Morphological Changes of Anterior Cerebral Artery (ACA) in Hydrocephalic Pediatric Patients

How to Cite This Article: Ozturk S, Ayan E, Kaplan M. Morphological Changes of Anterior Cerebral (ACA) Artery in Hydrocephalic Pediatric Patients. Iran J Child Neurol. Winter 2017; 11(1):37-42. AbstractObjectiveThe morphology of anterior cerebral artery (ACA) in patients with hydrocephalus (HCP) was analyzed, and its importance was discussed in maintaining cerebral perfusion.Materials & MethodsA total of 84 cases in 2 groups between 0 and 3 months, followed-up at Firat Universitesi Hastanesi, Beyin Cerrahisi Klinigi, Elazig, Turkiye due to in 2010-2013, were enrolled. Two groups were created for the study. Group 1; patients with HCP and Group 2; as control group without HCP. In both groups, the length of the A2 segment of ACA was measured from its origin to the junction of the genu and body portions of the corpus callosum on T2 mid-sagittal magnetic resonance (MR) scans. For all cases, axial MR imaging scans were used to calculate Evans’ index (EI), and the cases were divided into three groups: Group A, EI ≥50%; Group B, EI of 40-50% and Group C, EI <40%. The two groups (Groups 1 and 2) were compared with respect to ACA length, and the correlation with the EI was quantified. P values below 0.05 were considered statistically significant.ResultsMean length of ACA was 57.3 mm in Group 1 and 37.5 mm in Group 2. EI increased as the length of ACA increased. A statistical comparison of the two groups revealed that the ACA length was significantly greater in Group 1. The relationship between EI and ACA length was statistically significant.ConclusionReducing ventricular size appears to be an important factor in addition to reducing intracranial pressure in an attempt to maintain normal cerebral perfusion(CP).References1. Westra SJ, Lazareff J, Curran JG, Sayre JW, Kawamoto H Jr. Transcranial Doppler ultrasonography to evaluate need for cerebrospinal fluid drainage in hydrocephalic children. J Ultrasound Med 1998; 17): 561-569.2. Kolarovszki B, Zubor P, Kolarovszka H, Benco M, Richterova R, Matasova K. The assessment of intracranial dynamics by transcranial Doppler sonography in perioperative period in paediatric hydrocephalus. Arch Gynecol Obstet 2013; 287: 229-238.3. Tritton DJ. Fluid Mechanics. Physical fluid Dynamics. Tritton, DJ: 2nd ed. Oxford, Clarendon Press 1988; pp:536-540.4. de Oliveira RS, Machado HR. Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus. Neurosurg Focus 2003; 15: ECP3. 5. Kempley ST, Gamsu HR. Changes in cerebral artery blood flow velocity after intermittent cerebrospinal fluid drainage. Arch Dis Child 1993; 69: 74-76.6. Hanlo PW, Gooskens RH, Nijhuis IJ, Faber JA, Peters RJ, van Huffelen AC and et al. Value of transcranial Doppler indices in predicting raised ICP in infantile hydrocephalus. A study with review of the literature. Childs Nerv Syst 1995; 11: 595-603.7. Nishimaki S, Yoda H, Seki K, Kawakami T, Akamatsu H, Iwasaki Y. Cerebral blood flow velocities in the anterior cerebral arteries and basilar artery in hydrocephalus before and after treatment. Surg Neurol 1990; 34: 373- 377.8. Wang B, Cheng Z, Mu X, Fan B, Guo Z. Preoperative and postoperative transcranial Doppler sonographic evaluations of the cerebral hemodynamics of craniostenosis. J Craniofac Surg 2010; 21: 432-435.9. Bell SR, Vo AH, Armanda RA. Applied neurovascular anatomy of the brain and skull. In: Hurst RW, Rosenwasser RH, editors. Interventional Neuroradiology. New York: Informa; 2008: pp: 22-27.10. Kaplan M, Berilgen MS, Erol FS, Artas H, Serhatlioglu S, Ozveren MF. Relationship between Clinical Grade, Cerebral Blood Flow, and Electroencephalographic Alterations in Patients with Chronic Subdural Hemorrhage. Neurosurgery Q 2006; 16: 157-160.11. Riggo JD, Kolarovszki B, Richterova R, Kolarovszka H, Sutovsky J, Durdikc P. Measurement of the blood flow velocity in the pericallosal artery of children with hydrocephalus by transcranial Doppler ultrasonography-preliminary results. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007; 151: 285-289.12. Zenger MN, Kabataş S, Zenger S, Cakmakçi H. The value of power Doppler ultrasonography in the differential diagnosis of intracranial extraaxial fluid collections. Diagn Interv Radiol. 2007; 13: 61-63.13. Kaplan M, Erol FS, Bozgeyik Z, Koparan M: The effectiveness of simple drainage technique in improvement of cerebral blood flow in patients with chronic subdural hemorrhage. Turk Neurosurg 2007; 17: 202-206.14. Rozenfeld A. Ultrasound in diagnostics of blood vessels: the role of the assessment of both extra- and intracranial flows by Doppler ultrasonography. Neurol Neurochir Pol 1994; 28: 51-66.15. Miller SP, Cozzio CC, Goldstein RB, Ferriero DM, Partridge JC, Vigneron DB and et al. Comparing the diagnosis of white matter injury in premature newborns with serial MR imaging and transfontanel ultrasonography findings. AJNR Am J Neuroradiol 2003; 24: 1661-1669

A case of pulmonary aspergillosis in white storks

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗAspergillosis is a fungal infection affecting respiratory system both in mammals and avian species. It is more commonly encountered in birds, in comparison with its mammalian counterpart. Mostly isolated strains are Aspergillus fumigatus (95%) and Aspergillus flavus (5%). Affected lungs and air sacs reveal miliary to gross lesions like gray-yellowish or white-grayish granulomatous foci surrounded by white halos indicative of inflammatory infiltration. Five storks found dead in the rural areas near Istanbul were submitted to our faculty between years 2008 and 2014. Two of them were thought to be younger than 1-year-old and the other three were older than one year of age. Necropsies were performed right after their submissions. Aspergillosis lesions were observed in the lungs and thoracic air sacs of the first four storks. In addition to these changes the lesions were detected at the aortic bifurcation and on the testicular and renal capsule of the fifth stork. Histopathology revealed encapsulated granulomas with foci of caseous necrosis at the center surrounded by numerous macrophages, heterophil leukocytes, lymphocytes and foreign body giant cells in all the storks. Following the gross, histopathological and mycological examinations the agents were detected as Aspergillus fumigatus. Although, the number of reported deaths due to Aspergillosis is not high in storks, we believe that these birds are quite susceptible to the disease and stress factors such as migration increases the risk of pathogenicity. This report was designed as a contribution to literature since there is only one reported case available with respect to aspergillosis associated death in storks and stress factors such as migration may also predispose storks to the disease

Plasma Levels of Tumor Necrosis Factor-Alpha and Interleukin-6 in Obsessive Compulsive Disorder

Aim. Recent research implicated place of an immune mechanism in the pathophysiology of obsessive-compulsive disorder (OCD). Despite increasing evidence involvement of cytokine release in OCD, results of the studies are inconsistent. The aim of this study was to evaluate the plasma levels of the cytokines; tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in OCD patients. Methods. Plasma concentrations of TNF-α and IL-6 were measured in 31 drug-free outpatients with OCD, and 31-year age and sex-matched healthy controls. TNF-α and IL-6 concentrations in blood were determined by enzyme-linked immunosorbent assay (ELISA). Results. Both TNF-α and IL-6 levels showed statistically significant increases in OCD patients compared to controls (P < .000, P < .001, resp.). In addition, the age of onset was negatively correlated with TNF-α level (r = −.402, P = .025) and duration of illness was weakly correlated with IL-6 levels (r : .357; P : .048) in patients group. Conclusion. OCD patients showed increases in TNF-α and IL-6 levels compared to the healthy controls. This study provides evidence for alterations in the proinflamatory cytokines which suggest the involvement of the immune system in the pathophysiology of OCD

The impact of concurrent HPV infections on the presentation of high grade cervical intraepithelial lesions

Objectives: We investigate how concurrent high-risk (hr) HPV (human papillomavirus) genotypes affect CIN2-3 risk and evaluate the relationship of different genotype combinations with cervical epithelial lesions. Material and methods: This study included HPV positive patients between the ages of 30 and 60 who underwent liquid-based cervical smears and HPV screening through community-based, cervical cancer screening programs between June 2015 and June 2017. The impact of the increase in hrHPV types was calculated by estimating how it changed the odds ratio of CIN2-3 risk. Results: The rate of multiple concurrent HPV infections was 48.7% in the CIN2-3 group and 58.4% in the CIN1 group. Among patients in the CIN2-3 and CIN1 groups, the most common HPV coinfection was respectively HPV 16+31 and HPV 16+51. The HPV 51 ratio in CIN1 patients was 28.9% and the HPV 51 ratio in the CIN2-3 patient was 6.6%. With every increase in the number of hrHPV infection types, the frequency of CIN2-3 decreased [OR: 0.72, 95% CI: 0.54-0.95]. For all hrHPV combinations, the addition of HPV 16 was associated with a higher risk of CIN2-3. Conclusions: An increase in number of hrHPV types is associated with lower CIN2-3 risk. Further cohort studies with larger samples are needed to clarify this relationship. The available evidence suggests that HPV 16 genotype plays an important role in patients with high-grade cervical lesions and has a negative impact on the cervix in concurrent multiple HPV infections

Possible Protective Effect of Sertraline against Cisplatin-Induced Ototoxicity: An Experimental Study

Background/Objective. Cisplatin is a widely used chemotherapeutic agent, but its ototoxicity side effect can occur in the majority of patients. Lots of agents were tried to prevent this, but there is not a routine treatment modality yet. The aim of this study was to evaluate the otoprotective effect of sertraline, which is an antidepressant with neuroprotective effects, against cisplatin, in rats. Design. Experimental animal study. Material and Methods. Forty-eight rats were randomly separated in two groups as groups I and II. Group I was identified as the control group and only a single dose of intraperitoneal cisplatin was administered. In group II, in addition to cisplatin, sertraline was administered to the rats through an oral cannula for ten-day period. Distortion product otoacoustic emission measurements were performed at the first day and the 10th day. Results. When the ototoxicity rates after cisplatin in group I and group II in distortion product otoacoustic emission measurements were compared, it was statistically significantly lower in group II in frequencies of 5652, 6165, 6726, 7336, and 7996 Hz (). Conclusion. Sertraline seems to have a protective effect on cisplatin ototoxicity and could be used to prevent the ototoxicity and also to treat the depression that occurred in cancer patients together

MITF-MIR211 axis is a novel autophagy amplifier system during cellular stress

Macroautophagy (autophagy) is an evolutionarily conserved recycling and stress response mechanism. Active at basal levels in eukaryotes, autophagy is upregulated under stress providing cells with building blocks such as amino acids. A lysosome-integrated sensor system composed of RRAG GTPases and MTOR complex 1 (MTORC1) regulates lysosome biogenesis and autophagy in response to amino acid availability. Stress-mediated inhibition of MTORC1 results in the dephosphorylation and nuclear translocation of the TFE/MITF family of transcriptional factors, and triggers an autophagy- and lysosomal-related gene transcription program. The role of family members TFEB and TFE3 have been studied in detail, but the importance of MITF proteins in autophagy regulation is not clear so far. Here we introduce for the first time a specific role for MITF in autophagy control that involves upregulation of MIR211. We show that, under stress conditions including starvation and MTOR inhibition, a MITF-MIR211 axis constitutes a novel feed-forward loop that controls autophagic activity in cells. Direct targeting of the MTORC2 component RICTOR by MIR211 led to the inhibition of the MTORC1 pathway, further stimulating MITF translocation to the nucleus and completing an autophagy amplification loop. In line with a ubiquitous function, MITF and MIR211 were co-expressed in all tested cell lines and human tissues, and the effects on autophagy were observed in a cell-type independent manner. Thus, our study provides direct evidence that MITF has rate-limiting and specific functions in autophagy regulation. Collectively, the MITF-MIR211 axis constitutes a novel and universal autophagy amplification system that sustains autophagic activity under stress conditions.No sponso

Combined search for the quarks of a sequential fourth generation

Results are presented from a search for a fourth generation of quarks produced singly or in pairs in a data set corresponding to an integrated luminosity of 5 inverse femtobarns recorded by the CMS experiment at the LHC in 2011. A novel strategy has been developed for a combined search for quarks of the up and down type in decay channels with at least one isolated muon or electron. Limits on the mass of the fourth-generation quarks and the relevant Cabibbo-Kobayashi-Maskawa matrix elements are derived in the context of a simple extension of the standard model with a sequential fourth generation of fermions. The existence of mass-degenerate fourth-generation quarks with masses below 685 GeV is excluded at 95% confidence level for minimal off-diagonal mixing between the third- and the fourth-generation quarks. With a mass difference of 25 GeV between the quark masses, the obtained limit on the masses of the fourth-generation quarks shifts by about +/- 20 GeV. These results significantly reduce the allowed parameter space for a fourth generation of fermions.Comment: Replaced with published version. Added journal reference and DO

Compressed representation of a partially defined integer function over multiple arguments

In OLAP (OnLine Analitical Processing) data are analysed in an n-dimensional cube. The cube may be represented as a partially defined function over n arguments. Considering that often the function is not defined everywhere, we ask: is there a known way of representing the function or the points in which it is defined, in a more compact manner than the trivial one

Search for supersymmetry in events with b-quark jets and missing transverse energy in pp collisions at 7 TeV

Results are presented from a search for physics beyond the standard model based on events with large missing transverse energy, at least three jets, and at least one, two, or three b-quark jets. The study is performed using a sample of proton-proton collision data collected at sqrt(s) = 7 TeV with the CMS detector at the LHC in 2011. The integrated luminosity of the sample is 4.98 inverse femtobarns. The observed number of events is found to be consistent with the standard model expectation, which is evaluated using control samples in the data. The results are used to constrain cross sections for the production of supersymmetric particles decaying to b-quark-enriched final states in the context of simplified model spectra.Comment: Submitted to Physical Review