Effect of Doppler angle in diagnosis of internal carotid artery stenosis.

OBJECTIVE: The purpose of this study was to compare velocity measurements obtained with 2 fixed insonation angles and to investigate whether there is a difference in their ability in determining internal carotid artery (ICA) stenosis. METHODS: Eighty-seven patients with ICA stenosis were examined with color duplex ultrasonography. Velocity measurements were made at 60 degrees and 45 degrees insonation angles, and they were compared with Bland-Altman and receiver operating characteristic curve analysis. RESULTS: Peak systolic velocity (PSV) and end-diastolic velocity measurements obtained at the 60 degrees insonation angle were higher compared with those obtained at the 45 degrees insonation angle (24.2% and 24.7%, respectively). The ICA-to-common carotid artery PSV ratio, conversely, was slightly higher (3.9%). Although the threshold values for the same velocity parameters obtained at 2 different insonation angles were different, the accuracy ratios (sensitivity and specificity) were not. With application of the Society of Radiologists in Ultrasound consensus criteria to the data obtained at either of the 2 insonation angles, the accuracy ratios of PSV and end-diastolic velocity were found to be statistically different. In the ICA-to-common carotid artery PSV ratio, however, there were no statistically significant differences in the accuracy ratios. CONCLUSIONS: Doppler velocity measurements made at different fixed insonation angles show considerable differences. In determining ICA stenosis, although optimal thresholds are different, the diagnostic performance is not different. In determining ICA stenosis with color duplex ultrasonography, angle-specific thresholds must be determined, and examinations must be made at a fixed angle.     

Cytomegalovirus-induced pathology in human temporal bones with congenital and acquired infection

ObjectivePublications on histopathology of human temporal bones with cytomegalovirus (CMV) infection are limited. We aim to determine histopathology of the inner ears and the middle ears in human temporal bones with congenital and acquired CMV infections.MethodsTemporal bones from 2 infants with congenital and 2 adults with acquired CMV infection were evaluated by light microscopy.ResultsTwo infants with congenital CMV infection showed striking pathological changes in the inner ear. There was a hypervascularization of the stria vascularis in the cochlea of the first infant, but no obvious loss of outer and inner hair cells was seen in the organ of Corti. However, cytomegalic cells and a loss of outer hair cells were found in the cochlea of the second infant. The vestibular organs of both infants showed cytomegalic cells, mostly located on dark cells. There was a loss of type I and type II hair cells in the macula of the saccule and utricle. Loss of hair cells and degeneration of nerve fibers was also seen in the semicircular canals. Both infants with congenital infection showed abundant inflammatory cells and fibrous structures in the middle ear cavity. No evidence of cytomegalic cells and hair cell loss was found in the cochlea or vestibular labyrinth in acquired CMV infection.ConclusionsIn two infants with congenital CMV infection, the cochlea, vestibule, and middle ear were highly affected. Temporal bones of adult donors with acquired viral infection showed histological findings similar to donors of the same age without ear disease.     

Wi-Fi decreases melatonin protective effect and increases hippocampal neuronal damage in pentylenetetrazole induced model seizures in rats

AimEpilepsy is a common brain disorder in which the seizures could cause a neuronal loss in the hippocampus. Oxidative stress has an important role in the pathology of epilepsy. Some studies indicate that Wi-Fi increases oxidative stress and suppresses antioxidant systems. The aim of this study is to investigate the effect of Wi-Fi on melatonin anticonvulsive effect and oxidative damage in pentylenetetrazole-induced epileptic seizures in rats.MethodsIn our study, we used 30 male Wistar Albino rats, 230?250 grams of the body weight. The animals were divided into five groups as control, saline (1 ml/kg/day olive oil for 30 days), Wi-Fi (12 h/day for 30 days), melatonin (10 mg/kg/day for 30 days) and melatonin + Wi-Fi (10 mg/kg/day +12 h/day for 30 days). In the thirtieth day, thirty minutes after the last drugs administration at the indicated doses, PTZ in 45 mg/kg was administered to induce epileptic seizure. The animals were observed for 30 min during the seizure stages (according to the Racine Scale) and first myoclonic jerk times (FMJ). Twenty-four hours after PTZ injection, brain tissues were removed for biochemical and histopathological evaluation. The hippocampal Cornu Ammonis (CA) 1, CA3 and DG (dentate gyrus) regions were histopathologically evaluated in terms of a neuronal damage in addition that oxidative stress markers (total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI)) were measured in brain tissues.ResultsWi-Fi was not found to affect behavioral changes associated with epilepsy (p > 0.05). However, Wi-Fi reduced anticonvulsive and antioxidant effect of melatonin (p < 0.05). Moreover, Wi-Fi increased neuronal damage in hippocampus (p < 0.05).ConclusionWi-Fi did not directly affect epileptic seizures. Nevertheless, it inhibits the positive effects of melatonin on epilepsy and it also has negative effects on hippocampal neuronal damage. These effects of Wi-Fi may occur via oxidative pathways.     

A Rare Case of Popliteal Venous Aneurysm

ObjectivePopliteal venous aneurysms are uncommon but potentially fatal abnormalities, since they can cause pulmonary emboli. Here, we report a case of a popliteal venous aneurysm of the right popliteal fossa.MethodIn a 32-year-old healthy male complaining of a localised swelling and pain in his right popliteal fossa, duplex ultrasonography and angio-computed tomography revealed a giant popliteal vein aneurysm. The popliteal fossa was surgically explored and aneurysm was resected partially and sutured through posterior approach.ResultsRecovery was uneventful and patient still remains asymptomatic. Further duplex ultrasonography follow-ups revealed patency of popliteal vein without thrombotic changes in 1st, 6th, 12th and 15th months. Additionally, no dilatation of the operated vein segment has been observed in the follow-up ultrasound studies.ConclusionSurgical repair of popliteal venous aneurysms can be performed safely. Partial aneurysm resection together with lateral venorrhaphy is preferred. Due to pulmonary thrombo-embolic complication risks, we recommend surgery in early stages.     

Effect of lidocaine on reducing injury in a rat electrical burn model

Electrical injuries induce progressive tissue loss. We evaluated the effect of lidocaine on tissue necrosis after electrical burn injuries. Forty-two male Wistar albino rats (250-300 g) were divided into 3 groups [Group A (n=6), control group without an electrical burn injury; and Groups B (n=18) and C (n=18), electrical burn injury groups without and with lidocaine therapy, respectively]. Three separate analyses were performed at different time points on 6 of 18 rats from Groups B and C at each time point. Electrical burns were induced by applying 220 V AC between the left upper and right lower extremities for 10 seconds. Myeloperoxidase and malondialdehyde levels were measured in skin and muscle biopsy specimens after the first hour, fresh and dry weight differences in the amputated extremities were calculated after 24 hours, and live and necrotic tissue areas were measured at 7 days after burn injury. We found that lidocaine reduced edema, the number of neutrophils, and neutrophil damage in tissues. We conclude that lidocaine decreased the amount of necrotic tissue caused by electric injury.     

Diagnostic Significance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies

MethodsThe pisiform CSA (CSA_pisiform), swelling ratio (SR), palmar bowing, and CSA_pisiform/ulnar CSA (CSA_ulnar) measurements made in two subgroups of CTS patients (having sensory affection alone or having both sensory and motor affection) were compared with controls. CSA_ulnar was measured in Guyon''s canal at the level of most-protuberant portion of the pisiform bone.ResultsThe values of all of the measured US parameters were higher in patients with CTS (n=50) than in controls (n=62). CSA_pisiform could be used to diagnose CTS of mild severity. All of the parameters were positively correlated with the distal latency of the compound muscle action potential, and all of them except for SR were negatively correlated with the sensory nerve conduction velocity. A CSA_pisiform/CSA_ulnar ratio of ≥1.79 had a sensitivity of 70% and a specificity of 76% for diagnosing CTS.ConclusionsOnly CSA_pisiform measurements were reliable for diagnosing early stages of CTS, and CSA_pisiform/CSA_ulnar had a lower diagnostic value for diagnosing CTS.     

Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire: a cross-cultural adaptation and validation to the Turkish language

In chronic inflammatory rheumatic diseases (CIRD), it is important to understand patients’ fears towards their disease in order to improve patient-physician dialog, to raise the quality of care offered, and to optimize treatment adherence. In this study, we aimed to translate the Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire into Turkish and evaluate its psychometric properties in patients with CIRD. One hundred fifteen patients filled the provided socio-demographic information form, FAIR-Tr questionnaire, Hospital Anxiety and Depression Scale (HADS), and Beck’s Hopelessness Scale (BHS). For the analysis of short-term reliability, 50 patients re-filled the FAIR-Tr questionnaire 1 week later. Internal consistency was evaluated with Cronbach’s α coefficient and test-retest reliability was evaluated with intraclass correlation coefficients (ICC). Construct validity analysis was investigated based on the correlation with HADS and BHS. All patients found FAIR-Tr easily understandable and acceptable. FAIR-Tr internal consistency (Cronbach’s α?=?0.93) and test-retest reliability (ICC?=?0.91) were excellent. Psychometric validation was proved upon observing high correlation with HADS (Anxiety, r?=?0.77; Depression, r?=?0.70) and moderate correlation with BHS (r?=?0.65). FAIR-Tr is a questionnaire that has excellent internal consistency and test-retest reliability. The successful correlation with HADS and BHS supported its psychometric validity in terms of evaluating the fear in CIRD cases. We think that FAIR-Tr is a specific scale that can help to evaluate the disease- and treatment-related fears of the Turkish patients with CIRD and may be useful in both routine practice and clinical studies.     

Pericardial and pulmonary involvement in rheumatoid arthritis in Turkey

Summary Pericardial and lung involvement in rheumatoid arthritis (RA), suspected to be less severe in a developing nation (Turkey), have been evaluated. We have studied clinical, echocardiographic and pulmonary findings (radiological and functional) in 93 consecutive Turkish patients with definite/classical RA. Findings were compared with those of a group of patients with osteoarthritis or local rheumatological conditions (n=60) in a blind protocol. Fifty patients with systemic lupus (SLE) were studied as a high risk control group for pericardial involvement. While pericardial disease was detected in 5.5% (5/90) of RA patients, it was detected in 6.6% (4/60) of the control patients. SLE patients had a 26% (13/50) prevalence. Interstitial lung disease was found in 27.7% of RA patients but it was present in 6.6% (4/60) of the control patients. We observed that a group of patients with RA in Turkey had a low prevalence of pericardial disease. This is further evidence that RA has a mild course in developing countries.     

Sulphasalazine in the treatment of juvenile rheumatoid arthritis: a preliminary open trial

Sulphasalazine was administered to 18 patients with juvenile rheumatoid arthritis (JRA). The mean duration of therapy was 7.8 +/- 2.6 months. There was significant improvement in all clinical variables and erythrocyte sedimentation rate. Five children developed minor and transient side effects. Medication was discontinued in 3 patients: one because of leukopenia, 2 for lack of effect. These results suggest that sulphasalazine is an effective and relatively safe drug which may prove to be a useful second line agent in the management of JRA.