Effects of methylene blue in acute lung injury induced by blunt chest trauma.

BACKGROUND: We studied whether methylene blue (MB) treatment blunts chest trauma-induced lung injury in rats. MATERIAL AND METHODS: Forty male Sprague-Dawley rats, 200-300g, were used. The rats were divided into five groups (n=8): control, early contusion (EC), early contusion + methylene blue (2 mg/kg, EC+MB), late contusion (LC), and late contusion + methylene blue (2 mg/kg, LC+MB). RESULTS: Histopathological analysis showed increased hemorrhage, alveolar wall thickness, edema, and inflammatory cell infiltrates in the EC and LC rats, which decreased upon MB treatment. Immunohistochemical studies revealed that MB reduced activation of inducible nitric oxide synthase (iNOS) and the number of active terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive cells. A significant increase was observed in the malondialdehyde (MDA) and nitric oxide (NO) levels in the EC group compared to the control group (p<0.05). In addition, a significant decrease was reported in the glutathione (GSH), superoxide dismutase (SOD), and glutathione peroxidase (GPx) levels (p<0.01), but no significant difference was observed in the catalase (CAT) levels among the groups. The MDA level was significantly higher in the LC group compared to the control group, whereas the GSH level was significantly lower compared to the control group. The NO level in the EC+MB group was significantly lower when compared to the NO level in the EC group (p<0.05). CONCLUSION: The present study provides evidence that MB might serve as a therapeutic treatment for blunt chest trauma.

Chlamydia pneumoniae infection induces an unstable atherosclerotic plaque phenotype in LDL-receptor, ApoE double knockout mice.

OBJECTIVES: To study whether Chlamydia pneumoniae (Cpn) infection affects atherosclerotic plaque morphology in atherogenic (LDLr/ApoE(-/-)) mice. METHODS: In mice sacrificed 20 or 40 weeks after Cpn infection aortic arch sections were analysed for lesion and fibrous cap area and the presence of matrix metalloproteinases (MMP)-2 and -9. RESULTS: All infected mice seroconverted, demonstrated Cpn DNA in their aortas on PCR and developed atherosclerotic plaques. Infection was not associated with changes in lesion area or type, but was associated with reduced the fibrous cap area and increased MMP-2 and -9 immunoreactivity. CONCLUSION: These findings suggest that Cpn infection may predispose to plaque instability.

Chlamydophila pneumoniae (Chlamydia pneumoniae) accelerates the formation of complex atherosclerotic lesions in Apo E3-Leiden mice.

OBJECTIVE: Atherosclerosis is an inflammatory process and is characterised by the presence of T-lymphocytes in the lesions. To study the role of Chlamydophila pneumoniae (C. pneumoniae) in this process and the effect of infection on T-cell influx, we infected Apo E3-Leiden mice with C. pneumoniae and investigated the effect on lesion development and T-cell influx in atherosclerotic lesions at different time points post infection (pi). METHODS: Nine week old mice, fed an atherogenic diet, were either mock-infected or infected with C. pneumoniae and sacrificed at 1, 6 and 9 months pi. Longitudinal sections of the aortic arches of the mice were stained with hematoxylin-eosin for atherosclerotic lesion type and lesion area analysis, or with rabbit-anti-CD3(+) to detect the presence of T-cells in the atherosclerotic lesions. T-cell influx was expressed as number of T-lymphocytes/lesion area. RESULTS: At 1 month pi, type 1, 2 and 3 lesions were present. At other time points pi, more complex lesion types 4, 5a and 5b were also present. Although infection did not influence the total lesion number or area, we observed an effect of C. pneumoniae infection on lesion type. Infection resulted in a significant shift in lesion formation from type 3 to type 4 (P=0.022) at 6 months pi, and from type 4 to type 5a (P=0.002) at 9 months pi. T-cells were observed at every time point pi. At 1 month pi, a significant increase in T-cell influx in the C. pneumoniae-infected atherosclerotic lesions was observed (P=0.0005). CONCLUSION: This study shows that C. pneumoniae infection enhances the inflammatory process by increasing T-lymphocytes in the plaque and accelerates the formation of complex lesions.

Lipoblastoma: a rare cervical mass in childhood.

A 4-year-old girl had a left side cervical swelling for three months. The mass was free from surrounding tissues and excised completely. Histopathologic diagnosis of the specimen was lipoblastoma. Cervical lipoblastoma is a rapidly growing neoplasm. Only two cases of cervical lipoblastomas caused airway obstruction have been reported. Recurrence is rare in cases of lipoblastoma. Complete excision of the tumor is the treatment of choice. Seventeen cases of cervical lipoblastoma have been reported until now in the literature, but we think that lipoblastoma is more frequent than reported. Lipoblastoma must be remembered as a rare cause of cervical masses in childhood.

The Rapunzel syndrome (trichobezoar) causing gastric perforation in a child: a case report.

UNLABELLED: The Rapunzel syndrome (RS), is a rare form of gastric trichobezoar extending throughout the bowel. We report on a patient with RS causing gastric perforation and discuss the aetiology, pathogenesis, diagnosis and treatment of this unusual syndrome. RS is found characteristically in girls with varying gastro-intestinal symptoms. The recommended treatment for large or complicated trichobezoars is surgery. Psychiatric follow up is essential to diminish the frequency of recurrence. CONCLUSION: Symptoms of trichobezoars are nonspecific and may mimic those of other pathological gastro-intestinal conditions. Early diagnosis and treatment of this condition is of prime importance and may avoid later fatal complications.

Morgagni hernia in infants and children.

The cumulative data regarding five cases of Morgagni hernias in infants and children over the last six years have been reviewed. All five patients were clinically normal upon presentation; however, the most common symptoms and signs were respiratory. Chest x-ray was the most common diagnostic test. The diagnoses were also later confirmed with preoperative barium meal studies. All of the patients had additional congenital anomalies, of which malrotation of the gut was the most commonly encountered. Upon operation, all of the cases contained a hollow viscus, and had a sac. The defects were repaired through abdominal approaches. There was no mortality and postoperative complication in these series.

External jugular phlebectasia in children.

The most common cause of a mass in the neck appearing only during straining is a laryngocele. On the other hand, the rare jugular phlebectasia may present in a similar manner. The cause of the jugular phlebectasia remains unclear. No treatment is indicated for this benign self-limiting condition. However, surgical removal for cosmetic purposes alone consists of a unilateral excision of the internal or external jugular vein; this produces no gross side-effects. Conclusion. Every patient with a swelling in the neck that enlarges in size after the Valsalva manoeuvre, straining, coughing or sneezing should be suspected of having jugular phlebectasia.

Cavernous haemangioma of the penis in an infant.

We report on a 6-month-old boy with cavernous haemangioma of the penile shaft. He was admitted to our Department with the finding of a slowly enlarging penile mass two months in duration. Physical examination revealed an ovoid, solid and cystic subcutaneous mass 2 x 1, 5 x 1, 5 cm in size at the right side of the penile shaft. The tumour was completely removed surgically and histological examination demonstrated a cavernous haemangioma.

Spigelian hernia in children--report of two cases and review of the literature.

Two children with spigelian hernias are presented in this report. The etiopathogenesis and surgical anatomy of these rare hernias were discussed. Our cases are the fourth and fifth cases of spigelian hernia (SH) in patients under 2 years of age. Surgical intervention is indicated in all cases of SH because of the danger of strangulation of the bowel.

McKusick-Kaufman syndrome associated with esophageal atresia and distal tracheoesophageal fistula: a case report and review of the literature.

A female infant with McKusick-Kaufman syndrome associated with esophageal atresia and distal tracheoesophageal fistula is presented. To the best of our knowledge, this is the second report in the literature of this association.

Congenital lumbar (Grynfelt-Lesshaft) hernia.

Two children with superior lumbar hernias are presented in this report. The first one had many additional anomalies different from the literature and the other one is the second case report of congenital lumbar hernia with posterior meningomyelocele in the literature. Operative repair is recommended for these patients before 12 months of age.

Comparison of the effects of surgical and autologous fascial suture materials on testicular histology in rats subjected to orchiopexy.

In this study orchiopexy was performed in 30 Sprague-Dawley rats in order to compare traumatic effects of surgical and autologous fascial suture materials on testicular histology. Abscess formation was observed in 72.7% of the chromic, in 36.3% of the nylon, and in 18.1% of the vicryl fixed groups. There were no abscess formations in the dartos and autologous fascial fixed group. Examination of the testes revealed complete absence of spermatogenesis in the chromic fixed group. Spermatogenesis was normal, 72% in the vicryl, 18.1% in the nylon, 90.9% in the dartos and autologous fascial suture fixed groups. Antisperm antibody was not observed in any rat sera. We consider that it is preferred to use dartos pouch fixation. If necessary, it is advisable to use autologous fascial suture materials.

The Schinzel-Giedion syndrome. A case report and review of the literature.

The authors discuss a 1-day-old boy who had Schinzel-Giedion syndrome. This is the fifth case reported in the literature, and it presents additional abnormalities that have not been reported previously. The Schinzel-Giedion syndrome includes facially dysmorphic, skeletal, cardiac, and genito-urinary anomalies, but mainly congenital hydronephrosis. The diagnosis can be made by clinical and radiological examinations.