Developmental anomalies of the pancreas have been reported but dorsal pancreatic agenesis is an extremely rare entity. We report an asymptomatic 62-year-old woman with complete agenesis of the dorsal pancreas. Abdomin...Developmental anomalies of the pancreas have been reported but dorsal pancreatic agenesis is an extremely rare entity. We report an asymptomatic 62-year-old woman with complete agenesis of the dorsal pancreas. Abdominal computed tomography (CT) revealed a normal pancreatic head, but pancreatic body and tail were not visualized. Magnetic resonance imaging (MRI) findings were similar to CT. At magnetic resonance cholangiopancreatography (MRCP), the major pancreatic duct was short and the dorsal pancreatic duct was not visualized. The final diagnosis was dorsal pancreatic agenesis.展开更多
AIM： To prospectively investigate serum CA 19-9 levels in type 2 diabetic patients in comparison with age and gender-matched control subjects.METHODS： We recorded duration of diabetes and examined fasting glucose le...AIM： To prospectively investigate serum CA 19-9 levels in type 2 diabetic patients in comparison with age and gender-matched control subjects.METHODS： We recorded duration of diabetes and examined fasting glucose levels, HbAlc levels and serum CA 19-9 levels in 76 type 2 diabetic patients and 76 controls. Abdominal CT was performed in order to eliminate abdominal malignancy in the diabetic and control groups.RESULTS： The average CA 19-9 level was 46.0 ± 22.4 U/mL for diabetic patients whereas it was 9.97± 7.1 U/mL for the control group （P 〈 0.001 ）. Regression analysis showed a positive correlation between diabetes and CA 19-9 independent from age, gender, glucose level and HbAlc level （t = 8.8, P 〈 001 ）. Two of the diabetic patients were excluded from the study because of abdominal malignancy shown by CT at the initial evaluation. For all patients, abdominal CT showed no pancreatic abnormalities. CONCLUSION： CA 19-9 is a tumor-associated antigen, which is elevated in pancreatic, upper gastrointestinal tract, ovarian hepatocellular, and colorectal cancers, as well as in inflammatory conditions of the hepatobiliary system, biliary obstruction and in thyroid diseases. Diabetes has been claimed to be a risk factor for pancreatic cancer, which is increasing its incidence and has one of the lowest survival rates of all cancers. CA 19-9 is used in the diagnosis of pancreatic cancer but is also a marker of pancreatic tissue damage that might be caused by diabetes. We propose that a higher cutoff value of CA 19-9 should be used in diabetics to differentiate benign and malignant pancreatic disease, and subtle elevations of CA 19-9 in diabetics should be considered as the indication of exocrine pancreatic dysfunction.展开更多
BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main c...BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients.AIM To evaluate the effects of R to S ratio(RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction(MI), to three-vessel disease(TVD) and mortality.METHODS The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group Ⅰ, while those with an RSR value greater than Ⅰ were assigned to group Ⅱ.RESULTS In our study, 466(35.9%) of the 1,296 patients, 357(38.3%) in group 1 and 109(29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573(44.2%), unstable angina(UA) 502(38.7%) and non ST-elevation MI 220(17%)were more prevalent in group Ⅰ. Acute anterior MI 263(20.3) in group Ⅰ, and acute inferior MI 184(14.2) in group Ⅱ was higher. Ischemic heart failure was the most common complication. In group Ⅱ, the red cell distribution width(RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111(8.5), and the mortality rate was 72(5.6), which was significantly higher than group Ⅰ RDW; in MI with ST and nonST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.CONCLUSION RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.展开更多
BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments....BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments. OBJECTIVE： To determine thyroid hormone levels in patients with ischemic or hemorrhagic stroke at the early stage, and to investigate its correlation with stroke prognosis. DESIGN, TIME AND SETTING： A comparative, observational study was performed at the Department of Emergency, Tertiary-care University Affiliated Hospital from January 2004 to January 2006. PARTICIPANTS： A total of 113 patients presenting to the Emergency Department within 3 hours of stroke symptom onset were approached for enrollment in the study. The patients were diagnosed by computer tomography examination, and comprised 87 ischemic stroke and 26 hemorrhagic stroke patients. METHODS： Following a thorough history and examination by emergency physicians, venous blood samples were collected from each patient. Thyroid-stimulating hormone （TSH）, free triiodothyronine （free T3）, and free thyroxine （free T4） levels were measured using a chemiluminescence method. The nerve function of patients was evaluated with Glasgow Coma Scale （GCS） score, and the patients were accordingly assigned to two subgroups-mild stroke （GCS ≥ 9） and severe stroke （GCS ≤ 8）. MAIN OUTCOME MEASURES： Blood levels of TSH, free T3 and free T4; mortality at 7 days. RESULTS： Mean TSH values in hemorrhagic stroke patients with GCS ≤ 8 were significantly greater than those in ischemic stroke patients with GCS ≤ 8 and GCS ≥ 9 （P 〈 0.05）. Compared with patients who survived, the highest TSH levels were detected in patients that had died within 7 days. Correlation analysis results revealed a significant negative relationship between GCS values and TSH levels in patients with hemorrhagic stroke （r= 0.552, P〈 0.01）, and no correlation was determined between GCS values and TSH levels in patients with ischemic stroke （r = 0.239, P 〉 0.05）. CONCLUSION： In patients with hemorrhagic stroke, high TSH levels were observed within the first 3 hours of stroke onset, which could be considered an indicator of poor prognosis.展开更多
Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of e...Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function （ejection fraction 〈 45%） who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.展开更多
AIM： To investigate the individual and combined effects of allopurinol and hyperbaric oxygen （HBO） therapy on biochemical and histopathological changes, oxidative stress, and bacterial translocation （BT） in the e...AIM： To investigate the individual and combined effects of allopurinol and hyperbaric oxygen （HBO） therapy on biochemical and histopathological changes, oxidative stress, and bacterial translocation （BT） in the experimental rat acute pancreatitis （AP）. METHODS： Eighty-five Sprague-Dawley rats were included in the study. Fifteen of the eighty-five rats were used as controls （sham, Group I ）. AP was induced via intraductal taurocholate infusion in the remaining seventy rats. Rats that survived to induction of acute necrotizing pancreatitis were randomized into four groups. Group H received saline, Group m allopurinol, Group IV allopurinol plus HBO and Group v HBO alone. Serum amylase levels, oxidative stress parameters, BT and histopathologic scores were determined. RESULTS： Serum amylase levels were lower in Groups Ⅲ, Ⅳ and v compared to Group H （974 ± 110, 384 ± 40, 851 ＋ 56, and 1664 Ⅳ 234 U/L, respectively, P 〈 0.05, for all）. Combining the two treatment optionsrevealed significantly lower median [25-75 percentiles] histopathological scores when compared to individual administrations （13 [12.5-15] in allopurinol group, 9.5 [7-11.75] in HBO group, and 6 [4.5-7.5] in combined group, P 〈 0.01）. Oxidative stress markers were significantly better in all treatment groups compared to the controls. Bacterial translocation into the pancreas and mesenteric lymph nodes was lower in Groups m, iV and v compared to Group H （54%, 23%, 50% vs 100% for translocation to pancreas, and 62%, 46%, 58% vs 100% for translocation to mesenteric lymph nodes, respectively, P 〈 0.05 for all）. CONCLUSION： The present study confirms the benefit of HBO and allopurinol treatment when administered separately in experimental rat AP. Combination of these treatment options appears to prevent progression of pancreatic injury parameters more effectively.展开更多
AIM： To determine the effects of high osmolarity contrast media （HOCM） and iso-osmolar contrast media （CM） application, with or without pressure, on hepato-pancreato-biliary （HPB） system. METHODS： Sixty rats w...AIM： To determine the effects of high osmolarity contrast media （HOCM） and iso-osmolar contrast media （CM） application, with or without pressure, on hepato-pancreato-biliary （HPB） system. METHODS： Sixty rats were divided into six equal groups as follows： Group i： （0.9% NaCl, control）, Group 2： （diatrizoate meglumine Na, ionic HOCM, Urographin）, Group 3： （iodixanol, iso-osmolar nonionic CM, Visipaque）; each of which was applied without pressure, whereas the animals of the remaining three groups （1p, 2p, 3p） were subjected to the same CM with pressure. We performed a duodenal puncture and introduced a catheter into the ampulla. After the catheterization, 0.2 mL CM or 0.9% NaCI was injected with or without pressure. Blood samples were taken for biochemical evaluations. The histopathological examinations of liver, common bile duct, and pancreas were performed. RESULTS： There were no significant differences between the six groups for blood amylase, alanine aminotransferases, aspartate aminotransferases, bilirubin levels （P 〉 0.05）. Alkaline phosphatase and γ glutamyl transaminase levels were higher （P 〈 0.05） in the Urographin groups （2, 2p） than the Visipaque groups （3, 3p）, or control groups （1, 1p）. Hepatocyte necrosis, portal area inflammation, and Kupffer＇s cell hyperplasia were higher （P 〈 0.05） in the study groups than the control group. However, there were no significant differences （P 〉 0.05） between HOCM （2, 2p） and iso-osmolar CM （3, 3p） groups. Bile duct proliferation and regeneration in the Urographin groups （2, 2p） were significantly higher （P 〈 0.05） than the Visipaque~ groups （3, 3p） or the control groups （1, lp）. Although CM caused minor damage to the pancreas, there were no statistically significant differences （P 〉 0.05） between the groups. Application of the CM with pressure did not cause additional damage to the HPB system. CONCLUSION： Iso-osmolar, non-ionic CM could be more reliable than the ionic HOCM, whereas the application of pressure during the CM application had no effect on the HPB system.展开更多
Purpose: To evaluate the incidence of secondary glaucoma, re- lated complications and effect of treatment in patients with uveitis. Materials and methods: Patients with different types of uveitis that regularly follow...Purpose: To evaluate the incidence of secondary glaucoma, re- lated complications and effect of treatment in patients with uveitis. Materials and methods: Patients with different types of uveitis that regularly followed by Uveitis-Behcet Department were evaluated retrospectively. Results of medical and surgical展开更多
AIM： To investigate the role of mangafodipir trisodium （MnDPDP） in focal pancreatic masses and mass-like lesions by evaluating contrast uptake features of the lesions and pancreatic parenchyma after contrast medium...AIM： To investigate the role of mangafodipir trisodium （MnDPDP） in focal pancreatic masses and mass-like lesions by evaluating contrast uptake features of the lesions and pancreatic parenchyma after contrast medium injection. METHODS： A total of 37 patients with pancreatic mass or mass-like lesions were examined by unenhanced and MnDPDP-enhanced magnetic resonance imaging （MRI）. RESULTS： MRI was obtained 20-40 min after infusion of MnDPDP and homogeneous contrast enhancement was observed in normal pancreas parenchyma. In patients with atrophic pancreas there was no enhancement in pancreatic parenchyma on MnDPDP-enhanced MRI. In 37 patients with 41 pancreatic masses and mass-like lesions, contrast enhancement was observed at 5 lesions on MnDPDP enhanced MRI. Three of these 5 lesions were focal pancreatitis and the other 2 were adenocarcinoma. No contrast enhancement was determined in 36 pancreatic masses and mass-like lesions in 32 patients. CONCLUSION： MnDPDP contrast-enhanced MRI, especially in cases with no parenchyma atrophy, can distinguish focal pancreatic lesion margins. Information about the function of pancreatic parenchyma can be obtained out of tumor. MnDPDP facilitates staging of pancreatic tumors by detection of metastatic lesions in the liver. In addition, diminished heteregenous uptake of MnDPDP in patients with pancreatitis may be helpful in differential diagnosis.展开更多
Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes coul...Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.展开更多
Objectives: Cardiac resynchronisation therapy (CRT) has proven its effectiveness in patients with symptomatic heart failure [1,2]. Although rewarding, the procedure of biventricular pacemaker implantation is challengi...Objectives: Cardiac resynchronisation therapy (CRT) has proven its effectiveness in patients with symptomatic heart failure [1,2]. Although rewarding, the procedure of biventricular pacemaker implantation is challenging and subsequently fails in 8%-11% of patients. In patients whose left ventricular (LV) electrode cannot be placed transvenously, surgical implantation of an epicardial electrode can be achieved. Methods: Seventeen patients (14 male, 3 female), among whom LV electrode was failed to be placed transvenously, were included into our study. The epicardial LV electrodes were implanted through anterior mini thoracotomy. The patients were followed up for approximate six months and complications, ejection fraction (EF), New York Heart Association (NYHA) class, QRS durations as well as pacing parameters were recorded. Results: Mean age of the patients was 64.4 ± 7.01 (54-79) years. Preoperative mean EF of the patients was 26.1% ± 3.7%. The LV electrode was placed at the optimal place on the lateral LV wall through left sided mini thoracotomy. The mean duration of the operation was 26.76 ± 8.12 minutes and the mean hospital stay was 2.05 ± 0.42 days. There were no intraoperative or postoperative complications. Only 1 patient had LV electrode displaced on the 3rd postoperative month and the patient was reoperated successfully. The EF on the 6th postoperative month was 29.4% ± 3.81% and NYHA class was 2.58 ± 0.5. The etiology of heart failure had no influence on outcome. Conclusions: Surgical implantation of LV lead is associated with low complication rates and excellent follow-up results without exposure to radiation. Thus epicardial leads can be proposed as equal alternative to transvenous leads.展开更多
Objective: In this study, we plan to measure plasma Catalase (CAT), Antioxidant Activity (AOA) and Glu- tathione-S-Transferase (GST) levels to understand whether oxidative stress develops or not and whether or not the...Objective: In this study, we plan to measure plasma Catalase (CAT), Antioxidant Activity (AOA) and Glu- tathione-S-Transferase (GST) levels to understand whether oxidative stress develops or not and whether or not the detoxification mechanism properly functions in children with Attention Deficit and Hyperactivity Disorder (ADHD) with unknown etiology and pathogenesis. Method and Results: Plasma CAT, AOA, and GST activities were spectrophotometrically measured in forty patients (average age 10.27 ± 2.54) and thirty-five (average age, 9.97 ± 2.59) healthy individuals as the control group. While the CAT activity showed no difference in the patient group (P > 0.05) compared to the control group, AOA and GST levels were found significantly meaningful (P = 0.001). Conclusion: In this pilot study ,the study shows that no oxidative stress develops in individuals with ADHD in high AOA and stable CAT activity, and that the de- toxification mechanism functions extremely in high GST activity. These findings need to be supported by other studies.展开更多
文摘Developmental anomalies of the pancreas have been reported but dorsal pancreatic agenesis is an extremely rare entity. We report an asymptomatic 62-year-old woman with complete agenesis of the dorsal pancreas. Abdominal computed tomography (CT) revealed a normal pancreatic head, but pancreatic body and tail were not visualized. Magnetic resonance imaging (MRI) findings were similar to CT. At magnetic resonance cholangiopancreatography (MRCP), the major pancreatic duct was short and the dorsal pancreatic duct was not visualized. The final diagnosis was dorsal pancreatic agenesis.
文摘AIM： To prospectively investigate serum CA 19-9 levels in type 2 diabetic patients in comparison with age and gender-matched control subjects.METHODS： We recorded duration of diabetes and examined fasting glucose levels, HbAlc levels and serum CA 19-9 levels in 76 type 2 diabetic patients and 76 controls. Abdominal CT was performed in order to eliminate abdominal malignancy in the diabetic and control groups.RESULTS： The average CA 19-9 level was 46.0 ± 22.4 U/mL for diabetic patients whereas it was 9.97± 7.1 U/mL for the control group （P 〈 0.001 ）. Regression analysis showed a positive correlation between diabetes and CA 19-9 independent from age, gender, glucose level and HbAlc level （t = 8.8, P 〈 001 ）. Two of the diabetic patients were excluded from the study because of abdominal malignancy shown by CT at the initial evaluation. For all patients, abdominal CT showed no pancreatic abnormalities. CONCLUSION： CA 19-9 is a tumor-associated antigen, which is elevated in pancreatic, upper gastrointestinal tract, ovarian hepatocellular, and colorectal cancers, as well as in inflammatory conditions of the hepatobiliary system, biliary obstruction and in thyroid diseases. Diabetes has been claimed to be a risk factor for pancreatic cancer, which is increasing its incidence and has one of the lowest survival rates of all cancers. CA 19-9 is used in the diagnosis of pancreatic cancer but is also a marker of pancreatic tissue damage that might be caused by diabetes. We propose that a higher cutoff value of CA 19-9 should be used in diabetics to differentiate benign and malignant pancreatic disease, and subtle elevations of CA 19-9 in diabetics should be considered as the indication of exocrine pancreatic dysfunction.
文摘BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients.AIM To evaluate the effects of R to S ratio(RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction(MI), to three-vessel disease(TVD) and mortality.METHODS The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group Ⅰ, while those with an RSR value greater than Ⅰ were assigned to group Ⅱ.RESULTS In our study, 466(35.9%) of the 1,296 patients, 357(38.3%) in group 1 and 109(29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573(44.2%), unstable angina(UA) 502(38.7%) and non ST-elevation MI 220(17%)were more prevalent in group Ⅰ. Acute anterior MI 263(20.3) in group Ⅰ, and acute inferior MI 184(14.2) in group Ⅱ was higher. Ischemic heart failure was the most common complication. In group Ⅱ, the red cell distribution width(RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111(8.5), and the mortality rate was 72(5.6), which was significantly higher than group Ⅰ RDW; in MI with ST and nonST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.CONCLUSION RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.
文摘BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments. OBJECTIVE： To determine thyroid hormone levels in patients with ischemic or hemorrhagic stroke at the early stage, and to investigate its correlation with stroke prognosis. DESIGN, TIME AND SETTING： A comparative, observational study was performed at the Department of Emergency, Tertiary-care University Affiliated Hospital from January 2004 to January 2006. PARTICIPANTS： A total of 113 patients presenting to the Emergency Department within 3 hours of stroke symptom onset were approached for enrollment in the study. The patients were diagnosed by computer tomography examination, and comprised 87 ischemic stroke and 26 hemorrhagic stroke patients. METHODS： Following a thorough history and examination by emergency physicians, venous blood samples were collected from each patient. Thyroid-stimulating hormone （TSH）, free triiodothyronine （free T3）, and free thyroxine （free T4） levels were measured using a chemiluminescence method. The nerve function of patients was evaluated with Glasgow Coma Scale （GCS） score, and the patients were accordingly assigned to two subgroups-mild stroke （GCS ≥ 9） and severe stroke （GCS ≤ 8）. MAIN OUTCOME MEASURES： Blood levels of TSH, free T3 and free T4; mortality at 7 days. RESULTS： Mean TSH values in hemorrhagic stroke patients with GCS ≤ 8 were significantly greater than those in ischemic stroke patients with GCS ≤ 8 and GCS ≥ 9 （P 〈 0.05）. Compared with patients who survived, the highest TSH levels were detected in patients that had died within 7 days. Correlation analysis results revealed a significant negative relationship between GCS values and TSH levels in patients with hemorrhagic stroke （r= 0.552, P〈 0.01）, and no correlation was determined between GCS values and TSH levels in patients with ischemic stroke （r = 0.239, P 〉 0.05）. CONCLUSION： In patients with hemorrhagic stroke, high TSH levels were observed within the first 3 hours of stroke onset, which could be considered an indicator of poor prognosis.
文摘Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function （ejection fraction 〈 45%） who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.
文摘AIM： To investigate the individual and combined effects of allopurinol and hyperbaric oxygen （HBO） therapy on biochemical and histopathological changes, oxidative stress, and bacterial translocation （BT） in the experimental rat acute pancreatitis （AP）. METHODS： Eighty-five Sprague-Dawley rats were included in the study. Fifteen of the eighty-five rats were used as controls （sham, Group I ）. AP was induced via intraductal taurocholate infusion in the remaining seventy rats. Rats that survived to induction of acute necrotizing pancreatitis were randomized into four groups. Group H received saline, Group m allopurinol, Group IV allopurinol plus HBO and Group v HBO alone. Serum amylase levels, oxidative stress parameters, BT and histopathologic scores were determined. RESULTS： Serum amylase levels were lower in Groups Ⅲ, Ⅳ and v compared to Group H （974 ± 110, 384 ± 40, 851 ＋ 56, and 1664 Ⅳ 234 U/L, respectively, P 〈 0.05, for all）. Combining the two treatment optionsrevealed significantly lower median [25-75 percentiles] histopathological scores when compared to individual administrations （13 [12.5-15] in allopurinol group, 9.5 [7-11.75] in HBO group, and 6 [4.5-7.5] in combined group, P 〈 0.01）. Oxidative stress markers were significantly better in all treatment groups compared to the controls. Bacterial translocation into the pancreas and mesenteric lymph nodes was lower in Groups m, iV and v compared to Group H （54%, 23%, 50% vs 100% for translocation to pancreas, and 62%, 46%, 58% vs 100% for translocation to mesenteric lymph nodes, respectively, P 〈 0.05 for all）. CONCLUSION： The present study confirms the benefit of HBO and allopurinol treatment when administered separately in experimental rat AP. Combination of these treatment options appears to prevent progression of pancreatic injury parameters more effectively.
文摘AIM： To determine the effects of high osmolarity contrast media （HOCM） and iso-osmolar contrast media （CM） application, with or without pressure, on hepato-pancreato-biliary （HPB） system. METHODS： Sixty rats were divided into six equal groups as follows： Group i： （0.9% NaCl, control）, Group 2： （diatrizoate meglumine Na, ionic HOCM, Urographin）, Group 3： （iodixanol, iso-osmolar nonionic CM, Visipaque）; each of which was applied without pressure, whereas the animals of the remaining three groups （1p, 2p, 3p） were subjected to the same CM with pressure. We performed a duodenal puncture and introduced a catheter into the ampulla. After the catheterization, 0.2 mL CM or 0.9% NaCI was injected with or without pressure. Blood samples were taken for biochemical evaluations. The histopathological examinations of liver, common bile duct, and pancreas were performed. RESULTS： There were no significant differences between the six groups for blood amylase, alanine aminotransferases, aspartate aminotransferases, bilirubin levels （P 〉 0.05）. Alkaline phosphatase and γ glutamyl transaminase levels were higher （P 〈 0.05） in the Urographin groups （2, 2p） than the Visipaque groups （3, 3p）, or control groups （1, 1p）. Hepatocyte necrosis, portal area inflammation, and Kupffer＇s cell hyperplasia were higher （P 〈 0.05） in the study groups than the control group. However, there were no significant differences （P 〉 0.05） between HOCM （2, 2p） and iso-osmolar CM （3, 3p） groups. Bile duct proliferation and regeneration in the Urographin groups （2, 2p） were significantly higher （P 〈 0.05） than the Visipaque~ groups （3, 3p） or the control groups （1, lp）. Although CM caused minor damage to the pancreas, there were no statistically significant differences （P 〉 0.05） between the groups. Application of the CM with pressure did not cause additional damage to the HPB system. CONCLUSION： Iso-osmolar, non-ionic CM could be more reliable than the ionic HOCM, whereas the application of pressure during the CM application had no effect on the HPB system.
文摘Purpose: To evaluate the incidence of secondary glaucoma, re- lated complications and effect of treatment in patients with uveitis. Materials and methods: Patients with different types of uveitis that regularly followed by Uveitis-Behcet Department were evaluated retrospectively. Results of medical and surgical
文摘AIM： To investigate the role of mangafodipir trisodium （MnDPDP） in focal pancreatic masses and mass-like lesions by evaluating contrast uptake features of the lesions and pancreatic parenchyma after contrast medium injection. METHODS： A total of 37 patients with pancreatic mass or mass-like lesions were examined by unenhanced and MnDPDP-enhanced magnetic resonance imaging （MRI）. RESULTS： MRI was obtained 20-40 min after infusion of MnDPDP and homogeneous contrast enhancement was observed in normal pancreas parenchyma. In patients with atrophic pancreas there was no enhancement in pancreatic parenchyma on MnDPDP-enhanced MRI. In 37 patients with 41 pancreatic masses and mass-like lesions, contrast enhancement was observed at 5 lesions on MnDPDP enhanced MRI. Three of these 5 lesions were focal pancreatitis and the other 2 were adenocarcinoma. No contrast enhancement was determined in 36 pancreatic masses and mass-like lesions in 32 patients. CONCLUSION： MnDPDP contrast-enhanced MRI, especially in cases with no parenchyma atrophy, can distinguish focal pancreatic lesion margins. Information about the function of pancreatic parenchyma can be obtained out of tumor. MnDPDP facilitates staging of pancreatic tumors by detection of metastatic lesions in the liver. In addition, diminished heteregenous uptake of MnDPDP in patients with pancreatitis may be helpful in differential diagnosis.
文摘Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.
文摘Objectives: Cardiac resynchronisation therapy (CRT) has proven its effectiveness in patients with symptomatic heart failure [1,2]. Although rewarding, the procedure of biventricular pacemaker implantation is challenging and subsequently fails in 8%-11% of patients. In patients whose left ventricular (LV) electrode cannot be placed transvenously, surgical implantation of an epicardial electrode can be achieved. Methods: Seventeen patients (14 male, 3 female), among whom LV electrode was failed to be placed transvenously, were included into our study. The epicardial LV electrodes were implanted through anterior mini thoracotomy. The patients were followed up for approximate six months and complications, ejection fraction (EF), New York Heart Association (NYHA) class, QRS durations as well as pacing parameters were recorded. Results: Mean age of the patients was 64.4 ± 7.01 (54-79) years. Preoperative mean EF of the patients was 26.1% ± 3.7%. The LV electrode was placed at the optimal place on the lateral LV wall through left sided mini thoracotomy. The mean duration of the operation was 26.76 ± 8.12 minutes and the mean hospital stay was 2.05 ± 0.42 days. There were no intraoperative or postoperative complications. Only 1 patient had LV electrode displaced on the 3rd postoperative month and the patient was reoperated successfully. The EF on the 6th postoperative month was 29.4% ± 3.81% and NYHA class was 2.58 ± 0.5. The etiology of heart failure had no influence on outcome. Conclusions: Surgical implantation of LV lead is associated with low complication rates and excellent follow-up results without exposure to radiation. Thus epicardial leads can be proposed as equal alternative to transvenous leads.
文摘Objective: In this study, we plan to measure plasma Catalase (CAT), Antioxidant Activity (AOA) and Glu- tathione-S-Transferase (GST) levels to understand whether oxidative stress develops or not and whether or not the detoxification mechanism properly functions in children with Attention Deficit and Hyperactivity Disorder (ADHD) with unknown etiology and pathogenesis. Method and Results: Plasma CAT, AOA, and GST activities were spectrophotometrically measured in forty patients (average age 10.27 ± 2.54) and thirty-five (average age, 9.97 ± 2.59) healthy individuals as the control group. While the CAT activity showed no difference in the patient group (P > 0.05) compared to the control group, AOA and GST levels were found significantly meaningful (P = 0.001). Conclusion: In this pilot study ,the study shows that no oxidative stress develops in individuals with ADHD in high AOA and stable CAT activity, and that the de- toxification mechanism functions extremely in high GST activity. These findings need to be supported by other studies.
