The association of microRNAs in the development of retinopathy of prematurity

INTRODUCTION

Retinopathy of prematurity (ROP) is one of the main reasons of preventable childhood blindness. In the development of ROP, MicroRNAs may be effective in the balance of factors that inhibit and activate angiogenic factors. We aimed to determine the changes in the blood levels of miR-146a, miR-143, miR-210, miR-21, miR-126, miR-211, miR-221, miR-106 and let 7f and to investigate their association with ROP. We hypothesed that the level of these miRNAs changed significantly in ROP cases.

MATERIALS AND METHODS

This observational study was conducted prospectively in preterm infants with ROP. Serum levels of 8 miRNAs were measured. The relationship between disease stage and progression with miRNA gene expression was analysed. Preterm infants without ROP were taken as the control group.

RESULTS

47 patients with ROP and 14 controls, were included in the study. In the ROP group, miR-210, miR-146a, miR-21 were statistically significantly lower. In the ROP group the expression level of miR-143 was insignificantly lower, miRNA-221 was insignificantly higher, and miR-106, miR-126 and let 7f were variable.

CONCLUSION

It was observed that miR-210, miR-146a, miR-21 and miR-143 were significantly lower in patients with ROP compared to the control group. However, no association could be established between the type of miRNA and stage of ROP. These miRNAs may be used as adjunctive biomarkers for diagnosis of ROP.

Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3-4, Grade C periodontitis patients: a split-mouth, randomized control study

AIM

To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system.

MATERIALS AND METHODS

Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA.

RESULTS

Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05).

CONCLUSION

Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels.

CLINICAL RELEVANCE

LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.

The effect of alpha-lipoic acid on oxidative parameters, SCUBE-1 and SCUBE-2 in hepatic ischemia-reperfusion injury in cholestatic rats

OBJECTIVE

The aim of the study was to evaluate the protective effects of alpha-lipoic acid (ALA) on the liver, oxidative parameters, and signal peptide-CUB-epidermal growth factor-like domain-containing proteins 1 and 2 (SCUBE-1 and -2) in an experimental cholestatic hepatic ischemia-reperfusion (IR) model.

MATERIALS AND METHODS

Twenty-four female rats were included in the study and divided into four groups of six rats each. Group 1 was the control group, in which only laparotomy was performed; Group 2 underwent laparotomy and received alpha-lipoic acid (ALA) on a daily basis; bile duct ligation was performed in Group 3; bile duct ligation was performed, and ALA was administered to Group 4. All rats underwent relaparotomy on the seventh day, followed by 30 minutes of hepatic ischemia and 60 minutes of reperfusion in Groups 3 and 4. Liver tissue and blood samples were taken for histopathological and biochemical examinations. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), albumin, ischemia modified albumin (IMA), SCUBE-1, SCUBE-2, total antioxidant status (TAS) and total oxidant status (TOS) levels were also examined.

RESULTS

The SCUBE-1 and SCUBE-2 values in Group 4 were lower than in Group 3, but no significant difference was observed between all the groups. The AST, TBIL, and DBIL levels were significantly higher in Groups 3 and 4 than in Groups 1 and 2 (p<0.0001). Although TOS was the highest in Group 3, the measurements were similar across the groups (p=0.464). IMA and TAS were similar between Groups 3 and 4 but significantly higher in these groups than in Groups 1 and 2 (p=0.001). The hepatic injury observed in Groups 3 and 4 was significantly higher than that observed in Groups 1 and 2 (p<0.0001). In the histopathological examination, neutrophilic infiltration and bile duct proliferation were less commonly detected in the portal areas in Group 4 than in Group 3, and necrotic foci were not observed due to the administration of ALA.

CONCLUSIONS

The promising effects of ALA, known for its powerful antioxidant properties, on the IR injury of the liver can allow it to enter clinical practice in the future.

Comparison of COVID-19 patients who underwent thrombectomy with those in the pre-pandemic period in terms of etiology and prognosis

OBJECTIVE

We aimed at determining the effectiveness of mechanical thrombectomy (MT) in patients with major vessel occlusion and infected with COVID-19, evaluating its clinical outcome and comparing it with non-COVID patients.

PATIENTS AND METHODS

During the pandemic, 729 patients who underwent MT in stroke centers due to Acute Ischemic Stroke (AIS) with large vessel occlusion were evaluated. This study included 40 patients with a confirmed COVID-19 diagnosis by a positive PCR test between March 11, 2020, and December 31, 2020. These patients were compared to 409 patients who underwent MT due to major vessel occlusion between March 11, 2019, and December 31, 2019.

RESULTS

Of the patients with AIS who are infected with COVID-19, 62.5% were males, and all patients have a median age of 63.5 ± 14.4 years. The median NIHSS score of the COVID-19 group was significantly higher than that of the non-COVID-19 groups. Dissection was significantly more in the COVID-19 group. The mortality rates at 3 months were higher in the COVID-19 groups compared to non-COVID-19 groups.

CONCLUSIONS

This study revealed an increased frequency of dissection in patients with COVID-19. COVID-19-related ischemic strokes are associated with worse functional outcomes and higher mortality rates than non-COVID-19 ischemic strokes.

Clinical characteristics and myocardial function assessed by traditional and novel echocardiographic methods in competitive triathletes with and without myocardial fibrosis

Background

The aim of the present study was to compare clinical characteristics and cardiac structure and function in competitive triathletes with and without myocardial fibrosis.

Methods

Cardiac fibrosis in 61 healthy male competitive triathletes (&gt;10 hrs of training per week, age 45±10 yrs) was quantified using LGE-sequences in CMR (1.5 tesla scanner).

Transthoracic echocardiography, physical examination, past medical history and routine lab diagnosis for exclusion of other conditions were performed.

Baseline characteristics like blood pressure at rest (BP), bodymass-index (BMI), and systolic and diastolic echocardiographic parameters (left atrial volume index (LAVI), e', E, A, right ventricular pressure gradient) as well as global longitudinal strain, were analysed by two independent observers blinded to the CMR measurements. Triathletes were sub-divided into LGE-positives (LGE+) vs. LGE-negatives (LGE-).

Results

All individuals appeared healthy with no drug history. Focal non-ischaemic LGE was detected in 19 triathletes. Compared to LGE-negative triathletes, LGE-positives showed significantly higher systolic BP (142 vs. 128 mmHg, p=0.004). Logistic regression showed, that per 10 mmHg enhanced blood pressure the chance for LGE rises by 89%. Triathletes with and without LGE demonstrated no difference in conventional echocardiographic measurements such as left ventricular ejection fraction and volumes and no difference in diastolic parameters. But the presence of MF did mediate global longitudinal strain (GLS).

Global longitudinal strain was significantly reduced in LGE positive athletes (LGE+: −19.8±3.4; LGE-: −21.7±2.4, p=0.04)

Conclusions

Reduced global longitudinal strain mediated as an early echocardiographic marker for subclinical changes in asymptomatic competitive triathletes with myocardial fibrosis compared to triathletes without LGE. Novel echocardiographic parameter such as longitudinal strain might serve as an easy tool to identify high endurance athletes at higher risk for cardiovascular events and that individuals with enhanced blood pressure should undergo cardiac consultation before starting endurance-training in competitive disciplines.

Funding Acknowledgement

Type of funding source: None

An approach to evaluating the potential teratogenic and neurotoxic mechanism of BHA based on apoptosis induced by oxidative stress in zebrafish embryo (Danio rerio)

Butylated hydroxyanisole (BHA) has been widely used in the cosmetics, pharmaceutical, and food industries due to its antioxidant activity. Despite the antioxidant effects, reported adverse effects of BHA at the cellular level have made its use controversial. In this regard, this study was performed to elucidate the potential toxicity mechanism caused by BHA at the molecular level in zebrafish embryos. For this purpose, zebrafish embryos were exposed to BHA at levels of 0.5, 1, 5, 7.5 and 10 ppm and monitored at 24, 48, 72 and 96 hours. Survival rate, hatching rate and malformations were evaluated. We examined the potential for reactive oxygen species (ROS) production and apoptosis signalling accumulation in the whole body. Moreover, we evaluated histopathological and immunohistochemical (8-OHDG) characterization of the brain in zebrafish embryos at the 96th hour. We also examined apoptosis, histopathological and immunohistochemical (8-OHDG) characteristics in 96 hpf zebrafish larvae exposed to tertiary butylhydroquinone (TBHQ), one of the major metabolites of BHA, at doses of 0.5, 2.5, 3.75 and 5 ppm. Consequently, it has been considered that increased embryonic and larval malformations in this study may have been caused by ROS-induced apoptosis. After 96 h of exposure, positive 8-OHdG immunofluorescence, degenerative changes, and necrosis were observed in the brain of BHA and TBHQ-treated zebrafish larvae in a dose-dependent manner. BHA and TBHQ exposure could lead to an increase in 8-OHdG activities by resulting oxidative DNA damage. In particular, the obtained data indicate that the induction of ROS formation, occurring during exposure to BHA and/or multiple hydroxyl groups, could be responsible for apoptosis.

Effects of different pediatric drugs and toothbrushing on color change of restorative materials used in pediatric dentistry

Objective

The purpose of this study was to evaluate the effects of different pediatric drugs and toothbrushing on color changes of restorative materials used in pediatric dentistry.

Materials and Methods

Sixty specimens were prepared from each of three restorative materials (compomer [Dyract XP], glass hybrid [Equia Forte], and glass carbomer [GCP Glass Fill]). Specimens were divided into six solution groups (n = 10) and immersed in five different pediatric drugs (antibiotic, analgesic, common cold syrup, cough syrup, and an iron and vitamin formula) and distilled water. Two subgroups (brushed and unbrushed) were established for each group (n = 5). Specimens were agitated for 1 min every 8 h over 2 weeks. Color changes [CIEDE2000 (ΔE₀₀)] were calculated at baseline, 7, and 14 days. Data were subjected to 4-factor mixed-design ANOVA using a general linear model procedure for repeated measurements.

Results

After 14 days, the highest ΔE₀₀was found in the compomer/non-brushing group immersed in iron and vitamin formula (5.6 ± 0.27), and the lowest was in glass hybrid/brushing group immersed in distilled water (0.59 ± 0.8) pairwise. ΔE₀₀values were significantly greater for compomer than for glass hybrid or glass carbomer (P < 0.05). There were statistically significant differences between the brushing and non-brushing groups for all tested solutions on the compomer specimens (except antibiotic) and glass hybrid specimens (except antibiotic and cough syrup). The Δ₀₀ values in brushing groups were significantly lower statistically than in non-brushing groups (P < 0.05).

Conclusions

Toothbrushing dramatically affected the color stability of the aesthetic restorative materials. The content of pediatric drugs is also an important factor for color change. Glass hybrids and glass carbomers used with their surface sealants appeared to be more resistant to staining from pediatric drug formulations than compomers.

FRI0455 IS THERE AN INCREASE IN THE FREQUENCY OF INFLAMMATORY DISEASES IN THE FAMILIES OF PATIENTS WITH FMF?

Background:

Familial Mediterranean Fever (FMF) is the most common periodic fever syndrome in childhood with an autosomal recessive inheritance pattern and is characterized by unprovoked fever attacks, serositis episodes. The causative gene of the disease is MEFV that encodes pyrin protein. The pyrin protein takes a role in pathways related to inflammation, and mutations of it lead to increased inflammation. It is already shown that frequencies of some certain diseases like PAN, HSP increase in patients with FMF. Nevertheless, frequencies of inflammatory diseases in families of patient with FMF haven’t been investigated.

Objectives:

In this study, we have aimed to evaluate the comorbid disorders in a large cohort of families of patients with FMF.

Methods:

Four hundred and ninety-eight children with FMF, one hundred and forty patients with JIA and ninety-two healthy children were interviewed between December 2019 and January 2020. In JIA group and healthy control group, patients who have family history for FMF were excluded from the study. Patients were asked about characteristics of their disease attacks and if there is a relative with any inflammatory diseases who does not have FMF in patient’s 1stand 2th degree relatives.

Results:

Demographic features of study group have shown in Table 1. The most common MEFV mutations in patients with FMF were: M694V homozygotes (13.2 %), M694V heterozygotes (12 %), M694V homozygotes and R202Q homozygotes (6,8 %). Type II diabetes, asthma and hypothyroidism were the most commonly detected diseases in all cohorts. Frequency of Behçet’s disease, allergic rhinitis and type II diabetes were significantly higher in families of patients with FMF than other groups (p<0.05) (Table 2).

Table 1.

Demographic features of study population.

FMF†JIA††Healthy Controln: 498 (%)mean +/- SDn: 140 (%)mean +/- SDn: 92 (%)mean +/- SDFemale284 (57)91 (65)55 (59.8)Age (years)12.9 ± 8.211.7 ± 5.17.4 ± 4.6Age at Onset (years)4.3 ± 3.35.4 ± 4.1-Age at Diagnosis (years)6.3 ± 3.66.3 ± 4.5-Delay in Diagnosis (months)23.8 ± 29.211.3 ± 28.2-Follow-up Duration (years)6.9 ± 8.35.3 ± 4.0-Consanguinity100 (20)25 (17.8)8 (8.6)Family History of FMF282 (56.6)0 (0)0 (0)JIA subgroup-- Oligoarticular72 (51.4) Polyarticular (RF negative)16 (11.4) Polyarticular (RF positive)3 (2.1) Enthesitis Related Arthritis14 (10) Psoriatic Arthritis7 (5) Systemic23 (16.4) Other5 (3.5)Clinical Findings-- Fever392 (78.1) Abdominal Pain429 (86.1) Chest Pain102 (20.5) Arthralgia334 (67.1) Arthritis157 (31.5) Extremity Pain64 (12.8) Heel Pain44 (8.8) Myalgia43 (8.6) *ELE13(2.6) Serositis10 (2)

†Familial Mediterranean Fever††Juvenile Idiopathic Arthritis*Erysipelas like erythema

Table 2.

Comparison of frequencies of diseases detected among families of patient groups (shortened).

DiseasesFMFJIAHealthy Controlp1Type II Diabetes284 (57)64(45.7)44 (47.8)0.02Asthma139 (27.9)30 (21.4)20 (21.7)0.19Hypothyroidism122 (24.4)27 (19.2)14 (15.2)0.09Eczema68 (13.6)14 (10)5 (5.4)0.06Psoriasis49 (9.8)6 (4.2)7 (7.6)0.10Allergic Rhinitis49 (9.8)3 (2.1)1 (1)0.001Hyperthyroidism40 (8)9 (6.4)3 (3.2)0.24Behçet’s Disease31 (6.2)1 (1)2 (2.1)0.01Rheumatic Fever30 (6)10 (7.1)2 (2.1)0.25

Conclusion:

In this study, we have reported increased frequencies of Behçet’s disease, allergic rhinitis and type II diabetes in families of patients with FMF. Our results suggest that possible increased mutation load among families of patients with FMF may cause increased inflammatory diseases.

References:

[1]Yildiz M, Adrovic A, Tasdemir E, et al. Evaluation of co-existing diseases in children with familial Mediterranean fever.Rheumatol Int. 2020;40(1):57–64. doi:10.1007/s00296-019-04391-9

Disclosure of Interests:

None declared

PROTECTIVE EFFECT OF NIGELLA SATIVA OIL ON MYOCARDIUM IN STREPTOZOTOCIN-INDUCED DIABETIC RATS

Background

To evaluate the protective effect of Nigella sativa oil (NSO) on the myocardium in streptozotocin-induced diabetic rats.

Materials and methods

Thirty-two 7-8-week-old female Wistar albino rats (300-350 g) were equally divided into 4 groups: nondiabetic untreated animals (control), diabetes mellitus (DM), NSO, and DM+NSO groups. For the induction of diabetes, 45 mg/kg streptozotocin was applied to the rats in the DM and DM+NSO groups as a single intraperitoneal dose. NSO (400 mg/kg) was orally administered through an intragastric catheter once a day over 21 days. Formalin-fixed, paraffin-embedded tissue sections of the myocardium were evaluated histopathologically and immunohistochemically.

Results

Compared to the control, NSO, and DM+NSO groups, the myocardial tissue samples from the rats in the DM group had significantly higher myositis, hyaline degeneration, and Zenker's necrosis. Moreover, the Bcl-2 expressions were significantly higher in the control, NSO, and DM+NSO groups than in the DM group.

Conclusion

NSO has a protective effect on the myocardium of streptozotocin-induced diabetic rats, most likely via suppressing apoptosis.

Osteoblastoma originating from frontoethmoidal sinus causing personality disorders and superior gaze palsy

Osteoblastoma is a rare, solitary benign tumor that is usually situated in axial skeleton mainly in vertebra. It is rarely seen in ethmoid and frontal sinuses. A 40-year-old man who had osteoblastoma originated from frontal and ethmoidal sinuses that extends up to frontal lobe and gave rise to personality disorders by compressing the frontal lobe, and caused superior gaze palsy by compressing the superior rectus muscle. We present this rare case with clinical, radiological and histopathological findings.

Effect of pomegranate (Punica granatum L.) juice on kidney, liver, heart and testis histopathological changes, and the tissues lipid peroxidation and antioxidant status in lead acetate-treated rats

Pomegranate juice (PJ) contains relevant amounts of active biological compounds which alleviate the detrimental effects of chronic heavy metal exposure. This study investigated the protective potential of PJ against lead-induced oxidative stress. A total of forty adult male Sprague Dawley rats were divided into four experimental groups. The animals were fed a standard pellet diet and tap water ad libitum. The rats were divided into four groups (n=10 for each group): control, lead asetat (2000 ppm), low-treated PJ- a daily dose of 2.000 ppm lead plus 30µl pomegranate juice (included 1.050 µmol total polyphenols, gallic acid equivalent), and high-treated PJ- a daily dose of 2.000 ppm lead plus 60µl pomegranate juice (included 2.100 µmol total polyphenols, gallic acid equivalent). The treatments were delivered for 5 weeks. After the treatment period, the tissues samples (kidney, liver, heart and testis) were collected. Tissue lead (Pb) and mineral amounts (copper, zinc, and iron), tissues lipid peroxidation level and antioxidant status, and tissues histopathological changes were determined. The results showed that the highest rate lead loading was in the kidney and the testis. Pomegranate juice was decreased the lead levels of soft tissues examined; increased Zn amounts in tissues of which the lead accumulation was higher (kidney and the testis); decreased the copper, zinc and the iron levels of the liver and heart tissues, without creating a weakness in antioxidant capacity of these tissues, restricted the oxidative stress by decreasing lipid peroxidation, improved both of the activities of antioxidant enzymes such as superoxide dismutase (SOD) and catalaz (CAT), and the level of glutathione (GSH) in all the tissues examined in lead-treated groups. As histopathological findings, the cellular damage induced by lead in the tissues of the kidney, liver and the heart were observed to have been partially prevented by PJ treatment. The protective effect of PJ was more pronounced in the testis compared to those others.

Comparison of predictive factors for the diagnosis and clinical course of phyllodes tumours of the breast

BACKGROUND

To compare predicting factors for the diagnosis and clinical course of benign and malign/ borderline phyllodes tumours (PT) of the breast, and to discuss treatment modalities.

METHODS

Clinical and demographic characteristics of the patients with histopathological diagnosis of phyllodes tumour were examined. Patients were divided into group 1 (benign PT) and group 2 (borderline/malignant PT). Groups were compared in terms of demographic and clinical characteristics.

RESULTS

Of the patients studied, 37 (68.5%) had benign, 7 (12.9%) had borderline and 10 (18.5) had malignant histopathology. A statistically significant relationship was detected between the incidence of malignancy and mass diameter (p = 0.001) and age (p = 0.030) when the two groups were compared. Wide surgical excision was performed on 46 (82.5%) patients, simple mastectomy on 7 (13%) patients and modified radical mastectomy on one (1.9%) patient. Ten (18.5%) patients were re-operated for surgical margin positivity. Local recurrence was determined only in one (1.9%) patient. Distant metastasis due to malignant PT developed in two (3.7%) patients.

CONCLUSIONS

Among the patients who were considered to have PT, malignancy was likely to be present, especially if the patient's age was over 40 and the diameter of the mass was above 33.5 mm. Therefore, in patients with similar characteristics, surgical margins should be kept slightly wider or wider excisions should be preferred with or without simultaneous reconstructive surgery in appropriate cases.

Comparison of Predictive Factors For the Diagnosis and Clinical Course of Phyllodes Tumours of the Breast

BACKGROUND

To compare predicting factors for the diagnosis and clinical course of benign and malign/borderline phyllodes tumours (PT) of the breast, and to discuss treatment modalities.

METHODS

Clinical and demographic characteristics of the patients with histopathological diagnosis of phyllodes tumour were examined. Patients were divided into group 1 (benign PT) and group 2 (borderline/malignant PT). Groups were compared in terms of demographic and clinical characteristics.

RESULTS

Of the patients studied, 37 (68.5%) had benign, 7 (12.9%) had borderline and 10 (18.5) had malignant histopa-thology. A statistically significant relationship was detected between the incidence of malignancy and mass diameter (p = 0.001) and age (p = 0.030) when the two groups were compared. Wide surgical excision was performed on 46 (82.5%) patients, simple mastectomy on 7 (13%) patients and modified radical mastectomy on one (1.9%) patient. Ten (18.5%) patients were re-operated for surgical margin positivity. Local recurrence was determined only in one (1.9%) patient. Distant metastasis due to malignant PT developed in two (3.7%) patients.

CONCLUSION

Among the patients who were considered to have PT, malignancy was likely to be present, especially if the patient's age was over 40 and the diameter of the mass was above 33.5 mm. Therefore, in patients with similar characteristics, surgical margins should be kept slightly wider or wider excisions should be preferred with or without simultaneous reconstructive surgery in appropriate cases.

In vitro motility changes in Roux limb after Roux-en-Y reconstruction

BACKGROUND

The aim of this study is to compare the motility of Roux limb with that of normal segment.

MATERIALS AND METHODS

Rats were divided into 3 equal groups as control, Roux-en-Y (Group A) and Roux-en-Y with vagotomy (Group B). Only midline incision and manipulations were applied in control group. Following distal gastrectomy, Roux-en-Y reconstruction was applied in Group A, while vagotomy Roux-en-Y gastrojejunostomy was applied in Group B. Rats were sacrificed 1 month later by cervical dislocations under anesthesia. The obtained jejunal segments were cut into four equal parts. The bath was 37 °C warm while 95 % O2 and 5 % CO2 gases were supplied in 10 ml bicarbonate Krebs' solution.

RESULTS

KCl responses were similar in all three groups. Acetylcholine contraction responses in the vagotomy and non-vagotomy Roux-en-Y groups was higher than in those in control group significantly (p < 0.05). This response in vagotomy Roux-en-Y group was also higher than that in non-vagotomy group (p < 0.05). The induced electrical field stimulation contraction response in the vagotomy + Roux-en-Y group was lower than those in control group and non-vagotomy group (p < 0.05).

CONCLUSIONS

These results show that muscarinic receptor density and/or function may increase after vagotomy and non-vagotomy group operation, and vagotomy may contribute to this increase. The decrease in electrical signal response in vagotomy Roux-en-Y group may depend on the decrease in acetylcholine oscillation from the cholinergic nerve ending (Tab. 1, Fig. 5, Ref. 25).

Dabigatran Versus Warfarin in Atrial Fibrillation

Safety issues have been raised about dabigatran. We aimed to investigate the occurrence of safety outcomes in patients who had atrial fibrillation and a risk of stroke. We analyzed 439 patients prescribed dabigatran (n = 220) or warfarin (n = 219). Ischemic stroke occurred in 15 (6.8%) patients in the warfarin group versus 5 (5.2%) patients in the 110-mg group versus 1 (0.8%) patient in the 150-mg dabigatran group ( P = .015). Intracranial hemorrhage occurred in 6 (2.7%) patients in the warfarin group versus 3 (2.4%) patients in the 150-mg dabigatran group ( P = .104). Death from any cause occurred in 10 (4.6%) patients in the warfarin group versus 1 (1.0%) patient in the 110-mg dabigatran group ( P = .005). Dabigatran was associated with less ischemic stroke and death from any cause than warfarin. Dabigatran may be a better option for stroke prophylaxis, where recommended monitoring with warfarin is suboptimal.

Diagnostic Value of 25-Hydroxyvitamin D Level and New Cytokines in Neonatal Sepsis

The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D level, Upar, IL-33 and ST2 in comparison with C-reactive protein, TNF-α and Interleukin-6 in neonatal sepsis. A total of 106 term babies were included 20 of whom were the control group. We used only data of high probable sepsis with blood culture positive infants, therefore 46 infants were excluded. Blood was collected from infants from the first day of sepsis (1.value) and 48–72 hours later (2.value). There were significant differences between the controls and sepsis (1.value) for 25-hydroxyvitamin D levels (35±19ng/ml and 69±7.5ng/ml, p=0.01), for IL-33 levels (90±34 ng/ml and 412±170 ng/ml, p=0.01), for sST2 levels (453±44 ng/ml and 4120±2720ng/ml, p=0.01), for sUpar levels (2.1±1.3 ng/ml and 11.4 ± 5.2 ng/ml, p=0.01), respectively. There were significant differences between sepsis (1.value) and sepsis (2.value.) with reference to 25-hydroxyvitamin D, IL-33, sST2, and suPAR levels, respectively. In the light of these results, it may be suggested that 25-hydroxyvitamin D level, upar, IL-33 and ST2 can be used as an acute phase reactant like C-reactive protein, TNF-α and Interleukin-6 in diagnosis of neonatal sepsis.

Adiponectin and visfatin levels in extremely low birth weight infants; they are also at risk for insulin resistance

AIM

The aim of this study was to assess adiponectin, visfatin, HOMA-IR, glucose and triglyceride levels in term, preterm and extremely low birth weight (ELBW) babies. Each of these three groups was subdivided into two groups as small-for-gestational age (SGA), and appropriate-for-gestational age (AGA). 30 term, 30 preterm and 30 extremely low birth weight infants were included into the study.

RESULTS

There was no significant difference in term and preterm infants for serum adiponectin, visfatin, and HOMA-IR levels. There were also no significant differences between term and preterm infants for glucose and triglycerides. The serum visfatin, insulin and HOMA-IR levels (p = 0.001, p = 0.001 and p < 0.05, respectively) were higher in ELBW group than preterm group. Comparing the subgroups as SGA and AGA in all main groups, only in ELBW group there were no significant differences in serum adiponectin, visfatin, HOMA-IR and insulin levels.

CONCLUSIONS

We suggest that visfatin can be used as an early indicator of insulin resistance. Independent of being SGA, ELBW itself may be a risk factor for insulin resistance. In the follow-up of these babies the risk of obesity, metabolic syndrome and cardiovascular diseases may be increased as in SGA babies.  

Nursing academicians' attitudes towards work life and their personality traits

The purpose of this study was to determine the relationship between attitudes of nursing academicians towards job and organization and their personality traits. The research included 287 nursing academicians who worked in 14 School of Nurses in the Universities of Turkey. A descriptive information form, Job and Organization Related Attitude Scale and Temperament and Character Inventory were used as data collection tools. It has been determined that attitudes of nursing academicians towards job and organization and their personality traits depended upon socio-economic status, working year, academic title, the temperament feature of novelty seeking and persistence, and the character feature of self-directedness and cooperativeness.

Cu/Zn-superoxide dismutase, paraoxonase and arylesterase activities and malondialdehyde levels in patients with familial mediterranean fever

OBJECTIVES

In this study, alterations in antioxidant enzyme activities and malondialdehyde (MDA) levels in the serum samples of patients with familial Mediterranean fever (FMF), an autosomal recessive disease characterized by recurrent episodes of peritonitis, pleuritis, arthritis and fever, were investigated and compared with those of age- and sex-matched healthy controls.

METHODS

Twenty-five patients with FMF undergoing colchicine therapy at doses of 1-1.5 mg and 25 age- and sex-matched healthy controls were included in the study. In the patients with FMF and control subjects, the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were measured. Cu/Zn-superoxide dismutase (Cu/Zn-SOD), paraoxonase-1 (PON-1) and arylesterase (ARE) enzyme activities and MDA levels as a production of lipid peroxidation were evaluated using the appropriate methods.

RESULTS

No statistically significant differences in the serum levels of ESR, CRP, Cu/Zn-SOD, MDA and PON-1 between the groups were observed (p>0.05). Serum ARE activity was significantly decreased in the patients with FMF compared with the control subjects (p<0.01).

CONCLUSION

In conclusion, some abnormalities in the antioxidant defense system and lipid peroxidation may be observed in FMF patients during attack-free periods. However, further long-term studies on the subject are needed to explore altered lipid peroxidation and antioxidant defense mechanisms in patients with FMF (Tab. 1, Fig. 1, Ref. 35).

Comparison of the oxidant-antioxidant parameters and sialic acid levels in renal transplant patients and peritoneal dialysis patients

OBJECTIVE

Several studies have shown that in end-stage renal failure, increased oxidative stress and reduced antioxidant system functions may play an important role in inflammation, atherosclerosis, and many other complications. Paraoxonase (PON) and arylesterase (ARE) are antioxidant and malondialdehyde (MDA) an oxidant agent. Increased sialic acid (SyA) levels in uremic patients is an acute-phase response showing tissue and organ damage. The aim of this study was to compare PON, ARE, MDA, and SyA among continuous ambulatory peritoneal dialysis (CAPD) and renal transplant patients.

METHODS

Twenty-six CAPD patients including 7 women and 19 men of overall mean age 40.5 ± 10.66 years were included in this study. There were 28 preemptive transplant patients, namely 6 women and 22 men of overall mean age 36.5 ± 10.97 years. CAPD was the initial sole replacement therapy. Serum PON, ATE, MDA, and SyA levels were measured at 13-15 months of treatment.

RESULTS

Higher PON (P = .015) and ARE (P = .002) and lower MDA (P = .002) and SyA (P = .000) values were determined among transplanted compared with CAPD patients.

CONCLUSIONS

In the transplant group, antioxidant parameters were higher and oxidant parameters lower with less activation of SyA than in the CAPD group. We observed that renal transplantation had a constructive effect on the oxidant-antioxidant system and consequent tissue destruction, which were impaired in uremic subjects. This study showed that renal transplantation is a more appropriate replacement treatment than CAPD.

Stereological and histological analysis of the developing rat heart

We studied with quantitative and microscopical methods the heart of rats divided into five age groups: embryos at the age of 11 days, fetuses at the age of 16 days and 20 days and also heart samples of 3-day-old pups and young adults (5 weeks of age) were used (n = 10 samples in each group). At the end of the study; heart samples were obtained from all animals. Stereological estimations were performed on heart volume, volume of heart lumen (ventricles and atria), volume of myocardium, numerical density of the myocyte nuclei and mean nuclear diameter of myocytes. Volumetric values and numerical data were estimated via Cavalieri method and physical dissector, respectively. In this study, histological examination was performed at light and electron microscopic levels. The numerical density of the myocyte nuclei increased from fetuses to young adults. Differences between embryos and fetuses, between fetuses and 3-day-old pups, and between 3-day-old pups and young adults were statistically significant. These results indicate that myogenesis continued in the rat myocardium during prenatal life and after birth.

Emergent surgical treatment of radiation-induced enteropathies for patients with urogynecological and colorectal carcinomas

AIM

The aim of this study is to describe our 10-year experience in patients with urogynecological and colorectal carcinomas with radiation enteropathy treated surgically as an emergency, and to reassess symptoms and mortality.

PATIENTS AND METHODS

The study included 17 patients receiving emergency surgery for complications of radiotherapy. Data about the patients and outcomes of the treatment alternatives used were retrospectively analyzed.

RESULTS

Of 17 patients, nine had colorectal cancer, six had gynecological cancer, and two had cancer of the urinary system. As an emergency, 12 patients had ileus only, one patient had intestinal fistulae and ileus, two patients had bleeding and ileus and two patients had perforation on admission. Seven patients underwent resection and anastomosis, two patients intestinal by-pass, four patients resection and ostomy and four patients bridectomy. Morbidity (75% for early complications and 100% for late complications) and mortality in the early postoperative period (25%) were higher in the patients undergoing bridectomy than in the patients undergoing other surgical methods. The rate of early and late complications (71.4% and 66.6%, respectively) was lower in the patients undergoing resection-anastomosis with a higher of quality life. Only 11 patients survived during a long follow-up period (64.7%).

CONCLUSION

As the postoperative complication rate, overall and operative mortality of patients treated for radiation enteropaties as emergent surgery are high, specialists following this group of patients may favor removal of the pathologic tissue to avoid complications in the early and late postoperative period.

Actin complexes in the cell nucleus: new stones in an old field

Actin is a well-known protein that has shown a myriad of activities in the cytoplasm. However, recent findings of actin involvement in nuclear processes are overwhelming. Actin complexes in the nucleus range from very dynamic chromatin-remodeling complexes to structural elements of the matrix with single partners known as actin-binding proteins (ABPs). This review summarizes the recent findings of actin-containing complexes in the nucleus. Particular attention is given to key processes like chromatin remodeling, transcription, DNA replication, nucleocytoplasmic transport and to actin roles in nuclear architecture. Understanding the mechanisms involving ABPs will definitely lead us to the principles of the regulation of gene expression performed via concerting nuclear and cytoplasmic processes.

Diagnosis and treatment of mesenteric tumours

PURPOSE

To reveal clinical and diagnostic findings in patients with mesenteric tumours and to give an insight into the follow-up of these patients.

BACKGROUND

Primary tumours of the mesentery are very infrequent. These tumours are cystic or solid and show benign or malignant clinical behaviour. In this article, we report clinical and radiological findings from eight cases of mesenteric tumours.

PATIENTS AND METHODS

This study included eight patients with mesenteric tumours who underwent computed tomography in the Department of General Surgery, Baskent University, between December 2003 and April 2007.

RESULTS

Three mesenteric tumours were solid and five had cystic patterns. Seven were excised totally on laparotomy and one was excised on laparoscopy. None of the patients showed malignant progression. CT showed mesenteric cysts in only two cases, but failed to show solid tumours: the pre-operative diagnosis was made accurately in just (2/8) 25% of the patients.

CONCLUSIONS

It can be concluded that pre-operative CT is generally helpful, but inconclusive in an accurate diagnosis of mesenteric tumours. Surgery is required to make a definitive diagnosis of mesenteric tumours and to avoid complications.

A multicenter survey of childhood asthma in Turkey. II: Utilization of asthma drugs, control levels and their determinants

Many surveys worldwide have consistently demonstrated a low level of asthma control and under-utilization of preventive asthma drugs. However, these studies have been frequently criticized for using population-based samples, which include many patients with no or irregular follow-ups. Our aim, in this study, was to define the extent of asthma drug utilization, control levels, and their determinants among children with asthma attending to pediatric asthma centers in Turkey. Asthmatic children (age range: 6-18 yr) with at least 1-yr follow-up seen at 12 asthma outpatient clinics during a 1-month period with scheduled or unscheduled visits were included and were surveyed with a questionnaire-guided interview. Files from the previous year were evaluated retrospectively to document control levels and their determinants. From 618 children allocated, most were mild asthmatics (85.6%). Almost 30% and 15% of children reported current use of emergency service and hospitalization, respectively; and 51.4% and 53.1% of children with persistent and intermittent disease, respectively, were on daily preventive therapy, including inhaled corticosteroids. Disease severity [odds ratio: 12.6 (95% confidence intervals: 5.3-29.8)], hospitalization within the last year [3.4 (1.4-8.2)], no use of inhaled steroids [2.9 (1.1- 7.3)], and female gender [2.3 (1.1-5.4)] were major predictors of poor asthma control as defined by their physicians. In this national pediatric asthma study, we found a low level of disease control and discrepancies between preventive drug usage and disease severity, which shows that the expectations of guidelines have not been met even in facilitated centers, thus indicating the need to revise the severity-based approach of asthma guidelines. Efforts to implement the control-based approach of new guidelines (Global Initiative for Asthma 2006) would be worthwhile.

Effect of nitric oxide/cyclic guanosine mono-phosphate pathway on gallbladder relaxant response in bile duct-ligated guinea pigs

BACKGROUND/AIMS

Common bile duct ligation (CBDL) in the guinea pig is a well-defined model of acalculous cholecystitis. Nitric oxide (NO) mediates smooth muscle relaxation by stimulating the activity of soluble guanylate cyclase. The aim of this study was to determine whether the NO/cyclic guanosine monophosphate pathway plays a role in gallbladder relaxant response after CBDL.

METHODS

Relaxant response of gallbladder muscle strips from CBDL and sham-operated guinea pigs was studied in vitro. Animals were treated with saline, aminoguanidine or an aminoguanidine + L-arginine combination in vivo. Concentration-response curves of papaverine, diethylamine/NO, YC-1, sildenafil and amrinone were obtained and relaxations in each group were calculated as the percent of the contractions induced by carbachol (10(-6) M).

RESULTS

There was a significant decrease in the gallbladder muscle relaxant responses to these substances in CBDL and aminoguanidine groups compared with sham surgical controls. The decreased relaxant response was reversed by aminoguanidine + L-arginine but not by aminoguanidine alone.

CONCLUSION

Decreased relaxant responses might be due to the reduced guanylate cyclase enzyme activity, but further studies are required.

Asymmetries in breast cancer lateralization and both axillary lymph node number and metastatic involvement

Previous studies have demonstrated right or left lateralization of some paired organ cancers and left-sided asymmetry of different lymph nodes. We investigated left-right asymmetry lateralization of breast cancer and distribution of involved/ non-involved axillary lymph nodes following metastatic invasion in patients with breast cancer. One hundred and sixty five women who underwent axillary lymphadenectomy during the study period were included. Right or left axillary nodal regions were removed and sent for pathologic examination. Lymph nodes were palpatorily identified, isolated from fat tissue, counted and macroscopically examined. Pathological examination was performed on formalin fixed specimens. We found left-sided lateralization for breast cancer in this study group. Both total number as well as the number of axillary lymph nodes involved by metastatic breast cancer cells were higher on right side in patients with breast cancer on the right side. Although the mechanism is not known, and further investigation is needed, this phenomenon may be the result of stronger cell-mediated immune activity in the left sides of humans.

Effect of hypothyroidism on the purinergic responses of corpus cavernosal smooth muscle in rabbits

AIMS

Several studies have reported evidence of hormonal abnormalities in 25-35% of impotent men. Hypothyroidism has been reported to occur in 6% of impotent men. In the present study, we examined purinergic relaxation responses in hypothyroidism in an experimental rabbit model and compared them with controls to evaluate the possible involvement of the purinergic pathway.

MATERIALS AND METHODS

The study comprised 20 male New Zealand white rabbits. The rabbits were divided into two equal groups. We tested the effects of ATP, alpha beta ATP, and adenosine precontracted with phenylephrine on the isolated corpus cavernosum preparations from control and hypothyroid rabbits. We also evaluated the effects of ATP, alpha beta ATP, and adenosine on the cGMP levels in the isolated corpus cavernosum preparations from control and hypothyroid rabbits.

RESULTS

T3, T4, and testosterone levels were significantly lower in hypothyroid rabbits. ATP, alpha beta ATP, carbachol, and electrical field stimulation (EFS)-induced frequency-dependent relaxation responses in the isolated rabbit corpus cavernosum strips precontracted with phenylephrine reduced significantly (P<0.05). Adenosine-induced relaxation responses did not change significantly in hypothyroid rabbits.

CONCLUSION

Reduction of relaxation response in hypothyroid rabbits corpus cavernosum can depend on a decreased release of nitric oxide (NO) from nitrergic nerves and endothelium.

The role of dental pulp cells in resorption of deciduous teeth

OBJECTIVE

To address the question whether dental pulp cells of exfoliating human deciduous teeth have some roles for controlling or regulating the root resorption via secreting key molecules (OPG, RANKL, CSF-1, TGFbeta, MCP-1 and Cbfa-1) in osteoclastogenesis, we used a sensitive reverse transcriptase polymerase chain reaction (RT-PCR) method for detection of mRNA expressions for the cytokines listed.

STUDY DESIGN

The dental pulps were retrieved from incisor and molar teeth in the late stage of shedding (n = 30) and from sound premolar teeth extracted for orthodontic reasons (control group; n = 30). The RT-PCR assays were used to identify targeted gene expression.

RESULTS

Of the cytokines examined, RANKL and CSF-1 expressions showed significantly higher occurrence in deciduous dental pulps than in permanent teeth pulpal tissues (P < .040).

CONCLUSIONS

The findings may suggest an interactive role for pulp tissue cells in the physiologic root resorption process. The cells of dental pulp may have some cytokine-producing cells which mediate monocyte-macrophage lineage to form osteo/odontoclasts, and the RANKL/RANK system might be involved in human deciduous teeth resorption.

Investigation of the relaxant effects of propofol on ovalbumin-induced asthma in guinea pigs

BACKGROUND AND OBJECTIVE

Because the incidence of asthma appears to be increasing, the importance of proper perioperative management of individuals with asthma will also continue to increase. Although its mechanism of smooth muscle relaxation is unknown, propofol has been associated with less bronchoconstriction during anaesthetic induction. The aim of this study was to investigate the possible mechanism of these effects and the effects of propofol on the isolated trachea preparations from control and ovalbumin-sensitized guinea pigs.

METHODS

Adult male guinea pigs, weighing 280-330 g, were randomly allocated to two experimental groups, each consisting of 10 animals. Ten guinea pigs were sensitized by intramuscular injections of 0.30 mL of a 5% (w/v) ovalbumin/saline solution into each thigh (0.6 mL total) on days 1 and 4, whereas the remaining 10 served as controls receiving a total of 0.6 mL distilled water on days 1 and 4 as placebo. The isolated trachea preparations were mounted in tissue baths with modified Krebs-Henseleit solution and aerated with 95% oxygen and 5% carbon dioxide. We tested the effects of propofol (10(-7)-10(-3) M) on resting tension and after precontraction with carbachol and histamine on isolated trachea preparations from control and ovalbumin-sensitized guinea pigs. We also tested the effect of propofol on isolated trachea preparations precontracted with carbachol and histamine in the absence and presence of different inhibitors or antagonists. We investigated propofol responses in tracheal smooth muscle precontracted with CaCl2.

RESULTS

Propofol (10(-7)-10(-3) M) produced a concentration-dependent relaxation of isolated tracheal preparations precontracted by carbachol (10(-6) M) and histamine (10(-6) M) in both groups. Preincubation with N(w)-nitro L-arginine methyl ester (3x10(-5) M), indomethacin (10(-5) M) or propranolol (10(-4) M) did not produce a significant alteration on propofol-induced relaxation responses (P>0.05), while preincubation with tetraethylammonium (3x10(-4) M) significantly decreased the propofol-induced relaxation responses in both groups (P<0.05). Propofol (10(-7)-10(-3) M) induced concentration-dependently relaxations in isolated trachea rings precontracted with CaCl2 in both the control and ovalbumin-sensitized groups.

CONCLUSION

Propofol induced concentration-dependent relaxations in precontracted, isolated trachea smooth muscle of guinea pigs in both the control and ovalbumin-sensitized groups. These relaxations were independent of epithelial function and stimulation of beta adrenergic receptors. Opened Ca2+-sensitive K+ channels and inhibited L-type Ca2+ channels can contribute to these relaxations.

Objective risk definition for endometrial lesion spectrum: A diagnostic algorithm

OBJECTIVE

Investigations for risk definition in endometrial lesion spectrum still go on. In this study, molecular, morphometric, immunohistochemical techniques were combined with conventional morphology to realize whether an algorithm is definable for risk assessment to progress an invasive carcinoma in endometrial glandular lesion spectrum is possible.

METHODS

The study was carried out on 20 benign endometria, 35 hyperplasias, and 20 adenocarcinoma cases. Clonality of glandular cells, the volume percent of endometrial stroma (VPS), PTEN inactivation, and proliferative index (PI) were evaluated. Statistical analysis was evaluated to set an objective algorithm.

RESULTS

All benign tissues had polyclonal (PC), whereas all malignant tissues had monoclonal (MC) glandular epithelium. Of hyperplasias, 19 were MC, and 16 were PC. VPS value of 55% had 100% sensitivity, and 80% specificity (n=67) to distinguish MC from PC. Neither PTEN nor PI data augmented the specificity or the sensitivity of clonal distinction.

CONCLUSION

Clonality and VPS values were found to be significant in differential of endometrial lesions. With this rationale, a diagnostic algorithm for endometrial risk lesions was set. This algorithm is based on HE morphology, VPS and clonality findings, and has 100% sensitivity and specificity to discriminate neoplastic endometrium from hyperplasia.