Eosinophil cationic protein: A new diagnostic biomarker in coronary slow flow phenomenon.

AIM: This study has investigated the role of eosinophil cationic protein (ECP), released by eosinophils, in the coronary slow flow phenomenon. METHODS: This study included sixty patients with coronary slow flow (CSF) and sixty patients with normal coronary flow. The coronary flow rate was evaluated with TIMI frame count (TFC). ECP level, blood count and biochemical parameters were assessed. RESULTS: The ECP levels (18.9±7.5 vs 13.1±6.4 ng/ml, p<0.001) and eosinophil counts (0.25±0.14 vs 0.18±0.09 10³/mm³, p=0.001) were higher in the CSF group. Multivariable regression analysis showed that ECP level and eosinophil counts were independent predictors the presence of CSF (p=0.003 and p=0.006). There was a weak but important correlation among the ECP level, eosinophil count and mean TFC (p=0.001, p=0.003, respectively). The ROC analysis showed a cut off value of 14.05 ng/ml for ECP level to diagnose CSF with 73.3 % sensitivity and 66.7 % specificity, and area under the ROC curve was 0.745 (95% CI: 0.657-0.833, p<0.001). CONCLUSION: ECP levels were increased in CSF patients and this increasing correlated with coronary artery flow rates. The ECP level was independent predictor for the presence of SCF and it may be use as suitable diagnostic biomarker for CSF (Tab. 3, Fig. 3, Ref. 30).

Pomegranate extract: a potential protector against aminoglycoside ototoxicity.

OBJECTIVE: To investigate the effectiveness of pomegranate extract as protection against aminoglycoside ototoxicity. DESIGN: Prospective, randomised, controlled, experimental study. SUBJECTS: Eighteen Wistar albino rats were randomly allocated to 5 days of either: saline injections; gentamicin injections; or pomegranate extract (100 µl/day via gavage) plus gentamicin injections. Distortion product otoacoustic emissions were tested before treatment and on day 3. After treatment, reactive oxygen species levels were measured in each rat's right cochlea and right kidney via chemiluminescence. RESULTS: Baseline emission amplitudes were similar. Post-treatment emissions differed significantly in the two treatment groups (p < 0.001). Cochlear reactive oxygen species levels were significantly higher in the gentamicin group (mean ± standard deviation, 316.6 ± 36.5 relative light units per mg) than the gentamicin plus pomegranate extract group (240 ± 24.6 relative light units per mg) (p = 0.004); control group levels were 119.1 ± 10.3 relative light units per mg. Renal reactive oxygen species levels were similar for the control and gentamicin plus pomegranate extract groups (p = 0.59) but much higher in the gentamicin group (p = 0.004). CONCLUSION: Concurrent systemic pomegranate extract administration reduced reactive oxygen species level increases and otoacoustic emission changes, following aminoglycoside injection.

Evaluation of inferior turbinate hypertrophy in patients with congenital and traumatic nasal septum deviation.

OBJECTIVE: To compare mucosal and bony measurements in patients with congenital and traumatic nasal septum deviation and compensatory inferior turbinate hypertrophy. METHODS: The study examined 50 patients with nasal septum deviation (25 congenital and 25 traumatic) and compensatory inferior turbinate hypertrophy in the contralateral nasal cavity, confirmed by computed tomography. RESULTS: The study compared inferior turbinate measurements on the concave and convex sides of the septum, in the congenital and traumatic groups. MEASUREMENTS COMPRISED: the shortest distance from the median line to the medial border of the conchal bone; the distances from the most medial part of the conchal mucosa and the conchal bone to the lateral line; the projection angle of the inferior turbinate; and the widest parts of the whole inferior turbinate and the inferior turbinate conchal bone. The differences between the concave and convex side measurements were compared in the congenital group versus the traumatic group; for three measurements, the difference between these two groups was statistically significant (p < 0.05). CONCLUSION: The present study findings suggest that the conchal bone has a marked influence on nasal patency in patients with congenital septal deviation. These findings supported the decision to excise the inferior turbinate bone at the time of septoplasty, especially when treating congenital septal deviation.

Cardiac echinococcosis associated with cerebrovascular occlusive disease and subcutaneous bullous eruptions and ulcers.

Cardiac involvement is an uncommon complication of echinococcosis. It is usually asymptomatic and may only be diagnosed incidentally. A 7-year-old boy was admitted with acute stroke and bullous and ulcerated skin lesions. He was diagnosed with cardiac echinococcosis complicated by systemic emboli to the central nervous system and superficial cutaneous arteries. In endemic areas, echinococcosis should be considered in the differential diagnosis of cardiac disease and unexplained cerebral embolism.

Antioxidant effect of pomegranate extract in reducing acute inflammation due to myringotomy.

OBJECTIVE: To assess the effect of pomegranate extract on acute inflammation due to myringotomy. DESIGN: Prospective, randomised study. SUBJECTS: Thirty Sprague-Dawley rats were divided into three groups. Group one constituted controls. Group two underwent myringotomy. Group three underwent myringotomy and also received 100 µl/day pomegranate extract, via gavage, one day before and two days after surgery. Following sacrifice 48 hours after myringotomy, the animals' right ears were used to determine the concentration of reactive oxygen species, using the chemiluminescence method; left ears were used for histological study. RESULTS: Reactive oxygen species levels were significantly decreased in group three compared with group two (p < 0.01). The density of inflammatory cells in group three was significantly less than that in group two (p < 0.01). Lamina propria thickness and vessel density were also significantly decreased in group three compared with group two (p < 0.01). CONCLUSION: Our results indicate that oral pomegranate extract decreases reactive oxygen species concentration and acute inflammation in the tympanic membrane after myringotomy.

The effect of conversion type on P wave dispersion in patients with atrial fibrillation.

AIM: The aim of this study was to investigate whether conversion type of atrial fibrillation (AF) to sinus rhythm affects the P wave dispersion (PD) in patients with AF. METHODS: Based on conversion type, 95 consecutive patients with AF<3 months were divided into 3 groups: spontaneous cardioversion (SC) (N.=33, mean age: 60.6+/-11.6 years), pharmacologic cardioversion (PC) (N.=32, mean age: 59.2+/-9.6 years) and electrical cardioversion (EC) (N.= 30, mean age: 65.3+/-10.6 years). P wave duration (maximum and minimum) were measured in 12-lead ECG, and PD was calculated. RESULTS: Left atrial diameter and AF duration were significantly higher in EC (43.6+/-4.8 mm and 794.1+/-815.1 h) than SC (38.5+/-3.9 mm and 13.8+/-18.3 h) and PC (40.9+/-4.5 mm and 65.3+/-148.5 h) groups (P<0.01). P maximum was much longer in EC group compared with SC and PC group (121.6+/-9.7, 108.4+/-6.4 and 115.8+/-8.6 ms, P=0.01, respectively). There was a significant difference in PD among SC, PC and EC groups (44.4+/-9.2, 49.5+/-8.7 and 53.5+/-8.8 ms; P=0.005, respectively). PD correlated with AF duration (r=0.36, P=0.03), left atrial diameter (r=0.45, P=0.002) and conversion type (r=0.29, P=0.03). However, there was no significant association between PD and conversion type in multivariate analysis. The prolonged PD resulted from AF duration (P=0.01) and the left atrial size P=0.001). CONCLUSION: This study suggests that conversion type of AF to sinus rhythm has no effect on P wave duration and independent of AF duration and the left atrial diameter.

Histopathological changes of chorda tympani in chronic otitis media.

OBJECTIVE: To investigate whether histopathological changes of chorda tympani might exist in patients with chronic otitis media without facial paralysis. STUDY DESIGN: The study was designed as a prospective trial. METHODS: Twenty of 107 patients with chronic otitis media, in whom the chorda tympani were injured inadvertently during middle ear surgery, were enrolled into the study. The cases were divided into two groups based on the activity of chronic infection at the time of surgery. Twelve cases with suppurative disease were included in group I, and 8 cases with dry ear in group II. RESULTS: Histopathological examinations of the specimens revealed findings such as thickening of perineural and epineural connective tissue, vacuolar degeneration of Schwann cells, and proliferation of fibroblasts in endoneurium. Disorganization of the axons of some nerve fibers was also determined. CONCLUSION: Based on the histopathological changes of chorda tympani in chronic middle ear disease, it is postulated that chronic otitis media may give rise to functional loss of the nerve.

Improvement in bone conduction threshold after tympanoplasty.

OBJECTIVE: To investigate the causes of bone conduction threshold impairment associated with middle ear pathoses and the factors influencing improvement in bone conduction threshold after tympanoplasty. STUDY DESIGN AND SETTING: The records of 98 consecutive patients with unilateral chronic otitis media who underwent tympanoplasty were reviewed. Pre-operatively, 15 dB or more depression of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was considered to be significant. Similarly in the postoperative period, 15 dB or more improvement of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was regarded as significant. RESULTS: Twelve (12.5%) of 98 cases were found to have depressed bone conduction threshold; 6 of 12 cases had improved bone conduction threshold after tympanoplasty. CONCLUSION: In cases with cholesteatoma and extensive middle ear disease, successful results could be achieved after tympanoplasty disregarding the air-bone gap and deteriorated bone conduction threshold. SIGNIFICANCE: Bone conduction threshold may improve after tympanoplasty.