Prevalence of HLA B27 in Patients Diagnosed with Ankylosing Spondylitis (AS) in Diyarbakir, Southeastern Region of Turkey.

AIM: The research to be conducted on human leukocyte antigen (HLA)-B27 in patients diagnosed with ankylosing spondylitis (AS) in Diyarbakir between 2019-2021 is to contribute to the understanding of the prevalence and effect of this genetic marker in the local population. As a researcher working on HLA-B27 and AS, our focus is to research the following. HLA-B27 Prevalence: To determine the prevalence of HLA-B27 in patients diagnosed with AS during the specified period in Diyarbakir. This information can provide insight into the genetic factors associated with the disease in the local population. Disease Severity: Investigate the relationship between HLA-B27 positivity and severity of AS symptoms. To examine factors such as disease progression, pain levels, functional impairment, and quality of life in HLA-B27 positive patients compared to HLA-B27 negative patients. By Genetic Associations: To enable the discovery of potential genetic relationships between HLA-B27 and other genetic markers known to be associated with AS. To investigate whether there are any specific genetic variants associated with HLA-B27 that contribute to disease susceptibility or severity. Researchers: We recommend considering the following approaches to generate knowledge on this topic globally: Literature Review: Conducting a comprehensive review of the available scientific literature on HLA-B27 and AS. It is to describe relevant studies conducted globally and summarize their findings to provide a broader understanding of the subject. Collaboration and Data Sharing: To encourage cooperation with researchers from other regions or countries doing similar studies on HLA-B27 and ASs. By sharing our data and collaborating on analysis, we can improve the global perspective and generalizability of your findings. International Conferences and Journals: Presenting our research findings at international conferences focusing on rheumatology, genetics or related fields. To disseminate our findings globally is to submit your research articles to reputable journals specializing in AS or genetic studies. Online Platforms: Using online platforms such as Researchgate.net, academia.edu or social media networks to share our research findings, connect with other researchers in the field and participate in discussions on a global scale. By using these fields, it is possible to contribute to the global knowledge and understanding of the relationship between HLA-B27 and AS. It is also to obtain insights from studies carried out in other regions. MATERIALS AND METHODS: 198 (104 male and 94 female) patients who applied to Dicle University Faculty of Medicine Physical Therapy and Rehabilitation Clinic with AS symptoms between 2019-2021 and were referred to Dicle University Medical Biology and Genetics Department for evaluation. HLA-B27 positivity was included in our study as a case group. As the control group, 50 people (25 males, 25 females) were selected among the unrelated people who applied to our laboratory to be a bone marrow donor. In both groups, DNA isolation was performed from peripheral blood using the salt precipitation method. Rotar Gene Q device was used for real-time PCR analysis. As a statistical method in analysis; The prevalences of the variables of interest were calculated. The lower and upper limits of 95% were determined as the confidence interval. According to the presence of HLA 27 positivity, the mean of ESR, CRP, and age variables were compared. Mann-Whitney U test was used due to the small number of subjects. Also, correlations between ESR and CRP were calculated. Spearman rho correlation statistics were used as a statistical method. Analyzed. RESULT: Radiological examinations and laboratory tests were performed on 198 patients with suspicion AS and 50 healthy control group of 248 subjects. The prevalence of those with a definite diagnosis of AS was calculated as statistical analysis recalculated 20.16 (95% CI: 0.76-0.9552). The prevalence of HLA-B27 in 50 patients diagnosed with AS as a result of radiological examinations and laboratory tests was calculated as 92%. CONCLUSION: Our study is the first study covering the province of Diyarbakir in the Southeastern Anatolia Region, which we think will contribute to the literature in the evaluation of HLA-B27 positivity in AS patients. The prevalence of HLA-B27 in our region is higher than the prevalence in Turkey.

Virchow's node metastasis: an unusual presentation of ovarian cancer.

Ovarian primaries of supraclavicular metastases are extremely rare. The present study reports the case of a 64-year-old female with a left supraclavicular mass without any other symptoms. After performing a fine needle aspiration biopsy for pathological examination and positron emission imaging, she was diagnosed with FIGO Stage IV high-grade serous epithelial ovarian carcinoma. After three cycles of chemotherapy with paxlitaxel and carboplatin, complete response was achieved. There are only a few reports in literature that address patients with the initial symptom of left supraclavicular mass and final diagnosis of ovarian cancer. To the best of the authors' knowledge, this is the first report to describe the successful use of PET/CT to determine the primary site.

Mean platelet volume could be a useful biomarker for monitoring epithelial ovarian cancer.

New studies show that inflammatory markers and blood cells may be related to epithelial ovarian cancer (EOC). We aimed to examine whether mean platelet volume would be a useful marker for EOC patients to predict tumour burden and prognosis, and investigate the difference in MPV values between EOC patients and healthy controls. We retrospectively investigated 113 ovarian cancer patients who underwent surgery between January 2008 and July 2012 and 90 healthy subjects. MPV levels were significantly higher in preoperative EOC patients compared with healthy subjects (8.26 fl vs 7.71 fl; p = 0.004). Also NLR and PLR values were significantly higher in EOC patients (NLR, 3.48 vs 2.37; p = 0.000; PLR, 241 vs 148; p = 0.000). Surgical tumour resection resulted in a significant decrease in MPV levels (8.26 fl vs 7.61 fl; p = 0.001). NLR values also decreased after tumour resection significantly similar to CA125 (NLR, 3.48 vs 2.49; p = 0.000). Our data suggests that MPV could be a promising and easily available biomarker for monitoring EOC patients.

Long-term results of Ahmed glaucoma valve implantation with/without intravitreal anti-VEGF injection in neovascular glaucoma patients.

PURPOSE: This study aimed to evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation with or without anti-VEGF injections in neovascular glaucoma patients. MATERIALS AND METHODS: This single-center retrospective study assessed NVG patients who underwent AGV implantation with or without anti-VEGF injections. Demographic and clinical data, including ocular findings, intraocular pressure (IOP), visual acuity, and glaucoma medication count, were recorded preoperatively and postoperatively at one day, one month, and one year. The study included 35 patients. Group 1 consisted of 23 patients who received anti-VEGF injections before AGV surgery. Group 2, with 12 patients, had no anti-VEGF injections prior to surgery. Successful surgery was defined as IOP values between 6 and 21mmHg. The primary outcome was a 30% or more reduction in IOP. RESULTS: The groups displayed no significant difference in their demographic or clinical profiles (P>0.05). The visual acuity before and one year after surgery did not differ significantly between the groups. However, IOP values significantly decreased by the end of the one-year follow-up for both groups. No significant differences were found between the groups regarding visual acuity, IOP, or the number of medications during the one-year follow-up (P>0.05). Success rates were 95.7% for Group 1 and 91.7% for Group 2. No significant difference in complications between the groups was observed (P>0.05). CONCLUSION: Anti-VEGF injections prior to AGV implantation did not significantly impact visual acuity, IOP values, or medication count during the one-year follow-up.

The prognostic value of thrombocytosis in newly diagnosed lung cancer patients: a retrospective analysis.

PURPOSE: The importance of thrombocyte count as a prognostic factor has not been adequately investigated in patients with lung cancer. We retrospectively examined the value of thrombocytosis as a prognostic factor and investigated its relationship with other clinicopathologic factors and survival. METHODS: The medical records of 260 patients with lung cancer were reviewed. Pretreatment thrombocyte count, histopathological diagnosis, disease stage, gender, age, performance status (PS), thrombotic episodes, weight loss and paraneoplastic syndromes were recorded. Overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS) were evaluated in all patient subgroups. Thrombocytosis was defined as platelet count >400,000/µl. We assessed statistically the possible correlation between thrombocytosis, other clinicopathologic factors and survival parameters. A two-sided p value < 0.05 was considered significant. RESULTS: There were no statistically significant differences between histological subgroups (small cell/SCLC and non-small cell/NSCLC) according to age, disease stage and gender. Sixty-six (25.38%) patients had thrombocytosis before starting treatment. We found no relationship between thrombocytosis and disease stage, gender, age, PS and thrombotic episodes. Thrombocytosis was significantly correlated only with weight loss (p=0.011) and paraneoplastic syndromes (p=0.027). OS was shorter in the thrombocytosis group, but without statistical significance. PFS and DFS did not differ between thrombocytemic and non-thrombocytemic patients. CONCLUSION: Pretreatment thrombocytosis is not an independent prognostic factor of survival in lung cancer patients and is related with paraneoplastic syndromes.

Comparison of sedation method in pediatrics cardiac catheterization.

OBJECTIVE: Purpose of this study is to compare the effects of various anaesthetic combinations on hemodynamics, sedation level, recovery period and complications in the patients which undergo pediatric cardiac catheterization. PATIENTS AND METHODS: Four groups of anaesthetic combinations was created. The groups are classified as propofol-ketamine (group 1), propofol-dexmedetomidine (group 2), dexmedetomidine-ketamine (group 3), midazolam-ketamine (group 4) (for each group n=20). Baseline heart rate (HR), mean arterial blood pressure (MAP), respiratory rate (RR), peripheral oxygen saturation (SpO2) were recorded. This parameters values were recorded at 0., 5., 10., 15., 20., 25., 30. minutes; and the groups were compared according to these measurements data. RESULTS: For heart rate, Group 2 and 3 reduce the HR more than the drugs of Group 1 and 4 (p < 0.05). The SpO2 values of Group 1 were measured to have 5% further reduction compared to the Group 2 and 3; and Group 4 has the same SpO2 recordings compared to the Group 3 (p < 0.05). Comparing the recovery times; Group 4 was found to have the highest recovery time compared to the other drug groups. It is found that additional doses are needed for recovery in Group 4 (p < 0.008). Side effects were lowest for Group 3 and highest for Group 4. CONCLUSIONS: Considering the complication rates, it is concluded that Group 3 is spotted as the better sedation method among the other groups. In terms of additional propofol dose, Group 1 would be the better choice. Thus, the clinician should choose the suitable methods for the patient.

Primary testicular lymphoma: a single centre experience.

AIM: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin's lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. MATERIALS AND METHODS: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. RESULTS: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53-79 years). The mean follow-up time was 24.8 months (range 7-98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4-6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system after 6 months who had not received intrathecal prophylaxis. No contralateral testis relapse was observed. CONCLUSIONS: Primary testicular NHL is an uncommon entity and we evaluated 8 patients; with one relapse in central nervous system and no relapse in the contralateral testis.

High body-mass index is not associated with worse clinicopathological characteristics in predominantly obese breast cancer patients.

BACKGROUND: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI) is related to increased incidence of BC with poorer prognosis. AIM: The aim of the study was to evaluate the association in patients with BC between BMI at the time of diagnosis and biological characteristics, according to the menopausal status. MATERIALS AND METHODS: This retrospective study comprised a total of 318 women with BC. Clinicopathological differences between normal, overweight and obese patients according to menopausal status were evaluated. RESULTS: Premenopausal women had a significantly lower BMI than postmenopausal patients (28.7 vs. 31.5, respectively; p = 0.00001). No statistically significant association was determined between BMI and clinicopathological characteristics in either the premenopausal or the postmenopausal group (all p values are > 0.05). CONCLUSIONS: There are many conflicting results in literature on this relationship. The results of this study showed that a high BMI is not associated with worse clinicopathological characteristics in a predominantly obese population. In current medical oncology practice, BC should be evaluated on an individual patient basis and the impact of obesity on BC prognosis seems to be difficult to estimate especially in an obese population.

Amino acid residues required for the activity of avrD alleles.

Certain Pseudomonas syringae pathovars harbor avrD alleles belonging to two different homology classes. The nonfunctional avrD allele of P. s. pv. glycinea is highly homologous to active class II avrD alleles but has five unique amino acid substitutions. Three of these five amino acid changes were shown to be absolutely required for restoration of avrD activity to the P. s. pv. glycinea allele by oligonucleotide site-directed mutagenesis. They were cysteine 19 to arginine, alanine 280 to valine, and leucine 304 to serine. In addition, changing leucine 301 to phenylalanine was required for high activity. However, alteration of the leucine at position 245 of the P. s. pv. glycinea allele to serine, present in the active alleles, did not affect avrD activity. Results from recombinant gene constructs between the nonfunctional P. s. pv. glycinea avrD gene and the functional allele from P. s. pv. phaseolicola identified six other amino acid residues that may form contextual motifs important for AvrD function. These were a four amino acid stretch comprised of glutamate 41, alanine 42, asparagine 43 and arginine 44 in addition to aspartate 243 and phenylalanine 301. Some divergence is tolerated within the four amino acid motif, but phenylalanine 301 appears to be necessary for highly active class II avrD proteins.

Two different classes of avrD alleles occur in pathovars of Pseudomonas syringae.

Considerable variation was observed in the occurrence of avirulence gene D (avrD) in different isolates and pathovars of Pseudomonas syringae. Three functional alleles of avrD were cloned and characterized from P. s. pv. phaseolicola and P. s. pv. lachrymans. These avrD genes occurred on indigenous plasmids in both pathovars, like the allele originally cloned from P. s. pv. tomato. P. s. pv. lachrymans was unique in that it carried two different alleles on plasmids of different sizes. These alleles were cloned on 5.6- or 3.8-kb HindIII fragments that are conserved in several other P. syringae pathovars. Surprisingly, the two avrD alleles from P. s. pv. lachrymans were the most divergent of those compared, with only 85% amino acid identity. Allele 1 from P. s. pv. lachrymans was 95% identical to avrD from P. s. pv. tomato but less similar to the other three avrD genes. These two alleles were accordingly called homology class I. The avrD gene from P. s. pv. phaseolicola and allele 2 from P. s. pv. lachrymans were 97 and 98% identical, respectively, at the amino acid level with the nonfunctional P. s. pv. glycinea allele. These three alleles were therefore grouped into homology class II. Comparison of all the avrD alleles permitted the identification of four amino acid substitutions unique to the P. s. pv. glycinea allele at positions 19, 245, 280, and 304.

Avirulence gene avrPphC from Pseudomonas syringae pv. phaseolicola 3121: a plasmid-borne homologue of avrC closely linked to an avrD allele.

Cosmid clone pPsp01 from race 1 Pseudomonas syringae pv. phaseolicola isolate 3121 conferred a unique pattern of soybean cultivar reactions when expressed in P. s. pv. glycinea R4. The avirulence phenotype was shown to result from the presence in clone pPsp01 of an avrD allele as well as an additional avirulence gene located approximately 5-kb upstream. The new gene, called avrPphC, shows high identity to and is phenotypically identical to avrC, previously cloned from P. s. pv. glycinea race 0. avrD and avrPphC occur on an approximately 120-kb indigenous plasmid in P. s. pv. phaseolicola 3121. Although commonly observed in Xanthomonas campestris, this is the first noted occurrence of multiple avirulence genes on a single plasmid in Pseudomonas syringae. Unlike avrD, however, avrPphC does not appear to occur widely in pathovars of Pseudomonas syringae.

Reproductive performance after conventional metroplasty: an evaluation of 102 cases.

OBJECTIVE: To evaluate the influence of conventional metroplasty on reproductive performance of symmetric uterine anomalies and determine the complications of these procedures. DESIGN: A retrospective clinical analysis of consequently operated 102 women. SETTING: Institutional. PATIENTS AND PARTICIPANTS: One hundred two patients with bicornuate and septate uterus and a history of late recurrent abortion and/or preterm delivery were included in this study. INTERVENTIONS: Jones, Strassman, and Tompkins procedures for metroplasty and McDonald operation for cervical cerclage. MAIN OUTCOME MEASURE: The fetal survival rate has increased from 3.7% before operation to 75.0% afterwards. In only two patients uterine rupture was observed. RESULTS: Conventional metroplasty improves the fetal survival rate in women with symmetric uterine anomalies. CONCLUSIONS: Our results confirm the view that conventional metroplasty seems to be an operation of choice in women with symmetric uterine anomalies and a history of recurrent late abortion and preterm delivery. However, uterine rupture and postoperative infertility may be potential complications.

Risk factors for groin node metastasis in squamous carcinoma of the vulva: a multivariate analysis of 39 cases.

This study includes 39 patients with squamous carcinoma of the vulva subjected to radical surgery. Stage, tumor description, cell type, lesion localization, lesion size, depth of invasion, grade, lymphovascular space invasion, number of mitoses, degree of stromal inflammatory reaction, and tumors in surgical margins were analyzed for groin metastasis. Of the factors analyzed, stage (P = 0.018), grade (P = 0.007) and depth of invasion (P = 0.001) were found to be the most important predictors of node metastasis. While a combination of factors permitted to define a low-risk group with 0% node metastasis, it seems hard to identify preoperatively those patients with no risk of nodal metastasis.

Serum copper and zinc levels and copper/zinc ratio in patients with breast cancer.

Serum copper, zinc levels, and the Cu/Zn ratio were evaluated in 31 patients with breast cancer and 35 healthy controls. Copper and zinc were determined by atomic absorbtion spectrophotometry. The mean serum copper level and the mean Cu/Zn ratio in patients with breast cancer were significantly higher than the control group (p < 0.001 and p < 0.001). In addition, the mean serum zinc level in patients with breast cancer was significantly lower than the control group (p < 0.001). Neither serum copper and zinc levels nor the Cu/Zn ratio were of value in discriminating of the disease activity and severity. Interestingly, the Cu/Zn ratio in premenopausal patients was higher than postmenopausal patients (p < 0.05) and this was not related to age. The further combined biological and epidemiological studies are necessary to investigate the roles of copper and zinc in breast cancer.

Linkage disequilibrium between glucose-6-phosphate dehydrogenase deficiency and congenital color blindness in Turkish population.

No erythrocyte glucose-6-phosphate dehydrogenase (G6PD)-deficient person was detected among 90 male patients with congenital color blindness (CCB) diagnosed at the Ophthalmology Clinic of our Hospital. Eighteen complete G6PD-deficient subjects had normal color vision. These results suggest that there is a linkage disequilibrium between CCB and G6PD genes.

Single dose regorafenib-induced hypertensive crisis.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper reports the first case of Grade IV hypertension after the first dosage of regorafenib. We can suggest that hypertension is an idiosyncratic side effect unrelated to the dosage.

Evaluation of topical ciclosporin 0.05% for prevention of rejection in high-risk corneal grafts.

AIM: To evaluate the efficacy of combined treatment with commercially available 0.05% topical ciclosporin and topical corticosteroid compared with treatment with topical corticosteroids only after high-risk keratoplasty. PATIENTS AND METHODS: A total of 47 high-risk keratoplasties were randomly divided into two groups based on the postoperative immunosuppression. Twenty-five eyes (group 1) were treated with 0.05% ciclosporin and dexamethasone 0.1%, and 22 eyes (group 2) were treated with dexamethasone only. The clinical outcome of penetrating keratoplasty was evaluated by the rate of rejection-free graft survival and graft survival evaluation by the Kaplan-Meier logrank test. RESULTS: The average length of follow-up was 20.2 (SD 7.1) months in group 1 and 18.5 (6.6) months in group 2 (p = 0.421). Rejection-free graft survival rates were 60.8% in group 1 and 54.5% in group 2 (Kaplan-Meier logrank test, p = 0.474). In group 1, the graft survival rate was 73.9%; in group 2, the graft survival rate was 68.1%. The difference in the graft survival rates between the groups was also not statistically significant (Kaplan-Meier logrank test, p = 0.518). CONCLUSION: In high-risk corneal grafts, the efficacy of 0.05 percent commercially available topical ciclosporin combined with dexamethasone topically was not better than that of dexamethasone alone in preventing rejection.

Subcutaneous effusion resulting from an epidural catheter fragment.

The breakage of an epidural catheter within a patient is uncommon, but troublesome, complication of epidural block, and its cause is rarely discovered. In this case report, our aim was to present an effusion between s.c. tissue and fascia in the lumbar region because of a broken fragment of epidural catheter which was unnoticed during its removal.