Clinical Study Comparison of Efficiencies of Michigan Neuropathy Screening Instrument, Neurothesiometer, and Electromyography for Diagnosis of Diabetic Neuropathy

Aim. This study compares the effectiveness of Michigan Neuropathy Screening Instrument (MNSI), neurothesiometer, and electromyography (EMG) in detecting diabetic peripheral neuropathy in patients with diabetes type 2. Materials and Methods. 106 patients with diabetes type 2 treated at the outpatient clinic of Ankara Numune Education and Research Hospital Department of Endocrinology between September 2008 and May 2009 were included in this study. Patients were evaluated by glycemic regulation tests, MNSI (questionnaire and physical examination), EMG (for detecting sensorial and motor defects in right median, ulnar, posterior tibial, and bilateral sural nerves), and neurothesiometer (for detecting alterations in cold and warm sensations as well as vibratory sensations). Results. According to the MNSI score, there was diabetic peripheral neuropathy in 34 (32.1%) patients (score ≥2.5). However, when the patients were evaluated by EMG and neurothesiometer, neurological impairments were detected in 49 (46.2%) and 79 (74.5%) patients, respectively. Conclusion. According to our findings, questionnaires and physical examination often present lower diabetic peripheral neuropathy prevalence. Hence, we recommend that in the evaluation of diabetic patients neurological tests should be used for more accurate results and thus early treatment options to prevent neuropathic complications

Use of polyethylene glycol coatings for optical fibre humidity sensing

Humidity induced change in the refractive index and thickness of the polyethylene glycol (PEG) coatings are in situ investigated for a range from 10 to 95%, using an optical waveguide spectroscopic technique. It is experimentally demonstrated that, upon humidity change, the optical and swelling characteristics of the PEG coatings can be employed to build a plastic fibre optic humidity sensor. The sensing mechanism is based on the humidity induced change in the refractive index of the PEG film, which is directly coated onto a polished segment of a plastic optical fibre with dip-coating method. It is observed that PEG, which is a highly hydrophilic material, shows no monotonic linear response to humidity but gives different characteristics for various ranges of humidity levels both in index of refraction and in thickness. It undergoes a physical phase change from a semi-crystal line structure to a gel one at around 80% relative humidity. At this phase change point, a drastic decrease occurs in the index of refraction as well as a drastic increase in the swelling of the PEG film. In addition, PEG coatings are hydrogenated in a vacuum chamber. It is observed that the hydrogen has a preventing effect on the humidity induced phase change in PEG coatings. Finally, the possibility of using PEG coatings in construction of a real plastic fibre optic humidity sensor is discussed. (C) 2008 The Optical Society of Japan

Narköy (Niğde) hydrogeochemistry of geothermal water and the characteristics of the source area

Bu çalışma, yüksek lisans tez çalışması kapsamında, Narköy Acıgöl ve Ilısu jeotermal alanı ve çevresindeki sıcak ve mineralli sularının hidrojeokimyasal özelliklerini ve kaynakların karşılaştırmalı köken değerlendirmesi yapılmış olup, suların çevre kayaçlardaki etkileri belirlemeye çalışılmıştır. İnceleme alanındaki sıcak sularının kaynağı 5-10 km derinliklere kadar sokulmuş, katılaşmış fakat sıcaklığını henüz kaybetmemiş mağma sokulumları olabileceği düşünülmektedir. Bu kapsamda, Narköy-Acıgölde bulunan sıcaklığı 23,8 C ve Ilısu merkezinde yer alan sıcaklığı 34,0 C olan sıcak su kaynakları incelenmiştir. İnceleme alanın da sıcak sularının yakınında mevsimsel değişikliklere bağlı olan soğuk su kaynakları da gözlenmiştir. Yapılan incelemeler sonucunda sıcak suyun kaynak kayaçlarının Eosen yaşlı kireçtaşı, jips, kumtaşı birimleri ve Miyosen – Pliyosen yaşlı tüf, tüfit, andezit ve ignimbiritler olduğu belirlenmiştir. Hidrokimyasal analiz sonuçları diyagram üzerinde incelendiğinde katyon bakımından Ca+2- Mg+2, anyon bakımından HCO3-SO4 su tipinde olduğu görülmüştür. Ayrıca bunların katyonlarına göre Ca-Mg-Na, anyonlarına göre HCO3-SO4-Cl bölgesinde bulunmakta, Acıgöl göl suyu Na-Mg-Cl-HCO3, Acıgöl sıcak su Ca-SO4-HCO3, Ilısu sondaj Na-Ca-HCO3, Ilısu soğuk Ca-Mg-HCO3, Melendiz Ca-Mg-HCO3, Sofular Ca-HCO3 su tipindedirler. İnceleme alanın koyu siyah renkli ince taneli sert volkanik kayaçlar olanbazalt ve andezitler yüzeylenmektedir. Bazaltlar bölgede yer yer andezitlere geçiş göstermektedir. Bazaltları oluşturan koyu renkli minerallerin oranı (piroksen, amfibol, olivin ve biyotit) hacimsel alan olarak % 40 civarındadır. Açık renkli mineraller genellikle plajioklaslardan (labradorit) oluşmaktadır. Alkali feldspatlar ve feldspatoidler oldukça düşük miktarlarda gözlenmektedir. Bazaltlar içerisinde iri feno kristaller şeklinde sıkça gözlenen olivin ve piroksenler (ojit) nedeniyle kayaç, plajioklas-olivin piroksen bazalt olarak adlandırılmıştır.Thisstudy, athesis as part of Acıgöl and Ilisu geothermal field and surrounding hot and mineral water hydrochemical characteristics and origin of the comparati veorigins assessment is made,waters were studied to determine the irimpact on the surrounding rocks. The source of hot water in the study are aluredtodepths of 5-10 km, solidified magma intrusion shave not yet lost, but the temperature is thoughtto be . In this context, situated in Acıgöl temperature 23.8 ° C and 34.0 ° C Ilisu which is located in the center of the hot waterv supply temperature were investigated. In the study arean earth ewarm waters, the cold water supply is connected to seasonal changes were also observed. As a result of the examination, the hot water of sourcerocks of Eocene limestone, gypsum, sands to neunitsand Miocene - Pliocenetuff, tuffite, it was determined that the and esiteand ignimbrite . When analyzed on the diagram hydrochemical Analysis termscations Ca +2 , Mg +2, HCO3 - SO4 anionterms were found to be in water type . In addition, their cation according to the Ca- vii Mg – Naani on according to the HCO3 -SO4 -Cl located in theregion , the Acıgöl lake water, Na-Mg -Cl - HCO 3 , Acıgöl hot water Ca -SO4 - HCO3 Ilisu drilling Na-Ca -HCO3 , Ilisu cold Ca-Mg - HCO3 , Ca-Mg - HCO3 Melendiz , SufiCa - HCO3 water type . Dark black colored fine-grained views of thearea hard volcanic rocks are exposed in Ilisu Basalt to andesite in there gion suggests switching .Basalts fo rmingtheratio of dark-colored minerals ( pyroxene, amphibole, olivine andmica ) volumetric area is around 40% . Light colored minerals are usually composed from plagioclase (labradorite ) . Alkali feldspar and feldspatiod mikter is observed in fairly low.Working with in the basalt out cropping in the form of large crystals frequently observedphe olivine andpyroxene - olivine pyroxene basalt rock Plagioclase has been called

A Case of Hodgkin Transformation of Chronic Lymphocytic Leukemia

Richter’s transformation is a serious complication of chronic lymphocytic leukemia. We present a patient with Hodgkin transformation of chronic lymphocytic leukemia. This patient was admitted to our clinic with the complaints of weakness and fatigue. She had palpable axillary and cervical lymphadenomegaly. Positron emission tomography/computed tomography scans with fluorodeoxyglucose revealed multiple cervical axillary lymph nodes in the right axilla and the right side of the neck with minimally increased fluorodeoxyglucose uptake and paraaortic, pancreaticoduodenal, aortocaval lymph nodes with intense fluorodeoxyglucose uptake (SUVmax: 10.86). Excisional biopsy of the intraabdominal lymph node was performed which revealed classical Hodgkin disease. Combined chemotherapy was started. She died because of pneumonia after two cycles of the therapy

The effects of dual and triple combinations of trandolapril, telmisartan, and verapamil on overt proteinuria in the patients with diabetic nephropathy

Diabetic nephropathy (DN) is one of the most important causes of the end-stage renal failure and its prevalence is found to be increasing. The presence of hypertension and progressive proteinuria is among the important findings. In this study, the effects of double and triple combinations of trandolapril, telmisartan, and verapamil on proteinuria were investigated in diabetic patients with nephropathy. Seventy-eight patients (mean age: 56.11 ± 11.26 years; 47 females and 31 males) with overt proteinuria and DN were included in this study. The patients were divided into four groups: Group I (n: 18, trandolapril + telmisartan), Group II (n: 20, trando- lapril + verapamil), Group III (n: 20, trandolapril +telmisartan + verapamil), and Group IV (n: 20, telmisartan + verapamil). At the end of a three-month therapy, within and between group compa- risons were done about the effects of the use of double or triple drug combinations on proteinuria, glomerular filtration rate (GFR), electrolytes, serum albumin, low-density lipoprotein (LDL)- cholesterol, and HbA1C. There was no significant difference among groups in terms of age, gender, diabetes duration, body mass index, and retinopathy frequency. The decreases in protei- nuria and mean arterial blood pressure (MABP) were significant in all groups. The decrease in proteinuria was independent of the decrease in MABP [the reduction rate in proteinuria was 39% (P <0.001) in Group I, 37% (P <0.001) in Group II, 42% (P <0.001) in Group III, and 43% (P <0.001) in Group IV; the reduction rate in MABP was 10.6% (P <0.001) in Group I, 13.7% (P <0.001) in Group II, 17.5% (P <0.001) in Group III, and 15.4% (P <0.001) in Group IV]. Decrease in HbA1C (before and after treatment) was significant in Groups III and IV when com- pared to Groups I and II. Any adverse event, like hyperkalemia, was not observed. There was no significant difference among the groups in terms of GFR, LDL-cholesterol, albumin, and potassium. All the patients tolerated the drugs well. In conclusion, in patients with DN, both double or triple combinations of trandolapril, telmisartan and verapamil resulted in signi- ficant decreases in proteinuria and MABP. Triple combinations did not have any supe- riority over double combinations. Therefore, the suitable drug combinations may be chosen according to the clinical status of a patient

Can keto/amino acids reduce oxidative stress in peritoneal dialysis patients with hypoalbuminemia?

Introduction There is no consensus on an ideal marker of oxidative stress (OS). Disruption of the balance between free radical and antioxidant activity production by increasing oxidative markers results in OS. In this study, we aimed to investigate how OS, which increases mortality and morbidity due to various reasons, is affected by keto/amino therapy in patients with hypoalbuminemia undergoing peritoneal dialysis