The value of somatosensory-evoked potentials and bulbocavernosus reflex in patients with impotence

In 14 normal male adults and 97 male patients having impotence alone or together with systematic and/or neuro-psychiatric symptoms and signs, the somatosensory cerebral-evoked potentials were obtained by glans penis stimulation (penile SEP); by peroneal nerve stimulation (peroneal SEP) and by electrically-induced bulbocavernous (BC) reflex. In normal subjects, the configurations of both SEPs were basically similar, except that the onset of latency was 10-15 msec longer and the amplitude in the P1-N1 component was higher in penile SEP. BC-reflex latency was abnormally prolonged, especially in diabetic impotence and in patients with cauda/conus lesions, while the abnormalities on the penile and peroneal SEP were more frequent in patients with spinal cord injuries. MS and parkinsonism. In impotent patients with epilepsy, chronic prostatis and psychogenic problems, all the tests were generally normal.     

Comparison of free radicals and antioxidant enzymes in chronic otitis media with and without tympanosclerosis

Objective/Hypothesis The pathogenesis of tympanosclerosis is unclear. The study was performed to investigate the role of nitric oxide, free oxygen radicals, and antioxidants in development of tympanosclerosis in patients with chronic otitis media. Study Design A prospective study in patients with nasal polyps. Methods Sixty‐five patients who underwent tympanoplasty or tympanoplasty together with mastoidectomy were included in the study. Preoperative venous blood samples were drawn, and serum sodium, potassium, calcium, alkaline phosphatase, inorganic phosphorus, parathormone, and calcitonin levels were measured. The patients who had tympanosclerotic plaques on tympanic membrane or middle ear mucosa or near the ossicular chain or mastoid bone were designated as group 1 (n = 34), and the remaining patients as group 2 (n = 31). Intraoperatively, specimens were obtained from the middle ear mucosa and tympanic membrane to measure nitric oxide and malondialdehyde levels. In addition, plasma malondialdehyde levels and erythrocyte superoxide dismutase and catalase activity were determined. Results All patients had similar demographic features and serum electrolyte and hormone levels. Nitric oxide and malondialdehyde levels of the specimens obtained from the middle ear mucosa (P = .001) and tympanic membrane (P = .01) and, in parallel to this, the plasma malondialdehyde activity level were higher in group 1 than in group 2. Moreover, group 2 had significantly lower erythrocyte catalase activity levels (P = .001) compared with group 1, whereas such a significant difference was not present for superoxide dismutase activity levels (P > .05). Conclusion The study results suggest that nitric oxide, free oxygen radicals, and catalase may have a role in the development of tympanosclerosis in patients with chronic otitis media.     

Radiopacity of direct esthetic restorative materials

This study determined the radiopacity of 21 commercially available direct esthetic restorative materials with reference to an aluminum step wedge and an equivalent thickness of enamel and dentin. A total of 168 samples measuring 6 mm in diameter and 1 mm in thickness, with eight samples of each material, were prepared from restorative materials. Enamel and dentin samples 1-mm thick were also prepared by longitudinally sectioning eight extracted human permanent molars using a microslicing machine. The optical densities of each restorative material, along with one tooth section and an aluminum step wedge were measured from radiographic images using a transmission photodensitometer. The optical density values of the specimens were used to determine the aluminum thickness equivalent values. The data were analyzed with one-way analysis of variance (ANOVA) and Duncan's multiple range tests. The results showed statistically significant differences among materials. Tetric Ceram had the greatest radiopacity value and was higher than enamel. All materials except for the microfilled resin composite Filtek A 110 had radiopacity values greater than dentin and possessed sufficient radiopacity to meet ISO 4049 standard. Significant differences were found among materials of the same composition when compared to enamel.     

Blockade of inflammation and airway hyperresponsiveness in immune-sensitized mice by dominant-negative phosphoinositide 3-kinase-TAT

Phosphoinositide 3-kinase (PI3K) is thought to contribute to the pathogenesis of asthma by effecting the recruitment, activation, and apoptosis of inflammatory cells. We examined the role of class IA PI3K in antigen-induced airway inflammation and hyperresponsiveness by i.p. administration into mice of Deltap85 protein, a dominant negative form of the class IA PI3K regulatory subunit, p85alpha, which was fused to HIV-TAT (TAT-Deltap85). Intraperitoneal administration of TAT-Deltap85 caused time-dependent transduction into blood leukocytes, and inhibited activated phosphorylation of protein kinase B (PKB), a downstream target of PI3K, in lung tissues in mice receiving intranasal FMLP. Antigen challenge elicited pulmonary infiltration of lymphocytes, eosinophils and neutrophils, increase in mucus-containing epithelial cells, and airway hyperresponsiveness to methacholine. Except for modest airway neutrophilia, these effects all were blocked by treatment with 3-10 mg/kg of TAT-Deltap85. There was also significant reduction in IL-5 and IL-4 secretion into the BAL. Intranasal administration of IL-5 caused eosinophil migration into the airway lumen, which was attenuated by systemic pretreatment with TAT-Deltap85. We conclude that PI3K has a regulatory role in Th2-cell cytokine secretion, airway inflammation, and airway hyperresponsiveness in mice.     

First experience with transnasal and transseptal endoscopic and microscopic repair of anterior skull base CSF fistulae

Currently, endoscopic endonasal surgery is a valuable and safe procedure routinely performed for treatment of paranasal sinus disorders. Since the endoscopic technique has become popular in this area, interest has been increased in its possible use for some other indications such as transsphenoidal pituitary and anterior skull base surgery. In this paper, we present our experience in using the nasal endoscope for repair of anterior skull base cerebrospinal fluid (CSF) fistulae. Between 1994-1999, we observed 44 patients with CSF rhinorrhea. Out of 44 patients, 34 had improved with the conservative treatment in two weeks, in 10 patients endoscopic surgery was performed and in one patient endoscopic surgery failed and the defect was repaired with transsphenoidal microscopic surgery. The remaining 9 patients were doing well and no problem was encountered concerning the surgery.     

Toxic-dose warfarin-induced apoptosis and its enhancement by gamma ionizing radiation in leukemia K562 and HL-60 cells is not mediated by induction of oxidative stress

The purpose of this study was to test the hypothesis that warfarin may enhance free radical production and oxidative damage on cancer cells. We examined the possible concentration-dependent effect of warfarin on cytotoxicity with respect to oxidative stress on leukemia cell lines (K562 and HL-60) and normal human peripheral blood mononuclear cells (PBMC). Gamma radiation was used as a positive control agent for oxidative stress. At all concentrations of warfarin (5–200 μM), 5-amino-2,3-dihydro-1,4-phthalazinedione (luminol)- and bis-N-methylacridinium nitrate (lucigenin)-amplified chemiluminescence responses and lipid peroxidation and protein oxidation were stable after 72 h incubation at 37°C. However, The 2′,7′-dichlorofluorescein diacetate (DCFH-DA) oxidation was increased when cells were incubated with high concentrations (50–200 μM) of warfarin. In these concentration ranges, warfarin reduced cell growth in a dose-dependent manner, producing apoptosis. Our results also revealed that at concentrations above 5 μM, warfarin had a potentiating effect on radiation-mediated growth inhibition and apoptosis. Furthermore, marked effects were observed on leukemic cells compared with PBMC. We report here that the increase of DCFH oxidation might be due to the increase in the release of cytochrome C caused by warfarin, as cytosolic cytochrome C content was significantly elevated in the warfarin-treated cells compared with control cells, and because cotreatment with antioxidants N- acetylcysteine or 4,5-dihydroxy-1,3-benzene-disulfonic acid (Tiron) was unable to prevent cytochrome C release and DCFH oxidation induced by the drug. Taken together, these results suggest that high warfarin concentrations may be toxic to leukemic cells in vitro through apoptosis, although at the pharmacological concentrations (<50 μM), warfarin has no prooxidant or cytotoxic effect on PBMC, K562, and HL-60 cells. In addition, when the treatment of leukemic cells with warfarin at concentrations above 5 μM is combined with radiation, we observed an increase in radiation-induced cytotoxicity. The mechanism by which warfarin potentiates this cytotoxicity is unclear, but it may not be directly due to toxic damage induced by warfarin-generated free radicals.     

Novel thrombolytic drugs: will they make a difference in the treatment of ischaemic stroke?

Treatment of acute ischaemic stroke aims to recanalize the occluded artery, salvage the at-risk brain tissue and thus minimize neurological sequelae. Efforts a decade ago have led to the only currently approved medical treatment for acute ischaemic stroke, i.e. intravenous alteplase given within 3 hours of stroke onset. Recanalization occurs in only one-half of the patients receiving alteplase, and only approximately 5% of all ischaemic stroke patients in industrialized countries receive this treatment. Studies are currently being carried out to determine whether intravenous alteplase would be safe and effective for up to 4.5 hours after ischaemic stroke onset, and whether it should be followed by an intra-arterial approach. Two novel thrombolytic drugs being studied for acute ischaemic stroke are desmoteplase and tenecteplase. Although the first trials were promising, the most recent evidence suggests that desmoteplase is not superior to placebo, even in carefully selected patients, in the 3- to 9-hour time window after stroke onset. Tenecteplase has only been studied for acute ischaemic stroke in a single noncontrolled, dose-finding trial in the 3-hour time window after stroke onset, which suggested a similar efficacy to that demonstrated in the historical data from the alteplase trials. A trial to compare the safety and efficacy of tenecteplase versus alteplase is ongoing. Safer and more effective thrombolytic drugs for the treatment of ischaemic stroke are thus being sought. Such agents will be welcome, but they are not here yet. While waiting we are likely to see the emergence of additive therapies, including ultrasound insonation, neuroprotective/regenerative agents and invasive intra-arterial techniques. Novel thrombolytic drugs, or other novel therapies, possess great potential to make a difference in the future, but the most urgent priority now is in the organization of stroke treatment in such a way that more patients receive the currently available optimal treatments.     

Age-specific seroprevalence of serogroup C meningococcal serum bactericidal antibody activity and serogroup A, C, W135 and Y-specific IgG concentrations in the Turkish population during 2005

Like many other developing countries; there is no accurate information about the antibody levels against Neisseria meningitidis in Turkey. We collected serum samples from four health centers located in different geographic regions and stratified according to age in order to obtain a baseline seroprevalence of protective antibodies to meningococcal serogroup C and provide data on seroprevalence of IgG antibodies to serogroups A, C, W135 and Y. Sera were tested for serum bactericidal antibodies (SBA) to serogroup C meningococci using rabbit serum as the complement source and by a bead based assay for serogroup A, C, W135 and Y-specific IgG. It was observed that 30% and 12% of individuals within the study population had SBA titers of > or =8 and > or =128, respectively. Overall; at least 70% of the population are susceptible (SBA titer <8) to meningococcal serogroup C disease. The rate of susceptibility was highest in infants aged 7-12 months and young children (1-4 years). Regardless of age, for serogroup A, C, W135 and Y, 60.5%, 27.2%, 12.3% and 19.2% of subjects, respectively, had serogroup-specific IgG concentrations > or =2 microg/mL. These data highlight that a large proportion of the Turkish population are susceptible to serogroups C, W135 and Y and should be considered, along with serogroup-specific disease incidence data, in future decisions on possible meningococcal vaccination programmes.     

Initiation of antidepressants in young adults after ischemic stroke: a registry-based follow-up study

Journal of Neurology - Data on post-stroke use of antidepressants in young individuals are scarce. We examined pattern and factors associated with initiating post-stroke antidepressants (PSAD)...