Anatomic features of the intracranial and intracanalicular portions of ophthalmic artery: for the surgical procedures

The intracranial and intracanalicular portions of the ophthalmic artery is suspectible to various diseases and injuries; therefore, knowledge of the microanatomy of the complex bony, dural, vascular, and neural relationships of this segment is necessary for proper diagnosis and preservation of the neurovascular structures during subfrontal, pterional and intracanalicular procedures. The artery was studied in 38 human adult cadaver specimens regarding origin, intracranial and intracanalicular portions for surgical approachs. The ophthalmic artery originated from the intradural portion of the internal carotid artery, except in 5% where the ophthalmic artery originated extradurally. The ophthalmic artery originated from medial of superior wall of internal carotid artery in 73.7%, from the central in 21% and the lateral in 5.3% of the specimens. The diameter of the ophthalmic artery at its origin was 2.25±0.3 mm on the right and 2.16±0.4 mm on the left. The intracranial and intracanalicular course of the artery was divided into short limb, angle “a”, long limb, angle “b” and distal part to the apex of the orbit. Awareness of variations in anatomic structures is paramount importance both for diagnosis and treatment of vascular lesions of the brain.     

Changes in the oral caused by scurvy

This report presents a case of a psychiatric patient with scurvy. Upon the clinical examination of the oral cavity, dry and pale lips were noted. Gingiva was highly edematous, soft, purple blue with ulcerated margins. Bleeding was noted upon slightest provocation. Teeth were also affected by the vitamin C deficiency with multiple caries. The patient was asthenic and adynamic. Petechial bleeding and hematomas were present on the skin of extremities. Therapy consisted of rehydration and vitamin C compensation--2 g daily i.v. during 10 days period, and 1.5 g daily orally during the following 2 months. The patient maintained only partial plaque control, and complete recovery of the oral cavity was not established because the patient didn't comply. Concerning that scurvy is a rare disease nowadays, it is very important to recognize its clinical signs, and to establish a valid and prompt diagnosis, because, when untreated, scurvy can have severe consequences on the entire organism.     

Problems in running a tuberculosis dispensary in a developing country: Turkey.

Declining use of the services of local dispensaries has often been suggested as a significant factor in the rising trend of tuberculosis in Turkey after 1970. Data confirming this view were insufficient until this study, which consists of an evaluation of the records of 51,086 subjects seen by the tuberculosis dispensary in Elazi? between 1985-1989. We found that, despite an expected yearly population increase, there were no significant differences in the numbers of diagnostic and follow-up procedures as well as preventive and therapeutic interventions recorded in different years, and that cases of active tuberculosis lost to follow-up had gradually increased. The least effective method of case-finding, mass screening, had been employed most frequently. These results revealed a less than optimum use of the services of the tuberculosis dispensary and prompted us to suggest the following changes: (1) diversion of economic resources currently used for mass screening in order to use them for better purposes; (2) functional integration of tuberculosis dispensaries with local, general or university hospitals, since a separate system for tuberculosis care is accompanied by a segregating and stigmatising effect for all concerned; (3) entering all patients and contacts into a computerised database to alleviate the problems associated with inadequate follow-up. We conclude that existing control programmes should be reviewed and improved to prevent an increase of tuberculosis, particularly in developing countries like Turkey.     

Psychogeriatric hospitalization: terminable or interminable?

This paper takes issue with the stereotype of psychogeriatric patients in the general hospital using beds unnecessarily. With appropriate organization of services involving integrated teamwork, comprehensive patient assessment, early discharge planning and liaison with community resources, a positive outcome and early discharge was achieved with the majority of a group of psychogeriatric patients.     

Leptin-dependent toll-like receptor expression and responsiveness in preadipocytes and adipocytes

Leptin, an adipokine mainly produced by adipocytes, has been well characterized with regard to its regulatory function on immune cells. Thus the question occurred of how adipocytes and preadipocytes interact with the immune system and whether or not this communication is regulated by leptin. With the present study we evaluated the Toll-like receptor (TLR) expression and TLR ligand-specific activation of murine preadipocytes and adipocytes in the presence [wild type (WT), 3T3L1] or absence of leptin (ob/ob) or leptin signaling (db/db). The ob/ob as well as db/db adipocytes and preadipocytes were characterized by a significant up-regulation of TLR1 to -9 expression when compared with WT cells. In WT preadipocytes the TLR responsiveness increased during maturation to adipocytes; however, stimulation of ob/ob and db/db cells resulted in a 10- to 20-fold higher interleukin-6 production. Signaling studies revealed, in addition to the increased TLR expression, alterations in the phosphoinositide 3 kinase signaling cascade in ob/ob and db/db cells as an explanation for this increased responsiveness. In conclusion, the present study indicates the expression and responsiveness of TLR1 to -9 in murine preadipocytes as well as adipocytes, both of which are strongly regulated by the adipokine leptin. In summary, these data further emphasize the role of fat tissue in the immune system.     

Stochastic error whitening algorithm for linear filter estimation with noisy data.

Mean squared error (MSE) has been the most widely used tool to solve the linear filter estimation or system identification problem. However, MSE gives biased results when the input signals are noisy. This paper presents a novel stochastic gradient algorithm based on the recently proposed error whitening criterion (EWC) to tackle the problem of linear filter estimation in the presence of additive white disturbances. We will briefly motivate the theory behind the new criterion and derive an online stochastic gradient algorithm. Convergence proof of the stochastic gradient algorithm is derived making mild assumptions. Further, we will propose some extensions to the stochastic gradient algorithm to ensure faster, step-size independent convergence. We will perform extensive simulations and compare the results with MSE as well as total-least squares in a parameter estimation problem. The stochastic EWC algorithm has many potential applications. We will use this in designing robust inverse controllers with noisy data.