THE RELATIONSHIP BETWEEN TSH LEVELS, THYROID AUTOANTIBODIES AND ATHEROGENIC INDEX OF PLASMA, AST TO PLATELET RATIO INDEX SCORE, AND FIBROSIS 4 INDEX IN PATIENTS WITH HYPOTHYROIDISM.

Context: Thyroid hormones have metabolic effects such as relationship between hypothyroidism and atherosclerosis. Objective: Evaluate the effects of hypothyroidism on Non-Alcoholic Fatty Liver Disease and atherosclerosis by using AIP, APRI score, FIB-4 indices. Material and Methods: 1370 patients with hypothyroidism who applied to the Endocrinology and Metabolism outpatient clinic between 01.01.2017-30.12.2021 were included the study. Pregnants, patients with a history of thyroid carcinoma, cardiovascular and liver diseases were excluded. TSH, fT4, Anti TPO, Anti TG, thrombocyte, ALT, AST, HDL, Triglyceride values of the cases were analyzed and atherogenic index of plasma (AIP), AST to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) indices were calculated. Results: 1170 (85.4%) of the cases were female.The age of those who had high risk of AIP was found to be higher than those with low and moderate risk (p=0.001; p=0.003; p<0.01). The ages of those who had low-risk FIB-4 Index were found to be lower than those with moderate risk and high risk (p=0.001; p=0.001; p<0.01). A positive relationship was detected between APRI and FIB-4 (r=0.681; p=0.001; p<0.01).AIP increased as TSH increased in hypothyroid patients. No significant correlations were detected between TSH, APRI, and the FIB-4 Index. No significant differences were detected between AIP, APRI, FIB-4, and thyroid autoantibodies. Conclusion: In hypothyroid patients, the AIP index increased with age and the increase in TSH. A strong relationship was detected between AIP and TSH . For this reason, we think that keeping TSH within the normal range with regular follow-ups and treatment in patients with hypothyroidism will reduce the risk of atherosclerosis.

Evaluation of aqueous-deficient and evaporative dry eye cases with confocal microscopy.

INTRODUCTION: Dry eye disease (DED) is an important health problem affecting hundreds of millions of people worldwide. In vivo confocal microscopy (IVCM) is a non-invasive imaging tool that can visualize ocular surface diseases. In this study, we aimed to evaluate corneal structures and inflammatory cells with IVCM in DED patients. MATERIAL AND METHODS: The patients were divided into three subgroups: group 1, consisting of 22 patients with aqueous tear insufficiency; group 2, consisting of 21 patients with evaporative type DED; and group 3, consisting of 20 healthy patients. Imaging was performed with IVCM. The corneal epithelium, nerves, stroma, endothelial and inflammatory cells were compared between groups. RESULTS: There was a significant decrease in corneal epithelial cell density in cases with DED, and there was a significant increase in corneal basal epithelial cell density in the aqueous-deficient type. Keratocyte density was significantly increased in the aqueous-deficient type. A significant decrease in the number and density of sub-basal nerves was found in aqueous-deficient cases, and an increase was found in neural pilling and folding. Dendritic cell density, size, number and area were significantly increased in the aqueous-deficient type. There was also decreased corneal endothelial cell density in DED. CONCLUSION: We evaluated pathological changes in DED on the corneal surface by IVCM. This methodology is valuable in terms of objectively evaluating how the corneal surface is affected in accordance with disease severity and in predicting poor response to treatment.

Allium® ureteral stent, a new player in the treatment of ureteral stenosis: a prospective cohort study.

INTRODUCTION AND OBJECTIVES: Ureteral stricture is a chronic condition that can result in the obstruction of urinary drainage from the affected renal unit, leading to loss of renal function. Treatment methods can be categorized into two main headings: endourological and reconstructive procedures. We aimed to investigate the efficacy and safety of the self-expandable Allium® ureteral stent, which has been used in the minimally invasive treatment of ureteral stenosis in recent years. MATERIALS AND METHODS: Twenty patients who were applied Allium® ureteral stent between 2017 and 2021 included in the study. The demographic and clinical characteristics of the patients, the details of the treatments applied to the patients, the perioperative and postoperative complications, the treatments applied for the complications and the findings in the follow-up were recorded and evaluated prospectively. RESULTS: Etiology included urolithiasis in 16 patients (80%), malignancy in 3 patients (15%), and a previous gynecological operation in 1 patient (5%). Stent obstruction was found to be the most common complication in 3 patients (15%). Stent migration was the second most common complication in 2 patients (10%). Our follow-up continues with 15 patients without stent-related complications and stent obstruction. The mean follow-up period was 28 ± 15.7 months. CONCLUSIONS: Allium ureteral stent is an effective and reliable method in the minimally invasive treatment of ureteral stricture with complications seen at acceptable rates and ease of treatment in the management of complications.

When should contralateral testicular fixation be performed in postpubertal patients with testicular torsion: A comparative study.

OBJECTIVE: In this study, we aimed to describe the timing of contralateral testicular fixation with our ten year results in postpubertal patients with testicular torsion with a patient-based approach. METHODS: Postpubertal patients diagnosed with testicular torsion in a tertiary hospital between January-2012 and September-2022 were divided into 2 groups according to the "patient-based approach" criteria we adopted in our clinic. Group 1 in whom the contralateral teste was fixed in the same surgical act and group 2 in whom the fixation was deferred. Both groups, were retrospectively examined, statistically analyzed and compared. RESULTS: A total of 41 patients were included in the study. Among those, 19 (46.3%) were fixed in the same act, and 22 (53.7%) underwent postponed elective contralateral testicular fixation. Early term wound dehiscence was observed in one patient in each group (4.5% Group 1 vs. 5.3% Group 2). In the postoperative period, no contralateral testicular atrophy or torsion was detected in the study groups during 1-year follow-up. CONCLUSION: There is no algorithm for when contralateral testicular fixation should be performed in postpubertal patients with testicular torsion. Patient-based approaches, in which the clinical characteristics of the patient are prioritized in determining the timing of contralateral testicular fixation, can produce more effective and safe results.

The temperature induced current transport characteristics in the orthoferrite YbFeO3-δ thin film/p-type Si structure.

The perovskite ytterbium ferrite is a new ferroelectric semiconductor material. We presented the temperature induced current-voltage (I-V) characteristics of the Al/YbFeO3-δ/p-Si/Al hetero-junction. The orthoferrite YbFeO3-δ thin films were deposited on a single crystal p-type Si substrate by a radio frequency magnetron sputtering system. The potential barrier height (BH) [Formula: see text] and ideality factor n of the heterojunction were obtained by thermionic emission current method based on the recommendations in the literature. The fact that the calculated slopes of I-V curves become temperature independent implying that the field emission current mechanism takes place across the device, which has been explained by the presence of the spatial inhomogeneity of BHs or potential fluctuations. Moreover, a tunneling transmission coefficient value of 26.67 was obtained for the ferroelectric YbFeO3-δ layer at the Al/p-Si interface.

Frequency and temperature-dependent electric modulus spectroscopy of osmium-doped YbFeO3 structure.

Orthoferrites have occupied important place in the material science and condensed matter physics investigations due to their unique features such as electrical, magnetic and optical. The present investigation illuminates light on the electrical properties of osmium (Os) doped YbFeO3 (YbFO) rare-earth orthoferrite. The undoped YbFO and YbFe1-x Os x O3 (YbFOO) (x = 0.01 and 0.05) powders were synthesized via solid-state. X-ray diffractometer (XRD) has been utilized to examine the crystal structure of the YbFO and YbFOO powders. The cross sectional morphology of the obtained pellets was inspected via scanning electron microscope (SEM). Moreover, x-ray photoelectron spectroscopy was exploited to determine the oxidation states of the constituted elements. The electrical features for instance electrical modulus, dielectric constant and conductivity of the synthesized pellets were detailed at different frequencies and temperatures by dielectric/impedance spectroscopy studies. The x = 0.01 Os doped sample exhibits higher dielectric constant and conductivity compared to other samples. Moreover, in order to explain conductivity mechanism of the studied samples, multiple conduction models are needed to employ.

Our clinical experience on calcaneal bone cysts: 36 cysts in 33 patients.

BACKGROUND: Solitary bone cysts are lesions of benign nature with fluid content. The frequent locations for these cysts are the proximal femur or humerus. Rarely, they may occur in locations such as the calcaneus, mostly in adults. We have reported the second largest case series of calcaneal bone cysts. MATERIALS AND METHODS: Thirty-six calcaneal cysts in 33 patients, 3 of which showed bilateral involvement, diagnosed, and followed between 1995 and 2008 in our clinic were retrospectively evaluated. RESULTS: The third most common location was the calcaneus, with cysts in 36 (14%) patients. The age range of the patients was 13-74 years (mean, 37.9 years). The complaints of the patients upon presentation to the hospital were heel pain in 16 patients (44.4%). Eighteen patients (50%) underwent surgical treatment, of these ten patients (27.7%) were treated with curettage and autogenous iliac wing grafting. CONCLUSIONS: Simple bone cysts with the location of calcaneus are not a rare entity. According to our series, simple bone cysts have been shown to be typically located in the calcaneus bone in middle-aged patients in particular. Furthermore, in such patients, heel pain is considerably severe, which is a symptom to be kept in mind in differential diagnosis. Curettage and autogenous grafting is the successful method of treatment and it provides good results.

Bilateral capitellum humeri fracture; a case report.

This is the report of a 33-year-old female patient who was admitted to the Emergency Department with bilateral capitellum humerus fracture after a fall from a height. The patient was surgically treated with open reduction and internal fixation for both elbows, with 3 Kirschner wires on the right elbow and one mini-fragment screw on the left. Surgical intervention was carried out in emergency conditions. Following an early physical rehabilitation programme at the end of the 1st week, the roentgenograms in the 9th week showed acceptable bone union. However, in the 2nd year of follow-up the patient had consistent pain and 35 degrees of flexion loss in her right elbow due to degenerative change. The literature reveals only two reports of such cases. Thus, this rare case of bilateral capitellum humerus showed that early mobilisation after anatomic reduction and stable fixation with a mini-screw provided the optimal outcome.

The protective effect of aprotinin and alpha-tocopherol on ischemia-reperfusion injury of the rat liver.

BACKGROUND: Liver injury caused by ischemia-reperfusion (I/R) processes is a complication of hepatic resection surgery and transplantation, particularly using grafts from marginal donors. Despite improvements in organ preservation and advances in surgical techniques, I/R injury remains a significant clinical problem. In this study, we investigated whether aprotinin provided protection against the adverse effects of I/R injury in liver tissue. METHODS: Forty rats were randomized into four groups (n = 10): group I: (control group) I/R + no medication; group II: sham-operated group + no medication or I/R; group III: I/R + aprotinin; group IV: I/R + alpha-tocopherol. Malondialdehyde (MDA) was measured in the liver tissue and superoxide dismutase (SOD), catalase (CAT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactate dehydrogenase (LDH) in rat serum. RESULTS: Administration of aprotinin and alpha-tocopherol before I/R resulted in significant reductions of MDA levels compared to the I/R alone group (group I; P = .01 and P < .01, respectively). Administration of aprotinin or alpha-tocopherol prior to I/R resulted in significant increases in SOD and CAT levels compared with the I/R group (P < .05 each). Compared to the I/R group, significant decreases in plasma AST, ALT, and LDH levels were observed both in the aprotinin and in the alpha-tocopherol group (P < .05). Histological evaluation revealed the injury grade to be relatively lower among groups III and IV compared to group I. DISCUSSION: In conclusion, rat hepatic structures in aprotinin and alpha-tocopherol administered groups were well protected. Therefore, aprotinin may provide protection against the adverse effects of I/R injury in liver transplantation.

The electrical modulus and other dielectric properties by the impedance spectroscopy of LaCrO3 and LaCr0.90Ir0.10O3 perovskites.

We have prepared LaCrO3 (LCO) and 10% Ir doped LCO samples by the solid state reaction method and studied the electrical modulus and the other dielectric properties of the samples by means of the impedance spectroscopy in the -100 °C to 100 °C range, with steps of 20 °C. It has been clearly observed that the dielectric properties change due to Ir doping. The absolute dielectric constant value of Ir doped LCO has decreased and this reduction was attributed to decreasing Cr6+ ions which may play a vital role in space charge polarization and charge hopping. A plateau region appeared in the temperature-dependent real electrical modulus M' versus f curves of the pure LCO sample while almost no plateau region is visible in the Ir doped LCO sample. The temperature-dependent imaginary modulus M'' versus f curves has two peaks at each temperature; one of the peaks is at low frequency and the other at the high frequency region, which shifts through higher frequency region with increasing temperature. This originates from free charge accumulation at the interface with the increase of the temperature. Furthermore, it has been seen that the Ir doped LCO sample has higher impedance and resistance values than the undoped LCO sample at the same frequency and temperature. This phenomenon was attributed to doped Ir ions behaving like a donor in LCO because LCO is a p-type compound. Moreover, the activation energy values of 0.224 eV and 0.208 eV for LCO and of 0.161 eV and 0.265 eV for the Ir doped LCO have been obtained from the slopes of the ρ dc vs. (kT)-1 curves, respectively. Also the activation energies were calculated from the slopes of the f max vs. (kT)-1 curves and the obtained results from low frequency region were in good agreement with ρ dc vs. (kT)-1 ones.

Influence of Different ECM-Like Hydrogels on Neurite Outgrowth Induced by Adipose Tissue-Derived Stem Cells.

Mesenchymal stem cells (MSCs) have been proposed for spinal cord injury (SCI) applications due to their capacity to secrete growth factors and vesicles-secretome-that impacts important phenomena in SCI regeneration. To improve MSC survival into SCI sites, hydrogels have been used as transplantation vehicles. Herein, we hypothesized if different hydrogels could interact differently with adipose tissue-derived MSCs (ASCs). The efficacy of three natural hydrogels, gellan gum (functionalized with a fibronectin peptide), collagen, and a hydrogel rich in laminin epitopes (NVR-gel) in promoting neuritogenesis (alone and cocultured with ASCs), was evaluated in the present study. Their impact on ASC survival, metabolic activity, and gene expression was also evaluated. Our results indicated that all hydrogels supported ASC survival and viability, being this more evident for the functionalized GG hydrogels. Moreover, the presence of different ECM-derived biological cues within the hydrogels appears to differently affect the mRNA levels of growth factors involved in neuronal survival, differentiation, and axonal outgrowth. All the hydrogel-based systems supported axonal growth mediated by ASCs, but this effect was more robust in functionalized GG. The data herein presented highlights the importance of biological cues within hydrogel-based biomaterials as possible modulators of ASC secretome and its effects for SCI applications.

Evaluation of effects of ischaemia on the albumin cobalt binding (ACB) assay in patients exposed to trauma.

BACKGROUND: In the emergency department (ED), the diagnosis of acute myocardial ischaemia is very difficult because of the absence of a rapid, reliable diagnostic test. The albumin cobalt binding (ACB) assay is a good candidate as a marker for for detection of myocardial ischaemia, as it is an easy and rapid test. To date, however, the way in which alterations in metal binding sites of human serum albumin depend on ischaemic events has not been reported in detail. METHODS: We studied 92 patients admitted to the ED within 1 hour after exposure to trauma. Trauma patients divided into two groups according to their Injury Severity Score (ISS): group 1 comprised mildly injured patients who had ISS trauma score <15 (n = 60), and group 2 comprised moderately injured patients with ISS trauma score >15 (n = 32). The blood specimens of 30 healthy volunteers were studied as a control group. RESULTS: Group 2 showed significantly increased ACB levels (0.63 (0.18) absorbance units (ABSU)) compared with group 1 (0.54 (0.14) ABSU) (p<0.05) and controls (0.39 (0.05) ABSU) (p<0.01). Group 1 showed significantly enhanced ACB values compared with controls (0.54 (0.14) v 0.39 (0.05) ABSU) (p<0.01). CONCLUSION: Consequently, trauma enhances ACB levels, which may affect the diagnostic performance of the ACB assay, and this effect can limit the ability of the assay for detection of myocardial ischaemia in patients exposed to trauma.

Questioning the psycho-socio-cultural factors that contribute to the cases of suicide attempts: an investigation.

Suicide attempts can be described to include all actions taken by an individual to end their life as a result of acute desperation. In parallel with the changes in the make-up of human societies both globally and in this country in recent years, suicide attempts are receiving attention in ever increasing proportions. The current study is aimed at investigating the psycho-socio-cultural factors that contribute to the known cases of suicide attempts. The study included 116 cases admitted to the Emergency Internal Medicine and Surgery Units of the University of Istanbul, Faculty of Medicine Hospital between 1 December 1998 and 31 May 1999. In only 47 cases, a 30-point questionnaire was used in several face-to-face interviews with the patients following the preparation of a clinical case study. In establishing the socio-demographic, socio-cultural and socio-economic attributes of each individual case, a range of contributing effective factors is questioned. Including the specific reasons for each suicide attempt, the emotional state of the individual prior to the suicide attempt, the type of suicide action chosen and reasons for this selection, immediate family structure, personal psychiatric antecedent, substance abuse. The results of our investigations are compared with the existing literature in a multi-faceted discussion.

Clinical management of hydatid disease of the urinary tract.

This study reviews urinary hydatid disease in seven males and three females (mean age, 32.1 +/- 17.7 years; range, 7-67 years). Cysts were located in the kidney in six cases (one also involved the liver), the paravesical and retrovesical region in two cases (one coexisted with a bladder tumour), the adrenal gland (one case) and in the right parapelvic region (one case). Investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), abdominal ultrasonography, intravenous urography and computed tomography (CT). All patients underwent surgery and were followed for an average of 5.6 years. Lumbar or abdominal pain was the most common symptom. Eosinophilia was seen in five patients (50%), IHA positivity occurred in four patients (40%) and the Casoni skin test was positive in four patients (40%). Abdominal CT was the most useful diagnostic method of radiological investigation (100%). No complications or recurrences were seen on follow-up. Urinary hydatid disease is uncommon and is likely to cause considerable diagnostic difficulties, and should therefore be considered in the differential diagnosis of space-occupying lesions of the urinary tract.

Postgraduate forensic science education in Turkey.

Legal medicine in Turkey, has an educational background that goes back to 1839 and the first autopsy in modern terms was performed in 1841. In the early days, it was common practice for those involved in this work to extend their investigative knowledge into areas not directly concerned with medical matters. However forensic medical investigations cannot be entrusted in the hands of single investigators, but should rather be dealt with by cooperative groups of experts nowadays. This need was the major force for the establishment of the Institute of Legal Medicine and Forensic Sciences by a special article of the law (section 2547) as a training and research center in 1982. The Institute being the first and only institution giving master's and doctorate degrees in Forensic Sciences, has 3 major departments: 1) Medical Sciences Department, 2) Basic Sciences Department and 3) Social Sciences Department. Graduates of various fields ranging from medical doctors specialized in any field, biologists, chemists to lawyers, district attorneys, psychologists and other related fields are composing the multidisciplinary structure of the institute. The main research fields of the Institute are: population genetics, paternity investigation, child abuse, and identification of human remains.

Hydatid disease of the urinary tract: review of the management of 9 cases.

The aim of this study is to review 9 cases with urinary tract hydatid disease in terms of symptoms, findings, laboratory tests, radiological findings and treatment modalities. There were 7 males and 2 females with a mean age of 33.6 years (range from 7 to 67 years). In 6 patients hydatid cyst was located in the kidney (1 involved the liver), in 2 the cysts were in the paravesical and retrovesical region (1 coexisted bladder tumor) and 1 the cyst was located adrenal gland. The investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), transabdominal ultrasonography (TAUS), intravenous urography (IVU) and computed tomography (CT). All patients underwent various surgical procedures and were followed-up for an average of 3 years (range: 1 month to 5 years) period in terms of complications and recurrence rates. The most common symptom was lumbar or abdominal pain. Eosinophilia was seen in 4 patients (44.4%), IHA positivity in 3 patients (33.3%) and Casoni skin test were positive in 3 patients (33.3%). The most diagnostic method of radiological investigations was abdominal pelvic CT (100%). After surgical treatment, in mean a 3 year (range: 1 month to 5 years) follow-up period, no complication and recurrence were seen. Hydatid disease of the urinary tract is relatively uncommon and is likely to cause considerable diagnostic difficulties for clinicians and radiologists: therefore, it should be born in mind in the differential diagnosis of space-occupying lesions of the urinary tract.

Transvesical and transvaginal reparation in urinary vaginal fistulas.

Thirty-two cases of urinary vaginal fistulas treated surgically at our Department between 1985 and 1991 have been reviewed retrospectively. There were 26 cases of vesicovaginal fistulas, 1 case of urethrovaginal fistula and 5 cases of ureterovaginal fistulas. Gynaecological surgery was the leading cause of the fistulas (24/32). Eight cases of vesicovaginal fistulas and 1 case of urethrovaginal fistula were repaired transvaginally, with 88.8 per cent success. Seventeen cases of vesicovaginal fistulas were repaired by suprapubic transvesical approach, with 88 per cent success at the first attempt and 94 per cent success at 2 attempts. One patient with vesicovaginal fistula underwent ureterosigmoidostomy. Ureterovaginal fistulas were repaired successfully by simple ureteroneocystostomy in 4 cases and 1 case of ureterovaginal fistula required ureteric substitution with a Boari bladder flap.

Pharmacotherapy of benign prostatic hyperplasia: inhibitor of 5 alpha-reductase.

We studied the effects of 5 alpha-reductase inhibitor (finasteride) in the treatment of benign prostatic hyperplasia (BPH). This study is a randomized controlled trial. Sixty-two patients were treated with 5 alpha-reductase (finasteride 5 mg/day) and 61 patients (control group) with placebo for one year. Prostatic volume, maximal urine flow rate, AUA symptom scoring, residual urine volume and prostate-specific antigen (PSA) levels were evaluated at 3, 6, 9 and 12 months. In the first 6 months prostatic volume decreased rapidly (20.5%), in the second 6 months it decreased slowly and reached the maximal rate (23.3%). Maximal urine flow rate increased in the second 6 months. AUA symptom scores decreased first at 3 months and were 4.6 points lower at the end of the 12th month. There were no significant changes in residual volume. The 5 alpha-reductase inhibitor caused a 50% decrease in PSA levels, like in other studies. Because of the prolonged use of the drug, treatment with 5 alpha-reductase inhibitor is not tolerated by many patients and being expensive its future in the pharmacotherapy of BPH is unclear.

Peyronie's disease: intralesional treatment with interferon alpha-2A and evaluation of the results by magnetic resonance imaging.

In this clinical study, to determine the therapeutic efficacy of interferon (IFN) treatment for Peyronie's disease, we applied interferon alpha-2A (IFN alpha-2A) intralesionally in the treatment of Peyronie plaques in 15 patients and results were evaluated by magnetic resonance imaging (MRI). Patients whose plaque sizes were 0.5 and 1 cm responded better to the treatment. There was about a 90% lessening in the sizes of the plaques of 1.5 cm, 83.3% of 2 cm, as the ones which were 0.5 cm and 1 cm disappeared completely after treatment. As a conclusion, the treatment of Peyronie's disease with IFN alpha-2A is effective and side effects are minimum.

Transitional cell carcinoma of the bladder in patients under 40 years of age.

A review of our records between 1993 and 1998 identified 25 patients with transitional cell carcinoma of the bladder who were less than 40 years old, 22 males and 3 females. The youngest patient was 19 years old. At the time of diagnosis 16 patients had superficial (Ta/T1) and 9 had invasive disease. Twenty-four patients were followed up for a period of 3-71 months (mean: 19.2 months). The recurrence rate for patients with superficial disease was 12.5%, and the progression rate for patients with invasive disease was 77.7%. We concluded that the patients under 30 years of age presented with lower grade and lower stage disease than those over 30. Transitional cell carcinoma of the bladder in young adults has a natural history similar to that seen in older patients. Accordingly, all patients, regardless of age, should be treated as aggressively as necessary on the basis of the stage and the grade of the tumour.