Evaluation of total oxidant and antioxidant status in localized and generalized vitiligo

BACKGROUND

Vitiligo is an acquired depigmentation disorder, and oxidative stress is suggested to have a major role in its aetiopathogenesis.

AIM

To assess whether oxidative stress has a greater role in generalized than in localized vitiligo.

METHODS

We assessed 31 patients with active vitiligo (17 localized, 14 generalized) and 38 healthy controls. Serum total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were determined.

RESULTS

Patients with vitiligo had significantly lower TAS and higher TOS and OSI values than controls. Both localized and generalized vitiligo were associated with lower TAS and higher TOS and OSI values, compared with controls, and all three did not differ with vitiligo type.

CONCLUSIONS

A systemic oxidative stress exists in patients with vitiligo. These results indicate that the global antioxidant capacity of patients might have been exhausted through a defence mechanism against oxidative processes. The imbalance in TOS/TAS status may have an important role in the aetiopathogenesis of vitiligo, regardless of the clinical variant of the disease.

Penile fractures and our treatment policy

To evaluate our diagnosis and treatment policy of penile fractures, we reviewed 13 cases treated between August 1992 and August 1995. In ten patients early surgical correction, in one patient an elective surgical intervention was carried out. Two patients with minimal haematoma were suggested to undergo conservative treatment, but only one of them came to the control examination and he complained of fixed induration, pain and mild deviation in erection. In the group of early surgical repair there was no complication. In a patient who had had a delayed procedure small induration and minimal deviation were found. In the light of these findings we think that in penile fractures early surgical repair produces the best results.

ASSESSMENT OF SERUM ALARIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

OBJECTIVE

We aimed to investigate the potential relationship between plasma alarin levels and type 2 diabetes mellitus (T2DM).

PATIENTS AND METHOD

We included 154 participants, divided into four groups in a cross-sectional study design. The first group includes patients with T2DM without complications (n=30), the second group patients with T2DM with microvascular complications (T2DM-noC n=32), the third group patients with T2DM with macrovascular complications, T2DM-MV (n=32) and the last group is the healthy control group (n=60).

RESULTS

In our study 94 patients were diabetic; 47 females and 47 males. The control group consists of 60 people, 30 women and 30 men. It was found that these had a significant (p>0.05) variation in serum alarin levels among the T2DM (T2DM-noC=3.1±0.7 ng/mL T2DM-mV=2.8±0.4 ng/mL, T2DM-MV= 3.6±0.4 ng/mL) versus control group (15.6±2.6).We failed to find a significant variation of serum alarin levels (p>0.05) between T2DM subgroups. Serum alarin levels were significantly higher among control patients (p<0.05). There was no difference between diabetic sub-groups.

CONCLUSION

We concluded that serum alarin levels in patients with T2DM are lower than in normal people. Further studies are needed to investigate the possible prognostic value of alarin in clinical practice in T2DM.

Comparison of plasma and salivary meteorin-like protein levels in patients with newly diagnosed Type-2 diabetes and treated with metformin

OBJECTIVE

The present study compares the plasma and salivary Metrnl levels of patients newly diagnosed with type-2 diabetes who were treated with metformin for three months with those of a healthy volunteer group and immunohistochemically analyzes Metrnl in salivary glands.

PATIENTS AND METHODS

30 healthy volunteers and 30 newly diagnosed type-2 diabetes patients were included in the study. The newly diagnosed diabetes patients were treated with metformin for three months, and the plasma and salivary metformin levels of both groups were measured at baseline and after the three months of metformin treatment in the patient group. Plasma HbA1c, low-density lipoprotein (LDL-C) and Triglyceride (TG) values of all groups were also measured at baseline following three months of metformin treatment. Biopsies were taken from the parotid and submandibular glands and immunohistochemical staining was performed to show Metrnl immunoreactivity.

RESULTS

Plasma Metrnl, HbA1c, LDL-C and TG levels were higher in the newly diagnosed diabetes group than in the other group, and salivary Metrnl levels were higher than in the control group after three months of metrformin treatment. An examination of the immunohistochemical staining of salivary gland biopsies under light microscope revealed Metrnl immunoreactivity in the intralobular and interlobular ducts of the parotid gland, while Metrnl immunoreactivity was observed in the acinar cells in the intralobular striated duct and interlobular ducts in the submandibular gland.

CONCLUSIONS

Plasma Metrnl, HbA1c, LDL-C and TG levels were higher in the newly diagnosed diabetes group than in the other group. Metrnl immunoreactivity was detected in the parotid and submandibular glands. The relationship between Metrnl and DM should be investigated in larger groups.

Effect of long-term sitting on serum prostate-specific antigen levels

OBJECTIVE

The aim of this study was to evaluate the effect of long-term sitting on serum prostate-specific antigen (PSA) levels.

METHOD

The serum PSA levels of 50 bus drivers under the age of 45 (mean 37.7) years who worked at least 8 h a day for more than 3 weeks were compared with those of 50 healthy surgeons in similar age groups (mean 37.7 years) who spent most of their working time standing.

RESULTS

There was no statistically significant difference between the mean PSA level of the study group (1.211 +/- 0.96 ng/ml) and that of the control group (1.214 +/- 0.74 ng/ml; p > 0.05). The PSA levels returned to normal after a 5-day resting period in cases who had higher values than the anticipated 2.5 ng/ml for this age group at the initial determination.

CONCLUSIONS

These results suggest that there is no relationship between long-term sitting and serum PSA levels. A second PSA determination after a 5-day resting period may be helpful in cases with higher than normal initial values.

Differentiation of Borderline Epithelial Ovarian Tumors from Benign and Malignant Epithelial Ovarian Tumors by MRI Scoring

INTRODUCTION

The distinction between benign and borderline epithelial ovarian tumors is important because treatment and follow-up strategies differ

OBJECTIVE

We aimed to evaluate benign, borderline, and malignant epithelial ovarian tumors using MRI features and contributed to the preoperative evaluation.

METHODS

MRIs of 81 patients (20 bilateral), including 31 benign, 27 borderline, and 23 malignant, who had pelvic imaging between 2013-2020, were evaluated retrospectively. The evaluation was made blindly to the pathology result by two radiologists with MRI scoring and features that we determined. MRI evaluation was performed with T1 TSE, T2 TSE, fat-suppressed T2 TSE, and before and after contrast T1 fat-suppressed and non-fat-suppressed TSE images. The numbers and findings obtained in scoring were evaluated by Chi-Square, ordinal logistic regression, and 2 and 3 category ROC analysis.

RESULTS

The total score varied between 7 and 24. Among the three groups, a significant difference was found in terms of T1, T2 signal intensity (p <0.01), size (p = 0.055), solid area (p <0.001), septa number (p <0.05), ovarian parenchyma (p = 0.001), ascites (p <0.001), peritoneal involvement (p <0.001), laterality (p <0.001), contrast enhancement pattern (p <0.001). On the other hand, no significant difference was found in terms of wall thickness, lymph node involvement and endometrial thickness (p> 0.05). Cut-off values were found as 11.5 and 18.5 in the 3-category ROC analysis performed for the score (VUS: 0.8109). Patients with a score below 11.5 were classified as benign, those between 11.5-18.5 as borderline, and those over 18.5 as malignant.

CONCLUSION

The differentiation of borderline tumors from benign and malignant tumors by MRI scoring will contribute to the preoperative diagnosis.

Oral Rehabilitation of a Patient with Congenital Erythropoietic Porphyria: A Rare Case Report Porphyria: A Rare Case Report

Congenital erythropoietic porphyria (CEP) is an extremely rare disorder involved in chronic porphyrias. One of the recommended evaluations to determine disease severity and needs of a person with CEP is dental assessment. Objective: To present a case of CEP and its oral rehabilitation. Case Report: A 32-year-old female patient was admitted to the clinic with hyperkeratinization, skin fragility, fissures, and wounds in her perioral region and hands. Intraoral gingival bleeding, mucogingival stress, and missing teeth were recorded. After medical consultation, phase I and II periodontal therapies were performed. The patient expressed satisfaction of the results of the procedures in terms of the parameters evaluated. The rare occurrence of the disease may delay the diagnosis. An unmet need still exists for multidisciplinary orientation of patients with CEP. Conclusion: Dentists should have and follow guidelines for treating patients with CEP.

The importance in diagnosing patients with conflicting observational data for post surgery radioiodinated ablation of thyroid remnants

OBJECTIVE

There is a special group of patients, according to 2015 American Thyroid Association guidelines. This group is defined as "the patients with conflicting observational data for post-surgery radioiodine ablation (COD for PSRIA)". For this special group of patients RIA is applied after a thorough reassessment of histopathological, clinical and biochemical features, including thyroglobulin (Tg). However, there is no consensus on what is the suitable cut-off value for the radioiodine ablation (RIA) decision or for therapy prediction. Moreover, is also unclear which Tg parameters should be used for these purposes. If we can determine useful and practical cut-off values for excellent response (ER) and non-structural incomplete response (non-SIR) response categories, this will facilitate our therapy response prediction before RIA and may allow us to categorize the group of "COD for PSRIA" based on a higher risk of recurrence/relapse or disease specific mortality rates according to serum thyroglobulin (Tg). This categorization may also enable us to plan the follow-up frequency of patients more scientifically. Consequently, it may provide the more efficient use of medical facility and healthcare system resources.

SUBJECTS AND METHODS

Two hundred forty-nine patients (out of 577 examined) with "COD for PSRIA" were included in this study. Firstly, patients with indeterminate, biochemical incomplete and structural incomplete responses were considered as the non-ER group and compared to the ER group. Secondly, patients with excellent, indeterminate, and biochemically incomplete responses were considered as the non-SIR group and compared to the SIR group. The data were evaluated by MedCalc Statistical Software version 18.9.

RESULTS

The cut-off value for ER patients was calculated as ≤6.57ng/mL. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 67.9%, 75.4%, 55.6% and 83.8%, respectively. The cut-off value for non-SIR patients was calculated as ≤12.7ng/mL. Sensitivity, specificity, PPV and NPV were 78.5%, 91.7%, 35.5% and 98.6%, respectively.

CONCLUSION

If a patient has ≤6.57ng/mL pre-ablative Tg, follow-up intervals of patients with "COD for PSRIA" may be extended due to lower recurrence/relapse rates. However, if a patient has >12.7ng/mL pre-ablative Tg, these patients should be followed-up more frequently in order to determine SIR earlier. This approach may enable more efficient use of medical facility and healthcare system resources and a more scientific planning of their follow-up treatment. This approach seems to have the potential to contribute significantly to cost-effectiveness.

Long-term in vivo comparison of histopathological effects of two barbed sutures and a conventional suture material in a rat model

BACKGROUND

Urological repairs require secure suturing for effective healing. While conventional sutures like Vicryl are common, barbed sutures offer knotless options. This study aims to compare the histopathological effects of barbed and conventional sutures on the bladder.

METHOD

Forty-eight adult Wistar female rats underwent bladder suturing with one of three suture materials: V-Loc™ 90, Quill™, or Vicryl. Each rat's anterior bladder wall was sutured with the designated material, and rats were sacrificed at 6- and 9-weeks post-surgery for histopathological evaluation. Tissue reaction, inflammatory reaction, fibrosis, and suture dissolution were assessed by a blinded pathologist.

RESULTS

Vicryl sutures showed significant reductions in tissue reaction, inflammatory reaction, and fibrosis from 6 to 9 weeks (p < 0.05). Quill sutures exhibited an increase in fibrosis over the same period (p < 0.001), while V-Loc sutures showed no significant changes. Comparative analysis revealed Vicryl had the best overall performance in terms of reduced tissue reaction and inflammation.

CONCLUSIONS

Vicryl sutures demonstrated superior long-term histopathological outcomes compared to barbed sutures, indicating their potential preference for reconstructive bladder surgeries. Our findings emphasize the necessity of conducting additional studies on different anatomical tissues as well as refining suture selection for various surgical situations.

Pyruvate kinase M2 (PKM-2) expression and prognostic significance in glioblastoma patients

PURPOSE

Pyruvate kinase M2 (PKM2) is a key enzyme that catalyzes the irreversible and final step of glycolysis. It is closely associated with cancer development and progression. The relationship between PKM2 and prognosis in glioblastoma (GB) patients is unknown. The aim of this study was to measure PKM2 expression and evaluate its effect on prognosis in GB patients.

METHODS

Patients who underwent radiotherapy (RT) for glioblastoma between 2010 and 2021 were evaluated immunohistochemically. A single pathologist evaluated pathology specimens of all patients. The intensity and extent of staining of tumor cells were scored. Patients were categorized as low and high PKM2.

RESULTS

A total of 119 patients were evaluated. While 80.7% of the cases had a low score, 19.3% had a high PKM2 score. It was observed that the group with high PKM2 expression had lower performance, received more hypofractionated RT and received adjuvant chemotherapy (CT) less frequently. Median overall survival (OS) was 15.77 months in the low PKM2 expression group and 6.50 months in the high PKM2 group. In univariate analyses, PKM2 expression, age, performance status, type of surgery, RT scheme, and concurrent and adjuvant CT were prognostic factors in predicting OS. In multivariate analyses, PKM2 expression, type of surgery, RT scheme and receiving adjuvant CT were prognostic factors for OS.

CONCLUSION

PKM2 is an independent prognostic factor for survival and is associated with poor prognosis in GBM patients treated with radiotherapy. It may be a potential therapeutic target for anticancer therapy.

Determination of the diagnostic accuracy of peritoneal biopsy with an 18G cutting needle under ultrasonography guidance and the contribution of CT findings to diagnosis before biopsy (our 8-year clinical experience)

AIM

Ultrasound-guided percutaneous core needle biopsy is an important technique in diagnosing mesenteric involvement. Diagnostic results were compared with pre-biopsy CT findings. The purpose of this study was to determine the diagnostic efficiency of omental lesion biopsies performed under ultrasound guidance and to investigate the relationship between pre-biopsy diagnostic CT findings.

MATERIALS AND METHODS

Demographic data of 70 patients who underwent omental biopsy under ultrasound guidance in our clinic between August 2015 and July 2023, the presence of a primary malignancy focus during the investigations conducted during the research, biopsy histopathology results, and pre-biopsy CT findings were retrospectively reviewed.

RESULTS

This retrospective study included who underwent omental biopsy under ultrasound guidance, 48 (69%) were female, and 22 (31%) were male, with an average age of 61 (age range 15-95), and an average body mass index [BMI] of 27.7 ± 6.9. Five (7%) of the 70 biopsy procedures were not pathologically diagnostic. Diagnostic results were compared with pre-biopsy CT findings. In all omental lesions, the percentage of omental infiltrative involvement in diagnostic CT was subjectively evaluated by two radiologists. 65 patients diagnosed pathologically, 47 (67%) were malignant, and 18 (26%) were benign. No complications occurred.

CONCLUSION

Peritoneal biopsies under ultrasound guidance for mesenteric diseases detected on CT are a reliable procedure that can be easily applied. Ultrasonography imaging helps identify appropriate locations for targeted biopsies before deep percutaneous biopsy, increasing diagnostic accuracy, especially when omental lesions appear as infiltrative thickenings.