Systemic administration of interleukin-10 attenuates early ischemic response following spinal cord ischemia reperfusion injury in rats.

BACKGROUND: The aim of this experimental study was to investigate the early effects of interleukin-10 (IL-10) and interleukin-1beta antagonist (anti-IL-1beta) against cellular damage, inflammatory reactivity, lipid peroxidation (LPO), and myeloperoxidase (MPO) activity induced by spinal cord ischemia reperfusion injury (IRI). METHODS: Thirty-two single strain female Albino rats were divided into four groups: control (sham-operated), IRI-alone, IL-10-treated (100 mug/kg), and anti-IL-1beta-treated (1 mg/kg) groups after IRI. IRI was induced by balloon occlusion of the aorta and simultaneous hypovolemia during occlusion. The animals were sacrificed at 24 h. Histopathological and ultrastructural analyses, biochemical studies for determination of LPO and MPO activity and Comet assays (single cell electrophoresis for detecting DNA single strand breaks) were performed in all study groups. RESULTS: Compared with the levels of control (sham-operated) animals, IRI produced a significant increase in the levels of LPO and MPO activity, and prominent tissue damage characterized by leukocyte infiltration, edema and neuronal and glial damage in the affected spinal cord in 24 h. The administration of IL-10 decreased LPO and MPO activity, and suppressed initial inflammatory response in the first 24 h. The effects of anti-IL-1beta were limited to decrease in LPO activity without considerable evidence of cellular preservation. CONCLUSIONS: These data suggest that systemic administration of IL-10 attenuates the early ischemic response, and may restrict the tissue damage in the first 24 h after spinal cord ischemia reperfusion injury. Anti-IL-1beta has no considerable effect in this time window. The results of this preliminary study promote further studies with longer time windows on the effects of anti-inflammatory cytokines in spinal cord IRI.

Age-related changes in the incidence of pineal gland calcification in Turkey: A prospective multicenter CT study.

The goal of this cross-sectional observational study was to determine the incidence of pineal gland calcification (PGC), to investigate the interaction of PGC and aging, and to compare the incidence of PGC among the populations living in Turkey. In a prospective study the rate of PGC on CT scans of 1376 individuals in six referral centers from different regions of Turkey was investigated, with emphasis on effects of climatological parameters and aging on PGC. It was found that the incidence of PGC increased rapidly after first decade and the increase remains gradual thereafter, higher in males than in females for all age groups. There was a significant difference for incidence and degree of PGC between different clinics and between both sexes (p<0.001). In addition, there was a significant difference for the degree of PGC between the clinics in low altitude group and those in high altitude group (p<0.001 for each). Logistic regression analysis revealed that age, sex, altitude and intensity of sunlight exposure significantly affected the risk of PGC (odds ratios (OR) 1.335, 95% confidence intervals (CI) 1.261-1.414, p<0.001; OR 1.900, 95% CI 1.486-2.428, p<0.001; OR 0.715, 95% CI 0.517-0.990, p<0.05; OR 0.997, 95% CI 0.994-0.999, p<0.01, respectively). Furthermore, by multiple linear regression analysis, high altitude and increased intensity of sunlight exposure were found to affect the degree of PGC (beta=0.003, p<0.001). It is concluded that there is a close relationship between PGC and the aforementioned parameters, supporting a link between the development of PGC and these. This study provides some reference data for new clinical studies on the putative role of pineal gland in future.

Complications and limitations related to periprostatic local anesthesia before TRUS-guided prostate biopsy.

PURPOSE: To assess the frequency of complications specifically related to local anesthetic infiltration prior to transrectal ultrasound (TRUS)-guided prostate biopsy. METHODS: A total of 200 patients receiving 10 cm(3) (5 cm(3) on each side) of 2% lidocaine injected around the periprostatic nerve plexus under TRUS guidance before prostate biopsy were included. Various complications presumed to be associated with local anesthesia were noted during and after the biopsy procedure. Two weeks later, periprostatic tissue integrity and vascularization were re-examined with TRUS Doppler examination to assess for fibrosis or infection. RESULTS: The most common finding was pain due to puncture with the needle used for local anesthesia (27%). Also recorded were the need for repeated injections during the biopsy procedure (4.5%), symptoms associated with systemic lidocaine toxicity (2%), urinary incontinence (1.5%), and degradation of the image resolution due to anesthetic injection (1%). Increased vascularization within the periprostatic region was uncommon (2%) on the 2-week follow-up examination. No TRUS finding consistent with rectal wall hematoma or other periprostatic change and no erectile dysfunction associated with the procedure occurred. There was a significant difference in overall pain scores between the subgroups of patients (p < 0.001). CONCLUSION: TRUS-guided periprostatic nerve blockade is an effective method for relieving discomfort from prostate biopsy with very few complications.

Power Doppler ultrasonography of the feeding arteries of the prostate gland: a novel approach to the diagnosis of prostate cancer?

OBJECTIVE: The purpose of this study was to assess the role of spectral Doppler ultrasonographic parameters of the feeding arteries of the prostate for the detection of prostate cancer. METHODS: A total of 55 patients referred for prostate biopsy with a mean age of 66.4 years (range, 46-82 years) were included. In each patient, Doppler indices from bilateral capsular and urethral arteries were obtained. The indices were compared with regard to malignant (group A) and benign (group B) subgroups of histopathologic outcomes of transrectal ultrasonographically guided prostate biopsy for each side (n = 19 and n = 91 for groups A and B, respectively) and to assess whether the indices were significantly altered on the side with cancer compared with the contralateral side. RESULTS: The mean pulsatility index value for the capsular artery of group A (1.49 +/- 0.57) was significantly lower than that of group B (1.71 +/- 0.52; P = .048). The mean resistive index and systolic/diastolic ratio for the capsular artery of group A (0.78 +/- 0.10 and 5.40 +/- 2.74, respectively) were lower than those of group B (0.82 +/- 0.08 and 7.40 +/- 4.91) despite being statistically insignificant (P = .075 and .119, respectively). CONCLUSIONS: Spectral waveform measurements by power Doppler transrectal ultrasonography may be useful in differentiating prostate cancer from benign hypertrophy. Further research is needed to elucidate the potential of spectral Doppler indices of the capsular and urethral arteries.

Screening for psychological distress in Turkish cancer patients.

The distress thermometer (DT) is a useful measure of psychological distress in cancer patients. Our objective was to investigate distress impact on oncology patients in Turkey and determine the optimal cut-off score on the DT for identifying clinically significant distress. One hundred and eighty two cancer patients completed the DT, Problem List (PL), and Hospital Anxiety and Depression scale (HADS), The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30 version 3.0). The receiver operating characteristic (ROC) curve analyses of DT scores yielded an estimated area under the curve of 0.66 when compared to the HADS cut-off score, suggesting the DT is an effective scale to discriminate between classified cancer patients both with and without clinically significant distress. The DT cut-off score of 4 yielded the optimal combination of sensitivity and specificity. Scores on the DT were moderately correlated to the HADS (p<0.01) and EORTC QLQ-C30. Based on the significant correlations, we conclude that the DT has acceptable criterion validity.

Evaluation of parenchymal changes at the operation site with early postoperative brain diffusion-weighted magnetic resonance imaging.

PURPOSE: To evaluate diffusion changes in the brain parenchyma at the operation site during the first 24 hours following surgery. MATERIALS AND METHODS: The study group consisted of 52 patients, 39 who had tumor resection surgery and 13 who had epilepsy surgery. Early postoperative magnetic resonance imaging (MRI) included diffusion-weighted imaging (DWI) and routine contrast-enhanced cranial MRI, together with T2* weighted images on a 3T system. DWI findings and the presence of hemorrhage in the brain parenchyma were evaluated. Correlation between the findings, the primary lesion leading to surgery, and operation site were evaluated. RESULTS: Diffusion restriction in the parenchyma surrounding the resection cavity was seen in 17 tumor patients (32.7%, n=52) and in 8 epilepsy patients (15.4%, n=52). DWI showed increased diffusion in 7 patients and no abnormality in 4 patients. Twenty patients showed restricted diffusion pattern related to hemorrhage (38.5%, n=52). CONCLUSION: Restricted diffusion was the most common abnormality observed in the early postoperative DWI of brain parenchyma at the operation site after surgery, which suggested tissue injury caused by surgery. Yet, hemorrhaging in the operation bed can constitute another cause of a reduced apparent diffusion coefficient (ADC) value. Increased diffusion and normal diffusion can also be observed, though rarely.

Epidemiologic characteristics of rhinitis in Turkish children: the International Study of Asthma and Allergies in Childhood (ISAAC) phase 2.

Rhinitis is a common problem with important comorbidities. In order to search the association between rhinitis, allergic phenotypes and other risk factors in Turkish children, a parental questionnaire about allergic diseases and risk factors, and skin prick test (SPT) with 13 inhalant allergens were performed in a population-based sample of 2774 children aged 9-11 yr. Bronchoprovocation testing with hypertonic saline (HS)and total IgE analysis were limited to a subsample of 350 children. Rhinitis was defined as a problem with sneezing, rhinorrhea, or nasal congestion when the child did not have a viral respiratory infection. The prevalences of ever rhinitis, current (last 12 months) rhinitis (CR), and ever hay fever were 36.3%, 30.6%, and 8.3%, respectively. SPT positivity rate was 20.4% among children with CR. Current wheezing and flexural dermatitis were significantly associated with CR. CR significantly increased the risk of asthma among both atopic and non-atopic subjects [odds ratio (OR), 3.98; 95% CI, 1.81-8.76; and OR, 2.79; 95% CI, 1.82-4.26, respectively]. The association between CR and bronchial hyperreactivity (BHR) was not significant. The multiple logistic regression analysis revealed family atopy (OR=2.25, 95% CI=1.79-2.83, p<0.001), current indoor heating with gas stove (OR=1.78, 95% CI=1.18-2.64, p=0.006) and dampness/molds at home during the first year of life (OR=1.70, 95% CI=1.25-2.31, p=0.001) as significant risk factors for CR. Turkish school children showed a high prevalence of rhinitis with a preponderance of non-atopics. The highly significant association between rhinitis and asthma independent of atopic sensitization emphasize the importance of non-atopic forms of rhinitis.

Causes of chemoreduction failure in retinoblastoma and analysis of associated factors leading to eventual treatment with external beam radiotherapy and enucleation.

PURPOSE: To evaluate the causes of chemoreduction failure in retinoblastoma and to analyze the associated factors for eventual treatment with external beam radiotherapy and enucleation. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Seventy-one patients with 105 eyes with intraocular retinoblastoma that underwent chemoreduction therapy between October 1998 and January 2003. INTERVENTION: A 6-treatment cycle of chemoreduction therapy with vincristine, etoposide, and carboplatin was administered at monthly intervals. Unresponsive disease was defined as persistence of retinal tumors, vitreous seeds, or subretinal seeds after the second treatment cycle, with no appreciable sign of regression. Eyes with unresponsive disease were enucleated after the second treatment. Eyes that responded to chemoreduction therapy received focal treatment, including indirect laser photocoagulation, transpupillary thermotherapy, cryotherapy, and ruthenium 106 episcleral plaque radiotherapy after the second chemoreduction treatment, if necessary, to achieve complete tumor regression. Recurrence was defined as the regrowth of retinal tumors, vitreous or subretinal seeds after an initial favorable response, and regression. Recurrent retinal tumor, vitreous seeds, or subretinal seeds were treated with focal treatments and 2 to 3 additional chemoreduction treatments. When these methods failed or were not applicable, external beam radiotherapy and/or enucleation was administered. MAIN OUTCOME MEASURES: The use of external beam radiotherapy and enucleation for chemoreduction failure, which was defined as unresponsive or recurrent disease. RESULTS: The mean follow-up was 25.7 months (range: 6-49). Ten of 105 eyes (9.5%) with unresponsive disease were enucleated after the second treatment. Of the remaining 95 eyes, 42 (44.2%) developed recurrence after chemoreduction. Recurrent disease failing to be treated successfully by other methods was treated with external beam radiotherapy in 26 of 95 eyes (27.4%) and enucleation in 22 of 95 eyes (23.2%). External beam radiotherapy was successful in preventing enucleation in 20 of 26 eyes (76.9%). Overall, the globe salvage rate was 69.5%, ranging from 36.1% for Reese-Ellsworth group V disease to 87.0% for groups I to IV disease. Histopathologically, 29 of 31 enucleated eyes (93.5%) had poorly differentiated or moderately differentiated retinoblastoma. Using multivariate logistic regression analysis, factors predictive of eventual treatment with external beam radiotherapy were female gender (P = 0.010), presence of subretinal seeds (P = 0.023), and a greater number of chemoreduction treatments (P = 0.027). By multivariate analysis, the factors associated with the need for eventual treatment with enucleation were recurrence of retinal tumors (P = 0.004), presence of vitreous seeds (P = 0.008), greater tumor thickness (P = 0.015), presence of subretinal fluid (P = 0.040), and older patient age (P = 0.042). CONCLUSIONS: Chemoreduction failure in this article was defined as unresponsive or, more commonly, recurrent retinoblastoma. Older patient age, greater tumor thickness, presence of vitreous seeds and subretinal fluid at baseline, and retinal tumor recurrence after chemoreduction were factors associated with the need for enucleation.

Time distribution of seizures during long-term video-EEG monitoring.

The purpose of this study was to investigate the duration of monitoring, number of seizures recorded, and date and time of occurrence of seizures in different patient groups during video-EEG monitoring (VEEGM). Patients with partial or psychogenic seizures who were admitted to our VEEGM unit between September 1996 and March 2002 were retrospectively evaluated. Duration of monitoring, date and time of occurrence of seizures were identified in each patient. For practical reasons, a day was divided into 3 equal time periods (period 1: 08-16; period II: 16-24 and period III: 24-08 hrs), and the period in which the seizure occurred was noted. Patients were classified in 5 groups: 1-temporal; 2-frontal; 3-parieto-occipital; 4-psychogenic and 5-unclassified. Duration of monitoring, the number of seizures recorded and time distribution of seizures were identified in each group and compared statistically. We evaluated 746 seizures in 209 patients. Seizures were more likely to occur in periods I and III in groups 1 (p = 0.004) and 5 (p < 0.001). In group 4 they were more likely to occur in periods I and II (p < 0.001). Duration of monitoring was not statistically different between the groups. However, the number of seizures recorded varied significantly (p = 0.006). Patients in group 5 had the greatest number of seizures and were followed by groups 2, 4, 3 and 1, respectively. Groups also differed according to date of seizure occurrence (p < 0.001). We conclude that the number of seizures recorded and time distribution of seizures during VEEGM are influenced by the lobe of onset of seizures.