LIFESTYLE AND ANTHROPOMETRIC PARAMETERS IN PATIENTS WITH NONFUNCTIONAL ADRENAL INCIDENTALOMAS.

Objective: We aimed to investigate whether lifestyle and body fat mass have an impact on the occurence of nonfunctional adrenal incidentalomas (NFAI). Methods: 100 patients with NFAI were included . 50 people constituted the control group. Physical activities of these groups were evaluated (using the International Physical Activity Questionnaire), smoking status was determined, anthropometric measurements were made. Body fat mass, fat percentage, total body water and fat free mass were measured using bioelectrical impedance method. Results: Body mass index (BMI), waist, hip, neck circumference, total body fat percentage and fat mass and smoking rate were found to be statistically higher in the patient group. Physical activities did not differ significantly. When a subgroup with similar age and BMI among was created, waist circumference and total fat mass were again significantly higher in the patient group. There was a significant positive correlation between the size of the adrenal mass and waist, neck circumference, BMI, and cortisol after 1 mg dexamethasone suppression test. Conclusion: The increase in the fat mass may have an impact on the development of NFAI. Although the patients were regarded as nonfunctional, suppressibility of the cortisol decreases as the mass size of the incidentaloma increases.

Enrichment of probiotic ice cream with different dietary fibers: Structural characteristics and culture viability.

This study evaluated the effect of 5 dietary fibers (apple, orange, oat, bamboo, and wheat) on the physicochemical, rheological, and textural characteristics; sensory properties; and culture viability of probiotic ice cream stored at -18°C for 180 d. The presence of orange and apple fibers increased the titratable acidity, decreased the lightness (color) value of the ice creams, and enhanced the red and yellow coloration. Compared with the control sample, the consistency indices and apparent viscosities of the experimental samples increased with the addition of all dietary fibers except oat fiber. The highest viscosity was obtained in the sample fortified with apple fiber, whereas the ice cream containing orange fiber showed the highest hardness after d 60 of storage. The addition of orange and apple fibers significantly increased melting resistance; however, panelists did not generally like these samples in terms of taste-flavor. All ice creams had viable counts of Lactobacillus acidophilus of ≥7 log cfu/g during storage except the samples with orange and bamboo fiber. Bifidobacterium lactis counts were also found to be >6 log cfu/g in those samples until d 150 of storage.

Carotid intima-media thickness and insulin resistance changes in patients who underwent sleeve gastrectomy: A prospective study.

OBJECTIVES: Our aim was to examine changes in insulin resistance, Carotid Intima-Media Thickness (CIMT), in morbid obese patients without any known associated chronic diseases who underwent sleeve gastrectomy. MATERIALS AND METHODS: The subjects of this study were patients with minimum BMI of 40, who did not have any known chronic diseases. Sleeve gastrectomy was performed and perioperative control endoscopy was performed. The following values were measured before the operation and after follow-up period after the operation: Fasting blood glucose and insulin, lipid profile, BMI, liver function tests, right and left CIMT. Furthermore, the patients' insulin resistance was calculated by HOMA method, and the values of 2.7. PARTICIPANTS: Six-teen patients (14 women and 2 men, average age: 39.12 ± 10.63 years), who did not have a known additional chronic disease, took part in the study. RESULTS: There was a significant difference between baseline and follow-up values of the patients, and the mean weight loss was 20.5%. Given the statistical evaluation of baseline and follow-up values, there was a significant difference in BMI, insulin resistance rates and right and left CIMT values. CONCLUSIONS: Bariatric surgery may provide some additional advantages for the management of cardiovascular risks in obese patients. However, it should be kept in mind that the most important components of fight against obesity are appropriate diet and exercise programs.

Relationship between 1,25-dihydroxy Vitamin D levels and homeostatic model assessment insulin resistance values in obese subjects.

AIM: In this study, our aim is to evaluate the insulin resistance and quality of life in obese subjects and nonobese subjects and to find out the Vitamin D (VD) status and correlations between obesity and control groups and also according to their quality of life scores. MATERIALS AND METHOD: The study was carried out between May and October 2013 which is the period of VD synthesis in Turkey. The participants of this study were volunteering individuals - obese and nonobese individuals defined according to the body mass index (BMI) - that did not receive any VD support in the last 1-year and did not have any known chronic diseases. 1,25-OH VD status and homeostatic model assessment insulin resistance (HOMA-IR) values were evaluated. RESULTS: The study population consisted of 39 individuals with normal weight (23 women, 16 men) and 66 individuals categorized as obese (51 women, 15 men). The difference in HOMA-IR and VD values between the group of obese individuals and the group of nonobese individuals was significant (P < 0.001 vs. P <0.001). The median value of HOMA-IR was higher in the obese group than in the nonobese group (P < 0.001) while the median value of VD was higher in the nonobese group than in the obese group (P < 0.001). The results regarding the relationship of BMI with HOMA-IR and VD show that there was a positive correlation between HOMA-IR and BMI (rs = 0.507; P < 0.001) and there was a negative correlation between HOMA-IR and VD (rs = -0.316; P = 0.0001). CONCLUSION: Given serious diseases associated with low serum VD levels such as diabetes and cardiovascular disorders as well as low side effect incidence and low cost of VD treatment, it would be a reasonable approach to identify routine serum 25(OH) D and/or 1,25-OH VD levels of obese patients and administer a treatment to patients with low levels of VD.

Microstructural, textural, and sensory characteristics of probiotic yogurts fortified with sodium calcium caseinate or whey protein concentrate.

The influence of milk protein-based ingredients on the textural characteristics, sensory properties, and microstructure of probiotic yogurt during a refrigerated storage period of 28 d was studied. Milk was fortified with 2% (wt/vol) skim milk powder as control, 2% (wt/vol) sodium calcium caseinate (SCaCN), 2% (wt/vol) whey protein concentrate (WPC) or a blend of 1% (wt/vol) SCaCN and 1% (wt/vol) WPC. A commercial yogurt starter culture and Bifidobacterium lactis Bb12 as probiotic bacteria were used for the production. The fortification with SCaCN improved the firmness and adhesiveness. Higher values of viscosity were also obtained in probiotic yogurts with SCaCN during storage. However, WPC enhanced water-holding capacity more than the caseinate. Addition of SCaCN resulted in a coarse, smooth, and more compact protein network; however, WPC gave finer and bunched structures in the scanning electron microscopy micrographs. The use of SCaCN decreased texture scores in probiotic yogurt; probably due to the lower water-holding capacity and higher syneresis values in the caseinate-added yogurt sample. Therefore, the textural characteristics of probiotic yogurts improved depending on the ingredient variety.

A novel mechanism for chaperone-mediated telomerase regulation during prostate cancer progression.

Telomerase activity has been detected in >85% of all malignant human cancers, including 90% of prostate carcinomas. Using a well-characterized experimental prostate cancer system, we have found that telomerase activity is notably increased (>10-fold) during tumorigenic conversion. Expression profiles of the telomerase components (hTR and hTERT) revealed no substantive changes, which suggests a nontranscriptional mechanism for increased activity. Because the hsp90 chaperone complex functionally associates with telomerase, we investigated that relationship and found that along with telomerase activity, a number of hsp90-related chaperones are markedly elevated during transformation, as well as in advanced prostate carcinomas. Using the nontumorigenic cell protein extract as the source of telomerase, addition of purified chaperone components enhanced reconstitution of telomerase activity, which suggests a novel mechanism of increased telomerase assembly via a hsp90 chaperoning process during prostate cancer progression.

Intrathyroidal water-clear cell parathyroid adenoma: a case report.

Adenomas of the parathyroid gland, the majority of which contain mixed cell populations, are the most frequent cause of primary hyperparathyroidism. Parathyroid adenomas composed exclusively of water-clear cells are exceptionally rare. Until now, only 2 cases have been reported in English literature. We report a water-clear cell adenoma of the parathyroid gland in an intrathyroidal position, which has not been described previously according to our knowledge.

CD20 positive T cell lymphoma: is it a real entity?

CD20+ T cell lymphoma is a rare condition that includes both precursor and peripheral T cell types. However, these cases may be mistaken for T cell marker positive B cell lymphoma, thus creating diagnostic problems with subsequent clinical implications. This report describes a unique case of nodal CD20+ T cell lymphoma with simultaneous cutaneous and subcutaneous involvement. Both nodal and cutaneous lymphomas demonstrated identical monoclonal bands in the T cell receptor rearrangement assay. However, no CD20 expression was demonstrated in the skin lesion. The instability of the CD20 antigen in this tumour may imply that CD20 is not an integral part of the tumour immunophenotype and probably plays no important role in its clinical course. Techniques to avoid misdiagnosis of this lymphoma are discussed.

Effects of propylthiouracil, propranolol, and vitamin E on lipid peroxidation and antioxidant status in hyperthyroid patients.

OBJECTIVE: The purpose of this study was to examine lipid peroxidation and antioxidant states during hyperthyroidism states and after given different treatments. DESIGN AND METHODS: We examined 44 hyperthyroid patients and 19 euthyroid healthy controls. Patients were divided into three groups according to the treatment: Propylthiouracil (PTU) group, PTU + propranolol (PRP) group, PTU + PRP + vitamin E (vitE) group. RESULTS: In the hyperthyroid patients plasma malondialdehyde (MDA) levels were significantly high as compared to the control group (p < 0,001). There was a significant decrease in the MDA levels post-treatment (p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group, p < 0.01 in the PTU group). In the hyperthyroidism, blood reduced glutathione (GSH) levels were lower, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities were higher than in the control group, but these changes were not significant. Post-treatment in each of the three groups the GSH levels were increased significantly as compared to the pretreatment levels (p < 0.001). There was significant decrease in the SOD activity post treatment (p < 0.01 in all three groups). Post-treatment CAT activity was decreased (p < 0.05 in the PTU group, p < 0.001 in the other two groups). The erythrocyte glutathione peroxidase (Gpx) activity was lower significantly in the hyperthyroidism as compared to the control group (p < 0.001). Post-treatment, in the three groups Gpx activity increased significantly as compared to the pretreatment levels (p < 0.05 in the PTU group, p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group). CONCLUSION: We considered that giving all three treatments would be useful to the prevention of oxidative stress in the hyperthyroidism states.

Ultrasonographic follow-up of infantile hypertrophic pyloric stenosis after pyloromyotomy: a controlled prospective study.

Although the ultrasonographic assessment of hypertrophic pyloric stenosis (IHPS) has become the main radiological method for this disease, our knowledge about postoperative ultrasonographic follow-up is very limited. To evaluate the ultrasonographic outcome of the pylorus, we performed ultrasonographic measurements of the pylorus in 22 children with IHPS, before and after the operation in a prospective trial. The sonograms following surgery were undertaken at the end of the 1st postoperative week and of the 1st, 3rd and 6th month postoperatively. Three main ultrasonographic parameters were used: pyloric muscle thickness (MT), pyloric diameter (PD) and pyloric length (PL). The values of the pylorus, especially the "MT" measurements, began to decrease almost by the end of the first postoperative week, and were normal by the 3rd month in the majority of cases. However, the averages of the PL and PD values never returned to normal throughout the 6 months follow-up. There was a highly significant difference between the average values of pyloric muscle thickness at admission and at the 6th month after surgery (p < 0.001). Within one month after surgery, the ultrasonographic parameters returned to the levels of those in control infants. However, except for MT, they did not return to their normal ranges. Therefore, MT is the most useful parameter for ultrasonographic postoperative evaluation if the normal ultrasonographic values, as given in the literature, are used.

The treatment of a fusion between the maxillary central incisor and supernumerary tooth: report of a case.

Fusion has been described as a developmental anomaly characterized by the union of two adjacent teeth. Supernumerary teeth develop as a consequence of the proliferation of epithelial cells from dental lamina. In this paper a fusion between maxillary central incisor and a supernumerary tooth which required endodontic, surgical and periodontal treatment is presented.

Effects of inulin and oligofructose on the rheological characteristics and probiotic culture survival in low-fat probiotic ice cream.

The effects of supplementation of oligofructose or inulin on the rheological characteristics and survival of Lactobacillus acidophilus La-5 and Bifidobacterium animalis Bb-12 in low-fat ice cream stored at -18 degrees C for 90 d were studied. Addition of oligofructose or inulin to ice cream mix significantly increased apparent viscosity and overrun and developed the melting properties in ice cream during storage (P < 0.05). However, the highest increase in firmness, the lowest change in melting properties, and the longest 1st dripping time were obtained in probiotic ice cream containing inulin (P < 0.05). Some textural properties have also improved especially by the end of storage. Freezing process caused a significant decrease in the viability of Lactobacillus acidophilus La-5 and Bifidobacterium animalis Bb-12 (P < 0.05). Oligofructose significantly improved the viability of L. acidophilus La-5 and B. animalis Bb-12 in ice cream mix (P < 0.05). Although the viable numbers for both bacteria decreased throughout the storage, the minimum level of 10(6) CFU/g was maintained for B. animalis Bb-12 in only ice cream with oligofructose during storage.

Rapid cell blocks improve accuracy of breast FNAs beyond that provided by conventional cell blocks regardless of immediate adequacy evaluation.

A new "rapid cell block" technique (RCB; the predecessor of Cellienttrade mark Automated Cell Block System) is efficient at recovering sparse material. We previously found that RCBs of breast fine-needle aspirations (FNAs) frequently allow histologic classification of problematic ductal proliferative lesions. Previous studies that did not emphasize cell blocks found that on-site evaluation (OSE) of breast FNAs improves diagnosis. The purpose of this study was to determine if RCB could replace the utility of OSE of breast FNAs. The study included 604 consecutive ultrasound-guided noncyst breast FNAs composed of three cohorts based on the presence or absence of immediate adequacy assessment, conventional (collodion bag) cell blocks (CCB), and RCB. The cohort with OSE together with CCB did not perform as well as the cohort without OSE but with RCB. In a third cohort, performance characteristics of RCBs and CCBs were compared in an independent review by two cytopathologists blinded to the final cytology and follow-up histology diagnosis. By itself, the RCB histologic section was diagnostic 97% of the time, and it provided a diagnostic accuracy superior to CCB by itself and comparable to that provided by the combination of the smears with CCB. Highest accuracy was obtained by combining smears/monolayer preparations and RCB. Replacing OSE with RCBs provided substantial cost savings and savings of time for cytopathologists, radiologists, and their assistants.

Effects of fructooligosaccharide and whey protein concentrate on the viability of starter culture in reduced-fat probiotic yogurt during storage.

Viability of yogurt starter cultures and Bifidobacterium animalis was assessed during 28 d storage in reduced-fat yogurts containing 1.5% milk fat supplemented with 1.5% fructooligosaccharide or whey protein concentrate. These properties were examined in comparison with control yogurts containing 1.5% and 3% milk fat and no supplement. Although fructooligosaccharide improved the viability of Streptococcus thermophilus, Lactobacillus delbrueckii subs. bulgaricus, and Bifidobacterium animalis, the highest growth was obtained when milk was supplemented with whey protein concentrate in reduced-fat yogurt (P < 0.05). Supplementation with 1.5% whey protein concentrate in reduced-fat yogurt increased the viable counts of S. thermophilus, L. delbrueckii subs. bulgaricus, and B. animalis by 1 log cycle in the 1st week of storage when compared to control sample. Similar improvement in the growth of both yogurt bacteria and B. animalis was also obtained in the full-fat yogurt containing 3% milk fat and no supplement. Addition of whey protein concentrate also resulted in the highest content of lactic and acetic acids (P < 0.05). A gradual increase was obtained in organic acid contents during the storage.

The quality of hospital-based antenatal care in Istanbul.

The aim of this study was to gather comprehensive data from three hospitals in Istanbul, Turkey, in order to gain in-depth understanding of the quality of antenatal care in this setting. The Bruce-Jain framework for quality of care was adapted for use in evaluating antenatal care. Methods included examination of hospital records, in-depth interviews, exit questionnaires, and structured observations. The study revealed deficiencies in the quality of antenatal care being delivered at the study hospitals in all six elements of the quality-of-care framework. The technical content of visits varied greatly among the hospitals, and an overuse of technology was accompanied by neglect of some essential components of antenatal care. Although at the private hospital some problems with the technical content of care were identified, client satisfaction was higher there, where the care included good interpersonal relations, information provision, and continuity. Providers at all three hospitals felt constrained by heavy patient loads and a lack of resources. Multifaceted approaches are needed to improve the quality of antenatal care in this setting.

Frequency of angiotensin-converting enzyme gene polymorphism in Turkish type 2 diabetic patients.

We aimed to investigate the angiotensin-converting enzyme (ACE) gene polymorphism, ACE activity and their associations with diabetic complications in Turkish patients with type 2 diabetes mellitus. A total of 143 patients and 133 controls were screened for ACE gene I/D polymorphism by using polymerase chain reaction. Serum ACE activities were determined spectrophotometrically. There was no significant difference in the distribution of ACE I/D genotypes between patients and controls. The patients with DD genotype had a higher ACE activity than those with ID and II. Hypertensive diabetic patients with DD genotype had higher ACE activities than those with ID and II. There was no significant difference in the distribution of ACE I/D genotypes between patients with and without nephropathy, retinopathy and hypertension except for patients with and without neuropathy. In patients with DD genotype, creatinine clearance correlated with duration of diabetes. The grade of retinopathy was correlated with duration of diabetes in DD and ID genotypes. The highest ACE activity was measured in hypertensive diabetics with DD genotype. ID genotype was suggested to be a risk factor and II was suggested to be protective for diabetic neuropathy. The DD and ID genotypes might be a predictor for the development of retinopathy in relation to duration of diabetes.

Influence of yogurt and acidophilus yogurt on serum cholesterol levels in mice.

The effects of yogurt and acidophilus yogurt on the weight gain, serum cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, and the numbers of fecal lactobacilli and coliforms were investigated in mice assigned to three dietary treatments for 56 d: 1) commercial rodent chow and water (control), 2) commercial rodent chow and yogurt made from milk inoculated with a 3% (vol/vol) liquid culture of Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus (yogurt), and 3) commercial rodent chow plus yogurt made from milk inoculated with a 0.01% (wt/vol) freeze-dried culture of Streptococcus thermophilus plus Lactobacillus acidophilus. The weight gains of mice receiving yogurt or acidophilus yogurt were higher than those of the mice in the control group. The mean values for serum cholesterol concentrations and LDL cholesterol concentrations were significantly decreased when acidophilus yogurt was fed on d 28 and 56. High density lipoprotein cholesterol and triglycerides were not affected by yogurt or acidophilus yogurt. The highest number of fecal lactobacilli was found in mice receiving acidophilus yogurt, and the number of fecal coliforms of that group was also lower than in the other two groups.

Liquid chromatographic determination of thiamin in dairy products.

Concentrations of thiamin were determined in pasteurized and UHT-sterilized milks, yoghurt and kefir samples by high-performance liquid chromatography using a reversed-phase C-18 column connected to fluorescence detector. The linearity, recovery and reproducibility of the method were satisfactory. The thiamin content ranged from 0.305 +/- 0.02 to 0.252 +/- 0.03 mg/l in market milks. Yoghurt samples had higher concentration of thiamin (0.355 +/- 0.04 and 0.404 +/- 0.02 mg/l) than values found in market milks. The least thiamin content was found in kefir (0.175 +/- 0.03 mg/l) among the samples analyzed.