Alcohol-free synthesis, biological assessment, in vivo toxicological evaluation, and in silico analysis of novel silane quaternary ammonium compounds differing in structure and chain length as promising disinfectants

Quaternary ammonium compounds (QACs) are commonly used as disinfectants for industrial, medical, and residential applications. However, adverse health outcomes have been reported. Therefore, biocompatible disinfectants must be developed to reduce these adverse effects. In this context, QACs with various alkyl chain lengths (C12-C18) were synthesized by reacting QACs with the counterion silane. The antimicrobial activities of the novel compounds against four strains of microorganisms were assessed. Several in vivo assays were conducted on Drosophila melanogaster to determine the toxicological outcomes of Si-QACs, followed by computational analyses (molecular docking, simulation, and prediction of skin sensitization). The in vivo results were combined using a cheminformatics approach to understand the descriptors responsible for the safety of Si-QAC. Si-QAC-2 was active against all tested bacteria, with minimal inhibitory concentrations ranging from 13.65 to 436.74 ppm. Drosophila exposed to Si-QAC-2 have moderate-to-low toxicological outcomes. The molecular weight, hydrophobicity/lipophilicity, and electron diffraction properties were identified as crucial descriptors for ensuring the safety of the Si-QACs. Furthermore, Si-QAC-2 exhibited good stability and notable antiviral potential with no signs of skin sensitization. Overall, Si-QAC-2 (C14) has the potential to be a novel disinfectant.

Morphologically different hydroxyapatite nanoparticles exert differential genotoxic effects in Drosophila

Hydroxyapatite (HAP) occurs naturally in sedimentary and metamorphic rocks and constitutes the hard structures in many organisms. Since synthetic nano-sized HAP (HAP-NPs) are used in orthopedic applications and for heavy metal remediation in aquatic and terrestrial media, both environment and humans are exposed to them. Due to the concerns about their potential hazards, the genotoxic effects that round/rod forms of HAP-NPs were investigated in Drosophila using the wing-spot and the comet assays. Furthermore, caspase activities were evaluated to examine the activation of cell death pathways. As a novelty, the expression of 36 genes involved in DNA repair was investigated, as a tool to indirectly determine DNA damage induction. Obtained sizes were 35-60 nm (roundHAP-NPs) and 45-90 nm (rodHAP-NPs) with a low Zeta-potential (-1.65 and 0.37 mV, respectively). Genotoxicity was detected in the wing-spot (round form), and in the comet assay (round and rod-like HA-NPs). In addition, increased expression of Caspases 3/7, 8, and 9 activities were observed. For both HAP forms, increased changes in the expression were observed for mismatch repair genes, while decreased expression was observed for genes involved in ATM, ATR, and cell cycle pathways. The observed changes in the repair pathways would reinforce the view that HAP-NPs have genotoxic potential, although more markedly in the round form. Thus, the environmental presence of engineered nanoparticles, including HAPs, raises concerns about potential effects on human health. It is essential that the effects of their use are carefully assessed and monitored to ensure safety and to mitigate any potential adverse effects.

Genotoxic hazard assessment of cerium oxide and magnesium oxide nanoparticles in Drosophila

The use of metal oxide nanoparticles (NPs) is steadily spreading, leading to increased environmental exposures to many organisms, including humans. To improve our knowledge of this potential hazard, we have evaluated the genotoxic risk of cerium oxide (CeO₂NPs) and magnesium oxide (MgONPs) nanoparticle exposures using Drosophila as an in vivo assay model. In this study, two well-known assays, such as the wing somatic mutation and recombination test (wing-spot assay) and the single-cell gel electrophoresis test (comet assay) were used. As a novelty, and for the first time, changes in the expression levels of a wide panel of DNA repair genes were also evaluated. Our results indicate that none of the concentrations of CeO₂NPs increased the total spot frequency in the wing-spot assay, while induction was observed at the highest dose of MgONPs. Regarding the comet assay, both tested NPs were unable to induce single DNA strand breaks or oxidative damage in DNA bases. Nevertheless, exposure to CeO₂NPs induced significant increases in the expression levels of the Mlh1 and Brca2 genes, which are involved in the double-strand break repair pathway, together with a decrease in the expression levels of the MCPH1 and Rad51D genes. Regarding the effects of MgONPs exposure, the expression levels of the Ercc1, Brca2, Rad1, mu2, and stg genes were significantly increased, while Mlh1 and MCPH1 genes were decreased. Our results show the usefulness of our approach in detecting mild genotoxic effects by evaluating changes in the expression of a panel of genes involved in DNA repair pathways.

Insight into the Temperature Evolution of Electronic Structure and Mechanism of Exchange Interaction in EuS

Discovered in 1962, the divalent ferromagnetic semiconductor EuS (T_C = 16.5 K, E_g = 1.65 eV) has remained constantly relevant to the engineering of novel magnetically active interfaces, heterostructures, and multilayer sequences and to combination with topological materials. Because detailed information on the electronic structure of EuS and, in particular, its evolution across T_C is not well-represented in the literature but is essential for the development of new functional systems, the present work aims at filling this gap. Our angle-resolved photoemission measurements complemented with first-principles calculations demonstrate how the electronic structure of EuS evolves across a paramagnetic-ferromagnetic transition. Our results emphasize the importance of the strong Eu 4f-S 3p mixing for exchange-magnetic splittings of the sulfur-derived bands as well as coupling between f and d orbitals of neighboring Eu atoms to derive the value of T_C accurately. The 4f-3p mixing facilitates the coupling between 4f and 5d orbitals of neighboring Eu atoms, which mainly governs the exchange interaction in EuS.

Use of hyperbaric oxygen therapy of purpura fulminans in an extremely low birth weight preterm: A case report

Purpura fulminans (PF) is a rare and fatal complication of septic shock or diffuse intravascular coagulation (DIC) resulting in skin and soft tissue necrosis. PF can be caused by congenital or acquired protein C (PC) or protein S (PS) deficiency. The most common cause of PF in a neonate is sepsis. In our extremely low birth weight preterm case, due to PF that started in the right-hand fingers, examination was made and protein S deficiency was detected as well as MTHFR (A1298C) and Factor V Leiden (R506Q) homozygous mutations. While being unresponsive to fresh frozen plasma (FFP) and unfractionated heparin (UFH) therapy, we want to highlight the curative treatment with hyperbaric oxygen (HBOT), which has not previously been used in extremely low birth weight preterm infants for this purpose.

Genetic and phenotypic characterization of NKX6-2-related spastic ataxia and hypomyelination

Background and purpose

Hypomyelinating leukodystrophies are a heterogeneous group of genetic disorders with a wide spectrum of phenotypes and a high rate of genetically unsolved cases. Bi‐allelic mutations in NKX6‐2 were recently linked to spastic ataxia 8 with hypomyelinating leukodystrophy.

Methods

Using a combination of homozygosity mapping, exome sequencing, and detailed clinical and neuroimaging assessment a series of new NKX6‐2 mutations in a multicentre setting is described. Then, all reported NKX6‐2 mutations and those identified in this study were combined and an in‐depth analysis of NKX6‐2‐related disease spectrum was provided.

Results

Eleven new cases from eight families of different ethnic backgrounds carrying compound heterozygous and homozygous pathogenic variants in NKX6‐2 were identified, evidencing a high NKX6‐2 mutation burden in the hypomyelinating leukodystrophy disease spectrum. Our data reveal a phenotype spectrum with neonatal onset, global psychomotor delay and worse prognosis at the severe end and a childhood onset with mainly motor phenotype at the milder end. The phenotypic and neuroimaging expression in NKX6‐2 is described and it is shown that phenotypes with epilepsy in the absence of overt hypomyelination and diffuse hypomyelination without seizures can occur.

Conclusions

NKX6‐2 mutations should be considered in patients with autosomal recessive, very early onset of nystagmus, cerebellar ataxia with hypotonia that rapidly progresses to spasticity, particularly when associated with neuroimaging signs of hypomyelination. Therefore, it is recommended that NXK6‐2 should be included in hypomyelinating leukodystrophy and spastic ataxia diagnostic panels.

Association between attitudes towards Internet usage and health practices in high-school students in 2 schools in Turkey: a cross-sectional study

Excessive usage of the Internet can negatively affect health and health practices especially among youth. To examine the issue among Turkish students, this study determined the association between high-school students' attitudes towards Internet usage and their health behaviour. The sample (n = 2043) was randomly drawn from all students at two high schools in Turkey: one in Anatolia and one (a vocational school) in Istanbul. Data were collected using the Structured Questionnaire, Attitude Scale towards Internet Usage (ASTIU) and Adolescent Lifestyle Profile (ALP). The mean age of the students was 16.3 years, 77.7% were male and 96.9% used the Internet; mean duration of Internet use was 18.8 h/week. Female students had more positive attitudes towards Internet usage. Mean scores for ASTIU and ALP were 72.58 (SD 17.64) and 111.34 (SD 16.61) respectively, which were average levels. There was a statistically significant but weak overall negative correlation between adolescents' attitudes towards Internet usage and their health behaviour. Our results concur with studies in different cultures which suggest some negative effects, of heavy Internet use.

Time slicing in 3D momentum imaging of the hydrogen molecular ion photo-fragmentation

Photo-fragmentation of the hydrogen molecular ion was investigated with 800 nm, 50 fs laser pulses by employing a time slicing 3D imaging technique that enables the simultaneous measurement of all three momentum components which are linearly related with the pixel position and slicing time. This is done for each individual product particle arriving at the detector. This mode of detection allows us to directly measure the three-dimensional fragment momentum vector distribution without having to rely on mathematical reconstruction methods, which additionally require the investigated system to be cylindrically symmetric. We experimentally reconstruct the laser-induced photo-fragmentation of the hydrogen molecular ion. In previous experiments, neutral molecules were used as a target, but in this work, performed with molecular ions, the initial vibrational level populations are well-defined after electron bombardment, which facilitates the interpretation. We show that the employed time-slicing technique allows us to register the fragment momentum distribution that reflects the initial molecular states with greater detail, revealing features that were concealed in the full time-integrated distribution on the detector.

Treatment of Geriatric Proximal Humerus Fractures: Indications and Outcome

Treatment algorithms of proximal humerus fractures are still controversially discussed. The enthusiasm towards operative treatment after the introduction of locking implants, has not been justified by the functional results in the elderly population. The majority of those fractures in the geriatric patients can be successfully treated conservatively. Thorough clinical and radiological examination for fracture analysis, dynamic stability control with the use of an image intensifier, and meticulous reduction, in addition with the appropriate orthesis for its retention and rehabilitation, are the keys for the successful treatment of the proximal humerus fracture in the elderly patient. The present review reports on the main treatment aspects of proximal humerus fractures in the geriatric population and proposes a treatment algorithm.

Probing nonadiabatic molecular alignment by spectral modulation

We investigated molecular alignment wakes of femtosecond laser pulses. Evolution of nonadiabatic molecular alignment in nitrogen gas has been measured via its nonlinear interaction effects with a variably delayed probe pulse. The induced rotational wave packet was mapped as a function of the angular difference between polarization directions of femtosecond pump and probe pulses as well as their relative delay and the plot of the variations of the rotational wave packet, i.e. "quantum carpet", was found to be in good agreement with the calculated angular and temporal dependencies of molecular alignment parameter.

White-light generation control with crossing beams of femtosecond laser pulses

We investigated the variations in generated white-light when crossing two femtosecond laser beams in a Kerr medium. By changing the relative delay of two interacting intense femtosecond laser pulses, we show that white-light generation can be enhanced or suppressed. With a decrease of the relative delay an enhancement of the white-light output was observed, which at even smaller delays was reverted to a suppression of white-light generation. Under choosen conditions, the level of suppression resulted in a white-light output lower than the initial level corresponding to large delays, when the pulses do not overlap in time. The enhancement of the white-light generation takes place in the pulse that is lagging. We found that the effect of the interaction of the beams depends on their relative orientation of polarization and increases when the polarizations are changed from perpendicular to parallel. The observed effects are explained by noting that at intermediate delays, the perturbations introduced in the path of the lagging beam lead to a shortening of the length of filament formation and enhancement of the white-light generation, whereas at small delays the stronger interaction and mutual rescattering reduces the intensity in the central part of the beams, suppressing filamentation and white-light generation.

Pressure optimization of high harmonic generation in a differentially pumped Ar or H₂ gas jet

We experimentally studied the dependence of high harmonic generation in argon and molecular hydrogen on pressure changes in a gas jet that cause variations of the phase matching conditions and absorption. The study was performed at a peak laser intensity of ∼1.5 × 10(14) W/cm(2). To enable measurements over a wide range of pressures, we employed differential pumping with an additional cell (∼20 cm(3) volume) enclosing the gas jet. By increasing the pressure in the gas jet up to a maximum of 1.5 bars with argon or 0.5 bars with hydrogen, we observed an increase in the high harmonic (HH) yield until an optimum pressure of 0.2 bars was reached for Ar, beyond which the output began decreasing. For H2, we observed an increase of the HH output up to the maximum pressure of 0.5 bars. This pressure-dependence study allowed us to achieve a tenfold enhancement in the high harmonic yield at the optimum pressure.

White-light generation using spatially-structured beams of femtosecond radiation

We studied white-light generation in water using spatially- structured beams of femtosecond radiation. By changing the transverse spatial phase of an initial Gaussian beam with a 1D spatial light modulator to that of an Hermite-Gaussian (HGn,m) mode, we were able to generate beams exhibiting phase discontinuities and steeper intensity gradients. When the spatial phase of an initial Gaussian beam (showing no significant white-light generation) was changed to that of a HG01, or HG11 mode, significant amounts of white-light were produced. Because self-focusing is known to play an important role in white-light generation, the self-focusing lengths of the resulting transverse intensity profiles were used to qualitatively explain this production. Distributions of the laser intensity for beams having step-wise spatial phase variations were modeled using the Fresnel-Kirchhoff integral in the Fresnel approximation and found to be in good agreement with experiment.

In situ tomography of femtosecond optical beams with a holographic knife-edge

We present an in situ beam characterization technique to analyze femtosecond optical beams in a folded version of a 2f-2f setup. This technique makes use of a two-dimensional spatial light modulator (SLM) to holographically redirect radiation between different diffraction orders. This manipulation of light between diffraction orders is carried out locally within the beam. Because SLMs can withstand intensities of up to I ∼ 10(11) W/cm2, this makes them suitable for amplified femtosecond radiation. The flexibility of the SLM was demonstrated by producing a diverse assortment of "soft apertures" that are mechanically difficult or impossible to reproduce. We test our method by holographically knife-edging and tomographically reconstructing both continuous wave and broadband radiation in transverse optical modes.

Novel mutation in GLRB in a large family with hereditary hyperekplexia

Hereditary hyperekplexia (HH) is a disorder of the inhibitory glycinergic neurotransmitter system. Mutations in five genes have been reported to cause the disease. However, only single mutation in GLRB, the gene encoding beta-subunit of the glycine receptor, in a singleton patient with HH has been found to date. In this study, 13 patients with HH were identified through neurology and genetic clinics. Formal clinical examinations, linkage analysis, homozygosity mapping, in-mutation screening of GLRB and in silico functional analyses were carried out. A novel mutation in GLRB among nine patients was identified. This c.596 T>G perturbation results in the change of the highly conserved methionine at position 177 to arginine. Besides the classical HH phenotype, seven patients had esotropia and few of them had behavioral problems. This study presents a large family with HH as a result of homozygous mutation in GLRB and expands the clinical spectrum of HH to include eye misalignment disorder. Moreover, the report of these familial cases supports the previous evidence in a single patient of an autosomal recessive inheritance of HH because of defects in GLRB.

Is the Behcet's disease a risk factor for osteoporosis and is relation to cytokines?

BACKGROUND AND OBJECTIVES

To determine if the Behcet's disease poses a risk for a lower bone mineral density (BMD), and the relation to cytokines. Behcet's disease is a complex, multisystemic, chronic inflammatory disorder.

METHODS

This study was carried out on 60 patients and 24 sex- and age-matched healthy controls. Serum osteocalcin (OK) and bone specific alkaline phosphatase (BALP), which are bone formation markers and urine deoxipyridinolin (DOP) levels that is bone resorption marker were evaluated in patient and controls groups. Serum IL-1 and TNF-alpha levels were measured in both groups. BMD was measured with dual X-ray absorptiometry (DEXA) at the lumbar spine and left femur.

RESULTS

There were no significant differences in OK and DOP levels between BD and control groups. BALP levels were significantly higher in BD than control groups (p = 0.002). Although there were no statistically significant differences in IL-1 levels between BD and control groups, TNF-alpha levels were significantly higher in BD than control groups. There were significant differences in BMD values of lumbar spine (p < 0.05). No significant differences in BMD values of the left femur were detected in the groups (p > 0.05).

CONCLUSIONS

Behcet's disease can be a risk for osteoporosis especially in the lumbar spine. We determined a negative correlation between IL-1 and femur neck BMD (Tab. 4, Fig. 2, Ref. 23).

Growth hormone treatment prevents osteoporosis in uremic rats

INTRODUCTION

Growth hormone (GH) is responsible for longitudinal bone growth. GH-receptor in the growth plate was found to be decreased in chronic renal insufficiency. A therapeutic use of GH in chronic renal insufficiency is not established. The current study aims to clarify the effects of GH treatment on bone metabolism in a uremic rat model.

METHODS

Sprague Dawley rats were subjected to subtotal surgical renal ablation (SNX) or sham operation. SNX rats were randomized into 4 groups: treated with different doses of GH (1.5, 4.0, or 10.0 mg/kg) or vehicle after 10 weeks of uremia and treated for 6 weeks. Bone and renal morphology was evaluated: bone density, thickness of spongiosa, osteoblast surface, osteoid volume, osteoclast quantity, and resorptive volume.

RESULTS

GH treatment resulted in a decrease of resorption area and lower number of osteoclasts. Osteoid volume, number of osteoblasts, percentage of active osteoblasts, thickness of the growth plate and mean cortical width increased. GH receptor (GHR) protein expression increased in GH treated rats. IGF-1 expression was decreased in osteoblasts and chondroblasts of SNX-V rats and increased following GH treatment. The TGF-beta expression was down regulated in SNX+V group in osteocytes and chondroblasts as compared to sham operated animals. The down regulation was prevented in treated animals irrespective of the dose given.

CONCLUSIONS

Treatment with GH in uremic animals increased bone density to the levels of non-uremic controls. Thus GH seems to have a potential of preventing renal osteodystrophy.

Co-expression patterns of the neuropeptides vasoactive intestinal peptide and cholecystokinin with the transduction molecules α-gustducin and T1R2 in rat taste receptor cells

Taste receptor cells are primary sensory receptors utilized by the nervous system to detect the presence of gustatory stimuli in the oral cavity. These cells are particularly heterogeneous and may be divided into various subtypes based on morphological, histochemical, or physiological criteria. One example is the heterogeneous expression of neuropeptides, such as cholecystokinin and vasoactive intestinal polypeptide. These peptides are hypothesized to participate in the transduction processes. To pursue examination of this hypothesis, this study explored the relationship of peptide expression with two important and mostly non-overlapping transductive elements--the taste-specific G protein gustducin, involved in bitter and sweet transduction cascades, and the seven transmembrane taste receptor T1R2, hypothesized to respond to sweet compounds. Double labeling experiments were performed on taste buds of the posterior rat tongue combining immunocytochemistry for peptide expression and in situ hybridization experiments for either gustducin or T1R2 expression. Additionally, vasoactive intestinal peptide (VIP)-expression in posterior taste receptor cells was confirmed using the technique of RT-PCR. More than half (56%) of the CCK-expressing taste receptor cells co-expressed alpha-gustducin mRNA whereas far fewer (15%) co-expressed T1R2 mRNA. A majority of VIP-expressing taste receptor cells co-expressed alpha-gustducin mRNA (60%) whereas only 19% of these cells co-expressed T1R2 mRNA. More remarkable was the observation that these two peptides displayed almost identical expression patterns with these signal transduction molecules, suggesting that peptides are not randomly expressed with relation to signal transduction molecules. This observation supports the hypothesis that peptides may play roles in transduction. Further physiological exploration will be required to elucidate the nature of these roles.

The relatively good prognosis of bipolar disorders in a Turkish bipolar clinic

BACKGROUND

Bipolar affective disorder is considered to be a disabling illness with a relapsing and remitting course resulting in enduring psychosocial consequences. In this study, we aimed to determine the demographic and clinical characteristics of patients with bipolar illness, types of treatment at inpatient and outpatient settings and their outcome.

METHOD

Life charts of 61 bipolar outpatients and hospital charts of 47 manic inpatients were retrospectively evaluated regarding the demographics, course of illness and the treatment at both settings.

RESULTS

82.5% of the outpatients were euthymic and 42.5% were on lithium monotherapy at the time of investigation. Psychosocial adjustment was good. High level of education and marital status affected compliance positively. In the outpatient group, 24.2% were bipolar 2 (BP-II): they differed from bipolar 1 (BP-I) patients in having a higher number of lifetime episodes. Females outnumbered males in both settings, 11 had suffered higher numbers of previous episodes, as well as longer stays in hospital. Lithium was the most commonly used agent in acute mania (78.7%); 89.4% of the inpatients received combination treatment, mainly a mood stabilizer with a neuroleptic. Adjunctive neuroleptics decreased from 82.4 to 56.7% after 1995: This resulted in longer lengths of stay in hospital.

LIMITATIONS

Data were collected naturalistically in a non-blind fashion.

CONCLUSION

Lithium is still the leading mood stabilizer of choice for the acute and maintenance phases of bipolar disorder in our patient population. We submit that family support, high levels of education as well as an in-depth follow-up represented the contributory factors in the good overall outcome.

Protective effects of sucralfate and omeprazole on gastric mucosal damage induced by ethanol in rats

Studies on the protective effect of omeprazole, a proton-pump inhibitor, against damage to the rat gastric mucosa induced by strong irritants, are few and contradictory. We have investigated the protective effects of omeprazole and sucralfate against gastric mucosal damage induced by ethanol in rats. The study was performed on 4 groups of 10 rats each. Group A received omeprazole 7 mg/kg/day intraperitoneally (i.p.) for 7 days. Group B received an equivalent volume of 0.9% sodium chloride i.p. for 7 days, while no drugs were given to groups C and D. After 1 week, following 24 hours of fasting, group A received omeprazole 7 mg/kg, group B received an equivalent volume of 0.9% sodium chloride group C received omeprazole 7 mg/kg i.p. and group D received sucralfate, 100 mg/kg intragastrically (i.g.). 4 hours after groups A, B and C received the last medication and 30 minutes after group D received sucralfate, ethanol 95% was given i.g. All rats were sacrificed 1 hour after ethanol application and their stomachs were removed for macroscopic and microscopic examination. It was found that sucralfate was effective in preventing gastric lesions induced by ethanol. There was a significant difference between the sucralfate group and the other group (p < 0.001). Omeprazole was ineffective in preventing gastric lesions, either given as a single dose or after administration for 7 days. Our results indicate that sucralfate has a protective effect on gastric lesions induced by ethanol and omeprazole applied i.p. has no protective effect.

Behçet's disease and amyloidosis. Review of the literature

In this report, we present a patient with BD, amyloidosis and end-stage-renal-disease and discuss the literature on BD and amyloidosis. Forty-four patients with BD and amyloidosis are described in the literature. The type of amyloid fibrils were studied in 27 of this 44 patients and all were AA. The interval between the onset of first symptom of BD and the diagnosis of amyloidosis ranged from one to 27 years. This clinical observation and AA type amyloid fibrils in BD suggest that amyloidosis is secondary to inflammation. Behçet's disease should be considered in the differential diagnosis of AA amyloidosis.

Effect of dopamine on portal blood flow in cirrhotic patients

OBJECTIVE

The effects of dopamine infusion on portal blood flow were examined in 12 cirrhotic patients (seven men, five women) in a Child-B group.

METHODS

Dopamine was administered as an intravenous infusion (2 micrograms kg-1 min-1).

RESULTS

At 0, 30 and 60 min, portal blood flow, left ventricular systolic and diastolic functions were evaluated using the pulsed doppler method. No significant difference was found between heart rate, blood pressure and parameters demonstrating left ventricular systolic and diastolic functions before and after dopamine infusions. Portal blood flow decreased significantly at 30 and 60 min. Portal blood flow fell from 1802 +/- 88 to 1339 +/- 50 ml min-1 (P < 0.001) at 30 min and to 1121 +/- 60 ml min-1 (P < 0.001) at 60 min.

CONCLUSION

The reducing effects of dopamine on portal blood flow in cirrhotic patients were demonstrated by the pulsed doppler method, which is a noninvasive test.

Gastric emptying time in patients with primary hypothyroidism

BACKGROUND AND OBJECTIVES

Symptoms due to slowing of gastrointestinal motility constitute an important problem in most patients with primary hypothyroidism. The purpose of this study was to calculate gastric emptying time in patients with primary hypothyroidism using a radioisotopic method.

PATIENTS AND METHODS

Fifteen hypothyroid patients (2 male, 13 female) participated in the study. Mean age was 43 (range 38-50) years. Only patients who had been recently diagnosed and had received no previous therapy were included in the study. Radiological and endoscopic examination of the upper gastrointestinal tract was carried out. Patients with gastric outlet obstruction were excluded. Twelve healthy and euthyroid people with no detectable gastrointestinal pathology were examined as a control group. The mean age of this group was 45 (range 35-55) years. Patients and control group received a semisolid meal containing 1 mCi technetium-99m sulphur colloid and measurements were made from the epigastrium.

RESULTS

Mean gastric emptying half-time (t(half)) was 112.13+/-48.96 min in hypothyroid patients and 57.87+/-6.38 min in the control group. Gastric emptying time of the hypothyroid patients was significantly different from the control group (P< 0.001). There was no correlation between gastric emptying time and serum thyroid-stimulating hormone (TSH) levels.

CONCLUSION

We concluded that radioisotopic study is a safe, rapid and reliable method for determining gastric emptying time in patients with primary hypothyroidism.

Sectioning the hyoid bone as a therapeutic approach for obstructive sleep apnea

After research studies, including systematic lateral x-rays, of normal controls and obstructive sleep apnea syndrome (OSAS) patients, we decided to perform a medial resection of the hyoid bone in OSAS patients. The procedure is similar to that performed for ductus thyreoglossus. To date, three patients have undergone the operation under anesthesia. The two cases have been followed for several months (the third underwent surgery only recently) and have improved, indicating that this procedure can be beneficial for OSAS.

Impotence and blood pressure in the flaccid penis: relationship to nocturnal penile tumescence

Evaluations of nocturnal penile tumescence (NPT) and penile blood pressure were performed on (1) a group of nondiabetics with normal NPT, (2) a group of nondiabetics with abnormally diminished NPT, and (3) a group of diabetics with abnormally diminished NPT. The 12 subjects in each group complained of impotence. Analysis of blood pressure data taken before the NPT evaluation suggests the possibility of selective low arterial blood pressure in impotent patients who show no obvious signs of other vascular disorders.