Present report describes a 46 year old male patient with a diagnosis of major depression who developed tardive dyskinesia during bupropion therapy. Our patient had no history of neuroleptic use and his laboratory and neurologic examinations were normal. He had no family history of neurologic diseases. Although bupropion induced dyskinesia has been previously reported in the literature, it is rare and our case is the first case regarding tardive dyskinesia.
Bupropion* ; Depression ; Diagnosis ; Dyskinesias ; Humans ; Male ; Movement Disorders* ; Neurologic Examination

OBJECTIVETo investigate the relation between fruit seeds, plants residuals and appendicitis.

METHODSAmong cases that underwent appendectomy, the appendicitis cases having fruit seeds and undigested plant residuals in their etiology were examined retrospectively. Also, histopathological features, age, sex, and parameters of morbidity and mortality were used.

RESULTSFruit seed was found in one case (0.05%) with presence of pus in appendix lumen, undigested plant residuals in 7 cases (0.35%). It was determined that there were appendix inflammation in 2 of the plant residuals cases, while there were obstruction and lymphoid hyperplasia in the appendix lumen of 5 cases. No mortality was observed.

CONCLUSIONSThe ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

Adult ; Appendicitis ; etiology ; metabolism ; physiopathology ; Digestion ; Female ; Fruit ; adverse effects ; metabolism ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Seeds ; adverse effects ; metabolism ; Young Adult

AIM: To investigate how body temperature (BT) affects choroidal thickness (CT) according to measurements taken with enhanced depth imaging optical coherence tomography (EDI-OCT).METHODS: In this prospective study, the CT of 41 healthy patients was measured hourly from 9∶00 to 17∶00 at the fovea (SF-CT), 500 μm nasal to the fovea(N-CT), and 500 μm temporal to the fovea (T-CT) using EDI-OCT.BT was also measured hourly from 9∶00 to 17∶00 using a non-contact infrared thermometer.Possible correlations between diurnal variations of CT and BT were evaluated.RESULTS: SF-CT values significantly differed between measurements at 9∶00 and 13∶00 (P=0.021), 9∶00 and 14∶00 (P=0.012), 9∶00 and 16∶00 (P=0.048), and 9∶00 and 17∶00 (P=0.002).N-CT values also significantly differed between measurements at 9∶00 and 13∶00 (P=0.004), though T-CT did not significantly vary during the 8h period (P >0.05 for all).CONCLUSION: CT is not significantly associated with hourly changes in BT from 9∶00 to 17∶00.

BACKGROUND/AIMS: Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. METHODS: The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as "poor sleepers." Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. RESULTS: The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. CONCLUSIONS: Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.
Adult ; Arginine/*analogs & derivatives/blood ; Biomarkers/blood ; Cardiovascular Diseases/blood/*etiology/physiopathology ; Chi-Square Distribution ; Chromatography, High Pressure Liquid ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood/*complications/diagnosis/physiopathology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; *Sleep ; Sleep Wake Disorders/blood/*complications/diagnosis/physiopathology ; Surveys and Questionnaires

A 31-year-old male was presented with a very rare case of ipsilateral palsies of the nerves IX through XII (Collet-Sicard syndrome) after a closed head injury. An occipital condyle fracture that was associated with epidural hematoma was diagnosed by computed tomography. The patient was conservatively managed, and following the treatment, partial neurological recovery ensued. The phenomenon of occipital condyle fracture involving the last four cranial nerve palsies is relatively rare. Although 3 cases of Collet-Sicard syndrome that were caused by an occipital condyle fracture has been reported, the association between condyle fracture and epidural hematoma has never been described before.

There are some corrections in the body of the article.

PURPOSE: The purpose of this study was to evaluate whether surface treatments affect the translucency of laminate veneers with different shades and thicknesses. MATERIALS AND METHODS: A total of 224 disc-shaped ceramic veneers were prepared from A1, A3, HT (High Translucent) and HO (High Opaque) shades of IPS e.max Press (Ivoclar Vivadent) with 0.5 mm and 1.0 mm thicknesses. The ceramics were divided into four groups for surface treatments. Group C: no surface treatments; Group HF: etched with hydrofluoric acid; Group SB: sandblasted with 50-microm Al2O3; and Group L; irradiated with an Er;YAG laser. A translucent shade of resin cement (Rely X Veneer, 3M ESPE) was chosen for cementation. The color values of the veneers were measured with a colorimeter and translucency parameter (TP) values were calculated. A three-way ANOVA with interactions for TP values was performed and Bonferroni tests were used when appropriate (alpha=0.05). RESULTS: There were significant interactions between the surface treatments, ceramic shades and thicknesses (P=.001). For the 0.5-mm-thick specimens there were significant differences after the SB and L treatments. There was no significant difference between the HF and C treatments for any shades or thicknesses (P>.05). For the 1-mm-thick ceramics, there was only a significant difference between the L and C treatments for the HT shade ceramics (P=.01). There were also significant differences between the SB and C treatments except not for the HO shades (P=.768). CONCLUSION: The SB and L treatments caused laminate veneers to become more opaque; however, HF treatment did not affect the TP values. When the laminate veneers were thinner, both the shade of the ceramic and the SB and laser treatments had a greater effect on the TP values.
Cementation ; Ceramics ; Dental Porcelain* ; Hydrofluoric Acid ; Resin Cements

A four-headed biceps brachii muscle and three-headed coracobrachialis muscle, high-originated radial artery and communication between the median and musculocutaneous nerves have been well documented in the available literature. However co-existence of these variations is rare. In this study we aimed to describe multiple variations in the upper limb and discuss their co-existence from clinical and embryological points of view.
Median Nerve ; Muscles ; Musculocutaneous Nerve ; Radial Artery ; Upper Extremity

PURPOSE: Appendectomy applied from the diagnosis of acute appendicitis is one the most common operations in surgery. The rates of negative appendectomy are still high. The rates of negative appendectomy in males and females differ and are higher in females. In our study, these differences, particularly in females, were studied and possible solutions were discussed. METHODS: Between October 2002 and October 2009, among women receiving urgent appendectomies, those whose primary cause was gynecological pathology were studied retrospectively. All our women subjects were examined by preoperative gynecologists. After gynecological consultation, the patients were evaluated by a general surgeon due to lack of urgent ultrasonography, computed tomography (CT) and diagnostic laparoscopy and the patient received appendectomy due to acute appendicitis. RESULTS: In our series of 1,969 appendectomies, the rate of female/male is 811/1,158. It was determined that the primary cause in 47 (47/811; 5.8%) women with applied appendectomy was gynecological pathology. As a gynecological pathology, it was observed that the most common cause was ovarian cyst ruptures at a rate of 72.3%. The negative appendectomy rate in males was found to be 14.94% (173/1,158), and in females it was 22.56% (183/811). The difference between them is significant (P < 0.01). Of these women, 5.8% were gynecologically-induced and 16.76% were unrelated to gynecological causes. CONCLUSION: We believe that gynecological consultation before appendectomy in women is necessary, but not sufficient. It is also important that at least one of the facilities, such as us, CT, magnetic resonance imaging, and diagnostic laparoscopy should be available in surgical use for the diagnosis of negative appendicitis.
Appendectomy ; Appendicitis ; Female ; Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Male ; Ovarian Cysts ; Retrospective Studies ; Rupture

Objectives: Symptomatic local treatment of vaginal atrophy (VA) in menopausal women includes hormonal and nonhormonal preparations. Some women may be reluctant to use vaginal estradiol preparations because of the concern for developing breast cancer and endometrial hyperplasia. Therefore, it is necessary to compare the therapeutic effectiveness of alternative vaginal drugs, such as promestriene, an estrogen agonist, and sodium hyaluronate (NaH), a nonhormonal, water-based agent. Methods: Ninety-one postmenopausal women diagnosed with symptomatic VA were divided into three groups and treated for 12 weeks; 30 women with vaginal estradiol (VE), 30 women with promestriene, and 31 women with NaH. Composite scoring, vaginal maturation index (VMI), pH, frequency of sexual activity, serum hormone levels, and endometrial thickness were evaluated VA before and after treatment. Results: In the comparison of VA examination findings composite scoring, VMI, and vaginal pH values, three different drugs were found to be effective in the treatment (P < 0.05). The VMI following VE treatment was significantly higher than that after NaH treatment (P = 0.031), whereas the promestriene group had a more positive change than the others in terms of increase in after treatment composite scoring and sexual activity frequency (P = 0.031, P = 0.020). There were no differences between the groups in terms of pre and after treatment serum E2 levels and endometrial thickness. Conclusions Based on these findings, we can conclude that the use of promestriene or NaH can prove to be as effective and well tolerated as vaginal estradiol in the symptomatic treatment of vaginal atrophy.