Showing papers in "Interventional Medicine and Applied Science in 2016"

Effects of Moringa oleifera aqueous leaf extract in alloxan induced diabetic mice.

Abstract: ObjectiveThere is a lack of knowledge regarding the underlying mechanisms of the antidiabetic activity of Moringa oleifera. This study investigates the antidiabetic effect of M. oleifera and its im...

Norfloxacin and metronidazole topical formulations for effective treatment of bacterial infections and burn wounds.

Abstract: IntroductionOur various previous findings have shown the suitability of norfloxacin in the treatment of bacterial infections and burn wounds in alone as well as in combination with Curcuma longa in various topical (ointments, gels, and creams) and transdermal drug delivery systems.Aims and methodsKeeping these facts in consideration, we have made an another attempt to prepare semisolid formulations containing 1% w/w of norfloxacin and metronidazole with different bases like Carbopol, polyethylene glycol, and hydroxypropylmethyl cellulose for effective treatment of bacterial infections and burn wounds. The prepared formulations were evaluated for physicochemical parameters, in vitro drug release, antimicrobial activity, and burn wound healing properties.ResultsThe prepared formulations were compared with Silver Sulfadiazine cream 1%, USP. Antimicrobial activity of norfloxacin semisolid formulations was found to be equally effective against both aerobic and anaerobic bacteria in comparison to a marketed for...

Pathogenesis of Warthin’s tumors

Abstract: IntroductionWarthin’s tumor, also known as papillary cystadenoma lymphomatosum, monomorphic adenoma, or adenolymphoma, is a benign cystic tumor of the salivary glands containing abundant lymphocytes and lymph node-like stroma. It is named after the pathologist Aldred Scott Warthin, who described two cases in 1929.ObjectiveThe aim of this study is to analyze the pathogenesis of Warthin’s tumor.MethodsA total of 15 patients with Warthin’s tumor were studied. Hematoxylin and eosin stains, which have been used for at least a century and are still essential for recognizing various tissue types and the morphologic changes for cancer diagnosis, were used. Warthin’s tumor was evaluated for the expression of MGMT, CD3, HSP90AA1, MMP-1, Bcl-2, CD79A, IgG, Ki-67, p53, IgM, OPN, S100, myeloperoxidase, and VEGF by immunohistochemistry.ResultsImmunohistochemical staining confirmed that the immune cells within the follicles of Warthin’s tumor were positive for MGMT (10.0 ± 0.34%), Ki-67 (13.3 ± 0.45%), Bcl-2 (42.6 ± 8.3...

Pseudothrombocytopenia with multiple anticoagulant sample collection tubes

Abstract: The knowledge of pseudothrombocytopenia (PTCP) is important for the accuracy of a clinical assessment and for avoiding unnecessary treatment. An elderly patient was hospitalized with left lung pneumonia. Severe thrombocytopenia [platelet (PLT) number: 18 × 109/L] without any clinical bleeding was found in ethylenediaminetetraacetic acid blood collection tube. PLT measurement was repeated in various anticoagulant [sodium citrate, lithium heparin, disodium oxalate, hirudin, and magnesium sulfate (Mg-sulfate)] sample collection tubes and all of them showed thrombocytopenia except with Mg-sulfate. To the best of our knowledge, PTCP with five anticoagulant sample collection tubes has not been reported earlier.

Ventilator-associated pneumonia and the importance of education of ICU nurses on prevention - Preliminary results.

Abstract: Background and aimsVentilator-associated pneumonia (VAP) increases intensive care unit (ICU) length of stay, ICU mortality, the number of ventilator days, and costs. We implemented a VAP bundle and investigated its efficacy on prevention. Materials and methodsA prospective observational study was conducted between January 1, 2015 and December 31, 2015 in a 12-bed multidisciplinary ICU. The bundle was implemented on July 02, 2015. Comparative analysis was performed before and after the implementation of the bundle. The compliance of the nurses was also studied. ResultsThe incidence of VAP was 21.5/1,000 ventilator days (95% CI: 14.17–31.10) in the first phase and 12.0/1,000 ventilator days (95% CI: 7.2–19.49) in the second phase. Relative risk reduction was 44% (95% CI: −0.5 to 0.98). Most common bacteria identified during the first phase were Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Staphylococcus aureus; and in the second phase P. aeruginosa, Acinetobacter baumannii, and S. maltophilia w...

Characteristics of cellular composition of periodontal pockets

Abstract: PurposeThe development of inflammatory periodontal disease in young people is an urgent problem of today's periodontology, and requires a development of new methods that would give an opportunity not only to diagnose but also for prognosis of periodontitis course in a given patients contingent.ResultsCellular structure of periodontal pockets is presented by hematogenous and epithelial cells. Our results are confirmed by previous studies, and show that the penetration of periodontal pathogens leads to formation in periodontal tissue of a highly active complex compounds—cytokines that are able to modify the activity of neutrophils and reduce their specific antibacterial properties. Cytokines not only adversely affect the periodontal tissues, but also cause further activation of cells that synthesized them, and inhibit tissue repair and process of resynthesis of connective tissue by fibroblasts.ConclusionNeutrophilic granulocytes present in each of the types of smear types, but their functional status and qu...

Associations of sit-up ability with sarcopenia classification measures in Japanese older women.

Abstract: To test the hypothesis that sit-up performance is associated with sarcopenia classification measures, 93 older women aged 53–78 years were divided into three groups based on achieved repetitions (30 s) for the sit-up performance test: Group 0 (G 0, n = 33) performed 0 repetitions, Group 1–9 (G 1–9, n = 30) performed between 1 and 9 repetitions, and Group 10+ (G 10+, n = 30) performed over 10 repetitions. Dual-energy X-ray absorptiometry-derived appendicular lean soft tissue mass (aLM), handgrip strength (HGS), usual walking speed, and chair stand were measured, and low muscle mass (aLM index) and poor physical function were defined according to previous studies. Age and body mass index were similar among the three groups. HGS was higher in G 10+ compared with G 0. The prevalence rate of low muscle mass was 30% for G 0, 20% for G 1–9, and 3% for G 10+. Low HGS was observed in both G 0 (24%) and G 1–9 (20%), but not in G 10+. Only two persons in G 0 were classified as slow walking speed. Our results suggest...

Scaffold degradation during bone tissue reconstruction in Macaca nemestrina mandible.

Abstract: ObjectiveTo examine the degradation of three scaffolds composed of hydroxyapatite/tricalcium phosphate (HA/TCP) with 70∶30 ratio, HA/TCP with 50∶50 ratio, and HA/TCP/chitosan scaffold as analyzed by the RNA expression of matrix metalloprotease 2 (MMP2), interleukin 13 (IL13), and tartrate-resistant acid phosphatase (TRAP) genes.MethodsThe three tested scaffolds and dental pulp stromal cells (DPSCs) were transplanted into the mandibular bone defect of six young male Macaca nemestrina. Defect on the left mandible served as the experimental group and the right mandible served as control group (split mouth design). The biopsies were retrieved at 0, 2, and 4 weeks after cell-scaffold transplantation. The expression of MMP2, IL13, and TRAP was analyzed by real-time PCR (RT-PCR).ResultsThe inflammatory cells were still detected in areas where active bone and blood vessel formation occurred. The remnants of scaffold biomaterials were rarely seen. The expression of MMP2, IL13, and TRAP was observed in all samples....

Structural features of bone marrow.

Abstract: PurposeThis article is devoted to the investigation of the structural features of the bone marrow of mature rats.Materials and methodsThe investigation of the structural features of the bone marrow was performed on the femurs of the mature male rats. General structure of the organ was studied with hematoxylin–eosin and Van Gieson staining of samples. Certain features of the bone marrow structure were studied using immunohistochemical method (CD3, CD79α, S100, myeloperoxidase, and cyclin D1).ResultsWe can state that stromal–parenchymal structure is typical for the bone marrow of rats as for any other organ. The stromal component is presented with bone tissue (48.8 ± 3.3% at epiphyses), the net of blood vessels (18.7 ± 2.1%), fat tissue (11 ± 2%), fibrous tissue (0.7 ± 0.2%), and the network of reticular fibers. Hematopoietic tissue covers 20.9 ± 3.7% at the femoral epiphyses and 69.6 ± 2.2% at diaphysis. Among these tissues, myelopoiesis occupies 74.2 ± 4.7%, erythropoiesis – 24.3 ± 4.7%, and lymphopoiesis...

Effects of aqueous extract of alfalfa on hyperglycemia and dyslipidemia in alloxan-induced diabetic Wistar rats

Abstract: BackgroundThe aim of this study was to investigate the effects of aqueous extract of alfalfa on blood glucose and serum lipids in alloxan-induced diabetic rats.Materials and methodsThirty-two adult male Wistar rats weighing 210–250 g were selected and divided randomly into four groups of eight animals each for 21 days as follows: (1) control group, (2) diabetic control group, (3) diabetic group plus aqueous extract of alfalfa (250 mg/l), and (4) diabetic group plus aqueous extract of alfalfa (500 mg/l). Serum concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), very low-density lipoprotein (VLDL), glucose, and the liver enzymes such as aspartate transaminase (AST) and alanine transaminase (ALT) were measured at the end of period in all studied groups.ResultsAdministration of 250 and 500 mg/l aqueous alfalfa extract resulted in a significantly decreased glucose, TC, TG, LDL-C, VLDL, ALT, and AST levels and i...

A resistant case of pemphigus gestationis successfully treated with cyclosporine.

Abstract: Pemphigoid gestationis (PG) is a rare autoimmune blistering disease of pregnancy caused by antibasement membrane zone autoantibodies. The usual clinical findings are multiple pruritic urticarial papules and plaques, target lesions, vesicles, and blisters that occur during the second and third trimesters of pregnancy or in the immediate postpartum period. The disease is often treated with topical corticosteroids and oral antihistaminics. In more severe cases, systemic corticosteroids are needed. Herein, we report a case of resistant PG that responded to treatment with cyclosporine.

An uncommon cause of abdominal pain: Mesenteric cyst.

Abstract: Mesenteric cysts are benign cystic lesions. Here, we present the case of a patient with abdominal pain, which was diagnosed as mesenteric cyst. A 28-year-old male patient was admitted to the emergency department (ED) with abdominal pain and distention. Abdominal palpation revealed a smooth-surfaced mass palpable in the left upper quadrant. Ultrasonography depicted a hypoechoic heterogeneous mass-like structure with a size of 15 × 12 cm. Computerized tomography (CT) showed a well-defined cystic structure with a size of 12 × 12.5 cm near to the duodenum and pancreas. The patient was admitted, and the cystic structure was drained with a percutaneous drainage catheter; then, sclerotherapy was performed using ethyl alcohol with the aid of ultrasonography. The material was sent to the pathology lab and revealed negative results for malignant cell and mucin. The patient underwent a control CT with contrast, which revealed the catheter at the site of the operation and no cystic lesion after procedure. He was disc...

Formulation and evaluation of controlled release ethylcellulose and polyethylene glycol microspheres containing metoprolol tartrate

Abstract: Metoprolol tartrate is rapidly absorbed from both gastric and intestinal regions, after oral administration. To retard the release rate of the metoprolol tartrate, microspheres were prepared with varying concentrations of a mixture containing ethylcellulose and polyethylene glycol-6000. The prepared microspheres were evaluated for various physicochemical characteristics and in vitro drug release. The percent yield of microspheres was in the range of 75.2–87.3%. The particle size of microspheres was found to be in the range of 73.2–85.5 μm. Fourier transform-infrared spectral analysis and differential scanning calorimetry concluded the absence of any interaction between the drug and the carriers. The release time profile of metoprolol tartrate from microspheres in 0.1 N hydrochloric acid solution was to the extent of 33.4–60.2%. The complete release of metoprolol tartrate occurred from MPT-3 and MPT-4 in phosphate buffer solution (pH 7.4) within 8 and 7 h, respectively, whereas the incomplete release (72.3...

A rare case of tuberculous salpingitis.

Abstract: The objective of this study was to give an overview of a rare case of tuberculosis of the left fallopian tube in postmenopausal women. It is known that the isolated tuberculous salpingitis without spreading to the endometrium is extremely rare case. In our case, it simulated a cancer of appendages at the late stages that were proved by the increased level of CA-125. This fact as well as the macroscopic image of the left fallopian tube was incorrectly considered by the clinicians as a malignant neoplasm of fallopian tube. However, after pathomorphological examination of postoperative samples during histological study, the main method of verification of the diagnosis, revealed the specific granulomas in the samples that indicate the tubercular inflammation. It was considered by clinical and laboratory as data secondary focus.

Effects of amniotic epithelial cell transplantation in endothelial injury

Abstract: PurposeHuman amniotic epithelial cells (hAECs) are promising tools for endothelial repair in vascular regenerative medicine. We hypothesized that these epithelial cells are capable of repairing the damaged endothelial layer following balloon injury of the carotid artery in adult male rats.ResultsTwo days after injury, the transplanted hAECs were observed at the luminal side of the arterial wall. Then, 4 weeks after the injury, significant intimal thickening was observed in both untreated and cell implanted vessels. Constriction was decreased in both implanted and control animals. Immunohistochemical analysis showed a few surviving cells in the intact arterial wall, but no cells were observed at the site of injury. Interestingly, acetylcholine-induced dilation was preserved in the intact side and the sham-transplanted injured arteries, but it was a trend toward decreased vasodilation in the hAECs’ transplanted vessels.ConclusionWe conclude that hAECs were able to incorporate into the arterial wall without ...

Reversal of abnormal cardiac parameters following mitral valve replacement for severe mitral stenosis in relation to pulmonary artery pressure: A retrospective study of noninvasive parameters - Early and late pattern.

Abstract: Background and objectivesAlthough the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods.MethodsThe preoperative, early, and 1-year postoperative data – functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) – of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson’s), and their change (t-test), in relation to that in PAP. PH group-based [Group (Gp)-I PAP ≤60 mmHg, Gp-II PAP >60 mmHg] analysis highli...

Transgastric removal of a polycystic liver disease using mini-laparoscopic excision

Abstract: Surgical treatment is often necessary for patients with symptomatic or complicated polycystic liver diseases (PLD). In this paper, we describe a 52-year-old female with symptomatic PLD that had resulted in the formation of liver cysts, the largest of which was 23 cm in diameter. The patient underwent mini-laparoscopic fenestration through 5-mm abdominal trocars. The walls of the cysts were unroofed using a harmonic scalpel. Four thickened rubber-like pieces of specimens (sizes ranged between 9 × 6 × 0.5 cm and 6 × 3 × 0.1 cm) were not suitable for extraction through the 5-mm trocars. A gastrotomy was performed, and the specimens were extracted through the stomach with the help of an endoscope. Transoral removal of the specimens was completed without any complications, and the gastrotomy was closed intracorporeally. The patient was permitted to take fluids on day one, and oral intake was gradually increased. She was discharged on day four and was asymptomatic after two months of follow-up. The combination ...

Soluble vascular cell adhesion molecule-1 and magnesium sulfate with nifedipine treatment in Indonesian women with severe pre-eclampsia

Abstract: BackgroundEndothelial cell activation in pre-eclampsia is associated with elevated soluble vascular cell adhesion molecule-1 (sVCAM-1) levels. The objective of the study was to determine whether sVCAM-1 levels in Indonesian women with pre-eclampsia were similar to other ethnic studies and to determine the effects of magnesium sulfate with nifedipine on blood pressure.MethodsA total of 61 pregnant women were admitted, who had normal pregnancy (n = 25) and severe pre-eclampsia (n = 36). Blood sampling was performed at admission to the study, 1 h after placental separation, and 24 h postpartum. sVCAM-1 and blood pressure levels were determined.ResultsThe mean ages in normal pregnancy (n = 25) and in severe pre-eclampsia (n = 36) are 30.0 ± 3.4 years and 27.1 ± 6.1 years, respectively. Significantly elevated sVCAM-1 was seen in pre-eclampsia. No significant variation in sVCAM-1 levels during the study periods was seen in both groups of cohorts. Magnesium sulfate infusion and nifedipine significantly lowered t...

A new approach to detect epidemic of DHF by combining ARIMA model and adjusted Tukey’s control chart with interpretation rules

Abstract: The aim of this study was to propose a new method to detect the epidemic of dengue hemorrhagic fever (DHF) using seasonal autoregressive integrated moving average model [ARIMA(1,0,2)(0,1,2)12] with no constant and adjusted Tukey’s control chart and the results obtained were interpreted using seventh interpretation rule. Data on the number of DHF cases in Chonburi reported during 2007–2013 were used. The results indicated that this new approach efficiently detected the epidemic of DHF in October 2015 with the forecasted number of DHF (257 cases) and root-mean-squared error (RMSE = 46.71).

The effect of Ramadan fasting on sirtuin and visfatin levels.

Abstract: Objective Our aim was to determine how Ramadan fasting effects serum Human NAD-dependent deacetylase sirtuin 1 (SIRT1/SIR2L1) and visfatin levels during pregnancy. Materials and methods Thirty-six patients were included in this case-control study. The patient group consisted of 18 pregnant women who were Ramadan fasting. Another healthy 18 pregnant women with matching pregnancy weeks and ages formed the control group. Blood samples were obtained from the patients for biochemical analyses and serum adipokine level measurements. Results The mean sirtuin and visfatin levels in fasting pregnant women were 2.87 ± 0.95 and 60.18 ± 19.49 ng/mL, respectively, while the mean serum sirtuin and visfatin levels in the control group was determined to be 4.28 ± 1.45 and 23.26 ± 6.18 ng/mL, respectively. A statistically significant difference was determined between the groups (p = 0.002, p = 0.0001). A correlation analysis provided a negative correlation between number of fasting days and sirtuin levels (r = 0.45, p = 0...

Effect of scaling and root planing with and without adjunct use of an essential-oil-based mouthwash on whole salivary interleukin-1β levels in patients with periodontal disease: A short-term follow-up study.

Abstract: Objective The aim of the present short-term follow-up study was to assess the effect of scaling and root planing (SRP) with and without adjunct use of an essential-oil-based mouthwash (EOBM) on whole salivary interleukin (IL)-1beta (β) levels in patients with periodontal disease. Methods Ninety individuals with periodontal disease were divided into two groups. Patients in group 1 underwent SRP and were instructed to rinse with 10 mL of an EOBM twice daily for 30 days. Patients in group 2 underwent SRP and were instructed to rinse with 10 mL of water twice daily for 30 days. Whole saliva samples were collected, and IL-1β levels were measured at baseline and after 60 days of treatment. P-values < 0.05 were considered statistically significant. Results At baseline, whole salivary IL-1β levels were comparable among patients in groups 1 (135.6 ± 13.5 μg/mL) and 2 (141.2 ± 5.4 μg/mL). After 60 days of follow-up, there is a significant decrease in whole salivary IL-1β levels among patients in group 1 (10.2 ± 6.4...

The role of urotensin II and atherosclerotic risk factors in patients with slow coronary flow.

Abstract: BackgroundSlow coronary flow (SCF) is an angiographic finding characterized with delayed opacification of epicardial coronary arteries without obstructive coronary disease. Urotensin II (UII) is an important vascular peptide, which has an important role in hypertension, coronary artery disease, and vascular remodeling in addition to potent vasoconstrictor effect.ObjectivesWe investigated UII levels, hypertension, and other atherosclerotic risk factors in patients with SCF, a variety of coronary artery disease.MethodsWe enrolled 14 patients with SCF and 29 subjects with normal coronary arteries without SCF. We compared the UII levels and the atherosclerotic risk factors between patients with SCF and control subjects with normal coronary flow.ResultsUII concentrations were significantly higher in patients with SCF compared to controls (711.0 ± 19.4 vs. 701.5 ± 27.2 ng/mL, p = 0.006). We detected a positive correlation between SCF and age (r = 0.476, p = 0.001), BMI (r = 0.404, p = .002), UII concentrations ...

Quality of life after tonsillectomy versus azithromycin.

Abstract: BackgroundRecurrent tonsillitis is a common disease with marked evidence of affecting children quality of life (QOL) such as their progression in school and increased burden to extended families. The aim of this study was to compare the QOL outcomes after conventional dissection tonsillectomy versus azithromycin treatment in controlling recurrent tonsillitis.MethodsA double-blind, randomized clinical trial was carried out in 184 children with recurrent tonsillitis randomly divided into two groups: Group A was subjected to conventional dissection tonsillectomy, whereas Group B received single 250 mg (children ≤25 kg) and 500 mg (children ≥25 kg) of oral azithromycin once weekly.ResultsThere were no significant differences between the groups with regard to ear, nose, and throat infections during the 5-year follow-up. Better QOL was observed in both groups when compared with the pretreatment, but similar QOL in both groups QOL after treatment.ConclusionAzithromycin is an effective method as a prophylaxis aga...

Immunohistochemical characterization of FHIT expression in normal human tissues

Abstract: Background Fragile histidine triad (FHIT) is a tumor suppressor gene that is commonly inactivated in human tumors. Interestingly, the normal pattern of FHIT expression is largely unknown. Aim This study is aimed to characterize the expression of FHIT protein in normal human tissues. Materials and methods A total of 119 normal human tissue specimens were analyzed for the FHIT expression using immunohistochemistry technique. The inclusion criteria included: normal/inflammatory tissue with no evidence of cellular atypia. Results All studied specimens were stained positively with FHIT and showed either nuclear or cytoplasmic expression. Interestingly, the pattern of FHIT staining was similar among different specimens from each organ. FHIT is located predominantly in the nucleus, although cytoplasmic staining is also present in some cell types. Oral squamous epithelium, breast ductal epithelium, squamous and tubal metaplastic epithelium of the uterine cervix, esophageal squamous epithelium, salivary glands, an...

Proximal scalloped custom-made Relay® stent graft in chronic type B dissection: endovascular repair in a drug abuser patient.

Abstract: The best solution for enlarging chronic type B aortic dissection is not known. Hybrid surgical and endovascular procedures offer a reliable solution in such circumstances, but technically complex stent-graft designs are sometimes needed when the treatment segment of the aorta presents anatomical challenges. We report a case of a proximally scalloped custom-made stent-graft implantation following left subclavian artery transposition in a formerly cocaine-abuser patient. The one-month follow-up computed tomography angiography showed a proximal endoleak (type Ia) which was successfully solved by coil embolization. Proximally scalloped stent grafts offer a reliable solution in complex aortic dissections involving the supra-aortic branches.

Assessment of platelet function in patients receiving tirofiban early after primary coronary intervention

Abstract: BackgroundFollowing percutaneous coronary intervention, combined antiplatelet therapy is necessary. Platelet function testing (PFT) has prognostic value and may be applied in the risk assessment of acute coronary syndrome. In case of combined antiplatelet therapy, PFT may require special laboratory methods, as different antiplatelet agents may influence test results.Materials and methodsPlatelet functions were measured in stent thrombosis-segment elevation myocardial infarction patients receiving aspirin, clopidogrel, and tirofiban. The first sampling was obtained immediately after the termination of administration of tirofiban. The second sample was drawn at a randomly assigned time between 1 and 6 h. The third sampling was done after a minimum of 24 h of tirofiban cessation. Adenosine diphosphate (ADP)- and thrombin receptor-activating peptide (TRAP)-induced aggregations were measured.ResultsThirty-seven patients were included. Both TRAP- and ADP-induced aggregation values were significantly lower immed...

Single-organ vasculitis of the cervix accompanying human papillomavirus infection.

Abstract: Single-organ vasculitis (SOV) has rarely been reported to involve the female genital tract but mostly the uterine cervix. A 39-year-old woman was diagnosed to have a high-grade cervical intraepithelial lesion and was treated by large loop excision of the transformation zone. Histopathological evaluation of the excised specimen confirmed the diagnosis of cervical intraepithelial neoplasia grade III accompanied by human papillomavirus infection. The excised second specimen showed the evidence of vasculitis of medium-sized vessels of the cervix, which is a quite rare form of SOV. It seems to be important to be aware of the localized form of polyarteritis nodosa limited to the female genital tract to prevent unnecessary immunosuppressive therapies.

Clinical presentation and outcomes in type IV dual left anterior descending artery anomaly.

Abstract: Type IV dual left anterior descending artery (LAD) anomaly constitutes a rare subset of coronary anomalies in which the anterior and anterolateral wall of the left ventricle is supplied by a short LAD originating from the left coronary artery along with a long LAD that originates from the right sinus of Valsalva. Albeit rare, the angiographic presentation is challenging since the appearance of the short LAD is similar to a total occlusion beyond first few diagonal or septal branches. Here, we present a series of four cases with type IV dual LAD anomaly with different clinical and angiographic presentations.

The microscopic and ultramicroscopic changes in the skeletal muscles, caused by heavy metal salts.

Abstract: PurposeThe article is devoted to study the structural changes in the skeletal muscles caused by heavy metal salts.Materials and methodsThe study was conducted on 72 mature male rats. The experimental groups were given to drink water with combinations of heavy metal salts for one, two and three months. This type of water is typical for the water basins in the northern districts of the Sumy region. The study of morphological changes in the striated muscles was concluded using light and scanning electron microscopy.ResultsThe data analysis revealed that a prolonged duration of negative factor could intensify sclerotic and edematous processes. The structure of muscle fibers was destroyed, nuclei were deformed and placed irregularly, and many petechial hemorrhages occurred. Besides, cross-striation was irregular, I and A bands were deformed and destroyed, H band was hardly visualized. The inner mitochondrial membrane and cristae become deformed. The symplastic nuclei were placed irregularly within sarcoplasm. ...

An unusual radiological presentation of mucinous adenocarcinoma of the colon.

Abstract: We report a case of an elderly patient presenting with the left iliac fossa mass. The provisional diagnosis included an inflammatory diverticular mass or sigmoid colon cancer. Interestingly, computed tomography (CT) of the abdomen and pelvis demonstrated the left incarcerated Spigelian hernia containing an inflamed loop of the colon with signs of an early strangulation. However, at operation, a mucinous tumor was found involving the descending and upper sigmoid colon. The tumor eroded through the anterior abdominal wall, which was excised “en bloc.” In the presented case, CT findings suggestive of a benign etiology were misleading. This potentially could have had significant consequences if the patient was treated conservatively. This case highlights that clinical history and examination remain the core components of a safe surgical practice. Clinical judgment cannot be substituted even by the best quality imaging. Therefore, we feel that it is important to share our experience of the successful managemen...