The role of body composition and appetite-regulating hormones in idiopathic central precocious puberty and their changes during GnRH analog therapy.

PURPOSE: It was aimed to compare circulating levels of ghrelin, leptin, peptide YY (PYY), and neuropeptide (NPY) between girls with idiopathic central precocious puberty (ICPP) and prepubertal girls, as well as to evaluate alterations in these hormone levels and body composition during leuprolide acetate treatment in girls with ICPP. METHODS: This prospective study was conducted on girls with isolated premature thelarche (IPT), girls with ICPP, and age-matched prepubertal controls. Anthropometric measurements, body composition analysis and appetite-regulating hormone level measurements were performed in each group and also at the 6th and 12th months of the leuprolide acetate treatment for the girls with ICPP. RESULTS: Seventy-three girls participated in the study (24 girls with ICPP, 28 with IPT, and 21 prepubertal controls). No significant differences were observed in ghrelin, leptin, PYY, and NPY levels among the three groups. Leuprolide acetate treatment resulted in increased leptin, decreased PYY and NPY levels, and no significant changes in ghrelin. Despite no significant change in body mass index standard deviation score (BMI SDS), body fat percentage increased during treatment. CONCLUSION: While appetite-regulating hormones do not seem to directly contribute to precocious puberty pathogenesis, puberty blockade was shown to lead to altered levels of these hormones along with changes in body composition.

Feasibility of exergaming for upper extremity rehabilitation in people with multiple sclerosis: prospective clinical trial.

BACKGROUND: Exergaming has been suggested as a rehabilitation method since it is more motivational for people with multiple sclerosis (MS, pwMS). However, the major disadvantage of this method is the lack of specific scenarios designed for pwMS. OBJECTIVES: This study aims to assess the feasibility of exergaming, which was developed for pwMS. METHODS: This unblinded prospective clinical trial was performed in the outpatient MS Clinic of Dokuz Eylül University Hospital. Exergaming scenarios were developed in collaboration with medical personnel consisting of physiotherapists and doctors, and computer engineers. A total of 30 participants who had definite MS diagnoses were included. The exergaming scenarios were implemented using the Microsoft Kinect. A physiotherapist applied custom-made exergames for one session. All the participants were assessed immediately after the session. The User Satisfaction Evaluation Questionnaire was used to assess the user's satisfaction with the system and exergaming. RESULTS: The mean age was 41.5, the mean Expanded Disability Status Scale was 4.5 (range between 0 and 7), and the mean disease duration was 10.0 years. Twenty patients were relapsing-remitting, and 10 were secondary-progressive. The mean scores of the User Satisfaction Evaluation Questionnaire were 4.33 (SD = 0.84) for helpfulness for rehabilitation, 1.63 (SD = 1.1) for not disturbing, 4.50 (SD = 1.07) for understandability, 4.0 (SD = 0.91) for easiness to control, and 4.33 (SD = 0.84) for enjoyability. CONCLUSION: These results showed that our custom-made exergaming scenario could be feasible in upper extremity rehabilitation in MS. More research is needed to investigate its effectiveness in the rehabilitation of upper limbs.

Cryopreservation of Lilium candidum germplasm: analysis of pre- and post-freeze treatments.

BACKGROUND: Lilium candidum L. is a perennial ornamental plant that has various medicinal properties and is used in the cosmetic industry. The species is facing threats from urbanization and climate change and requires urgent protection. The most secure and efficient technology for the long-term storage of plant genetic resources is cryopreservation, which involves preserving genetic material at extremely low temperatures. OBJECTIVE: Today, plant biodiversity is endangered because of the narrowing of its natural distribution areas and/or destruction for different purposes. This study concentrated on creating a cryopreservation process using shoot tips and calluses as explant sources for the long-term conservation of L. candidum species. MATERIALS AND METHODS: Populations of L. candidum naturally distributed from three different regions of Turkey (Kepsut, Balikesir; the area surrounding Bafa Lake, Aydin; and Fethiye-Mugla) were grown in vitro to supply shoot tip and callus explants. Prior to freezing by droplet-vitrification and vitrification techniques, shoot tips and calluses were treated with MS nutritional medium supplemented with 0.4 M sucrose 7 g per L agar and plant vitrification solution 2 (PVS2). RESULTS: Cryopreserved shoot tips showed the highest levels of regeneration (71.8%) after a PVS2 treatment of 90 min, while calluses showed the highest levels of regrowth (63.9%) after a PVS2 exposure of 60 min. CONCLUSION: High levels of regrowth are produced when the various cryopreservation procedures described here are used to preserve both shoot tip and callus explants. This potentially makes the method promising for the long-term preservation of endangered L. candidum varieties. Doi.org/10.54680/fr23510110512.

A glucose biosensor based on novel Lutetium bis-phthalocyanine incorporated silica-polyaniline conducting nanobeads.

The facile preparation of highly sensitive electrochemical bioprobe based on lutetium phthalocyanine incorporated silica nanoparticles (SiO2(LuPc2)) grafted with Poly(vinyl alcohol-vinyl acetate) itaconic acid (PANI(PVIA)) doped polyaniline conducting nanobeads (SiO2(LuPc2)PANI(PVIA)-CNB) is reported. The preparation of CNB involves two stages (i) pristine synthesis of LuPc2 incorporated SiO2 and PANI(PVIA); (ii) covalent grafting of PANI(PVIA) onto the surface of SiO2(LuPc2). The morphology and other physico-chemical characteristics of CNB were investigated. The scanning electron microscopy images show that the average particle size of SiO2(LuPc2)PANI(PVIA)-CNB was between 180-220nm. The amperometric measurements showed that the fabricated SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor exhibited wide linear range (1-16mM) detection of glucose with a low detection limit of 0.1mM. SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor exhibited high sensitivity (38.53µAmM-1cm-2) towards the detection of glucose under optimized conditions. Besides, the real (juice and serum) sample analysis based on a standard addition method and direct detection method showed high precision for measuring glucose at SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor. The SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor stored under refrigerated condition over a period of 45 days retains ~ 96.4% glucose response current.

Virtual hysterosalpingography and hysteroscopy: assessment of uterine cavity and fallopian tubes using 64-detector computed tomography data sets.

Hysterosalpingography is the primary technique in providing coarse information on the morphology of endometrial cavity and fallopian tubes. In this preliminary study, 64-detector computed tomography was used for three-dimensional imaging of endometrium and fallopian tubes.

Recording event-related activity under hostile magnetic resonance environment: Is multimodal EEG/ERP-MRI recording possible?

Event-related potentials (ERPs) have high temporal resolution, but insufficient spatial resolution; the converse is true for the functional imaging techniques. The purpose of the study was to test the utility of a multimodal EEG/ERP-MRI technique which combines electroencephalography (EEG) and magnetic resonance imaging (MRI) for a simultaneously high temporal and spatial resolution. The sample consisted of 32 healthy young adults of both sexes. Auditory stimuli were delivered according to the active and passive oddball paradigms in the MRI environment (MRI-e) and in the standard conditions of the electrophysiology laboratory environment (Lab-e). Tasks were presented in a fixed order. Participants were exposed to the recording environments in a counterbalanced order. EEG data were preprocessed for MRI-related artifacts. Source localization was made using a current density reconstruction technique. The ERP waveforms for the MRI-e were morphologically similar to those for the Lab-e. The effect of the recording environment, experimental paradigm and electrode location were analyzed using a 2x2x3 analysis of variance for repeated measures. The ERP components in the two environments showed parametric variations and characteristic topographical distributions. The calculated sources were in line with the related literature. The findings indicated effortful cognitive processing in MRI-e. The study provided preliminary data on the feasibility of the multimodal EEG/ERP-MRI technique. It also indicated lines of research that are to be pursued for a decisive testing of this technique and its implementation to clinical practice.

Magnetic resonance imaging of muscular involvement in juvenile dermatomyositis: case report.

A case of 5 year old juvenile patient with dermatomyositis together with conventional and diffusion-weighted MRI images is reported. The reported case was atypical for the pattern of involvement of the accompanying oedema which was affecting distal parts of the extremities and anterior muscle groups. Electromyography was negative. The case confirmed by a pathologist demonstrates the use of diffusion weighted imaging in determining unequivocal oedema and its exact extent.

Estimating femoral nail length in bilateral comminuted fractures using fibular and femoral head referencing.

OBJECTIVE: Femoral nail length can be estimated preoperatively by several methods, but this usually requires an intact contralateral femur. The aim of this study was to determine an alternative method using fibula and femoral head as references. MATERIALS AND METHODS: Digital radiographic views of the lower limbs of 102 healthy volunteers were used to compare femoral medullary length with the sum of fibular length and transverse head diameter. RESULTS: Femoral medullary length and the estimated length were highly correlated (r=0.942, p<0.0001). Paired samples t-testing has produced a high significance (p<0.002). CONCLUSION: The formula provides a simple and accurate estimation of femoral medullary length, and may be used in nailing, particularly of bilateral comminuted femoral fractures.

Use of dynamic contrast-enhanced magnetic resonance imaging for differentiating between aggressive rectal tumours: two cases with small cell carcinoma and malignant melanoma.

Poorly differentiated small cell carcinomas and malignant melanomas are among the rarest of primary colorectal malignancies. Although very aggressive and lethal, small cell carcinomas and the amelanotic variety of malignant melanomas have similar radiological features to adenocarcinomas. We present two different cases with these unusual tumours, with special emphasis on their dynamic contrast-enhanced magnetic resonance imaging features. The dynamic contrast-enhanced magnetic resonance imaging revealed that these tumours have a faster and stronger enhancement pattern than most adenocarcinomas. The technique is thus potentially useful for the preoperative diagnosis of unusual aggressive tumours and for guiding the choice of treatment.

A case of frontal lobe abscess as a complication of frontal sinus ossifying fibroma.

Sinonasal ossifying fibroma is a rare, slow-growing, benign bony tumour, frequently involving the maxilla and mandible in the head and neck region. Although it is known to be the second most frequent fibro-osseous tumour of paranasal sinus, to the best of our knowledge, ossifying fibroma of frontal sinus causing brain abscess has not been presented yet in the relevant literature. We present the clinical, pathological and radiological findings of ossifying fibroma of the frontal sinus associated with brain abscess.

Brucellar breast abscess.

Brucellosis is an endemic disease seen in many countries. It may affect different organ systems. Brucellar breast abscess is a rare entity. We report the radiological findings of breast abscess due to brucella. A 63-year-old female was investigated with mammography, ultrasonography, magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS). A mass measuring 25 x 20 x 15 mm was detected in the left breast on mammography and ultrasonography. The mass was homogenously hyperintense on T1- and T2-weighted MRI images. On contrast-enhanced T1-weighted images, peripheral capsular enhancement was found. MR spectroscopic analysis of the mass revealed elevated lipid and acetate peaks. The diagnosis was provided by fine needle aspiration biopsy and specimen culture. The lesion had diminished in size after 12 months' treatment with combined tetracycline and rifampicine.

Synchronous endometrial and cervical tumors in a 26-year-old nullipara: diagnostic modalities updated.

Proton magnetic resonance spectroscopy (MRS), performed on conventional magnetic resonance imaging (MRI) scanners, provides useful information at the biochemical level. MRS has been used to measure tissue concentrations of proton-containing compounds such as organic and amino acids, and sugars in living tissues. We have used MRS in a 26-year-old female with suspected cervical and endometrial carcinomas. With the use of the above mentioned technique, biochemical differences in the endometrium and the cervix tissues were detected. The presented case is the first virgin patient in the relevant literature in whom endometrial and cervical carcinoma was detected. Choline (Cho), creatine (Cr), N-acetylaspartate (NAA), lipid and lactate region of the MRS spectrum suggested that the technique could be used as an indicator of metabolic alterations in the cervical and endometrial tumor cells.

Magnetic resonance spectroscopic comparison of the effects of resveratrol (3,4',5-trihydroxy stilbene) to conjugated equine estrogen, tibolone and raloxifene on ovariectomized rat brains.

OBJECTIVE: To investigate the effects of resveratrol on basic cerebral metabolites of in the brains of ovariectomized rats. MATERIALS AND METHODS: Twenty-four bilaterally ovariectomized rats were randomly assigned into six groups with four rats in each group. The groups consisted of sham-operated (control), ovariectomized, resveratrol, conjugated equine estrogen (CEE), tibolone and raloxifene treated rats. Drug administration started at the 5th day following ovariectomy and continued for 35 days. At the end of the entire course, in vivo single voxel magnetic resonance spectroscopy was performed on whole brains to determine choline, creatine and N-acetyl aspartate (NAA) concentrations. RESULTS: Compared to sham-operated group, ovariectomized group had significantly lower NAA (P<0.008) but significantly higher choline levels (P<0.031). Administration of CEE and resveratrol resulted in NAA levels that were similar to those in the sham-operated group, showing that the NAA decrease due to ovariectomy was prevented. Treatment with tibolone and raloxifene resulted in a smaller increase in NAA and the effect failed to reach significance. Administration of resveratrol, CEE, tibolone and raloxifene resulted in choline levels similar to those in sham-operated group, showing that the increase in the ovariectomy group was prevented. CONCLUSION: Resveratrol causes levels of cerebral metabolites that is similar to conventional hormone replacement agents. This finding may suggest that neuronal function in the postmenopausal state was preserved. More detailed investigation of this issue should be the task of future research.

Imaging of nail-patella syndrome.

Nail-patella syndrome is a rare disorder, which is inherited as an autosomal dominant trait. This condition is also known as hereditary osteo-onychodysplasia or Fong's syndrome. Posterior iliac horns are commonly found in this syndrome and are considered pathognomonic. In this report, we describe the appearance, location, and structure of iliac horns with respect to radiography and magnetic resonance imaging.

Imaging of granulomatous mastitis: assessment of three cases.

Granulomatous mastitis is a benign, inflammatory breast disease of unknown aetiology, which can mimic breast carcinoma in its clinical manifestations. Imaging features of three cases of granulomatous mastitis mimicking breast carcinoma on both clinical and radiographic examination are presented, with special emphasis on the role of dynamic contrast-enhanced-magnetic resonance mammography in the differential diagnosis.

Ultrasonographic evaluation of age-related changes in bowing of the flexor retinaculum.

The effects of age, gender, and hand dominance on bowing of the flexor retinaculum, used in diagnosing carpal tunnel syndrome, were analyzed. Forty men aged 23-58 years old (39.7 +/- 11.2) and 40 women aged 20-57 years old (39.6 +/- 11.3) were the normal subjects. A total of 160 wrists was examined with a linear array transducer. Bowing of the flexor retinaculum was measured as the distance from a line drawn between the trapezium and the hamate to the palmar apex of the outer surface of the flexor retinaculum. It was 0.5-3.7 mm (2.00 +/- 0.64) for all hands, 0.6-3.7 mm (2.06 +/- 0.62) for men, 0.5-3.4 mm (1.96 +/- 0.67) for women, 0.5-3.4 mm (1.00 +/- 0.64) for dominant, and 0.6-3.7 mm (2.03 +/- 0.65) for nondominant hands. There was no difference between genders or dominant vs non-dominant hands regarding this parameter. However, it was highly correlated with age (r=0.59, p<0.0001). In conclusion, bowing of the flexor retinaculum measurements should be carefully compared with the standardized values when diagnosing carpal tunnel syndrome.

Sonographic evaluation of the carpal tunnel after provocative exercises.

OBJECTIVE: Dynamic carpal tunnel syndrome (CTS) is a subtype of CTS in which symptoms usually subside with rest and return with repetitive motions. In this subgroup, nerve conduction studies, performed at rest, are often inconclusive. In this study, the diagnostic value of provocative sonography was evaluated in patients with dynamic CTS. METHODS: Twenty wrists of 13 patients with dynamic CTS and 10 control subjects were investigated with sonography before and immediately after provocative exercises imitating work-related stresses. In addition to conventional indices (palmar displacement, nerve area at the middle level, and swelling ratio before and after exercise), 2 newly formed indices (provocative nerve area ratio and provocative palmar displacement ratio) were investigated. RESULTS: In the pre-exercise period, there were no significant differences between patients and control subjects regarding palmar displacement and the swelling ratio. The difference was significant (P =.035) for the nerve area at the middle level. In the post-exercise period, all parameters were significantly different between patients and control subjects. The nerve area at the middle level and the swelling ratio had higher significance (P <.0001) than palmar displacement (P =.015). The post-exercise swelling ratio had the highest sensitivity (95%) in diagnosing dynamic CTS when a cutoff value of 1.26 was used. The provocative palmar displacement ratio had high sensitivity (80%) and the highest specificity (90%) for a cutoff value of 1.28. CONCLUSIONS: Provocative exercises increase sensitivity and specificity and contribute to the sonographic diagnosis of dynamic CTS. This examination should be performed if electrodiagnostic test results are negative.

Ultrasonographic assessment of mild and moderate idiopathic carpal tunnel syndrome.

AIM: To investigate the diagnostic value of ultrasonography in mild and moderate idiopathic carpal tunnel syndrome (CTS). MATERIALS AND METHODS: Cross-sectional areas (CSA), flattening ratios at three different levels, swelling ratio, and palmar displacement were analysed in 26 patients (14 with bilateral and 12 with unilateral disease, 40 wrists in total) for the presence and the severity of CTS. Twenty had normal nerve conduction studies (NCS) defined as "mild", and 20 of them had abnormal NCS defined as "moderate". The control group consisted of 20 healthy participants. RESULTS: All parameters were significantly different between patient and control groups. Palmar displacement, swelling ratio, CSA at all levels and distal flattening ratio had the highest significance (p < 0.0001). The criterion with the highest sensitivity was the swelling ratio > or = 1.3 (72.5%), followed by the middle CSA > 9 mm2 and the palmar displacement > 2.5 mm. All of these criteria had a higher sensitivity in diagnosing moderate cases (85-100%) than diagnosing mild cases (30-55%). There was a significant difference between normal and mild CTS groups regarding palmar displacement, distal flattening ratio, middle CSA and swelling ratio (p < 0.0001 for all) and between normal and moderate groups regarding all parameters (p < 0.01 - 0.0001) When combined middle CSA, palmar displacement and swelling ratio had an overall discriminatory accuracy of 83.8%. CONCLUSION: Additional diagnostic confirmation can be provided by ultrasonography and may be preferred as the initial step instead of electrophysiological studies. Detection of at least two of the three criteria (median nerve CSA > 9 mm2 at pisiform level, swelling ratio > or = 1.3, and palmar displacement > 2.5 mm) may be helpful for the verification of the diagnosis.

Dynamic MRI in indirect estimation of microvessel density, histologic grade, and prognosis in colorectal adenocarcinomas.

The relations of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters to microvessel density (MVD), histologic grade, and presence of metastasis were evaluated to establish new prognostic indicators in colorectal cancer (CRC). Fast-low angle shot DCE-MRI parameters (time-intensity curves, TICs; maximal relative enhancement within the first minute, E(max/1); maximal relative enhancement of the entire study, Emax; steepest slope of the contrast enhancement curve; and time to peak enhancement) of 21 CRCs (seven Duke stage B, 12 Duke stage C, and two Duke stage D) were retrospectively evaluated and correlated with corresponding postoperative MVD measurements, histologic grades, and presence of metastasis at 2 years. TICs were classified as type A in nine (43%), type B in seven (33%), and type C in five cases (24%). There was a significant difference between TIC types with regard to MVD (p < 0.05-0.001). Time to peak enhancement, steepest slope of TIC, and E(max/1) were strongly correlated with MVD (r = -0.765, p < 0.01; r = 0.681, p < 0.01; r = 0.634, p < 0.01; respectively). MVD, steepest slope of the enhancement curve, E(max/1), and Emax strongly correlated with histologic grade (r = 0.475, p < 0.05; r = 0.683, p < 0.01; r = 0.687, p < 0.01; r = 0.791, p < 0.01; respectively). There was a significant difference between groups of patients with and without metastasis with regard to histologic grade (p < 0.05) and two of the DCE-MRI parameters (p < 0.005 for E(max/1) and p < 0.05 for time to peak enhancement). Discriminant analysis correctly predicted the metastatic occurrence at 2 years in 90.5% of cases using E(max/1) (p < 0.001). Histologic grade resulted in lower rates of discrimination (66.7%; p < 0.05). DCE-MRI parameters may help in the prediction of MVD and histologic grade in CRC and may be used to predict therapeutic outcome.