Age Estimation Using Machine Learning Algorithms with Parameters Obtained from X-ray Images of the Calcaneus

BACKGROUND

Determination of bone age is a critical issue for forensics, surgery, and basic sciences.

AIM

This study aims to estimate age with high accuracy and precision using Machine Learning (ML) algorithms with parameters obtained from calcaneus x-ray images of healthy individuals.

METHOD

The study was carried out by retrospectively examining the foot X-ray images of 341 people aged 18-65 years. Maximum width of the calcaneus (MW), body width (BW), maximum length (MAXL), minimum length (MINL), facies articularis cuboidea height (FACH), maximum height (MAXH), and tuber calcanei width (TKW) parameters were measured from the images. The measurements were then grouped as 20-45 years of age, 46-64 years of age, 65 and older, and age estimation was made by using these at the input of ML models.

RESULTS

As a result of the ML input of the measurements obtained, a 0.85 Accuracy (Acc) rate was obtained with the Extra Tree Classifier algorithm. The accuracy rate of other algorithms was found to vary between 0.78 and 0.82. The contribution of parameters to the overall result was evaluated by using the shapley additive explanations (SHAP) analyzer of Random Forest algorithm and the MAXH parameter was found to have the highest contribution in age estimation.

CONCLUSIONS

As a result of our study, calcaneus bone was found to have high accuracy and precision in age estimations.

Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis

Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.

Evaluating the effect of sleep quality and chronotype differences on erectile dysfunction

OBJECTIVE

Erectile dysfunction (ED) refers to an inability to achieve or maintain a firm penile erection sufficient for satisfactory sexual intercourse. Insufficient, irregular sleep and sleep disorders adversely affect human health, including sexual function. Significant differences between biological rhythms (chronotypes) have been reported. In the present study we examine the effect of sleep quality and chronotype differences on ED patients and a control group.

PATIENTS AND METHODS

The study included 69 patients who presented with ED and 64 healthy controls. The respondents completed a sociodemographic data form, and disease severity in the ED group was measured using the International Index of Erectile Function (IIEF). The participants were further administered the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and Morningness-Eveningness Questionnaire (MEQ), and the scale scores were compared statistically between the patient and control groups.

RESULTS

There was no difference in the age, body mass index (BMI), alcohol use and smoking of the ED and healthy control groups, while the IIEF score was significantly lower in the ED group than in the control group. The PSQI subscale scores other than for sleep duration subscale, the PSQI global score and the HADS score were higher in the ED group than in the control group, while there was no difference between the groups in the MEQ and ISI scores. The IIEF score was correlated with the PSQI and HADS scores, and the PSQI score with the ISI and HADS scores.

CONCLUSIONS

It would be useful to evaluate sleep quality in addition to anxiety and depression while evaluating patients with ED. Our study found no relationship between chronotype differences and ED.

Are the conventional scoring systems efficient in predicting mortality of acute mesenteric ischemia?: Mortality estimation in patients with AMI

Acute mesenteric ischemia is a surgical emergency with high morbidity and mortality rates. Therefore, it is important to determine the prognosis for this disease. In the present study, we aimed to compare the prediction accuracy of 3 scoring systems: Acute physiology and chronic health evaluation II, sequential organ failure assessment score and simplified acute physiology score II (SAPS II). The retrospective cohort study was conducted in a university hospital. Eighty-two acute mesenteric ischemia patients were evaluated retrospectively. The mortality prediction abilities of the scoring systems were evaluated by comparing the prediction rates of > 10%, 30% and 50% and the actual mortality among survivors and non-survivors in pairs. Predicted mortality rates among survivors and non-survivors differed among the 3 classification systems. The mortality estimates of the SAPS II were closer to the actual mortality rates. Analysis of the estimated mortality rates as mortality risk limits showed that acute physiology and chronic health evaluation II was superior to sequential organ failure assessment score and SAPS II in estimating mortality rates, whereas SAPS II was more successful in detecting survivors. The estimated mortality rates of the 3 rating systems, the estimated mortality rates were higher in the non-survivor group than in the survivor group. The accuracy of the SAPS II in determining prognosis was relatively better.

The effects and mechanisms of the action of galangin on spatial memory in rats

BACKGROUND

Galangin, a flavonoid compound with acetylcholinesterase inhibitory activity, may improve cognitive functions by enhancing cholinergic transmission.

OBJECTIVES

We aimed to investigate the effects of galangin on spatial memory impairment in rats.

METHODS

The effects of galangin (50 and 100 mg/kg) and reference anti-dementia drug donepezil (1mg/kg) administrations were examined on memory impairment induced by the muscarinic cholinergic receptor antagonist scopolamine or the nicotinic cholinergic receptor antagonist mecamylamine in the Morris water maze (MWM) test. Hippocampal acetylcholine concentrations were also determined.

RESULTS

Galangin 50 and 100 mg/kg significantly decreased the mean distance to platform and increased the time spent in the escape platform quadrant in scopolamine-treated rats. Galangin 100 mg/kg significantly decreased the mean distance to platform and increased the time spent in the escape platform quadrant in mecamylamine-treated rats. The effects of galangin in the MWM were comparable with donepezil. Scopolamine and mecamylamine decreased acetylcholine concentrations, whereas galangin both alone and with mecamylamine or scopolamine administration increased acetylcholine concentrations.

CONCLUSION

Galangin improved memory impairment comparable to donepezil and nicotinic and muscarinic receptors may be involved in this effect. Galangin may be considered as a promising flavonoid in the prevention and treatment of memory impairment in Alzheimer's disease and other dementias (Fig. 7,Ref. 37).

Effects of Euterpe oleracea to Enhance Learning and Memory in a Conditioned Nicotinic and Muscarinic Receptor Response Paradigm by Modulation of Cholinergic Mechanisms in Rats

Euterpe oleracea (EO) includes a large number of polyphenolic compounds such as phenolics, flavonoids, and anthocyanins that have antioxidant activities. E. oleracea was suggested to ease the oxidative stress and inflammation in brain cells. Our aim was to analyze the effects of E. oleracea on learning and memory. Seventy-two (250 ± 25 g) male Wistar albino rats were used for this study. The groups consisted of control, EO100 mg/kg, EO300 mg/kg, scopolamine 1.5 mg/kg, mecamylamine 7.5 mg/kg, combinations of scopolamine with EO100 mg/kg, EO300 mg/kg, and rivastigmine 1.5 mg/kg; and mecamylamine combined with EO100 mg/kg. Before the start of the study, E. oleracea doses were provided once a day for a period of 15 days and for a 6-day experimental period. Thirty minutes after intraperitoneal scopolamine and mecamylamine injections, gastrogavage was applied to each group. Ninety minutes after the drug treatments, locomotor activity and Morris water maze tests were performed. Rats were killed and each hippocampus was used for the quantification of acetylcholine (Ach). Statistical analyses were calculated using one-way and two-way analyses of variance (ANOVA), and a value of P < .05 was considered significant. In groups EO100 mg/kg and EO300 mg/kg the results did not show any significant changes on learning and memory compared with the control group. Mecamylamine and scopolamine enhanced the latency for the escape platform, and decreased the time spent in escape platform quadrant when the memory tests were applied in reference to the control value of P < .05. Scopolamine and mecamylamine combinations of EO100 mg/kg, EO300 mg/kg, and rivastigmine were proven to improve the memory. There was significant difference between the first and fifth days of the learning tests in all the groups, but no significant difference occurred between the groups. Ach levels in hippocampi supported all memory tests. We suggest that E. oleracea made no alterations on learning and memory, but still improved nicotinic and muscarinic receptor-mediated and impaired memory just as rivastigmine.

Pregabalin Attenuates Carrageenan-Induced Acute Inflammation in Rats by Inhibiting Proinflammatory Cytokine Levels

Objective

Pregabalin (PGB) is a compound used in the treatment of epilepsy, anxiety, and neuropathic pain. Experimental data also indicate that PGB can reduce inflammatory pain. We aimed to investigate the anti-inflammatory effects of PGB on carrageenan (CAR)-induced paw edema and its effects on tumor necrosis factor-α (TNF-α) and interleukine-1β (IL-1β) acting as acute phase cytokines in inflammation, and anti-inflammatory cytokine IL-10, in rats.

Materials and Methods

Single doses of PGB 30, 50, and 100 mg/kg and indomethacin (INDO) 5 mg/kg in the treatment groups and saline in the control group were injected once intraperitoneally prior to administration of 100 μl of 1% CAR into the right hind paw of the rats. The paw thickness was measured using gauge calipers (Vernier calipers) before (0 hour) and every hour afterwards for 6 hours following the inflammation induction. The cytokine levels in the blood serum obtained intracardiacally were determined after 6 hours using the enzyme-linked immunosorbent assay method. p<0.05 was considered statistically significant.

Results

There was no significant difference between the 0 and 6^th hour considering the paw thickness in all groups, except in the CAR group. CAR significantly increased the paw thickness at 6 hours compared to the 0 hour. All doses of PGB and INDO significantly reduced the paw thickness after 6 hours compared to the CAR group. The TNF-α and IL-1β levels in the PGB and INDO groups were comparable to the control group, whereas in the CAR group, these levels were increased. The IL-10 level was enhanced in the PGB 50 mg/kg and INDO groups.

Conclusion

It was observed that all doses of PGB exerted anti-inflammatory-like effects comparable to INDO, supported by their effects on the levels of cytokines.

Comparison of the Effects and Mechanism of the Curcumin with Different Drugs in Experimental Vasospasm After Subarachnoid Hemorrhage

AIM

Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the most important complication that effects the mortality and morbidity of patients with intracranial aneurysm. Today, the mechanisms of vasospasm are not understood in spite of experimental and clinical researches. The aim of our study was to investigate the effects of curcumin on vasospasm following SAH.

MATERIAL AND METHODS

In this study, 64 rats (200-250 g weight) were divided into 7 groups. Group 1: having no treatment after SAH; Group 2: treatment with nimodipine after SAH; Group 3: treatment with nicorandil after SAH; Group 4: treatment with sildenafil citrate after SAH; Group 5: treatment with 150 mg/kg curcumin after SAH; Group 6: treatment with 300 mg/kg curcumin after SAH, Group 7: treatment with 600 mg/kg curcumin after SAH. The experimental SAH was induced by injection of autologous blood into the cisterna magna. After medical treatment, in the first hour, blood was taken for quantified the levels of TNF-α, IL-1β and IL-6. Then, cerebrum and cerebellum were removed for analysis. Basilar artery luminal diameter was measured and apoptotic cell count was performed with tissue samples.

RESULTS

Histopathological findings showed that, in sufficient dose, curcumin dilated the basilar artery beside anti-oxidant effect.

CONCLUSION

Curcumin can be used for the treatment of vasospasm as a new medical drug.

25-Gauge Transconjunctival Sutureless Pars Plana Vitrectomy

Purpose

To evaluate the effectiveness, feasibility, and safety of the transconjunctival sutureless vitrectomy (TSV) system for a variety of vitreoretinal diseases.

Methods

In this retrospective study, the authors evaluated 71 eyes of 63 patients who underwent pars plana vitrectomy (PPV) with the 25-gauge TSV system. The indications for surgical intervention were diabetic vitreous hemorrhage (29 eyes), diabetic macular edema (14 eyes), macular epiretinal membrane (13 eyes), endophthalmitis (5 eyes), vitreous opacities secondary to Behçet's disease (4 eyes), vitreous hemorrhage secondary to branch retinal vein occlusion (4 eyes), and vitreous hemorrhage secondary to age-related macular degeneration (2 eyes). Epiretinal membrane and internal limiting membrane removal, endolaser photocoagulation, and air-fluid exchange were performed when required.

Results

Mean follow-up was 3.6 months (range 1–8 months). Mean overall visual acuity (VA) was counting fingers (range light perception to 0.4) preoperatively and 0.2 (range 0.1 to 0.8) postoperatively (p=0.000). Statistically significant VA improvement was observed in eyes with vitreous hemorrhage, diabetic macular edema, and macular epiretinal membrane. VA improved postoperatively in all eyes with endophthalmitis and vitreous opacities secondary to Behçet's disease. The surgery was completed without conjunctival and scleral suturing in all eyes. Mean intraocular pressure (IOP) was 17.2 mmHg (range 10–26 mmHg) preoperatively, 12.4 mmHg (range 6–24 mmHg) on the first postoperative day, 16.6 mmHg (range 10–33 mmHg) at 1 week, and 15.4 mmHg (range 10–20 mmHg) at 1 month postoperatively. On the first postoperative day, IOP was below 10 mmHg (between 6 and 9 mmHg) in 12 eyes (16.9%). In these eyes, IOP was normalized within 1 week without affecting the visual outcome. Five eyes (7%) had transient increase of IOP controlled by topical antiglaucomatous medications. Vitreous washout using 25-gauge TSV system was performed in two eyes, in which vitreous hemorrhage recurred.

Conclusions

The TSV system was observed to be feasible, effective, and safe for a variety of vitreoretinal diseases. This minimally invasive and completely sutureless (transconjunctival) technique appears to decrease the convalescence period, operating time, and postoperative inflammatory response, and improve patient comfort.

Comparison of the symptomatic and chondroprotective effects of glucosamine sulphate and exercise treatments in patients with knee osteoarthritis

OBJECTIVES

The aim of the present study was to evaluate the symptomatic effects of glucosamine sulphate (GS) in comparison to the exercise therapy, as well effects on Magnetic Resonance Imaging (MRI) findings of cartilage loss in patients with knee osteoarthritis (OA).

MATERIALS AND METHODS

Seventy patients with a diagnosis of knee OA were randomly divided into two groups. First group of patients (n=40) were treated with 1500 mg/day oral glucosamine sulphate and the second group (n=30) performed a home exercise program for a period of 6 months.

RESULTS

Compared with baseline, significant improvements were observed in the visual analogue scale pain scores and the Western Ontario and McMaster Universities osteoarthritis index and 20-min walking time in both groups (p< 0.001); there were no significant differences between the two treatment groups. Upon the evaluation of joint cartilage thickness by MRI, an improvement was evident in only in the area of medial femoral condyle of patients who had performed a home exercise program (p< 0.05).

CONCLUSION

The results of the present study suggest that both oral GS treatment and exercise therapy are efficient in the symptomatic treatment of patients with knee OA. However, exercise therapy found to have a better chondroprotective effect than oral GS treatment in this patient population.

Evaluation of aqueductal CSF flow dynamics with phase contrast cine MR imaging in idiopathic intracranial hypertension patients: preliminary results

OBJECTIVE

We aimed to evaluate dynamic cerebrospinal fluid (CSF) flow in idiopathic intracranial hypertension (IIH) patients with new MRI technology phase contrast cine (PCC) MRI.

PATIENTS AND METHODS

Nineteen patients diagnosed with idiopathic intracranial hypertension and 11 healthy volunteers were included in this study. Nine of the IIH cases had been previously diagnosed and had been on drug treatment and 10 cases were diagnosed with IIH recently and had not been put on drug treatment yet. All CSF flow datas were evaluated by phase contrast-MRI using a 1,5 T MRI. The CSF flow was calculated in the equidistant MRI sequence which was taken through a cardiac cycle.

RESULTS

Mean aqueduct area in the IIH group was 3.04 ± 1.14 mm², mean peak rate was 3.29 ± 1.77 cm/sec, mean average rate was 0.35 ± 0.33 cm/sec and mean flow was 0.67 ± 0.95 ml/min. In the control group mean aqueduct area was 2.87 ± 1.01 mm², mean peak rate was 4.20 ± 1.40 cm/sec, mean average rate was 0.37 ± 0.18 cm/sec and mean flow was 0.64 ± 0.40 ml/min. A statistically significant difference was found for the PCC MRI parameter of mean rate value (p: 0.007) between the control group and IIH patients. A statistically insignificant (p: 0.058) but marked difference was found for mean flow value.

CONCLUSIONS

To our knowledge this study is the first CSF flow study in the idiopathic intracranial hypertension patients. We found a difference between the IIH groups and controls in mean rate and flow parameters. It was interesting that the mean rate and flow values of the untreated group that were higher than the controls. CSF flow analysis may be a marker to follow up IIH patients.

Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010

OBJECTIVE

To analyse suicides occurring in Turkey between 1990 and 2010 according to sex, age, reason and method.

METHODS

Data concerning suicides occurring in Turkey between 1990 and 2010 were obtained from annual records published by the Turkish Statistical Institute. Data were analysed according to sex, age, reason for suicide and suicide method.

RESULTS

The crude suicide rate was 2.42 per 100 000 population in 1990 and 4.02 per 100 000 population in 2010. The highest number of suicides was seen in those aged 15-24 years. In this age group, the number of suicides in females was significantly higher than in males. The most common suicide method in Turkey was hanging. Men used firearms more frequently than women. All the reasons for suicide occurred in a higher number of males than females; however, the difference between males and females was more significant for economic problems, relationship problems and educational failure. The leading reason for suicide in females was relationship problems.

CONCLUSION

Detecting population subgroups with a high suicide risk and obtaining regional demographic data are of great importance for future studies on suicide prevention.

Follicular phase serum and follicular fluid glycodelin measurements in gonadotropin-releasing hormone (GnRH)-antagonist assisted reproduction cycles: A prospective cohort study

PURPOSE

To establish the serum pattern for glycodelin and to investigate the possible correlations of serum and follicular fluid (FF) glycodelin with clinical pregnancy in gonadotropin-releasing hormone (GnRH)-antagonist controlled cycles.

MATERIALS AND METHODS

A prospective observational study conducted with 80 infertile couples who received a GnRH-antagonist controlled cycle. Glycodelin levels were measured in FF, day 2-3, and ovarian pick-up (OPU)-day serum samples.

RESULTS

There were no significant differences in serum glycodelin concentrations in either the early follicular phase or the preovulatory phase, and in FF glycodelin concentrations between clinically pregnant and non-pregnant patients. OPU-day serum glycodelin was found to be significantly higher than early follicular serum glycodelin level in all patients whether pregnancy occurred or not.

CONCLUSION

Although day 2-3 and OPU-day measurements of serum glycodelin levels were not significant in predicting clinical pregnancy, the pattern of serum glycodelin seems different in GnRH-antagonist controlled cycles than natural and GnRH-agonist controlled cycles.

Effects of placebo-controlled continuous and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial

OBJECTIVE

The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome.

METHODS

The study included 46 carpal tunnel syndrome patients who were randomly divided into 3 groups. The first group (n = 15) received a 0 W/cm2 ultrasound treatment (placebo); the second group (n = 16) received a 1.0 W/cm2 continuous ultrasound treatment and the third group (n = 15) received a 1.0 W/cm2 1:4 pulsed ultrasound treatment 5 days a week for a total of 15 sessions. All patients also wore night splints during treatment period. Pre-treatment and post-treatment Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale scores, median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the 2nd finger and palm were compared. Clinicaltrials.gov: NCT02054247.

RESULTS

There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score (p<0.05 for all groups), Symptom Severity Scale score (first group: p<0.05, second group: p<0.01, third group: p<0.001) and Visual Analogue Scale score (first and third groups: p<0.01, second group: p<0.001). Sensory conduction velocities improved in the second and third groups (p<0.01). Distal latency in the 2nd finger showed improvement only in the third group (p<0.01) and action potential latency in the palm improved only in the second group (p<0.05).

CONCLUSION

The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement. Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement; however, the results were not superior to those of the placebo.

Effects of doxycycline on intestinal ischemia reperfusion injury induced by abdominal compartment syndrome in a rat model

BACKGROUND

Abdominal compartment syndrome (ACS) refers to organ dysfunction and ischemia resulting from intra-abdominal hypertension (IAH). Ischemia of the gut results in the triggering of a systemic inflammatory response by releasing cytokines which, in turn, causes capillary leakage leading to bowel edema, further increasing intra-abdominal pressure and resulting in a morbid cycle of ischemia and edema.

OBJECTIVE

The aim of this study was to determine the effects of doxycycline on intestinal ischemia reperfusion (I/R) injury in a rat model of ACS.

METHODS

Sprague-Dawley rats were divided into 5 equal groups. In groups 1 and 2, saline (1 cc IP) was administered during induction of ACS and intestinal samples were removed at 1 and 24 hours, respectively, after decompression. In groups 3 and 4, doxycycline (10 mg/kg IP) was injected during induction of ACS and, similarly, intestinal samples were removed at 1 and 24 hours after decompression. In the control group (group 5), intestinal samples were collected without induction of ACS. Malon-dialdehyde (MDA), interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, matrix metalloproteinase-2 (MMP-2), and tissue inhibitor of metalloproteinase-1 were studied and the apoptotic cells were enumerated histopathologically. Apoptosis and β-cell lymphoma 2 (βcl-2) expression were assessed immunohistochemically.

RESULTS

Thirty-five rats were evenly divided into 5 groups of 7 rats each. MDA, IL-1β, IL-6, TNF-α, and MMP-2 levels were significantly higher in group 1 one hour after the reperfusion period compared with the control group (P < 0.001, P < 0.001, P < 0.05, P < 0.001, and P < 0.01, respectively). The same parameters were significantly lower in group 3, in which doxycycline was administered, than in group 1 (P < 0.001, P < 0.05, P < 0.05, P < 0.001, and P < 0.01, respectively). However, there was no significant difference between groups 2 and 4 in the 24th hour (all, P > 0.05). The mean (SD) number of apoptotic cells and the expression of βcl-2 was highest in group 2 at 24 hours after the reperfusion period (92.5 [11.4] and 35.9 [5.0], respectively) and significantly greater than that in group 4 (P < 0.001 and P < 0.05, respectively).

CONCLUSION

Doxycycline was associated with protective effects against I/R injury through decreasing apoptosis via attenuating the response of proinflammatory cytokines and inhibiting the activity of MMP-2 in this rat model.

Olfactory disfunction and its relation olfactory bulb volume in Parkinson's disease

OBJECTIVE

Olfactory dysfunction is the most frequently seen non-motor symptom of Idiopathic Parkinson's disease (IPD). The aim of this study is to analyze selective olfactory dysfunction, and olfactory bulb volume (OBV) in subtypes of IPD, and compare them with those of the healthy controls.

PATIENTS AND METHODS

Our study included 41 patients with IPD and age and gender matched 19 healthy controls. IPD patients were either tremor dominant (65.9%; TDPD) or non-tremor dominant (34.1%; NTDPD) type. All patients underwent neurological, ear, nose, and throat examinations, and orthonasal olfaction testing. Magnetic resonance imaging (MRI) technique was used to measure the volume of the olfactory bulb.

RESULTS

A significant decrease in olfactory identification scores was found in the patient group. The patients had difficulty in discriminating between odors of mothballs, chocolate, Turkish coffee and soap. OBV did not differ between the patient, and the control groups. In the TDPD group, odor identification ability was decreased when compared to the control group. However, odor test results of NTDPD, control and TDPD groups were similar. OBV estimates of the TDPD group were not different from those of the control group, while in the NTDPD group OBVs were found to be decreased. In all patients with Parkinson's disease OBV values did not vary with age of the patients, duration of the disease, age at onset of the disease, and Unified Parkinson's Disease Rating Scale motor scores (UPDRS-m).

CONCLUSIONS

Olfactory function is a complex process involving olfactory, and cortical structures as well. In Idiopathic Parkinson's disease, changes in OBV do not seem to be directly related to olfactory dysfunction.

The association of FOXO3A gene polymorphisms with serum FOXO3A levels and oxidative stress markers in vitiligo patients

Vitiligo is an acquired epidermal pigment loss of the skin. Oxidative stress is one of the major theories in the pathophysiology of vitiligo. FOXO3A is the forkhead members of the class O (FOXO) transcription factors, and plays an important role in cell cycle regulation, apoptosis, oxidative stress, and DNA repair. The aim of our study was to investigate FOXO3A gene polymorphisms and FOXO3A protein levels, activities of superoxide dismutase (SOD) and catalase antioxidant enzymes in vitiligo patients and healthy controls. Moreover, the level of plasma advanced oxidation protein products (AOPP) in subjects was evaluated to understand the possible role of protein oxidation in disease etiology. Study groups included 82 vitiligo patients and 81 unrelated healthy controls. FOXO3A polymorphisms were determined using polymerase chain reaction-restriction fragment length polymorphism method. FOXO3A levels and catalase activity were measured by ELISA whereas AOPP levels and SOD activity was measured by spectrophotometric analysis. We found a significant relationship between rs4946936 polymorphism of FOXO3A gene and vitiligo/active vitiligo patients (p=0.017; p=0.019 respectively), but not for rs2253310 (p>0.05). SOD activity and AOPP levels of vitiligo patient were increased compared with control group, whereas FOXO3A levels and catalase enzyme activity of vitiligo patient were decreased compared with control group (p<0.05). Our study indicates that rs4946936 of FOXO3A gene may associate susceptibility of vitiligo, especially active vitiligo. Moreover, our results confirm that oxidative stress may play a role in the pathophysiology of vitiligo. Further studies with larger samples are required to elucidate the role of FOXO3A in vitiligo.

Inhalation therapy of calcitonin relieves osteoarthritis of the knee

This study was conducted to determine if nasal salmon calcitonin has additional beneficial effects on clinical symptoms, serum NO, IL-1β, matrix metalloproteinase 3, urinary C-terminal telopeptide type II collagen (CTX-II) levels and MRI findings in knee osteoarthritis (OA) when used concomitantly with exercise therapy. Fifty female patients with knee OA were randomized into two groups. The first group (n = 30) received 200 IU/day nasal salmon calcitonin and a home exercise program; the second group (n = 20) received a home exercise program for 6 months. Compared with baseline,while significant improvements were observed in visual analogue scale (VAS), WOMAC pain, physical function scores, 20-m walking time (P < 0.001) and WOMAC stiffness score (P = 0.041) in the first group, walking and resting VAS, and WOMAC physical function scores were improved (P = 0.029) in the second group after treatment. Significantly increased levels of serum NO and urinary CTX-II (P < 0.001) and significant improvements in the area of medial femoral condyle (P < 0.05) were noted only in the first group. There were significant differences in VAS activation values (P = 0.032) and NO levels (P < 0.001) in the favor of the first group. In conclusion, nasal salmon calcitonin may have possible chondroprotective effects besides its known effects on symptoms in patients with knee OA.

Monitoring and assessment of airborne Cladosporium Link and Alternaria Nées spores in Sivrihisar (Eskisehir), Turkey

The spores of Cladosporium spp. and Alternaria spp., commonly described as the most allergenic spores, were collected by means of Durham gravimetric sampler from the Sivrihisar (Eskisehir) atmosphere throughout 2005 to 2006. The weekly variations in spores/cm(2) of Cladosporium and Alternaria were recorded. During this period, a total of 6,198 spores belonging to Cladosporium spp. and Alternaria spp. were recorded. Of these spores, 2,969 were identified in 2005 and 3,229 in 2006. While 69.55% of the total spores were those of Cladosporium spp., 30.45% were Alternaria spp. Relationships between airborne fungal spore presence and weather conditions were examined statistically. A Shapiro-Wilk test revealed that the airborne spores of Cladosporium spp. and Alternaria spp. had a normal distribution. Following this, Chi-square test, t test and Pearson correlation analysis were performed. The effects of temperature and relative humidity on the spore numbers of Cladosporium spp. and Alternaria spp. were significant according to the month in which they were collected (p < 0.01). The spore concentrations of each species reached to their highest levels in June 2006.

Sexual differences in the completed suicides in Turkey

The aim of this study was to determine whether there is a difference between men and women in terms of suicide age, suicide method and suicide reason in Turkey. This study recruited 17,327 cases that had committed suicide between 1990 and 2000. Of all the cases who committed suicide during a period of 11 years, 61.1% were men, 38.9% women. The highest suicide score fell into the age group 15-24 (P<0.001). The most frequently used methods for suicide were self-hanging (48.2%) and use of firearms (19.2%) (P<0.001). The proportion of those committing suicide taking chemicals (drugs, etc.) was higher in women than in men (P<0.001). The most frequently seen reasons for suicide were illness and (33.8%) unsatisfactory relationships (33.0%) (P<0.001, each one). Women committed suicide much more because of unsatisfactory relationships, whereas for men it was due to illness (20.8% and 14.6%, respectively). There were significant differences between men and women in terms of suicide age, suicide method and suicide reason in Turkey. When evaluating suicide cases it is essential that the differences between sexes be taken into consideration.

Does an acute increase of intraabdominal pressure effect esophageal sphincter pressure?

BACKGROUND/AIMS

The study was designed to observe the acute alterations between lower esophageal sphincter (LES) and intraabdominal pressure (IAP) in patients undergoing diagnostic laparoscopy.

METHODOLOGY

Eleven patients (7 Male), aged 49 fitting the criteria for manometric research and diagnostic laparoscopy were studied. To measure the IAP in sterile conditions a new device (IAP measurement system) was set. Pressures at basal (b), during intraabdominal CO2 insufflations (min, m2, m3) and at the end of laparoscopy (me), were recorded simultaneously. All results were given as the difference between two maneuvers (A). Paired sample t-test was used.

RESULTS

The results were as follows; at the time of maximum CO2 insufflations: p delta m1-b; 24.25 vs. 14.64 mmHg, during the stabile insufflations: p delta m2-m1; -2.88 vs. 2.99 mmHg, p delta m3-m2; -0.70 vs. -0.82 mmHg and after deflation of CO2; end of the laparoscopy; p delta m(e)-m3; -16.73 vs. -16.65 mmHg for LESP and IAP respectively. The response of the LESP and IAP were similar in all phases (p > 0.05). Also alterations of pressures according to gender or presence of cirrhosis were found to be similar.

CONCLUSIONS

LESP is changed synchronously in the presence of acute pressure changes in IAP. Gender or presence of cirrhosis does not affect the response of LES.

Preventive Effects of Ginkgo biloba Extract on Ischemia-Reperfusion Injury in Rat Bladder

AIMS

The aim of this experimental study was to evaluate the effects of Ginkgo biloba (EGb 761) on ischemia-reperfusion (I-R) injury in the rat bladder.

METHODS

A bladder I-R injury was induced by abdominal aorta occlusion by ischemia for 30 min, followed by 45 min reperfusion in rats. The rats were divided into four groups of 7 rats each; the control, I-R, and I-R groups were pretreated intraperitoneally with 50 or 100 mg/kg G. biloba 60 min before ischemia induction. Contractile responses to carbachol through isolated organ bath studies were recorded, histological sections were evaluated by light microscopy, and TUNEL staining was performed for the evaluation of apoptosis.

RESULTS

In the I-R group, the contractile responses of the bladder strips were lower than those of the control group (p < 0.01-0.001) and were restored by pretreatment with 100 mg/kg G. biloba (p < 0.05-0.001). Decreased polymorphonuclear leukocyte infiltration was detected in the G. biloba pretreatment groups when compared to the I-R group during histological evaluation. The ratio of TUNEL-positive nuclei was 1.84% in the I-R group, whereas it was decreased in both of the G. biloba pretreatment groups (p < 0.01, p < 0.01).

CONCLUSION

Our data indicated that G. biloba has a preventive effect on I-R injury in rat urinary bladder.

FACTORS INFLUENCING STUDENTS' SUCCESS: A GENERALIZED ESTIMATING EQUATIONS STUDY

The goals of this study were to determine the factors influencing children's success according to Generalized Estimating Equations (GEE) through the Family Report Form (FRF; constituted by the authors), Teacher's Report Form (TRF; Achenbach, 1991b) and Child Behavior Check List (CBCL; Achenbach & Edelbrock, 1983), and to form a new and actual reference success form for Turkish children. The study sample included 4130 primary school children in Eskisehir, Turkey. School success was measured as the total scores that students achieved in the following classes: cultural, social, science, foreign language, computer, picture, music and job-occupation. The TRF, CBCL and FRF forms consist of the sum of subtests, which includes 9 factor scales, namely anxiety/depression, somatic complaints, social withdrawal, delinquent behavior, social problems, thought problems, attention deficits, aggressive behavior, and other. As the statistical analyses, GEE method, stepwise regression analysis and missing value analyses were used. The items that had the greatest negative effect on the students' success were “has poor school work” and “can't concentrate or can't pay attention for long”. On the other hand, the item that had the greatest positive effect on students' success was “feels he/she has to be perfect”. It may be recommended that students, their families, and teachers should be informed about factors influencing school success.

Microfungi in cultivated fields in Eskişehir provience (Turkey)

The soil microfungi flora was investigated in four locations of Eskişehir (Turkey). 56 soil samples were seasonaly collected from 14 stations in the areas of Karacahöyük, Bahçecik, OGU I, and OGU II. A total of 110 species belonging to 32 genera were encountered including Absidia, Acremonium, Alternaria, Aspergillus, Beauveria, Botryoderma, Chaetomium, Chrysosporium, Cladosporium, Eupenicillium, Eurotium, Fusarium, Geotrichum, Gliocladium, Gonytrichum, Metarrhizium, Mucor, Myrothecium, Paecilomyces, Penicillium, Phoma, Plectosphaerella, Rhizoctania, Rhizopus, Scopulariopsis, Septonema, Stachybotrys, Trichocladium, Trichoderma, Ulocladium, Verticillium, and Wardomyces. Twenty five species were more frequent (all locations) while twenty seven species were rare (only one sample). Mainly, Acremonium kiliense, Aspergillus ochraceus, A. terricola var. americanus, A. versicolor, Cladosporium cladosporioides, Fusarium oxysporum, F. solani, Gliocladium roseum, Penicillium chrysogenum, P. corylophum, P. expansum, P. griseofulvum, P. implicatum, P. restrictum, and Stachybotrys chartarum were the most common and abundant microfungi in all locations. Five species Aspergillus subsessilis, A. terreus var. africanus, Eupenicillium egyptiacum, Paecilomyces ramosus, and Penicillium novae-zeelandiae are likely to be newly recorded for Turkey. The microfungi number in Eskişehir soils was between 25,000-234,000 CFU/g (mean value at 126,375 CFU/g).

Comparison of spiral CT and US in the evaluation of pediatric urolithiasis

The objective of the study was to determine the value of spiral computerized tomography (CT) in detecting urolithiasis in pediatric patients and compare its efficacy with ultrasound (US). Twenty-nine infants aged between 2 to 94 months with clinical presentation suggestive of urolithiasis and a negative or indeterminate plain film were included in the study. Abdominal US and spiral CT were performed in all patients. Presence, size and localization of stones were noted for each patient on both CT and US. The diagnosis of urolithiasis was confirmed by passage of stones spontaneously, extracorporeal shockwave lithotripsy (ESWL), surgery, or clinical follow-up. Presence of stones was confirmed in 23 of 29 patients (79%). Eight patients had single stone and the remaining 15 had multiple stones either in a single localization (single kidney or single ureter) or multiple localizations. Spiral CT detected 57 stones (45 renal and 12 ureteral). US detected 34 stones (59.6%) in 18 (78.2%) patients. US was able to localize 31 stones (68.8%) in 21 kidneys (75%), and 3 stones (25%) in 11 ureters (27.2%). Spiral CT is very effective in the diagnosis of pediatric urolithiasis. Spiral CT is more efficient than US in imaging pediatric patients with symptoms and signs of urolithiasis, when KUB is inconclusive.

Reduced jugular venous oxygen saturation during rewarming from deep hypothermic circulatory arrest: cerebral overextraction?

Deep hypothermic circulatory arrest may impair cerebral cellular functions, and physiological parameters following circulatory arrest may deviate from the normal. The intention of this study was to monitor jugular venous oxygen saturation during cardiopulmonary bypass before and after deep hypothermic circulatory arrest. Jugular venous oxygen saturation were obtained on 18 patients by using a retrograde jugular vein catheter during replacement of the ascending aorta. Indications for operations were ascending aortic dilatation (n=15) and acute aortic dissection (n=3). Hypothermic cardiopulmonary bypass (233+/-60 min), cardioplegic arrest (105+/-37 min) and circulatory arrest (22+/-7 min) were utilized during the operations. Jugular venous oxygen saturation increased during hypothermia and decreased during rewarming. Compared with cooling, jugular venous oxygen saturation during the initial part of rewarming were significantly lower (87+/-5% vs. 97+/-1%, 89+/-4% vs. 95+/-2%, 81+/-4% vs. 87+/-5% at 16, 20 and 24 degrees C respectively, p<0.05). One patient required re-exploration because of bleeding. All patients were found neurologically normal before being discharged from the hospital (mean 14+/-7 days). In conclusion, jugular venous oxygen saturation is inversely related to the body temperature in patients undergoing hypothermic cardiopulmonary bypass. Significantly decreased jugular venous oxygen saturation during the initial part of rewarming may signify an increased cerebral extraction of oxygen.

Inflammatory response to cold injury in remote organs is reduced by corticotropin-releasing factor

Current experimental evidence concerning the potential activity of corticotropin releasing factor (CRF) in inflammatory processes still remains controversial. To determine whether CRF has protective effects on three remote organs (liver, lung and stomach) affected by cold injury and to characterize the role of neutrophils in cold-induced inflammation, dorsums of anesthetized rats were exposed for 5 min to a 22% NaCl solution maintained at -20+/-0.5 degrees C and the rats were sacrificed at 24 h after the cold injury. The results indicate that cold-exposure-induced edema in the liver, lung and stomach was blocked by subcutaneous (s.c.; 1.2 and 12 nmol/kg; 30 min before cold trauma) CRF pretreatment, while the central administration of CRF (intracisternally (i.c.); 0.30 and 1.5 nmol/rat; 15 min before cold) had the similar effect at the higher dose. Histological assessment and the tissue myeloperoxidase activities also revealed that CRF given peripherally has a protective role in damage generation. Moreover, CRF had a facilitatory effect in the recovery of the body temperature following cold exposure. In conclusion, CRF is likely to act on its peripheral receptors in the inflamed remote organs, suppressing the edematogenic effects of inflammatory mediators, some of which are neutrophil-derived.

Percutaneous nephrolithotomy in patients aged 60 years or older

PURPOSE

To assess the safety and efficacy of percutaneous nephrolithotomy in patients more than 60 years old.

PATIENTS AND METHODS

We retrospectively evaluated and compared the data of 28 percutaneous nephrolithotomies (PCNL) performed on 27 patients aged 60 years and older (mean 65.8) with the data of the remaining 178 PCNL procedures on 166 patients performed in our clinic between December 1997 and December 1999.

RESULTS

Although staghorn stones seemed to be more common in the elderly group (25% v 22%), no statistical significance was demonstrated (P = 0.715), and the stone burden was similar for the two groups (P = 0.112). The only interesting finding in terms of patient characteristics was a significantly higher incidence of solitary kidney in patients aged 60 years or older (29% v 7%; P = 0.003). The success rates (stone-free patients and patients with residual stones <4 mm) were similar, being 89% for the elderly group and 92% for the younger patients (P = 0.718). Transfusion rates were also similar (21.4% in the elderly v 18% in the younger group; P = 0.662). No significant complication was observed in this elderly group, and no renal deterioration has been detected even in the follow-up of patients with a solitary kidney.

CONCLUSIONS

Despite the somewhat higher stone burden in the elderly patients (1077.92 mm2 v 920.85 mm2), the stone-free rate was similar to that obtained in the younger patients, without any higher rates of complications or blood transfusions or longer hospital stay. Percutaneous nephrolithotomy is a safe and effective method of stone treatment in the elderly, even if they have a solitary kidney or complex calculi.

The protective effect of melatonin on cisplatin nephrotoxicity

Regarding the mechanisms of cisplatin (CP) nephrotoxicity, several hypotheses have been put forward, among which oxidative stress (including depletion of glutathione and production of lipid peroxide) is noticeable. This investigation elucidates the role of the antioxidant system in CP-induced nephrotoxicity and the nephroprotection by melatonin. Balb/c mice were injected i.p. with: 1) vehicle control; 2) a single dose of 6.5 mg/kg cisplatin, CP group; 3) melatonin in a dose of 10 mg/kg for 5 days after CP injection, CP-M group; 4) melatonin (10 mg/kg) for 5 days before and after CP injection, M-CP-M group; 5) melatonin in a dose of 10 mg/kg for 5 days, M group. Mice were sacrificed 5 days after CP injection to determine blood urea nitrogen (BUN) and serum creatinine. Renal lipid peroxidation (LP) and glutathione (GSH) levels were evaluated in kidney homogenates. Cisplatin administration resulted in increased LP, BUN and serum creatinine levels and decreased GSH levels, whereas melatonin reversed these effects. Morphological kidney damage was apparent in the CP group. Mentioned degeneration was moderate in the CP-M group, whereas morphological findings of the M-CP-M group implied a well preserved kidney tissue. When M was administered alone, it didn't cause any significant change in biochemical parameters. Both C and M groups exhibited similar biochemical and morphological findings in light and transmission electron microscope observation. In conclusion, the present study suggests that melatonin may be of therapeutic benefit when used with CP.

Coronary risk factors in Turkish schoolchildren: randomized cross-sectional study

BACKGROUND

There is a strong association between the extent of atherosclerotic lesions in aorta and coronary arteries and antemortem risk factors in children and young adults. Cardiovascular diseases are the most common cause of death in adults in Turkey. However, the data about the extent of coronary risk factors in Turkish children is very limited. The aim of this cross-sectional study was to investigate the prevalence of coronary risk factors in Turkish schoolchildren living in Eskişehir, Turkey.

METHODS

A randomly selected population of 4026 schoolchildren, aged between 7 and 18 years, residing in urban and rural parts of Eskişehir were evaluated for coronary risk factors, using previously predicted risk threshold values.

RESULTS

Hypertension was found in 4.8% of the girls and 3.8% of the boys, 14.9% of the girls and 10.8% of the boys had abnormal lipid values, 18.2% of the girls and 26.4% of the boys had elevated total body fat percentages, 20.7% of the girls and 14.5% of the boys had physical inactivity and 3.8% of the girls and 11.4% of the boys were regular smokers. Urban children had higher rates of hypercholesterolemia; however, rural children had higher rates of physical inactivity. When the modifiable risk factors were considered, excluding family history, 47.7% of the children had at least one risk factor and 11.7% of them exhibited two or more risk factors.

CONCLUSIONS

Turkish schoolchildren living in Eskişehir had considerably high levels of coronary risk factors. The interventional measures established in childhood, during which the lifestyle and habits responsible for coronary heart diseases are acquired, will be very effective for preventing and modifying the risk factors predisposing children to coronary heart disease.

Occupational risk of hepatitis B and C infections in urologists

The purpose of this study is to evaluate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and the related risk factors among urologic surgery patients and urologists. This cross-sectional, prospective study included 300 consecutive urologic surgery patients and 24 urologists working in our department. The patients and urologists with positive serology for any of the hepatitis viruses were questioned for risk factors including previous transfusions, surgery, endoscopy, intravenous drug abuse and homosexuality. Positive serology for HBV and/or HCV was found in 47.4% of the patients, and the rate of the patients with antigenemia, the major risk group for the urology team, was 9.9%. Of the 24 urologists working in our department, 3 were antibody to HCV (anti-HCV) positive and 2 were hepatitis B surface antigen (HBsAg) positive. The presence of a risk factor among patients with HBsAg was found in 78.9% and in 100% of those with anti-HCV. The prevalence of hepatitis in urologic surgery patients and urologists is poorly described. This study indicates a high prevalence of HBV and HCV seropositivity in urology patients. In urology wards, the risk of hepatitis transmission is estimated to be appreciably high because of the renal transplantation procedure and frequent use of blood and blood-contaminated solutions for transurethral resections or catheter irrigations. Vaccination with HBV vaccine and application of universal precautions during daily practice seem to be the only and most effective means of protection against blood-borne infections.