Estimating motor unit numbers from a CMAP scan: Repeatability study on three muscles at 15 centres.

OBJECTIVE: To assess the repeatability and suitability for multicentre studies of MScanFit motor unit number estimation (MUNE), which involves modelling compound muscle action potential (CMAP) scans. METHODS: Fifteen groups in 9 countries recorded CMAP scans twice, 1-2 weeks apart in healthy subjects from abductor pollicis brevis (APB), abductor digiti minimi (ADM) and tibialis anterior (TA) muscles. The original MScanFit program (MScanFit-1) was compared with a revised version (MScanFit-2), designed to accommodate different muscles and recording conditions by setting the minimal motor unit size as a function of maximum CMAP. RESULTS: Complete sets of 6 recordings were obtained from 148 subjects. CMAP amplitudes differed significantly between centres for all muscles, and the same was true for MScanFit-1 MUNE. With MScanFit-2, MUNE differed less between centres but remained significantly different for APB. Coefficients of variation between repeats were 18.0% for ADM, 16.8% for APB, and 12.1% for TA. CONCLUSIONS: It is recommended for multicentre studies to use MScanFit-2 for analysis. TA provided the least variable MUNE values between subjects and the most repeatable within subjects. SIGNIFICANCE: MScanFit was primarily devised to model the discontinuities in CMAP scans in patients and is less suitable for healthy subjects with smooth scans.

The Effects of Lung Ischaemia/Reperfusion on TRPM Gene Expression

ABSTRACT Objective: Transient receptor potential melastatin (TRPM) are integral membrane proteins that have broad range of cellular functions. Roles of TRPM2, TRPM3, TRPM4 and TRPM7 among these channels are very important, and their roles in lung ischaemia/reperfusion injury have not been evaluated yet. The aim of this study is to investigate the contribution of these genes in lung ischaemia/reperfusion injury and evaluate histopathology of tissues. Methods: A total of 40 Wistar albino rats were enrolled for the study. Ischaemia was performed by the application of an atramvatic clamp to pulmonary artery. Gene expressions were determined by the semi-quantitative reverse transcription-polymerase chain reaction method. Histopatholical evaluations were held by a standard haematoxyline-eosin staining. Results: The major histopathological tissue damage was observed in ischaemia performed groups, and expression of TRPM channels was found to be obviously downregulated. Substantial changes were determined between TRPM2, TRPM3, TRPM4 and TRPM7 and lung ischaemia/reperfusion injury. In particular, expression of TRPM2 and TRPM7 was reversibly downregulated in ischaemia. Yet, the expression of TRPM3 and TRPM4 was irreversibly down-regulated after ischaemia. Conclusion: Consequently, these results indicate that TRPM family of cation channels may have significant roles in the lung ischaemia/reperfusion injury.

Can curcumin modulate allergic rhinitis in rats?

OBJECTIVES: This study aimed to explore the effects of curcumin on experimental allergic rhinitis in rats. METHODS: Twenty-eight male Wistar albino rats were randomly divided into four groups: a control group; a group in which allergic rhinitis was induced and no treatment given; a group in which allergic rhinitis was induced followed by treatment with azelastine hydrochloride on days 21-28; and a group in which allergic rhinitis was induced followed by treatment with curcumin on days 21-28. Allergy symptoms and histopathological features of the nasal mucosa were examined. RESULTS: The sneezing and nasal congestion scores were higher in the azelastine and curcumin treatment groups than in the control group. Histopathological examination showed focal goblet cell metaplasia on the epithelial surface in the azelastine group. In the curcumin group, there was a decrease in goblet cell metaplasia in the epithelium, decreased inflammatory cell infiltration and vascular proliferation in the lamina propria. CONCLUSION: Curcumin is an effective treatment for experimentally induced allergic rhinitis in rats.

An unusual case in endocrinology practice: Suture granuloma.

OBJECTIVE: Suture granuloma, the rare complication of thyroidectomy, results from the use of nonabsorbable suture materials. Despite its typical ultrasound images and benign course, it carries utmost importance in the diff erential diagnosis of lymph nodes, recurrent nodules, and recurrence in the case of thyroid cancers. Subject and Results. Fifty four years old female patient, who underwent bilateral thyroidectomy in July 2010, was diagnosed with multinodular goiter and incidentally discovered micropapillary carcinoma (2 mm). Four years later, she was readmitted to hospital due to painless swelling in the right and left anterior neck region. Ultrasonography revealed nodules with irregular boundaries, containing micro- and macro-calcifications and hyperechoic lines in both sides of the thyroid bed and isthmus. Fine needle aspiration biopsy was performed in the right and left sided mass and the cytological examination was compatible with the diagnosis of the suture granuloma. CONCLUSIONS: Suture granuloma should be considered in the differential diagnosis of the local recurrence.

Metastatic Melanoma of the Parotid Glands Bilaterally.

Melanoma is the most serious form of skin cancers and life-time risk of melanoma is increasing rapidly both in men and women. Melanoma in the parotid gland is seen rarely and it is more likely to be metastatic disease. We present here a rare case of metastatic malignant melanoma from the forehead skin to the parotid glands bilaterally.

TRP genes family expression in colorectal cancer.

UNLABELLED: Colorectal cancer (CRC) is the most common cancer of the gastrointestinal tract. Different factors are responsible for the development of CRC. Transient Receptor Potential (TRP) which is an important component of calcium channel is associated with several pathological conditions like cancer, neurodegenerative and cardiovascular diseases. Thirty members of the family of TRP ion channel in mammals have been determined till now. The aim of this study is to investigate TRPM, TRPV and TRPC gene expression levels in tumor tissues of CRC patients and to analyze the relationship of expression in tumor tissue of CRC with other known prognostic factors. MATERIAL AND METHODS: In this study, 93 CRC patients were included. The level of TRP gene expression in paraffin blocks of normal and cancerous colorectal tissue samples were studied at the level of mRNA with Real-time PCR. RESULTS: The mRNA expression level of TRPV3, TRPV4, TRPV5, TRPM4 and TRPC6 genes in 37 female and 56 male patients diagnosed with CRC was revealed lower in tumor tissue as compared to normal tissue (p < 0.05). No statistically significant differences of mRNA expression levels of other TRP genes were found. CONCLUSIONS: TRP gene family like TRPV3, TRPV4, TRPV5, TRPM4 and TRPC6 may be thought as potential genes contributing to tumorigenesis as their expression decreases in CRC as compared to normal tissues.

Is there any association between childhood cardiac septal defects and ROCK2 gene polymorphism?

Rho/Rho-kinase pathway plays a critical role in the regulation of cellular functions such as proliferation and migration. One of the possible theories of the development of ventricular septal defects is cell migration disorder. The aim of this study was to analyze the genotype distributions and allele frequencies for the ROCK2 gene Thr431Asn polymorphisms in the development of cardiac septal defects in a Turkish population. In this case-control study, 300 patients with cardiac defects (150 patients with ventricular and 150 patients with atrial septal defects) and control group (150 healthy control subjects) were investigated. A single-nucleotide polymorphism in ROCK2 gene Thr431Asn was analyzed by real-time PCR using a Light-Cycler. Neither genotype distributions nor the allele frequencies for the Thr431Asn polymorphism showed a significant difference between the groups. These results suggest that there is no association of the ROCK2 gene Thr431Asn polymorphism with the development of cardiac septal defects in pediatric patients.

Effect of verapamil and lidocaine on TRPM and NaV1.9 gene expressions in renal ischemia-reperfusion.

BACKGROUND: To determine effects on calcium and sodium channels of Ca(2+) and Na(+) channel blockers in the present study, expression levels of TRPM1, TRPM2, TRPM3, TRPM4, TRPM5, TRPM6, TRPM7, TRPM8, and NaV1.9 genes were evaluated in kidney tissues after induced ischemia-reperfusion. MATERIAL AND METHODS: Forty albino Wistar male rats were equally divided into 4 groups as follows: group I: control group (n = 10), group II: ischemia group (60 minutes of ischemia + 48 hours of reperfusion; n = 10), group III: ischemia (60 minutes of ischemia + 48 hours of reperfusion) + calcium channel blocker (n = 8), group IV: ischemia (60 minutes of ischemia + 48 hours of reperfusion) + sodium channel blocker (n = 8). RESULTS: When compared to ischemia group expression levels of TRPM2, TRPM4, TRPM6, and NaV1.9 in Ca(2+) and Na(+) channel blocker groups were increased, whereas that of TRPM7 was decreased. However, expression levels of TRPM1, TRPM3, TRPM5, and TRPM8 were not determined in kidney tissue. Histologically, the Ca(2+) channel blocker verapamil and the Na(+) channel blocker lidocaine inhibited the cell death in kidney tissue compared to control. CONCLUSION: Our study suggested that verapamil and lidocaine significantly reduce the degree of ischemia-reperfusion injury due to effects to TRPM and Nav1.9 genes.

The effects of sevoflurane and propofol anesthesia on renal sodium-potassium adenosine triphosphatase activity during pneumoperitoneum in rats.

OBJECTIVE: To evaluate the renal sodium-potassium adenosine triphosphatase (Na+/K+ATPase) activity, kidney morphology, and the probable protective effects of 2 different anesthetic agents used during pneumoperitoneum (PP). METHODS: The study was performed at Gazi University Experimental Research Center, Ankara, Turkey between January and July 2009. Twenty-four Wistar albino male rats weighing 320-380 g were randomly allocated to 4 groups after receiving ethics committee approval. All rats were cannulated, intubated, and ventilated under ketamine anesthesia. No further surgical intervention was performed for group I. An intraabdominal pressure (IAP) of 10 mm Hg was created by CO2 insufflation in 18 animals for one hour. The animals in group II received no further anesthetic agents, while the animals in groups III and IV received propofol and sevoflurane. At the end of the protocol, all animals underwent left nephrectomy without sacrificing. Urine was collected from each animal for the following 24 hour for the evaluation of urine creatinine and protein. RESULTS: The activity of renal Na+/K+ATPase was significantly lower in groups II (p=0.014), III (p=0.019), and IV (p=0.032) compared to group I. The pathological score was significantly higher in groups II (p=0.017), III (p=0.028), and IV (p=0.039) compared to group I. No statistically significant difference was found among groups II, III, and IV in terms of Na+/K+ATPase activity and pathological scores. CONCLUSION: Elevated IAP is related with impaired kidney functions and morphology, and the so-called renoprotective agents neither improved, nor worsened PP-related renal impairment.

Occupational lead exposure effect on liver functions and biochemical parameters.

The effect of occupational lead exposure on the liver function and on the blood biochemical parameters among the battery workers and the muffler repair workers was studied. The study included 22 battery and 38 muffler repair workers. Whole blood lead levels were determined by atomic absorption spectrophotometers. Total protein, albumin, globulin, cholesterol, triglyceride, total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyltransferase (GGT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) levels were determined in the serum by spectrophotometry. The blood lead levels of the battery workers, muffler repair workers, and the controls were found to be 36.83 +/- 8.13 microg/dL, 26.99 +/- 9.42 microg/dL, and 14.81 +/- 3.01 microg/dL, respectively. Blood lead levels of the workers were significantly higher than those of controls (p < 0.001). The lead level of the battery workers was also significantly higher than that of muffler repair workers (p < 0.001). Although, statisticly significant, higher blood lead levels are not related to toxicity for battery and muffler repair workers. Total protein, globulin, cholesterol, LDH, and ALP levels were within normal levels, however, they were slightly higher than the control levels. Increased LDH among the workers seems to be related rather to other causes than to the liver injury.

Deletion mapping of chromosome 4q22-35 and identification of four frequently deleted regions in head and neck cancers.

Head and neck squamous cell carcinoma (HNSCC) is a diverse group of cancers that are frequently aggressive in their biologic behavior. Inactivation of tumor suppressor gene (TSG) is one of the most critical steps leading to HNSCC. Loss of heterozygosity analysis is very sensitive method for the detection of frequent allelic loss in a chromosomal locus. This method has been considered as an important evidence for the localization of TSGs. We analyzed loss of heterozygosity (LOH) at chromosome 4q22-35 region by using 14 polymorphic microsatellite markers in 83 matched normal and HNSCC tissues. LOH was detected at least in one location in 71 of 83 (86%) tumor tissues. Frequent deletions were detected at the location of microsatellite markers, D4S2909 (46%), D4S2623 (51%), D4S406 (48%), D4S1644 (45%) and D4S2979 (40%). Four different frequently deleted regions at 4q22, 4q25, 4q31 and 4q34-35 were observed. These regions include several putative TSGs such as Caspase-6, SMARCAD1, SMARCA5, SAP30 and ING2. Further molecular analysis of each gene should be performed to clarify their roles in head and neck squamous cell carcinogenesis.

The effect of nicotine on the recovery of rats receiving anesthesia.

OBJECTIVE: To determine the effect of intraperitoneal (ip) nicotine on the recovery of rats receiving general anesthesia compared with placebo. METHODS: The placebo controlled experimental study was conducted in the Faculty of Medicine, Gazi University, Turkey, between April and May 2005. Twenty-one male and 21 female rats were randomly divided into 3 groups. Group C (n=14), comprising a female group CF (n=7), and male group CM (n=7) received ip 0.9% sodium chloride (NaCl), group P (n=14), comprising a female group PF (n=7), and male group PM (n=7) received ip propofol 150 mg/kg, and group NP (n=14), comprising a female group NPF (n=7), and male group NPM (n=7) received 0.4 mg/kg ip nicotine followed by 150 mg/kg propofol after 15 minutes. For the evaluation of recovery period, tail pinch test was used, and for cognitive performance, the radial arm maze test was used. RESULTS: The number of entrances and exits decreased in group P significantly compared to group C (p<0.05), and the decrease in group PF was higher than it was in group PM. Entrance and exit in group NP increased significantly compared to group P (p<0.05). The increase in entrance and exit in group NPF was much higher compared to group NPM. The recovery period in group NP was significantly shorter than in group P (p<0.05). CONCLUSION: The ip administration of nicotine in rats shortens the recovery from propofol anesthesia and improves cognitive performance.

The long-term effects of low-dose 17beta-estradiol and dydrogesterone hormone replacement therapy on 24-h ambulatory blood pressure in hypertensive postmenopausal women: a 1-year randomized, prospective study.

OBJECTIVE: The aim of this study was to assess the long-term effects of low-dose oral hormone replacement therapy (HRT) on 24-h blood pressure in hypertensive postmenopausal women. STUDY DESIGN: In this 12-month, prospective study, 66 postmenopausal women with mild or moderate hypertension were randomly assigned to receive either HRT with 1 mg/day micronized 17beta-estradiol sequentially combined with 10 mg/day dydrogesterone for 14 days of each 28-day cycle, or no therapy. Ambulatory blood pressure measurements were recorded for a 24-h period at baseline and after 12 months of treatment or follow-up. RESULTS: Blood pressure did not differ significantly between the groups at baseline. After 12 months, there were falls in 24-h systolic, diastolic and mean arterial blood pressure in both the HRT and control groups; only the fall in mean arterial blood pressure in the HRT group achieved statistical significance (-2.0 +/- 0.8 mmHg, p < 0.01). While there was no significant decrease in daytime systolic or mean arterial blood pressure in either group, a significant decrease in diastolic blood pressure (-1.8 +/- 10 mmHg, p < 0.001) was observed in the HRT group. Night-time systolic and mean arterial blood pressure also decreased significantly (p < 0.001) in the HRT group (-3.0 +/- 1.5 mmHg and -2.2 +/- 0.6 mmHg, respectively), but no significant change was observed in the control group. CONCLUSION: Low-dose oral HRT caused significant falls in both daytime and night-time ambulatory blood pressure in postmenopausal women with mild or moderate hypertension.

Depot-medroxyprogesterone acetate in anticoagulated patients with previous hemorrhagic corpus luteum.

OBJECTIVE: To investigate the safety of depot-medroxyprogesterone acetate (DMPA) in women of reproductive age with prosthetic heart valves, as well as the impact of DMPA on the prevention of hemorrhagic corpus luteum in these patients with previous bleeding events. METHODS: In this prospective study we enrolled 13 patients who were receiving chronic anticoagulation for prosthetic heart valves, and who suffered from ovarian bleeding. After the initial bleeding episode(s), DMPA was initiated with the intent of preventing recurrent bleeding events by means of ovulation suppression. Follow-up included close monitoring of anticoagulation intensity, lipid profile, measurement of systolic and diastolic blood pressures and weight, and a general physical and gynecological examination. RESULTS: Of the participating 13 patients, one stopped DMPA after the third injection because she wanted to have a child. Among the remaining 12 women, over a mean follow-up of 39.9 months all patients were well and no hemorrhagic corpus luteum was observed. During the follow-up, anticoagulation intensity, assessed by the international normalized ratio (INR), was in the optimum therapeutic ranges at all times (range 2.5-3.5), except for values of 4.6, 5.8 and 5.9 in three patients at 9, 12 and 24 months, respectively. With regard to lipid profile, we observed a significant decrease in high-density lipoprotein cholesterol levels at 12 months, and significant increases in total cholesterol and triglyceride levels after 30 months compared to baseline serum levels. No significant changes were observed in serum low-density lipoprotein cholesterol levels. Mean body weight was higher at months 12 and 30, compared with baseline values (p > 0.05). CONCLUSION: DMPA, which is an effective contraceptive agent, can be used to prevent bleeding from the corpus luteum by means of ovulation suppression in anticoagulated patients with prosthetic heart valves. However, meticulous surveillance should be provided during the follow-up, including close monitoring of anticoagulation intensity and lipid profile.

Turns-amplitude analysis of the electromyographic recruitment pattern following upper motor neuron lesions.

OBJECTIVE: To assess the pattern of motor unit recruitment of weak muscles in upper motor neuron (UMN) lesions. MATERIALS AND METHODS: Ten patients underwent turns-amplitude analysis (TAA) on the paretic and healthy brachial biceps muscles, in the acute and subacute stages of hemiparesis. The control group comprised 10 age- and sex-matched subjects. RESULTS: Although absent in the acute stage, five patients developed a myogenic cloud pattern in their paretic extremities in the subacute stage; which was statistically significant when compared with controls (P = 0.033). Mean amplitude was reduced in both acute and subacute stages of the hemiparesis compared with controls (P = 0.000). The turns/mean amplitude ratio in the subacute stage was increased compared with both the paretic limbs examined in the acute stage (P = 0.000) and to controls (P = 0.000). CONCLUSION: Abnormalities in the recruitment of motor units in UMN lesions give rise to a myogenic cloud pattern in the TAA, which is prominent in the third month after the initial insult. This may result from the increase in motor unit activity, while the recruitment of bigger motor units is still defective.

Blood lead levels of the battery and exhaust workers and their pulmonary function tests.

In an attempt to understand the impact of inhaled lead on the pulmonary functions, we assessed the blood lead levels and pulmonary functions of the battery and exhaust workers who are potential candidates for lead inhalation. The hospital staff served as control group. The measurements of lead levels were performed using atomic absorption spectrophotometry. Pulmonary function tests (PFTs) were performed using a portable spirometer. The blood lead levels of the battery workers, exhaust workers and controls were found to be 36.83, 26.94 and 14.81 microg/dl, respectively. The values of the workers were significantly higher than the controls (p < 0.001). The lead levels of the battery workers were also significantly higher than the exhaust workers (p < 0.001). PFT results (maximum voluntary ventilation, forced expiration flow and first forced expiration volume values of the workers) were significantly worse than the controls, and their pulmonary function test results were consistent with restrictive problems in the airways.

Effect of nicotine exposure during gestation on neonatal rat crystalline lenses.

PURPOSE: To assess histologically the influence of maternal nicotine exposure during gestation in vivo on crystalline lenses in neonatal rats using different dosages of the test compound simulating the range of low, moderate, and heavy smokers in humans. METHODS: Experimentally naive, adult female Wistar-albino rats (200-250 g) were mated with adult male rats over 2 days for copulation in the proportion of two females for every male animal. After confirming pregnancy with vaginal smear method, 40 gravid rats (dams) were then randomly assigned into four equal groups (three experimental and one control; n=10 in each). Groups 1, 2, and 3 experimental dams were treated with intraperitoneal (i.p.) (-)-nicotine tartrate at doses of 0.5, 1, and 2 mg/kg body weight/day, respectively, during pregnancy from gestational days 9 through 21. Group 4 control dams were given i.p. saline solution daily for the same period. After normal delivery, the eyes were removed at postnatal day 1 or day 30 for macroscopic and histopathologic investigation of the lenses. RESULTS: Control and group 1 litters had normal anterior lens capsules with a single layer of anterior cuboidal epithelial cells, regularly orientated cortical and nuclear lens fibres, and a clear posterior lens capsule with no lining epithelial cells behind the equator. On the other hand, some lenses in groups 2 and 3 litters had mature or immature cataract macroscopically at postnatal 30th day. Histopathologic findings suggesting cataractogenesis included cortical lens fibre cell swelling and liquefaction, prominent epithelial cells lining the posterior lens capsule behind the equator, and the retention of lens nuclei into the deeper and central area. Moreover, some lenses were immature developmentally, indicating arrested lenticular embryogenesis at vesicle stage. CONCLUSIONS: Nicotine exposure during pregnancy has teratogenic and cataractogenic effects on developing crystalline lenses in neonatal rats both macroscopically and histopathologically. If appropriate dose of nicotine can be identified, nicotine-induced cataract formation may possibly be used as a new experimental cataract model in animal studies. Therefore, future studies are needed in this respect. Eye (2004) 18, 67-73. doi:10.1038/sj.eye.6700511

Long-term pulmonary histopathologic changes in rats following acute experimental exposure to chlorine gas.

In this study, we aimed to investigate the long-term histopathologic changes in the lungs of rats exposed to a high concentration of chlorine gas. Twenty-four Sprague-Dawley rats were divided into three groups: the control group (group I) (n = 8), early-examined group (group II) (n = 8), and late-examined group (group III) (n = 8). In group II the lungs of rats were taken out just after the exposure, whereas in group III the lungs were taken out 45 days after the exposure. Eosinophilic liquid accumulation in alveoli and bronchi, diffuse intraalveolar edema, vascular congestion, severe perivascular edema, and free bleeding in intraalveolar and interstitial area were observed in the lungs of rats in group II. Interstitial fibrosis and thickening of the alveolar septa were observed in group III. These findings suggest that the people using these cleaning agents are at risk of harming themselves, and the victims of chlorine gas injury should be reexamined at a later period since they may have pulmonary damage even after 45 days of exposure.