Serum and Aqueous Concentrations of Inflammatory Markers in Diabetic Macular Edema

Purpose: To investigate the relationship between the serum and aqueous levels of inflammatory markers and diabetic macular edema (DME).

Methods: The study included four patient groups: the healthy control group (n?=?23 eyes); the diabetic control group (n?=?22 eyes); the groups with and without DME (n?=?20 eyes and n?=?22 eyes, respectively). The patients were evaluated based on their serum levels of HbA_1c, C-reactive protein (CRP) and serum and aqueous levels of tumor necrosis factor-alpha (TNF-α).

Results: Statistically significant differences were present for the serum CRP levels and for the aqueous TNF-α levels between the healthy control group and the group with DME (p?=?0.004 and p?=?0.03, respectively); for the serum TNF-α levels between the healthy control group and the groups without and with DME (p?=?0.009 and p?=?0.001, respectively).

Conclusions: Increased serum levels of CRP and serum and aqueous levels of TNF-α in DME suggest that inflammation is involved in the pathogenesis of DME.     

Early rehabilitation improves neurofunctional outcome after surgery in children with spinal tumors简

To investigate the effect of early rehabilitation on neurofunctional outcome after surgery in children with spinal tumors, this study reviewed the medical charts and radiographic records of 70 pediatric patients(1–17 years old) who received spinal tumor surgical removal. The peddiatric patients received rahabilitation treatment at 4(range, 2–7) days after surgery for 10(range, 7–23) days. Results from the Modified McCormick Scale, Functional Independence Measure for Children, American Spinal Injury Association Impairment Scale and Karnofsky Performance Status Scale demonstrated that the sensory function, motor function and activity of daily living of pediatric children who received early rehabilitation were significantly improved. Results also showed that tumor setting and level localization as well as patients' s clinical symptoms have no influences on neurofunctional outcomes.     

Microtensile bond strength of an etch-and-rinse adhesive to enamel and dentin after Er:YAG laser pretreatment with different pulse durations

The purpose of this study is to evaluate microtensile bond strength (μTBS) of an etch-and-rinse adhesive to enamel and dentin after treatment with Er:YAG laser using different pulse durations. Extracted human molars were flattened to obtain enamel or dentin surfaces. The enamel specimens (E) were divided into nine groups and the dentin (D) specimens were divided into seven groups according to the surface treatments (n = 6). E-C: acid was applied according to the manufacturer’s instructions and used as control, E-SSP: 120 mJ, 10 Hz, SSP (50 μs), E-SSP-A: 120 mJ,10 Hz, SSP+acid, E-VSP: 120 mJ, 10 Hz, VSP (100 μs), E-VSP-A: 120 mJ, 10 Hz, VSP+acid, E-SP: 120 mJ, 10 Hz, SP (150 μs), E-SP-A:120 mJ,10 Hz, SP+acid, E-LP:120 mJ,10 Hz, LP (300 μs), E-LP-A:120 mJ,10 Hz, LP+acid; D-C: acid was applied and used as control, D-SSP: 80 mJ, 10 Hz, SSP, D-SSP-A: 80 mJ, 10 Hz, SSP+acid, D-VSP: 80 mJ, 10 Hz, VSP, D-VSP-A: 80 mJ, 10 Hz, VSP+acid, D-SP: 80 mJ, 10 Hz, SP, D-SP-A: 80 mJ, 10 Hz, SP+acid. After application of etch-and-rinse adhesive, composite built-ups were created with a nanoceramic composite. Specimens were sectioned into serial 1-mm² sticks, and μTBS was measured in five sticks from each tooth randomly selected (n = 30). Failure modes were determined under a stereomicroscope. μTBS test data were analyzed by Welch-ANOVA followed by Dunnett's T3 tests and failure mode distributions were analyzed by Pearson Chi-square test (p = 0.05). μTBS was higher for enamel and dentin after additional acid etching than laser irradiation alone. E-SSP-A group exhibited the highest μTBS for enamel (p < 0.05). The D-SP-A group showed the highest value but the difference was not significant in comparison to D-C (p > 0.05). The μTBS of laser-irradiated but not acid-etched groups decreased when longer pulse durations were used. Laser treatment could enhance or impair the μTBS to enamel and dentin depending on the pulse duration used and additional acid application.     

Alternative bacterial two-component small heat shock protein systems

Small heat shock proteins (sHsps) are molecular chaperones that prevent the aggregation of nonnative proteins. The sHsps investigated to date mostly form large, oligomeric complexes. The typical bacterial scenario seemed to be a two-component sHsps system of two homologous sHsps, such as the Escherichia coli sHsps IbpA and IbpB. With a view to expand our knowledge on bacterial sHsps, we analyzed the sHsp system of the bacterium Deinococcus radiodurans, which is resistant against various stress conditions. D. radiodurans encodes two sHsps, termed Hsp17.7 and Hsp20.2. Surprisingly, Hsp17.7 forms only chaperone active dimers, although its crystal structure reveals the typical α-crystallin fold. In contrast, Hsp20.2 is predominantly a 36mer that dissociates into smaller oligomeric assemblies that bind substrate proteins stably. Whereas Hsp20.2 cooperates with the ATP-dependent bacterial chaperones in their refolding, Hsp17.7 keeps substrates in a refolding-competent state by transient interactions. In summary, we show that these two sHsps are strikingly different in their quaternary structures and chaperone properties, defining a second type of bacterial two-component sHsp system.     

The Comparison of the Effects of Ellagic Acid and Diclofenac Sodium on Intra-Abdominal Adhesion: An In Vivo Study in the Rat Model

Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P < 0.05), and glutathione level increased (P < 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects.Key words: Ellagic acid, Diclofenac sodium, Intraabdominal adhesion, RatPeritoneal adhesions are fibrotic adhesions that are formed intra-abdominally on the visceral or peritoneal surface during the healing of peritoneal injury.^1,2 Adhesions often occur after laparotomy and are also a significant cause of postoperative morbidity.^3,4 Adhesions can be asymptomatic but can also lead to serious complications such as intestinal obstruction, perforation and fistula.^3–6Adhesion formation begins with mesothelial cell injury on the peritoneal membrane surface. An inflammatory process consisting of cellular elements of small venules and fibrin exudation, edema, and hyperemia begins in this region and a serous exudates develops.^5,7–9 Fibrous bands develop between fibrinous exudate and serosal surfaces, leading to formation of fibrinous bridges. Mesothelial cells produce plasminogen activator that dissolves fibrin clots, and the fibrinolytic system is engaged causing the fibrinous exudates to be rapidly resorbed. Adhesions are formed otherwise.^10–12DS (diclofenac sodium) is a nonsteroidal anti-inflammatory agent often used in clinical practice for postoperative analgesia and is known to have a fibrinolytic effect.^13,14 EA (ellagic acid) is a natural antioxidant reported to be present in walnuts, carrots, tomatoes, pomegranate, grape juice, grape wine, blueberries, blackberries, and strawberries in significant quantities.^15–18 EA is a phenolic acid derivative that inhibits lipid peroxidation in addition to its anti-inflammatory, antiproliferative, anti-angiogenic and anticarcinogenic effects.^16,17We aimed to evaluate the effects of the oral use of DS that has an anti-inflammatory effect and EA that has an antioxidant effect in addition to its anti-inflammatory effect on intra-abdominal adhesion development in comparison in the present study.     

Growth Patterns of Children of Same Geographic Background Reared in Different Environments

Objective: Growth charts are essential tools used to assess children’s health status. The aim of the present study was to determine the effect of environmental factors on the growth of children of a common geographic background. We constructed growth charts for children living in the East of Turkey and compared them with those for Turkish children living in other regions or countries.Methods: Growth data were obtained from 6 917 school children living in Eastern Turkey. The median values on smoothed percentile curves for the study subjects were compared with those for Turkish children living in the West of Turkey, in Western Europe and in Germany.Results: Children living in Turkey were lighter than their European peers at early ages. Weight curves of children living in the West of Turkey reached those of their European peers, after 11 years of age in boys and after 12 years of age in girls. At all ages, girls and boys in our region had the lowest weight values. Between 7 and 11 years of age, the median height in boys and girls were similar in the West of Turkey and in Europe. At older ages, median height was higher in Turkey. Girls and boys living in Eastern Turkey were the shortest children until 16 years of age; after that age, their height was similar to their peers. Conclusions: Weight may interact with environmental factors, but genetic potential appears to be the most important factor determining height at 17 years of age. Growth patterns of children should be evaluated using specific reference values for specific regions.     

Rituximab as a new therapeutic option in granulomatosis with polyangiitis: a report of two cases

Findings of several reports suggest that rituximab, a chimeric monoclonal anti-CD20 antibody causing B-lymphocyte depletion, might represent a treatment option for people with granulomatosis with polyangiitis (GPA) (former Wegener's granulomatosis). This study presents the results of rituximab treatment in two patients with treatment-refractory GPA. First patient received rituximab for a granulomatous posterior orbital mass lesion, and eye symptoms were resolved after three courses of treatment. The second patient had eye and paranasal sinus involvement and benefited from two courses of rituximab treatment, with significant clinical improvement. Rituximab may represent an effective novel treatment for remission induction in GPA.     

Dynamic MR imaging of carpal tunnel syndrome

 Objective. To evaluate the diagnostic value of the MR imaging syndrome before and after performance of provocative exercises in patients with dynamic carpal tunnel syndrome. Design. Fat-suppressed proton-density and T2-weighted spin-echo images of the wrist were obtained prior to and after provocative, standardized exercises. Images were interpreted in masked fashion with regard to six MR criteria of carpal tunnel syndrome: (a) bowing of the transverse ligament, (b) and (c) deformation of the median nerve at the pisiform and hamate levels respectively, (d) signal abnormality of the median nerve, (e) presence of fluid in the wrist joints and/or carpal tunnel, and (f) presence of synovial swelling. Patients. Twenty-one wrists in 20 patients with subjective complaints of carpal tunnel syndrome and equivocal or negative clinical findings and negative electrodiagnostic examinations were included (age range 21–61 years, mean 37 years, 2 men and 18 women). The diagnosis of dynamic carpal tunnel syndrome was made and confirmed by surgery in 18 of the 21 symptomatic wrists. The control group consisted of 15 asymptomatic wrists in volunteers (age range 22–60 years, mean 35 years, 8 men and 7 women). Results and conclusions. Sensitivities and specificities of the six MR criteria were 90.5–100%, and 6.7–86.7%, respectively, both before and after exercise. Likelihood ratios proved statistically significant differences between the symptomatic and asymptomatic wrists (P<0.0001–0.0002) for the prevalence of all MR criteria with the exception of fluid within the carpal joints and/or carpal tunnel. Changes of the MR appearance after exercise had a low sensitivity (4.8–71.4%) but high specificity (86.7–100%) for dynamic carpal tunnel syndrome. In conclusion, MR imaging contributes to the diagnosis of carpal tunnel syndrome when clinical signs are confusing and electrodiagnostic studies are negative. Dynamic examinations improve specificity of MR imaging for such diagnosis.