Mustafa Koc

The association between intima media thickness, central obesity and diastolic blood pressure in obese and owerweight children: A cross-sectional school-based study

OBJECTIVEnTo examine relationship between carotid intima-media thickness (IMT) and central obesity, cardiovasculary risk factors, and chronic inflammation markers in overweight and obese schoolchildren in Eastern Turkey.nnnMETHODSnA cross-sectional school-based survey on 2765 schoolchildren was performed. We collected the clinical data (age, sex, percentage of body fat, and measured systolic blood pressure [BP] and diastolic BP, triglycerides, high- and low-density lipoprotein cholesterol, glucose, insulin, homocysteine and high-sensitivity C-reactive protein) in 67 obese and 24 overweight children. The control group was composed of nonobese children of similar age and sex.nnnRESULTSnMean systolic and diastolic BP values in the cases of overweight and obese groups were higher than those in the control group cases (p=0.001). Obese and overweight children demonstrated a significantly thicker intima media as compared with the control group (p=0.001). Carotid IMT was significantly correlated to the body mass index (r=0.396, p=0.001), fat mass percentage (r=0.257, p=0.036), waist circumference (r=0.390, p=0.001), diastolic BP (r=0.266, p=0.030), glucose (r=0.250, p=0.042), and high-sensitivity C-reactive protein levels (r=0.269, p=0.001) in the obese group. In multiple linear regression analysis, carotid IMT correlated significantly to waist circumference (p=0.045), and diastolic BP (p=0.031) in obese group.nnnCONCLUSIONSnObesity is related to cardiovascular risk factors leading to early atherosclerosis in schoolchildren. There is a relationship between atherosclerosis, and central obesity, diastolic BP, and chronic inflammation. Waist circumference measurement is more sensitive than other anthropometric measurements in predicting obesity and associated complications.

Early Effects of Treatment with Nebivolol and Quinapril on Endothelial Function in Patients with Hypertension

The objective of the present study was to compare the early effects of treatment with nebivolol and quinapril on the endothelial function in hypertensive patients. A total of 54 hypertensive patients was enrolled in the present study. One of the groups (n = 27) received quinapril 20 mg/day, and the other group (n = 27) received nebivolol 5 mg/day for a period of 4 weeks. The endothelial dysfunction was assessed using FMD (flow-mediated vasodilation) of the brachial arteries. The baseline characteristics of both groups were similar in age, gender, left venticular ejection fraction, left ventricular mass index, and body mass index. No significant difference was also found between the groups in the distribution of atherosclerotic risk factors as well as other echocardiographic, demographic, and biochemical measurements. Although the reduction of diastolic blood pressure was more pronounced in the nebivolol group after a 4-week treatment, the change in the systolic blood pressure was found to be similar in both treatment arms. Although a statistically nonsignificant increase was observed in flow-mediated vasodilation in the quinapril group (4.77% +/- 3.92%, 5.60% +/- 6.18%; p = .587), the increase in the post-treatment FMD was statistically significant in the nebivolol group (3.78% +/- 4.25%, 8.56% +/- 6.39%; p = .002). A significant change was observed in the resistive index value following flow-mediated vasodilation for both groups after treatment (p = .043; p = .027), whereas the change in the value of flow volume was significant only in the nebivolol group (p = .019).

Smaller pituitary volume in adult patients with obsessive-compulsive disorder

Aims:u2002 Another structure in the obsessive–compulsive disorder (OCD) circuit may be the pituitary gland because of the fact that limbic–hypothalamic–pituitary–adrenal (LHPA) axis abnormality has been reported in patients with OCD. There has been only one prior study, however, concerning pituitary volumetry, in which the sample was a pediatric group. The purpose of the present study was therefore to investigate this in an adult OCD patient group using magnetic resonance imaging (MRI).

Serotonin transporter gene polymorphism implicates reduced orbito-frontal cortex in obsessive–compulsive disorder

Although a number of magnetic resonance imaging (MRI) and genetic studies have been performed on obsessive-compulsive disorder (OCD), only limited studies in which genetic and neuroanatomical variables are evaluated concurrently have been performed. Therefore, the aim of our present study is (to understand) better understanding how genetic variation in the promoter region of the 5-HTT gene (5-HTTLPR) is associated with key brain structures in OCD, orbito-frontal cortex (OFC), thalamus and anterior cingulate. 5-HTT genotypes (SS, SL, LL) were determined for 40 patients with OCD and the same number of healthy controls. MRI-derived volumes of the OFC, thalamus, and anterior cingulate were determined by reliable tracing techniques. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5T, and were done blindly. In comparison with controls, OCD patients demonstrated volumes reduction in OFC, increased volumes of thalamus and total white matter volumes, but no difference in total brain volume, total gray matter volumes and anterior cingulate volumes. No significant difference was observed in allelic frequencies between the patients and controls. The stronger effects of 5-HTT polymorphism on brain morphology in OCD than those in controls were determined in the both OFC and thalamus. On the other hand, for the OCD patients, ANCOVA revealed a significant main effect of genotype for both the OFC and thalamus and a significant genotype-by-side interaction for the OFC, demonstrating that the short variants had a smaller right OFC than the long variants. In conclusion, we found a significant genotype-diagnosis interaction effects on key brain structures, with a stronger effects of 5-HTT polymorphism in OFC and thalamus of OCD patients, whereas no morphological changes related to the polymorphism were found in normal individuals.

The association of myelin oligodendrocyte glycoprotein gene and white matter volume in obsessive–compulsive disorder

BACKGROUNDnMorphological changes of white matter have been described in patients with obsessive-compulsive disorder (OCD). The aim of our study was to determine whether a functional polymorphism of the myelin oligodendrocyte glycoprotein (MOG) G511C (Val142Leu) is associated with white matter volumes in patients with OCD.nnnMETHODSnThe MOG G511C (Val142Leu) genotypes (Val/Val, Val/Leu and Leu/Leu) were determined for 30 patients with OCD and the same number of healthy controls. Magnetic resonance imaging (MRI) scans were obtained and analyzed by the software program.nnnRESULTSnIn comparison with controls, while no difference in total brain volume and total gray matter volumes was seen, total white matter volumes of the patients were larger than those of healthy controls. The genotypic pattern of distribution of MOG G511C was not different between the OCD patients and the controls. ANCOVA analysis in the OCD patients revealed a significantly larger total white matter volumes in patients carrying the MOG G511C (Val142Leu) Val/Val genotype compared with those carrying the Val/Leu and Leu/Leu genotypes. The analyses revealed no significant effects of genotype in the combined group but there was a statistically significant diagnosis effect, and an interaction between diagnosis and genotype effect.nnnCONCLUSIONSnOur study provides first evidence that the MOG G511C (Val142Leu) polymorphism might be associated with structural changes in the total white matter volumes of OCD patients, which might indicate an interaction between genetics and neuroimaging abnormalities in these patients.

Giant fibroepithelial stromal polyp of the vulva: extended field-of-view ultrasound and computed tomographic findings.

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[The relation of intima-media thickness with endothelial function and left ventricular mass index].

OBJECTIVEnWe aimed to investigate the relation of brachial artery intima-media thickness (IMT) with endothelial function and left ventricular mass (LVM).nnnMETHODSnFifty-four stage I-II hypertensive patients according to JNC VII who were not taking any medication and 27 age and sex-matched healthy controls were included to this cross-sectional observational study. IMT was measured by the same radiologist who was unaware of the patients clinical status by using high resolution ultrasound machine. Endothelial function was evaluated by flow mediated dilation (endothelium-dependent vasodilatation, FMD). LVM was calculated by using Devereux method. LVM index (LVMI) was obtained by dividing LVM to body surface area. Mann-Whitney U test was used to compare continuous variables, qualitative variables were compared by Chi-square test and the relations of parameters were evaluated by multiple linear regression analysis.nnnRESULTSnBoth groups (hypertensive and control) were similar with respect to age, sex, left ventricular ejection fraction. IMT was significantly higher in hypertensive group (0.43+/-0.09 vs 0.33+/-0.06 mm; p<0.001). FMD values were also significantly different between hypertensive and control groups (4+/-4% vs 13+/-12%; p<0.001). LVMI was significantly different between hypertensive and control groups LVMI (124 +/- 5 vs 99+/-6 gr/m2, p=0.002). The correlation between IMT and FMD (r=0.260; p=0.026) and IMT and LVMI (r =0.348; p=0.004) were statistically significant. A correlation was found between IMT and LVMI independently of other variables (beta=105; p=0.004) when LVMI was accepted as dependent variable in multivariate linear regression analysis (R2=0.570, p<0.001). According to this finding, the 105 units increase in LVMI occurs when IMT increases by 1 mm.nnnCONCLUSIONnBrachial artery IMT is related to endothelial function and LVM. According to these data, any negative changes of the IMT may reflect the similar negative changes in other parameters.

Do Defense Styles of Ego Relate to Volumes of Orbito-Frontal Cortex in Patients with Obsessive-Compulsive Disorder?

Objective Although the importance of orbito-frontal cortex (OFC) is established in the pathogenesis of obsessive compulsive disorder (OCD), no study have evaluated its relation to the traditional psychodynamic perspective. In the present study, we aimed to evaluate the relationship between the defense styles consisting of mature, immature and neurotic defenses and OFC volumes of patients with OCD. Methods Subjects were selected among those of our previous study, and so eighteen patients with OCD and same number of healthy controls were took into the study. The patients and controls had underwent magnetic resonance imaging (MRI). In addition, the Defense Style Questionnaire-40 was administered to obtain defense styles of patients and controls. Results No significant relationship was found between the right OFC volumes of both the patient and control groups and their scores of mature, neurotic, or immature defense mechanisms. As for the left OFC volumes, the only significant relationship for the scores of immature defense mechanism was found in the patient group. Conclusion The results of the present study indicated that there was no significant relationship between OFC volumes of the patient group and their scores of mature, neurotic, or immature defense mechanisms, except a significant relation with the scores of immature defense mechanisms.

Meningoencephalitis due to anthrax: CT and MR findings.

Anthrax is primarily a disease of herbivores, but it also causes cutaneous, respiratory and gastrointestinal infections in humans. Bacillus anthracis is an uncommon cause of meningitis and generally produces a haemorrhagic meningoencephalitis. We present the CT and MR findings of anthrax meningoencephalitis due to the cutaneous form of anthrax in a 12-year-old boy. They showed focal intracerebral haemorrhage with leptomeningeal enhancement.

Idiopathic postpartum intussusception: a rare cause of acute abdominal pain.

Objectives: To present a case with acute abdominal pain due to idiopathic intestinal intussusception diagnosed by ultrasound and computed tomography (CT) during the early postpartum period. Clinical Presentation and Intervention: A 21-year-old female patient was admitted to our hospital with abdominal pain, nausea and emesis after a normal vaginal delivery. Laboratory tests done at admission were within normal limits except for leukocytosis. Physical examination revealed abdominal distention, guarding and rebound tenderness. Abdominal ultrasound and oral contrast-enhanced CT showed a complex mass in the hypogastrium, with a typical configuration of intussusception. Emergent laparotomy revealed ileoileal invagination approximately 70 cm to the ileocecal valve but no lead point. A partial ileal resection was performed. Conclusion: This case shows that when intussusception is suspected, an abdominal ultrasound should be performed even in patients with atypical symptoms. CT may be used to confirm the diagnosis.