The association between homocysteine (hcy) and serum natural antioxidants in elderly bone mineral densitometry (BMD)

Previous studies showed oxidative stress had an important impact on osteoclastic and osteoblastic functions. Oxidative stress or low levels of antioxidants are supposed to reduce BMD and cause osteoporosis. hcy, gamma glutamyltransferase (GGT), uric acid, albumin and total bilirubin are simple laboratory parameters that are related with oxidative stress. In this study we compare the serum hcy and antioxidant levels in patients with osteoporosis, osteopenia and control subjects. A total of 2190 elderly persons (1348 patients with osteoporosis, 643 patients with osteopenia and 199 control subjects) who were referred to the outpatient clinic of the Department of Internal Medicine, Division of Geriatric Medicine at Hacettepe University Hospital for comprehensive geriatric assessment were included in this cross-sectional study. Mean age of subjects were 72.30±6.34 in osteoporosis group, 71.92±6.90 in osteopenia and 71.86±5.88 in control group (p: 0.260). Multivariate regression analysis revealed that hypertension (HT) (OR: 0.675, 95% CI: 0.534-0.854, p: 0.001), diabetes mellitus (DM) (OR: 1.669, 95% CI: 1.301-2.142, p: <0.001), age (OR: 1.025, 95% CI: 1.006-1.044, p: 0.009), male gender (OR: 0.451, 95% CI: 0.358-0.569, p<0.001), uric acid (OR: 0.893, 95% CI: 0.837-0.952, p: 0.001), hcy (OR: 1.042, 95% CI: 1.023-1.061, p<0.001), albumin (OR: 0.521, 95% CI: 0.376-0.724, p<0.001), GGT (OR: 1.010, 95% CI: 1.003-1.017, p: 0.003), creatinine (OR: 0.630, 95% CI: 0.459-0.864, p: 0.004) were independent variables predicting the occurrence of osteoporosis. This study shows there is an imbalance between natural antioxidative and oxidative markers in patients with osteoporosis. Higher serum uric acid and albumin levels are associated with a lower prevalence of osteoporosis whereas higher hcy and GGT levels are associated lower BMD and higher osteoporosis prevalence.     

Assessment of Endothelial Function in Alzheimer's Disease: Is Alzheimer's Disease a Vascular Disease?

OBJECTIVES: To compare endothelial function of people with Alzheimer's disease (AD) with that of people without. DESIGN: Case-control study. SETTING: Geriatric medicine outpatient clinic of a university hospital. PARTICIPANTS: Twenty-five patients with AD who were free of vascular risk factors and 24 healthy elderly controls were enrolled. Exclusion criteria were diabetes mellitus, hypertension, dyslipidemia, evident stroke, smoking, documented coronary artery disease, history of myocardial infarction, heart failure, acute or chronic infection, malignancy, peripheral artery disease, renal disease, rheumatologic diseases, alcohol abuse, and certain drugs that may affect endothelial function. Both groups underwent comprehensive geriatric assessment and neuropsychiatric assessment. MEASUREMENTS: Endothelial function was evaluated according to flow-mediated dilation (FMD) from the brachial artery. RESULTS: Mean age +/- standard deviation was 78 +/- 5.9 in the group with AD (11 female and 14 male) and 72.1 +/- 5.8 in the control group (9 female and 11 male). Multiple linear regression analysis revealed that FMD was significantly lower in patients with AD (median 3.45, range 0-7) than controls (median 8.41, range 1-14) (P < .001), independent of age. It was also found that FMD values were inversely correlated with the stage of the disease as determined according to the Clinical Dementia Rating scale (r=-0.603, P < .001). CONCLUSION: Endothelial function is impaired in patients with AD. Endothelial function was worse in patients with severe AD. These findings provide evidence that vascular factors have a role in the pathogenesis of AD.     

Sequence analysis of rpoB mutations in rifampin-resistant clinical Mycobacterium tuberculosis isolates from Turkey

Drug-resistant tuberculosis is a serious problem throughout the world. Resistance to Rifampicin (RIF) is mainly caused by the mutations in the rpoB gene coding the beta-subunit of RNA polymerase. In this study, we aimed to detect the distribution of rpoB gene mutations in 80 RIF-resistant clinical Mycobacterium tuberculosis (MTB) isolates from Turkey. The rpoB gene was amplified by PCR and mutations leading to RIF resistance were determined by automated sequence analysis. A total of 72 of the 80 isolates (90%) were found to carry mutations in the amplified region, whereas eight isolates (10%) carried no mutations. Overall, 24 different missense mutations affecting 14 codons, and two deletion mutants were identified. Nine new mutations, six in the hot-spot region and three outside this region, were found. The codon numbers of the most frequently encountered mutations were 531 (51.4%), 526 (18.1%), 516 (13.9%), and 513 (12.5%). As a result, 90% of the RIF-resistant MTB isolates from the Turkish patients were found to carry a mutation in the rpoB gene, Ser531Leu being the most frequent one. Although molecular methods identify mutations leading to RIF resistance very quickly, results of the antimycobacterial susceptibility tests must be taken into consideration for the patients carrying no mutations in this region.     

Postauricular cartilage storage in rhinoplasty

In the past decade, the number of patients demanding rhinoplasty has increased, and this has increased the use of grafts. Although different materials are used as grafts, cartilage is the most popular one. In secondary rhinoplasties the need for cartilage is very frequent. The most suitable cartilage grafts are the ones extracted during primary rhinoplasty. These grafts are disposed of after the operation and in a secondary operation, grafts are obtained from a new donor site. In our department, the surplus cartilages obtained during primary rhinoplasties of the patients who are thought to be probable secondary rhinoplasty candidates are stored in a postauricular pocket after their volumes are measured and marked down. In the secondary operations the volume of the grafts are measured again and the grafts are used. We have found out that there is no significant difference between the initial and secondary volumes of lower lateral cartilages (3.6% of initial volume is lost), but the difference between the initial and secondary volumes of septal cartilages is significant (6.9% of initial volume is lost), and the stored cartilages are sufficient qualitatively and quantitatively for the secondary rhinoplasties.     

Contribution of vitamin C administration for increasing lipolysis

This experiment was designed to investigate whether addition of vitamin C to the solution used in tumescent technique of liposuction might increase lipolysis and whether increased fibrosis might improve skin retraction where liposuction did not work properly and the skin had poor retraction ability. Eighteen Sprague-Dawley rats were used in two groups. Both inguinal fat pads of rats with their vascular structures were elevated and the right inguinal fat pad was injected with 1 cc tumescent solution as a control and the left fat pad with a 1 cc vitamin C-tumescent solution. Histopathological examination showed that all fat pads injected with tumescent solution had normal adipocytes. Those injected with vitamin C-tumescent were shown to have extreme fibrosis and occasional adipocytes.     

Gluteal region morphology: the effect of the weight gain and aging

The gluteal region is an important secondary sexual character itself and it has its place in the concept of the beauty in all communities. Interestingly, as far as we know, there is not any previous study addressing gluteal region morphology in an objective way in the aesthetic surgery literature. The aim of this study was to define the changes of the gluteal region morphology with aging and weight gain. Beside body weight, a total of five distances between predetermined anatomic points in gluteal region were measured on randomly selected 115 female volunteers, with their age ranging from 17 to 48 years (mean 22.7). All the records were analyzed by a correlation matrix using computer-based SPSS 7.5 program. As women grow older, the width of the gluteal region decreases and the gluteal sulcus elongates laterally and inferiorly. Contrary to aging, with weight gain the gluteal region becomes wider as the gluteal sulcus gets shorter. Although the subject does not sound new, our study is the first, documenting the changes in morphology of the gluteal region in relation to weight gain and aging in an objective way.     

Giant cell glioblastoma manifesting as traumatic intracerebral hemorrhage--case report

A 33-year-old male presented with intracerebral hemorrhage in the left temporoparietal region after a traffic accident. Ten months later, the traumatic hemorrhage was found to originate in an underlying giant cell glioblastoma. Our case indicates that non-traumatic underlying pathologies, such as vasculopathies, coagulopathies, or tumors, should be considered in the differential diagnoses of intracerebral hemorrhage occurring in unusual locations after traumatic accidents.