Virtual dynamic interaction games reveal impaired multisensory integration in women with migraine.

OBJECTIVE: In this cross-sectional observational study, we aimed to investigate sensory profiles and multisensory integration processes in women with migraine using virtual dynamic interaction systems. BACKGROUND: Compared to studies on unimodal sensory processing, fewer studies show that multisensory integration differs in patients with migraine. Multisensory integration of visual, auditory, verbal, and haptic modalities has not been evaluated in migraine. METHODS: A 12-min virtual dynamic interaction game consisting of four parts was played by the participants. During the game, the participants were exposed to either visual stimuli only or multisensory stimuli in which auditory, verbal, and haptic stimuli were added to the visual stimuli. A total of 78 women participants (28 with migraine without aura and 50 healthy controls) were enrolled in this prospective exploratory study. Patients with migraine and healthy participants who met the inclusion criteria were randomized separately into visual and multisensory groups: Migraine multisensory (14 adults), migraine visual (14 adults), healthy multisensory (25 adults), and healthy visual (25 adults). The Sensory Profile Questionnaire was utilized to assess the participants' sensory profiles. The game scores and survey results were analyzed. RESULTS: In visual stimulus, the gaming performance scores of patients with migraine without aura were similar to the healthy controls, at a median (interquartile range [IQR]) of 81.8 (79.5-85.8) and 80.9 (77.1-84.2) (p = 0.149). Error rate of visual stimulus in patients with migraine without aura were comparable to healthy controls, at a median (IQR) of 0.11 (0.08-0.13) and 0.12 (0.10-0.14), respectively (p = 0,166). In multisensory stimulation, average gaming score was lower in patients with migraine without aura compared to healthy individuals (median [IQR] 82.2 [78.8-86.3] vs. 78.6 [74.0-82.4], p = 0.028). In women with migraine, exposure to new sensory modality upon visual stimuli in the fourth, seventh, and tenth rounds (median [IQR] 78.1 [74.1-82.0], 79.7 [77.2-82.5], 76.5 [70.2-82.1]) exhibited lower game scores compared to visual stimuli only (median [IQR] 82.3 [77.9-87.8], 84.2 [79.7-85.6], 80.8 [79.0-85.7], p = 0.044, p = 0.049, p = 0.016). According to the Sensory Profile Questionnaire results, sensory sensitivity, and sensory avoidance scores of patients with migraine (median [IQR] score 45.5 [41.0-54.7] and 47.0 [41.5-51.7]) were significantly higher than healthy participants (median [IQR] score 39.0 [34.0-44.2] and 40.0 [34.0-48.0], p < 0.001, p = 0.001). CONCLUSION: The virtual dynamic game approach showed for the first time that the gaming performance of patients with migraine without aura was negatively affected by the addition of auditory, verbal, and haptic stimuli onto visual stimuli. Multisensory integration of sensory modalities including haptic stimuli is disturbed even in the interictal period in women with migraine. Virtual games can be employed to assess the impact of sensory problems in the course of the disease. Also, sensory training could be a potential therapy target to improve multisensory processing in migraine.

Does Pattern Scan Laser (PASCAL) photocoagulation really induce less VEGF expression in murine retina than conventional laser treatment?

To investigate the differences in the mRNA and protein expression levels of vascular endothelial growth factor (VEGF) in murine retina between mice subjected to conventional laser (AG) and those subjected to Pattern Scan Laser (PASCAL) system. Male C57BL/6 mice were randomly assigned to one of three groups: Group 1 (G1) receiving retinal scatter laser photocoagulation using with AG photocoagulator (n=16), Group 2 (G2) receiving retinal scatter laser photocoagulation using with PASCAL (n=16) and Group 3 (G3) served as an untreated control group (n=6). Molecular and morphological analyses of VEGF were performed on days 1, 2 and 5 by ELISA, real-time PCR and immuno-histochemical analysis. In samples which underwent AG (G1), when compared with the control group (G3), VEGF mRNA level increased 2.4 folds on day 2, whereas it decreased on day 5 (p□0.001). In samples which underwent PASCAL (G2), on the other hand, VEGF mRNA level increased 1.8 folds on day 1 and 2.2 folds on day 5 when compared with the control group (G3). In samples which underwent AG (G1), when compared with the control group (G3), VEGF protein level increased significantly on day 2, whereas it decreased on day 5 (p□0.001). In group G2, the VEGF levels in the sensory retina significantly increased as compared to control groups at both 2 and 5 days after laser photocoagulation using PASCAL laser (p=0.012, both time points). The peak expressions of VEGF protein in samples which underwent PASCAL and conventional laser were found on day 5 and day 2 respectively. In retinas of PASCAL-treated mice, VEGF immunoreactivity gradually increased during the 5-day follow-up. However, in argon laser group, the strongest VEGF immunoreactivity was detected on day 2, then started to decrease on day 5. In summary, the expression of VEGF protein and mRNA gradually increase during a 5-day follow-up period in PASCAL-treated mouse eyes, whereas in AG group they reach their peak levels on the second day of follow-up and started decreasing after then. These results may also explain why the PASCAL system is less effective in regressing neovascularization in the clinic.

Effects of green tea and vitamin E in the testicular tissue of streptozotocin-induced diabetic rats.

OBJECTIVE: To investigate the possible therapeutic or protective effects of green tea in diabetic rat's testicular tissue, either as a single agent, or together with vitamin E. METHODS: The present study was carried out at the Faculty of Medicine, Gazi University, Ankara, Turkey from May to August 2011 for 10 weeks. Forty-eight adult male Wistar albino rats, weighting 250-300 g, were divided into 8 groups: control; nondiabetic vitamin E (0.4 mg/kg/NG); nondiabetic green tea (300 mg/kg/NG); nondiabetic vitamin E plus green tea administered groups; diabetic group (60 mg/kg/IV streptozotocin); diabetic vitamin E; diabetic green tea; and diabetic vitamin E plus green tea administered groups. Proliferative and apoptotic indexes were determined using anti-PCNA antibody immunohistochemistry and TUNEL assays respectively. Tubule degeneration was evaluated using the Johnson's score and also seminiferous tubules diameters, epithelial thickness were measured. RESULTS: Histopathological examination in diabetic group revealed degenerative changes in the seminiferous tubules together with a statistically significant decrease in PCNA positive cells, in epithelial thickness, diameter of the tubules and in Johnson's score, while exhibited an increase in the number of apoptotic cells. When all these findings are considered together, the most successful protective effects in diabetes were obtained in the combined antioxidant group. CONCLUSION: Combined therapy of vitamin E and green tea in diabetes was more effective than monotherapy. Therefore, these antioxidants may be use as a supporting therapy for reproductive dysfunction.

Dose-related immunohistochemical and ultrastructural changes after oral methylphenidate administration in cerebrum and cerebellum of the rat.

Methylphenidate is a piperidine derivative and is the drug most often used to treat attention deficit/hyperactivity disorder of children and young adults. Our aim is to investigate dose-dependent dopamine-2 receptor and glial fibrillary acidic protein expression and ultrastructural changes of the rat brain, to demonstrate possible toxicity of the long-term and high dose use of the methylphenidate. In this study, 27 female prepubertal Wistar albino rats, divided into three different dose groups (5, 10 and 20 mg/kg) were treated orally with methylphenidate dissolved in saline solution for 5 days per week during 3 months. At the end of the third month, tissues were removed and sections were collected for immunohistochemical and ultrastructural studies. We believe that methylphenidate causes dose-related activation of the dopaminergic system in several brain regions especially in ventral tegmental area and also causing neuronal degeneration and capillary wall structural changes such as basal membrane thickness and augmentation of the pinostatic vesicle in the endothelial cells. Also, increased dose of Ritalin is inducing astrocytes hypertrophy especially astrogliosis in pia-glial membrane and this is the result of the degenerative changes in prefrontal cortex region due to high dose methylphenidate administration. The dose-related accumulation of the astrocytes in capillary wall might well be a consequence of the need for nutrition of the neuronal tissue, due to transport mechanism deficiency related to neuronal and vascular degeneration. Thus, we believe that the therapeutic dose of methylphenidate must be kept in minimum level to prevent ultrastructural changes.

Dose-dependent ultrastructural changes in rat cornea after oral methylphenidate administration.

OBJECTIVE: To investigate dose-dependent ultrastructural changes in rat cornea after oral methylphenidate Ritalin administration. METHODS: This study was conducted in the Department of Anatomy, Gazi University Faculty of Medicine, Ankara, Turkey between March and May 2005, with a total of 27 female prepubertal Wistar albino rats, divided into 3 different dose groups 5mg/kg, 10 mg/kg, 20 mg/kg, and their control groups. They were treated orally with methylphenidate, and eye tissue was removed to process for electron microscopic studies. RESULTS: We observed that all cells, and prominently basal cells of the corneal epithelium show dose-dependent degenerative changes such as apoptotic bodies, chromatin condensation, and ondulation in their nuclei and crystolysis of the mitochondrion. In the stroma, the most evident finding was the increase of the collagen fiber. In addition to dose-dependent changes related to the apoptotic process, which is chromatin condensation in their nuclei, electron dense material accumulation, and pericellular edema in the cytoplasm were also seen. In the endothelial cell lines, disruption of the junctional complexes, vacuolization in the cell cytoplasms, and crystolysis of the mitochondrion's with rough endoplasmic reticulum cisternae activity were observed. CONCLUSION: Ritalin is inducing an evident degeneration, especially in epithelium cells with increasing doses. Ultrastructural cell organelle composition degeneration with stromal fibrosis has a negative effect on cornea dehydration. In light of these findings, we believe that the Ritalin treatment doses need to be kept to a minimum to maintain healthy cornea ultrastructure and related physiology.

Morphometric study of a horseshoe kidney.

OBJECTIVE: To describe a horseshoe kidney, a congenital anomaly of the upper urinary tract. CLINICAL PRESENTATION: A case study of horseshoe kidney harvested from a 62-year-old cadaver at Gazi University Medical School is presented. RESULTS: The right and left kidneys were fused at their lower poles by a parenchymal isthmus located ventral to the abdominal aorta and formed a U-shape with two unequal arms. The isthmus of the ectopic kidney was placed obliquely to the left at the level of the fourth and fifth lumbar vertebra. The left kidney was larger and longer than the right one. The kidneys were supplied by three renal arteries arising from the abdominal aorta. Two arteries on the right side supplied blood of the two kidneys, while the third artery that directly originated from the aorta, above the origin of inferior mesenteric artery, supplied the isthmus. Venous drainage of the both kidneys and the isthmus were drained by three veins that opened independently into the inferior vena cava. The right ureter was duplicated in origin. CONCLUSION: This report shows that knowledge of anomalies such as this is very important in planning and conducting surgical procedures.

Effect of fresh and stored botulinum toxin a on muscle and nerve ultrastructure: an electron microscopic study.

The aim of this study was to compare the ultrastructural alterations of the muscle and nerve that appear following injection of freshly reconstituted and stored botulinum toxin A. Fifteen New Zealand white rabbits were assigned to 6 groups, and anterior auricular muscle was used for injections. Group 1 did not receive any injection and group 2 received saline injection. Groups 3 and 5 received fresh botulinum; muscles and motor nerves were harvested at 5 days and 12 weeks, respectively. Groups 4 and 6 received stored botulinum; muscles and motor nerves were harvested at 5 days and 12 weeks, respectively. Alterations in muscle and nerve ultrastructure were evaluated with electron microscopy. Degeneration findings in muscle after botulinum toxin injection revealed no significant difference between freshly reconstituted and stored toxin in the early period. When stored toxin was used, atrophic changes in the muscle were less severe than the fresh toxin at 3 months. On nerve evaluation, fresh toxin displays significant acute changes on nerve ultrastructure; however, fresh and stored toxin shows similar degeneration at 12 weeks.

Innervation of the rat anterior abdominal wall as shown by modified Sihler's stain.

OBJECTIVE: The purpose of this study was to use the modified Sihler's staining technique to demonstrate detailed distribution of the rat anterior abdominal wall nerves and test the value of Sihler's technique in demonstrating such a complex muscle-nerve relationship. MATERIALS AND METHODS: The anterior abdominal walls of 5 Wistar rats were isolated by making a deep incision from the costal arches on each side down to the inguinal region and processed using a modified Sihler's stain technique. RESULTS: This technique was successfully applied to visualize the innervation of the anterior abdominal wall muscles of the rat. The segmental nerves of T6-L1 and their terminal branches were shown and possible motor and sensory fibers identified. CONCLUSIONS: This technique is valuable in understanding the complex nature of final branching of the nerve endings, and it may be useful for studying experimental nerve models.

The immunohistochemical approach to determine the origin and possible function of the juxtaoral organ in dogs.

OBJECTIVE: In this study, we applied immuno- histochemical techniques on the functionally little known organ of Chievitz (juxtaoral organ [JOO]) in dogs to determine its origin and possible function. METHODS: The term abortive materials of 6 Doberman dogs were used for experimental procedures in July 2002 to June 2003 at Gazi University Faculty of Medicine, Ankara, Turkey, after routine light microscopic tissue preparation, the sections were stained with Masson's trichrome stain. In order to elucidate the function-related origin of the organ, we used epidermal growth factor (EGF-r), transforming growth factor (TGF-alpha) and nerve growth factor (NGF-beta) immunohistochemical stains. RESULTS: We observed a very strong and widespread immunoreactivity of EGF-r and TGF-alpha on simple squamous capsular cells. We detected nerve growth factor-beta positivity in granular form both in simple squamous capsular cells and in neighboring connective tissue. However, we did not detect EGF-r reactivity on parenchymal cells except a weak immunoreactivity on central ones. We noticed transforming growth factor-alpha in most of the parenchymal cells while we observed NGF-beta strongly in all the parenchymal cells. CONCLUSION: These results may point out that the JOO may be of mesothelial or epithelial origin. Having NGF-alpha positive granules and close relationship with blood vessels may imply a neurosecretory function. We believe that our study may add new perspectives to the function of the JOO.

The diagonal ear-lobe crease. As sign of some diseases.

OBJECTIVE: The present study dealt with the question of possible association between the diagonal ear lobe crease (ELC) and diabetes mellitus, hypertension, myocardial infarction, coronary artery diseases. METHODS: The present study was carried out as a field study with the contributions of 6 Primary Health Care Centers in Golbasi, Education and Research Area, Ankara, Turkey in May 2003 June 2003 and includes 3722 individuals (1250 males and 2472 females) of different age groups. From each individual, ELC was graded and a thorough medical history was taken. RESULTS: Ear lobe creases were found more in males and there was a statistically significant positive association between ELC and these diseases in both sexes. CONCLUSION: It was thus thought that ELC could well be included as a valuable sign in diagnosing and screening such diseases.

Gluteal region morphology: the effect of the weight gain and aging.

The gluteal region is an important secondary sexual character itself and it has its place in the concept of the beauty in all communities. Interestingly, as far as we know, there is not any previous study addressing gluteal region morphology in an objective way in the aesthetic surgery literature. The aim of this study was to define the changes of the gluteal region morphology with aging and weight gain. Beside body weight, a total of five distances between predetermined anatomic points in gluteal region were measured on randomly selected 115 female volunteers, with their age ranging from 17 to 48 years (mean 22.7). All the records were analyzed by a correlation matrix using computer-based SPSS 7.5 program. As women grow older, the width of the gluteal region decreases and the gluteal sulcus elongates laterally and inferiorly. Contrary to aging, with weight gain the gluteal region becomes wider as the gluteal sulcus gets shorter. Although the subject does not sound new, our study is the first, documenting the changes in morphology of the gluteal region in relation to weight gain and aging in an objective way.