Effects of 2100 MHz radio frequency radiation on ductus epididymis tissue in rats.

PURPOSE: The use of mobile phones is widespread since the beginning of 1990s. A great debate exists about the possible damage that the Radio Frequency - RF radiation from mobile phones exerts on different organs. The objective of this study was to investigate the possible histopathological effects of 2100 MHz RF radiation on rat ductus epididymis tissue using a light microscopy and immunohistochemical method after one or two month exposure. MATERIALS AND METHODS: The study was performed on 36 adult Wistar albino rats. 2100 MHz RF radiation was used with a specific absorption rate (SAR) of 0.36 W/kg for 30 min/day, 6 days per week for one or two months. There were 3 groups (n = 6 for each group): one month RF exposed group, two months RF exposed group, and the control group. RESULTS: At the end of the study, the structural changes in ductus epididymis tissue were evaluated. In both 2100 MHz RF exposed groups, the rat ductus epididymis sperm were not observed in some channels, a reduction in sperm density in some of the channels drew an attention. The loss of connective tissue and edematous areas were observed in cross channel interstitial connective tissue. In addition, it was observed that vascularization was highly increased with respect to the control group in cross-channel interstitial connective tissue. CONCLUSION: 2100 MHz RF exposure resulted in some structural changes in the male genital ducts of rats (Tab. 1, Fig. 5, Ref 20).

THYROID MALIGNANCY RISK OF INCIDENTAL THYROID NODULES IN PATIENTS WITH NON-THYROID CANCER.

CONTEXT: Thyroid incidentaloma is a common disorder in endocrinology practice. Current literature regarding the risk of thyroid cancer in incidentalomas found in patients with non-thyroid cancer is limited. OBJECTIVE: The aim of the present study was to investigate the frequency of thyroid malignancy in thyroid incidentalomas detected in patients with non-thyroid cancer. DESIGN: Case control study. SUBJECTS AND METHODS: The database of 287 thyroid nodules from 161 patients with a history of non-thyroid cancer followed between 2008 and 2014 were retrospectively evaluated. RESULTS: From 287 thyroid nodules, 69.7 % had a benign final cytology. Thyroid cancer detected in one nodule while follicular neoplasia detected in 4 nodules, atypia of unknown significance (AUS) detected in 10 nodules, Hurthle cell neoplasia detected in 5 nodules and suspicious for malignancy detected in 6 nodules according to fine needle aspiration biopsy results. Metastasis of the non-thyroid cancer to the thyroid gland was detected in 4 nodules. Twenty seven nodules from 15 patients were removed with surgery. There were 3 malignant nodules found after surgery (1 papillary, 1 follicular and 1 medullary cancer). In addition to these three thyroid cancers, two patients with benign nodules had co-incidental thyroid cancer detected after surgery. Finally, 11.1 % of thyroid nodules which underwent thyroid surgery had malignant histopathology except for co-incidental and metastatic cancers. CONCLUSIONS: The frequency of thyroid malignancy seems not to be substantially increased in incidental thyroid nodules detected in patients with non-thyroid cancer when these patients were evaluated in nodule-based approach.

The interplay among iron metabolism, endothelium and inflammatory cascade in dysmetabolic disorders.

PURPOSE: Metabolic syndrome (MetS) is considered as a proinflammatory and prothrombotic state with atherogenic risk factors including dyslipidemia, obesity and glucose intolerance. Oxidative stress is a unifying basis of several disorders including diabetes mellitus (DM) and MetS. We therefore designed this cross-sectional study to investigate the potential interaction among iron metabolism, inflammation and endothelial plexus in MetS and DM patients. METHODS: A total of 62 patients [median age 54 (23-76) years; male/female 16/46] and 18 healthy controls [median age 38 (30-64) years; male/female 6/12] were included in the study. Patient population was classified as MetS (n = 30) and DM (n = 32). RESULTS: Leukocyte count (p = 0.002) and osteopontin (OPN) levels (p = 0.008) were significantly higher, while C-reactive protein (CRP) (p = 0.056) and IL-6 (p = 0.059) represented a relative increase in the patient group. Leptin, endothelin 1 (ET1), hepcidin, nitric oxide synthase (NOS), erythrocyte sedimentation rate (ESR), iron, transferrin saturation (TS) and ferritin levels were not significantly different between the patient and control groups. Endothelin 1 was found to be higher in the DM group compared to MetS group (p = 0.15, p = 0.049). Leukocyte count, leptin, hepcidin, OPN, NOS, IL-6, ESR, CRP, iron, TS and ferritin levels were not different between DM and MetS groups. A positive correlation was demonstrated between leptin and OPN (p = 0.001, r = 0.360), ferritin and hepcidin (p < 0.01, r = 0.633), IL-6 and CRP (p = 0.023, r = 0.319), leptin and NOS (p = 0.005, r = 0.309) and OPN and NOS (p < 0.001, r = 0.803). There was a negative correlation between hepcidin and NOS (p = 0.009, r = -0.289). When the study cohort was divided into two particular groups based on median ferritin and hepcidin levels, hepcidin (p = 0.002), ALT (p = 0.001) and LDL (p = 0.049) levels were higher in the high-ferritin group. Nitric oxide synthase levels (p = 0.033) were lower, whereas ferritin levels (p = 0.004) were higher in the high-hepcidin group. CONCLUSION: Mechanisms involved in the vicious circle of MetS including inflammation, endothelial vasculature and iron metabolism remain to be elucidated. The role of iron metabolism in this complex interaction should be confirmed with further studies.

No genotoxic effect in exfoliated bladder cells of rat under the exposure of 1800 and 2100 MHz radio frequency radiation.

In this study, we aimed to investigate the effects of 1800 and 2100 MHz Radio Frequency (RF) radiation on the number of micronucleus (MN) in exfoliated bladder cells of rat which shows the genotoxic damage. Exposure period was 30 min/day, 6 days/week for a month and two months exposure periods. Thirty male wistar albino rats were used for five groups: Group I (n = 6): 1800 MHz RF exposed animals for one month, Group II (n = 6): 2100 MHz RF exposed animals for one month, Group III (n = 6): 2100 MHz RF exposed for two months, Group IV (n = 6): control group for one month, Group V (n = 6): control group for two months. Rats of the control groups were housed in their home cages during the entire experimental period without subjecting to any experimental manipulation. 1800 and 2100 MHz RF exposures did not result in any significant MN frequencies in rat bladder cells with respect to the control groups (p > 0.05). There was no statistically significant difference between 2100 MHz RF exposed groups, either. Further studies are needed to demonstrate if there is any genotoxic effect, micronucleus formation in other tissues of rats.

Association of polymorphisms in the IL-18 and IL-12 genes with susceptibility to Type 1 diabetes in Turkish patients.

BACKGROUND: Recent studies have indicated that polymorphisms of the interleukin-18 (IL-18) and interleukin- 12 (IL-12) genes are associated with the development of Type 1 diabetes mellitus (T1DM) in some populations, but not all. AIM: The present study was designed to examine the roles of polymorphisms in the IL-18 promoter and IL-12p40 with respect to susceptibility to T1DM in Turkish patients. SUBJECTS AND METHODS: Ninety-one patients with T1DM and 87 unrelated healthy subjects were included in the study. The IL-18 polymorphisms at positions -607 and -137 were detected by a sequence-specific PCR method. The single nucleotide polymorphism in the IL-12p40 3' untranslated region (3'-UTR) at position +1188 was analyzed by the PCR-restriction fragment length polymorphism (RFPL) method. RESULTS: The allelic and genotypic frequencies of the IL-18 and IL-12p40 polymorphisms did not differ significantly between subjects with T1DM and the controls (p>0.05). However, diabetic patients with the -137 (CC) genotype showed a younger onset age compared to patients with the -137 (GG) genotype (p=0.02). In addition, patients with the -607 (CC) genotype had higher levels of glycated hemoglobin (HbA1c) than patients with the -607 (AC) genotype (p=0.004). Furthermore, patients with the IL-12p40 (AC) genotype had higher HbA(1c) levels than patients with the IL-12p40 (AA) genotype (p=0.01). CONCLUSIONS: The results of the present study show that the IL- 18 and IL-12p40 polymorphisms may have some effect on the onset age and deterioration of glycemic control in Turkish patients with T1DM.

Calpain 10 gene single-nucleotide 44 polymorphism may have an influence on clinical and metabolic features in patients with polycystic ovary syndrome.

AIM: This study was designed in order to examine the relationship between Calpain 10 [single-nucleotide polymorphism (SNP) 19,43,44,63] gene polymorphisms and clinical and hormonal characteristics in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: One hundred and seven patients with PCOS and 114 healthy subjects were included in this study. Serum levels of sex steroids were measured for each individual. Insulin resistance (IR) was evaluated by the homeostasis model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) methods. Insulin and glucose responses to the oral glucose tolerance test (OGTT) were analyzed by calculating the areas under the curve for insulin (AUCI) and glucose by the trapezoidal methods.We used PCR and restriction fragment length polymorphism technique to examine Calpain 10 SNP 19, 43, 44, and 63 polymorphisms. RESULTS: Allele distribution of Calpain 10 SNP 44 gene polymorphism was observed as significantly different between the groups. Calpain 10 SNP 44 TC genotype was found to be increased in PCOS subjects (69.15%) compared to the control subjects (50%). However, when compared to control subjects, patients with PCOS had similar Calpain 10 SNP 19, Calpain 10 SNP 43, and SNP 63 gene polymorphisms. When compared with normal Calpain 10 gene SNP 44 allele in PCOS subjects, subjects with PCOS having Calpain 10 gene SNP 44 allele polymorphism had higher free testosterone, androstenedione, DHEA-S, and fasting insulin levels. Also, PCOS women with Calpain 10 gene SNP 44 allele polymorphism had high Ferriman-Gallwey (F-G) score, acne, prevalence of menstrual disturbances, waist-hip ratio, HOMA-IR, AUCI levels and low QUICKI levels. CONCLUSION: The findings show that Calpain 10 gene SNP 44 allele polymorphism may have a role in PCOS pathogenesis. However, larger-scale studies are needed in this field.

Event related potentials in hypothyroidism.

Central nervous system (CNS) dysfunction is an important consequence of thyroid hormone deficiency Several studies using objective behavioral measures reported that cognition is impaired in patients with hypothyroidism. The aim of the present study is to evaluate objectively the functional changes in the nervous system and possible cognitive effects of hypothyroidism by using event related potentials (ERP) in order to determine the frequencies of these changes in patients with hypothyroidism. Forty-two patients (3 males, 39 females) (mean age: 40 +/- 11) with newly diagnosed primary hypothyroidism were included in the study. In all patients the cause of hypothyroidism were chronic autoimmune thyroiditis. None of them had received thyroid hormone as a replacement therapy. In hypothyroid group both N2 and P300 latencies from FZ, CZ, PZ electrode positions were prolonged relative to controls and the differences were statistically significant; respectively (N200: P < 0.003, 0.003, 0.002--P300: P < 0.008, 0.02, 0.001) N100 and P200latencies from FZ, CZ, PZ electrode positions did not differed significantly from those of normal controls; respectively. (p < 0.140, 0.195, 0.153--p < 0.400, 0.185, 0.766) Latency and amplitudes of P300 did not correlated with FT3, FT4 or neither with TSH values in the patient group. We believe like other's that with the aid of this technique we are able to detect early effect on central information processing compatible with a reduction of processing resources and increased effort necessary for a given task in hypothyroid individuals.

The association of neurofibromatosis, bilateral pheochromocytoma and primary hyperparathyroidism.

Neurofibromatosis (NF) is a hereditary disease and carries increased risk of both benign and malignant tumor development. Pheochromocytoma or hyperparathyroidism have been reported to be associated with NF type 1 (NF1). However, the coexistance of pheochromocytoma and parathyroid adenoma in a patient with NF1 is very rare. We report a case of a 37-year-old male with NF1, bilateral pheochromocytoma and parathyroid adenoma. This association sould be kept in mind in patients with NF1 in initial evaluation as well as during follow-up.

Evaluation of Achilles tendon thickening in type 2 diabetes mellitus.

AIM: To investigate the effect of diabetes mellitus on the Achilles tendon, which may contribute to the long-term complications in the foot-ankle complex and to investigate the factors relating to its thickening. METHODS: The study group included 55 patients (26 female and 29 male) with type 2 DM, while the control group included 34 non-diabetic people (13 female and 21 male). We matched the female and male DM patients with their respective control groups in terms of age, BMI, height and body weight. Clinical and biochemical tests, as well as ultrasonographic evaluations of the internal carotid artery and the Achilles tendon, were carried out to evaluate the complications of diabetes mellitus, and to compare the Achilles tendon thickness (ATT) between the study and the control groups. RESULTS: In the female groups the Achilles tendon was significantly thicker in the diabetic patients than in their healthy controls (p<0.001). However, no difference was found in the ATT between the male diabetic patients and their male controls (p=0.74). The ATT correlated with the body mass index (BMI) (r=0.47, p=0.015) and body weight in diabetic female group (r=0.56, p=0.003). We also observed that the ATT values were higher in male DM patients with retinopathy (p=0.034) or neuropathy (p=0.019) compared to the male DM patients without these complications. CONCLUSIONS: The ATT in type 2 female diabetic patients was found to be higher than their non-diabetic controls, but no significant difference could be found between type 2 diabetic male patients and their non-diabetic controls by US. Our results might indicate a possible impact of diabetes on the ATT depending upon gender, but other mechanisms may also contribute to thickening of Achilles tendon.

Gait deviations of patients with diabetes mellitus: looking beyond peripheral neuropathy.

AIM: The aim of this paper was to define the gait deviations in patients with diabetes mellitus (DM), to investigate the associations between electrophysiological findings and gait characteristics, and to interpret the findings in preventive and therapeutic rehabilitation protocols. METHODS: Forty-six patients with DM and 20 healthy control subjects were enrolled into this controlled study. Electrophysiological studies and computerized gait analysis were performed. Gait deviations of DM patients with diabetic peripheral neuropathy (DPN) (n=20), without diabetic peripheral neuropathy (NDPN) (n=26) and healthy control subjects (C) (n=20) were compared, and associations between electrophysiological findings and gait characteristics were investigated. RESULTS: NDPN, but not DPN, group revealed slower gait, shorter steps, limited knee and ankle mobility, lower ankle plantar flexor moment and power than C group, and the difference was statistically significant. HbA1c levels and F-wave latency were significantly correlated with ankle mobility, peak ankle plantar flexion moment and power. CONCLUSION: Neuropathy may not be the only reason for gait deviations in DM patients. Considering the spectrum of hyperglycemic complications including the mechanical characteristics of bones, muscles and soft tissues, patients with DM should start mobility and strengthening exercises in early stages.

Ret proto-oncogene mutations in apparently sporadic Turkish medullary thyroid carcinoma patients: Turkmen study.

OBJECTIVE: Medullary thyroid carcinoma (MTC) frequently occurs in a sporadic form, but a substantial number of cases are hereditary and appear as part of the multiple endocrine neoplasia type 2 (MEN2) syndromes. Germline mutations in ret proto-oncogene have been shown to be the underlying cause of MEN2 syndromes. DESIGN: We carried out a multi-center study that aimed to perform mutational analysis of so called sporadic MTC patients. METHODS: Fifty-six MTC patients verified by histopathologic examination were subjected to genetic analysis. Exon 10, 11, 13, 14, 15 and 16 of the ret gene were analyzed by DNA sequencing and restriction enzyme digestion method. RESULTS: Among 56 apparently sporadic MTC patients, we identified 6 (10.7%) ret germline mutation carriers. Three individuals carried mutations at codon 634 in exon 11, one at codon 618 in exon 10, and two at codon 804 in exon 14. Identification of the predisposition gene mutation has allowed DNA-based strategy for direct mutation detection in patients with apparently sporadic MTCs. A substantial number of patients with apparently sporadic MTC carried germline mutations and 50% of their first degree relatives are expected to have or to develop MTC and/or other endocrine tumors. CONCLUSIONS: These results indicate the importance of careful genetic surveillance of any patient with apparently sporadic MTCs.

Changes in intraocular pressure and corneal and retinal nerve fiber layer thicknesses in hypothyroidism.

PURPOSE: To evaluate the changes in intraocular pressure (IOP), corneal thickness (CT), and retinal nerve fiber layer thickness (RNFLT) in patients with hypothyroidism before and after treatment. METHODS: A complete ophthalmic examination including visual acuity, IOP, anterior segment, and fundus examination together with CT and RNFLT measurements were performed for each patient with newly diagnosed hypothyroidism, at the initial diagnosis and the third and ninth months of the L-thyroxine treatment. Wilcoxon signed rank test and Spearman's correlation test were used for statistical evaluation of the results. RESULTS: A total of 56 eyes of 28 patients were included in the study. The mean IOP and CT values were found to decrease with medical treatment (p = 0.000). There was no significant change in any of the RNFLT parameters measured with scanning laser polarimeter after L-thyroxine treatment (Wilcoxon, p > 0.05). The change in IOP levels was not correlated with the change in thyroid hormone levels (Spearman's correlation test, p > 0.05). The mean increase in serum free T3 and serum free T4 levels and the mean decrease in serum TSH levels at the ninth month of the therapy were found to be correlated with the decrease in CT in the left eyes (Spearman's correlation test, R > 0.4 and p < 0.05). CONCLUSIONS: Hypothyroidism seems to cause a reversible increase in CT and IOP. IOP changes may be secondary to CT changes. RNFLT parameters measured with scanning laser polarimeter do not seem to be affected by hypothyroidism. When the CT is taken into account and the IOPs corrected for CT, the prevalence of glaucoma in hypothyroidism may not be as high as previously reported. This issue should be taken into account while assessing glaucoma in patients with hypothyroidism.

Changes in intraocular pressure and corneal and retinal nerve fiber layer thicknesses in hypothyroidism.

PURPOSE: To evaluate the changes in intraocular pressure (IOP), corneal thickness (CT), and retinal nerve fiber layer thickness (RNFLT) in patients with hypothyroidism before and after treatment. METHODS: A complete ophthalmic examination including visual acuity, IOP, anterior segment, and fundus examination together with CT and RNFLT measurements were performed for each patient with newly diagnosed hypothyroidism, at the initial diagnosis and the third and ninth months of the L-thyroxine treatment. Wilcoxon signed rank test and Spearman's correlation test were used for statistical evaluation of the results. RESULTS: A total of 56 eyes of 28 patients were included in the study. The mean IOP and CT values were found to decrease with medical treatment (p=0.000). There was no significant change in any of the RNFLT parameters measured with scanning laser polarimeter after L-thyroxine treatment (Wilcoxon, p>0.05). The change in IOP levels was not correlated with the change in thyroid hormone levels (Spearman's correlation test, p>0.05). The mean increase in serum free T3 and serum free T4 levels and the mean decrease in serum TSH levels at the ninth month of the therapy were found to be correlated with the decrease in CT in the left eyes (Spearman's correlation test, R>0.4 and p<0.05). CONCLUSIONS: Hypothyroidism seems to cause a reversible increase in CT and IOP. IOP changes may be secondary to CT changes. RNFLT parameters measured with scanning laser polarimeter do not seem to be affected by hypothyroidism. When the CT is taken into account and the IOPs corrected for CT, the prevalence of glaucoma in hypothyroidism may not be as high as previously reported. This issue should be taken into account while assessing glaucoma in patients with hypothyroidism. (Eur J Ophthalmol 2005; 15: 556-61).

The relationship between levels of alpha1-acid glycoprotein and metabolic parameters of diabetes mellitus.

The aim of this study was to investigate the relationship of alpha1-acid glycoprotein (AGP, orosomucoid), which is an acute-phase reactant, in patients with Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM), with the metabolic parameters and complications of diabetes mellitus. A total of 119 diabetic patients (89 T2DM, 30 T1DM) and 33 healthy controls were included in the study. The mean AGP level in the diabetic group was not different from the control group (82.4 +/- 28.9 and 81.6 +/- 16.6 mg/dl, respectively), but it was higher in T2DM than in T1DM subjects (86.6 +/- 28.3 and 69.7 +/- 26.9, respectively). AGP plasma levels showed a significant correlation with age and body mass index (r = +0.348 and r = +0.296, respectively). AGP plasma levels resulted higher in obese diabetic patients (97.7 +/- 28.0) than in non-obese diabetic patients (77.6 +/- 28.7 mg/dl) and controls (81.6 +/- 16.6), and also higher in diabetic subjects with poor glycaemic control (85.1 +/- 33.3 mg/dl) than in diabetic subjects with optimal glycaemic control (79.5 +/- 23.1 mg/dl). A relationship between AGP and macro- and microvascular complications of diabetes mellitus was not found. In conclusion, inflammatory findings were more prominent in obese diabetic patients.

Insulin secretion and insulin sensitivity in normal pregnancy and gestational diabetes mellitus.

The purpose of this study was to evaluate insulin sensitivity, beta-cell function and islet-cell-directed autoimmunity in pregnant women with normal glucose tolerance and gestational diabetes mellitus (GDM). A total of 21 women with normal glucose tolerance and 21 women with GDM were evaluated at 24-36 weeks' gestation. Insulin resistance and beta-cell function were evaluated using the continuous infusion of glucose with model assessment (CIGMA) method, which aims to give a near-physiological stimulus and to evaluate the endogenous insulin and glucose response. Islet-cell autoantibody was positive in one woman with GDM, and glutamic acid decarboxylase autoantibodies were negative in both groups. The calculated CIGMA insulin resistance (CIGMA IR) was 2.04 +/- 1.74 and 1.08 +/- 1.22 in patients with GDM and in control subjects, respectively (p < 0.05). CIGMA percentage beta-cell values were 64.04 +/- 44.55% and 87.07 +/- 52.77% in patients with GDM and control subjects, respectively (p > 0.05). Decreased insulin sensitivity in late pregnancy was more evident in lean GDM subjects with mild hyperglycemia who did not require insulin therapy, and beta-cell function was partially preserved in this group of patients.

The prevalence of autoimmune hepatitis in Hashimoto's thyroiditis in a Turkish population.

PURPOSE: Hashimoto's thyroiditis (HT) is an autoimmune thyroid disorder. Although its etiopathogenesis is obscure, there are many findings about the relationship between other autoimmune diseases and HT. The reason for this association is a topic of interest, but in our study we searched for the concurrence of autoimmune hepatitis (AH) with HT, which is a relatively new autoimmune disorder for this association. METHODS: Forty-six patients (44 female, 2 male) with HT were included in the study. Liver function tests, viral hepatitis markers, autoantibody panels, ultrasonography and liver biopsy were performed in certain cases. RESULTS: All patients were hepatitis B negative, only two patients were hepatitis C positive (4.3%). Smooth muscle antibody (SMA) was 21.7% positive, ANA was 26% positive, Anti-Liver kidney microsomal antibody-1 (LKM-1) was 13.4% positive. Anti-mitochondrial antibody (AMA) was not detected. Liver biopsy performed on six patients. Two of them had (+++) positive LKM-1 antibody titer, the other two had ANA and SMA positive results respectively and the last two had chronic hepatitis C infection. The pathology revealed AH in first four patients. We found four out of forty-six patients with HT as AH (8.69%). CONCLUSION: HT patients should be searched for autoimmune diseases and AH might be one of them.

Assessment of nerve fiber layer in diabetic patients with scanning laser polarimetry.

OBJECTIVES: To evaluate the effects of diabetes mellitus, diabetic retinopathy and degree of blood glucose (BG) regulation on retinal nerve fiber layer (RNFL) thickness by using a scanning laser polarimeter (NFA-GDx). METHODS: We prospectively assessed RNFL thickness in four groups of patients, who were all age matched. Diabetic patients without diabetic retinopathy were grouped according to their BG regulation level into two, as: BG-regulated group (BG <140 mg/dl, HbA1c <8%, fructosamine <285 micromol/l, TG <200 mg/dl, n = 50), and BG-non-regulated group (BG = 140-250 mg/dl, HbA1c >8%, fructosamine >285 micromol/l, TG >200 mg/dl, n = 44). A group of patients with nonproliferative diabetic retinopathy (NPDR) formed the 3rd group (n = 41). The 4th group consisted of healthy subjects and acted as a control group (n = 50). Symmetry, superior maximum, ellipse modulation and the average thickness variables of NFA-GDx were used for the assessment. ANOVA test was used for the statistical analysis of variables between groups. RESULTS: The mean superior maximum and ellipse modulation values were statistically significantly lower than the control group in BG-non-regulated and NPDR groups (P < 0.05). The average thickness value was also statistically significantly lower than the control group in NPDR group. These values in the BG-regulated group were not statistically significantly different from the control group (P > 0.05). CONCLUSIONS: This is the first clinical study demonstrating the effects of diabetic glucose regulation level on RNFL by using NFA-GDx. RNFL thickness was seen to decrease with development of diabetic retinopathy and with impairment of metabolic regulation. This issue should be taken into account while assessing RNFL in diabetic glaucomatous patients.

Sympathetic skin response in diabetic neuropathy.

Autonomic neuropathy is a complication of diabetes mellitus (DM) in substantial proportion of cases and may cause definite autonomic symptoms. Because conventional electrophysiological methods do not assess the autonomic nervous system, simple reproducible tests were developed. One of them is sympathetic skin response (SSR) which provides useful information about the status of sympathetic postganglionic function. The aim of this study is to perform SSR in diabetic patients to see whether this test can be used as an electrophysiological method for the diagnosis and confirmation of diabetic autonomic neuropathy. 20 diabetic patients who had electrophysiologically confirmed polyneuropathy but showed no symptoms or signs referable to autonomic system dysfunction were included. 14 (70%) patients demonstrated abnormal SSR. 2 abnormal patterns were observed. An absent response in at least one tested lower extremity (50%) and prolonged foot with normal hand latency (20%). 6 patients (30%) demonstrated no abnormalities. Foot and hand latencies in diabetics did not differ significantly from those of normal controls (p: 0.4, p: 0.1) and no correlation could be found with latencies and duration of sickness, patient's age and HbA1c values. We believe latency measurement is an objective measure of conduction in multineural pathways and can detect subclinical involvement of sympathetic nervous system in diabetics who do not manifest symptoms or signs referable to autonomic system dysfunction.

Acute and chronic effects of different concentrations of free fatty acids on the insulin secreting function of islets.

INTRODUCTION: Lipotoxic effects of free fatty acids (FFAs) on insulin secreting function of islet beta-cells have been demonstrated in recent studies. This toxic effect is especially prominent on postprandial hypertriglyceridemic period. Hypertriglyceridemia and high FFAs levels are the most common metabolic disturbances seen in diabetes mellitus (DM), in particular in uncontrolled cases. AIM OF STUDY: To investigate acute and chronic effects of different concentrations of FFAs on insulin secreting function of pancreas islet beta-cells. MATERIAL AND METHOD: We determined the acute and chronic effects of FFAs on insulin secretion dynamics of isolated rat islets. The insulinotropic effects of four D-glucose concentrations (Nil, 5.6, 8.3 and 27.7 mM) were studied in freshly isolated and perifused islets in the presence of two different concentrations (250 micromol/l and 1,250 micromol/l) of three FFAs (palmitate, stearate and oleate) to determine the acute effects. Chronic effects were investigated similarly on islet cells incubated for 72 hours in the presence of nil, 250 micromol/l and 1,250 micromol/l concentrations of FFAs. RESULTS: There was only a slight increase in insulin secretion at both concentrations of FFAs in freshly isolated islets, and the recovery was complete with a slight decrease in pathologic FFA channel. However, after 72 hour incubation at physiological or higher concentrations of FFAs, insulin secretion was significantly lower, even in the presence of high levels of D-glucose when compared to either nil channel results, or results of the fresh samples. Insulin levels of recovery phase were slightly but significantly lower in physiological and pathologically high FFA conditions when compared to nil condition. In addition, first phase insulin release response was lost in these islets. CONCLUSION: FFAs slightly increased the insulin output of normal fresh pancreas beta-cells. However, chronic exposure to FFAs resulted in loss of first phase insulin release and blunted insulin secretion response to various levels of D-glucose stimulation.