Electrical impedance measurements can identify red blood cell-rich content in acute ischemic stroke clots ex vivo associated with first-pass successful recanalization.

Background: Electrochemical impedance spectroscopy can determine characteristics such as cell density, size, and shape. The development of an electrical impedance-based medical device to estimate acute ischemic stroke (AIS) clot characteristics could improve stroke patient outcomes by informing clinical decision making. Objectives: To assess how well electrical impedance combined with machine learning identified red blood cell (RBC)-rich composition of AIS clots ex vivo, which is associated with a successfully modified first-pass effect. Methods: A total of 253 clots from 231 patients who underwent thrombectomy in 5 hospitals in France, Japan, Serbia, and Spain between February 2021 and October 2023 were analyzed in the Clotbase International Registry. Electrical impedance measurements were taken following clot retrieval by thrombectomy, followed by Martius Scarlet Blue staining. The clot components were quantified via Orbit Image Analysis, and RBC percentages were correlated with the RBC estimations made by the electrical impedance machine learning model. Results: Quantification by Martius Scarlet Blue staining identified RBCs as the major component in clots (RBCs, 37.6%; white blood cells, 5.7%; fibrin, 25.5%; platelets/other, 30.3%; and collagen, 1%). The impedance-based RBC estimation correlated well with the RBC content determined by histology, with a slope of 0.9 and Spearman's correlation of r = 0.7. Clots removed in 1 pass were significantly richer in RBCs and clots with successful recanalization in 1 pass (modified first-pass effect) were richer in RBCs as assessed using histology and impedance signature. Conclusion: Electrical impedance estimations of RBC content in AIS clots are consistent with histologic findings and may have potential for clinically relevant parameters.

A scale development study: Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment.

INTRODUCTION: As hemodialysis is a long-term treatment method requiring significant self-management skills, it affects both the patient and the caregiver in many ways. It is inevitable that changes in the burden perceived by the caregiver over time will not affect the patient's health care outcomes. The aim of this study was to develop an up-to-date scale by examining the psychometric properties of items created specifically for the care burden perceived by individuals who provide care for patients receiving hemodialysis treatment. METHODS: This study is a methodological study with the use of the COSMIN Checklist. The sample of the study included 404 individuals who were the primary caregivers of patients receiving hemodialysis treatment. Data were collected using descriptive characteristics form and the draft form of the Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment. Exploratory and confirmatory factor analysis and predictive validity were used to evaluate validity. The Cronbach's alpha reliability coefficient, item analysis, and test-retest method were employed to evaluate reliability. RESULTS: According to exploratory factor analysis, a scale structure with four subdimensions was determined, and goodness of fit was achieved using confirmatory factor analysis. The Cronbach's alpha coefficient of the final form of the scale consisting of 34 items was found to be 0.95 for the total scale, 0.93 for the self-management support subscale, 0.91 for the psychological support subscale, 0.91 for the caregiver symptom subscale, and 0.93 for the caregiver individual coping subscale. CONCLUSION: The Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment, which was found to meet the validity and reliability criteria, has a four-point Likert-type scoring structure, 34 items, and four subdimensions. It is thought that the scale can make significant contributions to the international literature if its validity and reliability are established with nursing practices and research.

Levetiracetam treatment in an experimental model of sciatic nerve injury: A randomized controlled trial.

AIM: This study examined whether levetiracetam contributes to improvements in the axon-nerve damage in an experimental rat model. MATERIALS AND METHODS: Forty-eight Wistar albino adult male rats weighing 250-300 gr were randomized into six groups having or not having sciatic nerve damages and receiving different (none, 300 and 600 mg/kg) levetiracetam doses, and control (non-levetiracetam). Functional gait analysis and tissue sample analysis with the aid of light microscopy and hematoxylin-eosin dye were evaluated between the groups. Additionally, scanning electron microscopy (SEM) was used for the detailed examination of sciatic nerves. S-100 (Schwann cell marker) immunoreactivities in sciatic nerve was detected by immunohistochemistry. RESULTS: Sciatic functional index of the injured rats receiving 300 mg/kg levetiracetam was -65.59 ± 29.48 and -47.13 ± 21.36 in the 2nd and 6th weeks, respectively (p < 0.001). Also, IMA and TOS levels were significantly higher in the control group compared to those receiving levetiracetam (p = 0.001 and p < 0.001, respectively).      The most significant nerve regeneration was in the group injured and treated with LEV 600 mg/kg (p < 0.05). CONCLUSION: There was a significant improvement in the sciatic functional index, histopathological findings, and parameters showing tissue oxidant status in rats with sciatic nerve injury receiving levetiracetam treatment. Further investigations should be performed to evaluate the contribution of levetiracetam as a treatment modality in sciatic nerve injuries.

A scale development study: Hemodialysis comfort scale version II.

Aim: Aim of this study was to develop a valid and reliable measuring tool in order to evaluate comfort of patients receiving hemodialysis treatment. Background: There has been available a scale developed to evaluate comfort of hemodialysis patients "HDCS (Hemodialysis Comfort Scale)." Due to HDCS consisted of nine items and evaluated comfort in two sub-dimensions, researchers who developed HDCS, stated that number of scale items and dimensions is not sufficient to fully evaluate comfort. Therefore, (Hemodialysis Comfort Scale Version II) HDCS-II was developed with this research and its development process were discussed in this article. Materials and Methods: Sample of this methodological research was consisted of 436 chronic hemodialysis patients, treated at five hemodialysis centers between October 2018 and May 2019. In process of creation item pool, comfort theory and literature was examined. The items in the old scale were also revised and included. Thereby a new question pool of 87 items was created. This draft scale was sent for expert opinion. In validity of scale; content validity index, exploratory and confirmatory factor analysis were used. In reliability study; Item analysis, cronbach's alpha reliability coefficient, parallel form reliability and item analysis based on upper-lower group averages were used. Results: There was consistency between expert views relating to items in scale. According to exploratory factor analysis, scale consisted of six dimensions. Cronbach alpha coefficient of 26-item scale was 0.79. Alpha values of the six factor in scale were, respectively; for physical relief 0.83, for physical ease 0.71, for psychospiritual ease 0.87, for psychospiritual transcendence 0.85, for environmental transcendence 0.82, and for sociocultural ease 0.61. Conclusion: HDCS-II is a 5-point likert type and consists of 26 items and 6 factors. This scale is a valid and reliable measurement tool that can be used to determine comfort of patients undergoing hemodialysis treatment.

Examining the relationship between symptoms watched in lung cancer patients and illness perception.

OBJECTIVE: To examine the relationship between the symptom experience of lung cancer patients and their illness perception of the disease. METHODS: The descriptive and cross-sectional study was conducted from April to September 2015 at the Chemotherapy Treatment Centre of the Medicine Chest Diseases Clinic at the Ege University, Izmir, Turkey, and comprised lung cancer patients of either gender aged >18 years. Data was collected using a predesigned Patient Questionnaire as well as the standard Lung Cancer Symptom Scale, Illness Perception Questionnaire and Karnofsky Performance Scale. The patients' sociodemographic characteristics and data on their illness, the symptoms they experienced and the numerical and percentage distribution of the items on the illness perception scale, mean and standard deviation values were examined. Pearson Correlation analysis was used to examine the correlation between illness perception and Karnofsky Performance Scale scores and other variables. RESULTS: Of the 105 patients, 86(81.9%) were males, 86(81.9%) were married, 49(46.7%) were elementary school graduates, 101(96.2%) were unemployed, and 95(90.5%) were receiving chemotherapy. The overall mean age of the sample was 61.43±8.24 years, the period since diagnosis was 11.38±17.84 months, and the duration of chemotherapy was 4.28±2.37 months. The mean symptom burden score was 22.75±10.85 and the Lung Cancer Symptom Scale score was 22.75±10.85. The mean score of the type of illness domain was 5.53±2.12. The overall mean global quality of life score was 64.30±12.60. CONCLUSIONS: As the symptom burden experienced by the lung cancer patients increased, their perception of the illness became more negative, and the longer the cyclical periods and the period of diagnosis, the patients' control over their illness decreased.

Conjugated linoleic acid protects brain mitochondrial function in acrolein induced male rats.

Acrolein (AC) is a toxic substance that can have a neurotoxic effect. It can cause oxidative stress and mitochondrial dysfunction. Conjugated linoleic acid (CLA), a dietary supplement, has many biological functions. Limited information is available about the effect of CLA on AC-induced brain toxicity. Therefore, the present study aims to investigate the effect of CLA on mitochondrial oxidative stress, respiratory enzymes, krebs cycle enzymes and ATP levels in AC treated rat brain. Sprague Dawley male rats were given AC (5 mg/kg i.p.), CLA (200 mg/kg orally) and CLA with AC for six days per week for 30 days. Some oxidative stress parameters and mitochondrial enzymes such as manganese super oxide dismutase, glutathione peroxidase, NADP+-dependent isocitrate dehydrogenase (ICDH), alpha-ketoglutarate dehydrogenase (α-KGDH), malate dehydrogenase, reduced glutathione (GSH), lipid peroxidation (LP), protein carbonyl (PC), oxidative phosphorylation (OXPHOS) and tricarboxylic acid cycle (TCA) enzymes, and ATP levels were determined. AC significantly decreased the activities of GSH, antioxidant enzymes, OXPHOS enzymes (complex I and IV), TCA enzymes (ICDH and α-KGDH) and ATP levels. Significant increases were also observed in mitochondrial LP and PC levels in AC group. Co-treatment with AC + CLA improved oxidative stress and mitochondrial dysfunction caused by AC. As a result of our findings, it was observed that CLA was effective in improving oxidative stress and impaired mitochondrial functions in brain tissue by the effect of AC. Considering the association between neurodegenerative diseases and mitochondrial dysfunction, CLA can play a role in the prevention and therapy of neurodegenerative disorders.

Ubiquitin proteasome system and autophagy associated proteins in human testicular tumors.

Ubiquitin proteasome sytem (UPS) and autophagy govern protein quality control by degradation and clearance of damaged proteins. Many proteins working in these pathways such as p97/VCP, Ubiquitin (Ub), Jab1/CSN5, p62, LC3B and Beclin 1 are known to be essential for different pathological conditions, especially in cancer, but their expression in human testicular tumors has not been characterized yet. In the present study, we aimed to investigate the expression of UPS (p97/VCP, Ubiquitin, Jab1/CSN5) and autophagic (p62, LC3B, Beclin 1) proteins in human testicular tumors and cancer adjacent normal testicular tissues. We used an immunohistochemical staining technique. 120 cases of testicular germ and non-germ cell tumors, which are 42 seminomas, 31 embryonal carcinomas, 11 yolk sac tumors, 25 intratubular germ cell neoplasms, 6 Leydig cell tumors, 5 Sertoli cell tumors, were collected and evaluated on tissue microarray. For the first time, the expression of p97/VCP, Ub, Jab1/CSN5, p62, LC3B and Beclin 1 in different type of human testicular tumors has been confirmed. We found that p97/VCP, Ub and Jab1/CSN5 were frequently expressed at higher levels in testicular tumours. In contrast to UPS markers, p62, LC3B and Beclin 1 showed significantly diminished expressions in testicular tumors. Accordingly, a negative correlation between p97/VCP and autophagic markers (p62 and LC3B) was found, suggesting a relationship between UPS and autophagy in different type of testicular tumors. The current results displayed elevated level of p97/VCP, Ub and Jab1/CSN5 expressions in contrast to the diminished expression of p62, LC3B and Beclin 1 in human testicular tumors, thereby supporting a correlation between p97/VCP and autophagic markers in testicular tumors.

Disruption of p97/VCP induces autophagosome accumulation, cell cycle arrest and apoptosis in human choriocarcinoma cells.

Gestational choriocarcinoma is aggressive trophoblastic disease. The development, progression and the cure of this disease is not well-established. p97/Valosin containing protein has been shown to play critical roles in many cellular processes. In various cancers, higher expression of p97/VCP has been reported and targeting of p97/VCP with its spesific inhibitors or siRNA's (siVCP) in cancer therapy was suggested. However, no study is avaible about the expression and function of p97/VCP in gestational choriocarcinoma. Hence, the aim of the study was to evaluate effects of p97/VCP inhibitor, DBeQ and siVCP on choriocarcinoma cells. We use human placental choriocarcinoma cell line (Jeg3) as model to find out the effects of DBeQ and VCP siRNA's (siVCP) on apoptotic and autophagic pathway by immunflouroscence staining, Western blotting, qPCR and flow-cytometry. p97/VCP siRNA's and DBeQ induced accumulation of autophagic proteins, LC3II and p62 in the cytoplasm of Jeg3 cells detected. Concurrently, Jeg3 cells treated with DBeQ and siVCP demonstrated G0/G1 cell cycle arrest, accompanied by accumulation of poly-ubiquitinated proteins. Moreover, disruption of p97/VCP by siRNA and DBeQ inhibited cancer cell growth managing the caspases-3 and -7. Our results show that inhibition of p97/VCP activity with DBeQ and depletion of p97/VCP expression with siRNA in Jeg3 cells induce caspase activation, inhibits cell proliferation and leads to a defect in autophagosome maturation, thus providing potential target for the prevention and treatment of choriocarcinoma.

Evaluation of the effect of nutrition-related visual education on the comfort of patients receiving hemodialysis therapy / Avaliação do efeito da educação visual relacionada com a nutrição no conforto dos doentes que recebem terapia de hemodiálise

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito da educação visual no conforto dos pacientes que recebem terapia de hemodiálise. Métodos Foi utilizado um projeto de estudo aleatório em um ambiente controlado. Este estudo foi realizado com 90 pacientes hemodialisados crônicos em dois centros de diálise, sendo que 45 pacientes pertenciam ao grupo de intervenção e os outros 45 pacientes perterciam ao grupo de controle. Formulário de dados do paciente, escala de conforto de hemodiálise - Versão II, escala de controle de fluidos do paciente de hemodiálise, escala de conhecimento dietético e escala de comportamentos dietéticos foram os documentos usados. No grupo de intervenção, foram conduzidas três entrevistas. Na primeira entrevista, a educação visual foi aplicada e reaplicada após 15 dias. No grupo de controle, duas entrevistas foram realizadas e nenhuma intervenção foi feita. Resultados Descobriu-se que o programa de treinamento tem um amplo efeito sobre o conforto e relaxamento físico do paciente, assim como relaxamento psicoespiritual, transcendência psicoespiritual, transcendência ambiental e relaxamento sociocultural. Além disso, foi notado um efeito moderado sobre o alívio físico no grupo de intervenção no terceiro mês. Dessa maneira, foi determinado que o programa de educação visual aplicado teve um amplo efeito no controle de fluidos, conhecimento de dieta e comportamento do grupo de intervenção. Conclusão Verificou-se que a educação visual tem um efeito positivo no estado de conforto, no conhecimento dietético e no comportamento dietético dos pacientes submetidos à terapia de hemodiálise

ABSTRACT Objective This study aimed to evaluate the effect of visual education on the comfort of patients receiving hemodialysis therapy. Methods A randomized controlled study design was used. This study was conducted in two dialysis centers with 90 chronic hemodialysis patients. A Patient introduction form, Hemodialysis Comfort Scale-Version II, Hemodialysis Patient Fluid Control Scale, Scale for Dietary Knowledge, and Scale for Dietary Behaviors were used. In the intervention group, three interviews were conducted. In the first interview, visual education was applied, and reinforcement education ensued after 15 days. In the control group, two interviews were conducted, and no intervention was performed. Results The training program was found to have a significant effect on comfort, physical and psychospiritual ease, psychospiritual and environmental transcendence, and sociocultural ease, and a moderate effect on physical relief in the intervention group in the third month. It was determined that the visual education program applied had a large effect size on fluid control, diet knowledge, and behaviors in the intervention group. Conclusion Visual education was found to have a positive effect on the comfort status, dietary knowledge, and dietary behavior of patients receiving hemodialysis therapy.

Inhibition of p97/VCP function leads to defective autophagosome maturation, cell cycle arrest and apoptosis in mouse Sertoli cells.

p97/valosin-containing protein (VCP) is expressed in many cells and plays critical functions in a broad range of diverse cellular processes. Because it is expressed in the mouse testes, predominantly in Sertoli cells, and is known to play a critical role in autophagy and apoptosis in different cell types, we set out to investigate its function in autophagosome maturation, apoptosis and cell cycle arrest in a mouse Sertoli cell line. To study the mechanism of p97/VCP action, p97/VCP siRNA and a specific p97/VCP inhibitor, N2,N4-dibenzylquinazoline-2,4-diamine (DBeQ), were used in the mouse 15P1 Sertoli cell line. Loss of p97/VCP activity due to DBeQ exposure and silencing of p97/VCP (siVCP) expression results in autophagosome (LC3 and p62) accumulation in the cytoplasm of Sertoli cells. The coexpression of autophagosomal and lysosomal markers (LAMP1 and LAMP2) was reduced in cells in which p97/VCP expression had been inactivated. To better understand in which step of autophagy p97/VCP functions, the interaction between autophagosomal and autolysosomal markers was studied by coimmunoprecipitation and colocalization experiments. The interaction between autophagosomal markers and lysosomal markers decreased in siVCP-expressing and DBeQ-exposed cells. Moreover, the expression of siVCP and DBeQ exposure caused cytoplasmic vacuolation, induced caspase 3-7-mediated cell death and decreased cell cycle progression in mouse Sertoli cells. Taken together, the results show that p97/VCP is essential for autophagosome maturation and cell survival in mouse Sertoli cells. When these functions are prevented, impaired autophagy and apoptosis may have a detrimental effect on germ cells and cause male infertility.

Altered expression of p97/Valosin containing protein and impaired autophagy in preeclamptic human placenta.

INTRODUCTION: Autophagy increases in placenta-related obstetrical diseases such as preeclampsia and intrauterine growth retardation but the regulation of autophagy by ubiquitin proteasome pathway (UPP) proteins, p97/Valosin containing protein (VCP) and ubiquitin (Ub) have not been previuosly studied in preeclampsia. The objective of this study is to investigate the expression of UPP (p97/VCP and Ub), autophagosomal (p62 and LC3) and autolysosomal proteins (Lamp1 and Lamp2) in the normal and preeclamptic human placentas and to explore the regulatory mechanism of these proteins in autophagic pathway. MATERIAL AND METHODS: Different portions of normal term placentas (n = 20) and preeclamptic placentas (n = 10) were snap-frozen in liquid nitrogen for Western blotting and coimmunoprecipitation and others were fixed-embedded in paraffin for immunohistochemistry. Colocalization and coimmunoprecipitation experiments were done for the detection of interaction between p97/VCP and autophagic proteins. RESULTS: Compared with normal placentas, expression of p97/VCP was significantly reduced; however accumulation of ubiquitinlated proteins were significantly increased in preeclamptic placentas. The expression of autophagosomal proteins (LC3-II and p62) were significantly increased and no significant alterations of the expression of autolysosomal proteins were observed in preeclamptic placentas. Additionally, p97/VCP was found to colocalized and interact with autophagosomal and autolysosomal markers in normal and preeclamptic placentas. Autophagosome maturation diminished and autophagosomes had decreased localization with lysosomal markers in preeclamptic human placentas. CONCLUSION: Decreased expression of p97/VCP and increased expression of Ub in preeclampsia might be related to impaired autophagy and pathophysiology of preeclampsia. Therefore, our study highlights an important potential relationship between p97/VCP and autophagic proteins in preeclampsia.

Horner Syndrome as the Only Focal Neurologic Manifestation of Hypothalamic Hemorrhage.

A 70-year-old woman suffered an anterior dorsal hypothalamic hemorrhage that caused an ipsilateral Horner syndrome (HS) as the only focal neurologic manifestation. This is only the second reported case of hypothalamic hemorrhage producing HS. Because HS was the sole focal neurologic manifestation, its confirmation with topical apraclonidine drops was a valuable clue toward prompt localization of the patient's confusional state.