Infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness in childhood.

Incidence of diabetes during pregnancy is increasing worldwide, and intrauterine hyperglycemia exposure may have long-term adverse effects on the cardiovascular health of children. We investigated prospectively the risk of atherosclerosis and carotid intima-media thickness (CIMT) in infants born macrosomic and in infants of diabetic mothers (IDM) at the age of 8-9 years in 2021. A total of 49 infants of diabetic mothers (IDM group) and 13 macrosomic infants (macrosomic group) were included in the study. They were compared with 26 age-matched healthy children with birth weight appropriate for gestational age born to non-diabetic mothers (control group). Anthropometric measurements, atherosclerosis risk factors, and CIMT measurements were performed. There was no significant difference between the groups in terms of age, gender, actual anthropometric measurements, blood pressure measurements, laboratory parameters, or atherosclerosis risk factors. Gestational age was lower in the IDM group (p < 0.001), while birth weight was higher in the macrosomic group (p < 0.001). High-density lipoprotein cholesterol level was lower in the IDM group than the other groups. Duration of exclusive and total breastfeeding was lower in IDM group than in the control group (p < 0.001 for both). Body mass index, skinfold thickness, waist-to-hip ratio, and waist-to-height ratio were higher in those breastfed for less than 6 months in the IDM group. The CIMT values were statistically higher in IDM [0.43 ± 0.047 (0.34-0.60)] and macrosomic [0.40 ± 0.055 (0.33-0.50)] groups than control group [0.34 ± 0.047 (0.26-0.45)]. CONCLUSION: CIMT values were higher in IDM and macrosomic groups at 8-9 years old age compared to children born with normal birth weight. This indicates intrauterine exposure in both groups. And also, breastfeeding seems very important for IDMs. WHAT IS KNOWN: • Intrauterine hyperglycemia exposure has long-term adverse effects on the cardiovascular health of children. • Infants of diabetic mothers have higher carotid artery intima-media thickness at birth. WHAT IS NEW: • Both infants of diabetic mothers and infants with macrosomia have increased carotid artery intima-media thickness at the age of 8-9 years. • Duration of breast feeding is important especially in infants of diabetic mothers as body mass index, skinfold thickness, waist to hip and height ratio were higher in those breastfed less than 6 months.

Duration of priapism is associated with increased corporal oxidative stress and antioxidant enzymes in a rat model.

Ischaemic priapism is characterised by hypoxia, hypercapnia and acidosis with resultant corporal fibrosis. Studies reported decreased erectile recovery after treatment of priapism longer than 36 h. However, a recent study revealed that half of patients with 3 days of priapism achieved recovery after T-shunt, although mechanism remains unclear. We aimed to investigate the effect of priapism duration on oxidative stress and antioxidant enzymes. Twenty-four male rats were divided into four groups. Group 1 served as control. Groups 2, 3 and 4 represented 1, 2 and 4 h, respectively, of priapism induced by vacuum device and rubber band placed at base of erect penis. After 30 min of reperfusion, penectomy and blood withdrawal were performed to investigate levels of malondialdehyde (MDA), protein carbonyl (PC), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx). Corporal MDA progressively increased with priapism duration (P = 0.01). Corporal SOD significantly differed between groups 1, 2 and 4. Also, there were significant differences in corporal GPx in groups 1 and 4 (P = 0.004) and groups 2 and 4 (P = 0.01). Corporal CAT was higher in group 4, but multivariable analysis revealed insignificant differences. Plasma MDA of the experimental groups was significantly higher than that of controls. There were no differences among groups in terms of other parameters. Increased antioxidant enzymes according to duration of priapism suggest that immediate treatment to relieve oxidative stress should be initiated in prolonged cases. However, further studies should be conducted to determine resistance mechanisms of the corpora to prolonged ischaemia.

Association between genetic variants in glutathione peroxidase 1 (GPx1) gene, GPx activity and the risk of prostate cancer.

AIM: The aim of this study was to investigate the association between GPx1 Pro198Leu polymorphism with the development and progression of prostate cancer (PCa) and evaluate whether smoking status and advanced age could modify this association. METHODS: A total of 134 PCa patients and 159 healthy control subjects with serum prostate specific antigen (PSA) levels <4 ng/mL and normal digital rectal examination (DRE) findings were enrolled in this prospectively designed study. PCA patients were classified as low (T1 or T2 and N0M0 stages) and high stage disease (T3 or T4 and N0M0 or N1 or M1 stages). GPx1 Pro198Leu polymorphism was determined using polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP). Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Compared to the carriers of Pro/Pro genotype, subjects with the variant genotypes (Pro/Leu or Leu/Leu) had significantly higher risk of PCa. The Leu/Leu genotype was correlated with lower GPx activity among both controls and PCa patients. With respect to tumor stage, Leu/Leu genotype was more frequent in patients with high stage disease than those of low stage disease. In stratified analyses, although the variant Leu/Leu genotype was significantly associated with increased risk of PCa in older age, smoking did not alter this association. CONCLUSION: The present data provide evidence that GPx1 Pro198Leu polymorphism may be associated with the development and progression of PCa and older ages may influence the association.between GPx1 Pro198Leu polymorphism and PCa.

ACE gene polymorphism in peripheral vascular disease.

Peripheral vascular disease is an atherosclerotic process. It has been suggested that angiotensin converting enzyme insertion/deletion polymorphism is associated with atherosclerosis. The aim of this study was to investigate the role of the insertion/deletion polymorphism of the angiotensin-converting enzyme in Turkish patients with peripheral vascular disease in Western part of Turkey. We also investigated the relationship between serum angiotensin converting enzyme activity and distribution of genotypes in both patients and control group. The study group consisted of 78 patients with peripheral vascular disease. The control group consisted of 73 healthy adults. Serum angiotensin converting enzyme activities in patients were higher than those of the control group (p<0.05). Angiotensin converting enzyme genotype frequencies in patients were observed as 28.2%, 18% and 53.8% for DD, II and ID polymorphism, respectively. These frequencies in controls were 42.5%, 20.5% and 37% for DD, II and ID, respectively. Serum angiotensin converting enzyme activities in both groups with II genotype were significantly lower than those with ID and DD genotype (p<0.05). Although conflicting results have been reported about this polymorphism in patients with peripheral vascular disease, we suggest that the angiotensin converting enzyme ID genotype may be a risk factor for peripheral vascular disease.

Extragastrointestinal stromal tumor of the retroperitoneum mimicking kidney tumor.

A case of extragastrointestinal tumor of the retroperitoneum in a 48-year-old woman complaining right sided flank pain without hematuria is reported. The mass was excised from the kidney without a positive margin. The histopathological examination revealed an extragastrointestinal stromal tumor of the retroperitoneum. These tumors usually originate from the small intestine or stomach. On the other hand, they are rarely located in the retroperitoneum. These tumors typically exhibit CD117 immunoreactivity, whereas they may reveal CD34, neuron specific enolase, smooth muscle actin, desmin and S-100 protein. In our case the specimen of the patient was positive for CD117, actin and desmin.

No association between oxidative stress and IL-6 in NIDDM patients with nephropathy.

Oxidative stress is hypothesized to play a role in the development of diabetes with and without nephropathy. In addition, it has been suggested that some metabolic abormalities associated with diabetes may be due to cytokine overproduction. In the light of this knowledge, we aimed to measure MDA levels as a marker of oxidative stress and the IL-6 level in diabetes with and without different stages of nephropathy. Plasma MDA levels in the group of NIDDM patients with advanced nephropathy were significantly higher than in the group of NIDDM patients without nephropathy, which had significantly higher levels compared with the control group. Although IL-6 levels were elevated in diabetic groups with and without nephropathy in comparison with the control, no significant difference was found between patient groups. As a conclusion, oxidative stress may play an important role in diabetes with and without nephropathy, but the IL-6 level may not be useful in the evaluation of diabetic nephropathy.

Myoepithelioma of the parotid gland: a report of two cases.

We describe the clinical and pathologic features of two benign myoepitheliomas of the parotid gland. Through 1985, only 42 other cases had been reported in the literature--39 benign and three malignant. Fewer than 100 cases had been reported through 1993. Since then, two other reports have been published. But are these tumors really rare, or are they simply not well recognized? It is our opinion that they are not as rare as is generally believed because the number of case reports is increasing as pathologists have become more aware of their existence.

Increased lipid peroxidation in the liver and kidney and their mitochondrial fractions following buthionine sulfoximine induced glutathione depletion in guinea pigs.

Malondialdehyde (MDA) and diene conjugates (DC) and vitamin C levels and the activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were determined in the liver and kidney and their mitochondrial fractions of guinea pigs 48 h after the injection of L-buthionine-(S,R)-sulfoximine (BSO), a glutathione (GSH) depleting agent. In BSO-induced GSH depletion, lipid peroxidation and SOD activities were found to be increased but GSH-Px activities did not change in the liver and kidney and their mitochondrial fractions. In addition, vitamin C levels remained unchanged in the liver and kidney homogenates. These results indicate that GSH depletion may influence oxidative stress in the liver and kidney and their mitochondrial fractions of guinea pigs.

Polypoid lesions of the gallbladder: report of 100 cases with special reference to operative indications.

BACKGROUND: The nature of polypoid lesions of the gallbladder is difficult to define before operation, and surgical indications still remain controversial. The aim of this study was to identify characteristics of each type of polypoid lesion of the gallbladder and indications for surgery. METHODS: Clinical data were retrospectively correlated with the histopathologic characteristics of polypoid lesions in 100 patients who had cholecystectomy. RESULTS: There were 74 benign polypoid lesions, including 39 cholesterol polyps, 20 adenomas, and 15 with adenomyomatous hyperplasia and 26 malignant polypoid lesions. Twenty-seven percent of patients with benign polyps and 73 percent of patients with malignant polyps were over 60 years of age. Polypoid lesions of the gallbladder were diagnosed by preoperative ultrasonography in only 36 patients (36%). All types of polypoid lesions of the gallbladder, whether benign or malignant, were frequently solitary, and gallstones coexisted in the majority of patients with all polypoid lesions of the gallbladder except cholesterol polyps. The lesions were > 10 mm in 88% of the malignant polyps and in only 15% of the benign polyps. CONCLUSIONS: The risk factors for malignancy were the age of the patient ( >60 years), the coexistence of gallstones, and the size of the polypoid lesions (>10 mm in diameter). In asymptomatic patients, cholecystectomy can be justified if there are risk factors for malignancy.

[Severe Frey syndrome after parotidectomy: treatment with botulinum neurotoxin type A]. / Syndrome de Frey sévère post-parotidectomie: traitement par la neuro-toxine botulique de type A.

Based upon an inception cohort of 30 patients with severe Frey's syndrome, after conservative parotidectomy, the technique and the results of intracutaneous injection of botulinum toxin type A are presented. The skin surface involved with Frey's syndrome was managed with intracutaneous injection of 2.5 international units of botulinum toxin type A per square centimeter. A minimum follow-up of 16 months was achieved. The only adverse side effect encountered was a temporary paresis of the upper lid noted in 2 patients. Frey's syndrome vanished within 2-5 days from the intracutaneous injection of botulinum toxin type A. Frey's syndrome was controlled in 53.2% of cases (17/30) after the initial injection of botulinum toxin type A. Five of the 13 patients with recurrence of Frey's syndrome elicited to undergo a watch and wait policy due to the lack of discomfort induced by the recurrence. The remaining eight patients with recurrence of Frey's syndrome were successfully managed with a secondary intracutaneous injection of botulinum toxin type A. Such preliminary data, together with the review of the literature suggests, that the intracutaneous injection of botulinum toxin type A should now be the first line treatment option in patients with severe Frey syndrome.

Effect of acute and chronic administration of sodium valproate on lipid peroxidation and antioxidant system in rat liver.

Changes in glutathione and lipid peroxide levels as well as in the activities of superoxide dismutase, glutathione peroxidase, catalase and glutathione-S-transferase have been studied in rats after acute and chronic sodium valproate treatments. Glutathione levels were decreased only after acute sodium valproate treatment. Neither acute nor chronic treatment influenced lipid peroxidation but induced glutathione-S-transferase activity significantly. On the other hand, no alterations in glutathione peroxidase and superoxide dismutase activities were found, except slight induction of catalase activity after acute administration of sodium valproate. These results indicate that sodium valproate treatment did not induce oxidative stress in the liver.

Protracted familial Mediterranean fever arthritis.

Familial Mediterranean fever (FMF) is an inherited disorder characterized by recurrent attacks of fever and abdominal, chest, and articular pain. The articular attack of FMF is typically an acute, self-limited, large joint monoarthritis most often affecting the knee or hip. Rarely, a more protracted arthritis may occur. We describe two unusual cases of long-standing FMF arthritis with excellent response to synovectomy.

Neo-adjuvant chemotherapy and supracricoid partial laryngectomy with cricohyoidopexy for advanced endolaryngeal carcinoma classified as T3-T4: 5-year oncologic results.

BACKGROUND: Historically, total laryngectomy with voice-prosthesis insertion and near-total laryngectomy were the surgical options advocated for advanced supraglottic and transglottic tumors classified as T3-T4. METHODS: The present retrospective study reviewed our experience with neo-adjuvant chemotherapy and supracricoid partial laryngectomy with cricohyoidopexy (SCPL-CHP) in a series of 60 patients with an isolated, untreated, advanced supraglottic/transglottic invasive squamous cell carcinoma classified as T3-T4. RESULTS: The Kaplan-Meier 5-year actuarial survival, local failure, nodal failure, and distant metastasis estimates were 72.7%, 8.3%, 9.2%, and 9.8%, respectively. Survival was significantly reduced in patients with nodal failure (p = .001) and distant metastasis (p = .007). Overall, a 91.7% laryngeal preservation rate and a 98.3% local control rate were achieved. CONCLUSION: Our report was a retrospective analysis and did not present a control group exclusively managed with SCPL-CHP. Therefore, we were unable to demonstrate that the use of neo-adjuvant chemotherapy prior to SCPL-CHP allowed for an increase in local control, laryngeal preservation, and survival. However, the use of neo-adjuvant chemotherapy allowed for remobilization of a fixed arytenoid cartilage in 10 patients who thus became amenable to SCPL-CHP. The key role of neo-adjuvant chemotherapy in this series was as a prognostic indicator for suitability for SCPL-CHP in the case of supraglottic-transglottic tumor with arytenoid cartilage fixation. Our data also supported the notion that SCPL-CHP is a valid alternative to total laryngectomy with voice prosthesis insertion and near-total laryngectomy in selected patients with a previously untreated supraglottic/transglottic invasive squamous cell carcinoma classified as T3-T4. Furthermore, the successful use (in terms of surgical outcome, laryngeal preservation, and survival) of SCPL-CHP after neo-adjuvant chemotherapy suggested that laryngeal organ-preservation strategies, in advanced endolaryngeal transglottic and/or supraglottic invasive squamous cell carcinoma, should not be limited to the use of laryngeal radiotherapy after neo-adjuvant chemotherapy.

Effect of streptozotocin on glutathione and lipid peroxide levels in various tissues of rats.

In this study, the effect of streptozotocin (STZ) on lipid peroxidation and glutathione (GSH) content was investigated in the liver, pancreas and kidney of rats. Lipid peroxide levels were significantly increased in homogenates and mitochondrial fractions of the liver, kidney and pancreas after STZ administration. GSH levels in hepatic and pancreatic tissues were decreased but unchanged in the kidney of diabetic rats. GSH content in hepatic mitochondrial fraction was also decreased compared to control group. On the other hand, the destruction of pancreatic beta-cells was also observed histopathologically. Our results indicate that oxidative stress may play an important role in STZ induced diabetes and mitochondrial fraction may be the target in this toxicity.

Cricotracheal anastomosis for assisted ventilation-induced stenosis.

OBJECTIVE: To review the long-term results and our experience with cricotracheal anastomosis via a cervical approach for assisted ventilation-induced stenosis. DESIGN: A case series of 41 patients consecutively treated with cricotracheal anastomosis. SETTING: A tertiary care center and university teaching hospital. PATIENTS: Group 1 consisted of 22 patients with stenosis reaching the lower border of the cricoid cartilage that did not require resection of the cricoid cartilage. Group 2 consisted of 19 patients in whom correction of the stenosis required cricoid resection. MAIN OUTCOME MEASURES: Statistical analysis of airway patency was based on the Kaplan-Meier actuarial life table method. Incidence for the various postoperative complications was presented. Univariate analysis was performed to analyze the relationships between various factors, airway patency, and the incidence for the various complications encountered. RESULTS: The Kaplan-Meier 5-year airway patency estimate was 100% in group 1 patients and 82.5% in group 2 patients. In group 2 patients, complementary treatment with dilatations in 2 patients resulted in an overall 94.8% airway patency rate. In the last patient, the airway patency was not reestablished after cricotracheal anastomosis, and a Montgomery T tube was inserted. Postoperative complications included unilateral inferior laryngeal nerve paralysis (3 patients), cervical neck abscess (2 patients), pneumothorax (1 patient), and major subcutaneous emphysema (1 patient). None of the following variables was statistically related to the airway patency or to the various complications encountered: sex, age, cause for stenosis, delay from initial injury, prior treatment, presence of a tracheotomy, number of tracheal rings resected, type of sutures used, and type of anastomosis performed. CONCLUSIONS: The data reported reemphasized that cricotracheal anastomosis with or without cricoid resection is a safe and reliable procedure for assisted ventilation-induced upper tracheal stenosis reaching and/or involving the subglottis and/or cricoid cartilage.

[Proventriculitis in domestic fowl (Gallus gallus var. dom. L., 1758) caused by megabacteria]. / Eine durch Megabakterien verursachte Drüsenmagenentzündung beim Haushuhn (Gallus gallus var. dom. L., 1758).

Three cases of a disease similar to going light syndrome in budgerigars in a flock of young laying hens in Turkey are reported. In all cases megabacteria in association with E. coli could be isolated. The causing agent appeared to be large, rod-shaped, gram-positive or gram-labil, and catalase test positive bacteria with cytochromoxydase activity. Subcultivation of these bacteria could not be achieved.

The effect of chronic stress on hepatic and gastric lipid peroxidation in long-term depletion of glutathione in rats.

The effect of chronic stress (immobilization and cold) on hepatic and gastric thiobarbituric acid reactive substances (TBARS) and vitamin C levels were investigated in rats having long-term depletion of glutathione (GSH) by applying buthionine sulfoximine (BSO). GSH and vitamin C levels decreased and TBARS levels increased in the liver and stomach of rats subjected to stress. Long-term BSO administration along with stress caused no additional changes in these parameters. These results may indicate that long-term glutathione depletion did not potentiate stress-induced hepatic and gastric lipid peroxidation.

Intraparenchymal schwannomas of the central nervous system: an additional case report and review.

Intraparenchymal location of schwannomas in the central nervous system (CNS) is rare. Occasional cases involving the cerebrum, cerebellum, brain stem, and spinal cord have been reported. We report here an additional case of thoracic intramedullary schwannoma in a 42 year old woman. The literature concerning intraparenchymal schwannomas in the CNS is reviewed and discussed.