The effect of quercetin on bone healing in an experimental rat model.

OBJECTIVES: This study aims to evaluate the effect of quercetin on fracture healing in an open fracture model in rats. MATERIALS AND METHODS: A total of 80 Wistar-Albino male rats were used in this study. The rats were divided into 10 groups. Daily oral treatment of 100 mg/kg of quercetin dissolved in corn oil were given to four groups, whereas the other four group of control rats were treated with corn oil only. Histopathological and radiological examinations of fracture healing were performed at the end of Weeks 2 and 4 in these rats, while biomechanical and biochemical examinations were performed at the end of Weeks 4 and 6, since harder callus was required. Among the rats in the last two group that were not subjected to the open fracture model, one group was given only quercetin for three weeks and the other for six weeks, and the biochemical markers in the blood were compared between these two groups. Computed tomography images were taken for radiological evaluation. The modified Lane and Sandhu scoring system was used for histological evaluation. The 3-point bending test was performed for biomechanical evaluation. For biochemical evaluation, plasma alkaline phosphatase (ALP), acid phosphatase (AP), total antioxidant status (TAS) and total oxidant status (TOS) levels were measured. RESULTS: Radiologically, there was no significant difference between the early-stage results of quercetin and control groups (p=0.247), while quercetin caused a significant increase in callus tissue in terms of latestage results (p=0.012). Histopathologically, there was no significant difference in the early stage (p=0.584); however, in the late stage, a borderline significant increase was observed in the quercetin group compared to the control group (p=0.091). Biomechanical analysis showed that quercetin significantly increased the fracture strength in the healing bone both in the early period (p=0.036) and in the late period (p=0.027). Among biochemical markers, TOS and AP were found to be significantly decreased in the quercetin group. In the non-operated and quercetin given groups, TAS levels was significantly higher (p=0.001) and AP levels were borderline significantly lower at the end of Week 6 (p=0.063). CONCLUSION: Quercetin did not have a significant effect on bone healing in the early period, but significantly promoted bone healing in the late period in rats. We recommend the use of quercetin, a strong antioxidant, in cases with high oxidative stress and conditions such as diabetes, smoking, and malnutrition which may inhibit fracture union, although further clinical studies are needed to confirm these findings.

Individualized Treatment of Tinnitus during Sleep Using Combined Tinnitus Signal and Music.

INTRODUCTION: Tinnitus is a widely seen otological symptom that interferes with daily activities and causes discomfort. Tinnitus treatments can be classified into 4 main groups: pharmacological treatments, cognitive and behavioral therapy, psychological treatments, and combined treatment approaches made up of at least 2 of these 3 treatment methods. OBJECTIVE: The aim of this study was to assess whether it would be possible to develop an individualized treatment method of tinnitus by application of a combined tinnitus signal and music during sleep. METHODS: Forty-three ears of 30 patients who had subjective tinnitus were included. The patients were evaluated using Tinnitus Handicap Inventory, Visual Analogue Scale, and Beck Depression Inventory. The psychoacoustic parameters of tinnitus, such as tinnitus frequency and loudness, and minimal masking levels, were determined. The patients were asked to select musical melodies that they liked. The tinnitus frequency of each patient was taken as the central frequency according to ANSI 2004. All sound files were prepared as stereo channels, with 16-bit resolution and 44,100 Hz sampling rate. The root mean square power value of the music and the band noise's average root mean square power value were equalized with the "Amplification" command, and 70% of the music and 30% of wide/narrow-band noise were mixed as a stereo channel by the "Mix Paste" command. The patients were instructed to listen to that individualized music/narrow-band noise (tinnitus signal) for 2 h during sleep for a duration of 6 months. RESULTS: Tinnitus frequencies of the patients measured prior to treatment and at the second, fourth, and sixth months of follow-up were not significantly different. A statistically significant decrease was seen in tinnitus loudness, minimal masking levels, and residual inhibition during the follow-up. Tinnitus Handicap Inventory scores decreased significantly during follow-up, and the number of patients who complained of tinnitus decreased (p < 0.05). The Visual Analogue Scale scores significantly decreased during follow-up (p < 0.05). Beck Depression Inventory scores decreased significantly during follow-up (p < 0.05). CONCLUSION: Stimulation of the auditory and limbic systems during sleep by the tinnitus signal combined with individualized musical melodies seems an alternative, effective, and cheap method in the treatment of tinnitus.

The Efficacy of Acupuncture in the Treatment of Bell's Palsy Sequelae.

OBJECTIVE: This study was planned to evaluate the effectiveness of acupuncture treatment for the treatment Bell's palsy sequelae. In this study, forty patients with Bell's palsy sequelae were randomly allocated to either the acupuncture or the control group. The clinical outcomes before and after treatment were assessed using the following assays: the facial nerve compound motor action potential and HouseeBrackmann (HB) and Sunnybrook (SB) grading scales. Agreement analysis was performed between the SB and HB grading scales. There was significant difference between pretreatment and posttreatment compound motor action potential values of the patients within the acupuncture group (p = 0.036). In pretreatment and posttreatment SB and HB scores, significant differences within the two groups were observed. However, the significance level in the improvement rate in the acupuncture group was higher than that of the control group. General agreement between the SB and HB scores of groups was an acceptable value, and weighted agreement between the scales was a moderate agreement. In this study, we found that acupuncture treatment is effective in improving Bell's palsy sequelae. Acupuncture can be used as a safe method in the treatment of Bell's palsy sequelae.

Resveratrol inhibits Src tyrosine kinase, STAT3, and Wnt signaling pathway in collagen induced arthritis model.

Resveratrol, a phytochemical, acts several cellular signaling pathways and has anti-inflammatory potentials. The purpose of this study is to research the therapeutic effect of resveratrol in collagen-induced arthritis (CIA) model in rats and whether resveratrol affects the activities of signaling pathways those are potent pathogenic actors of rheumatoid arthritis. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant in Wistar albino rats. One day after the onset of arthritis (day 14), resveratrol (20 mg/kg/day) was given via oral gavage, until day 29. The paws of the rats were obtained for further analysis. Tissue Wnt5a, mitogen-activated protein kinase (MAPK), Src tyrosine kinase and signal transducer, and activator of transcription-3 (STAT3) mRNA expressions were determined by real-time polymerase chain reaction. Resveratrol ameliorated the clinical and histopathological (perisynovial inflammation and cartilage-bone destruction) findings of inflammatory arthritis. The tissue mRNA expressions of Wnt5a, MAPK3, Src kinase, and STAT3 were increased in the sham group compared to the control group. Resveratrol supplement decreased their expressions. The present study shows that Src kinase, STAT3, and Wnt signaling pathway are active in the CIA model. Resveratrol inhibits these signaling pathways and ameliorates inflammatory arthritis. © 2018 BioFactors, 45(1):69-74, 2019.

Paricalcitol inhibits the Wnt/beta-catenin signaling pathway and ameliorates experimentally induced arthritis

Background/aim: The Wnt/ß-catenin pathway has important biological activities, including the differentiation of cells and joint formations. The aim of our study was to determine the effect of paricalcitol on experimentally induced arthritis. Materials and methods: Type II collagen combined with Freund's adjuvant was applied to induce arthritis in Wistar albino female rats. Paricalcitol (0.3 µg/kg daily) was subcutaneously injected starting 1 day after collagen applications (prophylactic group) or 1 day after the onset of arthritis (therapeutic group), until day 29. Results: The 29th day arthritis scores were lower compared to the 13th day scores in the paricalcitol groups (P < 0.05), while they were higher in the arthritis group (P < 0.05). Marked cartilage-bone destruction and extensive perisynovial inflammation were detected in the arthritis group. Decreased cartilage-bone destruction and perisynovial inflammation in the paws were observed in the paricalcitol groups. The tissue mRNA levels of DKK1, Wnt5a, and axin-2 were higher in the arthritis group than in the control group. In the paricalcitol groups, mRNA expressions were lower than in the arthritis group. Conclusion: The present study shows that the Wnt/ß-catenin signaling pathway is active in arthritis. Moreover, paricalcitol ameliorates arthritis via inhibiting the Wnt/ß-catenin pathway. Paricalcitol and the Wnt/ß-catenin pathway are candidates for research in human rheumatoid arthritis.

Benign transient hyperphosphatasemia in an infant during zinc supplementation.

Benign transient hyperphosphatasemia is characterized by a significant increase in alkaline phosphatase levels, which is detected incidentally in infancy and children without underlying bone and liver disease. This condition is a biochemical disorder rather than a clinical disorder and resolves within a short duration. Recognition of this entity by pediatricians is important to avoid unnecessary investigations. Here, we report an infant who was diagnosed as having benign transient hyperphosphatasemia based on clinical and laboratory findings who had increased alkaline phosphatase levels during zinc supplementation, with the aim of highlighting benign transient hyperphosphatasemia in infancy and childhood.

Repetitive Facial Nerve Stimulation Using Occipitalis Muscle.

PURPOSE: We aimed to evaluate the reliability and reproducibility of repetitive nerve stimulation recorded on occipitalis muscle by comparing recordings on nasalis muscle in healthy subjects. METHODS: A total of 23 healthy subjects (mean age: 44.7 ± 13.8 years) underwent detailed neurological examination and repetitive nerve stimulation using nasalis and occipitalis muscles. Amplitude and area percentage changes of compound muscle action potentials (CMAPs) after repetitive nerve stimulation with different frequency were compared between right and left sides and between recordings on nasalis and occipitalis muscles. RESULTS: Comparisons of percentage amplitude changes of nasalis and occipitalis CMAPs showed no differences (+0.1% ± 3.8% vs. +1.4% ± 3.9%, P = 0.129). Average area percentage change of nasalis CMAPs was 0.3% ± 19.0%, whereas the value of occipitalis CMAP was +2.8% ± 15.2% (P = 0.851). Comparisons of nasalis and occipitalis CMAPs values showed no differences. CONCLUSIONS: The repetitive nerve stimulation recorded on occipitalis muscle is simple, easy to apply, noninvasive, consistent, and reproducible.