The antitumoral effect of the esculetin in HeLa cells through endoplasmic reticulum stress

OBJECTIVE

Despite the multiple available treatment modalities, cervical cancer is one of the leading causes of mortality and morbidity among female gynecological cancers. Endoplasmic Reticulum (ER) is an effective organelle in ensuring cell homeostasis and is closely related to the development of cancer. Esculetin is a coumarin derivative that has anticancer, anti-inflammatory, antioxidant, and neuroprotective effects. Esculetin may have an anticancer effect by inducting apoptosis and ER stress. In this study, we evaluate that esculetin has an anti-tumor effect on human cervical cancer-derived (HeLa) cells via ER stress.

MATERIALS AND METHODS

Esculetin was applied to the HeLa cells, and a viability test was performed using the methyl thiazolyl tetrazolium proliferation (MTT) assay. Expression levels of apoptotic genes and anti-apoptotic genes were determined by real-time polymerase chain reaction. The results were statistically evaluated.

RESULTS

Analysis of the MTT assay detected that esculetin inhibited HeLa cell viability development. Based on Western blot and quantitative real-time polymerase chain reaction (qPCR) analyses, esculetin destroyed cervical cancer cells via the ER stress pathway.

CONCLUSIONS

The results showed that esculetin may have a potent antitumoral effect. It can potentially be utilized in the pharmacological therapy of cervical cancer.

The role of NMDA glutamate receptors in lung injury caused by chronic long-term intermittent hypobaric hypoxia

Chronic intermittent hypoxia (CIH), a component of sleep apnea-hypopnea syndrome, is suggested to cause damage to lung tissue, and the role of glutamate is not well studied. We used a chronic long-term intermittent hypobaric hypoxia (CLTIHH) model of rats to find out if such procedure causes lung injury and the potential effect of N-methyl-D-aspartate receptors (NMDARs) by using receptor antagonist MK-801 (dizocilpine). Thirty-two rats were placed into four groups; a control and three CLTIHH groups where rats were placed into a low-pressure chamber set to 430 mmHg for 5 h/day, 5 days/week, for 5 weeks. Only one group received MK-801 (0.3 mg/kg, ip) daily. We evaluated tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, and nuclear factor (NF)-kB for the inflammatory process, superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPX), total antioxidant status (TAS), and total oxidant status (TOS) for oxidative stress, and caspase-9 levels. Blood plasma, bronchoalveolar fluid (BALF), and lung tissue extracts were evaluated. Both oxidant and inflammatory parameters were significantly increased in all the mediums of the CLTIHH groups except the group that received MK-801. Significant evidence was collected on MK-801 alleviating the effect of CLTIHH. Histological evaluations revealed lung damage and fibrotic changes in the CLTIHH groups. It was first shown that the CLTIHH procedure caused chronic lung injury, and that inflammation and oxidant stress were influential in the formation of lung injury. Secondly, NMDAR antagonist MK-801 effectively inhibited the development of lung injury and fibrosis.

Effect of Previous Crosslinking on Intraoperative and Postoperative Outcomes and Complication Rates of Big-Bubble Deep Anterior Lamellar Keratoplasty for Keratoconus: A Comparative Study

PURPOSE

To compare surgical outcomes and intraoperative and postoperative complications of big-bubble deep anterior lamellar keratoplasty (DALK) in patients with and without a history of previous corneal collagen crosslinking (CXL) for keratoconus.

METHODS

Patients with keratoconus who underwent DALK surgery with big-bubble technique between January 2013 and January 2018 were retrospectively reviewed. Operative findings, intraoperative and postoperative complications, and visual and refractive outcomes were recorded. Patients were divided into 2 groups: with previous CXL (CXL-DALK group: 27 eyes) and without previous CXL (DALK group: 50 eyes). All parameters were compared between groups.

RESULTS

Big bubble was successfully achieved in 24 eyes (88.9%) in the CXL-DALK group and in 45 eyes (90.0%) in the DALK group (P = 0.87). Type 1 bubble was obtained in 22 eyes (91.7%) in the CXL-DALK group and in 42 eyes (93.3%) in the DALK group (P = 0.79). Intraoperative microperforation occurred in 3 eyes (11.1%) in the CXL-DALK group and in 5 eyes (10.0%) in the DALK group (P = 1). Visual and refractive outcomes were similar between groups. The mean endothelial cell loss rates were 5.7% ± 2.3 at 1 year and 10.2 ± 3.1 at 2 years in the CXL-DALK group and 6.4% ± 4.7 at 1 year and 10.9% ± 5.4 at 2 years in the DALK group. Postoperatively, persistent epithelial defect was the most common complication in both groups, and postoperative complication rates were similar between groups.

CONCLUSIONS

Our results have shown that previous CXL treatment does not influence the success of bubble formation and does not increase intraoperative or postoperative complication rates of DALK surgery for keratoconus. The improvement in visual acuity and refractive errors and endothelial cell loss rates were similar between CXL treated and untreated eyes after 2 years of follow-up.

Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case-control study

INTRODUCTION

Subclinical inflammation markers play a significant role in hyperemesis gravidarum (HEG). Simple hematological markers such as mean platelet volume (MPV), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), and platelet-to-lymphocyte ratio (PLR) have been shown to reflect inflammatory burden and disease activity in several disorders. Ketonuria is a parameter used in the diagnosis of severe HEG, but its correlation with disease severity remains controversial. The relationship of subclinical inflammation markers with degree of ketonuria has not been examined previously. In this study, we aimed to determine the diagnostic value of these subclinical inflammation markers and the relationship between these markers and grade of ketonuria in patients with HEG.

MATERIALS AND METHODS

A total of 94 pregnant women with a diagnosis of HEG and 100 gestational age-matched healthy pregnant women were enrolled in this retrospective study. MPV, PDW, NLR, PLR, PCT, and ketonuria were calculated and analyzed from complete blood cell counts and total urine analyses.

RESULTS

Lymphocyte count was significantly higher in the control group (P < 0,001); NLR and PLR values were significantly higher in the HEG group (P < 0,001). Among inflammation markers, RDW increased significantly (P = 0,008) with an increase in ketonuria in patients with HEG. A statistically significant correlation was found between white blood cell (WBC) and NLR, PLR, PCT. A moderate uphill relationship was observed between NLR and WBC and a weak uphill linear relationship was observed between WBC and PLR and between WBC and PCT.

CONCLUSIONS

PLR and NLR can be considered effective markers to aid in the diagnosis of HEG. No marker was found to correlate with ketonuria grade except RDW, although the relationship of the severity of ketonuria with severity of disease is controversial. RDW increases as the degree of ketonuria increases.

EVALUATION OF PREIMPLANTATION GENETIC ANEUPLOIDY SCREENING CASES AT A REFERENCE GENETICS CENTER: 10 YEARS' EXPERIENCE

The aim of this study is to review and evaluate our preimplantation genetic screening (PGS) records in terms of their demographic data, indications, cytogenetic results, pregnancy outcomes and discuss these findings in different aspects. PGS was performed in a total of 84 couples (87 cycles) between the period 2005 to 2015. Biopsied blastomeres from embryos on day 3 were fixed and fluorescence in situ hybridization was carried out for chromosomes 13, 16, 18, 21, 22, X and Y depending on the indication. The diagnostic and clinical data were retrospectively evaluated. A total of 450 blastomeres were biopsied. Ninety-eight of them were found to be suitable for transfer. They were transferred to 72 patients in 75 cycles resulting in 23 pregnancies and 20 healthy births. The most common indication was unexplained infertility. The implantation rate was calculated as 23.4% whereas the take-home baby rate was 26.6% per transfer. The highest rate of healthy living births is achieved in patients having low grade maternal mosaic sex chromosomal aneuploidy. All living births achieved by PGS had normal chromosomal structure which we can propose it as an alternative test for couples at risk to select normal embryos to improve the outcomes of assisted reproductive procedures and to avoid the transfer of chromosomally unbalanced and multiple embryos.

Inhibitory effect of sub-conjunctival tocilizumab on alkali burn induced corneal neovascularization in rats

BACKGROUND

To evaluate the effects of sub-conjunctivally applied interleukin-6 receptor (IL-6R) antibody (tocilizumab) on alkali burn induced corneal neovascularization (CNV) in rats.

METHODS

Alkali burn induced corneal neovascularization was created in 24 right eyes of 24 rats. The rats were then randomized into 2 groups. Group 1 received sub-conjunctival injection of 4 mg/0.2 ml tocilizumab and Group 2 received sub-conjunctival injection of 0.2 ml normal saline at the 5th day of alkali burn. The corneal surface area invaded with neovascular vessels were calculated on photographs. The rats were sacrificed and the corneas were excised at the15th day. The corneal specimens were stained with hemotoxylin-eosin to evaluate tissue morphology and with Willebrand factor (vWF) to evaluate microvascular structures immunohistochemically. Vascular endothelial growth factor (VEGF) expression was analyzed by ELISA.

RESULTS

The percent area of CNV was 26.9% in Group 1 and 56.5% in Group 2 (p < 0.001). The histological evaluation showed that the corneal structures were not visibly altered by sub-conjuntival tocilizumab injection. Group 1 showed significantly lower corneal inflammation score than Group 2 (p < 0.001). The number of vessels stained with vWF were significantly higher in Group 2 than Group 1 (15.23 and 5.46, respectively; p < 0.001). ELISA analyses showed that corneal VEGF levels were significantly lower in Group 1 compared to Group 2 (p = 0.013) CONCLUSION: The present data demonstrated first time the beneficial effects of sub-conjunctival tocilizumab on decreasing CNV in alkali burn model of the rat cornea. Further studies are warranted to confirm these findings for the clinical application.

The effect of intracameral anesthesia on macular thickness and ganglion cell-inner plexiform layer thickness after uneventful phacoemulsification surgery: prospective and randomized controlled trial

BACKGROUND

To evaluate the effect of intracameral lidocaine anesthesia on macular thickness and macular ganglion cell-inner plexiform layer (GC-IPL) thickness following uneventful phacoemusification in healthy subjects.

METHODS

This is a prospective, randomized and double- masked study. One hundred eyes of 74 consecutive patients were randomized to receive intracameral preservative-free lidocaine 1 % (intracameral lidocaine group) or intracameral injection of balanced salt solution (sham injection group) at the time of the phacoemulsification surgery. Preoperative and postoperative macular thickness analyses with spectral domain optical coherence tomography (SD-ODT) were performed and the results between the two groups were compared.

RESULTS

Postoperatively, both the central foveal thickness (CFT) and the thickness of perifoveal macula were significantly improved in both groups (p < 0.001). There was no statistically significant difference between CFT and the inner and outer macular zone thicknesses of the two groups at any follow-up time. In both groups, GC-IPL thickness was significantly increased at the first week and first month visits (p < 0.001). There was no statistically significant difference between GC-IPL thickness measurements of the two groups at any follow-up time.

CONCLUSION

The current study demonstrated that supplementary intracameral lidocaine 1 % did not cause more macular thickening than the intracameral sham injection during a follow-up period of 3 months. The present study also showed a tendency for a transient increase in high definition SD-OCT-based GC-IPL thickness measurements within a few months following cataract surgery under both intracameral lidocaine anesthesia and intracameral sham injection.

Calcium and magnesium elimination enhances accumulation of cardenolides in callus cultures of endemic Digitalis species of Turkey

Elimination of calcium (Ca), magnesium (Mg) or both from the medium of callus cultures of Digitalis davisiana Heywood, Digitalis lamarckii Ivanina, Digitalis trojana Ivanina and Digitalis cariensis Boiss. ex Jaub. et Spach increased cardenolides production. Callus was induced from hypocotyl segments from one-month old seedlings were cultured on MS medium containing 0.5 μg ml(-1) thidiazuron (TDZ) and 0.25 μg ml(-1) indole acetic acid (IAA). After 30 days of culture, callus was transferred in hormone-free MS medium (MSO) as well as Ca or Mg or both were completely eliminated from same medium. The amount of five cardenolides from D. davisiana Heywood, D. lamarckii Ivanina, D. trojana Ivanina and D. cariensis Boiss. ex Jaub. et Spach were compared. Higher amounts of five cardenolides and total cardenolides were obtained when callus of four Digitalis species were incubated on MS medium lacking both Ca and Mg. The mean contents of total cardenolides obtained were in the order of D. lamarckii (2017.97 μg g(-1))>D. trojana (1385.75 μg g(-1))>D. cariensis (1038.65 μg g(-1))>D. davisiana (899.86 μg g(-1)) when both Ca and Mg were eliminated from the medium, respectively. This protocol is useful for development of new strategies for the large-scale production of cardenolides.

Ochratoxin A causes oxidative stress and cell death in rat liver

The effect of ochratoxin A (OTA) on oxidant/antioxidant status and on histopathological changes and apoptotic cell death in livers of male Sprague-Dawley rats has been investigated. OTA (0.5 mg/kg body weight/day) was administered by oral route for 14 days. Plasma biochemical parameters, activities of liver selenoenzymes (glutathione peroxidase-1, thioredoxin reductase) and antioxidant enzymes (catalase, superoxide dismutase, glutathione S-transferase), and levels of total glutathione and thiobarbituric acid reactive substance in hepatic tissue were measured. In addition, histopathological examinations were performed and apoptotic cell death of hepatocytes was evaluated by the TdT-mediated dUTP nick-end labelling (TUNEL) assay. OTA exposure was found to induce focal necrosis of hepatocytes and mononuclear cell infiltration. Besides, exposure to OTA caused an imbalance in oxidant and antioxidant parameters in the rat liver, as evidenced by significant decreases in glutathione S-transferase activity and glutathione levels, and marked increases in concentrations of thiobarbituric acid reactive substances. Furthermore, TUNEL analysis revealed a significant ~2.7-fold increase in the number of TUNEL-positive liver cells of rats exposed to OTA compared to the control group. The results of this study showed that oxidative stress is at least one of the mechanisms underlying the hepatic toxicity of OTA, and that both necrosis and apoptosis are types of cell death in the hepatic toxicity of this mycotoxin.

Accuracy and safety of percutaneous US-guided needle biopsies in specific focal liver lesions: comparison of large and small needles in 1300 patients

AIM

The aim of this study was to compare small size aspiration needles with large size cutting needles in focal liver lesions for using small needles instead of large ones without on-site cytopathologist.

METHODS

Percutaneous ultrasonography-guided liver biopsy was evaluated retrospectively in a biopsy cohort study of 1300 patients. In this series, 690 patients were biopsied with large size (<19G) cutting needles and 610 with small size (20G) aspiration needles. On-site cytopathologist was not present in the biopsy-room at any intervention. Needles were compared for diagnostic accuracy and safety for various focal liver diseases.

RESULTS

We had diagnostic accuracy rate of 85.0% in small needle group vs. 96.9% in large needle group with metastasis (P<0.001). This rate was 85.5% in small needle group vs. 97.9% in large needle group with hepatocellular carcinoma (P=0.039). Accuracy rates of them were not different in hemangioma (P=0.277) and infection-inflammation (P=0.470). This rate was 75.0% in small needle group vs. 98.9% in large needle group with regenerative nodules (P=0.018). These rates were not different in focal steatosis (P=1.000). Sensitivity, specificity, and accuracy were 85.1%, 100%, and 89.2%, respectively. Only 2 (0.15%) major complications were found with small needles in uncooperative patients. Any major complication was not seen in hemangioma.

CONCLUSION

In uncertain diagnosis with modern imaging, we propose that large size cutting needles should be used in suspected liver metastasis, hepatocellular carcinoma, and regenerative nodules if cytopathologist was not present. Small needles can be successfully used as well as large ones in focal steatosis, infection-inflammation, and hemangioma of liver in unclear diagnosis.

A mysterious case of fatal embolism after the repair of tetralogy of Fallot: secondary to arrhythmia?

Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. The most important late complications observed after repair of TOF are atrio-ventricular arrhythmias and sudden cardiac death. We present a rare case of fatal embolism and sudden cardiac death in a 36-year-old patient, 30 years after the operation for TOF.

A novel WT1 gene mutation in a newborn infant diagnosed with Denys-Drash syndrome

Denys-Drash syndrome (DDS) is a rare disorder characterized by glomerulopathy, genital abnormalities and predisposition to Wilms' tumor. It is associated with constitutional Wilms'tumor suppressor 1 (WT1) gene mutations, in which the majority being missense mutations in the zinc-finger region. Here, we present a newborn with DDS, associated with a novel heterozygous missense mutation, p.Asp396His, on exon 9 of WT1.

The effect of calcineurin inhibitors on endothelial and platelet function in renal transplant patients

BACKGROUND/AIM

Posttransplant cardiovascular mortality is still an important problem in renal transplant patients. In addition to conventional coronary risk factors, coagulation abnormalities play a key role in the hypercoagulable state observed in transplanted patients. Though renal transplantation eliminates cardiovascular disease risk factors by restoring renal function, it introduces new cardiovascular risks derived, in part from immunosupressive medications. We aimed to assess the effect of calcineurin inhibitors on endothelial function, platelet activation and aggregation in renal transplant patients.

METHODS

62 renal transplant were studied. Staging was performed according to immunosuppression regimen. Group 1 (n = 37) were treated with cyclosporine/mycophenolate mofetil/methylprednisolone and Group 2 (n = 25) were treated with tacrolimus/mycophenolate mofetil/methylprednisolone. The control group consisted of 16 healthy subjects (Group 3). Hematological and biochemical tests, asymmetric dimethyl arginine (ADMA), sP-selectin levels and platelet aggregation tests were studied.

RESULTS

ADMA levels were higher in Group1 and statistically significant differences were observed compared with those of Group 2 and Group 3 (p < 0.05). Platelet aggregation values induced by all agonists (Adenosine diphosphate (ADP), epinephrine, ristocetin, collagen) were lower in Group 1 than Group 2 and Group 3, but the difference did not reach statistical significance (p > 0.05). There was a negative correlation between cyclosporine level and platelet aggregation values induced by ADP (r = -0.43, p < 0.01), ristocetin (r = -0.40, p < 0.05), epinephrine (r = -0.41, p < 0.05), and collagen (r = -0.43, p < 0.01). sP-selectin levels were appreciably higher in Group 1 and statistically significant differences were observed compared with those of Group 2 (p < 0.05) and Group 3 (p < 0.01).

CONCLUSION

The results of our study suggest that CsA induces platelet activation without inducing platelet aggregation. Endothelial dysfunction due to vascular endothelial damage reflected by increases in ADMA values may increase the tendency for thrombotic events in patients who had undergone renal transplantation.

Fine-needle aspiration biopsy of cervical lymph nodes: factors in predicting malignant diagnosis

The objective of the study was to determine the predicting factors in malignant diagnosis in ultrasonography guided fine-needle aspiration biopsy of cervical lymph nodes. Design is retrospective follow-up study. Ultrasonography guided fine-needle aspiration biopsies of cervical lymph nodes were performed in 290 patients. The mean age was 45.5 ± 14.4 years (range; 15-85). 207 (71.4%) and 83 (28.6%) were women and men, respectively. Cytopathologist was not present in any biopsy procedure. Factors in predicting malignancy were age, gender, presence of primary malignancy, localization (Level 1-6), hypoechogenicity with loss of echogenic hilum, microcalcification, cystic feature, minimum and maximum sizes, and index value (minimum size/maximum size). Factors were analyzed by univariate and multivariable tests. The mean minimum size and index value of the lymph nodes were 10.4 ± 5.5 mm and 0.58 ± 0.18, respectively. Age, gender, microcalcification, cystic feature, minimum size, and index value were poor predictors in malignancy. Predictors were presence of primary malignancy (p-< 0.001), the level of localization (p=0.001), and hypoechogenicity (p-< 0.001)- in malignancy. Microcalcification and cystic parts were specific US findings of metastasis of thyroid carcinoma; nevertheless cystic parts were seen more specific finding in the other malignancies. Malignant lymph nodes were often found in the presence of primary malignancy, mid neck and lower neck localizations as Level 3-6, and markedly hypoechoic lymph nodes. In 131 patients with a primary thyroid carcinoma, the predictors for malignancy were localization where the most often regions were Level 3, 4, and 6 and hypoechogenicity. Malignancy rate was relatively low in patients with thyroid malignancy than those with non thyroid malignancies in Level 5. Level 6 was the most difficult area for biopsy due to postoperative changes. Microcalcification was specific only in thyroid carcinoma, whereas cystic parts were more specific in the other malignancies

Accuracy and safety of percutaneous US-guided needle biopsies in liver metastasis and hemangiomas

AIM

The aim of this study was to compare small size aspiration and large size cutting needles on the diagnostic yield in the biopsies of liver and especially to investigate the reliability on percutaneous biopsy of liver hemangiomas.

METHODS

Nine hundred fifty patients with percutaneous ultrasonography-guided liver biopsies were evaluated retrospectively. This study enrolled 841 patients biopsied with either large size cutting needle (Tru-cut 14G-18G) or small size aspiration needle (WestCott 20G). Further evaluation was performed in 312 patients with metastasis and 48 patients with hemangiomas.

RESULTS

Diagnostic yield was higher in the large size cutting needle group (96.8%, 150/155) than in the small size aspiration needle group (84.1%, 132/157) in liver metastasis (P<0.001). There was no significant difference among diagnostic accuracies of Tru-cut 14G, 16G, and 18 G needles in metastasis (P=0.255). Accuracy rate was 77.9% (208/267) in benign and 89.5% (514/574) in malignant diseases. Sensitivity, specificity, and accuracy were 81.2% (514/633), 100% (208/208), and 85.8% (722/841), respectively. Only two major complications were found (0.16%) with small needles.

CONCLUSION

The authors suggest the use of large size cutting needles, because they provide more accurate diagnosis, and should be used in liver metastasis instead of small aspiration needles, if there is no on-site pathologist at aspiration biopsies or a more specific diagnosis is required. Among them, 18G cutting needle should be chosen. All the needles, including the large cutting type, were found safe in the biopsies of liver hemangiomas.

Effect of vitamin E supplementation with exercise on cognitive functions and total antioxidant capacity in older people

OBJECTIVE

We investigated the effects of six months vitamin E administration on cognition evaluated by event-related potentials in exercising older subjects.

DESIGN

Randomised controlled trial.

SETTING

Retirement home in Antalya, Turkey.

PARTICIPANTS

Fifty-seven adults aged 60-85 years were randomly assigned to one of four groups: sedentary control (C), vitamin E (V), exercise training (E) and vitamin E under training (EV).

INTERVENTION

V and EV groups were received vitamin E at a dose of 900 IU/day P.O. for 6 months. Trained groups were subjected to walking exercise involved 3 sessions per week for 6 months. Walking duration was gradually increased during 8 weeks, and stayed constant until the end of training period. Participants were begun walking at % 70 heart rate reserve for 20 min/day at the first two weeks, and walking duration was increased by 5 minutes/day of each week until subjects were reached a level of 50 min/day by week 8.

MEASUREMENTS

Plasma vitamin E concentration, total antioxidant capacity and two parameters of event-related potentials namely P3 latency and amplitude were performed on all study groups both before and after training.

RESULTS

Significant improvement in P3 latency was found in exercising groups. However, no significant differences were found between vitamin and other groups for P3 latency. Amplitude measurements were found unaltered among all groups.

CONCLUSION

We concluded that although six months training results improvement in P3 latency, vitamin E supplementation does not affect cognitive function evaluated by event-related potentials in older subjects.

Exposure of newborns to aflatoxin M1 and B1 from mothers' breast milk in Ankara, Turkey

Aflatoxins (AFs) are important risks for human health due to their widespread presence in foods and environment. However, contamination risk of breast milk with different pollutants including AFs is high in today's life conditions. Since breast milk is a major nutrient for infants, feeding of infants with safe milk is essential. Therefore, the objective of this study was to determine the levels of AF M(1) and B(1) in breast milk samples collected from 75 mothers in Ankara, Turkey. AF M(1) and B(1) levels were investigated by high performance liquid chromatography (HPLC) with a fluorescence detector following an extraction procedure. The limit of detection was found to be 5 ng/l. Both AFs were detected in diverse degrees in all breast milk samples: The level of AF M(1) were in the ranges of 60.90-299.99 ng/l, and AF B(1) were in the ranges of 94.50-4123.80 ng/l. These results pointed out the exposure of mothers and neonates to AF M(1) and B(1), and the necessity of further research on mycotoxin contamination both in foods and biological fluids as well as protection strategies.

Knowledge and attitudes towards emergency contraception of health-care providers in a region with a high birth rate

OBJECTIVE

To assess the knowledge of, attitude towards and practices of emergency contraception among health-care providers at a university hospital located in a region with a high birth rate.

METHODS

The survey was conducted among 214 health-care providers working at a university hospital located in eastern Turkey.

RESULTS

Two hundred participants completed the questionnaire. Of the respondents, 26.0% said that they did not know anything about emergency contraception, while the remaining 74.0% said that they knew about at least one of the methods of emergency contraception. But among these, the knowledge of 38.5% of the participants about emergency contraception was accurate and that of 61.5% was inaccurate. Thirty-four percent of the respondents stated that they had previously required personally to use emergency contraceptive methods. The most commonly used emergency contraceptive methods were oral contraceptives (69.1%) and intrauterine device (14.7%). None of the respondents knew anything about mifepristone and levonorgestrel.

CONCLUSION

There is a knowledge deficit among health-care providers who play a significant role in the dissemination of the information about emergency contraception.

Single-session percutaneous sclerotherapy in symptomatic simple renal cysts: long-term results

AIM

To evaluate the efficacy of single-session percutaneous sclerotherapy with needle aspiration or catheter drainage, under ultrasound (US) or computed tomography (CT) guidance, based on cyst size and depth in 22 symptomatic simple renal cysts.

METHODS

Sclerotherapy with 95% alcohol for 20 min was performed in 22 symptomatic simple renal cysts in 15 patients. The method (aspiration or drainage) was chosen according to cyst size and depth: catheter drainage was done for larger (>6 cm) and shallow (<7.5 cm) cysts (N=12) and needle aspiration was done for smaller (<6 cm) or deeper (>7.5 cm) cysts (N=10). The median follow-up period was 6.0 months (range 1-62).

RESULTS

Volume reduction of cysts (mean and median, respectively) was 94.1% and 97.0%. Average cyst volume reduction (mean and median, respectively) was 94.7% and 96.0% with US-guided methods and 93.3% and 99.0% with CT-guided methods (P=0.382). Median volume loss was 97.5% with needle aspiration and 96.5% with catheter drainage (P=0.839). No correlation between the groups and volume reduction was found. All procedures were successful. No major complications or recurrences were noted.

CONCLUSIONS

Single-session percutaneous alcohol sclerotherapy with needle aspiration or catheter drainage, under US or CT guidance, is an effective and safe method for treating symptomatic simple renal cysts. CT-guided needle aspiration may be more suitable for treating deeper and/or smaller (<6 cm) cysts, while US-guided catheter drainage may be preferable in cases of shallow and/or larger (>6 cm) cysts.

Effect of GM-CSF on tumor-specific immune response and antitumoral efficacy when combined with suicide gene therapy

e14610

Background: Suicide gene therapy is one of the promising treatment modalities in cancer treatment. Combination of an immunotherapy modality with suicide gene therapy would increase the tumor eradciating efficacy of either treatment strategy used alone. Methods: In the current study, we constructed adenoviral vectors carying ytosine deaminase (CD), granulocyte macrophage-colony stimulating factor (GM-CSF) vectors. We tested the in vitro efficacy of the vectors in both human and mouse tumor cell lines and in a syngeneic mouse model of colon cancer with tumor explants of CRL 2638 cells. Results: Our results show that the vectors carrying CD/GM-CSF transcription units are effective in terms of killing of tumor cells when 5-FC added. Addition of GM-CSF transgene induced a significant amount of GM-CSF secretion (250 pg/ml/105 cells) of infected cells. In the syngeneic colon cancer model, addition of GM-CSF significantly increased tumor-specific cellular immune response when compared to suicide gene therapy alone. (p<0.01). Likewise, GM-CSF addition caused a 8 times reduction in the ratio of Tregs infiltrating the tumor nodules (p<0.001). Accordingly, GM-CSF decreased the tumor growth by 2 times an d increased the median survival time by 50% (p<0.01). Conclusions: These impressive results of in-vitro cytotoxicity and encouraging results of in-vivo testing of the our newly constructed GM-CSF carrying vector suggest a potential for the use of the vector for the treament of established tumors by inducing tumor specific immune response.

No significant financial relationships to disclose.

Possible stretched exponential parametrization for humidity absorption in polymers

Polymer thin films have irregular transient current characteristics under constant voltage. In hydrophilic and hydrophobic polymers, the irregularity is also known to depend on the humidity absorbed by the polymer sample. Different stretched exponential models are studied and it is shown that the absorption of humidity as a function of time can be adequately modelled by a class of these stretched exponential absorption models.

Tumour necrosis factor alpha -308G/A gene polymorphism: lack of association with knee osteoarthritis in a Turkish population

OBJECTIVE

To study the association between TNFalpha-308 G/A polymorphism and susceptibility to and severity of knee osteoarthritis in a Turkish population.

METHODS

Genomic DNA was obtained from 151 patients with knee osteoarthritis and 84 ethnically matched healthy controls. Polymerase chain reaction-restriction fragment length analysis was used to identify G/A polymorphism at position -308 in the promoter region. Genotype distributions and allelic frequencies of TNFalpha-308 G/A polymorphism were compared between osteoarthritis patients and controls. Thereafter, this association was investigated between patients and controls of the same sex. In addition, the standard Kellgren-Lawrence grading score and the Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index were used to assess the radiological and functional severity of the disease and their relationship with the TNFalpha-308 gene polymorphism was investigated.

RESULTS

Genotype distribution and allelic frequencies of -308 G/A polymorphism in the TNFalpha gene did not differ significantly between patients with knee osteoarthritis and controls (p>0.05). Moreover, there were no significant differences between patients and controls of the same sex (p>0.05). In addition, no association was observed between the radiological and functional severity of the disease and TNFalpha-308 G/A polymorphism (p>0.05).

CONCLUSION

These findings suggest that the examined polymorphism in the TNFalpha gene does not contribute to susceptibility to or severity of knee osteoarthritis in the Turkish population.

Burkholderia cepacia as a cause of ecthyma gangrenosum-like lesion

Ecthyma gangrenosum (EG) is considered to be a pathognomonic sign of Pseudomonas aeruginosa septicemia and is predominantly seen in immunosuppressed patients. Although P. aeruginosa is the most recognized pathogen of EG, numerous other organisms have been reported to cause clinically identical lesions. We report a case of an EG-like eruption caused by Burkholderia cepacia, in an intensive care unit patient with multiple myeloma.

Effects of immunization with purified specific proteins on the formation of secondary hydatid cysts in mice

In this study, immunoreactive proteins (8, 68 and 116 kDa) of Echinococcus granulosus metacestode stages were partially purified using isoelectrical focusing by a Rotofor cell device. Sixty Swiss albino mice were separated into three experimental and three control groups (n = 10). The mice of the three experimental groups were immunized with 8, 68 and 116 kDa purified proteins, respectively. 25 days after immunization, serum samples from each group were examined to assess immunization status by Western blotting. Protoscolices were applied intraperitoneally to control and immunized groups. By necropsy, mice were examined for cyst formation, size, number and fertility 2, 5, 8, and 10 months after experimental infection, respectively. Immunization with all three proteins was found to have a significant inhibitory effect on the metacestode formation of in mice (p < 0.001).

[A comparison of respiratory muscle strength, pulmonary function tests and endurance in patients with early and late stage ankylosing spodylitis]

BACKGROUND

Ankylosing spondylitis (AS) is a multisystemic disease in which pulmonary function is altered owing mainly to the restriction of chest wall involvement. A restrictive ventilatory defect has been extensively reported. This has been suggested to be a consequence of reduced mobility of the thoracic cage. Respiratory function in AS shows a typical restrictive pattern but pulmonary compliance, diffusion capacity, and arterial blood gases are normal.

OBJECTIVE

The objective of the present study was to compare pulmonary function tests (PFT), respiratory muscle strength (MIP, MEP) and endurance (MVV) in early and late AS.

METHODS

A total of 35 patients (30 males, 5 females) took part, all of whom met the New York criteria for AS. Patients were divided into two groups for the comparison of early (disease duration <10 years, 20 patients) and late (disease duration >10 years, 15 patients) manifestations in pulmonary function tests, respiratory muscle strength and endurance, dyspnea score, chest expansion, and BASFI score. In addition, 21 healthy controls were compared with the AS patients. Measurement of chest expansion was performed in all subjects. Pulmonary function tests were performed by spirometry. Respiratory muscle strength was evaluated by a mouth pressure meter (MPM). Functional status was assessed by BASFI in all AS patients.

RESULTS

There was no significant difference in body mass index between the groups. The FVC and FEV(1) were significantly lower in late AS (p=0.003, p=0.03, restrictive ventilatory defect ). Chest expansion was significantly lower in late AS (p<0.05). There was no significant difference for MIP or MEP values between late AS, early AS and the controls (p>0.05). Endurance (MVV) was significantly lower in late AS patients (p=0.05). Although the BASFI and dyspnea scores were higher in late AS, they did not reach significant levels. In addition, age was negatively correlated with MIP and MEP in late AS (r=-0.733; p=0.02, r=-0.667; p=0.05).

CONCLUSION

This study demonstrates that FVC and FEV(1) (hallmarks of a restrictive pattern), MVV (endurance) and chest expansion are especially involved in long-standing AS. Therefore, improvement of the thoracic cage should be taken into consideration, especially in early AS. These patients should be encouraged to make regular respiratory exercises for preventing the limitation of chest expansion and also improving cardiopulmonary fitness and respiratory endurance.

Urinary profile of 6 beta-hydroxycortisol in workers exposed to aluminum

The aim of the present study was to evaluate whether aluminum exposure may cause alterations of cytochrome P4503A4 by measuring the urinary excretion of 6 beta-hydroxycortisol as biomarker. There is a positive correlation between urinary 6 beta-hydroxycortisol and aluminum excretion (p < 0.05). The correlations between occupational duration, smoking habits, and age were also evaluated. The increased excretion of the biomarker suggests that this element may induce formation of cytochrome P 450 in exposed individuals.

Evaluation of pteridine metabolism in battery workers chronically exposed to lead

Occupationally-exposed lead affects the neuromuscular junction and might cause disturbances in the locomotor activity. This study was undertaken to evaluate pteridine metabolism, in which neurotransmitters are synthesized in battery workers. Urinary neopterin, biopterin and creatinine were measured using high performance liquid chromatography. Serum neopterin concentrations were detected by enzyme-linked immunoassay. Blood dihydropteridine reductase (DHPR) activities and deltaaminolevulinic acid (delta-ALA) were measured spectrophotometrically. Blood and urinary lead were detected by atomic absorption spectroscopy. Significantly increased blood and urinary lead levels, urinary neopterin, biopterin and delta-ALA were found in workers, while DHPR activities were indifferent compared to control group. Urinary creatinine decreased. This is the first study to demonstrate that increased activity of the pteridine pathway results in the accumulation of the neurotransmitters that may be responsible for the neurological disorders.