An investigation on protection properties of Tantalum (V) oxide reinforced glass screens on unexposed breast tissue for mammography examinations

INTRODUCTION

The utilization of radiation shielding material positioned between the both breasts are crucial for the reduction of glandular dose and the safeguarding of the contralateral breast during mammographic procedures. This study proposes an alternative substance for shielding the contralateral breast from radiation exposure during mammography screening.

METHODS

In this study, we present an analysis of the shielding effectiveness of transparent glass that has been doped with Tantalum (V) oxide encoded as BTZT6. The evaluation of this shielding material was conducted using the MCNPX code, specifically for the ipsilateral and contralateral breasts. The design of the left and right breast phantoms involved the creation of three-layer heterogeneous breast phantoms, consisting of varying proportions of glandular tissue (25%, 50%, and 75%). The design of BTZT6 and lead-acrylic shielding screens is implemented using the MCNPX code. The comparative analysis of dose outcomes is conducted to assess the protective efficacy of BTZT6 and lead-acrylic shielding screens.

RESULTS

The utilization of BTZT6 shielding material resulted in a reduction in both breast dose and skin dose exposure when compared to the lead-acrylic shield.

CONCLUSION

Based on the findings acquired, the utilization of BTZT6 shielding material screens during mammography procedures involving X-rays with energy levels ranging from 26 to 30 keV is associated with a decrease in radiation dose.

IMPLICATIONS FOR PRACTICE

It can be inferred that the utilization of BTZT6 demonstrates potential efficacy in mitigating excessive radiation exposure to the breasts and facilitating the quantification of glandular doses in mammography procedures.

Health status, coronaphobia, quality of life, anxiety and depression in patients with lymphedema during COVID-19 pandemic

Covid-19 has physical damage as well as serious impact on the mental health in the community. Symptoms such as anxiety, depression, fear, stress, and sleep problems were more commonly reported during Covid-19 pandemic. The aim of this study was to assess the health status, psychological conditions, quality of life, and possible risk factors of patients with lymphedema during the pandemic. The study included male and female patients aged ≥18 years with primary or secondary upper or lower extremity lymphedema (stage 1, 2, or 3) who were followed in our outpatient clinic. The patients were interviewed by phone. Health and social status were examined using a questionnaire, Covid-19 phobia was assessed using Covid-19 Phobia Scale (C19P-S), and quality of life was assessed using Lymphedema Quality of Life Questionnaire Arm or Leg (LYMQOL). Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). The HADS scores showed that 35% of the patients had severe risk for depression and 10% had severe risk for anxiety. Factors with negative effect on HADS were lower education level, sedentary lifestyle, failure to perform lymphedema exercises, weight gain, and lymphedema duration. The C19P-S scores were higher indicating greater phobia in the overall score and subscores in patients with primary lymphedema and secondary lymphedema without malignancy, younger patients, those who are not able to walk regularly, and those who are not able to perform self manual lymphatic drainage (self-MLD). Factors with negative effects on LYMQOL were stage 3 lymphedema, female gender, younger age, and longer disease duration. Patients who performed regular self-MLD and lymphedema exercises demonstrated positive effects on LYMQOL. The results of this study suggest that patients with lymphedema affected by the COVID-19 pandemic are mostly younger patients, individuals with primary lymphedema, individuals with non-malignant etiology, individuals who unable to perform regular walking, and those unable to perform self- MLD.

Evaluation of the bilateral cardiac afferent distribution at the spinal and vagal ganglia by retrograde labeling

The identity of sensory neurons innervating the heart tissue and the extent of information reported to the brain via these neurons are poorly understood. In order to evaluate the multidimensional distribution and abundance of the cardiac spinal and vagal afferents, we assessed the retrograde labeling efficiency of various tracers, and mapped the cardiac afferents qualitatively and quantitatively at the bilateral nodose ganglia (NGs) and dorsal root ganglia (DRGs). From the five different retrograde tracers evaluated, Di-8-ANEPPQ yielded reproducibly the highest labeling efficiency of cardiac afferents. We demonstrated specific cardiac afferents at NGs and C4 to T11 DRG segments. Next, the 2D reconstruction of the tissue sections and 3D imaging of the whole NGs and DRGs revealed homogeneous and bilateral distribution of cardiac afferents. The quantitative analyses of the labeled cardiac afferents demonstrated approximately 5-6% of the soma in NGs that were equally distributed bilaterally. The neuronal character of Di-8-ANEPPQ labeled cells were validated by coimmunostaning with pan-neuronal marker Tuj-1. In addition, the cell diameters of labeled cardiac sensory neurons were found smaller than 20 μm, implying the nociceptor phenotype confirmed by co-labeling with TRPV1 and Di-8-ANEPPQ. Importantly, co-labeling with two distinct tracers Di-8-ANEPPQ and WGA-647 demonstrated exclusively the same cardiac afferents in DRGs and NGs, validating our findings. Collectively, our findings revealed the cardiac afferents in NGs bilaterally and DRGs with the highest labeling efficiency reported, spatial distribution and quantitation at both 2D and 3D levels, furthering our understanding of this novel neuron population.

Treatment of severely decayed anterior primary teeth with short-post technique (Mushroom Restorations) under general anesthesia

Aims

The aim of this study was to evaluation the treatment success of the short post technique (mushroom restoration) using a composite resin in severely decayed primary anterior teeth after 6, 12, and 18 months after treatment.

Methods

Eighteen children aged 3-5 years with severely decayed primary maxillary anterior teeth (60 anterior maxillary primary teeth in total) were included. Patients were treated under general anesthesia (GA). After pulpectomy, a "mushroom shape" was formed in the root canals for the purpose of retention, and the root canals were filled with zinc oxide-eugenol (ZOE), and the teeth were restored with composite resin. The status of treatment was evaluated clinically and radiographically for periapical radiolucency, pathological root resorption, marginal fracture, and loss of restoration for each treated tooth. All findings were recorded.

Results

As a result of the evaluation criteria, the success rates at 6, 12 and 18 months were 86%, 80%, and 71%, respectively. None of the teeth showed apical radiolucency or pathological root resorption at the end of the 18^th month period.

Conclusion

The short-post (mushroom restorations) technique is a clinically acceptable alternative method for restoration of severely decayed primary teeth. This study supports the feasibility of treatment with this technique for pediatric patients treated under GA.

Parvovirus B19 Infection as a Rare Cause of Fulminant Liver Failure: A Case Report

Parvovirus B19 infection is common in childhood. The clinical presentations range from benign to life threatening. The literature shows that the clinical presentation is influenced by the patient's age and the presence of chronic disease such as chronic hemolytic disorders and immunosuppressed conditions. As the majority of patients with liver failure are diagnosed as indeterminate, knowledge about parvovirus B19 associated liver disease is limited. We examined 3 children with parvovirus B19-induced fulminant liver failure, 2 of whom underwent liver transplantation. Although the presented patients received standard corticosteroid and tacrolimus therapy as an immunosuppressive regimen, acute rejection, parvovirus B19 persistence, or any other complications due to parvovirus B19 were not observed. Physicians should be aware of the parvovirus B19 infection in association to acute liver diseases.

Note: Parameter extraction of samples without the direct application of the passivity principle from reference-plane-invariant measurements

An extraction algorithm has been proposed for explicit complex permittivity and complex permeability determination of samples using reference-plane-invariant scattering parameters without resorting to the application of the passivity principle. The algorithm relies on the definition of new odd and even reflection coefficients which result in no-crossing of the negative real axis for the argument of the square-root functions. Permittivity measurements of two low-loss samples were performed for validation of our algorithm.

The impact of alternative donor types on viral infections in pediatric hematopoietic stem cell transplantation

Viral infections remain one of the most important complications following allogeneic HSCT. Few reports compare virus infection between different donor types in pediatric patients. We retrospectively analyzed viral infections and the outcome of one hundred and seventy-one pediatric patients (median 7.38 years) who underwent allogeneic HSCT from matched related donor (MRD, n = 71), 10 of 10 HLA allele-matched unrelated donors (MUD1; n = 29), 9 of 10 HLA allele-matched unrelated donors (MUD2; n = 40), and haploidentical donors (n = 31). PCR screening for BK virus, adenovirus, Epstein-Barr virus, parvovirus B19, human herpesvirus 6, and CMV were performed routinely weekly. Infections between 0-30, 31-100, and 101 days-2 years were identified separately. BK virus and CMV reactivations were significantly low in MRD transplant patients (P = .046 and P < .0001, respectively), but incidences of all virus infections between MUD1, MUD2, and haplo-HSCT were found statistically not different. The OS was found to be affected by having one or multiple virus infection (P = .04 and P = .0008). Despite antiviral prophylaxis and treatments, post-transplant viral infections are associated with reduced overall survival. Haplo-HSCT is comparable with MUD transplantation in the setting of viral infections. A larger study group and prospective studies are needed to confirm this observation.

Traumatic Asphyxia

Traumatic asphyxia is a clinical syndrome related to cervicofascial cyanosis, petechiae, subconjunctival haemorrhages and neurological symptoms. This syndrome occurs after a transient, severe and compressive blunt thoracic trauma. Here, we presented two cases of traumatic asphyxia. They both had prominent petechiae on upper parts of their bodies. The prognosis was excellent in the boy. Contrary, second case was dead in emergency department due to subarachnoid haemorrhage and intracerebral petechial haemorrhages. Traumatic asphyxia alone does not predict morbidity and mortality. It is the concomitant cardiovascular, pulmonary and neurologic injuries that affect the outcome.

THE USE OF 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY TO ASSESS CLINICAL OUTCOMES OF PATIENTS WITH BORDERLINE RESECTABLE PANCREATIC CANCER

The aim of this study is to evaluate the effect of 18FDG PET on preoperative staging and clinical management of pancreatic cancer. Between December 2011 and February 2015, 28 consecutive patients with borderline resectable pancreatic cancer were evaluated with both 18FDG PET scans and conventional preoperative imaging studies. Medical records of all patients were noted prospectively. 18FDG PET findings were compared with conventional imaging studies and over-staging or down-staging rates with changes in clinical management were evaluated. The correlation of 18FDG PET with conventional imaging studies was evaluated with a kappa agreement coefficient. A number of 22 (78.5%) patients had pancreatic head cancer and 6 (21.4%) patients had pancreatic body and tail cancers. Based on 18FDG PET, additional lesions were found in 4 (14.28%) of the patients which were lung and peritoneal lesions as metastasis. No hepatic metastasis or supraclavicular lymph node involvement was confirmed in patients. Routine use of 18FDG PET for preoperative staging has not an effect on cancer management in 96.8% of our patients. In conclusion, 18FDG PET has additional value over conventional radiologic techniques for monitoring the treatment response in locally advanced pancreatic cancer patients. It is feasible to predict early metastasis and patient outcome early (after one course of IC) during therapy.

A novel reconstruction method for giant incisional hernia: Hybrid laparoscopic technique

BACKGROUND AND OBJECTIVES:

Laparoscopic reconstruction of ventral hernia is a popular technique today. Patients with large defects have various difficulties of laparoscopic approach. In this study, we aimed to present a new reconstruction technique that combines laparoscopic and open approach in giant incisional hernias.

MATERIALS AND METHODS:

Between January 2006 and August 2012, 28 patients who were operated consequently for incisional hernia with defect size over 10 cm included in this study and separated into two groups. Group 1 (n = 12) identifies patients operated with standard laparoscopic approach, whereas group 2 (n = 16) labels laparoscopic technique combined with open approach. Patients were evaluated in terms of age, gender, body mass index (BMI), mean operation time, length of hospital stay, surgical site infection (SSI) and recurrence rate.

RESULTS:

There are 12 patients in group 1 and 16 patients in group 2. Mean length of hospital stay and SSI rates are similar in both groups. Postoperative seroma formation was observed in six patients for group 1 and in only 1 patient for group 2. Group 1 had 1 patient who suffered from recurrence where group 2 had no recurrence.

DISCUSSION:

Laparoscopic technique combined with open approach may safely be used as an alternative method for reconstruction of giant incisional hernias.

Clinical utility of hepatic-perfusion computerized tomography in living-donor liver transplantation: a preliminary study

BACKGROUND

Vascular complications are a primary diagnostic consideration in liver transplant recipients, with an overall incidence of 9%. Cross-sectional imaging techniques provide information regarding vascular structure and luminal patency but can not quantitatively assess hepatocyte damage in the liver graft parenchyma. Perfusion computerized tomography (CT) is a recently developed method that allows for quantitative evaluation of hemodynamic changes in tissue. Our objective was to evaluate the clinical utility of perfusion CT in assessing vascular complications during living-donor liver transplantation (LDLT).

METHODS

The 33 recipients were divided into 3 groups according to Doppler ultrasonographic findings: hepatic arterial complication group, portal venous complication group, and hepatic venous complication group. Blood volume (BV), blood flow (BF), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) were calculated for the affected vascular territory regions.

RESULTS

Compared with normal liver parenchyma, BV, BF, ALP, and HPI were significantly lower in the hepatic arterial complication group. Although PVP and BV were significantly lower, ALP, HPI, and BF were higher in the affected vascular territory region than in normal liver parenchyma for the portal venous complication group. In the hepatic venous complication group, PVP was significantly higher and BF, ALP, and HPI significantly lower in the affected vascular territory regions than in normal liver parenchyma.

CONCLUSIONS

Perfusion CT imaging is a noninvasive technique that enables the quantitative evaluation of vascular complications in the graft parenchyma after LDLT and permits a quantitative evaluation of the treatment response.

Effect of pre-operative red blood cell distribution on cancer stage and morbidity rate in patients with pancreatic cancer

BACKGROUND

The red blood cell distribution (RDW) is a test measure of erythrocyte variation and the volume level which shows the heterogeneity and it is a proven test in literature for the determination of survival on cardiovascular diseases. The main purpose of this research is to investigate the relationship between the RDW level and postoperative morbidity as well as its stages in diagnosed pancreatic cancer patients.

METHODS

In this study we covered 104 diagnosed pancreatic cancer patients who have been operated in 2011-2014. The RDW levels were separated into two groups. Group 1 contains higher level RDW patients (> 14) whereas group 2 contains only lower level RDW patients. We compared both groups in terms of the patients' demographic data, duration of hospitalization, ratio of pancreatic fistula, disease period, and the mortality rates.

RESULTS

In group 1 contains 39 patients whereas group 2 contains only 65 patients. We determined the positive correlation between stages of disease with RDW levels as well as the correlation between low level of blood albumin and Ca 19.9 levels (p = 0001). However we did not observe statistically important difference in postoperative morbidity.

CONCLUSIONS

Based on this study we report that RDW levels can be use as a marker to show the stages of pancreatic cancer in diagnosed patients.

Plasma Levels of Plasminogen Activator Inhibitor Type 1 and Vitronectin in Children With Cancer

BACKGROUND

The plasminogen activator system controls intravascular fibrin deposition; besides, it also participates in a wide variety of physiologic and pathologic processes, including cancer.

PROCEDURE

In this study, we examined the levels of plasminogen activator inhibitor 1 (PAI-1) and vitronectin in 32 newly diagnosed pediatric patients with malignancies, determined by enzyme-linked immunosorbent assay between January 2009 and January 2010 and compared them to 35 age-matched healthy children, using SPSS 16.0 software.

RESULTS

The mean level of PAI-1 was 23.02 ± 15 (8.2-71.19) ng/mL and vitronectin was 83.10% ± 23.77% (12%-126%) in the tumor group. Thirty-five healthy children in the same age range were enrolled in the control group. The levels of PAI-1 and vitronectin were 23.63 ± 10.44 (11.67-58.85) ng/mL and 85% ± 20.85% (39%-126%), respectively. No significant difference was found between the 2 groups by independent sample t-test (P = .86 and P = .69).

CONCLUSIONS

This is a preliminary study done in children with malignancies, investigating PAI-1 and vitronectin. Further study is needed, including larger trials and tumor tissue with histopathological examination as in adults.

A reliable pancreaticojejunal anastomosis with V-Loc 180 wound closure device for soft pancreatic stump

BACKGROUND/AIMS

Although mortality rates decreased in recent years, pancreaticoduodenectomy is still associated with high morbidity rates. Pancreatic fistula is the leading cause of morbidity after pancreaticojejunal anastomosis and commonly occurs in soft pancreas. The objective of this study is to compare outcomes of conventional modified invaginated end to side pancreaticojejunostomy with a new practical method using V-Loc 'rM 180 wound closure device in soft pancreas.

METHODOLOGY

Between December 2011 and August 2013, a total of 90 pancreaticoduodenectomy procedures were performed in our hospital. 28 of them were defined as soft pancreas according to attending surgeon and included in this study. Patients were divided into two groups consecutively and analysed for postoperative pancreatic fistula (POPF) rate, length of stay, operation time, cost and particular duration of anastomosis. Pancreatic fistulas were classified according to International Study Group on Pancreatic Fistula (ISGPF) definition.

RESULTS

1 grade A and 2 grade B fistulas appeared in V-Loc group (Group 1), whereas 1 grade A, 2 grade B and 1 grade C fistulas appeared in conventional anastomosis group (Group 2).

CONCLUSIONS

Pancreaticojejunostomy with V-Loc suture is a convenient method in soft pancreas and can be performed safely.

Does a predialysis education program increase the number of pre-emptive renal transplantations?

OBJECTIVES

Renal transplantation (RT) is the most appropriate form of treatment for end-stage renal disease (ESRD). Pre-emptive RT decreases the rates of delayed graft function and acute rejection episodes, increasing patient and graft survival, while reducing costs and complications associated with dialysis. In this study, we investigated the relationship between a predialysis education program (PDEP) for patients and their relatives and pre-emptive RT.

METHODS

We divided 88 live donor kidney transplant recipients into 2 groups: transplantation without education (non-PDEP group; n = 27), and enrollment in an education program before RT (PDEP group n = 61).

RESULTS

Five patients in the non-PDEP group underwent pre-emptive transplantation, versus 26 of the PDEP group. The rate of pre-emptive transplantations was significantly higher among the educated (42.62%) versus the noneducated group (18.51%; P < .001).

CONCLUSION

PDEP increased the number of pre-emptive kidney transplantations among ESRD patients.

Association of collagen type I alpha 1 gene polymorphism with inguinal hernia

PURPOSE

A positive family history is an important risk factor for inguinal hernia development, suggesting a genetic trait for hernia disease. However, gene mutations responsible for abdominal wall hernia formation in humans have not yet been studied. We aimed to evaluate whether the functional Sp1 binding site polymorphism within intron 1 of the collagen type I, alpha 1 (COL1A1) gene was associated specifically with inguinal hernia disease.

METHODS

85 participants with surgically diagnosed inguinal hernia disease, and 82 physically active controls without any history of connective tissue disease and hernia were recruited for this case-control genetic association study. Polymerase chain reaction and restriction fragment length polymorphism and agarose gel electrophoresis techniques were used to detect these polymorphisms.

RESULTS

Significantly, more patients gave a positive family history for an inguinal hernia compared to healthy controls (OR 3.646, 95 % CI 1.375-9.670, P = 0.006). COL1A1 Sp1 SNP (rs 1800012) was identified. Results demostrated statistically significant deviation from HWE for cases (P = 0.007), but not for the controls (P = 0.276). Our results revealed an increased frequency of COL1A1 Sp1 Ss genotype in inguinal hernia patients (OR 3.593, 95 % CI 1.867-6.915, P = 0.000).

CONCLUSIONS

This results suggest that polymorphism of the COL1A1 Sp1 binding site is associated with an increased risk for developing inguinal hernias. So, rs 1800012 locus is a potential candidate region for susceptibility in molecular mechanism of inguinal hernia pathophysiology.

The anticancer mechanism of caffeic acid phenethyl ester (CAPE): review of melanomas, lung and prostate cancers

BACKGROUND

Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, specifically inhibits NF-κB. It exhibits antioxidant, antiinflammatory, antiproliferative, cytostatic, and most importantly, antineoplastic properties.

AIM

The aim of the present mini-review is to summarize and evaluate the anticancer mechanism of CAPE with examples of several cancer types.

RESULTS

In view of the mechanisms and findings in our laboratory and those of others in literature, we suggest that CAPE possess anticancer and apoptosis inducing activities.

CONCLUSIONS

Further researches are needed regarding the anticancer basis of CAPE in all disciplines of medicine. Also, clinical potential toxicities of CAPE should be revealed if it is going to be used as an anticancer agent.

A Q fever case mimicking crimean-congo haemorrhagic fever

Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF) in terms of clinical and laboratory findings.

Eruptive disseminated Spitz naevi: dermatoscopic features

Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic features of nondisseminated, solitary forms of Spitz naevi are well known, there are no reports describing the dermatoscopic features of eruptive disseminated variant. We report an additional case and describe the dermatoscopic features. Two patterns were observed. In all pink lesions, the vascular pattern was seen, composed of dotted, linear or comma-like vessels located at the centre of the meshes of the reticular depigmentation. In all brown lesions, we observed only the reticular pattern, which is quite interesting as the reticular pattern is a rare feature of Spitz naevi. This observation may be a special feature particularly seen in the eruptive disseminated variant. A superficial black network also accompanied reticular pattern in some lesions. In dichromatic lesions, both patterns were observed in different areas of the body.

Photophysical and complexation properties of benzenesulfonamide derivatives with different donor and acceptor moieties

Pyrrolobenzosulfonamide, indolobenzosulfonamide and carbazolobenzosulfonamide derivatives with different acceptor groups were synthesized and their photophysical properties were compared. The electron donor linking sites are found to influence the emission characteristics of these compounds while acceptor linking sites have no noticeable effects on the spectral properties. P2-A5 which is a C-C linked pyrrole derivative exhibited different spectral properties from the C-N linked pyrrole derivatives. The complexation properties of the molecules were also investigated employing Na (I), Ca (II), Li (I), Mg (II), Zn (II) and Cu (II) ions.

The protective effect of aprotinin and alpha-tocopherol on ischemia-reperfusion injury of the rat liver

BACKGROUND

Liver injury caused by ischemia-reperfusion (I/R) processes is a complication of hepatic resection surgery and transplantation, particularly using grafts from marginal donors. Despite improvements in organ preservation and advances in surgical techniques, I/R injury remains a significant clinical problem. In this study, we investigated whether aprotinin provided protection against the adverse effects of I/R injury in liver tissue.

METHODS

Forty rats were randomized into four groups (n = 10): group I: (control group) I/R + no medication; group II: sham-operated group + no medication or I/R; group III: I/R + aprotinin; group IV: I/R + alpha-tocopherol. Malondialdehyde (MDA) was measured in the liver tissue and superoxide dismutase (SOD), catalase (CAT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactate dehydrogenase (LDH) in rat serum.

RESULTS

Administration of aprotinin and alpha-tocopherol before I/R resulted in significant reductions of MDA levels compared to the I/R alone group (group I; P = .01 and P < .01, respectively). Administration of aprotinin or alpha-tocopherol prior to I/R resulted in significant increases in SOD and CAT levels compared with the I/R group (P < .05 each). Compared to the I/R group, significant decreases in plasma AST, ALT, and LDH levels were observed both in the aprotinin and in the alpha-tocopherol group (P < .05). Histological evaluation revealed the injury grade to be relatively lower among groups III and IV compared to group I.

DISCUSSION

In conclusion, rat hepatic structures in aprotinin and alpha-tocopherol administered groups were well protected. Therefore, aprotinin may provide protection against the adverse effects of I/R injury in liver transplantation.

Correlation between the Serum Values of Soluble Intercellular Adhesion Molecule-1 and Total Sialic Acid Levels in Patients with Breast Cancer

BACKGROUND

In this study, we aimed to investigate serum total sialic acid (TSA) and soluble intracellular adhesion molecule-1 (sICAM-1) levels in breast cancer patients to find a correlation with the cancer stage.

METHODS

The parameters from sera of 61 patients with breast cancer were measured. The concentrations of serum sICAM-1 and TSA were measured in serum samples from 61 patients with breast cancer and 25 healthy control subjects using enzyme-linked immunoassay and thiobarbituric acid method.

RESULTS

Mean serum sICAM-1 and TSA levels were significantly higher in the total patient group than in the control group (p < 0.001). Thus, the correlation between TSA and sICAM-1 became more significant in metastatic breast cancer. There were significant positive correlations between TSA and sICAM-1 in stage I+II (r = 0.59, p < 0.05), stage III (r = 0.47, p < 0.05), and stage IV (r = 0.89, p < 0.01), and total patient group (r = 0.56, p < 0.001).

CONCLUSION

SerumsICAM-1 and TSA levels were higher in patients with breast cancer, than that of the control group, and also in the metastatic breast cancer group. Significant correlations between serum sICAM-1 and TSA may reflect the similar function of these molecules as adhesion molecules, and their roles in the carcinogenesis of breast cancer as well as metastasis.

Broad-band ultraviolet B phototherapy is associated with elevated serum thiobarbituric acid reactive substance and nitrite-nitrate levels in psoriatic patients

BACKGROUND

Although the local anti-inflammatory, immunosuppressive and oxidative activity of UVB is known, the systemic effect of UVB phototherapy in dermatological patients has not been investigated.

OBJECTIVE

We aimed to investigate the lipid peroxidation status (as represented by thiobarbituric acid reactive substance, TBARS) and nitrite-nitrate levels in psoriatic patients under broad-band ultraviolet B (BB-UVB) phototherapy in order to determine the systemic effects of UVB.

SUBJECTS AND METHODS

Thirty-two psoriatic patients and 20 healthy controls were included. Blood samples were obtained at the beginning, after 6-10 exposures to BB UVB phototherapy (mean 5 weeks) and at the end of the therapy period (mean 21 weeks). Serum TBARS and nitrite-nitrate levels were evaluated.

RESULTS

There was no statistically significant difference in serum TBARS and nitrite-nitrate levels between psoriatic patients (basal) and healthy volunteers. There was no statistically significant correlation between disease duration, disease severity, or the total cumulative dose of UVB and serum levels of TBARS and nitrite-nitrate in psoriatic patients. Total nitrite levels in samples obtained during and at the end of therapy were significantly higher than basal levels (P=0.033 and P=0.005, respectively). TBARS levels in samples obtained during and at the end of therapy were significantly higher than basal levels (P=0 and P=0.026, respectively). There was a negative correlation (r=-0.576, P=0.039) between the total nitrite and TBARS levels in psoriatic patients at the end of therapy.

CONCLUSION

Our study showed that chronic exposure to UV irradiation may lead to a systemic effect on lipid peroxidation and NO levels, which are shown by a significant elevation in TBARS and nitrite-nitrate levels in serum.

Spontaneous rupture of the spleen in secondary amyloidosis: a patient with rheumatoid arthritis

A 63-year-old man who had had a history of rheumatoid arthritis presented with shock and hemoperitoneum, without a history of trauma. An emergency laparatomy revealed hemoperitoneum and splenic rupture with massive bleeding. Splenectomy was performed. Histopathological examination of the spleen revealed amyloid deposition in the wall of the vessels. Rectal biopsy revealed amyloid deposition in mucosa that indicating amyloidosis was systemic. Histochemical studies showed that amyloid was secondary or AA.

Intussusception in adults

To review clinical, radiological and histopathological findings of adult intussusception and its management, 18 adult patients who had been treated surgically because of intussusception were reviewed. Of the patients, 5 (27.8%) had idiopathic intussusceptions, while the other 13 (72.2%) had a definable intraluminal pathology. The site of the intussusception was more common in the small bowel (83.3%) than the colon (16.7%). Ultrasonography and computed tomography were successful in demonstrating "target lesion" in 80% and 75% respectively. Patients with idiopathic intussusception were treated with simple reduction, while the others underwent segmental resection because of the possibility of malignant tumour. In contrast to intussusception in childhood, intussusception in adults usually has a definable lead point and resection of the involved bowel, rather than simple reduction, is indicated.

Fever of unknown origin: a report of 57 cases

Fever of unknown origin (FUO) is defined as the body temperature higher than 38.3 degrees C on several occasions and lasting longer than 3 weeks, with the aetiology remaining uncertain after 1 week of investigation. In this study, we reviewed 57 patients with FUO hospitalised in our inpatient department between 1998 and 2003. The median age of the patients was 44 years (17-84), and 26 were males (46%), while 31 were females (54%). In 24 patients (42%), infectious diseases such as tuberculosis (12 patients) and brucellosis (5 patients) were found under the aetiology of FUO. Inflammatory rheumatic diseases were the second most common cause of FUO (17 patients, 30%), while malignancies were found in 10 patients (18%). In six patients (10%), aetiology could not be identified. In conclusion, infectious diseases especially tuberculosis and brucellosis are the leading causes of FUO in our country.

Erythrocyte superoxide dismutase, catalase activities and plasma nitrite and nitrate levels in patients with Behcet disease and recurrent aphthous stomatitis

Behçet disease (BD) and recurrent aphthous stomatitis (RAS) are two distinct diseases of unknown aetiology which are both characterized by oral aphthae. The aim of this study was to determine the possible association of both diseases with antioxidant status and nitric oxide levels. Twenty-six patients (17 female, nine male) with RAS, 28 patients (17 female, 11 male) with BD and 31 (22 female, nine male) healthy control subjects were included in the study. Blood samples were studied for erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities and plasma nitric oxide (NO) levels. Erythrocyte SOD activity in BD patients was significantly higher than in RAS patients and controls. Although SOD activity in RAS patients was higher than in controls, the difference was not statistically significant. No significant differences in CAT activities or NO levels were found between the three groups. In conclusion, changes in SOD activity may be important in the inflammatory reactions observed in BD and RAS, but NO does not seem to play a primary role in the aetiopathogenesis.

Antigen-induced changes on high endothelial venules in rat cervical lymph nodes

The effect of antigenic stimulation (paratyphoid vaccine) on high endothelial venules (HEVs) of rat cervical lymph nodes was studied using conventional histological and histometrical techniques. The sequential changes of some morphometric parameters (lymph node weight, HEV diameters) after the antigenic stimulation were studied in rat cervical lymph nodes over a period of five days with daily measurements. Measurements were made on the HEVs in the paracortex especially near the corticomedullary junction. HEVs diameters began to increase two days after the antigenic stimulation (p<0.001) and erythrocytes were increased in the lumen of the HEVs. On day four, most of the lymphocytes were detected between the endothelial cells of the HEVs (p<0.001). On day five, not only HEVs were increased in number but also endothelial cells were increased in height (p<0.001). The weight of the lymph nodes was also highest on this day. The changes of HEVs determined after antigenic stimulation suggest that these specialized vessels have an important regulatory role in the primary immune response.

Guillain-Barré syndrome in a child with acute lymphoblastic leukemia

A 4-year-old boy with acute lymphoblastic leukemia receiving maintenance treatment developed quadriparesis, facial palsy, difficulty in swallowing, and hypertension following a respiratory infection and candida septicemia. Examination of the cerebrospinal fluid was normal initially but later showed albuminocytologic dissociation, the characteristic finding of Guillain-Barré syndrome. Complete recovery occurred after treatment with intravenous immunoglobulin. Differential diagnosis of Guillain-Barré syndrome from vincristine toxicity in patients with leukemia and possible association with the infections are discussed.

Urinary nitric oxide in newborns with infections

BACKGROUND

Neonatal sepsis is a major problem in newborn nurseries because of the difficulty in early diagnosis and because of the high morbidity and mortality. The objective of the present study was to investigate whether urinary nitric oxide (NO) levels could be useful for the diagnosis of infected newborns.

METHODS

Newborns with suspected infection according to previously defined criteria between ages of 1-7 days and 8-30 days were included as the study groups (p) to be compared with age-matched healthy controls (c). Urine NO levels were assayed by Sievers NOA based on chemiluminescence and expressed as corrected for urine creatinine.

RESULTS

20 newborns with suspected infection at 1-7 days of age (group 1p) were compared with 45 healthy age-matched newborns (group 1c). 16 newborns with suspected infection at 8-30 days of age (group 2p) were compared with 15 healthy age-matched newborns (group 2c). The groups were similar with regard to birth weight and gestational age; however, the urinary NO levels in newborns with suspected infection at 1-7 days of age (80.25+/-60.68 micromol/mg creatinine) were higher than in healthy newborns (25.45+/- 19.35 micromol/mg creatinine). Similarly, newborns with suspected infection at 8-30 days of age had higher urinary NO levels (81.78+/- 40.43 micromol/mg creatinine) than age-matched controls (36.99+/-24.58 micromol/mg creatinine; p < 0.05). The sensitivity of urinary NO levels to detect infection was 50% in both age groups, and the specificity was 95% for 1-7 days of age and 93% for 8-30 days of age. Groups 1p and 2p were similar with regard to NO production. Altogether 12 patients had culture-proven sepsis, 11 patients had clinical sepsis, and 13 patients had other infections. The NO levels were similar in patients with culture-proven and clinical sepsis and higher than in patients with other infections. No difference was observed among NO levels of patients with gram-positive and gram-negative sepsis.

CONCLUSIONS

Urinary NO levels which are quick and easy to measure are higher in infected newborns as compared with controls, and although the specificity is good, the sensitivity of the test is low, necessitating the use of another marker in addition to NO.