The effect of different preservation media and temperatures on sperm quality and DNA integrity in mouse cauda spermatozoa.

BACKGROUND: Mouse sperm can be stored for long or short-time periods. Nevertheless long-term storage leds to significantly reduced sperm quality and fertility because of cryodamage. Thus, in the storage of semen in mice, it is necessary to focus on media and temperatures that gives good results in short-term storage. OBJECTIVE: To determine favorable media for short-term storage of mice spermatozoa by evaluating progressive motility, viability, membrane function integrity, acrosome integrity and fragmented DNA rates at various storage temperatures. MATERIALS AND METHODS: Mouse spermatozoa were collected from epididymides of mature CD1 males and samples were stored at 24 degree C and 4 degree C for 60 h. RESULTS: Motility, viability and membrane function of mice spermatozoa were greatest when stored in KSOM media. Motility and viability were not different when stored at refrigerator or room temperature in KSOM compared to HTF or PBS mediums for 48 h, but were after 60 h. There was not any significant variation in terms of acrosome integrity in different preservation conditions. Fragmented DNA rates were similar in fresh sperm with KSOM and HTF media, while there was higher damage in PBS medium at 60 h. Overall, sperm parameters were affected significantly by the time of storage and type of preservation medium, and PBS extender was not suitable for mice spermatozoa at room and refrigerated temperatures as it caused the lowest progressive motility, viability, membrane function integrity and the highest DNA damage. CONCLUSION: Mice spermatozoa stored in KSOM retained the best sperm quality parameters both 24 degree C and 4 degree C for the first 48 h. doi.org/10.54680/fr22610110612.

Estimation of periostin as a biomarker for early pregnancy diagnosis in goats: a preliminary study.

BACKGROUND: Periostin (POSTN) is an extracellular matrix (ECM) protein that plays an important role in the metastatic process and cancer cell migration. As implantation is a similar mechanism to metastasis, it has been hypothesized that POSTN may also play a role in the implantation process. AIMS: The aim of the present study was to compare POSTN and progesterone levels during the early pregnancy stage in Damascus goats. METHODS: Forty goats were synchronized using progesterone based sponges and were mated upon estrus signs display. While ten goats were kept as control (CON) and were not allowed to mate. Blood samples were taken through jugular venepuncture from CON and synchronized goats on day 13, 15, 17, 19, and 21 of breeding. Progesterone and POSTN levels were determined by enzyme-linked immunosorbent assay (ELISA). Later the pregnancy diagnosis was confirmed by transabdominal ultrasonography on day 50 after mating. RESULTS: Progesterone level was influenced by status of pregnancy and day of observation with an interaction between the status of pregnancy and day of observation in goats. Whereas POSTN level was only affected by the day of observation. CONCLUSION: POSTN level did not vary with progesterone level during phase of embryonic implantation in goats; however, standardization and application of different procedures for POSTN assay in a large group of animals might be useful as an early pregnancy biomarker in goats.

Pseudo-hyperthyroidism: Biotin interference in a case with renal failure.

Introduction: Biotin treatment causes false-low or false-high results in some immunoassays methods. This phenomenon is called as biotin interference. In the present article, a seven-month-old male, with renal failure and laboratory hyperthyroidism due to biotin interference is presented. Case report: High free T4 (fT4), free T3 (fT3), anti-thyroid peroxidase antibody (anti-TPO), anti-thyroglobulin antibody (anti-TG) and low thyroid stimulating hormone (TSH) levels were detected in a seven-month-old male patient who has metabolic acidosis, renal failure, and suspected of metabolic disease. Anti-thyroid drug therapy was started. However, when he was re-evaluated due to the absence of euthyroidism with anti-thyroid therapy (methimazole 0.8 mg/kg /day), it was found that the patient had been given 20 mg/day biotin for acidosis for two months. Biotin interference was considered in hormone measurement. Thyroid function tests were found to be normal 12 days after discontinuation of biotin therapy. Conclusion: Immunoassay measurements which use biotin should be done 2-7days after the last dose of biotin in patients under biotin treatment, but this time may need be much longer in renal failure patients. During this period or if the biotin therapy cannot be stopped, alternative methods should be preferred for analysis.

THE EFFICIENCY OF ULTRASOUND ELASTOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF THYROID NODULES.

AIM: To evaluate the efficiency of ultrasound elastography (USE) in the differential diagnosis of thyroid nodules. METHODS: One hundred thyroid nodules in 100 patients (79 females, 21 males, age range 18-78; mean age = 45.6 years) were evaluated with real-time freehand USE, using Hitachi EUB 7500 equipment and elasticity scores were obtained. The elasticity was scored as follows: Score 1, elasticity in the entire nodule; Score 2, mainly elastic nodule with the presence of inelastic areas not constant during real time examination; Score 3, constant inelastic areas prevalently arranged at the periphery of the nodule; Score 4, constant inelastic areas prevalently arranged at the center of the nodule; Score 5, no elasticity in the nodule. Also mean strain ratio values were calculated for all nodules. RESULTS: Eighty-four (86%) of cases were benign and sixteen (16%) were malignant. Elasticity score 3 and higher and strain ratio higher than 2.485 had statistically significant relation with malignancy (p < 0.05). CONCLUSIONS: USE including strain ratio calculations besides subjective evaluation of elasticity scores is an efficient imaging method which may contribute to the differential diagnosis of thyroid nodules.

The effects of thiamine and thiamine pyrophosphate on alcohol-induced hepatic damage biomarkers in rats.

OBJECTIVE: This study examined the effects of thiamine and thiamine pyrophosphate on oxidative damage developing in association with hepatic injury caused by alcohol toxicity in rats and on hepatic injury markers. MATERIALS AND METHODS: Four groups of rats were used; control, a group receiving thiamine+ethanol, a group receiving thiamine pyrophosphate+ethanol and a healthy group. The experimental protocol was repeated over 30 days. Malondialdehyde, glutathione and DNA damage product levels in liver tissue were measured at the end of the study. Alanine amino transferase and aspartate amino transferase, markers of liver damage, levels were determined. The results were then compared among the groups. RESULTS: A statistically significant difference between antioxidant markers and markers of liver damage was determined between the group given thiamine pyrophosphate ethanol and the group given ethanol alone (p < 0.01) No statistically significant difference was observed between the group given thiamine and ethanol and the group given ethanol alone (p > 0.01). CONCLUSIONS: Our results suggest that thiamine pyrophosphate may have a protective effect against liver damage caused by alcohol toxicity.

Bilateral Occipital Arteries of Internal Carotid Origin: Report of a Case and Review of the Literature.

The present report describes a patient with bilateral occipital arteries of internal carotid origin, which is an extremely rare variation, and left vertebral artery ostial stenosis diagnosed by selective catheterization and digital subtraction angiography.

The prevention of ischemia/reperfusion induced oxidative damage by venous blood in rabbit kidneys monitored with biochemical, histopatological and immunohistochemical analysis.

The purpose of this study was to investigate the biochemical, histopathological and immunohistochemical effects of venous blood on ischemia/reperfusion-induced oxidative DNA damage and mutation in rabbit kidneys in comparison to melatonin treatment, which has a known protective effect against ischemia/reperfusion (IR) injury. The rabbits were divided into five groups: renal ischemia (RI), renal ischemia-reperfusion (RIR), renal ischemia-venous blood-reperfusion (RIVR), melatonin + renal ischemia-reperfusion (MRIR), and the healthy sham control group (HG). Melatonin (2.5 mg/kg delivered intraperitoneally) was administered one hour prior to ischemia. In the RIVR group, 1 ml of venous blood was administered 5 minutes before the reperfusion. The xanthine oxidase activity in the kidney tissue was determined as 53.50 ± 1.72, 31.00 ± 6.39, 45.66 ± 9.20, 28.66 ± 6.05 and 14.33 ± 1.28 U/g protein; the MDA levels were 6.32 ± 0.02, 19.50 ± 1.33, 7.00 ± 0.96, 7.50 ± 0.76 and 4.75 ± 0.34 mmol/g protein; and the GSH levels were 4.50 ± 1.08, 2.76 ± 0.13, 5.48 ± 0.22, 4.93 ± 0.55 and 6.98 ± 0.33 nmol/g protein in the RI, RIR, RIVR, MRIR and HG groups, respectively. Blood, blood urea nitrogen (BUN) and creatinine levels were classified as high only in the RIR group. The MRIR and RIVR groups, in which oxidative stress was best suppressed, had much milder histopathological and immunohistochemical findings compared to the RIR group. This study has revealed that it is useful to initiate reperfusion of the ischemic tissue with venous blood.

Association of vitamin D deficiency with muscle strength and quality of life in postmenopausal women.

AIM: The aim of this study was to analyze the effect of vitamin D deficiency on muscle strength and quality of life in postmenopausal women. METHODS: Self-sufficient, community-dwelling, postmenopausal women over 55 years old attending the Physical Medicine and Rehabilitation outpatient clinic were included in the study. 25-Hydroxyvitamin D levels below 20 ng/ml were accepted as indicative of vitamin D deficiency. A computerized isokinetic dynamometer (Cybex 770 Norm, Lumex Inc., Ronkonkoma, NY, USA) was used for testing knee extensor muscle strength. RESULTS: Forty-nine postmenopausal women with median age 64.3 years (interquartile range 59.0-69.5 years) were included in the study. Vitamin D deficiency was detected in 49% of the participants. There was no relation between vitamin D deficiency and knee muscle strength in both right and left legs. Vitamin D deficiency was found not to be associated with any of the domains of SF-36. CONCLUSIONS: Vitamin D deficiency is not related to decreased muscle strength and lowered quality of life in postmenopausal women. Other factors rather than vitamin D deficiency should be investigated for illuminating the causalities of these two common clinical conditions.

An investigation of the effect of thiamine pyrophosphate on cisplatin-induced oxidative stress and DNA damage in rat brain tissue compared with thiamine: thiamine and thiamine pyrophosphate effects on cisplatin neurotoxicity.

This study investigated the effects of thiamine pyrophosphate (TPP) at dosages of 10 and 20 mg/kg on oxidative stress induced in rat brain tissue with cisplatin and compared this with thiamine. Cisplatin neurotoxicity represents one of the main restrictions on the drug being given in effective doses. Oxidative stress is considered responsible for cisplatin toxicity. Our results showed that cisplatin increased the levels of oxidant parameters such as lipid peroxidation (thio barbituric acid reactive substance (TBARS)) and myeloperoxidase (MPO) in brain tissue and suppressed the effects of antioxidants such as total glutathione (GSH) and superoxide dismutase (SOD). TPP, especially at a dosage of 20 mg/kg, significantly reduced TBARS and MPO levels that increase with cisplatin administration compared with the thiamine group, while TPP significantly increases GSH and SOD levels. In addition, the level of 8-Gua (guanine), a product of DNA damage, was 1.7 ± 0.12 8-hydroxyl guanine (8-OH Gua)/105 Gua in brain tissue in the control group receiving cisplatin, compared with 0.97 ± 0.03 8-OH Gua/105 Gua in the thiamine pyrophosphate (20 mg/kg) group and 1.55 ± 0.11 8-OH Gua/105 Gua in the thiamine (20 mg/kg) group. These results show that thiamine pyrophosphate significantly prevents oxidative damage induced by cisplatin in brain tissue, while the protective effect of thiamine is insignificant.

Complicated Clostridium difficile colitis in children with cystic fibrosis: association with gastric acid suppression?

Patients with cystic fibrosis (CF) have several risk factors for Clostridium difficile colonization such as frequent hospitalization and exposure to a broad array of antibiotics utilized for the control, eradication, and prophylaxis of respiratory pathogens. However, despite this high rate of colonization, the occurrence of C. difficile infection (CDI) in CF is rare. We report three children with CF who presented with severe community-associated CDI. All three children had complicated courses and one died. These children were in good health without significant morbidities, and were not frequently hospitalized nor did they receive frequent antibiotic courses. The occurrence of 3 severe cases within a 15-month period prompted us to report these cases and review the literature in regard to CDI. We reviewed the CF GI tract as possible risk factors for a high rate of C. difficile colonization in individuals with CF. Since a high percentage of individuals with CF are on gastric acid blocking agents, we also focused on gastric acid suppression as a potential risk factor for CDI.

High sensitive C-reactive protein: a new marker for urinary tract infection, VUR and renal scar.

BACKGROUND: Accurate diagnosis and early treatment of urinary tract infections (UTI) are important because of its association with renal scarring (RS). AIMS: To investigate the serum levels of fibronectin, high sensitive CRP (Hs-CRP), urinary fibronectin, and beta-2 microglobulin (beta2MG) levels in patients with UTI and relationship of these parameters with VUR (vesicoureteral reflex) and RS. PATIENTS AND METHODS: 72 patients were included in study and divided into three groups: Group I (20 patients with first UTI); Group II (16 patients with recurrent UTI with VUR); Group III (16 patients without UTI with VUR). RESULTS: Serum and urine fibronectin levels were similar in all study groups and controls. Urinary beta2MG levels were higher in Group II (302±179 ng/ml) than in the Group I (134±90 ng/ml) (p < 0.001). Moreover, beta2MG levels were similar in Group II (302±179 ng/ml) and group III (218±147 ng/ml). By contrast, beta2MG levels were higher in Group III (218±147 ng/ml) than in the controls (64±32 ng/ml) (p < 0.001). Hs-CRP levels were higher in Group I (1.8±2.7 mg/L), Group II (23.1±32 mg/L), and III (0.4±0.1 mg/L) than the controls (0.2±0.08 mg/L) (p < 0.001). Hs-CRP levels were higher in Group II (23.1±31.9 mg/L) than in the Group I (1.8±2.7 mg/L) (p < 0.001). Hs-CRP levels were higher in Group I (1.8±2.7 mg/L) and Group II (23.1±31.9 mg/L) than in the Group III (0.4±0.1 mg/L) (p < 0.001). Hs-CRP levels were higher in group III (0.37±0.17 mg/L) than in the controls (0.2±0.08 mg/L) (p < 0.001). Hs-CRP (18.8±25 mg/L) and beta2MG levels (349.4±128.5 ng/ml) were different in UTI with RS from the controls (0.2±0.08 mg/L and 64±32 ng/ml respectively, p < 0.001). Fibronectin levels were similar in patients with and without RS. CONCLUSIONS: Increased urinary beta2MG and Hs-CRP were observed in initial UTI and recurrent UTI with VUR. Fibronectin levels were not useful for detection of first and recurrent UTI with VUR and RS. Elevated Hs-CRP levels can help us predetermine the patients with VUR prone to proceed to clinical chronic renal failure.

Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study.

STUDY DESIGN: Retrospective review of medical notes. OBJECTIVE: To evaluate spinal cord injury (SCI) patients' compliance with bladder emptying method at long-term period after discharge and determine the frequency of urinary tract infections (UTIs). SETTING: Inpatient rehabilitation unit of tertiary research hospital. METHODS: Bladder management method of 164 new spinal cord injured patients were noted at discharge from rehabilitation center and follow-up. Patients were questioned whether they continued the initial bladder emtying method at follow-up, reasons for discontinuation and the history of treated UTIs. RESULTS: The most common bladder management method at discharge from inpatient rehabilitation center was clean intermittent catheterization (CIC) (63.4%). At follow-up 42% of the patients who used CIC changed their bladder emptying method. Rate of reverting to urethral indwelling catheter (IC) was 21.4%. Reasons for the patients who switched to IC application were recurrent UTIs, incontinence, nephrolithiasis, dependence on care givers and urethral strictures. For all patients, the frequency of treated UTI in 1 year was 38.8%. The number of UTIs were highest in patients using IC. CONCLUSION: Many factors, including urological complications, patient's preference, living environment, life-style and level of injury should be considered in deciding the method of bladder management in SCI patients. The CIC is a reliable and effective method in selected SCI patients. Despite changes in bladder emptying method, CIC was the most preferred method at long-term follow-up. Education of patients on catheterization technique and periodic follow-up is necessary to maintain patient compliance.

Assessment of in vivo spinal cord conduction velocity in rats in an experimental model of ischemic spinal cord injury.

STUDY DESIGN: Experimental laboratory investigation of spinal cord conductivity alterations in a rat model of ischemic spinal cord injury (SCI). OBJECTIVE: To observe the epidural spinal cord stimulation-induced electromyography responses, and to investigate the possible alterations of spinal cord conduction velocity (SCCV) and compound muscle action potentials (CMAPs) after ischemic SCI in rats. SETTINGS: Adnan Menderes University, Institute of Health Science, Aydin, Turkey. METHODS: SCI was induced by transient occlusion of the abdominal aorta in male Sprague-Dawley rats. Spinal cord histopathology was examined to determine neuronal damage and Tarlov scale was used to grade locomotor functions. Epidural electrical stimulation of spinal cord was performed by monopolar needle electrodes sequentially at L1-L2 and L5-L6 levels, and CMAPs were recorded from the left gastrocnemius muscle by surface electrodes. Amplitudes and durations of CMAPs were evaluated and SCCVs were calculated by analyzing the latency difference of CMAPs. RESULTS: Ischemia-induced SCI resulted in significant reduction of Tarlov scores and a significant decline in number of viable neurons. Similarly, a significant decrement was observed in SCCV following spinal cord ischemia. CONCLUSION: This study demonstrated that measurement of SCCV via epidural electrical stimulation is possible and displays a significant decline after spinal cord ischemia in rats. We suggest that this method can be beneficial to quantify neuronal damage after experimental ischemic SCI.

Effects of diets containing different concentrations of propolis on hematological and immunological variables in laying hens.

To evaluate the effect of 4 different levels of propolis supplementation on the hematological and immunological parameters of laying hens, a trial was conducted with 60 White Leghorn layer hens. The experiment was conducted by using a randomized design with 5 treatments, 4 replicates, and 3 hens in each replicate. Treatments included basal diet (control) and basal diet plus 0.5, 1, 3, and 6 g of propolis/kg of diet, respectively. At the end of the 12-wk treatment period, samples of blood were collected to determine hematological and immunological values. The results showed that the addition of propolis at 3 g/kg in the diet resulted in significant increases (P < 0.05) in the serum IgG and IgM levels and significant decreases (P < 0.05) in the peripheral blood T-lymphocyte percentage compared with those of the control and other treatment groups. In addition, the level of 3 g/kg of propolis supplementation significantly increased (P < 0.05) erythrocyte count (red blood cells) compared with the other treatments. On the other hand, hemoglobin and hematocrit values and total leucocyte (white blood cells) and differential leucocytes counts were not influenced by propolis supplementation. These results indicate that the inclusion of propolis at the level of 3 g/kg of diet may have a positive effect on humoral immunity of laying hens.

Demographic characteristics after traumatic and non-traumatic spinal cord injury: a retrospective comparison study.

STUDY DESIGN: Retrospective, 12-year case series. OBJECTIVE: To compare neurological and functional outcomes, and complications of patients with traumatic vs non-traumatic spinal cord injury (SCI) after in-patient rehabilitation. SETTING: In-patient rehabilitation unit of a tertiary research hospital. MATERIALS AND METHODS: The sample consisted of 165 newly injured patients with traumatic and non-traumatic spinal cord lesions whose medical records were retrospectively reviewed. Demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) subgroup scores, length of stay and medical complications in both groups were compared. RESULTS: In all, 38 patients (23%) were non-traumatic and 127 patients (77%) were traumatic in etiology. Compared with patients with traumatic SCI (mean age 37.81±13.65 years), patients with non-traumatic SCI (mean age 53.97±14.48 years) were significantly older (P<0.05). Incomplete SCI was significantly higher in the non-traumatic group when compared with the traumatic group (P<0.001). In the non-traumatic group, admission motor FIM scores were significantly higher (28.29±16.04) than scores from the traumatic group (36.60±21.65; P=0.029); however, there was no significant difference in discharge motor FIM scores between the two groups (P=0.140). ASIA impairment scale scores were significantly higher in non-traumatic group both at admission and discharge (P=0.000 and P=0.000, respectively). The length of hospital stay was significantly shorter in the non-traumatic group (P=0.002). CONCLUSION: According to the results of this study, although patients with non-traumatic SCI had shorter length of stay and higher ASIA scores, there was no significant difference in functional outcomes between traumatic and non-traumatic SCI patients.

Evaluation of some coagulation parameters in hepatic coccidiosis experimentally induced with Eimeria stiedai in rabbits.

The objective of this study was to evaluate some coagulation parameters in hepatic coccidiosis experimentally induced with Eimeria stiedai in rabbits. Fourteen healthy New Zealand rabbits were equally divided into two groups. One group received no treatment, the other group was orally inoculated with 40 000 sporulated oocysts of E. stiedai in a 1 ml inoculum using a catheter. At day 24 after inoculation, blood samples were collected into sodium citrate-containing tubes to evaluate some coagulation parameters. Although statistically not significant, infected rabbits had prolonged prothrombin time and activated partial thromboplastin time compared with rabbits in the control group. A significant reduction (P < 0.05) was observed in the level of fibrinogen of infected rabbits compared with that of the controls. A slight decrease in thrombocyte counts of infected rabbits was not statistically significant.

Surgical treatment of pulmonary arteriovenous malformation: report of two cases and review of the literature.

Pulmonary arteriovenous malformations (PAVMs) are rare anomalies. The degree of right-to-left shunting, which can lead to cyanosis and paradoxical embolism causing neurological complications, determines the prognosis. We report two cases of PAVM and review the literature. A 45-year-old woman with clinical signs and symptoms of PAVM was examined using several different scanning techniques, which showed a large PAVM in the lower lobe of her right lung. A lobectomy was performed, which revealed a 5 cm diameter PAVM with one feeding artery and multiple veins. Intravenous angiography of a 7-year-old girl with symptoms of fatigue and acro-cyanosis confirmed the presence of a large PAVM in her right lower lobe. The PAVM had two major arteries arising from the aorta, which were ligated during a lobectomy. Both patients recovered well following surgery. Although PAVMs are rare, their neurological and haemodynamic consequences may be fatal. Interventional treatment techniques, including surgery, are usually curative.

The effects of probiotic and mannanoligosaccharide on some haematological and immunological parameters in turkeys.

The study was conducted to investigate the effects of mannanoligosaccharide (MOS) and probiotic supplementation on haematological and immunological parameters in turkeys. A total of 72, 15-day-old white hybrid converter turkey poults were used in this study. Poults were assigned into three groups, each group consisted of six poults and the trial was repeated four times. The control group was fed a basal diet without supplemented probiotic and MOS, and treatment groups were fed either 1 g/kg MOS or probiotic added diets. At the end of the 15-week treatment period, samples of blood were collected to determine immunological and haematological values. The comparison among the groups showed that both the probiotic and MOS supplementation resulted in significant increases (P < 0.05) in the serum IgG and IgM levels, and significant decreases (P < 0.05) in the peripheral blood T lymphocyte percentage compared with those of the control group. Mean serum IgG level (7.06 g/l) was significantly higher (P < 0.05) in poults supplemented with probiotic compared with MOS (6.76 g/l). It was observed that the probiotic supplementation caused statistically significant increases (P < 0.05) in the erythrocyte count, haemoglobin concentration and haematocrit values, but MOS supplementation did not have a significant effect (P > 0.05) on these parameters. Total leucocyte and differential leucocyte counts were not affected by dietary MOS and probiotic supplementation. These results show that MOS or probiotic may elevate IgG and IgM levels in turkey. The MOS and probiotic that enhance immunoglobulin levels will have a more positive effect on growth performance, production and turkeys' ability to resist disease.

Associated anomalies in asymmetric crying facies and 22q11 deletion.

Congenital asymmetric crying facies, a minor congenital anomaly due to unilateral absence or hypoplasia of the depressor anguli oris muscle, is associated at times with major congenital anomalies. A large number of asymmetric crying facies cases with chromosome 22q11 microdeletions have presently been reported. Fluorescence in situ hybridization (FISH) analysis for 22q11 deletion was performed on 8 infants with asymmetric crying facies. Five of our patients had at least one associated systemic anomaly. Two of 5 patients had conotruncal heart disease (Cayler cardiofacial syndrome). In three of the affected infants, we failed to reveal additional congenital malformation. The 22q11 deletion was present in only one patient. This baby had congenital hypoparathyroidism, severe neonatal hypocalcaemia and tetralogy of Fallot. We suggest, a 22q11 deletion should be excluded not in all cases but in cases with Cayler cardiofacial syndrome and in ACF associated with additional congenital anomalies.

Comparison of two different viscosupplements in knee osteoarthritis -- a pilot study.

A pilot study was designed to investigate the efficacy of two different hyaluronic acid preparations combined to physical therapy in patients with knee osteoarthritis in terms of reduction in pain and disability and muscle strengthening. Thirty-seven patients with symptomatic osteoarthritis of the knees were randomly assigned into three groups. First group received a lower molecular weight hyaluronic acid plus physical therapy, second group received a higher molecular weight hyaluronic acid plus physical therapy, and the third group received physical therapy alone. The isokinetic knee muscle strengths and index of severity for osteoarthritis of the knee scores were evaluated at baseline, at the end of treatment (3 weeks) and at 3 months of follow up. At both short-term (3 weeks) and long-term (3 months) evaluations, index of severity for osteoarthritis of the knee scores were reduced in all three groups, while there was no significant muscle strengthening.