Caffeic acid phenethyl ester modulates methotrexate-induced oxidative stress in testes of rat.

The aim of this study was to investigate the possible protective role of caffeic acid phenethyl ester on testicular toxicity of methotrexate in rats. Nineteen male rats were divided into three groups as follows: group I, control; group II, methotrexate-treated; group III, methotrexate + caffeic acid phenethyl ester-treated. In the second day of experiment, a single dose of methotrexate was intraperitoneally administered to groups II and III, although a daily single dose of caffeic acid phenethyl ester was intraperitoneally administered to group III for 7 days. At the end of the experiment, the testes of the animals were removed and weighed. In the tissue, the level of lipid peroxidation as malondialdehyde and activities of superoxide dismutase were higher in the methotrexate group than in the control group. Lipid peroxidation levels and superoxide dismutase activities were decreased in caffeic acid phenethyl ester + methotrexate group compared with methotrexate group. The activities of catalase in the methotrexate group decreased insignificantly although its activities were significantly increased by caffeic acid phenethyl ester administration. The activity of glutathione peroxidase did not change in the groups. There was significant difference in body weight between control and methotrexate-induced groups. In conclusion, the administration of methotrexate causes elevation of oxidative stress although treatment with caffeic acid phenethyl ester has protective effects on the oxidative stress in testes.

Autoimmune hemolytic anemia during interferon-beta-I b treatment for multiple sclerosis.

A 31-year-old patient with multiple sclerosis (MS), treated with interferon beta-1b (IFNB-1b) for two years, presented with fatigue and dizziness. Coombs' positive autoimmune hemolytic anemia (AIHA) was found. Other potential etiologies of AIHA were ruled out. An association with IFNB-1b was highly suspected. Interferon therapy was discontinued and prednisone therapy instituted. There was resolution of the hemolytic anemia, and prednisone therapy was tapered gradually. To the best of our knowledge, there is no reported case of the development of AIHA associated with IFNB-1b use in MS patients. We conclude that if an unexplained drop in hematocrit occurs with a MS patient receiving IFNB-1b, autoimmune mediated hemolysis should also be considered.

The role of ultrasonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome.

AIM: The aim of study was to assess the usefulness of ultrasonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome. MATERIALS AND METHODS: Eighty-six patients with carpal tunnel syndrome confirmed by electromyography and 45 asymptomatic controls were included in the study and underwent high-resolution ultrasonography of the wrists. The cross-sectional area and flattening ratio at the level of the pisiform bone of the proximal carpal tunnel were measured. Data from the patient group and control group were compared to determine the statistical significance. The accuracy of the ultrasonographic diagnostic criteria for carpal tunnel syndrome was evaluated using receiver-operating characteristic (ROC) analysis. RESULTS: One hundred and forty-eight wrists of 86 patients with carpal tunnel syndrome and 76 wrists of 45 control patients were examined. All measurements showed significant differences between patients and controls. Increased cross-sectional area of the median nerve was the most predictive measurement of carpal tunnel syndrome. Using the ROC curve, a cut-off value of >10.5 mm2 at the level of pisiform bone provided a diagnostic sensitivity of 89% and specificity of 94.7% CONCLUSION: The ultrasonographic measurement of the median nerve cross-sectional area is a sensitive, specific and useful non-invasive method for the diagnosis of carpal tunnel syndrome.

Three cases of recurrent epileptic seizures caused by Endosulfan.

To commit suicide, three young adults swallowed a relatively small amount of a widely used insecticide containing endosulfan. They developed recurrent epileptic seizures. After hospitalization they were treated and recovered without any sequel. These seizures were classified as acute symptomatic or provoked seizures. We suggest that if one faces acute repetitive seizures, especially in the rural areas, an intoxication such as endosulfan intoxication should be considered when the etiology is uncertain even in the absence of any signs of intoxication.

Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire.

The relationship between nerve conduction studies and the self-administered Boston Questionnaire that measures the severity of symptoms and functional status in carpal tunnel syndrome was assessed in 44 patients with idiopathic carpal tunnel syndrome. The patients were examined preoperatively and 3 and 6 months postoperatively. Although both the clinical outcome and electrophysiological findings improved significantly after surgery, we observed no correlation between improvements in nerve conduction and the questionnaire scores.

Carpal tunnel syndrome in carpet workers.

OBJECTIVE: Repetitive and forceful use of wrist and finger flexors is purported to be an occupational risk factor for carpal tunnel syndrome (CTS). While weaving carpet, wrist and finger flexors and extensors are used repetitively, with pinching movements and forced grasping. We aimed to investigate CTS frequency in hand-made carpet workers. METHODS: Seventy women from carpet workshops in the city center and 30 healthy unemployed women were evaluated by clinical examination and electrophysiology. The relationship between CTS development and employment duration, and work produced per year were also investigated. Our study is cross-sectional. RESULTS: CTS was present in 31 hands (22.1%) of workers and in four hands (6.7%) of the control group. The estimated relative risk of developing CTS was 3.3 times greater in carpet-workers than it was in controls. Considering all hands, we could not find any correlation between CTS development and employment duration (P = 0.977), or with work produced per year (P = 0.505); but these two were the prominent factors contributing to delayed median sensory latency (P = 0.013, P = 0.009, respectively). CONCLUSIONS: We could not find any correlation between CTS development and employment duration, or with work produced per year; but these two were the prominent factors contributing to delayed median sensory latency The results indicates that women working in the hand-made carpet industry have a higher risk of CTS development.

Bilateral thalamic infarction. Clinical, etiological and MRI correlates.

To determine clinical, behavioral, topographic and etiological patterns in patients with simultaneous bilateral thalamic infarction in varied thalamic artery territories, we studied 16 patients who were admitted to our stroke unit over a 7-year period. Patients with bithalamic infarction represented 0.6% of our registry which included 2,750 ischaemic stroke patients. On computed tomography and magnetic resonance imaging with gadolinium enhancement, there were 4 topographic patterns of infarction: 1) bilateral infarcts in the territory of paramedian artery (8 patients [50%]); 2) bilateral infarcts in the territory of thalamogeniculate arteries (3 patients [19%]); 3) bilateral infarcts involving territory of paramedian and thalamogeniculate arteries (3 patients [19%]); 4) bilateral infarcts involving territory of polar and thalamogeniculate arteries (2 patients [13%]). A specific clinical picture was found in up to 50% of the patients with bithalamic infarction. This included patients with bilateral paramedian infarction having disorder of consciousness, memory dysfunctions, various types of vertical gaze palsy and psychic changes. Bilateral sensory loss predicted accurately bilateral infarction in the territory of thalamogeniculate arteries. The main cause of bilateral thalamic infarction was small artery-disease, followed by cardioembolism. Cognitive functions in patients with bilateral paramedian infarction did not change significantly during the follow-up, in contrast to those with infarcts in varied arterial territories. Acute bilateral infarction involving both thalamus is uncommon, although they are often associated with specific neurologic-neuropsychological patterns, allowing diagnosis before radiological examination.

Familial idiopathic facial palsy.

The etiology of idiopathic facial palsy (IFP) is still not defined. Familial inheritance has been found in 4-14% of cases. Among 116 patients with IFP admitted to the otolaryngology and neurology clinics at Kütahya State Hospital, 12 had positive family histories involving 10 different families. Review of the patients' histories showed that 13 members of families previously had IFP. In all, the 25 patients with familial IFP consisted of 12 males and 13 females and had an average age at onset of 34.3 years. Class I human leukocyte antigen (HLA) was investigated in 11 patients with familial IFP belonging to four separate families. The follow-up period was approximately 2 months. All cases except one recovered completely, with the latter patient having minimal contracture and facial paresis. However, HLA showed no significant increases in class I antigens. No notable difference was found in the clinical courses of patients with familial and non-familial IFP.

Is there any change of stroke incidence during Ramadan?

Ramadan is a special month for Muslims, as fasting during Ramadan is a religious duty. In this study we investigated whether stroke incidence differs during Ramadan compared to other months. All patients with stroke admitted to any hospital in the Isparta Province between 1991-1995 were included in this study. Patients were divided into 2 groups according to the month of onset of stroke. The first group included patients with strokes that occurred in Ramadan and the second group strokes with onset in other months. The stroke incidence of Isparta has been found to be 137 per 100,000 for people older than 25 years. There were no statistically significant differences between the age and sex distribution of patients and the incidences of strokes in both groups. We concluded that fasting during Ramadan has no affect on stroke occurrence in the Isparta Province.