Bovine carbonic anhydrase (bCA) inhibitors: Synthesis, molecular docking and theoretical studies of bisoxadiazole-substituted sulfonamide derivatives

This paper describes the in vitro inhibition potential of bisoxadiazole-substituted sulfonamide derivatives (6a-t) against bovine carbonic anhydrase (bCA) after they were designed through computational analyses and evaluated the predicted interaction via molecular docking. First, in silico ADMET predictions and physicochemical property analysis of the compounds provided insights into solubility and permeability, then density functional theory (DFT) calculations were performed to analyse their ionization energies, nucleophilicity, in vitro electron affinity, dipole moments and molecular interactions under vacuum and dimethyl sulfoxide (DMSO) conditions. After calculating the theoretical inhibition constants, IC50 values determined from enzymatic inhibition were found between 12.93 and 45.77 μM. Molecular docking evaluation revealed favorable hydrogen bonding and π-interactions of the compounds within the bCA active site. The experimentally most active compound, 6p, exhibited the strongest inhibitory activity with a theoretical inhibition constant value of 9.41 nM and H-bonds with Gln91, Thr198, and Trp4 residues and His63 Pi-cation interactions with His63 residues. Overall, the study reveals promising bCA blocking potential for the synthesized derivatives, similar to acetazolamide.

Anatomy in the metaverse: Exploring student technology acceptance through the UTAUT2 model

The impact of technology on educational domains has been a subject of research for many years. Therefore, understanding how students perceive and utilize technologies for educational purposes is crucial. Especially in a critical subject like anatomy education, it is essential to employ various models to determine students' technology acceptance and usage levels. One of these models is the unified theory of acceptance and use of technology-2 (UTAUT2). In this study, the acceptance and usage levels of metaverse technology by students in the context of anatomy education in the metaverse environment have been investigated within the framework of the UTAUT2 model. The study was conducted with students from the Department of Midwifery at the Faculty of Health Sciences during the fall semester of the 2022-2023 academic year. After 6 weeks of anatomy education in the metaverse environment, the student's acceptance and usage levels of metaverse technology were assessed using the UTAUT2 scale. The collected data were analyzed using the partial least squares structural equation modeling method. The research has revealed the technology acceptance and usage levels of students who utilized metaverse technology in anatomy education. According to the obtained results, it has been observed that social influence affects behavioral intention, facilitating conditions influence behavioral intention, and habit variable affects behavioral intention, while habit, in turn, influences usage. Other variables explain behavioral intention with a proportion of 75.30%, whereas other variables explain usage behavior with 54.90%. Upon analyzing the responses to the UTAUT2 scale, it has been concluded that there is the highest level of participation in hedonic motivation. In contrast, the habit variable has the lowest participation level. The findings of this study have enabled the identification of the impacts of metaverse technologies on anatomy and health education. These results will likely contribute to improving the utilization of metaverse technologies in anatomy and health education.

Early prediction of gallstone disease with a machine learning-based method from bioimpedance and laboratory data

Gallstone disease (GD) is a common gastrointestinal disease. Although traditional diagnostic techniques, such as ultrasonography, CT, and MRI, detect gallstones, they have some limitations, including high cost and potential inaccuracies in certain populations. This study proposes a machine learning-based prediction model for gallstone disease using bioimpedance and laboratory data. A dataset of 319 samples, comprising161 gallstone patients and 158 healthy controls, was curated. The dataset comprised 38 attributes of the participants, including age, weight, height, blood test results, and bioimpedance data, and it contributed to the literature on gallstones as a new dataset. State-of-the-art machine learning techniques were performed on the dataset to detect gallstones. The experimental results showed that vitamin D, C-reactive protein (CRP) level, total body water, and lean mass are crucial features, and the gradient boosting technique achieved the highest accuracy (85.42%) in predicting gallstones. The proposed technique offers a viable alternative to conventional imaging techniques for early prediction of gallstone disease.

Could subcutaneous rifampicin administration be an effective approach for reducing episiotomy infections?

OBJECTIVE

The aim of this prospective cross-sectional study was to investigate whether cleaning the episiotomy line with rifampicin solution before suturing will reduce infection and wound dehiscence in women who had vaginal delivery with episiotomy.

PATIENTS AND METHODS

A prospective cross-sectional study was conducted with a total of 400 primigravida patients. In the study group, irrigation with rifampicin of the subcutaneous tissue of the episiotomy incision was applied, and in the control group, there was no irrigation. Patients were evaluated for infection at the 1st, 3rd week, and 1-month controls. The groups were compared according to episiotomy infection and wound dehiscence rates.

RESULTS

The episiotomy infection rate of the whole group was 8.5%, the wound dehiscence rate was 3.75%, and the average time of occurrence of the infection was 5.35±2.21 days. The most common infection findings were local pain and purulent discharge at 4.75%. In the control group, where the infection occurred earlier, the infection and wound dehiscence rates were significantly higher [11.5% vs. 5.5%; 6.0% vs. 1.5% (p<0.05)]. Purulent discharge was the most common finding in the control group, and local pain in the study group, but no significant difference was found between the two groups in terms of findings (p<0.05). When only the patients who developed episiotomy infection were evaluated among themselves, the only significant difference was found in wound dehiscence, which was higher in the control group (p<0.05).

CONCLUSIONS

Considering the high rates of episiotomy in our country, subcutaneous irrigation with rifampicin is a good option that can be kept in the foreground due to its low cost and ease of application.

High-resolution diffusion-weighted imaging compared with conventional diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging with regard to image quality and assessment of breast cancer morphology

PURPOSE

To evaluate the image quality and tumor morphology depiction ability of high resolution (HR) diffusion- weighted imaging (f-DWI) in comparison to conventional DWI (c-DWI) and dynamic contrast- enhanced magnetic resonance imaging (DCE-MRI) in the primary breast cancer setting.

METHODS

The f-DWI, c-DWI, and DCE-MRIs of 160 malignant breast masses were evaluated retrospectively by two independent radiologists. Data on image quality [sharpness, distortion, and perceived signalto- noise ratio (SNR)], apparent diffusion coefficient (ADC) value, lesion size, and tumor morphology (shape, margin, and internal pattern) obtained on f-DWI, c-DWI, and DCE-MRI were compared. Consistency between the readers and imaging methods for morphological parameters was analyzed.

RESULTS

The ADC values measured on f-DWI were significantly lower than those measured on c-DWI for both readers (P < 0.001 for each), whereas mean lesion size was significantly larger in c-DWI than in f-DWI and DCE-MRI for both readers (P < 0.001 for each). Higher consistency values were obtained for f-DWI compared with c-DWI when correlated with DCE-MRI for each morphological parameter. The least distorted images were obtained using DCE-MRI compared with c-DWI and f-DWI for both readers, whereas the highest distortion scores were obtained using c-DWI. Sharpness and perceived SNR scores were rated as significantly higher for f-DWI and DCE-MRI images compared with c-DWI by both readers (P < 0.001 for all). The concordance between c-DWI and DCE-MRI was fair to slight (κ = 0.15 to 0.41), whereas concordance between f-DWI and DCE-MRI was significantly better (κ = 0.68 to 0.87) for each reader and for all morphological parameters (P < 0.001). The highest concordance between the readers was achieved in margin assessment (κ = 0.87 to 0.89) regardless of the MRI method, followed by shape and internal pattern parameters (κ = 0.63 to 0.79).

CONCLUSION

The results demonstrated that f-DWI produces higher-quality images than c-DWI, enabling the morphological features to be identified in similar detail to that offered by HR DCE-MRI. Accordingly, f-DWI, as a method that highly correlates with DCE in determining the morphological characteristics of breast cancers, seems to have potential in the evaluation of breast tumors in patients for whom the use of contrast media is contraindicated.

AB0672 PATIENT CHARACTERISTICS AND DISEASE ACTIVITY, BUT NOT THE CRANIOCERVICAL POSTURE ABNORMALITIES PREDICT TEMPOROMANDIBULAR DISORDERS IN ANKYLOSING SPONDYLITIS PATIENTS: A CROSS-SECTIONAL, OBSERVATIONAL STUDY

Background:

There are contradictory results in the relevant literature about the relationship between objective determinants of craniocervical posture and temporomandibular disorder (TMD), whereas no study has worked on AS and TMD relationship.

Objectives:

To evaluate the predictors of TMD in AS patients and its relationship with craniocervical posture, we conducted this study

Methods:

AS patients aged between 18-50 years and consecutively admitted to our outpatient clinics were recruited. TMD was diagnosed by ‘Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)’ criteria. Spinal mobility was assessed by BASMI; disease activity by ASDAS-CRP and neck disability by Neck Disability Index. We measured the craniocervical angle, cervical curvature angle, suboccipital distance, atlas-axis distance, anterior translation distance by using the lateral cervical X-rays (Figure).

Results:

A total of 98 (58.2% female) patients with a mean age of 37.4 ±48.2 years was recruited (Table 1). TMD was diagnosed in 58 (59,2%) patients. Spinal mobility and craniocervical posture measurements were similar among the two groups (Table2). Smoking, bruxism (in females), neck disability and AS activity (in males) were higher in TMD patients (Table 1). Multivariate analysis revealed active smoking (aOR 6.86; CI: 1.83-25.60; p=0.004), bruxism in females (aOR 17.87; CI: 2.0-159.20; p=0.01), high ASDAS in males (aOR 11.82; CI: 1.14-122.5; p=0.038) and neck disability (aOR 12.67; CI: 3.75-42.85; p<0.001) as independent risk factors for TMD in AS patients.

Table 1.

The clinical and demographical data of the study population

ParameterAll patientsTMD (+)(n=58)TMD(-)(n=40)PvalueGender (Female)57 (58.2)38 (65.5)19 (47.5)0.076Age37.4±8.237.8±7.736.9±8.90.57Smoking Smoker33 (33.7)25 (43.1)8 (20.0)0.017 Non-smoker65 (66.3)33 (56.9)32 (80.0)AS disease duration (year)8.1±5.77.8±6.28.6±5.00.47AS treatment NSAID0.52  Regular13 (13.2)8 (13.8)5 (12.5)  On-demand49 (50.0)31 (53.4)18 (45.0) Sulphasalazine38 (38.7)24 (41.4)14 (35.0)0.67 Anti-TNF agents59 (60.0)33 (56.9)26 (65.0)0.42Bruxism Present61 (62.2)43 (74.1)18 (45.0)0.003  Nighttime18 (29.5)11 (25.6)7 (38.9)  Daytime15 (24.6)10 (23.3)5 (27.8)  Whole day28 (45.9)22 (51.2)6 (33.3) Absent37 (37.8)15 (25.9)22 (55.0)Table 2.

Comparison of AS-related and craniocervical posture measurements

ParameterAll patientsTMD (+)(n=58)TMD(-)(n=40)P valueAS-related measurementsASDAS2.4±0.952.7±0.932.0±0.850.001 Male2.3±1.32.7±1.141.7±0.850.007 Female2.5±0.92.7±0.822.4±0.780.11Tragus-wall distance (cm)11.7±2.5511.6±1.9712.0±3.240.41Cervical rotation (angle)71.6±12.7871.6±12.3271.5±13.590.94Chin-thorax distance (cm)2.1±1.642.1±1.442.1±1.910.90BASMI2.0±1.192.0±1.112.1±1.310.76mSASSS3.5±4.843.4±3.883.8±6.030.70Measurements of craniocervical postureCraniovercival angle79.6±10.3178.9±10.4780.6±10.110.41Cervical curvature angle165.4±12.42165.6±12.89165.0±11.840.82Suboccipital distance (mm)6.3±3.976.2±4.046.5±3.910.71Atlas-axis distance (mm)5.2±2.435.3±2.475.0±2.400.62Anterior translation distance (mm)10.9±13.7411.4±11.7910.1±16.350.66

Conclusion:

No relationship between the craniocervical posture measurements and TMD was found in AS patients. Active smoking, high disease activity in males, bruxism in females and neck disability were found as predictors of TMD in AS patients.

Figure.

Disclosure of Interests:

Esra Bilgin: None declared, Emre Bilgin: None declared, Oya Özdemir: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

The role of low keV virtual monochromatic imaging in increasing the conspicuity of primary breast cancer in dual-energy spectral thoracic CT examination for staging purposes

Background

The additive value of dual-energy spectral computerized tomography (DESCT) in breast cancer imaging is still unknown.

Purpose

To investigate the role of DESCT in improving the conspicuity of primary breast cancer.

Material and Methods

Twenty-nine patients who were histopathologically diagnosed with breast cancer and underwent DESCT for staging of lung metastasis were evaluated retrospectively. The visual conspicuity of breast cancer was scored by two readers separately in reconstructed virtual monochromatic images obtained at 40, 60, 80, and 100 keV. A circular region of interest slightly smaller than the maximum contrasted portion of the primary breast cancer was manually placed. Iodine enhancement (HU) and iodine content (mg/mL) values of tumor, normal breast tissue and pectoral muscle, and contrast-to-noise values of images at four different energy levels were calculated.

Results

The lesion conspicuity score peaked at 40-keV series for both readers and was significantly higher than those at other energy levels (all P < 0.001). Lesion iodine enhancement was highest at 40-keV virtual monochromatic image reconstructions ( P < 0.001). The iodine content was significantly higher in tumor than normal breast tissue, and pectoral muscle ( P < 0.001). The highest contrast-to-noise value was obtained at 60 keV (4.0 ± 2.5), followed by 40 keV (3.9 ± 2.2), without a significant difference ( P = 0.33).

Conclusion

The conspicuity of primary breast cancer was significantly higher in low keV virtual monochromatic images obtained by DESCT. This gives us hope that DESCT may play an effective role in detecting incidental breast lesions. It also raises the question of whether quantitative values obtained by DESCT can be used for characterization of primary breast lesion.

Contribution of diffusion-weighted imaging to conventional MRI for detection of haemorrhagic infarction in ovary torsion

Background

To assess the role of DWI in differentiation haemorrhagic ovary infarction from non-haemorrhagic one.

Methods

For this prospectively designed study, of 117 female patients who presented with acute lower quadrant pain and underwent MRI for suspicion of ovary torsion, results of only 29 patients (mean age, 24.7; SD, ±5.7; age range, 18–37), with surgical and pathological confirmation of adnexal torsion, were included to the study. All patients underwent DWI after conventional MRI. Quantitative and qualitative analysis of both the torsed and contralateral normal ovary were performed. Results of conventional MRI and DWI were noted.

Results

At operation 15 patients were found to have haemorrhagic infarction while 14 had non-haemorrhagic infarction. Of the 29 patients, 17 torsed ovaries could be salvaged in a viable state. We found statistically significant correlation of the ADC values, between haemorrhagic and non-haemorrhagic ovary infarction. The ADC values were significantly lower in patients with haemorrhagic infarction than non-haemorrhagic ones (p < 0.001). Using an ADC threshold of 1.27, the sensitivity of DWI for haemorrhagic infarction was 0.93 and specificity 0.85.

Conclusion

DWI may be used with a significant success for the preoperative diagnosis of haemorrhagic infarction. This may be alerting for pre-emptive surgery in avoiding serious complications and preventing irreversible structural damage of the ovary.

Granular cell tumor of the urinary bladder

Granular cell tumors (GCTs) are extremely rare neoplasms of the bladder. In the literature, there are only a few reported cases. We present a GCT case with clinical, radiological, histomorphological, immünohistochemical findings and its differential diagnosis.

Contribution of diffusion-weighted MR imaging in follow-up of inflammatory appendiceal mass: Preliminary results and review of the literature

Objective

We aimed to search the contribution of diffusion-weighted imaging (DWI) in follow-up of patients with acute appendicitis associated inflammatory appendiceal mass (IAM). DWI was used as a monitoring imaging method to assess the response of medical treatment.

Materials and methods

19 patients (mean age, 37+–13.1; age range, 19–69; M/F: 10/9), presented with clinical, laboratory and computed tomography (CT) findings suggestive of IAM were enrolled prospectively in this study. CT and DWI images were evaluated by two radiologists in consensus. b values 0, 500 and 1000 s/mm² were used, and DWI images were analysed both qualitatively and quantitatively. Laboratory parameters were C-reactive protein value and white blood cell count. During follow-up changes in the diameter of IMA and laboratory parameters were correlated with ADC values. Conservative treatment with interval appendectomy and a total conservative approach without surgery were the treatment options during follow-up.

Results

We found statistically significant correlation between the ADC values, maximum IAM diameter and laboratory parameters. During follow-up five surgical procedures were performed: one patient underwent surgery for cecal adenocarcinoma and four underwent interval appendectomy. One patient developed acute relapse of IAM at the sixth month of follow-up.

Conclusion

DWI may be used with a significant success for follow-up of patients with IAM. As a monitoring imaging method, DWI may also aid in determining of most appropriate timing for interval appendectomy as well as may help in diagnosing alternative diagnoses (e.g. malignancy and inflammatory bowel disease) that can mimic IAM.

Comparison of Rai and Binet Classifications in Chronic Lymphocytic Leukemia

Staging systems are essential for understanding disease, in predicting the outcome, and therapeutic decision making in any tumor as well as chronic lymphocytic leukemia (CLL). In this study, we compared the clinical correlation of the Rai and Binet classification systems in 133 CLL patients. The distribution of 133 patients according to the Rai system was as follows, stage 0:17, I:13, II:45, III:30, IV:28, and in the Binet system stage A:35, B:40, C:58 patients. Median survival of patients according to the Rai staging system was >67.0, >91.0, 63.8, 20.9 and 9.8 months, and >91.0, 63.4, 16.0 months according to Binet, respectively. Although no difference was found between Rai stages 0, I, II (p > 0.05) in terms of median survival, the difference between these stages and stages III and IV was statistically significant (p < 0.05). In the Binet staging system statistically significant survival difference was found between all stages (p < 0.05). We concluded that although both systems are comparable in terms of staging and predicting the outcome of patients with CLL, the Rai staging system appears to have an advantage over the Binet system by defining a subset of patients with excellent prognosis (stage 0) which is included within stage A of the latter.