The value of serum tau protein for the diagnosis of intracranial injury in minor head trauma

OBJECTIVE

Tau protein localizes in the axons of neuron cells, and it is released secondarily from the central nervous system because of hypoxia and trauma. In the present study, it was aimed to investigate the value of serum tau protein levels in diagnosing intracranial pathologies in minor head trauma.

METHODS

Patients were categorized into 2 groups: those without intracranial lesions in head CTs (group 1) and those with lesions in head CTs (group 2). Serum tau protein levels were determined.

RESULTS

Group 1 (n = 55) median serum tau protein level was 16.29 pg/mL (2.12-215.97 pg/mL) and group 2 (n = 33) median serum tau protein level was 18.39 pg/mL (2.19-714.47 pg/mL). Statistical analysis revealed no significant difference between the 2 groups for tau protein values, sex, age, mechanism of trauma, and Glasgow Coma Scale score.

CONCLUSION

It is suggested that serum tau protein has limited value in minor head trauma.

Paradoxically Developed Optochiasmatic Tuberculoma and Tuberculous Lymphadenitis: A Case Report with 18-Month Follow up by MRI

We report the first case ofextracranial tuberculous lymphadenitis which paradoxically developed during treatment of intracranial tuberculoma. Our patient, a 15-year-old girl who initially presented with meningitis and intracranial tuberculomas, developed extracranial tuberculomas during treatment for central nervous system tuberculosis. She was followed clinically with cerebrospinal fluid (CSF) studies and magnetic resonance imaging (MRI) at three monthly intervals. Within 18 months of specific antituberculous treatment, the patient had fully recovered. The course and response to therapy are discussed in light of the current literature.

Examination of the Effects of Degeneration on Vertebral Artery by Using Neural Network in Cases With Cervical Spondylosis

The scope of this study is to diagnose vertebral arterial inefficiency by using Doppler measurements from both right and left vertebral arterials. Total of 96 patients' Doppler measurements, consisting of 42 of healthy, 30 of spondylosis, and 24 of clinically proven vertebrobasillary insufficiency (VBI), were examined. Patients' age and sex information as well as RPSN, RPSVN, LPSN, LPSVN, and TOTALVOL medical parameters obtained from vertebral arterials were classified by neural networks, and the performance of said classification reached up to 93.75% in healthy, 83.33% in spondylosis, and 97.22% in VBI cases. The area under ROC curve, which is a direct indication of repeating success ratio, is calculated as 92.3%, and the correlation coefficient of the classification groups is 0.9234. It is also demonstrated that those medical parameters of age and systolic velocity, which were applied into the neural networks, were more effective in developing vertebral deficiency.

Effects of different weight loss protocols on serum leptin levels in obese females

We investigated the effects of different weight loss protocols on leptin levels in obese females with the aim of addressing the leptin resistance which has been found to be an aggravating factor in obesity. Twenty-four obese females enrolled to one of three 12-week weight loss protocols: orlistat-induced weight loss (OWL, n=8), exercise-induced weight loss (EWL, n=8) and orlistat plus exercise-induced weight loss (OEWL, n=8). Serum leptin levels were measured in duplicate by radioimmunoassay. There were significant reductions (P<0.01) in body weight and fat mass after the 12 week period in all groups: -11.4+/-0.5 kg and -9.8+/-0.5 kg (OEWL), -8.3+/-0.8 kg and -5.7+/-0.9 kg (OWL), -8.9+/-1.2 kg and -7.4+/-1.2 kg (EWL), respectively. Serum leptin levels were also decreased markedly in all groups: -59.2 % (OEWL1), -37.8 % (OWL) and -48.6 % (EWL) (P<0.01 all). In addition, there were marked decreases in leptin levels for each kilogram of fat mass after the 12 week period: -48.2+/-7.2 % (OEWL), -27.8+/-4.8 % (OWL) and -39.3+/-4.3 % (EWL) (P<0.01 all). Decreases in serum leptin levels expressed per kilogram of fat mass were significantly higher in the OEWL group compared to the OWL group (P=0.03). Consequently, an exercise training program in adjunct to pharmacotherapy provides higher weight reduction and fat mass loss in obesity treatment. It also seems to have further beneficial effects on leptin resistance, as indicated by decreases in leptin levels expressed per kilogram of fat mass.

Effects of different weight loss protocols on serum leptin levels in obese females

We investigated the effects of different weight loss protocols on leptin levels in obese females with the aim of addressing the leptin resistance which has been found to be an aggravating factor in obesity. Twenty-four obese females enrolled to one of three 12-week weight loss protocols: orlistat-induced weight loss (OWL, n=8), exercise-induced weight loss (EWL, n=8) and orlistat plus exercise-induced weight loss (OEWL, n=8). Serum leptin levels were measured in duplicate by radioimmunoassay. There were significant reductions (P<0.01) in body weight and fat mass after the 12 week period in all groups: -11.4+/-0.5 kg and -9.8+/-0.5 kg (OEWL), -8.3+/-0.8 kg and -5.7+/-0.9 kg (OWL), -8.9+/-1.2 kg and -7.4+/-1.2 kg (EWL), respectively. Serum leptin levels were also decreased markedly in all groups: -59.2 % (OEWL1), -37.8 % (OWL) and -48.6 % (EWL) (P<0.01 all). In addition, there were marked decreases in leptin levels for each kilogram of fat mass after the 12 week period: -48.2+/-7.2 % (OEWL), -27.8+/-4.8 % (OWL) and -39.3+/-4.3 % (EWL) (P<0.01 all). Decreases in serum leptin levels expressed per kilogram of fat mass were significantly higher in the OEWL group compared to the OWL group (P=0.03). Consequently, an exercise training program in adjunct to pharmacotherapy provides higher weight reduction and fat mass loss in obesity treatment. It also seems to have further beneficial effects on leptin resistance, as indicated by decreases in leptin levels expressed per kilogram of fat mass.

Investigation of the influence of training status on the relationship between the acute exercise and serum leptin levels in obese females

OBJECTIVE

Recent studies have concluded that an energy expenditure by an acute exercise session has no immediate effect on leptin levels while some showed a decline in leptin levels. The purpose of this study was to investigate any possible effects of training status of the subjects on acute exercise-leptin relationship in obese patients.

MATERIALS AND METHODS

Fourteen obese sedentary females were enrolled to the study and effects of acute incremental exercise on serum leptin levels were determined at rest and at maximal exercise performance. Then, they participated to a 12-weeks endurance aerobic training programme performed in the laboratory on a computer controlled cycle ergometer and their leptin levels were re-evaluated and the leptin-acute exercise relationships obtained under different training levels in the same group of subjects were compared. The body compositions were determined by bioelectrical impedance. Pre and post training blood samples were taken at rest and at the maximal exercise performance. Serum leptin levels were analysed in duplicate by RIA. Data were evaluated using, paired t and Pearson's tests.

RESULTS

Leptin levels were not acutely affected by the incremental exercise either before (23.62+/-3.5 ng/ml and 22.62+/-3.6 ng/ml) or after (13.13+/-3.4 ng/ml and 13.82+/-3.6 ng/ml) endurance training. The marked decrease in leptin levels following training was closely correlated with fat mass loss R= 0.899 (P= 0.0001).

CONCLUSIONS

This study indicates that an increase in energy expenditure by acute exercise has no significant acute effect on leptin level regardless of the training status of the subjects and decrease in leptin levels after a 12-weeks endurance aerobic training programme are closely associated with the fat mass loss.

Levels of paraoxonase and arylesterase activities and malondialdehyde in workers exposed to ionizing radiation

We examined levels of malondialdehyde (MDA) (an end-product of lipid peroxidation) and paraoxonase (PON1) (an antioxidant enzyme) activity and PON1 phenotypes in people who were exposed to ionizing radiation for different time periods and doses. A total of 78 individuals (mean age 34 +/- 7 years) were included in the study. Fifty-one of them were radiology workers whereas the control group was composed of 27 healthy volunteers who had never worked in a radiology-related job. Paraoxon was used as substrate for measurement of PON1 activity levels (basal and NaCl-stimulated). Phenylacetate was used as substrate for measurement of arylesterase activity levels. Cumulative levels of serum NaCl-stimulated PON1/arylesterase activities were utilized for phenotypic differentiation. In radiology workers, three different phenotypes were determined based on paraoxonase/arylesterase ratio. The ratios were 1.09 +/- 0.30 for AA (homozygote low activity); 2.91 +/- 1.07 for AB (heterozygote activity) and 4.97 +/- 1.21 for BB (homozygote high activity). There was a statistically meaningful negative correlation between serum MDA levels and PON1 activity levels in all phenotypes (p < 0.05). PON1 activity levels were found to be 25-35% lower in people who were exposed to long-term ( > 5 years) radiation compared to controls. There was no statistically significant correlation between serum arylesterase activity and MDA levels in these subjects (r = -0.185, p > 0.05). PON1 activity levels were decreased whereas serum MDA levels were increased in individuals exposed to radiation for a long period. PON phenotypes of people employed in jobs which expose them to radiation should be determined and based on these findings they should be advised to avoid risk factors inducing oxidative stress, such as smoking, and to consume foods rich in vitamins and trace elements to increase their antioxidant capacity.

Diminished cellular and humoral immunity in workers occupationally exposed to low levels of ionizing radiation

BACKGROUND

It has been reported that subgroups of T-lymphocytes are affected at different levels and different cell groups of immune system give different responses in individuals exposed to long-term ionizing radiation. The aim of this study was to investigate the effect of occupational exposure to low levels of ionizing radiation in selected indices of cellular and humoral immunity in radiology workers.

METHODS

Level of subgroups of peripheral blood lymphocytes, complements (C(3), C(4)), and total immunoglobulins (IgG, IgA, IgM) were analyzed in 50 radiology workers occupationally exposed to low levels of ionizing radiation and 35 age-matched healthy controls.

RESULTS

CD4(+) T lymphocyte (T-helper) levels were determined as significantly low in radiology workers exposed to ionizing radiation compared with controls (p <0.05). There were no statistically significant differences in groups in terms of other subgroups of lymphocytes (p >0.05). In addition, levels of serum total IgG, IgA, IgM, C(3,) and C(4) were determined as significantly lower in workers exposed to ionizing radiation compared with controls (p <0.001). Total IgA and IgM levels in radiology workers who were smokers were determined as significantly lower compared with non-smoking radiology workers (p >0.05).

CONCLUSIONS

Levels of CD4(+) T lymphocytes and humoral immune response (total immunoglobulins and complements) were determined as weaker in workers exposed to low levels of ionizing radiation compared with controls, indicating the importance of taking appropriate measures to protect radiology workers from exposure to ionizing radiation and for these workers to avoid smoking. Further studies are needed for determining the appropriateness of periodic check-ups of immune functions and the most efficient and cost-effective ways of monitoring immune functions in radiology workers for detecting early changes in the immune system.

Evaluation of the effects of sildenafil citrate (Viagra) on canine renal artery, carotid and aortic blood flow with the aid of color Doppler sonography

INTRODUCTION

Erectile dysfunction is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Oral use of sildenafil citrate has been proved to be effective in the treatment of erectile dysfunction. Although the effects of sildenafil citrate have been investigated in several studies, its effect on aortic, carotid and renal artery blood flow is unknown. The aim of this study was to investigate the early and late phase effects of sildenafil citrate on canine aortic, carotid and renal artery blood flow using color Doppler sonography (CDS).

MATERIALS AND METHODS

A total of 6 healthy adult dogs was used in this study. With the aid of CDS peak systolic flow rate, end diastolic flow rate, resistivity index (RI) and pulsatility index in aortic, renal and carotid artery were determined before the administration of sildenafil citrate, 45-75 min after drug administration and after 15 days of drug administration. Data were statistically analyzed using Friedman and Wilcoxon rank tests. p < 0.05 was considered to be statistically significant.

RESULTS AND CONCLUSIONS

Significant changes were determined in only 4 out of 28 parameters studied. The significantly changed parameters were as follows: a significant increase in the early and late phase of the postdrug peak of systolic aortic blood flow compared to values before drug administration, an increase in pre- and postdrug RI values of the aorta, a significant decrease in maximum velocity of the right carotid artery, and peak systolic maximum velocity of the left renal segmental artery after drug administration compared to their respective predrug basal values. The results from this study indicate that sildenafil citrate has no significant effects on aortic, renal and carotid artery blood flow rate either in the early or in the late phase. Since this study involved only 6 dogs there is a need for further clinical studies involving larger groups of subjects to conclude that this drug is safe with respect to the hemodynamic parameters evaluated in this study.

Color Doppler sonographic evaluation of inter-relations between diameter, reflux and flow volume of testicular veins in varicocele

OBJECTIVE

Reflux is an important criterion for the diagnosis of varicoceles and in the existence of reflux more than 1 s is the lower limit for the diagnosis of varicoceles. We proposed to assess the relationship of vein diameters with the incidence, duration and flow volume of reflux using color Doppler sonography (CDS) in patients with clinically diagnosed varicocele.

MATERIALS AND METHODS

Forty-seven patients with varicocele (aged 16-43) were included into the study. Reflux was assessed in spectral analysis using CDS and the duration, velocity and flow volume were measured.

RESULTS

Mean duration of reflux on right side was 1.5 +/- 0.3 s in 14 patients, throughout the Valsalva's maneuver in eight patients and no reflux in 25 patients. Mean duration of reflux on the left side was 1.5 +/- 0.3 s in 25 patients, throughout the Valsalva's maneuver in 18 patients and no reflux in four patients. The incidence of reflux in the testicular veins with a diameter lower than 3 mm was 62.3% whereas 94.4% in veins more than 3 mm in diameter. Flow volume of reflux was less than 10 ml/min in four patients and 21.7 +/- 24.3 ml/min in 18 patients on right side. Four patients had flow volume of reflux less than 10 ml/min and 39 patients had 27.9 +/- 35.6 ml/min on the left side. Flow volume meaningfully rose with increasing in vein diameter (r=0.83 on right; r=0.65 on left, P<0.01).

CONCLUSION

Measurement of flow volume of reflux has been considered as a more valuable method with respect to presence of reflux and/or measurement of venous diameter since flow volume reflects a combination of the vein diameters, duration and velocity of reflux.

Sonographic measurement of the fetal cerebellum, cisterna magna, and cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy

PURPOSE

Absence of the cavum septum pellucidum (CSP), the cisterna magna (CM), or both, and enlargement of either or both structures are associated with various central nervous system malformations. In an effort to determine normal sizes and relationships between these cranial structures, we measured the CSP and CM in normal fetuses in the second and third trimesters of pregnancy using transabdominal sonography.

METHODS

Women with uncomplicated pregnancies and normal singleton fetuses between 16 and 38 weeks' menstrual age were included in this prospective study. The width and anteroposterior (AP) diameters of the CSP were measured on the transverse transventricular plane, and the AP diameter of the CM was measured on the transcerebellar plane from the posterior aspect of the cerebellar vermis to the inner edge of the cranium. The transverse and AP diameters of the cerebellum were also measured. In addition, we measured the biparietal diameters (BPDs).

RESULTS

In total, 130 women participated; 64 were examined in their second trimester and 66 in their third trimester. The mean age of the women was 27.4 +/- 4.8 years (range, 18-38 years), and the mean menstrual age of the fetuses was 26.9 +/- 6.7 weeks (range, 16-38 weeks). The mean BPD was 66.8 +/- 18.7 mm (range, 30-96 mm). The mean width and AP diameter of the CSP and the mean AP diameter of the CM differed significantly between the second and third trimesters (p < 0.001). All measured parameters correlated significantly with menstrual age and BPD.

CONCLUSIONS

In normal fetuses, the CSP and CM should be visible on transabdominal sonography between 16 and 38 weeks' menstrual age. Because abnormalities in these cranial structures may be indicative of central nervous system malformations, the availability of mean sonographic measurements from normal fetuses should be helpful in determining the need for additional testing in fetuses with abnormal measurements.

Recombinant Tissue Plasminogen Activator Therapy for Pacemaker-Induced Thrombosis

A 50-year-old male who developed subclavian vein thrombosis following insertion of a demand pacemaker was treated with a short period of high-dose recombinant tissue plasminogen activator (100 mg over 3 hours). Total thrombolysis was achieved without complications.