Is there a Relationship between Serum IGF-1 and Thyroid Nodule, Thyroid or Ovarian Volume in Polycystic Ovarian Syndrome?

CONTEXT: Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. OBJECTIVE: We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. DESIGN: The study was performed between June 2017 and August 2019 as prospective design. SUBJECTS AND METHODS: Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. RESULTS: Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. CONCLUSION: Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.

Derotation of the mallet piece: A crucial point in mallet fracture surgery.

Mallet fracture is an avulsion of the extensor tendon and fracture of the dorsal rim of the articular surface of distal phalanx at the same time. If a part of the mallet fracture is angled or rotated to such a degree that prevents full anatomic reduction, malunion and deformities may occur as a result. The objective of this study was to describe a new surgical technique to provide derotation of the mallet fracture. A 22G or 21G needle is used like a joystick to reduce the mallet fracture with small, gentle movements. The extension block pinning technique described by Ishiguro was applied after proper alignment had been achieved. Bony union was achieved for all patients 6 weeks later. Derotation of type 2 and 3 mallet pieces with closed reduction to prevent surgical failure is simple but effective.

The effects of melatonin administration on KCNQ and KCNH2 gene expressions and QTc interval in pinealectomised rats.

Melatonin is a hormone secreted from the pineal gland and has different cardiovascular effects. KCNQ genes expressed in aorta related with vascu- lar tone and KCNH2 gene characterised in left ventricle associated with QT duration. The aim of this study was to investigate the effects of melatonin on the regulation of the blood pressure and the relationships between the expressions of aorta KCNQ1-5, left ventricle KCNH2 genes and the QTc interval. For that purpose, 42 male adult Sprague-Dawley rats were devided into six groups; SHAM, SHAM+L-NAME, PLT, PLT+L-NAME, PLT+MEL and PLT+L-NAME+MEL. Pinealectomy operation was applied in PLT groups. L-NAME was added in drinking water (40 mg/kg/day) and melatonin was given subcutanously (5 mg/kg/day). The blood pressure, heart rate (HR) and QTc interval values were recorded on 0, 1st, 7th, 14th and 21st days of experiment. Left ventricle and thoracic aorta samples were obtained to investigate the changes of gene expression levels of KCNQ1-5 and KCNH2, respectively. The increased blood pressure and HR were observed in SHAM+L-NAME, PLT, and PLT+L-NAME groups compared to MEL and SHAM groups (p<0.05). On the other hand, the long QTc interval was recorded in PLT and all L-NAME groups compared to others (p<0.05). The decreases in KCNH2 gene expression levels were observed in groups have QTc prolongation. In conclusion, PLT operation could cause an increasing in blood pressure, HR and QTc duration, melatonin was able to prevent these increasings and could change KCNQ and KCNH2 gene expresion profiles. Further molecular studies are required to evaluate these effects.

The antifungal activity and cytotoxicity of silver containing denture base material.

OBJECTIVE: Denture base materials are susceptible to fungal adhesion, which is an important etiological issue in the pathogenesis of denture stomatitis. The purpose of this in vitro study was to evaluate the antifungal activity and cytotoxicity of denture base material containing silver microparticles. MATERIALS AND METHODS: The polymethyl methacrylate (PMMA) denture base material was used, and silver microparticles were added to the polymer powder in different concentrations by volume (0%, 0.25%, 0.5%, and 1%). Their antifungal activity against Candida albicans was assessed in terms of colony-forming units. PMMA disc specimens containing silver microparticles were eluted with culture medium for 1, 2, and 5 days. The cytotoxicity of the eluates to cultured L929 mouse fibroblast cells was evaluated using a real-time cell analysis (RTCA) system and the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. RESULTS: The antifungal effect against C. albicans increased with the percentage of silver microparticles (P < 0.05). For both tests, both RTCA and the MTT assay, no time- or silver-dependent cytotoxicity of PMMA denture base material containing silver microparticles was observed. CONCLUSIONS: PMMA denture base material containing silver microparticles have antifungal activity and no cytotoxic effect.

Autologous osteochondral transplantation (mosaicplasty) in articular cartilage defects of the patellofemoral joint: retrospective analysis of 33 cases.

OBJECTIVE: The purpose of this retrospective study was to evaluate the results of osteochondral autografting (mosaicplasty) in isolated articular cartilage defects of the patellofemoral joint. MATERIALS AND METHODS: Thirty-three patients who underwent mosaicplasty for patellofemoral (either patella or trochlea) cartilage defects (modified Outerbridge classification: grades III and IV) of the knee joint were retrospectively reviewed. There were 25 male and 8 female patients with a mean age of 31.3 ± 6.7 (range 22-47) years. The average size of the lesion was 2.4 ± 0.55 cm2 (range 1.5-4.0). Patients with patellofemoral malalignment were excluded. All patients were followed at least one year with a mean of 19.3 ± 4.3 months (range 12-24 months) using Lysholm knee score. RESULTS: The mean preoperative Lysholm knee score was 51.9 ± 2.6 (47-58) points and increased to 85.5 ± 4.2 (75-89) points at the final follow-up. There was a significant increase in Lysholm score during follow-up period (p = 0.0001). The results were good in 24 cases and fair in 9 cases. No patients had poor results. No patients had infection. Five patients had postoperative mild painful hemarthrosis. Of these patients, four were treated with rest, ice, compression (elastic bandage) and elevation and the remaining one was treated by aspiration. No patients needed secondary open or arthroscopic drainage. No systemic complications occurred during the follow-up. CONCLUSIONS: Mosaicplasty is an effective technique for the treatment of articular cartilage defects of the patellofemoral joint knee which restores the joint function in a short period of follow-up. However, a meticulous surgical technique should be followed to restore the native articular surface and the congruity of the joint.

Investigation of endocrine and immunological response in fat tissue to hyperbaric oxygen administration in rats.

Though HBO treatment is becoming more common, the mechanism of action is not fully known. The positive effects of HBO administration on the inflammatory response is thought to be a possible basic mechanism. As a result, we aimed to research whether endocrine and immunological response of fat tissue changes in rats given HBO treatment model. This research was carried out on Wistar albino rats, they were treated with hyperbaric oxygen therapy. Their fatty tissue were taken from the abdomen, gene expression of the cytokines and adipokines were analyzed with Real time PCR method. When the gene expression of hormones and cytokines by fat tissue was examined, the leptin, visfatin, TNF-α, IL-1ß and IL-10 levels in the HBO treatment group were statistically significantly increased compared to the control group (p=0.0313, p=0.0156, p=0.0156, p=0.0156, p=0.0313). In conclusion, in our study we identified that HBO administration affected the endochrinological functions of fat tissue.

Investigation of histopathological effects after intra-arterial sugammadex injection in an experimental animal model.

PURPOSE: Intra-arterial injection of medications are related to mortality and morbidity. It was aimed to investigate the histopathological effects caused by two different intra-arterial doses of sugammadex, a new selective relaxant binding agent used to reverse the effects of steroidal systemic muscle relaxants used in surgeries carried out under general anesthesia. METHODS: A total of 15 rabbits were randomly divided into 3 groups. The control group was given 1 mL saline bolus into the central artery of the ear. The other two groups (Group Sgdx2 and group Sgdx16) were given 2 and 16 mg/kg sugammadex, respectively, intra-arterially. RESULTS: In control group, histopathological evaluation was in normal limits. The cross-sections belonging to Group Sgdx2 did not have any significant pathological change compared with control group (p > 0.05). Edema and single-cell necrosis were significantly higher in Group Sgdx16 when compared to control group (p < 0.05). In comparison to Group Sgdx2, single-cell necrosis was significantly higher in Group Sgdx16 (p < 0.05). CONCLUSION: Being broadly used in anesthesia, sugammadex should be administered with care because when given by intra-arterial route it may cause tissue damage and tissue loss and the patients' arteries should be carefully checked.

Comparison of effects of classic LMA, cobraPLA and V-gel rabbit on QTc interval.

AIM: We aimed to compare the effects of three different supraglottic airway devices, the classic LMA, PLA, and V-gel, on hemodynamics and QTc in rabbits under general anesthesia. METHOD: The rabbits were divided into four groups: Group C (n=5) control group with no airway device used, Group L (n=5, classic LMA), Group P (n=5, CobraPLA) and Group V (n=5, V-gel-rabbit). Basal values of heart rate (HR), mean arterial pressure (MAP) and ECG for QTc interval were measured and the measurements were evaluated at 1, 5, 15, and 30 minutes after inserting the airway device RESULTS: The values of HR, MAP and QTc in Group V at minutes 1 and 5 were significantly different to those in Group L and Group P (p<0.05). DISCUSSION: The classic-LMA and cobraPLA cover a wide part of the perilaryngeal area with cuffs inflated to about 60 cmH2O of pressure resulting in mucosal compression. As V-gel rabbit does not have a cuff, it covers a smaller part of the laryngopharyngeal area, and thus does not cause mucosal compression, and the hemodynamic response is weaker. CONCLUSION: When comparing hemodynamic responses to other supraglottic airway devices, the response to V-gel rabbit is minimal and we consider that similar studies using the I-gel on humans are required (Fig. 5, Ref. 31).

Attention deficit and hyperactivity disorder and infantile colic.

AIM: Attention deficit and hyperactivity disorder (ADHD) and infantile colic (IC) are heterogeneous diseases which's cause are unknown. Besides the different hypotheses in the etiology of both disorders maldevelopment in the metabolism of neurotransmitters in the central nervous system have been implicated. The goal of this study is to investigate the relationship between IC and ADHD due to possible common etiological factor as maldevelopment in neurochemical process. METHODS: A case-control study was carried out. The sample included 114 (77.2% male) children who were medically diagnosed with AD/HD and 149 (67.1% male) healthy children who were chosen from the same hospital's pediatric clinic as the control group. Parents and teachers completed the Conners Parent Rating Scale (CPRS), Conners Teacher Rating Scale (CTRS) and the patients were evaluated with The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The parents were asked questions on a survey form filled out. IC was defined according to Wessel's modified criteria. RESULTS: The mean age of AD/HD group was 10.14±2.48 years and 9.94±2.34 years in the non-AD/HD group. The rate of IC in AD/HD and non-AD/HD groups were 50.0% and 30.2%, respectively and the difference was statistically significant between two groups (P=0.001). Duration of IC was similar in the groups (P=143). CONCLUSION: IC may be a postnatal risk factor and marker for AD/HD during childhood. Both diseases may have a common mechanism. Such infants need to be examined and followed up more intensively.

[Seasonal and regional distribution of tularemia cases in Amasya, Turkey]. / Amasya'da tularemi olgularinin mevsimsel ve bölgesel dagilimi

Tularemia have attracted attention due to increased number of cases since 2009 in Amasya region which is located at Central Blacksea Region of Turkey. The aims of this letter were to provide information about the disease, to emphasize the importance of early treatment due to the outbreak peak in our province between 2009-2012 and water chlorination in epidemic areas. A total of 250 tularemia-suspected patients (117 female, 133 male; mean age: 42 yrs) who were admitted to our hospital with the symptoms of sore throat, fever, malaise and/or presence of neck mass, from 20 different locations within last four years were included in the study. Serum samples of 73 (29.2%) patients yielded ≥ 1/160 titers with F.tularensis microagglutination test which were considered as positive. All positive cases presented with the oropharyngeal form of the disease. The year with the highest number of tularemia cases was 2010. When the regional distribution was evaluated, it was detected that positive cases have precipitated especially in the southeastern (highland area) and northeastern (lowland area) parts of Amasya (34/73; 46.6%). Majority of the tularemia cases (53/73; 72.6%) were identified in colder seasons. The number of cases in rural and urban centers have decreased after 2010. In conclusion, it is considered that the emergence of new cases is likely to persist due to the geographical characteristics of Amasya and occupational properties (livestock breeding) of the population. Therefore, the clinicians should consider tularemia in differential diagnosis of the cases originated from risky rural areas.

Mid-term results for unicompartmental knee arthroplasty.

PURPOSE OF THE STUDY: The purpose of this study was to evaluate clinical and functional results for a series of patients undergoing unicompartmental knee arthroplasty (UKA) at mid-term follow-up. MATERIAL AND METHODS: This study included 32 patients with isolated medial compartment arthritis who underwent unilateral UKA. Outcomes were assessed using pre- and postoperative Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores and Knee Society Score (KSS) metrics. RESULTS: On physical examination at a follow-up of at least 5 years, mean knee flexion was 121° , mean knee extension was 2°, and mean varus angulation was 2°. At post-operative evaluation, the mean WOMAC score was 96.12 and the mean KSS score was 93. Pre- and postoperative WOMAC and KSS scores were evaluated by paired Student's t-tests; p < 0.001 determined a highly significant difference. DISCUSSION: Early UKA designs had poor outcomes. Newer implant designs and specific patient selection criteria have been reported to be associated with improved outcomes. This study examined mid-term outcomes (mean duration of follow-up, 5 years). CONCLUSION: The clinical and functional results of UKA at 5-year follow-up were shown to be satisfactory. Longer follow-up is needed to determine whether UKA provides satisfactory long-term outcomes.

The effect of wound dressings on the pH stability of fluids.

Wound healing is a complex process that is influenced by both intrinsic and extrinsic factors, and it is becoming increasingly complex with the latest treatment methods and investigations of wound nature. The term 'wound healing' covers all types of wounds, burns and ulcerations. There is a considerable global variation in the treatment of acute and chronic wounds, therefore, establishing a standardised, best way to manage wounds may not be possible. Complete wound healing, which includes restoration of function, is hardly ever achieved in those disfigured by wounds, especially when one includes the appearance of scarred skin or an amputation.

Salvage repair of anastomotic dehiscence following colon surgery using an expanded polytetrafluoroethylene graft.

Anastomotic dehiscence is a serious complication of colorectal surgery that causes death in up to 40% of cases in which it occurs. Edema and inflammation due to abdominal sepsis can prevent the use of standard management (i.e., colostomy, ileostomy or Hartmann's procedure), in which case alternative salvage repair methods are required. The present report describes the treatment of a 73-year-old female patient at high risk of mortality because of intraabdominal sepsis due to suture dehiscence following a right hemicolectomy and ileo-transversostomy. Several surgical repair procedures were tried, but all failed. We then used an expanded polytetrafluoroethylene (ePTFE) graft in salvage repair, and this approach proved successful. This is the first report to describe clinical, macroscopic and histopathological findings, following use of an ePTFE graft in colorectal repair in humans.

Effects of reduced glutathione on nitric oxide level, total antioxidant and oxidant capacity and adenosine deaminase activity.

The aim of this study was to determine the effect of exogenous GSH, an important antioxidant containing thiol group, on total antioxidant capacity (TAC) and total oxidant capacity (TOC), adenosine deaminase (ADA), a significant indicator of cellular immunity, and nitric oxide (NO) concentrations in rabbits. Sixteen healthy New Zealand rabbits were divided into 2 groups as control and GSH-treated group. Animals in control group received single intraperitoneal (ip) administration of 0.9% saline. Rabbits in GSH-treated group received reduced L-glutathione (10 mg/kg) (ip). Blood samples were taken from the marginal ear vein 0, 3, 6 and 12 hours after injection. Plasma TAC and NO levels were not statistically different between control and GSH group at 0 and 12 hours. Plasma TAC level was found to be significantly higher (p < 0.05) while NO level was found to be significantly lower (p < 0.05) in GSH treated group when compared to control group at 3 and 6 hours. Plasma TOC and ADA activity were not statistically different between control and GSH group during experiment. In conclusion, exogenous GSH resulted in an alteration of TAC and NO but not TOC and ADA, so exogenous GSH may be a valuable enhancer of the antioxidant system.

Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review.

INTRODUCTION: Duodenal injuries are uncommon and are associated with significant morbidity and mortality due to delayed diagnosis (in the case of blunt trauma) or associated major vascular injuries (in the case of penetrating trauma). Isolated blunt injuries may have a subtle clinical presentation, and are particularly difficult to diagnose when the perforation is located in the retroperitoneal part of the duodenum. MATERIALS AND METHODS: This paper presents in company with three cases of successfully treated isolated duodenal injuries due to blunt trauma, focusing on with their preoperative diagnosis, surgical management and final out comes. CONCLUSIONS: Early diagnosis and successful surgical planning require experience and clinical suspicion on the part of the surgeon, as well as meticulous laparotomy results.

Investigation of oral selegiline and rasagiline administration on QT interval in conscious rabbits.

Rasagiline (RSG) and selegiline (SEL) are potent selective monoamine oxidase-B inhibitors and used in the treatment of Parkinson's disease. Selegiline is metabolized in vivo to I-methamphetamine and I-amphetamine which effect cardiovascular system. Therefore, the aim of this study was to evaluate and to compare the effects of long-term use of these drugs on QT interval in conscious rabbits. The study involved 17 New Zealand rabbits of both sexes, aged between 7 and 14 months. Control group (CG, n = 6) was orally given isotonic saline solution at dose of 0.5 cc/per rabbit. The SEL group (SG, n = 6) received 5 mg/per rabbit SEL orally twice daily (09:00 am and 09:00 pm) for 14 days. The RSG group (RG, n = 5) was orally given of RSG at 1 mg/per rabbit daily for 14 days. Electrocardiographic records were taken before the experiment (baseline) and at 1st, 7th, and 14th days of experiment by direct writing electrocardiograph for two groups. Heart rate (HR), QT and QTc values were determined from ECG records. HR did not significantly differ in both treatment groups through the experimental period when compared to baseline values. The significant prolongation of QT and QTc values were observed at 7th, and 14th day (p < 0.01) in SG and 1st day of experiment in RG (p < 0.05) as compared to baseline values. In conclusion, the results obtained suggest a statistically significant effect of SEL on QTc prolongation when compared to RAS. QTc prolongations should be taken into account in Parkinson's disease where autonomic system is involved.

Effects of therapeutic dose of ivermectin on plasma nitric oxide and total antioxidant capacity in rabbits.

BACKGROUND: Ivermectin, an acaricide and anthielmintic drug of the family of avermectins may produce free radicals thus resulting cytotoxic effect on the parasite. Nitric oxide (NO) acts as free radicals and as host defense mechanisms. The antioxidant capacity (TAC) can be described by the analysis of single components in the defense systems against free radicals. It was aimed to study the effects of therapeutic doses of ivermectin on the plasma adenosine deaminase (ADA) and gamma glutamyl transpeptidase activities (GGT), total antioxidant capacity (TAC), nitric oxide (NO) and total protein, albumin, globulin levels in rabbits. MATERIAL AND METHODS: Twenty healthy New Zealand rabbits were allocated to 2 equal groups. Group I received 0.5 mg/kg and Group II received 1 mg/kg of ivermectin via subcutaneous injection. Blood samples were collected before the experiment, at 24 and 120 hours following the treatments. RESULTS: Ivermectin at therapeutic doses increased plasma NO level at 24 h while decreased TAC at 120 h and did not alter other parameters. CONCLUSION: These findings may suggest that ivermectin is a safe antiparasitic drug for mammals but to less extent, it may have an effect on the oxidant/antioxidant balance.

Effects of therapeutic doses of Pregabalin on QTc interval in conscious rabbits.

Pregabalin (PRG) is a new antiepileptic drug that has been used as supportive therapy for partial seizures in patients. Although many neuro-psychiatric and non-cardiac drugs are known to prolong ventricular repolarization as manifested by QTc prolongation on ECG of which provokes torsades de pointes, there is limited data available regarding the characteristics of QT interval in conscious laboratory animals after PRG administration. For that purpose, effects of different therapeutic doses of oral PRG administration on Heart Rate (HR), QT and QTc values in rabbits were evaluated at a predefined time interval in this research. The study involved 28 New Zealand rabbits of both sexes, aged between 8 and 12 months. Animals were divided into four equal groups. Rabbits in control group (CG) received saline 0.5 ml/per animal orally. Group I, II and III were orally given single dose of PRG at 1.25 mg/kg, 2.5 mg/kg and 5 mg/kg, respectively. ECG records were taken before experiment (baseline) and at 1st, 2nd, 4th, and 6th hour (h) of experiment by direct writing electrocardiograph. HR, QT and QTc values were determined from ECG records. Heart rates increased in all groups when compared to baseline values. The increases were evident at 4th h in group II (p < 0.001), at 2nd h (p < 0.05) and 4th h (p < 0.001) in group III compared with CG. After application of PRG, QTc began to prolong at 1st h through the 4th of experiment and then turned to baseline values at 6th h of the experiment. The QTc values obtained at 2nd h in Group II and III (p < 0.05) and 4th h (p < 0.001) of application in group III were significantly different from CG. Changes obtained in HR, QT and QTc values in PRG treated rabbits were time and dose dependent (p < 0.001). Increase in HR and QTc prolongation determined in PRG given rabbits may implied that clinicians should take care of these changes when using this drug and further studies are required to fully understand the mechanism involved.