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Variations of sphenoid and related structures

Abstract. The aim of this study was to delineate the precise relationship between the sphenoid sinus and internal carotid artery and the optic nerve, as well as to assess incidence of the anatomic variations of these structures. A review of 92 paranasal sinus tomographic scans was made for anatomic variations of the sphenoid sinus and related bony and neurovascular structures. Coronal and axial tomographic sections were obtained with 2.5-mm section thickness. We assessed the protrusion of the internal carotid artery (ICA) and the optic nerve (ON) into the sphenoid sinus, bone dehiscence of these structures, and pneumatization of the anterior clinoid process (ACP) and pterygoid recess (PR), as well as the variations of the sphenoid sinus septum. The protrusion of the ICA into the sphenoid sinus was found in 24 (26.1 %) patients. An ON protrusion was present in 29 (31.5 %) patients. Pneumatization of the PR was encountered in 27 (29.3 %) patients. There was not a statistically significant relationship between the pneumatization of the PR and ICA protrusion into the sphenoid sinus (χ2 = 0.258, p = 0.168). A significant relationship between the ACP pneumatization and protrusion of the ON into the sphenoid sinus was found (χ2 = 0.481, p = 0.007). Preoperative recognition of the anatomic variations by the radiologist is beneficial for identification of the limits of dissection. This is particularly important in the sphenoid sinus area where extensive pneumatization of the skull base bones may distort the anatomic configuration. Therefore, axial and coronal CT sections should always be obtained prior to any surgery in the sphenoid sinus area.

Ocular complications associated with brucellosis in an endemic area

PURPOSE To report the ocular manifestations associated with brucellosis in an endemic area. METHODS We prospectively evaluated 147 patients with the diagnosis of brucellosis between May 1996 to May 2000 and recorded the ocular and systemic findings. The diagnosis was based on clinical findings, positive serological and bacteriological tests (Brucella agglutination test: over 1/160 titer, blood culture). RESULTS Thirty-eight patients (26.0%) with brucellosis had ocular complications: conjunctivitis in 26 (17.7%), anterior uveitis in six (4.1%), posterior uveitis in one (0.7%), dacryoadenitis in two (1.4%), episcleritis in three (2.1%). Three of the seven patients with uveitis had spondylitis associated with brucellosis. Osteoarticular complications in brucellosis were more frequent in the patients with ocular involvement though the difference was not statistically significant compared with patients without ocular involvement. CONCLUSIONS Ocular manifestations are frequent in brucellosis so an ophthalmologic examination should be routinely performed in patients with brucellosis in endemic areas. (Eur J Ophthalmol 2002; 12: 232-7).

Angiotensin-converting enzyme gene polymorphism and microvascular complications in Turkish type 2 diabetic patients

The aim of this study was to investigate whether an association exists between the angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism and microvascular complications of type 2 diabetes mellitus in Turkish patients. A total of 239 type 2 diabetic patients and 138 sex and age matched control subjects were included into the study. The I/D polymorphism was determined by polymerase chain reaction (PCR). Nephropathy status was determined according to urinary albumin/creatinine ratio (microg/mg) (<30 normoalbuminuria, 30-300 microalbuminuria, >300 macroalbuminuria) and retinopathy was evaluated by fundoscopic examination and by flourescein fundus angiography. The distribution of ACE I/D polymorphism and allele frequencies in diabetic patients were not significantly different from controls, DD genotype 32.2 versus 37.2%; ID genotype 50.6 versus 47.1%; and II 17.2 versus 15.2%; D allele 57.5 versus 61.2%; I allele 42.5 versus 38.8%. Genotype distribution between normo-, micro- and macroalbuminuric patients did not differ significantly (DD:ID:II (%), normoalbuminuria, 35:46:19; microalbuminuria, 28:55:17; macroalbuminuria, 31:55:14). There was also no difference in genotype distribution between patients with and without retinopathy (DD:ID:II (%), retinopathy positive, 32:51:17; retinopathy negative, 33:49:18). In conclusion, the ACE I/D polymorphism does not seem to be associated with diabetic nephropathy and retinopathy in Turkish type 2 diabetic patients.

The Impact of Acute Dynamic Exercise on Intraocular Pressure: Role of the β2-Adrenergic Receptor Polymorphism

Effects of mutations in the β2-adrenergic receptor (β2AR) gene on intraocular pressure (IOP), in response to acute dynamic exercise, were investigated in 19 healthy males (age 22.6 ± 2.8 years). Intraocular pressures were measured pre- and post-exercise. Weight, height, body mass index, and maximal oxygen (VO2max) uptake were recorded and subjects were genotyped for Arg16Gly, Gln27Glu and Thr164Ile mutations of the β2AR gene. Post-exercise, reductions in mean IOP values were found in 16 subjects with the Gly16Gly and Arg16Gly genotypes, but these values remained low in the eight patients with the Gly16Gly genotype 3 h post-exercise, whereas they returned to baseline within 1 h in the eight subjects with the Arg16Gly genotype. β2AR stimulation during exercise could be an important regulator of IOP response and determining β2AR polymorphisms may improve understanding of pathogenesis and treatment selection in ophthalmic diseases, e.g. glaucoma.

Personalized medicine beyond genomics: alternative futures in big data—proteomics, environtome and the social proteome

No field in science and medicine today remains untouched by Big Data, and psychiatry is no exception. Proteomics is a Big Data technology and a next generation biomarker, supporting novel system diagnostics and therapeutics in psychiatry. Proteomics technology is, in fact, much older than genomics and dates to the 1970s, well before the launch of the international Human Genome Project. While the genome has long been framed as the master or “elite” executive molecule in cell biology, the proteome by contrast is humble. Yet the proteome is critical for life—it ensures the daily functioning of cells and whole organisms. In short, proteins are the blue-collar workers of biology, the down-to-earth molecules that we cannot live without. Since 2010, proteomics has found renewed meaning and international attention with the launch of the Human Proteome Project and the growing interest in Big Data technologies such as proteomics. This article presents an interdisciplinary technology foresight analysis and conceptualizes the terms “environtome” and “social proteome”. We define “environtome” as the entire complement of elements external to the human host, from microbiome, ambient temperature and weather conditions to government innovation policies, stock market dynamics, human values, political power and social norms that collectively shape the human host spatially and temporally. The “social proteome” is the subset of the environtome that influences the transition of proteomics technology to innovative applications in society. The social proteome encompasses, for example, new reimbursement schemes and business innovation models for proteomics diagnostics that depart from the “once-a-life-time” genotypic tests and the anticipated hype attendant to context and time sensitive proteomics tests. Building on the “nesting principle” for governance of complex systems as discussed by Elinor Ostrom, we propose here a 3-tiered organizational architecture for Big Data science such as proteomics. The proposed nested governance structure is comprised of (a) scientists, (b) ethicists, and (c) scholars in the nascent field of “ethics-of-ethics”, and aims to cultivate a robust social proteome for personalized medicine. Ostrom often noted that such nested governance designs offer assurance that political power embedded in innovation processes is distributed evenly and is not concentrated disproportionately in a single overbearing stakeholder or person. We agree with this assessment and conclude by underscoring the synergistic value of social and biological proteomes to realize the full potentials of proteomics science for personalized medicine in psychiatry in the present era of Big Data.

Effectiveness of retroequatorial recession surgery in congenital nystagmus.

OBJECTIVE The aim of this retrospective study was to evaluate the effectiveness of the retroequatorial recession technique in the surgical treatment of nystagmus and associated strabismus. METHOD The effect of large recessions of four horizontal extraocular muscles was analyzed qualitatively in seven patients with congenital nystagmus. RESULTS The ages of the patients ranged between 12 and 42 years (mean, 21.5 years). Of the seven patients, four had motor and three had sensory nystagmus. Visual acuity increased in five (71.4%) patients. Planned recovery of associated strabismus was attained in six patients (85.7%). In five patients who had abnormal head position, the head positions and nystagmus intensities were found to be decreased. No postoperative complication, such as diplopia, was encountered. CONCLUSION The retroequatorial recession technique is preferable in patients who have congenital nystagmus, especially in the presence of horizontal squint associated with low visual acuity, because of its success in increasing visual acuity and decreasing the amplitude of nystagmus, its reversibility, making posssible new operations in the future, as well as the absence of any significant complications.

Beta 2-adrenergic receptor polymorphism and susceptibility to primary congenital and primary open angle glaucoma

ObjectiveIt has been shown that arginine to glycine (Arg16Gly), glutamine to glutamic acid (Gln27Glu) and threonine to isoleucine (Thr164Ile) exchanges in codons 16, 27 and 164, respectively, of the beta 2-adrenergic receptor (B2AR) gene significantly alter receptor function. As B2ARs are located on the afferent blood vessels supplying the ciliary body and trabecular meshwork cells, which control aqueous humour dynamics, polymorphisms of B2AR may be involved in the pathophysiology of certain eye diseases, such as glaucoma. Therefore, the aim of the present study was to investigate the distribution of B2AR polymorphisms in patients with primary congenital and primary open angle glaucoma.MethodsA group of 30 patients with primary congenital glaucoma, 105 with primary open angle glaucoma and 92 control patients were analysed for the Arg16Gly, Gln27Glu, and Thr164IIe polymorphisms of the B2AR by polymerase chain reaction–restriction fragment length polymorphism.ResultsThe allelic frequencies of Gly16, Glu27 and IIe164 variant alleles were 66.7, 38.3 and 3.3% in patients with congenital glaucoma, 59.5, 31.0 and 1.0% with glaucoma, and 54.9, 26.6 and 0.5% in controls, respectively. Although statistically non-significant, the frequencies of variant alleles were slightly higher in both groups of the glaucoma patients.ConclusionsThese results suggest no evidence of an association between the Arg16Gly, Glu27Gln and Thr164Ile polymorphisms of the B2AR gene and risk of developing primary open angle glaucoma or primary congenital glaucoma. However, further studies are needed to understand the role of B2AR polymorphisms in patients with eye disease.

The predictive value of auditory brainstem responses for diabetic retinopathy.

OBJECTIVE The purpose was to find out whether there is a relationship between the central nervous system involvement and retinopathy in diabetes mellitus. STUDY DESIGN In a multidisciplinary clinical study, diabetic patients with and without retinopathy were examined utilising auditory brainstem response (ABR) testing, and the results were interpreted from clinical and pathophysiological point of view. PATIENTS AND METHODS Thirty-three diabetic patients with retinopathy (study group) and 20 diabetic patients without retinopathy (control group) were included. Audiometry and ABR testing were made. The results of both groups were compared for ABR parameters. RESULTS Audimetric results of the study and control groups were similar. In the study group, ABR testing revealed prolonged absolute and interpeak latency of the waves. The difference was significant for I-III interval (P<0.01). The amplitudes of the waves were similar in both groups and wave V amplitude was significantly diminished in the study group. Abnormal waveforms were recorded by 40 and 12.5% in the study and control groups, respectively. CONCLUSION Retinopathy is accompanied with lower brainstem disintegration. Microangiopathy is the possible mechanism that is involved in the occurrence of retinopathy and brainstem neuropathy. ABR can help diagnose retinopathy. Better understanding the role of ABR in diagnosis and early detection of retinopathy in diabetic patients needs further study.

A Code of Ethics for Ethicists: What Would Pierre Bourdieu Say? “Do Not Misuse Social Capital in the Age of Consortia Ethics”

What Would Pierre Bourdieu Say? “Do Not Misuse Social Capital in the Age of Consortia Ethics” Vural € Ozdemir, Gaziantep University Hakan Kilic, Gaziantep University and University of Vienna Arif Yildirim,Namik Kemal University Effy Vayena, University of Zurich Edward S. Dove, University of Edinburgh Kivanc G€ ung€ or, Gaziantep University Adrian LLerena, Extremadura University Hospital and Medical School Semra Şardas,Marmara University

Brucella melitensis dacryoadenitis: a case report

Purpose To present a case of brucellosis-related unilateral dacryoadenitis. Methods A 16-year-old boy had unilateral lacrimal gland enlargement, shown by magnetic resonance imaging of the orbits. Clinical findings, tube agglutination, the culture of a lacrimal gland aspirate, and histopathological examination confirmed the diagnosis of brucellosis. Results Tube agglutination testing for brucellosis gave a titer of over 1/640. The aspirate from the lacrimal glands grew Brucella melitensis and histopathological findings were consistent with brucellosis. Conclusions Dacryoadenitis may occur in the course of systemic brucellosis caused by Brucella melitensis