Targeted mesenchymal stem cell and vascular endothelial growth factor strategies for repair of nerve defects with nerve tissue implanted autogenous vein graft conduits.

Peripheral nerve gaps exceeding 1 cm require a bridging repair strategy. Clinical feasibility of autogenous nerve grafting is limited by donor site comorbidity. In this study we investigated neuroregenerative efficacy of autogenous vein grafts implanted with tissue fragments from distal nerve in combination with vascular endothelial growth factor (VEGF) or mesenchymal stem cells (MSCs) in repair of rat peripheral nerve defects. Six-groups of Sprague-Dawley rats (n = 8 each) were evaluated in the autogenous setting using a 1.6 cm long peroneal nerve defect: Empty vein graft (group 1), Nerve graft (group 2), Vein graft and nerve fragments (group 3), Vein graft and nerve fragments and blank microspheres (group 4), Vein graft and nerve fragments and VEGF microspheres (group 5), Vein graft and nerve fragments and MSCs (group 6). Nerve fragments were derived from distal segment. Walking track analysis, electrophysiology and nerve histomorphometry were performed for assessment. Peroneal function indices (PFI), electrophysiology (amplitude) and axon count results for group 2 were -9.12 ± 3.07, 12.81 ± 2.46 mV, and 1697.88 ± 166.18, whereas the results for group 5 were -9.35 ± 2.55, 12.68 ± 1.78, and 1566 ± 131.44, respectively. The assessment results did not reveal statistical difference between groups 2 and 5 (P > 0.05). The best outcomes were seen in group 2 and 5 followed by group 6. Compared to other groups, poorest outcomes were seen in group 1 (P ≤ 0.05). PFI, electrophysiology (amplitude) and axon count results for group 1 were -208.82 ± 110.69, 0.86 ± 0.52, and 444.50 ± 274.03, respectively. Vein conduits implanted with distal nerve-derived nerve fragments improved axonal regeneration. VEGF was superior to MSCs in facilitating nerve regeneration. © 2015 Wiley Periodicals, Inc. Microsurgery 36:578-585, 2016.

A Study on Olfactory Dysfunction in Turkish Population with using Survey Method and Validated Olfactory Testing.

The aim of this study was to evaluate the effect of olfactory dysfunction on quality of life (QOL), and to investigate olfactory dysfunction related self-reported clinical features in Turkish population. The participants were questioned about the presence of any olfactory dysfunction. Participants with a complaint of olfactory dysfunction were asked to fill out a survey and then a validated olfactory test was performed. We asked 2,824 volunteers whether they had olfactory dysfunctions or not. A total of 199 (6.7 %) people mentioned that they had, and filled out the questions in our survey. The mean age of the surveyed population was 44 ± 15 years. The current investigation produced four major findings (1) the feeling of inadequacy due to olfactory dysfunction was more common among females than males (2) there was a significant correlation between subjective olfactory complaints and objective olfactory testing (3) problems in QOL issues are typically reported primarily in the areas of safety and nutrition (4) the possible reasons for the olfactory dysfunction according to the volunteers were upper respiratory infections including rhinosinusitis (46 %), allergic rhinitis (27 %), severe face and head trauma (6.5 %). The effect of subjective olfactory dysfunctions on QOL among the Turkish population was investigated for the first time. Problems in daily life issues are typically reported primarily in the areas of safety and nutrition.

Diagnostic Role of ECG Recording Simultaneously With EEG Testing.

Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.

Is cognitive processing affected in adults with hypospadias?: P300 study.

BACKGROUND: Hypospadias is a common urogenital system disorder. The frenulum, which is the most sensitive area of the glans penis, is not present in patients with hypospadias. This may lead to a failure in sexual and ejaculatory function, and cause emotional problems affecting cognitive processes. AIM: We aimed to study auditory Event Related Potentials (ERP) in patients with hypospadias to understand the status of cognitive function. MATERIALS AND METHODS: Seventeen patients with hypospadias who presented to the Urology Outpatient Clinic of Çanakkale Military Hospital, and 11 healthy individuals of similar age were chosen. The auditory oddball paradigm with ERP from the Cz and Fz head regions were studied. The latency and amplitude of the P300 wave were measured. RESULTS: Both, the study and control groups consisted of young males. Although the study group had a longer P300 latency and lower P300 amplitude when compared to control group, the results were not statistically significant (p: 0.059 and 0.346 respectively). CONCLUSION: Although the results are not statistically significant, our findings indicate that there may be cognitive changes in patients with hypospadias. Further studies of larger sample size and older patient cohorts are needed.

The effect of obstructive sleep apnea on olfactory functions.

OBJECTIVES/HYPOTHESIS: The aim of this study was to investigate the effect of obstructive sleep apnea (OSA) on the parameters of olfactory functions (odor threshold, odor discrimination, and odor identification tests) for orthonasal olfaction, retronasal olfactory testing, and olfactory bulb (OB) volumes. STUDY DESIGN: Prospective clinical study. METHODS: This study was carried out in 78 volunteers between the ages of 20 and 60 years. The mean age of the patients was 46 ± 10.1 years. Patients were divided into three groups according to polysomnography results: 1) a control group, 2) a mild to moderate OSA group, and 3) a severe OSA group. Clinical features of the participants were evaluated with the Epworth Sleepiness Scale. Orthonasal and retronasal olfactory testing were performed with Sniffin' Sticks olfactory testing and retronasal olfactory testing, respectively. Olfactory bulb volumes were measured by planimetric manual contouring on magnetic resonance imaging (MRI). RESULTS: The current investigation produced four major findings: 1) The apnea-hypopnea index had a significant and strong negative correlation with odor threshold scores and odor discrimination scores; 2) The apnea-hypopnea index was significantly negatively correlated with odor identification score and both right and left OB volumes; 3) retronasal olfactory scores were not significantly affected by OSA; and 4) continuous O2 saturation had a significant positive correlation on orthonasal olfactory functions, particularly the odor threshold and discrimination scores. CONCLUSIONS: This study demonstrated that OSA had significant negative effects on all orthonasal olfactory tasks, especially on threshold and discrimination. MRI also revealed volumetric shrinkage of OB volumes.

The applicability of the "Sniffin' Sticks" olfactory test in a Turkish population.

BACKGROUND: Olfactory assessment is often neglected in clinical practice, although olfactory loss can assist in diagnosis and may lead to significant morbidity. "Sniffin' Sticks" is a modern test of nasal chemosensory performance that was developed in Germany and validated in many countries. Our aim was to validate the applicability of "Sniffin' Sticks" in a Turkish population. MATERIAL AND METHODS: The study included 123 healthy volunteers with a reported normal sense of smell and 51 patients complaining of a reduction in their olfactory function presenting either at rhinology or neurology clinics. The mean age of the subjects tested was 30.2±12.5 years in 126 males and 48 females. The participants were divided into 2 groups according to subjective olfactory function - healthy or abnormal. Each subject's olfactory function was assessed using the "Sniffin' Sticks" test. RESULTS: We found significant differences in "Sniffin' Sticks" test results between the abnormal and healthy groups. In healthy subjects, the 10th percentiles of odor threshold score, odor discrimination score, odor identification score, and TDI score were 7.25, 12, 11, and 32, respectively. Considering the 2 groups together, apple and turpentine were the least well-recognized odors from the 16 odors presented. CONCLUSIONS: Our study provides an update of normative values for routine clinical use of "Sniffin' Sticks" in a Turkish population. Also, the present study validates that "Sniffin' Sticks" olfactory test was applicable for clinical usage in a Turkish population.