Bioinformatic Investigation of Genetic Changes in Paraoxonase Genes in Breast Cancer and Breast Cancer Subtypes.

OBJECTIVE: Among women, breast cancer (BC) is the most prevalent form of cancer. Many molecular targets have been discovered for BC prognosis and treatment. However, new markers still need to be identified, as cancer pathogenesis is triggered by different mechanisms. The aim of this study was to examine the changes in the paraoxonase genes (PON1, PON2, and PON 3) involved in the pathogenesis of BC. MATERIALS AND METHODS: The characteristics of the mutations were evaluated with the Cbioportal database. Kaplan-Meier Plot evaluated recurrence-free survival (RFS). The UALCAN database determined the promoter methylation. Gene expression was evaluated by GEPIA2.0 database. RESULTS: PON1 harbored the most mutations. There was a significant decrease in PON3 expression levels in BC samples compared with healthy samples. PON1 and PON2 expression levels did not differ between BC tissue and normal adjacent tissue. Elevated expression levels of PON1 and PON2 genes were correlated with longer RFS, whereas reduced expression of the PON2 gene showed an association with longer RFS. Moreover, the promoter regions of PON1 and PON 3 were found to be hypermethylated, while the promoter region of PON 2 was found to be hypomethylated. The PON3 promoter region was significantly hypermethylated in luminal and human epidermal growth factor receptor 2 (HER2) + BC subtypes. However, the PON3 promoter region was significantly hypomethylated in the triple negative breast cancer (TNBC) subtype. CONCLUSION: These results suggest that methylation and expression status of PON3 in BC and BC subtypes (TNBC, luminal and HER2) may indicate a poor prognosis. The PON3 gene could be a negative prognostic marker in BC. However, the results should be supported by prospective studies.

Diagnosis and treatment of solid pseudopapillary tumor of the pancreas: A single center's experience.

OBJECTIVE: The present study reviews the records of patients with solid pseudopapillary pancreas neoplasm (SPT). METHODS: A total of 13 patients diagnosed with SPT were included in the study. The criteria for SPT in the pathology specimens were the presence of cells with an oval round orthochromatic nucleus, with a thin chromatin structure and no nucleolus distinction, lined around a fibrovascular papilla in cystic areas. RESULTS: The study included 11 female and two male patients, with a mean age of 33.07 (range: 16-73) years. All operated patients underwent open surgery, with five undergoing a subtotal pancreatectomy and splenectomy; one a distal pancreatectomy and splenectomy; four a spleen-preserving distal pancreatectomy; and one a pancreaticoduodenectomy. None of the operated patients developed recurrence during the long-term follow-up. The mean follow-up time of operable patients was 69.18 (range: 22-97) months, and none had metastasis at follow-up. The mean follow-up time for the malignant SPT patients was 2.75 (1.5-4) months. CONCLUSION: SPTs are rare pancreatic tumors encountered more frequently today due to advances in imaging methods and have a low potential of recurrence and a good prognosis.

The impact of subdermal adipose derived stem cell injections and early excision on systemic oxidative stress and wound healing in rats with severe scald burns.

AIM: This study aims to develop an experimental treatment model effective against oxidative stress in the acute period of severe burns and to analyze the mechanisms of healing large wound defects. METHODS: Five rats, including 2 females and 3 males, were used as donors to obtain adipose-derived stem cells (ADSC) from the inguinal fat pad. The stem cells were labeled with green fluorescent protein. The study included four groups of 17 rats, each with grade 3 scalding burns on 30 % of their body surface, and a control group of 10 rats with an equal number of males and females. After early excision, 106 ADSC-derived stem cells were administered subdermally to the burned wound and autografted to the stem cell group (n = 17). The early excision group (n = 17) received early excision and autograft, with 2 ml of normal saline injected subdermally into the burn wound edge. The PLM group (n = 17) was treated with a polylactic membrane (PLM) dressing after the burn. No treatment was given to the burn group (n = 17). Ten rats from all groups were sacrificed on the 4th day post-burn for oxidative stress evaluation. The control group (n = 10) was sacrificed on day 4. Blood and tissue samples were collected post-sacrifice. Oxidative stress and inflammation in the blood, as well as cell damage in the skin, liver, kidneys, and lungs, were investigated histopathologically and biochemically on the 4th day post-burn. On the 70th day after burn, wound healing was examined macroscopically and histopathologically. RESULTS: On the 4th day, oxidative stress results showed that the levels of Total Oxidative Capacity (TOC) in the blood were lowest in the stem cell (7.4 [6-8.8]), control (6.7 [5.9-7.6]), and early excision (7.5 [6.6-8.5]) groups, with no significant difference between them. The burn group (14.7 [12.5-16.9]) had the highest TOC levels. The PLM group (9.7 [8.6-10.7]) had lower TOC levels than the burn group but higher levels than the other groups. Histopathological examination on the 4th day revealed low liver caspase-3 immunoreactivity in the stem cell and early excision groups among the burn groups. Caspase-3 immunoreactivity levels were as follows: stem cell group (20 [10-30]), early excision group (25 [15-50]), PLM group (70 [50-100]), control group (0), and burn group (80 [60-120]). Other oxidative stress and end-organ damage outcomes were consistent with these results. All rats in the stem cell group had burn wounds that healed completely by the 70th day. Examination of the skin and its appendages from the stem cell group with an immunofluorescence microscope demonstrated green coloration, indicating incorporation of stem cells. CONCLUSION: Stem cells may have the potential to form new skin and its appendages, providing better healing for large skin defects. Early excision treatment, by removing local necrotic tissues after extensive and deep burns, can prevent end-organ damage due to systemic oxidative stress and inflammation. We also believe that when these two treatments are used together, they can achieve the best results.

Diagnostic Benefits and Surgical Implications of Methods for Tumor Localization in Sigmoid and Rectum Tumors.

(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon admission, we examined the patients' first diagnostic colonoscopies and their preoperative repeat control colonoscopies and computed tomography (CT) report. (3) Results: In this study, 23 patients (57.5%) were male. The overall accuracy rates were 80.0% (32/40) in colonoscopy, 65.0% (26/40) in preoperative CT, and 87.5% (35/40) in retro CT, and the differences among the examination methods were statistically significant (p = 0.049). The sensitivity levels decreased to 50.0% for colonoscopy and preoperative CT and 75.0% for retro CT in rectosigmoid colon tumors. In rectal tumors, the sensitivity levels were 75.0% in colonoscopy, 60.0% in preoperative CT, and 80.0% in retro CT. In two patients, the tumor location was given incorrectly, and postoperative pathological evaluations indicated T3N0 tumors; the initially planned treatment was thus changed to include radiotherapy in addition to chemotherapy in the postoperative period because the tumor was located in the middle rectum. (4) Conclusions: Accuracy in tumor localization in sigmoid, rectosigmoid, and rectum tumors still needs to be improved, which could be accomplished with prospective studies. CT evaluations for cancer localization in this patient group should be re-evaluated by a radiologist.

Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results.

(1) Background: We aimed to identify the possible relationship between various diseases of the upper digestive system and colon polyps by analyzing patients with gastric polyps and evaluating the cancers and diseases accompanying the polyps. (2) Methods: Each patient's age; gender; polyp type and size; presence of Helicobacter pylori (H. pylori), atrophic gastritis, and intestinal metaplasia; status of whether cancer developed during follow-up; status of whether a colonoscopy was performed or not; and colon pathologies detected during colonoscopy were analyzed retrospectively using hospital records. (3) Results: Between the study dates, 19,214 esophagogastroduodenoscopies were performed in the endoscopy unit of our hospital. Gastric polyps were detected in 178 (0.9%) patients. No significant relationship was found between the gastric polyp size and the occurrence of gastric cancer or gastrointestinal system malignancy (p > 0.05). A colonoscopy was performed in 86 of the 178 patients who underwent gastroscopy. The frequency of polyp detection during colonoscopy was statistically significantly higher in patients with gastric polyps than in patients without gastric polyps (p < 0.001). (4) Conclusions: New prospective studies are needed regarding the relationship between gastric polyps and gastrointestinal system diseases. Going forward, a colonoscopy will be required in gastric polyp patients, especially with FGP.

The Effect of Pringle Maneuver Applied during Living Donor Hepatectomy on the Ischemia-Reperfusion Injury Observed in the Donors and Recipients.

Background and Objectives: The aim of this study is to evaluate the clinical and laboratory changes of ischemia and reperfusion injury in the remnant livers of donors with and without Pringle maneuver. Furthermore, we evaluated the recipients who have been transplanted with liver grafts from these donors. Methods and Materials: A total of 108 patients (54 living liver donors and 54 liver recipients) who underwent donor hepatectomy and recipients who living donor liver transplantation, were included in this randomized double-blind study between February 2021 and June 2021. The donors were divided into two groups: Pringle maneuver applied (n = 27) and Pringle maneuver not applied (n = 27). Similarly, recipients with implanted liver obtained from these donors were divided into two groups as the Pringle maneuver was performed (n = 27) and not performed (n = 27). Blood samples from donors and recipients were obtained on pre-operative, post-operative 0 h day (day of surgery), post-operative 1st day, post-operative 2nd day, post-operative 3rd day, post-operative 4th day, post-operative 5th day, and liver tissue was taken from the graft during the back table procedures. Liver function tests and complete blood count, coagulation tests, IL-1, IL-2, IL-6, TNF-α, and ß-galactosidase measurements, and histopathological findings were examined. Results: There was no statistically significant difference in the parameters of biochemical analyses for ischemia-reperfusion injury at all periods in the donors with and without the Pringle maneuver. Similarly, there was no statistically significant difference between in the recipients in who received liver grafts harvested with and without the Pringle maneuver. There was no statistically significant difference between the two recipient groups in terms of perioperative bleeding and early bile duct complications (p = 0.685). In the histopathological examinations, hepatocyte damage was significantly higher in the Pringle maneuver group (p = 0.001). Conclusions: Although the histological scoring of hepatocyte damage was found to be higher in the Pringle maneuver group, the Pringle maneuver did not augment ischemia-reperfusion injury in donors and recipients that was evaluated by clinical and laboratory analyses.

C-terminal cross-linking telopeptide levels in COVID-19 patients: A prospective case-control study.

BACKGROUND: Coronavirus disease 19 (COVID-19) is a viral infection mediated by coronavirus-2 that causes severe acute respiratory syndrome (SARS-CoV-2). The disease may affect biochemical parameters and electrolytes. C-terminal cross-linking telopeptide (CTX-I) is released during mature bone resorption and is a biomarker for predicting bone resorption. OBJECTIVES: As the pandemic progressed, understanding the effects of COVID-19 disease remained critical. Inflammatory responses triggered by the virus can result in a bone metabolism regulation imbalance. As such, this study aimed to analyze serum levels of CTX-I, calcium (CA), phosphorus (P), magnesium (Mg), C-reactive protein (CRP), and alkaline phosphatase (ALP) in COVID-19 patients to investigate the relationship between bone resorption and the disease. MATERIAL AND METHODS: The study included 56 individuals with COVID-19 (divided into mild, moderate and severe subgroups depending on disease severity) and 25 healthy adults as a control group. Serum CTX-I concentrations were measured with enzyme-linked immunosorbent assay (ELISA). In addition, CRP, Ca, Mg, P, and ALP levels were measured using an automated clinical chemistry analyzer. RESULTS: Serum CTX-I levels were significantly higher in COVID-19 patients than in the control group (p < 0.05). Furthermore, a positive weak relationship was detected between CRP and CTX-I (r = 0.303, p < 0.05). CONCLUSIONS: Increased serum CTX-I levels in the patient group caused COVID-19-driven bone degradation, though serum CTX-I levels did not differ according to disease severity.

Ameliorative effects of thymoquinone on the caspase 3, kidney function and oxidative stress tartrazine-induced nephrotoxicity.

First in the literature this study aimed to investigate the effects of Tartrazine, a common industrial food dye, on kidney and whether Thymoquinone has a protective effect in tartrazine-induced nephrotoxicity. The study conducted on the rats bred at Inönü University Experimental Animals Production and Research Center. Wistar albino rats were randomly divided into 4 groups, where each group included 8 rats: control, Tartrazine, Thymoquinone, and Tartrazine + Thymoquinone groups. The experiments continued for 3 weeks and then, kidney tissues and blood samples were collected from the rats under anesthesia. Malondialdehyde (MDA), super oxidized dismutase (SOD), total oxidant status (TOS), increase in Oxidative stress index (OSI), glutathione (GSH), Glutathione peroxidase (GSH-Px), catalase (CAT), Total antioxidant status (TAS) levels decreased in the kidney tissues collected from the tartrazine group. Serum Bun and Creatinine levels increased in the tartrazine group. Tartrazine administration damaged and degenerated the glomeruli and cortical distal tubes in the histopathology of kidney tissues, also different degrees of inflammatory cell infiltration were observed in the renal cortex and medulla. Thymoquinone and tartrazine administration improved both biochemical and histopathological parameters. Tartrazine administration induced nephrotoxicity. This could be observed with the increase in oxidant capacity and the deterioration of kidney functions. Thymoquinone was observed to demonstrate strong antioxidant properties. Thymoquinone could be used primarily as a protective agent against Tartrazine-induced toxicity.

Protective effects of vitamin E against acrylamide-induced hepatotoxicity and nephrotoxicity from fetal development to adulthood: Insights into Akt/NF-κB and Bcl-xL/Bax signaling pathways.

Acrylamide (ACR), a toxin present in fried and baked carbohydrate-rich foods, is known to cause liver and kidney damage. This study aimed to investigate the mechanisms of oxidative stress, inflammation, and apoptosis that contribute to liver and kidney damage induced by chronic administration of ACR. Additionally, the effectiveness of vitamin E in mitigating these toxic effects was examined. The study initially involved dividing 40 pregnant rats into four groups. After lactation, the research continued with male offspring rats from each group. The offspring rats were divided into Control, Vitamin E, ACR, and ACR + Vitamin E groups. Following ACR administration, liver and kidney function tests were performed on serum samples. Biochemical analyses, evaluation of inflammation markers, histopathological examination, and assessment of protein levels of Akt/IκBα/NF-κB, Bax, Bcl-xL, and Caspase-9 were conducted on liver and kidney tissues. The analysis demonstrated that ACR adversely affected liver and kidney function, resulting in oxidative stress, increased inflammation, and elevated apoptotic markers. Conversely, administration of vitamin E positively impacted these parameters, restoring them to control levels. Based on the results, the mechanism of ACR's action on oxidative stress and inflammation-induced liver and kidney damage may be associated with the activation of apoptotic markers such as Bax and Caspase-9, as well as the Akt/IκBα/NF-κB signaling pathway. Consequently, the protective properties of vitamin E establish it as an essential vitamin for the prevention or mitigation of various ACR-induced damages.

Protective role of vitamin E against acrylamide-induced testicular toxicity from pregnancy to adulthood: insights into oxidative stress and aromatase regulation.

Acrylamide (ACR) is a toxic chemical frequently encountered in daily life, posing health risks. This study aimed to elucidate the molecular-level mechanism of ACR's toxic effects on testicles and investigate whether Vitamin E can mitigate these effects. A total of 40 adult pregnant rats were utilized, divided into four groups: Control, ACR, Vitamin E, and ACR + Vitamin E. ACR and Vitamin E were administered to the mother rats during pregnancy and lactation, and to the male offspring until the 8th week post-birth. Serum hormone levels, oxidant-antioxidant parameters, histopathological examination of testicular tissue, and mRNA and protein levels of the testicular and liver aromatase gene were analyzed. Spermiogram analysis was conducted on the collected sperm samples from the male offspring. The results revealed that ACR exposure adversely affected hormone levels, oxidant-antioxidant parameters, histological findings, as well as aromatase gene and protein expressions. However, Vitamin E administration effectively prevented the toxic effects of ACR. These findings demonstrate that ACR application significantly impairs the reproductive performance of male offspring rats by increasing liver aromatase activity.

Serum adiponectin and peroxisome proliferator-activated receptors-γ levels in obese patients with and without prediabetes

SUMMARY OBJECTIVE: Obesity is an increasingly prevalent global health problem, which is generally caused by the increase in body fat mass above normal and observed in all societies. If the blood glucose level is higher than normal but not high enough to diagnose diabetes, this condition is defined as prediabetes. Adiponectin increases fatty acid oxidation and insulin sensitivity and is closely associated with obesity. One of the nuclear receptor superfamily member peroxisome proliferator-activated receptors is shown to have an important role in various metabolic reactions. This study aimed to investigate the serum levels of adiponectin and peroxisome proliferator-activated receptors-gamma parameters, which are closely related to adipose tissue, energy metabolism, and insulin sensitivity, in obese patients with and without prediabetes. METHODS: For this purpose, 52 obese patients with prediabetes, 48 obese patients with non-prediabetes, and 76 healthy individuals were included in this study. Serum adiponectin and peroxisome proliferator-activated receptors-γ levels were analyzed by ELISA. RESULTS: Serum adiponectin levels were significantly higher in obese patients with prediabetes (18.15±15.99) compared with the control group (15.17±15.67; p=0.42). No significant difference was observed in both adiponectin and peroxisome proliferator-activated receptors-γ levels in the obese patients with the non-prediabetes group compared with the control group. However, no significant difference was observed in the obese patients with prediabetes group and obese patients with non-prediabetes group. CONCLUSION: Our results suggest that adiponectin may serve as an indicator of prediabetes. This implies that examining adiponectin levels in individuals diagnosed with prediabetes may enhance our understanding of the metabolic processes closely linked to prediabetes and related conditions.

Incidental appendiceal neoplasms: Single-centre results.

BACKGROUND: Histopathological examination of appendectomy specimens may reveal malignancies. Based on these results, either appendectomy is sufficient or sometimes a further treatment protocol can be needed. In this study, malignancy-diagnosed cases on appendectomy specimen were examined. METHODS: Patients who underwent appendectomy between January 2013 and December 2018 with a pre-diagnosis of acute appendicitis were evaluated retrospectively and those cases with malignancy were included in the study. Patients' age, sex, tumor type, tumor diameter, tumor grade, tumor localization, surgical margin, Ki-67 index, state of lymphovascular invasion, state of peri-neural invasion, and follow-up period duration were recorded. RESULTS: On examination of 2336 appendectomy specimens, 16 patients (0.7%) were found to have neuroendocrine tumors (NET), 11 patients (0.5%) were found to have low-grade mucinous neoplasm (LAMN), and five patients (0.2%) were found to have primary appendix carcinomas. Appendix tumors usually present with acute appendicitis symptoms. Despite re-operation with right hemicolectomy (RHC) being required in the treatment of adenocarcinoma cases, appendectomy provides adequate treatment in most cases with NET and LAMN. With these tumors, which usually have a benign prognosis, it is important to perform the necessary screening in the postoperative period and not to interrupt follow-up.

Osseointegration Levels of Implants Placed With Allogenic and Xenogenic Bone Ring: An Experimental Biomechanical Analysis.

This in vivo study aimed to do a biomechanical analysis of the early period bone-implant connection of titanium implants simultaneously inserted with xsenogenic and allogenic bone ring. In this study, 28 Sprague Dawley female rats were used. Four rats were killed to obtain an allogenic bone ring, and after this, the remaining rats were divided into control (n=8), xsenogenic (n=8), and allogenic (n=8) bone ring groups. Titanium-machined surfaced implants were integrated right tibias of the rats. In controls, only implants were integrated into right tibias. In the greft groups, the implants were integrated simultaneously with bone rings. After 2 weeks of the experimental period, the rats were killed ,and titanium implants and surrounding bone tissues were removed for biomechanic analysis. After biomechanical reverse torque analysis bone-implant connection was determined as Newton/cm 2 ; in controls 3.26 (1.2 to 4.5), in allogenic ring group 3.37 (2 to 4.4), in xsenogenic ring group 5.93 (2.8 to 10). Statistically significant differences were not detected between the groups ( P >0.05). Within the limitation of this study, both allogenic and xsenogenic bone grafts could be successfully used in bone augmentation in implant surgery.

Thymoquinone played a protective role against tartrazine-induced hepatotoxicity.

Objectives: The current study, the first of its kind in the literature, aimed to observe the toxic effects of Tartrazine, a commonly used dyestuff in industries and foods, on the liver, and investigate whether this toxicity could be eliminated with thymoquinone coadministration. Materials and Methods: 32 male Wistar albino rats were procured from Inönü University Experimental Animals Breeding and Research Center. The rats were randomly assigned to 4 equal groups: Control group, Thymoquinone group, Tartrazine group, and Thymoquinone + Tartrazine group. Rat liver tissue and blood samples were obtained and biochemical and histopathological examinations were conducted on the samples. Results: Tartrazine administration increased the oxidant (malondialdehyde and superoxide dismutase) and oxidative stress index parameters (total oxidant status) in the liver tissue and decreased the antioxidant parameters (glutathione, glutathione peroxidase, catalase, and total antioxidant status) leading to histopathological problems (hematoxylin-eosin staining and Caspase-3 immunoreactivity) and inflammation (tumor necrosis factor-α and interleukin-6) in the serum samples. Thymoquinone, on the other hand, improved antioxidant and anti-inflammatory effects. Conclusion: At this time and dose, thymoquinone has a protective effect against tartrazine hepatotoxicity. Thymoquinone can be used as a protective agent against tartrazine toxicity.

Effects of dietary supplementation of cumin (Cuminum cyminum L.) essential oil on expression of genes related to antioxidant, apoptosis, detoxification, and heat shock mechanism in heat-stressed broiler chickens.

This study was carried out to evaluate the impact of cumin essential oil (CEO) supplementation on levels of certain gene expression related to antioxidant, apoptotic, detoxific, and heat shock mechanisms in the breast meat and ileum of heat-stressed broilers. The study was conducted on a 2 × 6 factorial design (heat stress + feed additive) on 600 day-old male broiler chicks for a period of 42 days. From day 7 to 42, although broilers in heat stress groups (HT) were exposed to constant chronic heat stress (36 °C), others were housed at thermoneutral ambient temperature (TN). The chicks in both conditions were fed with 6 experimental diets: C0 (basal diet with no additive), ANTIB (basal diet + 100 mg/kg chloramphenicol), VITE (basal diet + 50 IU α-tocopherol), C2 (basal diet + 200 mg/kg CEO), C4 (basal diet + 400 mg/kg CEO), C6 (basal diet+ 600 mg/kg CEO). The results showed that heat stress upregulated (except for Bcl-2) the genes related to antioxidant, apoptosis, detoxification, and heat shock mechanism. However, cumin essential oil increased the dose-dependently positive effect on certain genes in tissues of the heat-stressed broilers and downregulated (except for Bcl-2) these genes.

Effects of cumin (Cuminum cyminum L.) essential oil and chronic heat stress on growth performance, carcass characteristics, serum biochemistry, antioxidant enzyme activity, and intestinal microbiology in broiler chickens.

This study was conducted on 600 one-day-old male broiler chicks, using a 2 × 6 factorial design (ambient temperature, A x feed additive, F), for a period of 42 days. The chicks assigned to different groups were exposed to thermoneutral (TN, 24 ± 1 °C) and constant heat stress (HT, 36 ± 1 °C) conditions, and were only fed on a basal diet, and a basal diet supplemented with either 100 mg/kg chloramphenicol, 50 IU/kg α-tocopherol, or 200, 400, and 600 mg/kg of cumin essential oil (CEO). The results showed that heat stress adversely affected performance and carcass characteristics, and increased both the mortality rate and footpad lesions. Moreover, constant chronic heat stress showed negative effects on serum biochemistry and the intestinal microbiota, increased antioxidant activity in both the plasma and breast meat, and increased counts of the pathogenic microorganisms in the small intestine. On the other hand, dietary CEO supplementation positively affected these parameters. CEO had a slight effect on performance, carcass characteristics, mortality rate and the incidence of footpad lesions. When compared to the control group, it was determined that CEO generally had a positive effect on lipid peroxidation in the plasma and tissues and decreased antioxidant enzyme activity. Furthermore, CEO positively affected serum biochemistry and counts of beneficial microorganisms in the small intestine.

The effect of immunonutrition on tumor infiltrative t lymphocytes and regulatory t cells in rectal tumor patients receiving neoadjuvant chemoradiotherapy: a prospective randomized clinical study.

BACKGROUND: The rationale behind using immunonutrition in cancer patients is to prevent malnutrition, manage the host's immune response, and keep cancer under control by utilizing the potential immune system available in the host against the tumor. This prospective- study aims to assess the impact of immunonutrition on tumor-infiltrating lymphocytes (TILs) and regulatory T cells (Tregs) in rectal cancer patients receiving neoadjuvant chemoradiotherapy. METHODS: This is a single-center, prospective study. Forty patients diagnosed with middle and lower rectal tumors were enrolled in the study between March 2018 and December 2019. Nutrition protocols were given to all study subjects prior to surgery. Tissue CD4, CD8, and Fox P3 expression prior to enrollment (endoscopic biopsy specimens) and following surgery (resected tissue) were compared. RESULTS: Longitudinal data was available for 30 patients. In the present study, 15 patients were given immuno-nutrition, and 15 patients received standard nutrition. The immunonutrition and standard nutrition groups were similar regarding CD4 [10 (5-20) vs. 10 (10-10), p = 0.653], CD8 [30 (20-35) vs. 30 (20-40), p = 0.870], lymphocyte counts [2 (2-3) vs. 2 (2-3), p = 0.325], fox p3 value [10 (10-10) vs. 10 (10-10), p = 0.775], and CD4/CD8 ratio [0.33 (0.29-0.66) vs. 0.50 (0.29-0.50), p = 0.870] on endoscopic biopsy. CD4 [10 (7.5-25) vs. 30 (10-50), p = 0.050], CD8 [60 (40-60) vs. 50 (40-60), p = 0.713] and Fox P3 [10 (5-10) vs. 10 (2.5-10), p = 0.935] were also similar in tissues extracted by surgery. However, the standard nutrition group had significantly higher CD4/CD8 values in their tissues removed on surgery [0.25 (0.14-0.50) vs. 0.66 (0.28-1), p = 0.026]. DISCUSSION: The present study revealed that CD4/CD8 ratios were lower in the immunonutrition group in comparison to the group receiving standard nutritional supplements before surgery.

Use of the Systemic Immune Inflammation Index, TNM classification, and CEA in pre- and post- prognostic evaluation of sporadic colorectal cancer.

AIM: The aim of this study was to investigate the correlation between preoperative systemic immune inflammatory index (SII) and carcinoembryonic antigen (CEA) and postoperative lympho-vascular invasion and TNM stage in patients with colorectal carcinoma. MATERIAL AND METHODS: A total of 153 patients with colorectal cancer admitted to our tertiary hospital between 2014 and 2018 were included in the study. RESULTS: While 71.2% of the patients had low preoperative CEA values, 28.8% had high preoperative CEA values. Lymphovascular invasion rate was found to be significantly higher in patients with high CEA levels than those in low levels (70.4% vs. 39.4%, p=0.002). The percentage of patients with lymphovascular invasion with a high SII (60.0%) was significantly higher than those without lymphovascular invasion (p=0.015). CONCLUSION: In our study, serum CEA and SII index values were found to provide critical information in terms of showing lympho-vascular invasion, which is considered as an independent "bad" prognostic factor in patients with colorectal carcinoma. In conclusion, we consider that CEA and SII index values can be used to determine the prognosis of patients with colorectal cancer. KEY WORDS: Carcinoembryonic antigen, Colorectal carcinoma, Microsatellite, lymphovascular invasion, TNM.

Ultra-structural and histopathological features of liver biopsy taken during laparotomy to confirm the diagnosis of biliary atresia.

Background: Neonatal cholestasis is caused by a group of diseases that cause jaundice, which can be encountered in the neonatal period. Biliary atresia (BA) and idiopathic neonatal hepatitis (INH) are among neonatal cholestasis diseases. Aims: The aim of this study was to perform histopathological and ultra-structural examinations of liver biopsy tissue samples from BA and INH patients with liver biopsies taken during laparotomy to confirm the diagnosis of biliary atresia. Settings and Design: A total of patients undergoing Kasai surgery before the age of 60 days were included in an "early" group (n = 7), whereas patients undergoing surgery after the age of 60 days were included in a "late" group (n = 11). The control group (n = 11) included INH patients. Materials and Methods: For histopathological examinations, liver tissue samples obtained intra-operatively were subjected to routine histopathological procedures after being stained with caspase-3 and cytokeratin-7 antibodies. Ultra-structural evaluations were also performed. Statistical analysis used: For comparisons between the groups, a one-way analysis of variance (ANOVA) test and the Mann-Whitney U test were used for continuous variables. Results: Histopathological findings reflected the specific liver pathologic findings seen in biliary atresia. Although there was no significant difference between the BA groups, these parameters were not detected in the control group. The histopathological evaluations revealed no significant differences in the findings of liver parenchyma damage between the early, late, and control groups. Electron microscopic examinations showed that the patients in the late group had more severe signs of intra-cellular damage to the liver. Conclusions: Although the histopathological examination revealed no significant differences in liver damage between the three groups, in ultra-structural evaluation, intra-cellular damage was found to be less in groups with better prognosis. Electron microscopy evaluations of intra-cellular damage may be more useful in this respect.