Showing papers by "Başkent University published in 2002"

Gonadal Determination and Adrenal Development Are Regulated by the Orphan Nuclear Receptor Steroidogenic Factor-1, in a Dose-Dependent Manner

Abstract: The orphan nuclear receptor steroidogenic factor-1 (SF-1, NR5A1) regulates the transcription of multiple genes involved in steroidogenesis, reproduction, and male sexual differentiation. A heterozygous loss-of-function SF-1 mutation (G35E) has been described in a patient with adrenal failure and complete 46XY sex-reversal, indicating that haploinsufficiency of this factor is sufficient to cause a severe clinical phenotype. This mutation in the P-box region of the DNA-binding domain markedly impairs SF-1 binding to most response elements. In an infant with a similar clinical phenotype, we identified an SF-1 mutation (R92Q) in a highly conserved residue of the A-box, a region that functions as a secondary DNA-binding domain. Strikingly, the affected infant was homozygous for the R92Q mutation, but three relatives (parents, sister) were phenotypically normal despite being heterozygous for the mutation. In functional assays, the R92Q mutant exhibited partial loss of DNA binding and transcriptional activity when compared with the G35E P-box change, consistent with its phenotypic expression only when transmitted as a homozygous trait. Taken together, these two naturally-occurring SF-1 mutations reveal the relative functional importance of the P-box and A-box regions for monomeric binding by nuclear receptors. In addition, these patients reveal the exquisite sensitivity of SF-1-dependent developmental pathways to gene dosage and function in humans.

Evaluation of the safety and efficacy of sibutramine, orlistat and metformin in the treatment of obesity.

Abstract: Aim: Some of our obese patients who were receiving 10 mg/day sibutramine reported feeling hunger at night. To address this, we designed a randomized, prospective clinical trial to study the efficacy and safety of 10 mg sibutramine twice daily (bid), and compare this treatment with 120 mg orlistat three times daily (tid) and 850 mg metformin (bid). Methods: A total of 150 female patients with body mass index (b.m.i.) > 30 kg/m2 were included. The subjects were all out-patients at the Baskent University Endocrinology and Metabolism Clinic. Each individual was assigned randomly to receive 10 mg sibutramine bid (group 1; n = 50; mean age 42.27 ± 1.40 years), 120 mg orlistat tid (group 2; n = 50; mean age 42.13 ± 1.32 years) or 850 mg metformin bid (group 3; n = 50; mean age 43.58 ± 1.40 years). All patients took the medications for 6 months. Two patients from the sibutramine group and two from the orlistat group were withdrawn from the study because of side-effects. Results: After 6 months of treatment, the sibutramine, orlistat, and metformin groups all showed significantly reduced b.m.i. (13.57%, 9.06% and 9.90% respectively); waist circumference (10.43%, 6.64%, and 8.10% respectively); fasting and postprandial blood glucose levels; insulin resistance as assessed by the homeostasis model for assessment of insulin resistance (HOMA)(38.63%, 32.73% and 39.28%, respectively); levels of total cholesterol, low-density lipoprotein (LDLC) cholesterol, very low-density lipoprotein (VLDLC) cholesterol, triglyceride, lipoprotein (a), and apolipoprotein B; uric acid level; pulse rate; and systolic and diastolic blood pressure. None of the groups showed any significant changes in levels of high-density lipoprotein (HDLC) cholesterol, or apolipoprotein A1. There was a significantly greater fall in b.m.i. in the sibutramine group than in either of the other groups (p < 0.0001). Conclusions: The results of this study confirm that sibutramine, orlistat and metformin are all effective and safe medications that reduce cardiovascular risk and can decrease the risk of type 2 diabetes mellitus in obese females. Overall, treatment with 10 mg sibutramine bid is more effective than orlistat or metformin therapy in terms of weight reduction.

Alveolar distraction: analysis of 10 cases.

Abstract: Objective. The purpose of this study was to evaluate intraoperative and postoperative complications of alveolar distraction and outcome. Study Design. Ten patients with alveolar ridge deficiencies were treated with alveolar distraction osteogenesis by means of intraosseous distractors (Lead system, Stryker Leibenger, Kalamazoo, Mich). The deficiencies were caused by atrophy after periodontal disease or atrophy after tooth extraction (n = 6), benign tumor resection (n = 2), trauma (n = l), or oligodontia in a case of ectodermal dysplasia (n = l). The location of the defects was the anterior mandible (7), posterior mandible (1), and anterior maxilla (2). The mean follow-up was 1.8 years, with a range of 10 months to 3 years. Results. The mean alveolar distraction achieved in 10 cases was 8.7 mm (5-15 mm). The intraoperative and postoperative problems encountered were lingual (n = 3) and palatal (n = 2) displacement of the distracted segment, fracture of the distracted segment in a very thin alveolar bone (n = 1), and intraoperative bleeding (n = 1). Conclusion. Overall complication rate was 70%. However, most of the complications were minor and eliminated easily. Implant success rate was 85%. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:561-5)

Oxygen plasma modification of polyurethane membranes.

Abstract: Polyurethane membranes were prepared under nitrogen atmosphere by using various proportions of toluene diisocyanates (TDI) and polypropylene-ethylene glycol (P) with addition of no other ingredients such as catalysts, initiator or solvent in order to achieve medical purity. Effects of composition on mechanical properties were examined. In general, modulus and UTS values demonstrated an increase and PSBR demonstrated a decrease as the TDI/Polyol ratio of the polymer increased. Elastic modulus, ultimate tensile strength (UTS) and per cent strain before rupture (PSBR) values were found to be in the range of 1.4–5.4 MPa, 0.9–1.9 MPa, and 60.4–99.7%, respectively. Surfaces of the membranes were modified by oxygen plasma applying glow-discharge technique and the effect of applied plasma power (10 W or 100 W, 15 min) on surface hydrophilicity and on the attachment of Vero cells were studied. Water contact angle values of the plasma modified surfaces varied between 67° and 46°, demonstrating a decrease as the applied plasma power was increased. The unmodified material had 42–45 cells attached per cm2. It was observed that as the applied power increased the number of attached cells first increased (60–70 cells/cm2 at 10 W) and then decreased (27–40 cells/cm2 at 100 W). These demonstrated that surface properties of polyurethanes can be modified by plasma-glow discharge technique to achieve the optimum levels of cell attachment.

Echocardiographic Evidence of Cardiac Involvement in Ankylosing Spondylitis

Abstract: Aortic insufficiency, myocardial fibrosis and conduction disturbances are known complications of ankylosing spondylitis (AS). However, few studies have assessed left ventricular diastolic function and no data are available about P-wave analysis. In this study 88 AS patients and 31 healthy volunteers underwent clinical examination, electrocardiography, echocardiography and signal-averaged P-wave analysis for the evaluation of asymptomatic cardiac involvement. The aortic root in AS patients was larger and this was correlated with the duration of the disease. Five of 88 AS patients (5.7%) had evidence of mitral valve prolapse, six (6.8%) had thick and redundant mitral valves without prolapse, five (5.7%) had mild mitral regurgitation, two had moderate (2.3%) and two had mild (2.3%) aortic regurgitation. Examination of diastolic function revealed a lower peak of E-wave velocity (E) and E/A ratio, a higher peak of A-wave velocity (A) and acceleration rate of the A wave, a longer deceleration time of E-wave velocity and isovolumic relaxation time in the AS group compared to controls. Mean filtered P-wave duration (PWD) in AS was similar to that of controls. However, PWD in AS patients was positively correlated with left atrial dimension and acceleration rate of the A wave and negatively correlated with E and E/A ratio. In conclusion, cardiac involvement may be seen in AS patients in the absence of clinical manifestations. Echocardiographic examination of diastolic function can be used in this asymptomatic period. Further studies are needed to clarify the prognostic significance of diastolic abnormalities and the value of P-wave analysis in cardiac evaluation of these patients.

Arthroscopic-assisted percutaneous screw fixation of select patellar fractures.

Abstract: Purpose: To describe a technique of arthroscopic-assisted reduction and percutaneous cannulated screw fixation for displaced patellar fractures and to present the results of 5 cases. Type of Study: Case series. Methods: Five patients (3 male, 2 female) with displaced patellar fractures treated with an arthroscopic-assisted reduction and percutaneous cannulated screw fixation were prospectively analyzed. The mean age was 53 years (range, 27 to 74 years). All fractures were fixed with at least 2 4-mm cannulated screws under arthroscopic visualization. Cerclage wiring through the cannulated screws was necessary in 2 patients with osteopenic bone. Controlled passive range of motion exercises were started on the first postoperative day. Full weight bearing with an immobilizer-type brace was allowed as tolerated. The mean follow-up was 28 months (range, 24 to 35 months). The patients were evaluated with Lysholm II scores, clinical examination, knee range of motion, thigh circumference measurements, and radiographs. Results: All fractures healed uneventfully. The mean Lysholm II score was 84.8 (range, 75-96). All but 1 patient regained full knee range of motion. A mean quadriceps atrophy of 0.8 cm compared with the contralateral side was seen in unilateral cases. There was no implant failure or infection. Conclusions: Arthroscopic-assisted reduction and percutaneous cannulated screw fixation is appropriate for displaced transverse patellar fractures without major separation and comminution. Longitudinal or oblique fractures, even if there are more than 2 major fragments, are amenable to arthroscopic techniques, providing the fragments are large enough to be fixed with screws. This technique is minimally invasive and does not disturb the vascular supply of patella. It allows clear visualization of the reduction and stability of the fracture, and facilitates early postoperative range of motion exercises. This method is not suitable for highly comminuted fractures or transverse fractures with major separation that are accompanied by rupture of the extensor mechanism. Key Words: Patella fracture—Arthroscopic treatment—Cannulated screws.

Systemic Inflammatory Response Related to Cardiopulmonary Bypass and Its Modification by Methyl Prednisolone: High Dose Versus Low Dose

Abstract: The objective of our study was to investigate the safety and efficacy of high-dose methyl prednisolone (MP) in modifying the systemic inflammatory response (SIR) to cardiopulmonary bypass (CPB) and to compare its efficacy with low-dose MP in children undergoing cardiac surgery for congenital heart disease. Thirty children with congenital heart disease undergoing CPB were randomly assigned to two groups: group 1 (n = 15) received 30 mg/kg MP by an intravenous infusion for 30 minutes and group 2 (n = 15) received 2 mg/kg intravenously, before the onset of CPB. Postoperative clinical parameters were recorded, and serum interleukin (IL)-6 and 8 levels, acute phase reactants, and blood biochemistry were determined serially for both groups. In both groups plasma IL-6 and 8 levels were elevated above the preoperative levels at 2 and 24 hours after declamping. The peak levels were obtained at 2-hour samples. The difference between the two groups in terms of postoperative IL-6 and 8 levels was not statistically significant. C-reactive protein (CRP) levels and polymorphonuclear leukocyte counts, postoperative core temperature, duration of mechanical ventilation, period of stay in intensive care unit, oxygenation indices, and biochemical parameters of patients did not significantly differ in the two groups. Only 1 patient in group 1 had elevated liver enzymes, blood urea nitrogen, and creatinine in the postoperative period. No significant complications were observed due to treatment with high-dose MP. Although postoperative IL and CRP levels indicated a SIR in our patients, the clinical picture was apparently affected in only 1 patient and she was in the high-dose MP group. CPB initiates a SIR that is associated with an increase in neutrophil count, CRP, and IL-6 and 8 levels. High-dose (30 mg/kg) MP was not superior to low-dose (2 mg/kg) in blunting the SIR to CPB in pediatric patients undergoing open-heart surgery.

Impact of Helicobacter pylori on the development of vitamin B12 deficiency in the absence of gastric atrophy.

Abstract: Background. Cobalamin (vitamin B 12 ) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B 12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B 12 . Materials and Methods. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pyloriinfected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B 12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed. Results. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B 12 level ( p < .01) on univariate analysis. Only H. pylori density was significantly associated with B 12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status ( p < .001). Conclusion. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with nonulcer dyspepsia and minimal or no gastric atrophy.

New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions

Abstract: Acta Obstet Gynecol Scand 2002; 81: 706-712. © Acta Obstet Gynecol Scand 81 2002 Background. Phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) is secreted by decidual cells and leaks into cervical secretions when fetal membranes detach from decidua. Our aim was to assess whether detection of phIGFBP-1 in cervical secretions by a rapid bed-side test could be used to predict preterm delivery in patients with regular uterine contractions. Study design. In our prospective study, 36 women between 20 and 36 weeks of gestation with regular, persistent contractions (> 10/h) and 18 women between 20 and 36 weeks gestation without symptoms of preterm labor were assessed for the presence of cervical phIGFBP-1. Dacron swabs were applied to the cervix and assayed in 5 min by using immunochromotography, a new rapid bed-side test (actim partus test, Medix Biochemica, Kauniainen, Finland). Data analysis included one-way variance analysis (ANOVA), Student's t -test, chi-square and Fisher's exact test....

Effects of methylprednisolone and betamethasone injections on the rotator cuff: an experimental study in rats.

Abstract: Thirty-one female Sprague-Dawley rats were used to determine the effects of subacromial corticosteroid injections on the rotator cuff. The injection technique was tested in 6 animals, which were excluded from the study. The remaining 25 rats were randomly divided into three groups of 8 animals each; a single rat received no injections. Every other week for 8 weeks, one shoulder in each rat was injected with methylprednisolone, betamethasone, or saline in a dosage equivalent to that used in humans. The supraspinatus and infraspinatus tendons were removed 10 days after the last injection and evaluated. There were no pathologic changes in the tendons injected with saline. In 43% of the methylprednisolone-treated rats and 29% of the betamethasone-treated rats, the tendons were abnormally soft and light-colored. In 43% of the methylprednisolone group and 71% of the betamethasone group, fragmentation of collagen bundles and inflammatory cell infiltration were evident. Subacromial injections of methylprednisolone or betamethasone repeated frequently can cause deleterious changes in the normal structure of the rat rotator cuff. In light of these findings, therapy for subacromial impingement syndrome of the shoulder with frequent, repeated steroid injections is potentially harmful.

The association of interdialytic weight gain with nutritional parameters and mortality risk in hemodialysis patients

Abstract: High interdialytic weight gain (IDWG) is considered as an indicator of noncompliance but could also be interpreted as an index of appetite. This study was designed to investigate the relationship I...

Intravenous ascorbic acid administration for erythropoietin-hyporesponsive anemia in iron loaded hemodialysis patients.

Abstract: Intravenous ascorbic acid administration (IVAA) could override recombinant human erythropoietin (rHuEPO) resistance in hemodialysis patients with iron overload. We investigated the hematopoietic response to IVAA in iron-overloaded hemodialysis patients. We included 36 patients whose ferritin levels were higher than 500 microg/L and who needed more than 100 U/kg/week of rHuEPO. The study included an initial phase (500 mg IVAA twice weekly was administered to all of the patients for 8 weeks) and a maintenance phase (patient groups were formed; Group 1 received IVAA 500 mg/week for 8 weeks and Group 2 received no therapy). We observed a significant increase in hematocrit and transferrin saturation and a decrease in the percentage of hypochromic red cells and ferritin levels at the end of the initial phase. The total weekly-required rHuEpo dose and rHuEpo/hemoglobin also fell significantly after the initial phase. The response remained stable in patient groups during the maintenance phase. In 6 nonresponders, the hypochromic red cells were <10%. In conclusion, IVAA effectively overrides rHuEPO resistance in iron-overloaded hemodialysis patients.

The Versatile Autogenous Costal Cartilage Graft in Septorhinoplasty

Abstract: Secondary septorhinoplasty often requires a large amount of tissue, and autogenous costal cartilage is one type of grafting material that can be used in these cases. In this study, 20 patients with severe nasal deformity received autogenous costal cartilage grafts. Nineteen of the 20 cases were revisions. Costal cartilage grafts were used for structural and nonstructural purposes in these patients. Follow-up ranged from 8 to 32 months. The complications included 1 patient with early wound infection and 3 with minor warping. There were no problems with graft resorption or extrusion. Other than temporary pain, there were also no complications at the donor sites. We conclude that the autogenous costal cartilage graft is an outstanding material for volume filling and structural support when large amounts of tissue are needed in septorhinoplasty.

Surgical and prosthodontic treatment alternatives for children and adolescents with ectodermal dysplasia: A clinical report

Abstract: Ectodermal dysplasia with oligodontia and anodontia is characterized by absence or deficiency of the alveolar ridges. The optimal surgical and prosthetic approach varies in relation to patient age and the amount of bone that is present. This clinical report presents rehabilitation alternatives for ectodermal dysplasia in children and adolescents.

Indocyanine green and fluorescein angiography in nonarteritic anterior ischemic optic neuropathy.

Abstract: PurposeTo assess the value of indocyanine green angiography (ICGA) for demonstrating choroidal vascular abnormalities in patients with nonarteritic anterior ischemic optic neuropathy (NAION).MethodsThe authors compared the ICGA and fluorescein fundus angiography characteristics of peripapillary circ

Factors predicting response and survival in 149 patients with unresectable hepatocellular carcinoma treated by combination cisplatin, interferon-alpha, doxorubicin and 5-fluorouracil chemotherapy.

Abstract: I t is often difficult to decide which patients with hepatocellular carcinoma (HCC) should be given chemotherapy, especially when extrahepatic disease is an issue. With this dilemma in mind, we read with great interest the study by Leung et al. regarding factors predicting survival and response to treatment in cases of unresectable HCC treated with chemotherapy. These authors used a moderately toxic chemotherapy regimen of cisplatin, interferonalpha, doxorubicin, and 5-fluorouracil (PIAF) but achieved very good objective response and even complete remission in some cases. Positive anti-hepatitis C virus titer, absence of cirrhosis, and low total bilirubin levels were identified as predictors of objective response. In addition, multivariate analysis revealed that earlier stage of disease, absence of cirrhosis, and absence of vascular involvement were associated with longer survival times. The authors reported two treatment-related deaths in the first 50 patients and stated that only a select group of HCC patients showed clinical benefits after PIAF combination therapy. In Turkey, approximately 15% of the population carries hepatitis B virus surface antigen (HbsAg), and the incidence of HCC is higher than the rates in western countries; thus, the predictors identified by Leung et al. are key for us in the treatment of HCC patients. It is well known that a visible hepatic mass consistent with HCC and a serum alpha-fetoprotein level higher than 500 ng/mL in an HBsAg carrier are diagnostic for HCC, and it is acceptable to institute treatment without tissue diagnosis. However, it is generally agreed that chemotherapy should only be administered to patients with histopathologically confirmed cancer. We believe that HCC should be histopathologically diagnosed before highcost, toxic regimens such as PIAF are given, especially if treatment response is to be evaluated in a trial. Systemic chemotherapy is usually not well tolerated in patients with significant underlying hepatic dysfunction. Leung et al. reported complete pathologic responses in resected tumor specimens from eight patients who achieved partial remission after chemotherapy. We wonder if these eight cases were pathologically confirmed before treatment. It would also be valuable to know whether the patients with suspected but not histopathologically diagnosed HCC had a higher response rate than those with histopathologically diagnosed disease. 2038

Distraction osteogenesis of basal mandibular bone for reconstruction of the alveolar ridge.

Abstract: Alveolar distraction is being used increasingly for alveolar bone reconstruction in patients with severe mandibular defects. When there has been total loss of alveolar bone, distraction of the mandibular basal bone is necessary. Distraction osteogenesis is considerably more challenging in mandibular basal bone than in alveolar bone. The low level of the cut increases the technical difficulty and may result in a poor outcome. We describe three cases in which more than 10 mm of distraction of mandibular basal bone was required. Semirigid distraction devices were used to reconstruct the alveolar structures in each case.

Levamisole treatment enhances protective antibody response to hepatitis B vaccination in hemodialysis patients.

Abstract: Hemodialysis shows a high risk for hepatitis B infection, and hepatitis B virus (HBV) vaccination has now become a routine procedure. Unfortunately, 40% to 50% of hemodialysis patients do not have adequate protective antibodies against the HBV vaccination which is thought to be due to depressed cell mediated immunity. Levamisole has been reported to stimulate depressed T-cell activity and enhance B lymphocyte function and restore delayed hypersensitivity reactions in immune-depressed patients. We studied the effects of levamisole, an immunomodulatory agent, on the protective antibody response of hemodialysis patients to the HBV vaccination. Our hemodialysis patients with negative anti-HBs antibody routinely received 40 microg doses of recombinant HBV vaccine intramuscularly at 0, 1, and 6 months, and we followed serum anti-HBs levels. Patients with a serum antibody level of >10 mIU/ml were considered as responders. Study groups were classified as follows. Group 1 was comprised of 96 chronic hemodialysis patients with negative anti-HBs and HBV core antibody (52 male, 44 female, mean age of 45 +/- 15 years and mean hemodialysis duration of 46 +/- 40 months) who received HBV vaccination; 55 patients (57%) were found to be responders. Group 2 was comprised of 19 randomly selected patients who had never received hepatitis B vaccine (13 male, 6 female, mean age of 42 +/- 14 years, mean duration of hemodialysis 31 +/- 27 months) and who were started on an HBV vaccination protocol with levamisole per os 80 mg after each hemodialysis session for 4 months and followed up on serum anti-HBs levels. Seventeen of the patients completed this levamisole treatment. Fourteen of the 17 patients had the levels of the protective serum antibody indicating a higher response rate when compared with patients who did not receive levamisole (82% versus 57%, respectively, p < 0.05). Group 3 was comprised of 19 patients randomly selected from persons who did not respond to previous vaccination programs (10 male, 9 female, mean age of 51 +/- 14 years, mean duration of hemodialysis 41 +/- 31 months). A second HBV vaccination program was started with the same levamisole protocol. In this group, 18 patients completed this treatment model. Fourteen of them responded to the vaccination model. In Group 4, a second HBV vaccination program was applied without levamisole to 20 randomly selected persons who did not respond to the previous routine vaccination program (12 male, 8 female, mean age of 53 +/- 17 years, mean duration of dialysis 51 +/- 38 months). Only 3 of them responded to a second vaccination program. Comparing Group 3 with Group 4, there was a higher responder rate to HBV vaccination (77% versus 15%, respectively, p < 0.0001). These results show that levamisole treatment increases the response rate to the first HBV vaccination and of the previously unresponsive cases by modulating possible cellular immune response.

The gluteal fasciocutaneous rotation-advancement flap with V-Y closure in the management of sacral pressure sores.

Abstract: The sacral region is one of the most frequent sites of pressure sore development, and local flaps in the gluteal region are usually preferred when surgical closure is needed. The authors used the gluteal fasciocutaneous rotation-advancement flap with V-Y closure to manage sacral pressure sores in 15 patients. The design was a combination of the classic rotation and V-Y advancement flap patterns. When the wound was closed, the tension at the distal end of the rotation flap was relieved by flap advancement and the combined rotation-advancement action was supported laterally with V-Y closure. A wide skin pedicle was preserved at the inferomedial part of the flap. This pedicle augmented the blood supply to the flap skin and kept the surgical incision small, thus helping to reduce the risk of fecal contamination and associated wound-healing problems. This flap can also be converted to any design of fasciocutaneous or musculocutaneous V-Y advancement flap, should such a change be required. The largest defects that were closed with a unilateral rotation-advancement flap and bilateral rotation-advancement flaps were 12 and 18 cm in diameter, respectively. In 1.5 to 35 months of follow-up, none of the patients developed wound dehiscence or flap necrosis requiring repeated surgery. This technique is simple, can be performed quickly, has minimal associated morbidity, and yields a good outcome.

An investigation of age and gender differences in physical self-concept among Turkish late adolescents.

Abstract: The purpose of the study was to evaluate age and gender differences in physical self-concept of Turkish university students. The Physical Self-Perception Profile was administered to participants for assessing physical self-concept. Multivariate analysis of variance revealed a significant main effect for gender, but no significant main effect for year in school. There was also no year in school by gender interaction. Univariate analysis indicated significant gender differences in sport competence, physical condition, body attractiveness, and physical strength (favoring males except for body attractiveness).

Value of Neuroimaging in the Evaluation of Neurologically Normal Children With Recurrent Headache

Abstract: Headache is one of the most frequent physical complaints in children. Although headaches in children are generally benign, neuroimaging studies are frequently performed in clinical practice for the fear of missing a serious underlying disease. Despite this, limited data exist about the utility of neuroimaging in recurrent headache of children with a normal neurologic examination. This prospective study was planned to determine the value of neuroimaging in neurologically normal children with migraine and tension-type headache. Among 95 consecutive patients presenting with headache, 72 patients receiving a diagnosis of migraine or tension-type headache were included in the study. Neuroimaging procedures were performed in 83%. Magnetic resonance imaging (MRI) was abnormal in 11 of 49 cases. Abnormalities consisted of foci of gliosis in four, sinusitis in two, pineal cyst in one, periventricular leukomalacia in one, arachnoid cyst in one, old traumatic changes in one, and cervical syrinx in one. Two of the 11 computed tomographic (CT) scans revealed sinus disease. The percentage of findings causally related to headache was about 10. None of the patients had undergone surgery because of neuroimaging results. In conclusion, the yield of neuroimaging in recurrent headaches of children with a normal neurologic examination is low, and neuroimaging should not be part of a routine initial examination of these patients.

Familial Arachnoid Cysts in Association With Autosomal Dominant Polycystic Kidney Disease

Abstract: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder well-known for its association with intracranial aneurysms. Recently, intracranial arachnoid cysts have also been reported to be associated with ADPKD. We describe a father and daughter who each has a posterior fossa arachnoid cyst and asymptomatic ADPKD. To our knowledge, this is the first report of familial occurrence of arachnoid cysts in association with ADPKD.