Essential tremor (ET) is classified as a pure motor system disease. It has been previously reported that impairments in cognitive functions can be associated with ET. The authors assessed cognitive functions in a relatively young patient group with ET and comparison subjects. Correlations between tremor severity and regional cerebral blood flow (rCBF) and neuropsychological test performances of ET patients and comparison subjects were investigated. Sixteen patients with ET and 16 comparison subjects were assessed by a comprehensive neuropsychological test battery designed to assess global attention, language, memory, visuospatial functions, and executive functions. In 11 of 16 patients and in nine of 16 comparison subjects, rCBF was measured by technetium-99m-hexamethyl propylene amine oxime single photon emission computed tomography (technetium-99m-HMPAO SPECT). The tremor severity was quantified using the Clinical Rating Scale for Tremor (CRST). Findings revealed that ET patients differed significantly from comparison subjects on tests assessing visuospatial functions and verbal memory, whereas differences in other tests did not reach statistical significance. There was no significant difference between the rCBF of ET patients and comparison subjects. There were statistically significant inverse correlations between tremor severity and executive functions. Tremor severity was inversely correlated with bilateral frontal blood flow by technetium-99m-HMPAO SPECT. Conclusions suggest that the subclinical cognitive deficits characterized by visuospatial and verbal memory impairments and executive dysfunction may be a clinical feature of ET, and the cerebello-thalamo-frontal network may play a role in the pathophysiology of this disorder.

Nitrate incorporation in humans takes place via drinking water and food. The water used for drinking and cooking in the goitrous areas is high in nitrate content. The aim of the present study was to evaluate both chronic effects and the dose-response relationship of nitrate on thyroid functions. A total of rats were divided into 5 work groups and sodium nitrate was added to their drinking water in different concentrations (0, 50, 100, 250 and 500 mg/l) over a 30-week period. The radioiodine uptake of thyroid was decreased in the 50 mg/l nitrate group, whereas it was increased in the 250 and 500 mg/l nitrate groups as compared to control. All hormones of thyroid gland except total thyroxine and thyroid-stimulating hormone were decreased in the 50, 250 and 500 mg/l nitrate groups. However, the level of total thyroxin was increased in the 100 mg/l nitrate group. Thyroid gland weights were increased in all experimental groups. Histomorphological changes were observed in the 250 and 500 mg/l nitrate groups. These findings suggest that nitrate impairs thyroid function involving the hypothalamo-hypophysio-thyroid axis. This observation could contribute to the current discussion about the acceptable daily intake of nitrate, as well as drinking water nitrate standard safety margins.

Tc-99m polyclonal immunoglobulin-G has been shown to be a successful agent in the depiction of active inflammation in rheumatoid arthritis (RA). The objective of this study was to compare the uptake behaviors of Tc-99m HIG and Tc-99m MDP in RA and variants of rheumatoid arthritis (VRA). Seventeen patients with RA and 8 patients with VRA presenting with active inflammation were included in this study. Ten subjects with well-diagnosed degenerative joint disease constituted the control group. All joints in patients were also imaged with Tc-99m HSA to evaluate the vascularization status of the joints. Tc-99m HIG and HSA scans were obtained at 2, 4 and 24 hours after the injection of 555 MBq Tc-99m HIG and 296 MBq Tc-99m HSA. Conventional bone scans were performed 4 hours after the injection of 740 MBq Tc-99m MDP. Target-to-background (T/B) ratios were obtained exclusively over the joint regions. Tc-99m HIG T/B ratios of the active joints in RA were significantly higher than those of the non-active joints and the control group (p< 0.05). Tc-99m HIG T/B ratios in active joints showed a progressive increase between 2 and 24 hour images (p < 0.05). In contrast, Tc-99m HSA T/B ratios decreased in all active joints significantly (p < 0.05) except the ankle joint region (p > 0.05). The T/B ratios in Tc-99m MDP bone scans were higher in all active joints than in non-active RA joints and joints of controls but significantly differences were only detected in wrist and elbow joints. All clinically active joints in VRA patients accumulated Tc-99m HIG and HSA, and showed increased Tc-99m MDP uptake. These joints had a very similar Tc-99m HIG retention pattern to the RA joints. The detection rate of active joint inflammation with Tc-99m HIG was much higher than that with Tc-99m MDP. The increasing Tc-99m HIG uptake ratio between 2 and 24 hours in contrast to Tc-99m HSA indicates the presence of other binding mechanisms besides increased vascularity in RA.

The results of our study showed that 39% (25 of 64) of the observed GER findings were achieved exclusively by means of cough provocation.

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