A modified trans-anconeus approach to facilitate fixation of a posterior radial head fracture: a cadaveric feasibility study / 대한해부학회지

Fixation of radial head fracture with minimally invasive posterior approach remains a significant challenge. The aim of this study was to determine the feasibility of trans-anconeus posterior elbow approach and to observe lateral ulnar collateral ligament (LUCL) in extended elbows. This cadaveric study was performed in twenty upper limbs of fresh fixed adult male cadavers. An oblique incision was made in the middle segment of anconeus until the lateral ligament complex and the joint capsule had been revealed. A deep dissection was explored to observe the anatomical relationship of the LUCL to the anconeus. Measurements of the LUCL were recorded while the elbow was fully extended. The mean distance between the edge of the radial head and the proximal insertion of the LUCL was 13.3 mm (11.5–16.2 mm); the mean distance between the edge of the radial head and the distal insertion of the LUCL was 20.9 mm (19.2–23.4 mm); the distance between the edge of the radial head and the distal edge of the annular ligament was 11.2 mm (8.22–11.7 mm). By estimate correlation of the previous measurements, the direct and accessible way to expose the posterolateral articular capsule of the elbow joint was through a window in medial 2/3 of the middle segment of anconeus muscle. These trans-anconeus approach is useful. It provides good visualization, facilitates applying the implants, and lessens the risk of radial nerve injury. Awareness of the anatomy is mandatory to avoid injury of LUCL.

Study of the role of oxidative stress in pre-eclampsia

Pre-eclampsia is a common obstetric syndrome affecting about 4-5% of pregnant women. The etiology of pre-eclampsia is still unclear. There is suboptimal placentation in the early stages of pregnancy, and an inadequate haemodynamic adaptation to pregnancy. Although the etiology of the disease is unknown, it has been suggested that a consequence of placental ischaemia is the generation of cytotoxic factors that may act systemically to activate or injure the endothelium. Oxidative stress is defined as an imbalance between the cellular generation of reactive oxygen species [ROS] and the capacity of antioxidants to prevent oxidative damage. Free radicals are formed in the energy / respiratory pathways of the body, as inflammatory mediators in the immune system and in other biochemical pathways that are essential aspects of cellular metabolism. It has been reported that oxidative stress and inflammatory mechanisms are involved in endothelial cell activation and dysfunction in pre-eclampsia. The aim of this study is to investigate the oxidative stress in preeclamptic cases. 60 women in the third trimester were enrolled in this prospective study, 30 had pre-eclampsia and 30 healthy pregnant women as control group. We have found increased levels of total ROS [Reactive Oxygen Species] in the pre-eclamptic group as compared to the control group. The results of this study suggest that oxidative stress is increased in pre-eclampsia and that it may play a critical role in the pathogenesis of the disease

Study of interleukin-6 levels in obese patients with polycystic ovarian syndrome

Premenopausal women with polycystic ovary syndrome [PCOS] are at a much higher risk for excessive daytime sleepiness, fatigue, and insulin resistance than control women. Elevated levels of interleukin 6 [IL-6] and tumor necrosis factor a [TNF-a] are presumably part of the pathogenesis of these clinical manifestations. The aim of this work is to evaluate the level of IL-6 in obese women with PCOS. Forty-two obese women with PCOS, 17 body mass index-comparable obese controls, and 15 normal-weight controls free from apnea participated in the study. Women with PCOS exhibited higher plasma concentrations of IL-6 than obese controls, who had intermediate values, or normal-weight controls, who had the lowest values [4.75 +/- 0.5 vs 3.65 +/- 0.4 vs 1.84 +/- 0.3 pg / mL, P < .01] within the PCOS group, IL-6 correlated more strongly with indices of insulin resistance than obesity. We conclude that IL-6 levels are elevated in obese women with PCOS independently of obesity or sleep apnea and may represent a pathophysiologic link to insulin resistance

IGF-1 and papp-a: early markers of pregnancy complications

Fetal growth is under control of genetic, environmental, and nutritional factors. IGFs and theirreceptors are implicated in the regulation of protein turnover and exert potent mitogenic and differentiating effectson most cell types. Dysregulation of IGF-I actions machinery may contribute to abnormal fetal growth.Pregnancy-associated plasma protein-A [PAPP-A] is produced by the trophoblast; its serum levels increaseduring pregnancy. The level of PAPP-A in maternal serum might reflect the local level of PAPP-A and theavailability of IGFs.In this study, we investigated the role of IGF-1 and PAPP-A in normal and high risk pregnancies, andstudied their levels in relation to pregnancy outcome and complications.Serum levels of both parameters were lower iti high risk groups as compared to low risk pregnant femalesat 11 and 22 weeks gestational age

Smoking increases dna damage in male infertile patients in Egypt

Environmental factors, have been shown to have a deleterious effect on spermatogenesis. Cigarette smoking is a major source of environmental pollution. Many studies have suggested that cigarette smoking is associated with altered semen quality, but conclusions about the extent of the deleterious effects vary widely. Sperm nuclear chromatin abnormalities /DNA damage could occur at the time of, or be the result of, DNA packing at spermatogenesis. Environmental stress, gene mutations, and chromosomal abnormalities can disturb the highly refined biochemical events that occur during spermatogenesis. This can ultimately lead to an abnormal chromatin structure that is incompatible with fertility. However, the exact mechanism by which chromatin abnormalities/DNA damage arise in human spermatozoa are not precisely understood. We have conducted a study on 50 infertile males, of whom 25 are smokers, to assess the degree of sperm DNA damage using the COMET assay and correlate our findings with other semen parameters. Conclusion: In the present study, the percentage of severe DNA fragmentation was significantly higher in smoker infertile group compared to no smokers and control groups

Ghrelin in polycystic ovarian syndrome with and without diabetes mellitus in Egyptian population

Background and aim: Ghrelin is a 28 amino acid peptide, which is primarily produced by the stomach. Ghrelin is a strong secretagogue of growth hormone [GH]. The polycystic ovary syndrome [PCOS] is traditionally characterized by chronic anovulation, functional hyperandrogenism. Obesity of the central type and Insulin Resistance [IR] arc highly associated with the syndrome, predisposing women with PCOS to the development of glucose intolerance and, ultimately, type 2 diabetes mellitus. In the current study, we investigated fasting plasma ghrelin levels in a group of patients with PCOS, with and without type 2 DM, and compared with an age matched control group

Results: Fasting plasma Ghrelin was significantly lower in PCOS patients than in control groups

Conclusion: In our study, fasting plasma ghrelin levels were significantly lower in PCOS groups as compared to the control group, Decreased plasma Ghrelin levels correlated significantly with Insulin resistance in the patients groups

Epidemiological characteristics and the role of cytogenetic investigation in primary amenorrhea

Primary amenorrhea is a major problem in girls of adolescent age This descriptive study was conducted to describe the epidemiology and to identify the proportion of genetic causes and the different chromosomal pattern among patients representing with delayed puberty or primary amenorrhoea who attended the medical genetic center, Ain Shams University. A total of 102 patients were included in the study. All patients underwent complete full history taking, general physical examination, local examination of genital system, hormonal assay, pelvic ultrasound and Karyotyping analysis. Their mean age at diagnosis were [20.1 +/- 4.2.] Secondary sexual characters were not developed among most of the study group [74.5%] Normal phenotypic 46, XX were found among 67.6% of cases, while chromosome abnormalities were found in 32.4%. Among all patients with chromosomal aberrations, 48.5% of then1 had pure line 45, X [turner syndrome], and the remainder had mosaic with normal XX or other aberrations in X. Only one had 46XY, and another one had 47XXX. The frequencies of causes of primary amenorrhea were primary ovarian failure [gonadal dysgenesis] [49%] followed by constitutional delay of puberty [22.5%] then mullerian duct abnormalities [15.7 5%] The study recommended that all females with primary amenorrhea should be investigated cytogenetically and counseling should be directed to hormonal replacement of estrogen and growth hormone for development of secondary sexual characters and normal stature and prevention of osteoporosis