Analysis of genetics and risk factors of Alzheimer's Disease.

Alzheimer's Disease is the leading neurodegenerative cause of dementia. The pathogenesis is not clearly understood yet, is believed to be the complex interaction between genetic and environmental factors. Consequently vascular risk factors and Apolipoprotein E genotyping are increasingly gaining importance. This study aimed at assessing the relationships between Alzheimer's Disease and Apolipoprotein E phenotype and vascular risk factors. Patients diagnosed with "possible Alzheimer's Disease" in the Gazi University, Department of Neurology, were included in the study and age-matched volunteer patients who attended the polyclinic were included as a control group. In this study, the risk factors including low education level, smoking, hyperlipidemia, higher serum total cholesterol levels, and hyperhomocysteinemia were found to be statistically significantly more common in the Alzheimer's Disease group in comparison to the Control Group, while all Apolipoprotein E ε4/ε4 genotypes were found in the Alzheimer's Disease group. The presence of the Apolipoprotein E ε4 allele is believed to increase vascular risk factors as well as to affect Alzheimer's Disease directly. The biological indicators which are used in identifying the patients' genes will be probably used in the treatment plan of the patients in the future.

[Outcomes after operative treatment of distal radius fractures - an analysis of 721 patients]. / Ergebnisse der operativen Versorgung distaler Radiusfrakturen - eine Analyse von 721 Patienten.

AIM OF THE STUDY: Treatment strategies in distal radius fractures differ nationally and internationally. Conservative and operative treatment options compete as well as implants, postoperative therapy regimens and the necessity of implant removal. In our institution operative treatment is favoured. In the following the results of 721 surgically treated patients are presented. PATIENTS: PATIENTS who underwent operative treatment of their distal radius fractures in our institution between 2008 and 2011 were retrospectively analysed. Following patient characteristics have been surveyed regarding age, sex, location of plate osteosynthesis, operation time, time of cast immobilisation and complications like infections, tendon ruptures, need of revision surgery. RESULTS: 721 patients (mean age: 59.03 years) were retrospectively analysed. 514 of them (71.29 %) were female. Time of operation was after a mean duration of 5.48 days. In 558 (77.39 %) patients we performed palmar plate osteosynthesis. 89 (12.34 %) had dorsal plate osteosynthesis and 74 (10.3 %) cases were treated with either K-wires or screws. 18 (2.5 %) patients had concomitant traumatic carpal tunnel syndrome and a concomitant SL rupture was seen in 38 (5.27 %) patients. 40 (5.55 %) patients underwent operative revision because of posttraumatic carpal tunnel syndrome (n = 15), tendon ruptures (n = 7), malposition of screws (n = 6), loss of reduction (n = 6) and infection (n = 3). Mean duration of in-hospital stay after operation was 6.6 days. Implant removal was performed in 77 (10.7) patients; 59 (8.2 %) patients had palmar plate osteosynthesis and 18 (2.5 %) patients had dorsal plating. CONCLUSION: Because of the low complication rate after operative treatment of distal radius fractures, osteosynthesis of this fracture seems to be warranted. Regarding the patients' higher age we have seen an unexpectedly long in-hospital stay with a mean time of 6.6 days. Herein attempts should be made to reduce time of in-hospital stay. In our opinion implant removal should not be recommended routinely.

Auditory event related potentials relate with the clinical progression in idiopathic generalized epilepsy.

Auditory event related potential (ERP) was studied in 60 patients with idiopathic generalized epilepsy and 33 age and sex matched healthy subjects. Thirty nine patients came to the control three months later and were reassessed. All auditory evoked potential latencies were prolonged in epileptics compared to those of healthy subjects. Multiple drug using or history of more than 100 seizures was associated with prolonged P3 latency. History of status epilepticus was observed together with prolongation of N2 and P3 latencies. Patients using their antiepileptic drugs more properly after the first control showed shortened P3 latency in the second control.

Combined (hormonal and microsurgical) therapy in infertile women with endometriosis.

Fifty patients with moderate or severe endometriosis received 5 mg/day lynestrenol for 6 months prior to microsurgery. A significant regression of the ovarian and peritoneal implants was observed in 72% of the cases after progestative treatment, but the presence of residual epithelium in all cases made surgical resection necessary. After preoperative medical treatment and microsurgery, intrauterine (living births) pregnancy rates of 60 and 47% were obtained in cases of moderate and severe endometriosis, respectively. The following prognostic factors were found in this series: the degree of endometriosis, the concomitant male factors, the decrease of endometriotic lesions after treatment, and the unilaterality of ovarian endometriosis.

Effect on ovulation of surgically induced endometriosis in rabbits.

To study the effect of endometriosis on follicular rupture, endometrial tissue was autografted to New Zealand White rabbits. Endometrium was surgically implanted into the peritoneal cavity or into the rectus muscle. Human chorionic gonadotropin was administered to induce ovulation. During three subsequent laparotomies, the number of corpora lutea and stigmata were counted. The viability of the implants was demonstrated histologically. Ovaries were removed during the last laparotomy and ovarian serial sections were examined. In rabbits with peritoneal induced endometriosis, the percentage of stigmata/corpora lutea was significantly decreased. Macroscopic study was confirmed by histological examination. Indeed, a high incidence of entrapped oocytes was found in rabbits with peritoneal endometriosis. Extraperitoneal endometriosis had no effect on ovulation. Our data demonstrated that endometriosis induced a failure of follicular rupture. After endometriumectomy, no failure to ovulate was observed, suggesting that the effect of endometriosis on the ovulation disappeared with excision of endometrial implants.

Surgical management of tubal obstruction at the uterotubal junction.

The advantages of microsurgical anastomosis for cornual occlusion are evaluated in a series of 82 pure cases of pathologic cornual occlusion. The term pregnancy rate was 44% and the ectopic pregnancy rate was 7%. The following factors were found influencing the pregnancy rate: maximized tubal length; preserved intramural portion; absence of chronic inflammation; absence of tubal inclusions; absence of tubal endometriosis.

[Unruptured luteinized follicle syndrome and experimental endometriosis in the female rabbit]. / Syndrome du follicule lutéinisé non rompu et endométriose expérimentale chez la lapine.

To study the effect of endometriosis on follicular rupture, endometrial tissue was autografted to New Zealand White rabbits. Endometrium was surgically implanted into the peritoneal cavity. Human chorionic gonadotropin was administered to induce ovulation. The viability of the implants was demonstrated histologically during three subsequent laparotomies, the number of corpora lutea and stigmata were counted. Ovaries were then removed and ovarian serial sections were examined. In rabbits with peritoneal induced endometriosis, the percentage of stigmata per corpora lutea was significantly decreased. Macroscopic study was confirmed by histological examination. Indeed, a high incidence of entrapped oocytes was found in rabbits with peritoneal endometriosis. Our data demonstrated that endometriosis induced a failure of follicular rupture.

[Morphological modifications in experimental hydrosalpinx]. / Modifications morphologiques dans l'hydrosalpinx expérimental.

Hydrosalpinges were mechanically induced in rabbits by ligation of the proximal and distal ends of the oviduct. Isthmic and ampullary biopsies were obtained at 2, 4 and 6 months after ligation. Deciliation and decrease of epithelial height were observed in the ampulla, but not in the isthmus. Microstereological study shows a decrease of both the number and the relative volume of capillaries in the ampullary muscularis. Considering the parallelism of time and localization between deciliation and reduction of vascularization, we suggest that epithelial deciliation is caused by vascular disorders. Our study shows also adrenergic denervation occurring in the muscularis.

Morphologic study of mechanically induced hydrosalpinges in rabbits.

Ligation of the proximal and distal ends of the rabbit oviduct was used to induce hydrosalpinges, which shows a remarkable resemblance, both macroscopically and microscopically, to human hydrosalpinges. Isthmic and ampullary biopsies obtained at varying intervals were examined with light microscopy. Progressive deciliation and decrease of epithelial and mucosal fold height were observed in the ampulla, but not in the isthmus. Microstereological study shows progressive reduction of both the number and the relative volume of capillaries in the ampulla. Considering the parallelism of time and localization, it is suggested that epithelial deciliation is caused by vascular disorders.