Early ablation of Ccr2 in aggrecan-expressing cells following knee injury ameliorates joint damage and pain during post-traumatic osteoarthritis.

OBJECTIVE: To investigate whether Ccr2 inactivation in aggrecan-expressing cells induced before post-traumatic OA (PTOA) onset or during progression, improves joint structures, synovial thickness and pain. DESIGN: We induced a Ccr2 deletion in aggrecan-expressing cells (CCR2-AggKO) in skeletally mature mice using a tamoxifen-inducible Ccr2 inactivation. We stimulated PTOA changes (destabilization of medial meniscus, DMM) in CCR2-AggKO and CCR2+/+ mice, inducing recombination before DMM or 4 wks after DMM (early-vs late-inactivation). Joint damage was evaluated 2, 4, 8, 12 wks post-DMM using multiple scores: articular-cartilage structure (ACS), Safranin-O, histomorphometry, osteophyte size/maturity, subchondral bone thickness and synovial hyperplasia. Spontaneous (incapacitance meter) and evoked pain (von-Frey filaments) were assessed up to 20 wks. RESULTS: Early aggrecan-Ccr2 inactivation in CCR2-AggKO mice (N=8) resulted in improved ACS score (8-12wk, P=0.002), AC area (4-12wk, P<0.05) and Saf-O score (2wks P=0.004, 4wks P=0.02, 8-12wks P=0.002) compared to CCR2+/+. Increased subchondral bone thickness was delayed only at 2 wks and exclusively following early recombination. Osteophyte size was not affected, but osteophyte maturation (cartilage-to-bone) was delayed (4wks P=0.04; 8 wks P=0.03). Although late aggrecan-Ccr2 deletion led to some cartilage improvement, most data did not reach statistical significance; osteophyte maturity was delayed at 12wks. Early aggrecan-Ccr2 deletion led to improved pain measures of weight bearing compared to CCR2+/+ mice (N = 9, 12wks diff 0.13 [0.01, 0.26], 16wks diff 0.15 [0.05, 0.26], 20wks diff 0.23 [0.14, 0.31]). Improved mechanosensitivity in evoked pain, although less noticeable, was detected. CONCLUSIONS: We demonstrated that deletion of Ccr2 in aggrecan expressing cells reduces the initiation but not progression of OA.

The effect of two calcium silicate-based and one epoxy resin-based root canal sealer on postoperative pain: a randomized controlled trial.

AIM: To compare the effect of two calcium silicate-based (Endoseal MTA and EndoSequence BC Sealer) and an epoxy resin-based (AH Plus) root canal sealer on postoperative pain following single-visit root canal treatment on molar teeth. METHODOLOGY: Patients (n = 90) having one first or second molar tooth diagnosed with asymptomatic irreversible pulpitis were randomly divided into three groups according to the sealer used (n = 30) and were treated by two endodontists having at least 10 years of experience. All patients received a single-visit root canal treatment. After the treatments, postoperative pain scores and analgesic intake were recorded at 6, 12, 24 and 48 h, and 3, 4, 5, 6 and 7 days. The data were analysed statistically using non-parametric Kruskal-Wallis tests (for the comparisons of the age and VAS scores), Friedman tests (for the assessments of the changes in pain scores over time), chi-squared tests (for the comparisons of categorical variables) and Spearman's correlation test (for the correlation assessments of the age and gender factors with postoperative pain; α = 0.05). RESULTS: There were no significant differences amongst the groups in terms of postoperative pain at any time-points assessed (P > 0.05) nor for analgesic intake of patients amongst the groups (P > 0.05). Analgesic intake decreased significantly after 12 h in all groups (P < 0.05). CONCLUSIONS: The sealers tested in this study were associated with similar levels of postoperative pain and were associated with a similar intake of analgesics.

The effect of parity on obstetric and perinatal outcomes in pregnancies at the age of 40 and above: a retrospective study.

AIM: To examine the characteristics of pregnancies at a very advanced maternal age and the effect of parity on adverse obstetric outcomes. METHODS: We retrospectively reviewed the records of women who gave birth at the Obstetrics and Gynecology Department of Okmeydani Training and Research Hospital between January 2012 and December 2019. Overall, 22 448 of women were younger than 40 and 593 were aged 40 and older. Women aged 40 and older were divided into the primiparous (52 or 8.77%) and multiparous group (541 or 91.23%). RESULTS: Significantly more women aged 40 and older had a cesarean section. The most common indications for a secondary cesarean delivery in both age groups were a previous cesarean procedure or uterine operation. The most frequent indication for primary cesarean section in both groups was fetal distress. Cesarean section rates due to non-progressive labor, fetal distress, and preeclampsia were significantly more frequent in primiparous women compared with multiparous women aged 40 and older. In primiparous women, fetal birth weight was lower and preeclampsia/gestational hypertension frequency were higher. CONCLUSION: Since primiparity was a risk factor for lower fetal birth weight and preeclampsia/gestational hypertension in the age group of 40 years and above, more attention should be paid to the follow-up and treatment of these patients.

Effect of gestational diabetes mellitus on testis and pancreatic tissues of male offspring.

The purpose of this study was to determine the effect of gestational diabetes mellitus (GDM) on some reproductive characteristics, testicular and pancreatic oxidative status and pancreatic endocrine receptor densities of male offspring at post-pubertal stage. A total of 36 1-day-old Wistar Albino male offspring including 12 pups of nontreated mothers (control group), 14 pups of 40 mg/kg STZ-injected mothers (STZ-40 group) and 10 pups of 60 mg/kg STZ-injected mothers (STZ-60 group) were used. The offspring were euthanised on post-natal day 60, their blood, reproductive organs and pancreatic tissues were obtained and examined. When compared with the control group, there was a significant decrease in body and absolute reproductive organ weights, serum testosterone level, testicular and pancreatic catalase activities, pancreatic glutathione level, epididymal sperm concentration of both STZ-40 and STZ-60 groups as well as in testicular glutathione level of only STZ-60 group. Significant increases were determined in testicular and pancreatic malondialdehyde level and glutathione peroxidase activity in both groups and in fasting serum glucose of only STZ-60 group in comparison with the control group. Although some histopathological damages were observed in testes of both STZ-40 and STZ-60 groups, there were no detectable differences between the groups in density of insulin, glucagon and somatostatin receptors in pancreas. In conclusion, GDM has negative effects on reproductive efficiency and testicular-pancreatic tissue oxidant/antioxidant balance of male offspring at post-pubertal stage.

Role of the C-C chemokine receptor-2 in a murine model of injury-induced osteoarthritis.

OBJECTIVE: We previously found in our embryonic studies that proper regulation of the chemokine CCL12 through its sole receptor CCR2, is critical for joint and growth plate development. In the present study, we examined the role of CCR2 in injury-induced-osteoarthritis (OA). METHOD: We used a murine model of injury-induced-OA (destabilization of medial meniscus, DMM), and systemically blocked CCR2 using a specific antagonist (RS504393) at different times during disease progression. We examined joint degeneration by assessing cartilage (cartilage loss, chondrocyte hypertrophy, MMP-13 expression) and bone lesions (bone sclerosis, osteophytes formation) with or without the CCR2 antagonist. We also performed pain behavioral studies by assessing the weight distribution between the normal and arthritic hind paws using the IITS incapacitance meter. RESULTS: Testing early vs delayed administration of the CCR2 antagonist demonstrated differential effects on joint damage. We found that OA changes in articular cartilage and bone were ameliorated by pharmacological CCR2 blockade, if given early in OA development: specifically, pharmacological targeting of CCR2 during the first 4 weeks (wks) following injury, reduced OA cartilage and bone damage, with less effectiveness with later treatments. Importantly, our pain-related behavioral studies showed that blockade of CCR2 signaling during early, 1-4 wks post-surgery or moderate, 4-8 wks post-surgery, OA was sufficient to decrease pain measures, with sustained improvement at later stages, after treatment was stopped. CONCLUSIONS: Our data highlight the potential efficacy of antagonizing CCR2 at early stages to slow the progression of post-injury OA and, in addition, improve pain symptoms.

Morphology, histology and phylogeny of Henneguya sinova sp. nov. (Myxobolidae: Myxozoa) infecting gills of Parablennius tentacularis in the Black Sea, Turkey.

Myxosporeans of the genus Henneguya have a global distribution and infect organs and tissues of both marine and freshwater fishes. Here we describe the morphological, histological and molecular characteristics of Henneguya sinova sp. nov. parasitizing the gill arches of tentacled blenny Parablennius tentacularis (Perciformes: Blenniidae) collected from the coast of Sinop on the Black Sea in Turkey. Several oval whitish plasmodia of different sizes in the gill arches of fish were found. The mature spores were rounded oval in frontal view, with a mean (range) total length 57.5 (51.5-68.0) µm; the spore body was 11.7 (11.3-12.0) µm in length by 7.6 (7.3-8.3) µm in width and 6.7 (6.6-6.8) µm in thickness. The caudal appendages, measuring 46.0 (40.0-55.0) µm in length, were very thin at the tapered end. The prevalence of infection by H. sinova sp. nov. was 35.5%. Phylogenetic analysis of nuclear small subunit ribosomal DNA (SSU rDNA) clearly suggested H. sinova as a new species which is clustered within the marine Henneguya lineage. Pairwise nucleotide similarities and DNA distance values of SSU rDNA between H. sinova sp. nov. and other related Henneguya species also supported this suggestion.

Molecular characterization and morphological aspects of Myxobolus parvus (Myxozoa) from Liza saliens (Mugilidae) off the Turkish Black Sea coasts.

Members of the phylum Myxozoa are among the most cosmopolitan parasites of fish, and the genus Myxobolus is the largest within the class Myxosporea in freshwater and marine environment from all over the world. Myxobolus parvus has been reported from mainly mugilid fishes from different localities including the Black Sea. Leaping mullet Liza saliens collected by fishermen off Sinop coasts of the Black Sea in the period between September 2014 and December 2015 was investigated for myxosporean parasites using conventional methods. M. parvus Schulman, 1962 was the only Myxobolus species identified and it was found in the gills, gall bladder, kidney tubules, and inside several cysts located on the lower jaw of examined fish in the present study. Morphometric data and all details of parasitic infection were determined and presented in tables and illustrated in figures. Molecular characterization was also conducted to reveal its position within Myxosporea. Two M. parvus samples from gills and kidney showed the same haplotype and appeared in the same sub-lineage with marine Myxobolus species. The closest haplotypes to M. parvus were Triactinomyxon sp. and Endocapsa sp. which are the actinosporeans forms of unknown myxozoan species. These data are the first in molecular characterization of M. parvus, its occurrence in lower jaw of leaping mullet along with its infection prevalence values off the Turkish Black Sea coasts.

Population structure of rice varieties used in Turkish rice breeding programs determined using simple-sequence repeat and inter-primer binding site-retrotransposon data.

Effective breeding programs based on genetic diversity are needed to broaden the genetic basis of rice (Oryza sativa L.) in Turkey. In this study, 81 commercial varieties from seven countries were studied in order to estimate the genomic relationships among them using nine inter-primer binding site (iPBS)-retrotransposon and 17 simple-sequence repeat (SSR) markers. A total of 59 alleles for the SSR markers and 96 bands for the iPBS-retrotransposon markers were detected, with an average of 3.47 and 10.6 per locus, respectively. Each of the varieties could be unequivocally identified by the SSR and iPBS-retrotransposon profiles. The iPBS-retrotransposon- and SSR-based clustering were identical and closely mirrored each other, with a significantly high correlation (r = 0.73). A neighbor-joining cluster based on the combined SSR and iPBS-retrotransposon data divided the rice varieties into three clusters. The population structure was determined using the STRUCTURE software, and three populations (K = 3) were identified among the varieties studied, showing that the diversity harbored by Turkish rice varieties is low. The results indicate that iPBS-retrotransposon markers are a very powerful technique to determine the genetic diversity of rice varieties.

Pedobarographic measurements after repair of Achilles tendon by minimal invasive surgery.

The aim of the current study was to assess the changes of plantar foot pressures with pedobarography in -patients with Achilles tendon repair by minimally -invasive surgical technique. This retrospective study consisted of 15 consecutive patients who were treated for acute Achilles' tendon repair with minimally invasive technique in our clinic in a two year period between 2010 and 2012. All patients were male. The mean age was 28.7 years (24-42) and the mean follow-up time was 2.3 years (1.5- 3). All patients had sports related Achilles' tendon rupture and all had undergone surgery in 24-48 hours. After surgery, extremity was immobilized with short leg cast for 6 weeks. Peak and mean heel and forefoot pressures in injured extremity were measured by -pedobarograph and compared with noninvolved foot. There wasn't any complication associated with -surgery such as wound problems, re rupture or -neurologic injury. Only three patients had some numbness at the incision site. When we compare the mean foot pressures between the operated foot and the normal foot, there was no statistical difference about peak and mean heel and forefoot plantar pressure between involved site and non involved site. As a result, Achilles tendon repair with minimal invasive technique and early rehabilitation may prevent changes of plantar foot pressure distribution.

Fear of childbirth in women with normal pregnancy evolution.

PURPOSE OF INVESTIGATION: The authors aimed to research the prevalence of fear of childbirth (FOC) in women with a positive birth experience and some factors associated with FOC. MATERIALS AND METHODS: The study sample consisted of 817 women with positive birth experience within the last month of their pregnancy from February 2012 to May 2013. The data were collected with a questionnaire form including women's demographic-obstetric information and the Turkish form of Wijma Delivery Expectancy Questionnaire. Whether it was a planned pregnancy and their preferable delivery method for the current pregnancy were recorded. RESULTS: The total number of women with FOC was found to be 128 (15.6%). None of the patients had severe FOC. Fear of labour pain was found as the major cause for preferring cesarean section (73.5%). FOC was associated with preferring delivery methods (OR 5.91, 95% CI 3.96-8.84). FOC was associated with pregnancy planning status (OR 2.4, 95% CI 1.66-3.58). CONCLUSION: Fear of childbirth may be seen to some extent in women with a positive birth experience. However even with woman's positive birth experience, it is important to avoid severe FOC. The pregnancy planning status should be evaluated in the early stages of pregnancy and maternal education programs may be offered to reduce FOC level.

Analysis of cerebral toxoplasmosis in a series of 170 allogeneic hematopoietic stem cell transplant patients.

INTRODUCTION: Cerebral toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant patients, which mostly is caused by reactivation of latent disease. METHODS: In this study, we report an analysis of cerebral toxoplasmosis in a series of 170 allogeneic stem cell transplant patients during a 30-month period at our institution. RESULTS: Among these allogeneic stem cell transplant patients, 5 were diagnosed with cerebral toxoplasmosis by brain magnetic resonance imaging and polymerase chain reaction of Toxoplasma gondii DNA. The incidence of cerebral toxoplasmosis was found to be 2.94%. CONCLUSION: Mortality rate is known to be very high in cerebral toxoplasmosis; therefore, it is life saving to diagnose the disease in the early stages and start treatment promptly, especially in high-endemic countries like Turkey.

Procalcitonin can be used as a marker of premature atherosclerosis in acromegaly.

The objective of the study was to evaluate arterial morphologic changes of early atherosclerosis and changes in procalcitonin (PCT) levels in patients with acromegaly according to disease activity. Thirty-three active and 20 inactive acromegaly patients followed at Endocrinology-Metabolism out-patient clinic of Cerrahpasa Medical Faculty between 2004 and 2008 were included in the study. Twenty gender and age matched healthy subjects were included as the control group. Intima-media thickness (IMT) of the carotid arteries was measured by ultrasonography. Blood was drawn for biochemical tests and the serum concentrations of C-reactive protein (CRP) and PCT. Intergroup analysis revealed no significant differences between Growth hormone (GH), insulin like growth factor-1 (IGF-1), and IMT (P = 0.42, P = 0.47 respectively). No significant differences were found in the fibrinogen, CRP and PCT levels of the acromegaly patients and the subjects in the control group (P = 0.57, P = 0.84, P = 0.68 respectively). In the patients with IMT ≥ 1 mm, PCT (0.4 [IQR: 0.4-0.55]) levels were significantly different from the patients without atherosclerosis (0.06 [IQR: 0.05-0.12], P < 0.001). The correlation between IMT and PCT (P = 0.001, r = 0.47) was more significant than the correlation between IMT and CRP (P = 0.01, r = 0.28). There was a positive correlation between IMT and atherosclerotic risk factors such as age (P = 0.01, r = 0.27) and body mass index (BMI; P = 0.005, r = 0.32). Our results showed that PCT increases before CRP and it can be useful for the assessment of premature atherosclerosis in acromegaly as well.

Topiramate and darbepoetin alpha ameliorate bilirubin-induced neuronal cell damage.

OBJECTIVE: The aim of this study was to determine whether prophylactic darbepoetin alpha and/or topiramate administration could prevent bilirubin neurotoxicity (BNTx) in experimental model of kernicterus. MATERIALS AND METHODS: A total of 60 Wistar albino rat puppies with experimental kernicterus model were included in the study. The Kernicterus was established administering a bilirubin injection via a cisterna magna puncture 30 minutes after ip drug injection. The puppies were divided into five groups with 12 in each group as shown below: a control group, bilirubin group, darbepoetin alpha group, topiramate group and darbepoetin alpha+ topiramate group. Darbepoetin alpha and/or topiramate were administered on day 5 intraperitoneally (ip). At the 6th and 24th hours, bilirubin induced neurological dysfunction (BIND) score was used to assess behavioral changes. Hearing functions were evaluated on days 10 and 28. On day 30, the Water Maze water tank test was implemented to evaluate spatial memory. The rats were sacrificed on days 6 and 34 and apoptosis in the globus pallidus and hippocampus was examined. RESULTS: The BIND score was improved following darbepoetin alpha treatment. Neither darbepoetin alpha nor topiramate therapy ameliorate spatial memory. There were no significant differences between groups in terms of the auditory brainstem response (ABR). The combined use of darbepoetin alpha and topiramate lead to slight decrease in apoptosis. CONCLUSIONS: Darbepoetin alpha or topiramate administration ameliorates bilirubin induced neurological dysfunction in experimental model of kernicterus.

Prolonged unconjugated hyperbilirubinaemia associated with the haem oxygenase-1 gene promoter polymorphism.

AIM: To elucidate the genetic factors causing hyperbilirubinaemia in prolonged jaundice of the newborns, we investigated whether the HO-1 gene promoter polymorphism is a cause in unexplained pathological or prolonged jaundice. METHODS: Three groups were defined: healthy newborns with no clinical jaundice, newborns hospitalized for jaundice without any identifiable pathological cause and newborns with prolonged jaundice associated with breast milk. Genomic DNA was extracted from the white blood cells and the promoter region of the HO-1 gene was amplified using PCR and their allelic repeats were determined. RESULTS: We did not detect any significant difference in the allele frequencies between the healthy newborns and the newborns whose serum total bilirubin levels were >12.9 mg/dL. However, the patients with short (<24 GT) dinucleotide repeat in the HO-1 gene promoter on either allele had significantly higher prolonged unconjugated hyperbilirubinaemia than the healthy newborns. There was no significant difference between the groups 2 and 3. CONCLUSION: The results indicate that polymorphism of HO-1 gene promoter region can be an underlying cause of the prolonged unconjugated hyperbilirubinaemia associated with breast milk. In this patient population, short repeat alleles of the HO-1 gene promoter polymorphism were associated with prolonged jaundice.

Asymmetric dimethylarginine and nitric oxide levels in migraine during the interictal period.

Nitric oxide (NO), which modulates endothelial function, is thought to be pivotal in the pathophysiology of migraines. The connection between migraine and cardiovascular diseases has also drawn attention to the endothelial dysfunctions and NO pathway abnormalities seen in patients with migraine. Our goal was to assess the levels of NO and the endogenous NO synthase inhibitor, asymmetric dimethylarginine (ADMA), in people with migraine during the interictal period. A total of 49 patients with migraine and 22 control subjects were enrolled in the study. Their plasma NO metabolites (nitrite [NO2-] and nitrate [NO3-]) and ADMA levels were measured using the enzyme-linked immunosorbent assay method, and were then compared with their cardiovascular risk factors, anthropometric measurements, and headache frequency and severity. The plasma ADMA, NO2- and NO3- levels of the patients with migraine during the interictal period did not differ from the control group, and no relationship was found between cardiovascular risk factors and migraine attack severity and frequency. We conclude that, in patients with migraine, there is no dysfunction of baseline NO and ADMA metabolism during the interictal period.

MRI screening of dysbaric osteonecrosis in hyperbaric-chamber inside attendants.

Inside attendants are medical staff who accompany patients during hyperbaric oxygen treatments. Dysbaric osteonecrosis (DON) is a well-known consequence of hyperbaric exposure. The aim of this study was to evaluate DON in inside attendants using magnetic resonance imaging (MRI). The bilateral shoulder, hip and knee joints of 12 inside attendants (four men, eight women; mean age 29 years; age range 22 - 36 years) were investigated. The mean +/- SD duration of employment as an inside attendant was 3.8 +/- 3.0 years (range 1 - 9 years) and the mean +/- SD number of hyperbaric exposures was 198 +/- 267 (median 96; range 30 - 950). None of the inside attendants had a history of decompression sickness. The MRIs of the attendants did not reveal bone lesions consistent with DON. This study failed to find an increased risk for DON in inside attendants. Additional multicentre epidemiological studies are warranted to investigate the occupational safety of inside attendants.

Spontaneous remission of acute lymphoblastic leukemia with mediastinal mass.

Spontaneous remission/regression of cancer is defined as partial or complete disappearance of malignant disease temporarily or permanently in the absence of medical treatment. This event is named as spontaneous regression for solid tumors and spontaneous remission for leukemia. The authors report the case of a girl aged 4 years and 3 months, who presented with mediastinal mass and leukemic findings in the bone marrow both of which reappeared after spontaneous regression and remission, respectively.

Evaporation and wetted area of single droplets on waxy and hairy leaf surfaces.

Understanding the evaporation of pesticide droplets and wetting of Leaf surfaces can increase foliar application efficiency and reduce pesticide use. Evaporation time and wetted area of single pesticide droplets on hairy and waxy geranium leaf surfaces were measured under the controlled conditions for five droplet sizes and three relative humidities. The sprays used to form droplets included water, a nonionic colloidal polymer drift retardant, an alkyl polyoxyethylene surfactant, and an insecticide. Adding the surfactant into spray mixtures greatly increased droplet wetted area on the surfaces while droplet evaporation time was greatly reduced. Adding the drift retardant into spray mixture slightly increased the droplet evaporation time and the wetted area. Also, droplets had Longer evaporation times on waxy leaves than on hairy leaves for all droplet diameters and all relative humidity conditions. Increasing relative humidity could increase the droplet evaporation time greatly but did not change the the wetted area. The droplet evaporation time and wetted area increased exponentially as the droplet size increased. Therefore, droplet size, surface characteristics of the target, relative humidity, and chemical composition of the spray mixtures (water alone, pesticide, additives) should be included as important factors that affect the efficacy and efficiency of pesticide applications.