Murat Baykara

Relation of serum leptin and insulin-like growth factor-1 levels to intima-media thickness and functions of common carotid artery in children and adolescents with type 1 diabetes.

Background and aim: Leptin and insulin‐like growth factor‐1 (IGF‐1) have been suggested to be involved in the pathogenesis of atherosclerosis. The aim of this study was to evaluate the relationship between serum leptin, IGF‐1 and intima‐media thickness (IMT) and functions of common carotid artery (CCA) in children and adolescent patients with type 1 diabetes. Material and methods: Serum leptin and IGF‐1 levels were measured in 45 diabetic patients (23 girls and 22 boys). Age, diabetes duration as well as major cardiovascular risk factors, including anthropometric and metabolic parameters, were matched between girls and boys. The relation of serum leptin and IGF‐1 levels to CCA structure and functions were measured by ultrasonography as IMT, cross‐sectional compliance (CSC), cross‐sectional distensibility (CSD), diastolic wall stress (DWS) and incremental elastic modulus (IEM). Results: Serum leptin levels of diabetic girls were higher than those in the boys (21.8 ± 14.5 μg/1 vs 8.9 ± 10.6 μ.g/1, p= 0.002). However, the difference for serum IGF‐1 levels was not significant between diabetic girls and boys (240.7 ± 96.8 μg/ml vs 234.7 ± 93.2 ng/ml; p < 0.05). In all subjects, leptin levels were correlated with CSC (p= 0.04), CSD (p= 0.04) and IEM (p= 0.01), and IGF‐I levels were only correlated with CSC (p= 0.01). Leptin did not show any correlation with ultrasonographic measurements in both girls and boys separately. IGF‐1 was correlated with CSC (p= 0.001), CSD (p= 0.002) and IEM (p > 0.001) in boys but not in girls. In a multivariate regression model, IGF‐1 emerged as independent correlates for mean CSD and IEM in boys but not in girls.

CT anatomy of pterygopalatine fossa and its communications: a pictorial review

In this article, we present a pictorial review computed tomography (CT) anatomy of pterygopalatine fossa and its communications. Since it represents a major pathway for spread of inflammatory or neoplastic disease between the various compartments, being familiar with the high resolution CT appearance of pterygopalatine fossa and its communications is necessary in selected cases. The diagnostic difficulties in determining the intercompartmental spread is discussed.

In vivo nephroprotective efficacy of propolis against contrast-induced nephropathy

PURPOSEnContrast agents administered in diagnostic imaging or interventional procedures of clinical radiology may cause contrast-induced nephropathy (CIN). Preventive measures against CIN involve pharmaceutical pretreatments, such as N-acetylcystein (NAC) or calpain, but alternative medicines can also be helpful. This study aims to assess the prospects of a natural compound, propolis, as a potential nephroprotector against a specific contrast agent, diatrizoate.nnnMETHODSnIn vivo experiments were performed on 35 male rats in five groups: control, diatrizoate alone, and pretreatments with propolis, NAC, or calpain one hour before diatrizoate administration. Three days later, blood and renal tissue samples were collected and quantitatively processed for determining induced changes in critical biomarkers malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT), as well as serum creatinine and plasma urea.nnnRESULTSnDiatrizoate increased creatinine (113%), urea (400%), and MDA (162%) levels and decreased GSH (-71%), SOD (-69%), GSH-Px (-77%), and CAT (-73%) levels. Evaluating the response of each pretreatment provided sufficient evidence that propolis was as effective as either NAC or calpain, but consistently more prominent in restoring the MDA, GSH, SOD, and GSH-Px levels close to their normal range. This outcome demonstrated the nephroprotective effect of propolis against CIN.nnnCONCLUSIONnPropolis protects renal tissue against toxicity, free radicals, and other adverse effects induced by diatrizoate. This function is most likely exerted through the antioxidant and antitoxic activities of propolis.

Association between apolipoprotein E polymorphism and subclinic atherosclerosis in patients with type 1 diabetes mellitus.

Objective The most important cause of morbidity and mortality in type 1 diabetes mellitus (DM) is atherosclerosis. Apolipoprotein E (Apo E) polymorphism is accused of being the genetic risk factor for atherosclerosis. The aim of the present study was to determine which Apo E polymorphism was related to atherosclerosis in patients with type 1 DM. Methods: Seventy-four patients with type 1 DM were enrolled in the study. Age, diabetes duration, daily insulin dose, microalbuminuria, and major cardiovascular risk factors including anthropometric and metabolic parameters were assessed in each patient. Non-invasive ultrasonographic measurements were also performed. For determination of Apo E genotype, DNA was extracted from venous blood from all subjects using standard methods. Apo E genotyping was performed using a PCR–restriction fragment-length polymorphism assay. Results: Systolic blood pressure and carotid artery intima-media thickness (CA-IMT) were increased in subjects with E4/E4 polymorphism. According to univariate analysis, when adjusted for all risk factors, genotypes did not differ for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides (p>0.05). However, E3/E3, E3/E4 and E4/E4 genotypes were found to be associated with an increase in CA-IMT (p<0.001). Conclusions: Our results suggest that the polymorphism associated with atherosclerosis in type1 DM is Apo E4/E4. Conflict of interest:None declared.

An investigation on magnetic imaging findings of the inner ear: A relationship between the internal auditory canal, its nerves and benign paroxysmal positional vertigo

Abstract Visualization of the inner ear has been performed using magnetic resonance imaging (MRI) to investigate benign paroxysmal positional vertigo (BPPV). In the patients with BPPV, our recent findings indicate the thickness of some internal auditory canal (IAC) nerves narrower than the thickness of healthy subjects. The thickness of the IAC and its nerves are measured using brain MRI images. The cross sectional area (CSA) of a nerve is assumed as its thickness. Some statistical measurement and a statistical classification are performed on the CSA data to investigate any relation between IAC, the nerves and BPPV.

Effectiveness of pentoxifylline on the cross-sectional area of intima media thickness and functions of the common carotid artery in adolescents with type 1 diabetes

Abstract Objective: The aim of the present study was to evaluate the effect of oral pentoxifylline on the cross-sectional area of intima media thickness (CSA-IMT) and functions of the common carotid artery, a marker of early atherosclerosis, in adolescents with type 1 diabetes. Patients and methods: Non-invasive ultrasonographic measurements were made in 56 type 1 diabetic patients. The diabetic patients were matched first in terms of age, diabetes duration, major cardiovascular risk factors, including anthropometric and metabolic parameters as well as ultrasonographic measurements, then one individual within each pair randomized into a pentoxifylline group and a placebo (control) group (i.e., 32 on pentoxifylline group and 24 on placebo). Pentoxifylline was administered for 6 months. We investigated the change of CSA-IMT, compliance, distensibility, diastolic wall stress (DWS), and incremental elastic modulus of the common carotid artery at 6 months after pentoxifylline. Results: In comparison of changes in common carotid artery measurements between the two groups, the pentoxifylline treatment group had significantly higher values than the controls for CSA-IMT (–2.6±0.1 vs. 0.7±0.4 mm2, p=0.001) and for DWS (–0.38±0.02 vs. –0.05±0.05 mm Hg×102, p<0.001). In a multivariate regression model for all patients, being in pentoxifylline group was the best predictor of the change DWS (β=–0.52, p<0.001). Conclusion: Our preliminary results suggest that pentoxifylline has an antiatherogenic action and might modulate risk factors for atherosclerosis in type 1 diabetes.

The relationship between bone mineral density and arterial stiffness in women.

PURPOSEnThe aim of this study was to investigate the correlation between bone mineral density (BMD) and arterial stiffness as a preclinical atherosclerosis criterion.nnnMATERIALS AND METHODSnCarotid and femoral artery Doppler ultrasonography and arterial stiffness measurements were performed on 113 female patients referred for BMD measurements.nnnRESULTSnThe cross-sectional compliance and cross-sectional distensibility of the carotid artery were positively correlated with the BMD of the Wards triangle, the femoral neck, and the lower femoral neck; and the Wards triangle, respectively. A negative correlation was found between the intima-media thickness of the femoral artery and the femoral elastic modulus with the BMD of L1, L12, L13, and L23; and the BMD of L1, L3, L13, L24, L34, the femoral neck, the lower femoral neck, and Wards triangle, respectively. The cross-sectional compliance and cross-sectional distensibility of the femoral artery were positively correlated with the BMD of the femoral neck, upper femoral neck, lower femoral neck, Wards triangle; and the BMD of the total femur and Wards triangle, respectively.nnnCONCLUSIONnThe arterial stiffness measurements in women are correlated with BMD, regardless of age and other demographic factors.

Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study.

Abstract Background: This study aimed to determine the strain index (SI) of normal thyroid parenchyma in a group of healthy children, using ultrasound elastography (USE). Methods: The participants consisted of 54 healthy children. The USE of the normal thyroid parenchyma was performed by using the Hitachi Hi VisionPreirus model ultrasonography (US) device. By following sinusoidal waves at the base of the screen, regular and slight compressions and decompressions were made by the transducer. After the regular sinusoidal waves were acquired, standard region of interest (ROI) circles were used to measure the SI values of the thyroid glands by placing one ROI on a superficial part of the normal thyroid gland parenchyma and the other on the adjacent soft tissue at the same depth (within 10-mm proximity). Three measurements were obtained for each (right and left) thyroid gland, and the mean value was used for statistics. Results: The mean SI value of normal thyroid glands was 0.54±0.38 for the whole group. There was no statistically significant difference between girls and boys on the basis of age, weight, height, BMI (body mass index), and thyroid SI values (p=0.15, p=0.18, p=0.12, p=0.31, and p=0.96, respectively). No correlation was found between thyroid gland SI values and each of the following variables: age (r=0.22, p=0.15), gender (r=0.007, p=0.96), and BMI (r=0.26, p=0.09). Conclusions: The study determined the normal elasticity values of thyroid glands in healthy children. Such information can serve as a baseline from which thyroid diseases can be examined.

Response of Arterial Stiffness Four Weeks After Terminating Short-term Aerobic Exercise Training in a Sedentary Lifestyle

The purpose of this study was to investigate the response of arterial stiffness in individuals with a sedentary lifestyle at 4 weeks after terminating a 2‐week aerobic exercise session.

The relationship between tinnitus and vascular anomalies on temporal bone CT scan: a retrospective case control study

IntroductionTinnitus is a common symptom in which etiology is unclear in a group of patients. Some of anatomic or vascular variations diagnosed on temporal bone computed tomography (CT) has been known to cause tinnitus particulary pulsatile form. Therefore significance of these anatomic variations has not been validated in patients with nonpulsatile tinnitus. The aim of this study is to ascertain several anatomic variations previously attributed to pulsatile tinnitus in nonpulsatile tinnitus patients. And secondly to assess the relationship between the amount of sigmoid sinus bulging and mastoid emissary vein (MEV), enlargement of those was not evaluated before in tinnitus patients.MethodsRetrospectively, temporal bone CT scans of 70 patients with an existing complaint of tinnitus with unexplained etiology were enrolled. As a control group, 70 patients were selected from paranasal sinus CT scans without any otological or clinical findings.ResultsThe type of tinnitus was subjective and nonpulsatile in the overall group. The diameters of enlarged MEV on the left side were significantly higher in the tinnitus group. Carotid canal dehiscence and high riding jugular bulb were significantly higher in the tinnitus patients. Petrous bone pneumatization was significantly lower in the tinnitus patients than in the control group.ConclusionsIn patients who complained of subjective nonpulsatile tinnitus with unknown etiology, some temporal bone vascular variations, including high riding jugular bulb, dehiscent carotid canal, left-sided MEV enlargement, and petrous bone pneumatization, seemed to have an association with tinnitus. Further studies comparing all these entities between pulsatile and nonpulsatile groups and healthy controls should be undertaken.