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Journal Article 2010; 31(2): 181-186 PubMed PMID: 20424592 Citation  Keywords:  Animals, Animals, Newborn, Brain:physiopathology, Disease Models, Animal, Electroencephalography, Hypoxia:physiopathology, Hypoxia, Brain:physiopathology, Recovery of Function, Severity of Illness Index, Swine, Time Factors,.   

OBJECTIVE: To evaluate the frequency content of the electroencephalogram (EEG) during recovery after a severe hypoxic insult in newborn piglets.

METHODS: EEG was continuously monitored in nine newborn piglets exposed to a severe hypoxic period. Power spectra in five frequency bands were calculated using Fourier transformation. Spectral edge frequency 90 (SEF90) was defined as the frequency below which 90% of the power in the EEG was located. The piglets were divided into two groups; Group 1 represented piglets with some EEG recovery and Group 2 represented piglets without any EEG recovery.

RESULTS: The recovery of the EEG in Group 1 had the same time course in all frequency bands. SEF90 indicates recovery earlier than the value of total power. But SEF90 also signals activity in the EEGs that were almost completely suppressed. When SEF90 was calculated during periods of periodic EEG activity during the very early phase of recovery, the values fell within the same range as during the control period.

CONCLUSION: Spectral analysis of continuous EEG in newborn piglets exposed to very severe hypoxia showed that no specific frequency band of the EEG preceded the other ones during recovery. The results of the SEF90 measure, demonstrates the need for critical analysis of the raw EEG before any reliable estimation of cerebral function can be made....

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Journal Article 2010; 31(2): 208-214 PubMed PMID: 20424591 Citation  Keywords:  Animals, Cell Nucleolus:radiation effects, Electromagnetic Fields, Erythroblasts:radiation effects, Leukocyte Count, Lymphocytes:radiation effects, Mice, Mice, Inbred Strains, Nucleolus Organizer Region:metabolism, Time Factors,.   

OBJECTIVES: We aimed to investigate the effects of weak extremely low frequency electromagnetic fields (ELF-EMFs) on the nucleus size, the silver staining nucleolar organizer regions (AgNORs), the frequency of micro nucleated peripheral blood lymphocytes (MPBLs) and the micro nucleated polychromatic erythrocytes (MPCEs).

METHODS: One hundred and twenty Swiss albino mice were equally divided into 6 groups. The study groups were exposed to 1, 2, 3, 4 and 5 microT 50 Hz-EMFs for 40 days. Micronucleus number (MN) per PBL was determined..

RESULTS: ELF-EMF exposure caused a nonlinear decline of nucleus area. A sharp drop occurred in AgNOR area of 1 microT group, and following it gained an insignificantly higher level than that of the control group. The field did not change mean AgNOR numbers per nucleus of the groups. Relative AgNOR area had the highest level in 1 microT-exposure group, and the level was quite similar to that of the 5 microT-exposure group. The remaining groups had significantly lower values quite similar to that of the control level. The field exposure at any intensity did not affect significantly the frequency of either MPBLs or MPCEs. The number of MN per PBL in the 4 and 5 microT-exposure groups were significantly higher than those of the lower intensity exposure groups. The males in 4 microT-exposure group displayed the highest MN number per PBL, whereas values changed in a nonlinear manner.

CONCLUSIONS: The results of the present study suggest that the mouse....

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Journal Article 2010; 31(2): 238-249 PubMed PMID: 20424590 Citation  Keywords:  Adult, Auditory Cortex:physiopathology, Chronic Disease, Electroencephalography, Female, Follow-Up Studies, Functional Laterality, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Tinnitus:physiopathology, Transcranial Magnetic .   

OBJECTIVE: The pathophysiologic mechanisms of idiopathic tinnitus remain unclear. Low frequency rTMS applied over the auditory cortex has been proposed as a new and causally oriented treatment approach for pathological conditions with abnormal, increased cortical activity including tinnitus with increased activity in the auditory cortex. However available studies are characterized by a positive reports on the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) for treatment of tinnitus, there are few details about the duration of specific treatment effects.

DESIGN: The design of the study was randomized, prospective, placebo-controlled. Right-handed patients were treated with either real or sham 1 Hz frequency rTMS over a period of two weeks. Fifty-two patients with chronic, treatment resistant tinnitus and stable medication were enrolled in the study after giving written informed consent and forty-two patients completed the study and were included in data analysis.

RESULTS: The ability to reduce the symptoms of tinnitus appeared in both randomized groups immediately after the 1 Hz rTMS and sham stimulation phase. There was a significant reduction in both groups of the tinnitus total score on the Tinnitus Handicap Inventory (THI) (real rTMS p=0.005; sham rTMS p=0.049) and Tinnitus Questionnaire (TQ) total score (real rTMS p=0.003; sham rTMS p=0.049). On the THI evaluation scale, in the real rTMS a mild worsening was noted during week 6 in comparison with the state attained in week 2. During the subsequent course of the study a significant reduction of the total score persisted in the case of THI (real rTMS week 14 p=0.033 and borderline week 26 p=0.058). The reduction of symptoms as evaluated using the TQ was significant compared to baseline in the real rTMS group at week 2, 6 and 14 (p=0.003; p=0.024; p=0.022). The group treated with sham stimulation reached significant reduction of symptoms only at week 2 (p=0.049). A comparison of the difference in the recorded values of the total score during follow-up in relation to baseline expressed as a percentage demonstrates the difference in the effect of rTMS and sham stimulation as evaluated by both the basic scales. Graphical analysis of mean patterns of treatment response according to stimulation type shows a similarity between treatment response patterns evaluated by reduction of the total scores using THI and TQ.

CONCLUSIONS: The principal finding of this study is that real 1 Hz rTMS treatment was capable of significantly reducing the total baseline score of basic scales that measure tinnitus severity. This result is important as it proves that significant reduction of symptoms can be achieved even in a group of patients with long-term symptoms resistant to pharmacological treatment....

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Journal Article 2010; 31(2): 198-202 PubMed PMID: 20424589 Citation  Keywords:  Animals, Body Temperature, Fasting:adverse effects, Fibroblast Growth Factors:deficiency, Hypothalamus:metabolism, Hypothermia:etiology, Ketogenic Diet:methods, Liver:metabolism, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Motor Activity, Neuropeptide.   

BACKGROUND: Fibroblast growth factor 21 (FGF21) is a key metabolic regulator that is induced by peroxisome proliferator-activated receptor alpha (PPARalpha) activation in response to fasting. We recently reported that bezafibrate, a pan-agonist of PPARs, decreases body temperature late at night through hypothalamic neuropeptide Y (NPY) activation and others have shown that mice overexpressing FGF21 are prone to torpor.

OBJECTIVES: We examined whether FGF21 is essential for fasting-induced hypothermia using FGF21 knockout (KO) mice.

RESULTS: Acute fasting decreased body temperature late at night accompanied by the induction of hepatic FGF21 and hypothalamic NPY expression in wild-type mice. A deficiency of FGF21 affected neither fasting-induced hypothermia nor hypothalamic NPY induction. Fasting enhanced locomotor activity in both genotypes. On the other hand, a deficiency of FGF21 significantly attenuated chronic hypothermia and hypoactivity induced by a ketogenic diet (KD).

CONCLUSIONS: Our findings suggest that FGF21 is not essential for the hypothermia that is associated with the early stages of fasting, although it might be involved in the adaptive response of body temperature to chronic starvation....

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Clinical Trial 2010; 31(2): 203-207 PubMed PMID: 20424588 Citation  Keywords:  Adult, Anticonvulsants:administration & dosage, Antipsychotic Agents:administration & dosage, Carbamazepine:administration & dosage, Dibenzothiazepines:administration & dosage, Drug Interactions, Drug Monitoring:methods, Drug Therapy, Combination:methods,.   

OBJECTIVE: Quetiapine is one of the most frequent prescribed antipsychotics. Based on the consensus guidelines of therapeutic drug monitoring (TDM) in clinical practice, TDM of Quetiapine is "useful". In this pilot study, using a natural sample, we investigated the influence of co-medication, age and gender on the serum concentrations and clearance of Quetiapine. Also we compared the individual clearance in our sample with the expected clearance for healthy subjects, obtained in controlled studies.

METHODS: 150 blood samples were collected anonymously under clinical conditions, Quetiapine trough serum levels were determined using HPLC. Additional information about gender, age, co-medication and dosage was obtained.

RESULTS: There was a significant, positive, but weak correlation between daily dose and serum levels of Quetiapine (r=0.44; p=0.01). When Carbamazepine was co-administered, the clearance was significantly higher (p=0.01). 83% of the serum levels were outside the therapeutic range, only 28% were within the expected clearance.

CONCLUSIONS: In addition to the therapeutic range the individual clearance related to the expected clearance may help to optimize individual pharmacotherapy, especially for combination therapy or in case of incompliance or abnormal metabolism....

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Case Reports 2010; 31(2): 178-180 PubMed PMID: 20424587 Citation  Keywords:  Aborted Fetus:abnormalities, Adult, Autopsy:methods, Brain:abnormalities, Brain Neoplasms:diagnosis, Cerebral Hemorrhage:diagnostic imaging, Diagnosis, Differential, Ependymoma:diagnosis, Female, Gestational Age, Humans, Lateral Ventricles:abnormalities, .   

: Pathological-anatomical autopsy is the gold standard for determining of foetal abnormalities, but in some cases its role is limited (pathology of central nervous system, in particular, in case of ventricular dilatation or developed autolysis). In pathology of central nervous system, where insufficiency of autopsy can occur, additional post mortem magnetic resonance imaging (MRI) is performed to determine type of malformation. In this case report, we would like to point out the fact that although all investigating methods including post mortem magnetic resonance and autopsy (incl. imunohistochemical tests) are used, this need not necessarily result in a clear diagnostic conclusion of the aborted foetus. Post mortem MRI visualized pathology: dilatation of both lateral ventricals, more in the left and, above all, a pathological focus parasagittaly on the right with haemorrhage and cystic component; it raised a suspicion on ependymoma. However imunohistochemical test did not give an unambiguous conclusion; therefore diagnosis based on MRI could not be uniquely verified....

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Journal Article 2010; 31(2): 270-274 PubMed PMID: 20424586 Citation  Keywords:  Adult, Blood Glucose:metabolism, Diabetes Complications:blood, Fasting:blood, Female, Hemoglobin A, Glycosylated:metabolism, Humans, Hyperprolactinemia:blood, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Gland:pathology, Prevalence, Prolactin:.   

OBJECTIVE: Prolactin levels have been shown to be reduced in poorly controlled diabetes mellitus; however, diabetic patients with high prolactin levels may be seen in clinical practice. The aim of this study was to evaluate diabetic patients with hyperprolactinemia, and to determine the role of macroprolactinaemia in these patients.

MATERIALS AND METHODS: The study included 174 patients (153 women and 21 men) with hyperprolactinemia, retrospectively reviewed over a 2 years period. Data on presenting symptoms, the presence of diabetes mellitus, prolactin levels, macroprolactin levels, pituitary magnetic resonance imaging were collected in all patients. In addition; HbA1c, fasting blood glucose levels and postprandial glucose levels were collected in diabetic patients.

RESULTS: Of the 174 patients, 27 were diagnosed with diabetes mellitus (15.5%). Eighteen of the diabetic patients with hyperprolactinaemia had macroprolactinaemia (66.6%). The prevalence of macroprolactinaemia in diabetic patients is higher than the non-diabetic population (66.6% vs. 39.5%, p=0.009). In diabetic patients with macroprolactinaemia, HbA1c levels were higher than the diabetic patients without macroprolactinaemia.

CONCLUSION: The prevalence of macroprolactinaemia in diabetic patients was higher than the non-diabetic population. It seems necessary to determine macroprolactin levels in diabetic patients with hyperprolactinaemia; and in this case, further diagnostic evaluation is not warranted....

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Case Reports 2010; 31(2): 174-177 PubMed PMID: 20424585 Citation  Keywords:  Adult, Brain:pathology, Brain Neoplasms:diagnostic imaging, Female, Fetal Diseases:diagnostic imaging, Gestational Age, Humans, Hydrocephalus:diagnostic imaging, Magnetic Resonance Imaging, Pregnancy, Prognosis, Teratoma:diagnostic imaging, Ultrasonograph.   

: Fetal intracranial teratomas are rare neoplasms that can be readily detected via USG and MRI. While early discovery of such a condition may be helpful, the prognosis remains poor. We present a case of a massive intracranial teratoma and hydrocephalus initially detected via USG at 33 weeks of gestation....

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