Biomedical subjects
Publications and source records attributed to A Celik.
Congenital granular cell tumors of the gingiva (synonyms: congenital myoblastoma, congenital epulis) originate from the alveolar ridge in newborns. They are rare granular-cell tumors with benign histology. The main differential diagnosis is epignathus (oral teratoma). Early surgical excision is recommended due to a risk of airway obstruction and difficulty feeding.
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BACKGROUND: Hepatitis C virus (HCV) infection acquired during dialysis treatment generally shows a relatively benign course after renal transplantation (RTx). However, less is known about the course of HCV infection acquired during or after RTx. METHODS: Clinical and histopathological assessment of 15 renal transplant recipients who acquired HCV infection during or after RTx. RESULTS: Alanine aminotransferase levels rose for the first time 1-19 weeks after RTx. HCV RNA was found positive in all patients, but anti-HCV became positive in only nine of them. During a mean follow-up of 21 +/- 12 months, jaundice appeared in 12 patients while ascites and/or hepatic encephalopathy occurred in six. Azathioprine was stopped in all patients. Cyclosporin was also stopped in four patients and in two of them prednisolone was also interrupted for a period of 3-7 weeks. Following this, ascites, hepatic encephalopathy and biochemical disturbances improved, while no deterioration was seen in graft function. Nine of the 15 patients had undergone two consecutive liver biopsies (LB). The first LB revealed cirrhosis in three and chronic hepatitis in six patients; the second LB showed cirrhosis in seven patients. The histological activity index (Knodell's score) progressed from 11.8 +/- 3.5 to 13.8 +/- 3.8. CONCLUSIONS: The results suggest that HCV infection acquired during or after RTx may run an unusual and rapidly progressive clinical and histopathological course at least in some of these patients. Decrease or withdrawal of immunosuppressive drugs may improve early hepatic failure without detrimental effect on graft function during that period.
T2*-weighted gradient echo magnetic resonance images of rat brain were obtained dynamically during acute hypoxemic hypoxia to investigate the relations between changes in cerebral blood oxygen saturation (deltaYb), blood hematocrit (Hct), and R2* (deltaR2*). Images from hypoxemic rats with normal Hct (42.8%+/-2.33%; n=12) were compared with those from hypoxemic rats with mild (33.4%+/-1.88%; n=8) or moderate (27.14%+/-2.7%; n=10) reduction of Hct. A linear relation between deltaYb and deltaR2* was obtained for all three groups. However, the slopes of the linear regressions were statistically different from one another (P < 0.001), with the slopes of the regression lines increasing inversely with Hct; that is, the slope for normal Hct is less than the slope for mildly reduced Hct, which is less than the slope for moderately reduced Hct. These data suggest that for any given reduction in the oxygen saturation of cerebral blood, the deltaR2* will be of a lesser magnitude when the hemoglobin concentration is reduced; the data are consistent with existing theoretical models of deoxyhemoglobin content-dependent effects in T2*-weighted magnetic resonance imaging.
BACKGROUND: Hypertrophic osteoarthropathy (HOA), well known in adults, is rarely encountered in children. The clinical features include clubbing of the fingers and toes, arthritis, and painful periosteal new bone formation of the tubular bones. The association of malignant disorders with HOA is more common in adults than in children. CASE: In this paper, a 12-year-old boy with intrathoracic Hodgkin disease and HOA is presented and four other children with HOA and Hodgkin disease in the literature reviewed. DISCUSSION: The presence of HOA has been thought to be a bad prognostic sign, but complete remission of Hodgkin disease and regression of clinical signs and symptoms of HOA were attained in our patient after chemotherapy and radiotherapy, and continue during 9 months post-therapy follow-up. CONCLUSIONS: HOA accompanying a malignant tumor in children is very rare. Only 5 cases have been associated with Hodgkin disease, including the present boy. It is important that patients with symptoms of HOA and an intrathoracic mass be examined carefully to rule out a malignancy.
Fetal tissue transplantation has gathered considerable interest among researchers dealing with organ transplantation. A large number of studies concerning fetal intestinal transplantation have been published in the past 2 decades, almost all of them aiming to determine the feasibility of a properly functioning fetal transplant in continuity with the host's own enteral system. This study was designed to determine the absorptive capacity of the neogut in vivo, without anastomosing the transplant to the host's intestine, and to evaluate its use as an accessory enteral segment. Intestinal segments taken from Wistar albino fetuses were transplanted subcutaneously into the abdominal wall of 20 Sprague-Dawley rats. Immunosuppression was maintained by daily cyclosporin A (Cy A) 10 mg/kg injections s.c. and evaluated by determination of serum Cy A level and T-helper/T-suppressor cell ratio. The neogut was converted into a Thiry-Vella loop 2 weeks after transplantation. A test solution composed of 20% glucose and Trophamine was perfused via the stomas; glucose and amino acid absorption gradients were calculated. The gamma-glutamyl transferase (GGT) activity and mitotic index of the neogut were determined. Results were compared to those obtained from the host. There was no significant difference (P > 0.05) in glucose absorption between the neogut and the host tissue. Amino acid absorption and specific GGT activity were significantly less (P < 0.01) in the neogut. There was no significant difference (P > 0.05) between neogut and host intestine in mitotic index. Our data support the idea of using a transplanted fetal intestinal segment as an accessory feeding route.
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The parental origin and mechanism of formation of polysomy X were studied in two polysomic cases, using four X-linked restriction fragment length polymorphisms, three (CA)n dinucleotide repeat sequences and one variable number tandem repeat (VNTR) locus as genetic markers. A nonradioactive technique based on the hybridization of the polymerase chain reaction (PCR) product was developed for the analysis of dinucleotide repeats. Segregation analysis using different nonradioactive approaches based on the PCR, revealed that all four X chromosomes were of maternal origin. These data provide additional evidence of an identical mechanism of successive nondisjunctions in maternal meiosis I and II.
The purpose of the study was to evaluate the non-infectious complications of continuous ambulatory peritoneal dialysis (CAPD) using peritoneal computed tomography (PCT). Twenty symptomatic patients were included in the study. Initially 2000 ml of dialysate fluid was infused into the peritoneal cavity and standard peritoneal computed tomography (SPCT) serial scans with 10 mm thickness were performed from the mid-thoracic region to the genital organs. Afterwards, 100 ml of non-ionic contrast material containing 300 mg/ml iodine was injected through the catheter and was distributed homogeneously in the intra-abdominal dialysate fluid by changing the positions of the patients; after waiting 2-4 h, the CT scan was released as peritoneal contrast computed tomography (PCCT). In patients (n = 20) both SPCT and PCCT revealed 90% (n = 18) pathological findings. But PCCT showed 60% (n = 12) additional pathological findings. We believe that PCT is beneficial for evaluation of non-infectious complications of CAPD. But PCCT is superior to SPCT in evaluating non-infectious complications encountered in patients on CAPD treatment.
Some chronic renal failure patients respond poorly to recombinant human erythropoietin (rHuEPO). In continuous ambulatory peritoneal dialysis (CAPD) patients, such a poor response may indicate inadequate dialysis or low body iron stores. To correct iron deficiency, once-a-week intravenous iron supplementation is recommended. However, hemodialysis patients receive iron supplements three times a week. This study was designed to compare the efficacy of iron supplementation between once-weekly and twice-weekly regimens. In both groups, rHuEPO doses were similar. Seventeen CAPD patients were studied. All had hemoglobin levels less than 10 g/dL. Ten patients were given 100 mg intravenous iron once weekly, and 7 were given 50 mg intravenous iron twice weekly until a total iron dose of 600 mg was achieved (stage I). The patients were crossed over to receive another 600 mg iron (stage II). Hematocrit increased significantly in patients receiving twice-a-week iron supplementation (+3.8% and 6%) compared to those receiving once-a-week iron supplementation (+1.3% and 1.4%) during stages I and II. The ferritin levels were not different between the groups. In conclusion, rHuEPO is more effective when administered with intravenous iron.
Structural data are presented on the protamine gene cluster (PGC) of human, mouse, rat, and bull. By restriction mapping we demonstrate that the organization of the protamine cluster is conserved throughout all four species, i.e., the genes are situated in a head to tail arrangement in the order: protamine 1-protamine 2-transition protein 2. Further, we established the nucleotide sequence of the entire human PGC (25 kb in total) and the 3' portion of the rat protamine cluster (PRM2 and TNP2 genes and intergenic region). In addition, a 1 kb fragment of the bovine and murine protamine cluster, situated between PRM2 and TNP2, was sequenced. This fragment is conserved regarding sequence, position, and orientation in all species examined, and was classified as likely coding region by gene recognition program GRAIL. Using the rat fragment as a probe in RNA blots, we detected a testis-specific signal of about 0.5 kb. Finally, we demonstrate a high density of Alu elements, both full and fragmented copies, in the human PGC and discuss their localization with respect to evolutionary and functional aspects.
Delay in the diagnosis of spermatic cord torsion (SCT) is still a significant cause of testicular loss in children. The aim of this experimental study was to assess the diagnostic value of serum creatine kinase (CK) in the early period following SCT. Forty male rats were assigned randomly into five similar groups: group A, control; group B, sham, right testis exposed, manipulated, and blood sampling at 6th h; group C, right SCT, blood sampling at 2nd h; group D, right SCT, blood sampling at 4th h; and group E, right SCT, blood sampling at 6th h. Ck and its isoenzymes were measured in the sera of all animals. All testes were removed and examined histopathologically. Significant increases in serum CK levels compared to control and sham groups were observed at 4 and 6 h following SCT. The major increase in CK was observed in the CK-MM isoenzyme fraction. Histologic pictures showed varying degrees of edema, vascular congestion, and hemorrhage in the testicular tissue, but no necrosis in any of the study groups. These results showed that serum CK levels in rats in the early period following SCT increase significantly before necrosis of testicular tissue. This may be of value as a diagnostic test, to corroborate findings from clinical studies.
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The combination of Wilms' tumor with aniridia, ambiguous genitalia/gonadoblastoma and mental retardation is defined as WAGR syndrome. The association with pseudohermaphroditism and nephropathy was also described as Drash syndrome. Here we report two cases with WAGR and Drash syndrome. The importance of early recognition and appropriate management of Wilms' tumor with those concurrent malformations is highlighted.
Bladder injury in the neonatal period is an exceedingly rare phenomenon that is usually iatrogenic. Bladder rupture as a complication of umbilical catheterization in a newborn with urinary ascites, respiratory distress and hematuria is presented and discussed.
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