The success of dorsal onlay buccal mucosal graft urethroplasty in challenging urethral stricture cases after multiple failed urethrotomies.

Background: Urethroplasty is the gold standard treatment procedure for male patients with urethral stricture and is becoming increasingly popular among urologists worldwide. Procedure success rates have risen with increased experience. Aims: Here we aimed to examine the results of urethroplasty in challenging cases of urethral stricture and its effect on sexual function. Patients and Methods: Data were collected retrospectively from the patients who had undergone urethroplasty after multiple failed direct vision internal urethrotomy (DVIUs) from 2017 to 2020. All patients were monitored for a minimum of 12 months. Outcomes of urethroplasty were analyzed according to stricture location, length, and the number of prior DVIUs. Penile length and sensation, erectile, and ejaculatory function of the patients were evaluated pre- and postoperatively. Results: The patient cohort consisted of 36 males with a mean age of 63 ± 3.2 years. The most prevalent stricture etiology was iatrogenic (83%). Patients who underwent three or more DVIUs before urethroplasty and stricture length >4 cm were included in the analysis. Accordingly, the overall success rate was 83% (30/36). When the success rate and the IIEF5 scores were assessed separately, there was no significant relationship between the number of DVIUs (P > 0.05). Similarly, no significant relationship was also found with the stricture length (P > 0.05). Conclusion: Appropriate and correctly applied surgical technique does not impair sexual activity, even in patients with severe urethral stricture, regardless of the length or location of the stricture and the number of prior endoscopic procedures.

Spontaneous regression of lumbar disc herniations: A retrospective analysis of 5 patients.

The aim of this study is to describe patients who represent spontaneous regression of lumbar disc herniations (LDHs) subsequent to conservative treatments. In this retrospective study, medical records of 862 patients who had presented to our neurosurgery department with LDHs between May 2014 and May 2016 were studied. All of these patients had a history of low back pain and radiculopathy. Lumbar magnetic resonance imaging (MRI) scans were performed to diagnose them.LDHs were categorized into four subtypes including disc bulging, protrusion, extrusion, and sequestration. Five patients developed spontaneous regression of LDHs according to spinal MRI scans. All patients relieved radiculopathy symptoms in 2 to 4 weeks and low back pain symptoms in 3 to 8 weeks except one patient. In one patient hypoesthesia symptom, in one patient motor deficit, and in one patient low back painremained after the regression. The clinical and diagnostic imaging characteristics and outcomes of these five patients are described and the pertinent literature regarding spontaneous regression of LDHs is reviewed. Sequestrated disc herniations represent the main candidates for spontaneous regression according to our clinical research and the pertinent literature. Dehydration and inflammation-related resorption are the main mechanisms for this event. Conservative treatment modalities should not be underestimated for the treatment of such patients in the absence of definitive surgical indications.

Factors affecting recurrence after surgery for ovarian mature cystic teratoma.

We aimed to evaluate the risk factors for recurrence of surgically managed ovarian mature cystic teratoma (MCT). A total of 178 women with MCT managed surgically at our clinic were included in this retrospective study. The cases were followed for a minimum of 34 months. Risk factors recorded were age, gravidity, diameter of MCT, tumour markers, bilaterality, operation time and recurrence time. One hundred forty-one women (79.2%) underwent laparoscopy and the other thirty-seven patients (20.8%) underwent laparotomy. The mean age of patients with cyst recurrence was significantly lower than that of patients without recurrence (p = 0.02). There was a significantly lower median gravidity and parity in this group. The capacity of younger age, lower gravidity and parity in predicting the recurrence of ovarian MCT was analysed using receiver operating characteristic curve analysis. The cut-off value of age, number of gravidity and parity was 26, 1 and 0, respectively. In conclusion, younger age and lower gravidity and parity were predictive of recurrence due to a more conservative approach in young and nulliparous patients. Therefore, we suggest regular follow-up visits during the postoperative period, especially for younger patients and those with lower numbers of gravidity and parity.

Assessment of primary radical hysterectomy and neoadjuvant chemotherapy followed by radical hysterectomy in Stage IB2, IIA bulky cervical cancer.

OBJECTIVE: Uncertainty concerning the treatment of Stage IB2-IIA (bulky) cervical cancer is still continuing. In this study, an analysis of Stage IB2-IIA (bulky) cervical cancer was performed. The efficacy of primary radical surgery and neoadjuvant chemotherapy followed by a radical surgery was investigated. MATERIALS AND METHODS: Medical data of 50 patients who were diagnosed with Stage 1B2-IIA (bulky) cervical cancer and treated between 2002-2009 were retrospectively assessed. In the radical surgery group, radical hysterectomy + bilateral pelvic + para-aortic lymphadenectomy were performed. In the neoadjuvant chemotherapy group, a combination of cisplatin/topotecan or paclitaxel/carboplatin was given to the patients and then radical surgery was performed. Each group was evaluated individually. Prognostic factors were determined and survival rates were compared between the groups. Ap value was taken < 0.05 for the statistical significance level for all results. RESULTS: Radical surgery after neoadjuvant chemotherapy was performed in 21 and primary radical surgery in 29 patients. Median follow-up time was 36.0 +/- 14.0 months. Average of the tumor size before treatment was 50.2 +/- 7.6 mm. In the radical surgery after neoadjuvant chemotherapy group, lymphovascular space invasion (LVSI) and tumor size (before and after treatment) were determined to be significant factors for each of disease-free survival (DFS) and overall survival (OS). On multivariate analysis, tumor size (before treatment) was found to be an independent prognostic factor for both of DFS (p = 0.006) and OS (p = 0.010). No significant difference in survival periods was observed among the groups. CONCLUSION: There was no significant superiority among the two treatment options. Nonetheless, further studies are needed to compare the multimodal approaches in these stages of cervical cancer.

Risk factors for adverse clinical outcomes in patients with tubo-ovarian abscess.

This study assessed the risk factors for poor clinical outcomes in patients with tubo-ovarian abscess (TOA). Patients managed with medical therapy and discharged within 7 days without complications constituted the favourable prognosis group (n = 22), whereas those who were managed surgically or discharged after 7 days of antibiotic therapy constituted the poor prognosis group (n = 87). Variables including age, gravidity, number of dilation and curettage procedures, caesarean delivery, smoking status, serum C-reactive protein levels, serum white blood count, body temperature, abscess diameter, presence of an intrauterine device (IUD), duration of IUD placement and length of hospitalisation were evaluated to assess their relationship with the clinical prognosis of TOA. Abscess diameter of ≥ 6 cm was a significant parameter that increased the risk eightfold for poor prognosis. No significant differences were observed regarding the other variables.

Ameliorative effect of Leflunomide on lung injury following an aspiration.

BACKGROUND: We aimed to investigate the therapeutic effectiveness of leflunomide (LEF) in lung injury after an aspiration of unknown pathophysiology. MATERIAL AND METHODS: Forty-two healthy Sprague Dawley rats were anesthetized and allocated to six experimental groups: saline (S) aspirated, S+LEF, hydrochloric acid (HCl) aspirated, HCl+LEF, formula aspirated (FOR), and FOR+LEF. The treatment groups (S+LEF, HCl+LEF, and FOR+LEF) received 20 mg/kg/day intraperitoneal (i.p.) injection of LEF for seven days. At the end of the seven days, blood and tissue samples were taken from the rats for histopathological, biochemical, and immunohistochemical examination. RESULTS: There was a significant increase in serum levels of YKL-40, a chitinase-like protein, in the HCl group after the aspiration (p<0.01). The increase in serum YKL-40 levels decreased significantly with LEF treatment (p<0.01). There was no significant difference in serum YKL-40 levels in the FOR group compared to the control group at pretreatment and in the FOR+LEF group at post-treatment. There was a significant increase in serum thiobarbituric acid-reactive species (TBARS) values in the HCl and FOR groups compared to the control group (p=0.001 and p<0.01, respectively). In both treatment groups, the serum TBARS values significantly decreased after treatment with LEF (p=0.001 and p<0.05, respectively). There was a significant improvement in the histopathological scores, which deteriorated after the aspiration, and in the number of inducible nitric oxide synthase (iNOS)-positive cells after treatment with LEF.

Attenuation of bleomycin induced lung fibrosis by erdosteine and inhibition of the inducible nitric oxide synthase.

BACKGROUND AND OBJECTIVES: Despite advances in treatment modalities, the discovery of optimal medical therapies still remains a necessity in the management of pulmonary fibrosis. MATERIAL AND METHODS: The experiments were performed in 35 adult Sprague Dawley rats, randomly allotted into one of five groups (n=7). The control group was treated with 1 ml/kg, 0.9 % saline; the BLM group was given a single dose of BLM (2.5 U/kg); the BLM+ER group was treated with ER (10 mg/kg/day po) for 14 days after BLM administration; the BLM+SMT group was treated with i.p injections of SMT (20 mg/kg/ day) for 14 days after BLM administration; the BLM+ER+SMT group was treated with ER and SMT for 14 days after BLM administration. At the end of day 14, the results of histopathological, biochemical, and immunohistochemical investigations were analyzed. RESULTS: Serum TNF-α, nitrate/nitrite, and TBARS levels significantly increased in BLM group compared to control group (p < 0.001, p < 0.001 and p < 0.05 respectively). Lung tissue content of IL-6 was found to be lower in BLM+ER, BLM+SMT and BLM+ER+SMT groups compared to BLM group by immunhistochemical examinations (p < 0.01, p < 0.01 and p < 0.001, respectively). Similarly, the TNF-α reactions (p < 0.01 for each group) and NF-kB expressions were shown to be significantly different among the study groups (p < 0.05, p < 0.05 and p < 0.001, respectively). CONCLUSION: Based on our study, ER and SMT attenuate BLM-induced pulmonary fibrosis; the combination of two agents has a greater protective efficacy against fibrosis than one alone, reducing the inflammatory markers (Tab. 2, Fig. 2, Ref. 31).

Protective effects of melatonin against oxidative injury in rat testis induced by wireless (2.45 GHz) devices.

Wireless devices have become part of everyday life and mostly located near reproductive organs while they are in use. The present study was designed to determine the possible protective effects of melatonin on oxidative stress-dependent testis injury induced by 2.45-GHz electromagnetic radiation (EMR). Thirty-two rats were equally divided into four different groups, namely cage control (A1), sham control (A2), 2.45-GHz EMR (B) and 2.45-GHz EMR+melatonin (C). Group B and C were exposed to 2.45-GHz EMR during 60 min day(-1) for 30 days. Lipid peroxidation levels were higher in Group B than in Group A1 and A2. Melatonin treatment prevented the increase in the lipid peroxidation induced by EMR. Also reduced glutathione (GSH) and glutathione peroxidase (GSH-Px) levels in Group D were higher than that of exposure group. Vitamin A and E concentrations decreased in exposure group, and melatonin prevented the decrease in vitamin E levels. In conclusion, wireless (2.45 GHz) EMR caused oxidative damage in testis by increasing the levels of lipid peroxidation and decreasing in vitamin A and E levels. Melatonin supplementation prevented oxidative damage induced by EMR and also supported the antioxidant redox system in the testis.

Clinicopathological features and prognostic factors of the uterine sarcomas: 20 years of experience at Cukurova University.

OBJECTIVE: Uterine sarcomas (US) are rare, malignant, and aggressive tumors of the uterus. In this study the authors aimed to evalu- ate retrospectively the clinical and pathologic features and to investigate the prognostic factors of the U.S. patients who were treated in their department in the last 20 years. MATERIALS AND METHODS: The archive files, medical, and pathological records of the 132 US patients who were operated on and regularly followed up in the clinic between March 1991-March 2011 were reviewed. Clinical features, operation characteristics, pathological findings, adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Analysis of disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier and Cox regression tests. Thep value was taken <0.05 to maintain the statistical significance level for all results. Results: Seventy of the patients were diagnosed with leiomyosarcomas (LMS), 33 were with carcinosarcomas, 12 were with endometrial stromal sarcomas (ESS), nine were with undifferentiated endometrial sarcomas, five were with adenosarcomas, and three were with botryoid rhabdomyosarcomas. The average patients' age was 53.7 +/- 12.6 (17-78). About two-thirds of the patients were in postmenopausal and one-third were in pre- menopausal period. Vaginal bleeding was detected as the most common reason for patients' admission (68.9%). All cases underwent surgery and a procedure of total abdominal hysterectomy + bilateral salpingo-oophorectomy (TAH + BSO) was performed for most of them (88%). The mean duration of follow-up was 36 months (4-198). The two- and five-year OS rates were 65% and 36%, respectively, with a median time of 37 months (95% CI, 28-45). The two- and five-year DFS rates were 59% and 33%, respectively, with a median time of 29 months (95% CI, 18-40). CONCLUSION: As a result of multivariate analysis, while age, stage, lymphovascular space invasion (LVSI), and lymphadenectomy were found to be independent prognostic factors affecting DFS, only stage was detected as an independent prognostic factor for OS.

The relationship between ovarian volume and serum CA-125 levels.

PURPOSE: The aim of this study was to investigate the relationship between ovarian volume and serum CA-125 levels. MATERIALS AND METHODS: Serum CA-125 levels and ovarian volume were compared among the cases with benign ovarian neoplasms, primary epithelial ovarian cancer (EOC), controlled ovarian hyperstimulation, and ovarian hyperstimulation syndrome (OHSS). Also, the correlation between CA-125 levels and ovarian volume were evaluated in the presence of peritoneal fluid and/or peritoneal carcinomatosis. RESULTS: Although ovarian volume was not different among the groups, CA-125 levels were higher in the cases with EOC than with benign ovarian tumors (p = 0.001). Baseline CA-125 levels were not found to have increased while ovarian volume went up with controlled hyperstimulation in the infertile group (p = 0.555). However, uncontrolled hyperstimulation of the ovaries and the presence of peritoneal fluid caused an increase in the levels of CA-125 (p = 0.001). There was no correlation between ovarian volume and CA-125 levels in the cases with malignant ovarian tumors (r = 0.083). CONCLUSIONS: The results of this study have confirmed that CA-125 is a peritoneal marker and increased ovarian volume with benign ovarian neoplasms or controlled hyperstimulation does not increase CA-125 levels in the same way. The presence of peritoneal carcinomatosis and/or peritoneal fluid seems to be an important factor for high CA-125 levels in patients with epithelial ovarian cancer (EOC).

Evaluation of uterine perfusion in postmenopausal women receiving hormone replacement therapy.

OBJECTIVES: The authors evaluated uterine perfusion in postmenopausal women receiving hormone replacement therapy (HRT) by using transvaginal Doppler ultrasonography. MATERIALS AND METHODS: A total of 60 postmenopausal women receiving HRT were included in this prospective case control study. The patients were divided into two groups. The study group received HRT for at least one year. Uterine perfusion was evaluated by transvaginal Doppler ultrasonography and pulsatility index (PI) and resistance index (RI) of uterine arteries were also recorded with a 5-7.5 MHz transvaginal probe. All patients gave informed consent to the study. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows. RESULTS: Demographic characteristics of the cases showed no statistically significant difference between the groups. There was a statistically significant difference between PI and RI of uterine arteries. In the study group PI and RI were lower than in the control group. As the duration of HRT use was prolonged, a decline in PI and RI increased (p < 0.05). CONCLUSION: The current study showed that HRT has positive effects on uterine blood flow in postmenopausal women and may be evaluated by transvaginal Doppler ultrasonography.

Recurrence factors in women underwent laparoscopic surgery for endometrioma.

AIM: The aim of this paper was to assess the risk factors for endometrioma recurrence in women underwent laparoscopic surgery for endometrioma. METHODS: This retrospective designed study included 113 cases that underwent laparoscopic surgery for endometrioma; of these women, recurrent endometrioma was detected in 33 (29.20%) subjects and other showed no recurrence (70.80%). Age, gravidity, parity, diameter of the mass, bilaterality, previous pelvic surgery, operation type, presence of adhesions, Ca 125 levels and recurrence time was obtained from hospital records and special gynecology forms. RESULTS: Demographic and obstetric past history of the cases showed no statistically significant difference between the groups (P>0.05). Higher diameter of the mass, previous pelvic surgery, operation type, presence of adhesion and higher Ca 125 levels were risk factors for endometrioma recurrence (P<0.05). Receiver operator curve (ROC) analysis demonstrated that diameter of the mass, previous pelvic surgery and Ca 125 levels may be discriminative risk factors for endometrioma recurrence. CONCLUSION: Endometriomas ≥ 4.5 cm, especially in cases with pelvic adhesions, previous pelvic surgery and higher Ca 125 levels should be excised totally.

Cardioprotective effect of aminoguanidine in combination with steroid therapy after blunt chest trauma.

BACKGROUND: Cardiac contusion is an important cause of mortality after blunt chest trauma (BCT). The aim of this study was to investigate the therapeutic efficacy of the usage of aminoguanidine (AG), in myocardial damage occurring after BCT, alone and in combination with methylprednisolone (MP). METHODS: Thirty-five female Wistar albino rats were randomly assigned to five groups (n = 7) including: sham controls (S); only cardiac contusion (CONT); cardiac contusion treated with methylprednisolone (CONT+MP); cardiac contusion treated with aminoguanidine (CONT+AG); and cardiac contusion treated with methylprednisolone and aminoguanidine (CONT+MP+AG). Seven days following the treatments, heart and serum specimens were evaluated histopathologically, immunohistochemically, and biochemically in all groups. RESULTS: Serum AOPP and Tn-I levels increased significantly after cardiac contusions. Haemorrhage, tissue degeneration, and necrosis development was evident following contusions. Increased iNOS expression in myocardial tissue was significantly decreased in the CONT+AG+MP group compared to CONT+AG and CONT+MP groups (p = 0.001 and p = 0.011, respectively). The combined treatment of AG and MP increased Bcl-2 expression significantly after contusions compared to the other treatment groups. CONCLUSIONS: Combined usage of AG, a selective iNOS inhibitor, with MP, in cardiac contusions, showed a more powerful cardioprotective effect by increasing Bcl-2 expression and reducing iNOS expression (Tab. 3, Fig. 4, Ref. 33).

Neuroprotective effects of carvacrol and pomegranate against methotrexate-induced toxicity in rats.

BACKGROUND: Studies related to the use of various antioxidant and anti-inflammatory drugs to decrease the toxic side effects related to MTX have been carried out. However, since no medicine providing full protection against the side effects of MTX has been discovered, the discovery of new agents is required. AIM: The aim of this study was to determine whether methotrexate (MTX) causes oxidative stress and an inflammatory response in sciatic nerve, as well as whether carvacrol (CAR) and pomegranate (POM) have protective effects against the resulting oxidative stress and inflammatory response. MATERIALS AND METHODS: 32 adult male Wistar albino rats were used in the study. The animals were divided into 4 groups: Group C: the rats were not given any medication; Group MTX: On study day 2, the rats were given a single dose of 20 mg/kg MTX, administered intraperitoneally; Group MTX+CAR: On study day one, the rats were administered a single dose of 73 mg/kg CAR intraperitoneally. On study day two, a single dose of 20 mg/kg MTX was administered intraperitoneally; Group MTX+POM: For seven days starting from the study day one, rats were given 225 mg/kg POM extract once a day through orogastric gavage. On study day two, a single dose of 20 mg/kg MTX was administered intraperitoneally. All animals were sacrificed on the day eight. TOS, TAS, MDA, TNF-α and IL-1ß levels were evaluated in the sciatic nerve tissue. RESULTS: In comparison to the control group, a decrease in TAS levels and an increase in TOS, MDA, IL-1ß and TNF-α levels were detected in the MTX group. Compared to the MTX group, the MTX+CAR group had a significant increase in TAS level and significant decreases in TOS, MDA, IL-1ß and TNF-α levels. In comparison to the MTX group, the MTX+POM group had a significant decrease in MDA, IL-1ß and TNF-α levels. When the MTX+CAR and MTX+POM groups were compared, the TNF-α level measured was lower in the MTX+CAR group. CONCLUSIONS: In this work, we have shown that MTX causes a significant oxidative stress and inflammatory response in rats' sciatic nerve tissue and that CAR had an antioxidant effect in this system. Furthermore, we have proven, for the first time, that both CAR and POM decreased the pro-inflammatory response.

Mature cystic teratoma of the fallopian tube.

Teratoma of the fallopian tube (cystic or solid) is a rarely encountered tumour and, to date, only 73 cases have been reported in the literature. A comprehensive review has not been done since 1972, when Mazzarella and colleagues reviewed 44 cases of tubal teratomas. This situation has prompted us to survey the literature to update the data on tubal teratoma cases. The majority of the tumours were benign. The tumour was cystic in nature in 50 cases. Patients' ages ranged between 17 and 67 years. None of them was diagnosed preoperatively. Half of the tumours were ≤ 5 cm, whereas the other half were > 5 cm in diameter. About two-thirds of the patients were associated with two or fewer gravidity. To the best of our knowledge, the present case included in our paper is the first tubal cystic teratoma reported from Turkey.

Candida vaginitis in non-pregnant patients: a study of antifungal susceptibility testing and virulence factors.

Vulvovaginal candidosis (VVC) is a major problem for the female population worldwide, and considerably little is known about the difference between acute VVC (AVVC) and recurrent VVC (RVVC). We investigated the susceptibility to six antifungal agents and boric acid of Candida spp. isolated from vaginal cultures, as described in the CLSI document M27-A3, from 228 non-pregnant sexually active women (aged 18-49 years), and the virulence factors of these isolates. The isolates were derived from patients with AVVC (n = 64), those with RVVC (n = 125) and those without signs or symptoms (n = 39). In total, C. albicans was the most commonly isolated species (50%), followed by C. glabrata (35.5%) and other Candida spp. (14.5%). We observed slightly different minimum inhibitory concentration (MICs) for various antifungals among the species and study groups that could have potential therapeutic benefits for the treatment. Analysis of the virulence factors revealed that haemolytic activity is not involved in VVC pathogenesis but that germ-tube formation, adhesion to VECs, and proteinase and phospholipase production may be important in the pathogenesis of VVC.

Candida vaginitis during contraceptive use: the influence of methods, antifungal susceptibility and virulence patterns.

No consensus exists about whether contraceptives cause an increased risk of vaginitis, including vulvovaginal candidosis (VVC). We investigated 495 women (252 who used contraceptives; 243 who did not) for the presence of VVC. Antifungal susceptibility testing was performed for five antifungal agents and for boric acid, and three virulence factors were also examined. We recovered 129 (26.1%) monofungal populations from vaginal samples of women with acute VVC (AVVC, n = 18), symptomatic recurrent VVC (RVVC, n = 22) and asymptomatic RVVC (n = 28), as well as of other contraceptive users who carried Candida in their vaginas (n = 61). It is important to note that the women who had VVC used the same contraceptive methods (p > 0.05). Candida albicans was the most common species isolated (45%), followed by C. glabrata (40.3%). Most of the vaginal yeast isolates exhibited low minimum inhibitory concentration levels for the five antifungals tested. However, this was not the case for boric acid. In addition, the yeast fungi that was derived from the AVVC and RVVC patients showed higher amounts of haemolytic activity than the yeast fungi found among the controls (p < 0.05). The use of contraception does not predispose women to VVC (p > 0.05). Also, both host- and organism-related factors were required to achieve optimal clinical treatment for VVC.

Clodronate changes neurobiological effects of pulsed magnetic field on diabetic rats with peripheral neuropathy.

Several studies have reported that pulsed magnetic fields (PMFs) can be a choice of therapy for diabetic peripheral neuropathy. However, the exact underlying mechanism of PMF is still not known. The purpose of this study was, therefore, to investigate the effects of clodronate encapsulated with liposome, a specific agent depleting macrophage, on PMF-treated streptozotocin-induced type I diabetic rats with peripheral neuropathy. Effects of PMF, liposome-encapsulated clodronate (LEC) or their combined treatments were investigated in diabetic rats by measuring the thermal latencies, mechanical thresholds, whole blood glucose levels, serum insulin level, and body mass. In diabetic rats, PMF exhibited a decrease in the blood glucose levels but did not change the serum insulin level. Both mechanical thresholds and thermal latencies of diabetic rats enhanced throughout the PMF treatment. During the PMF treatment, the administration of LEC suppressed the PMF-induced decrease in blood glucose level, PMF-induced increase in mechanical threshold and thermal latencies in diabetic animals. In addition, PMF reduced the LEC-induced increase in insulin levels of diabetic rats. Findings demonstrated that although effects of both PMF alone and LEC alone on diabetic animals are mostly positive, LEC may remove the therapeutic efficacies of PMF in combined treatment.

Determination of phytochemical content by LC-MS/MS, investigation of antioxidant capacity, and enzyme inhibition effects of nettle (Urtica dioica).

OBJECTIVE: Urtica dioica L. Subsp. dioica is an annual or perennial herbaceous plant belonging to the Urticaceae family that has an important place in ethnobotany. This study aimed to investigate the phytochemical content and the inhibition effect on acetylcholinesterase (AChE), which interact with beta-amyloid to promote the deposition of amyloid plaques and paraoxonase (PON1). This plays a role in the regulation of HDL and LDL and an antiatherogenic, and antioxidant capacity of Urtica dioica. MATERIALS AND METHODS: Phytochemical content was determined by the liquid chromatography/mass spectrometry (LC-MS/MS), and to assess the enzyme inhibition and antioxidant capacity the spectrophotometer technique was used. The antioxidant capacity of U. dioica extracts (methanol, hexane, and water) was determined by applying 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS•+), 2,2-diphenyl-1-picrylhydrazyl (DPPH•+), ferric reducing antioxidant power (FRAP), and cupric ion reducing antioxidant capacity (CUPRAC) methods. RESULTS: The methanol extract of the U. dioica exhibited significant inhibition on the AChE (IC50= 0.098 ± 0.011 mg/mL). However, methanol and water extracts of the U. dioica did not exhibit the inhibition effect on PON1. The highest activity for ABTS•+ was in the hexane extract (55.97%), and for DPPH•+ was in the methanol extract (62.42%). Compared to other solvents (hexane and water), the methanol extract of the U. dioica showed the highest activity for FRAP and CUPRAC methods. Results (as absorbance) were 0.302 for CUPRAC and 0.147 for FRAP in the methanol extract of the U. dioica. The acetohydroxamic acid, gallic acid, caffeic acid, ellagic acid, p-hydroxybenzoic acid, and quercetin were qualified and quantified in LC-MS/MS analyses of Urtica dioica extract. CONCLUSIONS: U. dioica, which has antioxidant, anti-atherosclerotic and neuroprotective effects, has a natural medicine potential if compared to synthetic drugs used in Alzheimer's patients.

Comparison of the effectiveness of liposomal doxorubicin and gemcitabine in patients with platinum-sensitive recurrent ovarian cancer receiving third-line chemotherapy.

OBJECTIVE: In this retrospective study, we compared the effectiveness and reliability of the third-line chemotherapies gemcitabine and liposomal doxorubicin, in patients with platinum-sensitive ovarian cancer (OC). PATIENTS AND METHODS: The retrospective study included platinum-sensitive epithelial ovarian cancer patients who had previously received paclitaxel and carboplatin therapy. Between 2013-2021, cross-matched 45 patients who received gemcitabine and 48 who received liposomal doxorubicin as third-line therapy were compared based on clinicopathological characteristics, biomarkers, and blood cancer antigen (CA) 125 levels. Time to treatment failure, survival, and quality of life were additional objectives. RESULTS: The study included a total of 93 patients. The reported mean survival durations for treatments, 19.45 months for gemcitabine and 17 months for liposomal doxorubicin, did not statistically significantly differ (p=0.398). The mean CA 125 levels for the liposomal doxorubicin and gemcitabine groups after treatment were 54.4±11.4 U/ml and 54.7±11.1 U/ml, respectively. There was no noticeable difference between the treatments when comparing the postop CA 125 value (p=0.37). CONCLUSIONS: For both pegylated liposomal doxorubicin (PLD) and gemcitabine as single agents in the third line, our data revealed comparable effectiveness results, and there was no substantial difference in progression-free survival (PFS) for recurrent ovarian cancer. These therapies were tolerated with an expected incidence of hematological toxicities.