Thirst intensity survey in ADPKD patients

INTRODUCTION

With increased fluid intake and tolvaptan treatment, the growth rate of cysts can be theoretically decelerated in autosomal polycystic kidney disease. In this prospective study, it was planned to evaluate thirst sensation in these patients and the parameters affecting its intensity.

METHODS

Forty-one ADPKD patients on tolvaptan and 40 ADPKD patients not on tolvaptan as the control group were evaluated for thirst distress sensation and intensity. The feeling of thirst and the discomfort caused by excessive fluid intake was assessed with Thirst Distress Scale-HF 12 questions (60/12). Thirst intensity was evaluated with a 100 mm visual scale.

RESULTS

Of the whole group, 35.8% (29) were males, and 64.2% (52) were females. The mean age of the tolvaptan group was 39.17 ± 9.35 years and for the control group, it was 41.95 ± 12.29 years. There was a negative correlation between the thirst distress score of the patients and an increase in creatinine level after a year of tolvaptan treatment (r = - 0.335, p = 0.035). The patients not taking thiazide had higher thirst intensity scores (p = 0.004). There was no impact of tolvaptan dosage, total kidney volume, serum sodium, urinary osmolarity or eGFR on thirst distress and thirst intensity scores.

DISCUSSION/CONCLUSION

Only thiazide co-treatment had a positive impact on thirst distress and intensity when given tolvaptan. Thirst Distress Scale for ADPKD patients can be used to classify patients before and during tolvaptan treatment.

Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study

PURPOSE

To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta.

METHODS

This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded.

RESULTS

Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations.

CONCLUSION

Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.

Comparison of superb microvascular imaging and shear wave elastography for assessing liver fibrosis in chronic hepatitis B

Purpose

The present study investigated the effectiveness and applicability of superb microvascular imaging (SMI) in determining the degree of liver fibrosis noninvasively in comparison with shear wave elastography (SWE).

Methods

Ninety-eight consecutive patients with chronic hepatitis B who underwent ultrasound (US)-guided needle biopsy were examined using US combined with SMI and SWE. The predictive performance of the two US techniques in staging liver fibrosis and inflammation was compared with reference to the histological findings obtained from liver biopsy. The intraobserver and interobserver reproducibility of SMI in vascularity scores were evaluated.

Results

SWE values and SMI vascular scores were statistically significantly different among fibrosis stages (χ²(3)=76.3, χ²(3)=81.5, P<0.001). The SWE and SMI models significantly predicted fibrosis stages separately, and SMI scores alone predicted fibrosis stages better than SWE values (50.1% for SWE, 63.5% for SMI, P<0.001). A model with both SMI scores and SWE values together explained 73.2% of variance in fibrosis stages. When other clinical and laboratory predictors were added to the model (81.5%, P<0.001), SWE values and SMI scores remained the main predictors of fibrosis stages. SWE and SMI were also applicable in predicting inflammatory grades, explaining 31% and 34% of variance, respectively, and 37.7% when used together (P<0.001).

Conclusion

Both SWE and SMI had good diagnostic performance in determining the degree of liver fibrosis in chronic hepatitis B patients. The efficacy of SMI was better than that of SWE. SMI can improve diagnostic performance for staging liver fibrosis and shows potential for estimating necroinflammation of the liver.

Prebiopsy multiparametric MRI and PI-RADS version 2.0 for differentiating histologically benign prostate disease from prostate cancer in biopsies: A retrospective single-center comparison

PURPOSE

To investigate the diagnostic performance of Prostate Imaging-Reporting and Data System version 2.0 (PI-RADSv2.0) for differentiating clinically significant prostate cancer (csPCa) from benign prostate disease on prebiopsy multiparametric MRI stratified by total prostate specific antigen (PSA) concentration.

MATERIALS AND METHODS

150 patients who had prebiopsy mpMRI, serum PSA concentration and subsequent biopsy were retrospectively analyzed. Patients were stratified by PSA concentration (Group1 ≥ 10 ng/mL; Group2 4.0-<10 ng/mL). MRI findings were assessed using PI-RADSv2.0 by two blinded radiologists. Lesions were graded histopathologically using the International Society of Urological Pathology (ISUP) score. Diagnostic performance of PI-RADSv2.0 was evaluated and compared to PSA and PSA Density (PSAD). The performance of the radiologists was compared including inter-observer agreement for PI-RADSv2.0. The correlation between imaging and histopathological biopsy results was analyzed.

RESULTS

The differences in total PSA, free/total PSA ratio and PSAD between benign (n = 78) and malignant (n = 72) groups were significant (p < 0.05). The PI-RADSv2.0 scores of the radiologists were strongly correlated (r = 0.912, p < 0.001) with excellent agreement, κ = 0.97 (95%CI: 0.90-1.03; p < 0.005). Receiver operating characteristics curve analysis showed significantly high predictive power for PI-RADSv2.0, total PSA and PSAD alone. Comparison of age, prostate volume, PSAD, free/total PSA ratio and total PSA values between ISUP1 and ISUP ≥ 2 cases revealed significantly increased PSAD (p < 0.001) and total PSA (p = 0.001) in the ISUP ≥ 2 group.

CONCLUSION

PI-RADSv2.0 had high diagnostic accuracy in both PSA groups. PI-RADSv2.0, PSAD and total PSA alone had significant high predictive power to detect csPCa. However, the combination of PI-RADSv2.0 and PSAD or total PSA for each reader showed no statistically significant improvement when compared to PI-RADSv2.0 alone.

Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with molecular subtypes and histological grades

PURPOSE

The purpose of this paper is to investigate whether the IVIM parameters (D, D *, f) helps to determine the molecular subtypes and histological grades of breast cancer.

METHODS

Fifty-one patients with breast cancer were included in the study. All subjects were examined by 3 T Magnetic Resonance Imaging (MRI). Diffusion-weighted imaging (DWI) was undertaken with 16 b-values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histopathological reports were reviewed to histological grade, histological type, and immunohistochemistry. IVIM parameters of tumors with different histological grades and molecular subtypes were compared.

RESULTS

D* and f were significantly different between molecular subtypes (p = 0.019, p = 0.03 respectively). D* and f were higher in the HER-2 group and lower in Triple negative (-) group (D*:36.8 × 10^-3 ± 5.3 × 10^-3 mm²/s, f:29.5%, D*:29.8 × 10^-3 ± 5.6 × 10^-3 mm²/s, f:21.5% respectively). There was a significant difference in D* and f between HER-2 and Triple (-) subgroups (p = 0,028, p = 0.024, respectively). D* was also significantly different between the HER-2 group and the Luminal group (p = 0,041). While histological grades increase, D and f values tend to decrease, and D* tends to increase. While the Ki-67 index increases, D* and f values tend to increase, and D tend to decrease.

CONCLUSION

D* and f values measured with IVIM imaging were useful for assessing breast cancer molecular subtyping. IVIM imaging may be an alternative to breast biopsy for sub-typing of breast cancer with further research.

Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder

Objectives: The aim of this study was to evaluate the metabolic changes in the anterior cingulate cortex (ACC) induced by electroconvulsive therapy (ECT) in patients with MDD via ¹H-MRS.Methods: The study was conducted on 13 MDD patients receiving ECT treatment and 14 healthy controls matched in terms of age, gender and education. The patients underwent six sessions of ECT. ¹H-MRS imaging and psychometric evaluations obtained before 1st and after the 6th sessions. The control group also went through the same procedures except for ECT. N-Acetyl aspartate (NAA), choline (Cho) and creatine (Cr) metabolite levels and the creatine to metabolite ratios were measured.Results: There was no significant difference in the ACC metabolite levels of the patients and those of the controls at the baseline. ECT associated with a statistically significant decrease in the NAA/Cr ratio in ACC. All of the patients had responded to ECT treatment as measured with the clinical scales.Conclusions: The results has suggested that indirect proof of an increase in energy metabolism without any evidence of impaired neuronal viability in the ACC induced by ECT. The relative increase in Cr levels following ECT in MDD seems to be associated with improvement in clinical severity.Key pointsECT is one the most effective method in the treatment of acute MDD.The mechanism of ECT's antidepressant activity remains unclear but it is thought to be related to the regulation of prefrontal cortical or cingulate areas.In this study the patients underwent six sessions of ECT and after ¹H-MRS imaging.The study revealed that baseline levels of metabolites in patients with MDD were not significantly different than those of control group.

Intravoxel incoherent motion imaging for diagnosing and staging the liver fibrosis and inflammation

PURPOSE

To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) model parameters for the diagnosis and staging of liver fibrosis and inflammation in patients with chronic hepatitis B.

METHODS

Fifty-four patients with chronic hepatitis B and 42 healthy volunteers were included in the study. All subjects were examined by 3 T magnetic resonance imaging. Diffusion-weighted imaging was undertaken with sixteen b values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histological evaluation of biopsy samples was considered the reference standard for the staging of liver fibrosis and inflammation. Differences in IVIM parameters between patient and control groups were analyzed. In the patient group, fibrosis stage and inflammation grade groups were analyzed with respect to IVIM parameters. The correlation was assessed between IVIM parameters and Ishak-modified scale of fibrosis stages and inflammation grades.

RESULTS

The D was significantly lower in the patient group than the control group, p = 0.038 with Cohen's d effect size of 0.452. D was significantly different between fibrosis stage levels. D values decreased in fibrosis stages from the minimal to moderate to marked fibrosis. Fibrosis grades significantly negatively correlated with D and D* values, p = 0.001, and 0.021, respectively. In addition, inflammation grades negatively correlated with f values, p = 0.047.

CONCLUSION

D values measured with IVIM imaging may help to diagnose liver fibrosis. IVIM imaging could be an alternative to liver biopsy for the staging of liver fibrosis.

Functional consequences of enhanced expression of STIM1 and Orai1 in Huh-7 hepatocellular carcinoma tumor-initiating cells

Background

The endoplasmic reticulum (ER) Ca²⁺ sensor, stromal interaction molecule1 (STIM1) activates the plasma membrane (PM) channel Orai1 in order to mediate store-operated Ca²⁺ entry (SOCE) in response to ER store depletion. Enhanced expression of STIM1 in cancer tissue has been associated with poor patient prognosis. Therefore, this study investigated the functional consequences of enhanced expression of STIM1 and Orai1 in a tumor-initiating subpopulation of Huh-7 hepatocellular carcinoma (HCC) cells that express epithelial cell adhesion molecule (EpCAM) and Prominin 1 (CD133).

Methods

We performed qRT-PCR, intracellular Ca²⁺ monitoring, protein analyses, and real-time cell proliferation assays on EpCAM(+)CD133(+) subpopulation of tumor-initiating Huh-7 HCC cells expressing high levels of STIM1 and/or Orai1. Statistical significance between the means of two groups was evaluated using unpaired Student’s t-test.

Results

Enhanced STIM1 expression significantly increased ER Ca²⁺ release and proliferation rate of EpCAM(+)CD133(+) cells.

Conclusion

STIM1 overexpression may facilitate cancer cell survival by increasing ER Ca²⁺-buffering capacity, which makes more Ca²⁺ available for the cytosolic events, on the other hand, possibly preventing Ca²⁺-dependent enzymatic activity in mitochondria whose Ca²⁺ uniporter requires much higher cytosolic Ca²⁺ levels.

Serum amyloid A and Omentin levels in acute appendicitis: a preliminary study for a novel diagnostic approach

BACKGROUND

The diagnosis of acute appendicitis is based on medical history and physical examination. Serum (S) amiloid A (AA) levels are elevated in many inflammatory conditions. Omentin is a recently discovered adipokine showing decreased levels associated with inflammatory conditions. We aimed to measure SAA and omentin levels in patients with acute appendicitis.

MATERIALS AND METHODS

36 patients with a diagnosis of acute appendicitis and 30 healthy subjects were enrolled to this research study. A statistical analysis was performed using IBM SPSS Statistics Version 16.0 (SPSS Inc.®, Chicago, IL, United States).

RESULTS

Patients in study group were significantly older than healthy control subjects (p=0.013). Body mass index of the patients with acute appendicitis (23.2 ± 1.3) was greater than that of the control group (22.7 ± 1), but the difference did not reach the statistically significance (p=0.076). ). Mean level of SAA was significantly raised in study group compared to healthy control subjects (p< 0.001). Mean omentin level was significantly lower in study group compared to healthy subjects (p=0.013).

CONCLUSIONS

In conclusion, although diagnosis of acute appendicitis is mostly based on clinical findings, omentin and especially SAA measurement in serum may help surgeons to avoid negative laparatomy.

Effects of MMP-1 and MMP-3 gene polymorphisms on gene expression and protein level in lumbar disc herniation

The aim of this study was to identify the possible correlation between polymorphisms in matrix metalloproteinase (MMP)-1 and MMP-3 and their corresponding protein levels in disc tissues obtained from patients with lumbar disc herniation (LDH) using biochemical and immunohistochemical analyses. Blood and disc samples were obtained from 100 patients with LDH who underwent a lumbar microdiscectomy. Based on the radiological degeneration, the patients were diagnosed with grade 2, 3, or 4 LDH. MMP-1 -1607 1G/2G and MMP-3 -1171 5A/6A were analyzed by real-time polymerase chain reaction. The expressions of MMP-1 and MMP- 3 were detected by biochemical and immunohistochemical analyses. We found no association between the MMP-1 polymorphism and disc degeneration and MMP-1 expression. However, patients expressing the 6A/6A and 5A/6A alleles of MMP-3 -11715A/6A showed higher MMP-3 expression, compared to those expressing the 5A/5A genotype. Additionally, the radiological degeneration grades were correlated with the histological degeneration scoring. Protein levels and immunopositive cell rates of MMP-1 and MMP-3 were associated with disc degeneration grades. Moreover, the MMP-1 and MMP-3 expression and the histological and radiological scores were positively correlated and the MMP-3 -11715A/6A polymorphism was associated with MMP-3 expression in herniated disc tissues. This study is the first to investigate polymorphisms in MMP-1 and MMP-3, as well as their corresponding protein expressions. We also quantified an association between the radiological degeneration grades and MMP-1 and MMP- 3 expression. Further genomic studies on MMPs could focus on the utilization of MMP-1 and MMP-3 as markers for the prevention and treatment of this disease.

Alterations of store-operated calcium entry and cyclopiazonic acid-induced endothelium-derived relaxations in aging rat thoracic aorta

The purpose of our study was to investigate whether endothelium-derived relaxations induced by store depletion are altered in aging rat thoracic aorta. Vascular responses were measured in aortic segments isolated from young (2-4 month) and old (20-24 month) male Sprague-Dawley rats. In phenylephrine-contracted intact tissues, receptor-mediated and receptor-independent endothelium-derived relaxations were induced by acetylcholine (ACh) and sarcoplasmic/endoplasmic reticulum Ca²⁺ ATPase (SERCA) blocker cyclopiazonic acid (CPA), respectively. In addition, CPA-induced changes in intracellular calcium levels were monitored in fura-2-loaded endothelium-denuded tissues. Real-time quantitative reverse transcription polymerase chain reaction and western blot analysis were performed to determine the transient receptor potential canonical (TRPC) 4 mRNA and protein levels. Endothelial TRPC4 mRNA levels were apparently decreased in aging rats. Immunoblot analysis showed that TRPC4 protein levels significantly decreased in intact aorta from 20- to 24-month-old rats compared to that from 2- to 4-month-old rats. ACh- and CPA-induced endothelium-dependent relaxations decreased in old rat aorta without any change in direct vasodilation induced by sodium nitroprusside. Store-operated Ca²⁺ entry (SOCE) induced by CPA was significantly decreased, whereas sarcoplasmic reticulum Ca²⁺ release was unaffected in endothelium-denuded aging rat aorta. In conclusion, TRPC4 downregulation could be associated with decreased endothelium-dependent vasorelaxations. As endothelial nitric oxide synthase is activated by SOCE-induced caveolar internalization, tracking the expression levels of SERCA, ion channels, and/or associated proteins involved in SOCE would lead to the development of novel therapeutics for age-related vasospastic disorders with dysfunctional endothelium.

Effects of the inflammatory response on serum omentin levels in early acute and chronic pancreatitis

BACKGROUND AND AIMS

Acute pancreatitis is an acute inflammation of the parenchyma of the pancreas. Several adipokines have been investigated in acute pancreatitis, and these cytokines contribute to inflammation in acute pancreatitis. However, not enough data exist regarding omentin in injuries of the pancreas. Because of a possible common pathogenesis, we aimed to study the association between pancreatic damage and serum omentin levels.

MATERIALS AND METHODS

Twenty-four Sprague Dowley rats weighing 200-250 g were randomly placed into three groups: a sham group (n=8), an acute pancreatitis group (n=8), and a chronic pancreatitis group (n=8). Both rats in the sham group underwent laparotomy, and 0.1 cc of saline solution was injected through the pancreatic canal. On the seventh day, a blood sample was obtained by abdominal aorta puncture, and the pancreas was resected for histological examination. In the acute and chronic pancreatitis groups, 0.1 cc of 4.5% Sodium Taurocholote was injected through the pancreatic canal. Blood samples were obtained and pancreatic resection was performed after 24 hours for the acute pancreatitis group and after 7 days for the chronic pancreatitis group.

RESULTS

Serum omentin levels of rats with chronic pancreatitis (49.37±2.82 ng/ml) were increased compared to both acute pancreatitis (37.79±1.24 ng/ml) (p<0.01) and sham rats (22.49±1.4 ng/ml) (p<0.01). In addition, the omentin level of rats with acute pancreatitis was significantly increased compared to the sham group (p<0.01).

CONCLUSIONS

The elevation in omentin levels in rats in the early stage of pancreatitis was due to the anti-inflammatory effects of omentin; hence, elevated omentin levels improved insulin resistance and caused a significant reduction in glucose levels.

The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury

OBJECTIVE

The aim of this study was to evaluate the effect of dexmedetomidine (100 µg/kg-ip) on liver ischemia and reperfusion (I/R) in rats.

METHODS

Twenty-four Wistar Albino rats were separated into three groups as control (C), ischemia-reperfusion injury (I/R) and dexmedetomidine group (I/R-D). Ischemia was induced with portal clampage for 45 minutes and reperfusion period was 45 minutes after declampage. Group I/R-D was received dexmedetomidine 100 µg/kg i.p. 30 min before portal clampage. Thiobarbutiric Acid-Reactive Substances (TBARS), glutathioneS-transferase (GST), superoxide dismutase (SOD), Catalase (CAT), and Paraoxonase 1 (PON-1) were investigated in blood samples. Also HSP60 and p53-positive hepatocytes were counted under ImageJ image analysis program.

RESULTS

All parameters, except GST levels, were significant between the groups (p < 0.05). Although HSP60 expression was significantly increased between I/R, I/R-D and C groups there were no significant differences between I/R-D and C (p = 0.443). On the other hand, p53 expression was also significantly increased between I/R, I/R-D and C groups At the same time, there were no significant differences between I/R-D and C groups (p = 0.354).

CONCLUSION

All the results suggest that dexmedetomidine has beneficial effects on liver ischemia/reperfusion stress (Tab. 1, Fig. 2, Ref. 49).

Serum omentin levels predicts mesenteric ischemia

BACKGROUND

Acute mesenteric ischemia (AMI) is an intestinal vascular disease with high mortality. Clinical diagnosis of acute mesenteric ischemia is difficult. Adipose tissue is an important mediator of metabolism and inflammation.Omentin is produced by visceral adipose tissue and decreased serum levels of omentin are associated with poor metabolic outcomes. We aimed to investigate whether serum omentin level predicts early diagnosis of AMI before development of transmural ischemia.

METHODS

Twenty-four Sprague Dawley rats weighted about 200-250 gr grouped in 3 experimental groups as sham, transient ischemia and permanent ischemia. Each group consisted of 8 rats. Blood samples were evaluated to determine serum urea, creatinine, omentin and C-reactive protein (CRP) levels. A blinded histological examination performed with the same histologist for hemotoxileneosine painted ileal tissue samples.

RESULTS

Mean serum omentin level in sham group (27.5±4.67) was significantly elevated compared to rats in Ischemia-reperfusion (IR) group (10.9±9.01).The difference reached the statistical significance (p=0.004). Serum omentin levels were not correlated to urea, creatinine or CRPlevels.

CONCLUSION

Omentin levels may be a biochemical indicator to detect AMI. However, further human studies are needed (Tab. 3, Fig. 3, Ref. 34).

Hepatocyte apoptotic index and p53 expression in obstructive jaundice rats

OBJECTIVE

Obstructive jaundice is a serious disease. It can deteriorate critical functions in the liver.

MATERIAL AND METHOD

A total of 20 male Wistar-Albino rats were randomly allocated into two groups consisting of ten in each as follows: Group I (Control) was subjected to a sham operation isolating the bile duct. Group II(Study) was subjected to acute cholestasis induced by bile duct ligation with 4/0 silk suture from two different places and full fold cut between ligatures. On the 7th day, group II rats were re-operated for liver sampling and sacrification-aimed histological analysis through the old incision with anaesthesia. Hepatic tissues were histologically and immunohistochemically processed. The number of apoptotic and p53(+) cells were measured.

RESULTS

On the 7th day, the averages of direct and indirect bilirubin values in Group II rats were found to be 6.99 and 11.70 mg/dl, respectively. They were observed to be statistically significant. In the immunohistochemical evaluation p53 expression in hepatocytes was assessed, p53-positive hepatocytes were determined to exist quite widely in the tissue samples taken from the livers of rats in the study group. Nevertheless, no cells exhibiting p53 expression were found in the tissue samples of the control group.

CONCLUSION

Apoptosis is a closed box and it might make it possible to stop the many disease processes or accelerate the healing. If the principal effective mechanism in the liver under a certain stress factor is apoptosis, it is definite that it will make a difference in the treatment approach. Consequently, we can say that both apoptotic index and p53 expression increase in the rats' liver with biliary obstruction (Fig. 4, Ref. 51).

Clinical analysis of emergency peripartum hysterectomies in a tertiary center

OBJECTIVE

To investigate the incidence, indications, complications, and risk factors associated with increased mortality and morbidity of emergency peripartum hysterectomy (EPH).

MATERIALS AND METHODS

The authors retrospectively analyzed 48 cases of EPH performed within six-year interval at Ondokuz Mayis University Hospital. EPH was defined as the operation performed for life-threatening hemorrhage which could not be controlled with conservative treatment modalities within 24 hours of a delivery.

RESULTS

The incidence of EPH was 5.03 per 1,000 deliveries. The most common indication for EPH was abnormal placental adherence (n = 22, 45.8%), followed by uter- ine atony (n = 19, 39.6%). All the patients with placenta accreta had a history of repeat cesarian section (CS) and placenta previa.Total hysterectomy was performed in almost all of the patients (n = 47, 97.9%). All women required blood transfusions. Maternal morbidity was significant, with bladder injury (31.3%) and disseminated intravascular coagulation (18.7%) among the most common complications. There were one maternal (2.1%) and five neonatal deaths (10.4%).

CONCLUSION

Since most of the EPH cases are associated with prior cesarean delivery, decision of the first CS should be made for true obstetrical indications.If conservative treatments fail to control massive obstetrical bleeding, blood products and an experienced obstetrician should be ready to perform EPH to decrease the maternal mor- bidity and mortality.

Detecting the translocation of DNA through a nanopore using graphene nanoribbons

Solid-state nanopores can act as single-molecule sensors and could potentially be used to rapidly sequence DNA molecules. However, nanopores are typically fabricated in insulating membranes that are as thick as 15 bases, which makes it difficult for the devices to read individual bases. Graphene is only 0.335 nm thick (equivalent to the spacing between two bases in a DNA chain) and could therefore provide a suitable membrane for sequencing applications. Here, we show that a solid-state nanopore can be integrated with a graphene nanoribbon transistor to create a sensor for DNA translocation. As DNA molecules move through the pore, the device can simultaneously measure drops in ionic current and changes in local voltage in the transistor, which can both be used to detect the molecules. We examine the correlation between these two signals and use the ionic current measurements as a real-time control of the graphene-based sensing device.

Protective effect of montelukast, a cysteinyl leukotriene receptor-1 antagonist, against intestinal ischemia-reperfusion injury in the rat

OBJECTIVE

Ischemia-reperfusion (I-R) injury of the intestine is a significant problem because the initial damage caused by ischemia is exacerbated by reperfusion. In this study, we examined the protective effect of montelukast against I-R-induced intestinal tissue damage.

MATERIALS AND METHODS

Eight-week-old male Sprague-Dawley rats were randomly divided into three treatment groups : a sham-operated group, a group receiving I-R, and a group receiving I-R plus montelukast (I-R/M). Tissue samples were evaluated and scored histologically. The blood levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), and cardiotrophin-1 (CT-1) were measured.

RESULTS

In the I-R group, the histological score and the levels of serum MDA and MPO were increased compared with those in the control group. In the I-R/M group, the histological score and serum MDA and MPO levels were significantly decreased compared with those in the I-R group. Additionally, compared with the IR group, the I-R/M group had increased serum GSH and CT-1 levels and a decreased intestinal injury score. Ileal sections from the I-R/M group showed minimal alterations, characterized by moderate lifting of the epithelial layer from the lamina propria, and few apoptotic enterocytes were observed compare with the number in the I-R group.

CONCLUSION

The findings of the present study demonstrated that montelukast can protect I-R-induced intestinal damage in rats.

Platelet function in euthyroid patients undergoing thyroidectomy in women

BACKGROUND

Several studies have reported several platelet abnormalities in patients with sub-clinical or overt thyroid dysfunctions. The primary mechanism that affects the hemostatic balance is excess or deficiency of thyroid hormones. The different ways of thyroid gland to the platelet function are not yet clearly understood. The relationship between in the thyroid gland and platelet activation without thyroid hormones has not been studied yet.

AIM

The aim of our study is to determine the platelet function in euthyroid patients undergoing thyroidectomy in females.

PATIENTS AND METHODS

The study group includes 52 female euthyroid patients undergoing thyroidectomy. The control group consisted with 21 healthy euthyroid female. Platelet count (PC), platelet mass (PM), mean platelet volume (MPV), and platelet distribution width (PDW) were measured. PM was calculated by multiplying MPV and PLT.

RESULTS

MPV (8.4 ± 1.3 versus 7.9 ± 0.8) and PDW (17.8 ± 1 versus 17.6 ± 0.8) values were similar between the two groups.

CONCLUSIONS

Thyroid gland does not directly affect platelet activation. Accordingly, platelet abnormalities of thyroid disease can be considered to be independent of the underlying thyroid tissue. This finding suggests that association between thyroid diseases and platelet function is dependent on the status of thyroid hormones.

Lung tissue apoptosis in abdominal hypertension : Apoptosis and necrosis of lung tissue in abdominal hypertension

OBJECTIVES

The aim of this study was to evaluate lung tissue histopathologic changes and the number of apoptosis with the increase of abdominal pressure.

METHODS

The study rats were randomly assigned into the following five groups: a sham operated group and groups 1, 2, 3 and 4, in which the intra-abdominal pressure was increased to 11, 15, 18 and 22 mmHg for 60 min, respectively. Lungs were harvested for histopathologic changes and the tissue apoptotic analysis were carried out in a blinded manner.

RESULTS

All of the data showed that the number of apoptotic cells and necrosis were increased in accordance with the pressure level. However, this increase was statistically significant, especially in groups 3 and 4 (18 and 22 mmHg, respectively; p < 0.05) when compared to the sham operated rats. There were no differences observed between groups 1 and 2 (11 and 15 mmHg, respectively) and the sham operated rats. There was also no difference between groups 1 and 2. There were findings of coagulation necrosis and the number of apoptotic cells linearly increased when the abdominal pressure was increased. The cut-off value was 15 mmHg.

CONCLUSION

The available findings suggest that intra-abdominal pressure greater than 15 mmHg could irreversibly damage pulmonary cells and both coagulation necrosis parameters and the number of apoptosis increase in accordance with the pressure level.

Primary carcinoma of the neovagina: a case report

We present a case of squamous cell carcinoma arising in the neovagina of a woman in whom we performed vaginoplasty 20 years before. To the best of our knowledge, this is the 23rd case of total carcinoma arising in the neovagina constructed because of vaginal agenesis, and the 3nd case of carcinoma arising in the neovagina performed without using a graft.

Clinical and molecular studies in two families with Fraser syndrome: a new FRAS1 gene mutation, prenatal ultrasound findings and implications for genetic counselling

Fraser syndrome is a rare autosomal recessive genetic disorder characterized by cryptophthalmus, variable expression of cutaneous syndactyly of fingers and toes, genital ambiguity and renal agenesis/dysgenesis. We present here molecular and clinical findings of four fetuses with FS from two families. Molecular genetic studies in the two families revealed mutations in FRAS1 gene allowing better genetic counselling and subsequent prenatal diagnosis in one of the two families. In family one, a nonsense mutation (c.3730C>T, p.R1244X) previously described in a Polish patient was found. In family two a novel nonsense mutation previously not known was detected (c.370C>T, p.R124X). PGD is planned for family 1.

Characterization of red raspberry (Rubus idaeus L.) genotypes for their physicochemical properties

The worldwide tendency for growing more small fruits, including raspberries, shows permanent increase because this group of fruits has a relatively higher content of bioactive nutrients. To study the health benefits of red raspberry fruits, 11 preselected wild-grown and 1 well-known cultivar, Heritage, were evaluated for some of their physicochemical properties such as fruit weight, total antioxidant capacity (measured by beta-carotene bleaching and FRAP assays), total phenolics, ascorbic acid, soluble solid content (SSC), and acidity. Fruit weight, SSC, and ascorbic acid contents were between 1.47 and 2.32 g, 10.87% and 13.60%, and 21 and 36 mg/100 g, respectively. Antioxidant activity and total phenolic content varied among genotypes and the ERZ5 genotype had the highest antioxidant capacity as ascertained by both methods. This genotype also had the highest total phenolic (2031 microg GAE/g FW) content. There are linear relationships between antioxidant capacities and total phenols. The present study demonstrates the potential of certain wild genotypes, notably ERZ5, for improving the nutritional value through germplasm enhancement programs.

Age-related diseases; degenerative aortic valve disease and osteoarthritis

OBJECTIVE

To examine the relationship between degenerative aortic valve disease and osteoarthritis Background: Degenerative aortic valve disease (DAVD) and osteoarthritis (OA) are age-related degenerative diseases whose pathogenesis involves mechanical stress and local inflammation.

METHODS

Forty-four patients with DAVD (Group 1) and 21 controls (Group 2) were included in this study, which was intended to investigate the similarity between the two conditions. The two groups were similar in terms of age, sex, body mass index, a history of hypertension, cholesterol levels, diabetes mellitus and cigarette consumption.

RESULTS

The average age + standard deviation of the DAVD patients were 71.3 +/- 7.5, compared to 67.5 +/- 10.6 in the control group. In radiological OA analysis, the Lane scale was employed in the lumbar region and the Kellgren-Lawrence scale in the knee joint. Comparison of Groups 1 and 2 revealed no difference in radiological OA in the lumbar region and knee joint.

CONCLUSION

Our study has shown that there is no relationship between these diseases that increased with age. However, extensive studies examining pathogenic mechanisms are needed (Tab. 2, Ref. 11).

Protective effects of doxycycline in ischemia/reperfusion injury on kidney

Renal ischemia and reperfusion injury is the major cause of acute renal failure and may also be involved in the development and progression of some forms of chronic kidney disease. The aim of this study was to evaluate whether doxycycline, a member of the tetracycline family of antibiotics, protects kidney tissue or not. 36 Sprague-Dawley rats (200-250 g) were used. The animals were divided into three groups: control, ischemia/reperfusion and ischemia/reperfusion+doxycycline group. Rats were subjected to renal ischemia by clamping the left pedicle for 1 h, and then reperfused for 1 h. The ischemia/reperfusion+doxycycline group were pretreated intraperitoneally with doxycycline suspension (10 mg/kg) 2 h before the induction of ischemia. Our results indicate that malondialdehyde, matrix-metalloproteinase-2, interleukin-2, interleukin-6, interleukin-10, interleukin 1-beta and tumor necrosis factor-alpha levels were significantly higher in the ischemia/reperfusion group than those in the control group. Doxycycline administration significantly decreased these parameters. Tissue inhibitor of metalloproteinases-1 levels also increased after ischemia/reperfusion and decreased with doxycycline pretreatment, but these changes were not significantly different. Glutathione levels significantly decreased after ischemia/reperfusion injury when compared with the control group and doxycycline pretreatment significantly increased glutathione levels when compared with the ischemia/reperfusion group. Apoptotic cells and p53 positive cells were significantly decreased in doxycycline treated group. These results suggest that doxycycline reduces renal oxidative injury and facilitates repair. Doxycycline may play a role in a renoprotective therapeutic regimen.

Efficacy of levamisole on experimental endometriosis

OBJECTIVE

To investigate the efficacy of levamisole on experimental endometriosis.

METHODS

After the implantation of endometrial tissue on abdominal peritoneum, 40 rats were randomized to 1 of 4 equal intervention groups. Levamisole (2 mg/rat) was applied subcutaneously to group "L" once a week. Depot medroxyprogesterone acetate (3 mg/kg) was applied intramuscularly to group "M" twice at 4-week intervals. Leuprolide (0.075 mg/kg) was applied subcutaneously to group "G" twice at 4-week intervals. Saline (0.1 cm(3)/rat) was applied subcutaneously to group "C" once a week for 8 weeks. The efficacy of levamisole was determined by volume measurement and characterizing the histological structure of the implants.

RESULT

Volume increase of the implants in group C (P<0.05), and volume decrease in groups M, G, and L was found (P<0.05, P<0.01, and P<0.01, respectively.) Stromal tissue and glandular activity were not different between groups L and G.

CONCLUSION

Levamisole was found to be as effective as leuprolide in regression of the volume of endometriotic implants.

Sarcoplasmic-endoplasmic reticulum Ca2+-ATPase inhibition prevents endothelin A receptor antagonism in rat aorta

This study tested whether sarcoplasmic-endoplasmic reticulum Ca(2+)-ATPase regulates the ability of endothelin receptor antagonist to inhibit the endothelin-1 constriction. The endothelin A receptor antagonist BQ-123 (1 microM) completely relaxed constriction to 10 nM endothelin-1 in endothelium-denuded rat aorta. Challenge with cyclopiazonic acid (10 microM), a sarcoplasmic-endoplasmic reticulum Ca(2+)-ATPase inhibitor, during the plateau of endothelin-1 constriction enhanced the constriction by approximately 30%. BQ-123 relaxed the endothelin-1 plus cyclopiazonic acid constriction by only approximately 10%. In contrast, prazosin (1 microM), an alpha-adrenergic receptor antagonist, still completely relaxed the 0.3 muM phenylephrine constriction in the presence of cyclopiazonic acid. Verapamil relaxed the endothelin-1 plus cyclopiazonic acid constriction by approximately 30%, whereas Ni(2+) and 2-aminoethoxydiphenyl borate, nonselective cation channel and store-operated channel blockers, respectively, completely relaxed the constriction. These results suggest that lowered sarcoplasmic-endoplasmic reticulum Ca(2+)-ATPase activity selectively decreases the ability of endothelin receptor antagonist to inhibit the endothelin A receptor. The decreased antagonism may be related to the opening of store-operated channels and subsequent greater internalization of endothelin A receptor.

Isokinetic muscle performance in major depressive disorder: alterations by antidepressant therapy

The aims of this study were (i) to examine whether patients with major depressive disorder (MDD) differ from healthy control subjects with respect to isokinetic muscle performance (IMP) as measured by a dynamometer; (ii) to investigate the effect of subchronic treatment on the IMP in depressed patients. Thirty-eight patients with MDD, and 41 sex- and age-matched healthy controls participated in this study. The severity of depression and anxiety levels were evaluated by the Hamilton Depression and Anxiety Scales. Quadriceps and hamstring IMPs were determined by using an isokinetic dynamometer before and after subchronic antidepressant treatment. The patients had lower IMP levels than healthy controls. After treatment for three months with selective serotonin reuptake inhibitors, the IMP levels increased significantly. These findings suggest that (i) MDD may be characterized by reduced IMP levels; and (ii) treatment with antidepressants may increase the IMP levels, as a state marker for depression. It was concluded that (i) isokinetic muscle performance may be used as a state marker for monitoring antidepressant drug effects on MDD; (ii) isokinetic exercise increasing IMP may be used in the treatment of depression.

Isokinetic muscle performance in major depressive disorder: alterations by antidepressant therapy

The aims of this study were (i) to examine whether patients with major depressive disorder (MDD) differ from healthy control subjects with respect to isokinetic muscle performance (IMP) as measured by a dynamometer; (ii) to investigate the effect of subchronic treatment on the IMP in depressed patients. Thirty-eight patients with MDD, and 41 sex- and age-matched healthy controls participated in this study. The severity of depression and anxiety levels was evaluated by the Hamilton Depression and Anxiety Scales. Quadriceps and hamstring IMPs were determined by using an isokinetic dynamometer before and after subchronic antidepressant treatment. The patients had lower IMP levels than healthy controls. After treatment for three months with selective serotonin reuptake inhibitors, the IMP levels increased significantly. These findings suggest that (i) MDD may be characterized by reduced IMP levels; and (ii) treatment with antidepressants may increase the IMP levels, being a state marker for depression. It was concluded that (i) isokinetic muscle performance may be used as a state marker for monitoring antidepressant drug effects on MDD; (ii) isokinetic exercise increasing IMP may be used in the treatment of depression.