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OBJECTIVE: Latent tuberculosis infection (LTBI) screening is strongly recommended in the pre-transplant evaluation of solid organ transplant (SOT) recipients, although it remains inadequate in many transplant centers. We decided to investigate pre-transplant TB risk assessment, LTBI treatment, and registry rates in Turkey. MATERIAL AND METHODS: Adult SOT recipients who underwent tuberculin skin test (TST) and/or interferon-gamma release test (IGRA) from 14 centers between 2015 and 2019 were included in the study. An induration of ≥5 mm on TST and/or probable/positive IGRA (QuantiFERON-TB) was considered positive for LTBI. Demographic features, LTBI screening and treatment, and pre-/post-transplant TB history were recorded from the electronic database of transplantation units across the country and pooled at a single center for a unified database. RESULTS: TST and/or IGRA were performed in 766 (33.8%) of 2266 screened patients most of whom were kidney transplant recipients (n = 485, 63.4%). LTBI screening test was positive in 359 (46.9%) patients, and isoniazid was given to 203 (56.5%) patients. Of the patients treated for LTBI, 112 (55.2%) were registered in the national registry, and 82 (73.2%) completed the treatment. Tuberculosis developed in 6 (1.06%) of 563 patients who were not offered LTBI treatment. CONCLUSION: We determined that overall, only one-third of SOT recipients in our country were evaluated in terms of TB risk, only 1 of the 2 SOT recipients with LTBI received treatment, and half were registered. Therefore, we want to emphasize the critical importance of pretransplant TB risk stratification and registration, guided by revised national guidelines.

Abstract Background Cerebrotendinous Xanthomatosis (CTX) is a rare autosomal recessive lipid storage disorder caused by loss of function variants in the CYP27A1 gene which encodes sterol 27-hydroxylase, on chromosome 2q35. Although the symptoms begin commonly in infancy, CTX diagnosis is often delayed. The aim of this study is to review the orthopedic findings of the disease by providing an overview of the clinical features of the disease. It is to raise awareness of this condition for which early diagnosis and treatment are important. Methods We retrospectively evaluated the clinical, laboratory, radiological, and genetic findings of eight patients from four families who were admitted to our Orthopedics and Traumatology Department between 2017 and 2022 due to bilateral Achilles tendon xanthomas, were found to have high cholestanol and CYP27A1 gene mutations. Results The mean age of patients was 37, and five of them were male. The mean age at the onset of symptoms was 9.25 years. The mean age of initial diagnosis was 33.75 years. Between symptom onset and clinical diagnosis, an average delay of 24.5 years was observed. All patients had bilateral Achilles tendon xanthoma. Notably, a novel variant (c.670_671delAA) in CYP27A1 gene was identified in three patients who also presented with peripheral neuropathy and bilateral pes cavus. One patient had osteoporosis and four patients had osteopenia. Five patients had a history of bilateral cataracts. Furthermore, three of the patients had early-onset chronic diarrhea and three of the patients had ataxia. Two of the patients had epilepsy and seven of the patients had behavior-personality disorder. All patients had low intelligence, but none of them had cardiac disease. Conclusion We present the diagnostic process and clinical features which the largest CTX case series ever reported from single orthopedic clinic. We suggest that patients with normal cholesterol levels presenting with xanthoma being genetically analyzed by testing at their serum cholestanol level, and that all siblings of patients diagnosed with CTX be examined.

Abstract We assessed the potential retinal microcirculation alterations for postoperative visual recovery in sellar/paraseller tumor patients with Optical Coherence Tomography Angiography (OCT-A). Two hundred ten eyes with sellar/parasellar tumor for which preoperative and postoperative (3 months) MRI Scans, Visual Acuity Test, Optical Coherence Tomography (OCT), OCT-A and, Visual Field Test data were available, besides 92 healthy eyes were evaluated. In the preoperative phase, significant reductions were observed in retinal vascular densities in various regions, including the Superficial Retinal Capillary Plexus (SRCP) (whole: p

Pediatric femur diaphyseal fractures are seen after serious traumas such as traffic accidents and fall from height. Although treatment algorithms are made according to age groups, treatment planning is individualized according to the patient and the degree of injury. In our study, we evaluated functional outcomes of pediatric femur fractures treated with titanium elastic nail (TEN). This is a retrospective study including pediatric femoral diaphyseal fractures treated with TEN between 2012 and 2021. Open fractures, pathological fractures, distal fractures involving the femoral condyles, and proximal fractures involving the trochanteric region were not included in our study. Thirty-three femoral diaphyseal fractures with complete data were identified as stable and unstable in length, and functional results and post-treatment complications were recorded by performing TEN in fracture fixation. Clinical functional results were analyzed with Flynn criteria. Thirty-three femoral fractures of 29 patients were included. Eighteen (62.1%) of our patients were boys and 11 (37.9%) were girls. The mean age was 6.51 years (4-13 years). The most common injury mechanism was traffic accidents seen in 19 patients (24.51%). The mean follow-up period after surgery was 26.6 (6-90 months) months. Stable fractures (transverse and short oblique) were found in 26 cases (78.7%) and unstable fractures (spiral/long oblique and comminuted) in 7 cases (21.7%). According to Flynn criteria, excellent results were found in 20 fractures (60.6%) and satisfactory results in 10 fractures (30.3%) and 3 poor (%9.09). There was no significant difference between stable and unstable fractures in terms of functional outcome (p=0.12). Femoral diaphyseal fractures are serious injuries that require surgery. Regardless of the type of fracture, stable or unstable in length, the results of treatment with TEN are very successful. Major complications such as nonunion and re-fracture are rarely seen with this treatment. [Med-Science 2023; 12(3.000): 746-52]

Background: Premenstrual syndrome (PMS) is the combination of physical, behavioral, and psychological symptoms that characterize the week leading up to menstruation, and it can last for a few days. This study aimed to investigate irregular PMS, eating attitude behavior, and body mass index values among university students. Methods: The study sample consisted of 140 Artvin Coruh University students studying Nutrition and Dietetics. The study includes questions from three separate sections. The first section contains a sociodemographic characteristic form, the second section consists of the Premenstrual Syndrome Scale (PMSS), and the third section includes the 26-item Eating Attitude Test (EAT-26). Results: In this study, the mean total score for PMSS was 135 ± 38.3, and the mean total score for EAT-26 was 17.0 ± 10.8. Individuals with irregular sleep patterns experienced more severe PMS (p < 0.01) and a shorter daily sleep duration (p < 0.05). Conclusions: High percentages of nutrition and dietetics students in our study experienced PMS, and the incidence of eating disorders was low. The relationship between PMS and EAT-26 must be understood for the health and well-being of university students.

IntroductionThe most prevalent head and neck cancer type is laryngeal cancer. Laryngeal cancer susceptibility is increased by a combination of genetic variables and environmental factors. Genetic predispositions that influence the functioning of the immune system can affect tumor development. Our study investigates the impact of alterations in CD40 (rs1883832) and CD40L (rs1126535) genes and the levels of their proteins on the development of laryngeal cancer.Materials and methodsThe PCR-RFLP method was used for genotyping SNPs in 96 patients with laryngeal cancer and 127 healthy individuals. Additionally, ELISA was utilized to measure circulating levels of sCD40 and sCD40L.ResultsWe identified a significant difference in the genotype distribution of CD40 (rs1883832) between laryngeal cancer patients and healthy individuals (p = 0.05). The C allele was dominant, and the CC genotype was more frequently observed in patients with laryngeal cancer (OR: 2.34, 95% CI: 0.98-5.54). In contrast, no statistically significant difference in the genotypes of CD40L (rs1126535) was detected between laryngeal cancer patients and the control group (p = 0.12). Additionally, no significant differences in serum sCD40 or sCD40L levels were observed between the groups (p = 0.48 and p = 0.15, respectively). However, a moderate positive correlation was found between sCD40 and sCD40L levels in the laryngeal cancer group (r = 0.52, pDiscussionAccording to the current findings, it is suggested that the CD40 (rs1883832) gene variation found in patients may indicate an individual's susceptibility to developing laryngeal cancer. On the other hand, CD40L (rs1126535) seems to not play a significant role. While serum sCD40 and sCD40L levels did not show significant differences between patients and controls, the correlation in cancer patients suggests that these markers may be relevant in tumor progression. Further research is required to clarify the functional implications of these genetic variants and their potential use as biomarkers for laryngeal cancer.

Aim: The aim of this study was to compare the resistance to asymptomatic bacteriuria (ABU) between term and preterm pregnancies. Material and Methods: Pregnant women aged 17-41 years who were followed up in the obstetrics department of our hospital and whose urine cultures were sent to the laboratory for analysis and reported as ABU were included in the study. Patients were divided into two groups according to gestational weeks as preterm (

INTRODUCTION: The aim of this study was to investigate microbiological profiles and antimicrobial resistance of hip and knee periprosthetic joint infection (PJI). METHODS: Patients over 18 years of age who underwent hip or knee primary arthroplasty between September 2018 and January 2022 were screened from the hospital database and retrospectively included in the study. Patients' demographic data, periprosthetic tissue culture, and joint fluids' antimicrobial resistances were evaluated. RESULTS: A total of 51 patients with 66.7% being female were enrolled. The hip joint was infected in 62.7% of the patients. The most common causative pathogen identified was Coagulase-negative staphylococci (CoNS) (41.2%), followed by Staphylococcus aureus (23.5%) and Acinetobacter baumanii (23.5%). The proportion of A. baumanii in hip PJI was higher than that in knee PJI (p=0.02). Twenty-five of the detected Acinetobacter strains were resistant to carbapenems. The distribution of Gram-positive or Gram-negative microorganisms between the knee and hip PJI groups was not statistically significant (p>0.05). The infection was monobacterial in 56.9% of the patients. Polymicrobial pathogens were more likely to occur in the hip prosthetic joint than in the knee prosthetic joint, but no statistical difference was observed between the two groups (p>0.05). DISCUSSION AND CONCLUSION: The predominant bacteria usually differ among different geographic area and location of the prosthesis. Knowing the causative agents and antimicrobial resistance is the basic strategy in infection management. Considering that there are limited evidence in literature about PJI's, further studies are needed to accumulate knowledge and to analyze better microbiological profiles of PJIs.

INTRODUCTION: In our study, we aimed to evaluate the causes of peripheral lymphadenopathy (LAP). METHODS: Patients older than 18 years old who were diagnosed with LAP and underwent peripheral lymph node biopsies between 01.11.2017 and 01.01.2020 were included in the study. The demographic data and histopathological findings of the patients were retrospectively reviewed on the computer database of the hospital. RESULTS: One hundred ninety-seven adult patients in total were included in the study, 51.27% (n=101) of whom were female. The rates of fever, night sweats, and weight loss symptoms were detected as 8.63%,13.70%,and20.30%, respectively. Excisional biopsy was performed in 93.40%of the patients, and the most frequently excised lymph node was the axillary node at a rate of 40.10%. According to the results of the histopathological analyses, the most common etiology was malignancy, and the second one was infectious, at 31.98% and 29.95%, respectively. Malignancy was caused by lymphoma in 93.65% of the cases, whereas the infectious etiology was caused by tuberculosis at 74.58%. A specific diagnosis could not be made for 26.90% of the cases, and their outpatient follow-up was continued. DISCUSSION AND CONCLUSION: Although LAP is often associated with infections, it also occurs as a manifestation of malignant diseases. In our study, the most common etiology was malignant diseases. Infections were the second most common etiology, and among infections, tuberculosis was the leading one.LAP is a frequently encountered clinical condition that is difficult to manage. To avoid delays in diagnosis, patients should be carefully evaluated and followed closely. Although a specific diagnosis cannot always be made, histopathology remains the gold standard for diagnosis.

Background: Broad-spectrum empirical antimicrobials are frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection. Aims: We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction. Study Design: The study was a national, multicenter, retrospective, and single-day point prevalence study. Methods: This was a national, multicenter, retrospective, and single-day point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey. Results: A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age ± standard deviation of the patients was 65.0 ± 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (37.2%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital (p < 0.001), requiring any supplemental oxygen (p = 0.005), presence of moderate/diffuse lung involvement (p < 0.001), C-reactive protein > 10 ULT coefficient (p < 0.001), lymphocyte count < 800 (p = 0.007), and clinical diagnosis and/or confirmation by culture (p < 0.001) were found to be independent factors associated with increased antibiotic use. Conclusion: The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings.

Abstract Our aim was to identify the differentially expressed genes (DEGs) in peripheral blood mononuclear cells (PBMC) of Parkinson’s disease (PD) patients and healthy controls by microarray technology and analysis of related molecular pathways by functional annotation. Thirty PD patients and 30 controls were enrolled. Agilent Human 8X60 K Oligo Microarray was used for gene level expression identification. Gene ontology and pathway enrichment analyses were used for functional annotation of DEGs. Protein–protein interaction analyses were performed with STRING. Expression levels of randomly selected DEGs were quantified by real time quantitative polymerase chain reaction (RT-PCR) for validation. Flow cytometry was done to determine frequency of regulatory T cells (Tregs) in PBMC. A total of 361 DEGs (143 upregulated and 218 downregulated) were identified after GeneSpring analysis. DEGs were involved in 28 biological processes, 12 cellular components and 26 molecular functions. Pathway analyses demonstrated that upregulated genes mainly enriched in p53 (CASP3, TSC2, ATR, MDM4, CCNG1) and PI3K/Akt (IL2RA, IL4R, TSC2, VEGFA, PKN2, PIK3CA, ITGA4, BCL2L11) signaling pathways. TP53 and PIK3CA were identified as most significant hub proteins. Expression profiles obtained by RT-PCR were consistent with microarray findings. PD patients showed increased proportions of CD49d+ Tregs, which correlated with disability scores. Survival pathway genes were upregulated putatively to compensate neuronal degeneration. Bioinformatics analysis showed an association between survival and inflammation genes. Increased CD49d+ Treg ratios might signify the effort of the immune system to suppress ongoing neuroinflammation.

A significant decrease in late diagnosis and requirement for surgical treatment have been observed due to the implementation of the National Developmental Hip Dysplasia (DDH) Early Diagnosis and Treatment Program, which has been in existence for about 10 years. However, patients with delayed diagnosis are still admitted to our clinic for treatment. In this study, we aimed to evaluate the effectiveness of this program and reveal its deficiencies. Patients and methods: Sixty-one patients diagnosed or treated for ddh later than six months of life were included in the study. Patients born between 2011 and 2014 (Group 1) and between 2015 and 2018, during which time the early screening program was performed intensively (Group 2), were compared. The patients risk factors, whether a hip ultrasound (US) was performed, and the reasons for the delay in diagnosis and treatment were questioned retrospectively. The number of DDH patients in Group 2 decreased by approximately 3 times (45/16) (p = 0.0009). Although 37 (61%) patients had a hip US assessment within the first 6 months, their treatment was delayed, and normal USs were reported for 20 (33%) of them. Hip US was not performed in 24 (39%) patients within the first 6 months. The number of late-diagnosed and -treated babies with DDH decreased significantly in recent years, but this is not sufficient. Preventing late diagnoses should be the main goal. This study detected families negligence and lack of information, family physicians non-compliance with the program, and improper US assessment as the confounding reasons. [Med-Science 2020; 9(4.000): 1023-6]

OBJECTIVE: Colorectal cancer (CRC) is the third most common type of cancer observed in cancer-related mortality because it has a high metastasis ratio. This study aims to investigate the expression levels of several genes, including metastasis-related colon cancer 1 (MACC1), Filamin A (FLNA), F-box/WD repeat-containing protein 7 (FBXW7), which has an important role in cell signaling, migration and adhesion through the remodeling of the cell skeleton. METHODS: In this study, 21 patients with a precise diagnosis of CRC and 21 controls were included. Gene expressions were examined using the RT-PCR technique. To define the relationship of the genes with metastasis, blood samples were collected from all patients with colon/rectal cancer diagnosis without metastasis at six months before and after the medication with Xelox. RESULTS: Our findings showed that no significant difference was observed in the pre-treatment values compared to the control group, whereas FLNA (p=0.001) expression was observed to be significantly increased following treatment with Xelox. CONCLUSION: To our knowledge, our study is the first study to investigate the effects of Xelox treatment on the expression levels of MACC1, FBXW7 and FLNA genes in non-metastatic colorectal cancer patients in Turkey.

INTRODUCTION[|]To investigate placental immunohistochemical findings and Doppler parameters in normal pregnancies and women with preeclampsia (PE).[¤]METHODS[|]Doppler measurements of umbilical, uterine, and spiral arteries of 23 PE and 12 normal pregnancies followed and delivered between 2008 and 2010 were performed and recorded. Placental specimens were obtained at birth and the microvessel density of spiral arteries was measured immunohistochemically using placental tissue CD 34 antibody expression. Three vessels with the most intense CD34 density were evaluated.[¤]RESULTS[|]There were no significant differences in the umbilical artery pulsatility index (PI), resistance index (RI), or systolic/diastolic ratio (S/D) between the PE and normal pregnancies. The spiral and uterine artery RI, PI, and SD ratios, however, were significantly higher in the PE group. There was no statistically significant difference in the mean microvessel density between the 2 groups.[¤]DISCUSSION AND CONCLUSION[|]The role of the placenta in the development of PE is unquestionable. Vascular pathologies and blood flow characteristics demonstrate significant differences and deteriorations compared with normal pregnancies. Further research is needed to further define the precise pathology.[¤]

The aim of the study is to investigate the possibility of reinnervation and prevention of muscle atrophy following side to side neurorrhaphy to the intact nerve after end to end repair of proximal transected peripheral nerves in order to prevent distal target organ atrophy. For this, four groups each containing five SpragueDawley female rats were used. In group I, no surgical procedure was performed as a control group. In group II, side to side distal neurorrhaphy performed to the tibial and peroneal nerves after end to end repair of transected proximal tibial nerve. In group III. distally side to side epineural neurorrhaphy performed to the tibial and peroneal nerves. In group IV, end to end epineural repair was performed after proximal tibial nerve transection. The rats were followed up for 3 months for nerve regeneration. Subsequently group II, III and IV were evaluated histopathologically. In all group, tibial and fibular bony weights, foot weights, anterior and posterior crural muscle weights and EMG parameters were evaluated. Comparison between the groups revealed no significant differences regarding EMG and muscle weights between groups 2 and 4 also axonal degeneration was observed in 3 group after neurorrhaphy. As result of experimental study, we think that side to side repair of intact distal nerves as an adjunct to end to end repair of proximal nerve transections has no additional benefit to prevent distal organ atrophy but rather may be caused harm on the intact nerve. In addition, it has been observed that this technique affects the intact nerve rather than the transected nerve. [Med-Science 2019; 8(4.000): 827-31]

Aim:We aimed to compare the efficacy of intravenous blood-fluid warming and forced-air warming systems for the prevention of perioperative hypothermia in pediatric patients under six years of age.Methods:Two-hundred children aged 0-6 years, who underwent elective surgery, were included in the study. Group 1 patients were warmed with forced-air warming system at the operating room. Group 2 patients were warmed with intravenous fluid and blood warming systems at the operating room. During the entire operation, heart rate, SpO2, end Tidal CO2 and esophagus temperature values were recorded at 10-minute intervals. The number of patients, who needed rescue warming, the starting time and duration of rescue warming were recorded. The duration of the anesthesia, the duration of the operation, and the time of recovery were recorded.Results:The groups were compared in terms of mean operating room temperature and body temperature and no statistically significant difference was found between the groups. There was no statistically significant difference between the groups for additional rescue warming need and time to rescue warming. The time to recovery was longer in the patients who needed rescue warming. There was a statistically significant positive correlation between the duration of the operation and the duration of the need for rescue warming with a confidence of 99%.Conclusion:In pediatric patients, i.v. fluid warming systems are as effective as forced-air warming systems in avoiding perioperative hypothermia.

Endometrial carcinoma is a metastatic and recurrent disease has a worse prognosis. We aim to investigate the MMP-3 gene polymorphism in Turkish patients with endometrial carcinoma. In recent years, number of genetic studies have been increased to find new prognostic and theraupeutic markers. Matrix metalloproteinases [MMPs] are proteolytic enzymes that degrade all components of the extracellular matrix which are play an important role of cancer metastasis and invasion. MMP-3, also known as stromelysin-1, to lyse basal membrane collagen and induce the synthesis of some other MMPs. 97 patients with endometrial carcinoma and 100 healthy controls were included in this study. MMP-3 E45K polymorphism was determined using polymerase chain reaction/ restriction fragment length polymorphism in study groups.There were no significant differences between any genotypes or allele in control and patient groups for MMP-3 E45K polymorphism. Besides no significant correlation was found between MMP-3 E45K polymorphisms and clinical characteristics, such as histology, grade, metastasis and family history. ur study suggests that the MMP-3 E45K polymorphism is not associated with endometrial carcinoma process in Turkish patients. [Med-Science 2018; 7(4.000): 762-5]

Objective Innate immunity factors are associated with type 2 diabetes (T2DM) and its complications. Therefore, T2DM has been suggested to be an immune-dependent disease. Elevated fasting glucose level and higher concentrations of innate immunity soluble molecules are not only related with insulin resistance, but inflammation is also an important factor in beta cell dysfunction in T2DM. Toll-like receptor 2 (TLR-2), which has an important role in inducing innate immune cells, is thought to have suppressive roles on immune responses in T2DM. We therefore aimed to investigate the possible role of TLR-2 del -196-174 and Arg753Gln variants in T2DM pathogenesis. Materials And Methods This study was designed as a case-control study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to genotype the two variants in 100 T2DM patients and 98 age- matched controls. Results We found significantly higher frequencies of TLR-2 del -196-174 DD genotype (P=0.003), ID genotype (P=0.009) and D allele (P=0.001) in patients compared with controls. In addition, the II genotype (P=0.001) and the I allele (P=0.003) frequencies were elevated in healthy controls. We did not find any significant differences in frequency distribution for the Arg753Gln variant in study groups. Conclusion We suggest that carrying the D allele of the TLR-2 del -196-174 variant may be related as a risk factor for T2DM.

Background: The humoral system is activated and various cytokines are released due to infections in tissues and traumatic damage. Nuclear factor-kappa B dimers are encoded by nuclear factor-kappa B genes and regulate transcription of several crucial proteins of inflammation such as tumour necrosis factor-alpha. Aims: To investigate the possible effect of polymorphisms on tumour necrosis factor-alpha serum levels with clinical and prognostic parameters of sepsis by determining the nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A) gene polymorphisms and tumour necrosis factor-alpha serum levels. Study Design: Case-control study. Methods: Seventy-two patients with sepsis and 104 healthy controls were included in the study. In order to determine the polymorphisms of nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A), polymerase chain reaction–restriction fragment length polymorphism analysis was performed and serum tumour necrosis factor-alpha levels were determined using an enzyme-linked immunosorbent assay. Results: We observed no significant differences in tumour necrosis factor-alpha serum levels between the study groups. In the patient group, an increase in the tumour necrosis factor-alpha serum levels in patients carrying the tumour necrosis factor-alpha (-308 G/A) A allele compared to those without the A allele was found to be statistically significant. Additionally, an increase in the tumour necrosis factor-alpha serum levels in patients carrying tumour necrosis factor-alpha (-308 G/A) AA genotype compared with patients carrying the AG or GG genotypes was statistically significant. No significant differences were found in these 2 polymorphisms between the patient and control groups (p>0.05). Conclusion: Our results showed the AA genotype and the A allele of the tumour necrosis factor-alpha (-308 G/A) polymorphism may be used as a predictor of elevated tumour necrosis factor-alpha levels in patients with sepsis

Objectives: To investigate the potential protective effects of sesamol in an experimental cataract model. Materials and Methods: Twenty-one Spraque Dawley rat pups were randomly assigned into three groups, seven rats in each. All the rats except for those in the control group were injected subcutaneously with a single dose of sodium selenite on postpartum day 9. On days 10-14, rats in the sham group were intraperitoneally administered 50 mg/kg/day saline solution, while rats in the sesamol group were given 50 mg/kg/day sesamol by the same route. Following cataract grading, the lenses and capsules were extracted and the mean levels of reduced glutathione (GSH), malondialdehyde (MDA), total antioxidant status (TAS) and total oxidant status (TOS) in lens supernatants were biochemically analyzed. Results: The control group did not show any development of cataract. It was found that the mean cataract grade in the sesamol group was significantly lower than that of the sham group (p

Scaphoid fractures are the most common fracture of the carpal bones and account for 60% carpal injuries. Nonunion may occur in 5-12% of scafoid fractures. Aim of this study is to present result of scaphoid nonuinon treated with 1-2 intercompartmental pedicled artery bone graft and canullated screw in our clinic. Between 2009-2012, 19 scaphoid nonunions ( 18 males, 1 female) were treated with 1-2 intercompartmental pedicled artery bone graft and canullated screw. The average age of patients were 31,2 (range 12-47 years). The average time from initial injury to operation was 40.8 months (range 8 months -20 years).All scaphoid nonunions healed with union at an average of 9,4 weeks( range 6-12 weeks) after surgery. The average Mayo score of patients were 76,6 (range-25-100). We determined that treatment with 1-2 intercompartmental pedicled artery bone graft and canullated screw is good option in scaphoid nonunions regardless of avascular necrosis. [Med-Science 2017; 6(3.000): 427-30]

Metabolic disorders such as hyperuricaemia and hyperuricaemic renal failure, hyperkalaemia and hyperphosphataemia in hematological malignancies with high tumour burden and high turnover and rarely in solid malignancies are defined as acute tumour lysis syndrome. It frequently occurs after treatment (chemotherapy / radiotherapy) and rarely occurs before treatment. In this case, it is called spontaneous acute tumour lysis syndrome. We aimed to remind clinicians of this rare clinical entity with high mortality risk by presenting a patient with non-Hodgkin’s lymphoma and acute spontaneous tumour lysis syndrome.

Sciatic nerve paralysis can be seen after hip joint traumatic dislocations and fractures of the posterior wall of acetabulum. In this article, we report sciatic nerve palsy due to heterotopic bone formation in early postoperative phase that was treated with heterotopic bone resection and sciatic nerve neurolysis in a patient who underwent open reduction and internal fixation for hip dislocation and fracture of posterior wall of right acetabulum. [Med-Science 2018; 7(2.000): 434-6]

Background: Only 15 cases of Ewing’s Sarcoma (EWS) family of tumors of urinary bladder have been documented in the literature to date. Case Report: We presented here a 38 year-old female with primary urinary bladder EWS with no distant metastases. She had presented with macroscopic hematuria and had undergone transurethral resection of the tumor within the following week. Microscopic examination revealed a tumor diffusely infiltrating the lamina propria and muscularis propria under an intact urothelium, which was composed of small round blue cells with scant cytoplasm, monotonous round or oval nuclei, stippled chromatin and small nucleoli. Immunohistochemistry showed strong vimentin, synaptophysin and membranous CD99 expression by the tumor. Fluorescent in situ hybridization analysis displayed the EWSR1 rearrangement. Radical cystectomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy, extended lymph node dissection, and ileal conduit were performed. As adjuvant chemotherapy, she received vincristine, doxorubicin, cyclophosphamide and mesna, alternating with courses of etoposide, iphosphamide and mesna. She is alive and well with no evidence of disease 14 months after the surgery. Conclusion: Surgery supported with chemotherapy should be considered as an option, especially in advanced Ewing’s sarcoma family of tumors of urinary bladder.

Background: Desmoid tumors are uncommon and benign mesenchymal neoplasms. The optimal treatment of patients with desmoid tumors is still controversial. Surgery is the primary treatment for locally invasive or recurrent desmoid tumors. Also, radiotherapy is a treatment option for patients at high risk for local failure such as those with positive margins or recurrent and unresectable tumors. Aims: To report our institutional experience and long-term results of patients with desmoid tumors who received radiotherapy. Study Design: Retrospective cross-sectional study. Methods: Between 1980 and 2009, 20 patients who received radiotherapy (RT) in our institution were analyzed. The majority of patients (80%) were referred with a recurrent tumor after previous surgery. Thirteen patients underwent marginal resection, 4 had wide local excision and 3 patients had only biopsy. Resection margin was positive in 15 (75%) patients. All patients received radiation therapy. The median prescribed dose was 60 Gy. Five patients received less than 54 Gy. Results: The median follow-up time was 77.5 months (28-283 months). Nine patients developed local recurrence after RT. Seven local failures (78%) were in field. Time to local recurrence ranged from 3-165 months (median 33 months). The 2-5 year local control (LC) rates were 80% and 69%, respectively. On univariate analysis, the 5 year local control rate was significantly better in the patients treated with ≥54 Gy than in patients who received

Neurological problems following supracondylar fractures are clinically challenging problem. Neurological damage has been reported about 10-20% of pediatric supracondyler fractures. Nerve injury caused by primarily directly damage of the fracture fragments, excessive stretching,entrapment of nerve in fracture line, or iatrogenically. Radial nerve injury is at least often seen by rate of %21 after supracondylar humerus fractures. Neural injuries of pediatric patients have mostly recover spontaneously. But in case of nerve defect; nerve grafting is needed for repair. [Med-Science 2016; 5(1.000): 266-70]

Injuries of flexor digitorum profundus tendons in children are rare (Nietosvaara at all.), certainly in newborns. In this case report, we discuss the presentation, treatment and outcome of a profundus tendon injury of the fifth finger of a ten days old baby. The tendon injury in this case was caused by a knife cut, unrelated to cesarean sectio. To our knowledge, this is the first report about a flexor digitorum profundus injury and repair in a newborn of this age. [Med-Science 2015; 4(4.000): 2909-13]

Objective: Gamma-glutamyltransferase (GGT) may be considered as a biomarker of “oxidative stress” associated with glutathione metabolism and a possible “proatherogenic” marker because of its indirect relationship with the biochemical steps in the oxidation of low density lipoprotein cholesterol. Serum inorganic phosphorus (P) level is also suggested as an independent risk factor for cardiac events and mortality in the long term. We aimed to observe the relationship of serum GGT, calcium (Ca), and P levels with 1 months’ mortality after myocardial infarction.Methods: Our retrospective study included 200 patients (124 men and 76 women) with acute coronary syndrome (ACS) who were admitted to our hospital. We excluded subjects with severe systemic illness, hepatobiliary disease, alcohol consumption, chronic metabolic bone disease, malignancy, parathyroid disease, and patients who had a glomerular filtration rate (GFR)

ObjectivesThe aim of the present study was to evaluate the internal auditory canal (IAC) and the nerves inside it to define possible structural differences in cases with subjective tinnitus of unknown origin.MethodsCases applying to the ear, nose and throat department with the complaint of tinnitus with unknown origin and having normal physical examination and test results were included in the study (n=78). Patients admitted to the radiology clinic for routine cranial magnetic resonance imaging (MRI) and whose MRI findings revealed no pathologies were enrolled as the control group (n=79). Data for the control group were obtained from the radiology department and informed consent was obtained from all the patients. Diameters of the IAC and the nerves inside it were measured through enhanced images obtained by routine temporal bone MRIs in all cases. Statistical evaluations were performed using Student t-test and statistical significance was defined as P

Background: Ganglioneuroblastomas (GNBs) are rare embryonic neoplasms in the spectrum of neuroblastic tumours and 80% of cases occur in the first decade. In adults, GNBs are usually located in the retroperitoneum, mediastinum and neck but intracranial GNBs are extremely rare. Case Report: A 34-year-old male applied to the Department of Neurology outpatient clinic with a two month history of headache and numbness in his legs. Detailed examinations and cranial CT were performed and showed a mass with a 5 cm diameter running from the third to the fourth ventricle. Referral to a neurosurgeon was performed for partial removal of the tumour, as the histological and immunohistochemical studies defined the diagnosis of GNB. Three months later, when the patient experienced dizziness, an MRI was performed, which showed a 4x3 cm ventricular mass, with hypointense characterisation in T1-weighted and hyperintense characteristics in T2-weighted and flair sequences. Afterwards, fractioned radiotherapy (54 Gy/30 fx) was chosen as the appropriate therapy. In the follow-up period, MRI was performed 3 months and 1 year after treatment, and revealed shrinkage of the tumour by at least 50%. Meanwhile the patient’s post-irradiation course was favourable. Conclusion: Data following the use of radiotherapy as treatment for intracranial GNB showing favourable results has been reported.

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction with exogenous gonadotropins. Pleural effusion and abdominal ascites frequently accompany this syndrome. In this paper, we present the case of a 22-year-old female patient who was admitted to our clinic with the complaints of sudden chest pain and dyspnea and was treated with ovulation induction. Exudative pleural effusion and ascites were determined in the patient. Pelvic ultrasonography revealed enlarged ovaries with numerous follicular cysts compatible with ovarian hyperstimulation syndrome (OHSS). Her estradiol level was >5054 pg/ml. The diagnosis of OHSS was established after elimination of other causative factors of polyserositis (pleural effusion and ascites). The disappearance of pleural effusion and ascites spontaneously in a week supported our diagnosis. Herein, we aimed to emphasize that OHSS should be considered in the differential diagnosis of polyserositis in young female patients with a history of ovulation induction history. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 56-9)

Background: Type 2 diabetes (T2DM) is characterized by hyperglycemia and insulin deficiency. Sirtuin 1 (SIRT1), serving as a deacetylase, is critical in the regulation of glucose and lipid metabolism. Recently, a number of studies have been conducted to investigate the role of SIRT1 in the pathogenesis of T2DM. However, there are no sufficient data about the relationship between SIRT1 and T2DM. The aim of this study was to analyze the expressions of microRNAs (miRNAs) (miR-34a, miR-9, miR-132, and miR-181a) involved in SIRT1 regulation and SIRT1 protein in the serum of T2DM patients and controls. Materials and Methods: miRNA expressions were determined by real-time polymerase chain reaction, and enzyme-linked immunosorbent assay was used to measure the SIRT1 protein levels in 25 T2DM patients and 25 controls. Results: Fasting blood glucose and glycated hemoglobin levels were significantly higher in patients when compared with controls (P < 0.001). There was no difference for miRNA expressions between the groups (P > 0.05). SIRT1 protein level was significantly increased in patients as compared to controls (P = 0.044). Moreover, SIRT1 was negatively correlated with miR-181a (r = −0.558,P = 0.005) and miR-132 (r = −0.435,P = 0.034) in patients. Conclusion: Obtained results indicate that serum SIRT1 may be a potentially new biomarker for T2DM and also miR-181a and miR-132 may be involved in the development of T2DM by targeting SIRT1. This is the first study reporting on the effects of SIRT1 and related miRNAs in Turkish T2DM patients.

Objective: Trace elements such as manganese (Mn), cobalt (Co) and chromium (Cr) play key roles in metabolic reactions and are important in many physiological enzymatic processes. In this study, we aimed to investigate the acute effects of moderate and strenuous running (treadmill) exercise on the levels of Mn, Co and Cr in the brain, liver, and spleen of trained rats. Study Design: Animal experiment. Material and Methods: Twenty-one Wistar-Albino adult male rats were used in the study. Rats were grouped as control group (no mandated exercise; n=8), moderate exercise group (30 min exercise duration; n=7), and strenuous exercise group (60 min exercise duration; n=6). The levels of Mn, Co, and Cr in the frontal lobe, temporal lobe, brain stem, liver, and spleen were determined by atomic absorption spectrophotometer. Results: Cr levels in liver of rats increased in parallel to the time course of running supporting the exercise training effect on the action of insulin. Compared to the control group, the level of Co significantly decreased in the brain stem of rats in the moderate exercise group (p=0.009) and in the frontal lobe of rats in the strenuous exercise group (p=0.004). In the strenuous exercise group, an examination of the brain stem revealed that the level of Mn significantly decreased (p=0.001), and levels of Co and Cr were apparently depleted to the extent that these elements were no longer detectable. Conclusion: A notable finding is that during or after single bout strenuous exercise, levels of Co decreased in the spleen and particularly decreased in the brain stem of regularly trained rats. From this study, it can be inferred that sportsmen should aware trace element disturbances among the body parts or depletion of some trace elements after single bout of chronic strenuous running exercise.

Trace elements have an important effect on and play a key role in a variety of the processes necessary for life. Studies have indicated a definite correlation between content of trace elements and many common diseases. It has been concluded that smoking may be a substantial source of intake of these hazardous elements, not only to the smoker, but to nonsmokers via passive smoke, as well. Even passive intake of such elements can change the metabolism of other trace elements and influence their concentrations. In order to assess their potential role in some human diseases, it is necessary to measure trace element concentrations in various tissues in experimental models. In this study, liver, kidney and spleen tissue samples from rats exposed to secondhand smoke were analysed for Fe, Cu, Zn, Cr, Mn and Co trace element levels by atomic absorption spectrophotometer. Cr, Mn, Fe and Co levels in the liver, Fe and Co levels in the kidney, and Zn, Cu, Mn and Co levels in the spleen were significantly lower than those of controls, but Cu levels in the kidney and Fe levels in the spleen were significantly higher than those of controls. Our data suggest that chronic exposure to cigarette smoke alters the trace element concentration of various tissues in rats exposed to secondhand smoke. These alterations may be attributable to oxidative stress produced by cumulative effect of inhaled smoke rather than the toxic effect of absorbed toxic metals. Low Mn levels in the liver and spleen, increased Cu levels in kidney and Fe levels in the spleen, and changes in the metabolism of Zn, Fe and Cu may be indicators of oxidative stress. Decreases in Co and Cr levels in rats exposed to secondhand smoke may also be related to the intake of the toxic trace elements present in cigarette smoke. [Med-Science 2012; 1(1.000): 1-12]

Aim: Today, the work environment is one of the factors affecting the quality of life. Indeed, in a stressful environment, health care providers must work carefully and diligently. In this study, we aimed to determine health workers’ perception towards quality of life and to explore its influential factors. Methods: A total of 110 health personnel who have been actively working within the last 6 months in our hospital were included in this study. The study was completed within one month period encompassing the months of June and July of 2010. The World Health Organization Quality of Life Questionnaire (WHOQOL- BREF) was administered in a face-to-face basis. The T test, ANOVA test and the Tukey’s multiple comparison test were used for analysis. Results: No significant conclusion could be drawn from the results for gender, educational level, smoking, number of children, living area, number of years of service, annual leave time, holiday status, frequency of reading, daily news resources, courses, movies, theater, concert, exhibition, surgery undertaken, and presence of chronic disease. In the WHOQOL- BREF domains, such as occupational group, alcohol use, monthly income level, working status, sports habits, psychological status, and chronic diseases, the results were significant. Conclusion: Factors negatively affecting the quality of life have adverse impact on work environment and productivity at work. (The Medical Bulletin of Haseki 2011; 49: 14-9)

Purpose. To compare the outcomes of external dacryocystorhinostomy (E-DCR) by using two different flap anastomosis patterns and skin incision types. Methods. This study included 79 patients (88 eyes) with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A) underwent E-DCR by suturing anterior and posterior flaps (H-flap) of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B) DCR was performed by suturing only anterior flaps (U-flap) with W skin incision. Results. The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%). In terms of groups, patency was 44 eyes (88.0%) in group A and 34 eyes (89.5%) in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores. Conclusion. Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation.

This paper proposes two edge detection methods for medical images by integrating the advantages of Gabor wavelet transform (GWT) and unsupervised clustering algorithms. The GWT is used to enhance the edge information in an image while suppressing noise. Following this, the k-means and Fuzzy c-means (FCM) clustering algorithms are used to convert a gray level image into a binary image. The proposed methods are tested using medical images obtained through Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) devices, and a phantom image. The results prove that the proposed methods are successful for edge detection, even in noisy cases.