Preparation, Characterization, Antioxidant Activities, and Determination of Anti-Alzheimer Effects of PLGA-Based DDSs Containing Ferulic Acid.

Nanoparticle (NP) systems have attracted the attention of researchers in recent years due to their advantages, such as modified release features, increased therapeutic efficacy, and reduced side effects. Ferulic acid (FA) has therapeutic effects such as anti-inflammatory, anti-Alzheimer's, antioxidant, antimicrobial, anticancer, antihyperlipidemic, and antidiabetic. In this study, FA-loaded PLGA-based NPs were prepared by a nanoprecipitation method and the effect of varying concentrations of Poloxamer 188 and Span 60 on NP properties was investigated. FA-loaded A-FA coded formulation was chosen as optimum. High encapsulation efficiency has been achieved due to the low affinity of FA to the water phase and, therefore, its lipophilic nature, which tends to migrate to the organic phase. It was determined that the release of FA from the A-FA was slower than pure FA and prolonged release in 24 h. Antioxidant and anti-Alzheimer's effects of A-FA coded NP formulation were investigated by biological activity studies. A-FA coded NP formulation showed strong DPPH free radical scavenging, ABTS cation decolorizing, and reducing antioxidant activity. Since it has both AChE inhibitor and antioxidant properties according to the results of its anti-Alzheimer activity, it was concluded that the formulation prepared in this study shows promise in the treatment of both oxidative stress-related diseases and Alzheimer's.

PET/CT FAPI: Procedure and evidence review in oncology.

Neoplasms are composed of malignant tumor cells, which are surrounded by other non-tumor cellular elements, in what has been defined as the microenvironment or tumor stroma. Evidence on the importance of the tumor microenvironment has not stopped growing in recent years. It plays a central role in cell proliferation, tissue invasion, angiogenesis and cell migration. The paradigm is the family of new FAPI radiopharmaceuticals that show the density of the fibroblast activation protein (FAP) which is overexpressed in the cell membrane of activated cancer-associated fibroblasts (CAF), and its presence is related to poor prognosis. This educational document includes the procedure for performing PET/CT FAPI, biodistribution and the main potentially clinical applications in oncology to date.

Ketorolac Tromethamine Loaded Nano-Spray Dried Nanoparticles: Preparation, Characterization, Cell Viability, COL1A1 Gene Simulation and Determination of Anti-inflammatory Activity by In vivo HET-CAM Assay.

BACKGROUND: Ketorolac tromethamine (KT) is a non-steroidal anti-inflammatory drug from the heteroaryl acetic acid derivatives family. The most widely used new nanotechnological approaches for topical drug delivery are polymeric nanoparticles (NPs). OBJECTIVE: Successful results have been obtained with low doses in many treatments, such as cancer, antimicrobial, pain, made with nanoparticle formulations of drug active ingredients. METHODS: NPs were prepared using Nano Spray-Dryer. The cytotoxicity of the optimum formulation in BJ (ATCC® CRL-2522™) human fibroblast cells was determined by the WST- 1 method and the gene activity was elucidated by mRNA isolation and real-time polymerase chain reaction (RT-PCR). The in vivo HET- CAM assay was performed for anti-inflammatory activity. RESULTS: NPs presented PDI values lower than 0.5, and therefore particle size distribution was decided to be monodisperse. Positive zeta potential values of NPs highlighted the presence of the cationic ammonium group of Eudragit® RS 100. The release rates observed from KT-NP coded formulations after 24 hours were 78.4% ± 2.9, demonstrating extended release from all formulations, relative to pure KT. The lowest concentration of KT-NP increased fibroblast cell proliferation higher than the highest concentration of KT. The 5-fold increased effect of KT-NP formulation on collagen gene expression compared to KT is also related to the enhanced anti-inflammatory effect in line with the in vivo HET-CAM assay results. CONCLUSION: With the obtained cell viability, gene expression, and HET-CAM results, it has the hope of a successful nano-topical formulation, especially in both wound healing and anti-inflammatory treatment.

Analysis of Patients with Major Fractures with and without COVID-19 Infection.

PURPOSE OF THE STUDY As in orthopedic trauma patients, a hyperinflammatory response due to cytokine release occurs in patients with moderate and severe COVID-19 infection. In these patients, untimely surgical intervention can create more destructive situations in the postoperative period. Our aim in this study was to investigate the effect of COVID-19, trauma and surgical intervention on acute phase reactants' levels in patients with and without COVID-19 infection. MATERIAL AND METHODS Twenty-four patients diagnosed with COVID-19 infection and major fractures requiring surgical treatment were evaluated retrospectively (Group 1). Twenty-four COVID-19 negative patients with similar trauma were included in the study as a control group (Group 2). These two groups were compared in terms of demographic data, time to surgery, total hospitalization time, and preoperative and postoperative acute phase reactants' [C-reactive protein (CRP), D-dimer, ferritin, fibrinogen and white blood cell (WBC)] values. RESULTS Time to surgery was 8.3 ± 0.7 days and the total hospital stay was 15.2 ± 0.8 days, in Group 1. These values were determined as 3.3 ± 0.4 and 6.5 ± 0.6 days, respectively for the patients in Group 2 (p < 0.001 and p < 0.001, respectively). When the acute phase reactant values studied during admission were examined, a significant difference was found between the two groups in terms of CRP, D-dimer, ferritin and WBC (p = 0009, p = 0.002, p < 0.001 and p < 0.001, respectively). In the preoperative period, a significant difference was observed between the groups in terms of CRP and ferritin (p = 0.011, p < 0.001, respectively). A significant difference was found only in terms of ferritin from the laboratory values studied in the postoperative period (p < 0.001). DISCUSSION To our knowledge, the present study is the first study which compares and investigates the effects of COVID-19 infection, major fracture and surgical intervention on acute phase reactants' values. Surgical treatment is generally recommended as soon as possible in daily orthopedic practice. However, in patients with asymptomatic or mildly symptomatic COVID-19 infection, it remains unclear how long surgical intervention will be delayed after admission and clinical stabilization of patients with a fracture that requires surgical fixation. In a meta-analysis, patients with COVID-19 infection accompanying hip fracture had a mortality rate of 32.6% in the early postoperative period, and the mortality risk of these patients was found to be 5.66 times higher compared to patients without COVID-19 infection. In our study, one patient (4.2%) with COVID-19 infection who underwent partial hip arthroplasty due to femoral neck fracture. CONCLUSIONS The follow-up and treatment of patients with COVID-19 infection with accompanying a major fracture requiring orthopedic surgery is a complex situation. We recommend that acute phase reactants such as CRP, D-dimer, erythrocyte sedimentation rate (ESR), and ferritin should be closely monitored in these patients during the period from admission to surgery, and surgical intervention should be performed while these values are in remission or decline. Key words: COVID-19, fracture, trauma, acute phase reactants, surgical timing.

Quercetin, Rutin And Quercetin-Rutin Incorporated Hydroxypropyl ß-Cyclodextrin Inclusion Complexes.

Quercetin (Q) and rutin (R) are well known and most studied flavonoids due to their activities in reduction of inflammation, oxidative damage, platelet aggregation and inhibition of cancer proliferation. Despite their remarkable potentials they have limited oral bioavailability due to the low water solubility. Therefore in this study inclusion complexes of Q and R with hydroxypropyl-ß-cyclodextrin (HP-ß-CD) were formulated to improve the aqueous solubility, antiproliferative efficacy and also antioxidant activity of the flavonoids. According to the analyses results, aqueous solubilities of Q and R were increased up to ∼630 fold and ∼55 fold, respectively. ZP values were ranged between -21.7±0.3 mV and -6.1±0.8 mV showing the anionic structure of the complexes. 1H-NMR analyses revealed the complex formation considering the shifts of the protons of the APIs as well as HP-ß-CD. The in vitro release analyses revealed that the cumulative release of Q was decreased from 22.9 % to 18.1 and 15.2 for T9 and T 24 formulations respectively while the cumulative release of R increased from 26.8 % up to 64.5 % and 75.8 % with T14 and T24 formulations respectively. According MTT analyses results, Q showed higher antiproliferative effect in MDA-MB-231 and A549 cell lines compared to NIH-3T3 cell lines while R showed remarkable effect only on MDA-MB-231 cell lines at the end of 48 h of incubation period. A synergistic effect was observed in the formulation of combined flavonoid (Q/R) inclusion complexes and an antiproliferative effect was ordered as MDA-MB-231 > A549 > NIH-3T3. The selected complexes T9 (Q), T14 (R) and T24 (Q/R) have shown the highest antioxidant activity with 93.8 %, 65.3 % and 93.1 % respectively with DPPH analyses. In conclusion incoporation of Q, R and Q/R to HP-ß-CD based inclusion complexes have great potentials with enhanced in vitro dissolution characteristics and antiproliferative effects on different types of cancer cell lines for efficient treatment of severe disorders.

The relationship between serum prolidase activity and histone H3 protein levels and fibromyalgia.

OBJECTIVE: Fibromyalgia (FM) is a clinical syndrome characterized by prominent physical and psychological impairment and widespread pain on both sides of the body, above and below the waist, and along the axial skeleton. It often causes sleep difficulties, memory impairment, mood changes, irritable bowel syndrome, and fatigue. Our study aimed to investigate the relationship between FM and prolidase (peptidase D) and histone H3 protein levels by comparing a patient group with a healthy control group. PATIENTS AND METHODS: In total, 176 people were examined in our study, 88 of whom were healthy and 88 of whom had FM. Serum level was measured by ELISA. Then the results were analyzed using SPSS. All p < 0.05 were considered statistically significant. RESULTS: A significant increase in the levels of prolidase was observed in the patient group compared with the control group (6.28-4.68, p <0.001). Histone H3 protein values were not significantly different between the patient and control groups (p=0.184). The ROC analysis indicated that prolidase was statistically significant in disease prediction (p<0.001, AUC: 0.795 (0.697-0.893), while histone H3 protein was statistically insignificant in predicting disease. CONCLUSIONS: The results of the study show that prolidase activity may play a role in diagnosing FM. In addition, since no study like ours has been performed before, it can bring a new perspective to the literature.

IS IRON DEFICIENCY A RISK FACTOR FOR THE DEVELOPMENT OF THYROID AUTOANTIBODIES IN EUTHYROID WOMEN WITH REPRODUCTIVE AGES?

CONTEX: The first trimester of pregnancy is the most sensitive period in terms of thyroid hypofunction. Iron deficiency has been associated with both thyroid function and thyroid autoimmunity. OBJECTIVE: We aimed to investigate whether iron deficiency is a risk factor for thyroid autoimmunity in non-pregnant women at childbearing age. DESIGN: This cross- sectional study was conducted in non-pregnant women who presented to the Internal Medicine Policlinic between January 2018 and December 2018 in the University of Health Sciences "Fatih Sultan Mehmet" Training and Research Hospital. METHODS: Three hundred fifty-eight non-pregnant women of reproductive ages (203 iron deficient-ID, 155 control) participated in this study. Women with known thyroid disease, currently undergoing treatment for thyroid disease or whose thyroid function tests were outside the reference range were excluded from the study. Blood sample was taken after at least 8-10 hours of fasting for measurement of serum iron (Fe), total iron binding capacity (TIBC), serum ferritin (SF), whole blood count, thyroid function tests (fT4, TSH), anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibody (TgAb). The patients with SF levels ≤ 15 ng/dL were accepted as iron deficiency. RESULTS: The group with ID had higher TSH and lower T4 values that did not reach statistical significance compared to the control group (p=0.101 and p=0.098, respectively). Antibody positivity was more frequent in the ID group than in the control group (35.96% vs. 20.65%, p = 0.002). CONCLUSIONS: Iron deficiency is associated with thyroid autoimmunity and it should be considered as a risk factor for screening thyroid antibody, particularly in pregnancy planning women.

Diclofenac sodium loaded PLGA nanoparticles for inflammatory diseases with high anti-inflammatory properties at low dose: Formulation, characterization and in vivo HET-CAM analysis.

The development of a new drug active substance is not only time-consuming and expensive, but also a chain of operations that often fails. However, increasing the bioavailability, effectiveness, safety, or targeting the drugs used in clinic by various methods, such as nanoparticles (NPs), may be a more effective way of using them in clinic. In addition, NP formulations are becoming increasingly popular in modern medical treatments. Angiogenesis, formation of new capillaries from a pre-existing one, fundamentally occurs in physiological processes such as wound healing, embryogenesis and menstrual cycle, also has a vital role in pathology of cancer, psoriasis, diabetic retinopathy and chronic inflammation. The Hen's Egg Test on the Chorioallantoic Membrane (HET-CAM) assay is a useful, well established and animal alternative in vivo procedure for evaluation of anti-inflammatory potentials and anti-irritant properties of nano drug delivery systems. In this study, diclofenac sodium (DS) loaded PLGA NPs were prepared and characterized. The particle size (PS) of DS-loaded PLGA NPs was between 114.7 and 124.8 nm and all NPs were monodisperse with negative zeta potential values. The encapsulation efficiency was in range of 41.4-77.8%. In vitro dissolution studies of NPs showed up to 24 h of DS release after the first 3 h of burst effect. The 3 h burst effect and 24 h release kinetics studied with DDSolver were found to be predominantly driven not only by one mechanism, by a combined mechanism of Fickian and non-Fickian. Solid state structures of formulations were clarified by DSC and FT-IR analysis. PS, EE% and release rates were found to be affected by the amount of DS added to the formulations. Increasing the amount of DS added to the formulations increased PS, while the EE% decreased. The release rates were affected by PS and the formulation with the lowest PS value showed slower release. The anti-inflammatory activity of optimum formulation (NP-1) was examined using in vivo HET-CAM assay. The anti-inflammatory activity results indicated that NP-1 coded NP formulation showed significantly good anti-inflammatory potential at low dose. As a result, a low dose high anti-inflammatory effect was achieved with the NP structure of DS. To the best of our knowledge this is the first study on in vivo anti-inflammatory activities of DS loaded PLGA NPs by HET-CAM.

Treatment of oxidative stress-induced pain and inflammation with dexketoprofen trometamol loaded different molecular weight chitosan nanoparticles: Formulation, characterization and anti-inflammatory activity by using in vivo HET-CAM assay.

Angiogenesis is a fundamental process of wound healing, embryogenesis etc. but occurs in cancer and chronic inflammation pathologically. HET-CAM assay is a useful, well established and animal alternative test to screen anti-inflammatory potentials of pharmaceutical products as well as nano-formulations. Dexketoprofen trometamol (DT) belongs to the nonsteroidal anti-inflammatory drug (NSAID) group which is a rapidly acting analgesic ingredient. Because DT has a short half-life, high and frequent dosing is used in treatment. The need of design and producing a new oral prolonged-release dosage form containing DT is the major aim of the study with low dose and low side effects. Chitosan (CS) has been widely used in the pharmaceutical area because of its favorable biological properties. In this study, DT loaded CS nanoparticles (CS-NPs) were produced by spray drying method for oral drug delivery. Structures of CS-NPs were elucidated by particle size, zeta potential, SEM, DSC, FT-IR and 1H NMR. High encapsulation efficiency was obtained (73-84%) for the prepared formulations. In vitro release was examined in pH 1.2 buffer and pH 6.8 buffer. DT-loaded CS-NPs showed prolonged release, particularly at pH 6.8. Weibull kinetic model was found to fit best to DT release from CS-NPs in both release medium. The anti-inflammatory activity of optimum formulation (M-DT) was examined using the in vivo HET-CAM assay. The anti-inflammatory activity results indicated that M-DT coded NPs formulation showed significantly good anti-inflammatory potential with closer inhibition value to the standard anti-inflammatory DT at one fifth lower dosage. According to the proposed method and results it can be successfully applicable to the NP preparation containing DT and it could be concluded that DT loaded CS-NPs seem to be a promising prolonged release drug delivery system for oral administration with low dose and high efficiency.

New approaches to tumor therapy with siRNA-decorated and chitosan-modified PLGA nanoparticles.

Objective: In this study, we aimed to develop a candidate modifited polymeric nanoparticle (NP) system that will kill cancer cells by facilitated to apoptosis and also reduce pain. Significance: The primary goal of treatment, especially for metastatic cancers, is to control the growth of the cancer and to alleviate the symptoms. Pain is one of the commonest symptoms of cancer. In cancer treatment, directing cancer cells to death while simultaneously relieving pain will be a new approach. Methods: Chitosan-modified PLGA NPs were prepared using an nanoprecipitation technique. The NPs were loaded with flurbiprofen and decorated with folic acid. STAT3-siRNA was adsorbed to these polymeric NPs using antisense technology. Results: The NPs were small in size (176.9-220.3 nm) with positive zeta potential (+14.1 mV to +27.2 mV). They had high loading capacity and prolonged release properties over 144 hours. Cytotoxicity studies performed with siRNA showed effective electrostatic interaction due to the positively charged NPs. Folic acid facilitated entry into cancer cells and helped to kill them. Conclusion: The formulation we developed is a potential carrier system for both treatment of cancer and prevention of pain, especially for metastatic cancers.

Endobronchial ultrasound-guided transbronchial needle aspiration is useful in the diagnosis of lymphoma: don't give up!

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered cautiously in the diagnosis of lymphoma. In this study, we present our data with literature review, to ask the readers to re-evaluate this opinion. MATERIALS AND METHODS: Several demographic, clinical and procedural variables of patients who had been diagnosed with lymphoma with EBUS-TBNA at our institution between January 2011 and December 2016 were noted and analyzed. RESULTS: We analyzed 27 patients with a proven diagnosis of lymphoma, out of whom twenty patients were with classical Hodgkin's lymphoma and seven with non-Hodgkin's lymphoma. The sensitivity, specificity, positive and negative predictive values and accuracy of EBUS-TBNA for the diagnosis of lymphoma was found to be 70.3 %, 100 %, 100 %, 99.4 % and 99.4 %, respectively. The diagnostic sensitivity of EBUS-TBNA in ten patients with the history of lymphoma was 100 %; while in patients with no history of lymphoma it was 52.9 %. The patients with non-Hodgkin's lymphoma were presented at older ages (p = 0.001), with larger lesions (p = 0.046) and higher SUVmax values (p < 0.001). No complications occurred. CONCLUSION: EBUS-TBNA may be used as an initial diagnostic modality in patients suspicious for lymphoma instead of repeated mediastinoscopy (Tab. 2, Fig. 1, Ref. 34).

Protection with thymoquinone against formaldehyde-induced neurotoxicity in the rats.

INTRODUCTION: This study aimed to investigate the neurotoxic damage of formaldehyde (FA), which is commonly used in medicine and industrial fields, for the hippocampus of rats and the protective role of thymoquinone (TQ) against this neurotoxicity. METHODS: There were five groups with eight rats in each. Two control groups were formed, in one of them physiological saline was applied and in the other one corn oil was applied. FA was injected in Group 3. Group 4 was exposed to FA and TQ simultaneously. Group 5 received TQ only. At the end of the experiment animals were sacrificed and brain tissues were removed for biochemical and histopathological investigation. RESULTS: catalase (CAT), glutathione peroxidase (GSH-px) and superoxide dismutase (SOD), all known as enzymes with antioxidant activities, were increased in FA and TQ simultaneously administered group. FA caused prominent subarachnoidal hemorrhage and vacuolization. Vacuolization was not observed but occasional subarachnoidal hemorrhage was detected in the FA+TQ group. CONCLUSION: Neurotoxic damage in hippocampus induced by FA was reverted by administration of TQ (Tab. 1, Fig. 1, Ref. 26).

The effects of irrigation volume to the heat generation during implant surgery.

BACKGROUND: To evaluate the effects of the amount of irrigation on heat generated during implant site preparation. MATERIAL AND METHODS: Ten freshly dissected sheep mandibles were sectioned into 30 equal bone blocks and transferred into a heat-controlled water tank. Implant socket preparations were performed with four consecutive drills. Temperature measurements were performed with a thermocouple inserted into the bone immediately before the preparation and after the drilling using three different physiologic saline irrigation set-ups: 1- No irrigation, 2- 12 ml/min and 3- 30 ml/min irrigation volume. The temperature differences between three different irrigation set-ups for implant drills 1, 2, 3 and 4, and the temperature differences between the drills for three different irrigation set-ups were separately compared. RESULTS: The temperature difference of no irrigation group was significantly higher than 12 ml/min and 30 ml/min groups for all four drills (p<0.05), whereas no statistically significant difference was found between 12 ml/min and 30 ml/min irrigation groups. (p>0.05) The temperature difference of drill 1 is significantly higher than drills 2, 3 and 4 for no irrigation group. (p<0.05) The temperature differences of drill 1, 2 and 3 were significantly higher than the temperature difference of drill 4 for 12 ml/min irrigation group. (p<0.05) Conclusions: The heat generated during drilling is not directly proportional to the coolant volume. Given that certain amount of irrigation is applied, implant sites can be prepared safely without the need for additional irrigation, which may result in reduced visibility of the surgical site and therefore a suboptimal surgery.

Comparison of inflammatory cytokine release from nasal epithelial cells of non-atopic non-rhinitic, allergic rhinitic and polyp subjects and effects of diesel exhaust particles in vitro.

BACKGROUND: Although studies have reported an association between air pollutants and increased allergic airway diseases, such as allergic rhinitis and nasal polyposis, the underlying mechanisms are not fully understood. A limited number of studies have suggested that diesel exhaust particles (DEP) play a role in atopy and the pathogenesis of allergic upper airway diseases. The aim of this study was to investigate the effect of DEP on inflammatory cytokine release, and mRNA expression of transcription factors such as JNK and NF-ß in primary nasal epithelial cells (NECs), in vitro. METHODS: NECs from non-atopic, non-rhinitic subjects (controls) and patients with allergic rhinitis and nasal polyps were cultured and incubated with 0-100µg/ml DEP for 24h. ELISA and RT-PCR were used to assess the release of IL-8, GM-CSF, and RANTES, and mRNA expression for JNK and NF-κB, respectively. RESULTS: Compared to control cells, NECs from subjects with atopic polyps released significantly greater amounts of IL-8 (median=887 vs. 176.6pg/µg cellular protein; p<0.0001) and RANTES (median=0.191 vs. 0.02pg/µg cellular protein; p<0.001). While 50µg/ml DEP induced release of RANTES in NECs from patients with allergic rhinitis, 100µg/ml DEP decreased IL-8 levels in NECs from both control and allergic rhinitic subjects. DEP did not affect mRNA expression for JNK and NF-κB from NECs of subjects with polyps. CONCLUSIONS: NECs from subjects with various pathologies may respond differently to DEP.

Effect of Different Surface Treatments on the Bond Strength of Lithium Disilicate Ceramic to the Zirconia Core.

OBJECTIVE: The aim of this study was to evaluate the effect of different surface treatments [sandblasting, Erbium:Yttrium-Aluminium-Garnet (Er:YAG), and femtosecond lasers] on the shear bond strength (SBS) of the CAD-on technique. BACKGROUND DATA: Although demand for all-ceramic restorations has increased, chipping remains one of the major problems for zirconia-based restorations. MATERIALS AND METHODS: Forty yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) zirconia plates (IPS e.max ZirCAD, Ivoclar Vivadent) were cut, sintered (12.4 × 11.4 × 3 mm) and divided into four groups according to the surface treatments (n = 10): a control group with no surface treatment (Group C), sandblasting with 50 µm Al2O3 (Group S), Er:YAG laser irradiation (Group E), and femtosecond laser irradiation (Group F). Also, 40 cylindrical (5 mm diameter, 2 mm height) lithium disilicate (IPS e.max CAD) veneer ceramics were cut and fused to all zirconia cores by a glass-fusion ceramic and crystallized according to the CAD-on technique. Specimens were subjected to shear force using a universal testing machine. The load was applied at a crosshead speed of 0.5 mm/min until failure. Mean SBS (MPa) were analyzed with one way ANOVA (p < 0.05). The failed specimens were examined under a stereomicroscope at ×20 to classify the mode of failure. RESULTS: The highest SBS was observed in Group F (36 ± 3.31 MPa), followed by Group S (33.03 ± 5.05 MPa), and Group C (32.52 ± 10.15 MPa). The lowest SBS was observed in Group E (31.02 ± 4.96 MPa), but no significant differences were found between the control and surface treated groups (p = 0.377). All the specimens showed a mixed type of failure. CONCLUSIONS: Femtosecond laser application increased the bond strength between zirconia-veneer specimens. However, the novel CAD-on technique with no surface treatment also showed high bonding strength. Thus, this technique could prevent ceramic chipping without additional surface treatments.

Doppler ultrasonography helps discriminate between cirrhotic and non-cirrhotic patients with viral B and C hepatitis.

OBJECTIVE: The aim of this study was to define the cutoff values between compensated cirrhosis and non-cirrhotic patients with viral hepatitis B and C, using the criteria of the Doppler parameters of liver vascularity. MATERIALS AND METHODS: Seventy non-cirrhotic patients with viral hepatitis B and C and 30 cirrhotic patients were included in this prospective study. The diagnostic decisiveness properties of the Doppler values in the pre-determination of liver cirrhosis were evaluated using receiver operating characteristics curve analysis. RESULTS: Taking the cutoff value for hepatic vein waveform index as 0.605, a sensitivity of 80% and a specificity of 77.1% were obtained. The sensitivity was 80%, and the specificity was 68.6% for a mean max portal velocity cutoff value of 18.25cm/s. When the hepatic artery resistivity index cutoff value was taken as 0.705 for the diagnosis of cirrhosis, the sensitivity was 82.5% and the specificity 72.1%. For a hepatic artery pulsatility index cutoff value of 1.295, a sensitivity of 82.5% and a specificity of 72.1% were found. CONCLUSION: It is not possible to diagnose cirrhosis with only hemodynamic changes. However, the cutoff values may be helpful in the selection of patients to undergo the procedure of liver biopsy.

Oxidant/antioxidant status in lambs and sheep with liver and lung cystic echinococcosis diagnosed by ultrasonography and necropsy.

The aim of this study was to evaluate total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) in sheep and lambs with cyctic eccinocoocosis (CE) diagnosed by ultrasonography and necropsy findings. A total of 9 sheep and 17 lambs with CE were used in this study and the findings were compared to those of 6 healthy control sheep. Ultrasonography were used for the diagnosis of CE in sheep and lambs, and necropsy was performed to check the presence of cysts in liver and lungs. Serum TOS and TAC were measured by a novel colorimetric method. The TOS-to-TAC ratios were also calculated as OSI values. Serum biochemical profiles were determined by conventional measurement methods as well. The mean values for TOS, TAC and OSI were significantly (p<0.001) lower in sheep and lambs with CE when compared with those of the control sheep, and they were also significantly lower in lambs with CE in comparison to the mean values obtained in sheep with CE. The levels of serum albumin, total cholesterol, creatinine, and triglycerides in lambs with CE were found out to decrease significantly (p<0.001) when compared with those of both sheep with EC and the control group. There were no significant differences between the groups in terms of other serum parameters. In addition, when clinically and some biochemical values were evaluated, CE was found to be more severe in lambs than in sheep. It was concluded that although common diagnostic cyst detection is performed by postmortem examination, ultrasonography could successfully be used in conjunction with serum biochemical profile detection and serum TOS, TAC and OSI measurements for diagnosis of cysts in liver and lungs of severely infected living sheep and lambs. Serum albumin, total cholesterol, creatinine, total protein and triglycerides might be used as indicators in sheep and particularly in lambs for the diagnosis of CE.

Morphometric analysis of the infraorbital foramen and its localization relative to surgical landmarks.

AIM: The infraorbital foramen (IOF) is an important anatomic landmark for maxillofacial surgery; therefore, its location should be well documented. In morphometric analyses of the IOF, various methods have been applied and differences have been found among the results of the measurements. The aim of this study was to facilitate localization of the IOF during clinical practice. METHODS: In the current study, in order to perform anatomic and morphometric analyses of the IOF, 112 skulls were used. The shortest distance from each IOF to certain determined points was identified and measured by digital calipers. RESULTS: The longest and the shortest diameters of the IOF were measured as 4.21±0.91 mm and 3.11±0.62 mm, respectively. The shortest distances between the IOF and the landmarks were measured as follows: the maxillary mid-line (ML) as 28.47±2.49 mm; the supraorbital foramen/supraorbital notch (SOF/SON) as 43.43±3.39 mm; the lower end of the nasomaxillary suture (LENS) as 26.47±3.05 mm; the lower end of the alveolar juga of the canines (LAJC) as 31.62±3.09 mm; the infra-orbital margin (IOM) as 6.98±1.72 mm; and the opposite IOF as 56.85±3.89 mm. CONCLUSION: Among the landmarks, the most useful ones in clinical practice might be the distances between the IOF and the IOM, IOF and LAJC, and even IOF and ML. SOF/SON and LENS provide more accurate localization when they are used together with the other parameters. Moreover, their importance increases when other parameters are not available for use (because of fractures or damage).

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation.

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o'clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.

Effect of epidermal growth factor receptor status on the outcomes of patients with metastatic gastric cancer: A pilot study.

The expression of epidermal growth factor receptor (EGFR) has been linked to clinical outcome in several solid tumors. However, the clinical significance of EGFR (c-erbB1) in gastric cancer remains unclear. The present study was designed to detect the clinical implications of EGFR in the Turkish population. Paraffin-embedded tissue microarrays containing gastric cancer tissue were obtained from 30 patients. EGFR expression was detected using immunohistochemistry. The correlation of this biomarker to the clinicopathological features and survival of patients with gastric cancer was studied. The overall positivity rate of EGFR was 63.3%. EGFR expression was significantly correlated with an improved progression-free survival (PFS) and overall survival (OS) rate (P=0.039 and 0.01, respectively). EGFR expression is a good prognostic marker for patients with gastric cancer.