Evaluation of serum vitamin D levels in patients with X syndrome.

OBJECTIVE: Cardiac X syndrome is defined in patients with normal coronary angiogram who has typical chest pain and objective myocardial ischemia evidence. Recent studies have evaluated the association between vitamin D deficiency (vit D def) and cardiovascular diseases. Our aim of this study was to compare serum vit D levels in patients with syndrome X and controls. PATIENTS AND METHODS: We included 66 patients (49 women, 17 men) with syndrome X and 47 (30 women, 17 men) healthy controls. All of the patients' demographic features, laboratory analysis and medications are recorded. Vit D is measured quantitatively by paramagnetic particle chemiluminescence method. RESULTS: Mean age of the syndrome X group was higher than controls (56 ± 9.2 vs. 49 ± 9.6 years p < 0.001). Body mass index was higher in the patient group than controls (31.2 ± 5.6 vs. 29.1 ± 4.7 kg/m2 p: 0.011). Vit D levels were significantly lower in the syndrome X group than controls (6 ± 5.2 vs. 11.9 ± 7 ng/ml, p < 0.001). Parathormone levels were significantly higher in the syndrome X group than the control group (38.3 ± 23.4 vs. 28 ± 17.2 pg/ml, p: 0.014). hsCRP levels were higher in the syndrome X group than controls (3.1 ± 5.4 vs. 1.8 ± 2.4 mg/L, p: 0.042). CONCLUSIONS: Our study demonstrated significantly lower vit D levels in patients with CSX. This finding is correlated with previous studies showing an inverse correlation with lower serum vit D levels and different types of cardiovascular diseases. Vit D def may be a risk factor for syndrome X. Vit D def related increased inflammation may lead to the development of endothelial dysfunction and microvascular angina.

Serum high-sensitivity C-reactive protein, amyloid associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia.

AIM: The aim of this study was to detect any relationship between serum high-sensitivity C-reactive protein (hs-CRP), serum amyloid-associated protein (SAA) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and reversible myocardial ischaemia during cardiovascular exercise tests and to determine whether these biomarkers could predict transient myocardial ischaemia. METHODS: Ninety-six patients (36 women, 60 men, mean age 57 ± 8.5 years) were included in the study. Venous blood samples were taken from patients before and 15 minutes after exercise testing. SAA and hs-CRP were analysed using immunonephelometric assays (Dade-Behring, BN II, Marburg, Germany). NT-proBNP (pg/ml) was determined using the immulite 1 000 chemiluminescence immunoassay system (Siemens Medical Solution Diagnostics, Deerfiled, USA). Forty-eight patients (18 women, 30 men) with positive exercise tests were allocated to the exercise-positive group and 48 (18 women, 30 men) with negative exercise tests were put in the exercise-negative group. Coronary angiography was performed on all patients in the exercise-positive group. RESULTS: There was no difference between the levels of hs-CRP, SAA and NT-pro-BNP before and after exercise testing in both of the exercise groups. CONCLUSION: Serum levels of hs-CRP, SAA and NT-proBNP could not predict the occurrence of reversible myocardial ischaemia during exercise. Large-scale clinical studies are needed to clarify the status of hs-CRP, SAA and NT-proBNP with exercise.

Eosinophilia and hyperimmunoglobulinemia E as the presenting manifestations of Wegener's granulomatosis.

Eosinophilia has long been known as a hallmark of Churg-Strauss syndrome but has rarely been reported in Wegener's granulomatosis (WG). Here we describe a patient with WG who had skin, kidney and lung involvement as well as striking peripheral eosinophilia and hyperimmunoglobulinaemia E (hyper-IgE). The patient's clinical picture was complicated by intra-alveolar haemorrhage resulting in severe anaemia and respiratory failure. The pulmonary symptoms recovered completely, but the renal involvement evolved into end-stage renal failure despite intensive immunosuppressive treatment, intravenous immunoglobulin and plasmapheresis. We suggest that the presence of eosinophilia and hyper-IgE might contribute to the development of different disease patterns in WG.

The anesthetic management of a patient with pemphigus vulgaris--a case report.

The anesthetic management of a patient with pemphigus vulgaris who required general anesthesia and endotracheal intubation for craniotomy operation is described. The anesthesia was assured with Diprivan. Vecuronium bromide/isoflurane/nitrous oxide in oxygen and fentanyl when necessary. No anesthetic and surgical complication occurred.

Epidermoid tumor of the interhemispheric fissure.

In this report, we present a case of an interhemispheric epidermoid presenting with generalized seizure. The tumor was demonstrated radiologically and discussed with the pertinent literature.

Primary Ewing's sarcoma of the temporal bone with intracranial, extracranial and intraorbital extension. Case report.

Primary cranial Ewing's sarcoma is a very rare malignant tumor. Primary temporal bone Ewing's sarcoma with intraorbital extension is also a very rare condition. In this article we describe a case of primary Ewing's sarcoma of the temporal bone which extended into intracranial, extracranial and intraorbital compartments; manifesting with a swelling in the zygomatic fossa and proptosis of the right eye. The tumor was excised partially, and the patient underwent radiochemotherapy. The patient died 6 months after the therapy, with lung metastasis. The case is discussed with the pertinent literature.

Effect of thyrotropin-releasing hormone on Na(+)-K(+)-Adenosine triphosphatase activity following experimental spinal cord trauma.

The effect of thyrotropin-releasing hormone (TRH) on spinal cord Na(+)-K(+-adenosine triphosphatase (Na+-K+-ATPase) activity after spinal cord injury was evaluated in rats. The rats were injured by compression of the cord at T-10 for 1 minute with a 50-g clip. Saline in the placebo group (n = 8) and TRH (0.6 mg per dose) in the TRH group (n = 9) were administered intraperitoneally as bolus injections in two doses, at 45 and 120 minutes after the injury. The Na(+)-K(+)-ATPase activity level in the TRH group was significantly higher (p = 0.024) than in placebo group. These results indicate a possible role for TRH treatment in spinal cord injury.

Hirsutism as a first manifestation of a giant arachnoid cyst of the sylvian fissure.

In this report, we present a case presenting with hirsutism. In this case, there was a large sylvian fissure arachnoid cyst demonstrated by radiology. This case is discussed in view of clinical findings and a literature review is presented.

Aneurysm of an azygos anterior cerebral artery: report of two cases and review of the literature.

Aneurysm of an azygos anterior cerebral artery is rare. Two cases are presented. In case 2, the coexistence of arachnoid cyst with this aneurysm is reported. Literature is reviewed.

Epidermoid tumor of the occipital bone.

Intradiploic epidermoid tumor of the occipital bone was presented. There were neither intracranial extensions nor neurologic deficits. The lesion started as a painless mass under the scalp. The total removal of the tumor was associated with a good prognosis.

Clinical and radiological evaluation of angiographically occult, calcified intracranial vascular malformation. Case report.

In this study, we present an angiographically occult, calcified intracranial vascular malformation. This lesion is rare and has some therapeutic difficulties and different approaches by authors. In this article, we also discuss the clinical, radiological characteristic features of this lesion. We pay attention on the totally calcified malformation.

Epidermoid cyst of the brain stem. Case report.

Brain stem epidermoid cysts are extremely rare lesions. Only nine cases have been reported. Management of the epidermoid cyst is decompression of cyst contents and removal of cyst capsule. But in some cases resection of the cyst may result in a poor outcome because of cyst wall adhesion into the brain stem.

Primary intraosseous meningioma of the temporal bone in an infant. A case report.

Primary intraosseous meningioma of the skull bone is a very rare entity. Although it can occur at any age, it is very rare in children. We present a case and review the literature.

Solitary plasmacytoma of the skull. A case report.

A case of solitary plasmacytoma of the skull is presented. The tumor was radically removed. There was no systemic involvement and the patient was not submitted to radiotherapy. Lytic lesions of the skull are discussed.

Giant cell tumor of the fronto-parietal bone. A case report.

Giant cell tumor of the skull is very rare clinical entity. This paper presents a case of giant cell tumor of the fronto-parietal bone and a brief review of the literature.

A case of acute encephalopathy after iohexol lumbar myelography.

A case of acute encephalopathy after lumbar myelography is reported in a female aged 26 years. Fourteen hours after the procedure, the patient developed coma (GCS 6) and had generalized slowing of EEG activity. This state lasted about 12 h, followed by gradual and full recovery.

Two unusual complications of ventriculo-peritoneal shunts. Report of two cases.

Two cases in which thoracal extrusion and cervical disconnection complicated ventriculo-peritoneal shunts are reported. Other complications of distal shunts are also reviewed.

Choroid plexus arteriovenous malformation (AVM) in a newborn. Case report.

We report here on an unusual case of AVM with intraventricular hemorrhage in a full-term newborn infant. Clinical and radiological findings are discussed in the light of the recent literature.

Bilateral posterior fossa epidural hematoma--report of two cases.

Two cases of posttraumatic bilateral posterior fossa epidural hematoma are presented. Such hematomas are extremely rare, but can be surgically cured. Computed tomography helps to establish the diagnosis and determine the neurosurgical treatment.

Non operative management of acute extradural hematomas in children.

The Authors have reported a series of 15 patients with acute epidural hematomas (EDHs) that were not evacuated surgically. These EDHs were diagnosed 6 hours after injury and were followed by serial CT scanning. All patients showed resolution of the hematoma on CT scanning over a period of 2 to 5 weeks. Factors that influence outcome of medical treatment have been discussed.