Prediction of Intraperitoneal Adhesions in Repeated Cesarean Deliveries with Stria Gravidarum Scoring System: A Cross-sectional Study

BACKGROUND

The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health.

AIM

The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system.

METHODS

A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair's and modified Nair's scoring systems.

RESULTS

Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair's and the modified Nair's scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score ≥3 and Vancouver score ≥4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively).

CONCLUSION

Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.

Screening for precancerous anal lesions linked to human papillomaviruses: French recommendations for clinical practice

In France, about 2000 new cases of anal cancer are diagnosed annually. Squamous cell carcinoma is the most common histological type, mostly occurring secondary to persistent HPV16 infection. Invasive cancer is preceded by precancerous lesions. In addition to patients with a personal history of precancerous lesions and anal cancer, three groups are at very high risk of anal cancer: (i) men who have sex with men and are living with HIV, (ii) women with a history of high-grade squamous intraepithelial lesions (HSILs) or vulvar HPV cancer, and (iii) women who received a solid organ transplant more than 10 years ago. The purpose of screening is to detect HSILs so that they can be treated, thereby reducing the risk of progression to cancer. All patients with symptoms should undergo a proctological examination including standard anoscopy. For asymptomatic patients at risk, an initial HPV16 test makes it possible to target patients at risk of HSILs likely to progress to cancer. Anal cytology is a sensitive test for HSIL detection. Its sensitivity is greater than 80% and exceeds that of proctological examination with standard anoscopy. It is indicated in the event of a positive HPV16 test. In the presence of cytological abnormalities and/or lesions and a suspicion of dysplasia on clinical examination, high-resolution anoscopy is indicated. Performance is superior to that of proctological examination with standard anoscopy. However, this technique is not widely available, which limits its use. If high-resolution anoscopy is not possible, screening by a standard proctological examination is an alternative. There is a need to develop high-resolution anoscopy and triage tests and to evaluate screening strategies.

Can pelvic floor muscle training positions be selected according to the functional status of pelvic floor muscles?

Background

Pelvic floor muscle (PFM) training varies according to the functional status of PFM. It is used to strengthen underactive PFM and relax overactive PFM.

Aim

This study aimed to determine the appropriate PFM training positions according to the functional status of the PFM in women with pelvic floor dysfunction.

Materials and Methods

Seventy-six women diagnosed with pelvic floor dysfunction were included. After the digital palpation, participants were divided into four groups according to the functional status of PFM: normal, overactive, underactive, and nonfunctional. Participants' PFM and abdominal muscle functions were assessed with superficial electromyography in three positions (modified butterfly pose-P1, modified child pose-P2, and modified deep squat with block pose-P3). Friedman's analysis of variance and the Kruskal-Wallis test were used to assess whether the function of the muscles differed according to the functional status of the PFM and training positions.

Results

Normal PFM maximally contracted and relaxed in P1, whereas nonfunctional PFM was in P3 (P > 0.05). Overactive and underactive PFM was most contracted in P2 (P > 0.05) and relaxed in P1 (P < 0.001). In each functional state of the PFM, all abdominal muscles were most relaxed in P1, while their most contracted positions varied (P < 0.05).

Conclusion

This study showed that the positions in which the PFM relaxes and contracts the most may vary according to the functional status of the PFM. Therefore, different PFM training positions may be preferred according to the functional status of the PFM in women with pelvic floor dysfunction. However, more study needs to be done in this subject.

Altered population activity and local tuning heterogeneity in auditory cortex of Cacna2d3-deficient mice

The α2δ3 auxiliary subunit of voltage-activated calcium channels is required for normal synaptic transmission and precise temporal processing of sounds in the auditory brainstem. In mice its loss additionally leads to an inability to distinguish amplitude-modulated tones. Furthermore, loss of function of α2δ3 has been associated with autism spectrum disorder in humans. To investigate possible alterations of network activity in the higher-order auditory system in α2δ3 knockout mice, we analyzed neuronal activity patterns and topography of frequency tuning within networks of the auditory cortex (AC) using two-photon Ca2+ imaging. Compared to wild-type mice we found distinct subfield-specific alterations in the primary auditory cortex, expressed in overall lower correlations between the network activity patterns in response to different sounds as well as lower reliability of these patterns upon repetitions of the same sound. Higher AC subfields did not display these alterations but showed a higher amount of well-tuned neurons along with lower local heterogeneity of the neurons' frequency tuning. Our results provide new insight into AC network activity alterations in an autism spectrum disorder-associated mouse model.

Magnesium yields opposite effects on the nuclear and cytosolic cascades of apoptosis in different rat brain regions

OBJECTIVE

Magnesium is considered as potential neuroprotective and therapeutic agent, but certain studies have provided evidence of its apoptotic effectiveness in neurons. We aimed to evaluate the possible apoptotic effects of long-term magnesium use in healthy adult rat brains.

MATERIALS AND METHODS

Magnesium citrate and magnesium glycinate compounds were administered orally to rats for 8 weeks (36 mg/kg). Expression levels of Bcl-2, Bax and Cyt-C genes were analyzed by real-time polymerase chain reactions (RT-PCR) in the prefrontal cortex, hippocampus and striatum regions. Bcl-2, Bax and CytC protein levels were measured using ELISA kits. Tissue sections were evaluated histopathologically with hematoxylin-eosin staining.

RESULTS

Compared to the control group, the magnesium-administered groups indicated gene expression reductions in almost all brain regions; pro-apoptotic Bax, anti-apoptotic Bcl-2 and Cyt-C gene expression levels were reduced. With magnesium, the Bcl-2 and Bax protein levels were increased. Bax/Bcl-2 gene and protein ratio were also increased in the striatum and hippocampus, whereas Cyt-C protein levels were decreased or did not change in the magnesium treated groups. There was no pathological finding in histological evaluation.

CONCLUSIONS

Long-term magnesium usage can promote apoptotic cascade in brain tissue by increasing Bax/Bcl-2 ratio. Cyt-C, a prominent factor processing caspase pathway, was decreased or unchanged. In addition, taking into account the histological evaluation, we supposed that the absence of Cyt-C in the cytosol can prevent the subsequent apoptotic pathway. Consequently, we obtained the findings of apoptotic initiation with magnesium in brain, but this cascade seems to be arrested at later stages.

Visualization of the auditory pathway in rats with 18F-FDG PET activation studies based on different auditory stimuli and reference conditions including cochlea ablation

Activation studies with positron emission tomography (PET) in auditory implant users explained some of the mechanisms underlying the variability of achieved speech comprehension. Since future developments of auditory implants will include studies in rodents, we aimed to inversely translate functional PET imaging to rats. In normal hearing rats, activity in auditory and non-auditory regions was studied using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET with 3 different acoustic conditions: sound attenuated laboratory background, continuous white noise and rippled noise. Additionally, bilateral cochlea ablated animals were scanned. 3D image data were transferred into a stereotaxic standard space and evaluated using volume of interest (VOI) analyses and statistical parametric mapping (SPM). In normal hearing rats alongside the auditory pathway consistent activations of the nucleus cochlearis (NC), olivary complex (OC) and inferior colliculus (IC) were seen comparing stimuli with background. In this respect, no increased activation could be detected in the auditory cortex (AC), which even showed deactivation with white noise stimulation. Nevertheless, higher activity in the AC in normal hearing rats was observed for all 3 auditory conditions against the cochlea ablated status. Vice versa, in ablated status activity in the olfactory nucleus (ON) was higher compared to all auditory conditions in normal hearing rats. Our results indicate that activations can be demonstrated in normal hearing animals based on ¹⁸F-FDG PET in nuclei along the central auditory pathway with different types of noise stimuli. However, in the AC missing activation with respect to the background advises the need for more rigorous background noise attenuation for non-invasive reference conditions. Finally, our data suggest cross-modal activation of the olfactory system following cochlea ablation–underlining, that ¹⁸F-FDG PET appears to be well suited to study plasticity in rat models for cochlear implantation.

Electrical stimulation of the midbrain excites the auditory cortex asymmetrically

BACKGROUND

Auditory midbrain implant users cannot achieve open speech perception and have limited frequency resolution. It remains unclear whether the spread of excitation contributes to this issue and how much it can be compensated by current-focusing, which is an effective approach in cochlear implants.

OBJECTIVE

The present study examined the spread of excitation in the cortex elicited by electric midbrain stimulation. We further tested whether current-focusing via bipolar and tripolar stimulation is effective with electric midbrain stimulation and whether these modes hold any advantage over monopolar stimulation also in conditions when the stimulation electrodes are in direct contact with the target tissue.

METHODS

Using penetrating multielectrode arrays, we recorded cortical population responses to single pulse electric midbrain stimulation in 10 ketamine/xylazine anesthetized mice. We compared monopolar, bipolar, and tripolar stimulation configurations with regard to the spread of excitation and the characteristic frequency difference between the stimulation/recording electrodes.

RESULTS

The cortical responses were distributed asymmetrically around the characteristic frequency of the stimulated midbrain region with a strong activation in regions tuned up to one octave higher. We found no significant differences between monopolar, bipolar, and tripolar stimulation in threshold, evoked firing rate, or dynamic range.

CONCLUSION

The cortical responses to electric midbrain stimulation are biased towards higher tonotopic frequencies. Current-focusing is not effective in direct contact electrical stimulation. Electrode maps should account for the asymmetrical spread of excitation when fitting auditory midbrain implants by shifting the frequency-bands downward and stimulating as dorsally as possible.

Abstract P4-12-10: Prognostic relevance of caspase 8 polymorphisms for breast cancer

Background: The minor allele of two caspase 8 polymorphisms, namely CASP8 -652 6N InsDel (rs3834129) and CASP8 Asp302His (rs1045485), were repeatedly associated with reduced breast cancer susceptibility. Contrarily, the presence of the -652 6N Del or the CASP8 302His variant was reported to be an unfavorable prognostic factor in colorectal cancer or neuroblastoma. However, prognostic relevance of these genetic variants for breast cancer is completely unknown and is therefore adressed by the current study.

Methods: Genotyping was performed by pyrosequencing. Caspase 8 mRNA expression was quantified by comparative RT-qPCR.

Results: We observed an allele-dose dependent association between CASP8 -652 6N InsDel and caspase 8 mRNA expression in breast cancer tissue, with homozygous deletion carriers showing lowest relative caspase 8 expression (p=0.0131). Intriguingly, the presence of the -652 6N Del or the 302His variant was shown to be a negative prognostic factor for breast cancer in terms of an allele-dose dependent influence on overall survival (OS, p=0.0018, p=0.0150, respectively). Moreover, both polymorphisms were independent predictors of OS after adjusting for co-variats (p=0.007, p=0.037, respectively). Prognostic relevance of both polymorphisms was independent from ER or Her2/Neu receptor status and a combined analysis of diplotypes revealed an additive influence on OS (p=0.0002).

Conclusion: This is the first report, showing negative and independent prognostic impact of the CASP8 -652 6N Del and the 302His variant for breast cancer. Our data provide rationale to further validate clinical utility of these polymorphisms for breast cancer and to extend this investigation to a broad scope of other malignancies.

Citation Format: Wimberger P, Jan Dominik K, Agnes B, Kurt S, Rainer C, Rainer K, Winfried S, Hagen B. Prognostic relevance of caspase 8 polymorphisms for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-10.

Testing non-additivity (interaction) in two-way ANOVA tables with no replication

Testing for any significant interaction between two variables depends on the number of replicates in each cell of the two-way table and structure of the interaction. If there is interaction between two factors model of observations include interaction term and is called ‘non-additive model’ which makes interaction and non-additivity equivalent in terms of meaning. When there are several observations taken at each level combination of two variables, testing non-additivity can easily be done by usual two-way ANOVA method which cannot be used when there is only one observation per cell. For the cases with only one observation per cell, some methods have been developed starting with Tukey’s one-degree-of-freedom test in which interaction is supposed to be the product of two factor’s effects. There are other methods which are used for different structures of interaction when there is only one observation. In this paper, we review some of these tests. After presenting general methodology for the two-factor linear model with interaction effect and the general two-way ANOVA method when there are n > 1 observations per cell, we present some methods for testing non-additivity when there is only one observation per cell. Finally, we illustrate these methods on examples.

Treatment of iron deficiency anemia induces weight loss and improves metabolic parameters

BACKGROUND

The treatment of iron deficiency anemia is oral iron replacement which has side effects mostly related with gastrointestinal system. A significant rate of the patients that discontinuing the treatment complained of weight gain during treatment in our clinical practise, despite, oral iron preparations are not known to have such a side effect in adults. Therefore, we planned to investigate this myth whether iron preparations cause an increase in weight, waist circumference, body mass index and laboratory metabolic parameters that may accompany to weight gain.

MATERIALS AND METHODS

Twenty-one women admitted to our out-patient clinics with iron deficiency anemia were enrolled to the study. Waist circumference, body weight, body mass index, systolic and diastolic blood pressures, hemogram and other laboratory parameters assessed and recorded at the first visit and repeated 4 to 6 moths after initiation of treatment.

RESULTS

Waist circumference, body weight and BMI significantly reduced in patients after treatment compared to pre-treatment period. Moreover, HDL was increased and triglyceride was decreased significantly in after treatment compared to pre-treatment period.

CONCLUSIONS

We suggest that treatment of iron deficiency may improve not only haematological but also metabolic and anthropometric parameters. Due to the small study population of our cohort, larger prospective studies are needed to confirm our results.

Treatment of uterine prolapse with bilateral hydronephrosis in a young nulliparous woman; a new minimally invasive extraperitoneal technique

A 37-year-old nulligravid woman presented with a 2-year history of uterine prolapse along with mixed incontinence. Gynecological examination confirmed third degree cystocele and uterine prolapse. Renal ultrasonography showed enlarged kidneys and marked dilation of the bilateral pelvicalyceal system. She was hospitalized and a ring pessary was inserted after bladder catheterization. Her preoperative evaluation was performed and the patient was operated one month after her first admission. Anterior colporrhaphy along with Kurt Extraperitoneal Ligamentopexy was performed without any complication. A control visit on second postoperative month revealed recovery of incontinence symptoms and no prolapse was observed. To our knowledge this is the first reported treatment of a case with bilateral hydronephrosis due to uterine prolapse that were corrected and overcame with a novel minimally invasive extraperitoneal approach by fixation of bilateral round ligaments to the rectus fascia sheet.

Quantitative analysis of neuronal response properties in primary and higher-order auditory cortical fields of awake house mice (Mus musculus)

Because of its great genetic potential, the mouse (Mus musculus) has become a popular model species for studies on hearing and sound processing along the auditory pathways. Here, we present the first comparative study on the representation of neuronal response parameters to tones in primary and higher-order auditory cortical fields of awake mice. We quantified 12 neuronal properties of tone processing in order to estimate similarities and differences of function between the fields, and to discuss how far auditory cortex (AC) function in the mouse is comparable to that in awake monkeys and cats. Extracellular recordings were made from 1400 small clusters of neurons from cortical layers III/IV in the primary fields AI (primary auditory field) and AAF (anterior auditory field), and the higher-order fields AII (second auditory field) and DP (dorsoposterior field). Field specificity was shown with regard to spontaneous activity, correlation between spontaneous and evoked activity, tone response latency, sharpness of frequency tuning, temporal response patterns (occurrence of phasic responses, phasic-tonic responses, tonic responses, and off-responses), and degree of variation between the characteristic frequency (CF) and the best frequency (BF) (CF-BF relationship). Field similarities were noted as significant correlations between CFs and BFs, V-shaped frequency tuning curves, similar minimum response thresholds and non-monotonic rate-level functions in approximately two-thirds of the neurons. Comparative and quantitative analyses showed that the measured response characteristics were, to various degrees, susceptible to influences of anesthetics. Therefore, studies of neuronal responses in the awake AC are important in order to establish adequate relationships between neuronal data and auditory perception and acoustic response behavior.

Relation of peritoneal fluid and serum vascular endothelial growth factor levels to endometriosis stage

OBJECTIVE

It is a well known fact that endometriosis is linked with apoptosis, extracellular matrix formation, and angiogenesis. In this study, the authors aim to investigate the relation between the extent of endometriosis and vascular endothelial growth factor (VEGF).

MATERIALS AND METHODS

Twenty-one patients who received laparoscopic intervention due to endometriosis constituted the patient group, whereas 19 patients who were operated due to extra-endometrial benign cyst were included in the control group. Following the laparoscopic pelvic assessment, peripheral blood samples and two cc of free peritoneal fluid from the Douglas pouch were obtained simultaneously. The samples were studied with regards to VEGF level via solid phase sandwich enzyme-linked immunosorbent assay (ELISA) method.

RESULTS

In the patient group, eight cases were diagnosed with Stages I and II endometriosis, while 13 cases were diagnosed with Stages III and IV endometriosis. Among the Stage I and II cases, serum VEGF levels were statistically significantly higher, as compared to the Stage III and IV cases, as well as the control group. Discussion: In conclusion, the authors found a relationship between elevated serum VEGF levels and early stage endometriosis.

Granulosa cell tumors of the ovary: review of 43 cases

PURPOSE

Granulosa cell tumors of the ovary (OGCT) are rarely seen tumors and display a quite interesting behavior profile. The purpose of this study was to evaluate the impact of stage, histological type (juvenile or adult type) and treatment on the prognosis of this disease.

METHODS

Forty-three females with OGCT operated between January 1990 and June 2007 were retrospectively evaluated. Radical surgery was performed to 37 patients (86%) without fertility desire, whereas conservative surgery was performed to 6 patients with early-stage disease and fertility desire.

RESULTS

Thirty-nine (90.6%) patients had stage I disease, whereas 4 (9.4%) had advanced-disease stage (stage II 2 and stage III 2 patients). All of the patients were surgically treated, but conservative surgery was applied to only 6 cases. Postoperative chemotherapy was administered to 18 cases and the remaining 25 cases were put under follow-up without chemotherapy. Recurrence was observed in 8 cases and 1 of these cases was of juvenile type. Mean time to recurrence was 55.14±32.18 months (range 15-122). Tumor stage was the most important prognostic factor, with 5-year overall survival of 96.77% in local disease, and 66.67% in advanced-stage disease (p<0.01).

CONCLUSION

OGCT can recur many years after primary therapy. Consequently these patients must be followed-up for long periods of time. Disease stage at diagnosis was the most important factor affecting the recurrence rate and prognosis. The evaluation of all factors affecting survival needs further studies with larger numbers of patients.

Critical role for cochlear hair cell BK channels for coding the temporal structure and dynamic range of auditory information for central auditory processing

Large conductance, voltage- and Ca²⁺-activated K⁺ (BK) channels in inner hair cells (IHCs) of the cochlea are essential for hearing. However, germline deletion of BKα, the pore-forming subunit KCNMA1 of the BK channel, surprisingly did not affect hearing thresholds in the first postnatal weeks, even though altered IHC membrane time constants, decreased IHC receptor potential alternating current/direct current ratio, and impaired spike timing of auditory fibers were reported in these mice. To investigate the role of IHC BK channels for central auditory processing, we generated a conditional mouse model with hair cell-specific deletion of BKα from postnatal day 10 onward. This had an unexpected effect on temporal coding in the central auditory system: neuronal single and multiunit responses in the inferior colliculus showed higher excitability and greater precision of temporal coding that may be linked to the improved discrimination of temporally modulated sounds observed in behavioral training. The higher precision of temporal coding, however, was restricted to slower modulations of sound and reduced stimulus-driven activity. This suggests a diminished dynamic range of stimulus coding that is expected to impair signal detection in noise. Thus, BK channels in IHCs are crucial for central coding of the temporal fine structure of sound and for detection of signals in a noisy environment.—Kurt, S., Sausbier, M., Rüttiger, L., Brandt, N., Moeller, C. K., Kindler, J., Sausbier, U., Zimmermann, U., van Straaten, H., Neuhuber, W., Engel, J., Knipper, M., Ruth, P., Schulze, H. Critical role for cochlear hair cell BK channels for coding the temporal structure and dynamic range of auditory information for central auditory processing.

Foxp2 mutations impair auditory-motor association learning

Heterozygous mutations of the human FOXP2 transcription factor gene cause the best-described examples of monogenic speech and language disorders. Acquisition of proficient spoken language involves auditory-guided vocal learning, a specialized form of sensory-motor association learning. The impact of etiological Foxp2 mutations on learning of auditory-motor associations in mammals has not been determined yet. Here, we directly assess this type of learning using a newly developed conditioned avoidance paradigm in a shuttle-box for mice. We show striking deficits in mice heterozygous for either of two different Foxp2 mutations previously implicated in human speech disorders. Both mutations cause delays in acquiring new motor skills. The magnitude of impairments in association learning, however, depends on the nature of the mutation. Mice with a missense mutation in the DNA-binding domain are able to learn, but at a much slower rate than wild type animals, while mice carrying an early nonsense mutation learn very little. These results are consistent with expression of Foxp2 in distributed circuits of the cortex, striatum and cerebellum that are known to play key roles in acquisition of motor skills and sensory-motor association learning, and suggest differing in vivo effects for distinct variants of the Foxp2 protein. Given the importance of such networks for the acquisition of human spoken language, and the fact that similar mutations in human FOXP2 cause problems with speech development, this work opens up a new perspective on the use of mouse models for understanding pathways underlying speech and language disorders.

Long-range effects of GABAergic inhibition in gerbil primary auditory cortex

Throughout the literature, the effects of iontophoretically applied neurotransmitter agonists or antagonists on the local activity of neurons are typically studied at the site of drug application. Recently, we have demonstrated long-range inhibitory interactions within the primary auditory cortex (AI) that are effective in complex acoustic situations. To further characterize this long-range functional connectivity, we here report the effects of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and the GABA(A) antagonist gabazine (SR 95531) on neuronal activity as a function of distance from the application site reaching beyond the diffusion radius of the applied drug. Neuronal responses to pure tone stimulation were simultaneously recorded at the application site and four additional sites, at distances between 300 and 1350 microm from the application site. We found that whereas application of GABA during best frequency (BF) stimulation in general led to a decrease, and gabazine to an increase, in neuronal activity at the application site, a considerable number of units at remote recording sites showed effects opposite to these local, drug-induced effects. These effects were seen both in spiking activity and in amplitudes of local field potentials. At all locations, the effects varied as a function of pure tone stimulation frequency, pointing to a Mexican-hat-like input function resulting from thalamic inputs to the BF region of the cortical neurons and intracortical interconnections projecting to off-BF regions of the neurons. These data demonstrate the existence of long-range, inhibitory interactions within the gerbil AI, realized either by long-range inhibitory projections or by long-range excitatory projections to local inhibitory interneurons.

Response surface optimization of pH and ionic strength for emulsion characteristics of egg yolk

Effects of pH (3.5, 4.5, 6.0, 7.5, and 8.5) and ionic strength (0.05, 0.15, 0.30, 0.45, and 0.55 M NaCl) on emulsion capacity, emulsion stability (ES), apparent yield stress of emulsion (AYS), and emulsion density (ED) of egg yolk were studied by using a model system. Ionic strength and pH had significant (P < 0.01) effects on the emulsion characteristics of egg yolk. Their interaction effects also have been found significant on ES, AYS, and ED. Predicted solutions of ES, emulsion capacity, and ED were minimum. The critical point of ES was determined to be at pH 6.08 and an ionic strength of 0.49 (M NaCl). Predicted solution for AYS was a maximum, which was determined to be at pH 6.04 and an ionic strength of 0.29 (M NaCl). Optimum values of pH and ionic strenght were 4.61 to 7.43 and 0.10 to 0.47, respectively.

Improvement of auditory discrimination learning by Ginkgo biloba extract EGb 761

The effect of oral application of Ginkgo biloba extract EGb 761 on auditory discrimination learning in Mongolian gerbils was investigated using discrimination tasks with three different degrees of difficulty and two protocols for administration starting 2 weeks prior to or at the beginning of training. In comparison to placebo-treated controls we observed significant improvement of learning performance in EGb 761 treated gerbils in discrimination tasks of all degrees of difficulty, from the easiest to the most demanding. EGb 761 has been reported to increase the extracellular concentration of dopamine in prefrontal cortex of rats which plays a major role in the type of discrimination learning used in the present study. We, therefore, suppose that EGb 761 improves discrimination learning through its effect on the dopaminergic system.

Modified sound-evoked brainstem potentials in Foxp2 mutant mice

Heterozygous mutations of the human FOXP2 gene cause a developmental disorder involving impaired learning and production of fluent spoken language. Previous investigations of its aetiology have focused on disturbed function of neural circuits involved in motor control. However, Foxp2 expression has been found in the cochlea and auditory brain centers and deficits in auditory processing could contribute to difficulties in speech learning and production. Here, we recorded auditory brainstem responses (ABR) to assess two heterozygous mouse models carrying distinct Foxp2 point mutations matching those found in humans with FOXP2-related speech/language impairment. Mice which carry a Foxp2-S321X nonsense mutation, yielding reduced dosage of Foxp2 protein, did not show systematic ABR differences from wildtype littermates. Given that speech/language disorders are observed in heterozygous humans with similar nonsense mutations (FOXP2-R328X), our findings suggest that auditory processing deficits up to the midbrain level are not causative for FOXP2-related language impairments. Interestingly, however, mice harboring a Foxp2-R552H missense mutation displayed systematic alterations in ABR waves with longer latencies (significant for waves I, III, IV) and smaller amplitudes (significant for waves I, IV) suggesting that either the synchrony of synaptic transmission in the cochlea and in auditory brainstem centers is affected, or fewer auditory nerve fibers and fewer neurons in auditory brainstem centers are activated compared to wildtypes. Therefore, the R552H mutation uncovers possible roles for Foxp2 in the development and/or function of the auditory system. Since ABR audiometry is easily accessible in humans, our data call for systematic testing of auditory functions in humans with FOXP2 mutations.

Femoral nerve involvement in diabetics

BACKGROUND AND PURPOSE

In this study, the conduction of the femoral nerve has been evaluated in diabetic patients without clinical signs of femoral nerve involvement and in a group of healthy subjects.

METHODS

Forty-eight patients have been included in the study. Patients have been examined in terms of neuropathy and their neuropathy scores have been calculated. In addition to the nerve conduction studies have been performed. The findings of the diabetic patients have been compared with those of the 26 healthy volunteers.

RESULTS

There has been a statistically significant difference between diabetics and the healthy volunteers in the control group in terms of both femoral nerve motor latency and amplitude. The femoral latencies of patients have significantly been related to the total neuropathy score. A significant difference between diabetic patients without polyneuropathy and the controls was observed with respect to their femoral latencies.

CONCLUSION

In our study, femoral nerve conduction abnormalities have been determined in diabetics who clinically did not have femoral nerve involvement. It has been observed that these abnormalities become more evident as the polyneuropathy of the patients becomes more serious. Our study has shown that femoral nerve conductions may increase the sensitivity of the diagnosis of polyneuropathy.

Umbilical metastasis of serous component as a first sign of mixed type epithelial ovarian cancer

Umbilical metastasis (Sister Mary Joseph's nodule) of malignant neoplasms is a rare condition. These nodules usually arise from the gastrointestinal or genitourinary tract and may present the first sign of a previously unknown primary tumor. We describe a 49-year-old woman presenting with Sister Mary Joseph's nodule as the first sign of an extremely aggressive Stage IV mixed type epithelial ovarian carcinoma, who died 15 months after the initial diagnosis. This is the first case of a Sister Mary Joseph's nodule from a serous component of a Stage IV mixed type epithelial ovarian cancer.

Assessment of serum paraoxonase and arylesterase activity in patients with endometrial cancer

PURPOSE OF INVESTIGATION

Serum paraoxonase (PON 1) is one of the most important enzymatic antioxidants that hydrolyzes lipid peroxidation, an indicator of carcinogenic activity. The aim of this study was to compare the serum levels of paraoxonase and arylesterase activity in patients with endometrial cancer to those of healthy controls.

METHODS

Serum paraoxonase and arylesterase activities, total free sulphydryl (-SH) groups and lipid hydroperoxide (LOOH) levels were measured in patients with endometrial cancer (n = 20) and controls (n = 23).

RESULTS

Serum paraoxonase, arylesterase activities and total -SH group levels were significantly lower in patients compared to controls (p < 0.05, p < 0.05 and p < 0.001; respectively), while LOOH levels were significantly higher (p < 0.001). Among patients, serum paraoxonase and arylesterase activities were inversely correlated with LOOH levels (r = -0.680, p < 0.05; r = -0.708, p < 0.001; respectively), while these were positively correlated with the total -SH group (r = 0.526, p < 0.05; r = 0.508, p < 0.05; respectively).

CONCLUSION

Reduced serum PON 1 activity might contribute to an impaired antioxidant defense system which plays a critical role in carcinogenesis in patients with endometrial cancer.

Spontaneous Bilateral Carotid Artery Dissection: Diagnosis and Follow-up with MDCT

Carotid artery dissection is usually unilateral. Rarely bilateral forms can be seen. Recent studies have shown the efficacy of computed tomography angiography (CTA) in the diagnosis of carotid dissection. Herein we report a case with bilateral carotid artery dissection diagnosis and follow-up which was carried out using mainly CTA.

Auditory cortical contrast enhancing by global winner-take-all inhibitory interactions

Brains decompose the world into discrete objects of perception, thereby facing the problem of how to segregate and selectively address similar objects that are concurrently present in a scene. Theoretical models propose that this could be achieved by neuronal implementations of so-called winner-take-all algorithms where neuronal representations of objects or object features interact in a competitive manner. Here we present evidence for the existence of such a mechanism in an animal species. We present electrophysiological, neuropharmacological and neuroanatomical data which suggest a novel view of the role of GABA(A)-mediated inhibition in primary auditory cortex (AI), where intracortical GABA(A)-mediated inhibition operates on a global scale within a circular map of sound periodicity representation in AI, with functionally inhibitory projections of similar effect from any location throughout the whole map. These interactions could underlie the proposed competitive "winner-take-all" algorithm to support object segregation, e.g., segregation of different speakers in cocktail-party situations.

Antifungal effects of essential oils from oregano and fennel onSclerotinia sclerotiorum

AIMS

The antifungal effects of essential oils of oregano (Origanum syriacum var. bevanii) and fennel (Foeniculum vulgare) were evaluated against Sclerotinia sclerotiorum. Effects of the essential oils on morphological structures of hyphae and sclerotia were studied under light and scanning electron microscopes (SEM).

METHODS AND RESULTS

Inhibitory effects of volatile and contact phases of the essential oils used were determined on hyphae and sclerotia. Both essential oils have a marked antifungal effect against S. sclerotiorum. Soil amendment with essential oils has significant effect on reducing sclerotial viability. Both essential oils significantly inhibited the fungal growth in soil, thereby increasing the number of surviving tomato seedling by 69.8% and 53.3%, respectively. Light and SEM observations on pathogen hyphae and sclerotia revealed considerable morphological alterations in hyphae and sclerotia.

CONCLUSIONS

The significant reduction in the mycelial growth and germination of sclerotia would greatly reduce the pathogen inoculum source. This may influence the rate of disease development in soil.

SIGNIFICANCE AND IMPACT OF THE STUDY

Considering the reduction in the number of diseased plants in infested soil amended with essential oils, we concluded that oregano and fennel essential oils could be used as possible bio fungicides alternative to synthetic fungicides against phytopathogenic fungi.

Recurrent Cerebral Fat Embolism Due to Pleural Irrigation: Fat Density Lesions on CT. A Case Report

Fat embolism syndrome is a rare, but life-threatening problem and is usually associated with severe trauma. Neurological symptoms are variable, and the clinical diagnosis is difficult. We describe a patient with fat density lesions on cranial CT sections and discuss the etiopathogenesis of cerebral fat embolism (CFE) in this patient who does not have a history of long bone fracture, but metastatic lung disease and empyema. This is probably the first case report of CFE secondary to pleural irrigation of empyema with demonstrative CT findings.

Cortical and subcortical sides of auditory rhythms and pitches

It is commonly assumed that different perceptual qualities arising from sensory stimuli depend on their physical nature being transformed by specific peripheral receptors, for example, colour, vibration or heat. A notable unexplained exception is the low and high repetition rates of any sound perceived as rhythm or pitch, respectively. Using auditory discrimination learning in bilaterally auditory cortex ablated animals, we demonstrate that the perceptual quality of sounds depends on the way the brain processes stimuli rather than on their physical nature. In this context, cortical and subcortical processing steps have different roles in analysing different aspects of sounds with the complete analysis accomplished not before information converges in the auditory cortex.

Surgery in temporal lobe epilepsy patients without cranial MRI lateralization

High resolution MRI is very important in the evaluations of patients with intractable temporal lobe epilepsy in preoperative investigations. Morphologic abnormalities on cranial MRI usually indicate the epileptogenic focus. Intractable TLE patients who have normal cranial MRI or bilateral hippocampal atrophy may have a chance for surgery if a certain epileptogenic focus is determined. We evaluated the patients who were monitorized in Gazi University Medical Faculty Epilepsy Center from October 1997 to April 2004. Seventy three patients, who had a temporal epileptogenic focus, underwent anterior temporal lobectomy at Ankara University Medical Faculty Department of Neurosurgery. Twelve of them (16, 4%), did not have any localizing structural lesion on cranial MRI. Of the 12 patients examined 6 had normal findings and 6 had bilateral hippocampal atrophy. Of these 12 patients, 6 (50%) were women and 6 (50%) were men. The ages of patients ranged from 7 to 37 (mean: 24.5). Preoperatively long-term scalp video-EEG monitoring, cranial MRI, neuropsychological tests, and Wada test were applied in all patients. Five patients, whose investigations resulted in conflicting data, underwent invasive monitoring by the use of subdural strips. The seizure outcome of patients were classified according to Engel with postsurgical follow-up ranging from 11 to 52 (median: 35.7) months. Nine patients (75%) were classified into Engel's Class I and the other 3 patients (25%) were placed into Engel's Class II. One patient who was classified into Engel's Class II had additional psychiatric problems. The other patient had two different epileptogenic foci independent from each other in her ictal EEG. One of them localized in the right anterior temporal area, the other was in the right frontal lobe. She was classified in Engel's Class II and had no seizure originating from temporal epileptic focus, but few seizures originating from the frontal region continued after the surgery. In conclusion, surgery was successful in all 12 patients. We think that patients with no MRI lateralizing or localizing lesion should undergo epilepsy surgery after detailed presurgical evaluations, including invasive monitoring.

Differential effects of iontophoretic in vivo application of the GABA(A)-antagonists bicuculline and gabazine in sensory cortex

We have compared the effects of microiontophoretic application of the GABA(A)-receptor antagonists bicuculline (BIC) and gabazine (SR95531) on responses to pure tones and to sinusoidally amplitude-modulated (AM) tones in cells recorded extracellularly from primary auditory cortex (AI) of Mongolian gerbils. Besides similar effects in increasing spontaneous and stimulus-evoked activity and their duration, both drugs elicited differential effects on spectral tuning and synchronized responses to AM tones. In contrast to gabazine, iontophoresis of the less potent GABA(A)-antagonist BIC often resulted in substantial broadening of frequency tuning for pure tones and an elimination of synchronized responses to AM tones, particularly with high ejecting currents. BIC-induced effects which could not be replicated by application of gabazine were presumably due to the well-documented, non-GABAergic side-effects of BIC on calcium-dependent potassium channels. Our results thus provide strong evidence that GABA(A)-mediated inhibition in AI does not sharpen frequency tuning for pure tones, but rather contributes to the processing of fast temporal modulations of sound envelopes. They also demonstrate that BIC can have effects on neuronal response selectivity which are not due to blockade of GABAergic inhibition. The results have profound implications for microiontophoretic studies of the role of intracortical inhibition in sensory cortex.

A prosthodontic management alternative for scleroderma patients

Hardening of the skin around the mouth causes the oral opening to become limited in scleroderma patients. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia induced by scleroderma. Sectional mandibular and maxillary trays and a collapsed mandibular denture were fabricated for the total edentulous patient. With the use of lingual midline hinge, the collapsed denture was successfully and easily inserted and provided adequate function in the patient's mouth. The cast hinge design reduced the overall costs and simplified the laboratory technique.

First Report of Septoria Blight of Parsley Caused by Septoria petroselini in the Mediterranean Region of Turkey

During December 2001 to March 2002, Septoria blight of parsley was observed in approximately 500 ha of commercial parsley crops in Arsuz County, Hatay, in the Mediterranean Region of Turkey. Incidence of disease ranged from 42 to 80%. Symptoms included irregularly shaped, grayish brown spots (average 3 to 8 mm diameter) with a slightly darker brown margin of necrotic tissue that developed into tan-to-brown lesions surrounded by chlorotic halo on the leaves. Oval-shaped lesions were observed occasionally on petioles. Lesions contained erumpent, dark brown, flask-shaped pycnidia with the ostiole on the upper surface of the foliage. Thirty samples, consisting of diseased leaves and petioles of parsley, were collected from each field. Infected tissues were surface-sterilized in 1% NaOCl for 2 min, rinsed in sterile distilled water, placed on petri dishes containing potato dextrose agar (PDA), and incubated for 10 to 14 days at 25°C. The fungus formed long, multiseptate (0 to 4), hyaline, filiform conidia (14 to 29 μm × 0.5 to 1.9 μm), and short conidiophores within the pycnidia. Based on the morphological characteristics of the fungus, the pathogen was identified as Septoria petroselini Desm. (1). Monoconidial cultures of 18 isolates were prepared. Pathogenicity was confirmed by brush-inoculating slightly wounded foliage of 5- to 7- week-old parsley plants (cv. Kereviz yapragi) with a conidial suspension (10⁶ conidia per ml of sterile water) of each isolate of S. petroselini. Control plants that were brush-inoculated with distilled water and inoculated plants were placed in clear polyethylene bags that were closed and incubated at 20°C for 48 h. The bags were removed, and plants were maintained in a dew chamber for 21 days at 65 to 70% relative humidity. Foliar symptoms developed 15 days after inoculation and appeared similar to lesions observed in the field. Yellowing and necrosis of leaves was also observed on >60% of inoculated plants. No lesions developed on the control plants. The pathogen was readily reisolated on PDA from inoculated plants. To our knowledge, this is the first report of Septoria blight of parsley in the Mediterranean Region of Turkey. Reference: (1) R. F. Cerkauskas and J. Uyenaka. Plant Dis. 74:1037, 1990.