Treatment with oestrogen-receptor agonists or oxytocin in conjunction with exercise protects against myocardial infarction in ovariectomized rats.

NEW FINDINGS: What is the central question of this study? Could the activation of oxytocin or oestrogen receptors be protective against myocardial injury after ovariectomy? If so, would exercising have an additional ameliorating effect? What is the main finding and its importance? The results revealed that when accompanied by exercise, both oestrogen receptor agonists and oxytocin improved cardiac dysfunction, inhibited the generation of pro-inflammatory cytokines and reduced myocardial injury in ovariectomized female rats, suggesting a new approach for protecting postmenopausal women against ischaemia-induced myocardial injury. To investigate the putative protective effects of oxytocin or oestrogen receptor agonists against myocardial injury of ovariectomized sedentary or exercised rats, female Sprague-Dawley rats assigned to sham-operated control and ovariectomized (OVX) groups were kept sedentary or undertook swimming exercise for 4 weeks and were treated with saline, an oestrogen receptor (ER) ß (DPN) or ERα agonist (PPT) or oxytocin. Ovariectomy increased weight gain and anxiety in sedentary rats, whereas exercise prevented weight gain. When accompanied by exercise, both ER agonists and oxytocin inhibited weight gain and anxiety; oxytocin, in the absence or presence of exercise, increased the left ventricular diastolic dimensions and ejection fraction, whereas ER agonists also increased left ventricular diameter when given to exercised rats. Upon the induction of myocardial ischaemia-reperfusion in the OVX rats, plasma creatine kinase-(muscle-brain) was depressed by PPT and oxytocin, whereas DPN, PPT and OT reduced plasminogen activator inhibitor-1 concentrations. The increased tumour necrosis factor-α concentration in OVX rats was also suppressed by exercise or DPN, PPT or oxytocin treatments, whereas the interleukin-6 concentration was diminished by all the treatments when given in conjunction with exercise. Disorganization of cardiac muscle fibres was reduced in all exercised rats. Oestrogen receptor agonists, as well as oxytocin, in conjunction with exercise may be effective new therapeutics to protect against myocardial ischaemia in postmenopausal women.

Time dependent impact of perinatal hypoxia on growth hormone, insulin-like growth factor 1 and insulin-like growth factor binding protein-3.

Hypoxic-ischemia (HI) is a widely used animal model to mimic the preterm or perinatal sublethal hypoxia, including hypoxic-ischemic encephalopathy. It causes diffuse neurodegeneration in the brain and results in mental retardation, hyperactivity, cerebral palsy, epilepsy and neuroendocrine disturbances. Herein, we examined acute and subacute correlations between neuronal degeneration and serum growth factor changes, including growth hormone (GH), insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) after hypoxic-ischemia (HI) in neonatal rats. In the acute phase of hypoxia, brain volume was increased significantly as compared with control animals, which was associated with reduced GH and IGF-1 secretions. Reduced neuronal survival and increased DNA fragmentation were also noticed in these animals. However, in the subacute phase of hypoxia, neuronal survival and brain volume were significantly decreased, accompanied by increased apoptotic cell death in the hippocampus and cortex. Serum GH, IGF-1, and IGFBP-3 levels were significantly reduced in the subacute phase of HI. Significant retardation in the brain and body development were noted in the subacute phase of hypoxia. Here, we provide evidence that serum levels of growth-hormone and factors were decreased in the acute and subacute phase of hypoxia, which was associated with increased DNA fragmentation and decreased neuronal survival.

Protective effects of melatonin therapy in model for neonatal hyperoxic lung injury.

CONTEXT: Bronchopulmonary dysplasia (BPD) is a common outcome of premature birth. Currently, no effective preventive therapy is available for BPD, but the major role of O2 toxicity in the development of BPD has gained attention, particularly for developing new antioxidants for prevention. The major protective mechanism of melatonin (MT) includes free-radical scavenging activity and activation of the cyclooxygenase-prostoglandin enzyme system. OBJECTIVE: The aim of this study was to evaluate the effects of MT on cytoprotection and healing in a model of hyperoxic lung injury in newborn rats. METHODS: This is a case-control study design. SETTING: The study occurred at the Gulhane Military Medical Academy in Ankara, Turkey. INTERVENTION: A total of 60 newborn pups from dated, Sprague-Dawley, pregnant rats were divided equally into 3 groups as follows: (1) control group, (2) hyperoxia-exposed group, and (3) hyperoxia-exposed plus MT-treated group (MT group). Hyperoxia was performed by placing these pups in an oxygen chamber for 14 d during which oxygen was continuously delivered. OUTCOME MEASURES: At the end of the 14 d, lung specimens were collected and evaluation of the lamellar-body count and determination of histopathological scores were performed. Also, the activities of superoxide dysmutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were assessed. RESULTS: The histopathological scores of the MT group were significantly lower than those of the hyperoxia-exposed group. The mean lamellar-protein and radial-alveolar counts in the MT group were found to be significantly higher than those of the hyperoxia-exposed group. Also, SOD and GSH-Px levels were significantly higher and MDA levels were significantly lower in the MT group compared with the hyperoxia-exposed group. CONCLUSION: MT therapy was found to have a protective effect in a model for hyperoxic lung injury in neonatal rats. Therefore, the research team suggests that MT therapy may be used for prevention of BPD in preterm infants after confirmation of this data by future clinical studies.

High serum 25-hydroxyvitamin D levels are associated with pediatric sepsis.

Despite major advances in intensive care, sepsis continues to be a major cause of morbidity and mortality. Vitamin D is involved in various physiologic functions, including cellular responses during infection and inflammation. The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D in childhood sepsis because it can be fatal if diagnosis delayed. The study included 40 children with sepsis and 20 children without sepsis (control group). We included only the patients with high probable sepsis, judged by clinical and laboratory findings, including positive blood culture. Blood samples were collected from patients with sepsis before treatment (pre-treatment group) and 48-72 hours later (post-treatment group). Treatment varied from ampicillin-sulbactam to cephalosporin. Blood samples were collected from control group once on admission. Serum 25-hydroxyvitamin D levels were significantly higher in sepsis (pre-treatment group) than control group (74 ± 8 ng/ml vs. 28 ± 12 ng/ml, p = 0.01) and the serum 25-hydroxyvitamin D levels were decreased to 44 ± 5 ng/ml (p = 0.01) after treatment. Moreover, we found significant positive correlation between 25-hydroxyvitamin D and each of well-know sepsis markers, C-reactive protein, tumor necrosis factor-α and interleukin-6. A cut-off point of 20 ng/mL for serum 25-hydroxyvitamin D showed 84% sensitivity and 76% specificity for sepsis diagnosis. This is the first study evaluating the diagnostic role of vitamin D in pediatric sepsis, thereby suggesting that serum 25-hydroxyvitamin D level can be used as a diagnostic marker for sepsis with high sensitivity and specificity.

Comparison between daily supplementation doses of 200 versus 400 IU of vitamin D in infants.

The daily supplementation of vitamin D is mandatory for infants. However, there are still conflicting opinions about the exact daily dose. Thus, we aimed to evaluate a daily supplementation dose of 200 IU is sufficient and compared the supplementation doses of 200 and 400 IU per day. One hundred and sixty-nine infants were randomly assigned to two groups (group 1, 200 IU/day; group 2, 400 IU/day) and there were 75 infants in group 1 and 64 were in group 2 with a total number of 139. The median levels of 25-hydroxyvitamin D3 were significantly increased in group 2 at the age of 4 months (group 1, 39.60 mcg/L; group 2, 56.55 mcg/L; p < 0.0001). We clearly demonstrated that at the age of 4 months, none of the infants on the group 2 had a serum level of 25-hydroxyvitamin D3 less than 30 mcg/L. However, 21.3% of the infants in group 1 had a level below 30 mcg/L. Thus, in order to avoid vitamin D deficiency and rickets, we recommend supplementation dose of vitamin D at 400 IU/day as a safe and effective dose.

Comparing beneficial effects of inhaled nitric oxide to L-arginine in necrotizing enterocolitis model in neonatal rats.

OBJECTIVE: Necrotizing enterocolitis (NEC) is a common and devastating gastrointestinal condition of neonatal infants. The pathophysiology of NEC remains poorly understood. We tried to evaluate the effectiveness of inhaled NO compared to L-arginine usage in necrotizing enterocolitis model in rats. MATERIAL-METHODS: 46 newborn pups from 4 time-mated Sprague-Dawley pregnant rats were divided equally into 4 groups as follows: NEC (subjected to NEC), NEC + L-arginine, NEC + inhaled NO and control. RESULTS: SOD, GSH-Px and NOx levels were significantly higher and MDA levels were significantly lower in NEC + inhaled NO group compared to NEC + L-arginine group. There was significantly lower intestinal injury and apoptosis index scoring in NEC + inhaled NO group compared to NEC + L-arginine group. CONCLUSION: We think that inhaled NO can be used as a novel therapeutic agent like L-arginine in NEC, like using in pulmonary hypertention in newborns but much more studies are needed.

A case of Mowat-Wilson syndrome caused by a truncating mutation within exon 8 of the ZEB2 gene.

Mowat-Wilson syndrome (MWS) is characterized by severe mental retardation with seizures, specific facial dysmorphism, Hirschsprung disease, anomalies of the corpus callosum, and genitourinary and cardiac malformations. The cause of MWS is a de novo mutation in the ZEB2 gene. This report describes a Turkish boy who was clinically diagnosed with MWS and had his diagnosis confirmed by molecular analysis of the ZEB2 gene. The investigation identified a heterozygous complex rearrangement in exon 8 of ZEB2, specifically a 48-nucleotide deletion and a 44-nucleotide insertion that caused a frameshift. MWS is a relatively newly identified disorder, and even MWS patients without Hirschsprung disease can be diagnosed easily based on clinical findings alone.

[Investigation of a nosocomial outbreak caused by ESBL positive Klebsiella pneumoniae in neonatal intensive care unit by AP-PCR]. / Yenidogan Yogun Bakim Ünitesinde Ortaya Çikan GSBL Pozitif Klebsiella pneumoniae Nedenli Nozokomiyal Bir Salginin AP-PCR ile Arastirilmasi

In the present study, we describe an outbreak caused by extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae in the neonatal intensive care unit (NICU) of a tertiary-care hospital. Nosocomial blood-stream infections were detected in three patients hospitalized in NICU. Two of the cases were transferred to NICU due to premature birth and the other due to the presence of cleft palate and retrognathia. K.pneumoniae was isolated on the 5th day of hospitalization of the first patient from umbilical swab and blood culture; on the 15th day of hospitalization of the second patient from blood culture and on the 7th day of hospitalization of the third patient from blood culture. The isolates were identified by automated API Rapid ID 32 Staph (BioMerieux, France) system in addition to conventional laboratory methods. Antibiotic susceptibilities of the isolates were determined by using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) criteria. The same antibiotic susceptibility patterns were detected in all isolates. Active surveillance cultures included environmental sampling from surfaces of NICU, laryngoscopes, ventilators and connections of ventilators, stethoscopes, nebulizers, aspiration tubings, disinfectant solutions, couveuse and couveuse distilled water. Two ESBL producing K.pneumoniae strains, presenting the same antibiotic susceptibility pattern with the clinical strains, were isolated from one couveuse distilled water sample and one aspiration tubing. All of the K.pneumoniae isolates were resistant to amoxycillin-clavulonic acid, cefazolin, cefepime, ceftriaxone, ceftazidime, cefuroxime, aztreonam and trimetoprim-sulphametoxazole and susceptible to cefoxitin, imipenem, meropenem, gentamicin, tobramycin, amikacin, netilmisin, tetracycline, ciprofloxacin and chloramphenicol. Arbitrarily primed polymerase chain reaction (AP-PCR) analysis done with M13 primer revealed the same genotype for the patient and environmental K.pneumoniae isolates. It was concluded that AP-PCR which is a simple, rapid and cheap method for the determination of genetic relatedness between isolates, can be applied for the detailed evaluation of nosocomial outbreaks to detect the source of infection and control the dissemination of the outbreak.

Apelin, vaspin, visfatin and adiponectin in large for gestational age infants with insulin resistance.

OBJECTIVE: To investigate the relation of circulating four adipokines (apelin, vaspin, visfatin, adiponectin) with markers of insulin sensitivity in large for gestational age (LGA) infants. PATIENTS AND METHODS: Forty LGA infants (20 LGA born from diabetic mothers and 20 LGA born from non-diabetic mothers) and 34 appropriate for gestational age (AGA) infants were recruited. Hyperinsulinism and insulin resistance was evaluated using the homeostasis model assessment (HOMA-IR), fasting glucose-to-insulin ratio (FGIR), quantitative insulin-sensitivity check index (QUICK-I) from fasting samples. Plasma adiponectin and vaspin levels were determined by radioimmunoassay. Determination of visfatin and apelin levels was performed by enzyme immunoassay. RESULTS: HOMA-IR, apelin and visfatin levels (p<0.001, p<0.001, p<0.001, respectively) were significantly elevated and adiponectin levels, FGIR and QUICK-I values. (p<0.001, p<0.001, p<0.05, respectively) were significantly lower in the LGA group. Vaspin levels were higher in the LGA group than AGA neonates without a significance. The LGA infants with diabetic mother had significantly higher visfatin, apelin, HOMA-IR values, fasting insulin levels and significantly lower adiponectin, FGIR, QUICK-I values. Apelin and visfatin were correlated positively, and adiponectin was correlated negatively with birthweight, HOMA-IR values and fasting insulin levels. CONCLUSION: Based on the findings of this study, it is too difficult to explain relation between birthweight and these adipocytokines, but findings of high insulin, HOMA-IR, visfatin, apelin and low adiponectin levels in the LGA neonates showed that these adipocytokines can be used as a good predictor for metabolic syndrome.

Bilateral renal hypoplasia and cystic dysplasia: a new phenotype of Thomas syndrome or a new syndrome?

Thomas syndrome is a rare syndrome including Potter sequence, renal anomalies, heart defects, cleft palate with other oropharyngeal anomalies. Here, we report a newborn with Potter sequence, bilateral renal hypoplasia and cystic dysplasia, multiple cardiovascular malformations, long large ears, frontal bossing, small lips, partial simple toe syndactyly, and cleft palate. To our best knowledge, this patient may be considered as a new variant of Thomas syndrome or a new syndrome.

Renal zinc clearance/glomerular filtration rate ratio as an indicator of marginal zinc deficiency associated with iron deficiency in childhood.

OBJECTIVE: To evaluate the usefulness of renal zinc clearance/glomerular filtration rate ratio (R(ClZn)/GFR) as an indicator of marginal zinc deficiency that is generally associated with iron deficiency in childhood. METHODS: Zinc status was evaluated in 36 iron-deficient children (22 boys and 14 girls) who ranged in age from 1 to 10 years using serum zinc concentration and U(Zn/Cr) and R(ClZn)/GFR ratios. The results were compared with the zinc status of 36 similar-aged healthy children (24 boys and 12 girls). RESULTS: Serum zinc concentrations were 96.72 +/- 2.13 microg/dL and 93.93 +/- 1.95 microg/dL in iron-deficient and healthy subjects, respectively (p > 0.05). U(Zn/Cr) ratios were 0.54 +/- 0.04 microg/mg and 0.88 +/- 0.04 microg/mg (p < 0.0001); R(ClZn)/GFR ratios were 2.27 x 10(-3) +/- 0.20 and 3.32 x 10(-3) +/- 0.20 (p < 0.001) in iron-deficient and healthy subjects, respectively. Individual values of R(ClZn)/GFR and U(Zn/Cr) ratios correlated with hemoglobin (Hb) concentrations (r = 0.34, p < 0.01 and r = 0.26, p < 0.05). Data grouped according to the ranges of Hb concentrations and R(ClZn)/GFR and U(Zn/Cr) ratios fit the following equations: The statistically significant difference in U(Zn/Cr) and R(ClZn)/GFR ratios between groups indicates decreased urinary estimation of marginal zinc deficiency, whereas no change was observed in serum zinc concentrations. According to the regression equation, it can be postulated that the R(ClZn)/GFR ratio is a linear function of Hb concentration and the U(Zn/Cr) ratio. CONCLUSION: R(ClZn)/GFR ratio was a reliable indicator for reduction in urinary zinc excretion; it estimated the marginal zinc deficiency associated with iron deficiency. The R(ClZn)/GFR ratio can be calculated using one sample of blood and urine; thus it could serve as an alternative indicator of marginal zinc deficiency, especially in routine health care.

The effects of omega-3 fatty acids on the newborn rat hyperoxic lung injury.

Objective: Bronchopulmonary dysplasia (BPD) is an important cause of morbidity in preterms. Inflammation plays a central role in the pathogenesis of the disease while omega-3 fatty acids are known to have anti-inflammatory effects. In this study, we examined the effects of supplementary omega-3 fatty acids on hyperoxic lung injury.Methods: Experimental hyperoxic lung injury induced newborn 3-day-old rats were monitored in a confined hyperoxic environment with an oxygen concentration of 90-95% for a 2-week period. Rats were divided into three groups as placebo, low-dose Omega-3, and high-dose Omega-3. During the 2-week study period, low and high-dose Omega-3 groups were given 300 and 600 mg/kg/day omega-3 docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) respectively, while those in placebo received the same amount of serum physiologic. At the end of the 2-week study, lungs of all the rats were removed and morphologic evaluation under light microscopy was performed. Mean cord length (Lm), alveolar surface area (SA), and alveolar wall thickness (Wt) were calculated to find out whether a statistically significant difference between groups existed.Results: Similar alveolar development was observed between groups. No difference was seen between mean Lm values. Although the alveolar surface area was found to be higher in high-dose omega-3 group, the difference was not considered to be statistically significant. While the widest alveolar wall thickness was observed in the placebo group, alveolar wall thickness difference between high-dose omega-3 group and placebo group was found to be statistically significant (placebo Wt=17,8 ± 2.3 µm, low-dose omega -3 Wt=15,6 ± 2,5 µm, high-dose omega -3 Wt=14,2 ± 2 µm) (p < .05).Conclusions: Omega-3 fatty acids were observed to prevent alveolar wall thickness to some extent, though with no noticeable effect on hyperoxic lung injury.

Melatonin improves cardiovascular function and ameliorates renal, cardiac and cerebral damage in rats with renovascular hypertension.

The effect of melatonin was investigated in an angiotensin II-dependent renovascular hypertension model in Wistar albino rats by placing a renal artery clip (two-kidney, one-clip; 2K1C), while sham rats did not have clip placement. Starting either on the operation day or 3 wk after the operation, the rats received melatonin (10 mg/kg/day) or vehicle for the following 6 wk. At the end of the nineth week, after blood pressure (BP) and echocardiographic recordings were obtained, plasma samples were obtained to assay lactate dehydrogenase (LDH), creatine kinase (CK), antioxidant capacity (AOC), asymmetric dimethylarginine (ADMA), and nitric oxide (NOx) levels. In the kidney, heart and brain tissues, malondialdehyde (MDA) and glutathione (GSH) levels, superoxide dismutase (SOD), catalase (CAT), myeloperoxidase (MPO) and Na(+)-K(+) ATPase activities were determined. 2K1C caused an increase in BP and left ventricular (LV) dysfunction. In hypertensive animals LDH, CK, ADMA levels were increased in plasma with a concomitant reduction in AOC and NOx. Moreover, hypertension caused a significant decrease in tissue SOD, CAT, and Na(+), K(+)-ATPase activities and glutathione content, while MDA levels and MPO activity were increased in all studied tissues. On the other hand, both melatonin regimens significantly reduced BP, alleviated oxidative injury and improved LV function. In conclusion, melatonin protected against renovascular hypertension-induced tissue damage and improved cardiac function presumably due to both its direct antioxidant and receptor-dependent actions, suggesting that melatonin may be of therapeutic use in preventing oxidative stress due to hypertension.

Treatment with human chorionic gonadotropin induces left ventricular mass in cryptorchid boys.

AIM: To examine the effects of human chorionic gonadotropin therapy on left ventricular mass index in boys with cryptorchidism. Cryptorchidism is the most frequent anomaly of male genitalia. PATIENTS AND METHOD: Thirty consecutive cryptorchid boys (mean age 4.8 +/- 3.2 years, range 1-8 years) undergoing human chorionic gonadotropin (hCG) therapy and 30 healthy controls were enrolled in the study. The patient group received hCG by intramuscular injection twice weekly for 5 weeks. At the end of the therapy, echocardiographic measures were reevaluated. The results of left ventricular mass were indexed to body surface area before and after therapy. RESULTS: Our results showed that cryptorchid boys undergoing hCG therapy had significantly higher left ventricular mass index than healthy controls at the end of therapy (p < 0.001). Serum total testosterone levels significantly increased in the patient group and positively correlated with left ventricular mass index (r = 0.48, p = 0.021). CONCLUSION: We demonstrated that hCG treatment for cryptorchidism caused a significant increase in left ventricular mass due to high testosterone levels. We conclude that hCG therapy may not be safe for the cardiovascular system in boys with cryptorchidism.

Posttreatment with aminoguanidine attenuates renal ischemia/reperfusion injury in rats.

Acute renal failure secondary to ischemia/reperfusion (I/R) injury is associated with significant mortality and morbidity. Aminoguanidine (AG), an inducible nitric oxide synthase inhibitor with antioxidant properties, has been reported beneficial in renal I/R injury. The aim of the present study was to investigate the effect of AG on renal I/R injury and compare the effectiveness of different AG treatment modalities. Sprague-Dawley rats were randomly assigned to one of four groups. The control group (n = 6) received sham operation. The I/R group (n = 6), AG-I group (n = 8), and AG-II group (n = 8) received bilateral renal ischemia for 45 min followed by 24 hours of reperfusion. The AG-I group received AG (50 mg/kg) intraperitoneally four hours and 10 minutes before the induction of ischemia. The AG-II group received AG (50 mg/kg) intraperitoneally four hours and 10 minutes after the initiation of reperfusion. Serum urea and creatinine levels increased significantly in the I/R and AG-I groups compared to the control group. Kidney samples from rats in the I/R and AG-I groups revealed severe tubular damage at histopathological examination. Posttreatment with AG significantly reduced serum urea and creatinine levels and improved histopathological lesions compared with the I/R group. Although pretreatment with AG failed to protect kidneys against I/R injury in this experimental model, posttreatment with AG attenuated renal dysfunction and histopathological changes after I/R injury.

Hyperbaric oxygen therapy improves myocardial diastolic function in diabetic patients.

Myocardial diastolic dysfunction is the relaxation abnormality of ventricles that limits the diastolic filling and generally precedes diastolic heart failure. Diastolic dysfunction is a common finding in diabetes. Diabetic patients receive hyperbaric oxygen (HBO) therapy for non-healing lower extremity ulcers, and exposure to HBO therapy is known to influence cardiovascular functions. This study was designed to evaluate the effect of HBO therapy on myocardial diastolic function in diabetic patients. Thirty diabetic patients (18 male and 12 female, 59.9 +/- 10 years old), who were planning to undergo HBO therapy, were consecutively enrolled. Myocardial diastolic function was evaluated by pulsed wave Doppler echocardiography and tissue Doppler echocardiography before the first HBO therapy and after the tenth HBO therapy session. HBO therapy improved the relaxation capability of left ventricular myocardium, which was reflected by reduction in E wave deceleration time of mitral valve inflow (286.1 +/- 65.8 msec vs 214.3 +/- 32.1 msec, p < 0.05). HBO therapy also affected favorably the diastolic filling dynamics of right ventricle, which was partially reflected by the changes in E wave peak velocity of tricuspid valve inflow (0.48 +/- 0.07 m/sec vs 0.46 +/- 0.09 m/sec, p < 0.05). Tissue Doppler parameters of mitral lateral annulus, which are better correlated with ventricular relaxation, tended to be improved after HBO therapy, but the degree of improvement was not statistically significant. In conclusion, we suggest that HBO therapy may improve the myocardial diastolic function of diabetic patients when applied repetitively.

Hyperbaric oxygen therapy decreases QT dispersion in diabetic patients.

Diabetes mellitus is frequently associated with the malignant ventricular arrhythmias and sudden death. The QT dispersion is the difference between the longest and shortest QT interval calculated from the standard 12-lead electrocardiogram. The QT dispersion is suggested as an index of myocardial electrical activity. An increase in QT dispersion is associated with the malignant ventricular arrhythmias and sudden cardiac death. Diabetic patients receive hyperbaric oxygen (HBO) therapy for non-healing lower extremity ulcers. The aim of this study was to determine the effect of HBO therapy on QT dispersion in diabetic patients. Thirty diabetic patients (18 male and 12 female, 59.9 +/- 10 years), who were planning to undergo ten sessions of HBO therapy in two weeks for non-healing lower extremity ulcers, were consecutively enrolled into the study. The 12-lead resting electrocardiography recordings were taken before the first HBO therapy and after the 10th HBO-therapy session. QT intervals were measured on electrocardiogram. QT intervals were corrected for heart rate by using Bazett's formula (corrected QT [QTc] = QT/ radical R - R [seconds]). QTc dispersion was significantly decreased from 59.8 +/- 17.4 msec to 52.2 +/- 15.5 msec after ten sessions of HBO therapy (p < 0.05). However, maximum QTc, minimum QTc and mean QTc did not change significantly after HBO therapy. We have concluded that HBO therapy may reduce the risk of malignant ventricular arrhythmia and sudden cardiac death in diabetic patients when applied repetitively.

A case of cerebello-oculo-renal syndrome with situs inversus totalis: a new phenotype.

Cerebello-oculo-renal syndromes are rare, autosomal recessive syndromes with uncertain nosology. Cerebello-oculo-renal syndromes involve many congenital malformations and may be associated with other disorders. The authors present a case of cerebello-oculo-renal syndrome with situs inversus totalis from a consanguineous family. The patient had cerebellar vermis hypoplasia, ocular abnormalities (Leber congenital amaurosis with retinal dystrophy, abnormal eye movements), developmental delay, growth deficiency, severe renal failure, and severe anemia. Imaging studies showed molar tooth sign, which was compatible with cerebello-oculo-renal syndromes and situs inversus totalis.

Determination of normal echocardiographic values for right ventricular volume in children with two-dimensional transthoracic echocardiography.

Assessment of right ventricular volume and functions is needed during the decision-making process in a number of cardiological disease states. We aimed to study these variables with conventional transthoracic two-dimensional echocardiography in 213 healthy cases, aged 15 days-15 years. Left ventricular systolic and diastolic volumes were measured from the apical five-chamber view and the right ventricular systolic and diastolic diameters, areas and volumes were measured from the subcostal coronal view, using the Simpson equation. Results were analyzed statistically to derive their relationship with age, height, body weight and body surface area. We conclude that right ventricular volumes measured with two-dimensional echocardiography in the subcostal coronal view using the Simpson equation are in accordance with data derived with other more complex methods reported in the literature; average values derived with this method in larger patient groups can be used as nomograms.