Dartos reflex: a sympathetically mediated scrotal reflex

The dartos muscle is a sympathetically innervated dermal muscle layer within the scrotum, distinct from the somatically innervated cremasteric muscle. We electrophysiologically demonstrate the presence of a dartos reflex (DR), which can be used to evaluate the thoracolumbar sympathetic and genitofemoral nerve pathways. In 20 healthy men, we evoked the DR by cutaneous stimulation of the thigh and recorded the resultant scrotal skin contraction. We recorded hand, foot, and perineal sympathetic skin responses (SSRs) as controls. The DR was reliable and reproducible, as were the SSRs. The mean left DR latency was 4.8 s (SD, 2.7 s) and right DR latency was 5.4 s (SD, 3 .4), both of which were longer than the mean hand, foot, and perineal SSRs (P < 0.05). An intact reflex arc reflects the integrity of the afferent and efferent branches of the genitofemoral nerve (T12-L2). The DR test can also be used to assess scrotal autonomic innervation. Abnormalities of dartos innervation may impact testis thermoregulation and spermatogenesis.     

The factors considered as trigger for the attacks in patients with familial Mediterranean fever

Although the inflammatory cascade of familial Mediterranean fever (FMF) is partially understood, triggering factors of those attacks has not been studied well. It is supposed that physical stresses such as cold exposure, tiredness and emotional stresses could provoke attacks. This study is aimed to survey the factors regarded as triggering the attacks in patients with FMF and their relationship with MEFV gene mutations. Clinical findings and genetic mutations (consist of M694V, M694I, M680I, V726A, E148Q) of patients were recorded. Patients were questioned about cold exposure, emotional stress, tiredness, long-lasting standing, long-duration travel, starvation, high intake of food, trauma, and infection as triggering factors for the attacks with both serositis and musculoskeletal pain. The study is comprised of 275 FMF patients (male/female: 177/98). The most common triggering factors for the attacks with serositis were cold exposure (59.3 %), emotional stress (49.8 %), tiredness (40.0 %) and menstruation (33.7 % in females). Long-lasting standing (78.8 %), long-duration travel (64.1 %) and tiredness (47.8 %) were the triggering factors for the attacks with musculoskeletal symptoms. The relationships between MEFV mutations and triggering factors were found as M694V allele with starvation, E148Q allele with high intake of food and V726A allele with long-duration travel. The attacks with serositis seem to be triggered by those factors to which whole body exposed, whereas the attacks with musculoskeletal complaints seem to be triggered by those factors to which regional or local part of body exposed. Since the number of alleles was small, a clear conclusion for a relationship between a particular gene variant and a specific trigger was not made.     

Comparison of demographic and clinical characteristics of patients with early vs. adult vs. late onset ulcerative colitis

Background & aimsThere is limited data comparing influence of age on the presentation, clinical course, and therapeutic response of patients with ulcerative colitis. We aimed to compare the demographic and clinical characteristics of patients diagnosed with UC in older age vs. adulthood vs. early age.MethodsFive-hundred sixty one patients with UC seen at our center from 1995 to 2011 were categorized into early onset (EO), adult onset (AO) and late onset (LO) due to age at date of initial diagnosis. Patients diagnosed younger than age 17 were defined as EO, while those diagnosed between 17 and 60 were defined as AO and older than age 60 as LO. All patients were analyzed for demographic and clinical characteristics.ResultsThere was a male predominancy among LO patients (50% vs. 57.7% vs. 78.6%, p = 0.004). Patients with EO UC were more likely to be non-smokers (p < 0.001), and had higher family history of UC (p = 0.02). Patients with EO UC had more steroid use (p = 0.03), total colectomy (p = 0.04), presence of chronic active disease (p = 0.04) rates when compared with AO and LO groups. Patients in EO group had higher overall probability of surgery in 1, 5 and 10 years, when compared with patients in LO group (p = 0.02), but it wasn't different between EO and AO groups (p = 0.09).ConclusionsOur study showed that clinical course of UC was more aggressive in younger ages. Also the difference between the demographic characteristics suggests that different age groups have different risk factors for the disease development.     

Mean platelet volume in patients with polycystic ovary disease

Platelets contribute to blood coagulation at sites of vascular injury and to the recruitment of leukocytes at sites of inflammation. Under pathological conditions, platelets are involved in numerous diseases and clinical complications, such as deep venous thrombosis, embolism and atherosclerosis. But so far, little is known about the mechanisms of inflammation in large veins and the role of platelets in inflamed large veins. For this purpose, we investigated primary and secondary interactions between platelets, leukocytes and endothelial cells in the femoral vein in vivo with special regard to the role of CD62P (P-selectin) and CD162 (PSGL-1). Mice were challenged with lipopolysaccharide (LPS)/D-galactosamine (D-gal) and either CD162 or CD62P was blocked by intravenous administration of a corresponding antibody at the time point of LPS/D-gal injection. Four hours after LPS/gal injection, intravital fluorescence microscopy of the femoral vein was performed and primary and secondary platelet-leukocyte-endothelial cell-interactions were visualized after in vivo platelet and leukocyte staining with rhodamine 6G. Analysis of intravital fluorescence microscopy revealed that LPS/D-gal caused a strong inflammatory reaction of the venous endothelium with significant induction of platelet and leukocyte tethering, rolling and adhesion. Secondary interactions of platelets to adherent or rolling platelets or leukocytes were also increased after LPS/D-gal-injection. Immunoneutralization of either CD162 or CD62P significantly decreased platelet primary and secondary capture as well as leukocyte rolling and adhesion. CD162 and CD62P play a central role in mediating inflammatory primary and secondary interactions of platelets and leukocytes to the endothelium in inflamed large veins in vivo. Thus, blocking CD162 or CD62P might be an attractive tool for preventing platelet and leukocyte-driven venous diseases.     

The effect of weight loss on the mean platelet volume in obese patients

Obesity is a chronic metabolic disorder associated with cardiovascular disease and atherosclerosis. Platelet activation and aggregation are central processes in the pathophysiology of cardiovascular disease. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk marker for atherothrombosis. Our objective was to evaluate the effect of weight loss on the MPV in obese patients. We selected 30 obese women patients and 30 non-obese healthy women subjects. All obese patients took the same content and caloric diet treatment for 3 months. Body mass index (BMI), metabolic parameters and MPV were measured at baseline and after 3 months diet treatment. Before diet treatment, obese group had significantly higher MPV levels than in the non-obese control group (8.18?±?1.09 fl vs. 8.01?±?0.95 fl, p?=?0.004). MPV showed positive correlations with BMI level in the obese group (r?=?0.43, p?=?0.017). BMI significantly decreased after diet treatment (36.2?±?3.2?kg/m² vs. 34.7?±?3.6?kg/m², p?<?0.001), in the obese group. MPV significantly decreased after diet treatment in the obese group (8.18?±?1.09 fl vs. 8.08?±?1.02 fl, p?=?0.013). There was a positive correlation between weight loss and reduction in MPV (r?=?0.41, p?=?0.024). In addition to its well-known positive effects on cardiovascular disease risk, weight loss may also possess significant anti-platelet activation properties that can contribute its antiatherogenic effects in obese patients.     

Platelet-rich plasma in combination with bovine derived xenograft in the treatment of generalized aggressive periodontitis: A case report with re-entry

Prominence has been given recently to the use of platelet-rich plasma (PRP) in combination with bone graft materials for predictably obtaining periodontal regeneration through bioengineering. The purpose of this report was to present clinical, radiographic and re-entry results of a generalized aggressive periodontitis (GAP) patient with wide intrabony periodontal defects treated with combined PRP and bovine derived xenograft (BDX). A-32 year old GAP patient who received non-surgical therapy and had 12 intrabony defects was treated with PRP and BDX combination. Prior to surgery and at 12 months, probing depth, marginal recession, relative attachment, probing bone and radiographic bone levels were measured. Re-entry was additionally performed at 12 months. Clinical and radiographic measurements together with re-entry results showed marked improvements from baseline with increased stabilization of whole dentition including the hopeless teeth. The surgical technique together with the materials used may be a possible solution for extensive bone loss.     

The predictive value of ectopic inner retinal layer staging scheme for idiopathic epiretinal membrane: surgical results at 12 months

Background/objectivesTo assess the effect of ectopic inner foveal layers (EIFL) based staging scheme, foveal avascular zone (FAZ) alterations and other microstructural optical coherence tomography (OCT) findings on visual function for patients undergoing idiopathic epiretinal membrane (iERM) surgery.Subjects/methodsIn this retrospective study, patients who underwent 27 G pars plana vitrectomy (PPV) for idiopathic ERM with a minimum follow-up of 12 months were included. Preoperative and postoperative OCT scans, FAZ area measurements on en face OCT angiography images and mean retinal sensitivity (MRS) using microperimetry were recorded in all cases. The correlation of FAZ area, EIFL and other OCT parameters with preoperative and postoperative best-corrected visual acuity (BCVA) was analysed.ResultsIn all, 112 eyes of 112 patients were included. Visual acuity improvement was statistically significant in all four stages; however, differences between Stages 2, 3 and 4 ERMs remained significant (p < 0.05). The presence and thickness of the EIFL was associated with worse baseline (p = 0.013; p = 0.005, respectively) and final (p < 0.001 for both) BCVA. The presence of cystoid macular oedema was associated with worse BCVA at baseline (p = 0.027) and postoperative month-6 (p = 0.04). The mean FAZ area was significantly reduced in all stages of ERM compared with the fellow eyes (p < 0.05 for all). Postoperative retinal sensitivity improvement was statistically significant in Stage 1 and Stage 2.ConclusionThe presence of EIFL is an independent predictor of worse postoperative BCVA. Accordingly, despite significant BCVA improvements in all stages of ERM, visual acuity gain remains limited in eyes with Stage 3 and Stage 4 ERM.Subject terms: Retinal diseases, Fluorescence spectroscopy     

Self-esteem in Turkish diabetic children

Self-esteem is the state of appreciation arising from the ratification of the ego concept that has resulted in self-assessment of their own skills, preferences, and psychologic traits. If people evaluate themselves in positive terms, we say they have high self-esteem. Self-esteem can be evaluated in relation to factors such as family, parents, level of education, age, occupation, and economic status. Children with diabetes mellitus type 1 live with physical, personal, and social developments that occur rapidly and intensively during adolescence. They also must cope with a chronic disease that may have a negative effect on their lives. This study was designed to evaluate the self-esteem of the children who have a diagnosis of diabetes mellitus type 1 and uses a prospective design. The sample consisted of Turkish children between the ages 10 and 14 years old. The study group was selected from the patients admitted to the diabetes outpatient clinics of the hospitals of the university and the Social Insurance Association, and had a diagnosis of diabetes mellitus type 1. The control group was selected from healthy children who were students in a primary school.