Histological assessment of endometrial polyps resected by hysteroscopy

OBJECTIVE

This study aimed to analyze the clinical data and pathologic aspects of endometrial polyps (EMPs) excised completely during surgical hysteroscopy and assess the connection between premalignant and malignant EMPs.

PATIENTS AND METHODS

This retrospective study includes 489 participants who underwent hysteroscopy due to endometrial polyps, and the clinical features and histological findings of the resected polyps analyzed.

RESULTS

Participants with EMPs were divided into six groups according to histologic findings. The histologic finding of most cases was simple benign endometrial polyp [397 patients (81.2%)]. Malignant polyp was detected in 3 patients (0.6%). The histologic findings according to age, menopausal status, and menstrual bleeding patterns at the time of presentation to the outpatient clinic were compared; however, no significant difference was observed. 237 patients were observed to have menometrorrhagia, which was the most prevalent symptom reported. The distribution of polyp sizes observed at hysteroscopy according to histologic findings was compared, but no significant difference was observed.

CONCLUSIONS

EMPs are often benign but can include premalignant or malignant tissue changes. Hysteroscopy is used for direct observation of the uterine cervix and resection of existing polyps, considering the increasing frequency of its use as a diagnostic and treatment tool.

Water/organic liquid interface properties with amine, carboxyl, thiol, and methyl terminal groups as seen from MD simulations

Molecular dynamics simulations were performed to study structural and dynamic properties of polar butanamine/water/butanamine, pentanoic acid/water/pentanoic acid, butanethiol/water/butanethiol, and nonpolar pentane/water/pentane systems. The mass density profiles along the interface normal to the organic liquid/water system, the difference in the local structure of H2 O molecules in bulk and in the vicinity of interface, as well as the diffusion behavior of water molecules at the interface with above-mentioned organic liquids have been investigated. Our MD simulation has shown that the diffusion of water molecules across the water/organic liquid interface is influenced by the hydrogen bondsn HB between water molecules and the terminal groups of organic liquids. It was found that the loss of the hydrogen bondsn HB in the nonpolar organic liquid leads to a decrease in the value of the normal component of the diffusion coefficientD z , while the tangential diffusion coefficients, bothD x andD y , increase.

Separation anxiety and depression in caregivers of epileptic patients

OBJECTIVE

Epilepsy is a common neurological disorder affecting both the patients and the caregivers psychologically. Caregivers of these patients might have to face several challenges throughout the course of the disease. This study examines the correlations between the separation anxiety and depression of caregivers of adult and child epileptic patients according to their relation to the patients (parent vs. partner).

PATIENTS AND METHODS

50 participants (caregivers of epileptic patients) were included. A sociodemographic form, Beck Depression (BDI) and Anxiety (BAI) Scales, and Adult Separation Anxiety (ASA) Scale were applied to the participants.

RESULTS

54% of the patients in the study had generalized seizures, whereas 46% had focal seizures. Our study has found the BAI of woman caregivers was higher compared to male caregivers. BAI and ASA were significantly higher for caregivers of patients with an illness duration lower than 5 years who were on multiple medications than for caregivers of patients who had an illness duration of more than 5 years who were on single medication (p<0.05). BDI, BAI and ASA scores were significantly higher in the generalized epilepsy group than in the focal epilepsy group (p<0.05). The ASA score was significantly higher in females than in males (p<0.05). The ASA score was significantly higher in the group with a low educational level than in the group with a high educational level (p<0.05) CONCLUSIONS: The findings of this study inform healthcare professionals regarding the needs of caregivers of epilepsy patients, especially around emotional problems. Results of this study demonstrate significant association between epilepsy seizure type, and separation anxiety and depression. Our study is the first study focused on the separation anxiety of the caregivers of epileptic patients. Separation anxiety has a negative impact on the personal independence of the caregiver.

Comparison of immunological, histological and oxidative effects of felbamate and levetiracetam in traumatic brain injury

OBJECTIVE

We aimed to compare immunological, histological and oxidative effects of antiepileptic agents; felbamate and levetiracetam on head trauma in rats.

MATERIALS AND METHODS

In this study, 32 Sprague-Dawley genus male rats were used. A closed head trauma mechanism was constituted in order to perform head trauma in rats. Rats were divided into 4 groups, and each group had 8 rats. Following head trauma, Group 1 (Control); normal saline was administered, Group 2; levetiracetam 50 mg/kg was administered, Group 3; felbamate 100 mg/kg was administered, and Group 4; levetiracetam 50 mg/kg and felbamate 100 mg/kg were administered with a combination. Injections were administered intraperitoneally once a day for 20 days. The rats were decapitated at the end of the 20th day. Blood and tissue samples were collected and analyzed for biochemical, immunohistochemical and histological parameters.

RESULTS

Serum cytokine levels in Group 2, 3 and 4 were lower when compared to the control group. In Group 4, in which combined therapy was performed, cytokine levels were found to be the lowest. In Groups 2 and 3, a significant decrease in vascular congestion, mononuclear cell infiltration, hemorrhage, and neural degeneration was noticed in the pia mater. In Group 2, a decrease in vascular congestion and Purkinje cell degeneration was obtained in the cerebellum. However, the best outcomes were determined in Group 4.

CONCLUSIONS

We determined that levetiracetam and felbamate alone are useful with respect to immunological, oxidative and histological alterations. However, their utility is better when used in a combination.

AB0573 IDIOPATHIC INFLAMMATORY MYOPATHIES: A SINGLE-CENTER EXPERIENCE

Background:

Idiopathic inflammatory myopathies (IIM), mainly dermatomyositis (DM) and polymyositis (PM) are the diseases of the musculoskeletal system most commonly affecting the proximal muscles of the limbs. In addition to muscle inflammation, these conditions are multisystemic, presenting with a variety of complaints.

Objectives:

As IIMs are infrequent, a single-center experience presenting quantitative data describing in-depth information on the nature of disease and treatment seems useful.

Methods:

This retrospective study was conducted at a tertiary rheumatology center. Patients were diagnosed with an idiopathic inflammatory myopathy (DM, PM) in order to be included in this study. Clinical signs and symptoms of the presentation were noted during the first patient encounter as well as the follow-up. Parameters of disease activity including acute phase reactants, muscle enzyme levels, and disease-specific autoantibodies were analyzed. Treatment and prognosis information was also noted with additional information from phone call interviews.

Results:

The study includes 108 patients (78 DM, 30 PM). The mean age of diagnosis was 43.17 ±18.73 years, follow-up duration was 44.37 ±60.58 months. The presenting signs and symptoms of the patients are shown in Figure 1. The parameters of disease activity before and after treatment are summarized in Table 1. The clinical tests ordered during the disease management are summarized in Table 2. The mean corticosteroid dose decreased from 45.65 ±114.53 mg to 15.22 ±16.77 (p=0.007). Other treatment methods were methotrexate (n=72), rituximab (n=28), Intravenous Immunoglobulin (IVIG) (n=9), and cyclophosphamide (n=5). Ten patients died during the follow-up. Thirty-six patients were lost to follow-up.

Table 1.

The Parameters of Disease Activity Before and After Treatment

Before TreatmentAfter TreatmentP ValueCPK, mean ± std (U/L)2429.55 ± 5503.85210.23 ± 352.97<0.0001LDH, mean ± std (U/L)659.48 ± 458.74262.83 ± 139.81<0.0001AST, mean ± std (U/L)82.22 ± 92.6325.94 ± 18.76<0.0001ALT, mean ± std (U/L)75.28 ± 83.326.48 ± 21.68<0.0001ESR, mean ± std (mm/hour)28.7 ± 25.3625.62 ± 22.530.35CRP, mean ± std (mg/L)14.76 ± 26.869.12 ± 18.230.07RF, mean ± std (U/mL)15.72 ± 19.96N/AN/AANA, n (%)26 (24.07)N/AN/AAnti- JO 1, n(%)5 (4.63)N/AN/ATable 2.

The Clinical Tests Ordered during the Disease Management

TestedPositive Muscle Biopsy, n(%)28 (25.93)23 (82.14) Skin Biopsy, n(%)9 (8.33)9 (100) Thorax CT, n(%)24 (22.2218 (75) Abdominal CT, n(%)11 (10.19)8 (72.73) EMG, n(%)43 (39.81)36 (83.72)Figure 1.

The Presenting Signs and Symptoms of the Patients

Conclusion:

IIMs are very rare and can present with very different signs and symptoms. Referral to rheumatology can be challenging along with treatment. With inadequate clinical insight diagnosis and management of these patients can be delayed and quite expensive. Long term follow-up in our center enabled adequate control of disease activity as proven by the highly significant decrease in parameters of disease activity, especially muscle enzyme levels. Furthermore, we reported the variety of clinical symptoms, investigation methods and treatment essays in our center trying to reflect the potential challenges that can hinder a health clinical practice as well as highlight the requirement of a standardized approach.

Disclosure of Interests:

None declared

AB0571 IS RITUXIMAB AN ADEQUATE GLUCOCORTICOID SPARING AGENT IN IDIOPATHIC INFLAMMATORY MYOPATHIES?

Background:

Idiopathic inflammatory myopathies (IIM) are essentially treated aiming improvement of muscle function and extra muscular disease manifestations. The backbone of the treatment is corticosteroids enhancing the survival and patient quality of life. The lack of consensus on target-specific immunosuppressive treatment highlights the need for further studies evaluating alternative treatment methods. Rituximab is potentially a glucocorticoid-sparing agent which was reviewed in multiple studies with small sample sizes due to the rarity of the disease.

Objectives:

Higher statistical power can enhance the trustworthiness of alternative treatment methods yielding the main objective of this study.

Methods:

This retrospective study was conducted at a tertiary rheumatology center. Patients were diagnosed with an idiopathic inflammatory myopathy (dermatomyositis [DM], polymyositis [PM]) and were treated with rituximab in order to be included in this study. Clinical signs and symptoms of the presentation were noted during the first patient encounter as well as the follow-up. Parameters of disease activity including acute phase reactants, muscle enzyme levels, and disease-specific autoantibodies were analyzed.

Results:

The study includes 28 patients (20 DM, 8 PM). The age of diagnosis was 43.44 ± 15.77 years, follow-up duration was 60.7 ± 70.7 months. The presenting signs and symptoms of the patients are shown in Figure 1. The parameters of disease activity before and after treatment are summarized in Table 1. The mean corticosteroid dose decreased from 31.429 ±23.934 mg to 10.278 ±12.001 (p=0.001). Other treatment methods were methotrexate (n=18), Intravenous Immunoglobulin (IVIG) (n=7), and cyclophosphamide (n=2). There were not any deaths during the follow-up. Two patients were lost to follow-up.

Table 1.

The Parameters of Disease Activity Before and After Treatment

Before TreatmentAfter TreatmentP ValueCPK, mean ± std (U/L)1426 ± 2049.92263.44 ± 265.630.004LDH, mean ± std (U/L)557.5 ± 365379.78 ± 192.10.03AST, mean ± std (U/L)62.52 ± 5930.16 ± 27.590.01ALT, mean ± std (U/L)56.48 ± 49.2127.64 ± 24.520.008ESR, mean ± std (mm/hour)26.38 ± 28.9820.39 ± 18.760.36CRP, mean ± std (mg/L)19.23 ± 46.1512.53 ± 26.670.5RF, mean ± std (U/mL)0 (0)N/AN/AANA, n (%)3 (10.71)N/AN/AFigure 1.

The Presenting Signs and Symptoms of the Patients

Conclusion:

Rituximab is shown to be effective in treating myositis along with corticosteroids as well as a corticosteroid-sparing agent in retrospective studies and open-label clinical trials; however, lack of statistical power should be underlined. Long term decrease in steroid use and decrease in disease activity markers hints the effective use of rituximab as a glucocorticoid sparing agent as well as its safety with minimal side effects.

Disclosure of Interests:

None declared

Therapeutic effects of melatonin and quercetin in improvement of hepatic steatosis in rats through supression of oxidative damage

BACKGROUND

Non-alcoholic steatohepatitis, a cause of cirrhosis, is characterized by fatty infiltration of the liver, inflammation, hepatocellular damage and fibrosis. The aim of the present study was to investigate the effects of melatonin and quercetin on CCl4-induced steatosis characterized by fatty infiltration of the liver, inflammation, hepatocellular damage and fibrosis.

METHODS

Rats were divided into 5 groups: Ethanol, Olive oil, CCl4, CCl4+Melatonin (CCl4+Mel), CCl4+Quercetin. Rats were sacrificed and livers were removed for being evaluated by histopathological, immunohistochemical and biochemical methods.

RESULTS

In CCI4 group, vacuolization, vascular congestion, haemorrhage, necrosis, and inflammatory infiltration were identified. The mean tissue MDA level was increased, whereas GSH level and SOD and CAT activities were decreased in comparison with ethanol and olive oil groups. MDA levels were decreased in CCI4+Quercetin and CCI4+Mel groups versus CCI4 group. CAT activity of CCI4+Mel group was higher than that of CCI4 and CCI4+Quercetin groups. The mean tissue GSH level of CCI4+Mel group versus CCI4 group was significantly increased.

CONCLUSIONS

By the means of histopathological examination, we suggest that both agents are beneficial against necrotic and apoptotic cell death during steatosis. Thus, melatonin and quercetin might be beneficial in the improvement of hepatic steatosis by supporting conventional therapy in humans (Tab. 1, Fig. 5, Ref. 53).

Effects of ciprofloxacin on fetal rat liver during pregnancy and protective effects of quercetin

Urinary tract infections are common in pregnant women and ciprofloxacin frequently is used as a broad spectrum antibiotic. It has been suggested that ciprofloxacin causes liver damage in fetuses. Quercetin is a flavonoid with antioxidant properties. We investigated the efficacy of quercetin treatment for preventing fetal liver damage caused by ciprofloxacin. Pregnant rats were divided into four groups: untreated control group (C), 20 mg/kg quercetin for 21 days group (Q), 20 mg/kg twice/day ciprofloxacin for 10 days group (CP), and 20 mg/kg, ciprofloxacin + quercetin for 21 days group (CP + Q). Fetal livers were removed on day 21 of gestation to measure antioxidants and for histological observation. Malondialdehyde (MDA) and glutathione (GSH) levels, and superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities were measured in tissue samples. GSH-Px, SOD and CAT activities were significantly lower in the CP group compared to group C. A significant increase in MDA was observed in the CP group compared to group C. There was no significant difference in GSH levels in any group. MDA levels were lower and CAT, SOD and GSH-Px enzyme activities were higher in the CP + Q group compared to group CP. Liver samples of the CP group exhibited central vein dilation, portal vein congestion, pyknotic nuclei and cytoplasmic vacuolization in some hepatocytes. Histological changes were less prominent in the rats treated with quercetin. Use of ciprofloxacin during pregnancy caused oxidative damage in fetal liver tissue. Oxidative stress was ameliorated by quercetin. Quercetin supports the antioxidant defense mechanism and it is beneficial for treating fetal liver damage caused by ciprofloxacin.

Everolimus as an mTOR Inhibitor Suppresses Endometriotic Implants: an Experimental Rat Study

Introduction Mammalian target of rapamycin is a pathway to block apoptosis. Recent studies showed that the activity of mammalian target of rapamycin pathway increases in endometriotic lesions. Aim of the present study was to study the effect of everolimus agent, a rapamycin analog, in an experimental endometriosis model. Materials and Methods Endometriosis established by the autotransplantation of uterine tissue in the peritoneal cavity was confirmed in 24 rats. The animals were then randomly divided into three groups to receive either everolimus (1.5 mg/kg/day, p. o.), anastrozole (0.004 mg/day, p. o.), or normal saline (0.1 mL, i. p.) for 14 days. Endometriotic foci were excised, stained with hematoxylin and eosin, and endometriosis was scored semiquantitatively. In addition, immunohistochemical examination were performed using primary antibodies of vascular endothelial growth factor, CD117, and Bax. Results Both anastrozole and everolimus lowered endometriosis scores. Significant decreases in ovarian follicles were observed following anastrozole treatment but not everolimus treatment. Conclusion Through its apoptosis-promoting effect, everolimus suppressed endometriotic foci without negatively affecting ovarian reserve. These findings support the hypothesis that everolimus merits further study on the way to developing a new endometriosis drug.

Combination of paracetamol or ketamine with meperidine enhances antinociception

OBJECTIVES

Dealing with pain is one of the most important issues of medicine. All of the studies aim to find a drug or combination of drugs in order to have more effective analgesia and less side effects. In this study, we aimed to investigate the antinociceptive effects of combination of paracetamol or ketamine with meperidine.

METHODS

In this study, we evaluated the systemic antinociceptive effects of meperidine, paracetamol, and ketamine one by one with their combinations. We used 50 mice (weighing 25-30 g), which were divided into 5 groups with each group consisting of 10 mice. Meperidine was applied to animals with increasing doses and their tail flick latencies (TFL) were noted at 20, 40, 60, 90, 120, 180, and 240 min. The same protocol was repeated after the combination of meperidine with paracetamol or ketamine.

RESULTS

There was no analgesic effect on low doses of ketamine and paracetamol at TFL measurements. But the combination of low doses of these drugs with meperidine significantly increased TFL (p < 0.05).

CONCLUSION

It was observed that meperidine + ketamine and meperidine + paracetamol combinations have potent analgesic effect.

Doppler ultrasonographic evaluation of the carotid and vertebral arteries in children with Crimean-Congo hemorrhagic fever

AIM

In children with Crimean-Congo hemorrhagic fever (CCHF), the aim of present study was to determine the cerebral hemodynamic changes assessed with Doppler ultrasonography with measurements of lumen diameter (LD), peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), pulsatility index (PI), and total cerebral blood flow volume (tCBFV) of common carotid artery (CCA), internal carotid artery (ICA, and vertebral artery (VA).

METHODS

This case-control study examined children with clinically defined CCHF as cases (N.=24) and healthy children as controls (N.=17). The CCHF and healthy children underwent ultrasonography of the CCA, ICA and VA for the measurements of flow velocity and cerebral blood flow volume. Doppler ultrasonography were performed in the CCHF children if vital signs were stable and fever lower than 37.5 °C.

RESULTS

There was no significant difference between the CCHF and healthy children in the lumen diameter of study arteries (P>0.05). PSV and EDV values were significantly higher in the CCHF children compared to the controls (P<0.05). Overall, the CCHF did not cause considerable change in RI and PI values (P>0.05). tCBFV values of CCHF children was found higher compared to healthy controls (P<0.05).

CONCLUSION

Overall, in children, CCHF causes an increase in the cerebral blood flow as determined by Doppler ultrasonography with flow velocity and cerebral blood flow volume measurements; however, this increase need to be accepted as mild to moderate degree. Several pathophysiological derangements may be contributory to the increased cerebral blood flow in children with CCHF.

Protective role of Diospyros lotus on cisplatin-induced changes in sperm characteristics, testicular damage and oxidative stress in rats

The aim of this study was to investigate the protective effect of Diospyros lotus (DL) on cisplatin (CP)-induced testicular damage in male rats. Twenty-eight male rats were randomly divided into four groups: group 1 - control, given isotonic saline solution; group 2 - CP 7 mg kg(-1) given intraperitoneally as single dose; group 3 - DL 1000 mg kg(-1) per day given orally for 10 days; group 4 - CP and DL given together at the same doses. CP caused a significant increase in thiobarbituric acid-reactive substances (TBARS) level and a significant decrease in superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and glutathione (GSH) levels in rats testis tissues compared to the control group. CP caused a significant increase in lipid peroxidation in testis tissues compared to the control group, whereas DL led to a significant increase in SOD and GSH levels. However, there were no statistically significant changes in GPx and CAT levels. In addition, serum testosterone levels, sperm concentration and sperm motility were significantly decreased, but abnormal sperm rate and histological changes were increased with CP. However, these effects of CP on sperm parameters, histological changes and the tissue weights were eliminated by DL treatment. In conclusion, our study showed that the reproductive toxicity caused by CP may be prevented by DL treatment.

Beneficial effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin in rats: A histological and biochemical study

Ciprofloxacin is a broad-spectrum quinolone antibiotic commonly used in clinical practice. Quercetin is an antioxidant belongs to flavonoid group. It inhibits the production of superoxide anion. In this study, we aimed to evaluate the effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin. Twenty-eight female Wistar albino rats were divided into four groups: control, quercetin (20 mg kg(-1) day(-1) gavage for 21 days), ciprofloxacin (20 mg kg(-1) twice a day intraperitoneally for 10 days), and ciprofloxacin + quercetin. Samples were processed for histological and biochemical evaluations. Malondialdehyde (MDA) and glutathione (GSH) levels, superoxide dismutase (SOD), and catalase (CAT) activities were measured in kidney tissue. The ciprofloxacin group showed histopathological changes such as infiltration, dilatation in tubules, tubular atrophy, reduction of Bowman's space, congestion, hemorrhage, and necrosis. In the ciprofloxacin + quercetin group, these histopathological changes markedly reduced. MDA levels increased in the ciprofloxacin group and decreased in the ciptofloxacin + quercetin group. SOD and CAT activities and GSH levels significantly decreased in the ciprofloxacin group. On the other hand, in the ciprofloxacin + quercetin group, SOD and CAT activities and GSH levels significantly increased with regard to the ciprofloxacin group. We concluded that quercetin has antioxidative and therapeutic effects on renal injury and oxidative stress caused by ciprofloxacin in rats.

Asymptomatic bacteriuria screened by catheterized samples at pregnancy term in women undergoing cesarean delivery

OBJECTIVE

The objective of this study was to assess the frequency of urinary tract infection (UTI) with urine samples obtained via catheterization among women undergoing cesarean delivery at term pregnancy.

MATERIALS AND METHODS

A cross-sectional study involving 159 women in whom cesarean delivery was conducted at term pregnancy after a regular follow-up from first to third trimester. For screening and diagnosis of UTI during antenatal period, the authors used dipstick test and microscopic urinalysis, and urine culture was used in the presence of symptomatic UTI unresponsive to initial antibiotic therapy. A urine sample was obtained immediately after insertion of Foley catheter for urine dipstick test, microscopic urinalysis, and culture during cesarean delivery. Obstetric and UTI data were recorded.

RESULTS

Of 159 pregnant women, 95 (59.8%) did not develop UTI during antenatal care. There was no patient with symptomatic UTI at the admission for cesarean delivery. The authors found UTI with urine dipstick and microscopic urinalysis in 12 patients and of them, four patients had no history of UTI, and all the remaining eight patients had asymptomatic UTI during antenatal follow-up. UTI according to urine culture was encountered in three patients, two of them had one episode of UTI, and one had two episodes of UTI during antenatal follow-up.

CONCLUSIONS

After regular antenatal follow-up screening with urine dipstick, microscopic urinalysis, and counseling of pregnant women regarding UTIs, the frequency of bacteriuria decreases considerably during cesarean delivery.

Antenatal counseling against passive smoking may improve birth weight for gestational age

AIM

The authors determined the impact of antenatal counseling against exposure to environmental cigarette smoke on the prevention of reduced neonatal birth weight according to gestational age.

MATERIALS AND METHODS

A cross-sectional study was conducted in pregnant women, with 77 passive smokers and 88 non-smokers. During motivational interviews, passive smoking status was monitored and additional follow-up visits were arranged to increase the knowledge regarding perinatal risks of passive smoking, including intrauterine growth restriction and low birth weight. The authors aimed to increase the woman's motivation to avoid second-hand tobacco smoke exposure.

RESULTS

The demographic and clinical findings of the study groups were found considerably similar, in this context, and the authors found positive and strong correlations between the gestational age and neonatal birth weight (r = 0.80 and r = 0.76, respectively; p < 0.05).

CONCLUSIONS

During antenatal care of women, regular counseling against second-hand smoke exposure may prevent negative effect of passive smoking on neonatal birth weight according to gestational age. This promising finding needs to be supported by further studies with larger sample size considering covariates relevant to passive smoking.

The effects of the informed consent given for cesarean section on anxiety and knowledge

PURPOSE

To determine the effects of information given before cesarean section on women's anxiety levels and their knowledge about informed consent regarding it.

MATERIALS AND METHODS

Sixty women who elected to undergo cesarean section were included in the study. The data were collected using the pregnancy-related clinical information form, informed consent form, cesarean information form, and State and Trait Anxiety Inventory. Kruskal-Wallis test, Mann-Whitney U test, chi-square test and Pearson correlation were used as statistical methods.

RESULTS

The women's knowledge scores before and after they were informed about cesarean section were 14.8 +/- 5.5 and 29.8 +/- 2.6, respectively (p < 0.05). Their state anxiety scores before and after they were informed about cesarean section were 28.4 +/- 6.6 and 28.0 +/- 5.9, respectively (p > 0.05).

CONCLUSION

It was determined that the participants' pre-training knowledge scores about cesarean section increased significantly after they were informed, and that their state and trait anxiety scores decreased very little after they were informed.

Fish oil, contained in eicosapentaenoic acid and docosahexaenoic acid, attenuates testicular and spermatological damage induced by cisplatin in rats

The aim of this study was to investigate the beneficial effects of the fish oil (FO) supplementation on oxidative stress, sperm characteristics and histological alterations in the male reproductive system of rats against cisplatin (CP) toxicity. The rats were divided randomly into 4 equal groups (control, FO, CP and FO + CP). FO was orally administered at the dose of 1 softgel per rat per day for 14 days and CP was intraperitoneally given at the dose of 7 mg kg(-1) with a single injection. In CP + FO group, they were applicated at the same doses and times. The results showed that CP caused a significant oxidative damage via induction of lipid peroxidation and reduction in the antioxidant defence system potency in the testis tissue. In addition, sperm motility and sperm concentration significantly decreased but the abnormal sperm rate and histopathological testicular damage increased with CP treatment. On the other hand, FO treatment prevented oxidative, histopathological and spermatological effects of CP and reversed side effects of CP. In conclusion, FO supplementation had significant beneficial effects against CP toxicity on male reproductive system and toxic effects of CP can be prevented by FO treatment. Therefore, it appears that fish oil may be useful for the prevention and treatment of cisplatin-induced reproductive system toxicity.

Effects of organic apricot on liver regeneration after partial hepatectomy in rats

BACKGROUND

The present study investigated the effects of (sun-dried organic apricot/SDOA) supplementation in chow on liver regeneration after partial hepatectomy/(PH) in rats.

METHOD

In this study, 28 female rats were randomized into four groups. On the 7th day of the study, group 1 underwent laparoscopic intervention while a PH was performed on the other three cohorts. On day 28, all rats were humanely killed. Blood and liver tissue samples were subjected to biochemical determinations, histological examinations, and measurement of tissue oxidative stress enzyme activity.

RESULTS

Serum levels of alanine transaminase (ALT), alkaline phosphatase (ALP), and liver tissue glutathione (GSH) activities were affected by PH and/or SDOA consumption (P < .05). Moderately staining cell counts in group 4 were significantly different from the other three groups (P < .05). However, no significant differences were detected among all groups in regard to aspartate aminotransferase (AST) serum levels or liver tissue superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) or glutathione peroxidase (GSHpx) activities (P < .05).

CONCLUSION

The 5% SDOA supplementation over a 21-day feeding period showed a beneficial effect on liver regeneration in rats, as reflects by Ki-67 finding although there was no change in ALT or ALP or in liver tissue GSH activity.

Prevalence of the palmaris longus muscle and its relationship with grip and pinch strength: a study in a Turkish pediatric population

Clinical studies generally reveal a trend of variation in the reported prevalence of the palmaris longus (PL) muscle absence. The aim of this study was to find an answer to the question of whether the congenital absence of tendon would affect hand functions or not. A total of 585 subjects, comprised of 305 males and 280 females, were included in our study. Mean age was 8.9 ± 1.4 standard deviation within a range of 6-11. For both sexes, the groups were divided further into three subgroups including 6-7, 8-9, and 10-11 years of age ranges. The grip strength of each hand and pinch strength of all fingers of each subject were measured separately. The absence of PL tendon in the right hand was 35.4 % in females, 25.9 % in males, and 30.4 % in overall average. The distribution of absence of the palmaris longus muscle between both genders was statistically significant. The p value for the right hand was 0.013. The absence of PL tendon in the left hand was 37.5 % in females, 27.9 % in males, and an overall average of 32.5 %. The p value for the left hand was 0.017. In terms of grip strength, a comparison between females and males did not reveal a significant difference. The pinch strength of the second fingers of both hands did not show any difference in both sexes. Pinch strength of the third finger of the right hand was different only in girls of subgroup 6-7 ages (p = 0.024). In girls, the pinch strength of the fourth finger of the right hand of subgroups 6-7 and 10-11 ages showed difference (p = 0.009 and p = 0.026, respectively). In boys, the fourth finger in subgroup of 8-9 ages showed significant difference in both hands (p = 0.011). The fifth fingers of both hands were found different in males for only subgroup of 8-9 ages (p = 0.001). Pinch strength of the fifth finger of the right hand was different in females for only subgroups of 6-7 and 10-11 ages (p = 0.023 and p = 0.047, respectively). While grip strength of the hand was not affected in the case of absence of the palmaris longus, in both sexes, pinch strength of the fourth and fifth fingers of both hands decreased.

What is the best treatment option in postmenopausal, hormone responsive breast cancer patients with isolated bone metastases?

BACKGROUND

Bone is the most common metastatic site for breast cancer.

AIM

To determine the effectiveness of addition of chemotherapy to hormonal therapy in postmenopausal hormone receptor-positive breast cancer patients with isolated bone metastases.

MATERIALS AND METHODS

Between June 2001 and January 2007, 101 patients were classified into two groups according to initial treatment modalities; patients who received hormonotherapy only (group I) and chemotherapy followed by hormonotherapy (group II). The effect of treatment choice on clinical course, time to progression, and overall survival were evaluated.

RESULTS

There were 70 patients in group I and 31 patients in group II. Bone metastases in 27 patients (26.7%) were synchronous and the remainder were metachronous. The median follow-up time was 41 months. The two groups showed similar results when patients' tumor characteristics were compared. However, 81% of synchronous cases had upfront chemotherapy following hormonotherapy, whereas this ratio was only 12% in the metachronous group. All patients received systemic antiresorptive bisphosphonates whereas only 24 patients required palliative radiotherapy at some time during the course of their disease. In groups I and II, the median time to progression was 12 and 16 months (P: 0.96) and median overall survival was 41 and 40 months (P: 0.79), respectively. In HER-2-positive patients, a trend of prolongation of overall survival was observed in group II, but it was not statistically significant (P: 0.12).

CONCLUSIONS

Anti-hormonal therapy still seems to be considered as the ideal treatment of choice for postmenapousal breast cancer patients with isolated bone metastases.

An analysis of Turkey's scientific contribution in ovarian cancer research

AIM

Bibliometric studies can be used to evaluate the performance of a country in contributing to the accumulation of medical evidences on a specific topic. The authors aimed to evaluate the contribution of Turkey to the scientific repertory in the field of ovarian cancer.

METHODS AND MATERIALS

The authors retrospectively searched papers published in the field of ovarian cancer between 1980 and 2012 by using the Web of Science software.

RESULTS

Turkish authors published 400 papers in Science Citation Index (SCI) Expanded indexed journals ranking Turkey 25th globally. Turkey's first publications in this field appeared at the beginning of the 1990s and showed a distinctive acceleration after 2000. Overall, publications from Turkey were cited 2,987 times and the trend of citations increased in 2000. Most of the papers from Turkey in this field were published in the European Journal of Gynaecological Oncology.

CONCLUSION

The authors observed a significant improvement in the scientific activity of Turkey in the field of ovarian cancer during last decade.

Effects of methylene blue, pentoxyphylline and enoxaparin on postoperative adhesion formation and markers of angiogenesis in a rat uterine horn model

OBJECTIVE

Postoperative adhesions still remain as a common and serious problem leading to morbidity, mortality and economic loss. Adhesions are the major cause of postoperative intestinal obstruction, infertility, and chronic pelvic pain. In this study, we aimed to compare adhesion prevention effects of pentoxyphylline, enoxaparin and methylene blue and to investigate the effects of these agents on angiogenesis, which is suggested as an important step in wound healing, in rat a uterine horn model.

MATERIAL AND METHODS

Forty female Wistar albino rats were randomized into four subgroups and underwent laparotomy. Adhesions developed following cauterization at the anti-mesenteric surfaces of both uterine horns. After 14 days, adhesions were investigated by using macroscopic, histopathological and immunohistochemical [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor (TGF-beta), platelet-derived growth factor (PDGF)] methods.

RESULTS

We found that enoxaparin significantly reduced adhesion formation. Pentoxyphylline had no significant effect on adhesion formation, whereas methylene blue had a significant decreasing effect on histopathologically determined adhesion markers and it may affect angiogenesis through PDGF.

CONCLUSION

Among three agents, which were intraperitoneally given by a single dose manner in order to prevent postoperative adhesions, methylene blue and enoxaparin exhibited a positive effect, while no such effect was shown with pentoxyphylline.

The antioxidant effects of dry apricot in the various tissues of rats with induced cold restraint stress

α-Tocopherol and β-carotene are the best known and most widely used natural antioxidant substances. Apricot contains β-carotene, tocopherols and flavonoids. This experimental study was designed to investigate the protective effect of Malatya kabashi apricot in stress-induced injury in various tissues of rats. In total, 32 male Wistar albino rats were divided into four groups: control, apricot, stress and apricot-stress groups. Apricot was administrated to rats by gavage for 10 days in the apricot and apricot-stress groups. Then rats were kept at 4°C for 4 h in stress and apricot-stress groups. The rats were killed at the end of the experiment for biochemical and histological examinations. This study shows apricot supplementation decreased oxidative stress injury in both the stomach and intestine.

Postoperative changes related to intraoperative blood transfusions

OBJECTIVE

Wound infection, flap necrosis rates and peripheral complete blood cell count changes related to intraoperative whole-blood transfusions were investigated.

BACKGROUND

Evidence is growing that whole-blood cell transfusions are immunosuppressive and predispose patients to postoperative infections.

METHODS

102 female breast carcinoma patients with hemoglobin levels = 10 g/dl before modified radical mastectomy and < 10 g/dl intraoperatively but with no signs of oxygen debt were included. Group I included patients who had received two units of whole-blood transfusions intraoperatively. Patients who had received no transfusion were in group II. Peripheral complete blood cell count, wound infection rates and flap necrosis were compared.

RESULTS

Perioperative neutrophile and monocyte count increased in both groups. This increase was especially significant in the transfused group (p < 0.05). In both groups, these changes returned to normal levels on the tenth postoperative day. The decreased perioperative basophile count did not return to the baseline even on the tenth postoperative day in group I (p < 0.05). Lymphocyte count, and flap necrosis did not differ between the groups (p > 0.05). Wound infection seemed to take place and increase in the transfused group (p < 0.05).

CONCLUSION

Two units of whole-blood transfusions seem to increase wound infection and decrease basophile count in this series (Tab. 3, Ref. 30).

Expression of CK-19 and CEA mRNA in peripheral blood of gastric cancer patients

AIM

To investigate the clinical and pathological relevance of detection of circulating tumor cells (CTC) in the peripheral blood of gastric carcinoma patients before operation.

PATIENTS AND METHODS

Fifty patients with gastric adenocarcinoma were analysed prospectively. Patients were divided into two groups according to the extent of the tumor. Group I (unresectable) consisted of 22, and group II (resectable) consisted of 28 patients. Peripheral blood samples were collected pre-operatively from all 50 patients as well as from ten healthy controls and analyzed for carcinoembryonic antigen (CEA) and cytokeratin-19 (CK-19) messenger ribonucleic acids (mRNAs). Tumor localisation, stage, presence of signet cell formation, nodal metastases, serousal and lymphovascular invasion were recorded for all patients.

RESULTS

Expression of CK-19 was detected in 24 (48%), and CEA in 10 (20%) cases. Nine patients (40%) in group I and 15 (53.6%) in group II were positive for CK-19 expression. CEA expression was more frequent among group I patients (6 vs. 4 cases). There was no significant difference between the groups in the expression of CK-19 and CEA mRNA, tumor localisation, presence of signet formation, and presence and extent of nodal metastases. Patients with major vascular invasion (MVI) expressed significantly higher levels of CTC mRNA compared to those without MVI (p = 0.023 for CEA, and p = 0.009 for CK-19). The median 1 and 2-year survival was 9.5 and 10.5 months for group I, and 20 and 28.5 months for group II, respectively (p = 0.001). The mean survival was 6.7 months for patients with MVI, and 30.2 months for those without MVI (p = 0.0001).

CONCLUSIONS

High levels of CTCs were observed in patients with MVI invasion, rather than other causes of unresectability. It can be suggested that expression of both CEA and CK-19 in the peripheral blood of gastric cancer patients are strong predictors of MVI and significantly worse survival rates.

Effects of selective and non-selective cyclooxygenase (COX) inhibitors on postoperative adhesion formation in a rat uterine horn model

OBJECTIVE

To investigate the effects of cyclooxygenase (COX) inhibitors including celecoxib, indomethacin, and nimesulide on postoperative adhesion formation.

MATERIAL AND METHODS

Forty-eight female Wistar-Albino rats were randomly divided into four groups: control (saline solution), celecoxib, indomethacin, and nimesulide groups. The uterine horns of rats were traumatized with unipolar electrocautery. Drugs of each group and saline in the control group were insillated on travmatized areas of horns as intraperitoneally. After three weeks, the extent and severity of adhesions with a standardized scoring system were evaluated.

RESULTS

The extent and severity of postoperative adhesions were significantly reduced in nimesulide group compared with the control group. The extent but not severity of adhesions in rats given indomethacin was significantly reduced. Celecoxib showed no significant reduction in the extent and severity of adhesions.

CONCLUSION

Nimesulide is more effective than the other COX inhibitors in the prevention of postoperative adhesions in rats.

Arthrogryposis multiplex congenita: analysis of twelve cases

OBJECTIVE

The term arthrogryposis multiplex congenita (AMC) refers to multiple joint contractures present at birth. AMC is not a specific disorder but is the consequence of neurological, muscular, connective tissue, and skeletal abnormalities or intrauterine crowding, which may lead to limitation of fetal joint mobility and the development of contractures.

METHODS

Cases referred to our perinatology department for detailed examination were retrospectively analyzed.

RESULTS

Twelve cases with AMC were detected during the antenatal period. The ultrasound features related to the "lack of movement" included limb abnormalities (multiple contractures, clenched hands, and clubbed feet), short umbilical cord, polyhydramnios, pulmonary hypoplasia, camptodactyly, and micrognathia. Five of the early detected cases (71%) were found to have increased nuchal translucency or nuchal fold. All of the cases at the third trimester resulted in neonatal death.

CONCLUSION

First trimester screening may be useful for early diagnosis of AMC. Sonographic findings in late pregnancy might be helpful in predicting the prognosis. Due to the high recurrence risk, a specific screening program should be performed for the following pregnancies by examination of the fetus several times for movement and position of the limbs.

Fetuses with single umbilical artery: analysis of 45 cases

OBJECTIVE

The aim of this study was to analyze cases and determine the clinical significance of a prenatally detected single umbilical artery (SUA) in our population.

MATERIALS AND METHODS

All second and third trimester sonographic examinations carried out between January 2004 and September 2007 in our perinatology unit were reviewed. The postnatal results of the fetuses with SUA were obtained from the medical records and the patients.

RESULTS

From a total of 5,620 pregnant patients who were examined by ultrasound (US) scan between 15-36 weeks, a single umbilical artery was found in 45 cases, representing an incidence of 0.8%. Of these, 20 (45%) also presented with other malformations. There were six neonatal deaths, one fetal demise, and six terminations of pregnancy due to severe malformations in this group. Three cases with associated anomalies underwent surgery and one case required intensive care in the neonatal period. The only cytogenetic abnormality was trisomy 18 in one case. Six of 45 fetuses (13%) with single umbilical arteries had abnormal echocardiographic findings. In two of the fetuses associated anomalies (cleft palate and esophageal atresia) were detected after birth. In pregnancies without associated anomalies no aneuploidy was found and they were completely normal at birth and during the neonatal period.

CONCLUSIONS

Scanning the umbilical cord is one of the essential parts of US examination. As the rate of cardiac malformations seen with single umbilical arteries is high, fetal echocardiography should be performed in suspected cases. The newborn should be reexamined immediately after birth due to the possibility of undetected anomalies.

Clinicopathologic analysis: relationship between endometrial carcinoma and uninvolved endometrium

OBJECTIVE

The aim of this study was to compare the histopathologic features and surgical stage of endometrial carcinoma with tumor-free endometrial tissues.

METHODS

Data from the files of 80 patients with endometrial carcinoma who were managed at Haseki Training & Research Hospital between January 2001 and July 2007 were evaluated. We assessed tumor-free endometrium, stage, histologic type and grade, depth of myometrial invasion, peritoneal cytology, adnexal-cervical involvement, lymphovascular space invasion (LVSI), and lymph node metastases.

RESULTS

Twenty-nine patients (43%) with endometrial carcinoma had concomitant endometrial hyperplasia. Seven patients (10%) had one or more areas of metaplasia in the endometrium adjacent to the carcinoma. Endometrial carcinoma with atrophic background was significantly associated with aggressive histopathologic type (p < 0.04) and LVSI (p < 0.02).

CONCLUSION

The histological characteristics of non-tumoral endometrium were found to be critical in determining the type of aggressive tumor and LVSI in atrophy-associated carcinomas.

Hand strengths in carpal tunnel syndrome

The purpose of this study was to determine whether a measurable decrease in isokinetic (dynamic) and isometric (static) hand strengths occurs in carpal tunnel syndrome (CTS) patients. Eighteen CTS patients and 20 healthy controls were included in the study. Isokinetic (eccentric and concentric) and isometric grip and pinch strengths were measured with a Biodex System 3 dynamometer (Biodex Medical System, Inc. New York). All strength measurements, except isometric and isokinetic (concentric/eccentric) three-point pinch and isokinetic (concentric) tip pinch, revealed statistically significant differences between CTS patients and controls. Measurable decrease in hand strengths may exist in CTS despite normal manual assessments. Although both isokinetic (dynamic) and isometric (static) dynamometers are capable of detecting this decrease, neither technique seems better than the other.