Determination of the cryoprotective effect of n-methylacetamide in rabbit semen.

BACKGROUND: Amides are low molecular weight cryoprotectants. N-methylacetamide (MA) is one of the cryoprotectant agents in this group. OBJECTIVE: To investigate the cryoprotective effect of MA in rabbit semen. MATERIALS AND METHODS: For this purpose, six ejaculates from six New Zealand rabbits were collected and pooled using an artificial vagina. Pooled semen was divided into four equal parts and diluted with TCG+ egg yolk. CPA was added to form the following groups: Control with 6% DMSO; Group 1 with 1% MA; Group 2 with 2% MA; and Group 3 with 3% MA. After the addition of CPA, the semen eqilibration procedure was started. Sperm were then drawn into 0.25 mL straws, frozen by automatic semen freezing and stored in a liquid nitrogen container. Pipettes were thawed after 24 h and analyses were performed. RESULTS: Total, progressive and rapid motility values of the Control group were higher than those of the MA groups (p<0.05). However, there was no statistical difference between the Control and Group 2 in terms of these parameters. While there was no statistical difference between the groups in terms of acrosome damage and mitochondrial membrane potential, the best results were observed in Control, Group 2, Group 1 and Group 3, respectively. When we compared all groups, no difference was found in terms of MDA, CAT and GSH-Px. There was a statistical difference between Group 3 and the Control in terms of GSH level (p<0.05). CONCLUSION: DMSO appeared to be more useful for the cryopreservation of rabbit semen compared to MA. Doi.org/10.54680/fr23610110812.

Arthroscopic Excision of Tendinous Giant Cell Tumors Causing Locking in the Knee Joint.

PURPOSE OF THE STUDY Non-osseous giant cell tumors are locally aggressive tumors arising around joints. They are commonly located around synovial joints such as wrist and knee and occasionally cause mechanical symptoms. MATERIAL AND METHODS This retrospective case series includes 7 patients operated due to intraarticular lesion. The mean age of the patients was 28.7 (range 22-37) years. Mean follow-up period was 12 months. RESULTS All patients underwent arthroscopic debridement. They were followed monthly with clinical examination and magnetic resonance imaging (MRI) was obtained at third month for all patients. Patients were contacted through phone call and evaluated with the WOMAC score retrospectively. No recurrence was detected in any patient. CONCLUSIONS Arthroscopic debridement is a safe surgical technique that may replace open surgery in the treatment of intraarticular tendinous giant cell tumors. Key words:tendinous giant cell tumor, arthroscopy, knee locking.

Insecticidal effects of extracts of Humulus lupulus (hops) L. cones and its principal component, xanthohumol.

Insecticidal effects of the dichloromethane, ethyl acetate, acetone, ethanol and methanol extracts of Humulus lupulus (hops) L. cones and its principal components, xanthohumol was investigated on five stored pests, Sitophilus granarius (L.), Sitophilus oryzae (L.), Acanthoscelides obtectus (Say.), Tribolium castaneum (Herbst) and Lasioderma serricorne (F.). The mortality of adults of the insects treated with 2, 5, 5, 10 and 20 mg mlÌ -1 concentrations of the extracts and xanthuhumol was counted after 24, 48, 72, 96 and 120 h. In order to determine the toxic effects of the substances tested against all tested insects, durations for 50% mortality of the adults, and LD50 values were also determined in the first 48 h by probit analysis. Our results also showed that xanthohumol was more toxic against the pests in comparison with the extracts applications. LD50 values for xanthohumol were found to be low dose as compared with the extracts. Xanthohumol was more toxic against S. granarius (L.) with 6.8 µg of LD50 value. Among the extracts, methanol extract was less effective than other extracts against all tested insects. The ethyl acetate extract of H. lupulus cones was the most effective extract against the tested pests. The quantitative amounts of xanthohumol in the extracts were determined using a high-performance liquid chromatography. The quantitative data indicated that amount of xanthohumol in the extracts increased with increase of polarity of the solvents used from methanol to dichloromethane. The methanol extract contained the high amount of xanthohumol with 5.74 g/100 g extract (0.46 g/100 g plant sample).

Ab initio Prediction of Martensitic and Intermartensitic Phase Boundaries in Ni-Mn-Ga.

Despite the importance of martensitic transformations of Ni-Mn-Ga Heusler alloys for their magnetocaloric and shape-memory properties, the martensitic part of their phase diagrams is not well determined. Using an ab initio approach that includes the interplay of lattice and vibrational degrees of freedom we identify an intermartensitic transformation between a modulated and a nonmodulated phase as a function of excess Ni and Mn content. Based on an evaluation of the theoretical findings and experimental x-ray diffraction data for Mn-rich alloys, we are able to predict the phase diagram for Ni-rich alloys. In contrast to other mechanisms discussed for various material systems in the literature, we herewith show that the intermartensitic transformation can be understood solely using thermodynamic concepts.

Unusual case of frontal mucocele presenting with forehead ulcer.

Paranasal mucoceles are benign slow-growing paranasal sinus lesions, which usually develop following the obstruction of the sinus ostiu. They most frequently occur in the frontal sinus. Frontal mucoceles are expansive lesions usually causing visual clinical signs and symptoms such as diminution of vision, visual field defects, diplopia, orbital swelling, retroorbital pain, displacement of eye globe, ptosis, and proptosis. When the frontal mucocele extends intracranially, it can manifest with meningitis, meningoencephalitis, intracranial abscess, seizures, or cerebrospinal fluid fistula. Very rarely it can cause forehead swelling. We report an 80-year-old woman presenting with a forehead skin ulcer and painless subcutaneous forehead induration. Histopathologic examination revealed mucin deposition and inflammation. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans showed a mass originating from the frontal sinus with frontal bony defect and frontocutaneous fistula. Surgical excision of the mass confirmed the mucocele diagnosis. In this article, we present a case of frontocutaneous fistula and skin ulcer, which is an unexpected complication of frontal mucocele. We propose that in the case of a localized non-healing ulcerated forehead skin lesions, mucocele should be considered in the differential diagnosis.

Anti-inflammatory and antioxidant properties of betaine protect against sepsis-induced acute lung injury: CT and histological evidence.

The aim of this research was to determine the anti-inflammatory effect of betaine on sepsis-induced acute respiratory distress syndrome (ARDS) in rats through histopathological examination, radiologic imaging, and biochemical analysis. Eight rats were included in the control group, and no procedure was performed. Feces intraperitoneal procedure (FIP) was performed on 24 rats to create a sepsis-induced ARDS model. These rats were separated into three groups as follows: FIP alone (sepsis group, n=8), FIP + saline (1 mL/kg, placebo group, n=8), and FIP + betaine (500 mg/kg, n=8). Computed tomography (CT) was performed after FIP, and the Hounsfield units (HU) value of the lungs was measured. The plasma levels of tumor necrosis factor (TNF)-α, interleukin-1ß (IL-1ß), IL-6, C-reactive protein, malondialdehyde (MDA), and lactic acid (LA) were determined, and arterial oxygen pressure (PaO2) and arterial CO2 pressure (PaCO2) were measured from an arterial blood sample. Histopathology was used to evaluate lung damage. This study completed all histopathological and biochemical evaluations in 3 months. All evaluated biomarkers were decreased in the FIP + betaine group compared to FIP + saline and FIP alone (all P<0.05). Also, the parenchymal density of the rat lung on CT and histopathological scores were increased in FIP + saline and FIP alone compared to control and these findings were reversed by betaine treatment (all P<0.05). Our study demonstrated that betaine suppressed the inflammation and ameliorated acute lung injury in a rat model of sepsis.

Nigella sativa as a potential therapy for the treatment of lung injury caused by cecal ligation and puncture-induced sepsis model in rats.

We investigated the potential protective effects of Nigella sativa (NS) on mortality, serum levels of proinflammatory cytokines, oxidative stress and histopathological changes in lung tissues, in cecal ligation and puncture (CLP)-induced sepsis model in rats. Sepsis induction by CLP, determination of serum cytokine levels by ELISA, spectrophotometric determination of oxidative stress parameters, and histological examination of lung tissues. The rat groups were: 1) CLP group, 2) sham group, 3) NS500-sham group, 4) NS125, 5) NS250, 6) NS500 groups. NS treatment significantly decreased proinflammatory cytokine levels in serum; LPO level, MPO activity, and pathological changes in lung tissues, in CLP-induced sepsis, while significantly increasing GSH levels and SOD activity in the lung tissue. NS treatment after CLP potentially reduced mortality and may exert effects through the reduction in tissue oxidative stress and serum cytokines. The histopathological changes were minimized in lung tissue by NS, under sepsis conditions. We can suggest that NS reverses the systemic inflammatory reaction to polymicrobial sepsis and thereby reduces multiple organ failure. It may be suggested that role of the NS ethanolic extract in preventing formation of CLP induced sepsis, is due to the anti-inflammatory and antioxidant effects of the different compounds of the black seeds.

Using SCC8, SCF27 and VMC7f2 markers in grapevine breeding for seedlessness via marker assisted selection.

We used molecular markers associated with seedlessness in grapes, namely SCC8, SCF27 and VMC7f2, to improve the efficiency of seedless grapevine breeding via marker assisted selection (MAS). DNA from 372 F1 hybrid progeny from the cross between seeded "Alphonse Lavallée" and seedless "Sultani" was amplified by PCR using three markers. After digestion of SCC8 marker amplification products by restriction enzyme BgIII, 40 individuals showed homozygous SCC8+/SCC8+ alleles at the seed development inhibitor (SdI) locus. DNA from 80 of the progeny amplified with the SCF27 marker produced bands; 174 individuals had 198-bp alleles of the VMC7f2 marker associated with seedlessness. In the second year, based on MAS, 183 F1 hybrids were designated as seedless grapevine candidates because they were positive for a minimum of one marker. Twenty individuals were selected as genetic resources for future studies on seedless grapevine breeding because they carried alleles for the three markers associated with seedlessness. The VMC7f2 SSR marker was identified as the marker most associated with seedlessness.

Intramedullary schwannoma of cervicomedullary junction: A case report.

BACKGROUND: Intramedullary schwannomas of brain stem and spinal cord are extremely rare. In almost all cases, homogeneous, asymmetrical or circular intensive gadolinium enhancement has been demonstrated. However, no cases reported previously with minimal contrast enhancement in cervicomedullary junction. CASE DESCRIPTION: A 38-year old man presented with a one-month history of constant, radiative right shoulder and arm pain. There was no pathological finding in his neurological examination. Also, physical evidence or family history of neurofibromatosis was not found. Magnetic resonance imaging of brain and cervical spine showed intramedullary, solid-cystic lesion localized in the cervicomedullary junction with unobvious gadolinium enhancement. The mass was gross totally resected through a sub-occipital craniotomy via midline approach. Postoperative pathological examination confirmed diagnosis of schwannoma. No changes were detected in the neurological examination of the patient after the operation. CONCLUSIONS: There are 3 previously reported intramedullary schwannomas of the cervicomedullary junction in the literature. To the best of our knowledge, this is the first case of unobvious contrast enhancing intramedullary schwannoma of the cervicomedullary junction. The possibility of schwannoma should not be excluded when a mass with slight contrast enhancement is detected in the intramedullary region of the cervicomedullary junction.

Dexpanthenol and ascorbic acid ameliorate colistin-induced nephrotoxicity in rats.

OBJECTIVE: Colistin is a potent antibiotic which is mainly preferred in the treatment of multidrug-resistant (MDR) gram-negative bacilli. However, due to the increased risk of acute kidney injury following its use, the clinical application is limited. This nephrotoxicity is known to be induced by oxidative stress and related inflammation. In this study on rats, potent antioxidants Dexpanthenol (DEX) and Ascorbic acid (Vit C) have been administered in combination with Colistin to find out whether they would weaken Colistin's nephrotoxic effects. MATERIALS AND METHODS: Inflammation biomarkers were studied with enzyme-linked immunosorbent assay (ELISA) kits, and oxidative stress biomarkers were studied with different photometric methods in blood and tissue samples taken after treatment with DEX and Vit C in rats with colistin nephrotoxicity. In addition, inflammation and necrosis in the kidney tissues were examined pathologically. RESULTS: It has been observed in the serum and tissue samples that DEX and Vit C decrease oxidative stress and inflammation biomarkers, therefore acting as nephroprotective agents. CONCLUSIONS: These compounds have been found to ameliorate the nephrotoxic effects of Colistin, which were demonstrated in the rats treated with Colistin, as well as the combinations.

Comparison of the effect of ranibizumab and dexamethasone implant in diabetic macular edema with concurrent epiretinal membrane.

OBJECTIVE: To compare the efficacy and safety of intravitreal ranibizumab (RZB) injections and intravitreal dexamethasone (DEX) implant in diabetic macular edema (DME) with concurrent epiretinal membrane (ERM). METHODS: This was a retrospective, observational, comparative study. Medical records of DME patients with concurrent ERM were retrospectively reviewed. Seventeen eyes of 16 patients treated with 3 consecutive monthly RZB injections (RZB group) and 22 eyes of 18 patients treated with a DEX implant (DEX group) were included. The groups were compared at baseline, 1st, 2nd, 3rd and 4th months in terms of best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP). RESULTS: Eighteen of the 39 eyes (46.1%) were phakic at baseline, 9 (52.9%) of which were treated with RZB, whereas 9 (40.9%) were treated with DEX implant (P=0.528). Although CMT improved significantly in both the RZB and DEX groups (P<0.001); the trend was different (P=0.003). The mean change in CMT at 1month in the DEX group was greater (DEX: 188.2±142.7µm; RZB: 95.7±110.7µm; P=0.034); it was in favor of RZB group at the 3rd and 4th months (DEX: -52.7±86.9µm; RZB: 1.4±31.4µm; P=0.012. DEX: -63±67.3µm; RZB: -5.8±43.9µm; P=0.004, respectively). BCVA improved significantly in both groups (P<0.001). There was no statistical difference between the groups with regard to gain in BCVA or IOP change throughout the study period (P=0.572, P=0.064, respectively). CONCLUSION: Both RZB and DEX are effective in improving anatomical and visual outcomes in DME with concurrent ERM. The DEX group was associated with a prompt anatomic response, but with a gradual decrease from 3rd month.

BK virus-associated nephropathy in two pediatric kidney recipients.

Posttransplant renal dysfunction episodes can result from a variety of causes, including polyomavirus (BK virus)-associated nephropathy (PVAN). It is a well-recognized entity with a high incidence of graft failure. The delicate balance of viral infection and immune regulation in the transplant population would allow development of successful long-term strategies. In this presentation, we have described two PVAN cases of our institution and reviewed the literature.

Effects of immobilization beds on the dose in the entrance and exit dose region for Co-60, 4, 6 and 15 MV photons.

PURPOSE: The aim of this study was to determine the effects of Styrofoam beds used for immobilization on build-up and exit dose regions for high energy photon beams. MATERIALS AND METHODS: Build-up dose and exit dose measurements in central axis of Co-60 and 4, 6 and 15 MV photons at various field sizes and source to phantom distances were made in a water equivalent solid phantom with 2, 5 and 10 cm thick uniform Styrofoam beds at the surface. A Markus type plane-parallel ion chamber with fixed separation between collecting electrodes was used to measure the percent depth doses. RESULTS: The surface dose increased almost linearly with field size for Co-60, 4, 6 and 15 MV X-ray beams. The effect of immobilization (Styrofoam beds) on the surface dose increased with the thickness and this effect was lower with higher energies. When a 2 cm thick Styrofoam bed was used for immobilization, the surface dose in a 10x10 cm field was higher (43.9, 36.8, 28.8 and 14.9% for Co-60, 4, 6 and 15 MV, respectively). CONCLUSION: As the Styrofoam bed was thicker, the maximum dose point moved closer to the surface of the phantom for all energies. The exit surface dose was also enhanced with the presence of Styrofoam beds and similar to the effects on the surface dose. This enhancement was the maximum 5% for high energy photon beams and 6% for Co-60 beam. The introduction of Styrofoam beds in the radiation beam for the immobilization of the patient increases surface and exit doses to a considerable extent.

The effect of mucine, IgA, urea, and lysozyme on the corrosion behavior of various non-precious dental alloys and pure titanium in artificial saliva.

The corrosion of dental alloys has biological, functional, and aesthetic consequences. Various studies have shown that protein solutions can inhibit the corrosion of alloys. This study is planned to determine the relationship of organic constituents of saliva and the corrosion of dental alloys. The organic constituents are IgA, mucine, urea, and lysozyme which are encountered in the highest amounts in saliva and the dental materials are titanium (Ti), Co-Cr-Mo and Ni-Cr-Mo alloys, and dental amalgam, the most often used metallic components in dentistry. In particular, the interactions between the commonest salivary proteins, IgA, mucine, urea and lysozyme, and Ti, Co-Cr-Mo, Ni-Cr-Mo and dental amalgam were investigated. Each alloy was evaluated by cyclic polarization in each medium. The general anodic and cathodic behavior during forward and reverse cycles, the corrosion and passivation current densities (muA/cm2 ), and the corrosion and the pitting potentials (mV) were determined. The results have shown that Ni-Cr-Mo and dental amalgam alloys are highly susceptible to corrosion in all the investigated media. The Co-Cr-Mo alloy has shown high passive current densities in the solution of mucine and lysozyme in artificial saliva. Titanium instead, has shown a high resistance to corrosion and a stable passive behavior in all media, especially in a solution of mucine and IgA in synthetic saliva. Mucine and IgA, as well as urea and lysozyme, appeared to enhance the formation of a passive film layer on the Ti metal surface, thus inhibiting the corrosion. Based on the study findings, and especially considering the problem of nickel allergy and toxicity of mercury released from dental amalgam, the use of Co-Cr-Mo alloys and Ti to Ni-Cr-Mo alloys is recommended and alternatives to dental amalgam should be sought for patients with impaired salivary flow.

The value of Nigella sativa in the treatment of experimentally induced rhinosinusitis.

The aim of this study was to investigate the effect of Nigella sativa and cephalexin in the therapy of experimental bacterial rhinosinusitis. Bacterial rhinosinusitis was induced with Staphylococcus aureus. Rabbits were divided into five groups; control (n = 6), N. sativa 50 mg/ kg/d (n = 6), N. sativa 100 mg/kg/d (n = 6), N. sativa 200 mg/kg/d (n = 6), and cephalexin 20 mg/kg/d (n = 6) groups. N. sativa was given orally for 7 days. The same volume of normal saline (0.9% NaCl) was given as a vehicle to the control group for the same period. After treatment period, sinus mucosa samples were evaluated using stereological and histopathological methods. Half of the maxillary sinus mucosa samples were frozen at -800C for further analysis of NO levels. Pathology revealed a severe acute inflammatory process in rabbits treated with saline. Only mild inflammation was determined in cephalexin group, N. sativa 100 mg/kg/d and N. sativa 200 mg/kg/d groups. The level of NO increased in the saline group was significantly reduced in all treatment groups. N. sativa may prevent histopathological changes of rhinosinusitis via decreased NO levels in a dose dependent manner and can be used in the treatment of rhinosinusitis diseases.

GATA3 expression and its relationship with clinicopathological parameters in invasive breast carcinomas.

GATA3, as a transcription factor, is associated with estrogen receptor (ER) expression and necessary for luminal cell differentiation in mammary glands. Association of GATA3 expression with clinicopathological parameters, molecular subtypes of tumors, disease free survival (DFS) and overall survival (OS) for breast carcinoma patients were evaluated in this study. We immunohistochemically stained GATA3, CK5/6, EGFR, CK14 and vimentin on tissue microarray blocks of 457 invasive breast carcinomas. Tumors are sub-classified as luminal A, luminal B, HER2 expressing, basal-like and null type according to their hormonal status with cerbB2, CK 5/6 and EGFR expressions. Follow-up data for 254 cases were obtained. 215/457 (47%) tumors were GATA3 positive. GATA3 expression was inversely correlated with mitotic count (p<0.0001), nuclear grade (p=0.001), histological grade (p=0.001), tumor necrosis (p=0.001), stromal lymphocytic response (p<0.01), nipple invasion (p=0.01), metastasis (p=0.03), vimentin (p=0.0003), EGFR (p=0.015) and CK14 (p=0.001) expressions; and directly associated with ER (p<0.0001) and progesterone receptor (PR) (p<0.0001) expressions. Luminal A carcinomas had the highest frequency for GATA-3 (140/245), however basal-like carcinomas had the lowest (1/42) (p<0.0001). None of the medullary and metaplastic carcinomas expressed GATA3. GATA3 was associated with good DFS and OS (p=0.001 and p=0.0009) and was an independent prognostic factor for OS. GATA3 expression, regardless of the subtype, may have a prognostic significance for breast carcinomas through its ability to promote the differentiation of luminal progenitor cells.

Determination of output factors for the Leksell gamma knife using ion chamber, thermoluminescence detectors and films.

PURPOSE: In stereotactic radiosurgery by the Leksell gamma knife, small fields of 4-18 mm in diameter are used. The difficulties associated with the dosimetry of small radiosurgical beams are well known. The output factors for small field sizes show a strong field size dependence, with rapidly decreasing output factors as the diameter of the field decreases. The main purpose of this study was to determine output factors of 18, 14, 8 and 4 mm collimators for Leksell gamma knife and to compare them with the values given by the manufacturer. MATERIALS AND METHODS: The relative output factors of the 18, 14 8 and 4 mm collimators for model B Leksell gamma knife were measured. The output factor measurements were prformed using a PTW 0.125 cc ion chamber, G200 thermoluminescence detectors (TLDs), KodakXV and Kodak ERD2 films. RESULTS: For 14 mm collimator, output measurements used with an ion chamber, TLD, Kodak XV film and Kodak ERD2 film were in agreement with the manufacturer's estimates within 1%. For 8 and 4 mm collimators, the best agreement with values given by the manufacturer were obtained by Kodak EDR2 films (2% and 5%, respectively). CONCLUSION: The measured output factors are in good agreement with the values recommended by the manufacturer for 18, 14 and 8 mm collimators. No good agreement was found for 4 mm collimator.

Shell-ferromagnetism of nano-Heuslers generated by segregation under magnetic field.

We report on a new functional property in an AF martensitic Heusler Ni50Mn45In5, which when annealed at high temperatures under a magnetic field, segregates and forms Ni50Mn25In25 Heusler precipitates embedded in a Ni50Mn50 matrix. The precipitates are paramagnetic whereas the matrix is antiferromagnetic. However, the spins at the interface with the Ni50Mn50 matrix align with the field during their nucleation and growth and become strongly pinned in the direction of the applied field during annealing, whereas the core spins become paramagnetic. This shell-ferromagnetism persists up to 600 K and is so strongly pinned that the remanent magnetization remains unchanged, even when the field is reversed or when the temperature is cycled between low temperatures and close to the annealing temperature.

Acute temozolomide induced liver injury: mixed type hepatocellular and cholestatic toxicity.

Temozolomide (TMZ) is an oral imidazotetrazine methylating agent which is used for the treatment of glioblastoma multiforme (GBM). We report a case of acute hepatotoxicity in a 53-year old male patient after administration of TMZ for GBM. He had fatigue, nausea, anorexia and jaundice. His laboratory analysis showed alanine aminotransferase(ALT): 632 IU/L (normal range 0-40); aspartate aminotransferase(AST): 554 IU/L (normal range 5-34); alkaline phosphatase(ALP): 1143 IU/L (normal range 40-150); γ-glutamyl transpeptidase(GGT): 514 IU/L (normal range 9-64 IU/L); total bilirubin: 15.1 mg/dL (normal range 0-1.2); direct bilirubin: 13.2 mg/dL and prothrombin time(PT): 13.5 s, with international normalized ratio (INR): 1.1 (normal range 0.8-1.2). His liver biopsy specimen showed mixed-type (both hepatocellular and cholestatic) hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that TMZ was the probable cause of the acute hepatitis. His liver function tests gradually normalized in 2 months after discontinuation of the drug. In susceptible individuals, TMZ use may lead to acute mixed type liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established. (Acta gastro-enterol. belg., 2016, 79, 363-365).

Acute temozolomide induced liver injury : Mixed type hepatocellular and cholestatic toxicity.

Temozolomide (TMZ) is an oral imidazotetrazine methylating agent which is used for the treatment of glioblastoma multiforme (GBM). We report a case of acute hepatotoxicity in a 53-year old male patient after administration of TMZ for GBM. He had fatigue, nausea, anorexia and jaundice. His laboratory analysis showed alanine aminotransferase(ALT) : 632 IU/L (normal range 0-40) ; aspartate aminotransferase(AST) : 554 IU/L (normal range 5-34) ; alkaline phosphatase(ALP) : 1143 IU/L (normal range 40-150) ; γ-glutamyl transpeptidase(GGT) : 514 IU/L (normal range 9-64 IU/L) ; total bilirubin : 15.1 mg/dL (normal range 0-1.2) ; direct bilirubin : 13.2 mg/dL and prothrombin time(PT) : 13.5 s, with international normalized ratio (INR) : 1.1 (normal range 0.8-1.2). His liver biopsy specimen showed mixed-type (both hepatocellular and cholestatic) hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that TMZ was the probable cause of the acute hepatitis. His liver function tests gradually normalized in 6 months after discontinuation of the drug. In susceptible individuals, TMZ use may lead to acute mixed type liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established. (Acta gastroenterol. belg., 2016, 79, 487-489).