Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population.

PURPOSE: Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study was to determine the impact of aging on cardiometabolic risk of the syndrome by examining women who had previously been diagnosed to have PCOS or to be healthy in an unselected population in 2009. PARTICIPANTS: Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort. METHODS: All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up. RESULTS: There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI). CONCLUSIONS: Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

Safety, Efficacy, and Durability of Stent-Assisted Coiling Treatment of M2 (Insular) Segment MCA Aneurysms.

BACKGROUND AND PURPOSE: Most distal MCA aneurysms are located within the insular segment, which lies between the limen insulae and circular sulcus. However, experience is limited in the microsurgical and endovascular management of insular segment MCA aneurysms. In this multicenter retrospective case series, we aimed to investigate the safety, efficacy, and durability of stent-assisted coiling for treatment of insular segment MCA aneurysms. MATERIALS AND METHODS: A retrospective review was performed to identify patients with insular MCA aneurysms that were treated with stent-assisted coiling. The technical success of the procedures and the initial and follow-up clinical and angiographic outcomes were assessed. Periprocedural and delayed complications were reviewed. RESULTS: Twenty-seven aneurysms in 27 patients with a mean age of 53.3 (SD,11.3) years were included. The mean size of the aneurysms was 6.3 (SD 2.6) mm. Endovascular procedures were successfully performed in all patients. Immediate postprocedural angiography revealed complete aneurysm occlusions in 81.5%. Periprocedural complications developed in 7.4% without causing permanent morbidity. A delayed thromboembolic complication resulted in a minor permanent morbidity in 1 patient (3.7%). There was no mortality. The mean duration of angiographic follow-up was 19.5 (SD, 9.8) months. The last follow-up examinations showed complete occlusion in 92.6%. During the follow-up period, none of the treated aneurysms showed recanalization. CONCLUSIONS: The results of this study demonstrate that stent-assisted coiling with a low-profile self-expandable stent is a feasible and relatively safe technique for endovascular treatment of insular segment complex MCA aneurysms. Additionally, it provides an effective and durable treatment for insular MCA aneurysms.

Multiscale FEM simulations of cross-linked actin network embedded in cytosol with the focus on the filament orientation.

The present contribution focuses on the application of the multiscale finite element method to the modeling of actin networks that are embedded in the cytosol. These cell components are of particular importance with regard to the cell response to external stimuli. The homogenization strategy chosen uses the Hill-Mandel macrohomogeneity condition for bridging 2 scales: the macroscopic scale that is related to the cell level and the microscopic scale related to the representative volume element. For the modeling of filaments, the Holzapfel-Ogden ß-model is applied. It provides a relationship between the tensile force and the caused stretches, serves as the basis for the derivation of the stress and elasticity tensors, and enables a novel finite element implementation. The elements with the neo-Hookean constitutive law are applied for the simulation of the cytosol. The results presented corroborate the main advantage of the concept, namely, its flexibility with regard to the choice of the representative volume element as well as of macroscopic tests. The focus is particularly placed on the study of the filament orientation and of its influence on the effective behavior.

Effect of hexavalent chromium on the growth and physiological and biochemical parameters on Brassica oleracea L. var. acephala DC.

In order to determine the toxic effect of chromium Cr(VI) on the seed germination, the root and shoot length, the root-cotyledonary leaves, the fresh and dry weight in eight-day-old seedlings Brassica oleracea L. var. acephala DC (kale) were treated with various concentrations of Cr in the growth medium. The accumulation of chromium in the tissues was determined in the cotyledons and the roots of the kale seedlings. High rate of Cr uptake was observed in the roots. But the organs could not accumulate large amount Cr. The effect of Cr on B. oleracea var. acephala was evaluated by changes in chlorophyll a, b, lipid peroxidation, proline, ascorbate, protein carbonyl groups, non-protein thiols and peroxidase activity. There were significant decreases in chlorophylls a, b content of the plants treated with Cr. Chromium treated kale seedlings had higher lipid peroxidation and the protein carbonyl groups in cotyledonary leaves than the roots. The changes refer to toxic effects of Cr. There were increases in the non-protein thiol, the total ascorbate, and proline content in the cotyledons and the roots of the seedlings grown on the media containing 0.1 and 0.15 mM Cr. The guaiacol peroxidase activity was higher in the roots of the seedlings than their cotyledons.

Determination of benzo[a]pyrene in charcoal grilled meat samples by HPLC with fluorescence detection.

In this study, an HPLC procedure for the quantitative determination of benzo[a]pyrene (BaP) in charcoal grilled meat samples has been applied to the analysis of the Turkish meat samples. The grilled meat samples were first treated in alkaline medium, then BaP was extracted into n-hexane phase, purified on XAD-2 column and eluted with n-hexane/dichloromethane mixture (9:1,v/v). Separation and quantitative determination of BaP has been carried out by a C18 reversed phase column mounted HPLC with a fluorescence detection of 254-355 nm (excitation-emission). The BaP levels determined in grilled and over-grilled lamb and beef meats were 43.80 +/- 1.80 microg/kg, 31.33 +/- 0.94 microg/kg and 62.60 +/- 3.72 microg/kg, 37.60 +/- 3.84 microg/kg, respectively.

Effect of ascorbic acid on surgical stress response in gynecologic surgery.

Surgical stress may cause neural, endocrine, metabolic and humoral responses depending on the severity of the procedure. In this study, we aimed to study the effect of the preoperatively given ascorbic acid (AA), which is an antioxidant, and its role in the biosynthesis of neuropituitary hormones on the surgical stress response. Twenty-two American Society of Anaesthesiologists I and II patients ageing between 18 and 40, who have no endocrine and metabolic disease, and undergoing abdominal operation for non-malignant diseases were allocated to the study. These non-premedicated patients were divided into two groups in random: Group I, etomidate group; and Group II, AA plus etomidate group. AA was given to patients in Group II 20min before etomidate injection. After monitoring the patient, anaesthetic induction was applied by giving 0.3 mg/kg of etomidate, 2 microg/kg of fentanyl and 0.1 mg/kg of vecuronium. Anaesthesia was continued with 1-0.7% isoflurane and N2O/O2 (67 and 37%, respectively). Tramadol was given for the management of post-operative analgesia. Blood samples were obtained from all patients before the operation and at second, sixth, twelfth and twenty-forth hours after the beginning of operation for cortisol, adrenocorticotropic hormone (ACTH), osteocalcin, insulin and blood glucose level analyses. There was no statistically significant difference in cortisol, osteocalcin, insulin and glucose levels in both groups, when compared to the control levels. Whereas, patients in Group II had higher levels of cortisol than the control group at sixth hour, which were in normal limits, and there was no decrease in osteocalcin concentration. ACTH level was increased at the second and sixth hours, which was statistically significant, but at twelfth and twenty-forth hours, they were close to control group levels. As a result, we conclude that AA given before anaesthesia achieved by etomidate is not sufficient for the prevention of surgical stress response and that AA induction before anaesthesia should be preferred, particularly for the prevention of decrease in osteocalcin levels.

Postoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+fentanyl combination.

PURPOSE: The aim of this study was to compare the effects of IV tramadol, IV fentanyl, epidural tramadol, and an epidural ropivacaine+fentanyl combination in patient-controlled analgesia (PCA) after lower abdominal surgery. METHODS: Eighty adult patients undergoing lower abdominal surgery were randomly allocated to one of four groups to receive analgesics with PCA pumps. Patients in group I received IV tramadol, group II patients IV fentanyl, group III patients epidural tramadol, and group IV patients an epidural infusion of 0.125% ropivacaine + 2 microg ml(-1) fentanyl combination. Analgesic effectiveness and side-effects were assessed at 1, 2, 3, 4, 5, 6, 8, 12, 16, 20, and 24 hours after surgery. RESULTS: Adequate analgesia was achieved in all groups. The analgesia was highest in group IV (p < 0.05), and lowest in group III patients (p < 0.05). Eleven patients (55%) in group I and eight patients (40%) in group II suffered from nausea/vomiting. CONCLUSION: Although adequate pain relief was achieved with all regimens that were used in the study, intravenous tramadol and intravenous fentanyl are associated with a high incidence of nausea and vomiting.

Evaluation of the frequency of HLA determinants in patients with gingival overgrowth induced by cyclosporine-A.

This study has been designed to investigate the immunogenetic susceptibility of Cyclosporine-A (CsA) immunosuppressed renal transplant patients to development of gingival overgrowth, and the amplifying effect of calcium channel blockers on the severity of this clinical entity. 52 renal transplant recipients were selected and initially grouped as follows: group (Gp)1: CsA (n = 7); Gp 2: CsA + verapamil (n = 26); Gp 3: CsA + diltiazem (n = 6); Gp 4: CsA + nifedipine (n = 13). These groups were not found to be significantly different in age, sex, plaque index (PlI), gingival index (GI), calculus index, periodontal probing depth, serum CsA level, or duration of CsA therapy (p > 0.05). No significant (p > 0.05) additive effect of the calcium channel blockers on the gingival overgrowth (GO) was assessed. The main group (n = 52) was evaluated for the correlations between the clinical and the pharmacological variables and the GO. GI (rs = 0.60) and the periodontal probing depth (rs = 0.71) were found to be moderately correlated with the GO. The patients were regrouped based on the severity of overgrowth and recognized as responders (n = 26) and nonresponders (n = 26). Age, sex, calculus index, serum CsA level, duration of the CsA therapy, were not statistically different among these groups (p > 0.05). PlI, GI, periodontal probing depth, and GO were significantly higher in the responder group (p > 0.05). Analysis of HLA distribution of the responders and the nonresponders and comparison with the controls (n = 3731) revealed that a statistically significant (p < 0.001)% of the nonresponders were positive for HLA-DR1. These data would indicate that an immunogenetic predisposition should be suspected in the pathogenesis of the entity, and that HLA-DR1 would have a protective rôle against gingival overgrowth induced by CsA.

Determination and speciation of mercury in a dental work-place by cold vapour atomic absorption spectrometry and gas-liquid chromatography.

Cold Vapour Atomic Absorption Spectrometry (CVAAS) and Gas-Liquid Chromatography (GLC) have been used for determination and speciation of mercury. Total mercury, methylmercury, ethylmercury and phenylmercury concentrations in urine samples taken from students and staff of a dental work-place were investigated. Air samples were also analyzed. Detection limits, as three times the standard deviation, and in units of ng analyte per ml urine were found to be 1.7, 12, 2.4 and 21 for total mercury, methylmercury chloride, ethylmercury chloride and phenylmercury chloride, respectively.