Cognition as a parameter in monitoring the effect of multiple sclerosis relapse treatment: A prospective controlled study.

BACKGROUND: Cognitive evaluation was considered to be very important in the relapse period, on the basis of the presence of isolated cognitive attacks and the necessity of monitoring the patient both physically and cognitively. MATERIALS AND METHODS: People with MS (pwMS) who were hospitalized during relapse were included in the study. All MS patients were evaluated by the neurologist with Expanded Disability Status Scale (EDSS), The 9 Hole Peg Test (9HPT) and the Timed 25-Foot Walk Test (T25-FWT). Additionally, all participants were examined cognitively with the Turkish version of the Brief International Cognitive Assessment for MS (BICAMS) battery. Also, schedules were indicated as during relapse before the treatment (pre-treatment) and the first month after relapse (1-month follow-up). RESULTS: A total of 140 MS patients (mean age; 34.98±10.09, mean disease duration; 6.05±5.29 years) and 86 healthy controls (mean age; 36.94±10.83) were included to the present study. The mean EDSS scores in pre-treatment in MS patients was 2.74±1.14 and decreased significantly in the 1-month follow-up (1.74±1.24; p<0.001). The mean SDMT score was lower by 8.76 points in MS patients than in HCs) in pre-treatment and 7.66 points in 1-month follow-up (p<0.001). The mean SDMT scores of all participants increased with measurement time gradually (p<0.001). CONCLUSION: In this study, it was detected which cognitive domains were affected after relapse treatment and cognitive changes in pwMS during relapse and remission periods compared to the healthy controls. All three BICAMS test scores significantly increased in one-month follow-up than the pre-treatment period. The results showed that CVLT-II and BVMT-R scores improved more in pwMS than in HCs, and also SDMT scores of pwMS showed a trend of increase, but was not a significant improvement.

Giant conjunctival melanoma treated with excision and primary reconstruction using a partial thickness skin graft.

Conjunctival melanoma is a rare type of malignancy of ocular surface tissue with a high recurrence rate, sight, and life-threatening malignancy. In this paper, we report a case of giant conjunctival melanoma in an 86-year-old woman, localized on her left eye. The pigmented tumor lesion was de novo occurred and treated by local wide excision and reconstruction of the presented defect by partial thickness skin from the inside parts of the forearm. The eye itself was not damaged, and the first-line lymph nodes showed no malignant activity. In the three years of follow-up, no signs of recurrence have been observed. The treatment approach with local excision and subsequent reconstruction with the partial thickness skin graft or excision with adjuvant therapy has given a good clinical outcome.

The role of ophthalmologists in diagnosing marfan syndrome.

Background: Marfan syndrome (MFS) is a multisystem connective tissue disorder involving the cardiovascular, skeletal, and ocular systems. Case Report: We present a case of a 15-year-old boy who was sent to the ophthalmologist for the checkup of the primary disease-hypercalciuria and gigantism for the first time at the age of 5.5 years. After the ophthalmological examination (low myopia <-3.0 diopters, ectopic lens with defects in the nasal lens zonules detected by ultrasound biomicroscopy) and owing to gigantism, suspecting of MFS, we referred the patient for further diagnosis, treatment, and follow-ups. Conclusion: The child's excessive growth pointed to the presence of gigantism in the very beginning. A duly identified problem of MFS in our patient at an early age contributed to the correct diagnosis and prevention of the development of amblyopia in the child.

Endometrioma and ovarian reserve: effects of endometriomata per se and its surgical treatment on the ovarian reserve.

Endometrioma is the cystic lesion of ovaries originating from endometrial glands and stroma. This condition is present in 17 to 44% of endometriosis patients. The ovarian reserve is decreased in women with endometriomas, as compared to similarly aged healthy women or women with other benign ovarian cysts. Some data suggest women with endometrioma experience a faster decline in AMH than age matched healthy women. Multiple well-designed studies consistently demonstrate that surgical excision of endometrioma is associated with a decline in the ovarian reserve. Recent studies with long term follow up suggest some recovery in the markers of ovarian reserve, but they almost never reach preoperative levels. The energy modality and choice of hemostatic method may be important. Limited data suggest ablation of the cyst wall with plasma energy is associated with less harm to reserve with similar recurrence rates as compared with excision and bipolar coagulation. In conclusion, bipolar diathermy seems to be the most harmful hemostatic method to ovarian reserve and its use should be cautiously minimized.

Ferric reducing antioxidant potential (FRAP) of antioxidants using reaction flow chromatography.

High performance liquid chromatography coupled with post column derivatisation (HPLC-PCD) may be used to profile the antioxidant content of a sample. There are, however, drawbacks in the use of HPLC-PCD setups; namely the high volume reaction coils that are typically used lowering the observed separation efficiency. Reaction flow chromatography has the ability to overcome these inefficiencies by using a more efficient mixing technique inside the outlet fitting itself, post column reaction loops can be removed with resulting improvement in signal to noise response, plus the separation efficiency is maintained. We assessed two methods of HPLC-PCD antioxidant analysis based on the ferric reducing antioxidant power (FRAP) assay in both conventional and reaction flow HPLC-PCD modes. It was found that the reaction flow technique demonstrated significant advantages over the conventional technique in terms of signal to noise, linear range, precision and observed separation efficiency.

The Effect of Ascorbic Acid on Mancozeb-Induced Toxicity in Rat Thymocytes.

Mancozeb, as a dithiocarbamate fungicide, has been found to exhibit toxicological manifestations in different cells, mainly by generation of free radicals which may alter antioxidant defence systems in cells. The effect of mancozeb on the cells of a primary lymphoid organ has not been studied. In the present study, the effects of mancozeb (0.2, 2 and 5 µg/ml) or mancozeb+ascorbic acid (100 µg/ml), or ascorbic acid alone or control medium alone on the levels of cell viability, apoptosis, intracellular reactive oxygen species production (ROS), mitochondrial membrane potential (MMP) and ATP levels in rat thymocytes were examined in vitro. Cells treated with mancozeb displayed a concentration-dependent increase of hypodiploid cells and ROS production followed by markedly decreased viability of the cells, MMP and ATP levels. Application of ascorbic acid significantly reduced cytotoxicity in cell cultures treated with 0.2 and 2 µg/ml of mancozeb, together with significantly decreased ROS levels and increased MMP and ATP levels. In cells treated with 5 µg/ml of mancozeb, ascorbic acid failed to reduce toxicity while simultaneously increasing the apoptosis rate of thymocytes. These results suggest that ROS plays a significant role in mancozeb-induced toxicity, through alteration of mitochondrial function. Ascorbic acid administration reduced the toxicity rate in cells treated with lower mancozeb concentrations, while it may have the ability to shift cells from necrosis to apoptosis in the presence of highest mancozeb concentrations.

Exaggerated placental site reaction detected during caesarean delivery: a case report.

Exaggerated placental site (EPS) reaction is an exuberant physiologic process in which intermediate trophoblasts infiltrate the underlying endometrium and myometrium at the implantation site. During a caesarean section, we noted a polypoid well shaped smooth lesion, about 3 cm in diameter on the anterior wall of the uterus apart from the placenta. The histopathologic examination revealed an exuberant proliferation of trophoblastic cells in the placental site, a low Ki-67 labelling index and the absence of mitotic activity. Distinguishing EPS reaction from the other intermediate trophoblastic tumours is critical, as the latter may likely involve surgical intervention and/or chemotherapy, although no specific treatment and follow-up is required for EPS reaction. It is necessary to be aware of this pathology and take biopsies from suspicious lesions in the placental site for pathologic examination.

Monosodium glutamate induces apoptosis in naive and memory human B cells.

The aim of this study was to establish the existence of mGluR7 in normal B lymphocytes and analyse the effect of monosodium glutamate (MSG) on B cell apoptosis in vitro. B cells were purified by magnetic cell sorting using anti-CD19-coupled magnetic beads. Cells (10(6)/ml) were cultured with increasing MSG concentrations (1-100 mM). Detection of apoptosis by flow cytometry was performed using the Annexin V-FITC/Propidium iodide (PI) apoptosis detection kit. Naïve and memory B cell population were identified by CD27 staining. Expression of GluRs was determined using PCR. Exposure to increasing MSG concentrations displayed dose dependent effect on B cell viability altogether, ranging from 35% with 100 mM up to 80% with 1 mM MSG. Moreover, the number of late apoptotic cells as well as necrotic cells was dose dependant. Both CD27- as well as CD27+ B cells were affected by MSG. Basal expression of GluRs7 was detected in unstimulated B cells. Glutamate induced apoptosis can be seen in memory as well as naive B cell population and is probably mediated through mGluR7, whose expression in B cells we also confirmed. Our study suggests a new possible mechanism of crosstalk between the nervous and the immune system through glutamate as a potential key mediator (Fig. 4, Ref. 27). Full Text (Free, PDF) www.bmj.sk.

Effect of monosodium glutamate on apoptosis and Bcl-2/Bax protein level in rat thymocyte culture.

Monosodium glutamate (MSG), the sodium salt of glutamate, is commonly used as a flavor enhancer in modern nutrition. Recent studies have shown the existence of glutamate receptors on lymphocytes, thymocytes and thymic stromal cells. In this study, we evaluated the in vitro effect of different MSG concentrations on rat thymocyte apoptosis and expression of two apoptosis-related proteins, Bcl-2 and Bax. Rat thymocytes, obtained from male Wistar rats, were exposed to increasing concentrations of MSG (ranging from 1 mM to 100 mM) for 24 h. Apoptosis was detected using the Annexin V-FITC/PI apoptosis detection kit and cells were analyzed using a flow cytometer. Expression of Bcl-2 and Bax proteins were determined with flow cytometry using respective monoclonal antibodies. Exposure to MSG resulted in a dose-dependent decrease in cell survival (as determined by trypan blue exclusion method). Annexin V-FITC/PI also confirmed that MSG increased, in a dose-dependent manner, apoptotic cell death in rat thymocyte cultures. MSG treatment induced downregulation of Bcl-2 protein, while Bax protein levels were not significantly changed. Our data showed that MSG significantly modulates thymocyte apoptosis rate in cultures. The temporal profile of Bcl-2 and Bax expression after MSG treatment suggests that downregulation of Bcl-2 protein and the resulting change of Bcl-2/Bax protein ratio may be an important event in thymocyte apoptosis triggered by MSG.

Modulatory effect of monosodium glutamate on rat thymocyte proliferation and apoptosis.

BACKGROUND: Monosodium glutamate (MSG) is the sodium salt of glutamic acid, widely spread in modern nutrition. Numerous recent studies have shown the existence of glutamic receptors on different nonneuronal cells, which among others also include lymphocytes and thymocytes. OBJECTIVES: The current study was designed to evaluate the prolonged effect of MSG on rat thymocyte proliferation, apoptosis and expression of two apoptosis related proteins, Bel-2 and Bax. MATERIAL AND METHODS: Wistar rats (male) were exposed to monosodium glutamate (MSG) (4 mg/g body wt, i.p.) for 6 consecutive days and sacrificed on 30th and 45th day after last MSG dose. Thymocyte proliferation was evaluated by measuring the expression of proliferating cell nuclear antigen by flow cytometry. Apoptosis was detected using the Annexin V-FITC/PI apoptosis detection kit and cells were analyzed using a flow cytometer. Expression of Bcl-2 and Bax proteins were determined with flow cytometry using respective monoclonal antibodies. RESULTS: The current study results demonstrate that MSG significantly decreased thymocyte proliferation (p < 0.001) induced by ConA and increased apoptosis rate (p < 0.001) of the cells during examination period. MSG treatment induced down regulation of Bcl-2 protein while Bax protein levels were not significantly changed. CONCLUSION: These results indicate that MSG significantly modulates thymocyte proliferation by modulating the apoptosis rate of the cells. The temporal profile of Bcl-2 and Bax expression, after MSG treatment, suggest that down regulation of Bcl-2 protein and resulting change of Bcl-2/Bax protein ratio may be an important event in thymocyte apoptosis, triggered by MSG (Tab. 1, Fig. 3, Ref. 36).

Portraits of pain and promise: a photographic study of Bosnian youth.

In the early 1990s, war erupted in Bosnia and Herzegovina, forcing large numbers of people to flee their homes and country, abandoning their culture and all that was familiar to them. For the children, often described as war's "innocent victims," the conflict and subsequent uprooting represented a dramatic end to their peaceful lives. Although many were fortunate enough to escape with their families and resettle amid more peaceful circumstances, there is considerable evidence that refugee youth are forever changed by their exposure to war and that the pain of war does not end when the fighting is over. This paper presents the results of a study with 7 Bosnian children, aged 11-14, who came to Canada as refugees during the 1990s. The everyday challenges and struggles faced by this group were explored using an innovative research method called photo novella. A secondary purpose of the research was to evaluate the merits and limitations of photo novella as a method for capturing children's perspectives and feelings. Participants were given disposable cameras and asked to take pictures of important people, places, and events. The meaning of the photographs was then explored through a dialogic process the researchers call phototalk. The findings revealed that while these children had many strengths, they continued to struggle to understand the events that so profoundly changed their lives. The results and the implications for nurses are discussed.

A combined spectrophotometric-AAS method for the analysis of trace metal, EDTA, and metal-EDTA mixture solutions in adsorption modeling experiments.

The adsorption of free- and bound-metal ions (metal complexes) as well as of ligands onto various hydrous oxide type sorbents have been extensively modelled using EDTA as the model ligand. This type of modelling uses metal ion-EDTA mixture solutions containing stoichiometrically equivalent or excessive amounts of either constituent. Consequently, for mixture solutions equilibrated with the sorbent, the aim was to develop a suitable method for determining either metal complex+free ligand (MY(2-)+H(2)Y(2-)) or metal complex+free metal (MY(2-)+M(2+)) in the aqueous filtrate, the metal M being lead or cadmium. The conventional method of analyzing such filtrates is exchanging different metal-EDTA complexes with Fe(NO(3))(3) followed by HPLC using UV detection. The developed method utilizes Vis- and AA-spectrometry widespread in common laboratories, eliminating the need for HPLC and UV techniques that require higher operational cost, expertise and contaminant-free media. The developed procedure is based on the following analyses for the possible constituents of equilibrated solution (with the sorbent). All EDTA (free or bound, as H(2)Y(2-) or MY(2-)) species are converted into FeY(-) by adding Fe(NO(3))(3), and heating at 80 degrees C for 1 h. All metal (free or bound, as M(2+) or MY(2-)) species are determined by AAS. All unbound (free) Fe(3+) species are determined by the thiocyanate spectrophotometric method at 480 nm. Then 'EDTA-bound iron (III)' is defined as added Fe minus colorimetrically (thiocyanate method) found Fe, and 'AAS-found metal' (lead or cadmium) corresponds to M(2+) and/or MY(2-), depending on the analyzed solution. If EDTA-bound Fe(III) is greater than AAS-found metal, then one has a (MY(2-)+H(2)Y(2-)) mixture where AAS-found metal is (MY(2-)), and free EDTA, i.e. (H(2)Y(2-)), is calculated from the difference. If EDTA-bound Fe(III) is smaller than AAS-found metal, then one has a (M(2+)+ MY(2-)) mixture where EDTA-bound Fe(III) is (MY(2-)), and the free metal, i.e. (M(2+)), is calculated from the difference. If the two compared quantities are equal, then one has a pure MY(2-) solution. Since surface complexes on the hydrous oxide sorbent ( approximately SOH) as bound metal ( approximately SOM), bound ligand ( approximately SOL) or bound metal complex ( approximately SOML) are much more difficult to desorb and analyze, the simple procedure developed here applicable to more conventional instruments carried out in sorbent equilibrated solutions (filtrates) may effectively aid heavy metal adsorption modelling in realistic environmental simulations.

[The effect of parathormone on arterial blood pressure in patients on hemodialysis]. / Uticaj parathormona na arterijski pritisak krvi kod bolesnika na hemodijalizi.

We evaluated the effect of PTH on blood pressure in haemodialysed patients. The correlation was found between systolic, diastolic pressure and PTH. The results have shown that PTH might have the influence on regulation of arterial blood pressure in these patients.

[Voice frequencies in patients treated with chronic hemodialysis]. / Osnovna frekvencija glasa bolesnika lecenih ponavljanim hemodializama.

Stress effects on respiration and muscle tension are most likely to affect phonation and articulation; the acoustic parameters reflecting vocal indicators of stress are fundamental frequency, duration and intensity. The aim of this study was to explore the link between some psychosomatic states of patients on dialysis and physical parameters of the vowel "e". Fundamental frequency, intensity and duration of the vowel "e" produced before, during and after dialysis were investigated. The results showed that in the period before dialysis the fundamental frequency was greater, duration was longer and intensity was unchanged. This investigation showed that the changes of the parameters of voice were induced with the changes of psychophysiological states of the patients on dialysis. These patients were in the state of chronicle stress, but the period before the treatment was associated with special, anticipatory stress that induced greater fundamental frequency and longer duration of the pronunciation of the vowel "e".