Visceral Adipose Tissue Quantification Using Lunar Prodigy

A dual-energy X-ray absorptiometry (DXA) application to measure visceral adipose tissue (VAT) in the android region of a total body DXA scan has recently been developed. This new application, CoreScan, has been validated on the Lunar iDXA (GE Healthcare, Madison, WI) densitometer against volumetric computed tomography. The geometric assumptions underlying the CoreScan model are the same on the Prodigy (GE Healthcare, Madison, WI) densitometer. However, differences between the peak X-ray voltage and detector array configurations may lead to differences in VAT quantification. The purpose of this study was to evaluate the agreement of Prodigy and iDXA CoreScan values and to characterize differences in VAT precision between the instruments. Data from volunteers with paired Prodigy and iDXA measurements were used to define empirical adjustments to the VAT algorithm parameters (n = 59) and validate performance on Prodigy (n = 62). Prodigy VAT measurements were highly correlated to iDXA (r = 0.984). The mean of the Prodigy-iDXA VAT volume differences was ?13.8 cm³ with a 95% confidence interval of ?45 to +17 cm³. The Bland-Altman 95% limits of agreement for the 2 methods were ?252 to +224 cm³. Measurement of short-term precision showed that measurement error variance on iDXA was smaller (p < 0.01) than Prodigy (coefficient of variance: 7.3% vs 9.8%). Precision results are in agreement with previous reports on the differences between Prodigy and iDXA for body composition measures. Prodigy and iDXA measures of VAT are similar, but the lower precision of the Prodigy may require investigators to target larger changes in VAT.     

Effects of different dentin thicknesses and air cooling on pulpal temperature rise during laser welding

The neodymium/yttrium–aluminum–garnet (Nd/YAG) laser has been suggested to repair broken prostheses in the mouth. This study investigated the effects of different dentin thicknesses and air cooling on pulpal temperature rise during laser welding. Three intact human maxillary molars were prepared for full-veneer crown. For each tooth, dentin thicknesses in mesiobuccal cusp was 2, 3, or 4 mm. Twenty dies were duplicated from each of the prepared teeth. For metal copings with 0.5-mm thickness, wax patterns were prepared with dip wax technique directly onto each of dies. All patterns were sprued and invested. The castings were made using a nickel–chromium alloy (Nicromed Premium, Neodontics). A hole with 0.5-mm diameter was prepared on the mesiobuccal cusp of each crown. The Nd/YAG laser (9.85 W; 1 Hz repetition rate; fluence, 1.230 J/cm²; Fidelis Plus 3, Fotona) was used for welding with or without air cooling (n?=?10). The temperature rise was measured in pulpal chamber with a J-type thermocouple wire that was connected to a data logger. Differences between start and highest temperature reading were taken, and temperature rise values were compared using two-way analysis of variance and Tukey’s honestly significant difference tests (α?=?.05). Pulpal temperature rise varied significantly depending on the dentin thickness and air cooling (p?<?0.05). The non-air cooling group induced significantly the highest temperature increases. There were no significant differences between 2- and 3-mm dentin thicknesses groups (p?>?0.05); however, pulpal temperature rise was the lowest for 4-mm dentin thickness group (p?<?0.05). The highest values of thermal increase were found in the pulp chamber (6.8°C) when no air cooling was used in 2-mm dentin thickness group. Laser welding on base metal castings with Nd/YAG laser can be applied with air cooling to avoid temperature rises known to adversely affect pulpal health when dentin thickness is 2 or 3 mm.     

A favourable response to surgical intervention and hyperbaric oxygen therapy in pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterised with ulcerations. Inflammatory bowel diseases (ulcerative colitis and Crohn's disease) and haematologic diseases (leukaemia, preleukaemia and monoclonal gammopathy) have been reported in about 40–50% of PG patients in whom the treatment of the underlying disease is important for the improvement of the lesions. We herein report a colorectal adenocarcinoma patient with PG, who responded partially to topical treatments and systemic immunosuppressants and healed completely with the aid of surgical wound repair and hyperbaric oxygen therapy.     

Oxidation of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in major depressive disorder

Major depressive disorder (MDD) is blaimed to play a role in the onset of coronary artery disease (CAD). The aim of the present study was to investigate serum paraoxonase/arylesterase activities and oxidation of apolipoprotein B-containing lipoproteins in patients with MDD. Oxidation of lipoproteins plays an important role in atherogenesis and the enzyme paraoxonase, has been shown to prevent lipoprotein oxidation. Furthermore, low paraoxonase activity was suggested to predict CAD. Eighty-six patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for MDD and 36 healthy control subjects were included in the study. Serum paraoxonase and arylesterase activities were determined spectrophotometrically. Malondialdehyde (MDA) levels of apolipoprotein B-containing lipoproteins were determined before (basal) and after incubation with copper-sulphate, that yielded basal- and Delta-MDA values, respectively. Serum paraoxonase/arylesterase activities were significantly reduced in the post-treatment group compared with the pre-treatment group. Basal-MDA (MDA) level was significantly higher in the MDD group compared with the control group. Delta-MDA level of the severe MDD group was significantly higher than that of the control group. There was a positive correlation between the oxidizability of apolipoprotein B-containing lipoproteins and the severity of the disease. Total cholesterol, HDL-cholesterol, LDL-cholesterol, apolipoprotein B levels were significantly higher and apolipoprotein AI levels were significantly lower in the MDD group compared with those of the control group. The findings of the present study suggest that: 1) antidepressant treatment might reduce serum paraoxonase activity/mass; 2) oxidation and oxidizability of apolipoprotein B-containing lipoproteins seem to be increased in MDD.     

Magnetic resonance imaging at first episode in pediatric multiple sclerosis retrospective evaluation according to KIDMUS and lesion dissemination in space criteria

Background: Several diagnostic imaging criteria are being described and examined in pediatric multiple sclerosis (MS). Compared to adults, children are more likely to experience acute or relapsing demyelinating episodes of various etiologies which show similar clinical and magnetic resonance imaging (MRI) findings. Aim: To investigate the fulfillment of MRI diagnostic criteria at initial episode in pediatric MS. Methods: We reviewed our series of children and adolescents with the final diagnosis of clinically definite MS and applied the McDonald dissemination in space (DIS) and KIDMUS criteria to their initial MRI scans. Results: Thirty patients (17 girls, 13 boys), most with brainstem dysfunction and polysymptomatic presentation, were included in the study. Twenty-five (83.3%) patients fulfilled both McDonald and KIDMUS criteria. Patients who did not meet any McDonald DIS criteria did not meet KIDMUS criteria either. Only one patient met the McDonald criteria but not the KIDMUS criteria because of the absence of lesions perpendicular to corpus callosum. Conclusions: Our results show 5/30 (16.6%) of MS patients may not present the diagnostic MRI features initially. The variable sensitivity observed for the current MRI criteria in different series can be due to referral biases, differences between populations and length of follow-up, and the definition of MS patients by two attacks only.     

Anatomical features of the opening of the nasolacrimal duct and the lacrimal fold (Hasner's valve) for intranasal surgery: A cadaveric study

The location and size of the opening of the nasolacrimal duct and the lacrimal fold (Hasner's valve) are variable. These features have clinical importance in nasal surgery because of the difficulty in determining their location. The aim of this study was to demonstrate the anatomical features of the opening of the nasolacrimal duct and the lacrimal fold and to discuss the importance of such knowledge in minimizing the risk of injury at surgery. Twenty sagittal head sections from formalin‐fixed cadavers were examined. The sections showed no evidence of pathology or trauma. The type of opening of the nasolacrimal duct was a vertical sulcus in 14 of 20 (70%), an oblique sulcus in 2 of 20 (10%), an oblique fissure in 2 of 20 (10%), a vertical fissure in 1 of 20 (5%), and an anteroposterior fissure in 1 of 20 specimens (5%). The lacrimal fold was present in 16 of 20 specimens (80%). Five different forms of this fold were observed. Some morphological features were evaluated quantitatively. We believe that detailed anatomical knowledge of the opening of nasolacrimal duct will be useful in surgical approaches to this area. Clin. Anat. 22:925–931, 2009. © 2009 Wiley‐Liss, Inc.     

Curcumin ameliorates impaired insulin/IGF signalling and memory deficit in a streptozotocin-treated rat model

Increased serum insulin levels and reduced peripheral insulin activities seen in insulin resistance syndrome are associated with age-dependent cognitive impairment and Sporadic Alzheimer’s Disease (SAD), suggesting a disturbance in the insulin signalling system in the brain and possibly being one of the causes of dementia. Therefore, the streptozotocin (STZ)-induced animal may be an appropriate model for the investigation of SAD and related dementia. This study was designed to investigate the beneficial effect of Curcumin (CUR), a neuroprotective agent, on intracerebroventricular (ICV) STZ-induced cognitive impairment in rats. For this purpose, adult male Wistar rats were bilaterally ICV injected with STZ (3 mg/kg). An artificial cerebrospinal fluid (aCSF) was given to the control group (SHAM) instead of STZ on days 1 and 3. Learning and memory performance were assessed using the “passive avoidance task” and the “Morris water maze test”. After confirmation of acquisition impairment with these tests, the STZ group was divided into two subgroups: STZ + vehicle (Vh) and STZ + CUR. The rats in the SHAM and STZ + Vh groups were administered intraperitoneally with 0.5 ml Vh and the rats in the STZ + CUR group were treated intraperitoneally with CUR (300 mg kg⁻¹ day⁻¹ in Vh) for 10 days starting from the 25th day after STZ injection. The Morris water maze test was reapplied on the 35th day after STZ injection and all of the rats were sacrificed on day 36 for quantitation of IGF-1 and for histopathological evaluation. Rats in the STZ + CUR group were found to have a higher performance in cognitive tests than rats in the STZ + Vh group (P < 0.01). In parallel with the cognitive tests, IGF-1 levels were decreased in all of the STZ-injected groups (1.78 ± 0.34) compared to the SHAM group (3.46 ± 0.41). In contrast, CUR treatment significantly increased IGF-1 levels (P < 0.001). The degree of neuronal loss decreased after CUR treatment compared to the SHAM group (P < 0.02). These results clearly indicate that CUR treatment is effective in reducing the cognitive impairment caused by STZ in rats, and may be a potential therapeutic agent for altering neurodegeneration in SAD.     

Relation of temperament and character properties with clinical presentation of bipolar disorder

OBJECTIVES: The purpose of this study was to examine the underlying temperament and character properties of patients with bipolar disorder and explore the possible connections between these properties and clinical presentation of the illness. METHODS: The sociodemographic and clinical properties of 90 patients with bipolar disorder, who were euthymic according to Young Mania Rating Scale and Hamilton Depression Scale scores, were recorded. Their temperament and character features were evaluated by using Temperament and Character Inventory and results were compared with 90 age- and sex-matched healthy controls and between patients with different clinical properties. RESULTS: Patients' scores on subscales of self-directedness and cooperativeness were significantly lower compared with controls. Significant associations were found between Temperament and Character Inventory subtitles and comorbid personality disorder, number of episodes, subtype of the first episode, rapid cycling, and previous suicide attempt. CONCLUSIONS: Temperament and character features of patients with euthymic bipolar disorder show some significant differences compared to the healthy population and may vary according to different clinical presentations.