Evaluating the Antioxidant Effects of Onion (Allium cepa) on Blood Biochemical Factors and Antioxidants after Consuming Tartrazine in Rats.

Colors have been added to food naturally and artificially for centuries to make them look more appetizing. According to the Food and Drug Organization, eight artificial colors were registered for the nutrition application, one of them, is tartrazine, which is widely used in foods and cosmetics. Food colors significantly decrease weight and increase proteins, liver enzymes, thyroid hormones, total cholesterol, and triglyceride. Onion, as an antioxidant, can reduce the harmful effects of artificial food colors on weight gain, antioxidant activity, and blood biochemical factors. The present study aimed to evaluate the effects of the onion's antioxidant properties on serum biochemical factors and antioxidants in Wistar rats after consuming tartrazine. Eighty Rats were divided into four groups, 20 mice in each. The first group received water without additives and was considered the control, the second group received tartrazine, the third group received tartrazine with onion juice, and the fourth group received only onion juice through gastric gavage. This experiment was performed for 60 days, and then the antioxidant activities of superoxide dismutase (SOD), Catalase (CAT), glutathione peroxidase (GPx), and the biochemical parameters of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were measured. Tartrazine decreased the antioxidant activities of SOD, CAT, GPx, and the biochemical parameters of HDL and LDL. The results showed that the consumption of tartrazine causes the production of free radicals, which is the reason for the significant reduction of antioxidant activities and serum biochemical factors. Onion, as an antioxidant in this study, reduces the effects of tartrazine on antioxidant activities and serum biochemical factors.

[Hip arthroplasty after pelvic and femoral osteotomies]. / Hüftendoprothetik nach Osteotomien des Beckens und des proximalen Femurs.

Pelvic and femoral osteotomies can be a challenge even for experienced orthopedic surgeons. Residual metal may complicate the insertion of the endoprosthesis in some cases. Sometimes, the anatomical modification of the previous osteotomy complicates the total hip replacement. This may require the use of an acetabular revision system for the primary implantation. Femoral deformities can require additional osteotomies of the femur during the implantation. In every case, accurate preoperative planning should be performed. A preoperative CT with 3D reconstruction is a powerful tool for further information beyond conventional imaging.

Regional Variation across Canadian Centers in Radioiodine Administration for Thyroid Remnant Ablation in Well-Differentiated Thyroid Cancer Diagnosed in 2000-2010.

Background. Use of radioactive iodine (RAI) ablation has been reported to vary significantly between studies. We explored variation in RAI ablation care patterns between seven thyroid cancer treatment centers in Canada. Methods. The Canadian Collaborative Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe and analyze patterns of care for thyroid cancer. We analyzed data from seven participating centers on RAI ablation in patients diagnosed with well-differentiated (papillary and follicular) thyroid cancer between 2000 and 2010. We compared RAI ablation protocols including indications (based on TNM staging), preparation protocols, and administered dose. We excluded patients with known distant metastases at time of RAI ablation. Results. We included 3072 patients. There were no significant differences in TNM stage over time. RAI use increased in earlier years and then declined. The fraction of patients receiving RAI varied significantly between centers, ranging between 20-85% for T1, 44-100% for T2, 58-100% for T3, and 59-100% for T4. There were significant differences in the RAI doses between centers. Finally, there was major variation in the use of thyroid hormone withdrawal or rhTSH for preparation of RAI ablation. Conclusion. Our study identified significant variation in use of RAI for ablation in patients with well-differentiated thyroid cancer both between Canadian centers and over time.

Cryptosporidium in humans and animals-a one health approach to prophylaxis.

Cryptosporidium is a major cause of moderate-to-severe diarrhoea in humans worldwide, second only to rotavirus. Due to the wide host range and environmental persistence of this parasite, cryptosporidiosis can be zoonotic and associated with foodborne and waterborne outbreaks. Currently, 31 species are recognized as valid, and of these, Cryptosporidium hominis and Cryptosporidium parvum are responsible for the majority of infections in humans. The immune status of the host, both innate and adaptive immunity, has a major impact on the severity of the disease and its prognosis. Immunocompetent individuals typically experience self-limiting diarrhoea and transient gastroenteritis lasting up to 2 weeks and recover without treatment, suggesting an efficient host antiparasite immune response. Immunocompromised individuals can suffer from intractable diarrhoea, which can be fatal. Effective drug treatments and vaccines are not yet available. As a result of this, the close cooperation and interaction between veterinarians, health physicians, environmental managers and public health operators is essential to properly control this disease. This review focuses on a One Health approach to prophylaxis, including the importance of understanding transmission routes for zoonotic Cryptosporidium species, improved sanitation and better risk management, improved detection, diagnosis and treatment and the prospect of an effective anticryptosporidial vaccine.

[Tönnis and Kalchschmidt triple pelvic osteotomy]. / Die 3­fache Beckenosteotomie nach Tönnis u. Kalchschmidt.

BACKGROUND: The Tönnis and Kalchschmidt triple pelvic osteotomy (TPO) has been performed at the Klinikum Dortmund for more than 30 years. In more than 5000 cases the TPO has proven its potential to deal with even severe dysplastic hips. TPO can be easily combined with other hip procedures as intertrochanteric osteotomies and even impingement treatment can easily be done. As an elaborate technique TPO respects the growth plates and can therefore also be used for treating Legg-Calve-Perthes disease. PROCEDURE: In most cases only conventional X­rays are needed for proving the indication. Further imaging like MRI or CT-scans are only needed in certain cases. In addition EOS® is becoming an increasingly useful tool in planning and performing the surgery. For adequate movement of the acetabulum, three clearly defined osteotomies are needed. Current osteosynthesis methods provide an enhanced stability due to a novel technique of screw fixation. This is in line with the general trends towards short hospitalization and early mobilization. THERAPY: A successful treatment requires not only experience in performing the surgical technique, but furthermore an experienced team, including care, physical examination and also pain management. The surgeon should be aware that he is performing highly elective surgery and complications or a poor outcome can significantly reduce the quality of life of the mainly young patients.

[Intertrochanteric femoral osteotomy : Indications, surgical technique, results]. / Die intertrochantäre Femurosteotomie : Indikationen, Operationstechnik, Ergebnisse.

BACKGROUND: Intertrochanteric osteotomies are part of joint-preserving hip surgery. Indications involve not only the mature but also the growing skeleton. After identification of the causative pathologies multidimensional corrections with the aim of a better joint situation and prevention of early osteoarthritis are possible. METHODS: The surgical technique of intertrochanteric osteotomies is presented. Potential indications are discussed on the basis of results in the literature. RESULTS: In the surgical treatment of developmental dysplasia of the hip intertrochanteric osteotomies are used as additional surgery. In Perthes disease the containment is improved while the onset of osteoarthritis in epiphysis capitis femoris can be decelerated. Treatment of torsion pathologies is reliable. Avascular necrosis of the femoral head and beginning osteoarthritis are critical indications. CONCLUSION: For appropriate indications intertrochanteric osteotomies are a valuable element in joint-preserving surgery with very good long-term results.

[Tönnis and Kalchschmidt triple pelvic osteotomy]. / Dreifache Beckenosteotomie nach Tönnis und Kalchschmidt.

OBJECTIVE: With three precise osteotomies it is possible to move the acetabulum to achieve sufficient coverage in dysplastic hips. INDICATIONS: Main indication is a painful dysplastic hip. Other acetabular pathologies, such as retroversion can also be addressed. In recent years young patients with Legg-Calve-Perthes disease CONTRAINDICATIONS: Patients with an arthrosis (Tönnis level 2) and obesity often have poor results. Therefore the combination of these parameters should be seen as a contraindication. SURGICAL TECHNIQUE: The operation starts with the patient in a lateral decubitus position. The first incision is parallel to the sacrotuberal ligament. The gluteus maximus muscle is spread until the ligament itself with its bony connection at the tuber ischiadicum is visible. After putting two special retractors in the foramen obturatorium and one to the spina ischiadica, osteotomy of the os ischium is performed from the incisura ischiadica to the foramen obturatorium. For the next osteotomy the os pubis is approached and it should be performed subperiostally. The vasa and nervus obturatorius and femoralis should be protected. At the os ilium the abdominal muscles are separated from the iliac crest. The third osteotomy has a 90° angle and starts at the linea terminalis and leads just below the spina iliaca anterior superior iliac spine. The acetabulum can now be moved with a Schanz screw. At this point it is necessary to elevate the os pubis while moving the acetabulum laterally. This prevents a lateralization and reduces the distance at the iliac osteotomy. The osteosynthesis is performed with screws at the os ilium and also at the os pubis. POSTOPERATIVE MANAGEMENT: Patients are advised to avoid weight bearing for 12 weeks. In the first 6 weeks they are allowed to perform a maximum flexion of 60°. RESULTS: According to the Harris hip score 80.4 % of the patients showed good and very good results after 11.5 years. In cases with arthrosis and obesity a higher rate of poor results were found.

Zeta potential vs apoptotic marker: which is more suitable for ICSI sperm selection?

PURPOSE: Selection of appropriate sperm is considered as a decision making point in the ICSI procedure. Canonically, sperm selection is based on morphology and motility. Recent advances in this field, have shown that, this procedure can be assisted by further selection based on membrane surface charge (Zeta potential) and surface apoptotic marker (phosphatidylserine externalization) using magnetic activated cell sorter (MACS). Based on the literature, both these procedures improve quality of selected sperm population. Therefore, this study aims to compare the efficiency of these two procedures. METHODS: Semen samples were collected from 36 fertile and infertile (teratozoospermic and /or asthenozoospermic) individuals. Sperm DNA fragmentation, protamine deficiency and morphology were assessed by TUNEL, CMA3 and papanicolaou staining in unprocessed, MACS and Zeta processed samples. RESULTS: Although both MACS and Zeta were able to separate a higher percentage of sperm with normal morphology, and lower DNA fragmentation and protamine deficiency compared to unprocessed, MACS procedure could significantly isolate, a greater percentage of sperm with normal acrosome and protamine content compared to Zeta procedure. CONCLUSION: Both MACS and Zeta procedures improve the quality of the selected spermatozoa for ICSI. However, MACS procedure is more efficient in individuals with severe male factor infertility to select sperm with normal acrosome and protamine content but concern regarding transfer of MACS beads into the oocyte remains to be resolved.

[Joint preserving surgery of the adult hip: pelvic osteotomies]. / Gelenkerhaltende Hüftchirurgie im Erwachsenenalter: Beckenosteotomien.

Deformity and malposition of the acetabulum can occur during the development of the hip. Developmental hip dysplasia and acetabular retroversion are possible causes of osteoarthritis in the young adult. Surgical management with reorientation of the acetabulum allows causal therapy of the deformity and preservation of the native hip joint. Established techniques are the Bernese periacetabular osteotomy (PAO) and the Tönnis and Kalchschmidt triple osteotomy of the pelvis. Both techniques permit three-dimensional correction of the position of the acetabulum. Advantages and disadvantages of each technique must be considered and are summarized in the present paper. If performed early (osteoarthritis grade Tönnis 0 and 1) with correct indication and proper technique, good results can be expected.

[Complications after hip operations]. / Komplikationen nach Hüftoperationen.

From 1999 to 2008, according to a prospective and sequential compilation of data, the 12,590 hip operations (11,059 in adults and 1,531 in children) performed in our hospital showed a postoperative complication rate of 4.96% (5.2% in adults and 1.96% in children). The most frequent complications were 110 thromboses (0.87%), which were clinically apparent and proven by Doppler ultrasonography or phlebography; 191 superficial and deep disorders of wound healing (1.5%), including 57 (0.45%) infections; 88 peripheral nerve lesions (0.7%); and 53 hematoma revisions (0.42%). Operation-specific statistics for complications (total hip replacements, revisions, femoral and pelvic osteotomies, hardware removals, and operations in children, including acetabuloplasty, femoral osteotomies, and open reductions) are presented here. Those statistics make it possible to judge and compare method-specific and department-specific risks and their development over time. An open and active attitude when dealing with postoperative complications can cost effectively and efficiently improve treatment results.

Distinct clonal composition of primary and metastatic adrencorticotrophic hormone-producing pituitary carcinoma.

The pathogenetic mechanisms underlying pituitary tumorigenesis are largely unknown. Previous reports have suggested that aggressive pituitary adenomas and/or carcinomas may be associated with genetic alterations that are distinct from those responsible for the more common and less aggressive pituitary adenomas. Here, we describe the clonal composition of a pituitary carcinoma, its recurrence and its metastasis. The samples studied were from a 48-year-old woman who presented with recurrent Cushing's syndrome. During the 8-year course of her disease, she had an ACTH-producing pituitary carcinoma requiring two transsphenoidal procedures and resection of a metastatic cervical lymph node. Her disease remained active despite surgical resection, external beam irradiation and medical treatment with ketoconazole. Ultimately, bilateral adrenalectomy was performed to control the hypercortisolism. Morphological and immunohistochemical studies revealed that the primary and recurrent pituitary tumours and the metastatic lesion were an endocrine tumour with ACTH and growth hormone immunoreactivity. Primary, recurrent and metastatic tumour DNAs were analysed for X-chromosome inactivation and loss of heterozygosity (LOH) at several microsatellite loci on chromosomes 9,10, 11, 13 and 22. All three lesions were monoclonal in composition as suggested by the pattern of X chromosome inactivation of the PGK-1 allele. Moreover, the primary, recurrent and metastatic lesions demonstrated LOH at the microsatellite allelic markers PYGM and D10S217. In contrast, however, the metastatic lesion showed a loss-to-retention pattern at two distinct loci (IFNA and D22S156) compared to the primary and recurrent pituitary tumours. These findings, while consistent with a clonal composition of the primary and metastatic pituitary lesions, show each clone to be distinct. This is the first description of a metastatic pituitary carcinoma with a distinct clonal composition from its primary source.

Technical aspects and results of the transhiatal resection in adenocarcinomas of the gastroesophageal junction.

The distribution of lymph node metastases of adenocarcinomas of the gastroesophageal junction is classified into three types. The R0 resection with complete lymphadenectomy therefore requires different resection methods for type 1 and type 2/3 tumors. Comparing the subtotal esophagectomy and the extended gastrectomy, no advantage in survival can be seen for one method or one tumor type (type 1 or type 2/3). The same is true for the lethality. Indeed, the transhiatal resection is accompanied by a higher complication rate. However, the different operation methods for cardiacarcinomas, with subtotal esophagectomy in type 1 and extended gastrectomy in type 2/3 tumors, should be maintained because of increased rates of local recurrence that may be expected if all cardiacarcinoma types were treated using subtotal esophagectomy with gastric tube interposition. Therefore, we suggest a subtotal esophagectomy only in type 1 tumors. In type 2/3 tumors, an extended gastrectomy with resection of the distal esophagus, lymphadenectomy of the lower mediastinum, and D2 lymphadenectomy should be performed.

Successful treatment of chloral hydrate cardiac toxicity with propranolol.

A case of chloral hydrate overdose causing resistant ventricular arrhythmias is presented. Our case and other case reports suggest that chloral hydrate-induced arrhythmias are resistant to standard antiarrhythmic agents and that intravenous beta blockers should be the firstline treatment for these arrhythmias.

Absence of heart rate increase during inferoposterior left ventricular hypoperfusion caused by dipyridamole infusion.

BACKGROUND: Stimuli such as inferoposterior myocardial infarction and right coronary injection with radiographic contrast media evoke a vasodepressor reflex characterized by bradycardia and hypotension (Bezold-Jarisch reflex). Dipyridamole acts by adenosine-mediated coronary vasodilation to disclose myocardial perfusion heterogeneity for thallium-201 scintigraphy. OBJECTIVE: To determine whether there is a relationship between the site of left ventricular hypoperfusion and the heart rate response to dipyridamole. DESIGN: One thousand eight hundred consecutive dipyridamole-thallium studies performed between 1985 and 1993 were reviewed to identify 48 subjects who met prespecified selection criteria. SETTING: Nuclear cardiology laboratory of a university teaching hospital. PATIENTS: Group 1 (n=26) had less than 5% pretest likelihood of coronary artery disease and normal thallium perfusion, group 2 (n=10) had isolated, completely reversible anterior perfusion abnormalities, and group 3 (n=12) had analogous inferoposterior perfusion abnormalities. INTERVENTIONS: Heart rate and blood pressure were recorded at baseline and each minute of supine dipyridamole infusion. MAIN RESULTS: After 4 mins of dipyridamole infusion, a significant increase in heart rate was observed in group 1 (+12 beats/min, P<0.05) and group 2 subjects (+12 beats/min, P<0.05) but not in group 3 subjects (+3 beats/min, not significant; P=0.016 compared with responses in the other two groups). Blood pressure was not affected by dipyridamole infusion in any group. CONCLUSIONS: Isolated, moderate or severe inferoposterior hypoperfusion in response to dipyridamole is not accompanied by an increase in heart rate, suggesting that the chronotropic response to dipyridamole is modulated by the presence and location of myocardial perfusion abnormalities. This observation is consistent with the concept that inhibition of adenosine reuptake by dipyridamole, leading to local increases of adenosine concentration, exerts direct and/or reflex effects on heart rate that are site specific. The absence of a rise in heart rate during dipyridamole infusion may be a marker of impaired coronary flow reserve in the inferoposterior left ventricular wall.