A case of herpes simplex encephalitis revealed by decompressive craniectomy

A 15-year-old girl was referred to our hospital due to fever, headache, and vomiting of 7 days duration and focal motor convulsion at the day of referral. Her clinical signs and cerebral imaging findings were found to be compatible with herpes simplex encephalitis. In spite of prompt acyclovir administration, her consciousness deteriorated gradually. Emergent cranial magnetic resonance imaging demonstrated a shift of midline intracranial structures. Decompressive surgery resulted in partial improvement in the shift of midline intracranial structures and potentially saved the patient's life. This case report stresses the importance of proper management of increased intracranial pressure in patients with herpes simplex encephalitis.

Relationship between myocardial performance index and aortic distensibility in patients with essential hypertension

We aimed to investigate the association between aortic distensibility (AD) and left ventricle myocardial performance index (MPI) in patients with newly diagnosed hypertension (HT). We studied 49 patients with HT and 24 healthy control subjects. AD was calculated from the echocardiographically derived ascending aorta diameters. The MPI was calculated from both conventional flow Doppler echocardiography and tissue Doppler echocardiography recordings. Conventional Doppler E/A and tissue Doppler derived Ea/Aa were determined for all the subjects. Aortic distensibility was lower, and both conventional and tissue Doppler MPI values were higher (p<0.001 for all) in patient group compared with control group. AD was correlated with systolic blood pressure (SBP) (beta=-0.436, p=0.037), Ea/Aa (beta=0.228, p=0.038) and tissue derived MPI (beta=-0.302, p=0.043) in multiple linear regression analysis. Aortic distensibility was independently related to tissue derived MPI and Ea/Aa besides SBP.

Subclinical neurological abnormalities in children with celiac disease receiving a gluten-free diet

OBJECTIVES

Because clinically evident manifestations are frequent in adults with celiac disease (CD), we aimed to investigate whether early neurological abnormalities may be detected in children with CD.

METHODS

Electroencephalography, electromyography, and somatosensory evoked potentials were performed in children with CD receiving a gluten-free diet.

RESULTS

The neurophysiological tests revealed subclinical neurological abnormalities associated with CD in 3 (11%) of 27 children: 2 had peripheral polyneuropathy documented with electromyography, and 1 had prolonged latencies in somatosensory evoked potential. Magnetic resonance imaging showed abnormalities in 2 (7.4%) of children: pontine demyelinization in 1 and cortical atrophy in the other.

CONCLUSIONS

Because the rate of neurological problems is increased in children with CD, neurological abnormalities should be carefully investigated early after the diagnosis of CD is made.

Efficacy of erythromycin for psoriasis vulgaris

Psoriasis is characterised by the presence of neutrophil overactivation and overproduction of interleukin (IL)-6 and IL-8 from keratinocytes. It is now clear that macrolide antibiotics have anti-inflammatory effects, such as inhibition of IL-6, IL-8 and tumour necrosis factor-alpha, perhaps by suppressing the transcription factor nuclear factor-kappaB or activator protein-1, and reduction of neutrophil activity. It is thus possible that macrolides might be a candidate for adjunctive treatment of psoriasis. In this study, we investigated the effectiveness of treatment with the macrolide antibiotic, erythromycin, for skin lesions and pruritus of patients with psoriasis. In total, 60 patients with psoriasis, especially pruritic psoriasis, were included. This was an open-label study and the analysis was on an intention-to-treat basis. Oral macrolide antibiotics and topical corticosteroids were given to the study group of 36 patients. The control group (24 patients) were treated only with topical corticosteroids. After a 4-week treatment period, scores on the Psoriasis Area and Severity Index (PASI) at baseline and at the end of the treatment, and the effectiveness in reducing itching were compared within and between both groups. Although there was no statistically significant difference between the baseline mean PASI of the two groups (P=0.81), there was a statistically significant difference between the mean PASI of the two groups at the end of the treatment (P=0.023, 95% confidence interval: - 3.45 to - 0.27). The comparison of the mean difference in PASI yielded a statistically significant difference (P=0.03, 95% confidence interval 0.73-3.55). Our study suggests that macrolides could be used as one of the adjunctive therapies for psoriasis vulgaris.

Neutralization of an extremely acidic sludge and stabilization of heavy metals in flyash aggregates

An extremely acidic, heavy metal-rich sludge (pH=-1.2) was scrubbed with a Class-F fly ash in order to simultaneously neutralize the acidity and stabilize the heavy metals contained in both wastes. This paper outlines the leaching behavior of the aggregate material generated by scrubbing. For proper fly ash/sludge ratios, the fly ash acted as an outstanding neutralizer for the acidic waste. Leaching of heavy metals from the aggregate samples was below the environmental limits within a pH range between 3 and 9. Subsequent washing of the leached aggregate with acidic CALWET solutions did not result in an additional release of heavy metals. It is proposed that coordinative bonding of the metal cations onto neutral surface sites and electrostatic adsorption led to stabilization of the heavy metals within the aggregate structure below hydrolysis pHs.

Effect of various treatment and glazing (coating) techniques on the roughness and wettability of ceramic dental restorative surfaces

Surface treatment procedures such as grinding and polishing are needed to provide the ceramic dental restorative materials with proper fitting and occlusion. The treated surfaces are customarily glazed to improve the strength and smoothness. Though smoothness and wetting of the dental surfaces are important to minimize bacterial plaque retention, influence of the surface treatment and glazing procedures on the final surface roughness and its correlation to wettability are overlooked. In this work, effect of various treatment (diamond fraising, stoning, sanding and aluminum oxide and rubber polishing) and glazing (auto and overglazing) techniques on the final roughness and the resulting wettability of dental ceramic surfaces were investigated using scanning electron microscopy (SEM) observations and atomic force microscopy (AFM) scans, 75 scans per sample. The surfaces were characterized and assigned an average roughness measure, R(a). The wettability of the same surfaces was evaluated using micro-contact angle measurements (25 micro-bubbles placed on a grid on each surface) to correlate the final surface roughness and wettability. The results show that overglazing prevails over surface irregularities from different treatment procedures and provides homegeneously smooth surfaces with mean R(a)<10 nm. It also produces uniformly wetted surfaces with low contact angles around 20 degrees . The autoglazed surfaces are less smooth (mean R(a) around 50 nm) and displays sporadic topographic irregularities. They display larger and less uniform contact angles ranging between 35 degrees and 50 degrees . The results suggest that overglazing should be preferred after surface treatment to obtain a smooth and well-wetted dental ceramic surface.

Effect of pH and hydration on the normal and lateral interaction forces between alumina surfaces

Interaction forces between alumina surfaces were measured using an AFM-colloid probe method at different pHs. For an alpha-alumina-sapphire system at acidic pH, the force curve exhibited a well-defined repulsive barrier and an attractive minimum. At basic pH, the interactive force was repulsive at all separations with no primary minimum. Lateral force measurements under the same conditions showed that frictional forces were nearly an order of magnitude smaller at basic pH than those observed at acidic pH. This behavior was attributed to the hydration of the alumina surface. Normal and lateral force measurements with the strongly hydrated rho-alumina surfaces supported these findings.

Relationship between impaired elastic properties of aorta with left ventricle geometric patterns and left ventricle diastolic functions in patients with newly diagnosed essential hypertension

The aim of this study was to investigate the association between elastic properties of aorta with left ventricle (LV) geometric patterns and LV diastolic functions in patients with newly diagnosed hypertension (HT). We studied 149 patients with newly diagnosed HT and 29 healthy control subjects. Echocardiographic examination was performed to all subjects. Ascending aorta (Ao) diameters (mm/m2) and Ao elastic indexes - namely, Ao strain [AS] (%), Ao distensibility [AD] (cm2 dyn(-1) x 10(-6)) were calculated. Four different geometric patterns were identified in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). Tissue Doppler-derived Ea/Aa was determined from the all subjects. Patients vs. control subjects had lower mean AS and AD (p < 0.001 for both). Mean AS and AD of all geometric patterns significantly decreased compared with control group (p < 0.05 for all). Both AS and aortic AD of concentric remodelling (CR; p = 0.017 for both) and concentric hypertophic groups (p < 0.001 for both) were decreased compared with normal LV group. AS and AD of concentric hypertrophic pattern was lower than that of the CR group (p = 0.011 and 0.020 respectively) and the eccentric hypertrophic group (p < 0.001 and p = 0.002, respectively). Both AS and AD of the CR group were similar to that of the eccentric hypertrophic group (p > 0.05 for both). Both AS and AD were significantly correlated with age (beta = -0.178, p = 0.025, beta = -0.158, p = 0.029 respectively), LVMI (beta = -0.223, p = 0.022, beta = -263, p = 0.003 respectively), RWT (beta = -0.196, p = 0.019, beta = -0.189, p = 0.013 respectively) and Ea/Aa (beta = 0.174, p = 0.045, beta = 0.247, p = 0.002 respectively) in multiple linear regression analysis. Elastic properties of aorta were impaired in newly diagnosed HT. The degree of this impairment is different among various LV geometric patterns. In addition, impaired elastic properties of aorta were associated with RWT, LVMI and diastolic disfunctions, besides age, but not with LV geometry.

Identification of axonal involvement in Hallervorden-Spatz disease with magnetic resonance spectroscopy

Hallervorden-Spatz disease is a neurodegenerative disorder associated with cysteine-iron complex accumulation typically seen as bilateral symmetrical hypointense signal changes in the medial globus pallidus on magnetic resonance imaging. We used magnetic resonance spectroscopy to identify and quantify neuronal damage in two siblings with Hallervorden-Spatz disease. The first patient presenting with a rapidly progressive extrapyramidal syndrome had markedly decreased N-acetylaspartate (NAA) to creatinine (Cr) ratios in the globus pallidi and the periatrial white matter. He also had increased myoinositol (mI) to creatinine (Cr) ratios implying glial proliferation in the affected regions. However the second patient who had the initial presentation of disease had normal NAA/Cr and mI/Cr ratios. These findings indicate that the quantification of NAA:Cr and mI:Cr ratios might be used to predict the extent of neuronal axonal loss and glial proliferation in patients with Hallervorden-Spatz disease respectively.

Role of free radicals on mechanism of radiation nephropathy

PURPOSE

In our study, after applying a single dose of 612 cGy irradiation, we aimed to observe the role of free radicals on tissue damage in the kidney caused by radiation by measuring NO level, Na/K-ATPase activity and TBARS amount which is an indicator of free radical damage. On the other hand we investigated whether the tissue damage can be prevented by vitamin A or not.

MATERIALS AND METHODS

This study was performed on three groups: 1. Control group 2. The group to which irradiation was administrated 3. The group which was given radiation + vitamin A. The irradiation group of animals were given a single dose of gamma irradiation at a sublethal dose. In the group which was administrated both irradiation + vitamin A, vitamin A was given for two days prior to irradiation. The amount of NO was measured by ESR spectroscopy, Na/K-ATPase and TBARS were measured by spectrophotometry.

RESULTS AND CONCLUSIONS

As a result of radiation mediated tissue damage in the kidney, we observed a NO loss, a decrease in Na/K-ATPase activity and an increase in TBARS amount. Although the administration of vitamin A before radiation, did not have any effect on NO loss and decrease in Na/K-ATPase.

Deletion polymorphism of the GSTM1 gene in lung cancer patients from the Lake District in Turkey

20089

Background: Association of glutathione-S-transferase M1 (GSTM1) polymorphisms and cancer has been demonstrated. Especially the deletion polymorphism of GSTM1 has been related to risk for lung cancer in some studies. We thus investigated the frequency of GSTM1-null genotype in lung cancer patients and healthy individuals from the Lake District in Turkey. Methods: Cases were recruited among patients with clinically and histologically confirmed diagnosis of lung cancer patients from the Lake District. Controls were selected among the nonsmoking healthy blood donors applied to hospital in same region. DNA samples were extracted from whole blood using proteinaz K (20 mg/mL) digestion in lysis buffer (10 mM Tris-HCl, 400 mM NaCl, 2 mM EDTA, % 10 SDS). Homozygous deletion of the GSTM1 gene was determined by PCR using the primers E4F: 5′-CTGCCCTACTTGATTGATGGG-3′, E5R: 5′-CTGGATTGTAGCAGATCATGC-3′, corresponding to exons 4 and 5 of the GSTM1 gene. PCR products were analyzed by 1% agarose gel electrophoresis and UV transilluminator was then used to evaluate the product content. Individuals carrying the GSTM1 gene were identified by the presence of a 273 bp DNA fragment. Results: The study comprised 30 patients and 30 controls. The frequency of GSTM1-null genotype was found to be (n = 14) 46.7% in lung cancer patients and (n = 5) 16.6% in controls. The difference was statistically significant (Fisher’s chi square test: 4.80, P: 0.0251). Conclusion: We found an increased incidence of GSTM1-null genotype among lung cancer patients, indicating that the GSTM1 absence is associated with a slightly increased lung cancer risk in people from the Lake District in Turkey.

No significant financial relationships to disclose.

Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases

Tamoxifen (TAM) is widely used in the treatment of breast cancer, and its paradoxical effects on female genital system are well known. During the past 10 years, many descriptions of nonepithelial uterine malignancies related to long-term TAM usage have been reported in the literature. Four uterine sarcoma patients who had history of TAM usage for previous breast cancer are presented in this study. The mean time of exposure to TAM was 6 (range 3-11) years, and the mean cumulative dose of drug was 43.82 g. All patients were postmenopausal, and the mean age was 66 (range 61-73) years at the time of the diagnosis of the uterine malignancy. Two (50%) patients had uterine malignant mixed müllerian tumor, and two (50%) had leiomyosarcoma. In one (25%) patient was diagnosed with endometrial biopsy made for a postmenopausal vaginal bleeding; the others (75%) were asymptomatic and their diseases were diagnosed during the pelvic examination and transvaginal ultrasonography. All patients underwent surgery +/- adjuvant therapy (chemotherapy and/or radiation therapy), and two (50%) patients died because of the sarcoma. In consequence, early detection of TAM-related uterine sarcoma is required for orderly gynecological examination in patients having history of TAM usage for previous breast cancer.

ESR detection and dosimetric properties of irradiated naproxen sodium

In the present work, the electron spin resonance (ESR) dosimetric properties of naproxen sodium (NS) was investigated in the dose range of (2.5-25 kGy). Irradiated NS exhibited a very simple ESR spectrum consisting of a broadened antisymmetric single resonance line not saturating up to 2 mW microwave power at room temperature. The sum of two exponential increasing functions associated with two different radicals of different spectroscopic features and relative weights were found best describing experimental dose-response curve. Radiation induced radicals were observed to be very stable at room temperature but the increase in storage temperature increased very appreciably the decay of the contributing radicals. The results of the simulation calculation based on a model of two radicals showed that two carbon dioxide ionic free radicals (*CO(2))(-) of different orientational and environmental features produced by preferential rupture of carboxyl group from the rest of NS molecules in the crystalline matrix, were, likely at the origin of the experimentally observed ESR spectrum. Features such as good time stability of the signal intensity and relatively high radiation yield (G=0.13) were considered providing NS with potential use as dosimetric material in measuring radiation dose in the range of 2.5-25 kGy by ESR technique.

An investigation of the presence of methane and other gases at the Uzundere-Izmir solid waste disposal site, Izmir, Turkey

Izmir is a large metropolitan city with a population of 3,114,860. The city consists of 27 townships, each township has a population of not less than 10,000 inhabitants. The two major solid waste disposal sites are in the townships of Uzundere and Harmandali. The amount of solid waste that is disposed at each of these sites is about 800 and 1800 t/day, respectively. In Uzundere, compost is produced from the organic fraction of urban solid wastes while the residual material is deposited at a disposal site with a remaining capacity of 700,000 m(3) as of 2001. Gas monitoring and measurements were carried out at the disposal site in Uzundere. For this purpose, nine sampling wells were drilled on selected locations. Each well was furnished with perforated metal pipes suitable for gas monitoring and measurements. The following gases were monitored: O(2), CH(4), CO, CO(2), and H(2)S. The most important finding was that the concentrations of CH(4) in the wells ranged from 7 to 57%. Dilution of the CH(4) by O(2) down to the LEL levels (5-15%) is always possible and poses a continuing risk at the site. Furthermore, the levels of O(2) require that access to the site be limited to only authorized personnel.