Comparison of the ABCD Score's Accuracy in Predicting Remission of Type 2 Diabetes Mellitus One Year After Sleeve Gastrectomy, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy with Transit Bipartition

PURPOSE

ABCD score is one of the scoring systems that predicts the probability of T2DM remission after bariatric surgery. Its success in determining T2DM remission after sleeve gastrectomy with transit bipartition (TB) has not yet been validated. The aim of this study was to evaluate the predictive value of ABCD score in TB.

MATERIALS AND METHODS

Of 438 patients with T2DM, 191 underwent sleeve gastrectomy (SG), 136 underwent one anastomosis gastric bypass (OAGB), and 111 underwent TB. Retrospective analysis of ABCD scores, 1-year postoperative remission rates, and the predictive accuracy of ABCD scores for these were conducted.

RESULTS

In the SG, OAGB, and TB groups, respectively, median ABCD scores were 7, 6, and 4, while complete remission rates were 95.3%, 84.6%, and 76.6% (p < 0.001). The area under curves (AUCs) for SG, OAGB, and TB were 0.829 (95% CI = 0.768 to 0.879, p < 0.0001), 0.801 (95% CI = 0.724 to 0.865, p < 0.0001), and 0.840 (95% CI = 0.758 to 0.902, p < 0.0001), respectively. There was no statistically significant difference between AUCs.

CONCLUSION

ABCD score predicts the probability of remission at 1-year follow-up in T2DM patients undergoing TB as accurately as in patients receiving SG or OAGB.

Potential application of cryogenic freezer on turbot sperm cryopreservation

BACKGROUND

Cryopreservation is a common practice to preserve fish sperm for prolonged periods.

OBJECTIVE

To examine the effect of different freezing protocols on sperm characteristics, fertilization, and hatching rate of turbot.

MATERIALS AND METHODS

Milt was obtained from ten 8-year-old turbot (54.3 ± 1.7 cm in length and 3,106 ±283 g in weight) at the peak of spawning season. Six batches of milts with >90% motility was pooled and diluted to 1:3 by adding dimethyl sulfoxide (DMSO, 10%) as cryoprotectant. Then straws filled with semen were subjected to three freezing protocols (cooling rates). Sperm characteristics were assessed using sperm class analyzer before and after cryopreservation. Cryopreserved and fresh sperm were used for artificial fertilization to assess fertilization and hatching rates.

RESULTS

Cryopreservation protocol has significantly deleterious effects on total motility, progressive motility, curvilinear velocity, straight line velocity, average path velocity, linearity index, straightness index, oscillation index, and amplitude of lateral head displacement of sperm. However, the beat frequency of cryopreserved sperm was found to be similar to control sperm. The fertilization rate of sperm subjected to three freezing protocols were similar, varying between 65.3 % and 75.6 %, and the hatching rates varied from 51.2 % to 70.7 %.

CONCLUSION

The results show the potential application of cryopreservation in fish hatcheries. doi.org/10.54680/fr22410110312.

High dose zoledronic acid increases ischemia-reperfusion damage of the liver

OBJECTIVE

Zoledronic acid (ZA), a nitrogen-containing bisphosphonate, has been reported to exhibit a protective effect against cancers and prevent bone fractures. It also induces apoptosis by increasing proinflammatory cytokines and oxidative stress. Oxidative stress increases significantly during ischemia-reperfusion (IR) injury. The liver is highly sensitive to IR injury. In this study, we aim to investigate whether high-dose ZA treatment affects the liver during IR.

MATERIALS AND METHODS

We used twenty-one Sprague-Dawley male rats in our study, and they were subdivided randomly into three groups, each containing seven rats. A single dose of 100 μg/kg ZA was administered via the intraperitoneal route in the ZA group. Forty-eight hours after the ZA administration, infrarenal abdominal aortic cross ligation was performed on the ZA and IR groups. After 2 hours of ischemia, 2 hours of reperfusion was applied.

RESULTS

The malondialdehyde (MDA) level of the control group was significantly lower than the IR (p = 0.006) and ZA (p<0.001) groups. However, the superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) values of the control group were significantly higher than the values of the IR group (p<0.05, p<0.001, and p<0.05) and ZA group (p = 0.002, p<0.001, and p<0.001). Caspase-3 activity was significantly higher in the IR group as compared to the control group (p<0.001). The caspase-3 activity in the ZA group, on the other hand, was higher than both the control (p<0.001) and IR groups (p<0.001).

CONCLUSIONS

High-dose ZA may exacerbate liver injury during IR by increasing reactive oxygen species production and apoptosis.

Diagnostic value of serum glial fibrillary acidic protein and S100B serum levels in emergency medicine patients with traumatic versus nontraumatic intracerebral hemorrhage

Background

Glial fibrillary acidic protein (GFAP) is a brain-specific astroglial protein that is released into the blood soon after traumatic brain injury by mature astrocytes. S100B is rapidly released into the cerebrospinal fluid and bloodstream after brain damage. We compared the serum concentrations of these proteins in patients with severe head trauma (bleeding and/or fracture) or nontraumatic intracerebral hemorrhage and healthy individuals.

Materials and Methods

The study included 63 patients (33 males and 30 females) with traumatic cerebral hemorrhage and/or cranial bone fractures or nontraumatic cerebral hemorrhage and 30 healthy control subjects. The reasons for attending the emergency department were as follows: fall from a height (n = 32), traffic accident (n = 18), nontraumatic intracerebral hemorrhage (n = 6), animal kick to the head (n = 4), and blow to the head (n = 3).

Results

Of the 63 patients included in the study, 33 (52.4%) were male and 30 (47.6%) were female. Of the 30 healthy controls, 12 (40%) were male and 18 (60%) were female. The average age of the patients was 27 years (range, 1 month to 86 years) and the average age of the control group was 21 years (range, 18-30 years). The mean serum GFAP concentrations were 86.37 ng/mL in the patients and 38.07 ng/mL in the controls (P < 0.05). The mean serum S100B concentrations were 428.37 pg/mL in the patients and 103.44 pg/mL in the controls (P < 0.05). Eight (12.7%) patients died in the hospital; of those, the mean GCS score was 4.6, and the mean GFAP and S100B levels were 127.8 ng/mL and 860.6 pg/mL, respectively.

Conclusion

The GFAP and S100B concentrations were significantly higher in patients with traumatic or nontraumatic brain injury than in healthy individuals, indicating that serum levels of these biomarkers may provide an alternative to computed tomography for the diagnosis of brain injury.

Sonographische Verlaufsuntersuchungen an trächtigen Hündinnen – ein Beitrag zur Bedeutung der Fruchtresorption beim Hund

Gegenstand: Sonographische Verlaufuntersuchungen an trächtigen Hündinnen zur Evaluierung von Häufigkeit und Bedeutung des Fruchtverlustes. Material und Methoden: Bei 39 Kangalhündinnen wurden vom 15. bis zum letzten Tag der Gravidität täglich die Fruchtanlagen/Feten ultrasonographisch gezählt und die Vitalität der Embryonen/Feten beurteilt. Ergebnisse: Bei fünf Hündinnen (12,8%) war die Resorption von Embryonen nachweisbar, wobei in einem Fall eine Resorption aller Fruchtanlagen vorlag. Bei vier Hündinnen wurde ein Fetaltod dokumentiert, der mit einem Totalverlust des Wurfes einherging. Nach dem ersten Hinweis auf embryonalen Tod ließen sich noch über durchschnittlich 8,6 ± 0,5 Tage Fruchtkammern nachweisen. Die Anzahl der Embryonen differierte bei Hündinnen mit (10,8 ± 1,8) und ohne Resorption (8,2 ± 2,1) statistisch signifikant (p < 0,05). Dagegen konnte hinsichtlich der Embryonenzahl kein signifikanter Unterschied zwischen Hündinnen ohne embryonale Resorption (8,2 ± 2,1) und Tieren mit fetalem Tod (9,5 ± 1,3) festgestellt werden (p > 0,05). Eine Beziehung zwischen Wurfgröße und Trächtigkeitsdauer ließ sich nicht nachweisen (r = 0,15; p > 0,05). Schlussfolgerung und klinische Relevanz: Aufgrund der Ergebnisse wird die Hypothese aufgestellt, dass die Resorption von Fruchtanlagen ein Schutzmechanismus vor einer zu großen Wurfgröße darstellt.

Epidemiology and Clinical Characteristics of Migraine Among School Children In The Menderes Region

The goal of this study was to collect and analyse information on the prevalence of childhood migraine and disability due to migraine in primary school children of 4th to 8th grades (ages ranging from 9 to 17 years) in the Aydin urban area. A cross-sectional school-based study was conducted between March and June 2004. There were 76 333 children of 4th to 8th grades in primary schools in Aydin. Nearly 10% of this population (7721 out of 76 333) was evaluated by a multistage clustered sampling procedure. Four questionnaire forms were applied to each child by a study neurologist during class time. Questionnaire A consisted of a single question, ‘Have you ever had a headache?’. To those who responded ‘yes’, questionnaire B was applied as a second step, which consisted of eight questions. Diagnosis of migraine headache was made according to International Classification of Headache Disorders 2004. Migraine disability was measured with questionnaire C, which was originally the Pediatric Migraine Disability Assessment (PedMIDAS). Migraine history, previous migraine diagnosis and pain intensity were measured with questionnaire D. According to questionnaire A, 79.6% of boys and 87.1% of girls suffered from headaches. The prevalence of migraine was 9.7% (7.8% in boys, 11.7% in girls) according to questionnaire B. The male:female ratio was 1:1.5. Total PedMIDAS score was 9.94 ± 8.41 days in boys and 11.50 ± 12.28 days in girls. Only 1.9% of the children had previously been diagnosed with migraine. The average migraine headache history was 2.48 ± 1.18 years in girls and 2.57 ± 1.18 years in boys. Although migraine is a common health problem among school children in Aydin, it is mostly still under-recognized.

Topiramate has protective effect on renal injury

BACKGROUND

Topiramate (TPM) decreases tumor necrosis factor-alpha (TNF-α) and oxidative stress. We investigated protective effects of TPM on cell damage in kidney tissue during ischemia-reperfusion (I/R) damage.

METHODS

A total of 30 male Wistar albino rats were divided into three groups: control, I/R, and I/R plus TPM (I/R+TPM). Laparotomy without I/R injury was performed in control group. After laparotomy, cross ligation of infrarenal abdominal aorta was applied for two hours in I/R groups which was followed by two hours of reperfusion. TPM (100 mg/kg/day) was orally administrated to animals in the I/R+TPM group for seven consecutive days before I/R.

RESULTS

The I/R group's TNF-α and interleukin-1 beta (IL-1β) levels were significantly higher (1184.2 ± 129.1 pg/mg protein; 413.1 ± 28.8 pg/mg protein, respectively) than those of the control (907.8 ± 113.0 pg/mg protein, p = 0.002; 374.7 ± 23.7 pg/mg protein, p = 0.010, respectively) and I/R+TPM groups (999.5 ± 115.2 pg/mg protein, p < 0.001; 377.9 ± 30.9 pg/mg protein, p = 0.007, respectively).

CONCLUSION

TPM may partially prevent renal damage in rats. The opening of new horizons of this kind of knowledge will help understand the complex challenge in the prevention of renal I/R damage (Tab. 1, Fig. 3, Ref. 42).

Topiramate has protective effect on renal injury

BACKGROUND

Topiramate (TPM) decreases tumor necrosis factor-alpha (TNF-α) and oxidative stress. We investigated protective effects of TPM on cell damage in kidney tissue during ischemia-reperfusion (I/R) damage.

METHODS

A total of 30 male Wistar albino rats were divided into three groups: control, I/R, and I/R plus TPM (I/R+TPM). Laparotomy without I/R injury was performed in control group. After laparotomy, cross ligation of infrarenal abdominal aorta was applied for two hours in I/R groups which was followed by two hours of reperfusion. TPM (100 mg/kg/day) was orally administrated to animals in the I/R+TPM group for seven consecutive days before I/R.

RESULTS

The I/R group's TNF-α and interleukin-1 beta (IL-1β) levels were significantly higher (1184.2 ± 129.1 pg/mg protein; 413.1 ± 28.8 pg/mg protein, respectively) than those of the control (907.8 ± 113.0 pg/mg protein, p = 0.002; 374.7 ± 23.7 pg/mg protein, p = 0.010, respectively) and I/R+TPM groups (999.5 ± 115.2 pg/mg protein, p < 0.001; 377.9 ± 30.9 pg/mg protein, p = 0.007, respectively).

CONCLUSION

TPM may partially prevent renal damage in rats. The opening of new horizons of this kind of knowledge will help understand the complex challenge in the prevention of renal I/R damage (Tab. 1, Fig. 3, Ref. 42).

Comparison between electronic method and conventional method recording and follow-up of general surgery ward-round notes taken

AIM

Patient anamneses and ward-rounds notes taken are two key elements which have been and will be used to ensure accurate and reliable sustainability at surgery services. In this study, we aimed to find a new method which is capable of better addressing the needs in this process, simplifying it and also saving time. We also targeted to compare this new method used by us with the method, also known as conventional method, having been used for years.

METHODS

Thirty patients were included in the study. The prehospitalization anamneses of the patients were taken using the two methods and the durations were recorded separately for the two methods. Thereafter, the patients were visited by two methods in the morning on each day of their stay. The durations were recorded daily and separately for the two methods. The durations were statistically evaluated separately for the anamneses and ward-round notes taken.

RESULTS

Evaluations showed that the method using hand terminal (1.2250 minutes) is more advantageous in terms of duration in recording ward-round scores than the conventional method (1.3853 minutes). It was founded that in regard to the duration, the average duration of manual anamnesis taking (16.3350 minutes) is higher than that of taking anamnesis by means of hand terminal (15.4733 minutes). Furthermore, it was also seen that the use of this new technique eliminated the problems previously experienced in data transfer, access to historical data etc.

CONCLUSION

In conclusion, this method that is tested by use of hand terminal is more advantageous than the conventional method in terms of time saving and accurate data transfer. It is our opinion that it will provide advantages in many more aspects if it is worked on.

Aspartame induces angiogenesis in vitro and in vivo models

Angiogenesis is the process of generating new blood vessels from preexisting vessels and is considered essential in many pathological conditions. The purpose of the present study is to evaluate the effect of aspartame on angiogenesis in vivo chick chorioallantoic membrane (CAM) and wound-healing models as well as in vitro 2,3-bis-2H-tetrazolium-5-carboxanilide (XTT) and tube formation assays. In CAM assay, aspartame increased angiogenesis in a concentration-dependent manner. Compared with the control group, aspartame has significantly increased vessel proliferation (p < 0.001). In addition, in vivo rat model of skin wound-healing study showed that aspartame group had better healing than control group, and this was statistically significant at p < 0.05. There was a slight proliferative effect of aspartame on human umbilical vein endothelial cells on XTT assay in vitro, but it was not statistically significant; and there was no antiangiogenic effect of aspartame on tube formation assay in vitro. These results provide evidence that aspartame induces angiogenesis in vitro and in vivo; so regular use may have undesirable effect on susceptible cases.

The relation between oxidative stress, inflammation, and neopterin in the paraquat-induced lung toxicity

Paraquat (PQ) is a well-known quaternary nitrogen herbicide. The major target organ in PQ poisoning is the lung. Reactive oxygen species (ROS) and inflammation play a crucial role in the development of PQ-induced pulmonary injury. Neopterin is synthesized in macrophage by interferon γ and other cytokines. We aimed to evaluate the utility of neopterin as a diagnostic marker in PQ-induced lung toxicity. Sprague Dawley rats were randomly divided into two groups (sham and PQ), administered intraperitoneally 1 mL saline and PQ (15 mg/kg/mL) respectively. Blood samples and lungs were collected for analyses. Lung injury and fibrosis were seen in the PQ group. Serum total antioxidant capacity, lactate dehydrogenase (LDH), and lung transforming growth factor-1β (TGF-1β) levels were significantly higher than the sham group (in all, p < 0.001). In addition, in the PQ group, serum neopterin and lung malondialdehyde (MDA) levels were also significantly higher than the sham group (in all, p = 0.001). Serum neopterin levels were correlated with LDH activities, lung MDA, lung TGF-1β levels, and the degree of lung injury. These findings demonstrated that oxidative stress, reduction of antioxidant capacity, and inflammation play a crucial role in the PQ-induced lung injury. Elevated serum neopterin levels may be a prognostic parameter to determine extends of PQ-induced lung toxicity. Further studies may be performed to clarify the role of neopterin by different doses of PQ.

A safety-based comparison of pure LigaSure use and LigaSure-tie technique in total thyroidectomy

BACKGROUND AND AIM

Sutureless total thyroidectomy by using vessel sealing devices has been shown to be safe in some recent clinical studies. However, some surgeons are still concerned about the use of these energy devices in the vicinity of there current laryngeal nerve and parathyroid glands. The objective of this study was to investigate the effects of the use of pure LigaSure on postoperative complications and to discuss the pertinent literature.

METHODS

A total of 456 patients having undergone a total thyroidectomy operation between June 2009 and March 2011 were included in the study. Data were prospectively collected and retrospectively evaluated. Patients were separated into 2 groups. Group L comprised of 182 patients where onlyLigaSure was used, and group LT consisted of 274 patients where ligation was used in the vicinity of the recurrent laryngeal nerve and parathyroid glands, and LigaSure was used in all other parts of the surgery. Patient's blood calcium values were checked preoperatively and at postoperative 24, 48, and 72 hours. Groups were assessed in terms of demographic properties, thyroid pathology, duration of operation, and postoperative complications.

RESULTS

Groups were similar in respect of demographic properties, operation duration, thyroid gland pathology. No mortality rate was recorded. Laboratory hypocalcemia rate was higher in group L (P 0.003), but no significant difference was identified between groups in terms of symptomatic hypocalcemia.No permanent hypocalcemia or recurrent laryngeal nerve injury developed in any of the patients in the two groups.

CONCLUSIONS

Pure LigaSure for total thyroidectomy may increase laboratory hypocalcemia rate, but not symptomatic hypocalcemia. Hemorrhage related complications were similar and low in the two groups. Ligations in the places close to delicate anatomic structures did not cause longer operative times and may be a safer option in total thyroidectomy.

The protective effect of infliximab on cisplatin-induced intestinal tissue toxicity

OBJECTIVE

Cisplatin (CP) is a popular chemotherapeutic agent. However, high doses of CP may lead to severe side effects to the gastrointestinal system. The aim of this study was to investigate the protective effects of infliximab on small intestine injury induced by high doses of CP.

MATERIALS AND METHODS

The A total of 30 rats were equally divided into three groups, including sham (C), cisplatin (CP), and cisplatin + infliximab (CPI). The CP group was treated with 7 mg/kg intraperitoneal cisplatin, and a laparotomy was performed 5 days later. The CPI group received 7 mg/kg infliximab intraperitoneally, were administered 7 mg/kg cisplatin 4 days later, and a laparotomy was performed 5 days after receiving cisplatin. Histopathological and immunohistochemical analysis of small intestine tissue sections were performed, and superoxide dismutase, malondialdehyde, and TNF-α levels were measured.

RESULTS

Histopathological evaluation revealed that the CP group had damage in the epithelium and connective tissue, but this damage was significantly improved in the CPI group (p < 0.05). In addition, these histopathological findings were confirmed by biochemical analyses.

CONCLUSIONS

These results suggest that infliximab is protective against the adverse effects of CP.

Hyperbaric oxygen treatment and N-acetylcysteine ameliorate acetaminophen-induced liver injury in a rat model

An overdose of acetaminophen (APAP) produces centrilobular hepatocellular necrosis. We aimed to investigate the hepatoprotective effects of N-acetylcysteine (NAC) only and hyperbaric oxygen (O(2)) treatment (HBOT) combined with NAC, and their anti-inflammatory properties in liver tissue. In the current study, a total of 32 male Sprague Dawley rats were divided into 4 groups: sham, APAP, NAC, and NAC + HBOT. In the APAP, NAC, and NAC + HBOT groups, liver injury was induced by oral administration of 1 g/kg APAP. The NAC group received 100 mg/kg NAC per day. NAC + HBOT group received intraperitoneal injection of 100 mg/kg/day NAC and were given HBOT at 2.8 ATA pressure with 100% O(2) inhalation for 90 min every 12 h for 5 days. Rats in the sham group received distilled water only by gastric tube. All animals were killed on day 6 after APAP or distilled water administration. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities, hepatic neopterin, tumor necrosis factor-α (TNF-α), and interleukin 6 (IL-6) levels were measured. There was a significant increase in serum AST and ALT activities in the APAP group compared with the sham group (in both p = 0.001). NAC and NAC + HBOT groups had significant decreases in hepatic neopterin, TNF-α, and IL-6 levels compared with the APAP group. APAP administration caused extensive hepatic necrosis. NAC and NAC + HBO treatments significantly reduced APAP-induced liver injury. Our results showed that the liver damage in APAP toxicity was attenuated by NAC and NAC + HBO treatments. NAC + HBOT exhibit hepatoprotective activity against APAP-induced liver injury in rats.

The protective effects of taurine on experimental acute pancreatitis in a rat model

The aim of this study was to investigate the protective effects of taurine (Tau) on experimental acute pancreatitis (AP) in a rat model by measuring cytokines and oxidant stress markers.

Forty rats were randomly divided into four groups: sham, AP, Tau and AP + Tau. AP was induced with sodium taurocholate. No treatment was given to the AP. All rats were killed 5 days later. Pancreatic tissues of rats and blood samples were obtained.

Tau treatment significantly decreased serum amylase activity ( p < 0.001), total injury score ( p < 0.001), malondialdehyde levels ( p < 0.001) and myeloperoxidase (MPO) activity ( p < 0.001). There was no significant difference between the Tau and AP + Tau groups in serum and pancreatic tumor necrosis factor-α, interleukin (IL)-1β and IL-6 levels ( p = 1.000). Histopathologic scores in the AP + Tau and Tau groups were significantly lower compared with the AP group (both p < 0.001).

These results showed that Tau reduces lipid peroxidation, amylase and MPO activities and the concentrations of proinflammatory cytokines secondary to AP and also increases superoxide dismutase and glutathione peroxidase activities in rats with sodium taurocholate-induced AP. It also has a marked ameliorative effect at histopathologic lesions. With these effects, Tau protects the cells from oxidative damage, reduces inflammation and promotes regression of pancreatic damage.

Scolicidal activity of taurolidine for the treatment of hydatid disease

OBJECTIVES

In this experimental study, we have evaluated in vivo and in vitro activities of taurolidine (TRD) against protoscolices of Echinococcus granulosus.

BACKGROUND

Scolicidal agent application is mandatory for the interventional treatment of hydatid cysts. Serious adverse effects of current scolicidal agents forced the scientist to search for less toxic chemicals.

METHODS

One milliliter of protoscolices suspension was administered into twelve Petri's dishes, six of them containing 5 ml of isotonic saline, and six of them containing 5 ml (5 mg/ml) TRD. Forty, male Balb/c mice were divided into five equal groups. Group 1: protoscolices inoculated group; Group 2: protoscolices inoculated and thereafter immediately administered with a single dose intravenous (IV) 0.5 ml TRD (400 mg/kg); Group 3: protoscolices inoculated and thereafter immediately administered with a single dose intraperitoneal (IP) 0.5 ml TRD (400 mg/kg); Group 4: three months after inoculating the protoscolices, one day before the sacrifice single dose IV 0.5 ml TRD (400 mg/kg) administered; Group 5: three months after inoculating the protoscolices, one day before the sacrifice single dose IP 0.5 ml TRD (400 mg/kg) administered.

RESULTS

All the protoscolices were dead in TRD-added Petri's Dishes in 90 minutes. In group 2 and group 3, no mouse had an intraabdominal hydatid cyst.

CONCLUSION

The results of this study are encouraging us to suggest TRD as an alternative scolicidal agent. Further clinical studies are needed to define the effectiveness and the mode of application of TRD for the treatment of hydatid disease (Tab. 1, Fig. 4, Ref. 30).

NPRL2 gene expression in the progression of colon tumors

Genetic and epigenetic factors affecting DNA methylation and gene expression are known to be involved in the development of colon cancer, but the full range of genetic alterations and many key genes involved in the pathogenesis of colon cancer remain to be identified. NPRL2 is a candidate tumor suppressor gene identified in the human chromosome 3p21.3 region. We evaluated the role of this gene in the pathogenesis of colorectal cancer by investigating NPRL2 mRNA expression in 55 matched normal and tumor colon tissue samples using quantitative RT-PCR analysis. There was significantly decreased NPRL2 expression in 45% of the patients. Lower NPRL2 expression was observed significantly more frequently in poorly differentiated tumor samples than in highly or moderately differentiated tumors. We conclude that expression of NPRL2 contributes to progression of colon cancer.

What has changed in the management of breast cancer in the past 25 years at the Istanbul University Hospital?

184

Background: There have been important changes in diagnosis and treatment of the breast cancer during the last century. Diagnosing the cancer in early stages brought the new approaches such as breast conserving surgery instead of mastectomy and sentinel lymph node biopsy instead of direct axillary disection. In this study our purpose is to compare the operations which were performed in 1983 and 2008 on breast cancer patients of our clinic and to search the differences in their ages and tumor characteristics.

Methods: In each group the files of 100 patients, who were operated in 1983 and 2008, were compared with each other including the variabilities such as size of the tumor, age of the patient and operation technique.

Results: There were 100 patients in both of the groups. Six of the patients (6%), who were operated on in 1983, were found to be between the ages of 20-39 and this percentage was found to be much higher as 19% (19 patients) in 2008. In 1983, there wasn't any patient at stage 0 and the number of patients at stage 1 was 15 (15%), in 2008 the number of stage 0 patient was 9 (9%) and stage 1 patient was 25 (25%). Breast conserving surgery rate was found to be 9% in 1983 and 41% in 2008.

Conclusions: According to the data of this study, breast cancer is now being seen at younger ages when compared to 25 years ago. Currently the patients have diagnosis at earlier stages and the breast conserving surgery is much more prevalent. Earlier-stage diagnosis can be explained by widespread use of screening mamographies and increasing consciousness of the patients.

Prevalence and clinical significance of GB virus type C/hepatitis G virus coinfection in patients with chronic hepatitis C undergoing antiviral therapy

Coinfection with GBV-C/HGV in patients with chronic hepatitis C (CHC) may influence clinical course and response rates of antiviral therapy. Aim of the study was to investigate the prevalence of GBV-C/HGV/HCV coinfection and its influence on outcome of interferon/ribavirin combination therapy. Three hundred and four patients with CHC [m/f = 211/93, age: 42 (18-65)] were investigated. HGV RNA detection was performed by polymerase chain reaction prior to and 6 months after the end of antiviral therapy. HGV/HCV coinfection could be identified in 37/304 (12.2%) patients with intravenous drug abuse as the most common source of infection (N = 21, (56.8%)). The predominant HCV genotype in coinfected individuals was HCV-3a (HCV-3a: 51.4%, HCV-1: 37.8%, HCV-4: 10.8%). HGV coinfection was more prevalent in patients infected with HCV-3 compared to HCV-1 or HCV-4 [19/45 (42.2%) vs. 14/185 (7.6%) vs. 4/52 (7.7%), P < 0.01]. Patients with HGV/HCV coinfection were younger [35 (18-56) vs. 43 (19-65), years; P < 0.01], and advanced fibrosis (F3-F4) was less frequent (22.2% vs. 42.9%, P < 0.05). A sustained virological response was achieved more frequently in HGV/HCV coinfected patients [26/37 (70.3%)] than in monoinfected patients [120/267 (44.9%), P < 0.01]. HGV RNA was undetectable in 65.7% of the coinfected patients at the end of follow-up. Intravenous drug abuse seems to be a major risk factor for HGV coinfection in patients with chronic hepatitis C. Coinfection with HGV does not worsen the clinical course of chronic hepatitis C or diminish response of HCV to antiviral therapy. Interferon/ribavirin combination therapy also clears HGV infection in a high proportion of cases.

[Follow-up ultrasonographic examinations in pregnant bitches - evaluation of frequency and significance of embryo resorption]

OBJECTIVE

Follow-up ultrasonographic examinations in pregnant bitches to evaluate frequency and significance of embryo resorption.

MATERIAL AND METHODS

In 39 Kangal bitches the number of gestational sacs was measured and vitality of embryos/fetuses was evaluated by real time ultrasonography daily from the 15th till the last day of gestation.

RESULTS

Five bitches (12.8%) showed embryonic resorption and one of these bitches exhibited a complete resorption. Fetal death could be observed in four females and was related to a total loss of the litter. After the first evidence of embryonic death gestational sacs remained detectable for 8.6±0.5days. The number of embryos of bitches with (10.8±1.8) or without embryo resorption (8.2±2.1) was statistically significantly different (p<0.05). On the other hand there was no statistically significant difference within the number of embryos of bitches suffering fetal death and bitches without embryo resorption (8.2±2.1) (p>0.05). A relationship between litter size and gestational length could not be verified (r=0.15; p>0.05).

CONCLUSION AND CLINICAL RELEVANCE

Due to these results the hypothesis is postulated that embryonic resorption is a kind of protective mechanism of the maternal organism against too large litter sizes.

Memory and prefrontal functions in earthquake survivors: differences between current and past post-traumatic stress disorder patients

OBJECTIVE

Many studies reported deficits in cognitive functions in post-traumatic stress disorder (PTSD). Most were, however, conducted on man-made trauma survivors. The high comorbidity of alcohol use and depression with PTSD in these studies further complicated the interpretation of their results. We compared prefrontal lobe functions and memory in three earthquake survivor groups: current PTSD, past PTSD and no PTSD. We hypothesized that prefrontal performances of the current and past PTSD groups would be worse than that of control group.

METHOD

Survivors of the 1999 earthquakes in Turkey were evaluated for current and lifetime PTSD. Memory and prefrontal functions were assessed by a neuropsychological test battery.

RESULTS

Current PTSD patients performed worse on attention, verbal memory, verbal fluency, and psychomotor speed. Past PTSD group was similar to the controls on most cognitive measures, except for their vulnerability to proactive interference and low performance in verbal fluency for animal names.

CONCLUSION

Our findings indicate that the prefrontal organization and monitorization of verbally processed information are defective in earthquake-related PTSD patients, more so in the current PTSD group.

Sonographische Geschlechtsfeststellung bei Schaffeten unter Feldbedingungen durch einmalige Untersuchung

Gegenstand und Ziel: Sonographische Geschlechtsfeststellung bei Schaffeten unter Feldbedingungen durch einmalige Untersuchung. Material und Methoden: Es standen 210 Mutterschafe mit Einlings- und Zwillingsgraviditäten zwischen dem 40.-90. Trächtigkeitstag zur Verfügung. Für die Ultraschalluntersuchungen wurde ein Scanner mit einem Real-time-5-MHz-Linearschallkopf verwendet. Der Tag nach der Bedeckung galt als Tag 1 der Gravidität. Die transrektalen und transabdominalen Ultraschalluntersuchungen erfolgten einmalig am stehenden Tier. Die ultrasonographischen Geschlechtsbestimmungen fanden zwischen dem 40.-49. (Gruppe I), 50.-59. (Gruppe II), 60.-69. (Gruppe III), 70.-79. (Gruppe IV) und 80.-90. (Gruppe V) Trächtigkeitstag statt. Die festgestellten Geschlechter wurden mit den Geschlechtern der geborenen Lämmer verglichen. Ergebnisse: Die Genauigkeit der Geschlechtsdiagnosen betrug in Gruppe I 0% (0/42), in Gruppe II 40,0% (13/42), in Gruppe III 33,3% (14/42), in Gruppe IV 64,2% (27/42) und in Gruppe V 47,6% (20/42). Die Unterschiede zwischen den Gruppen IV und V zu den Gruppen I bis III waren statistisch signifikant (p < 0,05). Weiterhin wurde die Genauigkeit der Diagnose durch das Vorliegen einer Einlingsoder Zwillingsgravidität beeinflusst (p < 0,05). Schlussfolgerung und klinische Relevanz: Die Ergebnisse dieser Studie zeigen, dass die einmalige sonographische Untersuchung zur pränatalen Geschlechtsbestimmung beim tragenden Schaf unter Feldbedingungen nicht mit einer ausreichenden Genauigkeit möglich ist.

Predictors of psychological distress in survivors of the 1999 earthquakes in Turkey: effects of relocation after the disaster

OBJECTIVE

Relocations after disasters are known to cause added distress in survivors. This study examined the effects of migration and other factors on psychological status of survivors 4 years after the two severe earthquakes in Turkey.

METHOD

Five hundred and twenty-six adult survivors of the 1999 earthquakes currently living in Ankara were given self-report measures assessing traumatic stress, depression, earthquake experience and social support.

RESULTS

The rates of current post-traumatic stress disorder (PTSD) and depression were 25% and 11%, respectively. Although both traumatic stress and depression factors were predicted by some demographic and trauma severity variables, relocation status predicted depression but not traumatic stress.

CONCLUSION

The rates of psychological distress were higher than expected in a city considered to be safe in terms of earthquake risk. Relocation after the disaster may increase psychological distress by disrupting the social network.

Number of follicular waves and their effect on pregnancy rate in the cow

In the study, the relationship of follicular growth waves, oestradiol and pregnancy rates were investigated during oestrus cycle in cows. A total of 22, Brown Swiss cows (3-5 years old) were used for the study. The ovaries of animals were examined from sixth day of cycle to next oestrus by ultrasound. The follicles that were present in the ovarium were recorded. Follicular growth was observed every day by means of ultrasound examination. The blood samples were taken for analysis of oestradiol simultaneously with ultrasound examinations. The oestrus animals were inseminated. Each animal that inseminated was examined by ultrasound on day 28 after insemination for pregnancy diagnosis. Two follicular growth waves were observed in nine of 22 (40.9%), three waves in 13 of 22 (59.1%) animals. The oestradiol was found in the same concentration but in different release patterns between two and three waves animals. Pregnancy rate in cows with three and two follicular waves did not differ. In conclusion, emergence of three waves of follicular growth was higher in Brown Swiss cows, the analysis of oestradiol could be used for determination of the wave numbers and the animals with different waves may have had the same pregnancy rates.

Protective effects of vitamins A and E pretreatment in venous ischemia/reperfusion injury

It has been suggested that venous ischemia is more injurious to tissue viability than is arterial ischemia of equivalent duration. The precise mechanism of tissue damage due to venous ischemia is still not well-determined. Current research has shown that it is multifactorial, and that lipid peroxides, prostanoid metabolism, and a free radical mechanism are the major contributors. Vitamins A and E are lipid-soluble vitamins that have been suggested to be successful in the treatment of arterial ischemia/reperfusion injury due to their antioxidant properties. In the present study, the authors examined the protective effects of vitamins A and E pretreatment on reperfusion injury induced by venous occlusion of rat epigastric island flaps based on an epigastric artery and vein pedicle. In the first part of the study, to determine critical ischemia time, epigastric island skin flaps (3 x 6 cm) were elevated on their vascular pedicles in 40 male Sprague Dawley rats. Total venous occlusion of the skin flap was produced by ligating all draining veins and clamping the epigastric vein. Arterial inflow was left intact. Rats were randomly assigned to five groups (n=8) for 2, 5, 7, 9, and 10 hr of venous ischemia. Despite the occurrence of widespread reperfusion injury, reflow was established (p<0.005) at 9 hr. In the second part of the study, 20 rats were randomly divided into four groups (n=5). The effects of vitamins A and E following 9 hr ischemia/reperfusion injury were examined. Rats were pretreated with vitamin E, vitamin A and vitamins A+E for 5 days. At the end of the fifth day, each rat had undergone an epigastric island skin flap and venous occlusion, as described above. Mean surviving flap area (percent) and plasma lipid peroxides (TBARs), total thiol content (t-SH), glutathione peroxidase (Gpx), and superoxide dismutase (SOD) were determined for each rat. Results suggest that, in the prevention of venous ischemia/reperfusion injury, vitamin A and vitamin E are not effective when used as single agents; however, when used in combination, they significantly increase surviving flap area by a synergistic effect.

[A case of primary intestinal lymphoma associated with intestinal perforation]

A 17 year old male with symptoms of acute abdomen was operated upon. The preoperative diagnosis was peptic ulcus perforation but at the operation there were multiple perforations throughout the small bowels, multiple lymphadenopathies in the mesentery of the jejunum. 60 cm small bowel resection-end to end anastomosis, raphe omentoplasty, primary repair with suture were performed. The patient got well after the operation and was discharged postoperative 14th day. The pathological diagnosis was diffuse grand cell lymphoma. We conclude that, this rare condition which we could be able to find only one case in the literature must be thought among the reasons of acute abdomen.

Effects of early pre- and postoperative irradiation on the healing of microvascular anastomoses

A comparative study was undertaken to evaluate the possible effects of time selection of irradiation on the healing of microvascular anastomoses. In this experimental study, 40 adult male Sprague-Dawley rats were divided into four groups, 10 animals in each. In Group 1, the rats were exposed to radiotherapy with a dose of 20 Gy in a single fraction at a 170,916 cby/min dose rate, at an 80-cm source to a skin distance from 3 to 4 cm in the right groin fields involving the femoral artery, using a Co60 megavoltage radiotherapy machine. The animals were operated on under general anesthesia 2 weeks later. During the operation, femoral microarterial anastomoses were performed. In Group 2, the rats were irradiated and operated on as in Group 1, on the same day. In Group 3, the rats were operated on and, 2 weeks later, irradiated, as in Group 1. In Group 4 (control group), the rats were operated on as in Group 1. No radiotherapy was performed. All rats were explored under general anesthesia after 1 month. Patency was evaluated, and the anastomotic sites were taken for histopathologic and electron microscopy studies. The authors found that there were no major differences in the healing of microvascular anastomoses in the early preoperative, immediate preoperative, and early postoperative irradiated groups. The patency rates of all radiotherapy groups were not statistically different from control arteries (p > 0.05).

Modeling of a roller-compaction process using neural networks and genetic algorithms

In this study, roller-compaction of acetaminophene was studied to model the effect of binder type (hydroxypropyl methyl cellulose (HPMC), polyethylene glycol (PEG), Carbopol), binder concentration (5, 10 and 20%), number of roller-compaction passes (one or two), and extragranular microcrystalline cellulose addition on the properties of compressed tablets. Forty-two batches resulted from the experimental design. The artificial neural network methodology (ANN) along with genetic algorithms were used for data analysis and optimization. ANN and genetic models provided R2 values between 0.3593 and 0.9991 for measured responses. When a set of validation experiments was analyzed, genetic algorithm predictions of tablet characteristics were much better than the ANN. Optimization based on genetic algorithm showed that using HPMC at 20%, with two roller-compaction passes would produce mechanically acceptable acetaminophene tablets. PEG and carbopol would also produce acceptable tablets perhaps more suitable for sustained release applications. Using PEG as a binder had the additional advantage of not requiring an external lubricant during tablet manufacturing.

[Changes in the activation markers of blood coagulation and fibrinolysis in the neonatal period]

BACKGROUND

Activation markers of the clotting and fibrinolytic systems are elevated immediately after birth and decline to near adult levels during the first 24 hours of life. The aims of this study were to investigate, whether the activation of both clotting and fibrinolysis is dependent on the mode of delivery, and to measure activation markers in newborns with infection beyond the first days of life.

PATIENTS

We have studied activation markers thrombin-antithrombin III complex, prothrombin fragment 1 + 2, D-dimer and plasmin-antiplasmin complex by use of commercially available ELISA techniques in 20 newborns after elective Cesarean sections because of previous sections, in 20 newborns after Cesarean sections and a trial of labor with uterine contractions over a period of > 20 hours and in 20 newborns (34.-41. gestational week) aged 10-25 days with infection. 20 healthy adults served as controls.

RESULTS

A significant elevation of all activation markers was observed both in the newborns after Cesarean sections and in the 10-25 days old children with infection. There were no differences among newborns after elective sections compared to newborns after section and a trial of labor with uterine contractions over a period of > 20 hours.

CONCLUSIONS

The clotting and fibrinolytic systems reveal increased activation immediately after delivery, but uterine contractions over a period of > 20 hours seem not to make a difference. During infection, the activation markers of the hemostatic system in newborns aged 10-25 days behaves similarly to the mature adult system.

Effects of insulin on the response of immunoreactive glucagon to an intravenous glucose load in human diabetes

The effects of exogenous insulin upon the response of immunoreactive glucagon (IRG) to i.v. glucose were studied in diabetic and nondiabetic subjects. In nondiabetics, a rapid injection of 25 g of glucose lowered plasma IRG levels. In adult-onset diabetics, the glucose-induced decline in IRG was normal despite a subnormal glucose-induced insulin rise, in contrast to impaired IRG suppressibility previously reported when such patients received an oral glucose load. The magnitude of their glucose-induced IRG decline was not augmented by exogenous insulin, even when insulin levels were acutely raised above 300 micro units/ml. In juvenile-type diabetics, basal IRG levels were normal following overnight insulin infusion, but the glucose-induced IRG decline was only half that of the nondiabetics. However, it became normal when hyperinsulinemia was acutely produced by supplementary insulin. Thus, whenever insulin levels rise in response to an increase in hyperglycemia, as they do spontaneously in nondiabetics and in adult-type diabetics and as they do when juvenile diabetics are given supplementary insulin together with the glucose bolus, the decline in IRG in response to an i.v. glucose load is as great as in nondiabetics. The findings are compatible with the view that glucose-induced suppression of IRG may require a concomitant rise in insulin.

Effect of insulin on the exaggerated glucagon response to arginine stimulation in diabetes mellitus

The effect of insulin on the glucagon response to intravenous arginine was studied in eight juvenile-type and six adult-onset diabetics. In the juvenile-type diabetics, concomitant administration of insulin significantly blunted the glucagon response from a mean maximal rise of 310 +/- 54 pg./ml. to only 184 +/- 39 pg./ml. (p less than 0.01), about the same as in nondiabetics. In the adult-onset patients, however, insulin had no effect, the mean maximal rise being 250 +/- 50 pg./ml. without insulin and 307 +/- 71 pg./ml. with insulin (N.S.). This study demonstrates that in juvenile-type diabetics concomitant administration of supraphysiologic quantities of insulin can reduce the exaggerated glucagon response to intravenous arginine to normal, whereas in the adult-type group, it has no apparent effect.