Autonomic dysfunction in patients with essential tremor

The aim of this study was to evaluate the autonomic function in patients with essential tremor (ET). Thirty-one adult patients with ET and 26 healthy controls were enrolled in the study. The electrophysiological evaluations of the autonomic nervous system function were performed by sympathetic skin response (SSR) and R–R interval variation (RRIV) tests. The mean latency of SSR in ET patients was significantly delayed compared with the controls (P = 0.01). The mean amplitude of sympathetic skin response was significantly lower in ET patients in comparison to the controls (P = 0.001). No differences were found in mean RRIV values in both group subjects. Sympathetic dysfunction may occur in patients with ET. This may be easily demonstrated by SSR tests.     

Imatinib-induced apoptosis: a possible link to topoisomerase enzyme inhibition

What is known and Objective: Imatinib is a specific BCR/ABL inhibitor, commonly used for the treatment of chronic myeloid leukaemia (CML), a hematological malignancy resulting from a chromosomal translocation that generates the BCR/ABL fusion protein. Recent studies showed that the imatinib has cytotoxic and apoptotic effects on many BCR/ABL‐negative cancers. Numerous compounds with cytotoxic potential exert their functions by interfering with the DNA topoisomerase. In this study, we examined the effects of imatinib on tumour cell‐killing in relation to DNA topoisomerase enzyme inhibition. Methods: We determined the cytotoxicity by cell proliferation assay (XTT; tetrazolium hydroxide), using the human K562 CML cells, and loss of mitochondrial membrane potential by monitoring the changes in caspase‐3 enzyme activity. Type I and II topoisomerase activities were measured by supercoiled plasmid relaxation and minicircle DNA decatenation assays respectively. Results and Discussion: Imatinib‐induced apoptosis and inhibited cell proliferation in a dose‐dependent manner. We also found that the imatinib was effective in both type I and type II topoisomerase reactions to a varying degree between 94% and 7% for the concentration range of 1 mm– 0·02 mm in a dose‐dependent manner. What is new and Conclusion: Our results suggest that the inhibition of topoisomerases may be a significant factor in imatinib‐induced apoptosis in CML.     

Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study

Background

Techniques for epiphysiodesis have evolved from open surgical techniques requiring direct observation of the physis to percutaneous techniques performed with fluoroscopy.

Questions/purposes

Our purposes were to (1) describe a new minimally invasive surgical technique used to achieve epiphysiodesis using radiofrequency ablation, (2) document the effect of radiofrequency ablation on tibia length at 2, 6, and 12 weeks after ablation in a skeletally immature rabbit model, and (3) assess the effects of radiofrequency ablation on the histologic appearance of the proximal tibia physis and proximal tibia articular cartilage.

Materials and Methods

We performed epiphysiodesis of the rabbit proximal tibia on 15 skeletally immature male New Zealand White rabbits using a 22-gauge radiofrequency probe. The probe was positioned percutaneously and heated to 90°C for 4 minutes on the medial and lateral ½ of the physis. The opposite tibia was used as a control. Five animals were sacrificed at 2, 6, or 12 weeks postoperatively. Tibia length was compared using Faxitron® radiographs and electronic calipers. Histology of the growth plate was assessed with light microscopy.

Results

We observed differences in tibia length between 4.16 mm and 11.59 mm (average 7.86 mm) at 12 weeks. The proximal tibia physis closed radiographically and histologically in all animals by 12 weeks. Histologic analysis showed no evidence of articular cartilage injury.

Conclusions

This technique was reproducible and resulted in bone fusion of the rabbit proximal tibial growth plate. The use of radiofrequency ablation as described in this report may be used as an alternative to other surgical epiphysiodesis techniques.

Clinical Relevance

This technique may be useful for epiphysiodesis of small tubular bones of the hands and feet in humans.     

Gray scale histogram analysis of solid breast lesions with ultrasonography: can lesion echogenicity ratio be used to differentiate the malignancy?

PurposeThe aim of this study was to investigate the diagnostic performance of lesion echogenicity ratios (LER) calculated by image histogram analysis for distinction of malignant and benign breast lesions.Material and methodsA total of 55 patients (mean age, 44 years) with 59 lesions were included. Ultrasound images were analyzed retrospectively.ResultsMean LER values in benign and malignant lesions were 1.63±0.41 and 3.1±0.87, respectively. The difference between LER values of benign and malignant breast lesions was statistically significant (P<.001).ConclusionLER can be used as an adjunct ultrasound parameter to differentiate between benign and malignant breast lesions.     

The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT

The aim of this study is to investigate the frequency of the SHC variations, and the distribution of the SP lengths in different age and sex groups using MDCT. MDCT scans were performed in 805 patients (401 males, 404 females). The patients were divided into six groups according to their ages. The length of the styloid process (SP) and its angulation on the transverse (TA) and sagittal (SA) planes were measured. Structural variations of the SHC were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Absence of the styloid process (n = 10), double proximal origin (n = 13), segmentation (n = 223), complete ossification (n = 24), and an SP with three proximal parts in one patient were among the anomalies detected. The mean length of the SP was greater in males than in females (33.2 ± 13.2 vs. 29.6 ± 10.5 mm, P < 0.001). Elongated SP (ESP) was observed in 56 % of the patients in the study group, and this ratio was the highest in Group 3 with 65.4 % (P < 0.05). TA and SA were 70.2° ± 4.1°, 69.9° ± 4.2° and 86.6° ± 6.5°, 88.3° ± 6.6° for the right and left sides, respectively. Besides, 3D and MPR images also present detailed and reliable data to radiologists and surgeons for the evaluation of the SHC. ESP has been detected in more than half of the patients, being more frequent in males and in individuals in the fifth decade of life. For an accurate diagnosis, clinicians should consider the ESP while evaluating the patients in this age group.     

The Effect of a Single Dose Prednisolone With and Without Diclofenac on Pain, Trismus, and Swelling After Removal of Mandibular Third Molars

PURPOSE: The purpose of this study was to evaluate the effect of a single intramuscular dose of prednisolone and the prednisolone-diclofenac combination on postoperative pain, trismus, and edema after the removal of third molars. PATIENTS AND METHODS: Forty-five patients who were to undergo surgical removal of lower third molars were studied. Patients were divided into 3 groups. In the first group, each patient was given 25 mg prednisolone intramuscularly immediately after surgery. In the second group, each patient was given 25 mg prednisolone and diclofenac intramuscularly immediately after surgery, and in the third group, each patient was given sterile saline solution as control group. Postoperative pain was evaluated by visual analogue scale on the day of surgery. Facial swelling and trismus were evaluated on postoperative days 2 and 7. ANOVA was used to analyze these data. RESULTS: Statistical analysis of the data indicated the prednisolone-diclofenac combination suppressed pain intensity in comparison with control (P < .05) at the 6-hour observation. Both the prednisolone and prednisolone-diclofenac combinations suppressed pain at the seventh postoperative hour in comparison with the control (P < .05). The prednisolone-diclofenac combination group also had a smaller loss of opening at postoperative days 2 and 7 in comparison with both the prednisolone and control groups (P < .05). Postoperative swelling was less in both the prednisolone and prednisolone-diclofenac combination groups, as compared with the control group (P < .05) at postoperative day 2. The prednisolone-diclofenac combination group also had a smaller swelling at postoperative day 7 in comparison with both the prednisolone and control groups (P < .05). CONCLUSION: It was determined that the combination of a single dose of prednisolone and diclofenac is well-suited to the treatment of postoperative pain, trismus, and swelling after dental surgical procedures and should be used when extensive postoperative swelling of soft tissue is anticipated.