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The antioxidant effect of β-Glucan on oxidative stress status in experimental spinal cord injury in rats

This study was performed to investigate the antioxidant effect of β-Glucan in experimental spinal cord injury (SCI). Injury was produced using weight-drop technique in rats. β-Glucan was given by intraperitoneal injection following trauma. The rats were sacrificed at the sixth day of injury. Oxidative stress status was assessed by measuring the spinal cord tissue content of Malonyldialdehyde (MDA), Superoxide Dismutase (SOD) and Gluthatione Peroxidase (GSH-Px) activities. No effect of β-Glucan on SOD and MDA activities was found but, GSH-Px levels were found to decrease to the baseline (preinjury) levels when it was compared to untreated group (U=0.000; p=0.002). According to our results, β-Glucan works like a scavenger and has an antioxidant effect on lipid peroxidation in spinal cord injury.

Time-dependent changes in the serum levels of prolactin, nesfatin-1 and ghrelin as a marker of epileptic attacks young male patients

A relationship between hormones and seizures has been reported in animals and humans. Therefore, the purpose of this study was to investigate the association between serum levels of prolactin, nesfatin-1 and ghrelin measured different times after a seizure or non-epileptic event and compared with controls. The study included a total of 70 subjects, and of whom 18 patients had secondary generalized epilepsy (SGE), 16 patients had primary generalized epilepsy (PGE), 16 patients exhibited paroxysmal event (psychogenic) and 20 healthy males were control subjects. The first sample was taken within 5min of a seizure, with further samples taken after 1, 24, and 48h so long as the patient did not exhibit further clinically observable seizures; blood samples were taken once from control subjects. Prolactin was measured immediately using TOSOH Bioscience hormone assays. Nesfatin-1 and ghrelin peptides were measured using a commercial immunoassay kit. Patients suffering from focal epilepsy with secondary generalization and primary generalized epilepsy presented with significantly higher levels of serum prolactin and nesfatin-1 and lower ghrelin levels 5min, 1 and 24h after a seizure than patients presenting with paroxysmal events (psychogenic) and control subjects; the data were similar but not statistically significant after 48h. The present study suggests that increased serum prolactin and nesfatin-1 concentrations, decreased ghrelin concentrations could be used as markers to identify patients that have suffered a recent epileptic seizure or other paroxysmal event (psychogenic).

Serum Adiponectin, TNF-α, IL-12p70, and IL-13 Levels in Multiple Sclerosis and the Effects of Different Therapy Regimens

Objectives: Multiple sclerosis (MS) is a chronic inflammatory disease of the human central nervous system. In the present study, we aimed to determine adiponectin, tumor necrosis factor-α, interleukin (IL)-12p70, and IL-13 levels in the sera of patients with MS and to investigate the effects of interferon (IFN), glatiramer acetate (GA), and immunosuppressive treatment regimens on these parameters. Methods: Fifty-seven patients with MS and 34 healthy controls were enrolled into the study. Serum cytokine levels were measured using enzyme immunoassay. Results: Significantly elevated levels of IL-12p70 and IL-13 were found in the sera of patients with MS, but decreased adiponectin levels were found in patients’ sera compared to healthy controls. The levels of IL-12p70 and IL-13 in the IFN therapy group were higher than those of the healthy controls. However, the IL-12p70 and IL-13 levels in the GA therapy group were not different from those of the healthy controls. There were no differences with regard to adiponectin levels among the subgroups of patients with MS according to therapy regimen and the healthy controls. At the end of a 2-year follow-up period, Expanded Disability Status Scale (EDSS) values were found to be increased in the IFN therapy group but unchanged in the GA therapy group. Conclusions: These findings suggest that adiponectin, IL-12p70, and IL-13 may play a role in the pathogenesis of MS. Additionally, GA therapy regimens in MS are more effective than IFN therapy with respect to decreasing the levels of IL-12p70 and IL-13 and stabilizing the EDSS value.

Effects of steroid with repetitive procaine HCl injection in the management of carpal tunnel syndrome: An ultrasonographic study

BACKGROUND AND AIMnWith the use of musculoskeletal ultrasonography (MSUS), morphological changes in the median nerve have been recently reported in patients with carpal tunnel syndrome (CTS). On the other hand, the literature still lacks the information whether those changes are further altered with steroid and local anesthetic injection which is a widely used treatment in this group of patients. Therefore, the aim of our study was to explore in-vivo the effects of steroid with repetitive procaine HCl injection on the median nerve of patients with CTS.nnnMATERIALS AND METHODnThis prospective clinical trial followed-up patients for 2 months. 22 patients (37 median nerves) with clinical and electrophysiological evidence of CTS were included in the study. All patients received both 40 mg of triamcinolone acetonide once and 4 ml of 1% procaine HCl twice a week for 2 weeks with the same technique. Clinical, functional, electrophysiological and ultrasonographic evaluations were performed at the study onset, and 2 months after the last injection.nnnRESULTSnElectrophysiological, ultrasonographic findings (median nerve anterior-posterior diameter, transverse diameter and cross sectional area in the proximal carpal tunnel and volar bulging,) VAS scores, Boston carpal tunnel symptom and function assessment scale improved significantly (P<0.05).nnnCONCLUSIONnSteroid injection with repetitive procaine HCl injection effectively reduced the symptoms of CTS, improved the Boston carpal tunnel symptom and function assessment scale and also electrophysiological and ultrasonographic findings. Long term effects remain to be studied. Indisputably, the use of MSUS seems to be promising in this regard.

Effect of pramipexole on cutaneous-silent-period parameters in patients with restless legs syndrome

OBJECTIVEnThe aim of this study was to investigate cutaneous-silent-period (CSP) parameters in patients with restless legs syndrome (RLS) and examine the effects of treatment on CSP which, to our knowledge, have not been investigated till date.nnnMETHODSnA total of 25 patients with RLS and 25 healthy volunteers were studied. CSP latency and duration in the upper and lower extremities were examined in the two groups. In RLS patients, the variables were examined before and after pramipexole treatment.nnnRESULTSnLower-extremity CSP latency was longer (106.22±11.69 ms vs. 91.67±8.53 ms; p<0.001) and CSP duration was shorter (35.50±10.91 ms vs. 49.47±6.43 ms; p<0.001) in patients, compared with controls. In the patient group, CSP durations in the upper (40.88±7.95 ms vs. 46.84±10.22 ms; p=0.006) and lower extremities (35.50±10.91 ms vs. 44.91±6.43 ms; p=0.005) were prolonged after treatment, compared with pre-treatment values.nnnCONCLUSIONSnSmall-fibre neuropathy may exist in RLS. In addition, we suggest that pramipexole may regulate cortical and spinal inhibitory mechanisms.nnnSIGNIFICANCEnThe use of CSP may aid in the diagnosis of RLS and may be used as a measure of treatment effectiveness.

Cutaneous silent period changes in Type 2 diabetes mellitus patients with small fiber neuropathy.

OBJECTIVEnSmall myelinated (A-delta) and unmyelinated (C) somatic sensory fibers are initially affected and may be the earliest exhibited sign of neuropathy in glucose dysmetabolism. Cutaneous silent period (CSP) is an inhibitory spinal reflex and its afferents consist of A-delta nerve fibers. The aim of this study was to evaluate CSP changes in Type 2 diabetic patients with small fiber neuropathy.nnnMETHODSnForty-three patients and 41 healthy volunteers were included. CSP latency and duration, as well as CSP latency difference of the upper and lower extremities, were examined.nnnRESULTSnNerve conduction studies were within normal limits in both groups. Lower extremity CSP latency was longer (122.1+/-15.5 vs. 96.4+/-6.4 ms; p<0.001), CSP duration was shorter (29.5+/-8.9 vs. 43.1+/-5.0 ms; p<0.001), and latency difference was longer (48.1+/-12.6 vs. 22.7+/-3.7; p<0.001) in patients than controls. The difference was more significant in patients with neuropathic pain. No significant difference existed in upper extremity on CSP evaluation.nnnCONCLUSIONnThe CSP evaluation together with nerve conduction study, has been demonstrated to be beneficial and performance of latency difference in addition to CSP latency and duration may be a valuable parameter in electrophysiological assessment of diabetic patients with small fiber neuropathy.nnnSIGNIFICANCEnAn additional CSP evaluation may be considered in cases which nerve conduction studies do not provide sufficient information.

Is asymmetric dimethylarginine responsible for the vascular events in patients under antiepileptic drug treatment

Some recent studies indicated that administration of antiepileptic drugs (AEDs) is associated with occlusive vascular diseases. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide (NO) synthase inhibitor and increased plasma ADMA levels are associated with cardiovascular morbidity. We hypothesized that elevated plasma ADMA concentrations exist in patients receiving AEDs and administration of AEDs may result in an increased risk of occlusive vascular disease. Thirty five newly diagnosed epilepsy patients participated, patients were classified into two groups according to their antiepileptic drug regimen. In the first group patients were treated with valproic acid (VPA, n=17) (500-1500 mg/day), and in the second group with carbamazepine (CBZ, n=18) (400-1200 mg/day). ADMA levels significantly increased after treatment in both VPA (p=0.002) and CBZ (p=0.024) groups. Homocysteine levels increased in both groups, but the difference was significant only in VPA group (p=0.005). Serum folate levels did not differ in VPA group, but significantly decreased in CBZ group (p=0.006). Vitamin B(12) levels significantly increased in VPA group (p=0.001) but did not differ in CBZ group. Correlation analysis showed that the increases in ADMA and homocysteine levels in the VPA group were higher however the differences between the groups were insignificant. The correlations of the changes between ADMA and other parameters were all insignificant in both VPA and CBZ groups. In conclusion our data suggest that elevated ADMA levels may be responsible for the increased cardiovascular risk in patients with epilepsy under AED therapy.

Effects of hyperbaric oxygen on energy production and xanthine oxidase levels in striated muscle tissue of healthy rats

We investigated the effects of hyperbaric oxygen (HBO) treatment on striated muscle tissue in healthy rats. The treatment group of rats (n=16) was given HBO daily on weekdays for 2 h over a 4-week period while a control group (n=8) was not treated. Tissue samples were taken from the left and right vastus lateralis before and after the HBO treatment period, respectively, for all rats in both groups. Levels of adenosine monophosphate (AMP), adenosine diphosphate, andenosine triphosphate (ATP) and xanthine oxidase in the muscle tissue were determined. HBO treatment caused a statistically significant increase in ATP (p=0.001) and decrease in AMP (p=0.02) in the HBO-treated group, while there were no significant differences in metabolites in the control group. These results suggest that HBO treatment induces an increase in the ATP levels of muscle tissue with normal mitochondria. Thus, HBO might have some beneficial effects in the treatment of heteroplasmic mitochondrial disease, where normal and defective mitochondria coexist.

Reversible cerebral vasoconstriction syndrome: case report

A 28-year-old woman had thunderclap headache (TCH), after 7xa0days she had left hemiparesis. She had a history of oral contraceptive and citalopram medications. Brain magnetic resonance (MR) angiography demonstrated multiple stenotic segments. Digital subtraction angiography (DSA) showed multiple segments of narrowing in vessel calibre. Two probable diagnoses performed; primary angiitis of the central nervous system and reversible cerebral vasoconstriction syndrome (RCVS). Because of clinical characteristics and normal cerebrospinal fluid findings she was set on medication for probable RCVS. Follow-up MR angiography after 4xa0weeks and DSA after 7xa0weeks demonstrated improvement in vessel calibre. Thus, diagnosis RCVS was established. Diagnosis and management of TCH contain many potential difficulties. Clinicians should consider the imaging of cerebral arteries, even if computed tomography scan and lumbar puncture are normal in TCH. Potential precipitating factors and triggers should also be known and avoided.

Nocturnal headache associated with melatonin deficiency due to a pineal gland cyst

The cyclic nature of some of headache disorders is closely related to melatonin, which is secreted by the pineal gland. We report a 29-year-old male patient with a 2.5-year history of headaches that woke him in the middle of the night. These headaches were pulsatile and continued until sunrise. During these attacks he also suffered from allodynia over the scalp, bilateral conjunctival hyperemia, and nervousness. His brain MRI showed a 5mm by 4mm neuroepithelial cyst in the pineal gland. The peak plasma melatonin level that was measured at 2 am was 28 pg/mL. The patient underwent oral melatonin treatment (6 mg/day). After 1 month he experienced a 70% reduction in his symptoms. When the melatonin dosage was increased to 10mg/day he became headache-free, and 5 months after the treatment began, had no complaints. His 5-month follow-up plasma melatonin level at 2 am was 61 pg/mL. To our knowledge this is the first report of a patient with nocturnal headache associated with a low level of melatonin due to a neuroepithelial cyst in the pineal gland.