whether permanent renal injury occurs.

Lithospermic acid and ischemia/reperfusion injury of the rat small intestine prevention.

BACKGROUND: Intestinal ischemia and reperfusion (I-R) injury of different causes, including cardiac insufficiency, sepsis, vasodepressant and cardiodepressant drugs, and complications of long-lasting surgery, represents a major clinical problem. OBJECTIVES: The purpose of the present study was to investigate whether lithospermic acid (LA) can reduce oxidative stress and histological damage in the rat small bowel subjected to mesenteric I-R injury. MATERIAL AND METHODS: The study was performed on three groups of animals, each composed of 7 rats: the SO (sham operation) group, the I-R/Untreated group and the I-R/LA (I-R plus LA pretreatment) group. Intestinal ischemia for 45 minutes and reperfusion for 60 minutes were applied. Ileum specimens were obtained to determine the tissue level of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and myeloperoxidase (MPO) activities and histological changes. RESULTS: Untreated intestinal I-R resulted in increased tissue MDA and MPO levels and diminished SOD and GPx activities. These changes were found to be almost reversed in the LA treatment group. Histopathologically, the intestinal injury in rats treated with LA was less than the untreated I-R group. CONCLUSIONS: Lithospermic acid attenuates mesenteric ischemia reperfusion injury in rat intestines by increasing tissue SOD and GPx activities and decreasing MDA and MPO levels. Lithospermic acid also improves morphological alterations which occurred after periods of reperfusion.

Effect of sirolimus on renal injury induced by bile duct ligation in rats / Efeito do sirolimo na lesão renal induzida pela ligadura do ducto biliar em ratos

PURPOSE: To evaluate the effects of sirolimus (SRL) on renal injury in rats with bile duct ligation. METHODS: A total of 21 male Sprague-Dawley rats weighing 220-260g were used. Group 1 (Sham-control, n=7) rats were undergone laparotomy alone and bile duct was just dissected from the surrounding tissue. Group 2 rats (BDL/Untreated, n=7) were subjected to bile duct ligation and no drug was applied. Group 3 rats (BDL/SRL, n =7) received a daily dose of sirolimus (0.5 mg·day-1xkg-1 dissolved 1 ml in saline) by orogastric tube for 14 days after BDL. At the end of the two-week period, biochemical and histological evaluation were processed. RESULTS: AST, ALT, AP and TB levels values were decreased in group 3 when compared to group 2. There was no significant difference in serum levels of BUN and creatinine among all the experimental groups. Histological evaluation of the liver of BDL/Untreated group rats demonstrated marked portal fibrosis and signs of major bile duct obstruction with prominent portal and lobular inflammation. In BDL/SRL group, moderate damage was seen. Tubular injury scores were higher in the BDL subgroups; however, group 3 rats showed considerably fewer lesions in the tubules and interstitium compared to the group 2 rats. In group 2 animals, in the epithelial cells of proximal tubules presented vacuoles and hydropic changes, atrophy and inflammatory cell infiltrate in the medullar interstitium. CONCLUSIONS: Sirolimus decreased tubulointerstitial lesions in kidney induced by bile duct ligation in rats. The improve effects of sirolimus on renal morphology can be due to improved liver function or due to direct action on the kidney.

OBJETIVO: Investigar os efeitos do sirolimo (SRL) na lesão renal induzida pela ligadura do ducto biliar em ratos. MÉTODOS: Foram utilizados 21 ratos Sprague-Dawley pesando entre 220-260 g. Grupo 1 (Sham-controle, n=7) submetidos a laparotomia e o ducto biliar dissecado do tecido circundante. Grupo 2 (BDL/Não tratado, n=7) foram submetidos a ligadura do ducto biliar e nenhuma droga foi aplicada. Grupo 3 (BDL/SRL, n=7) receberam dose diária de sirolimo (0,5 mg dia-1xkg-1 dissolvido em 1 ml em solução salina) por tubo orogástrico por 14 dias após BDL. Após duas semanas era realizada avaliação bioquímica e histológica. RESULTADOS: Níveis de AST, ALT, AP e TB estavam diminuídos no grupo 3 comparado ao grupo 2. Não houve diferença significante nos níveis séricos de BUN e creatinina em todos os grupos. Observou-se na avaliação histológica evidente fibrose portal e sinais de obstrução do ducto biliar com evidente inflamação portal e lobular. No grupo BDL/SRL verificou-se dano moderado. Lesão tubular foi maior nos subgrupos BDL; entretanto, o grupo 3 mostrou considerável menos lesões nos túbulos e interstício comparados ao grupo 2. No grupo 2 as células epiteliais dos túbulos proximais apresentaram vacúolos e alterações hidrópicas, atrofia e infiltrado celular inflamatório no interstício medular. CONCLUSÕES: Sirolimo diminuiu lesões tubulointersticial no rim induzida pela ligadura do ducto biliar em ratos. Os efeitos benéficos do sirolimo na morfologia renal pode ser devida à melhora da função hepática ou devido à ação direta no rim.

Iloprost, a prostacyclin (PGI2) analogue, reduces liver injury in hepatic ischemiareperfusion in rats / Iloprost, um análogo da prostaciclina (PGI2), reduz danos da isquemia/reperfusão hepática em ratos

PURPOSE: To evaluate the effects of iloprost a prostacyclin analogue on the hepatic IR injury in rats. METHODS: Forty male Sprague-Dawley rats (250-300 g) were divided into four groups each containing 10 rats;(1)- controls: data from unmanipulated animals; (2) sham group: rats subjected to the surgical procedure, except for liver I/R, and given saline; (3) I/R group: rats that underwent liver ischemia for 45 min followed by reperfusion for 45 min; (4) IR/ Iloprost group: rats pretreated with iloprost (10 µg kg-1, i.v). Liver tissues were taken to determine SOD, CAT, GSH, and MDA levels and for biochemical and histological evaluation. RESULTS: The plasma ALT and AST levels were increased in group 3 than in group 4. MDA values and the liver injury score decreased, while the SOD, CAT, and GSH values increased in group 4 compared to group 3. In group 3, hepatocytes were swollen with marked vacuolization. In group 4, there were regular sinusoidal structures with normal morphology without any signs of congestion. CONCLUSION: We demonstrated hepatoprotective effects of iloprost against severe ischemia and reperfusion injury in rat liver.

OBJETIVO: Avaliar os efeitos do iloprost, um análogo da prostaciclina nos danos causados ao fígado de ratos pela lesão de IR. MÉTODOS: Quarenta ratos machos Sprague-Dawley (250-300 g) foram distribuídos em quatro grupos de dez; - (1) grupo de controle: dados de animais não manipulados; (2) grupo "sham": ratos que sofreram intervenção cirúrgica sem I/R, aos quais foram administrados solução salina; (3) grupo I/R; animais que foram submetidos à isquemia por 45 minutos seguida de reperfusão por 45 minutos; (4) grupo I R/Iloprost: ratos previamente tratados com Iloprost ( 10µ kg-1, i.v). Tecidos hepáticos foram retirados para determinar os níveis de SOD, CAT, GSH, e MDA e para avaliação bioquímica e histológica. RESULTADOS: Os níveis de plasma ALT e AST aumentaram no grupo 3 mais do que no grupo 4. Os valores de MDA e o índice de lesões hepáticas diminuíram, enquanto os valores de SOD, CAT e GSH aumentaram no grupo 4, em comparação com o grupo3. No grupo 3, os hepatócitos se apresentaram edemaciados, e vacuolizados. No grupo 4, havia estruturas sinusoidais regulares, apresentando morfologia normal, sem sinais de congestão. CONCLUSÃO: Demonstramos os efeitos hepato-protetores do Iloprost contra a isquemia grave e o dano de reperfusão no fígado de ratos.

[Biliary ascaris-induced obstructive jaundice: a case of acute abdomen]. / Biliyer askariazisin neden oldugu tikanma ikteri: Bir akut karin olgusu.

Ascaris lumbricoides is one of the most common helminthic diseases worldwide and it can cause various complications. The presence of this worm in the biliary tree, however, is a rare condition, especially in children. We describe a child with biliary ascariasis who was presenting clinical symptoms mimicking surgical acute abdomen. The diagnosis was made by ultrasound. The child was successfully treated with mebendazole and anti-spasmolytic. Biliary ascariasis should be added to the differential diagnosis of acute abdominal pain in patients, even in children, from endemic areas.

The effects of N-acetylcysteine and vitamin C on liver and pulmonary tissue damage in rats following bile duct ligation.

OBJECTIVE: To evaluate the effects of N-acetylcysteine NAC and vitamin C on pulmonary histological alterations in bile duct-ligated (BDL) rats. METHODS: The current study was conducted in the Department of Pediatric Surgery, Medical School of Abant Izzet Baysal University, Bolu, Turkey between May 2007 and July 2007. Thirty-five males Sprague-Dawley rats, weighing 210-240 grams, were used. Group 1 rats (n=7) underwent only laparotomy. Group 2 rats (n=7) were subjected to BDL. Group 3 rats (n=7) were subjected to BDL and given vitamin C. Group 4 rats (n=7) were subjected to BDL and given NAC. Group 5 rats (n=7) were subjected to BDL and received NAC plus vitamin C. At the end of the 3 week period, biochemical and histological evaluations were processed. RESULTS: Total bilirubin values were decreased in group 5 compared to group 2, 3, and 4. Group 2 showed massive interstitial infiltration with inflammatory cells. Interstitial edema, focal cuboidal metaplasias of alveolar lining cells, and severely damaged pulmonary architecture were noted. Treatment of rats with NAC and vitamin C produced a significant reduction in the histopathological score compared to groups 2, 3, and 4. CONCLUSION: The combination of NAC and vitamin C reduced lung histological alterations in BDL rats with afforded by each drug individually.

The prognostic importance of serum IL-1beta, IL-6, IL-8 and TNF-alpha levels compared to trauma scoring systems for early mortality in children with blunt trauma.

The purpose of the present study was to determine whether a correlation exits between the main trauma scoring systems and the activation of inflammatory cells and mediators such as interleukin-(IL-) 1beta, IL-6, IL-8 and tumor necrosis factor alpha (TNF-alpha) after trauma, and moreover to assess if any of these can be used to predict the outcome in patients under care at a trauma center. Forty-seven children (37 boys, 10 girls) presenting with blunt trauma, were evaluated by an analysis of the relationship between overall mortality and potential risk factors. Admission data, including serum IL-1beta, IL-6, IL-8, TNF-alpha, pediatric trauma score (PTS), and injury severity score (ISS), were collected and analyzed. In descriptive statistics for independent variables, some prognostic factors such as IL-8 (P = 0.04), and ISS (P = 0.004) were significant in their relationship to mortality. In the univariate statistical analysis some other risk factors such as IL-8 (P = 0.004), >20 TNF-alpha (P = 0.04), and ISS (P = 0.007) were significant in their relationship to mortality. The relative risk of developing mortality was higher than two for each of the following risk factors: >10 ages, >25 IL-6, 10-20 TNF-alpha, >20 TNF-alpha, PTS 15. There was a positive correlation between IL-8 (r = 0.31, P = 0.33), ISS (r = 0.31, P = 0.0001), and mortality. There was also a correlation with ISS and IL-8 (r = 0.32, P = 0.02). ISS, and the serum IL-8 level are the most important determinants of clinical outcome in critically injured patients. A correlation exits between IL-8 and mortality and between ISS and IL-8.

PERSISTENT Müllerian duct syndrome associated with transverse testicular ectopia: report of two cases.

Persistent Mullerian duct syndrome (PMDS) with transverse testicular ectopia (TTS) is a very rare pathological association, often discovered during repair for inguinal hernia or cryptorchidism. We present 2 cases with PMDS associated with TTS and discuss the diagnosis and management. A hysterectomy was performed, with resection of the underdeveloped fallopian tubes. Both gonads wereplaced into subdartos pouches in each scrotum by the transseptal approach. The diagnosis of PMDS was confirmed postoperatively by genetic and hormonal investigations. Chromosome analysis revealed 46,XY. Pathological findings demonstrated the immature testes and the immature uterus.

A comprehensive analysis of 51 neonates with congenital intestinal atresia.

OBJECTIVE: To determine contemporary patterns of presentation and trends in the management and outcome of 51 newborn infants with intestinal atresia. METHODS: We retrospectively reviewed 51 cases of intestinal atresia between January 1983 and February 2003. Clinical data included antenatal history, age, gender, weight, presenting symptoms and signs, diagnostic procedures, location and type of atresia, associated abnormalities, surgical treatment, associated problems, morbidity, mortality and plans of treatment. RESULTS: Twenty children had duodenal obstruction, 24 had jejunoileal atresia, and 7 had colonic atresia. Approximately one-fourth of patients associated with duodenal atresia had preterm delivery and all patients with jejunoileal and colonic atresia were full term. Clinical features such as vomiting, abdominal distention, delayed meconium passage and jaundice were more frequent in jejunoileal atresia patients. Other associated organ anomalies particularly Down's syndrome were more frequent in duodenal atresia patients. A duodeno-duodenostomy was preferred in most of the patients with duodenal atresia and annular pancreas; duodenotomy and web excision for those with duodenal webs; and resection with end-to-end anastomosis for those with jejunoileal atresia. In all patients with colonic atresia, colostomy procedure was performed as the first step of surgery. CONCLUSION: Experienced neonatal care and prompt total parenteral nutrition by placing central line during surgery may improve the outcome of such patients.

Assessment of molecular events in squamous and non-squamous cell lung carcinoma.

Although considerable knowledge exists on the tumor biology of lung cancer, there is still a need to assess molecular events for the clinical management of the disease. We studied the pattern of chromosomal imbalances in 45 non-small cell lung carcinomas (NSCLC) by comparative genomic hybridization (CGH) and correlated the results with clinicopathological features including immunohistochemical (IHC) expression of the epidermal growth factor receptor (EGFR). Twenty-one tumors were squamous cell carcinomas (SCC) and 24 non-squamous cell lung carcinomas (NSCC) comprising 9 adenocarcinomas (ADC), 9 large cell carcinomas (LCC), 4 sarcomatoid carcinomas and 2 adenosquamous carcinomas. The mean number of individual imbalances was 7.1 for SCC (mean gains, 3.8; mean losses, 3.4) and 6.4 for NSCC (mean gains, 4.5; mean losses, 1.9). Several individual imbalances correlated significantly with increasing number of imbalances, that were +1q, -3p, +3q, -5q, -8p, +8q, +7p, +12p, and +14q. Altogether, the most frequent imbalances were +3q (49%), +5p (49%), -5q (36%), +8q (29%), -8p (24%), -3p (22%), +7p (22%), +12p (22%), +14q (20%), +18p (20%), +1q (18%), and +7q (18%). Among these, +3q and +18p correlated significantly with SCC, and +5p and +14q with NSCC. Remarkably, overlapping imbalances included +3q26, +7p11 in SCC and +1q21, +3q24, +12p11, and +14q12 in NSCC. EGFR expression was higher in SCC than in NSCC and correlated with +3q in the entire series. In addition, +12p correlated significantly with disease progress with the exception of nodal involvement in NSCC as well as with disease progress, regardless of nodal involvement, in the entire series. In conclusion, the present study contributes to the molecular biological characterization of NSCLC histological subtypes and through evaluation of molecular events to the recently emergent focus on novel markers for lung cancer treatment.