Treatment of Ingrown Toenail with a Minimally Invasive Nail Fixator: Comparative Study with Winograd Technique

BACKGROUND

Many surgical techniques have been reported for treatment of ingrown toenails. Occurrence of infection after matricectomy procedures could cause clinicians to prefer using external braces in the treatment of ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique.

METHODS

Patients who underwent ingrown toenail surgery were reviewed retrospectively. The patients' demographic characteristics (ie, age, gender, body mass index morphology according to Heifetz classification, surgical technique, visual analogue scale values, time to return to daily activities [days], complications, and satisfaction levels) were all recorded.

RESULTS

Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients' age, gender, body mass index, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and visual analogue scale values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique.

CONCLUSIONS

Nail fixation can be an effective surgical treatment option for ingrown toenail.

Analysis of post-migration traumatic events influence on immigrants and their personality traits

OBJECTIVES

This study aims to analyse the way immigrants and their personality traits get affected by traumatic events in the post-migration process.

METHODS

This descriptive study was conducted through Google Forms with the involvement of 2,509 immigrants. A descriptive questionnaire, the "IFOMA Post-Migration Post-Traumatic Effect Scale" and the "GADOT Personality Types Determination Scale" were used to collect the research data. Independent samples t-test, one-way ANOVA, and related sample Friedman's two-way analysis tests were used in data analysis.

RESULTS

Immigrants were exposed to significant effects in all sub-dimensions of the Post-Migration Post-Traumatic Effect Scale. Experiencing post-traumatic stress was found to be significantly related to the research parameters, which, respectively, are gender, age, marital status, educational background, legal status, years of living in the current country, employment status, ethnicity, Turkish language proficiency, and post-migration psychological problems (p < 0.05); 42.8% of the immigrants had the Type 9 personality, and all personality types were affected by the Psychological Affection, Physical Affection, Anxiety, and Social Adaptation sub-dimensions, respectively (p < 0.05).

CONCLUSION

By analysing the impact of migration-induced trauma on immigrants within their society, it can be recommended to implement initiatives specific to immigrants' personality traits and to carry out protective/preventive projects that will minimize immigrants' exposure to trauma and encourage their participation in social adaptation processes.

The effect of IHAPIM program on health perceptions and health responsibilities of immigrant men: a randomized controlled trial

BACKGROUND

Health promotion interventions for immigrant health are generally directed toward women and youth. There is no program specific to migrant male in the global and national literature to protect, improve and promote their health. The aim of this study was to examine the effect of the Increasing Health Awareness of Immigrant Men (IHAPIM) program on health perceptions, health responsibilities, perceived stress level, attitudes toward utilizing health care services and the types of coping strategies of immigrant male.

METHODS

Researchers applied the short-term IHAPIM program experimental group for 5 weeks. This study was held in the two districts where predominantly immigrants live. The immigrant male's health perceptions, health responsibilities, perceived stress level, attitudes toward utilizing health care services and the types of coping strategies measured before and after 3 months of the IHAPIM program was performed.

RESULTS

The study results showed that the levels of health perceptions, health responsibilities and the types of coping strategies of immigrant male were significantly different between the two study groups.

CONCLUSIONS

At the end of the study, the experimental group showed improvement in measures of the health perceptions, health responsibilities, attitudes toward utilizing health care services, the types of coping strategies and perceived stress level of male decreased. Nursing interventions specific to immigrant male and sensitive to their language have led to positive changes in the health variables of immigrant male.

Could twinkling artifact be a parameter in predicting the success of shock wave lithotripsy? A prospective study

Introduction

It is important to predict success before the treatment of urolithiasis. We aimed to predict the success of shock wave lithotripsy (SWL) by comparing twinkling artifact (TA) revealed through colour Doppler ultrasonography (CDUS) with stone density in non-contrast computed tomography (NCCT).

Material and methods

Eighty patients who underwent SWL between January 2021 and January 2022 were included in the study. Patients with stones of 5-20 mm in the renal pelvis and proximal ureter at NCCT were included. Patients' demographics, Hounsfield units (HU) in NCCT, and TA grades in CDUS were recorded. The stone-free rate after SWL, additional treatments, overall success rates, and the association between TA and success rates were evaluated.

Results

The mean age was 47.41 ±15.08 years. The mean BMI was 24.49 ±3.67 kg/m2. Twenty-three (28.8%) patients were TA grade 0, 33 (41.2%) patients were grade 1, and 24 (30%) were grade 2. The mean HU of TA grades 0, 1, and 2 of stones were 628 ±107, 864 ±123, and 1166 ±292, respectively. The HU increased along with the increase in the TA grade of the stone (p <0.01). The mean number of SWL sessions was 2.26 ±0.75 in patients with TA grade 0, and 2.92 ±0.40 in patients with TA grade 2. The mean number of SWL sessions increased along with the increase in TA grade (p <0.01). The stone-free rate decreased as the TA grade increased. Stone diameter and TA were the only predictors of SWL success.

Conclusions

We think that TA may be useful in predicting SWL success.

The Role of Endoplasmic Reticulum Stress in Gastroesophageal Reflux Disease Symptoms and Treatment

BACKGROUND

Gastroesophageal reflux disease is a common condition worldwide. There is no curative treatment for gastroesophageal reflux disease. Endoplasmic reticulum stress leads to the activation of the unfolded protein response and has an important role in inflammation. The aim is to determine the role of endoplasmic reticulum stress in the follow-up of individuals with gastroesophageal reflux disease and the temporal changes of endoplasmic reticulum stress markers with treatment.

METHODS

Twenty-four subjects in total were recruited prospectively, of whom 15 had nonerosive reflux disease. Two biopsies from 2 cm above the esophagogastric junction, 2 biopsies from gastric antrum mucosa, and 2 biopsies from gastric corpus mucosa were taken. Simultaneously, 2 tubes of venous blood samples were drawn from each individual (1 tube for studying the genetic markers and 1 tube for analyzing the CYP2C19 polymorphism).

RESULTS

The mean age was 42.3 ± 17.6 for women and 34.66 ± 11.2 for men. Pantoprazole, esomeprazole, rabeprazole, and lansoprazole preparations were used for treatment. There was no significant difference between tissue and blood samples for panel genes ATF-6, XBP-1, DDIT-3, DNAJC-10, and EIF-2-AK before treatment. There was a significant decrease in the level of ATF-6, XBP-1, DNAJC-9, EIF2-AK, and NF-2L-2 genes in blood after treatment. In the comparison of proton pump inhibitors, significant decreases in the expression of the ATF-6, XBP-1, and DNAJC-9 mRNAs were detected in blood from individuals after treatment.

CONCLUSION

Endoplasmic reticulum stress can be for evaluating the clinical improvement and the effectiveness of treatment in gastroesophageal reflux disease.

The Cytokines-Directed Roles of Spirulina for Radioprotection of Lacrimal Gland

PURPOSE

To evaluate the radioprotective effect of spirulina (SP) on the lacrimal glands after RAI treatment.

METHODS

A total of 30 rats were separated into control, RAI and SP group. The radioprotective effect of SP on lacrimal glands was evaluated with histopathological and cytopathological analysis. Lacrimal glands were analyzed for tumor necrosis factor alpha (TNF-α), interleukin-2 (IL-2), IL-4, IL-6, IL-10, nuclear factor-kappa B (NF-κB), total oxidant status (TOS) and total antioxidant capacity (TAC) levels.

RESULTS

RAI increased TNF-α (p = .001), IL-6 (p = .018), and NF-κB levels (p < .0005). Following the administration of SP, TNF-α (p < .0005), IL-4 (p = .026), and IL-6 (p = .006) levels decreased. RAI decreased the TAC levels (p = .001), and co-administration of SP increased the TAC level, but was not statistically significant. SP decreased the TOS level after RAI (p = .022)                .

CONCLUSIONS

SP protects lacrimal glands from RAI-induced damage.

Overexpressions of RHOA, CSNK1A1, DVL2, FZD8, and LRP5 genes enhance gastric cancer development in the presence of Helicobacter pylori

BACKGROUND AND STUDY AIMS

Intestinal metaplasia (IM), and Helicobacter pylori (HP) infection can be shown as risk factors in the development of gastric cancer (GC). WNT signaling pathway plays a critical role in carcinogenesis. However, the literature studies are limited on the significance of this pathway for the transition from IM to GC.

PATIENTS AND METHODS

We aimed to investigate the importance of the genes of WNT signaling pathways diagnostic and prognostic markers in the presence and absence of HP in conversion from IM to GC. 104 patients, (GC group n = 35, IM group n = 45, control group n = 25) were included in this case-control study. Expression of genes in WNT signalling were searched in study groups with qRT-PCR array and qRT-PCR method. Data were analysed using PCR array data analysis software.

RESULTS

Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in the GC and IM groups compared to the control group (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was observed in patients with metastatic GC compared to patients with GC without metastasis (p < 0.05). It was found that the RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes were statistically significantly over-expressed in diffuse GC patients compared to non-diffuse GC patients (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in HP positive IM patients compared to HP negative IM patients (p < 0.05).

CONCLUSION

Overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes in IM may suggest that these genes are important markers in the development of IM and inflammation with HP. In addition, these genes are linked to tumor burden in the GC group. Consequently, we can conclude that these genes are poor prognosis biomarkers for GC and have the potential to be used as markers for future treatment monitoring.

Investigation of cytotoxic and apoptotic effects of disodium pentaborate decahydrate on ovarian cancer cells and assessment of gene profiling

After revealing the anti-cancer properties of boron, which is included in the category of essential elements for human health by the World Health Organization, the therapeutic potential of boron compounds has been begun to be evaluated, and its molecular effect mechanisms have still been among the research subjects. In ovarian cancer, mutations or amplifications frequently occur in the PI3K/Akt/mTOR pathway components, and dysregulation of this pathway is shown among the causes of treatment failure. In the present study, it was aimed to investigate the anti-cancer properties of boron-containing DPD in SKOV3 cells, which is an epithelial ovarian cancer model, through PI3K/AKT/mTOR pathway. The cytotoxic activity of DPD in SKOV3 cells was evaluated by WST-1 test, apoptotic effect by Annexin V and JC-1 test. The gene expressions associated with PI3K/AKT/mTOR pathway were determined by real-time qRT-PCR. In SKOV3 cells, the IC₅₀ value of DPD was found to be 6.7 mM, 5.6 mM, and 5.2 mM at 24th, 48th and 72nd hour, respectively. Compared with the untreated control group, DPD treatment was found to induce apoptosis 2.6-fold and increase mitochondrial membrane depolarization 4.5-fold. DPD treatment was found to downregulate PIK3CA, PIK3CG, AKT2, IGF1, IRS1, MAPK3, HIF-1, VEGFC, CAB39, CAB39L, STRADB, PRKAB2, PRKAG3, TELO2, RICTOR, MLST8, and EIF4B genes and upregulate TP53, GSK3B, FKBP8, TSC2, ULK1, and ULK2 genes. These results draw attention to the therapeutic potential of DPD, which is frequently exposed in daily life, in epithelial ovarian cancer and show that it can be a candidate compound in combination with chemotherapeutics.

Differentially expressed genes related to lymph node metastasis in advanced laryngeal squamous cell cancers

Understanding the molecular mechanisms and gene expression in laryngeal squamous cell carcinoma (LSCC) may explain its aggressive biological behavior and regional metastasis pathways. In the present study, patients with locally advanced LSCC tumors were examined for differential gene expression in the normal mucosa (non-tumoral mucosa), tumors and lymph node tissues. The aim was to identify possible predictive genes for lymph node metastasis. A total of 16 patients who had undergone total laryngectomy with neck dissection for advanced LSCC were randomly selected from a hospital database: Eight of the patients had lymph node metastasis (Group 1) and the other eight patients did not have metastasis (Group 2). Overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) were analyzed. For each patient, paraffin-embedded tissue samples were collected from non-tumoral mucosa, tumoral lesions and lymph node tissues. RNA was extracted from the tissue samples and used for complementary DNA synthesis, and microarray analysis was subsequently performed on each sample. Gene expression levels were determined in each specimen, and Groups 1 and 2 were compared and statistically analyzed. The microarray results for lymph node metastasis-positive and -negative groups, indicated the differential expression of 312 genes in the lymph nodes, 691 genes in the normal mucosal tissue and 93 genes in the tumor tissue. Transgelin (TAGLN) and cofilin 1 (CFL1) were identified as possible target genes and validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The RT-qPCR results for TAGLN and CFL1 supported the microarray data. OS, DFS and DSS times were longer in Group 2 than in Group 1 (P=0.002, 0.015 and 0.009, respectively). In addition, TAGLN and CFL1 were associated with DFS and DSS. On the basis of these results, it is suggested that TAGLN and CFL1 expression may play an important role in the pathogenesis of regional metastasis and poor prognosis in advanced LSCC.

Is there a correlation between the femoral anteversion angle and the elasticity of the hip muscles in cases of intoeing gait due to increased femoral anteversion angle?

Purpose

One of the common causes of gait disturbance in children is increased femoral anteversion. There are not enough publications in the literature on muscles related to the hip joint in increased femoral anteversion. The aim of this study was to evaluate the relationship between the femoral anteversion angle and hip muscle elasticity in children walking inward, using shear wave elastography (SWE).

Material and methods

Seventeen children with bilateral increased femoral anteversion angle in computed tomography were prospectively included in this study. Elasticity values of the hip muscles (adductor magnus (adductor), iliopsoas (flexor), gluteus medius (abductor), gluteus maximus (extensor) muscles) were evaluated by ultrasound elastography by two observers. Quantitative measurements of the shear wave velocities were performed using virtual touch tissue imaging quantification.

Results

There was excellent harmony between the femoral anteversion angle measurements performed by the two observers and a good congruence between the muscle elastography evaluations. While there was a moderate significant correlation between the femoral anteversion angle and the elasticity values of the iliopsoas and adductor magnus muscles, no significant correlation was found with other muscle elasticity measurements.

Conclusion

Iliopsoas muscle and adductor magnus muscle elasticity are correlated with the femoral anteversion angle. With further studies, we think that physical therapy methods for the elasticity of the muscles associated with the femoral anteversion angle can reduce the complaints of the patients.

Diagnosis of Thyroid Micropapillary Carcinoma and Histopathological Changes after Fine-needle Aspiration Biopsy

OBJECTIVE

To investigate "worrisome histologic alteration following fine-needle aspiration of the thyroid'' (WHAFFT) in thyroid papillary microcarcinoma and the importance of tumor size, fibrosis, depth and concomitant diseases in ultrasonographic diagno Place and Duration of Study: Department of Pathology, Kutahya Health Sciences University, Evliya Celebi Research and Training Hospital, Turkey, from December 2015 to December 2020.

METHODOLOGY

A total of 208 TPMC nodules belonging to 87 (41.8%) fine-needle aspiration biopsy (FNAB)-case group and 121 (58.2%) non-FNAB-control group were included in the study. The thyroidectomy specimens were evaluated for worrisome histologic alteration following fine-needle aspiration of the thyroid (WHAFFT). The relationship between tumor size, depth and capsule distance and concomitant diseases were investigated, according to the detection status in ultrasonography.

RESULTS

In the FNAB group, hemorrhage, capsular distortion and tumor diameter were greater, while there was less non-tumor fibrosis and granulation tissue. Dysplasia focus was found to be higher in Hashimoto thyroiditis and lower in nodular goiter (p = 0.000). The rate of ≥0.5 cm tumors (p = 0.000), the rate of 0-25% tumor fibrosis (p = 0.038) and tumor-capsule distance between <0.2 cm (p = 0.030) was higher in thyroid micropapillary carcinomas detected in US.

CONCLUSION

In the FNAB group, hemorrhage, capsular distortion and tumor diameter were greater. While fibrosis was insignificant in the diagnosis with ultrasonography (US), tumor size and location were found to be more significant. Since US has a lower success rate in lesions <0.5 cm and is deeply located, it can be supported with radiological alternatives.

KEY WORDS

Worrisome histologic alteration, Thyroid micropapillary carcinoma, Fine-needle aspiration, Ultrasonography.

Borax Pentahydrate and Disodium Pentaborate Decahydrate Are Candidates as Anti-leukemic Drug Components by Inducing Apoptosis and Changing Bax/Bcl-2 Ratio in HL-60 Cell Line

Acute myeloid leukemia (AML) is the most common form of acute leukemia and has the lowest 5-year survival rates. Current treatment strategies do not meet the expectations also. Therefore, there is a need to improve therapeutic approaches still. Boron, which is a natural trace element in human diet, is gaining attention with its important roles in cellular processes for the development of new anti-cancer drug candidates. For instance, bortezomib, a dipeptidyl boronic acid, has encouraging results in the treatment of multiple myeloma and mantle cell lymphoma. However, severe toxic effects and resistance development are the limitations to its application for AML treatment. Hence, the development of alternative boron-derived anti-AML agents is unmet need. Therefore, we aimed to evaluate anti-leukemic effect of two promising boron compounds, borax pentahydrate (BP) and disodium pentaborate decahydrate (DPD), and comparison of each other in terms of the capacity to trigger apoptosis on acute promyelocytic leukemia cells (HL-60). Cell viability was assessed by MTT assay. Apoptotic effects of the boron compounds on HL-60 cells were evaluated by annexin V/propidium iodide dyes and caspase 3/7 activity assay by flow cytometry. In addition, Bax/Bcl-2 and cleaved PARP levels were detected by western blotting. Although BP showed greater apoptosis-inducing capacity, we observed that both DPD (6 mM) and BP (24 mM) treatment showed anti-leukemic effect by triggering apoptotic pathway through increasing Bax/Bcl-2 ratio for the first time. Our study suggests that BP and DPD are the promising candidates for anti-AML drug development research, which may be confirmed by further wide-spectrum studies.

Evaluation of the reliability of SE33 locus in forensic DNA identification in Turkish Population

Forensic DNA studies is a powerful tool in criminal investigations and paternity test. In recent years, STR (Short Tandem Repeat) DNA loci are being used more and more in forensic identification all over the world. In this context, polymorphism rates and frequency of the SE33 region, which is an autosomal STR locus, is aimed to be determined about its reliability. Evaluations were made on the samples of 500 individuals who did not have close relatives. Genomic DNA isolation was carried out by DNA isolation kits (EZ-1 investigator kit and Power Plex Fusion 6C Direct kit) previously by the authorized staff of İzmir Forensic Medicine Group Presidency. SE33 STR locus amplification was achieved with the Powerplex Fusion 6C kit from the isolated DNA. In the study, homozygote genotype rate was 5.4%, heterozygote genotype rate was 94.6%, power of discrimination (PD) 0.992 and matching probability (PM) was 0.008. The lowest frequency alleles were determined as 7,10,16.3,17.2,23,24,29, 34.2,35.2,37 alleles with 0.1%. It is seen that SE33 STR locus is a strong marker in forensic identification compared to other studies in terms of power of discrimination and matching probability.

An evaluation of quality of life, physical activity level and symptoms in patients with early stages of chronic venous disease

BACKGROUND

Chronic venous disease (CVD) is a common, long-term disease that has a variety of symptoms, signs and decreases the patients' quality of life (QoL) of the patients. The aim of this study was to evaluate QoL, symptoms, and physical activity level of CVD patients with early stages (C₁ and C₂ classes).

METHODS

The sample of this study composed of 40 patients diagnosed with CVD. The data were collected by face-to-face interview method in the cardiovascular surgery outpatient clinic. Participants were diagnosed with duplex ultrasound (DUS). A personal information form, venous insufficiency epidemiological and economic study-quality of life/symptoms (VEINS-QOL/Sym), and international physical activity questionnaire were used to assess the participants.

RESULTS

According to DUS results, 23 participants had unilateral CVD, 17 participants had bilateral CVD. Thirty-six of these limbs were stage C₂ according to CEAP, twenty one were stage C_3. The patients with CVD had low QoL and physical activity level, also moderate pain intensity. Pain, swelling, restless leg, heavy legs, night cramps, and itching were more common symptoms. There was no statistical difference between unilateral/bilateral CVD patients in QoL scores, physical activity level, and pain intensity (p˃0.05).

CONCLUSION

There was no difference between the extent and severity of the disease and QoL, physical activity level, variety of symptoms. To increase the physical activity level and to evaluate the quality of life may be important for the management of the disease from the early stages of the disease (C₁ and C₂ classes).

Endovascular treatment modalities for basilar artery fenestration aneurysms: experience of two centers and literature review

Background/aim

The aim of this study is to present our experience on various endovascular treatment modalities of basilar fenestration aneurysms and reviewing our findings together with literature data.

Materials and methods

A total of 26 basilar artery fenestration (BAF) aneurysms in 24 patients were endovascularly treated in two different neurointerventional radiology clinics. All patients had been evaluated with computed tomography (CT), CT angiography, and digital subtraction angiography before the procedure.

Results

Aneurysms of all patients were successfully occluded (technical success rate 100%). Procedure-related complications were seen in two patients. Our comprehensive literature research revealed that studies related with the topic are composed mostly of case reports. In the literature, a total of 113 BAF aneurysms of 101 patients had been treated endovascularly in 46 studies between 1993 and 2019. Success rate of the treatment was reported as 97%, clinical success rate as 91%, and complication rate as 8.8%, while these rates are 100%, 92%, and 7.6% in our study, respectively.

Conclusion

Although the number of cases is low in our study, to our knowledge, it is the widest series in the literature until today. Our results demonstrate that BAF aneurysms can be treated successfully and safely with different endovascular techniques, with more stent use in recent years.

Synthesis and cytotoxic activities of organometallic Ru(II) diamine complexes

A series of mono and bimetallic ruthenium(II) arene complexes bearing diamine (Ru_1-6) were prepared and fully characterized by ¹H, ¹³C, ¹⁹F, and ³¹P NMR spectroscopy and elemental analysis. The crystal structure of the bimetallic complex (Ru₅) was determined by X-ray crystallography. Monometallic analogues (Ru_1-3) were synthesized to investigate the contributions of ruthenium and the other organic groups (aren, ethylenediamine, butyl) to the activity. The electrochemical behaviors of mono and bimetallic complexes were obtained from the relationship between cyclic voltammetry (CV) and the biological activities of the compounds. The cytotoxic activities of the complexes (Ru_1-6) were tested against wide-scale cancer cell lines, namely HeLa, MDA-MB-231, DU-145, LNCaP, Hep-G2, Saos-2, PC-3, and MCF-7, and normal cell lines 3T3-L1 and Vero. Diamine Ru(II) arene complexes have unique biological characteristics and they are promising models for new anticancer drug development. MTT analysis reveals that each synthesized Ru complex showed cytotoxic activity towards the different cancer cells. In particular, three Ru complexes (Ru₃, Ru₅ and Ru₆) showed less toxic effects on the cancer cells than the others. These novel Ru complexes affected both cancer and normal cell lines. As they had a toxic effect on the cells, the dosage applied should be tested before being used for in vivo applications. Cytotoxicity tests have shown that the bimetallic complex Ru₆ was effective on all cancer cells. The effect of bimetallic enhancement on cancer cell lines, the systematic variation of the intermetallic distance and the ligand donor properties of the mono and bimetallic complexes were explored based on the cytotoxic activity. The interaction with FS-DNA and the stability/aquation of the complexes (Ru₃ and Ru₆) were investigated with ¹H NMR spectroscopy. The binding modes between the complexes (Ru₃ and Ru₆) and DNA were investigated via UV-Vis spectroscopy.

Frequency of anatomical variation of the sacroiliac joint in asymptomatic young adults and its relationship with sacroiliac joint degeneration

INTRODUCTION

To evaluate the variations of the sacroiliac joint (SIJ) in asymptomatic young adults and their relationship to SIJ degeneration.

MATERIALS AND METHODS

A total of 860 SIJs were retrospectively evaluated in 430 abdominal computed tomographies (CT) of abdominal pain cases. The study population consisted of 430 patients (176 female, 254 male) aged 20-45 years with abdominal pain. The anatomical variations of the SIJ were classified as (1) accessory sacroiliac joint, (2) iliosacral complex, (3) bipartite iliac bony plate, (4) semicircular defects, (5) crescent-like iliac bony plate, and (6) ossification center. The CT findings of SIJ degeneration included joint space narrowing, sclerosis, subcortical cysts, vacuum phenomenon, and osteophytes. Chi-square and cross tabulation tests were used for statistical analysis.

RESULTS

The iliosacral complex was the most common (bilateral) anatomical variation (7.7%, n = 66). A total of 71 SIJ degenerations were detected in cases with anatomical variations. They were determined in 22 (2.6%) iliosacral complex, 19 (2.2%) bipartite iliac bony plate, 15 (1.7%) accessory sacroiliac joint, 6 (0.7%) semicircular defect, 5 (0.6%) crescent-like iliac bony plate, and 4 (0.5%) ossification center cases.

CONCLUSION

We found that iliosacral complex was the most common SIJ variation in asymptomatic young adults and also that there was significantly more SIJ degeneration among subjects with anatomical variations of the SIJ than those without. SIJ degeneration was most common in subjects with the iliosacral complex variation.

RELIABILITY OF THE CORTICOTROPIN RELEASING HORMONE STIMULATION TEST FOR DIFFERENTIATING BETWEEN ACTH DEPENDENT AND INDEPENDENT CUSHING SYNDROME

Context

It is a challenge to determine the origin of Cushing syndrome (CS), especially in patients with low-normal adrenocorticotropic hormone (ACTH) concentrations.

Objective

To evaluate the reliability of the corticotropin-releasing hormone (CRH) stimulation test in patients with CS whose origin of disease was not clearly identified using ACTH values, the high-dose dexamethasone suppression test (HDDST), and imaging in a single tertiary referral center.

Design and Methods

Twenty-one patients with CS who were admitted to the endocrinology-metabolism clinic between 2004 and 2016 whose ACTH concentrations were 5-20 pg/mL and needed CRH stimulation test were retrospectively assessed.

Results

Nine out of 21 patients were diagnosed as having Cushing's disease (CD) and 12/21 had adrenal CS. The CRH stimulation test had a sensitivity and specificity of 100% and 8%, and positive and negative predictive values of 100% and 45% according to the current diagnostic criteria, respectively. An increase in ACTH ≥115% at 15 minutes and cortisol ≥86% at 60 minutes after CRH were associated with the highest likelihood ratio. The sensitivity and specificity of ACTH was 67% and 83% (AUC=0.75±0.12, 95% CI: [0.5-0.9]; p=0.03), and for cortisol it was 75% and 78% (AUC=0.71±0.15, 95% CI: [0.5-0.9]; p=0.03). Cortisol suppression of more than 64% from basal level in the HDDST suggested CD with the highest likelihood ratio. When these cut-off values were used together, both tests were negative in the patients with CD.

Conclusion

The CRH stimulation test has low specificity to localize CS in patients with ACTH concentrations of 5-20 pg/mL according to the current diagnostic criteria. Different diagnostic criteria may be used in the CRH stimulation test and also in the HDDST in this group of patients.

Life Quality and Compliance After Transplant: The Case of Turkey

OBJECTIVE

Chronic renal failure is one of the most significant health problems in Turkey, as it is all over the world, and negatively affects quality of life. The aim of this study is to find factors affecting compliance levels and quality of life of patients undergoing kidney transplant.

MATERIALS AND METHODS

The population of the study consisted of 244 patients who underwent kidney transplant. Although the study aimed to cover the entire target population in the sampling selection, it was conducted among 206 patients. The data were collected by face-to-face interview.

RESULTS

Of the patients, 92.7% were between 46 and 59 years of age, 54.4% had a living donor transplant, 54.9% had adverse effects, and 2.9% had rejection due to incompatibility. There was a significant relationship between compliance and quality of life; increasing frequency of adverse effects would decrease in direct proportion to compliance, which would, therefore, increase quality of life. All the subscale scores of the 36-Item Short Form Health Survey were found to have an average of 60 and above. The mean of the compliance scale was 48.33 (SD, 3.21), and, with the maximum score at 55, the mean of the group was high. In our country, patients view transplant as a final and definite treatment method. This might be related to fact that the longer the time after transplant, the lower the level of compliance.

A Comparative Study for Selectivity of Micronuclei in Cervical Exfoliated Cells on Chronic Boron Effects

Background:

Cervical cancer is one of the most frequent malignancies in women. Micronucleus (MN) testing has gained popularity as a biomarker in early diagnosis of many types of cancer.

Aims:

This study aims to investigate the role of MN testing on early detection of cervical cancer and the effect of boron exposure on cervical cells.

Settings and Design:

The study population comprised women who were diagnosed to be human papillomavirus (HPV)-positive and had atypical squamous cells of undetermined significance (ASCUS) as cervical cytology in a cervical screening project. A total of 15 HPV-positive and 36 ASCUS patients were identified. Randomly selected 20 women were selected from boron-rich region (n = 10) and nonboron region (n = 10).

Materials and Methods:

Cervical swab specimens were dyed using Papanicolaou (PAP) and May–Grünwalds–Giemsa (MGG) techniques, and MN count in 1000 cells was performed. The results were statistically evaluated.

Statistical Analysis Used:

Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. Quantitative data were presented as mean ± standard deviation. MN test scoring was compared using Mann–Whitney U-test.

Results:

Boron content of urine was measured to be 3.02 ± 1.45 and 0.98 ± 0.42 mg/day in boron-rich and nonboron regions, respectively. When MN counts were compared according to PAP and MGG staining in HPV- and ASCUS-positive women, there was statistically no significant difference (P > 0.05). Disregarding regions, HPV/control and HPV/ASCUS cases stained with PAP and MGG had statistically significant difference in MN count (P < 0.05).

Conclusion:

These findings suggest that MGG and PAP staining gives similar results with regard to MN count. On the other hand, it has been shown again that HPV induces MN and causes genomic instability.

Metachronous bilateral multifocal nodular oncocytic hyperplasia of the parotid gland

Multifocal nodular oncocytic hyperplasia (MNOH) is a rare lesion of the parotid gland and bilateral cases are extremely rare. We report the case of a 69-year-old woman who was operated from MNOH 10 years ago and the bilateralism of the case appeared 10 years later making the case metachronous.

A Rare Complication During Percutaneous Peritoneal Dialysis Catheter Insertion: Intravesical Placement

Peritoneal dialysis (PD) is one of the treatment options for patients with end-stage renal failure. To start PD treatment, a catheter must be placed for access to the abdominal cavity, and it can be placed using surgical, laparoscopic, or percutaneous methods. However, complications can develop during catheter placement.In the present case report, we describe a patient in whom treatment was pursued after an unusual complication rarely mentioned in the literature: a dialysis catheter accidentally inserted percutaneously into the bladder. Under ultrasonography guidance, the catheter was pulled from the urinary bladder and pushed into the intra-abdominal cavity. No complications resulted from the procedure, and the patient proceeded to PD treatment. This case is, to our knowledge, the only such report in the literature.

Endovascular Treatment in Traumatic and Spontaneous Carotid Cavernous Fistulas: with Different Embolization Agents and via Various Vascular Routes

PURPOSE

We evaluated carotid cavernous fistula (CCF) cases which were treated with various vascular routes and different embolization agents. Our aim was to present endovascular treatment procedures, clinical and radiological findings, and to discuss the safety and clinical efficacy of the treatment.

MATERIALS AND METHODS

The demographic information, presenting symptoms and clinical findings of 25 CCF cases in 23 patients treated with endovascular route were reviewed. The type of fistula, the feeding arteries, the draining veins, and the details of the treatment were documented on the basis of digital subtraction angiography (DSA) images. The efficacy of the treatment was evaluated according to current and follow-up DSA findings with clinical symptoms.

RESULTS

All of which 25 CCF were closed to the fullest extent, one of them closed spontaneously, 20 were closed in one session and 4 in two sessions (100%). 18 of the cases (75%; 18/24) were treated with a venous approach, 5 cases (21%; 5/24) with an arterial approach, and 1 case (4%; 1/24) with a combined arterial-venous approach. Coils were used in 18 cases (75%; 18/24), a covered stent was used in 1 case (4%; 1/24), a detachable balloon was used in 1 case (4%; 1/24), n-Butyl Cyanoacrylate was used in 1 case (4%; 1/24), and combined (2 stent-coil, 1 coil-ethylene vinyl alcohol copolymer) embolization agents were used.

CONCLUSION

The endovascular treatment of CCF has high success and low complication rates. The significant point of the treatment is achieving complete fistula obliteration in the least possible number of sessions with appropriate embolization agents.

Boron intake, osteocalcin polymorphism and serum level in postmenopausal osteoporosis

The relationship between daily boron intake and osteocalcin-mediated osteoporosis was studied in boron-exposed postmenopausal women. It is known that boron and osteocalcin are important in bone metabolism, however the effect of boron in bone metabolism has not been fully discovered. The study was performed on 53 postmenopausal women aged 55-60 living in parts of Balikesir, Turkey, where the subjects are naturally exposed to high (≥1 mg/L) or low (<1 mg/L) boron concentration in drinking water. 24-h urine samples were collected from all participants and creatinine clearance was detected. Boron intake levels of the subjects whose clearance levels were between 80-124 mL/min were measured by inductively coupled plasma-optical emission spectrometry (ICP-OES) in urine samples. Serum osteocalcin levels of the subjects were measured by osteocalcin enzyme-linked immunosorbent assay (ELISA) kit. Osteocalcin polymorphism rs1800247 was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Serum osteocalcin levels in boron-exposed postmenopausal women were significantly higher than that of control group (P ≤ 0.05) and the correlation between the serum osteocalcin level and rs1800247 polymorphism was not significant in both groups (P > 0.05). The differences in the distribution of osteocalcin genotypes and alleles in postmenopausal women were not significant between the boron exposed and the control groups (P > 0.05). Serum osteocalcin level in the CC genotype was significantly higher compared to the TC genotype in boron-exposed group (P ≤ 0.05). Our study suggests that daily boron intake of 1 mg/L may affect bone metabolism in postmenopausal women positively.

The protective effect of melatonin on sperm quality in rat after radioiodine treatment

This study was designed to investigate the potential radioprotective impact of melatonin on the testicular tissue and sperm quality in rat given radioactive iodine (RAI) therapy. Thirty-six male Wistar albino rats were randomly divided into three groups as untreated control (Group 1); oral radioiodine group (RAI, 111 MBq, administrated rats); and RAI+melatonin group (oral radioiodine and intraperitoneal 12 mg/kg/day melatonin, starting 2 days before and continuing for 1 week after oral RAI administration). Twenty-four hours after the injection of the last melatonin dose, blood samples were taken for hormone analyses and the determination of the total antioxidant capacity. Sperm samples taken from the cauda epididymis were examined for spermatological parameters. Tissue samples taken from the rat testes were stained by TUNEL assay and with haematoxylin-eosin to detect apoptosis and histological alterations. It was demonstrated a significant decrease in epididymal spermatozoa viability and motility in all of the treatment groups, in comparison with the control group (p < .001). A significant decrease was also detected in sperm DNA fragmentation, follicle-stimulating hormone (FSH) level and the index of apoptotic germ cells in the RAI+melatonin group when compared to the radioiodine group. It was concluded that melatonin prevents the adverse affects of RAI on apoptosis and spermatozoa quality.

Bridge treatment for early cholecystectomy in geriatric patients with acute cholecystitis: Percutaneous cholecystostomy

BACKGROUND

The main cause of acute cholecystitis (AC) is gallstones, and the incidence of gallstones in elderly patients is high.

METHODS

In this study, we aimed to investigate the efficacy of percutaneous cholecystostomy (PC) before early cholecystectomy in geriatric patients with AC. This retrospective study included 85 patients undergoing laparoscopic or conventional cholecystectomy during early stage of calculous AC.

RESULTS

All patients were over 65 years old and were divided into two groups: Group I, PC plus early cholecystectomy and Group II, only cholecystectomy without PC. Data on age, sex, status of PC before surgery, postoperative complications, postoperative mortality, surgical method, and postoperative hospitalization duration were recorded in our study. The average age in the groups I and II was 75.7±7.5 and 73.7±7.2 years, respectively, indicating insignificant difference (p=0.223). Although postoperative complication rate was two fold in the non-PC group, the PC plus cholecystectomy group has a few complications (p=0.032). Postoperative mortality was evidently lower in patients who first underwent PC and followed by cholecystectomy (p=0.017). The average hospitalization duration in groups I and II were 5.6±2.4 days and 11.2±7.7 days, respectively (p<0.001).

CONCLUSION

Urgent laparoscopic cholecystectomy is still the best surgical treatment modality for calculous AC. Further, our study results showed that in geriatric patients, bridge treatment, such as PC, can be useful for reducing postoperative complication rates.

Epigallocatechin-3-gallate reduces the proliferation of benign prostatic hyperplasia cells via regulation of focal adhesions

AIMS

Benign prostatic hyperplasia (BPH) is the most common urological disease that is characterized by the excessive growth of prostatic epithelial and stromal cells. Pharmacological therapy for BPH has limited use due to the many side effects so there is a need for new agents including natural compounds such as epigallocatechin-3-gallate (EGCG). This study was undertaken to assess the role of EGCG, suppressing the formation of BPH by reducing inflammation and oxidative stress, in cytoskeleton organization and ECM interactions via focal adhesions.

MAIN METHODS

We performed MTT assay to investigate cell viability of BPH-1 cells, wound healing assay to examine cell migration, immunofluorescence assay for F-actin organization and paxillin distribution and finally immunoblotting to investigate focal adhesion protein levels in the presence and absence of EGCG.

KEY FINDINGS

We found that EGCG inhibits cell proliferation at the concentration of 89.12μM, 21.2μM and 2.39μM for 24, 48 and 72h, respectively as well as inhibitory effects of EGCG on BPH-1 cell migration were observed in a wound healing assay. Furthermore, it was determined by immunofluorescence labeling that EGCG disrupts F-actin organization and reduces paxillin distribution. Additionally, EGCG decreases the activation of FAK (Focal Adhesion Kinase) and the levels of paxillin, RhoA (Ras homolog gene family, member A), Cdc42 (cell division cycle 42) and PAK1 (p21 protein-activated kinase 1) in a dose-dependent manner.

SIGNIFICANCE

For the first time, by this study, we found evidence that BPH-1 cell proliferation could be inhibited with EGCG through the disruption of cytoskeleton organization and ECM interactions. Consequently, EGCG might be useful in the prevention and treatment of diseases characterized by excessive cell proliferation such as BPH.

The effect of gigantomasty on vertebral degeneration: A computed tomography study

The main reason for waist and back pain in patients with gigantomasty is increased thoracic kyphosis and lumber lordosis. These symptoms and abnormal spinal angulations regress after reduction mammoplasty operations. However, the effect of chronic mechanical stress caused by gigantomasty on the spinal degenerative process is not clear yet. In this study with computed tomography it is shown that degenerative spondylosis is more widespread and severe in patients with large breasts.

A Study on the Anticarcinogenic Effects of Calcium Fructoborate

Evidences about the preventive and therapeutic effects of boron compounds on cancer have been increasing in the last years. Although calcium fructoborate (CaFB) is used as a nutritional supplement, data about its preventive and therapeutic effects on neoplastic transformations are limited. In the present study, the various concentrations of CaFB were applied to the MDA-MB-231 metastatic breast cancer cell line. First, we examined the cytotoxic effect and IC₅₀ value of CaFB by MTT assay. For the evaluation of the DNA damage, apoptosis and metastatic potential, expression levels of ATM, pATM, PARP, p53, p-p53, caspase-3, caspase-9, and VEGF were investigated by using immunoblotting and immunohistochemical methods. Cell viability was significantly reduced at 50 μM CaFB treatment. pATM, p-p53, and caspase-9 levels increased significantly in all groups; furthermore, there was approximately 12.5-, 2.4-, and 10.7-fold increase, respectively, for 100 μM CaFB treatment. ATM and p53 levels did not change with CaFB treatment, but PARP levels significantly 2.5-fold decreased. While VEGF immunoreactivity decreased in all groups, significant increase in caspase-3 immunoreactivity was observed only in the group treated with 50 μM CaFB (p < 0,001). Our results imply that CaFB may have therapeutic potential as well as preventive benefits in cancer.

Safety and functionality of transhepatic hemodialysis catheters in chronic hemodialysis patients

PURPOSE

We aimed to investigate the safety and functionality of tunneled transhepatic hemodialysis catheters in chronic hemodialysis patients.

METHODS

Thirty-eight patients (20 women aged 56±10 years and 18 men aged 61±11 years) with transhepatic tunneled hemodialysis catheters were evaluated. The date of the first transhepatic catheterization, indications, procedure details, functional time periods of catheters, reasons for the removal or revision of catheters, catheter-related complications, and current conditions of patients were retrospectively analyzed.

RESULTS

A total of 69 catheters were properly placed in all patients (100% technical success) under imaging guidance during the 91-month follow-up period. The functionality of 35 catheters could not be evaluated: five catheters were removed because of noncomplication related reasons (surgical fistulas were opened in two cases [2/35, 5.7%], transplantation was performed in three cases [3/35, 8.6%]), 18 patients died while their catheters were functional (18/35, 51.4%), and 12 catheters were still functional at the time of the study (12/35, 34.3%). The functionality of catheters was evaluated the remaining 34 catheters that necessitated revision because of complications. Furthermore, only half of the catheters were functional on day 136 when evaluated using Kaplan-Meier analysis. The four main complications were thrombosis (16/34, 47%; complication rate of 0.37 days in 100 catheters), infection (8/34, 23.5%; 0.18 days in 100 catheters), migration (8/34, 23.5%; 0.18 days in 100 catheters), and kinking (2/34, 6%; 0.04 days in 100 catheters).

CONCLUSION

Transhepatic venous catheterization is a safe and functional alternative route in chronic hemodialysis patients without an accessible central venou route. The procedure can be performed with high technical success and low complication rates under imaging guidance.

Clinical significance of renal cortical thickness in patients with chronic kidney disease

Purpose

The aim of this study was to evaluate the correlations between laboratory findings and ultrasonographic measurements of renal length and cortical thickness in patients receiving follow-up for chronic kidney disease (CKD).

Methods

A total of 41 CKD patients (18 males and 23 females; mean age, 65.2 years; range, 42 to 85 years) with a low glomerular filtration rate who did not require renal replacement therapy were included in this prospective study. Patients were followed up with laboratory assays at bimonthly intervals and with ultrasonography performed twice a year. Renal cortical thickness, renal length, and estimated glomerular filtration rate (eGFR) values were compared using the paired-samples t test. Additionally, Pearson correlation analysis was conducted between renal length and cortical thickness measurements and eGFR values to assess kidney function.

Results

At the beginning of the study and after 24 months, mean eGFR values of the 41 patients were 35.92 mL/min and 28.38 mL/min, respectively. The mean renal length was 91.29 mm at the beginning of the study and 90.24 mm at the end of the study. The mean cortical thickness was 5.76±2.05 mm at the beginning of the study and 5.28±1.99 mm at the end of the study. A statistically significant positive association was found between eGFR and mean renal length (r=0.66, P<0.01) and between eGFR and mean cortical thickness (r=0.85, P<0.01), with the latter being more prominent.

Conclusion

Our study suggests that ultrasonographic cortical thickness measurements may be an important imaging technique in the follow-up care of patients with CKD.

Biological effects of tolerable level chronic boron intake on transcription factors

The mechanism of boron effect on human transcription and translation has not been fully understood. In the current study it was aimed to reveal the role of boron on the expression of certain transcription factors that play key roles in many cellular pathways on human subjects chronically exposed to low amounts of boron. The boron concentrations in drinking water samples were 1.57±0.06mg/l for boron group while the corresponding value for the control group was 0.016±0.002mg/l. RNA isolation was performed using PAX gene RNA kit on the blood samples from the subjects. The RNA was then reverse transcribed into cDNA and analyzed using the Human Transcription Factors RT² Profiler™ PCR Arrays. While the boron amount in urine was detected as 3.56±1.47mg/day in the boron group, it was 0.72±0.30mg/day in the control group. Daily boron intake of the boron and control groups were calculated to be 6.98±3.39 and 1.18±0.41mg/day, respectively. The expression levels of the transcription factor genes were compared between the boron and control groups and no statistically significant difference was detected (P>0.05). The data suggest that boron intake at 6.98±3.39mg/day, which is the dose at which beneficial effects might be seen, does not result in toxicity at molecular level since the expression levels of transcription factors are not changed. Although boron intake over this level will seem to increase RNA synthesis, further examination of the topic is needed using new molecular epidemiological data.