Measuring 3D Cochlear Duct Length on MRI: Is It Accurate and Reliable?

BACKGROUND AND PURPOSE: Prior studies have evaluated cochlear length using CT to select the most suitable cochlear implants and obtain patient-specific anatomy. This study aimed to test the accuracy and reliability of cochlear lateral wall length measurements using 3D MR imaging. MATERIALS AND METHODS: Two observers measured the cochlear lateral wall length of 35 patients (21 men) with postlingual hearing loss using CT and MR imaging. The intraclass correlation coefficient (with 95% confidence intervals) was used to evaluate intraobserver and interobserver reliability for the 3D cochlear measurements. RESULTS: The mean age of the participants was 39.85 (SD, 16.60) years. Observer 1 measured the mean lateral wall length as 41.52 (SD, 2.25) mm on CT and 41.44 (SD, 2.18) mm on MR imaging, with a mean difference of 0.08 mm (95% CI, -0.11 to 0.27 mm), while observer 2 measured the mean lateral wall length as 41.74 (SD, 2.69) mm on CT and 42.34 (SD, 2.53) mm on MR imaging, with a mean difference of -0.59 mm (95% CI, -1.00 to -0.20 mm). An intraclass correlation coefficient value of 0.90 (95% CI, 0.84-0.94) for CT and 0.69 (95% CI, 0.46-0.82) for MR imaging was obtained for the interobserver reliability for the full-turn cochlear lateral wall length. CONCLUSIONS: CT-based 3D cochlear measurements show excellent intraobserver and interobserver reliability, while MR imaging-based lateral wall length measurements have good-to-excellent intraobserver reliability and moderate interobserver reliability. These results corroborate the use of CT for 3D cochlear measurements as a reference method and demonstrate MR imaging to be an alternative acquisition technique with comparably reliable results.

Assessment of knowledge of metabolic syndrome and health literacy level among adults in Western Turkey.

BACKGROUND: Metabolic syndrome (MetS) has become an issue in the public health discipline. AIMS: The primary aim of this study is to assess the potential determinants for both knowledge level of metabolic syndrome and health literacy (HL) level among the adult population. The second purpose of this study is to show whether there is a relationship between the MetS knowledge level and the HL level in western Turkey. METHODS: This cross-sectional study was conducted between October 10, 2017 and November 15, 2017 in western Turkey. The participants of the study were adult population who applied to seven "family health centers". The MetS knowledge level was measured with the Metabolic Syndrome Knowledge Level Scale (MetS-KS). HL level was measured with the HLS-EU-Q16. A General Linear Model was constructed to evaluate the relationship between MetS-KS scores and HLS-EU-Q16 scores. For statistical significance, P < 0.05 was accepted. RESULTS: Younger age, having higher education level, being single, having a high family income, not having a chronic disease, doing regular physical activity, viewing television less than 3 hours a day, previous measurement of waist circumference, previous attempts to lose weight, not being abdominally obese, not being at risk for hypertension and not having optimal body mass index (BMI) were associated with high HL levels (P < 0.05 for each one). According to the general linear model, the level of HL was not related to the level of MetS knowledge level (P > 0.05). CONCLUSIONS: Younger age, having a high educational level, high socioeconomic level and positive health behaviors were related with both MetS knowledge level and HL level. However, there was no direct relationship between MetS knowledge level and HL level.

Relationship between salivary calprotectin levels and recurrent aphthous stomatitis: A preliminary study.

AIM: Recurrent aphthous stomatitis (RAS) is an inflammatory condition of the oral mucosa. The etiology of RAS remains unclear. Calprotectin is a major cytoplasmic protein contained in granulocytes, monocytes/macrophages and epithelial cells, and its level is increased body fluids in some inflammatory diseases. The aim is to determine the relationship between salivary calprotectin and RAS. MATERIAL AND METHODS: In the cross-sectional study, 67 patients with active lesions of RAS (F/M: 43/24, mean age: 30.27 ± 9.14 years) and 42 healthy controls (HC, F/M: 30/12, 30.54 ± 9.49 years) were included. Calprotectin levels were evaluated in unstimulated whole saliva samples by using the ELISA method in both groups. RESULTS: Salivary calprotectin levels were significantly higher in RAS group (23.72 ± 4.28 mg/L) compared to the HC group (21.59 ± 4.27 mg/L) (P = 0.013). No significant relationship was found between calprotectin levels and age or gender in both groups (P >0.05). CONCLUSION: RAS is a very common inflammatory ulcerative condition of the oral cavity and its etiology is uncertain. Regarded as an inflammatory mechanism, releasing a high level of calprotectin in saliva has been suggested that it may play a role in pathogenesis of RAS.

Pain intensity and its objective determinants following implant surgery and sinus lifting: A 1-year prospective study.

OBJECTIVES: The main goal of this study was to evaluate the relationship between postoperative pain and short-term implant survival. Objective parameters, such as implant-related factors (type, diameter, length) and the surgical approach were also assessed to correlate them with pain. MATERIALS AND METHODS: This prospective, single-center study consisted of 144 patients scheduled for the surgical placement of one or more implants either with conventional surgery or with sinus-lifting together. All patients were asked to complete a questionnaire form of pain with a visual-analog scale (VAS, 1-10) for 7 days following surgery. The association of pain scores at each time-point was assessed on implant- and surgery-related factors. RESULTS: The overall cumulative survival rate of 546 implants in 144 patients was 98.17 % (10 implants lost) after 1-year follow-up. No statistical difference was found in pain (VAS) scores between patients with loss and survived implants at any observation period. The length and diameter of placed implants and the presence of a sinus-lifting procedure did not influence the pain scores at any period (P > 0.05). In patients with bilateral sinus lifting, the decrease in pain scores was significant after 3 days (P < 0.05), whereas it was significant after 6 hours for the conventionally treated group (P < 0.01). Although no severe pain was reported at any time, this study found a significant difference in pain intensities among different implant brands. CONCLUSIONS: This study was able to show that increased postoperative pain is not a sign of early implant failure. In addition to this, the implant dimensions and presence of sinus lifting procedure did not influence the pain experience. However, the bilateral sinus lifting prolongs the recovery time.

Development of a Reliable and Valid Organ Tissue Donation and Transplantation Knowledge Scale.

INTRODUCTION: Knowledge has an important role in an individual's willingness to donate organs upon death. Knowledge enables clarification of false beliefs, which can increase willingness to consent to organ donation. The purpose of the study was to describe and examine the validity and reliability of the Organ-Tissue Donation and Transplantation Knowledge Scale (ODTKS). METHODS: We performed a comprehensive literature review and chose 23 items for the scale according to specialists' recommendations. A total of 6 items were excluded from the scale. Finally, the scale consisted of 17 items and 2 subdimensions. RESULTS: The study group consisted of 540 (267 [49.4%] male and 273 [50.6%] female) nonmedical staff members; 23.5% were primary school graduates, 47.6% were high school graduates, and 28.9% had university degrees or higher. The difficulty index and discrimination index of the overall scale were 22.41% to 54.07% and 0.23 to 0.46, respectively. Cronbach α coefficient was 0.88 overall. Retest reliability scores were significant (r = 0.87, P < .001). CONCLUSIONS: The total score of the ODTKS was significantly higher among university graduates compared with primary school graduates and among people willing to donate. The ODTKS therefore has adequate reliability and validity for evaluating Turkish adults' knowledge about organ tissue donation and transplantation.

Ultrastructural evaluation of intramuscular applied botulinum toxin type A in striated muscles of rats.

BACKGROUND: Botulinum toxin type A (BTX-A) is clinically utilized for therapeutic and cosmetic purposes in maxillofacial surgery as well as many other medical specialties. There is no sufficient ultrastructural research about BTX and it is controversial whether BTX-A causes muscle degeneration to some extent, in the course of therapy. The aim of this study was to evaluate the histological effects of BTX-A when injected into masseter and gluteal muscles. MATERIALS AND METHODS: A total of 30 male Sprague-Dawley rats were used and randomly divided into experimental (n =15) and control groups (n =15). Masseter and gluteal muscles were injected with a single dose of BTX-A in normal saline (0.5 U/0.1 ml), or 0.1 ml of normal saline, in the experimental and control groups, respectively. After 12 weeks all the rats were sacrificed. Gluteal, masseter muscles, and the sciatic nerves of the rats were prepared and electron microscopic, and light microscopic evaluation was performed on semi-thin sections cut from Epon embedded tissues and stained with toluidine blue. Quantitative parameters such as muscle fiber thickness and qualitative assessments including sarcosomal (striated muscle mitochondria) deformation, glycogen content, features of the triad structures and the intensity of connective tissue around the muscle fibers, and endoneurial and perineural tissue around nerve fibers were evaluated microscopically. We paired BTX- A (+) and BTX-A (-) samples statistically. Independent Samples t-test was used for the statistical analysis. RESULTS: Muscle fiber's diameter was significantly decreased in BTX-A (+) group (p <0,001). Atrophic changes in the myofibrils were characterized by a decrease in the myofibrillar diameter and changes in the sarcomere structure, and were prominent in the BTX-A (+) group. Also, some other changes like dilatation in the sarcoplasmic reticulum cisternae, mitochondrial swelling, and clearing of mitochondrial cristae associated with degeneration, were detected. No morphologic difference in the sciatic nerve fibers was detected, and myelin sheaths of axon structures were intact in both groups. CONCLUSION: BTX-A-induced muscular changes that are predominantly related to atrophy instead of degeneration. Although predominantly related to atrophy, our degeneration related findings suggest that further studies are needed focusing on detecting BTX-A effects on a cellular level. Hippokratia 2016, 20(4): 292-298.

The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: a retrospective study of 18 cases.

Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis.

Retrospective analysis of echinococcosis in an endemic region of Turkey, a review of 193 cases.

BACKGROUND: The hydatidosis is endemic in our region. Some of the recent studies revealed that hydatid cyst prevalence is decreasing gradually in Turkey. The aim of this study was to investigate the actual prevalence of hydatidosis in an endemic region of Turkey, and to share our experiences in the medical and surgical management of hydatidosis. METHODS: Data were collected retrospectively from the records of 193 patients who had a diagnosis of hydatidosis, and admitted to Diyarbakir Education and Research Hospital. Imaging techniques, histology and serology were used for diagnosis. RESULTS: From records of 772 cystic patients whose cysts were localized in the lung and liver, 193 (25%) of them were diagnosed with cyst hydatidosis. Lung hydatidosis was found statistically significant among these cases (Chi-square=24.88, P< 0.0001). Postoperative recurrence was detected in seven (3.62%) patients. All postoperative recurrences were observed in the consequent three years period. CONCLUSION: The prevalence of hydatidosis is still high in southeast Turkey and not only in children but also in adult cases in our region lung hydatidosis is frequent corresponding with other organ hydatidosis. We also found that the most risky period in recurrence rates is the consequent post-operative three years. According to our experiences, transthoracic approach in lung hydatidosis, external drainage, and cystectomy in liver hydatidosis is safe and effective choices in surgical treatment.

Determining predominating histologic component in malignant mixed müllerian tumors: is it worth it?

Malignant mixed müllerian tumors (MMMT) are highly aggressive tumors, usually diagnosed in advanced stage. Cases of MMMT derive from either ovary or uterus. In our study, we investigated the role of carcinomatous and sarcomatous component on response to chemotherapy and disease outcome. We retrospectively analyzed 25 patients with MMMT who were treated in our outpatient clinic from 1998 to 2003. All the paraffin specimens were reevaluated according to the histopathologic features (primary site and percentages of carcinomatous and sarcomatous component) and the effect of predominant histologic type on response to treatment. Primary tumor sites were ovary and endometrium in 36% and 64% of patients, respectively. Ten of 25 patients (40%) were treated with a combination chemotherapy regimen of cisplatin-ifosfamide (PI) and 7 patients (28%) were treated with paclitaxel-carboplatin (PC) protocol. Despite chemotherapy, 17.6% of patients had progressive disease. The remaining 13 patients (54.2%) responded to chemotherapy. Response rates of patients treated with PC (100%) were remarkably higher than the response rates of patients treated with PI (66.6%). Moreover, patients with predominating carcinomatous component had a higher response rate (87.5%) than patients with predominating sarcomatous component (66.6%). MMMT are highly chemoresponsive tumors, irrespective of primary site. One of the best predictors to response is the histologic pattern. Predominating histopathologic feature (carcinoma or sarcoma) should be taken into consideration in predicting the response and planning the chemotherapy regimen.

Antibodies neutralizing Nogo-A increase pan-cadherin expression and motor recovery following spinal cord injury in rats.

STUDY DESIGN: A rat model of spinal cord injury was used to test the hypothesis that Nogo-A monoclonal antibody (NEP1-40) promotes morphologic and functional recoveries of injured spinal cord. OBJECTIVE: Nogo-A is a myelin-associated neurite outgrowth inhibitory protein, which blocks elongation nerve fibers and limits neuronal regeneration after central nervous system injury. METHODS: Forty-four rats were utilized and allocated into control (vehicle) and NEP1-40-treated groups. In all animals, the spinal cord was hemi-transected at Th-10 and phosphate-buffered saline solution was immediately applied on the injured area in the control group. NEP1-40 solution was immediately applied on the hemi-transected area in the treatment group. Each group was subdivided into three subgroups according to the postsurgical day of killing (3, 8 and 21 days). The spinal cords were removed for analysis. RESULTS: Motor scores in the NEP1-40-treated groups were significantly higher than those in the vehicle groups both at 8 and 21 days post injury. Immunohistochemical staining for pan-cadherin, a marker of neuronal cell adhesion and axonal sprouting, revealed a significant increase in staining in the NEP1-40 treatment group at 8 and 21 days post injury. Transmission electron microscopical evaluation revealed degeneration of the myelin and loss of cytoarchitectural organization in the axons of controls. Better preservation and normal histologic features were observed in the NEP1-40-treated groups. CONCLUSION: We have demonstrated improved preservation of injured axons and significant pan-cadherin expression after NEP1-40 treatment after the spinal cord injury. Inhibition of Nogo-A may improve the capacity for neuronal regeneration after spinal cord injury.

Attenuation of microtubule associated protein-2 degradation after mild head injury by mexiletine and calpain-2 inhibitor.

The objective of the study was to address the early effects of mild, closed, head injuries on neuronal stability and the prevention of microtubule-associated protein-2 (MAP-2) degradation by mexiletine and calpain-2 inhibitor. Twenty-four rats were divided into four groups: control group (1); trauma group without treatment (2); mexiletine-pretreated and subjected to trauma group (3); trauma subjected and then calpain-2 inhibitor received group (4). All animals were subjected to mild, closed, head trauma. Frontal lobes were removed and processed for staining and immunofluorescent labelling of MAP-2 cytoskeletal proteins, which were evaluated by confocal microscopy in serial optical sections showing the three dimensional cytoarchitecture of affected areas. MAP-2 decoration in almost all neurons obtained from traumatized brain regions drastically diminished, while minute filamentous and granular profiles in axons and/or dendrites were retained together implying a massive degradation/depolymerization of microtubules. In contrast, in mexiletine-pretreated animals, MAP-2 positivity in axonal and perikaryonal profiles was fairly retained, which clearly depicts the protective role of mexiletine after trauma. Compared with mexiletine-pretreated group, calpain-2 inhibitor treated group displayed a less well-preserved MAP-2 expression. Mexiletine can prevent cytoskeletal structure and protein degradation after mild head trauma. Calpain-2 inhibitor prevents protein degradation, but cytoskeletal organization is better preserved with mexiletine.

Fusiform aneurysm of the superior cerebellar artery: short review article.

Fusiform superior cerebellar artery (SCA) aneurysms are quite rare and only 9 cases have been reported in the literature. Fusiform aneurysms are a small group of cerebral aneurysms among the most difficult to treat. The therapeutic approaches in the limited number cited in the literature include surgery and endovascular occlusion. Surgical techniques which have been used are parent artery occlusion, trapping or body clipping of the bleeding site, and wrapping for fusiform aneurysms. Neurological condition, presence of collateral circulation, type and configuration of the aneurysm, and type of the dissection are important factors that predict the course of fusiform SCA aneurysms. We reviewed the literature on fusiform aneurysm of the SCA and report a further case treated surgically.

Neurosurgical practice at Baskent University, Turkey: a new model.

BACKGROUND: The Turkish Organ Transplantation and Burn Foundation was established in 1980. This was followed by the founding of the Turkish Transplantation and Burn Foundation Hospital in 1985. Under the aegis of this foundation and the Haberal Educational Foundation, Baskent University (BU) was founded in 1993 by Professor Mehmet Haberal, general surgeon and pioneer of organ transplantation in Turkey, and the President of the university since then. METHODS AND FINDINGS: The BU Neurosurgery Department began functioning in January of 1995, with the advancement of the department and with contributions from the other hospitals in cities of Adana, Konya and Alanya. Just 13 years after its foundation, BU became one of the most prestigious universities of the country. While establishing new neurosurgery units within BU health care facilities, the neurosurgeons appointed to the new center spend few months in the neurosurgery department at the BU Ankara Hospital, central hospital, at first in order to get acquainted with the BU medical system. After the new neurosurgery unit begins to operate, senior neurosurgeons from Ankara are called to supervise junior colleagues during major surgical procedures. In addition to these exchanges, residents are sent routinely to these centers as part of the neurosurgical residency programme. As the system is very integrated, neurosurgeons from other centers of the BU also routinely come to Ankara Hospital and Research Center for educational purposes. CONCLUSION: BU as a whole and its health system model in particular are certainly unique in Turkey. The statistical data from all hospitals of the BU reveal growing patient demand and consumer satisfaction.

Treatment of hydrocephalus with functionally isolated ventricles.

Rapid therapeutic drainage of one lateral ventricle may lead to ipsilateral slit ventricle, and the resultant functional obstruction of cerebrospinal fluid flow through the foramen of Monro may cause dilatation of the contralateral ventricle. Drainage of the lateral ventricle with a low-pressure shunt led to functionally isolated contralateral ventriculomegaly in this report. The patient's condition was complicated by a Candida albicans shunt infection. Following effective treatment of the infection by chemotherapy and removal of the shunt system, the patient was treated by bridging two lateral ventricles with ventricular catheters connected to an Ommaya reservoir. An occipital ventricular catheter was then inserted and connected to a programmable valve to drain the bridged lateral ventricles. Modern centers, caring for patients with infantile hydrocephalus, should have endoscopic facilities available but in cases with extensive ventricular adhesions and in asymmetric hydrocephalus where endoscopic septostomy between the ventricles is impossible our described technique may be used.

Sacral kyphoplasty for relieving pain caused by sacral hemangioma.

STUDY DESIGN: Case report describing sacral kyphoplasty in a patient with sacral hemangioma; the first account of this procedure in a sacral hemangioma. OBJECTIVES: To highlight the advantages of sacral kyphoplasty in the treatment of sacral tumors. SETTING: This study is made in Baskent University in Turkey. SUMMARY OF BACKGROUND DATA: Kyphoplasty and sacroplasty are new, minimally invasive techniques that are mostly used for treating osteoporotic vertebral body fractures. These techniques are very effective for achieving rapid pain relief and stabilizing the vertebra, and biopsy collection can be included in the procedure. The latter allows for informed treatment planning in patients with metastatic tumors. METHOD: A 74-year-old woman with known metastatic renal cell carcinoma was investigated for pain in the left sacral region. A tumoral lesion was detected, and sacroplasty was performed at S1. RESULTS: The sacral pain resolved completely after the procedure, and the patient was able to walk without assistance. The pathological diagnosis for the vertebral lesion was hemangioma. CONCLUSIONS: Sacral kyphoplasty is a very effective, minimally invasive surgical procedure. Patients with debilitating diseases such as primary sacral tumors or metastases can be treated by this technique with no significant complications.

Effect of pentoxifylline on endotoxin-induced haemostatic disturbances in rabbits.

Pentoxifylline (PTX, a methylxanthine derivative) has been found to interrupt early gene activation for tumour necrosis factor, interleukin-1, interleukin-6 and tissue factor production and to improve survival from experimental sepsis. During endotoxaemia, lipopolysaccharide (LPS, endotoxin) and proinflammatory cytokines trigger the development of disseminated intravascular coagulation (DIC) via the tissue factor-dependent pathway of coagulation. The present study was undertaken to determine whether pentoxifylline could prevent coagulation disturbances in LPS-treated rabbits. Endotoxaemia was induced with E. coli lipopolysaccharide in New Zealand White rabbits. Forty rabbits were used and divided into four equal groups. Group 1 served as a control group; Group 2: lipopolysaccharide was injected intravenously, Group 3: pentoxifylline was injected intraperitoneally, Group 4: lipopolysaccharide and pentoxifylline were injected simultaneously. Blood samples were collected 6 h after the treatments. In rabbits with endotoxin-induced DIC, platelet count, leukocyte count, percentage of differential leukocyte values, fibrinogen level, antithrombin III (AT-III) and protein C (PC) activity were decreased. Moreover, activated partial thromboplastin time (APTT) and prothrombin time (PT) were prolonged when compared to the control group. In conclusion, haemostatic disturbances associated with endotoxin-induced DIC were moderately suppressed by the administration of PTX.

Spontaneous corynebacterium discitis in a patient with chronic renal failure.

STUDY DESIGN: Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure. OBJECTIVES: To describe this very rare form of discitis and the results of surgical and antibiotic therapy. SETTING: University Department of Neurosurgery, Turkey. CASE REPORT: A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis. RESULTS: Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up. CONCLUSION: Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

Early effects of mild brain trauma on the cytoskeletal proteins neurofilament160 and MAP2, and the preventive effects of mexilitine.

OBJECTIVE: The aims were to investigate the early effects of graded, closed, mild head injury on neurofilament protein (NF160) and microtubule-associated protein-2 (MAP2) and to examine the levels of lipid peroxidation and the impact of mexilitine, inhibitor of lipid peroxidation, pretreatment on tissue damage. MATERIAL AND METHOD: One hundred and twenty-six rats were divided into groups as follows: Group 1 (n = 14) were controls; group 2 (n = 56) sustained trauma alone; and group 3 (n = 56) were pretreated with mexilitine (50 mg/kg). Groups 2 and 3 were subdivided into subgroups (n = 14 each), which were subjected to 100 g/cm2, 125 g/cm2, 150 g/cm2, and 175 g/cm2 trauma forces, respectively. Two hours after trauma, the frontal lobes from all groups were removed and processed for lipid peroxidation H&E staining, immunofluorescent labelling of neurofilaments and microtubules with anti-NF160 and anti-MAP2 antibodies. RESULTS: Compared to control findings, all the trauma-only animals showed increased lipid peroxidation levels and the elevations paralleled the amount of force applied. Administration of mexilitine significantly reduced the level of lipid peroxidation. In NF160 stainings, in group 2, the degree of impairment in axonal organization paralleled the different levels of force that were applied. Groups 3C and 3D (mexilitine pretreated) showed well-preserved axons and intact perikarya. In MAP2 stainings group 2 animals showed remarkably less MAP2 staining throughout the sections. There were no significant differences in MAP2 staining intensity or pattern among the group 2 subgroups. In contrast, in the sections from the group 3 animals, the level of MAP2 positivity was markedly preserved. CONCLUSION: In conclusion, our results show that the cytoskeletal proteins we investigated have different capacities for resisting injury, and that MAP2 is more vulnerable to injury than NF160. One of the reason for this cytoskeletal disruption may be increased lipid peroxidation. Inhibition of lipid peroxidation by pre-treatment with 50-mg/kg mexilitine significantly reduces the level of lipid peroxidation and may protect MAP2 and NF160 integrity in closed mild head injury. This protection is inversely proportional to the magnitude of the applied force.

Spontaneous resolution of lumbar vertebral eosinophilic granuloma.

Eosinophilic granuloma (EG) is a rare disease but is more common in adults than children. It's often self-limiting. Spinal involvement is rare. It is the localized and most benign form of Langerhans' cell histiocytosis (previously known as histiocytosis X), characterised by lytic lesions in one or more bones. Spontaneous resolution of vertebral body lesions is very rare. In this case, the patient had one EG in a cervical vertebra and a similar lesion in a lumbar vertebra. This case is important because it featured a symptomatic lesion in the cervical spine accompanied by an asymptomatic lesion in a lumbar vertebra. We treated the cervical lesion by surgical fusion and followed the lumbar lesion up conservatively, with the patient in a corset. After 8 years of follow-up, control MRI showed that the lumbar lesion had spontaneously resolved.