Glycerol affects vestibular-evoked myogenic potentials and pure-tone hearing in patients with Ménière’s disease

Conclusion: The pure-tone audiometry results following glycerol administration indicated a positive effect on cochlear endolymphatic hydrops. Glycerol cervical vestibular-evoked myogenic potential (cVEMP) tests are a useful means of diagnosing saccular hydrops. There was no correlation between cVEMP and audiological results. Objective: To document the changes in pure-tone hearing outcomes and cVEMPs in patients with Ménière’s disease (MD) and 10 healthy volunteers before and after oral administration of glycerol. Methods: Twenty-nine study group subjects were chosen with complaints of vertigo. cVEMP testing and pure-tone hearing level testing were performed before and at 1, 2, and 3 h after administration of glycerol. Results: The means of the latencies, amplitudes, and difference ratio in 20 normal subject ears were determined. Based on these values, 9/29 MD-affected (MDA) ears (31%) had a unilaterally absent cVEMP. Compared with difference ratio values of the control groups there were significant differences in both latencies and amplitudes in MDA ears after glycerol administration. Before glycerol administration, there were significant differences between control and MDA ears on mean values of pure-tone hearing outcomes. Twenty patients in the MDA group showed significant pure-tone hearing outcomes after glycerol administration.     

Fibroblast growth factor-19 levels in type 2 diabetic patients with metabolic syndrome

This study aimed to examine fibroblast growth factor-19 (FGF-19) in type 2 diabetic (T2DM) patients with metabolic syndrome (MetS) and to evaluate the relationship between FGF-19 and other cardiovascular risk factors, such as atherogenic index of plasma (AIP) and hsCRP. 26 T2DM patients with MetS and 12 healthy controls were enrolled in the study. Serum FGF-19 levels were measured by sandwich ELISA, and compared with other cardiovascular risk factors; lipid profile, AIP, glucose, HbA1c, and hsCRP. AIP was calculated as log (TG/HDL-c). The median (1-3.quartile) FGF-19 levels in T2DM patients with MetS and healthy controls were 122.90 (108.63-237.60) pg/ml and 293.45 (153.64-370.31) pg/ml, respectively (P=0.003). Patients were also grouped by body mass index (BMI) <30 kg/m(2) (n=13) and ≥30 kg/m(2) (n=13) with median (1-3.quartile) FGF-19 values 168.70 (113.54-275.77) pg/mL and 115.89 (97.94-200.40) pg/mL, respectively (P=0.007). Significant negative correlations were found between FGF-19 and BMI, triglyceride, log (TG/HDL-c), hsCRP, and HbA1c (r=-0.526, P=0.001; r=-0.327, P=0.05; r=-0.312, P=0.05; r=-0.435, P=0.006; r=-0.357, P=0.028, respectively). We showed that FGF-19 levels are low in T2DM patients with MetS. The negative relationship between FGF-19 and several known cardiovascular risk factors such as TG, log (TG/HDL-c), hsCRP and HbA1c in diabetic patients with MetS suggests that FGF-19 can be used as a contributing marker.     

A case of ichthyosiform sarcoidosis with unusual localization

Sarcoidosis is a systemic granulomatous disease of unknown cause that commonly involves the lungs, lymph nodes, bones, liver, spleen, or skin. Cutaneous findings of sarcoidosis occur in 20% to 35% of patients with systemic disease. The recognition of cutaneous lesions is important, because it gives important clues to diagnosis and also allows for easy biopsy. We report a 71-year-old Turkish woman with erythematous lesions, which included widespread, erythematous macules of various sizes on the chest, abdomen, and back on both sides of her body. Fine white scales covered some of the lesions. Hepatomegaly and bilateral hilar lymphadenopathy were also observed. Biopsy specimens of the skin showed dermal, noncaseating, epitheloid granulomas. The diagnosis, based on correlation of the clinical presentation and histopathological findings, was ichthyosiform sarcoidosis with systemic involvement. The difference between our case and other cases of ichthyosiform sarcoidosis described in the literature is that ours involved only the trunk and not the extremities. We are presenting this case because it is an interesting and rare variant of ichthyosiform sarcoidosis.