土耳其文版低视力生活质量量表的效度和信度研究

目的:把低视力相关的生活质量(LVQOL)文书改编为土耳其文,并评估其效度和信度。方法:这项研究是在387位参加安卡拉大学医学院,低视力康复中心的患者中进行的。使用Spearman相关系数,Cronbachα系数和验证性因素分析(CFA)进行统计分析。结果:根据CFA结果,在"调节能力"维的条目,因为有低于0.40的因子负荷故被排除在调查问卷之外。根据Cronbachα系数,对量表的信度进行了评估。"远视力,移动和光感"维的信度是α=0.863;"调节能力"维是α=0.694;"读和精细工作"α=0.791,"日常生活能力"α=0.770。因此,这些结果表明,用量表来衡量低视力患者的视力相关的生活质量是可靠的。对维之间的相关性也进行了分析,"调节能力"和"读和精细工作"之间的相关性被认为是最低的(rs=0.336,P<0.01),而"读和精细工作"与"日常生活能力"之间的相关性被发现是最强的。此外,"调节能力"仅与"远视力,移动和光感"表现最强的相关性。结论:删除第二个维中最后一个条目后,对LVQOL所有维的土耳其文改编已被证明是可靠的,有效的,适合在土耳其的低视力患者中使用。     

Chronic application of topiramate and carbamazepine differentially affects the EEG and penicillin-induced epileptiform activity in rats

Carbamazepine (CBZ) and topiramate (TPM) are among commonly used antiepileptic drugs. The acute actions of these drugs are well known but the effects of long-term use on partially induced epileptiform characteristics are yet to be clarified. The rats were received CBZ (154 mg/kg/day), TPM (10 mg/kg/day) or tap water by gavage. We investigated penicillin-induced cortical epileptiform activity and electroencephalogram spectral power of rats by using electrocorticogram recordings. Animals were anesthetized with i.p. urethane (1·25 g/kg). Analysis of electroencephalogram recordings prior to epileptiform activity revealed that 3-week treatment of CBZ significantly increased relative power of delta (P<0·01) while reduced alpha (P<0·017) and beta (P<0·017) relative power compared to both control group and TPM group. TPM had no effect on absolute power and relative power of any frequency band. TPM treatment of 21 days significantly reduced the spike frequency (P<0·01). This preventive effect was missing in CBZ-treated rats. Upon the application of the last dose of drugs during ongoing epileptiform activity, the drugs suppressed the epileptiform activity. However, TPM was more rapid and effective than CBZ. In conclusion, our in vivo electrophysiological data suggest that TPM is more effective in animal model of partial epilepsy at the applied doses in this study.     

The relationship between serum apelin levels and aortic dilatation in bicuspid aortic valve patients

Objective: The bicuspid aortic valve (BAV) is the most common congenital heart dis‐ ease. The process of aortic dilatation is not completely clear in patients with the BAV. Apelin is a peptide found at high levels in vascular endothelial cells which has a role in vascular regulation and cardiovascular function. The aim of this study was to de‐ termine the relationship between serum apelin levels and ascending aortic dilatation in adult patients with BAV.
Design: This cross‐sectional study included 62 patients with isolated BAV and to an age, gender, and body mass index‐matched control group of 58 healthy volunteers with tricuspid aortic valve. Transesophageal echocardiography was performed on all patients to determine the type of BAV. Aortic diameters of the aortic root, sinus val‐ salva, sinotubular junction, and ascending aorta were evaluated with echocardiogra‐ phy. Patients with BAV were divided into two subgroups according to the aortic diameters, as the nondilated BAV group and the dilated BAV group. Serum apelin level was analyzed with ELISA method.
Results: The serum apelin levels of the BAV patients were significantly lower than those of the control group (833.5, 25th‐75th percentile (713.5‐1745) pg/dL vs 1669 (936‐2543) pg/dL; P = 0.006). In the subgroup analysis, serum apelin level was signifi‐ cantly different between the nondilated BAV group and the dilated BAV group [977 (790‐2433) pg/dL vs 737 (693‐870) pg/dL, P < 0.05] and between the dilated BAV group and the control group [737 (693‐870) pg/dL vs 1669 (936‐2543) pg/dL, P < 0.001]. In multivariate logistic regression analysis apelin [7.27 (95% CI: 1.73‐30.42), P = 0.007] and age [1.05 (95% CI: 0.99‐1.20), P = 0.049] were determined as inde‐ pendent predictors for ascending aortic dilatation.
Conclusion: Low serum apelin level was associated with dilatation of ascending aor‐ tic in BAV patients. However, apelin was not relevant to BAV without aortic dilatation.     

The effects of digital image enhancement on the detection of vertical root fracture

Abstract – Aim: To determine the effects of digital image enhancement on observer ability to detect experimentally induced vertical root fractures (VRF). Material and methods: A total of 64 extracted human mandibular premolar teeth were used in this study. In 32 teeth, VRFs were created in the bucco‐lingual planes by gently tapping with screw‐type root‐canal pins. The remaining 32 intact teeth served as a control group. Digital images were obtained using a charge coupled device sensor. Three observers separately examined the original and four types of digitally enhanced images (enhanced using sharpness, zoom‐in, reverse‐contrast, and pseudo‐3D functions) at 1‐week intervals. All teeth were evaluated using a 5‐point scale for the presence/absence of VRF. Evaluations of each image set were repeated 1 month after the initial viewings. Kappa coefficients were calculated to investigate the degree of intra‐ and inter‐observer agreement. The areas under the receiver operating characteristic (ROC) curves (Az values) were calculated using the MedCalc statistical software. ROC values for each image type, observer and viewing were compared using t‐tests. A level of α = 0.05 was considered significant. Results: Kappa coefficients for intra‐observer agreement ranged from 0.304 to 0.679. Inter‐observer agreement kappa values ranged from 0.109 to 0.399 for the first reading and from 0.106 to 0.380 for the second reading. Statistical comparisons between Az values for each observer showed no significant differences (P > 0.05) among image types. Conclusion: There were no differences in diagnostic outcomes among differently enhanced images in the in vitro detection of VRF.     

Attention Deficit Hyperactivity Disorder in a Patient With Congenital Mirror Movement Disorder and Colpocephaly

Introduction:

Congenital mirror movement disorder designates involuntary movements on one side of the body that occur as mirror of the intentional movements on the contralateral side. Colpocephaly is described as persistence of fetal configuration of lateral ventricles.

Case Presentation:

A two-month old male infant was brought to the hospital due to bilateral identical movements of the hands. Except for bilateral involuntary synkinetic imitative movements in hands, neurological and physical examination was normal. Cranial MRI showed corpus callosum dysgenesis, hypogenesis and dilation of bilateral lateral ventricular posterior horns (colpocephaly). At the age of 7 years, he was started to use metylphenydate to mitigate attention deficit and hyperactivity disorder. The mirror movements were decreasing in amplitude by years and were not so serious to affect normal life activities.

Conclusions:

Mirror movements, diagnosed usually during childhood, may be congenital or secondary to neurological diseases. Although they generally do not affect normal life activities, in some cases severity of mirror movements causes a real debilitating disease. In our case the patient was diagnosed at the age of 2 months and on follow-up no debilitating problems were observed. This is the first case to describe the association of colpocephaly and mirror movements. The exact mechanism of this association is not known. Although it is known that mirror movements may be in relation with some pychiatric pathologies, this is the first report of attention deficit and hyperactivity disorder in conjunction with mirror movements and/or colpocephaly. Managing comorbidities, either physical or psyhchological, will help the patient to live in good health without trying to cope with other pathological diseases.     

Myofibrillar myopathies

PURPOSE OF REVIEW: The aim of this communication is to provide an up-to-date overview of myofibrillar myopathies. RECENT FINDINGS: The most important recent advance in the myofibrillar myopathies has been the discovery that mutations in Z band alternatively spliced PDZ-containing protein and filamin C, as well as in desmin, alphaB-crystallin and myotilin, result in similar pathologic alterations in skeletal muscle that are typical of myofibrillar myopathy. Despite the increasing genetic heterogeneity, the clinical and morphologic phenotypes are remarkably homogeneous. The typical clinical manifestation is slowly progressive proximal, distal or both proximal and distal limb muscle weakness. Cardiomyopathy can be associated and is sometimes the presenting finding. Peripheral neuropathy also occurs in some patients. In every myofibrillar myopathy, there is abnormal accumulation of an array of proteins at ectopic sites as well as accumulation of degraded myofibrillar proteins forming large aggregates. The key issue now is to analyze the molecular mechanisms underlying the cascade of events that destroy the myofibrillar architecture and trigger the aberrant expression of multiple proteins. SUMMARY: Several disease genes have recently been recognized in myofibrillar myopathies. So far, the disease proteins identified are components of or chaperone for the Z-disk. In each case, the molecular defect leads to a stereotyped cascade of structural events in the muscle fiber.