A novel and useful predictive indicator of prognosis in ST-segment elevation myocardial infarction, the prognostic nutritional index.

BACKGROUND AND AIM: The prognostic impact of poor nutritional status and cardiac cachexia in myocardial infarction is not clearly understood. Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in colorectal surgeries and postoperative septic complications. The present study aimed to evaluate the prognostic value of PNI in ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: We evaluated the in-hospital and long-term (3 years) prognostic impact of PNI on 1823 patients with STEMI undergoing primary percutaneous coronary intervention. Patients with lower PNI had significantly higher in-hospital and long-term mortality and major adverse cardiac events. After adjustment for all confounders, the in-hospital mortality rates were 7.9 times higher at the lower PNI level (95% CI: 5.0-15.8) than those at the higher PNI level. The long-term mortality rates were also 6.4 times higher at the lower PNI level (95% CI: 4.4-12.4) than those at the higher PNI level. CONCLUSION: The present study demonstrated that the PNI, calculated based on the serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with STEMI.

Transcriptomic analysis delineates preterm prelabor rupture of membranes from preterm labor in preterm fetal membranes.

BACKGROUND: Globally, preterm birth remains the leading cause of death in children younger than 5 years old. Spontaneous preterm birth is comprised of two events that may or may not occur simultaneously: preterm labor and preterm prelabor rupture of membranes (PPROM). To further explore the concept that spontaneous preterm birth can result from the initializing of two separate but overlapping pathological events, we compared fetal membrane tissue from preterm labor deliveries to fetal tissue from preterm labor with PPROM deliveries. We hypothesized that the fetal membrane tissue from preterm labor with PPROM cases will have an RNA-seq profile divergent from the fetal membrane tissue from preterm labor controls. METHODS: Chorioamnion, separated into amnion and chorion, was collected from eight gestationally age-matched cases and controls within 15 min of birth, and analyzed using RNA sequencing. Pathway enrichment analyses and functional annotations of differentially expressed genes were performed using KEGG and Gene Ontogeny Pathway enrichment analyses. RESULTS: A total of 1466 genes were differentially expressed in the amnion, and 484 genes were differentially expressed in the chorion (log2 fold change > 1, FDR < 0.05) in cases (preterm labor with PPROM), versus controls (preterm labor only). In the amnion, the most significantly enriched (FDR < 0.01) KEGG pathway among down-regulated genes was the extracellular matrix receptor interaction pathway. Seven of the most significantly enriched pathways were comprised of multiple genes from the COL family, including COL1A, COL3A1, COL4A4, and COL4A6. In the chorion, the most significantly enriched KEGG pathways in up-regulated genes were chemokine, NOD receptor, Toll-like receptor, and cytokine-cytokine receptor signaling pathways. Similarly, KEGG pathway enrichment analysis for up-regulated genes in the amnion included three inflammatory pathways: cytokine-cytokine interaction, TNF signaling and the CXCL family. Six genes were significantly up regulated in chorionic tissue discriminated between cases (preterm labor with PPROM) and controls (preterm labor only) including GBP5, CXCL9, ALPL, S100A8, CASP5 and MMP25. CONCLUSIONS: In our study, transcriptome analysis of preterm fetal membranes revealed distinct differentially expressed genes for PPROM, separate from preterm labor. This study is the first to report transcriptome data that reflects the individual pathophysiology of amnion and chorion tissue from PPROM deliveries.

Effects of pleural opening on respiratory function tests in cardiac surgery: a prospective study.

PURPOSE: To show the effects on lung function of the opening pleura in patients undergoing cardiac surgery. SUBJECTS AND METHODS: 66 patients were included. Patients were allocated into two groups. In group 1 (n=21) pleura was intact, in group 2 (n=45) pleura was opened. Both groups were compared prospectively in terms of preoperative and on the post-operative 5th day pulmonary function tests (PFT), preoperative, postoperative first and fifth day arterial blood gas analysis, preoperative and postoperative first day mixt venous oxygen saturation, bleeding, operation periods, pulmonary complications, intensive care and hospital stay period and mortality. RESULTS: There was significant decrease in all PFT indicators on 5th post-operative day in group 2 (p < 0.01). Although there was a significant decrease in FEV1 on 5th post-operative day in group 1 (p < 0.001), other pulmonary functions parameters were not change significantly (p > 0.025). In group 2 much more decline in pulmonary function test parameters than group 1 were observed (p < 0.05). There was not statistically significant difference in blood gas analysis and mixed venous oxygen saturation values in group 1 (p > 0.05). But in group 2 except pH and PaCO2, other blood gas measurements were significantly decreased on the postoperative first and fifth day (p < 0.008). In group 2 except pH and PCO2, other parameters were less than the other Group (p < 0.01). The drained amount was still significantly higher in group 2 (p < 0.001). The frequency of the revision due to bleeding was observed much more in group 2. CONCLUSIONS: Protection of the integrity of pleura may have positive effects on pulmonary functions in cardiac surgery.

Increased ischemia-modified albumin levels in patients with gastric cancer.

Reactive oxygen species (ROS) are found in the development stages of carcinogenesis. Fifty two patients with gastric cancer and 35 controls were enrolled in this trial. IMA, MDA, Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were evaluated. There was a significant increase in IMA and MDA levels in the patient group (0.405±0.111, 0.271±0.066; p= 0.0001 and 0.207±0.251, 0.077±0.103; p= 0.004 respectively). TOS was also higher in the patient group but it was not statistically different. TAS was statistically lower and there was significant difference in OSI (0.621±0.394, 0.996±0.37; p=0.0001 and 9.68±18.2, 2.9±3.85; p=0.001 respectively). The areas under receiver operating characteristics curves for the determination of gastric cancer were 0.842 for IMA and 0.708 for MDA. Increased levels of IMA, MDA and oxidative stress index were detected and this condition is associated with the impairment of oxidant-antioxidant balance.

Molecular characterization of sour orange (Citrus aurantium) accessions and their relatives using SSR and SRAP markers.

Citrus production with its many varieties is of importance since it provides economically important products for Turkish exports. Sour orange is a rootstock commonly used for propagating the different scion varieties. Knowledge of the genetic diversity of the rootstock accessions would be useful in order to improve citrus breeding programs. We studied genetic relationships and diversity of 51 accessions of sour orange (Citrus aurantium) and their relatives using SSR (simple sequence repeat) and SRAP (sequence-related amplified polymorphism) molecular markers. Twenty-one SRAP primer combinations were tested on these accessions and relatives, producing 167 polymorphic fragments, with a mean of 8.0 and a mean polymorphism information content value of 0.47. Seventeen SSR primers also produced 30 polymorphic fragments, with a mean of 1.4 per primer and a mean polymorphism information content value of 0.39. The unweighted pair-group method with arithmetic average analysis using combined SSR and SRAP data showed a similarity range from 0.71 to 1.00 among the accessions. In the cluster analysis, sour orange relatives were indicated as a separate group from sour orange. 'Macrophylla' and 'Mexican lime' were the accessions most distinct (0.71) from the others. We conclude that genetic diversity in these sour orange accessions is lower and some of them were identical.

Estimation of nasal cavity and conchae volumes by stereological method.

BACKGROUND: Studies evaluating the mean volumes of nasal cavity and concha are very rare. Since there is little date on the mentioned topic, we aimed to carry out the presented study to obtain a volumetric index showing the relation between the nasal cavity and concha. MATERIAL AND METHODS: The volumes of the nasal cavity and concha were measured in 30 males and 30 females (18-40 years old) on computed tomography images using stereological methods. RESULTS: The mean volumes of nasal cavity, concha nasalis media, and concha nasalis inferior were 5.95 ± 0.10 cm(3), 0.56 ± 0.22 cm(3), and 1.45 ± 0.68 cm(3); 7.01 ± 0.18 cm(3), 0.67 ± 0.31 cm(3) and 1.59 ± 0.98 cm(3) in females and males, respectively. There were statistically significant differences in the volume of the nasal cavity and concha nasalis media (p 〈 0.05) between males and females, except for concha nasalis inferior (p 〉 0.05). CONCLUSIONS: Our results could provide volumetric indexes for the nasal cavity and concha, which could help the physician to manage surgical procedures related to the nasal cavity and concha.

The effect of acute swimming exercise on plasma melatonin levels in rats.

BACKGROUND: This study aims to determine the changes in plasma melatonin levels of rats performing acute swimming exercise, immediately following the exercise and after 24 and 48 hours. METHODS: The study included 40 Spraque Dawley species adult male rats divided in to 4 groups as follows: group 1: general control group, group 2: swimming group A, the animals were decapitated after performing 30-minute acute swimming exercise, group 3: Swimming group B, the animals were decapitated 24 hours after performing 30-minute acute swimming exercise and group 4: swimming group C, the animals were decapitated 48 hours after performing 30-minute acute swimming exercise. Blood samples were collected from all experimental animals by decapitation method and plasma melatonin levels were determined according to RIA method. RESULTS: The comparison of plasma melatonin levels among groups revealed that group 3 had the highest plasma melatonin levels (p<0.01). The levels in group 1 (control) and group 4 were not different. The lowest plasma melatonin levels were found in group 2 (p<0.01). CONCLUSION: The results of our study demonstrate that plasma melatonin levels that decrease immediately after acute swimming exercise increase significantly after 24 hours and restore to resting levels after 48 hours (Tab. 1, Ref. 15).

The effect of acute swimming exercise on plasma leptin in rats.

Exercise is known to increase free fatty acid and glucose metabolism. In consideration of such physiological effects of leptin such as reducing food intake and increasing energy consumption, many researchers have studied the relation between leptin and exercise. Despite the inconsistency between results, it is generally accepted that physical activity causes changes in leptin secretion. The present study aims to determine the changes that occur in plasma leptin levels of the rats subjected to acute swimming exercise, immediately after exercise, and in the 24th and 48th hours following exercise.Forty adult male rats of Spraque Dawley species were equally allocated to 4 groups. Group 1: General Control Group. Group 2: Swimming Group, the group that was decapitated just after 30-minutes of acute swimming exercise. Group 3: Swimming Group, the group that was decapitated 24 hours after 30-minutes of acute swimming exercise. Group 4: Swimming Group, the group that was decapitated 48 hours after 30-minutes of acute swimming exercise. Plasma leptin levels of the experimental animals were determined according to RIA method in the blood samples collected by decapitation method. Comparison of plasma leptin levels between groups revealed that the Group 3 had the highest plasma leptin levels (p <0.01). Plasma leptin levels in the Group 1 (control) and 4 were not different and the Group 2 had the lowest plasma leptin levels (p <0.01). Results of the present study show that an acute swimming exercise and/or stress factors associated with an acute exercise inhibit leptin secretion from the adipose tissue (Tab. 1, Ref. 21).

A golden ratio for foramen magnum: an anatomical pilot study.

BACKGROUND: The foramen magnum (FM) is an important landmark because of its close relationship to key structures such as the brainstem and spinal cord, an extension of the medulla oblongata. Because of the similarity in their shape, the existence of a relationship between cranial length and anteroposterior diameter of the FM, and between cranial width and transverse diameter of the FM may reveal the magnificent harmony of the skull and FM. Based on this idea, we investigated the existence of this harmony in skulls that we used in our study. MATERIALS AND METHODS: In this study, 60 adult dry skulls belonging to the Turkish population were examined. The anteroposterior and transverse diameters of the foramen magnum and the length and width of the skull were measured. Measurements were made directly on the skull using a digital sliding calliper. New indices and ratios were applied with those measurements. RESULTS: Our study suggests that FM width and FM length could be estimated by using the cranial length and cranial width measurements in the skull by accepting the mean of these coefficients (4.62) as the golden ratio. The average of the coefficients of cranial width to FM width ratio (4.62 ± 0.35 [95% CI: 4.52-4.70]) and the average of the coefficients of cranial length to the FM length ratio (4.62 ± 0.50 [95% CI: 4.49-4.76]) were found to be equal to each other. In order to check the accuracy of this hypothesis, FM width and FM lengths were estimated with the help of new equations. CONCLUSIONS: In the present study, the ratio between the anteroposterior and transverse diameters of both FM and the cranium was estimated at 4.62, indicating a magnificent harmony between cranial and subcranial structures. With this ratio, it is easy to estimate FM's size based on simple cranial measurements.

Assessment of the nutritional status of children according to maternal reports: Are mothers' perceptions of their children's appetite accurate?

INTRODUCTION: This study determined whether there is a difference in the nutritional status of children with good and poor appetites, as reported by their mothers. METHODS: In all, 70 volunteer mothers of children aged 6-60 months participated in the study. Information about the nutrition of the child was obtained from the mothers via a questionnaire. RESULTS: Based on the mothers' statements, no significant difference was found in the mean or median values of the anthropometric measurements between children with good and poor appetites (p>.05), and no significant difference was observed between daily consumed energy and macro- and micronutrients (p>.05). While the blood zinc levels of children with a good appetite were higher than those with a poor appetite (p<.05), there was no difference regarding other parameters (p>.05). CONCLUSION: In this study, no significant difference was evident between children defined as having good or poor appetite by their mothers, especially in terms of energy and nutrients.

VIVA (VIsualization of VAriants): A VCF File Visualization Tool.

High-throughput sequencing produces an extraordinary amount of genomic data that is organized into a number of high-dimension datasets. Accordingly, visualization of genomic data has become essential for quality control, exploration, and data interpretation. The Variant Call Format (VCF) is a text file format generated during the variant calling process that contains genomic information and locations of variants in a group of sequenced samples. The current workflow for visualization of genomic variant data from VCF files requires use of a combination of existing tools. Here, we describe VIVA (VIsualization of VAriants), a command line utility and Jupyter Notebook based tool for evaluating and sharing genomic data for variant analysis and quality control of sequencing experiments from VCF files. VIVA combines the functionality of existing tools into a single command to interactively evaluate and share genomic data, as well as create publication quality graphics.

Complications associated with surgically assisted rapid palatal expansion without pterygomaxillary separation.

INTRODUCTION: The purpose of this retrospective clinical study was to evaluate the surgical complications associated with the surgically assisted rapid palatal expansion (SARPE) which does not involve pterygomaxillary separation (PMS). PATIENTS AND METHODS: A total of 40 (25 females, 15 males) skeletally mature patients, who had the diagnosis of maxillary transverse maxillary deficiency (TMD), were treated surgically under local or general anesthesia. The mean follow-up time was 6 months. RESULTS: Recorded perioperative and postoperative complications were discussed within the current literature. No serious complications were observed intraoperatively. Eight patients (20%) showed postoperative complications including neurosensory deficits, maxillary sinus infection, epistaxis, fistula formation and incisional dehiscence. DISCUSSION: Neurosensory deficits were the most common findings. The present findings suggest that minor complications were observed associated with SARPE without PMS. The technique may be performed safely also under local anesthesia.

Technetium-99m-MIBI scintigraphy in pulmonary tuberculosis.

UNLABELLED: We investigated the usefulness of 99mTc-methoxyisobutylisonitrile scintigraphy in patients with known or suspected pulmonary tuberculosis (PTB) in comparison with radiological and bacteriological findings. METHODS: Thirty-six patients aged 13-59 yr were scanned 15 and 60 min after intravenous injection of 370 MBq (10 mCi) 99mTc-methoxyisobutylisonitrile. Twenty-four patients had active PTB proven by chest radiograph and sputum examinations, two had miliary tuberculosis and ten were suspected of having relapsed PTB with negative sputum examinations and indeterminate chest radiographs. In 12 patients 99mTc-MIBI imaging was repeated 1-3 mo after chemotherapy. RESULTS: Of 24 patients with active localized PTB, 22 (92%) showed increased focal uptake of 99mTc-MIBI, but two patients with minimal infiltration on chest radiographs had no accumulation of 99mTc-MIBI. Both patients with miliary PTB showed diffuse 99mTc-MIBI uptake in the lungs. Among 10 patients with suspicion of relapse, 99mTc-MIBI scans were true-positive in 4 of 5 patients (80%) with culture-proven tuberculosis and false-positive in 2 of 5 (40%) patients with negative sputum cultures. For repeat imaging, 6 of 10 patients with active localized PTB showed reduced MIBI uptake, which correlated with chest radiograph findings, and one patient had increased MIBI uptake again concordant with clinical and radiological findings which were suggestive of resistance to first line chemotherapy of tuberculosis. The other three patients showed no significant scintigraphic changes despite clinical and partial radiological regression. CONCLUSION: Active PTB granulomas generally present considerable 99mTc-MIBI uptake that is most probably related to disease activity. Therefore, 99mTc-MIBI scanning could be used in the detection and follow-up of active PTB as a complement to routine techniques.

Thirty years survival without anticoagulation after aortic valve replacement with a Björk-Shiley prosthesis.

Anticoagulation is mandatory in all mechanical valve replacements and, when well-managed, permits both embolism and valve thrombosis to be kept at low levels. Here, we report the case of a male patient who has survived 30 years without anticoagulation following aortic valve replacement with the Björk-Shiley prosthesis.

Bilateral accessory anterior bellies of the digastric muscle and review of the literature.

OBJECTIVE: The aim of our paper is discussing anomalies of the anterior belly of the digastric muscle with presenting our case in light literature. METHODS: During dissection of the submental region of 26 years old Turkish female embedded cadaver, for this educational purpose in 2000, bilateral accessory digastric muscle was observed. RESULTS: The anterior and posterior bellies of the digastric muscle had their normal origin and course and were joined by an intermediate tendon, the accessory anterior bellies originated from the digastric fossa, and inserted to the hyoid bone, with a common fibrous band. The accessory anterior bellies of the digastric muscle were in the same shape and coursed parallel to each other. CONCLUSION: Anatomical variations of the anterior bellies of the digastric muscles can be easily confused with pathological conditions in CT and MR imaging, it is necessary to recognize that muscle variants of the digastric muscle occur to avoid confusion when diagnosing abnormal lesions of the floor of the mouth and submental region. In human body, such as these muscle variations have clinical significance.

A variation in the formation of the median nerve: communicating branch between the musculocutaneous and median nerves in man.

We encountered variation in the formation of the median nerve in a 66-year-old male cadaver during dissection of the upper extremity of 20 adult cadavers. The dissections were made at the Department of Cellular Biology and Anatomy, Louisiana State University Medical Center. The median nerve was formed by fusion of four branches, three of them coming from the lateral cord and one from the medial cord. The normal radix from the lateral cord followed a very close oblique course over the axillary artery. The first unusual radix to the median nerve had an anastomoses from the musculocutaneous nerve to the median nerve in the proximal part of the left arm. The second unusual radix also came from the musculocutaneous nerve after it had pierced the coracobrachialis muscle and then joined with the median nerve. These kinds of variations are vulnerable to damage in radical neck dissection and other surgical operations of the axilla and upper arm. The communicating branch can be explained on the basis of its embryologic development and also ought to be distinguished from the other nerve variations in the upper extremity. The aim of this paper is to provide additional information for the classification of previously found communications between the musculocutaneous and median nerves.

The anastomotic artery connecting the axillary or brachial artery to one of the forearm arteries.

A vessel connecting the axillary or brachial artery to one of the forearm arteries was found in a 65 year old male cadaver, during the gross anatomy dissection of the upper extremity of 20 adult cadavers at the Department of Cellular Biology and Anatomy, Louisiana State University Medical Center. The right radial artery originated from the brachial artery nearly at the usual level and was connected to the axillary or brachial artery by a long slender anastomotic artery (vasa aberrantia). The anastomotic artery coursed under the medial side of the biceps muscle between the median and musculocutaneous nerves, and gave off two muscular branches to the biceps muscle. The anastomotic artery coursed between the median and musculocutaneous nerves in the arm, it passed to the forearm under the bicipital aponeurosis and connected the main radial artery on the radial side of the forearm. The anastomotic artery can be explained on the basis of its embryologic development and also ought to be distinguished from the other common arterial variations in the upper extremity.

[Morphometric comparisons of the left and right cerebral hemispheres in Karayak sheep (Ovis aries)]. / Morfometricheskie sravneniia levogo i pravogo polusharii bol'shogo mozga ovtsy Karaiaka.

The study was performed in 32 male and 18 female 5-6 months sheep. After the decapitation their heads were perfused through a carotis externa. After the perfusion brains were exposed to define length, width and mass of left and right hemispheres separately. Significant diversities between the hemisphere parameters determined were found not to exist.

Comparison of four methods for the estimation of intracranial volume: a gold standard study.

Investigators can infer how much reduction in volume has occurred since brain volume was at its peak, by combining measures of brain volume with measures of intracranial volume (ICV). Several methodologies have been proposed to asses the ICV. However, we have not seen a gold-standard study evaluating the results of the methodologies for the assessment of ICV. In the present study, the actual intracranial volume of 20 dry skulls was measured using the water-filling method, using this as a gold standard. Anthropometry, cephalometry, point-counting, and planimetry techniques were applied to the same skulls to estimate the ICV. Anthropometric and cephalometric measurements were carried out directly on skulls and roentgenograms, respectively. Consecutive computed tomography sections at a thickness of 10 mm were used to estimate the ICV of the skulls by means of the point-counting and planimetry methods. The mean (+/-SD) of the actual ICV measured by the water-filling method was 1,262.0 +/- 160.4 cm(3) (1,389.5 +/- 96.5 cm(3) for males and 1,134.5 +/- 94.3 cm(3) for females, respectively). Our results showed that the estimated values obtained by all four methods differed from the actual volumes of the skulls (P < 0.05). The data obtained by anthropometry resulted in overestimation. However, cephalometry, point-counting, and planimetry methods produced underestimation. After calibration, there were no significant differences between the actual volumes and the results of the four methods (P > 0.05). While the anthropometric method is easy and quick to apply, its result may deviate from the actual values. The optimized stereological techniques of point-counting and planimetry methods may provide unbiased ICV results since they take the third dimension of the structures into account.

Preconcentration and separation with Amberlite XAD-4 resin; determination of Cu, Fe, Pb, Ni, Cd and Bi at trace levels in waste water samples by flame atomic absorption spectrometry.

A method for the preconcentration of Cu, Fe, Pb, Ni, Cd and Bi as their diethyldithiocarbamate chelates was proposed using a column filled with Amberlite XAD-4 resin. The retained analytes on the resin were recovered with a small volume of acetone. The metal ions in the effluent were determined by a flame atomic absorption spectrometer. Different factors including pH of sample solution, sample volume, amount of XAD-4 resin, amount of ligand, eluent volume and matrix effects for preconcentration were examined. The recoveries for the analytes under the optimum working conditions were higher than 95%. The relative standard deviations of the determinations were below 9%. The limits of detection (3 s, n=20) for analytes were found to be between 4 and 23 mug l(-1). The proposed method was applied to the analysis of some waste waters from the organized industrial region of Kayseri.