High Anxiety Levels before Elective Cesarean Section Can Negatively Affect the Mother and Fetus.

BACKGROUND: Both pregnancy and surgery cause anxiety. This situation may negatively affect the health of the mother and baby. AIM: The effect of anxiety level before cesarean section (CS) on feto-maternal outcomes was investigated. METHODS: The preoperative anxiety score was determined with the State-Trait Anxiety Inventory (STAI) in 224 pregnant women who were planned for elective CS. RESULTS: Among patients, 33.5% were in the low anxiety group, 27.2% in the moderate, and 39.3% in the high anxiety group. The average birth weight in the low anxiety group was noticeably higher than that of the high anxiety group (P = 0.018). The mean heart rate at postop 1st and 24th hour in the high anxiety group was higher than the moderate anxiety group (P < 0.028). In addition, diastolic blood pressure (DBP) at the sixth hour in the low anxiety group was found to be lower than in the moderate anxiety group (P < 0.05). CONCLUSION: According to these results, it was found that an increased anxiety score before CS is associated with low birth weight in the baby, higher heart rate, and DBP in the mother.

The effect of different preservation media and temperatures on sperm quality and DNA integrity in mouse cauda spermatozoa.

BACKGROUND: Mouse sperm can be stored for long or short-time periods. Nevertheless long-term storage leds to significantly reduced sperm quality and fertility because of cryodamage. Thus, in the storage of semen in mice, it is necessary to focus on media and temperatures that gives good results in short-term storage. OBJECTIVE: To determine favorable media for short-term storage of mice spermatozoa by evaluating progressive motility, viability, membrane function integrity, acrosome integrity and fragmented DNA rates at various storage temperatures. MATERIALS AND METHODS: Mouse spermatozoa were collected from epididymides of mature CD1 males and samples were stored at 24 degree C and 4 degree C for 60 h. RESULTS: Motility, viability and membrane function of mice spermatozoa were greatest when stored in KSOM media. Motility and viability were not different when stored at refrigerator or room temperature in KSOM compared to HTF or PBS mediums for 48 h, but were after 60 h. There was not any significant variation in terms of acrosome integrity in different preservation conditions. Fragmented DNA rates were similar in fresh sperm with KSOM and HTF media, while there was higher damage in PBS medium at 60 h. Overall, sperm parameters were affected significantly by the time of storage and type of preservation medium, and PBS extender was not suitable for mice spermatozoa at room and refrigerated temperatures as it caused the lowest progressive motility, viability, membrane function integrity and the highest DNA damage. CONCLUSION: Mice spermatozoa stored in KSOM retained the best sperm quality parameters both 24 degree C and 4 degree C for the first 48 h. doi.org/10.54680/fr22610110612.

The effects of intraperitoneal chemotherapeutic agents on adhesion formation.

PURPOSE: Intra-abdominal adhesions are a major complication of healing. Furthermore these adhesions may cause morbidity and sometimes mortality for patients, and also are a financial burden to the health system. MATERIALS AND METHODS: Cecum abrasion was performed in all rats and solutions containing saline to group 1, 5-fluorouracil to group 2, cisplatin to group 3, paclitaxel to the group 4, and mitomycin-C were administered into the abdomen of the groups, respectively. The intra-abdominal adhesions were scored after the macroscopic evaluation. RESULTS: Among the chemotherapeutic drugs, paclitaxel significantly increases occurring of intra-abdominal adhesions in comparison with the control group and the other drugs according to the evaluation of scoring and statistical studies. CONCLUSION: It is suggested to use the drugs which have a proven anti-adhesion feature or barriers to the patients who are going to be applied intraperitoneal chemotherapy with paclitaxel.

Cytoreductive surgery and perioperative intraperitoneal chemotherapy for gynecological malignancies: a single center experience.

INTRODUCTION: The objective of this study was to assess the outcome of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) plus early postoperative intraperitoneal chemotherapy (EPIC) in patients with advanced gynecological malignancies. MATERIALS AND METHODS: A retrospective series of 51 patients with advanced gynecologic cancer, evaluated between May 2008 to February 2014. Peritoneal Cancer Index (PCI) and Completeness of Cytoreduction (CCR) score were used in the study group. The study group consisted of the cancers of ovarian, fallopian tube, endometrial, and uterine sarcomas. RESULTS: Mean PCI score of the study group was 18, and the postoperative complications were similar with the literature. Patients were followed in a period of 15 days to 64 months and the mean survival time was 22.8 months. Fifty-two percent of the patients were alive without evidence of the disease and overall one-year survival was found 56%. CONCLUSIONS: The authors concluded that CRS, HIPEC, EPIC, and peritonectomy are a crucial options in patients with advanced gynecological cancers.

Antenatal counseling against passive smoking may improve birth weight for gestational age.

AIM: The authors determined the impact of antenatal counseling against exposure to environmental cigarette smoke on the prevention of reduced neonatal birth weight according to gestational age. MATERIALS AND METHODS: A cross-sectional study was conducted in pregnant women, with 77 passive smokers and 88 non-smokers. During motivational interviews, passive smoking status was monitored and additional follow-up visits were arranged to increase the knowledge regarding perinatal risks of passive smoking, including intrauterine growth restriction and low birth weight. The authors aimed to increase the woman's motivation to avoid second-hand tobacco smoke exposure. RESULTS: The demographic and clinical findings of the study groups were found considerably similar, in this context, and the authors found positive and strong correlations between the gestational age and neonatal birth weight (r = 0.80 and r = 0.76, respectively; p < 0.05). CONCLUSIONS: During antenatal care of women, regular counseling against second-hand smoke exposure may prevent negative effect of passive smoking on neonatal birth weight according to gestational age. This promising finding needs to be supported by further studies with larger sample size considering covariates relevant to passive smoking.

Relationship between uric acid albumin ratio and peripheral artery disease complexity.

OBJECTIVE: Uric acid to albumin ratio (UAR) reflects inflammatory activity and its predictive value has been shown in various diseases. In this study, we sought to evaluate the value of uric acid to albumin ratio in patients with peripheral arterial disease (PAD). PATIENTS AND METHODS: Two hundred forty-three PAD patients were divided into TransAtlantic Inter-Society Consensus-II (TASC-II) A-B and TASC-II C-D groups, according to their TASC-II classification. Biochemical variables of the patients were recorded, and the UAR of each patient was calculated. RESULTS: Patients who had TASC-II A-B disease were younger than the patients who had TASC-II C-D disease (60.7±8.71 vs. 63.28±8.8 years, p=0.024). Quade ANCOVA results showed that patients with TASC-II C-D disease had higher values of UAR when age was used as a covariate (t=-5.045, p<0.001). Lymphocyte count was significantly lower, and UAR was significantly higher in patients with TASC-II C-D disease (p=0.035 and p<0.001, respectively). UAR and lymphocyte count showed a significant positive correlation and a negative correlation with the TASC-II class of the disease (r=0.403, and r=-0.299, p<0.001 for both). A UAR of 1.54 predicted TASC-II C-D disease with a sensitivity and specificity of 57.9% and 78.8%, respectively. UAR predicted severe PAD with an OR of 3.723. CONCLUSIONS: UAR was a better tool for predicting TASC-II C-D disease compared to uric acid and albumin levels. UAR is an easily calculable parameter that can be used in clinical practice.

Effects of Oenothera biennis L. and Hypericum perforatum L. extracts on some central nervous system myelin proteins, brain histopathology and oxidative stress in mice with experimental autoimmune encephalomyelitis.

We investigated the effects of Oenothera biennis L. and Hypericum perforatum L. extracts on brain tissue histopathology, myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) in mice with experimental autoimmune encephalomyelitis (EAE). Forty-seven C57BL/6J mice were divided into the following groups: multiple sclerosis (MS), control (healthy mice), MS + H. perforatum treated (MS + HP), MS + O. biennis treated (MS + OB). All groups except the control group were immunized by EAE methods. Two weeks after the immunization, the mice in the MS + HP group were fed normal food containing 18 - 21 g/kg H. perforatum extract, the mice in MS + OB group were fed normal food containing 18 - 21 g/kg O. biennis extract, and the mice in control and MS groups were fed normal food for six weeks. Brain tissue samples were collected from all mice for histopathological and biochemical analysis. Clinical signs of the disease were scored using functional systems scores (FSS) daily. The H. perforatum and O. biennis extracts ameliorated the increased brain tissue MOG and MBP values for animals with MS. H. perforatum and O. biennis extract decreased the TOS and OSI values for brain tissue and increased TAS levels in brain tissue of animals with MS. In addition, H. perforatum and O. biennis extracts decreased the clinical signs at the end of the experiment compared to the beginning of extract administration. We found that myelin was lost in MS group vs. control group. H. perforatum and O. biennis extract treatments decreased the amount of myelin loss in the MS + HP and MS + OB groups. We also observed amyloid deposition on vascular walls, in the cytoplasm of the neurons and in the intercellular space in the MS group. O. biennis and H. perforatum treated groups exhibited neither abnormal amyloid deposition nor obvious cell infiltration. The beneficial effects of O. biennis and H. perforatum for attenuating myelin loss and amyloid deposition suggest their therapeutic utility for treatment of MS.

A prospective randomized trial of labor induction with vaginal controlled-release dinoprostone inserts with or without oxytocin and misoprostol+oxytocin.

OBJECTIVE: This study was designed in an aim to compare the efficacies of three labor induction methods, dinoprostone (PGE2) vaginal insert with or without concomittant oxytocin and misoprostol (PGE1) combined with oxytocin infusion. METHODS: This was a prospective observational trial of nulliparous women undergoing labor induction from December 2006 to January 2007. Inclusion criteria were: gestational age between 36 to 42 weeks, singleton cephalic presentation of the fetus, intact membrane and unfavorable cervical Bishop score < 6, and absence of spontaneous uterine contractions. Participants were then randomly assigned to preinduction cervical ripening with a dinoprostone vaginal insert (10 mg) administered into the posterior fornix for a total of 12 hours without oxytocin (group I); with oxytocin (group II), and with misoprostol (50 microg) intravaginally in the posterior fornix with repeat dosing at 6-hour intervals with a maximum dose of four with oxytocin (group III). RESULTS: A total number of 106 women met the inclusion criteria without distribution for 19 cases in group I, 44 and 43 cases in groups II and III, respectively. There were no statistically significant differences in terms of the demographic characteristics, indication of labor induction, interval from-induction-to-delivery, cardiotocographic abnormalities and neonatal outcomes and mode of deliveries among the three groups (p > 0.05). CONCLUSIONS: Three methods of labor induction were equally efficient in achieving succesful delivery without any maternal and fetal adverse outcomes.

Effects of thymoquinone on liver miRNAs and oxidative stress in Ehrlich acid mouse solid tumor model.

We investigated the effects of thymoquinone (TQ) on the expression of liver microRNAs (miRNAs), liver histopathology and oxidative stress in Ehrlich acid solid tumor model induced mice. We used 24 male BALB/c mice divided randomly into three groups. Control (C) group mice were injected intraperitoneally (i.p.) with 0.5 ml saline for four weeks. Tumor (T) group mice were injected i.p. with 0.5 ml saline for four weeks, then Ehrlich acid tumor cells were injected subcutaneously into the neck to induce solid tumor formation. TQ (T + Tq) group mice injected i.p. with 10 mg/kg TQ for four weeks, then Ehrlich acid tumor cells were injected subcutaneously into the neck of the mice in this group to induce solid tumor formation. At the end of the study, liver from all groups were removed for histopathological and miRNAs analysis, and oxidative stress measurement. We found that the expression of miR-206b-3p was up-regulated and the oxidative stress and necrosis increased in the liver tissue of mice with Ehrlich acid solid tumor. TQ application decreased the oxidative stress, prevented necrosis, increased regeneration and down-regulated the expression of miR-206b-3p in the liver tissue.

Everolimus as an mTOR Inhibitor Suppresses Endometriotic Implants: an Experimental Rat Study.

Introduction Mammalian target of rapamycin is a pathway to block apoptosis. Recent studies showed that the activity of mammalian target of rapamycin pathway increases in endometriotic lesions. Aim of the present study was to study the effect of everolimus agent, a rapamycin analog, in an experimental endometriosis model. Materials and Methods Endometriosis established by the autotransplantation of uterine tissue in the peritoneal cavity was confirmed in 24 rats. The animals were then randomly divided into three groups to receive either everolimus (1.5 mg/kg/day, p. o.), anastrozole (0.004 mg/day, p. o.), or normal saline (0.1 mL, i. p.) for 14 days. Endometriotic foci were excised, stained with hematoxylin and eosin, and endometriosis was scored semiquantitatively. In addition, immunohistochemical examination were performed using primary antibodies of vascular endothelial growth factor, CD117, and Bax. Results Both anastrozole and everolimus lowered endometriosis scores. Significant decreases in ovarian follicles were observed following anastrozole treatment but not everolimus treatment. Conclusion Through its apoptosis-promoting effect, everolimus suppressed endometriotic foci without negatively affecting ovarian reserve. These findings support the hypothesis that everolimus merits further study on the way to developing a new endometriosis drug.

Sequential avulsion of the anterior inferior iliac spine in an adolescent long jumper.

We present here an unusual case of a sequential avulsion fracture of the anterior inferior iliac spine (AIIS), occurring first in the right and then the left AIIS, during long jump attempts. The case of a 17 year old boy with pain around his right groin, which first occurred during a long jump attempt, is presented. Radiographic examination revealed an avulsion fracture of the right AIIS. After conservative treatment, full athletic activity was allowed 2 months after the injury. However, 4 months later the patient returned with a similar pain in the opposite side of his groin. Radiographs revealed another fracture of the left AIIS. The boy underwent the same treatment protocol; he was examined with isokinetic dynamometry. No complication or re-injury occurred during the 2 year follow up period. In the present study, we introduce the first case of a sequential bilateral AIIS avulsion fracture caused by a long jump.

A novel osteochondral implant.

A novel implant for the use as an osteochondral graft was designed. This implant was prepared by stepwise formation of calcium phosphate crystals within the matrix of a lyophilised collagen sponge. Chondrocytes were then grown on this material to create the osteochondral implant. The implant was characterized with light microscopy, scanning electron microscopy (SEM), electron diffraction crystallography (EDX), and IR. It was observed with IR that the implant had a peak, that was not found so distinctly in its components, at 1400 cm(-1), implying a strong interaction of the two main ingredients of the implant, calcium phosphate and collagen. This strong interaction was also shown in the graft degradation test while the untreated collagen sponge degraded rapidly (in one day) the mineral loaded implant was able to maintain its integrity for two weeks. In the chondrocyte culture medium degradation of the implant was shown by a decrease of the calcium content and calcium to phosphorous ratio. Also, EDX revealed the presence of sulfur one and two weeks after incubation, an element not found among the components of the implant, possibly due to the development of an extracellular matrix. SEM showed that the form of the crystals of calcium phosphate differed depending on whether they were prepared on the template, collagen, or in the absence of a template. The chondrocytes appeared to be growing in number on the implant and their shapes were morphologically normal. The chondrocyte loaded collagen-calcium phosphate composite could thus be considered a potential tissue engineered osteochondral implant.

Angiodysplasia in a duodenal diverticulum as an unusual cause of upper gastrointestinal bleeding.

The majority of duodenal diverticula are asymptomatic but may also induce major haemorrhage on rare occasions. Gastrointestinal bleeding due to angiodysplasia in a duodenal diverticulum is very rare. We present a 70-year-old woman with repeated melaena in whom the diagnosis of angiodysplasia in a diverticulum of the fourth part of the duodenum could be made by standard upper endoscopy.

The effect of trimetazidine on intrahepatic cholestasis caused by carmustine in rats.

This study investigated the effect of trimetazidine (TMZ), known as an anti-oxidant agent, on intrahepatic cholestasis caused by Carmustine (BCNU) in rats. Rats were assigned into four groups. The first group (Saline) consisted of 12 rats, which were injected with 2 ml/kg of saline intraperitoneally (IP) 48 h before the study. The second group (corn oil group, n=15), which were injected with 2 ml/kg of corn oil IP 48 h before the study. The third group (BCNU group, n=16), which were injected with 2 ml/kg of corn oil+25 mg/kg BCNU IP 48 h before the study. The fourth group (TMZ group, n=12), which were injected with 2.5 mg/kg per day of TMZ IP, administered at the same hour of the day as a single-dose. Twelve hour after the first dose of TMZ, corn oil 2 ml/kg+BCNU 25 mg/kg IP were injected, and the rats were included in the study 48 h after the administration of corn oil+BCNU. Following a pentobarbital anaesthesia, abdomen was opened with incision, a cannula was placed into the channel of choledocus, and the amount of bile was measured per hour. Then intracardiac blood sample was taken, and consequently centrifuged to obtain the plasma. Finally, the rats were killed with cervical dislocation, and their livers were removed and weighted. In addition to histopathological examination of liver, the levels of malon dialdehyde (MDA), oxidised glutation (GSSG), and reduced glutation (GSH) were detected. Also the osmolality of bile and plasma was estimated in mOsm/kg. As a result, the biliary flow was seen to decrease in BCNU group (P<0.005), but to be normal in TMZ group. The serum level of conjugated biluribin was higher in BCNU group compared to other groups (P<0.05 for each). Although the level of total glutation was lower (P<0.005) in TMZ group, GSH/GSSG ratio was normal. These findings suggest that TMZ has a protective effect on intrahepatic cholestasis caused by BCNU.

Omnivariate decision trees.

Univariate decision trees at each decision node consider the value of only one feature leading to axis-aligned splits. In a linear multivariate decision tree, each decision node divides the input space into two with a hyperplane. In a nonlinear multivariate tree, a multilayer perceptron at each node divides the input space arbitrarily, at the expense of increased complexity and higher risk of overfitting. We propose omnivariate trees where the decision node may be univariate, linear, or nonlinear depending on the outcome of comparative statistical tests on accuracy thus matching automatically the complexity of the node with the subproblem defined by the data reaching that node. Such an architecture frees the designer from choosing the appropriate node type, doing model selection automatically at each node. Our simulation results indicate that such a decision tree induction method generalizes better than trees with the same types of nodes everywhere and induces small trees.

Influence of sugar supplementation of the extender on motility, viability and acrosomal integrity of dog spermatozoa during freezing.

Influence of different sugars supplemented to the extender on the motility, viability and intact acrosome rates of dog spermatozoa during dilution, equilibration and freezing was studied. The ejaculate was divided into 10 aliquots, which were diluted 1:3 with TRIS-citric acid extender containing 240 mMTRIS, 63 mM citric acid, 8% (v/v) glycerol, 20% (v/v) egg yolk and 70 mM sugar, which was either fructose, galactose, glucose, xylose (monosaccharide), lactose, trehalose, maltose, sucrose (disaccharide) or raffinose (trisaccharide). No sugar was added to the extender in the control group. Extended semen samples were cooled to 5 degrees C over 45 min, packaged in 0.25-mL straws, equilibrated for 2 h at 5 degrees C and frozen in liquid nitrogen vapor. Samples were thawed by placing straws into 37 degrees C water for 30 sec. Motility, viable sperm and intact acrosome rates decreased gradually in all groups after equilibration and consecutively freezing (P<0.001). The type of sugar significantly effected motility, viability and acrosomal integrity during equilibration and freezing (P<0.05). Galactose, lactose, trehalose, maltose and sucrose reduced damaged acrosome percentages in equilibrated samples (P<0.05). Sugar supplementation did not enhance motility and viability during equilibration. The disaccharides, except lactose, reduced post-thaw dead sperm and/or damaged acrosome percentages without promoting post-thaw motility (P<0.01), whereas monosaccharides, especially fructose and xylose, improved motility (P<0.05) along with viability and intact acrosome rates (P<0.05). Trehalose, xylose and fructose significantly increased total active sperm rates (motility x live sperm rate x normal acrosome rate) compared to other sugars (P<0.01) and control (P<0.0001) in frozen thawed samples. Therefore, sugar supplementation of the extender influenced post-equilibration and post-thaw sperm quality, and the type or locality of protective impact of the sugar on dog spermatozoa vary according to type of the sugar.

The stretch-shortening cycle of the internal rotators muscle group measured by isokinetic dynamometry.

BACKGROUND: The ability to measure the stretch-shortening cycle of isolated muscle groups has been limited. The purpose of this study was to measure the stretch-shortening cycle of the internal rotator muscle group. METHODS: Sixty-eight volunteer subjects, 35 men and 33 women, participated in one test session; eight men and eight women also participated in a retest session; to examine the reliability of the test. A concentric contraction of the dominant internal rotator was measured for peak torque, standardized peak torque, power, standardized power and acceleration time on a Cybex Norm isokinetic dynamometer under three conditions: 1) concentric contraction only, 2) isometric preload before a concentric contraction, and 3) eccentric preload before a concentric contraction. RESULTS: Condition 3 showed a significant increase in peak torque production compared to condition 1 (p=0.001). Conditions 2 and 3 showed a significant increase in power production compared to condition 1 (p=0.0001, p=0.003). A significant difference was found in all three conditions between the men and women, with the men producing greatest peak torques and powers. CONCLUSIONS: The testing protocol was found to have high reliability. This testing protocol could be used to further study the stretch-shortening cycle in the internal rotator muscle group.

A study of the prevalence of having fractures and the affecting factors in young male adults throughout childhood and adolescence.

Injuries due to accidents in children and adolescents, who are more sensitive to different risk factors in their social and physical environments, play an important part in mortality and morbidity. Fractures are the most commonly seen problems among these injuries. This cross-sectional study was carried out in a two-year vocational military school in Ankara between 1-10 May 2000. All, 2720 students in the school were included and data were collected via a questionnaire distributed to the students. It was found that 418 (17%) out of 2,461 students we could interview had had a fracture. No statistically meaningful relationship was found between the frequency of having fractures and the educational status of the parents or employment status of the mother. However, it was seen that the frequency of fractures increased as the economical status of the parents increased. The high frequency of fractures in childhood and adolescence in young males, and the traditional practice of going to unlicensed and medically untrained adults, and "bonesetters" (27% of those surveyed) are two important findings that should be taken into consideration.

Outcomes of acute arthroscopic repair and conservative treatment following first traumatic dislocation of the shoulder joint in young patients.

INTRODUCTION: The aim of this study was to compare patients who had arthroscopic repair done following the first traumatic dislocation with patients who were treated conservatively, in terms of stability and function. MATERIALS AND METHODS: Acute arthroscopic Bankart repair with absorbable tack was used in 30 shoulders after the first dislocation, while 32 patients who sustained traumatic anterior dislocation were treated conservatively at Gülhane Military Medical Academy, Department of Orthopaedics and Traumatology between March 1997 and April 2001. Preoperative and postoperative range of motion of the shoulder and Constant score of all patients were recorded. RESULTS: In the conservative group, the average pretreatment Constant score was 46.8 (range, 30 to 70) and the average post-treatment Constant score was 71.4 (range, 30 to 95). In the surgical group, the average preoperative Constant score in cases with Bankart lesion was 44.7 (range, 30 to 60) and the average postoperative Constant score was 92.3 (range, 65 to 100), (P = 0.0001). CONCLUSION: Our results support the use of acute arthroscopic repair of traumatic anterior shoulder dislocations with absorbable tacks. Arthroscopic repair is the treatment of choice in young and active patients who are having their first traumatic dislocation.