Lack of association between MAOA-uVNTR variants and excessive daytime sleepiness

Sleep disorders are highly prevalent in the population and have dramatic health, social, and economic impacts. However, their treatments may remain symptomatic due to ignorance of molecular factors which may provide fundamental insights into the neurological bases of sleep. Excessive daytime sleepiness (EDS) is a common complaint encountered in neurological practice with significant effects both on individuals and on society. We aimed to investigate the role of monoamine oxidase A (MAOA) as a candidate gene in EDS. Epworth sleepiness scale (ESS) was applied to 221 subjects who were also genotyped for MAOA upstream variable number of tandem repeats (MAOA-uVNTR). Patient group displayed higher ESS values (mean 12.67) when compared with the control group (mean 6.38). However, MAOA-uVNTR genotypes did not show a significant association with ESS scores neither on women nor on men. Finally, these data suggest further replications in different populations. Moreover, the investigation of some other genes together with MAOA and/or some possible regulatory molecular mechanisms may offer a more comprehensive approach in the role of genetic factors contributing to EDS.     

Oropharyngeal angioneurotic edema due to recombinant tissue plasminogen activator following massive pulmonary thromboembolism

Although hypersensitivity reactions secondary to recombinant tissue plasminogen activator (rtPA) are rarely encountered, they may have important consequences. In this case presentation, oropharyngeal angioneurotic edema due to rtPA following pulmonary thromboembolism is presented. On the 4th hour of initiation of treatment, throat pain, laryngeal stridor and expansive edema in the neck ensued, upon which the patient was intubated and mechanically ventilated. The patient was extubated after her findings showed a remission on the 48th hour of his inotropic, antihistaminic and intravenous corticosteroid therapy.     

Immune compartmentalization of T cell subsets in chemically-induced breast cancer

In cancer, the phenotype and/or the function of T cells may differ according to their distribution through immune-associated tissues, namely immune compartments. Here, in N-methyl-N-nitrosourea (MNU)-induced mammary carcinomas of rat as a relevant model for human breast tumors, the impact of tumor burden on the T cell subsets populating the tumor microenvironment, the tumor-adjacent and -opposite mammary lymph nodes, and the spleen was assessed. In the tumors, ratio of CD8(+) cytotoxic and CD4(+) helper T cells were not significantly different than other immune compartments. On the other hand, most of these cells were further identified with CD4(+) CD25(hi) or CD4(+) Foxp3(+) , CD8(+) Foxp3(+) regulatory phenotype. The selective presence of Tregs in the mammary tumors but not in neighboring-mammary tissue was also confirmed by the expression of Treg-associated genes. The percentage of CD161(+) NKT cells was also significantly increased especially in the tumors and mammary lymph nodes. In the lymph nodes of tumor-bearing animals, in contrast to the spleen, total amount of CD8(+) cells and CD4(+) cells were increased but both of these compartments harbored high numbers of CD4(+) CD25(hi) Treg cells. TGF-β was determined as the major suppressive cytokine secreted by the immune cells of tumor-bearing animals, in addition, proliferation capacity of the T cells was diminished. Hence, the differential distribution of T cell subsets through the spleen, the mammary lymph nodes and the tumor mass in MNU-induced mammary tumor-bearing animals may contribute to a tumor-associated immunosuppression.     

Turkish adolescents' knowledge on and attitude toward emergency contraception

ObjectiveAdolescents tend to be at risk for unwanted pregnancies, so detecting their level of knowledge on emergency contraception and providing them information is important to prevent such pregnancies. Hence, in two faculties at Gazi University, this study aimed to detect freshman students' level and need of knowledge on emergency contraception and to evaluate their attitude towards emergency contraception.Materials and MethodsThe study was performed with freshman students of the Occupational Education Faculty and the Technical Education Faculty. A questionnaire including questions about demographic properties, obstetrical history, status of contraceptive use, level of knowledge and opinions on emergency contraception was administered to the students. Data was analyzed statistically with the computer program EPI Info 6.0.ResultsA total number of 385 adolescents were included in the studys; 157 of whom were males (40.8%) and 228 of whom were females (59.2%). To the question “is there any way to prevent a possible pregnancy after an unprotected sexual intercourse?”, 166 students replied “yes” (50.5%), 39 “no” (11.9%) and 124 “I do not know” (37.7%). Of 166 students replying “yes,” 114 (68.7%) listed a possible contraceptive method. The mostly cited method was “morning after pills” (n = 62; 54.4%), followed by curettage (n = 15; 13.2%). Among all students, 158 (49.8%) informed us that they were aware of the presence of “morning after pills” whereas 159 (50.2%) claimed they were not. Eighty-six male students (70.5%) and 115 female students (72%) emphasized that they would use emergency contraception upon necessity.ConclusionHalf of the participants were familiar with various options to prevent pregnancy after an unprotected sexual intercourse episode, but they lacked specific knowledge about possible methods and ways to use them. Thus, it is essential that information about emergency contraception be included in adolescents' educational programs and that adolescents be provided with easily accessible medical services.     

Successful living-related liver transplantation in a child with familial yellow nail syndrome and fulminant hepatic failure: report of a case

An 11-yr-old boy with familial YNS and FHF and who underwent LRLT is presented. LRLT was performed from his father with YNS. The findings of hepatic failure resolved immediately after LRLT, but severe respiratory complications and chylous ascites were observed during the follow-up. At 12 months after successful LT, the patient has good graft function, but findings of YNS including chronic cough, lymphedema and yellow nails are still present. To the best of our knowledge, this is the first case of YNS who underwent LRLT for FHF.     

Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation

OBJECTIVE: This study aimed to compare ultrasonography (US) with magnetic resonance imaging (MRI) with respect to the diagnosis of temporomandibular joint (TMJ) internal derangements. STUDY DESIGN: The study group consisted of 23 patients with a chief complaint of TMJ discomfort who were tentatively diagnosed by means of head-neck examination as having TMJ internal derangements and a control group of 9 volunteers who had no sign of TMJ internal derangements. All the patients were then examined by means of MRI and US. RESULTS: The results showed perfect agreement between MRI and US in the diagnosis of TMJ internal derangements (kappa = 1.000; P =.0001). CONCLUSION: MRI and US can be used to define the disk and its position, as well as the presence of TMJ internal derangements.