Systems genetics identifies Sestrin 3 as a regulator of a proconvulsant gene network in human epileptic hippocampus

Gene-regulatory network analysis is a powerful approach to elucidate the molecular processes and pathways underlying complex disease. Here we employ systems genetics approaches to characterize the genetic regulation of pathophysiological pathways in human temporal lobe epilepsy (TLE). Using surgically acquired hippocampi from 129 TLE patients, we identify a gene-regulatory network genetically associated with epilepsy that contains a specialized, highly expressed transcriptional module encoding proconvulsive cytokines and Toll-like receptor signalling genes. RNA sequencing analysis in a mouse model of TLE using 100 epileptic and 100 control hippocampi shows the proconvulsive module is preserved across-species, specific to the epileptic hippocampus and upregulated in chronic epilepsy. In the TLE patients, we map the trans-acting genetic control of this proconvulsive module to Sestrin 3 (SESN3), and demonstrate that SESN3 positively regulates the module in macrophages, microglia and neurons. Morpholino-mediated Sesn3 knockdown in zebrafish confirms the regulation of the transcriptional module, and attenuates chemically induced behavioural seizures in vivo

Comparative Evaluation of Immediate Effect of Root Instrumentation with Curettes and Mini-Insert Ultrasonic Scalers on Clinical Attachment Level

Background and Aim: Toothbrushes cannot reach all interdental areas. Interdental cleaning is an important part of oral hygiene care. The purpose of this study was to compare the supragingival plaque removal efficacy of an interdental cleaning power device (Aquajet) and dental floss. Materials and Methods: Thirty subjects were enrolled in this single-blind, split mouth clinical trial. All the subjects received both written and verbal instructions and demonstrated proficiency prior to the study. The subjects were asked to abstain from oral hygiene methods for 48 hours prior to the study. The subjects were scored using the Proximal/Marginal Plaque Index (PMI). Then, the four oral quadrants were randomly assigned to one of two treatment groups: One upper and one lower quadrant: Aquajet and the other two quadrants: dental floss.  The subjects were observed to ensure that they have covered all areas and have followed the instructions. Afterwards, they were scored again using the PMI. The pre and post-cleaning plaque scores were evaluated using two-way repeated measure ANOVA. Results: Both Aquajet and dental floss showed significant reduction of the baseline PMI in all dental areas (P0.05). Aquajet was significantly more effective than dental floss in reducing plaque on the mesial, mid-buccal and distal surfaces of upper first premolar and on the mesial and distal surfaces of upper second premolar and first molar (P<0.05). Conclusion: The results proved that oral irrigation with Aquajet is as effective as that with dental floss in plaque removal, and that Aquajet had significantly higher plaque removal efficacy at hard-to-reach dental surfaces

Effect of KTP Laser Made byAEOI on Resected Prostateafter Open Prostatectomy

Introduction & Objective: Transurethral resection of prostate (TURP) is the operation most frequently performed in urology. In view of the morbidity associated with this procedure, research has been conducted to propose an endoscopic alternative to TURP. Using of high energy laser is the most promising method in these cases. In this study, we evaluated the effect of home made KTP laser on re-sected prostate adenoma after open prostatectomy. Materials & Methods: 40 patients complaining of symptomatic BPH were treated by open prostatectomy. These 40 prostates were divided in to two parts. One part was sent for pathology assessment (group A) and the other part was sent to KTP laser room in the same hospital (group B). The prostates in group B were divided into 4 groups (1, 2, 3, 4), each with 10 prostate tissue. In groups 1, 2, 3 and 4, prostate lobes underwent laser ablation in one, two three and four stage. In any stage, KTP laser, 5 watts for 15 seconds, was used. All of prostate ablated with laser were sent to pathology for evaluation of tissue ablation capacity and deep tissue penetration. The study in all of stages was blinded for pathologist. Results: Mean age of participants was 73.25±6.8 years and mean level of PSA was 3.65±2.1 ng/dl. In both groups, with every stage laser, we have 1 to 2 mm tissue ablation associated with prostate type. In pathologic examination, we have 0-2 mm tissue destruction with disappearance of cells' nuclei, basophilia of stroma and damaged tissue (cutter like effect). Findings were compatible with burn effect. Conclusion: Pathologic findings proved, in the ex vivo investigation, that KTP laser offers a good tissue ablation capacity and minimal microscopic tissue damage. The risk of capsule perforation is very low. This procedure is safe and effective in which bladder outlet obstruction symptoms will be quickly relieves and has a low rate of complications. Moreover KTP laser has much cost effectiveness, although we need further studies on live prostatic tissue

An unusual Case of Transitional Cell Carcinoma of Renal Pelvis Presenting with Brain Metastases

ABSTRACT: Introduction & Objective: Transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case which should be diagnosed and treated in order to prevent further damages. Case: We report a rare case, who had presented with a constellation of neurological symptoms (due to multiple brain metastases), but without any urological symptoms. During evaluation of patient, we found transitional cell carcinoma (TCC) of left renal pelvis, for which palliative radical nephroureterectomy was performed . Conclusion: Although transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case, but the patient was managed with gamma knife stereotactic radiosurgery for the metastatic lesions. Afterward he received four cycles of paclitaxel and carboplatin chemotherapy. The patient is alive with stable disease at 32- months’ follow-up

Prolonged urinary leakage in the postoperative period of renal hydatic cyst treatment with oral desmopressin: a case report

<p>Abstract</p> <p>Introduction</p> <p>Prolonged extravasation after renal and ureter surgeries is a bothersome situation for both the patient and the doctor. It is usually related to the suture line not being watertight. The contact between urine and the edges of the wound also delay healing of the wound. In this situation, the first thing to do is to break the contact between the wound and the urine by inserting an adequate stent. Sometimes, this process is not enough. We approached this problem with a different treatment method for a case involving prolonged drainage.</p> <p>Case presentation</p> <p>A 52-year-old Caucasian woman who presented at our clinic with right flank pain was operated on due to a renal hydatic cyst, and cyst removal was performed. On follow-up, prolonged urinary leakage was observed and a desmopressin treatment was started on the patient. Drainage was greatly reduced after desmopressin was started and there was no drainage on the fifth day.</p> <p>Conclusion</p> <p>Prolonged extravasation is a bothersome situation and there can be many reasons for this. Whenever traditional approaches are not enough, oral desmopressin therapy can be started reliably if there are no contraindications for the patient. Eventually, contact between urine and the suture site will cease and therefore the fever and healing time will be shortened.</p