The effect of growth hormone addition protocols to poor ovarian responders in in vitro fertilization cycles.

OBJECTIVE: In vitro fertilization failure (IVF) is high in women with poor ovarian response or non-responder. For this reason, the addition of adjuvant treatments to IVF protocols has come to the fore. We assessed to investigate the effects of adjuvant GH therapy initiated in the mid-luteal phase on IVF success in poor ovarian response or non-responder women. PATIENTS AND METHODS: A retrospective study was performed in 93 poor ovarian response or non-responder women from a single center. GH treatment was added (GH-plus group) in the mid-luteal phase of the previous menstrual cycle to 47 of the women who underwent controlled ovarian stimulation with the flexible antagonist protocol. 46 women, as another group, were applied to a flexible antagonist-only protocol (GH-free group). The IVF outcome results were evaluated and compared within the groups. RESULTS: The number of retrieved oocytes was statistically significantly higher in the GH-plus group (2.28±1.975) than in the GH-free group (1.24±1.728) (p=0.01). Although statistically insignificant (p=0.55), the clinical pregnancy rate was higher in the GH-plus group [(8/47), 17%] than in the GH-free group [(5/46, 11%]. The cancellation rate was statistically significantly higher in the GH-free group (65.2%) than in the GH-plus group (44.7%) (p=0.04). No oocyte retrieved cycle rate was higher in the GH-free group (56%) than in the GH-plus group (25%) (p=0.002). CONCLUSIONS: Adjuvant GH therapy administration to IVF protocol in the mid-luteal phase gives poor ovarian response or non-responder women a chance to have a baby.

Comparison of clinical features and the impact of reproductive factors on by age at diagnosis young and elderly breast cancer patients in the middle Anatolian region of Turkey.

OBJECTIVE: Reproductive risk factors have been shown to influence breast cancer etiology for women of different origin worldwide; most studies in young/older patients have been limited to analyzing survival or tumor characteristics within their age group. This study aimed to compare the clinicopathological characteristics, treatment regimens, survival outcomes, and the impact of reproductive risk factors on young and elderly breast cancer patients. PATIENTS AND METHODS: The data were collected retrospectively between October 2015 and March 2021, where 77 young patients (≤ 40 years) and 107 elderly patients (>65 years) were included out of a total of 567 patients undergoing treatment at Kayseri City Training and Research Hospital General Surgery Clinic, Turkey. Logistic regression analysis was performed to assess the impact of risk factors according to age. RESULTS: Luminal-like tumors were in the majority in both age groups; there was no difference in diagnostic stages and survival between groups. The nulliparity ratio, total breastfeeding duration, number of biological children, first full-term pregnancy age, body mass index (BMI), and breast density distribution were significantly statistically different between groups. According to the multiple binary logistic regression analysis results for age, the most significant factors with risk effects were variables age of menarche OR= 3.36 (95% CI: 1.44-7.86) and child number OR= 2.58 (95% CI: 1.75-3.79), respectively. CONCLUSIONS: The importance of looking at the impact of different risk factors on breast cancer risk lies in the potential to develop valid risk prediction models that can allow targeted screening and preventive interventions for high-risk women. By identifying more influential risk factors in different geographical profiles, risk-based screening, and targeted prevention efforts can be encouraged, and these factors can be included in risk prediction models.

Quantitative assessment of temporomandibular disc and masseter muscle with shear wave elastography.

PURPOSE: To assess the normal stiffness values of temporomandibular joint disc (TMJ) and masseter muscle by shear wave elastography (SWE) in a healthy adult population. This may be helpful in diagnosing and understanding the mechanism of temporomandibular disorders (TMD). METHODS: This prospective study evaluated a total of 160 healthy adult volunteers (77 males, 83 females). The stiffness values of anterior, intermediate and posterior parts of the TMJ disc and masseter muscle were measured. Study cohort was classified into four groups based on age. Additionally, we investigated the changes in mean shear wave elasticity (kPa) and shear wave velocity(m/s) values of disc parts and masseter muscle in closed and open mouth positions, and the correlation of these SWE values with age and gender. RESULTS: Mean stiffness values of the disc were 37.02 ± 23.75 kPa and 3.28 ± 1.09 m/s in the anterior part, 30.47 ± 18.89 kPa and 2.97 ± 1.04 m/s in the intermediate part, 22.61 ± 13.97 kPa and 2.55 ± 0.88 m/s in the posterior part. Stiffness values showed significant decrease in the posterior part compared to the rest of the disc both in males and females. No significant differences in mean stiffness values of masseter muscle related to mouth position, age or gender. CONCLUSION: This study provides the normative quantitative elasticity values of disc and masseter muscle which could be a reference point for upcoming studies. Disc elasticity values are higher in women than men. Maybe this is one of the reason why TMD is more common in women. TMJ disc stiffness was significantly lower in the posterior part. SWE is a useful imaging method that can be used with routine ultrasonography in evaluation of the TMJ disc and masticatory muscles .

Evaluation of the signs and symptoms of pseudotumor cerebri syndrome in pediatric population.

PURPOSE: Pseudotumor cerebri syndrome (PTC) is characterized by increased intracranial pressure without a space-occupying lesion and a normal cerebrospinal fluid (CSF) composition without evidence of CSF infection. In this study, we aimed to compare the symptoms, signs, and clinical characteristics of patients presenting with a preliminary diagnosis of pseudotumor cerebri syndrome (PTC) who were diagnosed and not diagnosed with PTC. METHOD: We conducted a retrospective study of patients who were referred to our clinic with signs and symptoms of PTC. We compared the patients' symptoms, signs, and clinical characteristics who were diagnosed with PTC with those who were not diagnosed with PTC using modified Dandy criteria. RESULTS: Ninety-four patients with the pre-diagnosis of PTC were included in the study. LP procedure was done in all patients. After LP, 75.3% of the patients were diagnosed with PTC, but 24.7% did not meet the criteria for PTC. A statistically significant relationship was found between the increase in headache complaints when leaning forward, headache that keeps the child from playing, and the CSF pressure level (p = 0.014, p = 0.019; p < 0.05). There was no statistically significant correlation between papilledema and CSF pressure level (p > 0.05). A statistically significant relationship was found between papilledema grade and CSF pressure level (p = 0.038; p < 0.05), and the rate of high CSF pressure in the groups with Grades 2-3 and Grade 4 papilledema was higher than that in the group with Grade 1 papilledema. Cranial nerve 6 palsy (CN6) (p = 0.048) and flattening of the posterior aspect of the globe (FPS) are found independent risk factors (p = 0.004 p < 0.05). CONCLUSIONS: PTC signs and symptoms show variability among pediatric population.

CT angiography evaluation of intracranial aneurysms: Distribution, characteristics, and association with subarachnoid hemorrhage.

AIMS: To investigate the distribution, characteristics, and association with subarachnoid hemorrhage (SAH) of aneurysms identified in Turkish adult patients with computed tomography angiography (CTA) performed with suspicion of intracranial aneurysms and/or SAH. SUBJECTS AND METHODS: A total of 356 patients (164 male, and 192 female) with a mean age of 55.6 ± 4.0 (range, 18-90) years were analyzed retrospectively. The dimension in millimeters, localization, type, and multiplicity of aneurysms were noted. The differences in these parameters between females and males were investigated. The correlations of sex, aneurysm size, multiplicity, and size with SAH were researched. RESULTS: On 356 CTA, 140 cases were identified to have aneurysm (39.3%) (56 males [40.0%], 84 females [60.0%]). The incidence of aneurysms and SAH in females was high relative to males. In 140 patients, a total of 187 aneurysms were present (mean size, 7.25 ± 2.56 mm). The highest number of aneurysms was found in the middle cerebral artery 64 (34.2%) while the least was in posterior circulation 20 (10.7%). There was no significant difference between genders in terms of aneurysm size, type, and multiplicity. Individuals with aneurysm site on the internal carotid artery had lower SAH incidence. Receiver Operating Characteristic curve analysis results determined that individuals with aneurysm size >13.5 mm had increased incidence of SAH. CONCLUSIONS: The general properties of intracranial aneurysms investigated with CTA in Turkish adults had similarities to information defined in the literature. These results will likely be beneficial to direct approaches to aneurysm diagnosis and treatment in routine practice.

Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. AIM: In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. METHODS: In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. RESULTS: The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. CONCLUSIONS: Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.

Development of a Novel Human Cell-Derived Tissue-Engineered Heart Valve for Transcatheter Aortic Valve Replacement: an In Vitro and In Vivo Feasibility Study.

Transcatheter aortic valve replacement (TAVR) is being extended to younger patients. However, TAVR-compatible bioprostheses are based on xenogeneic materials with limited durability. Off-the-shelf tissue-engineered heart valves (TEHVs) with remodeling capacity may overcome the shortcomings of current TAVR devices. Here, we develop for the first time a TEHV for TAVR, based on human cell-derived extracellular matrix and integrated into a state-of-the-art stent for TAVR. The TEHVs, characterized by a dense acellular collagenous matrix, demonstrated in vitro functionality under aortic pressure conditions (n = 4). Next, transapical TAVR feasibility and in vivo TEHV functionality were assessed in acute studies (n = 5) in sheep. The valves successfully coped with the aortic environment, showing normal leaflet motion, free coronary flow, and absence of stenosis or paravalvular leak. At explantation, TEHVs presented full structural integrity and initial cell infiltration. Its long-term performance proven, such TEHV could fulfill the need for next-generation lifelong TAVR prostheses.

Assessment of paediatric Hashimoto's thyroiditis using superb microvascular imaging.

AIM: To evaluate the role of superb microvascular imaging along with greyscale and Doppler imaging for thyroid gland evaluation in Hashimoto's thyroiditis (HT) versus control subjects. MATERIALS AND METHODS: The study included 33 healthy volunteers with normal ultrasound and laboratory findings and 70 patients with HT based on laboratory and sonographic findings who were undergoing follow-up and receiving medical treatment. HT patients were classified based on the modification of the scheme proposed by Sostre and Reyes that incorporates the extent of hypoechoic foci or patchy infiltration as grade A (foci involving <50% of the gland) and B (foci involving >50% of the gland). Thyroid volume, mean resistive indices, peak-systolic and end-diastolic velocities based on Doppler imaging, and vascularity index via superb microvascular imaging were obtained using a Canon Aplio 500 ultrasound device using a linear 10-14 MHz transducer. RESULTS: Patients with HT had significantly higher median thyroid volume and peak-systolic velocities (7.32 ml and 19 cm/s, respectively) compared to control subjects (4.62 ml and 16 cm/s, respectively). HT patients had significantly higher median vascularity index (VI; 13.5%) compared to control subjects (7.95%). A significant fair positive correlation with VI and anti-thyroglobulin antibody levels (r=0.356, p<0.05) and significant moderate positive correlation with VI and anti-thyroid peroxidase antibody levels (r=0.503, p<0.05) were found. In HT diagnosis, the optimal VI cut-off value was 10.58% with a sensitivity and specificity of 67.1% and 90%, respectively. CONCLUSION: Superb microvascular imaging appears to allow assessment of subtle vascularity changes in early HT stages that cannot be detected by Doppler parameters. This technique demonstrates excellent visualization of the microvascular structures and quantitative assessment based on a novel parameter such as VI.

Comparison of culture and real-time polymerase chain reaction methods for detection of Mycoplasma hominis in amniotic fluids samples.

BACKGROUND: Mycoplasma hominis is often present in the amniotic cavity with microbial invasion associated with spontaneous preterm labor. Conventional culture method is the gold standard for detection of Mycoplasmas, but real-time polymerase chain reaction (real-time PCR) has revolutionized the diagnosis of M. hominis. OBJECTIVE: The purpose of this study is the comparison of the culture methodology with real-time PCR for the detection of M. hominis in amniotic fluid samples. METHODS: Amniotic fluid samples were collected from 65 pregnant women (age range: 25-45 years) previously followed at an infertility clinic. They were collected by transabdominal genetic amniocentesis during 16-21 weeks of gestation. Amniotic fluids were inoculated in SP4 broth for 48-72 h, and after becoming alkaline, culture suspension was spread on A7 agar plate for 1 week till the typical colonies seen in "fried-egg" morphology under stereomicroscope. DNA was extracted using a QIAGEN Mini DNA kit. The real-time-PCR was performed using Rotor-Gene Q Real-time PCR instrument. A melting-curve analysis was also performed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were measured by real-time PCR by taking culture as gold standard. RESULTS: Sixty-five women in 16-21 weeks of gestation, with a mean age of 33 ± 5.06 years, were enrolled into this study. M. hominis detected by culture and real-time PCR assay was 72% (47/65) and 69% (45/65), respectively. 66% (43/65) specimens were positive by both methods. Real-time PCR sensitivity was 91.5%, specificity 88.9%, PPV 95.6%, and NPV 80%. CONCLUSION: Rapid detection of Mycoplasmas causing maternal complications such as neonatal infections and preterm labor in pregnancy by real-time PCR may be important and necessary. The high sensitivity and shorter time requirement of real-time PCR support its further development for diagnosis of Mycoplasma infections.

Clomiphene citrate changes metabolite content of follicular fluid of PCOS women.

OBJECTIVE: To determine whether clomiphene citrate (CC) treatment affects the metabolite contents of a dominant follicle in polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: Twenty non-obese primary infertile anovulatory PCOS women undergoing CC treatment and ten fertile women were enrolled. 6 out of 20 patients had impaired glucose tolerance test (IGT). CC was given at a dose of 150 mg on days 3-7 of cycles in the first group. 10 fertile women with a regular menstrual cycle and normal ovaries during ultrasound examination were accepted as control group. They were not given any drug for ovarian stimulation. Transvaginal sonography and follicular tracking were done to each group of participant. Both groups of subjects underwent magnetic resonance spectroscopy when the dominant follicle with a mean diameter of at least 16-18 mm was detected. Lactate (Lac), N-acetylaspartate (NAA), creatine 1 (Cr1), creatine 2 (Cr2) and choline (Cho) signal of dominant follicles were measured. Peak of each metabolite was measured in units. Voxels were placed in the center of dominant follicle. RESULTS: Compared to control group significantly decreased Cho signal was found in follicular fluid of PCOS subjects taking clomiphene. Almost three-fold decline in Cho signal was detected in PCOS group compared to Cho signal of control group (0.64±1.01 vs. 2.01 ±1.13). On the other hand, significantly increased Lac signal was detected in the dominant follicle of PCOS subjects taking clomiphene compared to control group. Almost 2 fold increase in Lac signal was noted after clomiphene treatment (1.90±0.32 vs. 0.93±2.21). The results of spectroscopy signals obtained from PCOS subjects without IGT and PCOS subjects with IGT were similar. CONCLUSIONS: Unbalanced production of Cho signal in the follicular fluid may have occurred secondary to membrane damage of cumulus-oocyte-complexes due to CC therapy.

Coeliac trunk and common hepatic artery variations in children: an analysis with computed tomography angiography.

BACKGROUND: Understanding the coeliac trunk (CeT) and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyse the prevalence of CeT and common hepatic artery (CHA) variations in the paediatric population. MATERIALS AND METHODS: One hundred and seventy-four children who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analysed retrospectively. The patterns of CeT, CHA and their variant branches were revealed and compared with previous studies involving adults. RESULTS: A total of 157 (90.2%) of the 174 patients had normal CeT anatomy, whereas 17 (9.8%) had variations. Five types of CeT variations were identified according to Song's classification in which 'hepatosplenic trunk + left gastric artery + superior mesenteric artery' was the most prevalent. One hundred-twelve (64.4%) of the 174 patients had normal CHA anatomy; however, 62 (35.6%) had variations. Six types of CHA variations were identified according to Michel's and Hiatt's classification. The most common was 'replaced left hepatic artery originating from left gastric artery'. CONCLUSIONS: The prevalences of CeT and hepatic artery variations are high in children, as they are in older patients. Awareness of these variations is important in terms of avoiding iatrogenic injury and in promoting surgical procedure planning for liver transplantation or abdominal tumour surgery.

Time-series lipidomic analysis of the oleaginous green microalga species Ettlia oleoabundans under nutrient stress.

BACKGROUND: Microalgae are uniquely advantageous organisms cultured and harvested for several value-added biochemicals. A majority of these compounds are lipid-based, such as triacylglycerols (TAGs), which can be used for biofuel production, and their accumulation is most affected under nutrient stress conditions. As such, the balance between cellular homeostasis and lipid metabolism becomes more intricate to achieve efficiency in bioproduct synthesis. Lipidomics studies in microalgae are of great importance as biochemical diversity also plays a major role in lipid regulation among oleaginous species. METHODS: The aim of this study was to analyze time-series changes in lipid families produced by microalga under different nutrient conditions and growth phases to gain comprehensive information at the cellular level. For this purpose, we worked with a highly adaptable, oleaginous, non-model green microalga species, Ettlia oleoabundans (a.k.a. Neochloris oleoabundans). Using a mass spectrometry-based untargeted and targeted metabolomics' approach, we analyzed the changes in major lipid families under both replete and deplete nitrogen and phosphorus conditions at four different time points covering exponential and stationary growth phases. RESULTS: Comprehensive analysis of the lipid metabolism highlighted the accumulation of TAGs, which can be utilized for the production of biodiesel via transesterification, and depletion of chlorophylls and certain structural lipids required for photosynthesis, under nutrient deprived conditions. We also found a correlation between the depletion of digalactosyldiacylglycerols (DGDGs) and sulfoquinovosyldiacylglycerols (SQDGs) under nutrient deprivation. CONCLUSIONS: High accumulation of TAGs under nutrient limitation as well as a depletion of other lipids of interest such as phosphatidylglycerols (PGs), DGDGs, SQDGs, and chlorophylls seem to be interconnected and related to the microalgal photosynthetic efficiency. Overall, our results provided key biochemical information on the lipid regulation and physiology of a non-model green microalga, along with optimization potential for biodiesel and other value-added product synthesis.

To compare aneuploidy rates between ICSI and IVF Cases.

INTRODUCTION: Intracytoplasmic sperm injection (ICSI) currently helps many couples with male infertility. However, ICSI procedure may cause asynchronous sperm decondensation. This could introduce a risk for aneuploidy. The ICSI technique also could cause damage to the second meiotic spindle during injection and cause significantly abnormal pairing of chromosomes when compared with In vitro fertilization (IVF). In this study, we have examined whether ICSI has a higher incidence of aneuploidy when compared with IVF. MATERIAL AND METHODS: A retrospective study was conducted on 36 individuals. Common numbers of chromosome abnormalities were detected using fluorescent in-situ hybridization (FISH). Seven probes were used to detect chromosome X, Y, 13, 16, 18, 21, and 22. Chi-square test was used for statistical analysis and presented as odd ratios with confidence intervals. RESULTS: The age range was 26 through 44 (mean age 35.5) for IVF and 25 through 46 (mean age 35.8) for ICSI. From the 36 egg retrievals, 57 embryos were obtained from nine individuals using IVF and 183 embryos were obtained from 27 individuals using ICSI. For the IVF group, 37 of the 57 examined embryos were abnormal (65%), whereas 128 of 183 examined embryos were abnormal for the ICSI group (69.9%). Among the 57 embryos from the IVF cases, the number of absolute abnormal chromosomes were as follows: X&Y chromosomes: 4 (12.9%), chromosome 13: 9 (29%), chromosome 16: 7 (22.5%), chromosome 18: 6 (19.3%), chromosome 21: 8 (25.8%), chromosome 22: 10 (32.2%). For the ICSI embryos: X and Y chromosomes: 18 (14%), chromosome 13: 34 (26.5%), chromosome 16: 23 (18%), chromosome 18: 23 (18%), chromosome 21: 26 (20.3%), chromosome 22: 31 (24.2%). The odds ratios for the difference between IVF and ICSI for each chromosome were as follows: X&Y chromosomes: 1.53 (0.598-3.916), chromosome 13: 0.969 (0.443-2.122), chromosome 16: 0.709 (0.307-1.639), chromosome 18: 1.650 (0.650-4.188), chromosome 21: 0.777 (0.350-1.724), chromosome 22: 0.647 (0.311-1.348). Overall no significant difference between two insemination procedures was seen 0.948 (0.678-1.324). CONCLUSIONS: As a result; ICSI does not create a significantly higher aneuploidy number when compared with IVF as examined by FISH analysis of seven chromosome pairs.

Bone metastasis in endometrial cancer: evaluation of treatment approaches by factors affecting prognosis.

OBJECTIVE: The purposes of this study were to present an endometrial cancer case with a first sign of bone metastasis, and to reveal factors affecting survival and the appropriate treatment methods for bone metastases. MATERIALS AND METHODS: A total of 101 case reports that presented with bone metastasis of endometrial cancer were reviewed in this study. RESULTS: Survival time in the patients without surgical treatment for bone metastasis was found to be 12 months (95% CI = 5.89 - 18.10) and 42 months in patients who underwent surgical treatment in addition to one or more of chemo-radio-hormonotherapies (95% CI = 16.58 - 67.41) (p = .006). Histological type of cancer, extra-osseous metastasis, and lack of surgery were the factors significantly affecting survival (p = 0.012, p = 0.002, and p = 0.038, respectively). CONCLUSION: Histological type and the presence of extra-osseous involvement are important prognostic markers in endometrial cancer patients with bone metastasis. It may be appropriate to implement combination therapies including surgery in the treatment of bone metastases.

Intralesional treatments for hypertrophic scars: comparison among corticosteroid, 5-fluorouracil and botulinum toxin in rabbit ear hypertrophic scar model.

OBJECTIVE: Different treatment modalities have been used either alone, or in combination to achieve an optimum improvement for hypertrophic scars. Intralesional injections of corticosteroids and 5-fluorouracil are among the most commonly used treatments. Recently, botulinum toxin is proposed as a new treatment option. In this study, it is aimed to compare the efficacies of intralesional triamcinolone acetonide, 5-fluorouracil and botulinum toxin-A for hypertrophic scars. In order to minimize the variables affecting scar formation, standardized wounds in rabbit ear hypertrophic scar model was used. MATERIALS AND METHODS: Four surgical wounds were created on both ears of eight rabbits. Injections to be compared (triamcinolone acetonide, 5-fluorouracil, botulinum toxin-A and control) are administered intralesionally to established scars on day 30. Scars were harvested on day 60 for morphometric analysis including hypertrophic index, fibroblast density, and relative collagen density. RESULTS: Triamcinolone acetonide and 5-fluorouracil injections decreased hypertrophic indexes significantly compared to botulinum toxin-A and control group. However, only 5-fluorouracil was effective to reduce fibroblast counts significantly. No statistically significant differences were found between the treatment groups in terms of collagen index. CONCLUSIONS: According to the results of our study, triamcinolone acetonide and 5-fluorouracil are comparatively effective as monotherapy, but botulinum toxin-A was not effective on established hypertrophic scars.

Does amnioreduction increase success of emergency cervical cerclage in cases with advanced cervical dilatation and protruding membranes?

OBJECTIVE: To investigate whether amnioreduction has any impact on emergency cervical cerclage outcome. MATERIALS AND METHODS: Data of women who underwent emergency cervical cerclage for advanced cervical dilatation and protruding membranes were analyzed retrospectively. RESULTS: During the study interval, a total of 56 women who were underwent amnioreduction (n=26) and who did not (n=30) were eligible for analysis of the study. Gestational age at cerclage, delivery, and prolongation of pregnancy interval were comparable between the groups (21.3 ±3.3 vs. 20.6 ±3.1 weeks; p = 0.44; 28.3 ±6.1 vs. 28.1 ±5.6 weeks; p = 0.74; 53.7± 46.1 vs. 47.3± 36.7 days; p = 0.56 respectively). Number of live birth rates and perinatal mortality rates were also not statistically significantly different between the groups (73.1% vs. 70.0%; p = 0.80; 15.4% vs. 13.3%; p = 0.83). CONCLUSIONS: Emergency cerclage yields live take home baby rates in more than half of the patients. The decision to perform amnioreduction should be based on suspicion of chorioamnionitis and patient's motivation to know exactly what is the risk of chorioamnionitis.

Does removal of CU-IUD in patients with biofilm forming candida really maintain regression of clinical symptoms?

OBJECTIVE: To evaluate whether symptoms and recurrence would differ with and without Cu-IUD removal in patients with concomitant biofilm forming Candida spp. METHODS: The data of 270 consecutive patients wearing TCu380A Cu-IUD were evaluated. Among these patients, 100/270 were found to have Candida spp. isolated from the tail of Cu-IUD or vaginal samples. These patients were investigated in four groups: Group 1 (n = 24; Biofilm (+), Cu-IUD removed), Group 2 (n = 14; Biofilm (+), Cu-IUD not removed), Group 3 (n = 29; Biofilm (-), Cu-IUD removed), Group 4 (n = 33; Biofilm (-), Cu-IUD not removed). Patients in each group were followed for clinical signs and symptoms for 8-16 months and compared to each other. RESULTS: Symptoms, physical findings and candida positivity have decreased statistically significantly in Group 1 one year after removal of Cu-IUD (95.8% vs. 4.2%, p < 0.01; 95.8% vs. 4.2%, p < 0.01; 100% vs. 8.3%, p < 0.01 respectively). In Group 2, symptoms, physical findings and candida positivity have decreased after follow-up, but without a statistical significance. In Group 3, all the parameters have decreased, but only decrease in candida positivity has reached statistical significance (100% vs. 48.3%, p < 0.01). In Group 4 - as in Group 1- symptoms, physical findings and candida positivity have decreased statistically significantly (48.5% vs. 18.2%, p = 0.01; 72.7% vs. 48.5%, p = 0.05; 100% vs. 51.5%, p < 0.01 respectively). CONCLUSION: Biofilm forming microorganisms should be considered in the management of vaginal infections or symptoms for safer use of intrauterine devices.

Low temperature regeneration of activated carbons using microwaves: revising conventional wisdom.

The purpose of this work was to explore the application of microwaves for the low temperature regeneration of activated carbons saturated with a pharmaceutical compound (promethazine). Contrary to expectations, microwave-assisted regeneration did not lead to better results than those obtained under conventional electric heating. At low temperatures the regeneration was incomplete either under microwave and conventional heating, being this attributed to the insufficient input energy. At mild temperatures, a fall in the adsorption capacity upon cycling was obtained in both devices, although this was much more pronounced for the microwave. These results contrast with previous studies on the benefits of microwaves for the regeneration of carbon materials. The fall in the adsorption capacity after regeneration was due to the thermal cracking of the adsorbed molecules inside the carbon porous network, although this effect applies to both devices. When microwaves are used, along with the thermal heating of the carbon bed, a fraction of the microwave energy seemed to be directly used in the decomposition of promethazine through the excitation of the molecular bonds by microwaves (microwave-lysis). These results point out that the nature of the adsorbate and its ability to interact with microwave are key factors that control the application of microwaves for regeneration of exhausted activated carbons.

Êxpression of inducible nitric oxide synthase (iNOS) in the azoospermic human testis.

Azoospermia, which is the absence of spermatozoa in the ejaculate, is not a rare cause of male infertility. Inducible nitric oxide synthase (iNOS) is a calcium-independent NOS, which is present in the testis and involved in spermatogenesis, and apoptosis of Sertoli and germ cells. Twenty idiopathic infertile men presenting nonobstructive azoospermia were enrolled in this study, and testicular sperm extraction procedures were performed. Tissue extracts were dissected, and the fluid samples were investigated to determine the presence of spermatozoa. Histologic evaluation of the spermatozoa-present samples revealed that seminiferous tubules were normal and were lined by Sertoli cells and spermatogenic cells. However, in the spermatozoa-absent samples, the diameter of the seminiferous tubules was small, and Sertoli-cell-only syndrome was determined in most of the tubules. iNOS expression was very weak in Sertoli cells, germ cells, and in Leydig cells in the spermatozoa-present group. In the spermatozoa-absent group, the immunostaining was very intense in Sertoli and Leydig cells. Electron microscopy findings were supported the histologic results. In conclusion, complete germ cell loss and intense expression of iNOS in the Sertoli and Leydig cells in the spermatozoa-absent groups of azoospermic human testis suggest an essential role of iNOS in spermatogenesis.

The detection and genetic characterization based on the S1 gene region of BCoVs from respiratory and enteric infections in Turkey.

We investigated bovine coronavirus (BCoV) as an etiological agent in cattle with clinical respiratory and digestive signs using 147 feces and 199 nasal swab samples. A total of 18 test samples (16 feces and 2 nasal swap samples) were detected positive by ELISA and/or RT-PCR targeting the BCoV N gene. The partial S1 gene regions of BCoVs (An-4 and An-11) detected in feces samples from two herd-mate dairy calves were compared. Virological and serological results indicated that BCoVs are widespread in Turkey and are likely etiological agents in diarrhea cases in calves.