Slight conductive hearing loss in children with narrowed maxilla and deep palatal vault.

UNLABELLED: PROBLEM/OBJECTIVES: Maxillary constriction and high palatal arch are associated with increased risk of chronic eustachian tube dysfunction and conductive hearing loss (CHL) due to chronic effusion. However, this relationship has not been clearly demonstrated. This study assessed CHL in school children with a narrowed maxilla and deep palatal vault. METHODOLOGY: Thirty-two children with maxillary constriction were randomly selected for the study group and 28 children with normal transverse maxillary development were selected for the control group. Pure-tone audiograms were obtained for all children, and hearing levels and air-bone gaps were measured. RESULTS: Air-bone gap measurements in the control group ranged from 5.50 to 14.50 decibels (dB), and in the study group they were between 5.00 and 24.00 dB. In the study group, 14 (43.8%) children had slight CHL, and the remaining 18 (56.2%) children had normal hearing levels. In the control group, all of the children had normal hearing levels. Hearing levels and air-bone gaps were greater in the study group than the control group. CONCLUSION: This study showed that children with a narrowed maxilla and deep palatal vault may have slight CHL. Therefore, the onset of CHL should be followed with hearing screening programs.

Bioremoval of Reactive Blue 220 by Gonium sp. biomass.

Gonium sp. was tested for the bioremoval of Reactive Blue 220 (RB220) dye at different conditions such as pH values, initial dye concentrations and biomass concentrations to evaluate the possibility of using this microalga in treating wastewaters. According to the data obtained from the experiments, microalgae removed RB220 with the highest yield (54.2%) at pH 8, and could treat the applied dye with the highest removal percentage as 84.2% at the lowest dye concentration (26.2 mg/L RB220). Increasing Gonium sp. biomass concentration from 0.21 to 0.53 g/L stimulated RB220 removal rate from 87.7% to 96.8%. The present study clearly indicated that Gonium sp. biomass could be used as a bioremediation biosorbent in treating RB220 dye in the related wastewaters.

Is magnetic resonance imaging or cone beam computed tomography alone adequate for the radiological diagnosis of symptomatic temporomandibular joint osteoarthritis? A retrospective study.

This study was performed to compare the diagnostic accuracy of cone beam computed tomography (CBCT) alone and magnetic resonance imaging (MRI) alone in patients with clinical symptoms of temporomandibular joint osteoarthritis (TMJ-OA). Fifty-two patients (83 joints) with clinical signs of TMJ-OA were included in the study. Two examiners evaluated CBCT and MRI images. McNemar and kappa tests and Spearman's correlation analysis were applied. Radiological findings of TMJ-OA were detected in all 83 joints on CBCT or MRI . Seventy-four joints (89.2%) were positive for degenerative osseous changes on CBCT. MRI findings were positive in 50 joints (60.2%). Osseous changes were found in 22 joints, joint effusion in 30 joints, and disc perforation/degeneration in 11 joints on MRI. CBCT was more sensitive than MRI in detecting condylar erosion (P = 0.001), osteophyte (P = 0.001), and flattening (P = 0.002) and flattening of the articular eminence (P = 0.013) . Poor agreement (κ = -0.21) and weak correlations were found between CBCT and MRI. The study findings suggest that CBCT is superior to MRI in evaluating osseous changes of TMJ-OA, and that CBCT is more sensitive than MRI in detecting condylar erosion, condylar osteophyte, and flattening of the condyle and articular eminence.

Ghrelin and obestatin levels in end-stage renal disease.

Malnutrition is fairly common in end-stage renal disease (ESRD) patients, persistent lack of appetite being a major symptom. Ghrelin and obestatin are two hormones that are involved in appetite and energy homeostasis. The present study examined ghrelin and obestatin levels in 24 ESRD patients undergoing haemodialysis and 24 age-matched healthy controls. Serum and saliva ghrelin and obestatin levels in the ESRD patients were significantly higher compared with controls, while saliva ghrelin and obestatin levels in all study participants were significantly higher than serum levels. Saliva ghrelin correlated with serum ghrelin and saliva obestatin correlated with serum obestatin in all study participants, although there was no correlation between ghrelin and obestatin levels. In conclusion, the results suggest that the kidneys may have a role in the metabolism and/or clearance of obestatin, as they do for ghrelin. Further studies are needed to determine if elevated levels of these hormones in ESRD patients contribute to the malnutrition that is common in these patients.

Malignity-like peritoneal tuberculosis associated with abdominal mass, ascites and elevated serum Ca125 level.

Peritoneal tuberculosis (TB) is similar to ovarian cancers with respect to clinical, radiological laboratory findings. In this report, we present 10 TB cases with malignity pre-diagnosis based on the presence of ascites, pelvic mass, abdominal lymph nodes and elevated Ca125. The mean age of the cases was 29 +/- 14.4 years (18-63). Eight cases were associated with ascites, and the mean adenosine deaminase (ADA) value in ascitic fluid was 130.37 +/- 92.2. All cases had elevated levels of serum Ca125. In 6 cases, we identified lung pathologies based on chest radiography. Diagnoses were made based on diagnostic laparotomy in four cases, laparoscopy in two cases, percutaneous needle biopsy in two cases, and clinical evaluation in two cases. Anti-TB treatments lasted 12 months. Serum Ca125 levels normalised in the 3rd month of treatment. In the differential diagnosis of ascites and high serum Ca125 levels, tuberculosis should be considered in patients from developing countries.

The combination of low-dose levobupivacaine and fentanyl for spinal anaesthesia in ambulatory inguinal herniorrhaphy.

This study investigated whether the addition of 25 microg intrathecal fentanyl to levobupivacaine spinal anaesthesia for outpatient inguinal herniorrhaphy allows a sub-anaesthetic levobupivacaine dose to be used. Forty patients were assigned to receive 5 mg levobupivacaine 0.5% mixed with 25 microg fentanyl (group LF) or 7.5 mg levobupivacaine 0.5% (group L). The highest sensory block levels achieved were T7 (range T5 - T9) and T6 (range T4 - T9) in groups LF and L, respectively. The times to two-segment regression, S2 regression, ambulation, urination and discharge were all significantly shorter in group LF than group L. These results indicate that, for outpatient inguinal herniorrhaphy, intrathecal fentanyl combined with low-dose levobupivacaine provides good quality spinal anaesthesia and minimizes the need for intra-operative analgesia. This protocol is well suited for the outpatient setting because it features rapid recovery of full motor power, sensory function and bladder function.

[One molecule, two faces. Epithelial loss of cell adhesion molecule CEACAM1 activates angiogenesis in bladder and prostate cancer]. / Ein Molekül, zwei Gesichter. Epithelialer Verlust des Zelladhäsionsmoleküls CEACAM1 aktiviert Angiogenese beim Harnblasen- und Prostatakarzinom.

BACKGROUND: Angiogenesis is a prerequisite for tumor growth and metastasis in which CEACAM1 plays an essential role. PATIENTS AND METHODS: The role of CEACAM1 in vascularization and invasion of prostate and bladder cancer was studied. RESULTS: Our analyses demonstrate an epithelial downregulation of CEACAM1 in superficial bladder tumors and in PIN of the prostate. Concurrently, CEACAM1 is upregulated in endothelial cells of tumor blood vessels. CEACAM1 knockdown in tumor cell lines of the prostate and urinary bladder via siRNA results in an increase of tumor vascularization while CEACAM1 overexpression in these cells suppresses it. CONCLUSIONS: CEACAM1-induced signaling mechanisms play a role in induction of angiogenesis in superficial tumors of the prostate and bladder. Strategies to either conserve the epithelial CEACAM1 or to target endothelial CEACAM1 might be useful for an antiangiogenic therapy of bladder and prostate cancer.

Expression of FLT4 and its ligand VEGF-C in acute myeloid leukemia.

FLT4 represents a recently cloned member of class III receptor tyrosine kinases which include receptors for the angiogenic growth factor VEGF, namely FLT1 and KDR. The ligand of FLT4 has been identified as VEGF-C which shares sequence homology with VEGF and P1GF. In the adult FLT4 shows a restricted expression pattern that is limited to lymphatic endothelia and endothelia of some high endothelial venules (HEV). FLT4 has also been detected in some tumor cell lines including the hematopoietic line HEL. We therefore investigated expression of FLT4 and its ligand VEGF-C in fresh samples from patients with AML. Using a sensitive PCR method we detected FLT4 m-RNA in 15 of 41 patients with de novo AML at diagnosis or relapse and in three of 12 patients with secondary AML. FLT4 expression was confirmed by immunocytochemistry in a subgroup of the studied patient population. FLT4 was also found in leukemic cell line U937, but not TF-1 and KG1a. VEGF-C expression was found in leukemic samples of four of seven FLT4-positive and four of six FLT4-negative patients. U937 cells also produced VEGF-C m-RNA. Interestingly, FLT4 expression was not detected in bone marrow samples of 15 normal volunteer donors or in CD34-positive cells from three additional donors. Possible autocrine and paracrine growth stimulation of leukemic blasts by VEGF-C is currently being investigated in our laboratory.

Lipid peroxidation levels in patients with acute brucellosis.

The purpose of this study was to investigate levels of lipid peroxidation, indicated by plasma malondialdehyde (MDA), with consideration of clinical status and treatment outcomes in patients with acute brucellosis. Plasma MDA levels were measured in patients with acute brucellosis and healthy subjects. Significantly higher MDA levels were detected in plasma of patients with acute brucellosis compared to controls (P<0.01). Plasma levels of MDA were significantly decreased after the brucellosis treatment (P<0.01). The results of the present study indicate for the first time that a considerable level of lipid peroxidation is involved in acute brucellosis cases and this may be of importance with respect to the understanding of disease pathogenesis and may serve as a target for treatment regime.

Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA.

Vascular endothelial growth factor and its receptors in normal human testicular tissue.

Expression of vascular endothelial growth factor (VEGF), also known as vascular permeability factor (VPF), and its receptors Flt-1 and KDR (Flk-1 in mouse) and their localization in the human testis were analyzed by means of reverse transcriptase-polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry. VEGF mRNA was detected in the human testicular tissue and in fragments of seminiferous tubules by means of RT-PCR, while fragments of blood vessels isolated from testes were negative. Western blotting procedure using a specific VEGF antibody, revealed two protein bands corresponding to 24 and 49 kDa in the extracts prepared from the whole testis and in the seminiferous tubules while no such bands were found in isolated fragments of human testicular blood vessels. Also immunohistochemically, human testicular blood vessels show no VEGF immunoreactivity, while Leydig cells and Sertoli cells were positive. The mRNA of the VEGF receptor Flt-1 was found to be expressed in human testicular tissue, in isolated fragments of testicular blood vessels and in seminiferous tubules as determined by RT-PCR procedure. In accordance with these results, the Flt-1 protein was immunohistochemically localized in Leydig, Sertoli and perivascular cells. Endothelial cells of certain segments of human testicular microvasculature also stained positive for Flt-1. Expression of VEGF receptor, KDR, could be demonstrated in human testicular tissue, in isolated seminiferous tubules and in isolated fragments of human testicular blood vessels by means of RT-PCR. Immunohistochemically, the KDR protein was localized in endothelial cells and perivascular cells of capillaries within the lamina propria of seminiferous tubules. Leydig cells and Sertoli cells show KDR immunoreactivity, too. Thus we demonstrate the presence of both types of VEGF receptors Flt-1 and KDR on Leydig as well as on Sertoli cells which are normal non-endothelial cells, suggesting hitherto unrecognized and novel functions for such receptors. The results obtained permit us to suggest VEGF as a paracrine mitogenic and angiogenic factor, responsible for modulating the capillarization of the human testicular tissue and maintaining the functions of testicular microvasculature. VEGF may also influence the permeability of capillaries passing through the groups of Leydig cells and those localized within the lamina propria of human seminiferous tubules. The differences in the expression pattern of the VEGF receptors in the human testicular tissue probably reflect different VEGF effects in different compartments of human testis.

Melanoma-associated expression of vascular endothelial growth factor and its receptors FLT-1 and KDR.

The expression patterns of vascular endothelial growth factor (VEGF) and its two receptors, flt-1 and KDR, were assessed in normal human melanocytes, transformed melanocytes expressing the simian virus 40 Tgene (SV40T), and melanoma cells derived from primary and metastatic lesions. Constitutive expression of VEGF, flt-1, and KDR mRNA and proteins was observed in the majority of primary and metastatic melanoma cell lines, and in SV40T-transformed melanocytes. VEGF expression in melanoma cell lines was further enhanced by exogenous growth factors including insulin and fetal calf serum. By contrast, neonatal melanocytes did not express VEGF or VEGF receptors and VEGF expression could not be induced by exogenous growth factors. Exogenous VEGF had no significant effects on melanoma cell proliferation or on production of a transcriptional target for VEGF, urokinase-type plasminogen activator. Down-regulation of VEGF expression in the metastatic melanoma cell line WM164 through transfection of a VEGF antisense construct similarly did not affect proliferation of the transfected cells in the presence or absence of exogenous VEGF. In summary, coexpression of VEGF and its receptors is a tumor-associated phenomenon in melanoma development. However VEGF production does not support autocrine proliferation of the melanoma cell lines tested.

Biomonitoring study of a group of workers potentially exposed to traffic fumes.

Risk assessment of environmental pollutants is concerned with the identification of compounds in the environment that might be hazardous to human health: measuring exposure levels, measuring cellular damage and then estimating the probability of harm occurring. The feasibility of such a comprehensive approach has been explored in this study of two groups of workers, one of which may be occupationally exposed to exhaust fumes. No statistically significant difference in cellular damage, as measured by the lymphocyte micronucleus assay, was found between these two groups of workers, although clear differences in exposure levels to volatile organic compounds were detected. A number of other factors identified in the study did show clear effects on micronucleus frequency.

Methods to evaluate the formation and stabilization of blood vessels and their role in tumor growth and metastasis.

It is becoming more and more clear that angiogenic mechanisms leading to structural formation of blood vessels are very complex, and understanding them depends on studies performed by means of a wide methodological spectrum ranging from molecular biological techniques to morphological analyses (1-4). To study the maturation and stabilization of newly formed blood vessels, processes that include many successive steps, the following aspects and methods are important: 1. Examination of structural components of the vascular wall indicating vascular stabilization by means of light and electron microscopy. 2. Immunohistochemical and immune electron microscopic studies on tissues and cells with improved methods for precise localization of angiogenic factors during vascular maturation. 3. Chemotactic assay on human endothelial cells using the Boyden chamber to test their migration response to angiogenesis activators and inhibitors. 4. Three-dimensional endothelial tube formation assay on collagen gel: an in vitro angiogenesis model. 5. Chorioallantoic membrane (CAM) assay as an easy in vivo angiogenesis assay.

Oromandibular limb hypogenesis and gastroschisis.

The oromandibular limb hypogenesis syndromes (OLHS), which are congenital malformations involving the tongue, mandible, and the limbs are extremely rare with a few sporadic cases reported in the literature. In this report, the authors report a case of OLHS with gastroschisis, that has not been described previously according to the medline search.

Open surgical removal of tracheobronchial foreign bodies: a case report.

Tracheobronchial foreign bodies can usually be extracted by skillful application of endoscopic techniques. The authors report on experience in the treatment of an infant in whom a plastic object was extracted by an open surgical approach. The authors discussed clinical presentation and treatment options in the treatment of this patient who had a plastic pencil top lodged in the lung. In highly selected cases, an open surgical procedure entails less risk than endoscopic extraction.

Comparison of urodynamic investigations before and after posterior sagittal anorectoplasty for anorectal malformations.

METHODS: The authors evaluated 21 patients (10 boys, 11 girls) who had anorectal malformations (ARM). Ten of them had infralevator (low-group I) and 11 of them had supralevator (high-group II) type ARM. All of the patients underwent urodynamic investigation before and after posterior sagittal anorectoplasty (PSARP) operation. RESULTS: Sacral and spinal anomalies were found in 54% (6 of 11) patients who had supralevator type ARM. None of the patients with infralevator type ARM had additional sacral or spinal anomalies. Before PSARP operation urodynamic investigations of all infralevator type ARM patients were within normal limits, whereas 82% (9 of 11) of patients with supralevator type ARM showed neurovesical dysfunction (NVD). There was no significant difference between the preoperative and postoperative urodynamic findings. The possibility of additional sacral or spinal anomalies and NVD in supralevator type ARM was high. After PSARP operation no additional lower urinary tract dysfunction was detected in the urodynamic evaluation of ARM patients.

Ruptured spleen due to blunt trauma in children: analysis of blood transfusion requirements.

Selective non-operative management of splenic injury in children is generally considered to be safe, and the majority of those with isolated injuries do not require blood transfusion. Eighty-four children were treated for blunt splenic trauma from 1988 to 1997 in the Department of Paediatric Surgery, The Medical Faculty of Uludag University, Bursa, Turkey. Management involved non-operative care in 56 cases (66.7%), splenectomy in 20 (23.8%) and splenorraphy in eight (9.5%) cases. There were no later complications related to splenic injury. The overall mortality was 9.5% (8/84) and the factors effecting mortality were additional intra-abdominal and/or other system injuries. Twenty-two children were not transfused during non-operative treatment. In our study, only 57.1% of the children in the non-operative group received blood transfusions. Some of the patients in this group received only small amounts of blood and probably would have recovered without it. It is concluded that, based on a very strict protocol in conservative management, the total amount of transfused blood could be reduced in children with splenic injuries due to blunt abdominal trauma.

Aicardi syndrome associated with palatal hemangioma.

An 1-day-old female newborn who had typical clinical features of Aicardi syndrome, such as agenesis of the corpus callosum, ocular abnormalities and infantile spasm associated with a palatal hemangioma is reported. The intraoral mass, which occluded incompletely the oropharynx and right side of the nasopharynx, was partially excised under general anesthesia. This is the first reported patient with Aicardi syndrome with palatal hemangioma, according to the med-line search.

The effects of a fluoroquinolone on the growth and development of infants.

Growth and development were monitored for up to 42 months in nine neonates to whom ciprofloxacin, a fluoroquinolone, was given in the neonatal period at a dosage of 20 mg/kg/day. Ciprofloxacin was used only as a ¿life-saving' therapy in cases of sepsis produced by bacterial agents resistant to other antibiotics. Two other groups of nine neonates, matched by birth weight and gestational age, were studied as controls: one group with sepsis, which was effectively treated with cefotaxime and a group of healthy neonates. No statistically significant differences in growth and development between the groups were found during follow-up for 42 months. No osteoarticular problems or joint deformities were observed in the ciprofloxacin group. Ciprofloxacin appears to provide a therapeutic option as a ¿life-saving' therapy for newborns with sepsis produced by multiply resistant organisms.