The effect of BMSCs on implantation mechanisms and pregnancy process in the experimental Asherman model.

OBJECTIVE: In this study, we aimed to investigate the role of bone marrow-derived mesenchymal stem cells (BMSC) on the molecular mechanisms involved in the removal of endometrial adhesions and the implantation process in the experimentally-created Asherman syndrome model in rats. MATERIALS AND METHODS: An experimental model chemical agent was used. Culture medium (CM), only BMSC, 48-hour culture medium (Niche), and BMSC+ niche were used as therapy. Each group was divided into two subgroups, and changes in the endometrial tissue were investigated by histochemical and immunohistochemical staining. RESULTS: The results of the study show that BMSCs exhibit therapeutic properties in endometrial damage, increase endometrial thickness and vascularization, and contribute to the implantation of embryos by reducing fibrous areas. These results are promising for the prevention of Asherman-induced infertility. CONCLUSIONS: It has been shown that BMSC and Niche applications can be helpful in preventing adhesion molecules in the mechanisms that cause infertility.

EFFICACY OF INSULIN, HEPARIN AND FENOFIBRATE COMBINATION TREATMENT IN SEVERE HYPERTRIGLYCERIDEMIA: DOUBLE CENTER EXPERIENCE.

CONTEXT: Severe hypertriglyceridemia (SH), which calls for a triglyceride (TG) level above 1000 mg/dL, remains an important health issue. While some data exist to offer combination of heparin, insulin and fenofibrate as a reasonable treatment option, safety and benefits of this therapy have not been accurately weighted, largely due to the limited sample size of the relevant studies. AIM: Assess the efficacy and safety of the heparin, insulin and fenofibrate combination in the treatment of patients with SH. PATIENTS - METHODS: Patients aged ≥18 years with TG level above 1000 mg/dL and adequate organ function were included. Triglyceride levels were measured immediately before the treatment and on the 3rd and 6th days of the treatment. Treatment dosage, duration, response and side effects were assessed. Patients with hypertriglyceridemia presenting with acute pancreatitis were treated additionally with lipid apheresis. RESULTS: A total of 42 patients were included. Of these, 85.8% came to medical attention with some kind of secondary hypertriglyceridemia causes. The baseline median TG value of the cases was 2141.0 mg/ dL (1026-12250). There were 6 patients (14.3%) with acute pancreatitis at presentation. In patients without pancreatitis, with administration of insulin infusion, unfractionated heparin infusion and fenofibrate capsule, median TG values decreased to 921 mg/ dL (190-6400) on the 3rd day and to 437 mg/ dL (112-1950) on the 6th day of the treatment (p<0.0001, Friedman test). Potential toxicities related to insulin, heparin and fenofibrate combination treatment including hypoglycemia, hemorrhage, rise in creatine kinase levels, hepato - and nephrotoxicity were not observed. CONCLUSION: In this trial involving patients with SH, our data suggest that insulin, heparin and fenofibrate combination therapy was safe and effective.

Metronidazole resistance in Trichomonas vaginalis determined by molecular and conventional methods.

Trichomonas vaginalis (T. vaginalis) is a protozoan parasite that infects the urogenital tract of both women and men worldwide. Trichomoniasis can cause serious symptoms if untreated. Metronidazole is the drug of choice for the treatment of trichomoniasis. In recent years metronidazole-resistant T. vaginalis has often been mentioned in clinical isolates. The aim of this study was to determine the conventional and molecular methods to determine metronidazole-resistant T. vaginalis, which is seen commonly and to discuss the possible reasons for this. Samples taken from patients diagnosed with T. vaginalis from the gynaecology and obstetrics clinic between April 2015 and June 2016 were evaluated for metronidazoleresistance using molecular and conventional methods. A total of 170 patients were examined and T. vaginalis was determined in 6 (3.5%) patients. Metronidazole resistance was determined in 2 (33.3%) of the 6 clinical isolates as a result of the molecular and conventional tests applied. Metronidazole resistance was determined using nitroreductase genes ntr4Tv and ntr6Tv. These findings suggest that metronidazole-resistance T. vaginalis strains can be determined in laboratory samples of cases with trichomoniasis. This may be an important underlying factor in the unsuccessful management of recurrent cases seen in routine gynecological practice.

Is the TSHR D727E polymorphism a genetic predisposition for multinodular goiter in the Turkish population?

The D727E germline polymorphism in the thyroid-stimulating hormone receptor gene (TSHR) may cause genetic susceptibility to the development of goiter. Therefore, in this study we investigated allele frequencies and genotype distributions of the TSHR D727E polymorphism, their association with clinical parameters, and the development of goiter in the Turkish population. We investigated the TSHR D727E polymorphism in 123 patients and 97 healthy subjects using the polymerase chain reaction-restriction fragment length polymorphism technique. Peripheral blood was used for DNA extraction. Although no significant difference was found in TSHR D727E polymorphism frequencies between the patients with nodular goiters (26/123 patients, 21.1%) and the controls (12/97 patients, 12.4%) (P = 0.107), the frequency of the TSHR D727E polymorphism in the hyperthyroid+subclinical hyperthyroid patient groups (23%) was significantly higher than in the control subjects (12.4%) (P = 0.024). In this study, nodular goiter presented significantly earlier in GC genotype patients (mean age 35 years) than in CC genotype patients (mean age 42 years) in the hyperthyroid group (P = 0.009). More importantly, TSH levels in the GC variant controls were closely significant lower (1.26 ± 0.49) than in the CC variant controls (1.74 ± 0.84) (P = 0.053). The TSHR D727E polymorphism might be involved in the pathogenesis of toxic multinodular goiter (TMNG). Moreover, this polymorphism might be an indication of early-onset TMNG. However, development of MNG is multifactorial. Therefore, further case-control studies with larger populations are required to verify these observations.

Co-expression of truncated and full-length tau induces severe neurotoxicity.

Abundant tau inclusions are a defining hallmark of several human neurodegenerative diseases, including Alzheimer's disease. Protein fragmentation is a widely observed event in neurodegenerative proteinopathies. The relevance of tau fragmentation for the neurodegenerative process in tauopathies has yet remained unclear. Here we found that co-expression of truncated and full-length human tau in mice provoked the formation of soluble high-molecular-weight tau, the failure of axonal transport, clumping of mitochondria, disruption of the Golgi apparatus and missorting of synaptic proteins. This was associated with extensive nerve cell dysfunction and severe paralysis by the age of 3 weeks. When the expression of truncated tau was halted, most mice recovered behaviorally and functionally. In contrast, co-expression of full-length tau isoforms did not result in paralysis. Truncated tau thus induces extensive but reversible neurotoxicity in the presence of full-length tau through the formation of nonfilamentous high-molecular-weight tau aggregates, in the absence of tau filaments. Targeting tau fragmentation may provide a novel approach for the treatment of human tauopathies.

Folic acid modified clay/polymer nanocomposites for selective cell adhesion.

A folic acid (FA) modified poly(epsilon-caprolactone)/clay nanocomposite (PCL/MMT-(CH2CH2OH)2-FA) resulting in selective cell adhesion and proliferation was synthesized and characterized as a cell culture and biosensing platform. For this purpose, first the FA modified clay (MMT-(CH2CH2OH)2-FA) was prepared by treating the organo-modified clay, Cloisite 30B [MMT-(CH2CH2OH)2] with FA in chloroform at 60 °C. Subsequent ring opening polymerization of ε-caprolactone in the presence of tin octoate (Sn(Oct)2) using MMT-(CH2CH2OH)2-FA at 110 °C resulted in the formation of MMT-(CH2CH2OH)2-FA with an exfoliated clay structure. The structures of intermediates and the final nanocomposite were investigated in detail by FT-IR spectral analysis and DSC, TGA, XRD, SEM and AFM measurements. The combination of FA, PCL and clay provides a simple and versatile route to surfaces that allows controlled and selective cell adhesion and proliferation. FA receptor-positive HeLa and negative A549 cells were used to prove the selectivity of the modified surfaces. Both microscopy and electrochemical sensing techniques were applied to show the differences in cell adherence on the modified and pristine clay platforms. This approach is expected to be adapted into various bio-applications such as 'cell culture on chip', biosensors and design of tools for targeted diagnosis or therapy.

The retrospective annual surgical incidence of cystic echinococcosis in Sivas, Turkey.

Cystic echinococcosis is an important public health problem in our region. The aim of this study was to assess the surgical incidence of cystic echinococcosis in Sivas, Turkey. A retrospective follow-up study was carried out between 1997 and 2004. The mean age of 124 men (39.2%) and 192 women was 36.4 years. The liver was the primary site of cyst development (76.6%), followed by the lungs (19.9%), the spleen (5.4%), the kidneys (3.5%) and the peritoneal cavity (3.2%). Mean annual surgical incidence was 6.4 per 100,000 inhabitants for a 7-year period. The most common site of recurrence was the liver. Hepatic cysts were more frequently infected than pulmonary cysts (P < 0.05). In those patients with an infected cyst, the mean circulating eosinophil level was significantly lower than in those without. Rupture and infection were more common in men (P < 0.01). In conclusion, serious structural, legislative, surveillance, prevention and control measures for echinooccus should be undertaken in our region.

A case of brain abscess due to Entamoeba species, Eikenella corrodens and Prevotella species.

We report a case of brain abscess due to multiple pathogens including Entamoeba species, Eikenella corrodens and Prevotella species. Patient had odontogenic infection without any site of amoebic infestation. Complete recovery was achieved with surgical treatment and antimicrobial therapy.

Surface morphology of Al0.3Ga0.7N/Al2O3-high electron mobility transistor structure.

We present surface properties of buffer films (AIN and GaN) and Al0.3Gao.zN/Al2O3-High Electron Mobility Transistor (HEMT) structures with/without AIN interlayer grown on High Temperature (HT)-AIN buffer/Al2O3 substrate and Al2O3 substrate. We have found that the GaN surface morphology is step-flow in character and the density of dislocations was about 10(8)-10(9) cm(-2). The AFM measurements also exhibited that the presence of atomic steps with large lateral step dimension and the surface of samples was smooth. The lateral step sizes are in the range of 100-250 nm. The typical rms values of HEMT structures were found as 0.27, 0.30, and 0.70 nm. HT-AIN buffer layer can have a significant impact on the surface morphology of Al0.3Ga0.7N/Al2O3-HEMT structures.

Comparison of the catheter-technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery.

BACKGROUND: The aim of this study was to compare the intra- and postoperative analgesia provided by the catheter-technique psoas compartment block and the epidural block in hip-fractured patients. We also compared hemodynamic stability, motor blockade, ease of performing the technique, and complications. METHODS: Thirty patients who underwent partial hip replacement surgery were included in this prospective single-blind study. Subjects were randomly assigned to Group E (n=15; general anesthesia plus epidural block with 15 ml of 0.5% bupivacaine) or Group P (n=15; general anesthesia plus psoas compartment block with 30 ml of 0.5% bupivacaine). Hemodynamic parameters were recorded at 10-min intervals intraoperatively. Regional anesthesia procedure time, number of attempts at block, intraoperative blood loss, and need for supplemental fentanyl and/or ephedrine were noted. Postoperatively, a patient-controlled analgesia device delivered an infusion and boluses of bupivacaine/fentanyl. Pain, motor blockade, ambulation time, patient satisfaction with analgesia, and complications were recorded postsurgery. RESULTS: The epidural required significantly more attempts than the psoas block, thus procedure time was longer in this group. Group E also showed significantly greater drops in mean arterial blood pressure from baseline at 30, 40 and 50 min after the start of general anesthesia. Significantly more Group E patients required epinephrine supplementation. The groups were similar regarding pain scores (at rest and on movement) and patient satisfaction, but Group E had higher motor blockade scores, longer ambulation time, and significantly more complications. CONCLUSION: The continuous psoas compartment block provides excellent intraoperative and postoperative analgesia with a low incidence of complications for partial hip replacement surgery

Electrodermal activities and autonomic nervous system in Behçet's patients.

Behçet's disease is often a progressive disorder. In some cases, there is a possibility of subclinical involvement without neurologic signs and symptoms. The autonomic nervous system is affected in Behçt's disease. The aim of the present study was to investigate autonomic nervous system functions in Behçt's patients by analyzing electrodermal activities. A total of 16 patients and 16 healthy volunteers were accepted for the study. Skin potential recordings were taken at room temperature in a quiet place within a Faraday's cage. The mean values of basal skin potentials and skin potential responses in the patients' group were reduced when compared with those of the control group ( p=0.0001). There was no difference between the groups regarding the mean values of latency ( p=0.09). The findings suggest that electrodermal activities may reflect autonomic nervous system dysfunction in Behçet's patients, and the measurement of electrodermal activities may be useful for the assessment of autonomic nervous system involvement in Behçet's disease.

Kangal hot spring with fish and psoriasis treatment.

The effect of "Kangal Hot Spring with Fish" in the treatment of psoriasis is investigated. The study was carried out on 87 patients with psoriasis vulgaris and the patients were evaluated by a dermatologist for 21 days. The evaluation of the disease was performed using PASI (Psoriasis Area and Severity Index) scores. Recurrences were investigated in the patient population, who had been previously treated in the same hot spring. The first examination scores were significantly higher than the scores of the 3, 6, 9, 12, 15 and 21 days after treatment (p < 0.01). Longer remission periods, when compared to the topical corticosteroid treatment, expressed by the 35 patients previously treated in hot spring (p < 0.01). Spa therapy under observation of a dermatologist may be effective and useful for psoriasis vulgaris patients.

Elephantiasis neuromatosa and Becker's melanosis.

The most characteristic lesions of neurofibromatosis are the extremely large plexiform neurofibromas involving an entire extremity, which give rise to the condition known as elephantiasis neuromatosa. In this article, we present a patient who was diagnosed as elephantiasis neuromatosa with Becker's melanosis clinically and review the literature briefly.

[A 15th century manuscript concerning hemorroid and its treatment]. / Basur hastaligi ve tedavisiyle ilgili 15. yuzyila ait bir metin.

This study is about a 15th century Turkish text, a general survey of hemorroid. A copy of the text is available in the Diyarbakir Public Library. The 48 page treatise was composed upon the request of a statesman of the time. Hemorroid is described in terms of diagnosis, classification and treatment. This study contains important information on the methods of the treatment of hemorroids. A glossary is inserted at the end of the study in order to be used for deciphering the text, which is a rare example of old Turkish medical literature.

A survey of intestinal parasites in students of Adult Educational Center in Sivas, Turkey.

The prevalence of intestinal parasites in students of Adult Educational Center (Halk Egitim Merkezi) in Sivas, Turkey was assessed. All of the students were females and their age ranged from 12 to 46 with a mean age of 19. Diagnosis was made following examination of stool specimens and cellophane tape preparations (CTP). From each stool specimen only one preparation prepared in saline was searched for both protozoon and helminth parasites. A total of 524 stool specimens and 504 CTP were examined. One or more parasites were detected in 34.5% the former and 23.8% of the latter. When the findings in both specimens were combined the infection rate raised to 48.0%. 176 of the 485 students harboured one, whereas 57 had more than one parasite; 87 had only protozoa, 104 only helminths whereas 42 were infected with parasites of the two groups. The rate of parasites found was as follows: G. intestinalis 8.2%, E. histolytica 1.2%, E. coli 17.9%, A. lumbricoides 2.3%, T. trichiura 0.8%, E. vermicularis 12.6%, T. saginata 16.7%, H. nana 1.0%, and others 0.6. Findings were evaluated from several points.