The relationship of erythropoietin receptor expression and prognosis in glioblastoma multiforme patients.

BACKGROUND:: Glioblastoma multiforme (GBM) is the most common primary brain tumor characterized with poor prognosis and short survival. In addition to the standard treatment protocols, targeted molecular treatment options are under trial. In the recent trials, erythropoietin and erythropoietin receptor were found to be linked with the progression of GBM cells. AIM:: In this study, we compared the expression of EPOR with survival in GBM patients with mortality. MATERIALS AND METHODS:: Twenty-six patients operated for GBM in 2012-2014 were enrolled in this study. Tumor tissues were stained with EPOR, epidermal growth factor receptor, vascular endothelial growth factor, and assigned as (1+), (2+), and (3+) according to their immunohistochemical staining levels. The average postoperative follow-up time was 9.3 months. Kaplan-Meier's survival test and Spearman's correlation test were used in statistical analysis. RESULTS:: EPOR 1(+) stained group showed a median survival of 8 months (95% confidence interval [CI]: 0.954-15.046). EPOR 2(+) stained group showed a median survival of 6 months (95% CI: 2.901-9.090) EPOR 3(+) stained group showed a median survival of 2 months (95% CI: 0.400-3.600). (Kaplan-Meier P = 0.002). CONCLUSION:: These results portrayed that EPOR staining levels were inversely proportional with average survival time. In the future, specific inhibitors of this molecule could be used to form a novel treatment option for GBM.

Clinical experience with contact-force and flexible-tip ablation catheter designs.

PURPOSE: Lesion formation is a critical determinant of technical and clinical success of pulmonary vein isolation. Different catheter designs aim to enhance tissue contact during ablation to enable optimized lesion formation. We analyzed procedural characteristics and predictors of clinical success in patients ablated with three different contemporary ablation catheters. METHODS: Two hundred sixty-eight sequentially included patients receiving pulmonary vein isolation (PVI) with conventional (n = 122), contact-force (n = 96) and flexible-tip (n = 60) catheters were followed for a median of 14.1 months with 7d-Holter-monitoring and TTE at 3, 6, 12, and 24 months. Baseline characteristics and follow-up times were homogeneous across all groups. RESULTS: Multivariable Cox proportional hazard regression for arrhythmia recurrence demonstrated a favorable hazard ratio for contact-force and flexible-tip catheters vs. conventional open irrigation catheters. Procedure time and fluoroscopy time were shorter for contact-force and flexible-tip catheters versus conventional catheters, but equal between. Linear lesions were applied in 58 % of contact-force and 66 % of flexible-tip cases, and CFAEs were targeted in 26 % of either. CONCLUSIONS: Our non-randomized prospectively collected data do not show a difference in observed procedure characteristics and in clinical outcome for flexible-tip versus contact-force catheter designs, while both display improved performance against conventional open irrigated-tip catheters. Linear lesions and CFAEs ablation were not associated with improved arrhythmia-free survival.

What is the neutrophil/lymphocyte ratio in sarcoidosis?

AIM: Information regarding the Neutrophil/Lymphocyte ratio (NLR) in sarcoidosis and the data from studies recommending its use as an indicator of inflammation and in the differential diagnosis and prognosis, are limited. With this study, it was aimed to obtain data regarding the NLR level in the patients at the time of presentation to the hospital and to determine the characteristics of patients in whom the NLR value was > 2. RESULTS: During the study period, of the 3434 patients with the sub-diagnosis of D86, 1300 cases whose complete blood count values had been recorded at the time of presentation were included in the study. Of the cases, 40 % were pulmonary sarcoidosis, 7 % were pulmonary sarcoidosis with sarcoidosis of the lymph nodes, 8 % were lymph node sarcoidosis, 1 % were sarcoidosis, of other combined areas, and 40 % of the cases were sarcoidosis that were unspecified. The F/M of the cases were 947/353, and the average age of the cases was 44. When the sarcoidosis groups were grouped into NLR < 2 (Group 1) and NLR ≥ 2 (Gorup 2), 27 % were Group 1, 73 % were Group 2, and a significant correlation was found between the two groups. When the inflammatory indicators were compared with NLR, the PLT/MPV was found to be statistically insignificant, and the ACE, ESR and CRP were found to be statistically significant. CONCLUSION: The Neutrophil/Lymphocyte ratio in the complete blood count, which is an easy and cheap test, can be used as an indicator of inflammation in Sarcoidosis. In clinical practice, wide-based studies comprising the activity and the staging in the prognosis of sarcoidosis are required (Tab. 2, Fig. 2, Ref. 26).

Serum nesfatin-1 levels in overt and subclinical hyperthyroidism.

AIM: Nesfatin-1 was recently discovered anorexigenic peptide in the brain which is derived from nucleobindin-2. Central and peripheral administration of nesfatin-1, inhibits food intake, dose-dependently. Hyperthyroid patients have increased appetite and food intake with a craving for carbohydrate-rich food, at the beginning of disease, but the physiological mechanisms underlying this behavior is not known exactly. In this study, we investigated whether nesfatin-1 is involved in the regulation of appetite and body weight in hyperthyroidism, or not. METHODS: A total of 70 patients with subclinical (35) and overt hyperthyroidism (35) compared with 35 control patients. Serum nesfatin-1 level was measured from all samples by commercial ELISA kit. RESULTS: Serum nesfatin-1 levels were similar between three groups (P=0.293). After adjusting for age and body mass index, nesfatin-1 levels in control group was not different from subclinical and overt hyperthyroid group, respectively (P=0.567 and P=0.519). CONCLUSION: These data showed that serum nesfatin-1 levels do not significant change in overt and subclinical hyperthyroidism.

Significant correlation between uric acid levels and flow-mediated dilatation in patients with masked hypertension.

BACKGROUND: Serum uric acid (UA) level is associated with prognosis in cardiovascular disorders such as sustained hypertension, diabetes mellitus and chronic kidney diseases. Increased UA levels in sustained hypertension may reflect early renal vascular alterations. However, it remains unclear if serum UA is associated with endothelial dysfunction in masked hypertensive patients. METHODS: A total of 100 individuals (57% men and 43% women; mean 45 ± 8 years) with masked hypertension were included in the present study. The clinical and laboratory data were collected. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. RESULTS: Univariate regression analysis showed that the FMD was significantly negative correlated with uric acid (r = -0.300, p = 0.002), ambulatory 24-h systolic blood pressure (SBP) (r = -0.275, p = 0.008), hs-CRP (r = -0.222, p = 0.033) and diastolic aortic diameter (r = -0.243, p = 0.019). In multivariate linear regression analysis, only uric acid levels and ambulatory 24-h SBP were significantly associated with FMD. CONCLUSION: There was an independent correlation between UA and FMD, and a higher UA level was related to worse endothelial function which may contribute to hypertension and cardiovascular morbidity.

Prevalence of aspirin-exacerbated respiratory disease in patients with asthma in Turkey: A cross-sectional survey

Background: There are no country-based data focused on aspirin (ASA)-exacerbated respiratory disease (AERD) in Turkey. Objective: To assess the prevalence of AERD in adult patients with asthma. Methods: A structured questionnaire was administered via face-to-face interview by a specialist in pulmonology/allergy at seven centres across Turkey. Results: A total of 1344 asthma patients (F/M: 1081/263: 80.5%/19.5%, mean age: 45.7±14.2 years) were enrolled. Atopy rate was 47%. Prevalence of allergic rhinitis, chronic rhinosinusitis/rhinitis, and nasal polyposis (NP) were 49%, 69% and 20%, respectively. Of 270 patients with NP, 171 (63.3%) reported previous nasal polypectomy and 40 (25%) had a history of more than three nasal polypectomies. Aspirin hypersensitivity was diagnosed in 180 (13.6%) asthmatic patients, with a reliable history in 145 (80.5%), and oral ASA provocation test in 35(19.5%) patients. Clinical presentations of ASA hypersensitivity were respiratory in 76% (n = 137), respiratory/cutaneous in 15% (n = 27), and systemic in 9% (n = 16) of the patients. Multivariate analysis indicated that a family history of ASA hypersensitivity (p: 0.001, OR: 3.746,95% CI: 1.769-7.929), history of chronic rhinosinusitis/rhinitis (p: 0.025, OR: 1.713, 95% CI:1.069- 2.746) and presence of NP (p < 0.001, OR: 7.036, 95% CI: 4.831---10.247) were independent predictors for AERD(AU)

Prevalence of aspirin-exacerbated respiratory disease in patients with asthma in Turkey: a cross-sectional survey.

BACKGROUND: There are no country-based data focused on aspirin (ASA)-exacerbated respiratory disease (AERD) in Turkey. OBJECTIVE: To assess the prevalence of AERD in adult patients with asthma. METHODS: A structured questionnaire was administered via face-to-face interview by a specialist in pulmonology/allergy at seven centres across Turkey. RESULTS: A total of 1344 asthma patients (F/M: 1081/263: 80.5%/19.5%, mean age: 45.7 ± 14.2 years) were enrolled. Atopy rate was 47%. Prevalence of allergic rhinitis, chronic rhinosinusitis/rhinitis, and nasal polyposis (NP) were 49%, 69% and 20%, respectively. Of 270 patients with NP, 171 (63.3%) reported previous nasal polypectomy and 40 (25%) had a history of more than three nasal polypectomies. Aspirin hypersensitivity was diagnosed in 180 (13.6%) asthmatic patients, with a reliable history in 145 (80.5%), and oral ASA provocation test in 35 (19.5%) patients. Clinical presentations of ASA hypersensitivity were respiratory in 76% (n=137), respiratory/cutaneous in 15% (n=27), and systemic in 9% (n=16) of the patients. Multivariate analysis indicated that a family history of ASA hypersensitivity (p: 0.001, OR: 3.746, 95% CI: 1.769-7.929), history of chronic rhinosinusitis/rhinitis (p: 0.025, OR: 1.713, 95% CI: 1.069-2.746) and presence of NP (p<0.001, OR: 7.036, 95% CI: 4.831-10.247) were independent predictors for AERD. CONCLUSION: This cross-sectional survey showed that AERD is highly prevalent among adult asthmatics and its prevalence seems to be affected by family history of ASA hypersensitivity, history of rhinosinusitis and presence of NP.

A study of natural killer cell lectin-like receptor K1 gene (KLRK1/NKG2D) region polymorphisms in a European population sample.

Recent evidence has reinforced the belief in immunosurveillance as a powerful mechanism against cancer development. The natural killer (NK) cell has been recognized as a potent agent of cancer immunosurveillance. A Japanese cohort study correlated natural cytotoxic activity levels with subsequent cancer development and identified NK cell lectin-like receptor K1 gene (KLRK1/NKG2D) polymorphisms as genetic markers of cancer predisposition. In the present study, we genotyped 82 reference cell lines and 388 newborn samples at 10 KLRK1 region variants by TaqMan((R)) allelic discrimination assays and showed that the same polymorphisms occur at similar frequencies in Europeans. The same haplotype block that has been associated with lower natural cytotoxic activity also occurred with the highest frequency in our sample. We further detected evidence suggestive of natural selection at some of the loci analyzed and more importantly, sex specificity of this selection. It appeared that heterozygosity at loci forming a haplotype block was unfavorable for boys. Given the relevance of NK cells in fetal survival, this finding has potential implications in the study of genetics of maternofetal recognition. Our preliminary findings are of marginal statistical significance and should be replicated in a larger sample. We believe that our results will increase awareness of the involvement of KLRK1 in cancer immunosurveillance and possibly in prenatal selection.

Respirometric evaluation and modeling of glucose utilization by Escherichia coli under aerobic and mesophilic cultivation conditions.

The study presents a mechanistic model for the evaluation of glucose utilization by Escherichia coli under aerobic and mesophilic growth conditions. In the first step, the experimental data was derived from batch respirometric experiments conducted at 37 degrees C, using two different initial substrate to microorganism (S(0)/X(0)) ratios of 15.0 and 1.3 mgCOD/mgSS. Acetate generation, glycogen formation and oxygen uptake rate profile were monitored together with glucose uptake and biomass increase throughout the experiments. The oxygen uptake rate (OUR) exhibited a typical profile accounting for growth on glucose, acetate and glycogen. No acetate formation (overflow) was detected at low initial S(0)/X(0) ratio. In the second step, the effect of culture history developed under long-term growth limiting conditions on the kinetics of glucose utilization by the same culture was evaluated in a sequencing batch reactor (SBR). The system was operated at cyclic steady state with a constant mean cell residence time of 5 days. The kinetic response of E.coli culture was followed by similar measurements within a complete cycle. Model calibration for the SBR system showed that E. coli culture regulated its growth metabolism by decreasing the maximum growth rate (lower microH) together with an increase of substrate affinity (lower K(S)) as compared to uncontrolled growth conditions. The continuous low rate operation of SBR system induced a significant biochemical substrate storage capability as glycogen in parallel to growth, which persisted throughout the operation. The acetate overflow was observed again as an important mechanism to be accounted for in the evaluation of process kinetics.

Evaluation of long-term efficacy of an asthma education programme in an out-patient clinic.

The aim of the present study was to evaluate long-term efficacy of a patient education programme in an asthma out-patient clinic. The study included two groups. Educational group consisted of 25 patients who were given special education for one year. Usual care group included 27 patients who were not given special education. All patients were evaluated after 3 years follow-up period. Mean per cent asthma knowledge score (KS%), mean per cent demonstration score (DS%), daytime and nighttime symptom scores, Aas score, and pulmonary function tests were measured. The asthma-quality-of-life assessment was performed. The rate of application to emergency room and admission to hospital for last 1 year had been calculated. KS% was higher in educational group than in usual care group (P < 0.001). Daytime score was 0.3 +/- 0.6 in educational group and was 0.8 +/- 1.2 in usual care group (P = 0.08). Nighttime symptom score was found to be 0.5 +/- 0.9 and 0.9 +/- 1.3, respectively (P = 0.07). Usual care group had higher Aas score compared to educational group (P = 0.048). The total score of quality of life was 197.1 +/- 17.8 in educational group and was 176.7 +/- 33.7 in usual care group (P = 0.009). While none of the patients had emergency room application and hospital admission in educational group, seven patients had 21 emergency room application (P = 0.01) and four patients had four hospital admissions in usual care group. Additional short-acting inhaled beta-2 agonist usage was found lower in the educational group (P = 0.068). In conclusion, proper drug use and usual care of patients are not sufficient for asthma treatment. Patient education is an important component of therapy in asthma patients. For a life with optimum standards, in addition to these factors, patient education must be accepted first by doctors and then by patients.

The value of Ca 125 in the evaluation of tuberculosis activity.

The aim of the present study was to investigate the value of Ca 125, a tumour marker, in evaluation of pulmonary tuberculosis activity. This study included 96 subjects who were divided into three groups. Group 1 consisted of 40 patients with active pulmonary tuberculosis. Group 2 included 20 patients with inactive pulmonary tuberculosis. There were 36 healthy subjects in group 3. While measurement of serum Ca 125 level was performed only once in groups 2 and 3, Ca 125 levels were measured five times in group 1. The measurements were performed before the treatment, at the second, fourth and sixth months and the third year following the end of the treatment. Mean +/- SD serum Ca 125 concentrations were 109.7 +/- 86.9 U ml(-1) in group 1, 14.5 +/- 7.8 U ml(-1) in group 2 and 10.5 +/- 7.3 U ml(-1) in group 3. Serum Ca 125 levels were significantly higher in group 1 than in the other groups (P < 0.0001), but there was no significant statistical difference between the values of groups 2 and 3 (P > 0.05). Ca 125 levels in group 1 showed a significant decrease after treatment (P < 0.0001). For estimation of the activity of tuberculosis, the sensitivity and specificity of Ca 125 were found 97.5% and 100%, respectively at a 31 U ml(-1) cut-off point. Our results suggest that Ca 125 is beneficial in the determinaton of tuberculosis activity and in differentiation between active and inactive pulmonary tuberculosis.

Efficacy of inhaled budesonide and oral theophylline in asthmatic subjects.

The aim of present study was to evaluate clinical, functional, and anti-inflammatory effects of inhaled budesonide and oral theophylline treatments in patients with mild to moderate asthma. The study included 38 patients. After a 10-day run-in period, the patients were randomly assigned into two groups. Group 1 received inhaled budesonide (Pulmicort Turbuhaler) 800 microg/day for 4 weeks. Group 2 received oral theophylline (Talotren tablets, 200 mg twice daily) for 4 weeks. Inhaled budesonide therapy was accompanied by a significant decrease in serum interleukin (IL)-5 levels (p < 0.0005) and blood, sputum, and nasal eosinophil counts (p < 0.005). It produced a significant reduction in daytime (p < 0.01) and nighttime (p < 0.005) symptom scores and an increase in morning (p < 0.005) and evening (p < 0.05) peak expiratory flow (PEF) and forced expiratory volume in I sec (FEV1) values (p < 0.01). Theophylline therapy was associated with a significant decrease in blood (p < 0.02) and nasal (p < 0.01) eosinophil counts and serum IL-5 levels (p < 0.01). It resulted in significant improvements in daytime and nighttime symptom scores (p < 0.05), and morning PEF and FEV1 values (p < 0.05). These changes were more significant in group I than in group 2. There was no statistically significant difference between the two groups with respect to post-treatment values. Our results confirm the role of inhaled corticosteroids in the treatment of asthma and are consistent with the recommendation that theophylline exerts an anti-inflammatory effect. Further studies should be conducted to determine long-term benefits of theophylline.

A molecular NAND gate based on Watson-Crick base pairing.

[reaction: see text] A DNA-binding dye, 4',6-diamidino-2-phenylindole (DAPI) signals AT base pairing with a shift in the fluorescence emission spectrum. The signaling follows W-C base-pairing rules, and both dAMP and dTMP are required for the largest spectral shift. Thus, the dye with its two phosphate receptor sites functions as a molecular NAND gate accepting nucleotides as inputs. Moreover, when the observation wavelength is changed from 470 to 411.5 nm, the gate functions in TRANSFER logic.

A comparative analysis of the biochemical parameters used to distinguish between pleural exudates and transudates.

OBJECTIVE: The aim of the present study was to compare the various parameters used to identify exudates. METHODOLOGY: The study included 255 patients with pleural effusions. According to aetiological diagnosis, 105 pleural effusions were labelled as transudates and 150 were labelled as exudates. RESULTS: Using the criteria of Light et al., 94.5% of the effusions were correctly classified, yielding a sensitivity and specificity of 99.3% and 87.6%, respectively. Use of the pleural fluid/serum bilirubin ratio produced results of 92.9%, 90.7%, and 96.2%, respectively. Using pleural fluid cholesterol level yielded results of 95.7%, 95.3%, and 96.2%, respectively. When the combination of pleural fluid cholesterol level and lactate dehydrogenase (LDH) level was used, the specificity and accuracy were found to be higher than that using the criteria of Light et al. We found that there was no significant difference among the parameters with respect to accuracy. CONCLUSION: When the accuracy and cost are considered, differentiation of pleural exudates and transudates can be achieved only by pleural fluid cholesterol level or LDH level; and when two parameters were used together, the accuracy and specificity were higher than that using the criteria of Light et al.

Simultaneous determination of cadmium and zinc using a fiber optic device and fluorescence spectrometry.

A reservoir type of optode is described for simultaneous and remote determination of Cd and Zn using [9-(1',4',7',10',13'-pentaazacyclopentadecyl)methylanthracene] as the fluorophore. Simultaneous analysis was achieved by the significant perturbation in the fluorescence spectrum of the Cd-ligand complex while the Zn complex only results in enhancement in the fluorescence intensity as compared to ligand alone. The ion permeability of several membranes were examined; Nafion and cellophane were used for the construction of the optode. Using the optode constructed with cellophane, for 20 min immersion time, the 3-s detection limits were found to be 4.5 mug l(-1) for Cd and 0.6 mug l(-1) for Zn.

Styryl-based wavelength-ratiometric probes: a new class of fluorescent calcium probes with long wavelength emission and a large Stokes' shift.

We describe the chemical synthesis and fluorescence spectral characterization of a styryl-benzothiazole probe which contains the Ca2+ chelating group BAPTA as an integral part of the chromophoric system. The visible absorption spectrum of this probe displays a dramatic shift in the long wavelength maxima from 508 to 407 nm upon complexation with Ca2+, with a Ca2+ dissociation constant of 1.5 microM. The emission maximum centered at 615 nm is well shifted from the absorption. The emission spectrum displays a small blue shift upon binding Ca2+, allowing this probe to possibly be used as an emission wavelength-ratiometric probe using a single-excitation wavelength. This probe is likely to be the first of a series of long-wavelength ratiometric Ca2+ probes whose structure can be modified for improved quantum yield or altered Ca2+ affinity.