Search NEL Online

Journal Article 2009; 30(1): 85-90 PubMed PMID: 19300400 Citation  Keywords:  Adolescent, Adult, Female, Humans, Male, Middle Aged, Multiple Sclerosis:cerebrospinal fluid, Nerve Growth Factor:cerebrospinal fluid, Neuromyelitis Optica:cerebrospinal fluid, Research Design, Severity of Illness Index, Thyroid Hormones:cerebrospinal flu.   

OBJECTIVE: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the human central nervous system (CNS) and a major cause of neurological disability among adults in North America and Europe. Neuromyelitis optica (NMO) is a very severe disease of inflammatory demyelination located in the optic chiasm, nerves and the spinal cord. The aim of this study is to assess thyroid hormone (TH) and nerve growth factor (NGF) levels in cerebrospinal fluid (CSF) of MS, NMO patients and controls, and investigate whether there is any correlation between TH and NGF levels in the CSF.

PATIENTS AND METHODS: 38 relapsing-remitting multiple sclerosis (RRMS), 10 NMO and 19 controls were investigated whether there was any correlation between TH and NGF levels in the CSF.

RESULTS: MS and NMO patients exhibited significantly higher CSF NGF (respectively P<0.05, P<0.05), TT4 levels (P<0.001) and higher TT4/ rT3 ratio (respectively P<0.01, P<0.01) compared with the controls. Significant correlation was found between CSF NGF levels and CSF rT3 levels or TT4/ rT3 ratio in controls (respectively P<0.01, P<0.05). EDSS was significantly correlated with CSF rT3 levels and TT4/ rT3 ratio in MS patients (respectively P<0.05, P<0.001).

CONCLUSIONS: These results indicate that an abnormal thyroid hormone may exist within the brain in the patients with MS. CSF rT3 levels and TT4/ rT3 ratio could be regarded as useful markers of underlying disease activity....

Read abstract  Full text PDF

Controlled Clinical Trial 2009; 30(1): 39-45 PubMed PMID: 19300399 Citation  Keywords:  Age Factors, Aged, Aged, 80 and over, Alzheimer Disease:diagnosis, Anisotropy, Corpus Callosum:diagnostic imaging, Diffusion Magnetic Resonance Imaging:methods, Echo-Planar Imaging:methods, Female, Humans, Male, Middle Aged, Organ Size, Psychological Test.   

OBJECTIVE: The aim of the study was to assess structural changes in gray matter (GM) volume and fractional anisotropy (FA) in patients with Alzheimer's disease (AD) compared to control subjects using Voxel-Based Morphometry (VBM). Fractional anisotropy in the corpus callosum of both groups was also calculated using ROI analysis.

METHODS: Twenty-one patients and twenty-three control subjects underwent MRI examination using T1-weighted 3D MPRAGE sequence and diffusion spin-echo echo-planar imaging sequence in six directions. Structural MRI analyses for GM volume and FA were performed using an optimized VBM protocol implemented in SPM5. The influence of age and Mini-Mental State Examination (MMSE) was dealt with multiple regression analysis either for the whole group or for AD patients and controls separately.

RESULTS: Patients showed significant reduction of GM volume mainly in the temporal lobes. In AD patients, no correlation was observed between GM volume and age or MMSE. FA was reduced in AD patients mainly in frontal and temporal lobes. In both groups no correlation was found between FA and age or MMSE. Patients with AD showed a significant decrease in FA and an increase in mean diffusivity (p<0.0001) in the corpus callosum.

CONCLUSIONS: In patients with AD we observed a significant reduction in FA values and GM volume; however, no correlation with age and MMSE was proven for both FA and GM for AD patients. This finding supports the hypothesis that morphological changes in patients with AD are not a continuous aging related process but represent qualitative changes....

Read abstract  Full text PDF

Journal Article 2009; 30(1): 91-98 PubMed PMID: 19300397 Citation  Keywords:  Adult, Case-Control Studies, Endometriosis:blood, Estradiol:blood, Female, HLA Antigens:blood, HLA-G Antigens, Histocompatibility Antigens Class I:blood, Humans, Leiomyoma:blood, Menopause:blood, Menstrual Cycle:blood, Middle Aged, Ovarian Diseases:blood,.   

BACKGROUND: HLA-G is an antigen whose participation in the regulation of the immune system is well documented. The aim of the present study has therefore been to evaluate the sHLA-G blood serum concentrations levels in both women with ovarian endometriosis and women with uterine leiomyomas.

METHODS: In our study, the soluble HLA-G concentration level was evaluated in the blood serum samples obtained from 98 women who underwent laparotomies or laparoscopies due to either ovarian endometriosis or leiomyomatous uterus. The control group consisted of 42 women, including women on whom a diagnostic laparoscopy identified no lesions, and volunteers-healthy women who returned their blood serum samples during menstrual bleeding.

RESULTS: Patients who underwent surgical treatment because of ovarian endometriosis or uterine leiomyoma, as well as patients from the control group, exhibited no sHLA-G blood serum concentration level fluctuations between the proliferative and secretory menstrual cycle phases. The sHLA-G levels were significantly lower in the patients with ovarian endometriosis and in the patients from the control group during the menstrual cycle phase than in those patients with leiomyoma. A similar relation between the sHLA-G levels of the postmenopausal patients suffering from leiomyoma and the control patients was found. In contrast, the postmenopausal women suffering from endometriosis were typified by levels of sHLA-G blood serum concentration comparable to those of the patients with leiomyoma, and the levels were significantly higher than those observed in the blood sera of the postmenopausal patients from the control group.

CONCLUSION: The soluble HLA-G blood serum level would seem to be a useful marker for evaluating the status of the microenvironment, where the tumor-immune cell and ectopic and eutopic endometrial interactions take place....

Read abstract  Full text PDF

Comparative Study 2009; 30(1): 111-118 PubMed PMID: 19300391 Citation  Keywords:  Abortion, Induced:statistics & numerical data, Adolescent, Adult, Birth Rate:trends, Czech Republic:epidemiology, Europe:epidemiology, Female, Humans, Middle Aged, Population Growth, Pregnancy, Reproduction:physiology, Young Adult,.   

OBJECTIVES: The aim of study was to evaluate the importance of induced abortions for reproduction medicine in Czech Republic.

DESIGN: Demographic analysis of data published by EUROSTAT and Czech statistical office.

SETTING: Department of Demography and Geodemography Faculty of Science, Charles University Prague.

RESULTS: Widespread use of the liberal abortion law in socialist countries contributed to the decline of fertility rates only to the replacement level. In the Czech Republic total fertility rate dropped below 1.3 in 1995 and it did not increase above 1.5 children per woman till 2007. The increased use of modern contraceptive methods that results in a sharp decline in fertility and in a significant decrease of induced abortions can be documented. The total abortion rate fell from 1.54 abortions per a woman in 1990 to 0.34 in 2007. The proportion of women aged 15-49 years who were prescribed oral contraception increased from 4 percent in 1990 to 48 percent in 2007. An induced abortion is still used largely as a way to avoid birth of additional children by women who already have the number of children they want. This is in sharp contrast with the situation in the majority of Western European countries in which abortion is used mainly by teen-age girls whose attempts to avoid pregnancy have failed.

CONCLUSION: In contrast to other demographic characteristics which classify the Czech Republic to Eastern Europe, the level of induced abortion rate is comparable with the levels observed in some Western European countries....

Read abstract  Full text PDF

Journal Article 2009; 30(1): 119-124 PubMed PMID: 19300390 Citation  Keywords:  Adult, Brain Mapping, Case-Control Studies, Cerebrum:pathology, Depression:complications, Diabetes Mellitus:pathology, Diabetic Neuropathies:complications, Dominance, Cerebral:physiology, Evoked Potentials, Visual, Female, Humans, Male, Middle Aged, Psych.   

OBJECTIVES: The present study was undertaken in order to verify the hypothesis stating that patients with depression exhibit some abnormalities concerning a cerebral symmetry. For this purpose, an analysis of the relationship between the VEPs (Visual Evoked Potentials) results and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed.

MATERIAL AND METHODS: VEPs recordings were obtained from the two study groups (both aged 20-45 years), 20 healthy subjects and 32 diabetic patients with clinically documented depression. The VEPs examination was carried out using a computer system called STELLA (Stimulated Electroencephalogram on Line Analyzer).

RESULTS: VEPs examinations revealed a cerebral symmetry in the all control subjects and in 10 out of 32 diabetic patients with depressive disorders. It is noteworthy that 22 of 32 diabetic patients (68.8%) showed a hemispheric asymmetry in the VEPs recordings. Of 12 patients with a moderate depression, 10 showed the left cerebral laterality, and 2--the right laterality. In turn, all 10 patients with major depressive disorder (MDD) demonstrated in the VEPs recordings a significant cerebral laterality with the right hemisphere dominance.

CONCLUSIONS: The obtained results suggest that interhemispheric cerebral asymmetry might be considered a specific feature of depression, and, if this is a case, it could justify a conclusion that right hemisphere dominance could be a neurophysiological marker of MDD. It should be emphasized that intensification of the depressive symptoms has an unfavorable influence on course of diabetes mellitus, its self-control and severity of following complications....

Read abstract  Full text PDF

Journal Article 2009; 30(1): 61-66 PubMed PMID: 19300383 Citation  Keywords:  Aged, Aged, 80 and over, Body Mass Index, Carotid Arteries:pathology, Carotid Stenosis:complications, Case-Control Studies, Comorbidity, Female, Humans, Incidence, Male, Middle Aged, Neck:anatomy & histology, Sleep Apnea, Obstructive:complications,.   

OBJECTIVES: Sleep apnea is associated with advanced atherosclerosis. This study was focused on sleep breathing in patients with hemodynamically significant carotid stenosis, currently free from clinical symptoms.

DESIGN AND SETTINGS: 17 patients with carotid artery stenosis of 70% and more in the absence of actual neurological symptoms indicated for non-acute endarterectomy, and 17 age- and sex-matched controls were examined using sleep polygraphy. 12 patients had a follow-up sleep polygraphy a month after the surgery.

RESULTS: The criteria of obstructive sleep apnea (OSA) were met by 4 patients prior to operation, by 2 patients after the operation, and by 2 control subjects. The pre-surgery apnea/hypopnea index (AHI) was 14 (+/-SD=17.0), post-surgery 8.3 (+/-9.0) and in the controls 6.7(+/-6.7). The pre-surgery oxygen desaturation index was 20.1 (+/-17.7), post-surgery 15.0 (+/-12.0) and in the controls 11.6 (+/-6.1). A comparison between the pre-surgery results seen in the patients and in controls after adjustment for BMI revealed no significant difference. The only significant difference between the pre-surgery and post-surgery values was found in the AHI (P=0.045).

CONCLUSION: According to this study there exists an association between carotid stenosis and OSA, however this association is explainable by a higher BMI. The study also found a tendency toward OSA alleviation in response to endarterectomy....

Read abstract  Full text PDF

Case Reports 2009; 30(6): 709-714 PubMed PMID: 20038935 Citation  Keywords:  Arthropathy, Neurogenic:diagnostic imaging, Arthroplasty, Replacement, Hip, Female, Hip Joint:diagnostic imaging, Humans, Intervertebral Disc Displacement:complications, Middle Aged, Radiculopathy:complications, Spondylosis:complications, Tomography, X-Ra.   

: Neurogenic arthropathy is a rare joint disorder, characterized by rapid progression and marked destruction of articular surfaces (known as Charcot's joint) with only mild to moderate pain. Most cases are related to diabetic neuropathy, but they may complicate the course of other neurogenic clinical conditions such as neurosyphilis (tabes dorsalis), syringomyelia, myelomeningocele, Peroneal Muscular Atrophy, spine or peripheral nerve injury, alcoholism and avitaminosis. Loss of superficial sensation and proprioception plays a pivotal role in development of arthropathy because it affects the joint's normal protective reflexes and leads to joint instability, degeneration and destruction. The authors describe an unusual case of bilateral neurogenic hip arthropathy in a 61-year old women who developed this condition in the course of multilevel lumbar spondylosis with spinal and nerve root compression. The patient underwent a successful bilateral hip replacement and remains almost asymptomatic contrary to literature reports that suggest high risk of complications after the operative treatment of Charcot's joints....

Read abstract  Full text PDF

Comparative Study 2009; 30(6): 769-773 PubMed PMID: 20038932 Citation  Keywords:  Adolescent, Adult, Anxiety:complications, Depression:complications, Dissociative Disorders:complications, Female, Humans, Linear Models, Male, Middle Aged, Personality Inventory, Severity of Illness Index, Young Adult,.   

OBJECTIVE: The aim of our study is to examine if the dissociation, can influence intensity of psychopathology in patients suffering with dissociative disorders compare the level of dissociation of the patients with the data of healthy subjects.

METHODS: 32 patients suffering with various types of dissociative disorder (9 males and 23 females) and 93 healthy controls (29 males and 64 females) were included into the study. The patients were psychiatrically assessed and the subjective intensity of symptoms was evaluated by Beck Anxiety Inventory and Beck Depression Inventory. All participants were assessed with the Dissociative Experiences Scale (DES).

RESULTS: The two groups didn't differ in demographic variables like age, gender and education. Level of the psychological dissociation assessed with the DES was correlated with the severity of subjective anxiety symptoms (p<0.0001), and with the severity of depression symptoms (p<0.0001). Patients had statistically significant higher mean score of DES than healthy controls (p<0.0001).

CONCLUSIONS: Our results suggest that the level of psychological dissociation in dissociative disorder patients is associated with the severity of anxiety and depressive symptoms....

Read abstract  Full text PDF