Evaluation of blood supply and metabolism in tumor, axillary lymph node and normal breast tissue with F-18 FDG PET/CT in breast cancer: comparison with pathological prognostic factors.

BACKGROUND AND PURPOSE: Perfusion parameters obtained in F-18 FDG PET/CT performed for staging purposes in breast cancers may provide additional information about tumor biology as well as glucose metabolism. The aim of this study was to evaluate throughout F-18 FDG PET/CT the relationship between blood flow and glucose metabolism and histological parameters of the primary tumor, normal mammary gland, and axillary lymph nodes in breast cancer patients. MATERIALS AND METHODS: Sixty six female patients (mean age 51 y ± 12,81) were prospectively included to this study. We performed dynamic blood flow (f) study that started with 296-444 MBq (8-12 mCi) F-18 FDG injection and lasted for 10 minutes, and glucose metabolism (m) imaging one hour later. On each frame, mean activity concentration (AC) values (Bq/mL) were recorded on a spherical volume of interest (VOI) having a volume of ~ 1 cm3 on the hottest voxel of primary tumor (T), across normal breast gland (NG) and ipsilaterally axillary lymph nodes (iLN). Correlations among PET parameters and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (c-erbB2) and Ki67 index were analyzed. RESULTS: T volume (TV) ranged from 1.1 to 85.28 cm3 [median (IR): 6.44 (11.78)]. There were positive correlations between c-erbB2 and TACf and between c-erbB2 and iLNACf (p = 0.045, r = + 0.248; p = 0.050, r = + 0.242). In the ER positive (ERP) patients, TV and TACm were significantly lower than those of ER negative (ERN) (respectively p = 0.044 and p = 0.041). In patients with two positive Ki-67 indices, iLN-SUVmax was significantly higher than one-positive patients (p = 0.020). There was a negative correlation between NGACm and histological grade of tumor (p = 0.005, r = - 0.365). CONCLUSIONS: Breast cancer shows differences in progression, metastasis and survival due to its diversity in terms of molecular, biological and angiogenesis. High glucose metabolism in breast cancers is associated with tumor aggressiveness. Being able to examine tumor tissue characteristics such as blood flow and glucose metabolism with a single diagnostic technique and to reveal its relationship with histological parameters can provide a reliable pretherapeutic evaluation in breast cancers.

Cytoprotective, antimutagenic/antirecombinogenic and antibacterial properties of Lallemantia iberica extracts.

BACKGROUND: Plants have important chemical compounds to protect organisms from many mutagens but they may also have dangerous toxic substances that must be tested before use. Lallemantia iberica has been used by local people for treatment of some diseases but it was never tested for its cell protective and antimutagenic/antirecombinogenic properties. In this study, it was aimed to determine the cytoprotective, antimutagenic/antirecombinogenic, antibacterial, antioxidant and phenolic profile of L. iberica by MTS assay, micronucleus test/somatic mutation recombination test (SMART), disc diffusion method, ABTS/DPPH tests and liquid chromatography (LC), respectively. RESULTS: MTS assay results showed that both of the extracts supported the normal growth of healthy human lymphocytes and there was no significant difference between extracts. Although there was no significant increase in micronucleus concentration (‰) of the cultures treated with ethanol or methanol extracts, methanol extract caused slightly lower micronucleus concentration (12.64 ± 3.65‰) than the ethanol extract (24.46 ± 4.50‰). SMART results showed that ethanol and methanol extracts prevented harmful mitotic recombination. Lallemantia iberica also showed antibacterial activity against all of the strains tested, and the largest inhibition zones were observed with Pseudomonas aeruginosa (17.9 mm) and Enterobacter aerogenes (13.8 mm). Methanol extracts showed better antioxidant activities (ABTS IC50 : 104.07 µg mL-1 , DPPH IC50 : 58.8 µg mL-1 ) than ethanol extracts (ABTS IC50 : 344.03 µg mL-1 , DPPH IC50 : 233.7 µg mL-1 ). According to the LC results, the most abundant phenolic compounds were rutin hydrate (1796.4 ± 62.9 mg kg-1 ) and p-coumaric acid (228.1 ± 7.60 mg kg-1 ). CONCLUSION: Lallemantia iberica extracts had cell-protective, antimutagenic/antirecombinogenic, antibacterial and strong antioxidant characteristics in relation to their rich phenolic content. © 2022 Society of Chemical Industry.

Effects of Androgen Deprivation Therapy on the Extraocular Muscles, Retrobulbar Orbital Fat and the Optic Nerve in Patients with Prostate Cancer.

INTRODUCTION: To evaluate radiologically the effects of long-term Luteinizing hormone-releasing hormone (LHRH) agonist therapy on extraocular muscle thickness, retrobulbar orbital fat (ROF), and optic nerve (ON) in prostate cancer (PCa) patients. METHODS: This retrospective study included patients with primary or recurrent PCa who received androgen deprivation therapy (ADT) for at least 12 months. Each patient underwentallium-68 prostate-specific membrane antigen positron emission tomography-computed tomography (Ga-68 PSMA PET/CT) both before and at the end of the 12-month treatment. Thickness of the ON, lateral rectus muscle (LRM), medial rectus muscle (MRM), superior rectus muscle (SRM) and the inferior rectus muscle (IRM) were measured by using the coronal CT sections in soft tissue window. ROF, ocular protrusion and ON length were measured in sagittal and coronal planes. Changes in these anatomical structures induced by LHRH analogs were investigated by comparing pre- and post-treatment measurements. RESULTS: A total of 57 patients were included in the study. Median PSA and TT values of the patients before treatment were 36.5 ng/mL (range, 19.6-51.2) and 614.0 ng/dL (range, 472.0-743.0), respectively, and these values decreased significantly after the treatment (10.6 [range, 5.2-14.2] ng/mL and 36.5 [range, 19.6-51.2] ng/dL, p<0.001 for both). After the treatment, there was a statistically significant decrease in the areas of IRM, SRM, LRM, and MRM (for each, p<0.001), while significant increases were observed in ROF (11.9%, p<0.001) and ON thickness (14.3%, p=0.004). The amount of ocular protrusion also showed a significant increase of approximately 14% after the treatment (14.0 [range, 12.0-16.0] mm vs. 16.0 [range, 14.0-17.2] mm, p<0.001). DISCUSSION/CONCLUSION: Our findings indicated for the first time that ADT causes a decrease in extraocular muscle mass and an increase in ROF with ocular protrusion. It can be asserted that these changes are similar to the changes in skeletal muscle and fat mass in other body parts. Further studies with a higher level of evidence are needed to clinically evaluate the increase in ocular protrusion and ON enlargement, which are likely to be caused by the increase in ROF.

Relationship between Serum YKL-40 Level and Forearm Arterial Patency after Repair.

BACKGROUND: The study aimed to assess the effects of serum YKL-40 level on patency at the repair site in patients who underwent arterial repair at the level of the forearm. METHODS: The study included 58 subjects, including 29 patients (aged 18-50 years) who had ulnar or radial artery injury secondary to cut injury to wrist between June 2015 and November 2019 and no comorbid disease and 29 age- and sex-matched healthy controls. The vascular patency was assessed using Doppler sonography in patients who underwent arterial repair at the level of the forearm. The patients were defined as flow failure if the blood flow was ≤50%, and sufficient flow if the blood flow was >50% of those in the synonymous artery on the intact extremity. The YKL-40 level differences in the patient and control groups were compared to those in the sufficient and insufficient flow groups. RESULTS: The patients were stratified into 2 groups based on the presence of sufficient flow. The mean YKL level was 11.96 ± 8.87 in the sufficient flow groups, whereas it was 32.22 ± 15.43 in the insufficient flow groups (p= 0.038). Besides, it was found that each unit of increase in the YKL-40 level increased the likelihood of having flow failure by 1.128. CONCLUSION: Based on our results, it was observed that over-expression of the YKL-40 level has adverse effects on patency following arterial repair.

What are the requirements for patient-centered breast imaging? Communication preferences of mammography patients in Turkey.

We have investigated communication preferences of mammography results in 90 patients through a structured interview approach. About 81% of patients expressed that they wanted to get the results, and 18% expressed that getting the results does not help if they are incomprehensible. In patients who want to get the results, 80% preferred face-to-face interaction with physicians, whereas the others preferred other modes of communication to prevent loss of time. Majority of patients infavor of face-to-face interaction (57%) preferred both the referring physician and the radiologist. Comprehensibility and fast delivery of reports, plus direct communication with radiologists are the requirements in mammography patients while implementing patient-centered radiology.

The ability and utility of diffusion-weighted magnetic resonance imaging with different 'b' values in the differentiation of benign from malignant lung lesions.

PURPOSE: To evaluate the ability and the utility of diffusion-weighted magnetic resonance imaging (MRI) with different 'b' values to visualise benign and malignant lung lesions, and to determine which 'b' value (b = 300, 500, or 1000 s/mm2) was most useful in differentiating benign from malignant lung lesions. MATERIAL AND METHODS: A total of 100 patients (28 women, 72 men; mean age = 57.19 ± 13.44 years; age range = 20-83 years). Diffusion-weighted imaging (DWI) was obtained with 'b' values of 300, 500, and 1000 s/mm2. The signal intensity of lesions on DWI images was analysed, and the apparent diffusion coefficient (ADC) values of the lesions were calculated. MRI was performed in all patients after having presented at our department for thoracic computed tomography for various reasons. RESULTS: A statistically significant difference in DWI signal scores was detected between benign and malignant lesions for all 'b' factors (p < 0.0001 for each). The sensitivity and specificity were 95% and 64%, respectively, when a score of 3 for ß = 300 s/mm2; 90% and 69%, respectively, when a score of 3 for ß = 500 s/mm2; and 84% and 74%, respectively, when a score of 3 for ß = 1000 s/mm2. ADC values showed significant differences between benign and malignant lesions for all 'b' factors (p < 0.0001 for each). CONCLUSIONS: Using 'b' values of 300, 500, and 1000 s/mm2, DWI signal intensity scores and ADC values are effective methods for the differential diagnosis of malignant and benign pulmonary lesions.

Autosomal dominant polycystic kidney disease: new role for ultrasound.

OBJECTIVES: To evaluate the accuracy of US in calculating renal volumes and renal resistive index (RRI) that was obtained using a new method in patients with autosomal dominant polycystic kidney disease (ADPKD). METHODS: In this prospective study, US and MRI were performed in 57 patients with ADPKD (31 female and 26 male; age range, 19-79 years) between August 2017 and May 2018. The volumes determined using US and MRI were compared. The ellipsoid formula was re-evaluated using different multipliers. RRI was obtained 1.5-2 cm distal to the outlet of main renal arteries. The relationship between mean RRI, renal function tests, and kidney volumes and difference between mean RRI of ADPKD patients with and without renal failure were investigated using a two-sided independent samples t test and Pearson correlation test. Interobserver agreements for volume assessments and RRI measurements were determined. RESULTS: By changing the ellipsoid formula, a very good agreement was found (ICC 0.970 for the right kidney and ICC 0.973 for the left kidney). The mean RRI in the right renal artery was 0.61 ± 0.07 and in the left renal artery 0.63 ± 0.06. The mean RRI of ADPKD patients with renal failure was significantly higher than that of patients without renal failure (p = 0.005). There was a significant correlation between mean RRI and renal function tests. CONCLUSION: The accuracy of the US in calculating renal volumes increases by adapting the ellipsoid formula. RRI may be used for the management of ADPKD independently of volumes. KEY POINTS: •The accuracy of ultrasonography for renal volume measurement increases by changing the classical ellipsoid formula. •Renal resistive index measured by color Doppler ultrasonography is helpful for the management of autosomal dominant polycystic kidney disease. •The role of Doppler US in autosomal dominant polycystic kidney disease should increase as a result of our findings.

Percutaneous treatment of liver hydatid cysts in 190 patients: a retrospective study.

Background Hydatid liver disease (HLD) is a significant health problem, especially in endemic areas worldwide. Percutaneous treatment is an effective alternative therapeutic option. Purpose To present the clinical and radiological results of percutaneous treatment of HLD in 190 patients. Material and Methods Percutaneous treatment of HLD between April 2005 and March 2015 was analyzed retrospectively. The demographic data, numbers and types of cysts, initial and final volumes of the cysts, types of percutaneous treatment, and procedure-related complications were determined. Results A total of 190 patients (95 male patients and 95 female patients; age range, 5-82 years) with 283 liver hydatid cysts who underwent percutaneous treatment were included in the study. Of the 283 cysts, 234 (83%) were cystic echinococcosis CE1, 31 (11%) were CE3a, and 18 (6%) were CE2 cysts, according to the World Health Organization (WHO) classification. The percutaneous procedure was successful in all patients. A total of 12 (6.3%) major complications, including anaphylaxis, allergic skin reaction, perihepatic hemorrhage, and cavity infection, were seen. No mortality was noted. Recurrence in one patient and an additional cyst in one patient were seen. All patients were asymptomatic during the follow-up period. Mean volume reduction was 77.5%, with a mean follow-up period of 18 months. Conclusion Percutaneous treatment is an effective and safe method for the treatment of HLD. It should be regarded as a first-line treatment method for uncomplicated hydatid cysts.

Usefulness of Apparent Diffusion Coefficient of Diffusion-Weighted Imaging for Differential Diagnosis of Primary Solid and Cystic Renal Masses.

BACKGROUND: To evaluate the value of diffusion-weighted imaging (DWI) for distinguishing between benign and malignant renal masses. MATERIAL/METHODS: Seventy-five patients with 75 unilateral renal lesions were included, and 75 normal contralateral kidneys served as controls. The lesions were categorized into four groups as malignant cystic, malignant solid, benign cystic and benign solid. The apparent diffusion coefficients (ADCs) were evaluated for two different b values (b=600 s/mm2 and b=1000 s/mm2). Receiving operating characteristic analysis was performed to identify threshold ADCs. RESULTS: Sensitivity and specificity were 67% and 77% (p=0.003) at the cutoff value of 1.5 for b=600 s/mm2, and 79% and 62% (p=0.004) at the cutoff value of 1.99 for b=1000 s/mm2 as regards the differentiation between solid benign and malignant renal lesions. Sensitivity and specificity were 78% and 79% (p=0.001) at the cutoff value of 3.1 for b=600 s/mm2, and 86% and 61% (p=0.003) at the cutoff value of 2.9 for b=1000 s/mm2 as regrads the differentiation between benign and malignant cystic renal lesions. CONCLUSIONS: DWI can be an effective diagnostic method for distinguishing between benign and malignant renal masses.

Imaging findings and management of diaphragmatic mesothelial cysts in children.

BACKGROUND: Diaphragmatic mesothelial cysts are rare benign congenital lesions with typical imaging findings. OBJECTIVE: To present imaging and treatment outcomes in 30 children with diaphragmatic mesothelial cyst. MATERIALS AND METHODS: We conducted a retrospective chart review and recorded demographic data, imaging findings, treatment and US follow-up results, initial and final volume of the cysts and length of follow-up period for each case of diaphragmatic mesothelial cyst in a specialist hospital. RESULTS: The study included 30 children (16 girls, age range 1-17 years, mean age 7.9 years) diagnosed with diaphragmatic mesothelial cyst between January 2010 and December 2015. Imaging findings included thin-walled bilobulated or oval-shape cysts located between the diaphragm and right lobe of the liver. Treatment consisted of percutaneous drainage in 17 children and was successful in all. Cysts disappeared completely in 12 of these 17 children (70.5%, 95% confidence interval [CI] 44-90%). Mean volume reduction was 98%. No complication or mortality was seen. The other 13 children were followed with US without treatment. In 4 of these 13 children (30.8%, 95% CI 9-61%), cysts spontaneously decreased in size. No cyst increased in size. CONCLUSION: In children with typical imaging findings, percutaneous drainage appears safe and effective when treatment is deemed necessary.

Percutaneous ultrasound-guided core needle biopsy of solid pancreatic masses: Results in 250 patients.

BACKGROUND: To determine the diagnostic accuracy and complications of percutaneous sonographic (US)-guided core needle-needle biopsy in the diagnosis of solid pancreatic masses. METHODS: Cases of US-guided percutaneous core needle biopsy of solid pancreatic masses performed in our department between July 2009 and June 2015 were analyzed retrospectively. The demographic data, lesions' size and location, pathology results, accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and complications of the biopsies were determined. RESULTS: A total of 250 patients (150 males, 100 females; age range, 16-88 years; mean age, 64.3 ± 12.1 years) were included in the study. The overall diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of all 250 biopsies were 94.8%, 94.3%, 97.2%, 99.5%, and 75%, respectively, and changed to 98.4%, 99%, 94.7%, 99%, and 94.7%, respectively, after the biopsy was repeated in 12 patients. Four (1.6%) major complications, including a pseudoaneurysm of the gastroduodenal artery, and three cases of acute pancreatitis, and one (0.4%) minor complication (a vaso-vagal syncope), were observed. There was no biopsy-related death. CONCLUSIONS: US-guided percutaneous core needle biopsy is a safe and highly effective method with acceptable complication rates in the diagnosis of solid pancreatic masses. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:470-473, 2016.

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results.

BACKGROUND: To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. MATERIAL/METHODS: The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. RESULTS: The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. CONCLUSIONS: For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful.

Views and experiences of individuals with autism spectrum disorder and their mothers during the COVID-19 pandemic.

Background: The COVID-19 pandemic is thought to have a variety of effects on people with an autism spectrum disorder (ASD). The purpose of this study was to look into the perspectives and experiences of people with ASD and their mothers regarding the effects of the COVID-19 pandemic. Method: The current study employs a qualitative research approach. Semi-structured interviews were used to collect data. The study included the participation of 16 individuals. Eight of them had ASD, while the remainder were their mothers. Results: The information was divided into two categories: people with ASD and their mothers. The data collected from individuals with ASD were organized into four major themes: (a) the meaning of COVID-19 for them; (b) pandemic activities; (c) measures taken during the pandemic; and (d) pandemic reflection on the school. The data drawn from the mothers of the individuals with ASD were categorized into two themes: (a) the impact of the pandemic and (b) changes in children with ASD during the pandemic. Conclusions: The study results show that individuals with ASD could not perform as many activities during the pandemic as they would usually do. Hence, the results suggested that the participants were adversely affected by the pandemic.

The Depth of Invasion and Level IV Cervical Node Metastasis in Patients with Clinically N0 Tongue Cancer.

BACKGROUND: The accurate indication for level IV dissection is crucial for preventing complications such as phrenic nerve damage and chylous fistulas in clinically N0 tongue cancer. Although the depth of invasion is an established independent risk factor for occult lymph node metastasis in tongue cancer, its relationship with level IV metastasis has not been evaluated. This study investigated the relationship between the depth of invasion and level IV nodal metastasis in clinically N0 tongue cancer. METHODS: We retrospectively investigated clinical N0 patients who underwent glossectomy and level I-IV neck dissection. We examined lymph node metastasis, risk factors, and the relationship between depth of invasion and metastasis. RESULTS: Our study included 58 patients, and no patient had isolated level IV metastasis. Additionally, there was no level IV metastasis in well-differentiated tumors. Tumor size, depth of invasion, differentiation, and perineural invasion were significantly associated with level IV neck metastasis. We found a critical tumor size of 2.5 cm and depth of invasion of 8 mm for level IV neck metastasis. CONCLUSION: Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and those deeper than 8 mm. This study highlights the importance of depth of invasion as a prognostic factor for predicting level IV metastasis and suggests that our findings can be used to prevent unnecessary level IV dissections that may lead to complications in tongue cancer surgery.

Generation of magnetic biohybrid microrobots based on MSC.sTRAIL for targeted stem cell delivery and treatment of cancer.

Background: Combining the power of magnetic guidance and the biological activities of stem cells transformed into biohybrid microrobots holds great promise for the treatment of several diseases including cancer. Results: We found that human MSCs can be readily loaded with magnetic particles and that the resulting biohybrid microrobots could be guided by a rotating magnetic field. Rotating magnetic fields have the potential to be applied in the human setting and steer therapeutic stem cells to the desired sites of action in the body. We could demonstrate that the required loading of magnetic particles into stem cells is compatible with their biological activities. We examined this issue with a particular focus on the expression and functionality of therapeutic genes inside of human MSC-based biohybrid microrobots. The loading with magnetic particles did not cause a loss of viability or apoptosis in the human MSCs nor did it impact on the therapeutic gene expression from the cells. Furthermore, the therapeutic effect of the gene products was not affected, and the cells also did not lose their migration potential. Conclusion: These results demonstrate that the fabrication of guidable MSC-based biohybrid microrobots is compatible with their biological and therapeutic functions. Thus, MSC-based biohybrid microrobots represent a novel way of delivering gene therapies to tumours as well as in the context of other diseases.

Social robots in the instruction of social skills in autism: a comprehensive descriptive analysis of single-case experimental designs.

PURPOSE: The rapid technological advances, the traits of individuals with ASD and their interest in technology are promising for the instruction of social skills to individuals with autism spectrum disorder (ASD) using various technological interventions. Robotic interventions are among these. However, although robotics is frequently used with individuals with ASD, there is a limited number of reviews on social skills instruction and methods. The present study aimed to conduct a comprehensive descriptive analysis on single-case experimental designs where social skills were instructed to individuals with ASD and social robots were included as independent variables. MATERIALS AND METHODS: Thirteen single-case experimental designs published in peer-reviewed journals in which social skills were taught to individuals with ASD using social robots were reviewed with a comprehensive descriptive analysis based on five categories: (a) key characteristics, (b) methodological characteristics, (c) findings, (d) data analysis, and (e) key parameters in single-case experimental designs. RESULTS: Social robots are generally effective in the instruction of social skills. Several social skills (e.g., making eye contact, social interaction, simple greetings) were instructed in the studies. Humanoid robots and NAO were used generally. The study data were predominantly analyzed statistically. There were several problems in research based on the basic parameters in single-case experimental designs. CONCLUSIONS: The researches in this study differ in several respects (e.g., results, data analysis, and dependent variable). Thus, there is still a need for several robotics studies in the instruction of social skills. IMPLICATIONS FOR REHABILITATIONThis study will be a guide for teachers who currently use robots in their classrooms but do not know which skills to use in teaching and how to use them functionally, as it shows applied research with robots.The findings of this research will show implementers working with children with ASD that technological tools can be used in rehabilitation environments, and that teachers can take a place in their robots in interventions for children with ASD, giving them a different perspective.It will be seen that the education of children with ASD is not only 1:1 and with humans, but robots can also provide education. In this way, the power of technology in teaching will become clearer. Especially in rehabilitation.Finally, this research will offer new options in teaching especially for teachers who aim at teaching social skills and will give them the opportunity to comprehensively examine the processes of different studies on these subjects.

Biological activities of some Salvia species.

In this study, total phenolic, flavonoid and protein contents, antiradical capacities, antibacterial and cytotoxic properties of five different Salvia species (Salvia macrochlamys Boiss., Salvia kronenburgii Rech.f., Salvia euphratica Montbret. ex Aucher var. euphratica, Salvia huberi Hedge and Salvia kurdica Benth) were investigated. The total phenolic content of the species was in the range of 59.6 ± 20 to 150.1 ± 1.1 mg/g, total flavonoid content in the range of 20.4 ± 2.2 to 38.9 ± 4.1 mg/g, and total protein content in the range of 14.0 ± 0.5 to 22.0 ± 1.1 mg/g. Radical scavenging capacities of the Salvia species were determined in the range of 84.1 ± 4.5 to 96.8 ± 0.1%. Moreover, Salvia extracts showed powerful antibacterial activity against Escherichia coli and Staphylococcus aureus bacteria. Cytotoxic effects of the samples on human lymphocytes were determined by MTS assay and S. kronenburgii and S. euphratica var. euphratica decreased the harmful effects of 2-hydroperoxy-2-methylpropane (tert-butyl hydroper-oxide, t-BOOH) at all time points tested. The highest amounts of rutin hydrate belong to S. kronenburgii and S. euphratica var. euphratica, and the highest amounts of luteolin-7-glucoside belong to S. huberi and S. kronenburgii. Vanillic acid was present only in S. huberi and S. kurdica.

Assessment of clinical, biochemical, and radiological outcomes following intra-articular injection of Wharton jelly-derived mesenchymal stromal cells in patients with knee osteoarthritis: A prospective clinical study.

The aim of the present study was to perform clinical, biochemical, and radiological evaluation of the efficacy of mesenchymal stem cells derived from Wharton jelly (WJ) present within the human umbilical cord in the treatment of knee osteoarthritis. Between 2018 and 2019, 10 patients with knee osteoarthritis for whom the conservative treatment was not beneficial were included in the study. Patients were clinically, radiologically, and biochemically evaluated before treatment initiation. Thereafter, the patients were intra-articularly injected using a solution containing 1 × 108 WJ-derived MSCs. Evaluations were performed on day 21 (V1) and 42 (V2) and month 3 (V3), 6 (V4), and 12 (V5) after the procedure. At 1-year post-injection, visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, and Lequesne scores of patients were lower than those observed during the initial evaluation, whereas the mean 36-Item Short Form Health Survey score was higher. Cartilage thicknesses were found to be increased in all regions except in the medial femur, medial posterior femur, lateral posterior femur, and lateral posterior tibia regions in magnetic resonance imaging. A significant increase was observed in tumor necrosis factor-alpha, interleukin-1ß, adiponectin, resistin, and interleukin-6 levels compared with pre-injection values. The leptin levels at 6-month and 1-year controls were lower than the pre-injection levels, and the decrease observed at 6 months was significant. In patients with knee osteoarthritis, intra-articular WJ-derived MSC injection causes significant pain reduction, satisfactory functional improvement, and increased patient satisfaction following a 1-year follow-up. These clinical improvements were supported by magnetic resonance images, along with changes in adiponectin and leptin levels in synovial fluid. Level of evidence: IV.

Effect of long-term and high-dose allopurinol therapy on endothelial function in normotensive diabetic patients.

OBJECTIVES: Endothelial dysfunction is a well known risk factor for atherosclerosis. Uric acid levels are associated with endothelial dysfunction and atherosclerosis even if in physiological range. Xanthine oxidase inhibition with allopurinol decreases uric acid levels and oxidative stress and improves endothelial function. We have investigated the effect of high-dose and long-term allopurinol therapy on endothelial function in diabetic normotensive patients. METHODS: This study is a randomized, single-blind, placebo-controlled trial. Both treatment and placebo groups consisted of 50 patients. In the treatment group, daily oral 900 mg allopurinol was started after randomization and maintained for 12 weeks. Brachial artery flow-mediated dilatation (FMD) and nitrate-induced dilatation (NID) were measured at baseline and after the allopurinol therapy to evaluate endothelial function. RESULTS: HbA1c and uric acid levels decreased after allopurinol therapy (6.1 ± 2.1 vs 5.5 ± 1.0%, 5.0 ± 0.8 vs 3.3 ± 0.5 mg/dl, respectively, p = 0.01) but no change was observed in the placebo group (7.7 ± 1.9% vs 7.6 ± 2.0%, 5.3±2.1 vs 5.6 ± 0.8 mg/dl, respectively, p > 0.05). FMD and NID increased significantly in the treatment group (5.6 ± 2.1% vs 8.5 ± 1.2%, 10 ± 7.4% vs 14 ± 4.0%, 10 ± 7.4% vs 14 ± 4.0%, respectively, p = 0.01), whereas no change was observed in the placebo group (5.8 ± 1.8% vs 6.1 ± 0.8%, 12 ± 9.5 vs 10 ± 3.8%, respectively, p > 0.05). CONCLUSION: Long-term and high-dose allopurinol therapy significantly improved endothelial function in diabetic normotensive patients. In addition, allopurinol therapy contributes to the lower HbA1c levels.