Course of Acute Pancreatitis Patients with Renal Failure According to Balthazar Classification.

Background and Aim: There are criteria that include many organ systems to predict the prognosis in acute pancreatitis (AP) patients. In this study, we aimed to show how the course of the disease changes according to the Balthazar classification in AP patients presenting with renal failure. Methods and Materials: Our study included 352 patients who were admitted to the Emergency Service of our hospital and were diagnosed and hospitalized with AP. According to the Balthazar score, patients with scores of 0-2, 4-6, and 8-10 were evaluated as mild, moderate, and severe AP, respectively. Demographic data (age, gender) of all patients were documented. The etiology of AP was determined in all patients. Biliary, drug/toxic, alcohol, infections, hyperlipidemia, post-endoscopic retrograde cholangiopancreatography (ERCP), genetics, hypercalcemia, structural anomalies, and malignancy were evaluated as the etiology. Those without any underlying pathology were evaluated as idiopathic AP. The patients were divided into two groups as those with and without renal insufficiency. All patients underwent helical computed tomography (section 64, Aquilion; Toshiba Medical Systems, Tokyo) within the first 12 hours and between days 3 and 7. Pancreas, peripancreatic and extrapancreatic findings, and complications were examined. "The Statistical Package for the Social Sciences 19.0 (SPSS Armonk, NY: IBM Corp.)" was used for all analyses. Kolmogorov-Smirnov test and histograms were used to determine whether there was a normal distribution. The non-parametric data of the groups were compared using the Mann-Whitney U test and the parametric data using the independent t test. Chi-square test was used to test categorical data. Cases with P < 0.05 were considered statistically significant. Results: : While 22 (6.2%) patients had renal insufficiency, 332 (95.8%) patients did not have renal insufficiency. In the evaluation made in terms of AP severity; according to Balthazar classification at admission, there was no difference in mild and moderate pancreatitis for kidney insufficiency in both groups, but it was significantly higher in the group with severe pancreatitis [2 (9.1%) versus 1 (0.3%), P < 0.001]. In the evaluation made after 72 hours; renal failure was significantly lower in the group with mild pancreatitis [11 (50.0%) versus 245 (73.8%), P: 0.016] and severe renal failure was significantly higher in severe pancreatitis [7 (31.8%) versus 13 (%) 3.9), P < 0.001]. Conclusions: Early intensive care unit admission and close follow-up and early treatment in AP patients change the course of the disease. In our study, we showed that serum creatinine level is an important parameter in the course of AP and has a predictive value for the course of the disease.

Potential of essential oil combinations for surface and air disinfection.

In this study, it was aimed to develop a novel disinfectant from various essential oils containing active components with antimicrobial activity. The mixture of oregano, cinnamon and clove oils (1 : 1 : 1) with 10% oil concentration (SOM) was used as potential disinfectant on various areas and showed the highest antimicrobial activity among oil combinations tested. SOM reduced the numbers of total mesophilic aerobic bacteria (TMAB; 2·27 log CFU per 25 cm2 ) and Escherichia coli (4·60 log CFU per 25 cm2 ) under the detection limits. Application of SOM (1, 2, 3, 4 and 6%) into incubators reduced TMAB and mould-yeast counts of incubator air by 82·9 and 100% respectively. SOM application (3%) into ambient air also reduced its TMAB and mould-yeast counts by 92 and 84·6% respectively. While ethanol is commonly used for the disinfection of environments, equipment and surfaces, SOM is an important alternative that may also be used for the disinfection of various surfaces as well as air.

Dispersion of elastic waves in a layer interacting with a Winkler foundation.

Dispersion of plane harmonic waves in an elastic layer interacting with a one- or two-sided Winkler foundation is analyzed. The long-wave low-frequency polynomial approximations of the full transcendental dispersion relations are derived for a relatively soft foundation. The validity of the conventional engineering formulation of a Kirchhoff plate resting on an elastic foundation is investigated. It is shown that this formulation has to be refined near the cutoff frequency of bending waves. The associated near cutoff expansion is obtained for both cases. A simple explicit formula demonstrating veering of bending and extensional waves is presented for a one-sided foundation.

The role of 15-lipoxygenase-1 expression and its potential role in the pathogenesis of endometrial hyperplasia and endometrial adenocarcinomas.

PURPOSE OF INVESTIGATION: To investigate the presence of 15-lipoxygenase-1 (15-LOX-1) expression and its potential role in the pathogenesis of endometrial hyperplasia and endometrial adenocarcinomas. MATERIALS AND METHODS: The authors investigated the presence of 15-LOX-1 expression in samples from patients diagnosed with normal endometrium (n = 12), endometrial hyperplasia (n = 12), and endometrial cancer (n = 12). The immunohistochemical stainings were scored by three independent pathologists. A Western blot of 15- LOX-1 determined the presence of protein expression in normal endometrium. A Kolmogorov-Smirnov test was used to evaluate the data's distribution pattern. For pairwise comparisons of the combined scores between groups, the Mann-Whitney U test was used. RESULTS: Based on the combined scores for 15-LOX-1 expression, strong immunochemistry staining was observed in samples diagnosed with normal endometrium. There was a significant difference in 15-LOX-1 expression between normal endometrium and endometrial adenocarcinoma (p = 0.03). Comparing tissues from normal endometrium and endometrial hyperplasia, there was a decline in the expression from normal endometrium to endometrial hyperplasia. However, the difference was not statistically significant. CONCLUSION: The present results show that a decrease of 15-LOX-1 expression in the endometrial tumorigenesis process, starting from normal endometrium to hyperplasia and endometrial cancer, might be a trigger. Further studies are required to determine its potential use as a marker in a larger randomized multicenter study.

Early-Stage Quantitative Analysis of the Effect of Laparoscopic versus Conventional Inguinal Hernia Repair on Physical Activity.

AIM: To compare the effects of laparoscopic versus conventional inguinal hernia repair techniques on patients physical activity. MATERIALS AND METHODS: Ninety-three patients (between 20 and 59 years old) who presented with a need for inguinal hernia repair at the private Safa Hospital, General Surgery Clinic, were evaluated prospectively between November 2011 and March 2013. The patients mean age was 46.1 (+-12.9) years. They were divided into three groups according to hernia repair technique. Thirty underwent total extraperitoneal repair (TEP), 31 had transabdominalpreperitoneal repair (TAPP) and 32 had modified Bassiniprolene mesh grafting (MBPMG). All patients were examined in the physical therapy and rehabilitation unit just before and after the operation. Lower extremity muscles isokinetic and isometric functions were measured with the Cybex isokinetic testing device. Patients length of stay in hospital, need for analgesics in the postoperative period, visual analogue scale (VAS) scores, time of return to work and postoperative complications were also compared. RESULTS: Patients need for postoperative analgesics, the use of VAS scoring system (between 0 and 10), complication rates and the patients VAS scores on movement results were similar to those in the literature. On the postoperative third day, measurements recorded by the Cybex isokinetic testing device showed that the loss of strength in the lower extremities after the MBPMG procedure was greater than with TAPP and TEP. The isokinetic and isometric assessment of all cases revealed that postoperative mean muscle strength loss was two-thirds less in association with the laparoscopic procedure. Within a 95% confidence interval (CI), the significance of findings was accepted at P-values of less than 0.05 (p 0.05). CONCLUSION: The quantitative data showed that there is a more favourable impact from laparoscopic hernia repair versus open surgery on patients physical activity and return to active work.

An investigation on protection properties of Tantalum (V) oxide reinforced glass screens on unexposed breast tissue for mammography examinations.

INTRODUCTION: The utilization of radiation shielding material positioned between the both breasts are crucial for the reduction of glandular dose and the safeguarding of the contralateral breast during mammographic procedures. This study proposes an alternative substance for shielding the contralateral breast from radiation exposure during mammography screening. METHODS: In this study, we present an analysis of the shielding effectiveness of transparent glass that has been doped with Tantalum (V) oxide encoded as BTZT6. The evaluation of this shielding material was conducted using the MCNPX code, specifically for the ipsilateral and contralateral breasts. The design of the left and right breast phantoms involved the creation of three-layer heterogeneous breast phantoms, consisting of varying proportions of glandular tissue (25%, 50%, and 75%). The design of BTZT6 and lead-acrylic shielding screens is implemented using the MCNPX code. The comparative analysis of dose outcomes is conducted to assess the protective efficacy of BTZT6 and lead-acrylic shielding screens. RESULTS: The utilization of BTZT6 shielding material resulted in a reduction in both breast dose and skin dose exposure when compared to the lead-acrylic shield. CONCLUSION: Based on the findings acquired, the utilization of BTZT6 shielding material screens during mammography procedures involving X-rays with energy levels ranging from 26 to 30 keV is associated with a decrease in radiation dose. IMPLICATIONS FOR PRACTICE: It can be inferred that the utilization of BTZT6 demonstrates potential efficacy in mitigating excessive radiation exposure to the breasts and facilitating the quantification of glandular doses in mammography procedures.

Oestrogens improve human pancreatic islet transplantation in a mouse model of insulin deficient diabetes.

AIMS/HYPOTHESIS: Pancreatic islet transplantation (PIT) offers a physiological treatment for type 1 diabetes, but the failure of islet engraftment hinders its application. The female hormone 17ß-oestradiol (E2) favours islet survival and stimulates angiogenesis, raising the possibility that E2 may enhance islet engraftment following PIT. METHODS: To explore this hypothesis, we used an insulin-deficient model with xenotransplantation of a marginal dose of human islets in nude mice rendered diabetic with streptozotocin. This was followed by 4 weeks of treatment with vehicle, E2, the non-feminising oestrogen 17α-oestradiol (17α-E2), the oestrogen receptor (ER) α agonist propyl-pyrazole-triol (PPT), the ERß agonist diarylpropionitrile (DPN) or the G protein-coupled oestrogen receptor (GPER) agonist G1. RESULTS: Treatment with E2, 17α-E2, PPT, DPN or G1 acutely improved blood glucose and eventually promoted islet engraftment, thus reversing diabetes. The effects of E2 were retained in the presence of immunosuppression and persisted after discontinuation of E2 treatment. E2 produced an acute decrease in graft hypoxic damage and suppressed beta cell apoptosis. E2 also acutely suppressed hyperglucagonaemia without altering insulin secretion, leading to normalisation of blood glucose. CONCLUSIONS/INTERPRETATION: During PIT, E2 synergistic actions contribute to enhancing human islet-graft survival, revascularisation and functional mass. This study identifies E2 as a short-term treatment to improve PIT.

Cytology at the time of cervical colposcopy.

OBJECTIVE: The efforts of the authors are to evaluate the role of performing a Papanicolaou (Pap) smear at the time of colposcopy. MATERIALS AND METHODS: This retrospective chart review included patients from 2004 to 2009 who underwent cold knife cone (CKC) biopsy or loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia types 2 and 3 (CIN 2 and 3) or patients with discrepancy between Pap and colposcopic results. All patients presented to the gynecology clinics in a tertiary care hospital. Results were compared which included: the abnormal Pap smear which led to referral for colposcopy, the Pap smear performed at the time of colposcopy, the colposcopic biopsy, and the excisional biopsy. Interpretation of results was calculated with Cohen's K Statistics. RESULTS: One hundred forty-seven patients qualified for the study. One hundred five patients had excisional biopsy proven high-grade squamous intraepithelial lesion (HSIL). Eighty-two of these high-grade excisional pathology results were preceded by high-grade Pap cytology at the time of colposcopy; however 23 Pap cytology results indicated either low-grade squamous intraepithelial lesion (LSIL) or negative (20 and 3 respectively), but were followed by an excisional procedure revealing high-grade pathology. Eighty-one colposcopic biopsies confirmed high-grade excisional biopsy pathology. However, 24 colposcopic biopsies were low-grade or negative (13 and 11 respectively), but followed by a high-grade excisional biopsy. CONCLUSION: The addition of a Pap smear at the time of colposcopy has the potential role of recognizing high-grade cervical dysplasia.

Tungsten (VI) oxide reinforced antimony glasses for radiation safety applications: A throughout investigation for determination of radiation shielding properties and transmission factors.

We report the functional assessment of tungsten (VI) oxide on gamma-ray attenuation properties of 60Sb2O3-(40-x)NaPO3-xWO3 antimony glasses. The elemental mass-fractions and glass-densities of each glass sample are specified separately for the MCNPX Monte Carlo code. In addition to fundamental gamma absorption properties, Transmission Factors throughout a broad radioisotope energy range were measured. According to findings, holmium (Ho) incorporation into the glass structure resulted in a net increase of 0.3406 g/cm3, whereas cerium (Ce) addition resulted in a net increase of 0.2047 g/cm3. The 40% WO3 reinforced S7 sample was found to have the greatest LAC value, even though seven glass samples exhibited identical behavior. The S2 sample had the lowest HVL values among the glass groups evaluated in this work, computed in the energy range of 0.015-15 MeV. The lowest EBF and EABF values were reported for 40% WO3 reinforced S7 sample with the highest LAC and density values. According to the findings of this research, WO3 will likely make a significant contribution to the gamma ray absorption properties of antimony glasses, which are employed for optical and structural modification. Therefore, it can be concluded that WO3 may be treated monotonically and can be employed successfully in circumstances where gamma-ray absorption characteristics, optical properties, and structural qualities need to be enhanced.

Toward the strengthening of radioprotection during mammography examinations through transparent glass screens: A benchmarking between experimental and Monte Carlo simulation studies.

Introduction: A lead-acrylic protective screen is suggested to reduce radiation exposure to the unexposed breast during mammography. The presence of toxic lead in its structure may harm the tissues with which it comes in contact. This study aimed to design a CdO-rich quaternary tellurite glass screen (C40) and evaluate its efficiency compared to the Lead-Acrylic protective screen. Methods: A three-layer advanced heterogeneous breast phantom designed in MCNPX (version 2.7.0) general-purpose Monte Carlo code. Lead acrylic and C40 shielding screens were modeled in the MCNPX and installed between the right and left breast. The reliability of the absorption differences between the lead acrylic and C40 glass were assessed. Results and discussion: The results showed that C40 protective glass screen has much superior protection properties compared to the lead acrylic protective screen. The amount of total dose absorbed in the unexposed breast for C40 was found to be much less than that for lead-based acrylic. The protection provided by the C40 glass screen is 35-38% superior to that of the Lead-Acrylic screen. The C40 offer the opportunity to avoid the toxic Pb in the structure of Lead-Acrylic material and may be utilized for mammography to offer superior radioprotection to Lead-Acrylic and significantly lower the dose amount in the unexposed breast. It can be concluded that transparent glass screens may be utilized for radiation protection purposes in critical diagnostic radiology applications through mammography.

Comparative analysis on application conditions of indium (III) oxide-reinforced glasses in nuclear waste management and source transportation: A Monte Carlo simulation study.

This study's primary objective is to provide the preliminary findings of novel research on the design of Indium (III) oxide-reinforced glass container that were thoroughly developed for the purpose of a nuclear material container for transportation and waste management applications. The shielding characteristics of an Indium (III) oxide-reinforced glass container with a certain elemental composition against the 60Co radioisotope was thoroughly evaluated. The energy deposition in the air surrounding the designed portable glass containers is measured using MCNPX general-purpose Monte Carlo code. Simulation studies were carried out using Lenovo-P620 workstation and the number of tracks was defined as 108 in each simulation phase. According to results, the indium oxide-doped C6 (TZI8) container exhibits superior protective properties compared to other conventional container materials such as 0.5Bitumen-0.5 Cement, Pb Glass composite, Steel-Magnetite concrete. In addition to its superiority in terms of nuclear safety, it is proposed that the source's simultaneous observation and monitoring, as well as the C6 (TZI8) glass structure's transparency, be underlined as significant advantages. High-density glasses, which may replace undesirable materials such as concrete and lead, provide several advantages in terms of production ease, non-toxic properties, and resource monitoring. In conclusion, the use of Indium (III) oxide-reinforced glass with its high transparency and outstanding protection properties may be a substantial choice in places where concrete is required to ensure the safety of nuclear materials.

Utilization of three-layers heterogeneous mammographic phantom through MCNPX code for breast and chest radiation dose levels at different diagnostic X-ray energies: A Monte Carlo simulation study.

Introduction: We report the breast and chest radiation dose assessment for mammographic examinations using a three-layer heterogeneous breast phantom through the MCNPX Monte Carlo code. Methods: A three-layer heterogeneous phantom along with compression plates and X-ray source are modeled. The validation of the simulation code is obtained using the data of AAPM TG-195 report. Deposited energy amount as a function of increasing source energy is calculated over a wide energy range. The behavioral changes in X-ray absorption as well as transmission are examined using the F6 Tally Mesh extension of MCNPX code. Moreover, deposited energy amount is calculated for modeled body phantom in the same energy range. Results and discussions: The diverse distribution of glands has a significant impact on the quantity of energy received by the various breast layers. In layers with a low glandular ratio, low-energy primary X-ray penetrability is highest. In response to an increase in energy, the absorption in layers with a low glandular ratio decreased. This results in the X-rays releasing their energy in the bottom layers. Additionally, the increase in energy increases the quantity of energy absorbed by the tissues around the breast.

Accuracy of physician and nurse practitioner colposcopy to effect improved surveillance of cervical cancer.

PURPOSE: To compare physician and nurse practitioner accuracy in recognizing cervical dysplasia during colposcopy. MATERIALS AND METHODS: A retrospective review was performed of cervical excisional biopsies from 2007 to 2009 performed by gynecologists and nurse practitioners in the same patient population. Cervical cone biopsy and loop electrosurgical excision procedure (LEEP) pathology were used as a gold standard compared to the previous colposcopy biopsies. RESULTS: Four hundred fifty-five patients qualified for the study. Patients were stratified according to age: under 30 years, 30-39, and 40 and above. For physicians, 77% of high-grade colposcopy biopsy results agreed with high-grade pathology on cone biopsy or LEEP. This was statistically similar to nurse practitioner results (p = 0.12). Likewise, there was no significant difference between physician and nurse practitioner accuracy within the various patient age strata. CONCLUSION: Colposcopy biopsy results compared to cone biopsy or LEEP results were statistically similar between gynecologists and nurse practitioners.

Levels of depression, anxiety and behavioural problems and frequency of psychiatric disorders in children with chronic idiopathic urticaria.

BACKGROUND: Several studies reported that adults with chronic idiopathic urticaria (CIU) frequently exhibit psychiatric comorbidity, most commonly depression and anxiety disorders. However the literature about children is limited. OBJECTIVES: To investigate the frequency of psychiatric disorders and to determine the levels of depression, anxiety and behavioural problems in a group of children with CIU. METHODS: The study included 27 children with CIU and 27 age- and sex-matched healthy subjects. Psychiatric assessment was done by using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). The State-Trait Anxiety Inventory for Children (STAI-C), Children's Depression Inventory (CDI) and Child Behavior Checklist (CBCL) were used to examine the levels of depression, anxiety and behavioural behaviours, respectively. RESULTS: The study group had more frequent psychiatric diagnoses than the control group (70% vs. 30%) and the most common psychiatric disorders were social anxiety disorder, separation anxiety disorder and specific phobia. Depression, trait anxiety, internalizing problems, somatic complaints and anxiety/depressed scores were significantly higher in children with CIU. No correlation was found between the severity and duration of illness and psychological functioning. CONCLUSION: This study showed that children with CIU had high psychiatric morbidity. The results suggest that the psychological status of children with CIU should be screened by clinicians and that an interdisciplinary approach combining dermatological and psychiatric evaluations is necessary for the management of CIU.