Relationship between ACE gene polymorphism and ischemic chronic heart failure in Turkish population.

BACKGROUND: Angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been associated with the development of left ventricular hypertrophy, myocardial infarction, and remodeling. However, little is known about its role in ischemic chronic heart failure (CHF). We investigated the relationship between ACE gene I/D polymorphism and ischemic CHF and its influence on exercise capacity. METHODS: ACE gene I/D polymorphism was analyzed in 209 Turkish patients with coronary artery disease (CAD) undergoing coronary angiography. ACE genotype distributions were examined in 84 consecutive patients with ischemic CHF, functional capacity class II-IV to New York Heart Association and left ventricular ejection fraction (LVEF) < 40% and 125 consecutive patients with stable angina pectoris and LVEF > or = 40%. Furthermore the results of the cardiopulmonary exercise testing (CPX) in each ACE genotype were compared in medically treated ischemic CHF patients (n = 84). RESULTS: ACE genotype distributions were similar between the patients with and without symptomatic CHF in CAD. The odds ratios were 0.95 for D homozygotes (p > 0.05) and 0.98 for the D allele (p > 0.05). In patients with ischemic CHF the differences in CPX findings were statistically not significant in ACE D/D, I/D and I/I genotypes (peak oxygen consumptions 13.7 +/- 4.6; 14.6 +/- 5.1 and 14.5 +/- 5.0 ml/kg/min, respectively (p >0.05). CONCLUSIONS: In this study population, there was no evidence that ACE gene I/D polymorphism plays a role in the development of CHF in CAD or any influence on exercise capacity in treated patients with ischemic CHF.

Cows milk consumption in constipation and anal fissure in infants and young children.

OBJECTIVE: To examine daily cows milk consumption and duration of breastfeeding in infants and young children with anal fissure and constipation. METHODS: Two groups of 30 consecutive children aged between 4 months and 3 years were evaluated retrospectively. Group I comprised children with chronic constipation and anal fissure in whom surgical causes were excluded, and group II comprised normal children. The daily consumption of cows milk, duration of breastfeeding and other clinical features of the children were investigated RESULTS: The mean daily consumption of cows milk was significantly higher in group I (756 mL, range 200-1500 mL) than group II (253 mL, range 0-1000 mL) (P < 0.001). Group I children were breastfed for a significantly shorter period (5.8 months, range 0-18 months) than group II (10.1 months, range 2-24 months) (P < 0.006). The odds ratios for the two factors - children consuming more than 200 mL of cows milk per day (25 children in group I, 11 children in group II) and breastfeeding for less than 4 months (16 children in group I, 5 children in group II) - were calculated to be 8.6 (95% confidence interval [CI]: 0.23-0.74, P = 0.0005) and 5.7 (95% CI: 0.37-0.66, P = 0.007), respectively. CONCLUSIONS: Infants and young children with chronic constipation and anal fissure may consume larger amounts of cows milk than children with a normal bowel habit. Additionally, shorter duration of breastfeeding and early bottle feeding with cows milk may play a role in the development of constipation and anal fissure in infants and young children.

Pneumoperitoneum: an absolute indication for surgery in infants with necrotizing enterocolitis?: Report of a case.

It is generally agreed that neonates with necrotizing enterocolitis (NEC) and pneumoperitoneum should be treated surgically. We report herein the case of a 3-day-old male newborn with NEC in whom a pneumoperitoneum subsequently developed without any cause found at laparotomy. This case is presented to discuss the nonsurgical management of pneumoperitoneum in selected patients.

A novel navel presenting as an umbilical polyp and urachal sinus associated with an epigastric cleft: a clue to anterior midline fusion defects.

Umbilical and periumbilical disorders may present with a diverse group of anomalies and reflect the developmental embryological events they result from. A rare occurrence in a newborn of an umbilicus with an umbilical polyp together with an urachal sinus associated with a supraumbilical abnormal skin area known as epigastric cleft is reported herein, to help to elucidate embryological steps of anterior midline fusion defects and urachal remnants.

Epidermoid cyst of the cecum.

An epidermoid cyst of the cecum is reported in an 8-year-old girl who presented with vague abdominal pain. Abdominal ultrasound scan showed a mass that was cystic in nature. During operation, a subserosal cystic mass was found in the wall of the cecum and confirmed to be an epidermoid cyst histopathologically. This is the first case of epidermoid cyst of the cecum in children reported in the literature.