Association of single nucleotide polymorphisms in CXCR1, CXCR2 and CXCL5 with Behçet disease: a study in the Denizli province of Turkey.

BACKGROUND: Behçet disease (BD) is associated with the immune system, especially neutrophilic activity. The CXCR1, CXCR2 and CXCL5 genes mediate the activation and migration of neutrophils. AIM: To investigate CXCR1, CXCR2 and CXCL5 single nucleotide polymorphisms (SNPs) and examine their association with BD. METHODS: We studied polymorphic sites in CXCR1 (four sites: rs16858811, rs9282752, rs16858809 and rs16858808), CXCR2 (three sites: rs2230054, rs1126579 and rs1126580) and CXCL5 (one site: rs352046) in 87 patients with BD and 111 healthy controls (HCs), using a PCR restriction-fragment length polymorphism-based approach for genotyping. RESULTS: We found that the CXCR2 rs2230054 TT genotype and the CXCL5 rs352046 polymorphism might be possible genetic factors responsible for BD. We did not find any association between the development of BD and any of the four CXCR1 polymorphisms or the other two CXCR2 SNPs. In addition, our haplotype analysis results indicated that the haplotypes of the CXCR2 and CXCR1-CXCR2 polymorphic loci were different between the BD and HC groups. CONCLUSION: Our study suggests that polymorphisms of CXCR1, CXCR2 and CXCL5 may affect susceptibility to BD and increase the risk of developing the disease. These loci need to be studied in larger groups of patients from different geographical areas around the world in order to clarify the genetic background for BD pathogenesis.

Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke.

BACKGROUND: The index of cardioelectrophysiological balance (iCEB), measured as QT interval divided by QRS duration, has recently been defined as a new risk marker for arrhythmias. Increased or decreased iCEB is associated with malignant ventricular arrhythmias. AIM: In this study, we aimed to investigate the relationship between iCEB and stroke severity in patients with acute ischemic stroke. METHODS: The study comprised 105 adult patients (males, 58; females, 47; 69 ± 15 years) with acute ischemic stroke. Nine patients were excluded. Patients were divided into two groups based on the calculated National Institutes of Health Stroke Scale (NIHSS) score (Group 1, NIHSS score <16; Group 2, NIHSS score ≥16). Demographic, clinical, and laboratory data for all patients were collected. Electrocardiography (ECG) was recorded from all patients on admission to the neurology care unit. iCEB (QT/QRS) was calculated from the 12-lead electrocardiogram. RESULTS: There were no significant differences among the demographic parameters of patients. iCEB score was significantly higher in Group 2 patients than Group 1 patients (3.97 ± 0.61 vs 3.43 ± 0.57, P = 0.0024). CONCLUSION: Our results suggested that iCEB is associated with stroke severity on admission in patients with acute ischemic stroke. It is known that high iCEB is associated with torsade de pointes (TdP), ventricular tachycardia.

Genetic origin of Behçet's disease population in Denizli, Turkey; population genetics data analysis; historical demography and geographical perspectives based on ß-globin gene cluster haplotype variation.

In our study, we aimed to investigate the possible genetic drift, relationships, expansion and historical origin based on haplotype frequencies of the ß-globin gene cluster of normal and Behçet's disease (BD) population in Denizli, Turkey. We examined blood DNA samples obtained from our DNA bank. The association of population genetic parameters such as haplotypes, diversity, differentiation, Hardy-Weinberg equilibrium and demographic analysis for two populations was performed by Arlequin ver. 3.5. Our results show that both populations have high similarity in genetic parameters in terms of development and expansion based on haplotype diversity through the history. We found that historical levels of gene flow were significantly higher between the two populations. According to historical population, growth parameter of τ values for normal and BD populations dated approximately 42 000 to 38 000 ybp, respectively. In conclusion, historically, two populations show similar genetic parameters and unimodal growth distribution. Our results are consistent with the view that the BD may have occurred in area, independent from Silk Road.

Carpal Tunnel Syndrome Surgery Anti-Adhesion Gel Is Effective?

PURPOSE OF THE STUDY The purpose of the current study is to assess the efficacy of anti-adhesion gel on the symptom severity and functional outcomes after mini incision open surgery for carpal tunnel syndrom (CTS). MATERIAL AND METHODS A total of 200 CTS patients (154 women, 46 men) were included in this study. Group I (n = 100; 78 women, 22 men) did not receive local administration of anti-adhesion gel, while anti-adhesion gel consisting of hyaluronic acid-carboxymethylcellulose (Seprafilm®, SanofiBiosurgery, Bridgewater, NJ, USA) was locally applied to patients in Group II (n = 100; 76 women, 24 men). All patients recruited in this study had received conservative treatment comprised of non-steroidal antiinflammatory drugs, steroid injection, replacement of vitamin B and stabilization with splints. Cases that did not benefit from these therapeutic options during one year were assigned as candidates for surgical treatment. RESULTS There was no significant difference between two groups in terms of mean age, gender distribution, preoperative and postoperative Boston questionnaire (BQ) scores, difference of BQ scores after the operation, and the presence of the disease on the left or right side. According to postoperative 1. Year results, there was no significant difference between two groups. CONCLUSIONS Results of the current study demonstrated that use of anti-adhesion gel during mini incision open surgery for CTS did not bring about significant advantages in terms of functional or symptomatic outcomes. Further, controlled trials on larger series are warranted to understand the beneficial effects of anti-adhesive materials during the surgical treatment of CTS. Key words: anti-adhesion gel, Boston questionnaire, carpal tunnel syndrome.

Treatment of resistant idiopathic hiccups with pulse radio frequency on phrenic nerve and gabapentin: A case report.

Hiccups affect life quality, career and family life when they become persistent. We present here a 54-year-old man who worked as a mason and a blacksmith with hiccups complaint for nearly one and a half years. In this period, he was admitted to emergency service ten times with fainting or almost fainting, cold sweating and hand stretching complaints. The patient expressed that he frequently threw up when he had hiccups and his social life was negatively affected. He reported that he was treated with baclofen, esomeprazole and hyoscine-n-butyl bromur without relief. He used escitalopram and chlorpromazine for a short time and quit because they negatively affected his sleeping. As he did not have any relief from medications, he refused any oral medical therapy including gabapentin and started to seek remedy from paramedical treatments resulted with no benefit. The patient was referred to algology department and an intervention on phrenic nerve with pulse radio frequency (8 minutes, 45 Volts, 20 milliseconds wavelength) was performed. Symptoms stopped immediately after the procedure but one week later, although the patient reported a significant decline in symptoms he still had hiccups. The patient was offered oral medical therapy again. With considerable relief from symptoms, the patient accepted oral therapy this time. Gabapentin 300 mg bid was prescribed. The symptoms were completely recovered and the patient reported no hiccups after 30 days of Gabapentin administration. Our case suggests that administration of gabapentin after pulsed radiofrequency might be effective for the treatment of persistent hiccups.

Can rs3767140 SNP of the perlecan (HSPG2) gene affect the diabetes mellitus through the dyslipidemia?

Perlecan (HSPG2) play an important role in the lipoprotein metabolisms. The G allele of the HSPG2-rs3767140 may affect the binding of heparan sulfate (HS) chains and hence cause loss of HS from the basement membrane. HSPG2-rs3767140 was studied in 60 T2DM patients and 109 healthy controls. In diabetic patients HSPG2-rs3767140 T variant allele carriers (TT+GT) have decreased fasting plasma glucose (FPG) and serum LDL-C levels (p=0.071 and p=0.060, respectively) versus GG genotype carriers. Moreover, in both of the two groups in which the T allele carriers HDL-cholesterol levels tend to be high. We investigated that the HSPG2-rs3767140 promoted to the dyslipidemic phenotype in the type 2 diabetes mellitus (T2DM) patients. We suggest that the HSPG2-rs3767140 might be associated with the decreased FPG and LDL-C and with the increased HDL-C in diabetics. Therefore, the HSPG2-rs3767140 might be a protective for the diabetes mellitus due to its ameliorating effect on the dyslipidemic phenotype.

The evaluation of Nesfatin-1 levels in patients with OSAS associated with metabolic syndrome.

PURPOSE: The association of obstructive sleep apnea syndrome (OSAS) and metabolic syndrome (MS) has been demonstrated in studies and in recent years; the effect of OSAS on insulin resistance independent of the level of obesity is being investigated. Nesfatin-1 is a newly defined 82 amino acid protein with a precursor molecule of NUCB2 (nucleobindin 2). Nesfatin-1 is not only essential in regulation of food ingestion but also important in regulation of some brain functions, autonomic regulation, stress, mental state, and paradoxical sleep. We aimed to evaluate the relationship between OSAS and MS and the MS dependent or independent effect of Nesfatin-1 on this relationship. METHODS: Patients admitted with clinical signs of OSAS are included. Patients are divided into three groups based on Apnea-Hypopnea Index (AHI) on Polysomnography (PSG) as mild, moderate, and severe OSAS. A total of 59 patients were included the control patients. Several OSAS parameters and laboratory findings which are and are not MS dependent are compared. Nesfatin-1 levels are evaluated in all OSAS patients with and without MS. RESULTS: There were significantly more males in all groups (p = 0.007). There was no significant difference between groups in terms of Nesfatin-1 levels. Nesfatin-1 levels were significantly lower in MS group compared to non-MS group (p = 0.021). CONCLUSION: Nesfatin-1 which is known to play a role in the pathophysiology of insulin resistance can be a beneficial target in developing new therapeutic targets for treatment of patients with obesity without any toxic effects in the future.

Use of state administrative data sources to study adolescents and young adults with rare conditions.

BACKGROUND: Effective care of young people with rare conditions requires ongoing coordinated medical treatment as well as educational and social support services. However, information on treatment is often lacking due to limited data. South Carolina has a repository of comprehensive health and human service data with which individuals may be tracked across the data systems of multiple state agencies and organizations. OBJECTIVE: To develop a method for studying health care of young persons with rare conditions using this repository. METHODS: We identified individuals aged 15 to 24 years diagnosed during 2000-2010 with Fragile X syndrome (FXS), spina bifida (SB), or muscular dystrophy (MD) using a series of algorithms. ICD-9-CM codes were used to initially identify the cohort from medical billing data. Demographics, medical care, employment, education, and socioeconomic status data were then extracted from linked administrative sources. RESULTS: We identified 1,040 individuals with these rare conditions: 125 with FXS, 695 with SB, and 220 with MD. The vast majority of the cases (95%) were identified in the Medicaid database. Half of the cohort was male, with a higher percentage in the FXS and MD groups. Sixty-two percent of the cohort was enrolled in the last year of high school. Over half of the cohort received support services from the state's disability and special-needs agency; 16% received food assistance. Thirty-eight percent were employed at some point during the study period. Forty-nine individuals with SB and 56 with MD died during the study period. CONCLUSIONS: We used a linked statewide data system to study rare conditions. Strengths include the diversity of information, rigorous identification strategies, and access to longitudinal data. Despite limitations inherent to administrative data, we found that linked state data systems are valuable resources for investigating important public health questions on rare conditions.

Effect of foreign impurity and growth temperatures on hexagonal structure and fundamental properties of ZnO nanorods.

This study examined the influence of growth temperature and dopant concentration on the properties of Gd- and Ni-doped zinc oxide nanorods (ZnO NRs). ZnO seed layers were deposited on glass substrates using a sol-gel and dip-coating approach. Gd- and Ni-doped ZnO NRs were hydrothermally grown on the seed layers at different temperatures such as 75, 90, and 105°C for a constant growth time of 5 h. The crystal structure, optical, surface morphology views, and electrical properties of the NRs were extensively investigated by x-ray diffraction (XRD), scanning electron microscopy (SEM), UV-visible spectroscopy, and four probe experimental methods. The XRD analysis confirmed the successful substitution of Zn2+ ions by Gd3+ and Ni2+ within the ZnO main matrices. The reordering of hexagonal structures with varied electronegativity, ionic radius dimensions, and valence electron states of Gd and Ni dopants affected seriously the fundamental characteristic features of NRs. The SEM images showed that the ZnO NRs grown at 90°C possessed a more favorable surface morphology and well-defined hexagonal shape compared with those grown at other growth temperatures. Higher dopant concentration led to an increase in NR diameter but a decrease in density depending on the increase in the space between the NRs. Additionally, the optical transmittance was found to generally enhance with increasing dopant concentration. The results obtained highlighted the interplay between growth temperature, dopant type and concentration in tailoring the structural, morphological, and optical properties of Gd- and Ni-doped ZnO NRs, paving the way for the development of optimized nanomaterials for various applications. RESEARCH HIGHLIGHTS: The XRD analysis confirmed the successful substitution of Zn2+ ions by Gd3+ and Ni2+ within the ZnO main matrices. The SEM images showed that the ZnO NRs grown at 90°C possessed a more favorable surface morphology and well-defined hexagonal shape compared with those grown at other growth temperatures. The optical transmittance was found to generally enhance with increasing dopant concentration. The results obtained highlighted the interplay between growth temperature, dopant type and concentration in tailoring the structural, morphological, and optical properties of Gd- and Ni-doped ZnO NRs, paving the way for the development of optimized nanomaterials for various applications.

The effects of paranoia and dopamine on perception of cohesion and conspiracy: a pre-registered, double-blind, placebo-controlled experiment.

Paranoia is a common symptom of psychotic disorders but is also present on a spectrum of severity in the general population. Although paranoia is associated with an increased tendency to perceive cohesion and conspiracy within groups, the mechanistic basis of this variation remains unclear. One potential avenue involves the brain's dopaminergic system, which is known to be altered in psychosis. In this study, we used large-N online samples to establish the association between trait paranoia and perceptions of cohesion and conspiracy. We further evaluated the role of dopamine on perceptions of cohesion and conspiracy using a double-blind, placebo-controlled laboratory experiment where participants received levodopa or a placebo control. Our results were mixed: group perceptions and perceptions of cohesion were higher among more paranoid individuals but were not altered under dopamine administration. We outline the potential reasons for these discrepancies and the broader implications for understanding paranoia in terms of dopamine dysregulation.

Frequency of metabolic syndrome and 25-hydroxyvitamin D3 levels in patients with non-alcoholic fatty liver disease.

AIM: It is known that insulin resistance has an important role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and that serum 25-hidroksivitamin D3 [25-(OH)D] levels are found low in the presence of insulin resistance. Metabolic syndrome (MetS) is characterized by insulin resistance. The purpose of the present study was to determine the levels of 25-(OH)D and the frequency of MetS in patients with NAFLD, and to evaluate the association of 25-(OH)D with the histology of NAFLD and metabolic parameters. METHOD: Sixty-three patients with NAFLD confirmed by liver biopsy (29 females and 34 males, mean age 42.70±9.82 years) and 46 healthy controls (16 females and 30 males, mean age 37.54±8.56 years) were included in the study. International Diabetes Federation criteria were used for MetS diagnosis. Insulin resistance was determined according to the Homeostasis Model of Assessment (HOMA-IR) method. The groups were compared for 25-(OH)D levels and MetS frequencies. Correlation analysis was used to evaluate relationships between 25-(OH)D and metabolic parameters and/or NAFLD histology. RESULTS: 25-(OH)D levels were lower in the NAFLD group compared to the control group (36.06±13.07 ng/mL vs. 51.19±23.45 ng/mL, respectively, P<0.01), while MetS frequency was higher (66.7% vs. 15.2%, P<0.01). In the NAFLD group, 25-(OH)D levels were negatively correlated with non-alcoholic steatohepatitis scores and HOMA-IR (r=-0.317, P=0.011 and r=-0.437, P=0.001, respectively). CONCLUSION: The present study demonstrated higher frequency of MetS and lower levels of 25-(OH)D in patients with NAFDL, and a negative association of 25-(OH)D levels with non-alcoholic steatohepatitis scores and insulin resistance.

The effect of demographic and clinical data on anxiety and depression levels in breast cancer patients receiving radiotherapy.

PURPOSE: The aim of this study is to investigate the effects of sociodemographic and clinical data on depression and anxiety levels in patients who undergoing radiotherapy for breast cancer. MATERIALS AND METHODS: A total of 111 patients with breast cancer treated in the Radiation Oncology Department of Kayseri City Education and Research Hospital were included in this study. The study was planned prospectively as a survey research based study. Ethics committee approval was obtained. After obtaining the necessary consent for voluntary participation, patients were interviewed face-to-face. The research survey included the Hospital Anxiety and Depression Scale (HADS), as well as demographic and clinical information. Statistical analysis was performed with the collected data. RESULTS: According to the results of repeated measures analysis of variance, the mean difference between the 3-month and 6-month measurements of the depression scale values on the first day of radiotherapy was statistically significant (P < 0.001). Mean differences were statistically notable for age and marital status variables in anxiety and for age, education level, marital status, employment status, family history of cancer, menopause, surgery, chemotherapy and hormone therapy variables in depression. When the change in the presence (> 10 depression scale) or absence (< 10 depression scale) of depression at three different times of radiotherapy (first day, 3 and 6 months) was examined, a statistically notable difference was found between the depression scale values of patients receiving radiotherapy on the first day, 3 months after radiotherapy and 6 months after radiotherapy (P < 0.05). CONCLUSION: According to the results of our study, the psychological health of women with breast cancer was affected during and after radiotherapy. As a response, psychiatric counseling should be considered as a part of the treatment for depression and anxiety that occur during and after treatment in breast cancer patients.

The impact of the COVID-19 pandemic on the orthopaedics outpatient clinic.

OBJECTIVE: The COVID-19 pandemic has significantly impacted orthopaedic practice since it started. In our study, we aimed to examine these effects on outpatient services. PATIENTS AND METHODS: The patients who applied to the orthopedic outpatient clinic (n=1,518) in six months period under the effect of the COVID-19 pandemic (September 2020-March 2021) and patients (n=1,207) who applied during the same period before the pandemic (September 2019-March 2020) were analyzed according to the demographic characteristics (age, gender), reasons for admission, duration of complaints, treatments applied, surgical acceptance rate, and compliance with treatment. RESULTS: The mean age in the pre-pandemic outpatient clinic admissions was 39.1 years (1-91 years), the gender ratio was 635/572 (Female/Male), the mean age of the patients was 38.1 years (1-95), and the sex ratio was 793/725 (F/M) during the pandemic. Admissions of patients with acute complaints decreased after the pandemic, and applications for subacute or chronic complaints increased. Applications for sports medicine, pediatrics, and hand surgery increased, applications for trauma, foot and ankle surgery decreased, and applications for oncology and spine did not change. Conservative treatment recommendations decreased, the surgical treatment recommendation did not change, and the rate of patients who were given only follow-up decisions increased. There was no significant difference in the treatment rejection and surgical acceptance rate. CONCLUSIONS: We observed that the number of traumas decreased, and the hospital admission duration extended. The increase in the consultation rate and follow-up preference indicates that the treatment is more conservative in this period. In this process, patients should be adequately informed about the precautions taken, and their treatment should not be interrupted.

Perceived complexity of total hip arthroplasty: results of a survey of orthopedic surgeons.

OBJECTIVE: No analysis of the perception of the complexity of total hip arthroplasty (THA) has been performed so far. This study aimed to evaluate the perceived complexity of the disorders faced by orthopedic surgeons in the evaluation process prior to THA. SUBJECTS AND METHODS: A three-part online survey was administered to orthopedic surgeons. In the first part, the participants were asked questions about demographic and academic knowledge, as well as their experiences with THA. In the second part, it was asked to rate the complexity of certain disorders, such as soft tissue abnormalities, ankylosis/arthrodesis, dysplastic hip, high dislocated hip, post-traumatic arthrosis, protrusio acetabuli, etc., on a scale of one to five. Perceived complexity was classified as mild if the calculated mean score was <1.67, moderate if it was between 1.67 and 3.34, and complex if it was >3.34. In the last section, the effects of perceived complexity on surgical preferences were investigated. RESULTS: THA administered for femoral neck fracture was graded as the least complex surgical challenge (mean score of 1.85±0.99), while high dislocated hip (Crowe III-IV) was scored with the highest mean score of 4.10±0.99. None of the disorders were evaluated as easy by orthopedic surgeons. Disorders of the high dislocated hip (Crowe III-IV) and protrusio acetabuli were identified as the most complicated cases by surgeons. CONCLUSIONS: Perception of complexity affected preference for surgical approach. Besides, the level of education after participating in a course related to THA may affect the preferences of orthopedic surgeons when planning an operation.

Revisiting traditional risk factors for rejection and graft loss after kidney transplantation.

Single-antigen bead (SAB) testing permits reassessment of immunologic risk for kidney transplantation. Traditionally, high panel reactive antibody (PRA), retransplant and deceased donor (DD) grafts have been associated with increased risk. We hypothesized that this risk was likely mediated by (unrecognized) donor-specific antibody (DSA). We grouped 587 kidney transplants using clinical history and single-antigen bead (SAB) testing of day of transplant serum as (1) unsensitized; PRA = 0 (n = 178), (2) third-party sensitized; no DSA (n = 363) or (3) donor sensitized; with DSA (n = 46), and studied rejection rates, death-censored graft survival (DCGS) and risk factors for rejection. Antibody-mediated rejection (AMR) rates were increased with DSA (p < 0.0001), but not with panel reactive antibody (PRA) in the absence of DSA. Cell-mediated rejection (CMR) rates were increased with DSA (p < 0.005); with a trend to increased rates when PRA>0 in the absence of DSA (p = 0.08). Multivariate analyses showed risk factors for AMR were DSA, worse HLA matching, and female gender; for CMR: DSA, PRA>0 and worse HLA matching. AMR and CMR were associated with decreased DCGS. The presence of DSA is an important predictor of rejection risk, in contrast to traditional risk factors. Further development of immunosuppressive protocols will be facilitated by stratification of rejection risk by donor sensitization.

Efficacy of combination of biofeedback therapy and pelvic floor muscle training in dyssynergic defecation.

BACKGROUND: It is now known that with appropriate exercises, the functions of the muscles in the body ameliorate and increase in strength. We applied pelvic floor muscle relaxation training and exercises that strengthen the abdominal and pelvic muscles in combination with biofeedback therapy (BFT) to patients with dyssynergic defecation (DD). METHODS: Patients who met the criteria for DD and had no underlying organic cause were included in this study. The electromyography (EMG) technique was used for BFT therapy. Patients had received at least six sessions of BFT. BFT was considered successful in patients when the DD pattern in anorectal manometry (ARM) disappeared and/or adequate anal relaxation was obtained following BFT and in patients who had full clinical recovery. RESULTS: Data of 104 patients (58 females [55.8%] and 46 males [44.2%]) was evaluated. Abdominal and rectal symptoms disappeared in 71 (68.26%) patients. Of the patients who achieved symptomatic improvement, 58 (55.76%) saw a disappearance of the dyssynergic defecation pattern. When the differences between anal sphincter pressures before and after treatment were compared in patients who responded to BFT and those who did not, no significant differences were observed, but significant changes were found in anal squeezing pressures. It was found that those who had high squeezing pressures before BFT, those who increased their squeezing pressures after BFT, and those who decreased their resting pressure responded better to BFT. CONCLUSIONS: In this study, BFT was found to be more effective in those with a high squeezing pressure and those that increased squeezing pressure after BFT. These findings will influence the treatment of patients with dyssynergic defecation who do not respond to treatment. A combination of abdominal and pelvic floor muscle exercises and BFT increases patient response.

Focusing on functional knee parameter determination to develop a better clinical gait analysis protocol.

BACKGROUND: Attempts to improve protocol standards of marker-based clinical gait analysis (CGA) have been one of the main focuses of research to enhance robustness and reliability outcomes since the 1990s. Determining joint centres and axes constitutes an important aspect of those protocols. Although the hip joint is more prominent in such studies, knee joint center (KJC) and axis (KJA) directly affect all outcomes. RESEARCH QUESTION: What recommendations arise from the study of the scientific literature for determining knee joint parameters (KJP) for protocols of CGA? METHODS: A systematic, electronic search was conducted on November 2018 using three databases with the keyword combination ("functional approach" OR "functional method" OR "functional calibration") AND ("hip joint" OR "knee joint" OR "ankle joint") and analyzed by four reviewers. Given the existence of a recent review about the hip joint and the lack of material about the ankle joint, only papers about the knee joint were kept. The references cited in the selected papers were also screened in the final round of the search for these publications. The quality of the selected papers was assessed and aspects regarding accuracy, repeatability, and feasibility were thoroughly considered to allow for a comparison between studies. Technical aspects, such as marker set choice, KJP determination techniques, demographics, and functional movements, were also included. RESULTS: Thirty-one papers were included and on average received a rating of about 75 % according to the quality scale used. The results showed that functional methods are superior or equivalent to predictive methods to estimate the KJA, while a regression method was slightly better for KJC prediction. SIGNIFICANCE: Calibration methods should be applied to CGA whenever feasibility is reached. No study to date has focused on evaluating the in vivo RoM required to obtain reliable and repeatable results and future work should aim in this direction.

Direct and indirect effects of kisspeptin on liver oxidant and antioxidant systems in young male rats.

Kisspeptin is a recently discovered hypothalamic peptide which plays an important role in the central control of reproductive functions. We have investigated direct and indirect effects of kisspeptin on the liver oxidative stress in young male rats. Twenty-four rats were divided into four groups (n = 6/group). First group served as control and received saline. Kisspeptin-10 was administered to the animals in the second group (20 nmol/rat/day), for a period of 7 days. Rats were given only one dose gosereline (0.9 mg/rat), a GnRH agonist in the third group. The last group received kisspeptin-10 with gosereline. The activities of catalase, superoxide dismutase (SOD), xanthine oxidase (XO), adenosine deaminase (AD) and level of malondialdehyde were studied in liver tissue. Serum samples were separated for total antioxidant capacity (TAC), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, blood urea nitrogen (BUN), colesterol, high-density lipoprotein (HDL) and triglyceride. Kisspeptin increased the activities of SOD and catalase (p < 0.05). When compared to the control group, the levels of malondialdehyde, TOS and AST were lower, but levels of BUN, cholesterole, HDL and AD were higher in the other three groups (p < 0.05). In conclusion, our findings suggest that kisspeptin may have antioxidant and thus protective effects on the liver tissue.

Testicular versus epididymal spermatozoa in intracytoplasmic sperm injection treatment cycles.

BACKGROUND: Normal fertilization and ongoing pregnancy can be achieved using intracytoplasmic sperm injection (ICSI), even with severely immature spermatozoa. However, the published literature documents conflicting results as to the outcome of ICSI. METHODS: Surgical extraction of spermatozoa in 111 ICSI treatment cycles performed over five years at the Assisted Conception Unit (ACU), University College Hospital (UCH), was retrospectively evaluated to compare the outcome of ICSI treatment using either testicular or epididymal spermatozoa. RESULTS: A higher normal fertilization rate and lower abnormal fertilization rate was observed in the epididymal spermatozoa group than in the testicular spermatozoa group. Embryo development on day 3 after fertilization and implantation was significantly better in the epididymal spermatozoa group. Clinical and ongoing pregnancy rates were higher and the spontaneous miscarriage rate lower in the epididymal spermatozoa group, but only the clinical pregnancy rate reached statistical significance. CONCLUSIONS: The origin of surgically extracted spermatozoa has an effect on the success of assisted reproduction using ICSI, and the immaturity of testicular spermatozoa may affect fertilization, embryo development, implantation and pregnancy.

Is there any relationship between serum and urine neopterin and serum interferon-gamma levels in the activity of Behcet's disease?

BACKGROUND: Behcet's disease (BD) is a chronic, inflammatory, multisystem vasculitic disorder. There is no reliable laboratory marker that indicates disease activity. Neopterin is an immunological marker of cellular immune activation, which is secreted by monocytes/macrophages as a result of interferon-gamma (IFN-gamma) secretion by activated T lymphocytes. OBJECTIVE: We aimed to investigate serum and urine neopterin levels in BD patients. METHODS: Forty-five patients who were diagnosed according to the criteria of the International Study Group for BD and 45 age- and sex-matched healthy controls were enrolled in the study. Disease activity was considered by clinical findings. Serum and urine neopterin levels and serum IFN-gamma levels were measured. RESULTS: The mean values of serum and urine neopterin levels were 12.68 +/- 4.87 nmol/L and 167.53 +/- 148.73 micromol/mol creatinine, respectively, in BD patients (P = 0.000 and P = 0.008, respectively), which were statistically significantly different from the control group. However, there was no significant statistical difference between serum and urine neopterin levels of the clinically active and inactive patients. It was also found that the mean value of serum IFN-gamma levels was higher in healthy controls than in BD patients (P = 0.000). CONCLUSIONS: We conclude that serum and urinary neopterin measurement can not be used as a reliable laboratory marker as the BD patients' serum and urinary neopterin levels do not increase in the active stage even though these levels increase when compared to healthy controls.