Glucose-6-phosphate dehydrogenase, glutathione peroxidase, total glutatione and reduced nicotinamide adenine dinucleotide phosphate in milk cells of subclinical mastitic cows

This study aimed to determine the levels of milk cell total protein (TP), reduced nicotinamide adenine dinucleotide phosphate (NADPH), total glutathione (tGSH), activities of glucose-6-phosphate dehydrogenase (G6PD) and glutathione peroxidase (GPx) in subclinical mastitic cows. Milk from each udder was collected and grouped by the California Mastitis Test. Then, a somatic cell count (SCC) was performed, and the groups were re-scored as control (5-87 × 103 cells), 1st group (154-381 × 103 cells), 2nd group (418-851 × 103 cells), 3rd group (914-1958 × 103 cells), and 4th group (2275-8528 × 103 cells). Milk cell TP, NADPH, tGSH levels, G6PD, and GPx activities were assessed. Microbiological diagnosis and aerobic mesophyle general organism (AMG, cfu/g) were also conducted. In mastitic milk, TP, NADPH, and tGSH levels, and G6PD and GPx activities were significantly reduced per cell (in samples of 106 cells). In addition, milk SCC was positively correlated with AMG (r=0.561, p⟨0.001), NADPH (r=0.380, p⟨0.01), TP (r=0.347, p⟨0.01) and G6PD (r=0.540, p⟨0.001). There was also positive correlation between NADPH (r=0.428, p⟨0.01), TP (r=0.638, p⟨0.001) and AMG. NADPH was positively correlated with TP (r=0.239, p⟨0.05), GPx (r=0.265, p⟨0.05) and G6PD (r=0.248, p=0.056). Total protein was positively correlated with tGSH (r=0.354, p⟨0.01) and G6PD (r=0.643, p⟨0.001). There was a negative correlation between tGSH and GPx activity (r=-0.306, p⟨0.05). The microbiological analysis showed the following ratio of pathogens: Coagulase-Negative Staphylococci 66.6%, Streptococcus spp 9.5%, Bacillus spp 9.5%, yeast 4.8%, and mixed infections 9.5%. As a conclusion, when evaluating the enzyme and oxidative stress parameters in milk, it is more suitable to assign values based on cell count rather than ml of milk. The linear correlation between the SCC and AMG, milk cell NADPH, TP and G6PD suggests that these parameters could be used as markers of mastitis.

Synthesis of Morphine Loaded Hydroxyapatite Nanoparticles (HAPs) and Determination of Genotoxic Effect for Using Pain Management

Morphine is used as a standard analgesic for intensive pain relief. It relieves acute and chronic pain by acting directly on the central nervous system and to treat myocardial infarction and shortness of breath. However, the use of morphine for the alleviation of chronic pain is controversial because of the its adverse side effects. The overall success of this medicine in chronic therapy is due to the long-term activity of the drug at a reasonable concentration. Nanoparticle-based carriers have emerged as a new class of drug delivery systems that can overcome traditional drug side-effect limitations by reducing toxicity to a minimum. In this study, a morphine-loaded HAPs drug delivery system was investigated. Fouirer Transform Infrared Spektrofotometre (FTIR) analysis was used to characterize typical functional groups found in the chemical composition of Hydroxyapatite Nanoparticles (HAPs) and morphine loaded HAPs (HAP+M). Scanning electron microscopy (SEM) and Transmission electron microscope (TEM) analyzes were performed to examine the size, morphology, and porosity of morphine loaded HAPs. Characterization analysis showed that HAP nanoparticles were loaded with morphine. The effects of pH on release of morphine-loaded HAPs was determined. The release time of the entrapped morphine in the nanoparticle increased in all conditions, thus increasing the morphine time in the human body. Thus, patients will have to take less morphine. In addition, it was investigated whether the morphine loaded HAP cell produced oxidative stress and genotoxic effect on DNA. Findings presented in this paper suggested that morphine-loaded HAPs have a promising future as a nanocarrier for pain treatment.

Inhibition of human DNA topoisomerase IIα by two novel ellipticine derivatives

Ellipticine (5,11-dimethyl-6H-pyrido[4,3-b]carbazole) is an antineoplastic agent that intercalates into DNA and alters topoisomerase II activity. Unfortunately, this compound displays a number of adverse properties. Therefore, to investigate new ellipticine-based compounds for their potential as topoisomerase II-targeted drugs, we synthesized two novel derivatives, N-methyl-5-demethyl ellipticine (ET-1) and 2-methyl-N-methyl-5-demethyl ellipticinium iodide (ET-2). As determined by DNA decatenation and cleavage assays, ET-1 and ET-2 act as catalytic inhibitors of human topoisomerase IIα and are both more potent than the parent compound. Neither compound impairs the ability of the type II enzyme to bind its DNA substrate. Finally, the potency of ET-1 and ET-2 as catalytic inhibitors of topoisomerase IIα appears to be related to their ability to intercalate into the double helix.

Melatonin prevents retinal oxidative stress and vascular changes in diabetic rats

PURPOSE

To evaluate the role of melatonin, an antioxidant agent, in diabetic oxidative stress and vascular damage.

METHODS

Diabetes was induced in 21 male Wistar rats by intraperitoneal (IP) administration of streptozotocin and then the rats were equally and randomly allocated to diabetic, melatonin, and vehicle groups. Seven healthy normal rats with similar features comprised the control group as the fourth group. All animals were followed for 12 weeks. The melatonin group received IP melatonin daily and the vehicle group received 2.5% ethanol IP at the last month. At the end of 12 weeks, the rats were killed and retinas were harvested. The retinas were investigated for the existence of hypoxia-inducible factor 1-α (HIF-1α), vascular endothelial growth factor A (VEGF-A), and pigment epithelium-derived factor (PEDF) by ELISA. Retinal oxidative stress is quantitated by measuring nitrotyrosine and malondialdehyde levels. Retinal immunohistochemistry with antibody against CD31 antigen was carried out on retinal cross-sections. For statistics, ANOVA test was used for multiple comparisons.

RESULTS

Hyperglycemia increased retinal oxidation as measured through levels of nitrotyrosine and malondialdehyde. Diabetic retinas are also associated with abnormal vascular changes such as dilatation and deformation. HIF-1α, VEGF-A, and PEDF were all increased because of diabetic injury. Melatonin showed a potential beneficial effect on retinopathy in diabetic rats. It decreased retinal nitrotyrosine and malondialdehyde levels, showing an antioxidative support. The vasculomodulator cytokines are decreased accordingly by melatonin therapy. Melatonin normalized retinal vascular changes as well.

CONCLUSION

Melatonin may show some advantage on diabetic vascular changes through decreasing oxidative stress and vessel-related cytokines.

(4,9-Dimethyl-9H-carbazol-3-yl)methanol

In the title compound, C₁₅H₁₅NO, the carbazole skeleton includes a methanol group at the 3-position. The indole ring system is almost planar [maximum deviation = 0.045 (2) Å]. In the crystal, O—H⋯O hydrogen bonds link the mol­ecules into zigzag chains along the b-axis direction. There are weak C—H⋯π inter­actions within the chains and linking neighbouring chains forming sheets lying parallel to (001).

Ethyl 4,9-dimethyl-9H-carbazole-3-carboxylate

In the title compound, C₁₇H₁₇NO₂, the carbazole skeleton includes an eth­oxy­carbonyl group at the 3-position. The indole three-ring system is almost planar [maximum deviation = 0.065 (2) Å], and the ethyl ester group is inclined to its mean plane by 15.48 (2)°. In the crystal, there are π–π stacking inter­actions between parallel benzene rings and between parallel benzene and pyrrole rings of adjacent mol­ecules [centroid–centroid distances = 3.9473 (8) and 3.7758 (8) Å, respectively]. Weak C—H⋯π inter­actions are also present.

2-{N-[(2,3,4,9-Tetrahydro-1H-carbazol-3-yl)methyl]methylsulfonamido}ethyl methanesulfonate

In the title compound, C₁₇H₂₄N₂O₅S₂, the indole ring system is nearly planar [maximum deviation = 0.032 (1) Å] and the cyclo­hexene ring has a half-chair conformation. In the crystal, N—H⋯O hydrogen bonds link the mol­ecules into a chain running along the b-axis direction. Weak C—H⋯O hydrogen bonds and weak C—H⋯π inter­actions are observed between the chains.

2-{4-Methyl-N-[(2,3,4,9-tetra-hydro-1H-carbazol-3-yl)meth-yl]benzene-sulfon-amido}-ethyl 4-methyl-benzene-sulfonate

In the title compound, C29H32N2O5S2, the indole ring system is nearly planar, with a maximum deviation of 0.013 (2) Å, and the cyclo-hexenone ring has an envelope conformation with the methine C atom as the flap. The two methyl-benzene rings are approximately perpendicular to each other, making a dihedral angle of 89.09 (8)°. In the crystal, N-H⋯O hydrogen bonds link the mol-ecules into a chain running along the a-axis direction, and weak C-H⋯O hydrogen bonds and C-H⋯π inter-actions are observed between the chains.

3,9-Dimethyl-2,3-dihydro-spiro-[carb-az-ole-1,2'-[1,3]dithio-lan]-4(9H)-one

The title compound, C₁₆H₁₇NOS₂, consists of a carbazole skeleton with methyl and dithiol­ane groups as substituents. In the indole ring system, the benzene and pyrrole rings are nearly coplanar, forming a dihedral angle of 1.02 (11)°. The cyclo­hexenone ring has a twisted conformation, while the dithiol­ane ring adopts an envelope conformation with one of the CH₂ C atoms at the flap. In the crystal, weak C—H⋯O hydrogen bonds link the mol­ecules into supra­molecular chains nearly parallel to the c axis. These hydrogen bonds together with weak C—H⋯π inter­actions link the molecules into a three-dimensional supramolecular network.

2-(Naphthalen-1-yl)-4-(thio-phen-2-yl-methyl-idene)-1,3-oxazol-5(4H)-one

The asymmetric unit of the title compound, C₁₈H₁₁NO₂S, contains two crystallographically independent mol­ecules. In one mol­ecule, the oxazole and thio­phene rings are oriented at dihedral angles of 17.40 (9) and 18.18 (7)° with respect to the naphthalene ring system, while the oxazole and thio­phene rings are oriented to each other at a dihedral angle of 0.86 (9)°. In the other mol­ecule, the corresponding angles are 3.05 (8), 9.62 (6) and 7.02 (8)°, respectively. In each mol­ecule, a weak intra­molecular C—H⋯N hydrogen bond links the oxazole N atom to the naphthalene group. Weak inter­molecular C—H⋯O hydrogen bonding is present in the crystal structure. π–π stacking between the oxazole and thio­phene rings, between the thio­phene and naphthalene rings, and between the oxaozole and naphthalene rings, [centroid–centroid distances = 3.811 (2), 3.889 (2), 3.697 (2) and 3.525 (2) Å] may further stabilize the crystal structure.

2-(Naphthalen-1-yl)-4-(naphthalen-1-yl-methyl-idene)-1,3-oxazol-5(4H)-one

In the title compound, C₂₄H₁₅NO₂, the oxazole ring is oriented at dihedral angles of 10.09 (4) and 6.04 (4)° with respect to the mean planes of the naphthalene ring systems, while the two naphthalene ring systems make a dihedral angle of 4.32 (3)°. Intra­molecular C—H⋯N hydrogen bonds link the oxazole N atom to the naphthalene ring systems. In the crystal, inter­molecular weak C—H⋯O hydrogen bonds link the mol­ecules into centrosymmetric dimers. π–π contacts between the oxazole and naphthalene rings and between the naphthalene ring systems [centroid–centroid distances = 3.5947 (9) and 3.7981 (9) Å] may further stabilize the crystal structure. Three weak C—H⋯π inter­actions also occur.

11-Butyl-3-methoxy-11H-benzo[a]carbazole

The title compound, C₂₁H₂₁NO, consists of a carbazole skeleton with a meth­oxy­benzene ring fused to the carbazole, and a butyl group attached to the carbazole N atom. The carbazole skeleton is nearly planar [maximum deviation = 0.078 (2) Å], and it is oriented at a dihedral angle of 4.22 (4)° with respect to the adjacent meth­oxy­benzene ring.

Ethyl 4-hydroxy-9-tosyl-9H-carbazole-3-carboxylate

In the title compound, C₂₂H₁₉NO₅S, the carbazole skeleton is nearly planar [maximum deviation = 0.043 (1) Å] with the pyrrole ring oriented at dihedral angles of 2.32 (6) and 1.77 (6)° with respect to the adjacent benzene rings. The dihedral angle between the benzene ring of the tosyl group and the carbazole skeleton is 82.25 (5)°. Intra­molecular O—H⋯O hydrogen bonding results in the formation of a planar six-membered ring, which is oriented at a dihedral angle of 3.06 (4)° with respect to the adjacent carbazole skeleton. In the crystal structure, weak inter­molecular C—H⋯O inter­actions link the mol­ecules into infinite chains and π–π contacts between the benzene rings and between the pyrrole and benzene rings [centroid–centroid distances = 3.374 (1) and 3.730 (1) Å, respectively] may further stabilize the structure. A weak C—H⋯π inter­action is also present.

Ethyl 1-oxo-1,2,3,4-tetra-hydro-9H-carbazole-3-carboxyl-ate

The title compound, C₁₅H₁₅NO₃, contains a carbazole skeleton with an ethoxy­carbonyl group at the 3 position. In the indole ring system, the benzene and pyrrole rings are nearly coplanar, forming a dihedral angle of 1.95 (8)°. The cyclo­hexenone ring has an envelope conformation. In the crystal structure, pairs of strong N—H⋯O hydrogen bonds link the mol­ecules into centrosymmetric dimers with R²₂(10) ring motifs. π–π contacts between parallel pyrrole rings [centroid–centroid distance = 3.776 (2) Å] may further stabilize the structure. A weak C—H⋯π inter­action is also observed.

Differential effects of nifedipine and verapamil on non-adrenergic non-cholinergic relaxations at different levels of active tone: assessment of the contribution of nerve-derived hyperpolarizing factor

1. The objective was to investigate a possible contribution of a nerve-derived hyperpolarizing factor to the differences between non-adrenergic non-cholinergic (NANC) nerve-mediated relaxations in different states of active tone in the rat gastric fundus. 2. NANC relaxations induced by electrical field stimulation (ES: 0.1, 0.5 and 1 Hz; 25 V; 1 ms; 10 s) in 40% contracted strips (S40) were greater when compared with those in 80% contracted strips (S80). 3. ES-induced relaxations were effectively attenuated by N(omega)-nitro-L-arginine (L-NNA; 100 microm) in S40 and S80. Percentage reduction of the responses obtained in the presence of L-NNA in S40 group was less than that of S80. 4. In S40 group, nifedipine (0.5-1 microm) and verapamil (0.5-1 microm) inhibited the responses to 0.1 and 0.5 Hz. Nifedipine (1 microm) and verapamil (0.5 microm) caused no change in the responses to ES in S80. 5. In S40, when L-NNA (100 microm) and nifedipine or verapamil, either in 1 microm concentration, were administered together, the inhibition on the electrical relaxations were more than that of each drug alone. 6. In conclusion, NANC nerve-mediated relaxations are increased when studied in an active state of 40%, and a factor, sensitive to nifedipine seems to be responsible for this distinction.

Evidence for the interaction between nitric oxide and vasoactive intestinal polypeptide in the mouse gastric fundus

The involvement of nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) in nonadrenergic noncholinergic (NANC) nerve-induced relaxation and the interaction between NO and VIP were investigated in the mouse gastric fundus. N(omega)-nitro-L-arginine (L-NOARG; 100 microM) completely inhibited the NANC relaxations induced by electrical stimulation (ES) (0.5, 1, 2, 4, and 8 Hz; 25 V; 1 ms; 15-s trains). Hemoglobin (20 microM), hydroxocobalamin (100 microM), and 1H-[1,2,4,]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10 microM) diminished ES-induced relaxations, but alpha-chymotrypsin (10 U/ml) and VIP antiserum (1/200 dilution) had no effect on NANC relaxations. L-NOARG (100 microM) did not have any effect, whereas ODQ (10 microM) attenuated sodium nitroprusside (SNP; 100 nM)-induced relaxations. alpha-Chymotrypsin (10 U/ml) had no effect on the response to SNP. Furthermore, alpha-chymotrypsin (10 U/ml) abolished and VIP antiserum (1/200 dilution) diminished VIP (50 nM)-induced relaxations. L-NOARG (100 microM) caused an inhibition of VIP-induced relaxation that was reversed by L-arginine (1 mM) but not by D-arginine (1 mM). Similarly, ODQ (10 microM) inhibited the responses to VIP. 2-Amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (5 microM) had no effect on these relaxations. L-NOARG (100 microM) and ODQ (10 microM) did not affect isoproterenol (10 nM)-induced relaxations. In conclusion, these results provide evidence that NO is involved in NANC nerve-induced relaxation and the participation of VIP (and related neuropeptides) cannot be excluded in causing relaxation of mouse gastric fundus muscle strips. These findings support the idea that VIP directly stimulates the production of NO by increasing NOS activity and thereby activating soluble guanylyl cyclase in smooth muscle.

Involvement of nitric oxide in non-adrenergic non-cholinergic relaxation and action of vasoactive intestinal polypeptide in circular muscle strips of the rat gastric fundus

We examined the characteristics of the non-adrenergic non-cholinergic (NANC) nerve induced relaxation and the possible interaction between nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) on the basal tone of the circular muscle of the rat gastric fundus. Electrically induced NANC relaxations were partly inhibited by N(omega)-nitro-L-arginine (100 microM), whereas sodium nitroprusside (SNP; 10 microM) and VIP (5 nM) induced relaxations were not affected. 2-Amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (AMT; 5 microM) also inhibited the responses to electrical stimuli to a similar extent as N(omega)-nitro-L-arginine but not VIP. However, AMT plus N(omega)-nitro-L-arginine did not give an additional inhibition above that of each drug alone on NANC relaxations, and dexamethasone (10 microM) had no effect on NANC nerve induced relaxations. 1H-[1,2,4,]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10 microM), a selective inhibitor of guanylate cyclase, abolished the responses to NANC nerve stimulation and SNP, while VIP responses were not influenced. N-ethylmaleimide (100 microM), an adenylate cyclase inhibitor, attenuated relaxations to NANC nerve stimulation, VIP and isoproterenol (1 nM), while having no effect on those to SNP, but in combination with N(omega)-nitro-L-arginine, there was no additional inhibition on the responses to nerve stimulation. Alpha-chymotrypsin (10 u ml(-1)) severely diminished VIP induced relaxations, but did not reduce electrical responses. In conclusion, these results suggest that NO is involved in the relaxations induced by short-term electrical stimulation. However, another possible unidentified transmitter that can trigger the accumulation of cyclic GMP is not entirely ruled out and there is no interaction between NO and VIP in the circular muscle strip of the rat gastric fundus, even in the basal state of the tissue.

The influence of nitric oxide donors on the responses to nitrergic nerve stimulation in the mouse duodenum

We investigated whether exogenous nitric oxide (NO) donors have a prejunctional and/or postjunctional inhibitory effect on the nitrergic responses and whether this inhibitory effect was mediated by NO itself and in part, by cyclic GMP in mouse duodenal strips. N(omega)-nitro-L-arginine inhibited relaxations induced by electrical field stimulation of nitrergic nerves, but not those with acidified NaNO2. Furthermore, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ) inhibited both types of relaxations while 2-amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (AMT) and N-ethylmaleimide were ineffective. NO donors, nitroglycerin and sodium nitroprusside, inhibited relaxations induced by nitrergic nerve stimulation, but not those with acidified NaNO2. Hemoglobin, exogenous Cu(2+)/Zn(2+) superoxide dismutase, diethyldithiocarbamic acid and pyrogallol did not influence the relaxation with nitrergic nerve stimulation. However, hemoglobin, diethyldithiocarbamic acid, pyrogallol and diethyldithiocarbamic acid plus pyrogallol attenuated the inhibitory effect of NO donors on relaxation with nitrergic nerve stimulation, and exogenous superoxide dismutase potentiated this inhibitory effect. Moreover, nitrergic nerve-mediated relaxations were inhibited by 8-bromo-cyclic GMP, but not by 8-bromo-cyclic AMP. These results suggest that exogenous NO donors have a prejunctional inhibitory effect on the nerve-mediated nitrergic relaxation and that the inhibitory effects of nitroglycerin and sodium nitroprusside are NO-dependent, but not related to NO metabolites such as peroxynitrite or a nitrosothiol intermediate. However, a contribution of S-nitrosothiol formed intracellularly cannot be entirely ruled out. Also, this prejunctional inhibition is mediated, at least in part, by the cyclic GMP, but not the cyclic AMP, pathway.

4-Methylcarbazole-3-carboxylic acid

The title compound, C(14)H(11)NO(2), consists of a carbazole skeleton with carboxylic acid and methyl groups at positions 3 and 4, respectively. Molecules are linked about inversion centres by O-H.O hydrogen bonds [O.O 2.620 (3) A] to form centrosymmetric dimers.

Complications of radical hysterectomy: clinical experience of 115 early stage cervical cancers

We evaluated the clinical experience of 115 women with early stage cervical cancer who had been operated in our Gynecologic Oncology Clinic. Of these, 85 were in stage I, and 30 in stage II. Intraoperative complications occurred in 16 patients including 3 cases concerning bladder, 1 ureter, 1 aorta, 5 v.cava inferior, 1 internal iliac a., 3 internal iliac v., 1 obturator nerve and 1 rectovaginal septum hematoma formation. Postoperative complications were observed in 38 patients. These were 14 bladder dysfunctions, 10 lymphocyst formations, 6 urinary infections, 12 wound infections, 3 pelvic infections, 2 eviscerations and 1 incisional hernia. However, no death occurred due to intraoperative or postoperative complications. Pelvic lymph node metastases were observed in 32 patients of whom 17 had only unilateral involvement, most often in the obturator region. Para-aortic lymph node metastases were diagnosed in 4 patients, all of whom were in stage II.

Possible postsynaptic action of aminoglycosides in the frog rectus abdominis

The present study was undertaken to investigate the postsynaptic effects of aminoglycosides on contractions evoked by acetylcholine (ACh), KCl, electrical field stimulation (EFS) and Na(+)- and Ca(2+)-free Ringer solution with 0.2 mM Na2 EDTA (NaFCaFR) in the isolated frog rectus abdominis. Neomycin inhibited contraction elicited by ACh, NaFCaFR, and EFS at the higher frequencies (8 and 10 Hz) but not those elicited by KCl and EFS at the lower frequencies (2, 3 and 5 Hz). D-tubocurarine inhibited ACh-induced contractions in a concentration-dependent manner. In addition, drug reduced EFS-evoked contractions to a limited extent. Lower concentrations (10(-5), 5 x 10(-5), 10(-4), 2 x 10(-4) and 3 x 10(-4) M) but not higher concentrations (4 x 10(-4) and 5 x 10(-4) M) of methoxyverapamil exhibited a concentration-dependent inhibitory action on NaFCaFR-induced contractions. Similar inhibitions of the same type of contraction were displayed by aminoglycosides (neomycin, streptomycin, netilmycin, gentamycin and amikacin). These results suggest that in addition to their antagonistic action on nicotinic receptors in the frog rectus abdominis, aminoglycosides may exert stabilizing effects on some functional components contributing to contractions at the membrane.

Endoscopic retrograde cholangiopancreatography in the diagnosis and management of choledochal cysts

Choledochal cysts are an uncommon anomaly of the biliary system manifested by cystic dilatation of the extra or intrahepatic biliary tree or both. It is most frequently found in Orientals and in females. Endoscopic retrograde cholangiopancreatography is a valuable imaging technique in the diagnosis of choledochal cysts in adults. Additionally, in selected cases, a choledochocele may be effectively managed by endoscopic sphincterotomy. We present clinical and endoscopic findings of six adult patients with choledochal cysts. Clinical symptoms were characterized by abdominal pain, jaundice and cholangitis. Associated hepatobiliary pathologic findings included cholelithiasis, recurrent acute pancreatitis, gallbladder carcinoma, Cystolithiasis, choledocholithiasis, biliary stricture and hepatic abscess.

Vulvar syringoma exacerbated during pregnancy

Although syringoma of the eyelids and the cheeks are well known and defined, vulvar syringoma is a rare clinical variant of this benign eccrine tumor. A case of syringoma of the vulva exacerbated during pregnancies with regression in the periods in between is presented. Histopathological examination showed typical features of syringomas. Only 20 patients with vulvar syringoma have been previously reported in the literature.

Cases of acute mountain sickness on Mount Agri

Between 1983 and 1990 a total of 74 freestyle mountaineers and 88 mountaineers with skis attempted to climb Mount Agri (Ararat). From the freestyle group two mountaineers were affected by acclimatisation disorder at 3200 m and seven at 4200 m above sea level. Acute mountain sickness (AMS) affected four mountaineers at 4200 m, eight at 4700 m, two at 5000 m and two at 5165 m, while 49 reached the summit. Only one of the mountaineers with skis was affected by AMS (at 4200 m), while all the others reached the summit. The symptoms of acclimatisation disorder and AMS, according to their degree of frequency, were headache, weakness, dyspnoea and palpitation, anorexia, nausea, vomiting, giddiness, ataxia and insomnia. Pulse rates varied between 115 and 124/min, and breathing between 30 and 38/min.

Is there any relationship between pica and liver failure?

Pica is defined as the compulsive eating of anything and has been known for more than a hundred years. It is a worldwide problem which can be seen in every race, age, sex and geographic region. Its true incidence is not known and may be greater than expected. Although it is a widespread phenomenon, the causes and risk factors of pica are not well established. Clinical signs and symptoms of pica syndrome are numerous but liver disorder associated with this syndrome is not widely reported. We reported here liver disorder possibly related with pica.