Brain Diffusion Changes in Perinatal Asphyxia Cases.

BACKGROUND: Prolonged perinatal asphyxia (PA) may cause hypoxic-ischemic damage to the brain. The aim of this study was to investigate the brain diffusion changes of patients with PA and examine the relationship with brain damage. METHODS: This retrospective study included 55 patients diagnosed with PA, separated into mild and severe PA groups. For the evaluation of brain damage in all the study neonates, brain and diffusion MRI scans were performed using a 3T device. The scans were taken between 5 and 10 days postnatal, after completion of hypothermia treatment, in accordance with the standard clinical protocol of our institution. Apparent diffusion coefficient (ADC) values of the lentiform nucleus, thalamus, frontal white matter, and posterior limbs of the internal capsule were measured. Minitab package programs and SPSS version 20.0 software were used for statistical analysis and graphic drawing. Spearman's rank correlation analysis was used. RESULTS: The bilateral lentiform nucleus, thalamus, frontal white matter, and posterior limbs of the internal capsule ADC values were significantly higher in the severe PA group than in the mild PA group. CONCLUSIONS: In neonates with severe perinatal asphyxia, brain damage can be evaluated on diffusion-weighted imaging (DWI) of the cerebral deep white matter and basal ganglia. DWI, imaging with conventional brain MRI comes to the fore in clinical importance in PA patients.

Modeling fate and transport of pesticides from dryland agriculture using SWAT model.

The aim of this study was to understand pesticide fate and transport from dryland agriculture in a major drinking water basin using SWAT and to identify critical source areas in the basin. Hydrological calibration results indicated satisfactory simulation of hydrologic processes within the catchment. Long term average observed sediment values (0.16 ton/ha) were compared with the annual average simulated SWAT outputs (0.22 ton/ha). Generally, the simulated concentrations were higher than the observed values, but the distribution pattern and trends were similar among the months. Average concentrations in water were 0.036 µg/L and 0.006 µg/L for fenpropimorph and chlorpyrifos, respectively. Transfer rates of pesticides from landscape to rivers showed that 0.36% of fenpropimorph and 0.19% of the applied amount of chlorpyrifos were exported to the river. Higher amount of fenpropimorph transport from land to the reach was attributed to its lower Koc (soil adsorption coefficient) value compared to chlorpyrifos. Higher amounts from HRUs were observed in the application month (April) and following month (May) for fenpropimorph, while the months after September showed higher amounts for chlorpyrifos. The specific HRUs (Hydrological Response Units) located in sub-basins 3, 5, 9 and 11 presented highest dissolved pesticide amounts, while HRUs in sub-basins 4 and 11 exhibited highest concentrations for adsorbed pesticides. Best management practices (BMPs) were recommended in critical subbasins to protect the watershed. Despite the limitations, the results demonstrate the potential contributions of modeling in terms of assessing pesticide loadings, critical zones and application timing.

Association of sociodemographic profile, dyslipidemias, and obesity in smoker, former smoker, and nonsmoker patients with coronary artery disease.

INTRODUCTION: In patients with established coronary artery disease (CAD), there are different reports on gender, age, dyslipidemia, and obesity according to smoking behavior. Smoking, obesity, and dyslipidemia are targets in secondary prevention. In this study, we aimed to investigate the sociodemographic differences, lipid profiles, body mass index (BMI), and cigarette smoking status in patients diagnosed with CAD. METHODS: Patients with records of angiography, smoking behavior, sociodemographic information, lipid levels, and BMI present at the outpatient visits were included in the study. Patients were grouped as active smokers, nonsmokers, and former smokers. Statistical methods were used for comparison of variables and means. RESULTS: A total of 235 patients, 167 (71.1%) men and 68 (28.9%) women, were included in the study. Nonsmokers group (31.4%) consisted of mostly women while active (22.6%) and former smoker (46%) groups consisted mostly of men (P < 0.0001). The mean age was 60.65 ± 11.55. Age was associated with the smoking status of patients, and nonsmokers consisted of geriatric patients significantly (P = 0.001). Educational status was associated with smoking history. Cessation of smoking after CAD diagnosis was achieved in 46% of patients. Active smokers had highest mean triglyceride (TG) values while nonsmokers had highest mean high-density lipoprotein-cholesterol (HDL-C) values. Active smokers had the highest mean TG values while nonsmokers had the highest mean HDL-C values. BMI was higher in nonsmokers than active smokers. CONCLUSION: Gender, age, and educational status are determinants of smoking behavior in patients with CAD. BMI is associated with smoking history. In nonsmokers, values of HDL were highest while TG values were lowest. To prevent reoccurring cardiovascular events, young patients and men are two groups which health professionals need to concentrate in motivating to quit smoking.

First molecular detection and characterization of Akabane virus in small ruminants in Turkey.

Abortion outbreaks associated with congenital malformations in two distinct small-ruminant flocks were reported in Turkey in 2013-2014. This paper describes the first molecular characterization of Turkish Akabane virus strains in small-ruminant flocks using partial sequence analysis of the S segment and pathological findings.

Does hepcidin play a role in the pathogenesis of aphthae in Behçet's disease and recurrent aphthous stomatitis?

BACKGROUND: Aphthae constitute one of the major signs in Behçet's disease (BD) and recurrent aphthous stomatitis (RAS). No scientific study has yet explored the relationship of hepcidins, which have antimicrobial effects, with RAS and BD. OBJECTIVES: In this study, we aimed to evaluate by immunohistochemistry whether hepcidin is synthesized by the salivary glands and to measure levels of prohepcidin and hepcidin (an antibacterial peptide) in the serum and saliva of patients with BD and RAS. METHODS: The study included 25 BD patients and 30 RAS patients, as well as a control group comprising 25 healthy individuals. Serum and saliva samples were collected at the same time from all subjects. Levels of prohepcidin and hepcidin were measured by ELISA. The presence of hepcidin in salivary glands was assessed by immunohistochemistry. RESULTS: Hepcidin was localized in the striated ducts of the sublingual and parotid glands. Saliva prohepcidin and hepcidin levels were correlated with blood levels. Saliva prohepcidin levels were found to be lower in RAS patients than in BD patients and healthy controls (P < 0.001 and P = 0.007 respectively). In addition, RAS patients had lower saliva hepcidin levels than did the control group (P = 0.03). CONCLUSIONS: The lower serum and saliva prohepcidin and hepcidin concentrations found in RAS and BD patients indicate that hepcidin may be involved in the aetiopathogenesis of these diseases. Because it can be obtained non-invasively and easily, saliva may provide a useful alternative to serum in quantifying prohepcidin and hepcidin concentrations.

Impact of micronised purified flavonoid fraction on increased malondialdehyde and decreased metalloproteinase-2 and metalloproteinase-9 levels in varicocele: outcome of an experimentally induced varicocele.

To analyse the levels of an indirect marker of ROS-induced lipid peroxidation [i.e. malondialdehyde (MDA)] in both testes and the levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) in the left testis after induction of varicocele and investigated the impact of micronised purified flavonoid fraction (MPFF) on these markers. Forty-nine adolescent (6-week-old) male Wistar rats were included in this study. The rats were divided into seven groups as follows:Group-1, control; Group-2, sham; Group-3, left varicocele-induced; Group-4, varicocele + varicocelectomy + MPFF-treated (for 4 weeks); Group-5, varicocele + MPFF-treated (for 8 weeks); Group-6, varicocele-induced and 4 weeks later, MPFF-treated (for 4 weeks); and Group-7, varicocele + varicocelectomy. MDA was measured in the tissues of both testes using the thiobarbituric acid reactivity method. The ELISA method was used for the quantification of MMP-2, MMP-9 and TIMP-1 in the left testicular tissue. The levels of MDA were significantly higher in the varicocele group than in the other groups. The MDA levels in the left testicular tissues of Group-7 were significantly higher than those of Group 4 (P = 0.03). In the varicocele group, the MMP-2 and MMP-9 levels decreased, whereas the levels of TIMP-1 increased. The tissue levels of MMP-2 in Groups 4, 5 and 7 were significantly higher than those in Group 1 (P < 0.05).

Behcet disease and pregnancy.

PURPOSE: Behcet disease (BD) is a multisystemic vaculitis commonly diagnosed in reproductive years. The authors aimed to investigate the relationship between BD and pregnancy outcomes. MATERIALS AND METHODS: In this multicenter retrospective survey study, the authors compared the pregnancy outcomes of BD patients with the healthy controls. RESULTS: A total of 298 pregnancies of 94 patients with BD and 219 pregnancies of 95 healthy controls were evaluated. The mean birth weight of all babies of women with BD and the control group were 3,214 grams and 3,351 grams, respectively (p = 0.028). The miscarriage rates were also higher in the BD group. The com- plication rates of pregnancy with hypertension, preeclampsia, preterm labour in the study group and the control group were 12.8% and 11.6%, respectively (p = 0.489). CONCLUSION: The current study demonstrated that BD patients delivered smaller babies and they have higher miscarriage rates when compared to the healthy controls which might be due to the vasculitis of the placenta.

Evaluation of testicles by sonoelastography in men recovering after Covid-19 disease.

INTRODUCTION: Testicular cells, seminiferous tubule cells, spermatogonia, Leydig and Sertoli cells showing angiotensin-converting enzyme 2 expression have the potential to be targets and to be damaged by the coronavirus. We aimed to use Two-Dimensional Shear Wave Elastography (2D-SWE) as an effective technique to identify parenchymal damage in the testicles of patients recovering from COVID-19 infection. METHODS: 35 Male patients (group 1) who recovered after COVID-19 infection between 4 and 12 weeks were included in this prospective study. Before 2D-SWE, these male patients were confirmed with control Rt-PCR test negativity. In addition, the first Rt-PCR test positivity of these patients was confirmed. A control group was formed of 31 healthy subjects (group 2). These two groups were compared in terms of age, volume of each testis, and SWE values. Ultrasound including SWE was applied to all the testes. A total of 9 measurements were taken as 3 SWE measurements from each third of the testis (superior, mid, inferior) and the average of these was calculated. Data obtained in the study were analyzed statistically. A value of p < 0.05 was accepted as statistically significant. RESULTS: The mean SWE values for the right testis and the left testis were determined to be statistically significantly higher in Group 1 than in Group 2, respectively (p < 0.001, p < 0.001). CONCLUSION: There is an increase in testicular stiffness in males who have recovered from COVID-19 infection. The underlying cause of testicular damage is changes at the cellular level. The 2D-SWE technique can predict potential testicular parenchymal damage in male patients recovering from COVID-19 infection. IMPLICATIONS FOR PRACTICE: Two-Dimensional Shear Wave Elastography (2D-SWE) seems to be a promising imaging technique in the evaluation of testis parenchyma.

An investigation of bovine papillomaviruses from ocular squamous cell carcinomas in cattle.

Background: Ocular squamous cell carcinomas (OSCCs) in cattle has been studied for many years, but no definite etiology has been established. Squamous cell carcinomas (SCCs) may occur in different body parts of cattle. Depending on the location, it can cause an economic loss of varying degrees. Aims: The aim of this study was to investigate the causes of OSCCs in the eye region of cattle. Methods: Sixty tumoral masses taken form 60 cattle with proliferation in the eye region that were collected between the years 2012-2022 were used. These cases were admitted to our department for routine diagnosis. The tissues were diagnosed as OSCC using histopathological methods. The presence of bovine papillomavirus (BPV), one of the causative factors, was investigated using immunohistochemical and polymerase chain reaction (PCR). Results: Macroscopically masses were nodular or cauliflower-like and fragile and had hemorrhagic surfaces. Considering the keratin pearls, tumoral islands, and squamous differentiation, 20 out of 60 cases were classified as well, 20 as moderately, and 20 as poorly-differentiated OSCCs. 47 of the 60 cases were BPV positive using immunohistochemical methods. However, BPV nucleic acid was detected in only two cases with PCR. Only one of the cases could be sequenced. After phylogenetic analysis, virus strain was identified as BPV-1. Conclusion: Our results indicated that papillomaviruses can contribute to the development of OSCCs, in both precursor lesions and also advanced stage OSCCs. We found that BPV-1 has a possible causative role; however, more studies are needed to investigate the role of other viral agents and their interaction with secondary factors.

Does diffusion weighted imaging have a prognostic value in differentiating gynecological diseases?

INTRODUCTION: Apparent diffusion coefficient (ADC) values are effective in the diagnosis of different gynecological lesions. METHODS: A retrospective evaluation was made of 12 patients with uterine cervix carcinoma and 151 patients with uterine lesions, comprising endometrial cancer, endometrial polyps, carcinosarcoma, submucous myoma, adenomyosis, endometrial hyperplasia, gestational trophoblastic neoplasm (GTN), and leiomyomas. As a control group, 20 healthy volunteers with normal endometrium and normal cervix were also evaluated. In three series, one-shot, spin echo, echo planar, b = 1000 s/mm2 value and diffusion-weighted imaging (DWI) were applied to all subjects and ADC values were obtained. RESULTS: The mean ADC values of Group 1 (Endometrial carcinoma) were lower than those of all the other groups (P < 0.001) and the mean ADC value of group 6 (GTN) was higher than that all other groups (P < 0.001). A statistically significant difference was found between the groups in terms of the lesion-myometrium ADC ratios (P < 0.001). CONCLUSION: There are few studies in literature related to ADC measurements in GTN. The ADC values of GTN were found to be significantly higher than the other uterine lesions. These results will aid in the design of future studies and might be used to guide management of patients with GTN. IMPLICATIONS FOR PRACTICE: Diffusion-weighted MRI seems to be a promising imaging technique in differentiating different uterine lesions.

Periodontal health and treatment needs among hospitalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: The aim of the study was to evaluate the periodontal health and treatment needs of chronically hospitalized psychiatric patients in Istanbul, Turkey. METHOD: The subjects' periodontal health was recorded by the CPI (Community Periodontal Index) method. RESULTS: Of the 330 patients examined, 179 (52.5%) were males and 151 (47.5%) females. The mean age of the patients was 49.2 +/- 11.7 years. The majority (61.8%) was diagnosed with schizophrenia and 30.6% diagnosed with mental retardation. The mean length of hospitalization was 16.0 +/- 10.9 years. Healthy periodontal tissues (CPI 0) were found in 8.8% of the subjects. Bleeding on probing (CPI 1) was recorded in 6.3%, and dental calculus (CPI 2) in 51.8% of the subjects. These were determined as the worst findings. Altogether, 33% of the subjects had deep periodontal pockets, 14.2% with at least one 4- to 5-mm pocket (CPI 3), and 18.8% with at least one 6-mm pocket (CPI 4). The stepwise logistic regression analysis, between the final CPI score and seven variables including age, gender, psychiatric diagnosis, length of hospitalization, degree of helplessness, tooth brushing habits and smoking, showed that irregular tooth brushing habits and male gender were significant contributors to having a final CPI score of 2 or more. The regression analysis also showed that tooth brushing habits remained as an explanatory variable in CPI 0 coded subjects; helplessness and psychiatric diagnosis (mental retardation) in CPI 2; tooth brushing habits and psychiatric diagnosis (schizophrenia) in CPI 3; and only helplessness in CPI 4. CONCLUSION: The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Istanbul. Efforts need to be focused above all on raising this population's awareness of the importance of oral hygiene and on early diagnosis of periodontal problems.

The structure of the high-energy spin excitations in a high-transition-temperature superconductor.

In conventional superconductors, lattice vibrations (phonons) mediate the attraction between electrons that is responsible for superconductivity. The high transition temperatures (high-T(c)) of the copper oxide superconductors has led to collective spin excitations being proposed as the mediating excitations in these materials. The mediating excitations must be strongly coupled to the conduction electrons, have energy greater than the pairing energy, and be present at T(c). The most obvious feature in the magnetic excitations of high-T(c) superconductors such as YBa2Cu3O6+x is the so-called 'resonance'. Although the resonance may be strongly coupled to the superconductivity, it is unlikely to be the main cause, because it has not been found in the La2-x(Ba,Sr)(x)CuO4 family and is not universally present in Bi2Sr2CaCu2O8+delta (ref. 9). Here we use inelastic neutron scattering to characterize possible mediating excitations at higher energies in YBa2Cu3O6.6. We observe a square-shaped continuum of excitations peaked at incommensurate positions. These excitations have energies greater than the superconducting pairing energy, are present at T(c), and have spectral weight far exceeding that of the 'resonance'. The discovery of similar excitations in La2-xBa(x)CuO4 (ref. 10) suggests that they are a general property of the copper oxides, and a candidate for mediating the electron pairing.

One-dimensional nature of the magnetic fluctuations in YBa2Cu3O6.6

There is increasing evidence that inhomogeneous distributions of charge and spin--so-called 'striped phases'--play an important role in determining the properties of the high-temperature superconductors. For example, recent neutron-scattering measurements on the YBa2Cu3O(7-x) family of materials show both spin and charge fluctuations that are consistent with the striped-phase picture. But the fluctuations associated with a striped phase are expected to be one-dimensional, whereas the magnetic fluctuations observed to date appear to display two-dimensional symmetry. We show here that this apparent two-dimensionality results from measurements on twinned crystals, and that similar measurements on substantially detwinned crystals of YBa2Cu3O6.6 reveal the one-dimensional character of the magnetic fluctuations, thus greatly strengthening the striped-phase interpretation. Moreover, our results also suggest that superconductivity originates in charge stripes that extend along the b crystal axis, where the superfluid density is found to be substantially larger than for the a direction.

Resonance as a measure of pairing correlations in the high-Tc superconductor YBa2Cu3O6.6

One of the most striking properties of the high-transition-temperature (high-Tc) superconductors is that they are all derived from insulating antiferromagnetic parent compounds. The intimate relationship between magnetism and superconductivity in these copper oxide materials has intrigued researchers from the outset, because it does not exist in conventional superconductors. Evidence for this link comes from neutron-scattering experiments that show the unambiguous presence of short-range antiferromagnetic correlations (excitations) in the high-Tc superconductors. Even so, the role of such excitations in the pairing mechanism for superconductivity is still a subject of controversy. For YBa2Cu3O(6+x), where x controls the hole-doping level, the most prominent feature in the magnetic excitation spectrum is a sharp resonance (refs 6-11). Here we show that for underdoped YBa2Cu3O6.6, where x and Tc are below their optimal values, modest magnetic fields suppress the resonance significantly, much more so for fields approximately perpendicular to the CuO2 planes than for parallel fields. Our results indicate that the resonance measures pairing and phase coherence, suggesting that magnetism plays an important role in high-Tc superconductivity. The persistence of a field effect above Tc favours mechanisms in which the superconducting electron pairs are pre-formed in the normal state of underdoped copper oxide superconductors, awaiting transition to the superconducting state.

Oral health and treatment needs of institutionalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: To assess the oral health status and treatment needs in a group of hospitalized chronic psychiatric patients. METHOD: The dental status was assessed using the DMFT index. Demographic and medical data were retrieved from the institutional clinical files. RESULTS: 491 patients were examined in the study. 258 (52.5%) of the patients were males. The mean age was 52.3 +/- 12.3 years and the average length of hospitalization was 17.5 years. The majority of the patients (69%) were diagnosed with schizophrenia. The mean DMFT was 19.25 +/- 7.85. Missing teeth (81.4%) comprised the largest proportion of the DMFT while filled teeth (0.5%) the smallest. 18.1% of the DMFT consisted of decayed teeth. Stepwise logistic regression analysis showed that the DMFT significantly increased with age (p < 0.001) and was significantly higher in schizophrenia patients than those with mental retardation (p < 0.01). Males had significantly higher decayed teeth (p < 0.01) and fewer missing teeth (p < 0.01) than females. 58 dentate subjects (14.4%) were caries free. Two hundred and thirty five patients (58.5%) required restorative care, the mean number of treatments required per patient was 1.42 +/- 1.82. Eighty-nine subjects (18.1%) were found to be completely edentulous with only 17 wearing complete dentures. 70.6% of dentate patients needed tooth extraction for caries and 36.1% for periodontal disease. CONCLUSION: The findings of this study demonstrate poor oral health status with extensive unmet dental and prosthetic needs. These underline the urgent need for specific preventive oral health programme to improve the dental care of these chronic psychiatric inpatients.

MDR1 inhibition increases sensitivity to doxorubicin and etoposide in adrenocortical cancer.

Chemotherapy for adrenocortical carcinoma (ACC) has limited efficacy and is accompanied by severe toxicity. This lack of effectiveness has been associated with high tumoral levels of the multidrug resistance (MDR) pump P-glycoprotein (P-gp), encoded by the MDR1 gene. In this study, effects of P-gp inhibition on the sensitivity of ACC cells to cytotoxic drugs were evaluated. MDR1 mRNA and P-gp expression were determined in human adrenal tissues and cell lines. H295R, HAC15 and SW13 cells were treated with mitotane, doxorubicin, etoposide, cisplatin and streptozotocin, with or without the P-gp inhibitors verapamil and tariquidar. Cell growth and surviving fraction of colonies were assessed. MDR1 mRNA and P-gp protein expression were lower in ACCs than in adrenocortical adenomas (P < 0.0001; P < 0.01, respectively). MDR1 and P-gp expression were positively correlated in ACC (P < 0.0001, ρ = 0.723). Mitotane, doxorubicin, cisplatin and etoposide dose dependently inhibited cell growth in H295R, HAC15 and SW13. Tariquidar, and in H295R also verapamil, increased the response of HAC15 and H295R to doxorubicin (6.3- and 7.5-fold EC50 decrease in H295R, respectively; all P < 0.0001). Sensitivity to etoposide was increased in H295R and HAC15 by verapamil and tariquidar (all P < 0.0001). Findings were confirmed when assessing colony formation. We show that cytotoxic drugs, except streptozotocin, used for ACC treatment, inhibit ACC cell growth and colony formation at clinically achievable concentrations. P-gp inhibition increases sensitivity to doxorubicin and etoposide, suggesting that MDR1 is involved in sensitivity to these drugs and could be a potential target for cytotoxic treatment improvement in ACC.

[Quality of life after deep pelvic endometriosis surgery: Evaluation of a French version of the EHP-30]. / Qualité de vie après chirurgie de l'endométriose pelvienne profonde : évaluation d'une version française de l'EHP-30.

OBJECTIVE: To evaluate the changes in the quality of life of patients after deep pelvic endometriosis surgery, with a French version of EHP-30 questionnaire, and the capacity of the EHP-30 to carry out this measurement. MATERIAL AND METHODS: Study prospective monocentric, conducted in the obstetrics and gynecology department of the CHU Dijon during the period of October 2012 from October 2013. A EHP-30 questionnaire was given to patients before surgery. The same questionnaire was sent to their homes, away from surgery (3-6 months) to inform about their postoperative quality of life. The difference in preoperative and postoperative scores was tested using the test Wilcoxon signed ranks. A difference was considered significant if the p-value was less than or equal to 0.05. Sensitivity to change was calculated by the method of effect size (ES). The size of the effect is defined as the difference in mean preoperative and postoperative scores divided by the standard deviation of preoperative scores. A size effet of 0.20 indicates less change scores, of 0.50 a moderate change and of 0.80 a material change. RESULTS: We included 22 patients in total in the prospective analysis. The majority of patients had gynecological symptoms of dysmenorrhea with 69.7%, 75.7% and 75.7% dyspareunia chronic pelvic pain. Nineteen patients (57.6%) had gastro-intestinal symptoms. Urinary symptoms were less frequent. The results of the EHP-30 showed a significant improvement for the items "pain" (P=0.01), "control and powerlessness" (P=0.02), "emotional well-being" (P<0,01) "social relations" (P<0.01), "sexual intercourse" (P=0.03) and "relationship with the medical world" (P=0.05). We observed a non-significant improvement for the items "self-image" (P=0.44), "work" (P=0.48) and "relationships with children" (P=0.50). The size of the effect (ES) was low to high for all dimensions of the questionnaire, ranging from 0.1 to 0.6 for the entire group. A significant sensitivity to change was found for the items "pain" (ES=0.60), "control and powerlessness" (ES=0.62), "social relations" (ES=0.57). A moderate sensitivity to change was found for the items "emotional well-being" (ES=0.29), "relationship with the medical world" (ES=0.26). A low sensitivity to change was found for the items "relationships with children" (ES=0.06), "self-image" (ES=0.16), "work" (ES=0.18), "sexual intercourse" (ES=0.20). A size that is important to moderate effect corresponded to a statistically significant improvement of the score EHP-30. CONCLUSION: This study showed that the EHP-30 is a sensitive tool to change the health status and an appropriate instrument for the assessment of treatment effects in patients with deep pelvic endometriosis.

Methylation of IGF2 regulatory regions to diagnose adrenocortical carcinomas.

Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis. Discrimination of ACCs from adrenocortical adenomas (ACAs) is challenging on both imaging and histopathological grounds. High IGF2 expression is associated with malignancy, but shows large variability. In this study, we investigate whether specific methylation patterns of IGF2 regulatory regions could serve as a valuable biomarker in distinguishing ACCs from ACAs. Pyrosequencing was used to analyse methylation percentages in DMR0, DMR2, imprinting control region (ICR) (consisting of CTCF3 and CTCF6) and the H19 promoter. Expression of IGF2 and H19 mRNA was assessed by real-time quantitative PCR. Analyses were performed in 24 ACCs, 14 ACAs and 11 normal adrenals. Using receiver operating characteristic (ROC) analysis, we evaluated which regions showed the best predictive value for diagnosis of ACC and determined the diagnostic accuracy of these regions. In ACCs, the DMR0, CTCF3, CTCF6 and the H19 promoter were positively correlated with IGF2 mRNA expression (P<0.05). Methylation in the most discriminating regions distinguished ACCs from ACAs with a sensitivity of 96%, specificity of 100% and an area under the curve (AUC) of 0.997±0.005. Our findings were validated in an independent cohort of 9 ACCs and 13 ACAs, resulting in a sensitivity of 89% and a specificity of 92%. Thus, methylation patterns of IGF2 regulatory regions can discriminate ACCs from ACAs with high diagnostic accuracy. This proposed test may become the first objective diagnostic tool to assess malignancy in adrenal tumours and facilitate the choice of therapeutic strategies in this group of patients.

An evaluation of subacute sclerosing panencephalitis patients with diffusion-weighted magnetic resonance imaging.

PURPOSE: This study aimed to evaluate the contribution of diffusion weighted magnetic resonance imaging to the diagnosis and staging of subacute sclerosing panencephalitis. MATERIAL AND METHOD: The study comprised 26 patients diagnosed with subacute sclerosing panencephalitis at our clinic who were undergoing regular follow-up, and a control group of 18 subjects. Clinical staging was determined by Risk and Haddad classification; 12 at Stage II and 14 at Stage III. Diffusion weighted magnetic resonance images were taken of six areas (frontal, parieto-occipital, cerebellar, deep white matter, thalamus and basal ganglia) and by calculating the apparent diffusion coefficient (ADC) values, and a comparison was made between the stages and with the control group. RESULTS: The ADC values of all the areas of the subacute sclerosing panencephalitis patients were found to be significantly higher compared to the control group (p < 0.05). While the mean ADC values of the deep white matter, basal ganglia, frontal and parieto-occipital areas of the Stage II patients were found to be significant compared to the control group (p < 0.05), there was no significance in the other areas (p > 0.05). The ADC values of all the areas of the Stage III patients were found to be significantly high compared to the Stage II values (p < 0.05). CONCLUSION: Diffusion weighted magnetic resonance imaging can be used with other diagnostic criteria to confirm diagnosis of subacute sclerosing panencephalitis and to reveal differences between the stages.

[Does low-risk delivery exist?]. / L'accouchement à bas risque: existe-t-il ?

OBJECTIVES: The main objective of our study is to evaluate the rate of call of the obstetrician during childbirth supposed in low-risk and compare it to high-risk deliveries in a maternity service level II. The secondary objective is to assess the level of intervention of the obstetrician with the patient in both groups. PATIENTS AND METHODS: This is a prospective study of 490 patients including 259 classified as low risk based on obstetric criteria of Bourgogne Perinatal Network. The criteria considered for the call and/or intervention of the obstetrician were the following: altered fetal heart rate, lactate scalp, instrumental delivery, cesarean section, complete or complicated perineal, serious event during labor (cord prolapse, uterine rupture…), postpartum hemorrhage treated by prostaglandin ocytocic. The high-risk group is taken as reference for the calculation of confidence intervals. RESULTS: The rate of call of the obstetrician in the low versus high risk are: 37% [95% CI: 0.98-2.11] and 29% [95% CI: 1.00] (P=0.0587). The rate of intervention of the obstetrician in the low versus high risk is 21% [95% CI: 1.15-3.07] and 12% [95% CI: 1.00] (P=0.0109). CONCLUSION: The delivery process is unpredictable and potentially risky. Thirty-seven percent of patients classified as low risk at the beginning of labour have required intervention of the obstetrician and 21% of them his intervention.